RESUMO
Quality of life (QOL) was studied in gastric cancer patients treated on a randomised, controlled trial comparing D1 (level 1) with D3 (levels 1, 2 and 3) lymphadenectomy. A total of 221 patients were randomly assigned to D1 (n=110) and D3 (n=111) surgery. Quality-of-life assessments included functional outcomes (a 14-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) was performed before and after surgery at disease-free status. Patients suffered from irrelative events such as loss of partners was excluded thereafter. Main analyses were done by intention-to-treat. Thus, 214 D1 (106/110=96.4%) and D3 (108/111=97.3%) R0 patients were assessed. Longitudinal analysis showed that functional outcomes decreased at 6 months after surgery and increased over time thereafter, while health perceptions increased over time in general. On the basis of linear mixed model analyses, patients having total gastrectomy, advanced cancer and hemipancreaticosplenectomy, but not complications had poorer QOL than those without. D1 and D3 patients showed no significant difference in QOL. The results suggest that changes of QOL were largely due to scope of gastric resection, disease status and distal pancreaticosplenectomy, rather than the extent of lymph node dissection. This indicates that nodal dissection can be performed for a potentially curable gastric cancer.
Assuntos
Gastrectomia , Qualidade de Vida , Neoplasias Gástricas/cirurgia , Idoso , Feminino , Humanos , Estudos Longitudinais , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia , Neoplasias Gástricas/patologiaAssuntos
Malformação de Arnold-Chiari/diagnóstico , Fossa Craniana Posterior/anormalidades , Procedimentos Neurocirúrgicos , Malformação de Arnold-Chiari/cirurgia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
The outcomes of traditional epineural, microsurgical epineural and interfascicular sutures of the median and ulnar nerves in the lower third of the forearm were compared in children. Evidence is provided for the differential approach to applying an interfascicular and microsurgical epineural suture, as well as for limitations in the use of an interfascicular suture. The authors show it necessary to make investigations to clarify whether the fascicles on the ends of a diseased nerve may be more validly identified and whether the studies into connective and nerve tissue relationships in the suture line.
Assuntos
Traumatismos dos Nervos Periféricos , Nervos Periféricos/cirurgia , Técnicas de Sutura , Adolescente , Criança , Pré-Escolar , Seguimentos , Humanos , Nervo Mediano/lesões , Nervo Mediano/cirurgia , Microcirurgia/métodos , Nervo Radial/lesões , Nervo Radial/cirurgia , Nervo Ulnar/lesões , Nervo Ulnar/cirurgiaAssuntos
Tumor de Células Gigantes do Osso/diagnóstico , Osso Parietal , Neoplasias Cranianas/diagnóstico , Criança , Doença Crônica , Diagnóstico Diferencial , Seguimentos , Tumor de Células Gigantes do Osso/cirurgia , Humanos , Masculino , Osso Parietal/diagnóstico por imagem , Osso Parietal/cirurgia , Radiografia , Neoplasias Cranianas/cirurgiaAssuntos
Microcirurgia , Nervo Fibular/lesões , Nervo Fibular/cirurgia , Ferimentos Penetrantes/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Nervo Sural/transplante , Técnicas de Sutura , Transplante Autólogo , Resultado do Tratamento , Ferimentos Penetrantes/diagnósticoAssuntos
Afasia Acinética/etiologia , Astrocitoma/complicações , Neoplasias Cerebelares/complicações , Neoplasias do Ventrículo Cerebral/complicações , Complicações Pós-Operatórias/etiologia , Convulsões/complicações , Adolescente , Astrocitoma/cirurgia , Neoplasias Cerebelares/cirurgia , Neoplasias do Ventrículo Cerebral/cirurgia , Criança , Fossa Craniana Posterior , Feminino , Humanos , Masculino , Meningite/etiologia , Convulsões/cirurgia , Técnicas Estereotáxicas , Fatores de TempoRESUMO
Examination of 49 children with injuries to the nerves of the lower extremity showed that trauma was inflicted most frequently to the common peroneal and the deep or superficial peroneal nerve. The outcomes of surgical treatment are often poor because of delayed hospitalization for surgical management, imperfect surgical techniques, and anatomicophysiological features of the peroneal nerves.
Assuntos
Traumatismos da Perna/cirurgia , Perna (Membro)/inervação , Traumatismos do Sistema Nervoso , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Traumatismos da Perna/diagnóstico , Tecido Nervoso/transplante , Procedimentos Neurocirúrgicos , Técnicas de Sutura , Fatores de Tempo , Transplante AutólogoAssuntos
Asfixia Neonatal/tratamento farmacológico , Gluconato de Cálcio/efeitos adversos , Gluconatos/efeitos adversos , Glucose/efeitos adversos , Isquemia/induzido quimicamente , Nervo Isquiático/irrigação sanguínea , Tiamina Pirofosfato/efeitos adversos , Gluconato de Cálcio/administração & dosagem , Feminino , Glucose/administração & dosagem , Humanos , Lactente , Recém-Nascido , Injeções Intra-Arteriais , Masculino , Tiamina Pirofosfato/administração & dosagem , Artérias Umbilicais/efeitos dos fármacosRESUMO
The investigation of blood flow in injured nerves in 14 patients by the method of hydrogen clearance has revealed substantial difference of the blood flow value in children and adults. The authors consider that it may be of significance for the interpretation of differences in the course of regeneration in patients of different age.
Assuntos
Antebraço/inervação , Nervo Mediano/lesões , Nervo Ulnar/lesões , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Humanos , Nervo Mediano/irrigação sanguínea , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Nervo Ulnar/irrigação sanguíneaRESUMO
Eleven children with injuries to the cranial nerves were examined. It has been revealed that as a result of surgical interventions, the facial nerve gets affected more frequently. The results of the treatment often appear unsatisfactory because of the late referral of the victims to hospitals for operative treatment.
Assuntos
Traumatismos dos Nervos Cranianos , Ferimentos Penetrantes/cirurgia , Nervo Acessório/cirurgia , Traumatismos do Nervo Acessório , Adolescente , Criança , Pré-Escolar , Nervos Cranianos/cirurgia , Nervo Facial/cirurgia , Traumatismos do Nervo Facial , Feminino , Nervo Glossofaríngeo/cirurgia , Traumatismos do Nervo Glossofaríngeo , Humanos , Nervo Hipoglosso/cirurgia , Traumatismos do Nervo Hipoglosso , Técnicas de Sutura , Nervo Vago/cirurgia , Traumatismos do Nervo Vago , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/etiologiaRESUMO
It is shown on the basis of comparative analysis of 39 cases with combined injuries of the nerves and vessels in children that the main blood flow must be restored even in compensated circulation in the limb; this improves regeneration of the nerve and lessens the delay in the growth of the limb. The time of the intervention is determined by the degree of ischemia of the limb and the existence of special conditions.
Assuntos
Traumatismos do Braço/cirurgia , Braço/inervação , Vasos Sanguíneos/lesões , Traumatismo Múltiplo/cirurgia , Traumatismos do Sistema Nervoso , Adolescente , Braço/irrigação sanguínea , Criança , Pré-Escolar , Humanos , Lactente , Procedimentos Neurocirúrgicos , Técnicas de SuturaRESUMO
A comparative assessment of results of autoplasty and the epineural suture in 32 cases was made on the basis of a well-known scores system. It was established that under similar or close conditions influencing the regeneration the results proved to be the same in both groups. It suggests that the epidural suture is the method of choice in those children where it is not associated with technical difficulties. Autoplasty is indicated in cases where putting the epidural suture is impossible or difficult.