Base de dados : MEDLINE
Pesquisa : A03.556.124.526.356.500 [Categoria DeCS]
Referências encontradas : 248 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 25 ir para página                         

  1 / 248 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28953667
[Au] Autor:Lian R; Zhang G; Zhang G
[Ad] Endereço:aDepartment of Emergency Medicine bDepartmentof General Surgery, China-Japan Friendship Hospital, Beijing, China.
[Ti] Título:Empyema caused by a colopleural fistula: A case report.
[So] Source:Medicine (Baltimore);96(39):e8165, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATINALE: Empyema is a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. An empyema caused by colo-pleural fistula is a rare but potentially life-threatening condition. PATIENT CONCERNS: We describe a case of 42-year-old man was brought to our Emergency Department for chest pain with dyspnea and fever. DIAGNOSES: The final diagnoses are empyema caused by colo-pleural fistula and colon cancer. INTERVENTIONS: The patient underwent laparotomy surgery, during which a tumor was found in the splenic flexure of the descending colon. The tumor penetrated the colonic serosa and invaded the left side of the diaphragm. A left hemicolectomy was performed. OUTCOMES: After the operation, the patient recovered smoothly and was discharged on postoperative day 14. It's been over 3 years now, CT and colonoscopy assessments show no recurrence or metastasis. LESSONS: This case serves as a reminder to test for pathogens in patients with an unexplained empyema. If normal intestinal bacteria are detected, the empyema may be derived from intestinal disease. In addition, an abdominal examination should be performed in patients with an empyema of unknown origin.
[Mh] Termos MeSH primário: Colectomia
Colo Descendente
Neoplasias do Colo
Empiema Pleural
Fístula
Cavidade Pleural
[Mh] Termos MeSH secundário: Adulto
Colectomia/efeitos adversos
Colectomia/métodos
Colo Descendente/diagnóstico por imagem
Colo Descendente/patologia
Neoplasias do Colo/complicações
Neoplasias do Colo/patologia
Colonoscopia/métodos
Empiema Pleural/diagnóstico
Empiema Pleural/etiologia
Empiema Pleural/microbiologia
Empiema Pleural/terapia
Enterococcus faecium/isolamento & purificação
Escherichia coli/isolamento & purificação
Fístula/diagnóstico
Fístula/etiologia
Fístula/fisiopatologia
Fístula/cirurgia
Microbioma Gastrointestinal
Seres Humanos
Masculino
Invasividade Neoplásica
Estadiamento de Neoplasias
Cavidade Pleural/diagnóstico por imagem
Cavidade Pleural/patologia
Toracentese/métodos
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008165


  2 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28287437
[Au] Autor:Makowska K; Obremski K; Zielonka L; Gonkowski S
[Ad] Endereço:Department of Clinical Physiology, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, ul. Oczapowskiego 13, 10-718 Olsztyn, Poland. krystyna.makowska@uwm.edu.pl.
[Ti] Título:The Influence of Low Doses of Zearalenone and T-2 Toxin on Calcitonin Gene Related Peptide-Like Immunoreactive (CGRP-LI) Neurons in the ENS of the Porcine Descending Colon.
[So] Source:Toxins (Basel);9(3), 2017 Mar 10.
[Is] ISSN:2072-6651
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:The enteric nervous system (ENS) can undergo adaptive and reparative changes in response to physiological and pathological stimuli. These manifest primarily as alterations in the levels of active substances expressed by the enteric neuron. While it is known that mycotoxins can affect the function of the central and peripheral nervous systems, knowledge about their influence on the ENS is limited. Therefore, the aim of the present study was to investigate the influence of low doses of zearalenone (ZEN) and T-2 toxin on calcitonin gene related peptide-like immunoreactive (CGRP-LI) neurons in the ENS of the porcine descending colon using a double immunofluorescence technique. Both mycotoxins led to an increase in the percentage of CGRP-LI neurons in all types of enteric plexuses and changed the degree of co-localization of CGRP with other neuronal active substances, such as substance P, galanin, nitric oxide synthase, and cocaine- and amphetamine-regulated transcript peptide. The obtained results demonstrate that even low doses of ZEN and T-2 can affect living organisms and cause changes in the neurochemical profile of enteric neurons.
[Mh] Termos MeSH primário: Peptídeo Relacionado com Gene de Calcitonina/metabolismo
Colo Descendente/efeitos dos fármacos
Neurônios/efeitos dos fármacos
Toxina T-2/toxicidade
Zearalenona/toxicidade
[Mh] Termos MeSH secundário: Animais
Colo Descendente/inervação
Colo Descendente/metabolismo
Feminino
Neurônios/metabolismo
Óxido Nítrico Sintase Tipo I/metabolismo
Substância P/metabolismo
Suínos
Proteínas Vesiculares de Transporte de Acetilcolina/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vesicular Acetylcholine Transport Proteins); 33507-63-0 (Substance P); 5W827M159J (Zearalenone); 83652-28-2 (Calcitonin Gene-Related Peptide); EC 1.14.13.39 (Nitric Oxide Synthase Type I); I3FL5NM3MO (T-2 Toxin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE


