cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.7452614.v1
title: LATE IMPACT OF THE LAPAROSCOPIC TREATMENT OF DEEP INFILTRATING ENDOMETRIOSIS WITH SEGMENTAL COLORECTAL RESECTION

description: ABSTRACT Background: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. Aim: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. Methods: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. Results: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p&lt;0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. Conclusion: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.
DOI: 10.6084/m9.figshare.7562747
title: COMPARATIVE EVALUATION OF MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AND PERIOPERATIVE CHOLANGIOGRAPHY IN PATIENTS WITH SUSPECT CHOLEDOCHOLITHIASIS

description: ABSTRACT Background: Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis. Aim: To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography. Methods: This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Results: It was observed that the presence of dilatation of the biliary tract or choledocholithiasis in the ultrasonography was four and eight times increased risk of perioperative cholangiography for positive choledocholithiasis, respectively. For each unit increased in serum alkaline phosphatase was 0.3% increased the risk of perioperative cholangiography for positive choledocholithiasis. In the presence of dilatation of the bile ducts in the ultrasonography was four times greater risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. In the presence of pancreatitis these patients had five times higher risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. On the positive magnetic resonance cholangiopancreatography presence to choledocholithiasis was 104 times greater of positive perioperative cholangiography for choledocholithiasis. Conclusions: The magnetic resonance cholangiopancreatography is a method with good accuracy for propedeutic follow-up for the diagnosis of choledocholithiasis, consistent with the results obtained from the perioperative cholangiography; however, it is less invasive, with less risk to the patient and promote decreased surgical time when compared with perioperative cholangiography.
DOI: 10.6084/m9.figshare.7562747.v1
title: COMPARATIVE EVALUATION OF MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AND PERIOPERATIVE CHOLANGIOGRAPHY IN PATIENTS WITH SUSPECT CHOLEDOCHOLITHIASIS

description: ABSTRACT Background: Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis. Aim: To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography. Methods: This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Results: It was observed that the presence of dilatation of the biliary tract or choledocholithiasis in the ultrasonography was four and eight times increased risk of perioperative cholangiography for positive choledocholithiasis, respectively. For each unit increased in serum alkaline phosphatase was 0.3% increased the risk of perioperative cholangiography for positive choledocholithiasis. In the presence of dilatation of the bile ducts in the ultrasonography was four times greater risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. In the presence of pancreatitis these patients had five times higher risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. On the positive magnetic resonance cholangiopancreatography presence to choledocholithiasis was 104 times greater of positive perioperative cholangiography for choledocholithiasis. Conclusions: The magnetic resonance cholangiopancreatography is a method with good accuracy for propedeutic follow-up for the diagnosis of choledocholithiasis, consistent with the results obtained from the perioperative cholangiography; however, it is less invasive, with less risk to the patient and promote decreased surgical time when compared with perioperative cholangiography.
DOI: 10.6084/m9.figshare.7710926
title: IMPLEMENTATION OF ENHANCED RECOVERY AFTER COLORECTAL SURGERY (ERAS) PROTOCOL: INITIAL RESULTS OF THE FIRST BRAZILIAN EXPERIENCE

description: ABSTRACT Background: Guidelines for enhanced recovery after surgery have their bases in colonic surgery, through the first protocols published in 2012. Since then, this practice has spread throughout the world, mainly due to improvements in surgical outcomes associated with resource savings. Aim: To analyze the first prospective results after the implementation of the guidelines. Methods: Were retrospectively analyzed 48 patients operated in the institution prior to the standardization. This group was then compared with a series of 25 patients operated consecutively after the guidelines were implemented. Results: With a 68.6% compliance rate, hospital length of stay (p=0.002), use of abdominal drains (p&lt;0.001) and mechanical bowel preparation (p&lt;0.001) were reduced. Mortality rates, anastomotic fistula, abdominal abscesses and reoperations were also reduced, but without statistical significance. Conclusion: Enhanced recovery after surgery protocols benefit patients care, resulting in better outcomes and possibly resource savings. Even with some limitations, its implementation is feasible in the Brazilian Public Health System.
DOI: 10.6084/m9.figshare.7710926.v1
title: IMPLEMENTATION OF ENHANCED RECOVERY AFTER COLORECTAL SURGERY (ERAS) PROTOCOL: INITIAL RESULTS OF THE FIRST BRAZILIAN EXPERIENCE

