RESUMO
BACKGROUND: Female sex has been associated with worse outcomes after groin hernia repair (GHR), including a higher rate of chronic pain and recurrence. Most of the studies in GHR are performed in males, and the recommendations for females extrapolate from these studies, even though females have anatomy intricacies. The round ligament of the uterus (RLU) is associated with pelvic stabilization and plays a role in sensory function. Transection of the RLU during GHR is controversial as it can allow easier mesh placement but can favor genitourinary complications and chronic pain. As no previous meta-analysis compared preserving versus transecting the RLU during minimally invasive (MIS) GHR, we aim to perform a systematic review and meta-analysis evaluating surgical outcomes comparing the approaches. METHODS: Cochrane Central, Embase, and PubMed databases were systematically searched for studies comparing transection versus preservation of the RLU in MIS groin hernia surgeries. Outcomes assessed were operative time, bleeding, surgical site events, hospital stay, chronic pain, paresthesia, recurrence rates, and genital prolapse rates. Statistical analysis was performed using RevMan 5.4.1. Heterogeneity was assessed with I2 statistics. A review protocol for this meta-analysis was registered at PROSPERO (CRD 42023467146). RESULTS: 1738 studies were screened. A total of six studies, comprising 1131 women, were included, of whom 652 (57.6%) had preservation of the RLU during MIS groin hernia repair. We found no statistical difference regarding chronic pain, paresthesia, recurrence rates, and postoperative complications. We found a longer operative time for the preservation group (MD 6.84 min; 95% CI 3.0-10.68; P = 0.0005; I2 = 74%). CONCLUSION: Transecting the RLU reduces the operative time during MIS GHR with no difference regarding postoperative complication rates. Although transection appears safe, further prospective randomized studies with long-term follow-up and patient-reported outcomes are necessary to define the optimal management of RLU during MIS GHR.
Assuntos
Hérnia Inguinal , Herniorrafia , Humanos , Feminino , Herniorrafia/métodos , Hérnia Inguinal/cirurgia , Duração da Cirurgia , Ligamentos Redondos/cirurgia , Laparoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , RecidivaRESUMO
Background: Ligamentum teres (LT) has traditionally been considered a vestigial or redundant structure in humans; however, based on new studies and the evolution of hip arthroscopy, the LT injury has been viewed as a source of hip pain. Therefore, LT reconstruction can be beneficial in some cases. Rabbits have been frequently used as a model for cranial cruciate ligament reconstruction but few studies are available for ligamentum teres reconstruction. Objective: To evaluate the semitendinosus tendon to replace ligamentum teres with the toggle technique, using rabbits as an experimental model. Methods: Twenty-six female Norfolk rabbits with approximately 3 months of age were divided into two equal groups after excision of ligamentum teres (LT) from the right hip joint: G1-no reconstruction of LT and capsulorrhaphy; G2-double-bundle reconstruction of the LT using semitendinosus tendon autograft. In both groups, the LT was removed from the right hip joint. In G2 the autograft was harvested from the left hind limb of the same rabbit. The rabbits were evaluated clinically at different time intervals; before surgery (M1), 48 h (M2), 15 days (M3), 30 days (M4) and 90 days (M5) after surgery. Results: The rabbits supported their limbs on the ground in both the groups. As complications of the procedure, four hip joints showed subluxations in the radiographic evaluation of G1; three at M4 and one at M5. In G2; two luxations of hip joints at M3 and one subluxation at M4 were seen. On ultrasound, irregular articular surface was seen in 30.8% of the rabbits that had subluxation of hip joints. Gross evaluation identified tendon graft integrity in 76.92% of the rabbits. Histological analysis revealed graft adhesion to the bone in the early phase comprised of sharpey-like collagen fibers. Conclusion: The double-bundle reconstruction of the LT using autologous semitendinosus tendon associated with the toggle rod shows an early phase of tendon graft ligamentization at 90 days post-operatively in young rabbits, but biomechanical bias suffered by the tendon during gait must be considered.
