256 resultados para esophagus resection


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The occurrence of perineal hernias in dogs during routine clinical surgery is frequent. The coexistence of rectal diseases that go undiagnosed or are not correctly treated can cause recurrence and postoperative complications. The objective of this report is to describe a surgical technique for treatment of rectal sacculation through lateral resection in dogs with perineal hernia, whereby restoring the rectal integrity.

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Pós-graduação em Medicina Veterinária - FMVZ

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Laparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated.

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Electromanometric measures of the gastroesophageal junction were performed in 20 adult, male and female, anesthetised opossums. The electromanometric examinations were performed according the intermitent pull through technique. The research was divided in four groups, according to the drug to be analysed: group 1 (20 animals) IM injection of physiological solution (control group); group 2 (20 animals) IM injection of metoclopramide; group 3 (20 animals) IM injection of ranitidine; group 4 (20 animals) IM injection of droperidol. Electromanometry was done 15 minutes before the drug injection, just after the injection and 15, 30, 45 and 60 minutes after the injection. In each one of the moments the pressure of the lower esophageal sphincter (LES-mmHg) was analysed. Considering LES pressure the results observed were: in group 1 it was not observed any significative alteration after IM injection of physiologic solution; in group 2 it was observed significative pressure increase, 15 minutes after metoclopramide IM injection; in group 3 it was observed pressure increase, being significative at 15 and 30 minutes after IM injection; in group 4 it was observed significative increase in LES pressure in every moment, 15 minutes after droperidol IM injection.

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The evolution and phenotypic expression of mucosal lesions of the gastric stump were investigated in male rats submitted to gastric resection with reconstruction by the Billroth II technique (BII with biliopancreatic reflux, BPR) or by the Roux-en-Y procedure (without BPR). Animals were studied at 24, 36, 54 and 64 weeks after surgery and the phenotypic expression of lesions analysed using routine hematoxylin and eosin staining, immunohistochemical staining for pepsinogen isoenzyme 1 and histochemical procedures for mucins (paradoxical concanavalin A, galactose oxidase Schiff (GOS) and sialidase GOS reactions). BPR was found to be responsible for the formation of adenomatous hyperplasia (AH), increasing in incidence and size with time, since the Roux-en-Y procedure failed to induce the gastric stump lesions observed after BII reconstruction. AHs always occurred in the transition of the gastrojejunal junction, a site offering special conditions for BPR influence, and were classified as gastric (G), intestinal (I) and G+I types according to their phenotypic expression. No pure I type AH was diagnosed at any time point. The G and G+I types developed at approximately equal incidences (i.e., G type 7/17, G+I type 10/17 at the 64th week). It was suggested that both gastric and intestinal mucosal elements were stimulated to proliferate by BPR, with the gastric mucosa tending to demonstrate AH. Intestinal type components of AH were found adjacent to the jejunum and not at the stomach margin, indicating an origin from intestinal mucosa. No metaplasia of the gastric mucosa was observed in any animal after partial gastric resection. In 101 rats submitted to the BII procedure, 5 mucinous adenocarcinomas were eventually diagnosed, mostly located in the subserosa of the gastrojejunal junction. All carcinomas expressed the phenotype of cells of the small intestine. Evidence of malignant transformation within the gastric components of AH was not observed even at the 64th week. In conclusion, all lesions induced by BPR in the rat remnant stomach are benign, and the few true cancers that arise in association are derived from the small intestine.

