Good Postoperative Evolution Research Articles

Gastrointestinal Involvement in Pediatric Polyarteritis Nodosa

Gastrointestinal Involvement in Pediatric Polyarteritis Nodosa

Renal cell carcinoma with thrombus in the inferior vena cava: extracorporeal circulation and deep hypothermia without open-chest surgery

Renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. Over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, Wilms' tumor, as well as renal cell carcinoma. A 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. The patient presented good post-operative evolution.

Transección traumática aguda de la aorta torácica: Tratamiento endovascular

Traumatic rupture of the aorta has a near 80% mortality. Most patients die on the site of the accident. Conventional surgical repair of these lesions has a high morbidity and mortality, generally associated to the severity of associated lesions. Over the last decade, endovascular treatment has become an effective therapeutic alternative. We report a 40 years old male, that suffered a traumatic rupture of the descending thoracic aorta in a car accident. A successful endovascular repair was performed, installing an endoprothesis on the site of the lesion, using a femoral artery approach. The patient had a good postoperative evolution and was discharged from the hospital once complete rehabilitation of his associated lesions was obtained.

Ulcerative colitis and cancer

We present two cases of ulcerative colitis complicated with rectum carcinoma, after ten years of the beginning of the illness. The author present 50 cases of ulcerative colitis treated in Bahía Blanca, Buenos Aires, Argentina between 1958 and 1986. In two of these cases we found the cancer localized in rectum (4%). The first was a 62 years old man, to have had a good post operative evolution with Miles operation. The second was a 56 years old woman who had a bad evolution with proctocolectomy and ileostomy, surviving 4 years with multiple metastasis. We recommend to perform an efficient control of the patients with more than ten years of evolution of the disease with colonoscopy and biopsies of mucosal of the colon and rectum, and C.E.A. echography, etc. We think that the technique of ileoanal-anastomosis with ileal reservoir is the best current method for the treatment of the cases of ulcerative colitis and cancer.

Gravidez e Tumor Filodes Bilateral: Uma Associação Rara

E apresentado um caso de tumor filodes bilateral benigno diagnosticado durante a gravidez, que apresentou crescimento rapido, atingindo grandes dimensoes. O tratamento foi mastectomia bilateral total na 20a semana de gestacao. Houve boa evolucao pos-operatoria e o parto ocorreu na 40a semana, com recem-nascido vivo do sexo masculino. Sao discutidos os achados clinicos e anatomopatologicos e a evolucao de gravidez.

Tratamento cirúrgico da ectasia ânulo-aórtica com interposição de tubo sintético e conservação da valva aórtica

A ectasia ânulo-aórtica é lesão cujo tratamento preferencial compreende a substiuição da aorta ascendente dilatada por tubo sintético, acompanhada da substituição da valva aórtica. Essa substituição geralmente ocorre pela disfunção da valva graças à dilatação do anel e a prótese empregada nesses casos e, preferencialmente, mecânica. Dentre os vários autores empenhados na resolução dessa lesão, Cabrol vem contribuindo com inovações nesse campo. Os autores relatam sua experiência de dois pacientes do sexo masculino (34 e 62 anos), operados para correção de ectasia ânulo-aórtica, sendo o primeiro portador de síndrome de Marfan e dissecção aórtica crônica associada. A técnica cirúrgica empregada constou da substituição da aorta ascendente por tubo de "Dacron double velour". A valva aórtica foi preservada realizando-se, inicialmente, a ressecção das paredes aórticas comprometidas dos seios de Valsalva. O tubo de Dacron era implantado externamente à valva, sendo suturado abaixo do plano da valva com suspensão da valva aórtica no interior do tubo. Os ósticos coronarianos foram reimplantados no tubo, de maneira habitual. Os dois pacientes apresentaram boa evolução pós-operatória, encontrando-se assintomáticos após 45 e 120 dias de pós-operatório. Esta técnica vem se somar às outras para tratamento dessas doenças, devendo-se enfatizar a conservação da valva aórtica.

Ulcerative colitis and cancer.

We present two cases of ulcerative colitis complicated with rectum carcinoma, after ten years of the beginning of the illness. The author present 50 cases of ulcerative colitis treated in Bahía Blanca, Buenos Aires, Argentina between 1958 and 1986. In two of these cases we found the cancer localized in rectum (4%). The first was a 62 years old man, to have had a good post operative evolution with Miles operation. The second was a 56 years old woman who had a bad evolution with proctocolectomy and ileostomy, surviving 4 years with multiple metastasis. We recommend to perform an efficient control of the patients with more than ten years of evolution of the disease with colonoscopy and biopsies of mucosal of the colon and rectum, and C.E.A. echography, etc. We think that the technique of ileoanal-anastomosis with ileal reservoir is the best current method for the treatment of the cases of ulcerative colitis and cancer.