Assuntos
Tendões dos Músculos Isquiotibiais , Luxações Articulares , Ligamentos Redondos , Humanos , Animais , Coelhos , Feminino , Ligamento Cruzado Anterior/cirurgia , Articulação do Quadril/diagnóstico por imagem , Artroscopia/métodosRESUMO
PURPOSE: In the classical description of normal liver anatomy, the umbilical fissure is a long, narrow groove that receives the ligamentum teres hepatis. The pons hepatis is an anatomic variant, where the umbilical fissure is converted into a tunnel by an overlying bridge of liver parenchyma. We carried out a study to evaluate the existing variations of the umbilical fissure in a Caribbean population. METHODS: We observed all consecutive autopsies performed at a facility in Jamaica and selected cadavers with a pons hepatis for detailed study. A pons hepatis was considered present when the umbilical fissure was covered by hepatic parenchyma. We recognized two variants: an open-type (incomplete) pons hepatis in which the umbilical fissure was incompletely covered by parenchyma ≤ 2 cm in length and a closed type (complete) pons hepatis in which the umbilical fissure was covered by a parenchymal bridge > 2 cm and thus converted into a tunnel. We measured the length (distance from transverse fissure to anterior margin of the parenchymatous bridge), width (extension across the umbilical fissure in a coronal plane) and thickness (distance from the visceral surface to the hepatic surface measured at the mid-point of the parenchymal bridge in a sagittal plane) of each pons hepatis. A systematic literature review was also performed to retrieve data from relevant studies. The raw data from these retrieved studies was used to calculate the global point prevalence of pons hepatis and compared the prevalence in our population. RESULTS: Of 66 autopsies observed, a pons hepatis was present in 27 (40.9%) cadavers. There were 15 complete variants, with a mean length of 34.66 mm, mean width of 16.98 mm and mean thickness of 10.98 mm. There were 12 incomplete variants, with a mean length of 17.02 mm, width of 17.03 mm and thickness of 9.56 mm. The global point prevalence of the pons hepatis (190/5515) was calculated to be or 3.45% of the global population. CONCLUSIONS: We have proposed a classification of the pons hepatis that is reproducible and clinically relevant. This allowed us to identify a high prevalence of pons hepatis (41%) in this Afro-Caribbean population that is significantly greater than the global prevalence (3.45%; P < 0.0001).
Assuntos
Variação Anatômica , Fígado/anormalidades , Ligamentos Redondos/anormalidades , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
A literatura atual discute múltiplas modalidades de imagem para acompanhar o processo de cicatrização da origem do ligamento suspensor do boleto (LSB) em equinos, mas nenhuma pode garantir que eles possuam fibras colágenas com calibre suficiente para suportar o retorno ao exercício. Já as técnicas morfológicas e bioquímicas, bem como a análise de birrefringência, podem ser mais apropriadas para caracterizar o processo de cicatrização e avaliar a eficiência do tratamento. O objetivo deste artigo é descrever procedimento simples que possibilita a coleta de amostras teciduais de boa qualidade e em sentido longitudinal, por biópsia em equinos em estação. Após antissepsia local, sedação e bloqueio do nervo palmar lateral no aspecto medial do osso acessório do carpo (OAC), o membro foi colocado em suspensão com o carpo flexionado em 90º; a agulha de biópsia guiada por ultrassom foi introduzida em sentido distoproximal, 11 a 13cm distal ao OAC, ângulo de 20º em relação ao LSB, até a região de sua origem. O equipamento foi disparado e coletou-se a amostra tecidual. Essa técnica possibilitou a coleta de fragmentos de boa qualidade para análise histológica e de birrefringência, sem reações adversas, podendo ser usada em modelos experimentais ou na prática clínica.(AU)
Assuntos
Animais , Ligamentos Redondos/diagnóstico por imagem , Cavalos , Biópsia Guiada por Imagem/veterináriaAssuntos
