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Gastrotomy followed by gastrorrhaphy as a reliable and more physiologic technique for inducing peritoneal adhesion in rats
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PIRES, ANTONIO AUGUSTO RIBEIRO DIAS

; TAKIYA, CHRISTINA MAEDA

; SILVA, PAULO CESAR

; MANSO, JOSÉ EDUARDO FERREIRA

Revista do Colégio Brasileiro de Cirurgiões

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2023, Volume 50 elocation e20233453

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: this research objective was to develop a new peritoneal adhesion animal model that would lead to adhesions formation in all operated animals, simple and reproducible, associated with maintenance the animal’s health. Methods: eighteen adult male Wistar rats (Rattus norvegicus) were randomly distributed into three groups: Control Group (anatomical and clinical parameters), Sham Group (delicate manipulation of the stomach and exposure of the peritoneal cavity to ambient air) and Surgery Group (gastrotomy followed by gastrorrhaphy). The animals were analyzed and classificated macroscopically according to two adhesion classification models and differences between groups were considered significant when p<0.05. Results: the six animals in the control group had no peritoneal adhesions, three of the six animals in the sham group had focal peritoneal adhesions, and all animals in the surgery group (gastrotomy followed by gastrorraphy) had firm peritoneal adhesions. All adhesions found were macroscopically quantified and microscopically confirmed, without carrying out a microscopic classification of the adhesions. Conclusion: the new model developed of gastrotomy followed by gastrorrhaphy, proved to be safe and efficient to induce and study peritoneal adhesions.

RESUMO Objetivo: o objetivo deste estudo foi criar um novo modelo animal de indução de aderências peritoneais capaz de levar à formação de aderências em todos os animais operados, simples e reprodutível, associado a manutenção da saúde dos animais. Métodos: Dezoito ratos machos, adultos, da linhagem Wistar (Rattus norvegicus) foram distribuídos aleatoriamente em três grupos: Grupo Controle (parâmetro anatômico e clínico), Grupo Sham (manipulação delicada do estômago e exposição de cavidade peritoneal ao ar ambiente) e Grupo Cirurgia (gastrotomia seguida de gastrorrafia). Os animais foram submetidos à análise e classificação macroscópicas, seguindo dois modelos de classificação de aderências. As diferenças entre os grupos foram consideradas estatisticamente significantes se p<0,05. Resultados: os seis animais do grupo controle não apresentavam aderências peritoneais, três dos seis animais do grupo sham apresentavam aderências peritoneais focais e todos os seis animais do grupo cirurgia (gastrotomia seguida de gastrorrafia) apresentavam aderências peritoneais firmes. Todas as aderências encontradas foram quantificadas macroscopicamente e confirmadas microscopicamente, sem a realização de classificação microscópica das aderências. Conclusão: o novo modelo desenvolvido, de gastrotomia seguida de gastrorrafia, mostrou-se seguro e eficiente para induzir e estudar aderências peritoneais.

https://doi.org/10.1590/0100-6991e-20233453-en

PANCREATODUODENECTOMY IN PATIENT WITH VON HIPPEL-LINDAU DISEASE: A LITERATURE REVIEW
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Eulálio, José Marcus Raso

; Carvalho, Thales Penna

; Brabo, Eloá Pereira

; Araújo, Antonio Luis Eiras

; Eulálio, Adriana de Oliveira

; Beirão, Felipe Nogueira

; Manso, José Eduardo Ferreira

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2022, Volume 35 elocation e1697

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO RACIONAL: A doença de von Hippel Lindau é uma síndrome autossômica dominante que se caracteriza por maior incidência de tumores em diferentes órgãos. OBJETIVO: Descrever um caso de pancreatoduodenectomia em paciente do sexo masculino de 30 anos com von Hippel Lindau. MÉTODO: Apresentamos o caso e a revisão da literatura realizada para otimizar o manejo do paciente, que apresentava feocromocitoma, hemangioblastoma capilar na retina periférica e dois tumores neuroendócrinos no pâncreas. RESULTADOS: O maior tumor pancreático localizava-se no processo uncinado medindo 31 mm. A lesão menor estava localizada no corpo proximal do pâncreas e foi detectada apenas na tomografia computadorizada por emissão de pósitrons com DOTATOC-68Ga. A investigação genética revelou uma mutação no locus NM_000551.3 c.482G>A (p.Arg161Gln) do gene supressor humano de Von Hippel-Lindau. O tumor no processo era maior que 30mm e o paciente apresentava mutação no exon 3. Indicamos pancreatoduodenectomia envolvendo o corpo proximal do pâncreas para ressecar em bloco ambos os tumores. No pós-operatório o paciente apresentou coleção líquida peripancreática que foi tratada como fístula pancreática grau B, com resolução clínica da complicação. Ele recebeu alta hospitalar no vigésimo primeiro dia pós-operatório. CONCLUSÕES: o manejo de pacientes com doença de von Hippel Lindau e tumores neuroendócrinos pancreáticos é complexo e deve ser centrado em instituições terciárias com grande volume de cirurgia pancreática. Embora a literatura atual auxilie na tomada de decisão na maioria das situações, cada etapa do tratamento requer análise e discussão entre diferentes especialidades médicas, incluindo cirurgiões, clínicos, radiologistas e anestesiologistas.

