Base de dados : MEDLINE
Pesquisa : A10.615.789 [Categoria DeCS]
Referências encontradas : 1193 [refinar]
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  1 / 1193 MEDLINE  
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[PMID]:28546283
[Au] Autor:Paskaranandavadivel N; Cheng LK; Du P; Rogers JM; O'Grady G
[Ad] Endereço:Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; npas004@aucklanduni.ac.nz.
[Ti] Título:High-resolution mapping of gastric slow-wave recovery profiles: biophysical model, methodology, and demonstration of applications.
[So] Source:Am J Physiol Gastrointest Liver Physiol;313(3):G265-G276, 2017 Sep 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Slow waves play a central role in coordinating gastric motor activity. High-resolution mapping of extracellular potentials from the stomach provides spatiotemporal detail on normal and dysrhythmic slow-wave patterns. All mapping studies to date have focused exclusively on tissue activation; however, the recovery phase contains vital information on repolarization heterogeneity, the excitable gap, and refractory tail interactions but has not been investigated. Here, we report a method to identify the recovery phase in slow-wave mapping data. We first developed a mathematical model of unipolar extracellular potentials that result from slow-wave propagation. These simulations showed that tissue repolarization in such a signal is defined by the steepest upstroke beyond the activation phase (activation was defined by accepted convention as the steepest downstroke). Next, we mapped slow-wave propagation in anesthetized pigs by recording unipolar extracellular potentials from a high-resolution array of electrodes on the serosal surface. Following the simulation result, a wavelet transform technique was applied to detect repolarization in each signal by finding the maximum positive slope beyond activation. Activation-recovery (ARi) and recovery-activation (RAi) intervals were then computed. We hypothesized that these measurements of recovery profile would differ for slow waves recorded during normal and spatially dysrhythmic propagation. We found that the ARi of normal activity was greater than dysrhythmic activity (5.1 ± 0.8 vs. 3.8 ± 0.7 s; < 0.05), whereas RAi was lower (9.7 ± 1.3 vs. 12.2 ± 2.5 s; < 0.05). During normal propagation, RAi and ARi were linearly related with negative unit slope indicating entrainment of the entire mapped region. This relationship was weakened during dysrhythmia (slope: -0.96 ± 0.2 vs -0.71 ± 0.3; < 0.05). The theoretical basis of the extracellular gastric slow-wave recovery phase was defined using mathematical modeling. A novel technique utilizing the wavelet transform was developed and validated to detect the extracellular slow-wave recovery phase. In dysrhythmic wavefronts, the activation-to-recovery interval (ARi) was shorter and recovery-to-activation interval (RAi) was longer compared with normal wavefronts. During normal activation, RAi vs. ARi had a slope of -1, whereas the weakening of the slope indicated a dysrhythmic propagation.
[Mh] Termos MeSH primário: Fenômenos Eletrofisiológicos/fisiologia
Motilidade Gastrointestinal/fisiologia
Modelos Biológicos
Músculo Liso/fisiologia
Membrana Serosa/fisiologia
Estômago/fisiologia
[Mh] Termos MeSH secundário: Animais
Eletromiografia
Membrana Serosa/citologia
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170527
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00127.2017


  2 / 1193 MEDLINE  
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[PMID]:28238645
[Au] Autor:Takai S; Yoshino M; Takao K; Yoshikawa K; Jin D
[Ad] Endereço:Department of Innovative Medicine, Osaka Medical College Graduate School of Medicine, Takatsuki, Japan. Electronic address: pha010@osaka-med.ac.jp.
[Ti] Título:Periostin antisense oligonucleotide prevents adhesion formation after surgery in mice.
[So] Source:J Pharmacol Sci;133(2):65-69, 2017 Feb.
[Is] ISSN:1347-8648
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:To study the role of periostin in adhesion formation, the effect of periostin antisense oligonucleotide (PAO) on adhesion formation was evaluated in mice. Under anesthesia, the serous membrane of the cecum was abraded, and the adhesion score and mRNA levels of periostin and its related factors were determined after surgery. Saline, 40 mg/kg of negative sense oligonucleotide (NSO), or 40 mg/kg of PAO were injected into the abdomen after surgery, and the adhesion score and mRNA levels were evaluated 14 days later. Filmy adhesion formation was observed 1 day after surgery, and the adhesion score increased gradually to 14 days. The mRNA levels of periostin, transforming growth factor (TGF)-ß, and collagen I increased gradually from 3 days to 14 days. The adhesion score of PAO was significantly lower than of saline or NSO 14 days after surgery. The mRNA levels of periostin, TGF-ß, and collagen I were also significantly attenuated by treatment with PAO compared with saline or NSO. Thus, these results demonstrated that the periostin mRNA level increased in the abraded cecum, and PAO prevented adhesion formation along with attenuation of the periostin mRNA level.