Ductos Biliares/cirurgia , Colecistite Aguda/cirurgia , Ligamentos Redondos/cirurgia , Idoso , Ductos Biliares/lesões , Ductos Biliares/patologia , Colecistectomia Laparoscópica , Colecistite Aguda/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Necrose , Ligamentos Redondos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Humanos , Masculino , Idoso , Ductos Biliares/cirurgia , Colecistite Aguda/cirurgia , Ligamentos Redondos/cirurgia , Ductos Biliares/lesões , Ductos Biliares/patologia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Colecistectomia Laparoscópica , Colecistite Aguda/diagnóstico por imagem , Ligamentos Redondos/diagnóstico por imagem , NecroseRESUMO
El ligamento falciforme es una reflexión peritoneal abdominal relacionada con la superficie anterior del hígado, que en su borde inferior libre contiene el ligamento redondo (LR); las lesiones únicas en este son infrecuentes. Presentamos un caso de metástasis única en el ligamento redondo en un paciente con antecedente de carcinoma renal de células claras. Realizamos una búsqueda bibliográfica para identificar casos similares. Nuestro paciente es un varón de 71 años con antecedente de carcinoma renal de células tratado con nefrectomía radical izquierda laparoscópica (estadio pT3a). En tomografía computarizada (TC) control a los 5 años se evidencia lesión focal en la periferia del segmento IVa, ante la sospecha de malignidad, se realiza laparotomía exploradora revisando toda la cavidad abdominal sin evidenciar otros implantes peritoneales. Se halla un nódulo de 1 cm en el ligamento redondo y se realiza su exéresis completa, con diagnóstico anatomopatológico de metástasis de células claras. El LR generalmente está afectado en casos de carcinomatosis peritoneal y solo existen dos casos publicados de metástasis únicas.
The falciform ligament is a peritoneal reflection that attaches the liver to the anterior abdominal wall; its lower edge contains the round ligament (RL). Single lesions in the RL are rare and usually correspond to perivascular epithelioid cell tumors. We present a case report of a single metastasis in the RL in a patient with clear cell renal cell carcinoma who underwent surgery five years ago. We conducted a literature review to identify similar cases and we found two case reports of single metastasis in the RL. Our patient was a 71-year-old man with a history of renal cell carcinoma who underwent left laparoscopic radical nephrectomy (stage pT3a), laparoscopic right adrenalectomy and total thyroidectomy due to multinodular goiter. The pathological examination revealed metastases of renal cell carcinoma. A computed tomography (CT) scan performed at 5-year follow-up showed a focal lesion in segment IVa with no FDG uptake in the PET scan, but as malignancy was suspected, the patient underwent exploratory laparatomy with no evidence of peritoneal implants. A 1-cm node was found in the round ligament that was completely resected. The pathological examination revealed metastatic clear cell renal cell carcinoma. The RL is involved in cases of peritoneal carcinomatosis and only two cases of single metastasis have been reported: in one patient with papillary renal cell carcinoma pT1aN0 and another one with left breast adenocarcinoma.
Assuntos
Humanos , Masculino , Idoso , Carcinoma de Células Renais/complicações , Ligamentos Redondos/lesões , Neoplasias Renais/complicações , Metástase Neoplásica/diagnóstico , Carcinoma de Células Renais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ligamentos Redondos/patologiaRESUMO
Abstract Recurrent adnexal torsion is a rare gynecological emergency. We report a case of recurrent ipsilateral adnexal torsion in a woman with polycystic ovaries, previously submitted to a laparoscopic plication of the utero-ovarian ligament. Due to the recurrence after the plication of the utero-ovarian ligament, the authors performed a laparoscopic oophoropexy to the round ligament, which is an underreported procedure. The patient was asymptomatic for 1 year, after which she had a new recurrence and needed a unilateral laparoscopic adnexectomy. Since then, she regained the quality of life without any gynecological symptoms. Oophoropexy to the round ligament may be considered when other techniques fail or, perhaps, as a first option in selected cases of adnexal torsion, as it may allow the prevention of recurrence without increasing morbidity while preserving the adnexa.