ABSTRACT BACKGROUND: The von Hippel-Lindau disease is a highly penetrant autosomal dominant syndrome characterized by tumor predisposition in different organs. AIM: This study aimed to describe a case of a pancreatoduodenectomy for a 30-year-old male patient with von Hippel-Lindau disease. METHODS: We present a case study and the literature review aiming at the state-of-the-art management of a patient with pheochromocytoma, capillary hemangioblastoma in the peripheral retina, and two neuroendocrine tumors in the pancreas. RESULTS: A larger pancreatic lesion was located in the uncinate process, measuring 31 mm. The smaller lesion was located in the proximal pancreas and was detected only on the positron emission tomography-computed tomography scan with DOTATOC-68Ga. Genetic investigation revealed a mutation in the locus NM_000551.3 c.482G>A (p.Arg161Gln) of the Von Hippel-Lindau Human Suppressor gene. The uncinate process tumor was larger than 30 mm and the patient had a mutation on exon 3; therefore, we indicated a pancreatoduodenectomy involving the proximal pancreas to resect both tumors en bloc. During the postoperative period, the patient presented a peripancreatic fluid collection, which was treated as a grade B pancreatic fistula with clinical resolution of the complication. On postoperative day 21, he was discharged home. CONCLUSION: The management of patients with von Hippel-Lindau disease and pancreatic neuroendocrine tumors is complex and must be centered on tertiary institutions with a large volume of pancreatic surgery. Although the current literature assists in decision-making in most situations, each step of the treatment requires analysis and discussion between different medical specialties, including surgeons, clinicians, radiologists, and anesthesiologists.

https://doi.org/10.1590/0102-672020220002e1697

Healing effect of andiroba-based emulsion in cutaneous wound healing via modulation of inflammation and transforming growth factor beta 3
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Chia, Chang Yung

; Medeiros, Andréia Dantas

; Corraes, André de Menezes Silva

; Manso, José Eduardo Ferreira

; Silva, César Silveira Claudio da

; Takiya, Christina Maeda

; Vanz, Ricardo Luís

Acta Cirúrgica Brasileira

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nov 2018, Volume 33 N. 11 Pages 1000 - 1015

Abstract: En | Text: En | PDF: En

Abstract Purpose: To evaluate the effects and mechanisms of andiroba-based emulsion (ABE) topical treatment on full-thickness cutaneous wounds in rats. Methods: The wounds were harvested on days 3, 7, 15, and 20 post-surgery. Wound contraction rate, quantitative immunohistochemistry [macrophages, myofibroblasts, capillaries, collagens (col) I and III, transforming growth factor β3β (TGFβ3)], and tensile strength were assessed. Results: Treated wounds were smaller, contracted earlier and had increased angiogenesis, fewer CD68+ and M2 macrophages on days 7 and 15, but higher on day 20. Myofibroblasts appeared on days 3 to 7 in untreated wounds and on days 7 to 15 in treated wounds. TGFβ3 levels were higher in the treated wounds, less dense collagen fibers, lower col I/III ratios and a higher tensile strength. Conclusion: These results demonstrate the important anti-inflammatory role of treatment and the associated modulation of macrophages, myofibroblasts, and TGFβ3 levels. Collagen fibers in the treated wounds were more organized and less dense, similar to unwounded skin, which likely contributed to the higher tensile strength.

https://doi.org/10.1590/s0102-865020180110000007 1390 downloads

Rat models of high risk colorectal anastomoses
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Alvarenga Junior, Valter

; Ferraz, Edna Delabio

; Rolim, Marcia

; Carra, Amabile Marran

; Silva, Pedro Teixeira da

; Franco, Olavo Borges

; Cordeiro, Mariana Menegat Dias

; Takiya, Christina Maeda

; Baetas-da-Cruz, Wagner

; Manso, José Eduardo Ferreira

; Ferreira, Manoel Luiz

; Eulálio, José Marcus Raso

; Silva, Paulo César

; Souza, Heitor Siffert Pereira de

; Schanaider, Alberto

Acta Cirúrgica Brasileira

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oct 2018, Volume 33 N. 10 Pages 914 - 923