description: ABSTRACT Background: Guidelines for enhanced recovery after surgery have their bases in colonic surgery, through the first protocols published in 2012. Since then, this practice has spread throughout the world, mainly due to improvements in surgical outcomes associated with resource savings. Aim: To analyze the first prospective results after the implementation of the guidelines. Methods: Were retrospectively analyzed 48 patients operated in the institution prior to the standardization. This group was then compared with a series of 25 patients operated consecutively after the guidelines were implemented. Results: With a 68.6% compliance rate, hospital length of stay (p=0.002), use of abdominal drains (p&lt;0.001) and mechanical bowel preparation (p&lt;0.001) were reduced. Mortality rates, anastomotic fistula, abdominal abscesses and reoperations were also reduced, but without statistical significance. Conclusion: Enhanced recovery after surgery protocols benefit patients care, resulting in better outcomes and possibly resource savings. Even with some limitations, its implementation is feasible in the Brazilian Public Health System.
DOI: 10.6084/m9.figshare.7710527
title: ENHANCED RECOVERY (ERAS) AFTER LIVER SURGERY:COMPARATIVE STUDY IN A BRAZILIAN TERCIARY CENTER

description: ABSTRACT Background: After the publication of the first recommendations of ERAS Society regarding colonic surgery, the proposal of surgical stress reduction, maintenance of physiological functions and optimized recovery was expanded to other surgical specialties, with minimal variations. Aim: To analyze the implementation of ERAS protocols for liver surgery in a tertiary center. Methods: Fifty patients that underwent elective hepatic surgery were retrospectively evaluated, using medical records data, from June 2014 to August 2016. After September 2016, 35 patients were prospectively evaluated and managed in accordance with ERAS protocol. Results: There was no difference in age, type of hepatectomy, laparoscopic surgery and postoperative complications between the groups. In ERAS group, it was observed a reduction in preoperative fasting and in the length of hospital stay by two days (p&lt; 0.001). Carbohydrate loading, j-shaped incision, early oral feeding, postoperative prevention of nausea and vomiting and early mobilization were also significantly related to ERAS group. Oral bowel preparation, pre-anesthetic medication, sub-costal incision, prophylactic nasogastric intubation and abdominal drainage were more common in control group. Conclusion: Implementation of ERAS protocol is feasible and beneficial for health institutions and patients, without increasing morbidity and mortality.
DOI: 10.6084/m9.figshare.7710527.v1
title: ENHANCED RECOVERY (ERAS) AFTER LIVER SURGERY:COMPARATIVE STUDY IN A BRAZILIAN TERCIARY CENTER

description: ABSTRACT Background: After the publication of the first recommendations of ERAS Society regarding colonic surgery, the proposal of surgical stress reduction, maintenance of physiological functions and optimized recovery was expanded to other surgical specialties, with minimal variations. Aim: To analyze the implementation of ERAS protocols for liver surgery in a tertiary center. Methods: Fifty patients that underwent elective hepatic surgery were retrospectively evaluated, using medical records data, from June 2014 to August 2016. After September 2016, 35 patients were prospectively evaluated and managed in accordance with ERAS protocol. Results: There was no difference in age, type of hepatectomy, laparoscopic surgery and postoperative complications between the groups. In ERAS group, it was observed a reduction in preoperative fasting and in the length of hospital stay by two days (p&lt; 0.001). Carbohydrate loading, j-shaped incision, early oral feeding, postoperative prevention of nausea and vomiting and early mobilization were also significantly related to ERAS group. Oral bowel preparation, pre-anesthetic medication, sub-costal incision, prophylactic nasogastric intubation and abdominal drainage were more common in control group. Conclusion: Implementation of ERAS protocol is feasible and beneficial for health institutions and patients, without increasing morbidity and mortality.
DOI: 10.6084/m9.figshare.7710860
title: PANCREATIC NEUROENDOCRINE TUMORS: SURGICAL RESECTION