Resumo A torção anexial recorrente é uma emergência ginecológica rara. Os autores descrevem um caso de torsão anexial unilateral recorrente em uma paciente com síndrome de ovário policístico, previamente submetida a plicatura do ligamento utero-ovárico por laparoscopia. Nesta circunstância, os autores decidiram realizar uma ooforopexia laparoscópica ao ligamento redondo, uma técnica pouco descrita na literatura. A paciente manteve-se assintomática durante 1 ano, período após o qual teve nova recorrência, tendo-se decidido realizar uma anexectomia laparoscópica unilateral. Desde então, ela recuperou a qualidade de vida sem qualquer sintoma ginecológico. A ooforopexia ao ligamento redondo é uma técnica que deverá ser considerada quando outras falham e, em casos selecionados de torsão anexial recorrente, poderá ser considerada a primeira abordagem, para prevenir a recorrência e preservar o anexo.
Assuntos
Humanos , Feminino , Adulto , Anormalidade Torcional/cirurgia , Doenças dos Anexos/cirurgia , Ovário/cirurgia , Procedimentos Cirúrgicos em Ginecologia , Ligamentos Redondos/cirurgiaRESUMO
Recurrent adnexal torsion is a rare gynecological emergency. We report a case of recurrent ipsilateral adnexal torsion in a woman with polycystic ovaries, previously submitted to a laparoscopic plication of the utero-ovarian ligament. Due to the recurrence after the plication of the utero-ovarian ligament, the authors performed a laparoscopic oophoropexy to the round ligament, which is an underreported procedure. The patient was asymptomatic for 1 year, after which she had a new recurrence and needed a unilateral laparoscopic adnexectomy. Since then, she regained the quality of life without any gynecological symptoms.Oophoropexy to the round ligament may be considered when other techniques fail or, perhaps, as a first option in selected cases of adnexal torsion, as it may allow the prevention of recurrence without increasing morbidity while preserving the adnexa.
A torção anexial recorrente é uma emergência ginecológica rara. Os autores descrevem um caso de torsão anexial unilateral recorrente em uma paciente com síndrome de ovário policístico, previamente submetida a plicatura do ligamento utero-ovárico por laparoscopia. Nesta circunstância, os autores decidiram realizar uma ooforopexia laparoscópica ao ligamento redondo, uma técnica pouco descrita na literatura. A paciente manteve-se assintomática durante 1 ano, período após o qual teve nova recorrência, tendo-se decidido realizar uma anexectomia laparoscópica unilateral. Desde então, ela recuperou a qualidade de vida sem qualquer sintoma ginecológico.A ooforopexia ao ligamento redondo é uma técnica que deverá ser considerada quando outras falham e, em casos selecionados de torsão anexial recorrente, poderá ser considerada a primeira abordagem, para prevenir a recorrência e preservar o anexo.
Assuntos
Doenças dos Anexos/cirurgia , Anormalidade Torcional/cirurgia , Adulto , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Ovário/cirurgia , Recidiva , Ligamentos Redondos/cirurgiaRESUMO
Objective: To perform a histological study describing the microstructure of the ligamentum teres of the hip, with special emphasis on the presence of nerve bundles. Our study aims to correlate the microstructure of the ligamentum teres with its postulated functions, allowing greater understanding of its role within the hip joint. Methods: Fresh specimens excised intra-operatively in 11 patients undergoing open hip procedures were preserved in formalin and sent to the laboratory for histological analysis by our collaborating pathologist. The specimens were sectioned and stained, and examined under the microscope to look at their microstructure. In addition, a novel staining technique was employed to detect neural elements within the individual specimens . Results: The ligamentum teres is composed predominantly of a connective tissue matrix of collagen fibers, fibrous and adipose tissue, with an overlying layer of investing synovium. In addition, there are blood vessels of various sizes surrounded by a layer of encircling fat. In all specimens examined, there were nerve bundles of various shapes and sizes, regardless of the age of the patient. Conclusion: The ligamentum teres has both mechanical and biological functions within the hip joint and should no longer be considered a developmental vestige. Where possible, any surgical procedures around the hip joint should aim to limit damage to this structure to minimize any potential loss of function. Level of Evidence Basic Science Study.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Ligamentos Redondos/anatomia & histologia , Quadril , Articulação do Quadril , Ligamentos/anatomia & histologiaRESUMO
