ABSTRACT
ABSTRACT Objective To evaluate post-operative complications of circumcision requiring surgical reintervention. Methods Retrospective analysis of medical records of patients submitted to circumcision from May 1st, 2015 to May 31st, 2016. Results A total of 2,441 circumcisions were performed; in that, 1,940 using Plastibell and 501 by the classic technique. Complications requiring surgical reintervention were found in 3.27% of patients. When separated by surgical technique, 3.4% of circumcisions using Plastibell device required reoperation, as compared to 3% of conventional technique (p=0.79). Preputial stenosis was most frequently found in classic circumcision, with statistical significance (p<0.001). Bleeding was more frequent when using Plastibell device, but the difference was not statistically different (p=0.37). Patients' age was also evaluated to investigate if this variable influenced on the postoperative outcome, but no significant difference was found. Conclusion There was no statistically significant difference when comparing complications between the different techniques performed at this hospital. Preputial stenosis was most frequently found in the classic circumcision, while bleeding was more prevalent when using Plastibell device. Patients' age did not influence in complications.
RESUMO Objetivo Avaliar as complicações pós-operatórias de postectomia que necessitaram de reintervenção cirúrgica. Métodos Estudo retrospectivo com análise de prontuários de pacientes submetidos à postectomia entre 1o de maio de 2015 a 31 de Maio de 2016. Resultados Foram realizadas 2.441 postectomias no período, sendo 501 utilizando a técnica clássica e 1.940 utilizando o dispositivo Plastibell. Apresentaram complicações que necessitaram reintervenção cirúrgica 3,27% dos pacientes. Quando separados por técnica operatória, 3,4% das postectomias com Plastibell foram reoperadas, comparando com 3% das postectomias convencionais (p=0,79). A estenose de prepúcio foi mais frequentemente encontrada na técnica clássica, com significância estatística (p<0,001). Sangramento foi mais frequente nos casos com uso do Plastibell, porém sem diferença significativa (p=0,37). A idade dos pacientes também foi avaliada para investigar se esta variável influenciou na taxa de complicações pós-operatórias, porém não houve diferença significativa. Conclusão Não houve diferença estatisticamente significativa quando comparadas as complicações entre as diferentes técnicas cirúrgicas utilizadas neste serviço. A estenose de prepúcio foi mais frequentemente encontrada nos pacientes operados pela técnica convencional enquanto demonstrou-se tendência a maior sangramento com uso do Plastibell. A idade dos pacientes não influenciou na presença de complicações.
Subject(s)
Humans , Male , Child, Preschool , Child , Adolescent , Postoperative Complications/surgery , Reoperation , Circumcision, Male/adverse effects , Paraphimosis/surgery , Paraphimosis/etiology , Penis/surgery , Postoperative Complications/etiology , Retrospective Studies , Age Factors , Circumcision, Male/instrumentation , Treatment Outcome , Constriction, Pathologic , Hematoma/etiologyABSTRACT
Papiloma urotelial é raro em pacientes na infância, sendo mais comum em pacientes na sua sexta ou sétima década de vida. Comumente é indolor, sendo os sinais mais frequentes: hematúria, sintomas irritativos durante a micção, retenção urinária. O diagnóstico é realizado a partir de cistoscopia e anatomopatologia. No caso L.A.V, masculino, 10 anos, chegou ao pronto-socorro com dor de baixo-ventre, de forte intensidade, tipo cólica, não apresentando outros sintomas associados. Realizou-se um ultrassom de abdome, que evidenciou uma lesão sólida única, vegetante em base medindo 15 milímetros, lobulada e bem delimitada. O parcial de urina foi negativo para hematúria. Depois de realizada uma cistoscopia com retirada da lesão, a análise anatomopatológica diagnosticou o papiloma urotelial. O tratamento da lesão foi realizado com a sua retirada durante a cistoscopia com sucesso. Papiloma urotelial na infância tem baixa taxa de mutação e recidiva, portanto há um ótimo prognóstico para o paciente
Urothelial papilloma is rare in patients in childhood and is more common in patients in their sixth or seventh decade of life. Commonly it is painless, being the most frequent symptoms: hematuria, irritative symptoms during urination, urinary retention. The diagnosis is made from cystoscopy and pathology. In case LAV, male, 10 years, came to the emergency room with lower abdominal pain, high intensity, cramping, showing no other symptoms. We conducted an abdomen ultrasound which showed a solid lesion only vegetating in base measuring 15 mm, lobulated and well-defined. The partial urine was negative for hematuria. After a cystoscopy performed with removal of the lesion, the histopathological analysis diagnosed urothelial papilloma. The treatment of the lesion was performed with the withdrawal successfully during cystoscopy. Urothelial papilloma in childhood have low mutation rate and recurrence, so getting a good prognosis for the patient.
ABSTRACT
OBJECTIVE: Study aim was to analyze early and late effects of physical therapy in the mouth opening of patients with trismus after treatment for oral and oropharyngeal cancer. METHODS: This was an ambispective cohort study, including 29 patients with oral and oropharyngeal squamous cell carcinomas treated by surgery and/or adjuvant radiotherapy. Physical therapy including an active range of motion exercises, manual stretching and CRAC (contract-relax, antagonistcontract) technique were applied. Information about tumor, cancer treatment, physical therapy and mouth opening was obtained from the medical or physical therapy records. Assessment of mouth opening was performed at three moments: pre-physical therapy, at the end of the last session of treatment (early results) and when patients were invited for a new functional evaluation (long-term results).RESULTS: Mouth opening increased significantly in both early and long-term evaluations (p < 0.001). The initial mouth opening measurements (23.2mm) were significantly smaller than the post-physical therapy (33.9 mm) and long-term measurements (38.1 mm) (p < 0.001). Effect size was 1.0 and 1.4, related to early and late results, respectively. Surgically treated patients seem to have a better long-term response than those treated with adjuvant radiotherapy (p = 0.053). CONCLUSIONS: Mouth opening increased significantly after physical therapy in patients with trismus, and these results were sustained after therapy had been concluded. There seems to be a larger increase in mouth opening in patients treated exclusively by surgery than in patients treated with adjuvant radiotherapy