Browsing by Author "Cidade-Rodrigues, J."
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- Recorrência do refluxo gastro-esofágico após fundoplicatura em criançasPublication . Moreira-Pinto, J.; Osório, A.; Ferreira de Sousa, J.; Enes, C.; Pereira, F.; Cidade-Rodrigues, J.RESUMO Introdução e Objectivos: A fundoplicatura de Nissen é o tratamento padrão da hérnia do hiato e da doença do refluxo gastro-esofágico resistente à terapêutica médica. A recorrência da doença (rRGE) é um problema comum. O objectivo deste estudo foi perceber em que doentes a rRGE será mais provável e porquê? Material e métodos: Análise retrospectiva dos processos dos doentes submetidos a fundoplicatura de Nissen entre Fevereiro de 2000 e Março de 2009, na nossa Instituição. Dividiram-se os doentes em: grupo rRGE e grupo controlo (sem sinais clínicos ou imagioológicos de rRGE). Compararam-se os dois grupos quanto ao sexo, idade e percentil de peso à data da cirurgia, presença de hérnia do hiato, outras comorbilidades, presença de compromisso neurológico, história de convulsões, de medicação pulmonar crónica, de necessidade de O2 e/ou antibióticos cronicamente no período pré-operatório, técnica usada (aberta ou laparoscópica), colocação de gastrostomia, usando o teste exacto de Fischer. Resultados: 65 doentes foram submetidos a fundoplicatura de Nissen. Foram incluídos no grupo rRGE 10 doentes (15,4%). Dos parâmetros em análise, apenas foi encontrada diferença significativa em relação à colocação de gastrostomia prévia ou simultaneamente (50% no grupo rGE versus 13%, p=0,015). Conclusões: No nosso estudo, a rRGE foi maior nos doentes a quem foi colocada gastrostomia prévia ou simultaneamente. Este pode ser um sinal indirecto de um compromisso neurológico mais grave, embora não fosse encontrado significado estatístico para os restantes parâmetros comparados. Serão necessários mais estudos e com um maior número de casos para conclusões mais seguras. ABSTRACT Introduction and aim: Nissen fundoplication is the standard treatment of hiatal hernia repair and treatment of gastroesophageal reflux resistant to medical therapy. Recurrence of the disease (rGER) is a common problem. The aim of this study was to understand in which patients rGER will most probably appear and why. Material and methods: Retrospective analysis of the charts of patients submitted to Nissen fundoplication between February 2000 and March 2009 in our Hospital. Patients were divided in: rGER group and control group (without rGER). We compared both groups, concerning gender, age, and weight at the time of surgery, diagnosis of hiatal hernia, other comorbidities, presence of severe neurological failure, frequent seizures, chronic pulmonary medication, O2 supplementation, and/or chronic antibiotherapy pre-operatively, surgical technique (open or laparoscopic), gastrostomy tube placement, using exact Fischer’s test. Results: 65 patients were submitted to Nissen fundiplication. Ten patients were included in the rGER group (15,4%). After analyzing the above parameters, we found only find statistical signifi cance for gastrostomy tube placement previous or simultaneously to the fundoplication (50% in rGER group versus 13% in control group, p=0,015). Conclusions: In our study, rGER was higher in patients in whom a gastrostomy tube was placed previous or simultaneously. This could be an indirect sign of a worse neurological impair, although no statically difference was found in the other parameters. Further studies with more cases will be necessary for more reliable conclusions.
- Testículos no palpables: experiencia del Hospital Central Especializado de Crianças Maria PiaPublication . Bonet, B.; Recaman, M.; Ferreira-Sousa, J.; Carvalho, F.; Enes, C.; Cidade-Rodrigues, J.La incidencia de criptorquidia es del 1% en niños de 1 año de edad, siendo en el 20% de los casos el testículo no palpable. El objetivo de este trabajo fue estudiar la contribución de la cirugía mínimamente invasiva en el diagnóstico y tratamiento de estos pacientes. Los autores realizaron un estudio prospectivo, analítico y longitudinal durante el período de enero de 2001 a diciembre de 2004, englobando 89 niños portadores de 98 testículos no palpables sometidos a laparoscopia. Los autores analizaron los siguientes parámetros: localización del testículo no palpable, examen objetivo bajo anestesia general ecografía inguinoescrotal, edad de la intervención, hallazgos laparoscópicos, tratamiento efectuado, resultados anatomopatológicos de las piezas extirpadas y seguimiento después de la cirugía.
- Varicocoelectomy in adolescents: laparoscopic versus open high ligation techniquePublication . Moreira-Pinto, J.; Osorio, A.; Carvalho, F.; Castro, J.; Enes, C.; Reis, A.; Cidade-Rodrigues, J.Background: Treatment of varicocoele is aimed at eliminating the retrograde reflux of venous blood through the internal spermatic veins. The purpose of this investigation was to compare laparoscopic varicocoelectomy (LV) with open high ligation technique in the adolescent population. Materials and Methods: We retrospectively evaluated 33 adolescents who underwent varicocoelectomy at our paediatric hospital, between May 2004 and September 2008. Patients were divided into two groups depending on the technique: those who had an LV and those submitted to an open varicocoelectomy (OV). We analysed side, age of surgery, follow-up period and the incidence of recurrence/persistence, hydrocoele formation and wound complication. Results: There were 24 patients in the LV group and 9 in the OV group. All varicocoeles were in the left side. Mean age was 12 years in both groups. Mean follow-up time was 32 months for the LV group and 38 months for the OV group (P = 0.49). There was no significant difference in the incidence of hydrocoele in both the groups (25% versus 22%, P = 0.626). There was no recurrence/persistence on the LV group, while in the OV group there were three cases (P = 0.015). Conclusion: LV seems more efficient than open high ligation technique in the treatment of adolescents«SQ» varicocoeles. Larger series are necessary to draw more reliable conclusions.