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Gastroesophageal reflux is the most common benign disorder of the esophagus and laparoscopic Nissen fundoplication has become the standard surgical treatment for its treatment. In our area, where the use of bougie calibration is debatable, postoperative dysphagia is encountered often after this surgery although it is usually not permanent. The aim of this study was to investigate the effect of using a soft silicone tube 39 F in diameter for esophageal calibration during laparoscopic Nissen fundoplication on the incidence of postoperative dysphagia. We divided cases scheduled to undergo laparoscopic Nissen fundoplication between January 2009 and November 2010 into two groups, each consisting 25 patients. Esophageal calibration with a 39 F silicone orogastric tube was used for the first group while there was no operative calibration in the second group. The surgical duration was recorded; the presence and severity of the postoperative dysphagia was calculated by using a dysphagia severity scoring system during the 1-year postoperative follow-up. The dysphagia severity scores were significantly lower in group 1 than group 2 on the postoperative second day and at the end of the first week and first month. We did not find a significant difference at the end of the 6-month and first year. There was also no significant difference regarding surgery duration. The use of a soft orogastric tube 39 F in diameter for esophagus calibration during laparoscopic Nissen fundoplication has significantly decreased the incidence of postoperative transient dysphagia without affecting the duration of surgery. Although dysphagia gradually resolves in the majority of patients, a safe and easy calibration method for its prevention is worth developing, and we believe that the use of our method in larger series could be beneficial. 相似文献
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Rubens Souza de OLIVEIRA Lanna Jamile Corrêa da COSTA Fernanda Atanaena Gon?alves de ANDRADE Wilson UIEDA Luzia Fátima Alves MARTORELLI Ana Paula de Arruda Geraldes KATAOKA Elizabeth Salbé Travassos da ROSA Pedro Fernando da Costa VASCONCELOS Armando de Souza PEREIRA Ant?nio Ismael Barros do CARMO Marcus Emanuel Barroncas FERNANDES 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(6):497-503
The outbreaks of rabies in humans transmitted by Desmodus rotundus in 2004 and 2005,
in the northeast of the Brazilian State of Para, eastern Amazon basin, made this a
priority area for studies on this zoonosis. Given this, the present study provides
data on this phenomenon in an urban context, in order to assess the possible
circulation of the classic rabies virus (RABV) among bat species in Capanema, a town
in the Amazon basin. Bats were collected, in 2011, with mist nets during the wet and
dry seasons. Samples of brain tissue and blood were collected for virological and
serological survey, respectively. None of the 153 brain tissue samples analyzed
tested positive for RABV infection, but 50.34% (95% CI: 45.67-55.01%) of the serum
samples analyzed were seropositive. Artibeus planirostris was the most common
species, with a high percentage of seropositive individuals (52.46%, 95% CI: 52.31
52.60%). Statistically, equal proportions of seropositive results were obtained in
the rainy and dry seasons (c2 = 0.057, d.f. = 1, p = 0.88). Significantly
higher proportions of males (55.96%, 95% CI: 48.96-62.96%) and adults (52.37%, 95%
CI: 47.35-57.39%) were seropositive. While none of the brain tissue samples tested
positive for infection, the high proportion of seropositive specimens indicates that
RABV may be widespread in this urban area. 相似文献
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