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Search Results: 1 - 10 of 72891 matches for " Luiz Carlos Von Bahten "
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Manuseio da síndrome compartimental abdominal em unidade de tratamento intensivo
Von Bahten, Luiz Carlos;Guimar?es, Paulo de Souza Fonseca;
Revista do Colégio Brasileiro de Cirurgi?es , 2006, DOI: 10.1590/S0100-69912006000300004
Abstract: abdominal compartment syndrome (acs) is attributed to acute increase in the intra-abdominal pressure (iap), leading to adverse physiologic alterations because of involving the main organic systems and can lead to organic failure and obit. background: the purpose of this work is to evaluate the intra-abdominal hypertension (iah) and acs conduct in patients submitted to intensive care unit (icu). methods: in this retrospective work were analysed 548 patients submitted to laparotomy and icu, during the period from 1997, january to 2001, march. results: acs was noted in 29 patients (5.29%). analysing the maximum iap value, 9 (31.03%) were grade ii, 10 (34.48%) were grade iii and 10 were grade iv. eighteen (62.07%) were submitted to reoperation and temporary closure was used in 6 (20.69%). the global mortality was 68.97%, the acs grade ii mortality was 55.56%, the acs grade iii was 50%, the acs grade iv was 100%. the reoperad patients mortality was 61.11%. conclusion: the acs has a elevated mortality in spite of early reoperation and adequate management in icu, and we need to identify this problem in a precocius way without delaying preventive actions.
Perda de calor determinada pela exposi??o das al?as intestinais em ratos
Bahten, Luiz Carlos Von;Mantovani, Mario;Nicoluzzi, Jo?o Eduardo Leal;Silveira, Fábio;Bahten, Aline Cadena Von;
Revista do Colégio Brasileiro de Cirurgi?es , 2006, DOI: 10.1590/S0100-69912006000500002
Abstract: background: this study has the intent to quantify the caloric energy loss that occurs when a laparotomy is done and the bowel is exposed to room temperature in rats; to find the thermodynamic loss measured in watt/m2 over the rat peritoneal area exposed and discuss ways to manage that heat loss. methods: this research project used 30 male rats, wistar, separated in 5 groups of 6 animals, from 8 to 9 weeks old and weighting between 200 to 220g. group a animals, the control group, received inhalation general anesthesia only. group b rats were submitted to a median laparotomy with bowel loops exposure to open room temperature. groups c, d and e rats were subjected to median laparotomy with bowel loops exposure to open room temperature and treated with wet sponge, dry sponge and polyester film packing, respectively. results: the result showed there is a significant 620,72 kj/m2 heat energy loss with laparotomy procedures and bowel loops exposure to room temperature in a non-monitored environment. the thermodynamic loss analysis showed, due to rat exposed body surface, there was a 382,97 w/m2 heat loss. conclusion: different types of treatment assessments used in this research showed the most effective method for maintaining heat was the polyester film use (pvc), when compared to t wet sponge and/or dry sponge methods, respectively.
Influência da técnica de anestesia no tempo de ocupa??o de sala cirúrgica nas opera??es anorretais
Kotze, Paulo Gustavo;Tambara, Elizabeth Milla;Von Bahten, Luiz Carlos;Silveira, Fábio;Wietzikoski, Eduardo;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000200012
Abstract: introduction: around ninety percent of anorectal surgical procedures are performed as day cases. the choice of a proper anesthetic technique is important to achieve reduced time in the operating rooms, hospital stay and low costs. there is no evidence in the literature that a superior type of anesthesia for these procedures exists. objective: to compare the time spent on operating rooms in patients submitted to anorectal surgical procedures through spinal anesthesia (0,5% bupivacaine) with combined anesthesia (propofol and local perineal block with 2% lidocaine and 0,5% bupivacaine). methods: fifty patients were operated with spinal anesthesia (group one) and forty-nine patients were operated with combined anesthesia (group two). the type of anorectal procedure and the time spent on anesthetic and surgical procedures were analyzed. results: there were no significant differences between the studied groups regarding the type of operation, gender and age. the time of anesthetic and surgical procedures was 53,1 minutes in group one and 44,08 minutes in group two (p=0,034). conclusions: these anesthetic techniques had similar efficacy. there was a lower time of anesthetic and surgical procedures in the combined anesthesia group, with statistical significance.
