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Marroni, Norma Anair Possa
Corso, Carlos Otavio
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Id: biblio-949345
Autor: Motta, Guilherme Lang; Souza, Pablo Cambeses; Santos, Emanuel Burck dos; Bona, Silvia Regina; Schaefer, Pedro Guilherme; Lima, Caetano Araújo Torres; Marroni, Norma Anair Possa; Corso, Carlos Otávio.
Título: Effects of remote ischemic preconditioning and topical hypothermia in renal ischemia-reperfusion injury in rats
Fonte: Acta cir. bras;33(5):396-407, May 2018. tab, graf.
Idioma: en.
Resumo: Abstract Purpose: To evaluate whether combining hypothermia and remote ischemic preconditioning (RIPC) results in protection from ischemia-reperfusion (IR). Methods: Thirty-two Wistar rats underwent right nephrectomy and were randomly assigned to four experimental protocols on the left kidney: warm ischemia (group 1), cold ischemia (group 2), RIPC followed by warm ischemia (group 3), and RIPC followed by cold ischemia (group 4). After 240 minutes of reperfusion, histological changes in the left kidney, as well as lipid peroxidation and antioxidant enzyme activity, were analyzed. The right kidney was used as the control. Serum creatinine was collected before and after the procedures. Results: RIPC combined with hypothermia during IR experiments revealed no differences on interventional groups regarding histological changes (p=0.722). Oxidative stress showed no significant variations among the groups. Lower serum creatinine at the end of the procedure was seen in animals exposed to hypothermia (p<0.001). Conclusions: Combination of RIPC and local hypothermia provides no renal protection in IR injury. Hypothermia preserves renal function during ischemic events. Furthermore, RIPC followed by warm IR did not show benefits compared to warm IR alone or controls in our experimental protocol.
Descritores: Traumatismo por Reperfusão/prevenção & controle
Estresse Oxidativo/fisiologia
Precondicionamento Isquêmico/métodos
Hipotermia Induzida/métodos
Rim/irrigação sanguínea
-Superóxido Dismutase/metabolismo
Ratos Wistar
Terapia Combinada
Modelos Animais de Doenças
Isquemia Fria
Isquemia Quente
Rim/patologia
Limites: Animais
Masculino
Ratos
Responsável: BR1.1 - BIREME


  2 / 14 LILACS  
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Costa, Waldemar Silva
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Id: biblio-827658
Autor: Bechara, Gustavo Ruschi; Damasceno-Ferreira, José Aurelino; Abreu, Leonardo Albuquerque dos Santos; Costa, Waldemar Silva; Sampaio, Francisco José Barcellos; Pereira-Sampaio, Marco Aurélio; Souza, Diogo Benchimol De.
Título: Glomerular loss after arteriovenous and arterial clamping for renal warm ischemia in a swine model
Fonte: Acta cir. bras;31(11):753-758, Nov. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT PURPOSE: To evaluate the glomerular loss after arteriovenous or arterial warm ischemia in a swine model. METHODS: Twenty four pigs were divided into Group Sham (submitted to all surgical steps except the renal ischemia), Group AV (submitted to 30 minutes of warm ischemia by arteriovenous clamping of left kidney vessels), and Group A (submitted to 30 minutes of ischemia by arterial clamping). Right kidneys were used as controls. Weigh, volume, cortical volume, glomerular volumetric density (Vv[Glom]), volume-weighted glomerular volume (VWGV), and the total number of glomeruli were measured for each organ. RESULTS: Group AV showed a 24.5% reduction in its left kidney Vv[Glom] and a 25.4% reduction in the VWGV, when compared to the right kidney. Reductions were also observed when compared to kidneys of sham group. There was a reduction of 19.2% in the total number of glomeruli in AV kidneys. No difference was observed in any parameters analyzed on the left kidneys from group A. CONCLUSIONS: Renal warm ischemia of 30 minutes by arterial clamping did not caused significant glomerular damage, but arteriovenous clamping caused significant glomerular loss in a swine model. Clamping only the renal artery should be considered to minimize renal injury after partial nephrectomies.
Descritores: Artéria Renal/cirurgia
Laparoscopia/métodos
Isquemia Quente/métodos
Glomérulos Renais/irrigação sanguínea
Nefrectomia/métodos
-Tamanho do Órgão
Suínos
Modelos Animais de Doenças
Glomérulos Renais/anatomia & histologia
Glomérulos Renais/fisiopatologia
Limites: Animais
Masculino
Responsável: BR1.1 - BIREME