  3 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28187878
[Au] Autor:Yamashita S; Odisio BC; Huang SY; Kopetz SE; Ahrar K; Chun YS; Conrad C; Aloia TA; Gupta S; Harmoush S; Hicks ME; Vauthey JN
[Ad] Endereço:Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
[Ti] Título:Embryonic origin of primary colon cancer predicts survival in patients undergoing ablation for colorectal liver metastases.
[So] Source:Eur J Surg Oncol;43(6):1040-1049, 2017 Jun.
[Is] ISSN:1532-2157
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In patients with primary colorectal cancer (CRC) or unresectable metastatic CRC, midgut embryonic origin is associated with worse prognosis. The impact of embryonic origin on survival after ablation of colorectal liver metastases (CLM) is unclear. METHODS: We identified 74 patients with CLM who underwent percutaneous ablation during 2004-2015. Survival and recurrence after ablation of CLM from midgut origin (n = 18) and hindgut origin (n = 56) were analyzed. Prognostic value of embryonic origin was evaluated. RESULTS: Recurrence-free survival (RFS) and overall survival (OS) after percutaneous ablation were worse in patients from midgut origin (3-year RFS: 5.6% vs. 24%, P = 0.004; 3-year OS: 25% vs. 70%, P 0.001). In multivariable analysis, factors associated with worse OS were midgut origin (hazard ratio [HR] 4.87, 95% CI 2.14-10.9, P 0.001), multiple CLM (HR 2.35, 95% CI 1.02-5.39, P = 0.044), and RAS mutation (HR 2.78, 95% CI 1.25-6.36, P = 0.013). At a median follow-up of 25 months, 56 patients (76%) had developed recurrence, 16 (89%) with midgut origin and 40 (71%) with hindgut origin (P = 0.133). Recurrent disease was treated with local therapy in 20 patients (36%), 2 (13%) with midgut origin and 18 (45%) with hindgut origin (P = 0.022). CONCLUSION: Compared to CLM from hindgut origin tumors, CLM from midgut origin tumors were associated with worse survival after ablation, which was partly attributable to the fact that patients with hindgut origin were more frequently candidates for local therapy at recurrence.
[Mh] Termos MeSH primário: Carcinoma/cirurgia
Colo Ascendente/patologia
Colo Descendente/patologia
Neoplasias Colorretais/patologia
Neoplasias Hepáticas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma/secundário
Ablação por Cateter
Colo Ascendente/embriologia
Colo Descendente/embriologia
Neoplasias Colorretais/mortalidade
Seres Humanos
Neoplasias Hepáticas/secundário
Meia-Idade
Análise Multivariada
Recidiva Local de Neoplasia
Prognóstico
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Taxa de Sobrevida
Proteínas ras/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.6.5.2 (ras Proteins)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170212
[St] Status:MEDLINE