Objetivo: Presentar un caso de quiste de Nuck de la región inguinal. Métodos: Paciente adolescente de 16 años con aumento de volumen en región inguinal derecha y presencia de dolor, cuadro clínico de una hernia inguinal atascada. Resultados: El hallazgo quirúrgico de la intervención resultó ser un quiste de la región inguinal y cuyo resultado de anatomía patológica reporta ser un quiste de Nuck. Conclusión: Se define como quiste de Nuck, o quiste del ligamento redondo, un divertículo del peritoneo parietal en el canal inguinal que acompaña al ligamento redondo en la mujer encontrándose en condiciones fisiológicas obliterado. Este se manifiesta como un aumento de volumen en la región inguinal,irreductible, que puede ir acompañado o no de dolor; a veces puede presentarse simulando una hernia inguinocrural incarcelada y es frecuente en niños, siendo su presencia en adolescente y mujeres adultas y de avanzada edad una entidad muy rara(AU)
Objective: To present a case of Nuck's cyst in the inguinal region. Methods: A 16-year female teenager with an increase of volume in the right inguinal region and presence of pain. Clinical symptoms of an incarcerated inguinal hernia. Results: Surgical finding at the intervention turned out to bea cyst of the inguinal region and the result of pathology reported to be a cyst of Nuck. Conclusion: It is defined as cyst of Nuck, or cyst of the round ligament, a diverticulum of the peritoneum in the inguinal canal accompanying the round ligament in women being in physiological conditions obliterated. This is manifested as an increase in volume in the inguinal region, irreducible, that can go with or without pain, and sometimes mimicking a hernia can occurs inguinocrural incarcerated and is common in children being its presence in adolescent and adult women and elderly a very rare(AU)
Assuntos
Humanos , Feminino , Adolescente , Adolescente , Cistos , Virilha , Hérnia Inguinal , Dor , Patologia , Peritônio , Ligamentos RedondosRESUMO
As luxações coxofemorais traumáticas são importantes afecções ortopédicas nos cães e gatos devido a sua grande freqüência. O tratamento primário de escolha é a redução fechada, no entanto em algumas circunstâncias faz-se necessário o uso do método aberto/ cirúrgico. O presente trabalho tem por obje¬tivo propor um método cirúrgico para o tratamento das luxações coxofemorais traumáticas em cães, estabilizando a articulação coxofemoral pela substituição do ligamento redondo femoral utilizando-se a fáscia lata. Foram utilizados 18 cães adultos, sem raça definida, machos e fêmeas, separados em três grupos de acordo com o peso corporal. A estabilização foi obtida por um loop de fáscia lata inserido a partir do terceiro trocânter, emergindo na fóvea capitis e através do acetábulo, retornando ao pon¬to de inserção. Não se utilizou em nenhum dos casos imobilização após a cirurgia. A deambulação foi avaliada diariamente e as articulações foram observadas macroscopicamente aos 60 e 90 dias de pós-operatório. Dois animais não apoiaram o membro operado no pós-operatório imediato, porém, a recuperação total não foi afetada. Os outros animais dos grupos A, B e C apoiaram o membro no pós-¬operatório imediato e a recuperação total foi obtida aos 15,5, 18 e 16,5 dias, respectivamente. Os resul¬tados desse experimento demonstram que a técnica cirúrgica proposta permite manter a estabilidade articular, com apoio precoce e uso funcional do membro em período relativamente curto(AU)
The traumatic coxofemural luxations are important orthopedics injuries in dogs and cats due to their great frequency. Close reduction is the first choice of treatment, but at some circumstances the use of open/ sur¬gical methods are necessary. The present study has as an objective to propose a surgical method for treat¬ment of traumatic hip dislocations in dogs, stabilizing the coxofemoral articulation by the replacement of the round femoral ligament using the fascia lata. For this experiment 18 adult dogs, without defined race, males and females, were used, separated in three groups according to corporal weight. The stabilization was obtained for loop of fascia lata inserted from the third trochanter, emerging in the fóvea capitis and through the