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1.
Pediatr Surg Int ; 40(1): 163, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38935193

RESUMO

The aim of this study was to compare the operative parameters and complication rates between the umbilical (UMB) and right upper quadrant (RUQ) skin incisions for Ramstedt's pyloromyotomy for the treatment of infantile hypertrophic pyloric stenosis (IHPS). PubMed, EMBASE, Web of Science and Scopus databases were systematically searched. The studies where any one of the main outcomes of interest, i.e., operative time, wound infection rate, mucosal perforation rate were reported were eligible for inclusion. The statistical analysis was performed using a random-effects model. The methodological quality of the studies was assessed utilizing the Newcastle-Ottawa Scale. Fifteen studies comprising 2964 infants were included. As compared to the UMB group, the RUQ group showed a significantly lower mean operative time (p = 0.0004), wound infection rate (p < 0.0001) and mucosal perforation rate (p = 0.02). Although UMB incision produces an almost undetectable scar, this approach results in significantly more complications. Therefore, the risks and benefits must be weighed and discussed with the caregivers in deciding the surgical approach in patients with IHPS. However, due to a poor methodological quality of nine out of fifteen studies, further studies need to be conducted for an optimal comparison between the two groups.


Assuntos
Estenose Pilórica Hipertrófica , Piloromiotomia , Umbigo , Humanos , Estenose Pilórica Hipertrófica/cirurgia , Piloromiotomia/métodos , Umbigo/cirurgia , Lactente , Complicações Pós-Operatórias/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Duração da Cirurgia , Recém-Nascido
2.
Pediatr Surg Int ; 40(1): 50, 2024 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-38308698

RESUMO

PURPOSE: Transumbilical laparoscopic-assisted surgery (TULS) mixed benefits of laparoscopic and open surgeries. Transumbilical laparoscopic-assisted appendectomy (TULAA) is a well-known procedure, accepted and currently used by pediatric surgeons for treatment of uncomplicated appendicitis (UA). There is no current agreement in its use for the complicated appendiceal infections (CA). We reported our results using TULAA for both UA and CA. METHODS: We retrospectively collected TULAA performed between April 2017 and April 2022. Appendicitis were classified in UA and CA. We analyzed conversion rate, operative time, length of stay, surgical site infections (SSIs) rate, postoperative intra-abdominal abscess and costs. RESULTS: Over 5 years, 316 children underwent TULAA. Conversion rate was 3%. Mean age at surgery was 9.36 years (IQR 2-16). Forty-nine appendicitis were CA. Operative time and hospital stay was higher in CA than in UA group (38.33 vs. 60.73 min, p < 0.00001; 4 vs. 7 days, p < 0.00001). SSIs rate showed no statistically significant difference between two groups. Incidence of postoperative intra-abdominal collections was 11% in CA and 1% in UA. TULAA's cost was 192.07 €. CONCLUSION: In our series, TULAA seems to be safe, feasible and cost-effective for both uncomplicated and complicated appendicitis, with no disadvantage in terms of outcomes compared to what is reported in literature for CLS.


Assuntos
Apendicite , Laparoscopia , Criança , Humanos , Pré-Escolar , Adolescente , Resultado do Tratamento , Apendicite/cirurgia , Apendicectomia/métodos , Estudos Retrospectivos , Umbigo/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Laparoscopia/métodos , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia
3.
Aesthetic Plast Surg ; 48(15): 2851-2860, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38649525

