RESUMO
Basing on the long-term experience in radical surgery of 252 patients with invasive bladder cancer, the authors come to the conclusion that the establishment of intestinal bladder with postcystectomy recovery of physiological uresis is the most proper therapeutic approach. Extra- or intraperitoneal position of the transplant was decided upon regarding the type and stage of cystectomy and prior methods of derivation. The techniques of one- and multistage operations are presented. Clinical practice evidences that more rapid recovery of urethral uresis can be obtained with application of primary continuous suture of artificial intestinal bladder (ideal enterocystoplasty) at the end of the surgery. Urodynamic low urinary tract findings are provided. The technique developed by the authors offers new surgical opportunity for bladder cancer patients following cystectomy.
Assuntos
Derivação Urinária/métodos , Cistectomia/métodos , Humanos , Íleo/cirurgia , Masculino , Pessoa de Meia-Idade , Reoperação , Fatores de Tempo , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/fisiopatologia , Neoplasias da Bexiga Urinária/cirurgia , UrodinâmicaRESUMO
The authors present the results of the examination of 70 patients with complicated injuries of the thoracic spine making use of clinical and electrophysiologic methods of investigations, axial computer tomography of the spinal column and of the spinal cord, thermography and ultrasound scanning of the spinal cord. The substantiation for using one or the other method is given in order to determine the indications for a repeated surgery. To make a reliable evaluation of the degree and the extent of the spinal cord lesion the authors prefer to make a complex examination of the patients using functional and organic-structural methods of investigation.
Assuntos
Fraturas Ósseas/diagnóstico , Traumatismos da Medula Espinal/diagnóstico , Vértebras Torácicas/lesões , Adolescente , Adulto , Doença Crônica , Diagnóstico Diferencial , Feminino , Fraturas Ósseas/cirurgia , Humanos , Masculino , Métodos , Exame Neurológico , Traumatismos da Medula Espinal/cirurgia , Vértebras Torácicas/cirurgiaAssuntos
Colo Sigmoide/transplante , Gravidez , Bexiga Urinária/cirurgia , Adulto , Feminino , HumanosAssuntos
Vértebra Cervical Áxis , Atlas Cervical , Osso Occipital/cirurgia , Fusão Vertebral , Neoplasias da Coluna Vertebral/secundário , Vértebra Cervical Áxis/cirurgia , Placas Ósseas , Atlas Cervical/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Neoplasias da Coluna Vertebral/cirurgiaAssuntos
Cauda Equina/cirurgia , Traumatismos da Medula Espinal/cirurgia , Adulto , Cauda Equina/lesões , Cauda Equina/fisiopatologia , Humanos , Vértebras Lombares , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Regeneração Nervosa , Condução Nervosa , Traumatismos da Medula Espinal/fisiopatologiaAssuntos
Vértebras Cervicais/lesões , Insuficiência Vertebrobasilar/etiologia , Adulto , Autopsia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/patologia , Insuficiência Vertebrobasilar/diagnóstico por imagem , Insuficiência Vertebrobasilar/patologiaRESUMO
The authors analyse the clinical picture and the results of nonoperative and surgical treatment of unilateral traumatic compression of the optic nerve in 23 patients with closed craniocerebral trauma. The principle role in the pathogenesis of the damage to the optic nerve is attributed to its functional compression within the optic canal as the result of impaired intratruncal circulation and edema of the nerve. This mechanism of the compression may in some cases serve as the reason for undertaking decompression of the optic nerve by resection of the superior wall of the optic canal. Eight patients were operated on, a positive ophthalmological effect was produced in 5 of them. In 15 patients who did not undergo surgery the process terminated in unilateral amaurosis.
Assuntos
Lesões Encefálicas/complicações , Síndromes de Compressão Nervosa/etiologia , Traumatismos do Nervo Óptico , Fraturas Cranianas/complicações , Adolescente , Adulto , Cegueira/etiologia , Feminino , Hematoma Epidural Craniano/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/cirurgiaRESUMO
Under observation there were 43 patients aged 10 to 22 years and showing the syndrome of femorolumbar extension rigidity. On surgical verification it was found that 5 pateints had productive epiduritis, 20 protrusions and prolapses of the discs complicated with productive epiduritis in the lumbar division of the vertebral column; 11 had tumours in the lumbar, 3 in the thoracic, 3 in the cervical divisions of the vertebral column. The syndrome was frequently accompanied by dysplasia of the lumbar division. This syndrome is similar to meningeal contractures; it manifests in reflectory disturbances of the extensor tone, and can be classed with traction syndromes. An adequate treatment method consists in surgical mobilization of the spinal cord, its radicles, and the dural sac.
Assuntos
Dor nas Costas/diagnóstico , Lordose/diagnóstico , Rigidez Muscular/diagnóstico , Adolescente , Adulto , Dor nas Costas/etiologia , Criança , Humanos , Lordose/etiologia , Região Lombossacral , Masculino , Rigidez Muscular/etiologia , Osteocondrite/complicações , Canal Medular , Neoplasias da Medula Espinal/complicações , Doenças da Coluna Vertebral/complicações , Síndrome , Coxa da PernaAssuntos
Intoxicação Alcoólica/diagnóstico , Concussão Encefálica/diagnóstico , Hemorragia Cerebral/diagnóstico , Hematoma/diagnóstico , Intoxicação Alcoólica/terapia , Concussão Encefálica/cirurgia , Hemorragia Cerebral/cirurgia , Diagnóstico Diferencial , Hematoma/cirurgia , Humanos , Cuidados Pré-OperatóriosRESUMO
Five patients with traumatic pneumocephalus are reported. A case with traumatic ventricular and subarachnoidal pneumocephalus resulting from damage to the sphenoidal sinus is described. Treatment of traumatic pneumocephalus is nonoperative is nonoperative in most cases.