[Mh] Termos MeSH primário: Ceco/cirurgia
Moléculas de Adesão Celular/metabolismo
Oligonucleotídeos Antissenso/genética
Membrana Serosa/lesões
[Mh] Termos MeSH secundário: Animais
Ceco/patologia
Colágeno Tipo I/metabolismo
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Fator de Crescimento Transformador beta/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cell Adhesion Molecules); 0 (Collagen Type I); 0 (Oligonucleotides, Antisense); 0 (Postn protein, mouse); 0 (Transforming Growth Factor beta)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170228
[St] Status:MEDLINE


  3 / 1193 MEDLINE  
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[PMID]:28035728
[Au] Autor:Angeli TR; Du P; Paskaranandavadivel N; Sathar S; Hall A; Asirvatham SJ; Farrugia G; Windsor JA; Cheng LK; O'Grady G
[Ad] Endereço:Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
[Ti] Título:High-resolution electrical mapping of porcine gastric slow-wave propagation from the mucosal surface.
[So] Source:Neurogastroenterol Motil;29(5), 2017 05.
[Is] ISSN:1365-2982
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gastric motility is coordinated by bioelectrical slow waves, and gastric dysrhythmias are reported in motility disorders. High-resolution (HR) mapping has advanced the accurate assessment of gastric dysrhythmias, offering promise as a diagnostic technique. However, HR mapping has been restricted to invasive surgical serosal access. This study investigates the feasibility of HR mapping from the gastric mucosal surface. METHODS: Experiments were conducted in vivo in 14 weaner pigs. Reference serosal recordings were performed with flexible-printed-circuit (FPC) arrays (128-192 electrodes). Mucosal recordings were performed by two methods: (i) FPC array aligned directly opposite the serosal array, and (ii) cardiac mapping catheter modified for gastric mucosal recordings. Slow-wave propagation and morphology characteristics were quantified and compared between simultaneous serosal and mucosal recordings. KEY RESULTS: Slow-wave activity was consistently recorded from the mucosal surface from both electrode arrays. Mucosally recorded slow-wave propagation was consistent with reference serosal activation pattern, frequency (P≥.3), and velocity (P≥.4). However, mucosally recorded slow-wave morphology exhibited reduced amplitude (65-72% reduced, P<.001) and wider downstroke width (18-31% wider, P≤.02), compared to serosal data. Dysrhythmias were successfully mapped and classified from the mucosal surface, accorded with serosal data, and were consistent with known dysrhythmic mechanisms in the porcine model. CONCLUSIONS & INFERENCES: High-resolution gastric electrical mapping was achieved from the mucosal surface, and demonstrated consistent propagation characteristics with serosal data. However, mucosal signal morphology was attenuated, demonstrating necessity for optimized electrode designs and analytical algorithms. This study demonstrates feasibility of endoscopic HR mapping, providing a foundation for advancement of minimally invasive spatiotemporal gastric mapping as a clinical and scientific tool.
[Mh] Termos MeSH primário: Eletrofisiologia/métodos
Motilidade Gastrointestinal
Membrana Mucosa/fisiologia
Membrana Serosa/fisiologia
[Mh] Termos MeSH secundário: Animais
Eletrodos
Fenômenos Eletrofisiológicos
Eletrofisiologia/instrumentação
Feminino
Processamento de Sinais Assistido por Computador
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161231
[St] Status:MEDLINE
[do] DOI:10.1111/nmo.13010


  4 / 1193 MEDLINE  
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[PMID]:27562801
[Au] Autor:Khan O; Ligato S
[Ad] Endereço:1 Hartford Hospital, Hartford, CT, USA.
[Ti] Título:Identification of Signet Ring Cell Change in Colonic Subserosa in the Setting of Clostridium difficile Colitis.
[So] Source:Int J Surg Pathol;25(2):168-172, 2017 Apr.