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Both adalimumab [ADA] and infliximab [IFX] seem to be effective in the prevention of early postoperative endoscopic recurrence [EPER] after ileocaecal resection in Crohn's disease [CD] patients. There is lack of data with direct comparison between the two agents in the postoperative scenario. The aim of this study was to compare the rates of EPER in patients treated with ADA and IFX after ileocaecal resection for CD. This was a multicentre retrospective analysis of EPER rates in CD patients after ileocaecal resections, from seven referral centres in three countries. Endoscopic recurrence was defined as Rutgeerts' score ≥ i2. The patients were allocated according to treatment to two groups: ADA or IFX. The EPER rates were compared between the two treatment groups. Among the 168 patients included in the database, 96 received anti-tumour necrosis factor [TNF] agents after resection [37 in the ADA and 59 in the IFX groups] and were included in this comparative study. The groups were comparable in all baseline characteristics, mainly age, gender, previous resections, perianal CD, and mono or combination therapy. EPER was identified in 9/37 [24.32%] in the ADA group vs 16/59 [27.12%] in the IFX group [p = 0.815]. In this retrospective direct comparison between ADA and IFX therapy after ileocaecal resection, there was no significant difference between the two anti-TNF agents in terms of EPER rates. However, prospective randomised studies are needed to confirm these data and better define the role of each agent in the prevention of EPER.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The preferential sites of infection of Cysticercus bovis were evaluated in the skeletal muscle and entrails of 25 cattle that were experimentally infected with Taenia saginata (2 x 10(4) eggs). Two other animals were not inoculated (control). Ninety days after inoculation, all the cattle were euthanized. The carcasses were deboned and dissected into 26 anatomical sections (masseter muscles, brain, tongue, esophagus, heart, diaphragm, lungs, liver, kidneys, spleen, top sirloin butt, bottom sirloin butt, outside round, top (inside) round, transversus abdominus, top sirloin cap, strip loin, full tenderloin, eye of round, knuckle, shoulder clod, foreshank, shank, chuck, back ribs, and tail muscles). The dissected tissues were sliced into 5 mm sections. From the 25 cattle, 9258 C. bovis (cysticerci) were recovered; 75.02% (6946) of these were recovered from skeletal muscles and 24.98% (2312) from the entrails. A high parasitism level was found in the shoulder clod (12.55%), heart (11.02%), liver (9.48%), masseter muscles (8.51%), chuck (8.25%), strip loin and full tenderloin (7.26%), knuckle (6.63%), and back ribs (5.53%), totaling 69.23% (5738) of all of the detected cysticerci. on the other hand, there was a low C. bovis parasitism level in the brain, spleen, tail muscles, kidneys, esophagus, and diaphragm, representing just 3.9% of the total number of cysticerci. Given these results, we conclude that specific skeletal musculature regions, such as the shoulder blade, chuck, strip loin and full tenderloin, knuckle, back ribs and top round, which are not officially examined in many countries, are effective sites to efficiently screen C. bovis infection. To date, these regions have not been considered as preferential sites of C. bovis infection. Based on our work, however, these regions deserve greater attention from health inspectors because they contained a greater number of Cysticercus than the other regions of carcasses that are parasitized by T. saginata larvae. (c) 2010 Elsevier Ltd. All rights reserved.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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A new entomopathogenic nematode, Steinernema brazilense n. sp., was isolated from a single soil sample collected from a natural forest in Mato Grosso do Sul state, Brazil. S. brazilense n. sp. is characterized morphologically by features of infective juveniles (IJ), males and females. For the IJ, body length averaging 1157 (1023-1284) mu m, distance from anterior end to excretory pore 95 (87-102) mu m, from anterior end to end of esophagus 148 (139-153) mu m, tail length 85 (80-104) mu m, D% and E% values 63 (58-70) and 106 (95-118.0), respectively. Lateral field pattern variable; the formula for the arrangement of ridges from head to tail is: 2, 4, 6, 8, 6, 2. For the male, the diagnostic characters include spicule averaging 83 (75-89) mu m; D% about 65; the ratio SW% about 192. The length of spicule head is greater than width. Lateral field with one narrow ridge. First generation females are characterized by the presence of a ventral postanal swelling. S. brazilense n. sp. is morphologically close to Steinernema diaprepesi. It can be differentiated from S. diaprepesi by its longer IJ body length (1157 vs 1002 mu m), longer distance from anterior end to excretory pore (1110 vs 75 mu m), a longer tail length (103 vs 83 mu m); males of the new species with longer spicule (83 vs 79 mu m). The new species can be distinguished further from other members of Steinernema glaseri group by characteristics of rDNA of ITS and D2D3 regions. Published by Elsevier B.V.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Background: In this case report we presented the stand-alone posterior approach for hemivertebra resection with unilateral laminar hooks.Case report: The patient was male and five years old. The coronal and sagital X-Rays images showed a failure of vertebral formation, segmented hemivertebra of third lumbar vertebra. The segmented hemivertebra caused a thoracolumbar scoliosis from T12 to L4 (rightside convexity), of 30 degrees (Cobb angle). The patient was submitted to a hemivertebra resection from posterior approach with two unilateral laminars hooks stabilization (superior lamina in L2 and inferior lamina of L4) in association to a compression system and autologus bone graft. The coronal X-Ray image after surgery showed a partial improvement to 25 degrees (Cobb angle) between L2 and L4. After three years of follow up it was not observed system failure (hook pull-out), maintance of curve (25 degrees of Cobb angle) and correction of trunk inbalance.Conclusion: The hemivertebra resection with posterior approach is safe, with satisfactory correction of scoliosis curve, which means is a good choice for congenital scoliosis surgical treatment.