  4 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28058512
[Au] Autor:Isik O; Benlice C; Gorgun E
[Ad] Endereço:Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A-30, Cleveland, OH, 44195, USA.
[Ti] Título:A novel approach for robotic mobilization of the splenic flexure.
[So] Source:Tech Coloproctol;21(1):53-57, 2017 Jan.
[Is] ISSN:1128-045X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The techniques of robotic splenic flexure mobilization in the colorectal surgery setting are not well defined and have been challenging due to limited range of motion of the second-generation robotic platform in multiple quadrants. METHODS: This report describes a novel technique for robotic splenic flexure mobilization with medial-to-lateral approach without a need for robotic cart repositioning during left-sided colon and rectal surgery. The dissection is started with ligation of the inferior mesenteric artery and vein. Unique in this approach, entering the lesser sac is accomplished by extension of the dissection cranially by lifting up the mesocolon from the anterior surface of the pancreatic body toward the stomach. RESULTS: This technique presented in the video allows the mobilization of the splenic flexure without excessive tractions and avoidance of potential splenic injuries. CONCLUSIONS: The described novel approach demonstrates total robotic splenic flexure takedown without excessive traction, with improved visualization, and reduction of potential risk of splenic injury. This approach provides totally robotic mobilization of the splenic flexure at single docking without changing the patient's position.
[Mh] Termos MeSH primário: Colectomia/métodos
Colo Descendente/cirurgia
Colo Transverso/cirurgia
Dissecação/métodos
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Ligadura
Artéria Mesentérica Inferior/cirurgia
Posicionamento do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1007/s10151-016-1572-x


  5 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27870592
[Au] Autor:Bae SU; Jeong WK; Baek SK
[Ad] Endereço:Department of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center , Daegu, Korea.
[Ti] Título:Robot-Assisted Colectomy for Left-Sided Colon Cancer: Comparison of Reduced-Port and Conventional Multi-Port Robotic Surgery.
[So] Source:J Laparoendosc Adv Surg Tech A;27(4):398-403, 2017 Apr.
[Is] ISSN:1557-9034
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The robotic single-port access plus one conventional robotic port, a reduced-port robotic surgery (RPRS) for left-sided colon cancer, can enable lymphovascular dissection using the wristed instrumentation and safe rectal transection through an additional port maintaining the cosmetic advantage of the single-port surgery. The aim of this study is to compare the clinicopathological outcomes between reduced-port and conventional multi-port robotic colectomy for left-sided colon cancer. METHODS: The study group included 23 patients who underwent an RPRS and 16 patients who underwent a multi-PRS (MPRS) for left-sided colon cancer between August 2013 and January 2016. RESULTS: The operative time was significantly shorter in the RPRS group than in the MPRS group (mean time 258 ± 67 vs. 319 ± 66 minutes, P = .009). There were no apparent differences in tolerance of diet, postoperative pain score, length of hospital stay, the rate of postoperative complications, and the mean number of harvested lymph node, but the RPRS group had a significantly smaller total incision length (38 ± 12 mm vs. 83 ± 6 mm, P = .013). CONCLUSIONS: This study shows the feasibility and safety of the RPRS, with clinicopathological outcomes that is comparable with that of the MPRS for left-sided colon cancer.
[Mh] Termos MeSH primário: Colectomia/métodos
Neoplasias do Colo/cirurgia
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Colectomia/instrumentação
Colo Descendente/cirurgia
Neoplasias do Colo/patologia
Dissecação
Feminino
Seres Humanos
Laparoscopia
Tempo de Internação
Masculino
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Reto/cirurgia
Estudos Retrospectivos
Neoplasias do Colo Sigmoide/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161122
[St] Status:MEDLINE
[do] DOI:10.1089/lap.2016.0427


