RESUMO
The authors report their experience about the use of the timostimoline in the perioperative time in 114 cases of gastric and rectum cancer. They think that this method can be of help for neoplastic patients about the time of surgical stress.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Neoplasias Colorretais/terapia , Cuidados Pré-Operatórios , Neoplasias Gástricas/terapia , Extratos do Timo/uso terapêutico , Terapia Combinada , Humanos , Estresse Fisiológico/terapiaRESUMO
Personal experience with papillotomy and papillosphincterotomy in calculosis of the PBD is reported. The indications and results obtained are discussed. The techniques employed are described and an assessment is made of the extent to which these operations can be performed without causing unnecessary damage to the sphincter.
Assuntos
Ampola Hepatopancreática/cirurgia , Colelitíase/cirurgia , Esfíncter da Ampola Hepatopancreática/cirurgia , Colecistite/cirurgia , Colelitíase/complicações , Cálculos Biliares/cirurgia , Humanos , MétodosRESUMO
Personal experience with biliodigestive derivations in calculosis of the principal bile way is reported. The operating technique is presented and indications and results discussed. It is concluded that biliodigestive anastomosis must be carried out with an appropriate technique and in the presence of particular bile duct lesions, primarily choledochic ectasia.
Assuntos
Ducto Colédoco/cirurgia , Duodeno/cirurgia , Cálculos Biliares/cirurgia , Jejuno/cirurgia , Humanos , MétodosRESUMO
The Authors produced their series of pancreatic cysts and pseudocysts. In order to a correct surgical therapy they deem it essential to do the Wirsungraphia or the cysto-wirsungraphia to recognize the "communicating cyst" and the "non communicating cyst". The simple resection and the cystoparenchimal resection are the operations of choice but the cystoanastomosis provides suitable and definitive results in the same way. Whereas the marsupialization and the external drainage are operations to reserve for the high risk patients, for the hazard of the pancreatic fistula particularly in the "communicating cyst".
Assuntos
Cisto Pancreático/cirurgia , Humanos , Cisto Pancreático/diagnóstico por imagem , Pseudocisto Pancreático/diagnóstico por imagem , Pseudocisto Pancreático/cirurgia , RadiografiaRESUMO
The treatment of perforated peptic ulcer, according to the experience of the Authors (327 cases), must be very pressing and always surgical. The closure of the perforation, the simplest treatment, seems the most suitable and the least dangerous for the survival of the patient, even though 68% of these patients will have to undergo surgery again in the course of 10 years. The radical treatment of resection, is reserved to few and carefully chosen cases, because it is loaded with sufficient risk. Acute bleeding peptic ulcer (86 cases) requires the operation: immediate or delayed according to the importance of the hemorrage: very serious, serious, moderate.
Assuntos
Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/cirurgia , Emergências , Gastrectomia , Humanos , Piloro/cirurgia , Fatores de Tempo , VagotomiaRESUMO
On the basis of two new cases of cancer of the papilla of Vater, stress is laid on the indication for and value of duodeno-cephalopancreatectomy as the sole radical intervention. Conservative papillectomy should be confined to special cases (advanced age, general condition poor) with good long-term results.
Assuntos
Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pâncreas/cirurgiaRESUMO
The paper illustrates the Authors' personal experience of the use of somatostatin in high digestive hemorrhages. Endoscopy continues to be the principal method for hemorrhage diagnosis and therapy and the additional use of somatostatin undoubtedly accelerates recovery by blocking gastric and pancreatic secretions and blood flow at the splanchnic level.
Assuntos
Hemorragia Gastrointestinal/tratamento farmacológico , Somatostatina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Úlcera Duodenal/complicações , Varizes Esofágicas e Gástricas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/tratamento farmacológico , Úlcera Gástrica/complicaçõesRESUMO
Laser-Doppler flowmetry is presently one of the methods of choice in measuring cochlear blood flow. The techniques is non-invasive and is based on the frequency shift of the laser beam induced by the red blood cell movement. Previous studies of cochlear blood flow carried out on animals and humans demonstrated the reliability of laser-Doppler flowmetry and its usefulness in understanding inner ear microcirculation physiology. In this paper we present preliminary data obtained from three patients examined under general anesthesia while undergoing tympanoplasty. Results showed that tracings, whose baseline is proportional with the blood flow, are characterized by waves correlated to pulse beat and automatic ventilation. Moreover, intrinsic contractions of inner ear vessels (waves of vasomotion) as exist in cerebral microcirculation, were observed. Pharmacological hypotension hypocapnia and the application of epinephryne determine a significant reduction of cochlear blood flow. These results suggest that while cochlear blood flow is related to systemic pressure, it has an intrinsic control system. As well since we did not obtain any modification in bone conduction threshold after surgery, we conclude that laser-Doppler flowmetry is a safe technique.
Assuntos
Cóclea/irrigação sanguínea , Fluxometria por Laser-Doppler/métodos , Adolescente , Adulto , Anti-Hipertensivos , Cóclea/efeitos dos fármacos , Epinefrina/farmacologia , Feminino , Humanos , Hipocapnia/etiologia , Hipocapnia/fisiopatologia , Hipotensão/induzido quimicamente , Hipotensão/fisiopatologia , Período Intraoperatório , Fluxometria por Laser-Doppler/instrumentação , Masculino , Miringoplastia , Piperazinas , Fluxo Sanguíneo Regional/efeitos dos fármacosRESUMO
Sclerosing cholangitis is a rare liver disease of unknown etiology with a slow but progressive course. The authors report their experience and illustrate some surgical procedures to preserve bile duct patency in view of a liver transplantation program.