  3 / 14 LILACS  
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Costa, Waldemar Silva
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Id: biblio-837710
Autor: Damasceno-Ferreira, José Aurelino; Bechara, Gustavo Ruschi; Costa, Waldemar Silva; Pereira-Sampaio, Marco Aurélio; Sampaio, Francisco José Barcellos; Souza, Diogo Benchimol De.
Título: The relationship between renal warm ischemia time and glomerular loss. An experimental study in a pig model
Fonte: Acta cir. bras;32(5):334-341, May 2017. tab, graf.
Idioma: en.
Resumo: Abstract Purpose: To investigate the glomerular number after different warm ischemia times. Methods: Thirty two pigs were assigned into four groups. Three groups (G10, G20, and G30) were treated with 10, 20, and 30 minutes of left renal warm ischemia. The sham group underwent the same surgery without renal ischemia. The animals were euthanized after 3 weeks, and the kidneys were collected. Right kidneys were used as controls. The kidney weight, volume, cortical-medullar ratio, glomerular volumetric density, volume-weighted mean glomerular volume, and the total number of glomeruli per kidney were obtained. Serum creatinine levels were assessed pre and postoperatively. Results: Serum creatinine levels did not differ among the groups. All parameters were similar for the sham, G10, and G20 groups upon comparison of the right and left organs. The G30 group pigs' left kidneys had lower weight, volume, and cortical-medullar ratio and 24.6% less glomeruli compared to the right kidney. A negative correlation was found between warm ischemia time and glomerular number. Conclusions: About one quarter of glomeruli was lost after 30 minutes of renal warm ischemia. No glomeruli loss was detected before 20 minutes of warm ischemia. However, progressive glomerular loss was associated with increasing warm ischemia time.
Descritores: Isquemia Quente/efeitos adversos
Rim/irrigação sanguínea
Córtex Renal/irrigação sanguínea
Glomérulos Renais/irrigação sanguínea
-Fatores de Tempo
Distribuição Aleatória
Creatinina/sangue
Modelos Animais
Sus scrofa
Rim/cirurgia
Rim/fisiopatologia
Córtex Renal/fisiopatologia
Glomérulos Renais/cirurgia
Glomérulos Renais/fisiopatologia
Limites: Animais
Masculino
Responsável: BR1.1 - BIREME


  4 / 14 LILACS  
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Id: lil-742869
Autor: Abarzua-Cabezas, Fernando G.; Sverrisson, Einar; Cruz, Robert De La; Spiess, Philippe E.; Haddock, Peter; Sexton, Wade J..
Título: Oncological and functional outcomes of salvage renal surgery following failed primary intervention for renal cell carcinoma
Fonte: Int. braz. j. urol;41(1):147-154, jan-feb/2015. tab, graf.
Idioma: en.
Resumo: Purpose To assess the oncologic and functional outcomes of salvage renal surgery following failed primary intervention for RCC. Materials and Methods We performed a retrospective review of patients who underwent surgery for suspected RCC during 2004-2012. We identified 839 patients, 13 of whom required salvage renal surgery. Demographic data was collected for all patients. Intraoperative and postoperative data included ischemic duration, blood loss and perioperative complications. Preoperative and postoperative assessments included abdominal CT or magnetic resonance imaging, chest CT and routine laboratory work. Estimated glomerular filtration rate (eGFR) was calculated according to the Modification of Diet in Renal Disease equation. Results The majority (85%) of the patients were male, with an average age of 64 years. Ten patients underwent salvage partial nephrectomy while 3 underwent salvage radical nephrectomy. Cryotherapy was the predominant primary failed treatment modality, with 31% of patients undergoing primary open surgery. Pre-operatively, three patients were projected to require permanent post-operative dialysis. In the remaining 10 patients, mean pre- and postoperative serum creatinine and eGFR levels were 1.35 mg/dL and 53.8 mL/min/1.73 m2 compared to 1.43 mg/dL and 46.6 mL/min/1.73 m2, respectively. Mean warm ischemia time in 10 patients was 17.4 min and for all patients, the mean blood loss was 647 mL. The predominant pathological stage was pT1a (8/13; 62%). Negative surgical margins were achieved in all cases. The mean follow-up was 32.9 months (3.5-88 months). Conclusion While salvage renal surgery can be challenging, it is feasible and has adequate surgical, functional and oncological outcomes. .
Descritores: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Terapia de Salvação/métodos
-Carcinoma de Células Renais/patologia
Carcinoma de Células Renais/fisiopatologia
Creatinina/sangue
Taxa de Filtração Glomerular
Complicações Intraoperatórias
Neoplasias Renais/patologia
Neoplasias Renais/fisiopatologia
Recidiva Local de Neoplasia
Nefrectomia/métodos
Período Perioperatório
Complicações Pós-Operatórias
Reoperação
Estudos Retrospectivos
Resultado do Tratamento
Isquemia Quente
Limites: Idoso
Feminino
Humanos
Masculino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