acetabulum, returning to the insert point. In none of the cases immobilization after surgery was used. Walking movement was daily evaluated and articulations were macroscopically observed at 60th and 90th day of postoperative. Two animals didn't weightbear the operated member during the im¬mediate postoperative, but total recover was not affected. Other animals of groups A, B and C weightbea¬red the member at immediate postoperative and the total recover was at 15.5, 18 and 16.5 days, respective¬ly. These experiment' s results show that the surgical technique proposed allows maintaining the articulate stability, with an early weightbearing and relatively short period of functional use of the member(AU)
Assuntos
Animais , Cães , Cães , Ligamentos Redondos , Displasia Pélvica Canina , Fascia LataRESUMO
As luxações coxofemorais traumáticas são importantes afecções ortopédicas nos cães e gatos devido a sua grande freqüência. O tratamento primário de escolha é a redução fechada, no entanto em algumas circunstâncias faz-se necessário o uso do método aberto/ cirúrgico. O presente trabalho tem por obje¬tivo propor um método cirúrgico para o tratamento das luxações coxofemorais traumáticas em cães, estabilizando a articulação coxofemoral pela substituição do ligamento redondo femoral utilizando-se a fáscia lata. Foram utilizados 18 cães adultos, sem raça definida, machos e fêmeas, separados em três grupos de acordo com o peso corporal. A estabilização foi obtida por um loop de fáscia lata inserido a partir do terceiro trocânter, emergindo na fóvea capitis e através do acetábulo, retornando ao pon¬to de inserção. Não se utilizou em nenhum dos casos imobilização após a cirurgia. A deambulação foi avaliada diariamente e as articulações foram observadas macroscopicamente aos 60 e 90 dias de pós-operatório. Dois animais não apoiaram o membro operado no pós-operatório imediato, porém, a recuperação total não foi afetada. Os outros animais dos grupos A, B e C apoiaram o membro no pós-¬operatório imediato e a recuperação total foi obtida aos 15,5, 18 e 16,5 dias, respectivamente. Os resul¬tados desse experimento demonstram que a técnica cirúrgica proposta permite manter a estabilidade articular, com apoio precoce e uso funcional do membro em período relativamente curto
The traumatic coxofemural luxations are important orthopedics injuries in dogs and cats due to their great frequency. Close reduction is the first choice of treatment, but at some circumstances the use of open/ sur¬gical methods are necessary. The present study has as an objective to propose a surgical method for treat¬ment of traumatic hip dislocations in dogs, stabilizing the coxofemoral articulation by the replacement of the round femoral ligament using the fascia lata. For this experiment 18 adult dogs, without defined race, males and females, were used, separated in three groups according to corporal weight. The stabilization was obtained for loop of fascia lata inserted from the third trochanter, emerging in the fóvea capitis and through the acetabulum, returning to the insert point. In none of the cases immobilization after surgery was used. Walking movement was daily evaluated and articulations were macroscopically observed at 60th and 90th day of postoperative. Two animals didn't weightbear the operated member during the im¬mediate postoperative, but total recover was not affected. Other animals of groups A, B and C weightbea¬red the member at immediate postoperative and the total recover was at 15.5, 18 and 16.5 days, respective¬ly. These experiment' s results show that the surgical technique proposed allows maintaining the articulate stability, with an early weightbearing and relatively short period of functional use of the member
Assuntos
Animais , Cães , Cães , Displasia Pélvica Canina , Fascia Lata , Ligamentos RedondosRESUMO
Compararam-se duas técnicas cirúrgicas de redução e estabilização da articulação coxofemoral experimentalmente luxada em cães. Dois grupos de animais, submetidos às respectivas técnicas após a indução cirúrgica da luxação, foram acompanhados clínica e radiograficamente por um período de 60 dias, findos os quais, realizaram-se avaliações macroscópica e histológica e teste de tensiometria das articulações. Cada grupo foi constituído por oito animais, clinicamente sadios, com pesos entre 5 e 20kg. Os animais submetidos ao implante de fáscia apresentaram, ao exame físico, evolução da deambulação significativamente precoce em relação aos do grupo submetido ao implante de pino de Steinmann, além de menor grau de atrofia muscular. Os testes de tensiometria, as avaliações macroscópicas e radiográficas e os exames histológicos não diferiram entre os grupos, evidenciando também que ambas as técnicas não geraram alterações deletérias à articulação operada. Conclui-se que a técnica de estabilização da articulação coxofemoral com implante de fascia lata foi clinicamente eficaz e vantajosa quando comparada à técnica do pino transarticular.(AU)