  6 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27784831
[Au] Autor:Alnajar H; Murro D; Alsadi A; Jakate S
[Ad] Endereço:1 Rush University Medical Center, Chicago, IL, USA.
[Ti] Título:Spectrum of Clinicopathological Deviations in Long-Segment Hirschsprung Disease Compared With Short-Segment Hirschsprung Disease: A Single-Institution Study.
[So] Source:Int J Surg Pathol;25(3):216-221, 2017 May.
[Is] ISSN:1940-2465
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hirschsprung disease (HSCR) is a congenital disorder characterized by intestinal aganglionosis leading to pseudoobstruction. The majority of cases are limited to the rectum or rectosigmoid (S-HSCR). A variably longer segment can be affected (L-HSCR), which may show many deviations from S-HSCR. We retrospectively reviewed 48 clinicopathologically confirmed total cases of HSCR at a single institution in a 21-year period to identify L-HSCR cases and determine their deviations from known features of S-HSCR. Eight L-HSCR cases were found where aganglionosis extended to the terminal ileum (7/8) or to the splenic flexure (1/8). L-HSCR lacked male preponderance and was in contrast more common in females (6/8). Associated anomalies included congenital heart disease (2) and neonatal hypothyroidism (1), previously underreported associations. The clinical diagnosis of L-HSCR was often delayed (average age at diagnosis 13 days) and the diagnosis was more often made operatively (5/8) rather than on rectal suction biopsy (3/8). Histologically, apart from aganglionosis, neural hyperplasia was either absent or focal, compounding the diagnostic difficulty. Although the number of cases in our study was limited due to the rarity of L-HSCR, this study still highlights the spectrum of deviations of L-HSCR from known clinicopathological features of S-HSCR.
[Mh] Termos MeSH primário: Doença de Hirschsprung/patologia
[Mh] Termos MeSH secundário: Colo Descendente/inervação
Colo Descendente/patologia
Colo Sigmoide/inervação
Colo Sigmoide/patologia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Reto/inervação
Reto/patologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161028
[St] Status:MEDLINE
[do] DOI:10.1177/1066896916675729


  7 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27738989
[Au] Autor:Makowska K; Gonkowski S; Zielonka L; Dabrowski M; Calka J
[Ad] Endereço:Department of Clinical Physiology, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, ul. Oczapowskiego 13, 10-718, Olsztyn, Poland. krystyna.makowska@uwm.edu.pl.
[Ti] Título:T2 Toxin-Induced Changes in Cocaine- and Amphetamine-Regulated Transcript (CART)-Like Immunoreactivity in the Enteric Nervous System Within Selected Fragments of the Porcine Digestive Tract.
[So] Source:Neurotox Res;31(1):136-147, 2017 Jan.
[Is] ISSN:1476-3524
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:T-2 toxin is a mycotoxin produced by some Fusarium species, which may affect the synthesis of DNA and RNA and causes various pathological processes. Till now, the influence of T-2 toxin on the enteric nervous system (ENS) located in the wall of gastrointestinal tract has not been studied. On the other hand, cocaine- and amphetamine-regulated transcript (CART) is one of enteric neuronal factors, whose exact functions in the intestines still remain not fully explained. The present study describes the influence of low doses of T-2 toxin on CART-positive neuronal structures in porcine stomach, duodenum, and descending colon. Distribution of CART was studied using the double immunofluorescence technique in the plexuses of the ENS, as well as in nerve fibers within the circular muscle and mucosal layers of porcine gastrointestinal tract. Generally, after T-2 toxin administration the greater number of CART-LI structures were studied, but intensity of changes depended on part of the ENS and digestive tract fragment studied. The obtained results show that even low doses of T-2 toxin may change the expression of CART in the ENS.
[Mh] Termos MeSH primário: Colo Descendente/imunologia
Duodeno/imunologia
Sistema Nervoso Entérico/imunologia
Proteínas do Tecido Nervoso/metabolismo
Estômago/imunologia
Toxina T-2/toxicidade
[Mh] Termos MeSH secundário: Animais
Colo Descendente/patologia
Duodeno/patologia
Sistema Nervoso Entérico/patologia
Feminino
Imunofluorescência
Estrutura Molecular
Músculo Liso/imunologia
Músculo Liso/patologia
Neurônios/imunologia
Neurônios/patologia
Estômago/patologia
Sus scrofa
Suínos
Toxina T-2/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nerve Tissue Proteins); 0 (cocaine- and amphetamine-regulated transcript protein); I3FL5NM3MO (T-2 Toxin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE
[do] DOI:10.1007/s12640-016-9675-8