  5 / 14 LILACS  
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Id: lil-721065
Autor: Silva, Jose Carlos Faes da.
Título: Estudo da congestão venosa após amputação subtotal de membro de ratos: efeito protetor do alopurinol, vitamina c, tirofiban ou heparina na isquemia secundária / Study of venous congestion after partial limb amputantion in rats: protective effects of Allopurinol, Vitamin C, Tirofiban or Heparin in secondary ischemia.
Fonte: São Paulo; s.n; 2013. [125] p. ilus, tab, graf.
Idioma: pt.
Tese: Apresentada a Universidade de São Paulo. Faculdade de Medicina para obtenção do grau de Doutor.
Resumo: A trombose venosa é a principal complicação da microcirurgia vascular e a intervenção precoce é necessária para o salvamento dos retalhos, com índices de sucesso de apenas 50% das revisões cirúrgicas; trombose da microcirculação, produção de radicais livres de oxigênio (RLO) e edema são os elementos principais da lesão de isquemia/reperfusão (I/R), e o planejamento das terapias protetoras tem como objetivo amenizar estas alterações. Os fármacos antioxidantes, antiagregantes plaquetários e anticoagulantes são utilizados no controle da lesão de I/R em diferentes órgãos. Neste estudo, em modelo de amputação subtotal de membro posterior de rato submetido a isquemia global primária, foi testado o efeito protetor dos fármacos alopurinol, heparina, tirofiban ou vitamina C durante a isquemia secundaria pós congestão venosa. Foram operados 100 ratos, que apos isquemia global de 90 minutos, foram divididos em cinco grupos de 20 animais recebendo uma das respectivas drogas na veia femoral contra-lateral: 1ml de solução fisiológica 0,9% no grupo controle (GC), 1ml de alopurinol 45mg/kg no grupo experimental 1 (G1), 1ml de heparina 200UI/kg no grupo experimental 2 (G2), 1ml de tirofiban 50 ug /ml no grupo experimental 3 (G3) e 1 ml de vitamina C 100mg/kg no grupo experimental 4 (G4); o clampe foi então retirado do feixe vascular e se iniciou a reperfusão de 60 minutos; a colocação do clampe vascular apenas na veia femoral direita iniciou a congestão venosa (isquemia secundária) do membro por 90 minutos seguido de outra reperfusão de 60 minutos; O músculo gastrocnêmio foi dissecado e retirado para analise histológica e os animais sacrificados por injeção letal. Foram estudados a porcentagem de viabilidade celular muscular, o edema e o extravasamento de hemácias. A porcentagem de lesão celular do músculo do grupo controle foi 54,6% (±10,6), do G1 31,5% (±13,6), do G2 24,7% (±11,7), do G3 24,6% (±8,6) e do G4 21,3% (±8,6). Os grupos foram comparados por modelo de comparação...