It was compared both surgical techniques of reduction and stabilization of experimentally luxated coxofemoral join in dog. Two groups were submitted to the techniques after surgical induction of the luxation. All animals were clinically and radiografically observed during 60 days. After that, a macroscopic study, an histological exam, and a tensiometry test in the articulations were performed. Each group had eight healthy animals, weighting from 5 to 20kg. The most important advantage was related to the deambulation, which the animals submited to the facia lata implant showed a faster evolution after the surgery at the physical exam, and muscular atrophy in a smaller degree. The tensiometry tests, the radiographic and the histological exams did not present important differences between both groups, but they were useful to show that the two techniques did not cause alterations in the studied articulation. It can be concluded that the stabilization of the coxofemoral articulation using bubaline fascia lata implant was clinically efficient and more advantageous compared to the transarticular pin technique.(AU)
Assuntos
Animais , Adulto , Cães , Fascia Lata/transplante , Transplante Heterólogo/métodos , Transplante Heterólogo/veterinária , Pinos Ortopédicos , Luxações Articulares , Ligamentos RedondosRESUMO
Cysts of the inguinal cord are disorders that simulate inguinal hernias and manifest as inguinal masses and, in some cases, are accompanied by pain that can simulate a complicated inguinal hernia. We report the third case of a round ligament cyst in a 21-year-old female with a mass in the right inguinal area with intermittent pain. The patient was subjected to surgical exploration of the right inguinal area where a round ligament cyst was found. The ligament was resected and reported as a serous cyst. The patient's outcome was excellent and she was discharged 24 h after surgery. She has been followed up for 3 months without recurrence. Round ligament cysts are very rare disorders, and the diagnosis is perioperative. Resection of the round ligament causes complete symptom relief, and every case requires inguinal hernioraphy.
Assuntos
Humanos , Feminino , Adulto , Cistos/diagnóstico , Doenças dos Genitais Femininos/diagnóstico , Hérnia Inguinal/diagnóstico , Ligamentos Redondos , Diagnóstico DiferencialRESUMO
Leiomiossarcomas são tumores mesenquimais pouco comuns e tornam-se raros quando sua etiologia é de tecido estromal gastrintestinal ou de outra musculatura lisa. Objetivo - relatar um caso de tumor cístico de ligamento redondo de difícil diagnóstico clínico. Relato de caso - paciente de 31 anos com tumoração em hipocôndrio direito e epigástrio há aproximadamente três anos, sem perda de peso ou / Leiomyosarcomas are uncommon mesenchymal tumors and are even scarcer when they develop from gastrointestinal stromal tissue or some other smooth muscle. Aim - To report a case of cystic tumor from the round ligament, with difficult clinical diagnosis. Case report - 31 year-old patient presents with a lumping at the right hypochondrium and epigastrum for about 3 years, with no weight loss or any other complaints...
Assuntos
Feminino , Adulto , Humanos , Leiomiossarcoma/diagnóstico , Ligamentos Redondos , Imuno-Histoquímica , Ligamentos Redondos/patologiaRESUMO
El quiste de nuck o quiste de ligamento redondo raramente se presenta en la mujer y menos aún en la niñaSon tumoraciones en el canal inguinal.El diagnóstico cierto preoperatorio es problemática y hay que diferenciarlas principalmente de la hernia inguinal indirecta incarcerada.Los caso publicaso son escasos,sobre todo en la infancia,pero posiblemente si tuviera en cuenta este diagnostico la frecuencia de presentación sería mayor.En 1986 sólo estaban recogidos en la literatura 53 casos de 14 a 73 años.Después de 1986 se describen 19 casos más,6 de los cuales son niñas de menos de 14 años.Nosotros hemos atendidos a dos niñas que constituyen el séptimo y el octavo caso en la infacia