RESUMO

INTRODUCTION: Combined ventral hernia repair and abdominoplasty treat risk factors such as high body mass index and weak abdominal musculature, providing excellent intraoperative exposure and improved patient outcomes. Unfortunately, a combination of traditional procedures is unfeasible as the umbilical blood supply would be compromised, leading to increased umbilical necrosis risk. This narrative review aimed to identify new techniques and solidify evidence in preserving umbilical blood supply and associated level of evidence. METHODS: Two authors conducted a thorough literature search on PubMed, Scopus and Cochrane CENTRAL databases from January 1901 to July 2023, adhering to the methodologies of the preferred reporting items for systematic reviews and meta-analyses. Studies were reviewed for their surgical technique and quality of evidence. The primary outcomes of interest consisted of umbilical complications of this combined procedure. RESULTS: Six techniques were identified that included laparoscopic, pre-rectus, unilateral, distal bilateral, proximal bilateral, and inferior midline approaches. All techniques demonstrated as viable options in preserving umbilical blood supply as reported complications were few, minor, and compounded by risk factors. However, all included techniques were limited to low-to-moderate-quality evidence. CONCLUSION: Despite the lack of high-quality evidence, all techniques remain viable options for combined ventral hernia repair and abdominoplasty. Large-scale high-quality RCTs are required to compare the effectiveness of various approaches with additional outcomes of hernia recurrence rates, intraoperative time, and patient- and surgeon-reported satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Abdominoplastia , Hérnia Ventral , Herniorrafia , Umbigo , Humanos , Abdominoplastia/métodos , Abdominoplastia/efeitos adversos , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Herniorrafia/efeitos adversos , Umbigo/cirurgia , Umbigo/irrigação sanguínea , Feminino
4.
Gan To Kagaku Ryoho ; 50(13): 1828-1830, 2023 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-38303221

RESUMO

A metastatic tumor of the umbilicus is called"Sister Mary Joseph's nodule", and patients with this tumor show a poor prognosis. Sister Mary Joseph's nodule is a rare occurrence, and there are few case reports. We report a case of cecal cancer first presented with the metastatic tumor in the umbilicus. A 90-year-old woman, complained umbilical induration and foul-smelling discharge, had been treated as omphalitis for 2 months. Because her symptom didn't improve, biopsy of the umbilical tumor was performed, and the findings revealed an adenocarcinoma. She was referred to our hospital. Abdominal CT showed wall thickening in the cecum, and multiple liver metastases. Therefore, we performed lower gastrointestinal endoscopy, which revealed a cecal tumor. We performed biopsy of the tumor and the findings were consistent with adenocarcinoma. Based on these results, we diagnosed the umbilical tumor as a metastasis from the colorectal cancer. Umbilical resection and ileocecal resection were performed, and multiple peritoneal metastases was detected. Post operative course was uneventful, she died 11 months after surgery. Umbilical metastases may worsen the patient's quality of life; thus, the local resection of umbilicus was recommended positively.


Assuntos
Adenocarcinoma , Neoplasias do Ceco , Nódulo da Irmã Maria José , Humanos , Feminino , Idoso de 80 Anos ou mais , Nódulo da Irmã Maria José/cirurgia , Nódulo da Irmã Maria José/secundário , Qualidade de Vida , Neoplasias do Ceco/cirurgia , Neoplasias do Ceco/patologia , Umbigo/cirurgia , Umbigo/patologia , Adenocarcinoma/diagnóstico
5.
Gan To Kagaku Ryoho ; 50(13): 1659-1661, 2023 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-38303374

RESUMO

In August 2022, a 59-year-old female noted a mass in her umbilicus and sought evaluation at Toyokawa City Hospital. Abdominal computed tomography(CT)scan revealed a 1.6 cm mass in the umbilical region, ascites in the pelvis, and increased absorption in the omentum. Peritoneal dissemination of the carcinoma and Sister Mary Joseph's nodule due to an unknown primary tumor were suspected because no abnormalities were detected during upper and lower gastrointestinal endoscopy. She underwent an umbilical lumpectomy and diagnostic laparoscopy to establish a definitive diagnosis. The surgical findings included numerous white nodules throughout the abdominal cavity. The umbilical mass and omental white nodules were resected. A final diagnosis of epithelial peritoneal mesothelioma was made based on the histopathologic examination. In general, peritoneal mesothelioma has a poor prognosis, and early treatment is essential; however, making a timely definitive diagnosis is difficult. Peritoneal mesothelioma should be included in the differential diagnosis for a patient with unexplained ascites and abdominal pain. Diagnostic laparoscopy and biopsy will facilitate the establishment of a definitive diagnosis.


