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Estudo clínico comparativo entre anastomose colocólica com anel anastomótico biofragmentável e com sutura manual n?o absorvível
Saad, Sarhan Sydney;Matos, Delcio;
Revista do Colégio Brasileiro de Cirurgi?es , 2000, DOI: 10.1590/S0100-69912000000300006
Abstract: the use of suture in anastomosis presents some theoretical disadvantages that they would be avoided by using sutureless intestinal anastomosis. the biofragmentable ring idealized by hardy et al.(1985), is composed by polyglycolic acid and barium sulfate. it is constituted by two identical components that are coupled, not returning to the original position after its occlusion. this ring suffers desintegration in 2 to 3 weeks, and is eliminated with evacuation. this device allows a sutureless anastomosis by the compression of intestinal walls. the purpose of this prospective and randomized study was to compare the clinical and endoscopic results in eletive and low risk colonic anastomosis accomplished with biofragmentable anastomosis ring and with non absorbable suture. material: thirty-six patients were stratified in two groups of 18 that were denominated group i (biofragmentable anastomosis ring) and group ii (non absorbable suture). the average age for group i was 36 years and for group ii was 42. the most frequent surgical indication in both groups was reconstruction of the intestinal flow after colostomy. all patients were submitted to biochemical blood tests, nutritional and surgical risk evaluation. the statistical analysis used for comparison between groups demonstrated that they were homogeneous. results: comparative analysis of the intraoperative period parameters revealed that the anastomosis with biofragmentable anastomosis ring is faster ant there are no significant differences regarding intraoperative complications rate, period of ileus, time to reintroduce the oral diet, mortality and long term folloow-up. the incidence of anastomotic leak was higher in the group i . the endoscopic analysis demonstrate no difference because there was the same results for both groups . there was a significant higher incidence of exposed suture in suture anastomosis when compared to biofragmentable anastomosis ring. conclusions: it can be concluded that the biofragmentabl
Marcadores tumorais no cancer colorretal
Fernandes, Luís César;Matos, Delcio;
Revista do Colégio Brasileiro de Cirurgi?es , 2002, DOI: 10.1590/S0100-69912002000200009
Abstract: colorectal cancer is a clinical entity of a persistent relevance in clinical practice and its early diagnosis is a determinant factor to obtain better therapeutic results. tumor markers are helpful means for a better approach to individuals with such neoplasm. in the present review, the authors analyze the phases in which surgical-clinical treatment markers must be used: diagnosis, determination of tumor stage, establishment of prognosis and detection of recurrence. current and future markers and the consensus on their use are discussed. causal factors for errors in diagnosis with markers and perspectives of use are also presented.
A Filosofia e seu ensino a partir de uma perspectiva da teoria crítica
Tesser, Gelson Jo?o;Horn, Geraldo Balduíno;Junkes, Delcio;
Educar em Revista , 2012, DOI: 10.1590/S0104-40602012000400009
Abstract: this paper analyzes two central theoretical assumptions regarded in the practice of teaching and learning philosophy: communicative action in habermas and thinking as a way of resistance in adorno. philosophy and its teaching are developed from habermas's theory of communicative action which provides us with a theoretical basis for reflection and critical education. in the adornian perspective, the social function of education is intrinsically linked to the critique of the bourgeois society and, therefore, the cultural industry. adorno seeks to show that formal education has a strong power of resistance against the chaotic path of civilization. bringing this adornian sense of resistance to the practice of philosophy teaching is the purpose proposed here. teaching philosophy does not consist of accepting the political, institutional and social enforcements as natural. the task of critical theory - as teaching philosophy -, has a dimension that refers to the pursuit of autonomy by the individual and his social emancipation.
