ABSTRACT
Introducción: La colecistectomía laparoscópica se ha convertido rápidamente en el procedimiento de elección de rutina para la enfermedad de la vesícula biliar, y actualmente es el procedimiento abdominal mayor que se realiza con mayor frecuencia en los países occidentales; la mayoría de los autores sugieren que es seguro observar a pacientes con cálculos biliares asintomáticos, y que la colecistectomía solo se realiza por aquellos pacientes que desarrollan síntomas. El quince por ciento de los pacientes persiste teniendo síntomas posteriores a la colecistectomía. Este estudio tuvo como objetivo evaluar el uso de la esofagogastroduodenoscopía previa a la colecistectomía laparoscópica y su impacto en el manejo. Método: Este fue un estudio clínico prospectivo que involucró a pacientes con cálculos biliares ingresados en el Hospital Docente de Al-Basra, Departamento de Cirugía General desde enero de 2016 hasta diciembre de 2019. Todos los pacientes fueron seguidos desde el momento del ingreso hasta seis meses después. Estos pacientes se dividieron en siete grupos según la edad. A todos los pacientes se les realizó una ecografía abdominal para diagnosticar la presencia de colelitiasis y descartar otros problemas abdominales. Todos los pacientes programados para colecistectomía laparoscópica se sometieron a una endoscopia del tracto gastrointestinal superior antes de la operación. Resultados: Se incluyeron un total de 1200 pacientes con rango de edad de 21 a 82 años (mujeres, 83,33%, hombres, 16,66%) con colelitiasis. La proporción de mujeres a hombres fue de 5:1. Se observaron hallazgos endoscópicos positivos en 380 (31,6%) pacientes. En estos pacientes se modificó el plan de manejo con hallazgos positivos por endoscopia y se pospuso su cirugía hasta recibir el tratamiento adecuado. Conclusión: El uso rutinario de esofagogastroduodenoscopia previa a la colecistectomía disminuiría la colecistectomía innecesaria en pacientes con colelitiasis y hallazgos endoscópicos positivos, lo que disminuye la persistencia de síntomas post colecistectomía.
Introduction: Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder disease, and it is currently the most performed major abdominal procedure in Western countries, most authors suggest that it's safe to observe patients with asymptomatic gallstones, with cholecystectomy only being performed for those patients who develop symptoms. Fifteen percent of patients persist to have post cholecystectomy symptoms. This study aimed to evaluate the use of oesophagogastroduodenoscopy prior to laparoscopic cholecystectomy, and its impact on the management. Method: This was a prospective clinical study involving patients with gallstone admitted to the Al-Basra Teaching Hospital, Department of General Surgery from January 2016 to December 2019. All patients were followed up from the time of admission until six months later. These patients were divided into seven groups according to age. All patients were having an abdominal ultrasound examination in order to diagnose the presence of cholelithiasis and to exclude other abdominal problems. All patients scheduled for laparoscopic cholecystectomy underwent upper GIT endoscopy preoperatively. Results: A total of 1200 patient age range from 21 to 82 years were included (women, 83.33%, men, 16.66%) had cholelithiasis. Female to male ratio was 5:1. Positive endoscopic findings were observed in 380(31.6 %) patients. The management plan was changed in these patients with positive findings by endoscopy and their surgery was postponed until they received proper treatment. Conclusion: The routine use of oesophagogastroduodenoscopy prior to cholecystectomy would decrease the unneeded cholecystectomy in patients with cholelithiasis and positive endoscopic findings, which decrease post cholecystectomy persistence of symptoms.
