ABSTRACT
ABSTRACT Objective: To demonstrate the standardization of deep endometriosis surgery with intestinal involvement. Methods: Prospective study evaluating 74 women undergoing standardized surgery for deep intestinal endometriosis. Divided into two groups, according to the findings of three-dimensional anorectal ultrasound, Group I with lesions affecting perirectal fat and Group II with lesions affecting at least the muscular layer of the rectum. Results: There was no statistically significant difference between the groups in relation to the size of the focus and the distance of the lesion to the puborectalis muscle (p > 0.05). The type of surgery performed was laparoscopy without lesions in one patient (1.35%), disk resection in 13 patients (17.56%), shaving in 45 patients (60.81%), and rectosigmoidectomy in 15 patients (20.27%). The complications were bleeding from the drain with conservative treatment in three patients (4.05%), fistula in two patients submitted to the shaving method (2.70%), and three patients (4.05%) with lower anterior recession syndrome (LARS), with improvement from conservative treatment. Lesions in other organs were also observed during videolaparoscopy. Conclusion: Surgical standardization is important to guide the general/colorectal surgeon in the effective approach of intestinal endometriosis.
RESUMO Objetivo: Demonstrar a padronização da cirurgia de endometriose profunda com acometimento intestinal. Métodos: Estudo prospectivo que avaliou 74 mulheres submetidas à cirurgia padronizada para endometriose profunda intestinal. Divididas em dois grupos, segundo os achados da ultrassonografia anorretal tridimensional, o Grupo I com lesões acometendo a gordura perirretal e o Grupo II com lesões acometendo, pelo menos, a camada muscular própria do reto. Resultados: Não houve diferença estatisticamente significativa entre os grupos em relação ao tamanho do foco e à distância da lesão ao músculo puborretal (p > 0,05). O tipo de cirurgia realizada foi laparoscopia sem achados da lesão em um paciente (1,35%), ressecção em disco em 13 pacientes (17,56%), Shaving em 45 pacientes (60,81%) e retossigmoidectomia em 15 pacientes (20,27%). As complicações encontradas foram sangramento pelo dreno com tratamento conservador em 3 pacientes (4,05%), fístula em 2 pacientes submetidas ao método de shaving (2,70%), 3 pacientes (4,05%) com Síndrome da Ressecção Anterior do Reto (LARS), com melhora ao tratamento conservador. Lesões em outros órgãos também foram observadas durante a videolaparoscopia. Conclusão: A padronização cirúrgica é importante para orientar o cirurgião geral/colorretal na abordagem eficaz na endometriose intestinal.
Subject(s)
Humans , Female , Adult , Middle Aged , Laparoscopy , Endometriosis/surgery , Quality of Life , Colorectal SurgeryABSTRACT
Abstract Human scabies affects all social classes and different races around the world. It is highly contagious, but the exact figures on its prevalence are unknown. A 19-year-old male patient was admitted to the emergency room reporting fever (38°C) and multiple lesions throughout the body, except face, soles, and palms. Lesions were non-pruritic, which hampered the initial diagnostic suspicion. Skin biopsy was performed, and the final diagnosis was crusted scabies (Norwegian). It was concluded that human scabies is a significant epidemic disease, due to its different clinical manifestations, and because it is extremely contagious.