RESUMO
Nowadays oncologic surgery is defining new criteria in the treatment of rectal cancer: preservation of sfincterial function, ultra-low resections with distal margin at only 2 cm distally to the tumor, role of mesorectum as preferential site of lymphatic diffusion, preservation of lombo-aortic and pelvic nerves. Laparoscopy is showing good results in bowel surgery so as previously got on biliary tract: less visceral manipulation, less stimulation of immunologic system, less pain, early resumption of peristalsis and food intake, better recovery, less hospital stay. We experimented on pig ultra-low laparoscopic resection of the rectum, with preservation of sfincterial function, and mechanical anastomosis at the upper edge of the sfincterial ring. The evaluation of surgical technique, post-operative supervision, and follow-up instrumental control (anal manometry, endo-rectal ultrasonography, sfincterial electtromanometry, Rx barium enema) show technical feasibility and confirm a better recovery with regular defecatory function.
Assuntos
Canal Anal/cirurgia , Colo/cirurgia , Laparoscopia , Anastomose Cirúrgica/métodos , Animais , Estudos de Avaliação como Assunto , SuínosRESUMO
Authors report the results of an experimental application of one of the more recent techniques of liver transplantation, which has the preparation ex situ as a basilar step of the procedure. 18 pig were operated on, from september 1991 to march 1993; they were divided in two groups: the first (group A) underwent an auxiliary segmental autotransplantation of left lobe to heterotopic subdiaphragmatic location; in group B an orthotopic segmental autotransplantation of right lobe after ex situ preparation of the liver according the technique of Pichlmayr was performed. The results show that a bigger application of ex situ surgery may help to find a resolution to the problem of the small number of liver donation.
