RESUMEN
ABSTRACT Objective To describe and compare the number of surgeries, mortality rate, length of hospital stay, and costs of transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia, between 2008 and 2018, in the Public Health System in São Paulo, Brazil. Methods Ecological and retrospective study using data from the informatics department of the Brazilian Public Health System database. Procedure codes were "open prostatectomy" and "transurethral resection of the prostate." The outcomes analyzed were compared between transurethral resection of the prostate and open prostatectomy according to the hospital surgical volume and presence or absence of a residency program. Results A total of 18,874 surgeries were analyzed (77% transurethral resection of the prostate) and overall mortality was not statistically different between procedures. Intermediate and high-volume centers had shorter length of hospital stay than low-volume centers for transurethral resection of the prostate (3.28, 3.02, and 6.58 days, respectively, p=0.01 and p=0.004). Length of hospital stay was also shorter for open prostatectomy in high-volume compared to low-volume centers (4.86 versus 10.76 days, p=0.036). Intrahospital mortality was inversely associated with surgical volume for transurethral resection of the prostate. Centers with residency program had shorter length of hospital stay considering open prostatectomy and less mortality regarding transurethral resection of the prostate. Open prostatectomy was 64% more expensive than transurethral resection of the prostate. Conclusion The findings suggest the importance of investing in specialized centers, which could be potential referral centers for surgical cases.
RESUMEN
O diabetes mellitus constitui afecçäo de elevada prevalência, morbidade e mortalidade em todo o mundo. O diabetes mellitus representa atualmente a terceira doença mais comum e a oitava causa de morte nos Estados Unidos. Esta doença acomete cerca de 5 por cento da populaçäo geral naquele pais e aproximadamente 15 por cento destes pacientes representam diabetes insulino-depedente (diabetes mellitus tipo 1, forma juvenil da doença), numeros estes semelhantes no Brasil...
Asunto(s)
Humanos , Trasplante de Riñón , Diabetes Mellitus/complicaciones , Trasplante de Páncreas/métodos , Procedimientos Quirúrgicos Operativos , Terapia de Inmunosupresión/métodosRESUMEN
Os autores apresentam um caso de paciente com feocromocitoma, interna no hospital com diagnóstico de síndrome hipertensiva e tumor de supra-renal, abordando aspectos dos exames laboratoriais e de imagem, do preparo operatório e do tratamento cirúrgico. Uma discusäo atual é apresentada sobre estes aspectos, ressaltando a importância do plano cirúrgico em tumor grande como o do presente caso; além de um resumo sobre os critérios atuais de determinaçäo de malignidade do feocromocitoma e seu prognóstico a longo prazo