Subject(s)
Humans , Adult , Middle Aged , Aged , Prospective Studies , Endoscopy, Digestive System/statistics & numerical data , Cholecystectomy, Laparoscopic , Aftercare , Unnecessary Procedures , Gallbladder Diseases/therapyABSTRACT
BACKGROUND/AIMS: Interval gastric cancer (IGC) is defined as cancer that is diagnosed between the time of screening and postscreening esophagogastroduodenoscopy (EGD). Unfortunately, little is known about the characteristics of IGC in Korea, a country with a high incidence of gastric cancer. The aim of this study was to evaluate the clinicopathologic characteristics of IGCs in Korea. METHODS: From January 2006 to July 2011, a total of 81,762 subjects underwent screening EGD at Yonsei University Health Promotion Center, Seoul, Korea. We defined missed cancer as cancer diagnosed within 1 year of screening EGD and latent cancer as cancer diagnosed more than 1 year after EGD. RESULTS: A total of 16 IGC patients (17 lesions; three missed cancers and 14 latent cancers) were identified, with a mean age of 60.68 years and a mean interval time of 19.64 months. IGCs tended to be undifferentiated (12/17, 70.6%), located in the lower body of the stomach (12/17, 70.6%) and exhibited flat/depressed endoscopic morphology (11/17, 64.7%). The patients with missed cancer were generally younger than the patients with latent cancer (51.3 years vs 62.8 years, p=0.037), and the patients with undifferentiated cancer were significantly younger than those with differentiated cancer (57.0 years vs 68.8 years, p=0.008). CONCLUSIONS: IGCs tended to be undifferentiated, located in the lower body of the stomach, and exhibited flat/depressed endoscopic morphology.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Age Factors , Carcinoma/pathology , Delayed Diagnosis/statistics & numerical data , Diagnostic Errors/statistics & numerical data , Early Detection of Cancer , Endoscopy, Digestive System/statistics & numerical data , Seoul , Stomach/pathology , Stomach Neoplasms/pathologyABSTRACT
BACKGROUND/AIMS: Interval gastric cancer (IGC) is defined as cancer that is diagnosed between the time of screening and postscreening esophagogastroduodenoscopy (EGD). Unfortunately, little is known about the characteristics of IGC in Korea, a country with a high incidence of gastric cancer. The aim of this study was to evaluate the clinicopathologic characteristics of IGCs in Korea. METHODS: From January 2006 to July 2011, a total of 81,762 subjects underwent screening EGD at Yonsei University Health Promotion Center, Seoul, Korea. We defined missed cancer as cancer diagnosed within 1 year of screening EGD and latent cancer as cancer diagnosed more than 1 year after EGD. RESULTS: A total of 16 IGC patients (17 lesions; three missed cancers and 14 latent cancers) were identified, with a mean age of 60.68 years and a mean interval time of 19.64 months. IGCs tended to be undifferentiated (12/17, 70.6%), located in the lower body of the stomach (12/17, 70.6%) and exhibited flat/depressed endoscopic morphology (11/17, 64.7%). The patients with missed cancer were generally younger than the patients with latent cancer (51.3 years vs 62.8 years, p=0.037), and the patients with undifferentiated cancer were significantly younger than those with differentiated cancer (57.0 years vs 68.8 years, p=0.008). CONCLUSIONS: IGCs tended to be undifferentiated, located in the lower body of the stomach, and exhibited flat/depressed endoscopic morphology.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Age Factors , Carcinoma/pathology , Delayed Diagnosis/statistics & numerical data , Diagnostic Errors/statistics & numerical data , Early Detection of Cancer , Endoscopy, Digestive System/statistics & numerical data , Seoul , Stomach/pathology , Stomach Neoplasms/pathologyABSTRACT
Introduction: Upper gastrointestinal studies are routine diagnostic and therapeutic procedures. In pediatrics, however, they are limited by the need for sedation and monitoring. Objectives: Po evaluate sedation, indication, and parent perception of these exams. Patients and Methods: A prospective study of 190 pediatric upper gastrointestinal endoscopies was undertaken. Demographic data, as well as information regarding the exam was obtained. Results: Patients' average age was 8.5 +/- 4.2, mostly referred by pediatricians (60 percent) Main reason for referral was recurrent abdominal pain (29.8 percent). Patients were classified according to ASA criteria (93 percent ASA I and II). Most patients required two or more medications for optimal sedation, with satisfactory procedure in over 90 percent. Over 75.5 percent had complete amnesia, 42.7 percent presented minor discomfort after the procedure. Findings of these procedures included 61 percent of normal exams, 13.9 percent esophagitis. More findings were there result of analyses according to children's weight (over or under 14 kg), age, ASA, reason for referral, nurse's evaluation of sedation. Conclusion: Ambulatory endoscopio procedures can be performed safely in children, with moderate sedation. Requirements are adequate monitoring, and deep knowledge of resuscitation techniques.