Abstract: En | Text: En | PDF: En

Abstract Purpose: To evaluate the most frequent surgical techniques of high-risk colorectal anastomoses in rats. Methods: Wistar rats were enrolled in three different models comprising inflammatory (TNBS enema), vascular (portal vein occlusion) or obstructive (a non-ischemic constricting ring) mechanisms associated with colonic anastomosis that had accomplished after these former lesions. Histological analyses (Hematoxylin and eosin and Picrosirius red) were performed. Results: All anastomoses techniques were associated with risk factors and had complications, mainly anastomotic leakage. In Study 1, the use of a pharmacological agent, trinitrobenzene sulfonic acid (TNBS) mimicked an inflammatory bowel disease such as Crohn’s disease with 50% of anastomosis leakage, the higher percentage among all models tested. In Study 2, after portal ischemia followed by reperfusion it was observed a dense neutrophil infiltrate in the midst of necrotic tissue and fibrin at the anastomotic site and 5 days after the anastomosis, no collagen was produced. In Study 3, 5 days after the mechanical obstruction some denuded areas of epithelium with marked oedema of mucosa and submucosa were seen, at the anastomotic site and anastomosis group showed some reduction of collagen density when compared with Control/Sham group. Conclusion: All the experimental surgical techniques tested in rats were associated with high-risk colorectal anastomoses and were useful to study colonic anastomotic healing and intestinal leakage.

https://doi.org/10.1590/s0102-865020180100000006 1058 downloads

A technical note on low cost rat laparoscopy an initial experience
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Eulálio, José Marcus Raso

; Ferreira, Manoel Luiz

; Silva, Paulo César

; Manso, José Eduardo Ferreira

; Nicolau, Andrei Ferreira Costa

; Carvalho, Thales Penna de

; Silva, Julia Radicetti de Siqueira Paiva e

; Fernandes, Adrielle Rodas

; Schanaider, Alberto

Acta Cirúrgica Brasileira

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sep 2018, Volume 33 N. 9 Pages 853 - 861

Abstract: En | Text: En | PDF: En

Abstract Purpose: To evaluate a novel and adapted low-cost set model for laparoscopic surgery in rats. Methods: Nine Wistar rats underwent two different laparoscopic procedures, splenectomy (n=3) and distal pancreatectomy with splenectomy (n = 6), after assembling a low-cost set replacing the conventional one (monitor, micro camera, image processor, light source, laparoscope and insufflator). The new set included an Android Tablet 10.5 ", a 5mm USB Endoscope and semiautomatic sphygmomanometer monitor. Results: The same surgeon performed the laparoscopic procedures. Total surgical time ranged from 36 to 60 minutes with a mean of 45.8 minutes. Three rats died during the distal pancreatic and splenectomy procedure (33.3%), due to respiratory failure (n = 1), uncontrolled abdominal hemorrhage (n=1) and iatrogenic gastric perforation (n = 1). We followed the other six rats (66.6%) for seven days with no further evidence of complications. Conclusions: The laparoscopic partial pancreatectomy and splenectomy can be performed with the novel low-cost set assembled in the present experimental study. Both specific training and skills development are required to validate more advanced laparoscopic procedures and achieve a desirable outcome.

https://doi.org/10.1590/s0102-865020180090000014 1088 downloads

Student insight about the discipline of surgical technique on the formative process in the School of Medicine of UFRJ
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Senna, Victor Diniz

; Cozer, Keren

; Ferreira, Manoel Luiz

; Eulálio, José Marcus Raso

; Silva, Paulo Cesar

; Manso, José Eduardo Ferreira

; Schanaider, Alberto

Acta Cirúrgica Brasileira

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jan 2017, Volume 32 N. 1 Pages 74 - 80

Abstract: En | Text: En | PDF: En

Abstract Purpose: To evaluate whether undergraduate students feel motivated to develop surgical skills and know their impression about the importance of having a surgical technique discipline in the curriculum of a medical school. Methods: A prospective study including three classes in a row, from the 8th period (n = 265) evaluated the knowledge acquired at the Center of Experimental Surgery, Department of Surgery, School of Medicine of Federal University of Rio de Janeiro (UFRJ). The importance of the discipline for medical training as a way of encouragement to arouse and deepen the interest in surgical technique was emphasized. The questions were scored from 1 to 5 (worst to best grade) . Results: Concerning the importance of the discipline for medical training, 78% and 18% of the students assigned a score 5 and 4, respectively. Regarding the stimulus to improve their surgical technical skills, 40% and 32% attributed the score 5 and 4, respectively. Conclusion: Undergraduate students from the Medical School of UFRJ effectively shared the understanding that the operative technique bases improve the formative process with significant impact, not only in the development of skills, but also to arouse vocations and stimulate new attitudes aimed to knowledge acquirement in the field of Surgery.

