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N F Safatle

Publications and source records attributed to N F Safatle.

12 recordsLinked to original sources
PubMed1999

Relationship between persistence of Helicobacter pylori and dysplasia, intestinal metaplasia, atrophy, inflammation, and cell proliferation following partial gastrectomy.

Helicobacter pylori and partial gastric resection are risk factors for gastric cancer. Our aims were to investigate the presence of H. pylori in postgastrectomy patients and to correlate that with alterations in mucosal architecture and cell proliferation. One hundred fifty-one endoscopic biopsies from 22 patients, (15-47 years of age, mean 29.2 years) following partial gastrectomy with Billroth II reconstruction for peptic ulcer disease, were examined for the presence of H. pylori using Giemsa staining. Sections were scored for grade of hyperplasia, intestinal metaplasia, dysplasia, inflammation, and atrophy. Immunohistochemistry for proliferative cell nuclear antigen (PCNA) was used to characterize cell proliferation. H. pylori was observed in 17/22 (77.3%) of patients or in 57/151 (37.7%) of biopsies. Metaplasia was seen in 18/22, chronic atrophic gastritis in 20/22, and cystic glandular dilation in 21/22 patients. The highest type of metaplasia in each patient was: four Type I, five Type IIA and nine Type IIB. Dysplasia was present in 16 biopsies from nine patients. H. pylori was more prevalent in intestinal metaplasia type I (44.8% of biopsies), than in type IIA (32.7%) or type IIB (25%). No H. pylori was detected in regions showing dysplasia or cystic glandular dilation. H. pylori colonization was associated with degree of inflammation (P = 0.00001) and cell proliferation (P = 0.0001). In conclusion, H. pylori is commonly seen many years after gastrectomy, it is associated with an increased epithelial cell proliferation, and it is not present in areas of histologic markers of premalignancy (type IIB metaplasia and dysplasia).

Adolescent↗
PubMedDate not supplied

[Cholecystectomy using median minilaparotomy. A new method].

A new methodization is proposed to perform cholecystectomy through a minor laparotomy (3-6 cm) in midline (in the middle third of the linea alba). Twenty-one patients were submitted to cholecystectomy by gallstones including acute cholecystitis. No postoperative complications occurred and the discharge from hospital was in the first and second day.

Adult↗
PubMedDate not supplied

[Ruptura of the thoracic esophagus due to closed abdominal trauma].

The authors present a rare case of closed abdominal trauma in a five year old girl resulting from a washtub fall on her causing three lacerations in the middle third of the esophagus, identified 48 hours after the trauma. The stitcher surgical treatment of the lacerations associated with gastrostomy and lengthy parenteral nutrition did not prevent the recurrence of the esophagus-pleural fistula, and an esophagectomy plus cervical esophagostomy was required. After a 10-month follow-up, the digestive passage was reconstructed by an esophagocoloplasty. At present, after 5 years of follow-up, the patient is cured. The authors discuss the causes of esophagus rupture in children and its etiopathogeny. They propose that preservativement the esophagus is the best initial treatment, in spite of the foot that this procedure was ineffective in the present case.

Child, Preschool↗
PubMedDate not supplied

[Antiperistaltic duodenojejunal pouch in the reconstruction of digestive transit after subtotal, total gastrectomy and in the postgastrectomy syndrome. Technic].

A new technic for reconstruction of the digestive tract after total and subtotal gastrectomy in patients with BII postgastrectomy syndrome is proposed. This technic is based on: 1) the to-and-from motion of the barium inside the duodenal arch, and 2) the duodenogastric reflux, both observed in X-ray examinations in normal and in patients bearing gastroduodenal ulcers. The advantage of this technic is to associate the inverted Y en Roux with an interposition of a small bowel segment, besides a reservoir with dynamic function which is obtained using the duodenal arch, as well as 10 cm of jejunum, where the ingested food is mixed with the digestive secretions and is eliminated with antiperistalsis, without stasis. From 1977 to 1983, 36 patients were operated on with the above mentioned technic. Ten of them were admitted to total gastrectomy, 16 to subtotal gastrectomy, 7 to minimal radical gastrectomy and three to postgastrectomy syndrome.

Adult↗
PubMedDate not supplied

[An antiperistaltic duodenojejunal pouch in the reconstruction of digestive transit after subtotal and total gastrectomy and in the postgastrectomy syndrome. Results].

The author presents the results of a new surgical technique for the reconstruction of the gastrointestinal tract after gastrectomy. It was utilized in 36 patients (ten with total, 16 with subtotal and seven with minimal radical gastrectomy and also three cases of post-gastrectomy syndrome). The initial methodology, using the lost tie (group striction (GST)) to the duodenojejunal reservoir was not successful since it showed recanalization and consequent refluxing esophagitis (55,5%). For that reason, we changed to a complete section of the intestinal loop (group section (GS)). The follow up period ranged from one to 49 months. The following complications were observed: incisional hernia, one case (GST); early postoperative period death (19th day), one case (GS); dumping syndrome, one case (GST); bilious vomiting, two cases (GS); diarrhea, four cases (one GST and three GS). Clinically, in the late follow up of patients without recurrency of neoplasia, 17 of them have gained weight, four have lost weight and two were unaltered. Laboratory tests such as amilasemia, hematologic, proteins and glycemia were favorable to the method. Postoperative function, studied roentgenologically, showed that the average time emptying of the remmant stomach was 115 minutes in the subtotal resections and 82 minutes in total resections. The filling of the reservoir by the barium solution ranged from 40 to 60%; this variation depended on whether the duodenum was in peristalsis or antiperistalsis. Late death occurred in 13 patients, none because of the proposed technique.

Duodenum↗
PubMedDate not supplied

[Lumbar hernia].

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Adipose Tissue↗