[Is] ISSN:1940-2465
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Signet ring cell change of intestinal epithelial cells is a rare but well-known mimicker of signet ring cell carcinoma and is often associated with ischemic and/or pseudomembranous colitis. Instead, signet ring cell change involving nonepithelial cells in the subserosa of the intestine is an extremely rare finding with only a single case report in the literature to date. We report a new case of benign signet ring cell change localized in the subserosa of the large bowel incidentally identified in a resection specimen for Clostridium difficile colitis mimicking a metastatic signet ring cell carcinoma. Based on the morphologic features and immunohistochemical profile, we propose that these signet ring cells may possibly represent modified/degenerated fat cells. Furthermore, we discuss how to differentiate benign signet ring cells from a signet ring cell carcinoma.
[Mh] Termos MeSH primário: Clostridium difficile
Enterocolite Pseudomembranosa/patologia
Membrana Serosa/patologia
[Mh] Termos MeSH secundário: Colo/patologia
Feminino
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160827
[St] Status:MEDLINE
[do] DOI:10.1177/1066896916664988


  5 / 1193 MEDLINE  
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[PMID]:27784873
[Au] Autor:Shiina K; Hayashida KI; Ishikawa K; Kawatani M
[Ad] Endereço:Departments of Neurophysiology, Akita University Graduate School of Medicine.
[Ti] Título:ATP release from bladder urothelium and serosa in a rat model of partial bladder outlet obstruction.
[So] Source:Biomed Res;37(5):299-304, 2016.
[Is] ISSN:1880-313X
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Overactive bladder is one of the major health problem especially in elderly people. Adenosine triphosphate (ATP) is released from urinary bladder cells and acts as a smooth muscle contraction and sensory signal in micturition but little is known about the role of ATP release in the pathophysiology of overactive bladder. To assess the relationship between ATP and overactive bladder, we used a partial bladder outlet obstruction (pBOO) model in rats. The bladder caused several changes by pBOO: An increase in bladder weight, hypertrophy of sub-urothelium and sub-serosal area, and frequent non-voiding bladder contraction during urine storage. Basal ATP release from urothelium and serosa of pBOO rats was significantly higher than that of normal rats. Distentioninduced ATP release from urothelium of normal and pBOO rats had no significant change. However, distention-induced ATP release from serosa of pBOO rats was higher than that of normal. These findings may identify ATP especially released from serosa as one of causes of non-voiding contractions and overactive bladder symptoms.
[Mh] Termos MeSH primário: Trifosfato de Adenosina/secreção
Membrana Serosa/metabolismo
Obstrução do Colo da Bexiga Urinária/metabolismo
Urotélio/metabolismo
[Mh] Termos MeSH secundário: Animais
Modelos Animais de Doenças
Feminino
Ratos
Membrana Serosa/patologia
Obstrução do Colo da Bexiga Urinária/patologia
Obstrução do Colo da Bexiga Urinária/fisiopatologia
Urotélio/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
8L70Q75FXE (Adenosine Triphosphate)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170118
[Lr] Data última revisão:
170118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161028
[St] Status:MEDLINE


  6 / 1193 MEDLINE  
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[PMID]:27782848
[Au] Autor:Liu XH; Batueva MD; Zhao YL; Zhang JY; Zhang QQ; Li TT; Li AH
[Ad] Endereço:Fish Diseases Laboratory, State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Science, 430072, Wuhan, China.
[Ti] Título:Morphological and molecular characterisation of Myxobolus pronini n. sp. (Myxozoa: Myxobolidae) from the abdominal cavity and visceral serous membranes of the gibel carp Carassius auratus gibelio (Bloch) in Russia and China.
[So] Source:Parasit Vectors;9(1):562, 2016 Oct 25.