Introducción: El estudio endoscópico alto es un procedimiento diagnóstico y terapéutico considerado de rutina, pero su realización en pediatría se encuentra limitada dada la necesidad de sedación y monitoreo adecuados. Objetivos: Evaluar la sedación, indicación y percepción de los padres del examen. Materiales y Métodos: Estudio prospectivo de 190 niños sometidos a endoscopia digestiva alta. Se obtuvieron datos bio-demográficos, tipo de sedación y resultados del examen. Resultados: La edad fue 8,5 + 4,2 años, la mayoría referidos por pediatra (60 por ciento). La principal indicación del estudio fue el dolor abdominal recurrente (29,8 por ciento). Los pacientes fueron clasificados de acuerdo al ASA (93 por ciento ASA I y II). En la mayoría se requirió de 2 ó más drogas para lograr sedación óptima. La calidad del procedimiento fue satisfactoria en más del 90 por ciento. Un 75,5 por ciento presentaron amnesia completa y un 42,7 por ciento molestias leves posterior al procedimiento. Entre los hallazgos destacaron signos de esofagitis en el 13,9 por ciento, observándose un 61 por ciento de los exámenes normales. Al analizar los pacientes por peso (mayores y menores de 14 kg), se encontraron diferencias en edad (p < 0,00001), ASA (p = 0,001), indicación de endoscopia (p = 0,001) y evaluación de la sedación por enfermera (p = 0,038). Conclusión: Procedimientos endoscópicos en niños pueden realizarse de manera segura en forma ambulatoria mediante sedación moderada. Una adecuada monitorización y conocimiento de técnicas de reanimación son básicos al momento de realizar dichos procedimientos.
Subject(s)
Humans , Male , Female , Child , Endoscopy, Digestive System/methods , Pediatrics/methods , Conscious Sedation/methods , Deep Sedation/methods , Age Factors , Endoscopy, Digestive System/statistics & numerical data , Follow-Up Studies , Hypnotics and Sedatives/administration & dosage , Monitoring, Physiologic , Meperidine/administration & dosage , Midazolam/administration & dosage , Prospective Studies , Pediatrics/statistics & numerical dataABSTRACT
Se realizó un estudio observacional, descriptivo, de carácter retrospectivo, con el objetivo de conocer el comportamiento de las patologías diagnosticadas por endoscopia digestiva superior en un grupo de pacientes atendidos en el Centro de Diagnóstico Integral Yagua, del municipio Guacara, Estado Carabobo, en el período comprendido entre julio a diciembre de 2007. Utilizamos como universo 1542 pacientes de los cuales 464 representaron nuestra muestra simple aleatoria, predominando los pacientes de 45 a 59 años de edad, siendo la mayoría del sexo femenino. El promedio de edad de los casos fue de 46.2 años. La gastritis fue la patología de mayor diagnóstico endoscópico presente en algo más de la tercera parte de los pacientes, correspondiéndose principalmente con el sexo femenino. El estrés mantenido afectaba a más de la mitad de los pacientes estudiados, así como el tabaquismo y el consumo de alcohol fueron otros factores exógenos asociados de alta ocurrencia. El estudio endoscópico fue indicado principalmente bajo la impresión diagnóstica de dolor abdominal, síndrome ulceroso y esofagitis, encontrándose como hallazgo endoscópico fundamental en estos casos la gastritis, la úlcera péptica y la hernia hiatal respectivamente.
