Subject(s)
Gallbladder Neoplasms/surgery , Laparoscopy/methods , Robotic Surgical Procedures/methods , Adult , Cholecystectomy , Female , Humans , Male , Middle AgedABSTRACT
Laparoscopy is considered the gold standard approach to perform left lateral sectionectomy (LLS). Furthermore, laparoscopy for cirrhotic patients can reduce intraoperative bleeding and postoperative morbidity when compared to open surgery. Although robotic surgery is feasible for both minor and major liver resections, it remains a work in progress and only few series reported this approach for cirrhotic patients. We reported two cases of 62-year-old men, both with hepatitis C virus and alcoholic cirrhosis, but with compensated liver functions (MELD 9-10 and Child-Pugh A5-A6). The patients were diagnosed with a single lesion in the left lobe. Robotic LLS was performed using intraoperative ultrasound to confirm findings of pre-operative image, and linear staplers were used to control left lobe inflow and outflow. The specimens were removed through Pfannenstiel incision in both patients. Both procedures followed the same standardization. The total operative time was 250 and 151 min with estimated blood loss of 100 and 70 ml, respectively, for cases 1 and 2. The procedures were made without Pringle maneuver and postoperative course was uneventful with hospital discharge at third and fourth postoperative day, respectively. The pathology examination confirmed a 2.5- and 4.5-cm hepatocellular carcinoma, respectively; both presented negative margins and cirrhosis. Robotic LLS seems to be as feasible as conventional laparoscopic approach as a stepwise procedure in a robotic learning curve for liver resection. Its benefits can also be offered to selected cirrhotic patients.
Subject(s)
Hepatectomy/methods , Hepatitis C/surgery , Liver Cirrhosis, Alcoholic/surgery , Minimally Invasive Surgical Procedures/methods , Robotic Surgical Procedures/methods , Humans , Liver/surgery , Male , Middle AgedABSTRACT
The Maternal Mortality Ratio (MMR) is an indicator that analyses the life conditions and care given to pregnant women, and indicates whether the constitutional rights related to life and health are being complied with. This study shows losses of lives among adolescent women associated with pregnancy, childbirth and the puerperal period, in the state of Santa Catarina between 1994 and 2005. It is an exploratory study of a quantitative nature. There were 72 maternal deaths in adolescents, 67% had a direct obstetric cause, 23% had an indirect obstetric cause and about 9% were classified as accidental or incidental. The Maternal Mortality Ratio in adolescents was high and most could have been prevented and its causes controlled. The identified situation shows an absence of quality health care. To reduce these deaths it is central that nursing action be combined with other professionals and other organized sectors of society.
Subject(s)
Maternal Mortality/trends , Pregnancy in Adolescence/statistics & numerical data , Adolescent , Brazil , Female , Humans , PregnancyABSTRACT
A razão da mortalidade materna é um indicador para análise das condições de vida e de assistência prestada à mulher, e instrumento para avaliar o cumprimento dos direitos constitucionais relativos à vida e à saúde. Esta pesquisa demonstra a vida perdida de mulheres adolescentes associadas à gestação, parto e puerpéreo, em Santa Catarina, no período de 1994-2005. Trata-se de um estudo exploratório quantitativo. Encontrou-se no período 72 mortes maternas em adolescentes, sendo que 67 por cento foram obstétrica direta, 23 por cento obstétrica indireta e 9 por cento acidentais e incidentais. A razão da mortalidade materna entre adolescentes foi elevada e a maioria dos óbitos poderia ter sido evitada, pois existem recursos técnicos para prevenir e controlar suas causas. A situação identificada demonstra a ausência de assistência de qualidade. Para reduzir estas mortes é fundamental o cuidado de enfermagem, numa ação articulada com outros profissionais e diferentes segmentos organizados da sociedade.
