SERGIO EDUARDO ALONSO ARAUJO
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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- Functional outcome of autologous anorectal transplantation in an experimental model(2015) SEID, V. E.; GALVAO, F. H. F.; VAIDYA, A.; WAISBERG, D. R.; CRUZ JR., R. J.; CHAIB, E.; NAHAS, S. C.; ARAUJO, S. E. A.; D'ALBUQUERQUE, L. A. C.; ARAKI, J.Background: Although anorectal transplantation is a challenging procedure, it is a promising option for patients who have completely lost anorectal function or in whom it failed to develop, as in congenital malformations. The paucity of animal models with which to test functional outcomes was addressed in this study of anorectal manometry in rats. Methods: Wistar rats were assigned randomly to four groups: orthotopic anorectal transplantation, heterotopic transplantation, sham operation, or normal control. Bodyweight and anal pressure were measured immediately before and after operation, and on postoperative days 7 and 14. ANOVA and Tukey's test were used to compare results for bodyweight, anal manometry and length of procedure. Results: Immediately after the procedure, mean(s.d.) anal pressure in the orthotopic group (n=13) dropped from 31.4(13.1) to 1.6(13.1) cmH(2)O (P < 0.001 versus both sham operation (n=13) and normal control (n=15)), with partial recovery on postoperative day 7 (14.9(13.9) cmH(2)O) (P=0.009 versus normal control) and complete recovery on day 14 (23.7(12.2) cmH(2)O). Heterotopic rats (n=14) demonstrated partial functional recovery: mean(s. d.) anal pressure was 26.9(10.9) cmH(2)O before operation and 8.6(6.8) cmH(2)O on postoperative day 14 (P < 0.001 versus both sham and normal control). Conclusion: Orthotopic anorectal transplantation may result in better functional outcomes than heterotopic procedures.
- The Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance(2018) JULIAO, Guilherme Pagin Sao; ORTEGA, Cinthia D.; VAILATI, Bruna Borba; COUTINHO, Francisco A. B.; ROSSI, Gustavo; HABR-GAMA, Angelita; FERNANDEZ, Laura Melina; ARAUJO, Sergio Eduardo Alonso; BROWN, Gina; PEREZ, Rodrigo OlivaObjective To estimate the improvement in surgical exposure by removal of the coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Methods Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of coccyx (no coccyx resection) or the tip of last sacral vertebra (coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon's view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference (""Gain"") in surgical field exposure by removal of the coccyx was compared by the solid angle variation between the two estimates (with and without the coccyx). Results Routine removal of the coccyx determines an average 42% (95% CI 27-57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had >= 30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Conclusions Routine removal of the coccyx during APR may result in an average increase in 42% in surgical field exposure during APR's perineal dissection. Precise estimation of surgical field exposure gain by removal of the coccyx may be predicted by MR sagittal series for each individual patient.