cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14281313
title: Surgical management of cystic dilatation bile ducts in adults

description: BACKGROUND: The cystic dilatation of the biliary tract is a rare disease and uncertain origin. It is recognized more frequently in children; however, its incidence comes increasing in adults, representing 20% of the cases. AIM: To evaluate morbimortality rates, evolution and handing of patients with cystic dilatation bile ducts in adults. METHODS: Were evaluated, retrospectively, five adults who had the diagnosis of choledochal cyst and that had been submitted to some surgical procedure. RESULTS: Abdominal pain was the commonest complain to all patients. Jaundice was present in 80%. Ultrasound scanning was done in all the cases as initial examination. CT scan, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography were also done in some patients; however, the diagnosis was established intra-operatively in all cases. The cyst resection with reconstruction of the biliary tract was done in 60%; the cystojejunostomy in 20%; and in 20% biliary tract drainage. CONCLUSIONS: Biliary tract cystic dilatation is a rare disease. However, its incidence is increasing in the adult population, so, it must be thought as differential diagnosis when facing obstructive jaundice.
DOI: 10.6084/m9.figshare.14281315.v1
title: Total clipless cholecystectomy by means of harmonic sealing

description: BACKGROUND: In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. AIM: To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver. METHODS: Was evaluate a series of 125 patients who underwent laparoscopic cholecystectomy where the sealing and division of cystic artery and duct was carried out only by harmonic shears. The intact extracted gallbladder was submitted to a reverse pressure test for assessment of the technique safety by means of CO2 insuflation. RESULTS: The most common indication for surgery was gallstones. The mean operative time was 26 min and all gallbladders were dissected intact from the liver bed. There was no mortality and the overall morbidity rate was 0.8% with no hemorrhage or leaks. The reverse pressure test showed that all specimens support at least 36-mmHg of pressure without leaking. CONCLUSION: The harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time.
DOI: 10.6084/m9.figshare.14281320
title: Unfeasible experimental model of normothermic hepatic ischemia and reperfusion in rats using the Pringle maneuver

description: BACKGROUND: The negative result of a research does not always indicate failure, and when the data do not permit a proper conclusion, or are contrary to the initial project, should not simply be discarded and archived. AIM: To report failure after performing experimental model of liver ischemia and reperfusion normothermic, continuous or intermittent, in small animals aiming at the study of biochemical and histological parameters after postoperative recovery. METHODS: Fifteen Wistar rats were divided into three groups of five animals each; all underwent surgery, the abdomen was sutured after the proposed procedures for each group and the animals were observed for 6 h or until they died, and then were reoperated. In Group 1, control (sham-operated): dissection of the hepatic hilum was performed; in Group 2: clamping of the hepatic hilum for 30 m; in Group 3: clamping of the hepatic hilum for 15 m, reperfusion for 5 m and another 15 m of clamping. Data from Groups 2 and 3 were compared with Student's t test. RESULTS: All animals of Group 1 survived for 6 h. Two animals in Group 2 died before the 6 h needed to validate the experiment; two did not recover from anesthesia and one survived until the end. In Group 3, four animals died before the 6 h established and one of them survived the required time. Only one animal in Group 2 and one in Group 3 survived and were able to accomplish the study. There was no statistical significance when the results of Groups 2 and 3 were compared (p&gt;0.05). CONCLUSION: The death of six animals before the necessary period of observation turned the initial proposal of the experiment unfeasible.
DOI: 10.6084/m9.figshare.14281320.v1
title: Unfeasible experimental model of normothermic hepatic ischemia and reperfusion in rats using the Pringle maneuver

description: BACKGROUND: The negative result of a research does not always indicate failure, and when the data do not permit a proper conclusion, or are contrary to the initial project, should not simply be discarded and archived. AIM: To report failure after performing experimental model of liver ischemia and reperfusion normothermic, continuous or intermittent, in small animals aiming at the study of biochemical and histological parameters after postoperative recovery. METHODS: Fifteen Wistar rats were divided into three groups of five animals each; all underwent surgery, the abdomen was sutured after the proposed procedures for each group and the animals were observed for 6 h or until they died, and then were reoperated. In Group 1, control (sham-operated): dissection of the hepatic hilum was performed; in Group 2: clamping of the hepatic hilum for 30 m; in Group 3: clamping of the hepatic hilum for 15 m, reperfusion for 5 m and another 15 m of clamping. Data from Groups 2 and 3 were compared with Student's t test. RESULTS: All animals of Group 1 survived for 6 h. Two animals in Group 2 died before the 6 h needed to validate the experiment; two did not recover from anesthesia and one survived until the end. In Group 3, four animals died before the 6 h established and one of them survived the required time. Only one animal in Group 2 and one in Group 3 survived and were able to accomplish the study. There was no statistical significance when the results of Groups 2 and 3 were compared (p&gt;0.05). CONCLUSION: The death of six animals before the necessary period of observation turned the initial proposal of the experiment unfeasible.
DOI: 10.6084/m9.figshare.14281322
title: Laparoscopic management of cholecystocolic fistula