O efeito em curto prazo do bypass gástrico sobre pacientes obesos diabéticos Short-term effect of gastric bypass in obese diabetic patients
Aluisio Stoll,Jean Carl Silva,Luiz Carlos Von Bahten,Giovana Gugelmin
Revista do Colégio Brasileiro de Cirurgi?es , 2013,
Abstract: OBJETIVO: estudar o efeito do bypass gástrico sobre a glicemia e o uso de medica o antidiabética em pacientes obesos portadores de diabetes. MéTODOS: estudo de coorte retrospectivo com 44 pacientes obesos portadores de DM2, provenientes de 469 pacientes submetidos ao bypass gástrico no período de dezembro de 2001 a mar o de 2009. Os desfechos primários avaliados foram: glicemia em jejum e a necessidade de medica o antidiabética. RESULTADOS: a popula o foi composta de dez (22,7%) homens e 34 (77,3%) mulheres, com média de idade de 45,3 (±8,23) anos e índice de massa corporal de 40,9 (±5,03) kg/m2. O tempo médio de evolu o do DM2 foi 63,6 (±60,9) meses. Dos 40 pacientes que utilizavam medica o para controle do DM2, 20 (50%) tiveram sua medica o suspensa na alta hospitalar e 13 (32,5%) até nove meses depois. Em uma paciente n o foi possível avaliar o uso de medica o, sendo essa a única exclus o. A insulina foi suspensa nos dez (100%) pacientes que a utilizavam, sendo seis (60%) na alta hospitalar. Houve redu o (P<0,05) da glicemia em jejum, em todo o período estudado, em compara o com o valor pré-operatório, e foram atingidos valores inferiores a 100mg/dl no período de sete a nove meses. CONCLUS O: Pacientes obesos portadores de DM2, submetidos ao bypass gástrico, apresentaram melhora do controle glicêmico e redu o do uso de hipoglicemiantes em curto prazo. OBJECTIVE: To study the effect of gastric bypass on blood glucose levels and the use of antidiabetic medication in obese patients with diabetes. METHODS: We carried out a retrospective cohort study with 44 obese patients with DM2, from 469 patients undergoing gastric bypass from December 2001 to March 2009. The primary endpoints evaluated were fasting glucose and the need for antidiabetic medication. RESULTS: The study population consisted of ten (22.7%) men and 34 (77.3%) women, with a mean age of 45.3 (±8.23) years and a body mass index of 40.9 (±5.03) kg/m2. The average time to progression of DM2 was 63.6 (±60.9) months. Of the 40 patients who used medication to control type 2 diabetes, 20 (50%) had their medication discontinued at discharge and 13 (32.5%), until nine months later. In one patient it was not possible to evaluate the use of medication, this being the only exception. Insulin was suspended in ten (100%) patients who used it, six (60%) at discharge. Fasting plasma glucose levels decreased throughout the study period (p <0.05) when compared with preoperative values, and values below 100mg/dl were achieved within seven to nine months. CONCLUSION: Obese patients with DM2 undergoing
Papel da laparoscopia no trauma abdominal penetrante
Von Bahten, Luiz Carlos;Smaniotto, Benjamin;Kondo, William;Vasconcelos, Cynthia Neves de;Rangel, Marlon;Laux, Gerson Luiz;
Revista do Colégio Brasileiro de Cirurgi?es , 2005, DOI: 10.1590/S0100-69912005000300005
Abstract: background: the role of laparoscopy in reducing the rate of non-therapeutic laparotomies and the morbidity in patients sustaining penetrating abdominal trauma has been widely discussed over the last years. the aim of this article is to report the initial experience from a university hospital in the laparoscopic management of penetrating abdominal traumas. methods: in a 3-year period, laparoscopy was performed in 37 patients who were hemodynamically stable and sustained penetrating abdominal trauma. medical records were reviewed and the evaluation was conducted to determine indications for laparoscopy, associated injuries, the need for exploration, lenght of hospital stay and complications. results: there were 18 (48.6%) positive and 19 (51.4%) negative diagnostic laparoscopies (dl). in patients with positive dl, 8 (44.4%) underwent exploratory laparotomy. in this group, all of them had either therapeutic laparotomy or laparotomy for better lesion identification. there were 10 (55.6%) positive dls, in whom laparotomy was not performed. four of them had their injuries repaired laparocopically, hepatorraphy (n=2) and diaphragmatic repairs (n=2). the other ones had isolated nonbleeding injuries, and nontherapeutic laparotomy was successfully avoided. patients were allowed a diet in the first postoperative day and the mean postoperative hospital stay was 3.8 days. conclusion: our initial experience confirms that laparoscopy is a good method of evaluation and treatment for penetrating trauma. the morbidity from an unnecessary laparotomy may be minimized when the procedure is well indicated, and treatment can be performed successfully in selected cases.