Venous thrombosis is the main complication of vascular microsurgery an early intervention is mandatory to rescue the flap, with a success rate of only 50% of surgical revisions; microcirculation thrombosis, oxygen free radicals production and edema are the main elements of ischemia/reperfusion (I/R) injury, and protective therapies aim to mitigate these changes. Antioxidants, antiplatelets and anticoagulants are used in different organs to control this injury. In this study, in a partial hind limb amputation model submitted to global ischemia, it was tested the protective effect of Allopurinol, Heparin, Tirofiban or Vitamin C during secondary ischemia after venous congestion. A hundred rats divided in five groups of 20 animals each were operated; after global ischemia of 90 minutes each group was injected into the contra lateral femoral vein one of the following solutions: 1 ml of saline solution NaCl 0,9% - control group (CG); 1ml of Allopurinol 45mg/kg - experimental group 1 (G1); 1ml of Heparin 200 UI/kg - experimental group 2 (G2); 1ml of Tirofiban 50 ug /ml - experimental group 3 (G3); 1ml of Vitamin C 100mg/kg - experimental group 4 (G4). Sixty minutes of limb reperfusion was performed, and a secondary period of limb ischemia started with the clamping of the femoral vein only (limb congestion) which lasted for 90 minutes (secondary ischemia). After that, the vein clamp was removed and a 60 minute reperfusion period was observed; at the end of the second reperfusion period, the right gastrocnemius muscle was removed and fixed in 10% formaldehyde, animals were euthanized with a lethal dose of Pentobarbital. Muscle fibers were scored as uninjured or injured based on the morphology of individual fibers; interstitial edema and bleeding were graded on a four-point scale. The control group had more damaged muscle cells 54.6±10.6% when compared to allopurinol 31.5±13,6%, heparin 24.7±11.7%, tirofiban 24.6±8.6% and Vitamin C 21.3±8.6%...
Descritores: Alopurinol
Ácido Ascórbico
Heparina
Ratos Wistar
Reperfusão
Reimplante
Trombose Venosa
Isquemia Quente
Limites: Animais
Ratos
Responsável: BR66.1 - Divisão de Biblioteca e Documentação
BR66.1


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Id: lil-711687
Autor: Ke, Wang; Yu-Lian, Zhang; Chun-Hua, Lin; Dong-Fu, Liu; Chang-Ping, Men; Jian-Ming, Wang; Zhen-Li, Gao.
Título: Application of Self-retaining Bidirectional Barbed Absorbable Suture in Retroperito- neoscopic Partial Nephrectomy
Fonte: Int. braz. j. urol;40(2):220-224, Mar-Apr/2014. tab, graf.
Idioma: en.
Resumo: ObjectiveTo investigate the safety and feasibility of self-retaining bidirectional barbed absorbable suture application in retroperitoneoscopic partial nephrectomy.Materials and MethodsFrom Sep 2011 and Aug 2012, 76 cases of retroperitoneoscopic partial nephrectomy were performed at our hospital. The patients were divided into two groups: self-retaining barbed suture (SRBS) group (n = 36) and non-SRBS group (n = 40). There was no significant difference in age, sex, tumor size and location between the two groups. Clinical data and outcomes were analyzed retrospectively.ResultsAll 76 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery or serious intraoperative complications. In the SRBS group, the suture time, warm ischemia time and operation blood loss were significantly shorter than that of non-SRBS group (p < 0.01), and operation time and hospital stay were shorter than that of non-SRBS group (p < 0.05).ConclusionsThe application of self-retaining bidirectional barbed absorbable suture in retroperitoneoscopic partial nephrectomy could shorten suture time and warm ischemia time, with good safety and feasibility, worthy of being used in clinic.
Descritores: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Espaço Retroperitoneal/cirurgia
Técnicas de Sutura
Suturas
-Perda Sanguínea Cirúrgica
Nefrectomia/efeitos adversos
Duração da Cirurgia
Complicações Pós-Operatórias
Reprodutibilidade dos Testes
Estudos Retrospectivos
Estatísticas não Paramétricas
Técnicas de Sutura/efeitos adversos
Suturas/efeitos adversos
Resultado do Tratamento
Isquemia Quente
Limites: Adulto
Feminino
Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