https://doi.org/10.1590/s0102-865020170109 1252 downloads

Critical analysis and systematization of rat pancreatectomy terminology
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Eulálio, José Marcus Raso

; Bon-Habib, Assad Charbel Chequer

; Soares, Daiane de Oliveira

; Corrêa, Paulo Guilherme Antunes

; Pineschi, Giovana Penna Firme

; Diniz, Victor Senna

; Manso, José Eduardo Ferreira

; Schanaider, Alberto

Acta Cirúrgica Brasileira

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oct 2016, Volume 31 N. 10 Pages 698 - 704

Abstract: En | Text: En | PDF: En

ABSTRACT PURPOSE: To critically analyze and standardize the rat pancreatectomy nomenclature variants. METHODS: It was performed a review of indexed manuscripts in PUBMED from 01/01/1945 to 31/12/2015 with the combined keywords "rat pancreatectomy" and "rat pancreas resection". The following parameters was considered: A. Frequency of publications; B. Purpose of the pancreatectomy in each article; C. Bibliographic references; D. Nomenclature of techniques according to the pancreatic parenchyma resection percentage RESULTS: Among the 468, the main objectives were to surgically induce diabetes and to study the genes regulations and expressions. Five rat pancreatectomy technique references received 15 or more citations. Twenty different terminologies were identified for the pancreas resection: according to the resected parenchyma percentage (30 to 95%); to the procedure type (total, subtotal and partial); or based on the selected anatomical region (distal, longitudinal and segmental). A nomenclature systematization was gathered by cross-checking information between the main surgical techniques, the anatomic parameters descriptions and the resected parenchyma percentages. CONCLUSION: The subtotal pancreatectomy nomenclature for parenchymal resection between 80 and 95% establishes a surgical parameter that also defines the total and partial pancreatectomy limits and standardizes these surgical procedures in rats.

https://doi.org/10.1590/S0102-865020160100000010 1386 downloads

Ultrasound biomicroscopy and claudication test for in vivo follow-up of muscle repair enhancement based on platelet-rich plasma therapy in a rat model of gastrocnemius laceration
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Pinheiro, Cristiane Lima

; Peixinho, Carolina Carneiro

; Esposito, Cristiano Costa

; Manso, José Eduardo Ferreira

; Machado, João Carlos

Acta Cirúrgica Brasileira

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feb 2016, Volume 31 N. 2 Pages 103 - 110

Abstract: En | Text: En | PDF: En

PURPOSE: To track the regeneration process of lateral gastrocnemius due to a muscle laceration in rats, and to treatment with plateletrich plasma (PRP). METHODS: Ultrasound (40 MHz) images were used for measuring pennation angle (PA), muscle thickness (MT) and mean pixel intensity, along with claudication scores, of treated (PRPG) and non-treated (NTG) groups of rats. RESULTS: NTG showed a PA increase for the non-injured leg (p<0.05) and a tendency of MT to increase, whereas for PRPG there were no differences. There was a progressive reduction of the claudication score for the PRPG group throughout the entire period, with an immediate difference after seven days (p<0.05), whereas the NTG had a significant reduction only at day 28 (p<0.05). CONCLUSION: It was observed a compensatory hypertrophic response due to the overload condition imposed to healthy leg for NTG that did not occur in PRPG, suggesting an accelerated repair process of the injured leg due to treatment, anticipating its use.

https://doi.org/10.1590/S0102-865020160020000004 1670 downloads

Agenesis or pseudoagenesis of the dorsal pancreas
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Guimarães, Alberto Brunning

; Guimarães, Carlos Alberto

; Manso, José Eduardo Ferreira

Revista do Colégio Brasileiro de Cirurgiões

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oct 2015, Volume 42 N. 5 Pages 352 - 355

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os autores apresentam um relato de caso baseado em evidência de uma paciente com agenesia ou pseudoagenesia de pâncreas dorsal.

The authors present an evidence-based case report of a patient with agenesis or pseudoagenesis of the dorsal pancreas.

https://doi.org/10.1590/0100-69912015005015 5225 downloads

10.