Assuntos
Mesotelioma , Nódulo da Irmã Maria José , Neoplasias Cutâneas , Humanos , Feminino , Pessoa de Meia-Idade , Nódulo da Irmã Maria José/diagnóstico , Nódulo da Irmã Maria José/cirurgia , Ascite , Umbigo/cirurgia , Umbigo/patologia , Neoplasias Cutâneas/patologia , Mesotelioma/diagnóstico , Mesotelioma/cirurgia
6.
Ugeskr Laeger ; 186(8)2024 02 19.
Artigo em Dinamarquês | MEDLINE | ID: mdl-38445337

RESUMO

Sister Mary Joseph nodule (SMJN) is a rare clinical finding in patients with metastatic adenocarcinoma. This is a case report of a 69-year-old man, who presented with a cutaneous element by his umbilicus at his GP. He was referred to a dermatologist, then a plastic surgeon. The element was a metastasis from adenocarcinoma originating from his caecum. It is important for doctors to know of SMJN as a rare presentation of metastatic cancer, and to clinically examine the patient for an abdominal starting point, when presented with a cutaneous tumour at the position of the umbilicus.


Assuntos
Adenocarcinoma , Neoplasias Cutâneas , Cirurgiões , Masculino , Humanos , Idoso , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Umbigo/cirurgia
7.
Medicine (Baltimore) ; 103(3): e36919, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38241543

RESUMO

RATIONALE: Patent vitellointestinal duct is the most common omphalomesenteric duct anomaly to present with symptoms. PATIENT CONCERNS: A 10-day-old child presented with increase in the size of a polypoidal lesion into a large, "Y"-shaped reddish, prolapsing lesion, discharging gaseous, and fecal matter at her umbilicus. A laparoscopic exploration was performed, followed by wedge resection and anastomosis. No complications occurred during postoperative follow-up. DIAGNOSES: A patent vitellointestinal duct with ileal prolapse. INTERVENTIONS: The resection of extended intraperitoneal intestinal tube was performed. OUTCOMES: During the follow-up 3 months after surgery, the umbilical cord of the child healed well after surgery. LESSONS: Timely surgical treatment can minimize the occurrence of complications, and the overall prognosis is good after surgery.


Assuntos
Anormalidades do Sistema Digestório , Enteropatias , Ducto Vitelino , Humanos , Recém-Nascido , Criança , Feminino , Intestinos , Umbigo/cirurgia , Ducto Vitelino/cirurgia , Ducto Vitelino/anormalidades , Prolapso
8.
J Pediatr Urol ; 20(4): 759-761, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38565485

RESUMO

Ureteropelvic junction obstruction (UPJO) can be treated by various pyeloplasty techniques. We present a hybrid technique incorporating elements of laparoendoscopic single-site surgery and open pyeloplasty through a single umbilical incision. As a result, seven infants with UPJO underwent the hybrid pyeloplasty smoothly. The mean operative time was 131.9 min. At a follow-up of 11.8-50.0 months, all infants showed significant improvement and no symptoms except for one febrile urinary tract infection. The cosmetic results were very satisfactory without obvious visible scars. Therefore, the hybrid pyeloplasty appears to be a simple and effective minimally invasive surgery for treating infant UPJO.


Assuntos
Pelve Renal , Laparoscopia , Umbigo , Obstrução Ureteral , Procedimentos Cirúrgicos Urológicos , Humanos , Obstrução Ureteral/cirurgia , Pelve Renal/cirurgia , Lactente , Umbigo/cirurgia , Masculino , Procedimentos Cirúrgicos Urológicos/métodos , Feminino , Laparoscopia/métodos , Seguimentos , Resultado do Tratamento
9.
J Med Case Rep ; 18(1): 67, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38311773