The Maternal Mortality Ratio (MMR) is an indicator that analyses the life conditions and care given to pregnant women, and indicates whether the constitutional rights related to life and health are being complied with. This study shows losses of lives among adolescent women associated with pregnancy, childbirth and the puerperal period, in the state of Santa Catarina between 1994 and 2005. It is an exploratory study of a quantitative nature. There were 72 maternal deaths in adolescents, 67 percent had a direct obstetric cause, 23 percent had an indirect obstetric cause and about 9 percent were classified as accidental or incidental. The Maternal Mortality Ratio in adolescents was high and most could have been prevented and its causes controlled. The identified situation shows an absence of quality health care. To reduce these deaths it is central that nursing action be combined with other professionals and other organized sectors of society.
La Tasa de Mortalidad Materna (MMR, según siglas en inglés) es un indicador para el análisis de las condiciones de vida y cuidados prestados a la mujer, y sirve como instrumento para evaluar el cumplimiento de los derechos constitucionales relacionados con la vida y la salud. Esta investigación analiza las defunciones de mujeres adolescentes por causas asociadas a la gestación, parto y puerperio, en el Estado de Santa Catarina (Brasil) durante el período 1994-2005. Se trata de un estudio exploratorio de naturaleza cuantitativa. Se detectaron en dicho periodo 72 muertes maternas en adolescentes, siendo 67 por ciento del tipo obstétricas directas, 23 por ciento obstétricas indirectas y 9 por ciento accidentales e incidentales. La Tasa de Mortalidad Materna entre adolescentes presentó valores elevados y la mayoría de las muertes podría haber sido evitada, siendo que existen recursos técnicos para prevenir y controlar las causas determinadas. Para reducir estas muertes, la atención de enfermería es fundamental, en acciones coordinadas con otros profesionales y diferentes segmentos organizados de la sociedad.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Maternal Mortality/trends , Pregnancy in Adolescence/statistics & numerical data , BrazilABSTRACT
A mortalidade materna associada ao aborto revela as condições sociais da mulher. Este estudo, exploratório-descritivo, tem o objetivo de identificar o perfil das mulheres que tiveram morte associada ao aborto no Estado de Santa Catarina, no período de 1996 a 2005. As fontes para a coleta dos dados foram: o Sistema de Informações sobre Mortalidade e o Sistema de Informações sobre os Nascidos Vivos, do Ministério da Saúde do Brasil. Foram encontradas 31 mortes maternas associadas aoaborto; destas, 51,61% ocorreram em mulheres casadas; 38,71% das mulheres tinham de 1 a 8 anos de escolaridade, e para 48,39% o grau de instrução foi registrado como ignorado. Os dois valores mais elevados da razão de mortalidade materna foram encontrados na Região Oeste, 5,148, e na Região Norte, 4,761.
The Maternal Mortality associated with abortion reveals woman social conditions in life. The goal of this exploratory and descriptive study is to identify the profile of women who havehad death associated with abortion in the Santa Catarina State during the period of 1996 to 2005. The source of data collection was the Information System on Mortality and the InformationSystem of Live Newborns from the Brazilian Ministry of Health. The authors analyzed 31 maternal deaths associated to abortion, 51.61% was married women; 38.71% had between one to 8years of study and 48.39 % had a level of schooling ignored. The West and the North Region of Santa Catarina State were the regions in which the Maternal Mortality Ratio (MMR) was higher,5.148 and 4.761 respectively.
La mortalidad materna asociada al abor to revela las condiciones sociales de la mujer. El objetivo de este estudioexploratorio descriptivo es identificar el perfil de la mujer con muerte asociada al aborto en el estado de Santa Catarina, en el período de 1996 hasta 2005. Las fuentes para la colecta de los datos fueron el Sistema de Informaciones sobre Mortalidad y el Sistema de Informaciones sobre los Nacidos Vivos, del Ministerio de la Salud de Brasil. Fueron analizadas 31 muertesmaternas asociadas al aborto, de estas 51,61% ocurrieron en mujeres casadas; 38,71% tenían de 1 a 8 años deescolaridad, y 48,39% grado de instrucción ignorado. En la región Oeste del estado fue observada la razón de mortalidad materna de 5,148, seguida de la Región Norte con 4,761.