Infection on the meshes implantation area in the abdominal wall of rats with induced bacterial peritonitis
Sebben Geraldo Alberto,Rocha Sérgio Luiz,Von Bahten Luiz Carlos,Biondo-Sim?es Maria de Lourdes Pessole
Acta Cirurgica Brasileira , 2006,
Abstract: PURPOSE: Evaluate incidence of bacterial growth on implanted meshes in the abdominal wall of rats after to induce bacterial peritonitis. METHODS: 36 rats were used. They were allocated in two groups: group B, experiment group (n =18) and group S, control group (n =18). They were submitted to the implant of polypropylene meshes on the abdominal wall, at the preperitoneal space. Then, in the animals of the experiment group, the induction of peritonitis was made through the inoculation in the peritoneal cavity of standardized solution of Escherichia coli. In the animals of the control group it was made through the inoculation of physiologic solution. The animals of both groups were reallocated in three subgroups of six animals and observed until the reoperations time, for evaluation of the implantation sites, collection of the meshes for cultures, evaluation of the abdominal cavity and peritoneal lavage for cultures. The reoperations occurred in 24, 48 and 72 hours. RESULTS: All the animals of the experiment group presented clinical symptoms of peritonitis. The cultures of the meshes taken off from the implantation sites were positive in 83% of the animals when the moment of the evaluations was of 24 hours, decreasing to 33% in 48 hours and 17% in 72 hours. Globally, it was of 44%. In the animals of the control group there was no case of positive culture neither in the meshes, nor in the peritoneal lavages. CONCLUSIONS: The experimental model used was effective, producing 100% of peritonitis. The incidence of bacterial growth on the implanted polypropylene meshes was 83% in 24 hours, decreasing with the time.
Colecistopatia aguda e cr?nica: análise comparativa das taxas e causas de convers?o para laparotomia
Von Bahten, Luiz Carlos;Isa, Ana Cristina;Figueiredo, Pamela Concei??o;Campezato, Hugo;Isa, Rosana Hapsi;Olandoski, Márcia;
Revista do Colégio Brasileiro de Cirurgi?es , 2009, DOI: 10.1590/S0100-69912009000200008
Abstract: objectives: to analyze the rate and main causes for conversion to open surgery among acute and chronic cholecystitis. methods: a retrospective analysis of 1359 patient medical charts submitted to cholecystectomy in hospital universitário cajuru's general surgery department was done during the period from january 2000 to october 2006. results: one thousand and sixty six laparoscopic cholecystectomies were performed, 701 (65.75%) due to chronic cholecystolithiasis, 356 (33.39%) due to acute cholecystolithiasis, seven (0.65%) had gallbladder polyps and two (0.21%) cases had hydropic gallbladder. the conversion rate in acute cases was 7.86%, and in chronic cases were 2.85% (p=0.0003). the average age for conversion was 50.96 ± 17.49 years-old for acute cases and 56.45 ± 12.28 years-old for chronic cases. the operative meantime was 152.5 minutes (30 - 36) for acute and 157.5 minutes (90 - 240) for chronic cholecystolithiasis (p=0.959). the conversion reasons for chronic cholecystolithiasis were: obscure anatomy in 16 cases (80%) and adhesions in 14 cases (70%), considering that in ten cases both causes were associated. for acute presentation, conversions were due to adhesions in 13 (46.42%) patients and technical difficulties were found in 8 (28.57%) patients (p=0.008). conclusion: the rate for conversion of laparoscopic cholecystectomy to open surgery is higher in acute cholecystolithiasis when in comparison to chronic ones. both, the presence of adhesions in acute cases, and difficult anatomy identification in chronic cases, were the most common reasons to impair the laparoscopic procedures performance in our department.
