RESUMEN
PURPOSE: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. METHODS: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. RESULTS: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. CONCLUSION: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin.
Asunto(s)
Pared Abdominal/patología , Carcinoma de Células Escamosas/etiología , Infecciones Relacionadas con Prótesis/complicaciones , Mallas Quirúrgicas/efectos adversos , Pared Abdominal/cirugía , Materiales Biocompatibles/efectos adversos , Carcinoma de Células Escamosas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Poliésteres/efectos adversos , Infecciones Relacionadas con Prótesis/etiologíaAsunto(s)
Glucemia/análisis , Diabetes Mellitus Experimental/sangre , Diabetes Mellitus Experimental/cirugía , Glucagón/sangre , Insulina/sangre , Trasplante de Páncreas , Anastomosis Quirúrgica , Animales , Supervivencia de Injerto , Masculino , Sistema Porta/cirugía , Ratas , Ratas Wistar , Trasplante IsogénicoRESUMEN
We review five years experience on inguinal hernia repair under local anesthesia in a small hospital in the interior of the State of São Paulo, Brazil. Sixty patients were submitted to repair and they were evaluated according to their immediate results, kind of hernia, anesthetic and operatory techniques and recurrences. The results were considered excellent in 20% of the cases, good in 65%, regular in 13.3% and in 1.7% the results were bad. No recurrence was observed up to now. Most of the patients were discharged within 24 hours. The proposed technique has provided reduced hospital expenses and low risks of infection.
Asunto(s)
Anestesia Local/métodos , Hernia Inguinal/cirugía , Lidocaína , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
Foi estudada em caes a acao antiarritmica de metoclopramida (Plasil) em arritmias experimentais causadas por doses toxicas de desacetil-lanatosideo C e de digitoxina Foi realizada comparacao entre a metoclopramida e a fenil-hidantoina em arritmias causadas pela digitoxina. Os resultados mostram que a metoclopramida antagonizou com eficacia as arritmias causadas pelo desacetil-lanatosideo C e reverteu temporariamente, na maioria das experienicas, aquelas decorrentes da administracao de digitoxinas. Ja a definil-hidantoina nao exerceu acao antiarritmica na maioria dos caes estudados