[Colonoscopy as a diagnostic and therapeutic method in large intestine diseases. Results of 1715 exams]. / Emprego da colonoscopia como método diagnóstico e terapêutico das doenças do intestino grosso. Resultados observados em 1.715 exames.

Widespread use of colonoscopy in clinical practice results from the continuous progress of the techniques developed for exam completion and from the therapeutic perspective for several colorectal conditions. This paper analyses in a retrospective basis the results associated to the employment of fibrocolonoscopy between 1984 and 1995 at Discipline of Coloproctology from the University of São Paulo School of Medicine. For this period, 1,715 exams were realized. More than 50% of the patients were between the 50th and 70th decade. Habit change of hemorrhage were indications for the exam in more than 35%. Inflammatory bowel disease and cancer follow-up were indications, respectively, in 18% and 16%. "Express mannitol" bowel prep resulted satisfactory in more than 97% but precluded complete exam for seven (0.4%) patients. In 42.5%, colonoscopic examination was normal. Polyps were found in 248 (14.5%) patients for whom 376 polypectomy procedures were done successfully. Endoscopists could not reach the cecum in 68 (3.9%) patients. Incidence of hemorrhage and perforation was nill for this series. Authors conclude that fibrocolonoscopy remains as a safe and efficient method for the diagnosis and treatment (polypectomy) of common colorectal conditions.

[Muscle-aponeurotic transposition for treatment of anal incontinence]. / Transposições músculo-aponevróticas utilizadas para o tratamento da incontinência anal grave.

The management of anal incontinence varies. It can be treated either clinically or surgically depending on its etiology and the intensity of the signs and symptoms. The variety of procedures and techniques employed in its treatment is proof of the incomprehension of the pathophysiological mechanisms involved as well as their diversity. Sphincteroplasties are indicated for those patients with well-defined muscle injury, usually resulting from obstetrical trauma, iatrogenic surgery or vehicular accidents. In cases of persistent anal incontinence after previous sphincteroplasty or those in which extensive destruction of the sphincteric musculature is confirmed, muscle-aponeurotic transpositions are an attractive option. A detailed survey of the literature of the chief techniques utilized and their results is presented.

[Stoma therapy: an emerging specialty for Brazilian nursing]. / Estomaterapia: uma especialidade que emerge para a enfermagem brasileira.

The authors relate the experience in the organization and development of the I Enterostomal Therapy Specialization Course, the pioneer in Brazil. They report the concepts and history about enterostomal therapy as a specialty; discuss the objectives, contents, teaching strategies, and evaluation process of the course.

Alteracoes estruturais no tubo digestivo apos derivacoes jejuno-ileais. / Structural changes in digestive tract after jejunoileal bypass

Os autores estudaram 42 coelhos mesticos, distribuidos em dois grupos, cada qual com 21 animais: os coelhos do grupo I foram submetidos a exclusao cirurgica da metade distal do intestino delgado; os animais do grupo II serviam como controle. No vigesimo primeiro dia de evolucao, os animais eram anestesiados realizando-se laparotomia para retirada de segmentos do intestino, em pontos previamente determinados. Tais segmentos foram estudados por meio de exame histologico habitual, ao microscopio ocular e foram avaliados sob o ponto de espessura das diferentes tunicas por meio de tecnica original. Nessas condicoes, foi possivel verificar que os animais do grupo I apresentavam espessamento da submucosa do segmento que permaneceu no transito e atrofia da mucosa de alca excluida. Do ponto de vista microscopico, observaram-se: no segmento que permanece no transito, edema da tunica muscular e infiltrado linfoplasmocitario da mucosa; na alca excluida, edema da submucosa e da muscular e infiltrado linfoplasmocitario da mucosa, com intensidade variavel conforme o nivel da alca examinada