  7 / 14 LILACS  
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Srougi, Miguel
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Id: lil-687300
Autor: Marchini, Giovanni Scala; Duarte, Ricardo Jordao; Mitre, Anuar Ibrahim; Tiseo, Bruno Camargo; Cassao, Valter Dell'Acqua; Torricelli, Fabio Cesar Miranda; Arap, Marco Antonio; Srougi, Miguel.
Título: Infrared Thermometer: an accurate tool for temperature measurement during renal surgery
Fonte: Int. braz. j. urol;39(4):572-578, Jul-Aug/2013. tab, graf.
Idioma: en.
Resumo: Purpose To evaluate infrared thermometer (IRT) accuracy compared to standard digital thermometer in measuring kidney temperature during arterial clamping with and without renal cooling. Materials and Methods 20 pigs weighting 20Kg underwent selective right renal arterial clamping, 10 with (Group 1 - Cold Ischemia with ice slush) and 10 without renal cooling (Group 2 - Warm Ischemia). Arterial clamping was performed without venous clamping. Renal temperature was serially measured following clamping of the main renal artery with the IRT and a digital contact thermometer (DT): immediate after clamping (T0), after 2 (T2), 5 (T5) and 10 minutes (T10). Temperature values were expressed in mean, standard deviation and range for each thermometer. We used the T student test to compare means and considered p < 0.05 to be statistically significant. Results In Group 1, mean DT surface temperature decrease was 12.6 ± 4.1°C (5-19°C) while deep DT temperature decrease was 15.8 ± 1.5°C (15-18°C). For the IRT, mean temperature decrease was 9.1 ± 3.8°C (3-14°C). There was no statistically significant difference between thermometers. In Group 2, surface temperature decrease for DT was 2.7 ± 1.8°C (0-4°C) and mean deep temperature decrease was 0.5 ± 1.0°C (0-3°C). For IRT, mean temperature decrease was 3.1 ± 1.9°C (0-6°C). No statistically significant difference between thermometers was found at any time point. conclusions IRT proved to be an accurate non-invasive precise device for renal temperature monitoring during kidney surgery. External ice slush cooling confirmed to be fast and effective at cooling the pig model. IRT = Infrared thermometer DT = Digital contact thermometer D:S = Distance-to-spot ratio .
Descritores: Temperatura Corporal
Raios Infravermelhos
Rim/cirurgia
Termômetros/normas
-Isquemia Fria
Constrição
Desenho de Equipamento
Ilustração Médica
Valores de Referência
Reprodutibilidade dos Testes
Propriedades de Superfície
Sus scrofa
Fatores de Tempo
Isquemia Quente
Limites: Animais
Masculino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


  8 / 14 LILACS  
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Malheiros, Denise Maria Avancini Costa
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Id: lil-674237
Autor: Machado, Christiano; Malheiros, Denise Maria Avancini Costa; Adamy, Ari; Santos, Luiz Sergio; da Silva Filho, Agenor Ferreira; Nahas, William Carlos; Lemos, Francine Brambate Carvalhinho.
Título: Protective response in renal transplantation: no clinical or molecular differences between open and laparoscopic donor nephrectomy
Fonte: Clinics;68(4):483-488, abr. 2013. tab, graf.
Idioma: en.
Resumo: OBJECTIVE: Prolonged warm ischemia time and increased intra-abdominal pressure caused by pneumoperitoneum during a laparoscopic donor nephrectomy could enhance renal ischemia reperfusion injury. For this reason, laparoscopic donor nephrectomy may be associated with a slower graft function recovery. However, an adequate protective response may balance the ischemia reperfusion damage. This study investigated whether laparoscopic donor nephrectomy modified the protective response of renal tissue during kidney transplantation. METHODS: Patients undergoing live renal transplantation were prospectively analyzed and divided into two groups based on the donor nephrectomy approach used: 1) the control group, recipients of open donor nephrectomy (n = 29), and 2) the study group, recipients of laparoscopic donor nephrectomy (n = 26). Graft biopsies were obtained at two time points: T-1 = after warm ischemia time and T+1 = 45 minutes after kidney reperfusion. The samples were analyzed by immunohistochemistry for the Bcl-2 and HO-1 proteins and by real-time polymerase chain reaction for the mRNA expression of Bcl-2, HO-1 and vascular endothelial growth factor. RESULTS: The area under the curve for creatinine and delayed graft function were similar in both the laparoscopic and open groups. There was no difference in the protective gene expression between the laparoscopic donor nephrectomy and open donor nephrectomy groups. The protein expression of HO-1 and Bcl-2 were similar between the open and laparoscopic groups. Furthermore, the gene expression of B-cell lymphoma 2 correlated with the warm ischemia time in the open group (p = 0.047) and that of vascular endothelial growth factor with the area under the curve for creatinine in the laparoscopic group (p = 0.01). CONCLUSION: The postoperative renal function and protective factor expression were similar between laparoscopic ...
Descritores: Transplante de Rim
Doadores Vivos
Laparoscopia/métodos
Nefrectomia/métodos
Coleta de Tecidos e Órgãos/métodos
-Creatinina/sangue
Função Retardada do Enxerto/fisiopatologia
Expressão Gênica
Heme Oxigenase-1/sangue
Período Pós-Operatório
Reação em Cadeia da Polimerase em Tempo Real
Traumatismo por Reperfusão/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Fator A de Crescimento do Endotélio Vascular/sangue
Isquemia Quente/métodos
Limites: Adulto
Feminino
Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