Relação entre o estado nutricional de vitamina a e a regressão da esteatose hepática após gastroplastia em Y- de- Roux para tratamento da obesidade classe III
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Silva, Luiz Gustavo de Oliveira e

; Manso, José Eduardo Ferreira

; Silva, Rejane Andréa Ramalho Nunes da

; Pereira, Silvia Elaine

; Saboya Sobrinho, Carlos José

; Rangel, Cesar Wakoff

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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dec 2012, Volume 25 N. 4 Pages 250 - 256

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RACIONAL: A vitamina A participa de várias funções primordiais no organismo humano e as suas concentrações séricas podem estar diminuídas nas doenças crônicas não transmissíveis. OBJETIVO: Avaliar a relação entre o estado nutricional da vitamina A, e a regressão da esteatose hepática em indivíduos submetidos à gastroplastia em Y-de-Roux para tratamento da obesidade classe III. MÉTODOS: Foram estudados 30 pacientes obesos classe III, de ambos os sexos, com esteatose hepática, submetidos à gastroplastia em Y-de-Roux. Seis meses após a operação, os pacientes foram submetidos à ultrassonografia abdominal e distribuídos em dois grupos: grupo 1 - pacientes com esteatose detectada na ultrassonografia e grupo 2 - pacientes sem esteatose detectada na ultrassonografia. No pré-operatório e seis meses após a operação foram realizadas análises antropométricas e exames bioquímicos: insulina basal, glicemia, Homeostasis Model Assessment Index (HOMA IR), colesterol, HDL, LDL, triglicerídeos, AST, ALT, Gama-GT, albumina, bilirrubina total, retinol, e beta caroteno. RESULTADOS: A média de perda de peso foi de 35,05 + 10,47 (p<0,01) e a diminuição no Índice de Massa Corporal (IMC) de 11,6 + 4,99 Kg/m² (p<0,01). Após seis meses, todos os exames bioquímicos apresentaram diminuição significativa das concentrações (p<0,05). O grupo 2 (sem esteatose) apresentou no pós-operatório, concentrações significativamente inferiores (p<0,05), nas variáveis: peso, IMC, AST, ALT, gama GT, HOMA IR, insulina basal. As concentrações séricas de albumina apresentaram valores médios aproximados, sem diferença significativa nos dois tempos avaliados. Observaram-se concentrações séricas mais elevadas de retinol e de β-caroteno e redução menor em relação as concentrações do pré-operatório nos pacientes sem esteatose, porém sem diferença estatística. CONCLUSÃO: Adequado estado nutricional de vitamina A pode contribuir na regressão da esteatose hepática em pacientes submetidos à Gastroplastia em Y-de-Roux para tratamento da obesidade classe III.

BACKGROUND: Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases. AIM: To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity. METHODS: Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 - patients with steatosis detected in the ultrasonography (16 subjects) and group 2 - patients without steatosis detected in the ultrasonography (14 subjects). Before and six months after the surgery, were carried out anthropometrical analyses and biochemical exams (basal insulin, glicemy, Homeostasis Model Assessment Index (HOMA IR), cholesterol, HDL, LDL, triglycerides, AST, ALT, Gamma-GT, albumin, total bilirubin, retinol, and beta carotene. RESULTS: The individuals presented an average weight loss of 35.05 + 10.47 (p<0.01) and a decrease in the Body Mass Index (BMI) of 11.6 + 4.99 Kg/m² (p<0.01). After six months, all the biochemical exams presented a significant decrease in their basal concentrations (p<0.05). In the post-operative period the group 2 (without steatosis) presented concentrations significantly lower (p<0.05) in the following variables: weight, BMI, AST, ALT, Gamma-GT, HOMA IR, basal insulin. The albumin serum concentrations presented close average values, with no significant difference in the two periods evaluated. In the assessment of retinol and beta carotene, higher serum concentrations and a small decrease in relation to the concentrations of the pre-operative period in the group without steatosis were observed, however, no statistical difference was found. CONCLUSION: An adequate nutritional status of vitamin A might contribute in the improvement of the hepatic esteatosis after Roux-en-Y gastric bypass for class III obesity treatment.

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11.

