Navegando por Palavras-chave "Video-Assisted Surgery"

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    Cicatrização da miotomia de Heller por acesso videolaparoscópico com e sem fundocardioplastia de dor associada, em porcos
    (Colégio Brasileiro de Cirurgiões, 2004-12-01) Azevedo, João Luiz Moreira Coutinho [UNIFESP]; Kozu, Fábio Okutani [UNIFESP]; Azevedo, Otávio Cansanção [UNIFESP]; Paiva, Vanessa Carla [UNIFESP]; Silva, Cássio Edvan Paulino da [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: It has been argued that a Dor's fundoplication following myotomy is useful to prevent leakage due to overlooked iatrogenic perforations of esophagus and it is able to stop sphincter reconstruction, avoiding recurrent achalasia. Another strain of thought is that anterior fundoplication causes significant local distortion by fibrosis because the gastric patch impairs mesotelial epithelization by covering the myotomy and that iatrogenic perforations are easily diagnosed by laparoscopic magnification. The purpose of this research is to compare the wound healing of the laparoscopic esophageal myotomy with and without a gastric patch. METHODS: Eighteen male pigs were distributed into three groups of six. Esophageal myotomy was performed in group A. A gastric patch was associated to group B. Myotomy was not performed in group C. On the 21st postoperative day, lumen molding was accomplished to determine the index of stenosis (IS) at the area of myotomy (AM) and at the oesophagogastric junction (OJ) RESULTS: Longer operative duration (t Student) in group B (93. 6) than in group A (45). At AM, IS was negative (lumen increased) and equivalent in both groups (Mann-Withney): -11.1% in group A and -12.7% in group B. IS at OJ was always higher than IS at AM (Wilcoxon): 18% versus -11.1% in group A and 37.7% versus -12.7% in group B. IS at OJ in group B (37.7%) was predominant among all groups (Kruskal-Wallis): group A = 18%; group C = 15.5%. Mesotelial epithelium was observed in group A. Inflammatory reaction was greater in group B (leucocytes: 22 versus 8.6; fibrosis: 25.5 fibers versus 15.6; and granulation tissue: 18.7 vessels versus 9.7) than in group A. CONCLUSION: Esophageal myotomy followed by Dor's fundoplication does not heal adequately and also results in lumen stricture at the oesophagogastric transition. Myotomy without gastric patch is faster and causes less inflammation.
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    O papel do pneumoperitônio na avaliação de parâmetros respiratórios e hemodinâmicos de ratos anestesiados, com ou sem intubação intratraqueal
    (Colégio Brasileiro de Cirurgiões, 2005-10-01) Botter, Flávia Coelho De Souza [UNIFESP]; Taha, Murched Omar [UNIFESP]; Fagundes, Djalma José [UNIFESP]; Fagundes, Anna Tereza Negrini; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro
    BACKGROUND: To investigate hemodynamic and respiratory changes in rats submitted to CO2 pneumoperitoneum or not, under anesthesia with and without endotracheal intubation. METHODS: Male albino rats (n = 40), average weight of 300g, three months aged, were randomized: GA - anesthesia with endotracheal intubation for one hour with CO2 pneumoperitoneum (4mmHg); GB - anesthesia without intratracheal intubation for one hour with CO2 pneumoperitoneum (4mmHg); GC - anesthesia without endotracheal intubation for one hour without pneumoperitoneum; GD - anesthesia with endotracheal intubation for one hour without pneumoperitoneum. Median arterial pressure (MAP- mmHg), heart rate (HR-beat/min), respiratory frequency (RF - rm/min), central venous pressure (CVP - cmH2O), peripheral oxygen saturation (STO2), partial CO2 pressure (PaCO2), arterial bicarbonate (HCO3-), oxygen saturation (SO2) and pH were recorded. Measurements were performed at the begining of the procedure (MO) and after, 30 minutes (M1) and 60 minutes (M2). RESULTS: In GA and GC (groups with CO2 pneumoperitoneum) there was an increase of MAP, PaCO2, HCO3-, HR, CVP and decrease of pH, CO2, STO2 in comparison with those without pneumoperitoneum. On the other hand, endotracheal intubation attenuated these changings during the first hour of anesthesia. CONCLUSION: General anesthesia with endotracheal intubation, associated to CO2 pneumoperitoneum (4 mmHg) during one hour, proved advantageous in hemodynamic and respiratory systems, in relation to the animals with pneumoperitoneum without endotraqueal intubation, and to those within four hour of anesthesia, in spite of intubation.