Trauma hepático: análise do tratamento com bal?o intra-hepático em um hospital universitário de Curitiba
Smaniotto, Benjamin;Bahten, Luiz Carlos Von;Nogueira Filho, Dorivam Celso;Tano, Agajanian Lumi;Thomaz Junior, Laertes;Fayad, Omar;
Revista do Colégio Brasileiro de Cirurgi?es , 2009, DOI: 10.1590/S0100-69912009000300007
Abstract: objective: the authors discuss the surgical strategies in the management of complex penetrating hepatic lesions through liver balloon tamponade. methods: eighteen patients who received care in a trauma referral center in southern brazil over the last 5 years were selected retrospectively. data and variables evaluated were age, sex, hepatic injury grade and location, amount of saline solution filling the balloon and the length of time it was kept in place, associated injuries, the nutritional therapy instituted, hem concentrate transfusion, complications, antibiotics use, icu need and length of hospital stay. results: all patients were male with an average age of 22.5 years (18-48). gunshot wounds were more prevalent than stab wounds and their most common locations were the thorax and thoraco-abdominal regions. the m most commonly associated injury was in the diaphragm, and couinaud segment viii was the most often injured hepatic region (29.6%). seven patients (38.9%) survived and the most common complication were biliary fistulae (42.8%). from the eleven deceased patients (61.1%), 6 died on the day of admission, 3 stayed for 18.6 days in hospital and the others died on the 2nd and 3rd postoperative days. conclusion: transfixing hepatic lesions are usually difficult to manage and carry high morbidity and mortality rates. the use of intrahepatic balloon tamponade can be useful as a therapeutic tool, but not rid of complications, and for that reason it has specific and selected indications.
Fatores prognósticos em pacientes submetidos à cirurgia por trauma pancreático
Von Bahten, Luiz Carlos;Smaniotto, Benjamin;Kondo, William;Tsunoda, Audrey Tieko;Lima, Thienes Maria da Costa;Garcia, Mariana Jorge;
Revista do Colégio Brasileiro de Cirurgi?es , 2004, DOI: 10.1590/S0100-69912004000500011
Abstract: background: traumatic lesions of the pancreas following blunt or penetrating abdominal trauma are infrequent. the aim of this retrospective study on traumatic pancreatic injuries was to assess the experience of an academic center and to report prognostic factors and surgical treatment. methods: patients with pancreatic injuries were identified during a 9-year period from the registries of a level i trauma center and medical records were reviewed. parameters analyzed were mechanism of injury, presence of shock, degree of injury, trauma score, operative management, outcome, morbidity and mortality. results: eighty-nine patients sustaining pancreatic injuries were identified and diagnosis was made during laparotomy in all cases. penetrating abdominal trauma was observed in 67.4% of the cases. using the organ injury scale, grade ii and iii wounds were more common and management was defined according to the degree and site of injury. mortality was 21.3% and it was significantly higher in patients presenting shock on admission, pancreatic injury grades iv and v and higher injury severity score (iss). conclusion: pancreatic injury is a rare but deadly phenomenon and mortality rate is related to the presence of shock on admission, degree of pancreatic injury and trauma scores.
Infection on the meshes implantation area in the abdominal wall of rats with induced bacterial peritonitis
Sebben, Geraldo Alberto;Rocha, Sérgio Luiz;Von Bahten, Luiz Carlos;Biondo-Sim?es, Maria de Lourdes Pessole;Ramos, Fernando Henrique Azevedo;Pilonetto, Marcelo;Zonatto, Luciana Munhoz;
Acta Cirurgica Brasileira , 2006, DOI: 10.1590/S0102-86502006000300007
Abstract: purpose: evaluate incidence of bacterial growth on implanted meshes in the abdominal wall of rats after to induce bacterial peritonitis. methods: 36 rats were used. they were allocated in two groups: group b, experiment group (n =18) and group s, control group (n =18). they were submitted to the implant of polypropylene meshes on the abdominal wall, at the preperitoneal space. then, in the animals of the experiment group, the induction of peritonitis was made through the inoculation in the peritoneal cavity of standardized solution of escherichia coli. in the animals of the control group it was made through the inoculation of physiologic solution. the animals of both groups were reallocated in three subgroups of six animals and observed until the reoperations time, for evaluation of the implantation sites, collection of the meshes for cultures, evaluation of the abdominal cavity and peritoneal lavage for cultures. the reoperations occurred in 24, 48 and 72 hours. results: all the animals of the experiment group presented clinical symptoms of peritonitis. the cultures of the meshes taken off from the implantation sites were positive in 83% of the animals when the moment of the evaluations was of 24 hours, decreasing to 33% in 48 hours and 17% in 72 hours. globally, it was of 44%. in the animals of the control group there was no case of positive culture neither in the meshes, nor in the peritoneal lavages. conclusions: the experimental model used was effective, producing 100% of peritonitis. the incidence of bacterial growth on the implanted polypropylene meshes was 83% in 24 hours, decreasing with the time.
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