Assuntos
Colecistite/induzido quimicamente , Éter de Diematoporfirina/efeitos adversos , Neoplasias Duodenais/tratamento farmacológico , Papiloma/tratamento farmacológico , Fotoquimioterapia/efeitos adversos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Idoso , Colecistite/diagnóstico , Colecistite/cirurgia , Neoplasias Duodenais/patologia , Duodenoscopia , Evolução Fatal , Humanos , Laparotomia , Masculino , Papiloma/patologiaRESUMO
Use of varicose saphenous veins for infrainguinal bypass is often contraindicated because of the risk of immediate rupture or long-term aneurysm. In this report we describe four cases in which prosthetic reinforcement allowed successful femoropopliteal bypass grafting using highly varicose saphenous veins while preserving normal endothelium. No thrombosis or any other complication was observed after a mean follow-up of 41 months.
Assuntos
Prótese Vascular , Artéria Femoral/cirurgia , Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Artéria Poplítea/cirurgia , Veia Safena/transplante , Varizes/cirurgia , Idoso , Implante de Prótese Vascular , Feminino , Humanos , Masculino , PolitetrafluoretilenoRESUMO
BACKGROUND/AIMS: Proctocolectomy with ileoanal anastomosis (IAA) has proved to be the most suitable surgical treatment for ulcerative colitis. The aim of this study was to compare the results of IAA according to the evolution of surgical procedures and particularly to compare the results of stapled versus hand-sewn anastomosis. METHODOLOGY: From 1984 to 1996, 37 men and 31 women were operated on in our centre for ulcerative colitis. The anastomosis between the J pouch and the dentate line was handsewn in 35 patients (group 1) and stapled in 33 patients (group 2). RESULTS: The mean operative time was significantly shorter in group 2 as compared with group 1 (265+/-59 vs. 323+/-53, p<0.01, respectively), whereas morbidity and functional results were comparable in both groups. In 10 patients with stapled IAA, a diverting ileostomy was not performed and the morbidity in this group did not increase. CONCLUSIONS: These results suggest that stapled IAA anastomosis is a safe procedure. The stapling technique of IAA simplifies total excision of the rectum and could mean that a diverting ileostomy is not necessary.
Assuntos
Colite Ulcerativa/cirurgia , Proctocolectomia Restauradora/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Reoperação , Estudos Retrospectivos , Grampeadores Cirúrgicos , Técnicas de Sutura , Resultado do TratamentoRESUMO
A 42-year-old man was consulted because of a pain in his left leg. He was a highly trained biker since 20 years. The echo-Doppler and arteriography evidenced a stenosis, probably due to endofibrosis of the external iliac artery. In addition, it showed an aneurysm and an intimal dissection of this artery. The arteriography confirmed this diagnosis, and normal aspect of the other arteries. Neither conservative nor endovascular treatments were possible because of the anatomic lesions. We resected the external iliac artery and performed a by-pass with the great saphenous. The result at the 5th month was clinically good. The echo-Doppler control did not show any abnormality. The natural course of the endofibrosis of athletes is unknown, although stenosis, revealed by intermittent claudication is usually observed. Only a few cases of dissection and no aneurysmal degeneration have been described before.