description: ABSTRACT Introduction: Pancreatic neuroendocrine tumors (pNET) correspond to about 3% of all tumors in pancreas and could be presented as a difficult diagnosis and management. Objective: To review the diagnosis and treatment of the pNET available in scientific literature. Method: A bibliographic survey was performed by means of an online survey of MeSH terms in the Pubmed database. A total of 104 articles were published in the last 15 years, of which 23 were selected as the basis for the writing of this article. Results: pNET is an infrequent neoplasia and their incidence, in USA, is about 1:100.000 inhabitants/year. Thereabout 30% of them produce hormones presenting as a symptomatic disease and others 70% of the cases could be silent disease. Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) have similar sensitivy to detect pNET. They are very important when associated to nuclear medicine mainly Positron Emission Tomography (PET-CT) Gallium-68 to find primary tumor and its staging. The appropriate treatment should be chosen based on characteristics of the tumor, its staging and associated comorbidities. Conclusion: The surgical resection is still the best treatment for patients with ressectable pancreatic NETs. However, the size, grade, tumor functionality, stage and association with multiple endocrine neoplasia type 1 (MEN-1) are important to define who will be eligible for surgical treatment. In general, tumors bigger than 2 cm are eligible for surgical treatment, except insulinomas whose surgical resection is recommended no matter the size.
DOI: 10.6084/m9.figshare.7710860.v1
title: PANCREATIC NEUROENDOCRINE TUMORS: SURGICAL RESECTION

description: ABSTRACT Introduction: Pancreatic neuroendocrine tumors (pNET) correspond to about 3% of all tumors in pancreas and could be presented as a difficult diagnosis and management. Objective: To review the diagnosis and treatment of the pNET available in scientific literature. Method: A bibliographic survey was performed by means of an online survey of MeSH terms in the Pubmed database. A total of 104 articles were published in the last 15 years, of which 23 were selected as the basis for the writing of this article. Results: pNET is an infrequent neoplasia and their incidence, in USA, is about 1:100.000 inhabitants/year. Thereabout 30% of them produce hormones presenting as a symptomatic disease and others 70% of the cases could be silent disease. Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) have similar sensitivy to detect pNET. They are very important when associated to nuclear medicine mainly Positron Emission Tomography (PET-CT) Gallium-68 to find primary tumor and its staging. The appropriate treatment should be chosen based on characteristics of the tumor, its staging and associated comorbidities. Conclusion: The surgical resection is still the best treatment for patients with ressectable pancreatic NETs. However, the size, grade, tumor functionality, stage and association with multiple endocrine neoplasia type 1 (MEN-1) are important to define who will be eligible for surgical treatment. In general, tumors bigger than 2 cm are eligible for surgical treatment, except insulinomas whose surgical resection is recommended no matter the size.
DOI: 10.6084/m9.figshare.9739295
title: DOES MALE GENDER INCREASE THE RISK OF LAPAROSCOPIC CHOLECYSTECTOMY?

description: ABSTRACT Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p&lt;0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p&lt;0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.
DOI: 10.6084/m9.figshare.9739295.v1
title: DOES MALE GENDER INCREASE THE RISK OF LAPAROSCOPIC CHOLECYSTECTOMY?

description: ABSTRACT Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p&lt;0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p&lt;0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.
DOI: 10.6084/m9.figshare.9739334
title: FAILURE AFTER FUNDOPLICATION: RE-FUNDOPLICATION? IS THERE A ROOM FOR GASTRECTOMY? IN WHICH CLINICAL SCENARIES?

