RESUMO
The spleen preservation by distal pancreatic resection can be performed either with spleen vessels preservation or with the ligation of the least. The experiment evolved ligation of all gastric arteries but the short gastric arteries in 20 cadaveric organocomplexes, followed by ink perfusion through the left gastric and left gastro-epiploic arteries. The study was amplified with the intraoperative dopplerography of portal arteries of the spleen after crossclamping of the left gastro-epiploic and short gastric arteries. Ten patients after distal pancreatic resection with spleen preservation and splenic vessels ligation had the CT-angiography before and after the surgery. All the conducted studies demonstrated the incapability of short gastric arteries to supply the satisfactory spleen perfusion. The left gastro-epiploic artery proved to be the main source of splenic blood supply after splenic vessels ligation.
Assuntos
Pâncreas/cirurgia , Baço/irrigação sanguínea , Baço/cirurgia , Artéria Gastroepiploica/fisiologia , Humanos , Ligadura/métodosRESUMO
The aim of our trial was to investigate correlation between the size of the prostate and probability of cancer detection with transperineal biopsy. Transperineal 12-sample biopsy of the prostate was made in 203 men aged 48-58 years (mean age 68.0 +/- 8.6 years) suspected of having prostatic cancer (PC). Total detection of cancer was 33.5%. PC patients had higher levels of PSA, more frequent alterations at rectal palpation and transrectal ultrasound investigation, while mean size of the prostate was the same in cancer and cancer-free patients. Differences in PC detection rate in patients with different sizes of the prostate were statistically insignificant. Use of sextant biopsy could not detect PC in 15 males (22.1%) cases. Thus, there is no correlation between the size of the prostatic gland and diagnostic value of transperineal biopsy obtaining 12 tissue samples. The above data do not support the necessity of extended biopsy in patients with large prostate.
Assuntos
Biópsia por Agulha/métodos , Próstata/patologia , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos RetrospectivosRESUMO
We studied 137 males (mean age 68 +/- 8.6 years) with suspected prostatic cancer who had undergone transperineal biopsy of the prostate (12 tissue samples). The biopsy was made under local anesthesia either as paraprostatic block (n=76, group 1) or paraprostatic block in combination with block of the sexual nerve (n=61, group 2). Pain intensity was evaluated with visual analogue scales. Induction of anesthesia was more painful in group 2, three other stages--in group 1. Mean pain at biopsy was significantly (p < 0.001) lower in group 2. Thus, addition of sexual nerve blockade to standard paraprostatic block increases efficacy of anesthesia in conduction of transperitoneal biopsy of the prostate.
Assuntos
Anestesia Local/métodos , Próstata/patologia , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor/métodosRESUMO
Experience of examination and treatment of 102 patients with lesion of retroperitoneal space undergone surgery for pancreonecrosis is analyzed. Based of data of ultrasonic examination, computed tomography, surgery and autopsy laws of morphologic transformation and ways of spread of pathologic process into retroperitoneal space in pancreonecrosis were revealed. Developed scheme is important for substantiation of surgical policy.