Prevenção do tromboembolismo na cirurgia do câncer do aparelho digestivo
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Malafaia, Osvaldo

; Montagnini, Andre Luís

; Luchese, Angélica

; Accetta, Antonio Carlos

; Zilberstein, Bruno

; Malheiros, Carlos Alberto

; Jacob, Carlos Eduardo

; Quireze-Junior, Claudemiro

; Bresciani, Cláudio José Caldas

; Kruel, Cleber Dario Pinto

; Cecconello, Ivan

; Sad, Eduardo Fonseca

; Ohana, Jorge Alberto Langbeck

; Aguilar-Nascimento, José Eduardo de

; Manso, José Eduardo Ferreira

; Ribas-Filho, Jurandir Marcondes

; Santo, Marco Aurélio

; Andreollo, Nelson Adami

; Torres, Orlando Jorge Martins

; Herman, Paulo

; Cuenca, Ronaldo Mafia

; Sallum, Rubens Antônio Aissar

; Bernardo, Wanderley Marques

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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dec 2012, Volume 25 N. 4 Pages 216 - 223

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RACIONAL: Tromboembolismo venoso é complicação frequente após tratamento cirúrgico em geral e, de um modo especial, na condução terapêutica do câncer. A cirurgia do aparelho digestivo tem sido referida como potencialmente indutora desta complicação. Os pacientes com câncer digestivo, têm risco substancialmente aumentado de iniciarem ou de terem recorrência de processo tromboembólico. OBJETIVO: Oferecer aos cirurgiões que atuam na cirurgia digestiva e geral orientação segura sobre como efetuar a tromboprofilaxia dos pacientes que necessitam de operações no tratamento de doenças malignas digestivas. MÉTODOS: A Diretriz foi baseada a partir da elaboração de 15 questões clínicas relevantes e relacionadas ao risco, tratamento e prognóstico do paciente submetido ao tratamento cirúrgico do câncer do aparelho digestivo. Elas focaram tanto os eventos tromboembólicos associados às operações quanto os aspectos relacionados à sua profilaxia. As questões foram estruturadas por meio do P.I.C.O. (Paciente, Intervenção ou Indicador, Comparação e Outcome), permitindo gerar estratégias de busca da evidência nas principais bases primárias de informação científica (Medline/Pubmed, Embase, Lilacs/Scielo, Cochrane Library, Premedline via OVID). Também foi realizada busca manual da evidência e de teses (BDTD e IBICT). A evidência recuperada foi selecionada a partir da avaliação crítica utilizando instrumentos (escores) discriminatórios de acordo com a categoria da questão: risco, terapêutica e prognóstico (JADAD para Ensaios Clínicos Randomizados e New Castle Otawa Scale para estudos não randômicos). Após definir os estudos potenciais para sustento das recomendações, eles foram selecionados pela força da evidência e grau de recomendação segundo a classificação de Oxford, incluindo a evidência disponível de maior força. RESULTADOS: Foram avaliados 53.555 trabalhos pelo título e/ou resumo. Deste total foram selecionados (1ª seleção) 478 trabalhos avaliados pelo texto completo. A partir deles, para sustentar as recomendações, foram incluídos neste consenso 132 trabalhos. As 15 perguntas formuladas puderam ser respondidas com artigos com grau de evidência correspondentes à 31 A, 130 B, 1 C e 0 D. CONCLUSÃO: Esta revisão possibilitou elaborar orientação segura para a profilaxia do tromboembolismo nas operações sobre o câncer do aparelho digestivo, abordando os tópicos mais frequentes do quotidiano do trabalho dos cirurgiões gerais e do aparelho digestivo.

BACKGROUND: The venous thromboembolism is a common complication after surgical treatment in general and, in particular, on the therapeutic management on cancer. Surgery of the digestive tract has been reported to induce this complication. Patients with digestive cancer have substantial increased risk of initial or recurrent thromboembolism. AIM: To provide to surgeons working in digestive surgery and general surgery guidance on how to make safe thromboprophylaxis for patients requiring operations in the treatment of their gastrointestinal malignancies. METHODS: The guideline was based on 15 relevant clinical issues and related to the risk factors, treatment and prognosis of the patient undergoing surgical treatment of cancer on digestive tract. They focused thromboembolic events associated with operations and thromboprophylaxis. The questions were structured using the PICO (Patient, Intervention or Indicator, Comparison and Outcome), allowing strategies to generate evidence on the main primary bases of scientific information (Medline / Pubmed, Embase, Lilacs / Scielo, Cochrane Library, PreMedline via OVID). Evidence manual search was also conducted (BDTD and IBICT). The evidence was recovered from the selected critical evaluation using discriminatory instruments (scores) according to the category of the question: risk, prognosis and therapy (JADAD Randomized Clinical Trials and New Castle Ottawa Scale for studies not randomized). After defining potential studies to support the recommendations, they were selected by the strength of evidence and grade of recommendation according to the classification of Oxford, including the available evidence of greater strength. RESULTS: A total of 53,555 papers by title and / or abstract related to issue were found. Of this total were selected (1st selection) 478 studies that were evaluated as full-text. From them to support the recommendations were included in the consensus 132 papers. The 15 questions could be answered with evidence grade of articles with 31 A, 130 B, 1 C and 0 D. CONCLUSION: It was possible to prepare safe recommendations as guidance for thromboembolism prophylaxis in operations on the digestive tract malignancies, addressing the most frequent topics of everyday work of digestive and general surgeons.