RESUMO

BACKGROUND: Patent omphalomesenteric duct is one of the birth defects included in the spectrum of vitelline duct abnormalities. It is a rare anomaly with estimated prevalence of 0.13-0.2% in the general population. The most common presentation of patent vitelline duct is yellowish or mucoid type umbilical discharge which is usually noted in neonatal age or infancy. The main stay of diagnosis is clinical and outcome is favorable as long as timely surgical correction is offered. Here we present a 2 years old male child who presented with ileal prolapse through patent vitelline duct which is an exceptional mode of presentation of this pathology. CASE PRESENTATION: 2 years old Ethiopian male child who was noticed to have umbilical discharge since early infancy presented with protrusion of pinkish mass per the umbilicus of 4 h duration. He had no signs and symptoms of bowel obstruction. Abdominal examination revealed a prolapsed bowel which was viable via the umbilicus which was about 6 cm long. Otherwise, he had no abdominal tenderness or rigidity. He was explored with a smiley incision just above the umbilicus. The prolapsed bowel was reduced gently to the abdominal cavity. The tract of the Patent vitelline duct was identified and completely resected along with a wedge of ileum at its base. Primary repair of the ileal end where the tract was inserted was done in two layers and abdomen was closed in layers. The child had smooth post op course and was discharged on the 4th post-operative day. CONCLUSION: Prolapse of a bowel through the umbilicus is unusual presentation of a rare anomaly namely patent vitelline duct. This presentation warrants early surgical intervention before bowel ischemia issues. Hence, all clinicians dealing with children should be aware of this rare pathology so that urgent surgical management can be offered.


Assuntos
Anormalidades do Sistema Digestório , Ducto Vitelino , Pré-Escolar , Humanos , Masculino , Íleo/diagnóstico por imagem , Íleo/cirurgia , Intestinos , Prolapso , Umbigo/cirurgia , Umbigo/anormalidades , Ducto Vitelino/cirurgia , Ducto Vitelino/anormalidades
10.
Ginekol Pol ; 95(5): 343-349, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38099663

RESUMO

OBJECTIVES: Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and transumbilical laparoendoscopic single-site surgery (LESS) have shown the prospection as minimally invasive procedures. Here we aimed to compare ovarian cystectomy assisted by vNOTES and by LESS for ovarian mature cystic teratoma (OMCT). MATERIAL AND METHODS: A total of 81 premenopausal women with OMCT were randomized to undergo ovarian cystectomy assisted by either vNOTES (n = 41) or LESS (n = 40). The main outcome was the operative time. Secondary outcomes included the length of hospital stay, visual analog scale (VAS) pain scores, abdominal contamination by teratoma contents, and intraoperative and postoperative complications. RESULTS: There were no intergroup differences in age, body mass index, tumor size, or bilaterality of tumor. The operative time for the vNOTES group was significantly shorter than that for the LESS group (68.41 ± 20.92 min vs 85.05 ± 32.94 min, p = 0.008). The highest VAS pain score 24 hours postoperatively was 1.21 ± 0.48 in the vNOTES group and 2.43 ± 0.57 in the LESS group (p < 0.001). Twenty-four of the 40 patients in the LESS group experienced teratoma rupture intraoperatively, leading to abdominal contamination by the teratoma content, while 5 abdominal contamination was observed in the vNOTES group (p = 0.005. No significant differences between the two groups were observed in the other outcomes. CONCLUSIONS: vNOTES assisted ovarian cystectomy has short operative time, fast recovery, no scarring, less pain, and low rate of abdominal contamination. Consequently, vNOTES might be superior to LESS for treating OMCTs.


Assuntos
Laparoscopia , Cirurgia Endoscópica por Orifício Natural , Neoplasias Ovarianas , Teratoma , Humanos , Feminino , Cirurgia Endoscópica por Orifício Natural/métodos , Adulto , Teratoma/cirurgia , Neoplasias Ovarianas/cirurgia , Laparoscopia/métodos , Resultado do Tratamento , Duração da Cirurgia , Umbigo/cirurgia , Pessoa de Meia-Idade , Adulto Jovem , Tempo de Internação/estatística & dados numéricos
15.
Rev. bras. ciênc. vet ; 30(1): 19-23, jan./mar. 2023. il.
Artigo em Português | LILACS, VETINDEX | ID: biblio-1531962

