RESUMO
Oesophageal cancer is among the ten most common types of cancer worldwide. More than 80% of the cases and deaths related to the disease occur in developing countries. Local socio-economic, epidemiologic and healthcare particularities led us to create a Brazilian guideline for the management of oesophageal and oesophagogastric junction (OGJ) carcinomas. The Brazilian Group of Gastrointestinal Tumours invited 50 physicians with different backgrounds, including radiology, pathology, endoscopy, nuclear medicine, genetics, oncological surgery, radiotherapy and clinical oncology, to collaborate. This document was prepared based on an extensive review of topics related to heredity, diagnosis, staging, pathology, endoscopy, surgery, radiation, systemic therapy (including checkpoint inhibitors) and follow-up, which was followed by presentation, discussion and voting by the panel members. It provides updated evidence-based recommendations to guide clinical management of oesophageal and OGJ carcinomas in several scenarios and clinical settings.
RESUMO
Gastric cancer is among the ten most common types of cancer worldwide. Most cases and deaths related to the disease occur in developing countries. Local socio-economic, epidemiologic and healthcare particularities led us to create a Brazilian guideline for the management of gastric carcinomas. The Brazilian Group of Gastrointestinal Tumors (GTG) invited 50 physicians with different backgrounds, including radiology, pathology, endoscopy, nuclear medicine, genetics, oncological surgery, radiotherapy and clinical oncology, to collaborate. This document was prepared based on an extensive review of topics related to heredity, diagnosis, staging, pathology, endoscopy, surgery, radiation, systemic therapy and follow-up, which was followed by presentation, discussion, and voting by the panel members. It provides updated evidence-based recommendations to guide clinical management of gastric carcinomas in several scenarios and clinical settings.
RESUMO
BACKGROUND: The development of laparoscopy in bariatric surgery has attracted a large number of surgeons. Learning this method for future clinical practice requires intensive training with inert tissues, simulators and experimental surgery in animals. Performing these procedures in small animals, with the same equipment used in humans, is feasible, allowing familiarization with and comprehension of the basic techniques. Wistar rats weighing 300-600 g were used. The animals were kept in standard laboratory conditions. A laparoscopic video-system, Veress needle, three ports, a 0 degree optic, a laparoscopic needle-holder, two 5-mm graspers, a 5-mm dissection clamp and a 5-mm scissors were used. An orogastric catheter with three 4-0 nylon sutures and one 6-0 nylon suture were also utilized. For the gastric band, we used a plastic device similar to the human gastric band. The present study describes a simple, inexpensive and reproducible technique for laparoscopic gastric banding in a rat model utilizing the same instruments developed for humans. The experimental rat model is more motivating than simulators, requires less space, and has easier maintenance compared with bigger animals, and consequently allows the use of more animals for teaching, training and application in many scientific studies.
Assuntos
Derivação Gástrica/métodos , Laparoscopia/métodos , Cirurgia Vídeoassistida/métodos , Animais , Desenho de Equipamento , Derivação Gástrica/instrumentação , Modelos Animais , Ratos , Ratos WistarRESUMO
The staplerless Roux-en-Y gastric bypass (RYGBP) is a new option in bariatric surgery. The first to describe it was Himpens (2004) utilizing the LigaSure Atlas (LSA) in a series of 10 patients. The laparoscopic RYGBP is performed utilizing the LSA for the gastric and jejunal partition; after that, an imbricating running suture is performed to ensure stomach and bowel hermetic closure. All anastomoses are hand-sewn. Technical disadvantages are: learning curve; complications related to suture failure; possible thermal/electricity related injuries; longer operating time. Advantages are: stapler-associated bleeding, leaks, staple-line disruption, and fistulas are avoided; cost reduction. The staplerless RYGBP is complex; the surgeon involved requires expertise and ability. This technique will evolve and will be used by more surgeons. It is a new option for the surgeon preoccupied with costs, which is particularly important in developing countries.
Assuntos
Derivação Gástrica/métodos , Anastomose em-Y de Roux , Brasil , Competência Clínica , Custos e Análise de Custo , Eletrocoagulação , Derivação Gástrica/economia , Humanos , Jejunostomia , Laparoscopia , Azul de Metileno , Suturas , Estados UnidosRESUMO
O tumor pancreatico cistico papilar e neoplasia rara, maligna que ocorre tipicamente em mulheres jovens, evoluindo de modo benigno, apresentando excelente prognostico. Relata-se o caso de uma jovem de 19 anos de idade, gravida, assintomatica, acompanhada pela Divisao de Cirurgia Oncologica do Aparelho Digestivo do Hospital Sao Rafael, Salvador, Bahia, Brasil, depois de identificacao ultra-sonografica incidental de massa tumoral em cabeca pancreatica. A paciente foi submetida a resseccao tumoral, sendo obtido o diagnostico anatomopatologico de ...
Assuntos
Humanos , Feminino , Gravidez , Adulto , Complicações na Gravidez , Neoplasias Pancreáticas/cirurgia , Espectroscopia de Ressonância Magnética/métodos , Neoplasias PancreáticasRESUMO
As formacoes tumorais do espaco retrorretal sao frequentemente diagnosticadas erroneamente, alem de serem inadequadamente tratadas, principalmente pela pobreza de sintomas apresentados pelo paciente, duracao do crescimento neoplasico e pela raridade de per si...