RESUMO
Background: Some of the variability in functional results after reconstructive proctocolectomy (RP) may be explained by the excessive intrinsic motility of the ileum and ileoanal pouches. The effect of performing a single or double myotomy on several functional variables after RP was the aim of this prospective, randomized and single blinded experimental study in beagle dogs . Materials and Methods: 33 beagle dogs were randomized in three groups: Group I (12 dogs), a standard RP with a 10 cm ileal J-pouch-anal anastomosis was performed; Group II (10 dogs), a longitudinal myotomy of 8 cm on the wall of the pouch was added to the RP; Group III (11 dogs), same as group II with a further 10 cm longitudinal myotomy in the afferent prepouch ileum loop. Variables studied were daytime and night-time number and characteristics of the stools, as well as their changes over the study period, the intestinal transit time, measured in minutes, and the compliance and capacity of the pouches. Results: No difference in morbidity between groups was found. Mean nocturnal stools were statistically significant lower in groups II and III. Although we observed a trend for lower daytime stool frequency, more percentage of soft-hard stools over the study period, longer intestinal transit time and larger reservoirs in group II, none of these variables reached statistical significant differences. Conclusions. Although the myotomies do not increase the morbidity of the RP, there is no clear clinical evidence of their effectiveness in providing better functional outcomes. Performing two myotomies is not better than only one. Our study do not support a hypothetic use of myotomies for patients with functional failure after a RP
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Assuntos
Animais , Cães , Colectomia/métodos , Bolsas Cólicas , Bolsas Cólicas/veterinária , Anastomose Cirúrgica/métodos , Anastomose Cirúrgica/veterinária , Doenças do Íleo/cirurgia , Doenças do Íleo/veterinária , Íleo/cirurgia , Estudos Prospectivos , Análise de Variância , Hemorragia Gastrointestinal/cirurgia , Hemorragia Gastrointestinal/veterináriaRESUMO
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Assuntos
Humanos , Masculino , Idoso , Doenças da Vesícula Biliar/diagnóstico , Anormalidade Torcional/complicações , Vesícula Biliar/anormalidades , Colecistectomia , ApendicectomiaRESUMO
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Assuntos
Masculino , Pessoa de Meia-Idade , Humanos , Tumor Carcinoide/patologia , Neoplasias Hepáticas/patologia , Intervalo Livre de DoençaRESUMO
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Assuntos
Feminino , Adulto , Humanos , Pseudolinfoma/patologia , Neoplasias Hepáticas/patologia , Diagnóstico Diferencial , Carcinoma Hepatocelular/patologiaRESUMO
Four cases of costal chondrosarcoma were observed in the Thoracic Surgery Department of Nostra Señora de Aránzazu Hospital in San Sebastián. This tumour rarely occurs in the ribs and no papers concerning more than one personal case, over such a brief interval, have been reported. The diagnosis was established on the basis of clinical and radiological data in three cases and after biopsy in the fourth case. Large surgical resection allowed complete histological examination, which confirmed the diagnosis of chondrosarcoma. The tumours were classified into grade I and II according to the degree of differentiation of the tumour cells. All 4 patients were treated exclusively by surgical resection. Marlex mesh was necessary to repair the chest wall defect in 3 cases. The functional result was satisfactory. One of these patients was lost to follow-up and no signs of recurrence have been observed in the other 3 patients, although the follow-up remains relatively short (9, 8 and 7 months, respectively).