description: INTRODUCTION: Cholecystocolic fistula is a rare complication of gallbladder disease. Its clinical presentation is variable and nonspecific, and the diagnosis is made, mostly, incidentally during intraoperative maneuver. Cholecystectomy with closure of the fistula is considered the treatment of choice for the condition, with an increasingly reproducible tendency to the use of laparoscopy. AIM: To describe the laparoscopic approach for cholecystocolic fistula and ratify its feasibility even with the unavailability of more specific instruments. TECHNIQUE: After dissection of the communication and section of the gallbladder fundus, the fistula is externalized by an appropriate trocar and sutured manually. Colonic segment is reintroduced into the cavity and cholecystectomy is performed avoiding the conversion procedure to open surgery. CONCLUSION: Laparoscopy for resolution of cholecystocolic fistula isn't only feasible, but also offers a shorter stay at hospital and a milder postoperative period when compared to laparotomy.
DOI: 10.6084/m9.figshare.14281317
title: Constriction rate variation produced by partial ligation of the portal vein at pre-hepatic portal hypertension induced in rats

description: BACKGROUND: Partial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow. AIM: To assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats. METHODS: Three groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - π r 2 / π R2) x 100% and the statistical analysis with the Student t test. RESULTS: The initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p&gt;0.05). CONCLUSION: Pre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate.
DOI: 10.6084/m9.figshare.14281317.v1
title: Constriction rate variation produced by partial ligation of the portal vein at pre-hepatic portal hypertension induced in rats

description: BACKGROUND: Partial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow. AIM: To assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats. METHODS: Three groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - π r 2 / π R2) x 100% and the statistical analysis with the Student t test. RESULTS: The initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p&gt;0.05). CONCLUSION: Pre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate.
DOI: 10.6084/m9.figshare.14281326
title: Robotic Roux-en-Y gastric bypass: operative results in 100 patients

description: BACKGROUND: Laparoscopic gastric bypass is gold-standard for morbid obesity treatment. AIM: To describe the results of robotic gastric bypass for morbid obesity patients. METHOD: Were operated on 100 morbidly obese patients through totally robotic gastric bypass between 2013 and 2014. They were 83% female. The age ranged from 20 to 65 years old (medium 48,5 years); the body mass index varied between 38-67 (medium 42,3 kg/cm2). The procedure was designed with 3 cm long gastric pouch, 1 m biliopancreatic limb, 1,2 m alimentary limb, manual or stapled anastomosis. There were four super-super-obese patients and four revisional surgeries. RESULTS: Docking time varied from 1 to 20 min (medium 4 min). Console time varied from 40-185 min (medium 105 min). There were no intra operative complications or mortality. There were two lower limb deep venous thrombosis. There was no readmission in the first 30 days. CONCLUSION: Totally robotic gastric bypass is safe and reproduceable, with excellent results even during the initial experience with regular surgeries, revisional surgeries or in super-obese patients. Adequate training may shortens or obviates the learning curve.
DOI: 10.6084/m9.figshare.14281322.v1
title: Laparoscopic management of cholecystocolic fistula

description: INTRODUCTION: Cholecystocolic fistula is a rare complication of gallbladder disease. Its clinical presentation is variable and nonspecific, and the diagnosis is made, mostly, incidentally during intraoperative maneuver. Cholecystectomy with closure of the fistula is considered the treatment of choice for the condition, with an increasingly reproducible tendency to the use of laparoscopy. AIM: To describe the laparoscopic approach for cholecystocolic fistula and ratify its feasibility even with the unavailability of more specific instruments. TECHNIQUE: After dissection of the communication and section of the gallbladder fundus, the fistula is externalized by an appropriate trocar and sutured manually. Colonic segment is reintroduced into the cavity and cholecystectomy is performed avoiding the conversion procedure to open surgery. CONCLUSION: Laparoscopy for resolution of cholecystocolic fistula isn't only feasible, but also offers a shorter stay at hospital and a milder postoperative period when compared to laparotomy.
DOI: 10.6084/m9.figshare.14281326.v1
title: Robotic Roux-en-Y gastric bypass: operative results in 100 patients

description: BACKGROUND: Laparoscopic gastric bypass is gold-standard for morbid obesity treatment. AIM: To describe the results of robotic gastric bypass for morbid obesity patients. METHOD: Were operated on 100 morbidly obese patients through totally robotic gastric bypass between 2013 and 2014. They were 83% female. The age ranged from 20 to 65 years old (medium 48,5 years); the body mass index varied between 38-67 (medium 42,3 kg/cm2). The procedure was designed with 3 cm long gastric pouch, 1 m biliopancreatic limb, 1,2 m alimentary limb, manual or stapled anastomosis. There were four super-super-obese patients and four revisional surgeries. RESULTS: Docking time varied from 1 to 20 min (medium 4 min). Console time varied from 40-185 min (medium 105 min). There were no intra operative complications or mortality. There were two lower limb deep venous thrombosis. There was no readmission in the first 30 days. CONCLUSION: Totally robotic gastric bypass is safe and reproduceable, with excellent results even during the initial experience with regular surgeries, revisional surgeries or in super-obese patients. Adequate training may shortens or obviates the learning curve.
DOI: 10.6084/m9.figshare.14281328
title: Implementing laparoscopy in Brazil´s National Public Health System: the bariatric surgeons´ point of view