Risk factors for indications of intraoperative blood transfusion among patients undergoing surgical treatment for colorectal adenocarcinoma
Gon?alves, Iara;Linhares, Marcelo;Bordin, Jose;Matos, Delcio;
Arquivos de Gastroenterologia , 2009, DOI: 10.1590/S0004-28032009000300009
Abstract: context: identification of risk factors for requiring transfusions during surgery for colorectal cancer may lead to preventive actions or alternative measures, towards decreasing the use of blood components in these procedures, and also rationalization of resources use in hemotherapy services. this was a retrospective case-control study using data from 383 patients who were treated surgically for colorectal adenocarcinoma at "funda??o pio xii", in barretos-sp, brazil, between 1999 and 2003. objective: to recognize significant risk factors for requiring intraoperative blood transfusion in colorectal cancer surgical procedures. methods: univariate analyses were performed using fisher's exact test or the chi-squared test for dichotomous variables and student's t test for continuous variables, followed by multivariate analysis using multiple logistic regression. results: in the univariate analyses, height (p = 0.06), glycemia (p = 0.05), previous abdominal or pelvic surgery (p = 0.031), abdominoperineal surgery (p<0,001), extended surgery (p<0.001) and intervention with radical intent (p<0.001) were considered significant. in the multivariate analysis using logistic regression, intervention with radical intent (or = 10.249, p<0.001, 95% ci = 3.071-34.212) and abdominoperineal amputation (or = 3.096, p = 0.04, 95% ci = 1.445-6.623) were considered to be independently significant. conclusion: this investigation allows the conclusion that radical intervention and the abdominoperineal procedure in the surgical treatment of colorectal adenocarcinoma are risk factors for requiring intraoperative blood transfusion.
Avalia??o dos efeitos da circula??o extracorpórea na forma??o de cálculos biliares
Costa, Sergio Renato Pais;Goldenberg, Alberto;Matos, Delcio;Buffolo, Enio;
Revista Brasileira de Cirurgia Cardiovascular , 2006, DOI: 10.1590/S0102-76382006000100010
Abstract: objective: the objective of the present study was to clarify the relationship between cardiopulmonary bypass with the use of a heart-lung machine and gallstones in a short-term follow-up. method: a total of 135 patients with ischaemic heart disease were included in this study. all were followed up by the cardiology department of hospital s?o paulo, federal university of s?o paulo. they were divided into three groups: group 1 - 51 patients who were treated clinically; group 2 - 43 patients who underwent coronary artery grafting bypass without cardiopulmonary bypass; and group 3 - 41 patients who underwent coronary artery grafting bypass with cardiopulmonary bypass and the use of a heart-lung machine. there were no statistically significant differences between the groups in relation to gender, age, body mass index or associated diseases (p<0.05). all the patients underwent ultrasound examination 12 months after beginning their cardiological treatment (clinical treatment alone or surgical plus follow-up). results: the prevalence of gallstones in the groups was: group 1 - 7.84%, group 2 - 11.62%, and group 3 - 19.51%. there was no statistically significant differences between the groups (p = 0.248). conclusion: it was concluded that cardiopulmonary bypass does not appear to have a close relationship with gallstone formation one year after coronary artery bypass grafting. however, long-term follow-up is advisable.
