Comparison between endoscopic and open surgery in 37 patients with nasopharyngeal angiofibroma.

UNLABELLED: Juvenile nasopharyngeal angiofibroma is a rare benign vascular tumor of the nasopharynx. Although the treatment of choice is surgery, there is no consensus on what is the best approach. AIM: To compare surgical time and intraoperative transfusion requirements in patients undergoing endoscopic surgery versus open / combined and relate the need for transfusion during surgery with the time between embolization and surgery. MATERIAL AND METHODS: Study descriptive, analytical, retrospective study with a quantitative approach developed in the Otorhinolaryngology department of a teaching hospital. Analyzed 37 patients with angiofibroma undergoing surgical treatment. Data obtained from medical records. Analyzed with tests of the Fisher-Freeman-Halton and Games-Howell. Was considered significant if p <0.05. STUDY DESIGN: Historical cohort study with cross-sectional. RESULTS: The endoscopic approach had a shorter operative time (p <0.0001). There is less need for transfusion during surgery when the embolization was performed on the fourth day. CONCLUSION: This suggests that the period ahead would be ideal to perform the process of embolization and endoscopic surgery by demanding less time would be associated with a lower morbidity. This study, however, failed to show which group of patients according to tumor stage would benefit from specific technical.

Comparação entre cirurgia endoscópica e aberta em 37 pacientes com nasoangiofibroma / Comparison between endoscopic and open surgery in 37 patients with nasopharyngeal angiofibroma

O nasoangiofibroma é um tumor vascular benigno raro da nasofaringe, 0,5 por cento de todas as neoplasias da cabeça e pescoço. Embora o tratamento de escolha seja a cirurgia, não há consenso sobre qual a melhor abordagem. OBJETIVOS: Comparar o tempo cirúrgico e a necessidade de transfusão intraoperatória em pacientes submetidos à cirurgia endoscópica versus aberta/combinada e relacionar a necessidade de transfusão intra-operatória com o tempo entre embolização e cirurgia. MATERIAL E MÉTODO: Estudo descritivo, analítico, retrospectivo, com abordagem quantitativa desenvolvido no serviço de otorrinolaringologia de um hospital-escola. Analisados 37 pacientes com nasoangiofibroma submetidos ao tratamento cirúrgico. Dados obtidos de prontuários. Analisados com os testes de Fisher-Freeman-Halton e de Games-Howell. Considerou-se significante se p < 0,05. Desenho do estudo: Estudo de coorte histórica com corte transversal. RESULTADOS: A abordagem endoscópica teve um menor tempo (p <0,0001).Houve uma menor necessidade de transfusão intraoperatória quando a embolização foi realizada no quarto dia. CONCLUSÃO: Sugere-se que o período citado seria o ideal para a realização da embolização e que a cirurgia endoscópica por demandar menos tempo estaria associada a uma menor morbidade. Entretanto, não se conseguiu demonstrar qual grupo de pacientes de acordo com o estádio tumoral se beneficiaria com determinada técnica.

Juvenile nasopharyngeal angiofibroma is a rare benign vascular tumor of the nasopharynx. Although the treatment of choice is surgery, there is no consensus on what is the best approach. AIM: To compare surgical time and intraoperative transfusion requirements in patients undergoing endoscopic surgery versus open / combined and relate the need for transfusion during surgery with the time between embolization and surgery. MATERIAL AND METHODS: Study descriptive, analytical, retrospective study with a quantitative approach developed in the Otorhinolaryngology department of a teaching hospital. Analyzed 37 patients with angiofibroma undergoing surgical treatment. Data obtained from medical records. Analyzed with tests of the Fisher-Freeman-Halton and Games-Howell. Was considered significant if p <0.05. Study design: Historical cohort study with cross-sectional. RESULTS: The endoscopic approach had a shorter operative time (p <0.0001). There is less need for transfusion during surgery when the embolization was performed on the fourth day. CONCLUSION: This suggests that the period ahead would be ideal to perform the process of embolization and endoscopic surgery by demanding less time would be associated with a lower morbidity. This study, however, failed to show which group of patients according to tumor stage would benefit from specific technical.

Reconstrução em ressecções mandibulares bastante extensas: aplicação de retalho peitoral menor com o 6º arco costal

sem resumo

Nova tática reparadora em grandes perdas cutâneas pós-mastectomia utilizando retalho miocutâneo reto-abdominal bilateral / A new reconstrution technic in great loss of tissue after mastectomy using recto-abdominal myocutaneous flap

Apresentam-se nova tática na cobertura cutânea de grandes defeitos pós-mastectomia, utilizando retalho miocutâneo reto-abdominal bilateral. Um é confeccionado em ilha cutânea transversa superior homolateral, o qual é transferido para reparar a perda de substância torácica: e o outro em ilha cutânea vertical superior contralateral, que é transferido para o defeito secundário da área doadora do primeiro retalho, permitindo seu fechamento completo após amplo descolamento de toda a pele e subcutâneo do abdome inferior e lateral homolateral. Säo apresentados dois casos no qual se aplicou este novo método reconstrutivo, com bons resultados. Sua indicaçäo é enfatizada e as vantagens comentadas