6539 downloads Cited 1 time in SciELO

12.

CBC e SBAIT: somando para multiplicar
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Fraga, Gustavo Pereira

; Manso, José Eduardo Ferreira

; Starling, Sizenando Vieira

Revista do Colégio Brasileiro de Cirurgiões

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aug 2012, Volume 39 N. 4 Pages 247 - 248

Abstract: Pt | Text: Pt | PDF: Pt

1657 downloads Cited 1 time in SciELO

13.

Adenocarcinoma gástrico Borrmann tipo IV: análise dos resultados da ressecção curativa
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Accetta, Antonio Carlos

; Manso, José Eduardo Ferreira

; Mello, Eduardo Linhares Riello de

; Paiva, Rubens Kesley Siqueira de

; Castro, Leonaldson dos Santos

; Accetta, Pietro

Revista do Colégio Brasileiro de Cirurgiões

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aug 2011, Volume 38 N. 4 Pages 237 - 244

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Avaliar o resultado obtido com a ressecção de intenção curativa do adenocarcinoma gástrico Borrmann IV(B IV), através da análise de variáveis clínicas, cirúrgicas e anatomopatológicas, identificando quais destes fatores prognósticos se associaram à sobrevida. MÉTODOS: Foram analisados retrospectivamente, no período de janeiro de 1997 a dezembro de 2005, 123 pacientes com adenocarcinoma gástrico B IV submetidos ao tratamento cirúrgico no Serviço de Cirurgia Abdômino-Pélvica do Instituto Nacional de Câncer (INCA). O grupo submetido à ressecção curativa teve analisado diversos fatores prognósticos com relação à sobrevida global. RESULTADOS: Dos 123 pacientes estudados, 68 foram submetidos à gastrectomia, 52 (42,3%) com intenção curativa e 16 (13%) como ressecção paliativa, enquanto 55 (44,7%) tiveram doença não passível de ressecção. Três óbitos no pós-operatório seguiram-se à ressecção curativa, configurando uma taxa de mortalidade de 5,76%. Em nove (17,3%) pacientes ocorreram complicações técnicas, sendo a fístula esofagojejunal com sete casos, a mais frequente. Todos os óbitos e complicações técnicas ocorreram após gastrectomias totais, que foi o tipo de ressecção curativa mais realizada nesta série. O padrão de recidiva mais comum foi a carcinomatose peritoneal. A localização do tumor, metástase linfonodal, invasão linfática e estadiamento patológico foram considerados fatores prognósticos significantes. O tempo de sobrevida mediano foi de 29 meses, com taxa de sobrevida em cinco anos de 33% nos pacientes submetidos à ressecção curativa CONCLUSÃO: A ressecção com intenção curativa do adenocarcinoma gástrico B IV apresentou um impacto positivo na sobrevida dos pacientes com a doença nos estágios IB, II e III; com até 15 linfonodos comprometidos (pN2) e no tipo localizado.

OBJECTIVE: To evaluate the results obtained with curative resection of Borrmann IV gastric adenocarcinoma (B IV) through the analysis of clinical, surgical and pathological data, identifying which of these prognostic factors were associated with survival. METHODS: We retrospectively analyzed 123 patients with B IV gastric adenocarcinoma undergoing surgical treatment at the Department of the pelvic-abdominal surgeries of the National Cancer Institute (INCA) from January 1997 to December 2005. The group undergoing curative resection was examined for various prognostic factors regarding overall survival. RESULTS: Of the 123 patients studied, 68 underwent gastrectomy, 52 (42.3%) with curative intent and 16 (13%) palliative resection, while 55 (44.7%) had disease not subject to resection. Three postoperative deaths followed the curative resection, constituting a mortality rate of 5.76%. In nine (17.3%) patients there were technical complications, and esophagojejunal fistula seven cases, the most frequent. All technical complications and deaths occurred after total gastrectomy, which was the most commonly performed curative resection type in this series. The most common pattern of recurrence was peritoneal carcinomatosis. The location of the tumor, lymph node metastasis, lymphatic invasion and pathological staging were considered significant prognostic factors. The median survival time was 29 months, with a rate of five-year survival of 33% in patients undergoing curative resection. CONCLUSION: The curative resection of B IV gastric adenocarcinoma had a positive impact on survival of patients with the disease in stages IB, II and III, with up to 15 lymph nodes (pN2) and localized type.