We made an observational, descriptive, retrospective study with the objective of knowing the behavior of the pathologies diagnosed by upper digestive endoscopy in a group of patients attended at the Integral Diagnostic Center Yagua, municipality of Guacara, Carabobo State, in the period from July to December 2007. Our universe were 1 542 patients, 464 of which were our simple randomized sample prevailing the 45 to 59 years-old patients, most of them women. The media age in these cases was 46.2 years. Gastritis was the pathology most frequently diagnosed by endoscopy, present in more than a third of the patients, mainly of the female sex. The maintained stress affected more than a half of the studied patients, and smoking and alcoholism were other exogenous factors associated to the high occurrence. The endoscopic study was indicated mainly under the diagnostic impression of abdominal pain, ulcerous syndrome and esophagitis, having as main endoscopic findings in these cases, gastritis, peptic ulcer and hiatal hernia respectively.
Subject(s)
Humans , Middle Aged , Abdominal Pain/diagnosis , Endoscopy, Digestive System/statistics & numerical data , Endoscopy, Digestive System/history , Endoscopy, Digestive System/methods , Gastritis/diagnosis , Hernia, Hiatal/diagnosis , Peptic Ulcer/diagnosis , Epidemiology, Descriptive , Observational Studies as TopicABSTRACT
OBJECTIVE: We undertook this study to determine the morbimortality in gastric surgery for gastric carcinoma. METHODS: We carried out a retrospective, observational study performed at the Gastroenterology Service of the General Hospital of Mexico City between January 2004 and October 2005. Variables included sex, age, diagnosis, surgery performed and trans- and postoperative complications. RESULTS: Clinical files of 2208 patients were reviewed: 36 (1.63%) cases with gastric carcinoma were found. Twenty patients fulfilled inclusion criteria; there were nine (45%) females and 11 (55%) males with a median age of 60.3 years. Radiological studies performed were upper gastrointestinal series, esophagogastroduodenoscopy, chest x-ray, and computed tomography (CT). Localization of the tumors was as follows: 15 in the antrum, three in the fundus and body and two in the body portion of the stomach. Clinical staging was T3 N0 M0. Surgical procedures were as follows: 11 partial gastrectomies and 4 gastrojejunostomies. In three cases, total gastrectomy was done and in two cases lymphatic biopsy was done. No mortality was reported. Morbidity was reported in one case (5%) with enterocutaneous fistula. CONCLUSIONS: Surgery is the treatment for gastric carcinoma. Preoperative staging is done with CT and laparoscopy. There was no mortality in our study. Morbidity is similar to that reported by other hospitals.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Adenocarcinoma/surgery , Postoperative Complications/epidemiology , Gastric Bypass/statistics & numerical data , Gastrectomy/statistics & numerical data , Stomach Neoplasms/surgery , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Postoperative Complications/etiology , Diagnostic Imaging , Endoscopy, Digestive System/statistics & numerical data , Cutaneous Fistula/etiology , Intestinal Fistula/etiology , Gastrectomy/methods , Hospitals, General/statistics & numerical data , Lymphatic Metastasis , Neoplasm Staging , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Retrospective StudiesABSTRACT
OBJECTIVES: The objective of the present study was to determine pre-endoscopic predictive factors of nonsignificant endoscopic findings in patients with suspected upper gastrointestinal tract hemorrhage (UGIH). MATERIAL AND METHOD: Medical records of 187 patients admitted with the primary diagnosis of UGIH were reviewed. Non-significant endoscopic findings were defined as "normal": "mild gastritis" or unspecified gastritis with a hospital stay of two days or less. Possible predictors of non-significant endoscopic findings included pertinent history, physical examination, nasogastric tube aspirate, routine laboratory findings, and units of infused packed red cells (PRC). Multiple logistic regression analysis was used to determine significant predictors. RESULTS: Predictors of non-significant endoscopic findings included the absence of comorbid diseases (OR: 6.4; 95%CI: 3.0-13.6), higher platelet count (OR. 1.7 per 100,000 increase; 95%CI: 1.1-2.5) and less PRC infusion (OR: 1.9 per unit decrease; 95%CI: 1.3-2.7). CONCLUSION: Patients with UGIH who may have a negative EGD can be identified prior to endoscopy.
