RESUMO
Almost 10% of patients with Crest syndrome associated with severe gastroesophageal reflux and 5-10% of patients with failed cardiomyotomy for achalasia present with cardial or distal esophageal organic stricture. Some of these cases are poor risk patients for surgery and therefore the surgeon must offer a safe procedure with low morbimortality, keeping in mind the pathophysiological motor pattern of these patients.In order to treat the stricture to improve the esophageal transit we treated patients with esophagocardioplasty associated with vagotomy-antrectomy and Roux-en-Y gastrojejunostomy, thereby avoiding the potential acid or biliary reflux in poor risk patients in whom esophagectomy would be a very deleterious procedure. All four patients had a good postoperative evolution and late control demonstrated good esophagogastric transit with no postoperative esophagitis.
Assuntos
Transtornos da Motilidade Esofágica/cirurgia , Estenose Esofágica/cirurgia , Adulto , Idoso , Anastomose em-Y de Roux , Síndrome CREST/cirurgia , Cárdia/cirurgia , Esofagoplastia , Feminino , Derivação Gástrica , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Antro Pilórico/cirurgia , VagotomiaRESUMO
Se presenta un caso clínico de paciente con diagnóstico de cáncer de pene (T2 Nx M0) sometido a linfocintigrafía para identificación de linfonodo centinela. Se analiza el rol de este procedimiento como método de etapificación en esta patología y se revisa la historia y la experiencia de centros internacionales con este método diagnóstico.
Assuntos
Humanos , Masculino , Idoso , Carcinoma de Células Escamosas , Metástase Linfática , Neoplasias Penianas , Biópsia de Linfonodo Sentinela , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Estadiamento de Neoplasias , Neoplasias PenianasAssuntos
Aldeídos/síntese química , Alcanos/síntese química , Éteres Cíclicos/química , Poliaminas/química , Cátions/análise , Cátions/metabolismo , Concentração de Íons de Hidrogênio , Espectroscopia de Ressonância Magnética , Metais/análise , Metais/metabolismo , Isótopos de Nitrogênio , TitulometriaRESUMO
Almost 10% of patients with Crest syndrome associated with severe gastroesophageal reflux and 5-10% of patients with failed cardiomyotomy for achalasia present with cardial or distal esophageal organic stricture. Some of these cases are poor risk patients for surgery and therefore the surgeon must offer a safe procedure with low morbimortality, keeping in mind the pathophysiological motor pattern of these patients. In order to treat the stricture to improve the esophageal transit we treated patients with esophagocardioplasty associated with vagotomy-antrectomy and Roux-en-Y gastrojejunostomy, thereby avoiding the potential acid or biliary reflux in poor risk patients in whom esophagectomy would be a very deleterious procedure. All four patients had a good postoperative evolution and late control demonstrated good esophagogastric transit with no postoperative esophagitis.