RESUMO

O objetivo desse trabalho foi relatar um caso de onfaloarterioflebite em bezerro mestiço com oito dias de vida, apresentando aumento de volume umbilical associado à miíase. O hemograma revelou neutrofilia e hiperfibrinogenemia, sendo realizado também exame ultrassonográfico para avaliação do comprometimento de estruturas internas e confirmação diagnóstica. Devido à gravidade do quadro, optou-se pelo tratamento cirúrgico do animal, através da técnica de onfalectomia. No transoperatório, foi instituída terapêutica com antimicrobiano, antipirético, analgésico e mucolítico, além do internamento do paciente para continuidade da terapia sistêmica e realização de curativos. Após 72h da cirurgia, observou-se excelente cicatrização da ferida operatória e novos exames laboratoriais detectaram ausência de neutrofilia e hiperfibrinogenemia, possibilitando a alta médica, com recomendações de curativos diários na propriedade e retorno, após 10 dias, para reavaliação e retirada dos pontos. Este estudo reportou os achados clínicos e a abordagem terapêutica em um caso de onfaloarterioflebite em bezerro. A anamnese e o exame físico são fundamentais para o diagnóstico de onfalopatias e, quando associados à exames complementares, permitem ao veterinário a determinação das estruturas afetadas, possibilitando a instituição do tratamento mais eficiente e específico. O procedimento cirúrgico é um método terapêutico que apresenta resultados mais rápidos e melhores taxas de recuperação quando comparado ao tratamento clínico de forma isolada.


The objective of this study was to report a case of omphaloarteriophlebitis in an eight-day-old crossbred calf, presenting an increase in umbilical volume associated with myiasis. The blood count revealed neutrophilia and hyperfibrinogenemia, and an ultrasound examination was also performed to assess the impairment of internal structures and diagnostic confirmation. Due to the severity of the condition, we opted for the surgical treatment of the animal, using the omphalectomy technique. In the intraoperative period, therapy with antimicrobial, antipyretic, analgesic and mucolytic agents was instituted, in addition to the patient's hospitalization for continuity of systemic therapy and dressings. After 72 hours of surgery, excellent healing of the surgical wound was observed and new laboratory tests detected the absence of neutrophilia and hyperfibrinogenemia, allowing medical discharge, with recommendations for daily dressings on the property and return, after 10 days, for reassessment and removal of stitches. This study reported the clinical findings and therapeutic approach in a case of omphaloarteriophlebitis in a calf. Anamnesis and physical examination are fundamental for the diagnosis of omphalopathies and, when associated with complementary exams, allow the veterinarian to determine the affected structures, enabling the institution of the most efficient and specific treatment. The surgical procedure is a therapeutic method that presents faster results and better recovery rates when compared to clinical treatment alone.


Assuntos
Animais , Cirurgia Veterinária/métodos , Artérias Umbilicais/anormalidades , Veias Umbilicais/anormalidades , Umbigo/cirurgia , Ruminantes/cirurgia , Bovinos/cirurgia , Hérnia Umbilical/veterinária , Animais Recém-Nascidos/cirurgia , Miíase/veterinária
16.
Rev. chil. obstet. ginecol. (En línea) ; 86(6): 538-544, dic. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388695

