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Biomedical subjects

N F Margarido

Publications and source records attributed to N F Margarido.

At least 19 recordsLinked to original sources
PubMed1998

Laparoscopic extraperitoneal repair of inguinal hernias.

The world of surgical laparoscopy is evolving. Laparoscopic prosthetic inguinal hernia repair is gaining rapid and wide acceptance. This experience consisted of 144 hernia repairs in 105 patients (40 bilateral, 31 recurrent, and 33 unilateral nonrecurrent hernias), treated through an extraperitoneal laparoscopic repair. When compared with transabdominal repair, operative time and postoperative recovery were similar, with some advantages related to the avoidance of intraabdominal manipulation and potential related complications. In spite of a relatively short follow-up (up to 40 months), there were no recurrences in this series. Morbidity rate was acceptable (16.1%), mainly reported as minor complications. Anatomical and technical skills to perform the operation are required and achieved through training. Extraperitoneal hernia repair with synthetic mesh is safe and feasible, with the advantages of being associated with less pain, rapid return to full activities, and the already proven milder systemic responses following interventional laparoscopy.

Female↗
PubMed1998

Transabdominal or totally extraperitoneal laparoscopic hernia repair?

Laparoscopic repair of inguinal hernias follows some principles that have already proven its efficiency, as a posterior approach and the prosthetic repair that allows a "tension-free" repair with consequent early return to work and low recurrence rate. To determine the most appropriate laparoscopic repair, we compared the transabdominal preperitoneal (TAPP) and the totally extraperitoneal (TEP) approach. Patients undergoing TAPP and TEP were compared regarding technical feasibility and difficulties, time until return to work and follow-up, including intraoperative and postoperative complications. Seventy-eight patients (108 hernias) were submitted to TAPP and 67 (100 hernias) were repaired through TEP. All data were analyzed by Yates-corrected chi-square test to qualitative analysis of each group and p < or = 0.05 was considered significant. Both procedures were indicated mainly for bilateral and/or recurrent hernias (68%). The operative time was shorter in TAPP (not statistically significant). Surgeons complained of more technical difficulties while performing the TEP approach (70% complaints of difficulty in TEP--four conversions to TAPP). There was no difference in hospital stay (mean of 30 h) and return to work (TAPP 7 days and TEP 5.5 days). Regarding the complication rate (TAPP = 20.5% and TEP = 13.5%; not significant), none were related to the pneumoperitoneum technique or its systemic effects. In the TAPP approach, two trocar site hernias occurred, and in the TEP approach, one severe cellulitis occurred, which was managed without surgical intervention. The mean follow-up period for each procedure was not the same, so the recurrence rates are not comparable statistically (rate of 1.85% in TAPP and 0 in TEP). Both techniques are safe and have the same advantages, but TAPP is easier: a better view of the anatomy is achieved, shortening the learning curve. We suggest that TAPP can be an adequate laparoscopic approach to groin hernias. A longer follow-up period and more cases are needed to determine recurrence rates.

Adult↗
PubMed1985

Effects of protein depletion and repletion on experimental open wound contraction.

A controlled comparative study was conducted on the contraction of open wounds in protein-depleted and depleted-repleted Wistar rats. The wounds were photographed on days 1, 4, 8, 11, 15, 18, and 22 after infliction. The slides were projected and the areas corresponding to the wound were measured by planimetry. The results were analyzed using exponential regressions. Wound contraction was slowed in the protein-depleted animals but was normalized in the animals repleted immediately after the wound was produced. Comparing these results with observations from previous studies, the authors inferred that deficiencies in wound contraction in depleted animals are caused by morphological and functional changes in the granulation tissue. These deficiencies are promptly corrected by protein repletion.

Animals↗
PubMed1984

The effects of protein malnutrition on wound contraction: an experimental study.

The effects of protein malnutrition on wound contraction experimentally produced in Wistar rats were studied. The wounds were photographed on the first, fourth, eighth, eleventh, fifteenth, eighteenth, and twenty-second days. From dressings made from the projection of transparencies the contracted wounds were measured with a planimeter. Open wounds contracted more slowly in the malnourished group. Matching these observations with histopathological findings based on serial observations in these same animals, the differences between the contraction of open wounds in poorly nourished animals and in the control group seem to be associated with delay in the formation and the poor quality of granulation tissue in the malnourished.

Animals↗
PubMed1979

[Effects of choledochal perfusion with biliary acid solutions on activity of the sphincter of Oddi (author's transl)].

The changes of sphincter of Oddi's resistance, induced by choledochal perfusion of conjugated (taurocolic) and non-conjugated (colic) biliary acid solutions, in anesthetized dogs, were studied. The perfusions were made at a constant flow and intracholedochal pressures were registered. The mean number of contractions per minute, the mean maximal pressures and the mean minimal pressures in each study periods were analysed. The choledochal perfusion with the biliary acids solutions induced a slight but significative increase in sphincteric resistance. After 15 minutes, the perfusion with colic acid solution induced maximal pressures significantly more elevated than the ones observed with taurocolic acid solution. The non-conjugated solution induced a pressure tracing significantly distinct from the tracing observed with the conjugated acid solution. No changes in resistance were observed with a 2% NaCl solution. This implies that the observed changes in resistance were not related to osmotic stimulation of the sphincter of Oddi.

Ampulla of Vater↗
PubMedDate not supplied

Experimental injury to the spleen study of interaction: contamination/preservation.

Ablation of the spleen leads to a significant risk of postsplenectomy invasive sepsis. This concept has become very important in the last three decades because of awareness of the spleen's important role in immunological functions. Hence, this has led many research centers to study hemostasis of the injured spleen in order to preserve its function. The objective of this study is to analyze the use of nylon mesh for preservation of the wounded spleen in the presence or absence of local contamination. Twenty dogs were operated, randomly divided into two groups and followed postoperatively for eight weeks. A standard splenic injury was produced in all animals and hemostasis accomplished by attaching nylon mesh to the organ. Postoperatively, in one of the groups the "wounded organ + mesh" was contaminated with a bacterial count proportional to the animal's weight. The other group was not contaminated, maintaining it as control. Both groups were studied as to interaction of contamination/preservation, i.e., body weight, surgical findings, splenic size and histology, blood and tissue culture and hematological data. The dogs adequately withstood the standardized trauma regardless of local contamination. And the nylon mesh effectively arrested bleeding in all animals. At sacrifice inoculated germs were confirmed in the contaminated group by histological methods or tissue cultures. A cellular infiltrate of lymphocytes and plasmocytes was present close to the mesh only in the latter. The mesh attached to the injured spleen did not lead to abscesses, intrasplenic or intraperitoneal fluid collections. Based on analysis of the data, we can infer that local contamination of the injured spleen and the presence of non-absorbable material (nylon mesh) did not markedly alter the overall behavior of the dogs compared to the uncontaminated group.

Animals↗