Subject(s)
Acute Disease , Ambulatory Care , Comorbidity , Diagnosis, Differential , Emergency Service, Hospital , Endoscopy, Digestive System/statistics & numerical data , Female , Gastrointestinal Hemorrhage/classification , Hospitalization , Humans , Male , Middle Aged , Needs Assessment , Predictive Value of Tests , Preoperative Care , Prognosis , Prospective Studies , Risk Assessment , Risk Factors , ThailandABSTRACT
O achada da cardia incompetente (CI) ou frouxa à endoscopia digestiva alta não é raro mas seu significado é obscuro. Considerando que tal incompetência pode favorecer o refluxo gastroesofágico, seguido de instalação de esofagite de refluxo (ER), realizamos o presente trabalho retrospectivo que teve como objetivo investigar a existência de associação entre CI e ER. Foram revisados os laudos de 395 endoscopias digestivas consecutivas de adultos de ambos os sexos, realizadas no Serviço de Endoscopia do HC de Botucatu-Unesp. O diagnóstico de CI foi definida pela imagem endoscópica da cárdia entreaberta e/ ou envolvimento frouxo do endoscópio pela cárdia; o diagnóstico de ER foi baseado na classificação de Los Angeles. A análise estatística dos resultados utilizou o teste de Goodman e revelou significante grau de associação entre a presença de CI e de ER ( p<0,0001). Embora não haja explicação clara para tal associação, algumas hipóteses podem ser sugeridas envolvendo hipotonia do EIE, distúrbios do RTEIE e esfíncter crural diafragmático ineficaz como condições capazes de não só relaxar a cárdia como simultaneamente favorecer o refluxo seguido de esofagite
Subject(s)
Adult , Male , Female , Humans , Cardia , Esophagitis, Peptic/physiopathology , Endoscopy, Digestive System/statistics & numerical data , Cross-Sectional Studies , Gastroesophageal RefluxABSTRACT
El desarrollo técnico permitió la realización de una gran variedad de nuevos procedimientos endoscópicos. En este trabajo, se describen brevemente los nuevos métodos implementados en el Laboratorio de Endoscopía Digestiva de Servicio de Gastroenterología de nuestro hospital, desde la adquisición de los primeros videoendoscopios en 1994 hasta junio de 1999. En este período se observó un aumento de 30 por ciento en el número anual de los procedimientos endoscópicos con una proporción creciente de procedimientos terapéuticos, aparecieron 20 nuevas técnicas y se formó una nueva generación de endoscopistas. El progreso permitió que nuestro centro se colocó entre los más grandes y más completos del país. Sin embargo, mientras tanto se desarrollaron los métodos de la endoscopía virtual que probablemente reemplazarán la mayor parte de los procedimientos diagnósticos endoscópicos. Endoscopistas, cirujanos y radiólogos deben prepararse en conjunto para enfrentar el gran desafío: el cambio cualitativo y cuantitativo en el trabajo cotidiano, en consecuencia de la endoscopía virtual. En el próximo futuro
Subject(s)
Humans , Digestive System Diseases/diagnosis , Endoscopy, Digestive System/trends , Hospitals, Teaching/statistics & numerical data , Endoscopes, Gastrointestinal/supply & distribution , Endoscopy, Digestive System/statistics & numerical data , Pancreatic Diseases/diagnosis , Hospital Statistics , Hospitals, Teaching/supply & distributionABSTRACT
Estudaram quatro pacientes, dois do sexo masculino e dois do sexo feminino portadores de neoplasia nao-adenocarcinoma do estômago, diagnosticados e tratados na Disciplina de Moléstias do Aparelho Digestivo I do Departamento de Clínica Cirúrgica da Faculdade de Ciências Médicas da PUC-Campinas, a idade variou de 40 a 75 anos. O diagnóstico foi realizado basicamente pela esofagogastroduodenoscopia com biópsia, revelando dois deles como sendo portadores de linfoma, um de plasmocitoma e um de leiomiossarcoma. Em relaçao ao tratamento, dois deles foram submetidos à gastrectomia (um parcial e o outro total), os outros dois foram considerados irressecáveis durante a laparotomia. Um paciente faleceu no pós-operatório, um nao retornou para acompanhamento e os outros dois estao realizando acompanhamento ambulatorial, após tratamento quimioterápico, sem sinais de recidiva tumoral.