description: BACKGROUND: Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. AIM: 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. METHODS: A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. RESULTS: From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. CONCLUSION: 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy.
DOI: 10.6084/m9.figshare.14281329
title: Nutritional status and life quality in patients undergoing bariatric surgery

description: BACKGROUND: The obesity has achieved an alarming increase in recent years, which led this disease to global epidemic condition. AIM: To evaluate the nutritional status as well as the quality of life of obese patients undergoing bariatric surgery. METHODS: A transversal study was conducted with obese adults of both genders who underwent bariatric surgery by Fobi-Capella technique for at least 30 days. It was evaluated: age, gender, marital status, occupation, weight before surgery, current weight, height, preoperative and current BMI, weight loss and loss of excess weight percentages, presence of clinical manifestations and food intolerances. RESULTS: The sample consisted of 70 patients, being 81.4% female, 37.1% aged 30 to 39 years, 58.6% were married, 41.4% have undergone the bariatric surgery in the last 12 months. It was observed a reduction in BMI from 37.2 kg/m2 (one to three months) to 28.9 kg/m2 (&gt;12 months) and consequent increase in weight loss and loss of excess weight percentages. The most frequent clinical manifestation was alopecia (62.9%). The most reported food intolerance was on the red meat (24%). According to the Baros questionnaire, 50% of patients were classified as having good quality of life. CONCLUSION: The operation of Fobi-Capella proved to be effective in promoting gradual and lasting weight loss. Quality of life was considered good in most patients, indicating that the operation had a positive impact on their lives.
DOI: 10.6084/m9.figshare.14281328.v1
title: Implementing laparoscopy in Brazil´s National Public Health System: the bariatric surgeons´ point of view

description: BACKGROUND: Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. AIM: 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. METHODS: A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. RESULTS: From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. CONCLUSION: 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy.
DOI: 10.6084/m9.figshare.14281329.v1
title: Nutritional status and life quality in patients undergoing bariatric surgery

description: BACKGROUND: The obesity has achieved an alarming increase in recent years, which led this disease to global epidemic condition. AIM: To evaluate the nutritional status as well as the quality of life of obese patients undergoing bariatric surgery. METHODS: A transversal study was conducted with obese adults of both genders who underwent bariatric surgery by Fobi-Capella technique for at least 30 days. It was evaluated: age, gender, marital status, occupation, weight before surgery, current weight, height, preoperative and current BMI, weight loss and loss of excess weight percentages, presence of clinical manifestations and food intolerances. RESULTS: The sample consisted of 70 patients, being 81.4% female, 37.1% aged 30 to 39 years, 58.6% were married, 41.4% have undergone the bariatric surgery in the last 12 months. It was observed a reduction in BMI from 37.2 kg/m2 (one to three months) to 28.9 kg/m2 (&gt;12 months) and consequent increase in weight loss and loss of excess weight percentages. The most frequent clinical manifestation was alopecia (62.9%). The most reported food intolerance was on the red meat (24%). According to the Baros questionnaire, 50% of patients were classified as having good quality of life. CONCLUSION: The operation of Fobi-Capella proved to be effective in promoting gradual and lasting weight loss. Quality of life was considered good in most patients, indicating that the operation had a positive impact on their lives.
DOI: 10.6084/m9.figshare.14281331
title: Nutritional profile of patients in a multidisciplinary treatment program for severe obesity and preoperative bariatric surgery

description: BACKGROUND: Along with the augmentation in obesity rates in recent years, the demand for bariatric surgery has startlingly increased. Nutritional counseling in the preoperative period is very important because it contributes to higher success rate in the post-operative period. AIM: To assess the nutritional status of patients in a multidisciplinary program for the treatment of severe obesity and pre-operatively for bariatric surgery, characterizing the consumption of healthy nutrients. METHODS: A retrospective analysis of 30 patients was conducted. Personal information, anthropometric data and dietary assessment by 24-hour food record were collected. The analysis of energy intake was performed in Dietpro 5.1 Professional(r) program. The statistical treatment of the caloric intake was performed by an ANOVA test with Bonferroni´s post hoc and for anthropometric data the paired t test was used. RESULTS: From the total, 73% of the patients were women and 27% male, mean age was 48.4+12.9 and 49.8+8.1, respectively. A lower weight in the 5th appointment was observed when compared with the 1st one. There was a reduction in caloric intake in the 2nd, 3rd, 4th and 5th appointments when compared with the 1st. It was observed that in the 5th appointment more than 50% of the patients underwent six meals a day. There was an increase in the consumption of fruit along the appointments and 72.2% of patients consumed 1-2 servings of fruit a day. Vegetables intake was high in all appointments in the pre-operative period and, although low, the whole grain products consumption has increased during the pre-operative period achieving 30% of the study population. CONCLUSION: There was a decrease in body weight, a trend in the decrease of the body mass index and waist circumference and quantitative and qualitative improvement of food consumption.