[Is] ISSN:1756-3305
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Myxozoa is a well-known economically and ecologically important group of metazoan parasites, phylogenetically related to Cnidaria. High diversity of myxosporeans has been recorded in Russia and China; however, most of the species were solely morphologically characterised. Here, we identified a new gibel carp-infecting Myxobolus species and morphologically and molecularly compared the Russian and Chinese isolates of this new myxosporean. RESULTS: Myxobolus pronini n. sp. was found free in the abdominal cavity of Carassius auratus gibelio (Bloch, 1782) in Lake Baikal watershed, Russia, and embedded in the visceral serous membranes of the same fish species in Lake Taibai, Hubei province, China. The morphometric data of the plasmodia and mature spores exhibited some differences between the Russian and Chinese isolates, but SSU rDNA sequences indicated that these two geographical isolates are conspecific. The mature spores from the two locations are obovate in frontal view, with wider anterior than posterior end and lemon-shaped in sutural view. Spores of the Russian isolate were 14.3-16.2 (mean 15.1 ± 0.2) µm long, 9.6-10.8 (10.1 ± 0.1) µm wide and 6.4-7.4 (6.7 ± 0.15) µm thick; those of the Chinese isolate were 13.8-15.6 (14.7 ± 0.24) µm long, 9.6-13.3 (9.6 ± 0.65) µm wide and 6.2-7.2 (6.6 ± 0.16) µm thick. The newly-generated rDNA sequences (including SSU rDNA, ITS and LSU rDNA) from the two isolates represented some variations within the intraspecific range. Homology search by BLAST showed that the newly obtained rDNA sequences do not match any sequences available on GenBank. Phylogenetic analysis based on the aligned partial SSU rDNA sequences indicated that this novel species clustered with several gibel carp-infecting Myxobolus spp. with round anterior end of spores. Additionally, phylogenetic analysis based on all obtained ITS sequences showed that distinct genetic geographical differentiation occurred for this new parasite. CONCLUSIONS: Myxobolus pronini n. sp. is described by integrating morphological, ecological and molecular evidence. Two geographical isolates of this species showed some morphological and genetic differences but within the intraspecific range of variation.
[Mh] Termos MeSH primário: Doenças dos Peixes/parasitologia
Carpa Dourada/parasitologia
Myxobolus/isolamento & purificação
Doenças Parasitárias em Animais/parasitologia
[Mh] Termos MeSH secundário: Cavidade Abdominal/parasitologia
Animais
China
Análise por Conglomerados
DNA Ribossômico/química
DNA Ribossômico/genética
DNA Espaçador Ribossômico/química
DNA Espaçador Ribossômico/genética
Myxobolus/anatomia & histologia
Myxobolus/classificação
Myxobolus/genética
Filogenia
RNA Ribossômico/genética
RNA Ribossômico 18S/genética
Federação Russa
Análise de Sequência de DNA
Membrana Serosa/parasitologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Ribosomal); 0 (DNA, Ribosomal Spacer); 0 (RNA, Ribosomal); 0 (RNA, Ribosomal, 18S); 0 (RNA, ribosomal, 26S)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161027
[St] Status:MEDLINE


  7 / 1193 MEDLINE  
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[PMID]:27698325
[Au] Autor:de Bruin AF; Tavy A; van der Sloot K; Smits A; Van Ramshorst B; Boerma CE; Kars P; Noordzij PG; Boerma D; van Iterson M
[Ad] Endereço:Departments of Anesthesiology, Intensive Care and Pain Medicine, St Antonius Hospital, Nieuwegein, The Netherlands.
[Ti] Título:Use of an Image Acquisition Stabilizer Improves Sidestream Dark Field Imaging of the Serosa during Open Gastrointestinal Surgery.
[So] Source:J Vasc Res;53(3-4):121-127, 2016.
[Is] ISSN:1423-0135
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate whether an image acquisition stabilizer (IAS) mounted on the sidestream dark field camera (SDF) during gastrointestinal surgery improves image stability and acquisition. METHODS: Serosal SDF imaging was compared with SDF imaging combined with an IAS (SDF + IAS) during gastrointestinal surgery. Stability was assessed as the image drift in pixels and the time to obtain stable images. The success rate was determined as the percentage of analyzable images after recording. The effect of negative pressure from the IAS was determined during single-spot measurements and by comparing microvascular parameters between groups. Data are presented as mean ± SD. RESULTS: Sixty serosal measurements were performed per group; 87% were successful in the SDF group and 100% in the SDF + IAS group (p = 0.003). Image drift in the SDF group was 148 ± 36 versus 55 ± 15 pixels in the SDF + IAS group; p < 0.001. Time to stable image was 96 ± 60 s in the SDF group versus 57 ± 31 s in the SDF + IAS group; p = 0.03. No effect of negative pressure was seen. CONCLUSION: The use of an IAS mounted on an SDF camera during serosal microvascular assessment improves the success rate of image acquisition and stability and reduces the time to stable image with no effect on the microcirculation.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório
Trato Gastrointestinal/cirurgia
Aumento da Imagem/métodos
Microcirculação
Microscopia de Vídeo/métodos
Membrana Serosa/irrigação sanguínea
Membrana Serosa/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos Eletivos
Desenho de Equipamento
Feminino
Seres Humanos
Aumento da Imagem/instrumentação
Interpretação de Imagem Assistida por Computador
Cuidados Intraoperatórios
Masculino
Microscopia de Vídeo/instrumentação
Meia-Idade
Países Baixos
Valor Preditivo dos Testes
Estudos Prospectivos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; VALIDATION STUDIES
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161005
[St] Status:MEDLINE


  8 / 1193 MEDLINE  
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[PMID]:27592711
[Au] Autor:Jackson-Jones LH; Rückerl D; Svedberg F; Duncan S; Maizels RM; Sutherland TE; Jenkins SJ; McSorley HJ; Bénézech C; MacDonald AS; Allen JE
[Ad] Endereço:School of Biological Sciences, University of Edinburgh, Edinburgh, EH9 3FL, UK.