  9 / 14 LILACS  
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Id: lil-643039
Autor: Huang, Ling-Jin; Reese, Shannon; Djamali, Arjang.
Título: Contributing factors to complications and surgical success in mouse kidney transplantation
Fonte: Int. braz. j. urol;38(3):395-404, May-June 2012. ilus, graf, tab.
Idioma: en.
Resumo: PURPOSE: Mouse kidney transplantation is a challenging technique for novice microsurgeons. Factors that affect transplant outcomes for a clinical surgeon starting microsurgery have not yet been investigated. MATERIALS AND METHODS: 110 consecutive mouse kidney transplants were performed over a 9-month period. Data were recorded, and surgical results and complication were analyzed. RESULTS: Three and thirty day survival rates improved from 0 (0/6) to 92.3% (12/13) between months 1 and 9. Bleeding, arterial thrombosis, kidney failure and hydronephrosis were the most common causes of transplant failure. From month 1 to month 7, using the same surgical technique, practice significantly decreased the incidence of bleeding and increased the 3-day survival rate; however, it didn't significantly decrease the incidence of thrombosis, kidney failure, but improved the 30-day survival rate. From month 8, when surgical technique used on artery anastomosis switched from continuous suture to interrupted suture, surgical survival rate at 3 and 30 days improved significantly. Interestingly, ischemia time was not a significant factor determining the success of transplantation in this study. CONCLUSIONS: Practice is essential for novice microsurgeons, and the choice of surgical techniques significantly affects surgical results. The use of interrupted arterial sutures can significantly improve mouse kidney transplantation outcomes compared with continuous sutures. Ischemic time was not a factor in determining successful of kidney transplantation in mice in this study.
Descritores: Modelos Animais de Doenças
Transplante de Rim/efeitos adversos
Transplante de Rim/métodos
Microcirurgia/métodos
-Competência Clínica
Curva de Aprendizado
Camundongos Endogâmicos BALB C
MICE, INBRED CABDOMENABDOMINAL INJURIESBL
Duração da Cirurgia
Fatores de Tempo
Falha de Tratamento
Resultado do Tratamento
Isquemia Quente
Limites: Animais
Masculino
Camundongos
Responsável: BR1.1 - BIREME


  10 / 14 LILACS  
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Srougi, Miguel
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Id: lil-643034
Autor: Dall'Oglio, Marcos F.; Ballarotti, Lucas; Passerotti, Carlo C.; Paluello, Davi V.; Colombo Junior, Jose Roberto; Crippa, Alexandre; Srougi, Miguel.
Título: Anatrophic nephrotomy as nephron-sparing approach for complete removal of intraparenchymal renal tumors
Fonte: Int. braz. j. urol;38(3):356-361, May-June 2012. ilus, tab.
Idioma: en.
Resumo: OBJECTIVE: Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy. PATIENTS AND METHODS: A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identified. Patient demographics, perioperative outcomes and oncological results were evaluated. RESULTS: Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no significant creatinine changes or local or systemic recurrences were observed. CONCLUSION: The operative technique described is a safe and effective nephron-sparing option for complete removal of endophytic renal tumors.
Descritores: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Néfrons/cirurgia
Tratamentos com Preservação do Órgão/métodos
-Carcinoma de Células Renais/patologia
Estudos de Viabilidade
Neoplasias Renais/patologia
Estudos Retrospectivos
Resultado do Tratamento
Carga Tumoral
Isquemia Quente
Limites: Adulto
Feminino
Humanos
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME



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