[Body temperature variations during laparoscopic cholecystectomies]. / Variaciones de la temperatura corporal en el curso de colecistectomías laparoscópicas.

OBJECTIVE: To study changes over time in body temperature related to insufflation of CO2. PATIENTS AND METHOD: Fifty patients were randomly assigned to 2 groups of 25 to undergo cholecystectomy by either laparoscopy or laparotomy. Total intravenous anesthesia with propofol, pancuronium and fentanyl was used in both groups. Ventilation was maintained at 0.5 FiO2. Central temperature was continuously measured by a distal esophageal thermometer and results were recorded every 10 minutes in both groups. All operations lasted approximately 80 min. RESULTS: We found that temperature gradually decreased over time in both groups. In the laparotomy group the decrease reached 0.20 degree C (SD 0.03) at 80 min. During laparoscopy the temperature decrease was 0.43 degree C (SD 0.04) for the same time period. The differences were statistically significant. We observed no pathophysiologic repercussions associated with these results. CONCLUSIONS: Laparoscopic surgery, even when the abdominal cavity is not exposed to room air, induces a loss of temperature that is greater than that of laparotomy, because of insufflation of CO2 at 4 degrees C. The decrease was 0.4 degree C for every 50 l of CO2 insufflated during the study.

Rhabdomyosarcoma of the ovary: ultrastructural study of a case and review of literature.

Pure rhabdomyosarcomas are extremely rare and lethal primary neoplasms of the ovary. The available literature revealed 14 such cases. This report describes the light and electron microscopic findings of another case. At the electron microscopic level, rhabdomyogenesis recapitulates skeletal muscle differentiation during early fetal life. Rhabdomyoblasts in the ovary may arise from either the uncommitted stromal fibroblasts or from fibroblasts of endometriotic stroma. The age of patients at diagnosis ranged between 13 months and 86 years with 60% of women aged 40 years and older. About 50% of the cases were diagnosed with disease beyond the ovary, and survival ranged between 18 days and 15 months after diagnosis. Aggressive combination therapy including surgery, radiation, and chemotherapy appears to be the only hope for improved survival.

Ovarian Sertoli-Leydig cell tumor with rhabdomyosarcoma: an ultrastructural study.

The clinical and light and electron microscopic findings of a moderately differentiated, virilizing, Sertoli-Leydig cell tumor (SLT) with pleomorphic rhabdomyosarcoma of the ovary are presented. The tumor recapitulates the primitive embryonal testis and rhabdomyogenesis, respectively. The natural history, including pathogenesis, of this peculiar and rare tumor is discussed in the light of the pertinent literature on SLT and ovarian rhabdomyosarcoma. It seems that when rhabdomyosarcoma is a significant or predominant component of SLT, as occurred in this case, the prognosis is poor and is that of rhabdomyosarcoma in general.