Subject(s)
Humans , Middle Aged , Adult , Biopsy/statistics & numerical data , Endoscopy, Digestive System/statistics & numerical data , Stomach Neoplasms , Gastrectomy , Leiomyosarcoma , Lymphoma , PlasmacytomaABSTRACT
A correlaçao entre o Helicobacter pylori e as neoplasias epiteliais gástricas, reconhecida pela Organizaçao Mundial de Saúde, é decorrente de estudos epidemiológicos extensos, baseados fundamentalmente na positividade dos anticorpos anti-Helicobacter pylori. Poucos estudos prospectivos baseados no achado direto ou indireto desta bactéria na mucosa gástrica de pacientes portadores de carcinomas gástricos foram levados a cabo. Restam dúvidas, portanto, acerca da importância e da universalidade desta associaçao. O presente estudo, baseado no teste rápido da urease pré-formada como forma de screening para o Helicobacter pylori e sua confirmaçao histológica nos casos de neoplasias gástricas, envolvendo um total de 5227 exames endoscópicos realizados em um total de 35 adenocarcinomas gástricos detectados, demonstra um risco relativo da associaçao de 0,37, sugerindo que a subpopulaçao em estudo, composta básicamente de descendentes de imigrantes italianos apresenta baixo risco de carcinogênese gástrica associada ao Helicobacter pylori.
Subject(s)
Humans , Endoscopy, Digestive System/statistics & numerical data , Helicobacter pylori , Stomach Neoplasms/epidemiology , Biopsy , Gastric Mucosa/microbiology , UreaseABSTRACT
A ingestäo de substâncias cáusticas (ácidos ou álcalis) pode provocar lesöes graves ao trato digestivo alto. A maior parte das lesöes por cáusticos na infância ocorre em menores de cinco anos e requerem do médico atençäo e açäo rápida para evitar as complicaçöes agudas, como penetraçäo transmural ou queimaduras laríngeas. Estenose esofágica é uma complicaçäo comum e näo há nenhum tratamento efetivo em reduzir sua incidência. Na fase aguda, a endoscopia precoce é de crucial importância para avaliar a extensäo da lesäo, sendo um método seguro para definiçäo de condutas e prognóstico. Neste artigo fornecemos uma revisäo do assunto e discutimos as controvérsias em torno do diagnóstico e tratamento.
Subject(s)
Humans , Child, Preschool , Burns, Chemical , Caustics/adverse effects , Emergencies , Endoscopy, Digestive System/statistics & numerical data , Esophageal Stenosis/chemically induced , Child Care , Esophagus/injuries , Burns, Chemical/prevention & controlABSTRACT
El objetivo es analizar la experiencia adquirida en el diagnóstico y tratamiento de las HDB. Material y Métodos - Se revisaron las historias clínicas de 94 pacientes ingresados entre diciembre de 1985 y septiembre de 1995 (72 en el Hospital y 22 en la práctica personal). Resultados - Población añosa con predominio femenino que requirió para su compensación 261 unidades de sangre (media de la serie de 1388 cc). La pérdida fue masiva en 5 (5,3 por ciento), persistente en 15 (16 por ciento) y reiterada en 12 (12,8 por ciento). Cesó en 64 casos. Se ubicaron 57 lesiones: 12 en ano, 8 en recto, 14 en colon izquierdo, 18 en colon derecho, 3 pancolónicas, 1 ileal y 1 gastroyeyunocólica (hallazgo de autopsia). En diez casos, se efectuó terapéutica médica exclusiva, acorde con el diagnóstico. Se operaron treinta y dos y se efectuaron cuatro polipectomías, dos embolizaciones y una alcoholización. Se negaron al tratamiento siete pacientes con diagnóstico topográfico y nueve con hallazgos angiográficos de lesión no sangrante. Veinticuatro casos (25,5 por ciento) registraron episodios previos. Fallecieron once pacientes (11,7 por ciento). Cuarenta y tres (51,8 por ciento de los supervivientes) continúan en control. Cinco (11,5 por ciento), presentaron nuevos episodios de sangrado. Conclusiones: 1 - Frente a una HDB debe procederse a certificar la pérdida, tratar la hipovolemia, ubicar la zona sangrante y solucionar la causa. 2 - El diagnóstico topográfico de la zona responsable es sustantivo para determinar el tratamiento. 3 - La búsqueda ordenada en sentido caudo oral condujo al diagnóstico en el 60 por ciento de los casos. 4 - La asociación anoscopia - rectoscopia - colonoscopia brindó el 70 por ciento de los hallazgos. El mapeo con Tc 99 y la angiografía mostraron eficacia en pleno sangrado. Su uso está limitado por la dificultad para su ejecución en la emergencia. 5 - El comportamiento impredecible del sangrado y la mayor facilidad de diagnóstico intrahemorrágico justifica maniobras diagnóstico-terapéuticas agresivas.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Algorithms , Gastrointestinal Hemorrhage/diagnosis , Angiography/standards , Elective Surgical Procedures/standards , Endoscopy, Digestive System/statistics & numerical data , Endoscopy, Gastrointestinal/statistics & numerical data , Feces/chemistry , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy , Occult Blood , Retrospective StudiesABSTRACT
O objetivo deste estudo é analizar o resultado do tratamento cirúrgico em 43 pacientes, em três pacientes (30 homens e 13 mulheres) portadores de câncer gástrico precoce, em três instituições hospitalares (Hospital Geral de Jacarepaguá, Santa Casa da Misericórdia do Rio de Janeiro e Hospital Central Penitenciário) entre os anos de 1969 e 1996. A idade dos pacientes variou entre 21 e 83 anos com média de 58 anos. Na avaliação dos sinais e/ou sintomas, observou-se que 36% dos pacientes queixavam-se de dor epigástrica, 15% de náuseas e vômitos, 14% de distúrbios gástrico mal definidos, 21% de pirose e 11% de perda de peso. O diagnóstico de câncer gástrico precoce foi obtido pelo REED e ou esofagogastroduodenoscopia com biópsia na maioria dos casos e a acuidade dos exames foi de 29% e 90% respectivamente. O critério de avaliação do câncer gástrico precoce segundo Sakita mostrou o seguinte resultado: tipos: I(7,5%), IIa (7,5%), IIb (2,5%), IIc (32,5%), III(30%) e misto (20%), enquanto que o estudo histopatológico baseado na conceituação de Lauren revelou que 49% eram do tipo intestinal e 51% da forma difusa...O acompanhamento pós-operatório foi possível em 35 pacientes e evidenciou os seguintes achados: quatorze pacientes com sobrevida acima de cinco anos, cinco tiveram sobrevida superior a dez anos, dois estão com mais de vinte anos de sobrevivência, três faleceram no pós-operatório imediato e quatro entre um e quatro anos, sete estão vivos mas não completaram ainda cinco anos.
Subject(s)
Humans , Male , Female , Young Adult , Middle Aged , Aged, 80 and over , Biopsy , Endoscopy, Digestive System/statistics & numerical data , Endoscopy, Digestive System , Stomach Neoplasms/surgery , Stomach Neoplasms/classification , Stomach Neoplasms/complications , Stomach Neoplasms/diagnosis , Stomach Neoplasms/history , Stomach Neoplasms/pathology , Stomach Neoplasms/therapyABSTRACT
Se comunica la experiencia del Hospital San Martín de Quillota en el diagnóstico y tratamiento de cáncer gástrico desde marzo de 1988 hasta julio de 1992. Se revisó las 4.310 endoscopías realizadas en el período pesquisándose 139 tumores malignos (3,2 por ciento ). Sólo un 2,8 por ciento de los pacientes tuvo un cáncer incipiente. Fueron sometidos a estudio clínico 100 pacientes, de los cuales se intervino quirúrgicamente a 48, pudiendo efectuar resecciones curativas en 16 de ellos. Hubo 39 pacientes que abandonaron el control después del diagnóstico. La distribución geográfica de los pacientes mostró una notable concentración en la comuna de Quillota, situación que debe ser investigada a futuro