Identifica??o do papilomavírus humano em doentes com carcinoma de células escamosas do canal anal e sua rela??o com o grau de diferencia??o celular e estadiamento
Soares, Paulo Cardoso;Ferreira, Silvaneide;Villa, Luisa Lina;Matos, Delcio;
Revista Brasileira de Coloproctologia , 2011, DOI: 10.1590/S0101-98802011000100002
Abstract: objective: to identify the most predominant types of human papillomavirus (hpv) in carriers of the anal canal carcinoma (acc), relating them to the cell differentiation and lesion staging degree, in patients from belém, pará, brazil, between 1998 and 2000. methods: a case-control study was conducted with 75 patients, divided into test group, with 33 carriers of the anal canal carcinoma, and control group, with 42 carriers of non-neoplastic diseases of the anal canal. the methods employed to identify the viral types were the polymerase chain reaction and the dot blot. the fisher's exact test was used to assess the hpv occurrence. the distribution of hpv types was analyzed by 3x2 contingency tables, representing the distribution of hpv types. for hypothesis testing, the significance level α=0.05 was previously established for rejection of the null hypothesis. results: hpv was significantly prevalent (p=0.0027) in the test (60.6%) and control groups (26.2%) (p=0.0027). the most prevalent viral types were hpv 16 (42.4%) and 18 (15.2%). significant differences related to the prevalence of hpv 16 and 18 were verified between both groups (p=0.027 and p=0.043, respectively). in the control group, hpv 16 was found in 19.0%, whereas hpv 18 was observed in 2.4%. in the test group, we evaluated the distribution of hpv types according to the staging and degree of cell differentiation, and found no significant differences between the results of the different groups. conclusion: squamous cell carcinoma of the anal canal is associated with the hpv presence, and the 16 and 18 types are the most frequently found
Diagnóstico e tratamento de tumores carcinóides do trato digestivo
Revista da Associa??o Médica Brasileira , 2002, DOI: 10.1590/S0104-42302002000100038
Abstract: the authors analyzed the characteristics of carcinoid tumors according to their site in the digestive tract. despite their low speed of growing and metastasis process, such neoplasias are malignant and must be submitted to surgical resection. advanced cases with metastases are treated with somatostatin derivatives, lessening symptoms, causing occasional regression of lesions and presenting an extended survival. appendicular and rectal lesions have a better prognosis maybe due to the early diagnosis performed.
Hérnia de Littré
Lima Neto, Edgar Valente de;Goldenberg, Alberto;Matos, Delcio;
Revista do Colégio Brasileiro de Cirurgi?es , 2004, DOI: 10.1590/S0100-69912004000100015
Abstract: littré's hernia is an extremely rare surgical event. it is characterized by the presence of meckel's diverticulum in the hernial sack. the authors report one case of littré's hernia in a 42 year-old male who had the diagnosis accomplished in the intraoperative. the diverticulum presented no signs of complications and was treated conservatively , without exeresis.
Diagnóstico e tratamento de tumores carcinóides do trato digestivo
Revista da Associa??o Médica Brasileira , 2002,
Abstract: Os autores verificam as características dos tumores carcinóides de acordo com sua localiza o no trato digestivo. Apesar de sua baixa velocidade de crescimento e de metastatiza o, tais neoplasias s o malignas e devem ser submetidas a ressec o cirúrgica. Casos avan ados com metástases s o tratados com derivados da somatostatina, com palia o dos sintomas, ocasional regress o das les es e obten o de maior sobrevida. Les es apendiculares e retais têm melhor prognóstico, talvez pelo diagnóstico precoce efetuado.
Relationship between peripheral and mesenteric serum levels of CEA and CA 242 with staging and histopathological variables in colorectal adenocarcinoma
Cardoso, Mauro Lamelas;Fernandes, Luís Cesar;Kim, Su Bong;Matos, Delcio;
Acta Cirurgica Brasileira , 2009, DOI: 10.1590/S0102-86502009000500012
Abstract: purpose: to compare histopathological variables and staging in colorectal adenocarcinoma cases with cea and ca 242 in peripheral and mesenteric blood. methods: in 169 individuals underwent surgery for colorectal cancer, cea and ca 242 were analyzed and compared to mesenteric and peripheral blood and correlated with macroscopic tumor's morphology and size, degree of cell differentiation, venous, neural and lymphatic involvement and tnm classification. results: there was a difference between the mesenteric (m) and peripheral (p) serum levels of cea (p=0.020). higher levels of markers were correlated with venous invasion cea (p) p=0.013, cea (m) p=0.05, ca 242 (m) p=0.005 and ca 242 (p) p=0.038; with advanced staging cea (p) < cea (m) (p < 0.05); ca 242 (p) < ca 242 (m) (p < 0.05); and with greater dimensions cea (p) < cea (m) (p < 0.001); ca 242 (p) < ca 242 (m) (p < 0.001). ca 242 became higher with neural invasion (p): p=0.014, (m): p=0.003). conclusions: there were higher mesenteric than peripheral levels of cea. both mesenteric and peripheral levels of cea and ca 242 were higher in neoplasm with venous involvement, greater diameter and advanced stages. there was a correlation between ca 242 and neural invasion.
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