Navegando por Palavras-chave "Dilatação com balão"

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    Comparison between endoscopic brush cytology performed before and after biliary stricture dilation for cancer detection
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2006-03-01) Ornellas, Laura Cotta; Santos, Gilda Da Cunha [UNIFESP]; Nakao, Frank Shigueo; Ferrari, Angelo Paulo [UNIFESP]; Department of Gastroenterology; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Confirmation of malignancy within biliary strictures is endoscopically challenging. Dilation of strictures has been reported to enhance cytological diagnosis. AIM: To compare brush cytology results before and after biliary stricture dilation. PATIENTS AND METHODS: Patients with extra-hepatic biliary stricture at endoscopic retrograde cholangiopancreatography were included in the study. Brushing was performed before and immediately after dilation using a 10 Fr dilating catheter. Cytology samples were classified as: negative for malignancy, presence of atypical cells, insufficient material, suspicious for malignancy or positive for malignancy. Final diagnosis was established by surgery, biopsy or follow-up. RESULTS: Biliary brush cytology was performed in 50 patients, with an overall sensitivity of 40% and 27.5%, before and after dilation, respectively. The combination of results increased cancer detection rate to 45%. There were 5/50 (10%) minor complications and one death related to the procedure. CONCLUSIONS: Brush cytology performed before biliary stricture dilation has a similar cancer detection rate to that following dilation, although the combination of results enhances sensitivity.
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    Nova bandagem ajustável das artérias pulmonares na Síndrome de Hipoplasia de Câmaras Esquerdas
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2007-03-01) Assadi, Renato Samy; Zamith, Marina Maccagnano [UNIFESP]; Silva, Maria Fernanda; Thomaz, Petrônio Generoso; Miana, Leonardo Augusto; Guerra, Vitor Coimbra; Pedra, Carlos Augusto Cardoso; Barbero-marcial, Miguel; Universidade de São Paulo (USP); Children's Hospital; Hospital Samaritano de São Paulo; Universidade Federal de São Paulo (UNIFESP); UNIFES Curso de Rastreamento Pré-Natal das Malformações Cardíacas; Instituto do Coração de Ipatinga; Instituto do Coração de Juiz de Fora; Hospital for Sick Children; Instituto Dante Pazzanese de Cardiologia; Instituto Dante Pazzanese de Cardiologia Seção Médica de Intervenção em Cardiopatias Congênitas; Hospital Samaritano de São Paulo Laboratório de Cateterismo; Associação Sanatório Sírio Hospital do Coração
    OBJECTIVE: Hypoplastic left heart syndrome remains a challenge for worldwide surgeons. Initial palliation employing bilateral pulmonary artery banding along with ductal stent implantation and atrial septostomy has been proposed as an alternative approach. However, the surgically placed bands are fixed and may become inadequate after sternum closure or with somatic growth of the patient. We describe the first case in which a neonate with hypoplastic left heart syndrome was initially managed using a mini banding system that allows for fine percutaneous adjustments of pulmonary blood flow. METHOD: Through a mid sternotomy, a 5 day-old neonate underwent bilateral pulmonary artery banding using this new system combined with placement of a main pulmonary artery to innominate artery shunt. RESULTS: The patient had an uneventful postoperative course. Three percutaneous adjustments of the banding system were necessary to keep the arterial oxygen saturation in the 75%-85% range. On the 48th day of life, she was submitted to stent placement (6 mm) within the atrial septum to treat a restrictive atrial septal defect. The Norwood operation and the bidirectional Glenn shunt were carried out on the 106th day of life. The bands were removed with no distortion of the pulmonary arteries. CONCLUSIONS: The clinical use of this innovative pulmonary artery banding system was feasible, safe and effective. It allowed for customization of the pulmonary blood flow according to the underlying clinical needs, resulting in a more precise balance between the pulmonary and systemic circulations.