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14.

Molars extraction for bone graft study in rabbits
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Manso, José Eduardo Ferreira

; Mourão, Carlos Fernando de Almeida Barros

; Pinheiro, Flávio Alexandre Lima

; Ferreira, Manoel Luiz

; Silva, Paulo César

; Schanaider, Alberto

Acta Cirúrgica Brasileira

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2011, Volume 26 Suppl. 2 Pages 66 - 69

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Descrever uma técnica cirúrgica em coelhos para avaliação de enxertos ósseos. MÉTODOS: A técnica operatória consiste numa incisão na topografia da comissura labial até o ultimo molar. Uma incisão de 1cm no rebordo para expor o osso alveolar e a região cervical dos molares. Realizou-se a exodontia com fórceps e o alvéolo é preenchido com hidroxiapatita. Após o tempo de cicatrização é realizada a avaliação histológica. RESULTADOS: A análise histológica mostrou o novo osso formado rodeando biomaterial. CONCLUSÃO: O modelo cirúrgico para avaliação de enxertos ósseos utilizando molares de coelhos se mostrou factível.

PURPOSE: The aim of this study was to describe an experimental surgical technique to be used in the evaluation of bone grafts in rabbits. METHODS: The operative technique was performed in jaws, with external approach from the labial commissure to the last molar tooth. An incision about 1cm extended forward to the alveolar ridge, followed by a exposing the cervical region of the alveolar bone and dental elements was done. Thus, after extraction of first molar with forceps, the tooth socket left was filled with hydroxyapatite. The bone gain was analyzed by histopathological studies. RESULTS: The histological analyses indicated formed bone surrounding the biomaterial. CONCLUSION: The experimental model using the tooth socket of the rabbit molar is a feasible procedure for studies of bone grafts.

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15.

Classification of journals in the QUALIS System of CAPES URGENT need of changing the criteria!
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Andriolo, Adagmar

; Souza, Aécio Flávio Meireles

; Farias, Alberto Queiroz

; Barbosa, Alfredo José Afonso

; França Netto, Antonio Spina

; Hernandez, Arnaldo José

; Camargos, Aroldo F.

; Barraviera, Benedito

; Kadunc, Bogdana Victoria

; Caramelli, Bruno

; Campos, Carlos Eduardo Aguilera

; Brites, Carlos

; Nascimento, Dejair Caitano do

; Braile, Domingo M.

; Goldenberg, Dov Charles

; Baracat, Edmund Chada

; Kimura, Edna T.

; Marchiori, Edson

; Vieira, Eduardo de Paula

; Almeida, Eros Antônio de

; Jotz, Geraldo Pereira

; Camanho, Gilberto

; Friedman, Gilberto

; Cerri, Giovanni Guido

; Duarte, Ivomar Gomes

; Costa, Izelda Maria Carvalho

; Mello Júnior, João Ferreira de

; Faintuch, Joel

; Martinez, José Antônio Baddini

; Antonio Livramento, José

; Manso, José Eduardo Ferreira

; Amaral, José Luiz Gomes do

; Battistella, Linamara Rizzo

; Machado, Luís dos Ramos

; Moreira, Luiz Felipe P.

; Gebrim, Luiz Henrique

; Madeira, Marcelo

; Riberto, Marcelo

; Bastos, Marcus

; Falcão, Mário Cícero

; Conceição, Mario J. da

; Silva, Mauricio Rocha e

; Ruiz, Milton Artur

; Shibata, Milton K.

; Santiago, Mittermayer Barreto

; Andreollo, Nelson Adami

; Malafaia, Osvaldo

; Martins, Regina Helena Garcia

; Procianoy, Renato Soibelmann

; Baroudi, Ricardo

; Fuller, Ricardo

; Viebig, Ricardo Guilherme

; Nitrini, Ricardo

; Moura, Rita Cristina Mainieri R. de

; Dedivitis, Rogério

; Damião, Ronaldo

; Lianza, Sergio

; Rode, Sigmar de Mello

; Yoshida, Winston Bonetti

; Handar, Zuher

Arquivos de Neuro-Psiquiatria

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apr 2010, Volume 68 N. 2 Pages 327 - 329

Abstract: En | Text: En | PDF: En

3236 downloads Cited 9 times in SciELO

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