RESUMO
AIM: The aim of this study is to demonstrate the added value of three-dimensional (3D) reconstruction models and artificial intelligence for preoperative planning in complex perianal Crohn's disease. MRI is the gold standard for diagnosis of complex perianal fistulas and abscess due to its high sensitivity, but it lacks high specificity values. This creates the need for better diagnostic models such as 3D image processing and reconstruction (3D-IPR) with artificial intelligence (AI) algorithms. METHOD: This is a prospective study evaluating the utility of 3D reconstruction models from MRI in four patients with perineal Crohn's disease (pCD). RESULTS: Four pCD patients had 3D reconstruction models made from pelvic MRI. This provided a more visual representation of perianal disease and made possible location of the internal fistula orifice, seton placement in fistula tracts and abscess drainage. CONCLUSION: Three-dimensional reconstruction in CD-associated complex perianal fistulas can facilitate disease interpretation, anatomy and surgical strategy, potentially improving preoperative planning as well as intraoperative assistance. This could probably result in better surgical outcomes to control perianal sepsis and reduce the number of surgical procedures required in these patients.
Assuntos
Doença de Crohn , Fístula Retal , Humanos , Doença de Crohn/complicações , Doença de Crohn/cirurgia , Doença de Crohn/diagnóstico , Abscesso/cirurgia , Estudos Prospectivos , Inteligência Artificial , Fístula Retal/diagnóstico por imagem , Fístula Retal/etiologia , Fístula Retal/cirurgia , Resultado do TratamentoRESUMO
The surgical repair of lateral hernias is considered a challenge. Laparoscopic intracorporeal rectus aponeuroplasty (LIRA) has been described as a minimally invasive technique for primary incisional ventral hernias of the midline, especially for M2 to M4 ventral hernias but the indications of the concept associated to LIRA are beginning to expand to other complex locations. The aim of this video is to show the surgical steps for lateral hernias where the concept associated to LIRA is followed to repair this type of hernias. (AU)
La reparación quirúrgica de las hernias laterales se considera un reto. La aponeuroplastia intracorpórea de rectos laparoscópica (LIRA) ha sido descrita como una técnica mínimamente invasiva para tratar las hernias incisionales primarias de la línea media, especialmente para las hernias ventrales M2 a M4, pero las indicaciones del concepto asociado a LIRA comienzan a expandirse a otras localizaciones complejas. El objetivo de este vídeo es mostrar los pasos quirúrgicos de las hernias ÿaterals siguiendo el concepto asociado a LIRA para reparar este hernias. (AU)
Assuntos
Humanos , Hérnia , Reto , Laparoscopia , Hérnia Ventral , Cirurgia GeralRESUMO
The surgical repair of lateral hernias is considered a challenge. Laparoscopic intracorporeal rectus aponeuroplasty (LIRA) has been described as a minimally invasive technique for primary incisional ventral hernias of the midline, especially for M2 to M4 ventral hernias but the indications of the concept associated to LIRA are beginning to expand to other complex locations. The aim of this video is to show the surgical steps for lateral hernias where the concept associated to LIRA is followed to repair this type of hernias.
Assuntos
Hérnia Ventral , Hérnia Incisional , Laparoscopia , Humanos , Hérnia Ventral/cirurgia , Laparoscopia/métodos , Hérnia Incisional/cirurgiaRESUMO
Laparoscopic intracorporeal rectus aponeuroplasty (LIRA) is a minimally invasive technique described to repair M2-M4 primary and incisional hernias. Defects below this area (M5 - Suprapubic area) could be treated using the concept associated to LIRA, expanding the indication of this technique in combination with a transabdominal partially extraperitoneal (TAPE) repair. The aim of this video is to show the surgical steps in the combination of LIRA & TAPE for M2-M5 ventral hernias.
Assuntos
Hérnia Ventral , Hérnia Incisional , Laparoscopia , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Humanos , Hérnia Incisional/cirurgia , Laparoscopia/métodos , Telas CirúrgicasRESUMO
No disponible
Assuntos
Humanos , Glândulas Paratireoides , Cintilografia , Toracoscopia , Timectomia , AdenomaAssuntos
Neoplasias do Mediastino , Cirurgia Torácica Vídeoassistida , Humanos , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Mediastino/diagnóstico por imagem , Mediastino/cirurgia , Glândulas Paratireoides/cirurgia , Cintilografia , Compostos Radiofarmacêuticos , Cirurgia Torácica Vídeoassistida/métodosAssuntos
Parede Abdominal , Adenocarcinoma , Neoplasias do Colo Sigmoide , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Humanos , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias do Colo Sigmoide/patologia , Neoplasias do Colo Sigmoide/cirurgiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Apendicite/diagnóstico por imagem , Corpos Estranhos/cirurgia , Apendicectomia/métodos , Tomografia Computadorizada por Raios X , Apêndice/diagnóstico por imagemRESUMO
El edema pulmonar de altura (EPA) es una forma de edema pulmonar no cardiogénico en individuos que ascienden a la altura 0 descienden de ella. Para su diagnóstico se utilizan los criterios de Louise y algunos estudios adicionales como la tomografía pulmonar, excluyéndose otras causas. Se presenta el caso de una adolescente extranjera que presento EPA al viajar a Cusco y se revisa la literatura...
High-altitude pulmonary edema (HA PE) is a form of non- cardiogenic pulmonary edema in individuals who ascend to or descend from high-altitudes. For its diagnosis, Louise criteria are used and some auxiliary tests like pulmonary CT, excluding other causes. We present the case of a foreign teenager who presented HAPE travelling to Cusco and make a review of the literature...