[Ti] Título:IL-33 delivery induces serous cavity macrophage proliferation independent of interleukin-4 receptor alpha.
[So] Source:Eur J Immunol;46(10):2311-2321, 2016 Oct.
[Is] ISSN:1521-4141
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:IL-33 plays an important role in the initiation of type-2 immune responses, as well as the enhancement of type 2 effector functions. Engagement of the IL-33 receptor on macrophages facilitates polarization to an alternative activation state by amplifying IL-4 and IL-13 signaling to IL-4Rα. IL-4 and IL-13 also induce macrophage proliferation but IL-33 involvement in this process has not been rigorously evaluated. As expected, in vivo delivery of IL-33 induced IL-4Rα-dependent alternative macrophage activation in the serous cavities. IL-33 delivery also induced macrophages to proliferate but, unexpectedly, this was independent of IL-4Rα signaling. In a filarial nematode infection model in which IL-4Rα-dependent alternative activation and proliferation in the pleural cavity is well described, IL-33R was essential for alternative activation but not macrophage proliferation. Similarly, during Alternaria alternata induced airway inflammation, which provokes strong IL-33 responses, we observed that both IL-4Rα and IL-33R were required for alternative activation, while macrophage proliferation in the pleural cavity was still evident in the absence of either receptor alone. Our data show that IL-33R and IL-4Rα promote macrophage proliferation independently of each other, but both are essential for induction of alternative activation.
[Mh] Termos MeSH primário: Alternaria/imunologia
Alternariose/imunologia
Filariose/imunologia
Proteína 1 Semelhante a Receptor de Interleucina-1/metabolismo
Interleucina-33/metabolismo
Macrófagos/fisiologia
Receptores de Superfície Celular/metabolismo
Membrana Serosa/imunologia
[Mh] Termos MeSH secundário: Animais
Proliferação Celular
Células Cultivadas
Filarioidea/imunologia
Proteína 1 Semelhante a Receptor de Interleucina-1/genética
Ativação de Macrófagos
Camundongos
Camundongos Endogâmicos BALB C
Camundongos Knockout
Cavidade Pleural/patologia
Receptores de Superfície Celular/genética
Transdução de Sinais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Il4ra protein, mouse); 0 (Interleukin-1 Receptor-Like 1 Protein); 0 (Interleukin-33); 0 (Receptors, Cell Surface)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160906
[St] Status:MEDLINE
[do] DOI:10.1002/eji.201646442


  9 / 1193 MEDLINE  
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[PMID]:27515579
[Au] Autor:Honda G; Hasegawa H; Umezawa A
[Ad] Endereço:Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. ghon@ax3.mopera.ne.jp.
[Ti] Título:Universal safe procedure of laparoscopic cholecystectomy standardized by exposing the inner layer of the subserosal layer (with video).
[So] Source:J Hepatobiliary Pancreat Sci;23(9):E14-9, 2016 Sep.
[Is] ISSN:1868-6982
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:An incorrect approach to the critical view of safety can cause bile duct and/or vascular injury. However, only superficial anatomical features have been proposed as surgical landmarks to initiate laparoscopic cholecystectomy (LC) safely in previous reports. Accordingly, we have proposed a novel surgical anatomical definition of the gallbladder wall, in which the subserosal (SS) layer is divided into the inner layer of the SS (SS-Inner) layer consisting of vasculature and fibrous tissue, and the outer layer of the SS (SS-Outer) layer consisting of abundant fat tissue. By dissecting the gallbladder along the SS-Inner layer after exposure at a safe region, bile duct and/or vascular injury can be avoided, even in cholecystitis cases. Furthermore, recognition of this surgical anatomy reveals several aspects. In cholecystitis cases associated with severe fibrotic change, completion of LC by dissecting along the SS-Inner layer is impossible, resulting in abandonment of regular LC. An abscess in the liver bed associated with acute cholecystitis usually forms in the SS-Outer layer, thus, the gallbladder can be dissected easily. In the dome-down technique, the right hepatic duct is endangered by whole-layer dissection, in which the SS-Outer layer is also removed. The proposed procedure should become the universal standard for LC.
