RESUMO
BACKGROUND: Peroral endoscopic myotomy has recently been developed and performed on patients with good results. AIMS: To evaluate the technical feasibility of peroral endoscopic full-thickness and partial thickness myotomy in a porcine model. MATERIAL AND METHODS: Eighteen criollo pigs were randomly assigned to 2 groups: group A (partial-thickness myotomy) and group B (full-thickness myotomy). The mucosal defect proximal to the myotomy site was left open. On the seventh postoperative day the pig was euthanized and follow-up surgical exploration was performed. The duration of each procedure, postoperative progression of the animal, complications, and anatomopathologic findings were registered. RESULTS: The procedure was viable in all the pigs. The mean surgery duration was 81±35.3min (group A 51.11±11.12, group B 111±22.61; P<.05). The main complication during myotomy was subcutaneous emphysema (16%). The histopathologic study of the group A surgical specimens reported complete circular myotomy in all cases, and complete circular and longitudinal myotomy was reported in 100% of the group B sample. CONCLUSIONS: The endoscopic myotomy technique is feasible. Endoscopic partial-thickness myotomy was associated with shorter surgery duration and better results during the intraoperative period and the 7-day follow-up.
Assuntos
Endoscopia Gastrointestinal/métodos , Esôfago/cirurgia , Boca/cirurgia , Anestesia , Animais , Endoscopia Gastrointestinal/efeitos adversos , Acalasia Esofágica/cirurgia , Esfíncter Esofágico Inferior/cirurgia , Feminino , Músculos/cirurgia , Cirurgia Endoscópica por Orifício Natural , Hemorragia Pós-Operatória , SuínosRESUMO
OBJECTIVE: To assess whether coronary stenting in diabetic patients provides in-hospital results and clinical evolution similar to those in nondiabetic patients. METHODS: From July '97 to April '99 we performed coronary stent implantation in 386 patients with coronary heart disease, who were divided into two groups: diabetic patients and nondiabetic patients. The in-hospital results and the clinical evolution of each group were retrospectively analyzed. RESULTS: The nondiabetic group comprised 305 (79%) patients and the diabetic group 81 (21%) patients. Basic clinical and angiographic characteristics were similar. Angiographic success was in diabetics = 96.6% vs in nondiabetics = 97.9% (p=ns). Among the major complications in the in-hospital phase, the rate of myocardial infarction was higher in the diabetic group (7.4% vs 1.9%) (p=0.022). In the follow-up, a favorable and homogeneous evolution occurred in regard to asymptomatic patients, myocardial infarction, and death in the groups. A greater need for revascularization, however, existed in the diabetic patients (15% vs 2.4%, p<0.001). CONCLUSION: Coronary stenting in diabetic patients is an efficient procedure, with a high angiographic and clinical success rate similar to that in nondiabetic patients. Diabetic patients, however, had a higher incidence of in-hospital myocardial infarction and a greater need for additional myocardial revascularization.
Assuntos
Doença das Coronárias/terapia , Angiopatias Diabéticas/terapia , Stents , Estudos de Casos e Controles , Angiografia Coronária , Diabetes Mellitus Tipo 1/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Revascularização Miocárdica , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Angiomyofibroblastoma is a rare mesenchymal tumor predominantly of vulvar location. It is characterized being of superficial and slow-growth, low propensity for local recurrence and often misdiagnosed as a Bartholin's gland cyst, hydrocele of the canal of Nuck and aggressive angiomyxoma. A case of vulvar angiomyofibroblastoma in a 56 year-old woman is presented. The specimen was processed by structural and immunohistochemical analysis. It's important to suspect the diagnosis and to distinguish it of aggressive angiomyxoma.