  8 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27671155
[Au] Autor:Yoon J; Kwon SH; Lee CK; Park SJ; Oh JY; Oh JH
[Ad] Endereço:Department of Radiology, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
[Ti] Título:Radiologic Placement of Uncovered Stents for the Treatment of Malignant Colonic Obstruction Proximal to the Descending Colon.
[So] Source:Cardiovasc Intervent Radiol;40(1):99-105, 2017 Jan.
[Is] ISSN:1432-086X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the safety, feasibility, and patency rates of radiologic placement of uncovered stents for the treatment of malignant colonic obstruction proximal to the descending colon. MATERIALS AND METHODS: This was a retrospective, single-center study. From May 2003 to March 2015, 53 image-guided placements of uncovered stents (44 initial placements, 9 secondary placements) were attempted in 44 patients (male:female = 23:21; mean age, 71.8 years). The technical and clinical success, complication rates, and patency rates of the stents were also evaluated. Technical success was defined as the successful deployment of the stent under fluoroscopic guidance alone and clinical success was defined as the relief of obstructive symptoms or signs within 48 h of stent deployment. RESULTS: In total, 12 (27.3 %) patients underwent preoperative decompression, while 32 (72.7 %) underwent decompression with palliative intent. The technical success rate was 93.2 % (41/44) for initial placement and 88.9 % (8/9) for secondary placement. Secondary stent placement in the palliative group was required in nine patients after successful initial stent placement due to stent obstruction from tumor ingrowth (n = 7) and stent migration (n = 2). The symptoms of obstruction were relieved in all successful cases (100 %). In the palliative group, the patency rates were 94.4 % at 1 month, 84.0 % at 3 months, 64.8 % at 6 months, and 48.6 % at 12 months. CONCLUSIONS: The radiologic placement of uncovered stents for the treatment of malignant obstruction proximal to the descending colon is feasible and safe, and provides acceptable clinical results.
[Mh] Termos MeSH primário: Colo Descendente/cirurgia
Neoplasias Colorretais/complicações
Neoplasias Colorretais/cirurgia
Obstrução Intestinal/complicações
Obstrução Intestinal/cirurgia
Stents
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160928
[St] Status:MEDLINE
[do] DOI:10.1007/s00270-016-1474-3


  9 / 248 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27659370
[Au] Autor:Meecham L; Brookes A; Macano C; Stone T; Cheetham M
[Ad] Endereço:Shrewsbury and Telford NHS Trust , UK.
[Ti] Título:Anatomical siting of the splenic flexure using computed tomography.
[So] Source:Ann R Coll Surg Engl;99(3):207-209, 2017 Mar.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION Often, left-sided colorectal surgery requires splenic flexure mobilisation (SFM) to allow a tension-free anastomosis to be carried out. This step is difficult and not without risk. We investigated a system of anatomical siting of the splenic flexure using computed tomography (CT). METHODS The Shrewsbury Splenic Flexure Siting (SSFS) system involves siting of the splenic flexure using the vertebral level (VL) as a reference point. We asked three surgical registrars (SRs) to analyse 20 CT scans of patients undergoing colonic resection to ascertain the anatomical site of the splenic flexure using the SSFS system. The distance from the centre of the vertebral body to the lateral edge (CVBL) of the splenic flexure was measured, as was the distance from the centre of the vertebral body to the inner abdominal wall (CVBI) along the same line, on axial images. RESULTS VL assessment demonstrated substantial inter-observer agreement with a kappa (κ) value of 0.742 (95% confidence interval (CI), 0.463-0.890). CVBL and CVBI demonstrated very strong inter-observer agreement (CVBL: κ = 0.905 (95% CI, 0.785-0.961); CVBI: 0.951 (0.890-0.979) (p<0.001). Overall, there was strong correlation between assessments by all three SRs across the three variables measured. CONCLUSIONS The SSFS system is an accurate method to site the splenic flexure anatomically using CT. We can use the SSFS system to develop a validated scoring system to help colorectal surgeons assess the difficulty of SFM.
[Mh] Termos MeSH primário: Colo Transverso/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Anastomose Cirúrgica
Pontos de Referência Anatômicos
Colectomia
Colo Descendente/cirurgia
Colo Transverso/anatomia & histologia
Colo Transverso/cirurgia
Feminino
Seres Humanos
Masculino
Projetos Piloto
Cirurgia Assistida por Computador
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2016.0298