[Mh] Termos MeSH primário: Colecistectomia Laparoscópica/métodos
Colecistite/cirurgia
Segurança do Paciente
Membrana Serosa/cirurgia
[Mh] Termos MeSH secundário: Colecistectomia Laparoscópica/efeitos adversos
Colecistite/patologia
Feminino
Vesícula Biliar/patologia
Vesícula Biliar/cirurgia
Seres Humanos
Imuno-Histoquímica
Masculino
Microdissecção/métodos
Peritônio/cirurgia
Medição de Risco
Membrana Serosa/patologia
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160813
[St] Status:MEDLINE
[do] DOI:10.1002/jhbp.382


  10 / 1193 MEDLINE  
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[PMID]:27490841
[Au] Autor:Iwashita Y; Ohyama T; Honda G; Hibi T; Yoshida M; Miura F; Takada T; Han HS; Hwang TL; Shinya S; Suzuki K; Umezawa A; Yoon YS; Choi IS; Huang WS; Chen KH; Watanabe M; Abe Y; Misawa T; Nagakawa Y; Yoon DS; Jang JY; Yu HC; Ahn KS; Kim SC; Song IS; Kim JH; Yun SS; Choi SH; Jan YY; Sheen-Chen SM; Shan YS; Ker CG; Chan DC; Lee KT; Toyota N; Higuchi R; Nakamura Y; Mizuguchi Y; Takeda Y; Ito M; Norimizu S; Yamada S; Matsumura N; Shindoh J; Sunagawa H; Hasegawa H; Rikiyama T; Sata N; Kano N
[Ad] Endereço:Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.
[Ti] Título:What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey.
[So] Source:J Hepatobiliary Pancreat Sci;23(9):533-47, 2016 Sep.
[Is] ISSN:1868-6982
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Serious complications continue to occur in laparoscopic cholecystectomy (LC). The commonly used indicators of surgical difficulty such as the duration of surgery are insufficient because they are surgeon and institution dependent. We aimed to identify appropriate indicators of surgical difficulty during LC. METHODS: A total of 26 Japanese expert LC surgeons discussed using the nominal group technique (NGT) to generate a list of intraoperative findings that contribute to surgical difficulty. Thereafter, a survey was circulated to 61 experts in Japan, Korea, and Taiwan. The questionnaire addressed LC experience, surgical strategy, and perceptions of 30 intraoperative findings listed by the NGT. RESULTS: The response rate of the survey was 100%. There was a statistically significant difference among nations regarding the duration of surgery and adoption rate of safety measures and recognition of landmarks. The criteria for conversion to an open or subtotal cholecystectomy were at the discretion of each surgeon. In contrast, perceptions of the impact of 30 intraoperative findings on surgical difficulty (categorized by factors related to inflammation and additional findings of the gallbladder and other intra-abdominal factors) were consistent among surgeons. CONCLUSIONS: Intraoperative findings are objective and considered to be appropriate indicators of surgical difficulty during LC.
[Mh] Termos MeSH primário: Colecistectomia Laparoscópica/métodos
Complicações Intraoperatórias/prevenção & controle
Laparoscópios
Cirurgiões/estatística & dados numéricos
[Mh] Termos MeSH secundário: Colecistectomia Laparoscópica/efeitos adversos
Estudos Transversais
Dissecação/métodos
Feminino
Seguimentos
Vesícula Biliar/parasitologia
Vesícula Biliar/cirurgia
Seres Humanos
Internacionalidade
Cuidados Intraoperatórios/métodos
Japão
Masculino
Duração da Cirurgia
Controle de Qualidade
República da Coreia
Fatores de Risco
Membrana Serosa/patologia
Membrana Serosa/cirurgia
Inquéritos e Questionários
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160805
[St] Status:MEDLINE
[do] DOI:10.1002/jhbp.375



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