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Estudou-se o comportamento biológico e histopatológico de uma cepa genuínamente mariliense de Trypanosoma cruzi, isolada em 1997 através de xenodiagnóstico artificial. Vinte e cinco camundongos swiss foram infectados intraperitonealmente, sendo 11 utilizados para a realização da curva parasitêmica e observação da morfologia dos tripomastigotas e 14 foram sacrificados após o 17, 23, 30, 60 e 180 dias pós-infecção e coletados coração, esôfago, fígado, cólon, e músculo esquelético (fragmento da coxa direita) para análise histopatológica. Cultura em meio LIT foi realizada para análise de DNA. Os resultados mostraram predomínio de formas largas, baixa parasitemia com picos médios de 860 tripomastigotas/5mil de sangue ao redor do 20º dia de infecção. Nenhum camundongo morreu na fase aguda da infecção. Exame histopatológico mostrou poucos ninhos de amastigotas em coração, raros em músculo esquelético e cólon com discreto processo inflamatório. Comparada com a cepa Y, que foi isolada de uma paciente da mesma região, notamos diferentes características biológicas e comportamentais, porém a análise de DNA as coloca no mesmo grupo, demonstrando a proximidade dessas cepas.

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OBJETIVO: Utilizar a ultrassonografia do esôfago intra-abdominal para avaliar o tempo de trânsito esofágico para água e iogurte, em posição ortostática, e avaliar a influência do gênero e índice de massa corpórea. MATERIAIS E MÉTODOS: Foram estudados 89 indivíduos adultos jovens, sem clínica de doenças do trato gastrintestinal superior, sendo 40 do gênero feminino (média de 20,13 ± 1,62 anos) e 49 do gênero masculino (média de 20,43 ± 2,17 anos). O tempo de trânsito esofágico foi cronometrado, com o paciente em posição ortostática, durante a deglutição de água e iogurte. RESULTADOS: O tempo de trânsito esofágico para as mulheres e para os homens foi, respectivamente: para água, de 5,84 ± 1,60 segundos versus 6,66 ± 1,68 segundos, e para iogurte, de 9,12 ± 1,96 segundos versus 9,28 ± 1,70 segundos. Não se constatou diferença entre os gêneros masculino e feminino, apesar de o fator índice de massa corpórea ser menor nas mulheres. CONCLUSÃO: Os dados obtidos do tempo de trânsito esofágico para alimento líquido (água) e pastoso (iogurte), em posição ortostática, em adultos jovens não mostraram diferença entre os gêneros, mesmos nas mulheres com índice de massa corpórea menor em relação aos homens.

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Racional — A resposta do esfíncter esofágico superior ao refluxo gastroesofágico é controvertida. A perfusão esofágica com ácido clorídrico é modelo de estudo da ação do ácido o componente mais agressivo do refluxo sobre o esfíncter. Objetivos - Estudar o efeito da acidificação esofágica sobre o esfíncter esofágico superior através da eletromanometria esofágica. - Material e Métodos - em 30 cães adultos de ambos os sexos foram registrados estudos eletromanométricos do esôfago. A técnica utilizada foi a de puxada intermitente da sonda e perfusão contínua dos cateteres com água destilada. Estes exames permitiram as medidas da amplitude da pressão (mm Hg) e do comprimento (cm) do esfíncter superior do esôfago em condições basais (momento 1). Após esta fase, os animais foram submetidos a perfusão esofágica e divididos em 3 grupos de 10, na dependência da solução utilizada na perfusão e do momento do estudo: Grupo 1: perfusão esofágica com água destilada e estudos eletromanométricos realizados aos 15 minutos (momento 2) e 30 minutos (momento 3) do término da perfusão; Grupo 2: perfusão esofágica com HCl 0,1 N e estudos eletromanométricos realizados 15 minutos após o término da perfusão (momento 2); Grupo 3: perfusão esofágica com HCl 0,1 N e estudos eletromanométricos realizados 30 minutos após o término da perfusão (momento 3). Resultados/Conclusão - Os resultados observados permitiram concluir que a acidificação do esôfago não provocou alterações significativas sobre a amplitude de pressão e comprimento do esfíncter superior do esôfago.