RESUMO
The objectives of this study were to (1) determine the number of punctures surgeons and assistants suffer during operations involving a laparotomy during the intraabdominal and closure phases; and (2) determine if the number of puncture injuries during wound closure can be reduced using a new surgical instrument (PdB) that protects the surgeon's hands and the patient's viscera against needlesticks. For the first objective, all laparotomies performed during 1 month (n = 52) were controlled, collecting the gloves used and determining the number of perforations. For the second objective, a randomized prospective controlled study, involving two series of 100 medial laparotomies, was carried out. The incidence of perforations was 29% during the intraabdominal phase and 16% during the wound closure phase. The glove perforation rate while closing medial laparotomies was 31.5% if the PdB was not used and 3% if the PdB was used (p < 0.0001). The glove perforation rate during laparotomy is significant, but with the use of the PdB this incidence can be significantly reduced.
Assuntos
Traumatismos dos Dedos/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Laparotomia/instrumentação , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Técnicas de Sutura/instrumentação , Músculos Abdominais/cirurgia , Desenho de Equipamento , Cirurgia Geral , Luvas Cirúrgicas , Humanos , Incidência , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Assistentes Médicos , Estudos ProspectivosRESUMO
Villous adenomas of the vermiform appendix are uncommon. Their malignant potential is unknown and their treatment is controversial. Because of a reported association between adenomas of the appendix and other gastrointestinal neoplasms, long-term surveillance is recommended. A new case of appendicular villous adenoma is reported.
Assuntos
Adenoma/diagnóstico por imagem , Neoplasias do Apêndice/diagnóstico por imagem , Adenoma/cirurgia , Idoso , Neoplasias do Apêndice/cirurgia , Colectomia , Feminino , Humanos , RadiografiaRESUMO
We report the case of a male patient, 49 years of age, who was admitted to our hospital to clarify the diagnosis of a solid liver tumor of the left lobe of the liver which had been made by image methods (U.S., scan and scintigraphy). Laparoscopy showed an isolated tumor emerging from the left lobe of the liver featuring hypervascularity and umbilication at the top. A visual diagnosis of malignancy was made which was not confirmed neither by biopsy nor the cytological examination. Liver resection was undertaken, and a diagnosis of nodular hyperplasia was made by the pathologist. We have never encountered before this endoscopic appearance of focal nodular hyperplasia either in our own experience or in the search of the literature.
Assuntos
Carcinoma Hepatocelular/diagnóstico , Endoscopia do Sistema Digestório , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Carcinoma Hepatocelular/patologia , Diagnóstico Diferencial , Hamartoma/diagnóstico , Hamartoma/patologia , Humanos , Hiperplasia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
We present 10 cases of early gastric carcinoma with lymph node invasion in a series of 40 cases early gastric cancer operated between 1974 and 1984 in our unit. Two tumours were mucosal and 8 were submucosal. One tumour was polypoid, 5 were superficiel and 4 were ulcerated. The mean number of invaded lymph nodes was 2.7. We performed a total gastrectomy in two patients and a distal gastrectomy in the other eight patients. Two patients died 26 and 27 months after the operation. The others are alive and tumour free. We believe that early gastric cancer must be treated aggressively by means of total or partial gastrectomy with resection of the N1 and N2 lymph node chains, when ever possible.
Assuntos
Metástase Linfática , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Neoplasias Gástricas/classificação , Neoplasias Gástricas/patologiaRESUMO
The authors report experience with three patients with leiomyomas of the rectum between the years 1979 and 1987. Since Malassez's first description in 1872, approximately 200 cases have been reported. The diagnosis of these rare tumors is difficult. The authors present the ultrasonic characteristics of rectal leiomyoma by means of endorectal ultrasound, a method which, although not definitive, does delimit and orient the diagnosis in regard to the rectal mass and the follow-up of these tumors. A histologic diagnosis constitutes a dilemma between benign and malignant forms. The authors believe that treatment should always be surgical, realizing local extirpation when the histologic study reveals no signs of malignancy; even though it is mandatory to perform regular follow-up checkups (mainly with endorectal ultrasound) and radical treatment in regard to malignant lesions and local relapse of the anterior forms.