  10 / 248 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27351656
[Au] Autor:Kawada K; Hasegawa S; Wada T; Takahashi R; Hisamori S; Hida K; Sakai Y
[Ad] Endereço:Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. kkawada@kuhp.kyoto-u.ac.jp.
[Ti] Título:Evaluation of intestinal perfusion by ICG fluorescence imaging in laparoscopic colorectal surgery with DST anastomosis.
[So] Source:Surg Endosc;31(3):1061-1069, 2017 Mar.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Decreased blood perfusion is an important risk factor for postoperative anastomotic leakage (AL). Fluorescence imaging with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. This study evaluated the utility of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery with double stapling technique (DST) anastomosis. METHODS: This was a prospective single-institution study of 68 patients with left-sided colorectal cancers who underwent laparoscopic colorectal surgery between August 2013 and December 2014. After distal transection of the bowel, the specimen was extracted extracorporeally and then the mesentery was divided along the planned transection line determined by the surgeons' judgement under normal q. After ICG was injected intravenously, intestinal perfusion of the proximal colon was assessed in the fluorescent imaging mode. Intestinal perfusion was examined in relation to the patient-, tumor- and surgery-related variables using univariate and multivariate analyses. RESULTS: ICG fluorescence imaging showed that intestinal perfusion was present at 3 mm (median) distal to the initially planned transection line. ICG fluorescence imaging resulted in a proximal change of the transection line by more than 5 mm in 18 patients (26.5 %) and, particularly, by more than 50 mm in 3 patients (4.4 %), compared with the initially planned transection line. Univariate analysis revealed that diabetes mellitus, anticoagulation therapy, preoperative chemotherapy and operative time were significantly associated with poor intestinal perfusion. Multivariate analysis identified anticoagulation therapy (P = 0.021) and preoperative chemotherapy (P = 0.019) as independent risk factors for poor intestinal perfusion. Three patients (4.5 %) with a change of transection line developed AL. CONCLUSIONS: ICG fluorescence imaging is useful for determining the transection line in laparoscopic colorectal surgery with DST anastomosis. Anticoagulation therapy and preoperative chemotherapy are important risk factors for poor intestinal perfusion.
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Fístula Anastomótica/epidemiologia
Colectomia/métodos
Colo Descendente/irrigação sanguínea
Neoplasias Colorretais/cirurgia
Imagem Óptica/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Anticoagulantes/uso terapêutico
Antineoplásicos/uso terapêutico
Colo Descendente/cirurgia
Corantes
Diabetes Mellitus/epidemiologia
Feminino
Seres Humanos
Verde de Indocianina
Laparoscopia/métodos
Masculino
Meia-Idade
Análise Multivariada
Terapia Neoadjuvante
Duração da Cirurgia
Imagem de Perfusão
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Antineoplastic Agents); 0 (Coloring Agents); IX6J1063HV (Indocyanine Green)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160629
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-016-5064-x



página 1 de 25 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde