RESUMEN
Gastric cancer (GC) ranks fourth in overall cancer mortality. Bariatric surgical procedures, especially the gastric bypass surgery (GBS), raise a concern about the risk of GC in the excluded stomach (ES). Diagnosis of GC in the ES is challenging due to anatomical changes and impossibility of endoscopic access to the ES. There are few reports of GC after GBS, and it occurs more in the gastric stump than in the ES. We report a case of a 54-year-old female with GC in the ES 18 years after GBS. The increasing number of GBS and the aggressiveness of the GC show how relevant this case is to emphasize the need to consider this diagnosis in patients who develop upper abdominal symptoms, anemia or weight loss.
RESUMEN
O advento de procedimentos como a minilaparoscopia (MLC) tem feito com que a laparoscopia convencional (LC) seja reconsiderada. Contudo, ainda não está claro se a MLC adiciona benefícios aos já gerados pela LC. Objetivo: Este estudo busca comparar tempo cirúrgico, complicações peri e pós-operatórias, marcadores inflamatórios e dor referida das colecistectomias por LC e MLC. Métodos: Foi realizado um ensaio clínico randomizado no Hospital da Cruz Vermelha-PR, sendo analisados os dados de 37 pacientes, 18 submetidos à LC e 19, à MLC. Desses, 24,32% foram homens e 75,77%, mulheres. Resultados: Dentre os resultados, a LC apresentou menor tempo cirúrgico e a MLC menor dor no sétimo pós-operatório, ambos com significância estatística. Conclusão: Conclui-se que ambas as técnicas se mostraram seguras e efetivas, cabendo cirurgião a escolha da técnica que apresenta maior habilidade e que seja mais adequada para o paciente
The advent of procedures as minilaparoscopy (MLC) has made conventional laparoscopy (LC) be reconsidered. However, it's still unclear whether MLC adds benefits to those already generated by LC. Objective: This study aims to compare surgical time, peri and postoperative complications, inflammatory markers and referred pain of LC and MLC cholecystectomies. Methods: A randomized clinical trial was conducted at the Hospital da Cruz Vermelha-PR, where the data of 37 patients were analyzed, 18 submitted to LC and 19, to MLC. Of these, 24.32% were men and 75.77% were women. Results: Among the results, LC presented shorter surgical time and MLC had lower pain at the seventh postoperative day, both with statistical significance. Conclusion: It was concluded that both techniques proved to be safe and effective and it's the surgeon's choice to opt for the technique that he has more dexterity with and is more appropriate for the patient