RESUMO

INTRODUCCIÓN: La endometriosis es una patología benigna, dependiente de estrógenos, en la que el tejido que normalmente crece dentro del útero aparece fuera de este. Su localización habitual es en la pelvis, pero en ocasiones puede aparecer en otras áreas, como es el caso de la endometriosis umbilical. OBJETIVO: Familiarizar al ginecólogo con esta patología y entregar una serie de herramientas para diagnosticar, tratar y seguir a las pacientes que la presentan. CASOS CLÍNICOS: Se presentan dos casos clínicos de endometriosis umbilical primaria diagnosticados en el Hospital La Paz, en Madrid (España), entre los años 2018 y 2019. Las pacientes, de 30 y 34 años, consultaron por dolor o sangrado umbilical durante la menstruación. Ninguna tenía antecedentes de patología ginecológica ni cirugía abdominal previa. Tras una exhaustiva exploración física y una ecografía de alta resolución, se decidió extirpar la lesión con la colaboración del servicio de cirugía plástica. En ambos casos, el estudio anatomopatológico confirmó que se trataba de tejido endometriósico. Las dos pacientes presentaron una buena evolución posquirúrgica, sin recidivas hasta la fecha. CONCLUSIONES: La endometriosis umbilical primaria es una patología infrecuente, pero es necesario incluirla en el diagnóstico diferencial de una mujer con un nódulo umbilical. Siempre deben realizarse una exploración física exhaustiva y una ecografía ginecológica, para descartar posibles patologías concomitantes. El tratamiento de elección es la extirpación quirúrgica de la lesión y el diagnóstico final se establece con el estudio anatomopatológico.


INTRODUCTION: Endometriosis is an estrogen-dependent benign pathology in which endometrial tissue develops outside the uterus. Its most frequent location is the pelvis, although it can appear in other areas such as the umbilicum. OBJECTIVE: To familiarize the gynecologist with this pathology and provide a series of tools to diagnose, treat and provide continued care to these patients. CASE REPORTS: Retrospective study of two clinical cases of primary umbilical endometriosis diagnosed at La Paz University Hospital, in Madrid (Spain), between 2018 and 2019. Both patients (30 and 34 years old respectively) presented with pain and/or bleeding around the umbilical area during menstruation. Neither of them had any previous gynecologic conditions or abdominal surgeries. After exhaustive physical examination and a high-resolution ultrasound, lesions were surgically removed in collaboration with the plastic surgery department. In both cases, histology confirmed the presence of endometrial tissue. Both patients made a full recovery after surgery and havent had a recurrence of said lesions. CONCLUSIONS: Primary umbilical endometriosis is an infrequent disease. However, it must be included in the differential diagnosis of umbilical nodes in women. Exhaustive physical examination and gynecologic ultrasound should always be performed to rule out any other pathologies. Surgical removal of the nodes is the preferred treatment, and the final diagnosis is reached through histology.


Assuntos
Humanos , Feminino , Adulto , Umbigo/cirurgia , Umbigo/patologia , Endometriose/cirurgia , Endometriose/patologia , Endometriose/diagnóstico
17.
Rev. cir. (Impr.) ; 73(2): 208-211, abr. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388797

RESUMO

Resumen Introducción: El quiste pilonidal del ombligo (QPO) es una entidad muy infrecuente y por eso no es reconocida precozmente. El objetivo de este manuscrito es dar a conocer esta patología. Reporte de casos: Presentamos dos pacientes referidos por un proceso inflamatorio del ombligo, con descarga de mal olor. El primer paciente, luego de dos meses de tratamiento local sin resolución, es intervenido resecando la lesión umbilical, comprobando en ese momento la existencia de contenido piloso en el quiste. En el segundo paciente se plantea el diagnóstico durante la anamnesis y se confirma con el examen físico. En ambos casos se efectuó una resección parcial del ombligo incluyendo la lesión pilonidal. La biopsia confirmó el diagnóstico. El resultado posoperatorio ha sido satisfactorio y sin recaídas. Discusión y Conclusión: Hay escasa literatura relacionada con el QPO. Se proponen el tratamiento conservador y la opción de resección quirúrgica del quiste. En nuestra limitada experiencia se procedió a resecar la lesión y recomendar la depilación de la región periumbilical. No podemos descartar la alternativa de manejo conservador en futuros casos, antes de proponer la cirugía.