description: ABSTRACT Background: Re-fundoplication is the most often procedure performed after failed fundoplication, but re-failure is even higher. Aim: The objectives are: a) to discuss the results of fundoplication and re-fundoplication in these cases, and b) to analyze in which clinical situation there is a room for gastrectomy after failed fundoplication. Method: This experience includes 104 patients submitted to re-fundoplication after failure of the initial operation, 50 cases of long segment Barrett´s esophagus and 60 patients with morbid obesity, comparing the postoperative outcome in terms of clinical, endoscopic, manometric and 24h pH monitoring results. Results: In patients with failure after initial fundoplication, redo-fundoplication shows the worst clinical results (symptoms, endoscopic esophagitis, manometry and 24 h pH monitoring). In patients with long segment Barrett´s esophagus, better results were observed after fundoplication plus Roux-en-Y distal gastrectomy and in obese patients similar results regarding symptoms, endoscopic esophagitis and 24h pH monitoring were observed after both fundoplication plus distal gastrectomy or laparoscopic resectional gastric bypass, while regarding manometry, normal LES pressure was observed only after fundoplication plus distal gastrectomy. Conclusion: Distal gastrectomy is recommended for patients with failure after initial fundoplication, patients with long segment Barrett´s esophagus and obese patients with gastroesophageal reflux disease and Barrett´s esophagus. Despite its higher morbidity, this procedure represents an important addition to the surgical armamentarium.
DOI: 10.6084/m9.figshare.9739334.v1
title: FAILURE AFTER FUNDOPLICATION: RE-FUNDOPLICATION? IS THERE A ROOM FOR GASTRECTOMY? IN WHICH CLINICAL SCENARIES?

description: ABSTRACT Background: Re-fundoplication is the most often procedure performed after failed fundoplication, but re-failure is even higher. Aim: The objectives are: a) to discuss the results of fundoplication and re-fundoplication in these cases, and b) to analyze in which clinical situation there is a room for gastrectomy after failed fundoplication. Method: This experience includes 104 patients submitted to re-fundoplication after failure of the initial operation, 50 cases of long segment Barrett´s esophagus and 60 patients with morbid obesity, comparing the postoperative outcome in terms of clinical, endoscopic, manometric and 24h pH monitoring results. Results: In patients with failure after initial fundoplication, redo-fundoplication shows the worst clinical results (symptoms, endoscopic esophagitis, manometry and 24 h pH monitoring). In patients with long segment Barrett´s esophagus, better results were observed after fundoplication plus Roux-en-Y distal gastrectomy and in obese patients similar results regarding symptoms, endoscopic esophagitis and 24h pH monitoring were observed after both fundoplication plus distal gastrectomy or laparoscopic resectional gastric bypass, while regarding manometry, normal LES pressure was observed only after fundoplication plus distal gastrectomy. Conclusion: Distal gastrectomy is recommended for patients with failure after initial fundoplication, patients with long segment Barrett´s esophagus and obese patients with gastroesophageal reflux disease and Barrett´s esophagus. Despite its higher morbidity, this procedure represents an important addition to the surgical armamentarium.
DOI: 10.6084/m9.figshare.10025693
title: EFFECT OF COPAIBA OIL IN INTESTINAL MUCOSA OF RATS SUBMITTED TO HYPOVOLEMIC SHOCK

description: ABSTRACT Background: Hypovolemic shock is a common disease in polytrauma patients and may develop ischemia in various organs, increasing morbidity and mortality. The bowel is usually most affected by this condition. Aim: To evaluate the effects of copaiba oil on the intestinal mucosa’s injury of rats submitted to hypovolemic shock. Method: Fifteen rats were divided into three groups: sham - simulated surgery; ischemia - animals submitted to hypovolemic shock; and copaiba - animals submitted to hypovolemic shock previously treated with copaiba oil. Mean blood pressure, arterial blood gas after shock induction, degree of intestinal lesion and villus length were evaluated. Results: The sham presented the lowest values of lactate and PaCO2 and the highest values of mean arterial pressure, pH and bicarbonate in relation to the other groups. The degree of mesenteric lesion was zero in the sham group; 3.00±1.00 in the ischemia group; and 3.00±0.71 in the copaiba group. The villus length was 173.60±8.42 in the sham, 142.77±8.33 in the ischemia and 143.01±9.57 in the copaiba group. There was a significant difference between the sham and the other groups (p&lt;0.05); however, there not significant difference between groups Ischemia and copaiba. Conclusion: Administration of copaiba oil did not reduce the intestinal mucosa lesion of rats after hypovolemic shock.