Navegando por Palavras-chave "Natural orifice endoscopic surgery"

Agora exibindo 1 - 3 de 3
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Effect of transgastric peritoneal access on peritoneal innate cellular immunity: experimental study in swine
    (Springer, 2013-03-01) Rodrigues, Rodrigo [UNIFESP]; Rezende, Marcelo [UNIFESP]; Gomes, Gustavo [UNIFESP]; Souza, Fernando; Blagitz, Maiara; Della Libera, Alice; Taha, Murched [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]; Della Libera, Ermelindo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fleury Med & Saude; Hosp Israelita Albert Einstein
    One of the main concerns of natural orifice surgery is the local and systemic impact on physiology. Few studies have compared natural orifice transluminal endoscopic surgery (NOTES) with other surgical modalities. Most studies are based on systemic variables such as postoperative serum cytokines, with conflicting results. Surgical trauma induces an early inflammatory response, release of cytokines, and local leukocyte activation and oxidative burst. Major surgical trauma is related to impairment of phagocytic function and an increase in production of active oxygen species by phagocytes. the aim of this study was to evaluate the impact of transgastric peritoneoscopy on peritoneal innate immune response compared with laparoscopy and laparotomy in swine.Thirty-four male Sus scrofa domesticus swine were assigned to four groups: transgastric peritoneoscopy (13), laparoscopy (7), laparotomy (7), and sham procedure (7). Twenty-four hours after the procedure, peritoneal fluid cells were harvested by peritoneal washing after necropsy. Flow cytometry analysis of labeled S. aureus and E. coli phagocytosis by peritoneal neutrophils and macrophages was blindly performed. Oxidative burst activity measured by H2O2 production under different challenges was also evaluated.Total operative time varied between all groups. the transgastric, laparoscopy, and laparotomy groups required 56, 17.2, and 40.3 min of mean operative time, respectively (p < 0.05). Even though the mean percentage and intensity of phagocytosis by peritoneal phagocytes were higher in the sham, transgastric, and laparoscopy groups, there was no significant difference between these groups and laparotomy. Macrophage production of H2O2 has been shown to be similar among the transgastric, laparoscopy, and sham groups, and smaller than that in laparotomy (p < 0.05), either under basal conditions, while performing E. coli phagocytosis, or challenged by the presence of E. coli membrane lipopolysaccharide.Under the conditions of this study, transgastric peritoneoscopy has been shown to have minimal impact on peritoneal innate immune response.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions
    (Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2017) Wawginiak, Guilherme Henrique; Balsalobre, Leonardo [UNIFESP]; Kosugi, Eduardo Macoto [UNIFESP]; Mangussi-Gomes, Joao Paulo [UNIFESP]; Samaniego, Raul Ernesto; Stamm, Aldo Cassol
    Introduction: Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. Objective: To investigate the efficacy of topical sinonasal therapy with syringe and the influence of the middle turbinate on this process Methods: Intervention study in training models (S.I.M.O.N.T.). After standard dissection, three interventions were performed (Nasal Spray 4 puffs, 60-mL syringe and 240-mL Squeeze Bottle) with normal and Sutured Middle Turbinate. Images of each sinus were captured after the interventions, totalizing 144 images. The images were classified by 10 evaluators according to the amount of residual volume from zero to 3, with zero and 1 being considered poor penetration and 2 and 3, good penetration. The 1440 evaluations were used in this study. Results: Considering all middle turbinate situations, the amount of good penetrations were 8.1% for Spray
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Quebrando paradigmas na epistaxe grave: a importância de procurar o S-point
    (Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Kosugi, Eduardo Macoto [UNIFESP]; Balsalobre, Leonardo [UNIFESP]; Mangussi-Gomes, Joao [UNIFESP]; Tepedino, Miguel Soares; San-da-Silva, Daniel Marcus [UNIFESP]; Cabernite, Erika Mucciolo; Hermann, Diego; Stamm, Aldo Cassol
    Introduction: Since the introduction of nasal endoscopy into the field of Otorhinolaryngology, the treatment paradigm for cases of severe epistaxis has shifted toward early and precise identification of the bleeding site. Although severe epistaxis is usually considered to arise from posterior bleeding, an arterial vascular pedicle in the superior portion of the nasal septum, around the axilla projection of the middle turbinate, posterior to the septal body, frequently has been observed. That vascular pedicle was named the Stamm's S-point. Objective: The aim of this study was to describe the S-point and report cases of severe epistaxis originating from it. Methods: A retrospective case series study was conducted. Nine patients with spontaneous severe epistaxis, where the S-point was identified as the source of bleeding, were treated between March 2016 and March 2017. Results: Male predominance (77.8%) with age average of 59.3 years old were reported. Most cases presented comorbidities (88.9%) and were not taking acetylsalicylic acid (66.7%). A predominance of left sided involvement (55.6%) and anteroposterior bleeding being the principal initial presentation (77.8%) was seen. Six patients (66.7%) presented with hemoglobin levels below 10g/dL, and four (44.4%) required blood transfusion. Cauterization of S-point was performed in all patients, with complete resolution of bleeding. No patient experienced recurrence of severe epistaxis. Conclusion: The Stamm's S-point, a novel source of spontaneous severe epistaxis, is reported, and its cauterization was effective and safe. Otolaryngologists must actively seek this site of bleeding in cases of severe epistaxis. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license.