Introduction: Umbilical pilonidal sinus (UPS) is a rare condition and is therefore not detected early. The aim of this document is to discuss this pathology. Case report: We present two patients referred due to an inflammatory process of the navel, with the presence of a malodor. The first patient, after two months of unsuccessful local treatment, was intervened by a resection of the umbilical lesion, verifying hair content in the sinus. In the second patient the diagnosis was evident during anamnesis and confirmed with the physical examination. In both cases, a partial resection of the umbilicus was performed, including the pilonidal sinus. Biopsy confirmed the diagnosis. The postoperative result has been satisfactory, without relapse. Discussion and Conclusion: There are not much literature related to UPS. Conservative treatment or surgical resection of the sinus is proposed. In our limited experience we proceeded to a surgical resection of the lesion and recommend eliminating the hairs of the periumbilical region. We cannot rule out the conservative management option in future cases, before proposing surgery.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Seio Pilonidal/cirurgia , Seio Pilonidal/diagnóstico , Dermatopatias , Umbigo/cirurgia , Umbigo/patologia
18.
Rev. bras. cir. plást ; 34(1): 38-44, jan.-mar. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-994542

RESUMO

Introdução: Na abdominoplastia convencional, a cicatriz do novo umbigo representa o ponto de maior desafio. Em sua execução, já foram descritas e utilizadas várias técnicas e táticas cirúrgicas, com resultados nem sempre satisfatórios, sob o ponto de vista do paciente e também do médico. O objetivo é demonstrar a aplicabilidade e satisfação com a onfaloplastia em triângulo isósceles e com dupla fixação na abdominoplastia. Métodos: Foram selecionadas 97 pacientes do sexo feminino, com idades entre 25 e 65 anos. Todas foram submetidas à dermolipectomia abdominal clássica associada à lipoaspiração moderada de todo abdome anterior e flancos e avaliadas com 90, 180 e 360 dias pós-operatórios, pelo mesmo cirurgião. Resultados: Observou-se um índice de resultados satisfatórios das cicatrizes umbilicais na maioria dos casos (92,8%). Algumas cicatrizes umbilicais apresentaram estenoses (3,1%) e outras, cicatrizes inestéticas (4,1%). Não se observaram necroses. Conclusão: A utilização desta técnica demonstrou ser eficaz, de fácil execução e com resultados muito satisfatórios na estética da cicatriz umbilical nas dermolipectomias abdominais.


Introduction: In conventional abdominoplasty, the creation of a new umbilical scar is challenging. Several surgical techniques and approaches have previously been described and applied, but not always with satisfactory results. The objective is to demonstrate the applicability and satisfaction with omphaloplasty based on an isosceles triangle with double fixation in abdominoplasty. Methods: The study included 97 female patients aged between 25 and 65 years. All underwent classic abdominal dermolipectomy with moderate abdominal liposuction of the entire anterior abdomen and flanks by the same surgeon and were evaluated at 90, 180, and 360 days postoperatively. Results: Patients were satisfied with the umbilicus in most cases (92.8%). Some umbilical scars had contracted (3.1%) and others appeared unsightly (4.1%). No necrosis was observed. Conclusion: This technique was effective and easy to perform, with satisfactory umbilical scar aesthetic outcomes in abdominal dermolipectomy.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Umbigo/cirurgia , Lipectomia/métodos , Cicatriz , Abdominoplastia/efeitos adversos , Abdominoplastia/métodos , Abdominoplastia/reabilitação , Abdome/anormalidades , Abdome/cirurgia
19.
Rev. bras. cir. plást ; 33(3): 433-436, jul.-set. 2018. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-965666

RESUMO

A endometriose é caracterizada pela presença de tecido endometrial fora da cavidade uterina. Seu mecanismo fisiopatológico é pouco esclarecido, mas várias hipóteses são descritas - dentre elas a disseminação de células endometriais por via hematogênica ou linfática. A apresentação clínica é bastante variável, mas podem estar presentes massa palpável, sangramentos cíclicos ou alterações de coloração da pele na região afetada. O diagnóstico é estabelecido a partir do exame clínico, associado a exames de imagem e biópsia da lesão. O tratamento de escolha é o cirúrgico com excisão da lesão e reconstrução da anatomia local. Apresentamos um relato de caso de uma paciente de 35 anos, com endometriose umbilical, com necessidade de excisão da lesão e confecção de novo umbigo. A evolução da afecção descrita é estritamente relacionada ao manejo diagnóstico e propedêutico instituído; sendo assim, a exclusão de diagnósticos diferenciais, benignos ou malignos, é de suma importância.


Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity. The pathophysiology of this condition is poorly understood. However, several hypotheses have been proposed, including the spread of endometrial cells via hematogenous or lymphatic routes. The clinical presentation is variable but includes a palpable nodule, cyclic bleeding, and changes in the color of the skin in the affected region. Diagnosis is established by clinical examination combined with imaging and lesion biopsy. The treatment of choice is surgical, with excision of the lesion and tissue reconstruction. We report the case of a 35-year-old female patient with umbilical endometriosis and the need for removal of the lesion with umbilical reconstruction. The presentation of this condition determines the diagnostic and management approach. Therefore, the exclusion of other benign or malignant disorders is essential.


Assuntos
Humanos , Feminino , Cirurgia Plástica/métodos , Umbigo/cirurgia , Umbigo/fisiopatologia , Procedimentos de Cirurgia Plástica/métodos , Endometriose/diagnóstico , Endometriose/fisiopatologia , Endometriose/diagnóstico por imagem , Endometriose
20.
Rev. bras. cir. plást ; 33(3): 355-363, jul.-set. 2018. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-965555

RESUMO

Introdução: A onfaloplastia é um momento crucial durante a cirurgia de abdominoplastia. Apesar de ser considerada uma etapa de grande importância nos dias de hoje, a onfaloplastia não foi sempre utilizada nas abdominoplastias, sendo o umbigo, algumas vezes, descartado junto ao retalho gorduroso. Com a finalidade de preservar a cicatriz umbilical, várias técnicas foram utilizadas e, com o tempo, vêm sofrendo modificações que possibilitam um resultado cada vez mais natural. Método: A técnica "Y"/"V" proposta consiste em modelar o coto umbilical de modo que este encaixe perfeitamente no mesmo local onde havia a cicatriz umbilical. A ilha umbilical, após ser modelada, é suturada, resultando em uma imagem de "Y"/"V", razão pela qual a técnica recebe este nome. Resultados: Durante o estudo, foi evidenciado um número baixo de complicações (11,34%) ao analisar o pós-operatório. Deiscência de sutura, estenose umbilical, alterações crômicas na cicatriz e queloide foram as complicações observadas, sendo corrigidas cirurgicamente seis meses após a cirurgia. Conclusão: A técnica proposta demonstra simples execução, com baixos índices de complicações e aspecto mais natural da cicatriz do neoumbigo. Portanto, tornam-se cada vez mais necessários estudos que a utilizem para comprovar sua eficácia perante às demais técnicas utilizadas atualmente.


Introduction: Omphaloplasty is a crucial procedure during abdominoplasty surgery. Although it is currently considered an important step, omphaloplasty was not always performed during abdominoplasties, and the umbilicus was sometimes discarded together with the fat flap. Various techniques were used to preserve the umbilicus and underwent modifications with time to allow for an increasingly natural result. Method: The proposed "Y"/"V" technique consists of modeling the umbilical stump to perfectly fit in the same place where the umbilicus was located. The umbilical island, after being modeled, is sutured, resulting in a "Y"/ "V" image, which gives rise to the name. Results: A low number of complications (11.34%) were observed when analyzing the postoperative follow-up data. Suture dehiscence, umbilical stenosis, color alterations in the scar, and keloid scars were the complications observed, which were surgically corrected six months postoperatively. Conclusion: The proposed technique is simple to implement, with low rates of complications and results in a more natural aspect of the neoumbilicus scar. Further studies are required to prove its effectiveness in comparison to the other techniques that are currently in use.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Umbigo/cirurgia , Umbigo/lesões , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/complicações , Procedimentos de Cirurgia Plástica/métodos , Abdominoplastia/métodos , Queloide/cirurgia , Complicações Pós-Operatórias , Umbigo , Ferimentos e Lesões , Cicatriz , Cicatriz/cirurgia , Procedimentos de Cirurgia Plástica , Abdominoplastia , Queloide
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