Publications by authors named "Antonio Carlos Garrido Iglesias"

4 Publications

  • Page 1 of 1

Inflammation in laparoendoscopic single-site surgery versus laparoscopic cholecystectomy.

Surg Innov 2014 Jun 14;21(3):263-8. Epub 2013 Aug 14.

Universidade Federal do Estado do Rio de Janeiro-UNIRIO, Rio de Janeiro, Brazil.

Introduction: Laparoendoscopic single-site surgery (LESS) uses a multiple-entry portal in a single 3.0- to 4.0-cm incision in a natural scar, the umbilicus. The present study aimed to compare the inflammatory impact of classic video laparoscopic cholecystectomy (LC) versus LESS cholecystectomy.

Methods: A prospective randomized controlled study was conducted from January to June 2011 at 2 university hospitals in Rio de Janeiro, Brazil. Fifty-seven patients (53 women, 4 men; mean age = 48.7 years) were randomly assigned to receive LC (n = 29) or LESS (n = 28) cholecystectomy. C-reactive protein (CRP) and interleukin 6 (IL-6) were measured from blood samples collected during induction of anesthesia and at 3 and 24 hours postoperatively.

Results: Median IL-6 levels in the LESS and LC groups, respectively, were 2.96 and 4.5 pg/mL preoperatively, 11.6 and 28.05 pg/mL at 3 hours postoperatively (P = .029), and 13.18 and 15.1 pg/mL at 24 hours postoperatively (P = .52). Median CRP levels in the LESS and LC groups, respectively, were 0.33 and 0.44 mg/mL preoperatively, 0.40 and 0.45 mg/mL (P = .73) at 3 hours postoperatively, and 1.7 and 1.82 mg/mL (P = .84) at 24 hours postoperatively. We did not find a significant association between IL-6 (and CRP) and body mass index in the LESS group.

Conclusions: LESS cholecystectomy requires a larger size incision than LC. We found a tendency of less postoperative pain following LESS cholecystectomy than LC. There was also a tendency toward lower early inflammatory impact following LESS cholecystectomy versus LC.
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http://dx.doi.org/10.1177/1553350613499454DOI Listing
June 2014

Randomized clinical study for assessment of incision characteristics and pain associated with LESS versus laparoscopic cholecystectomy.

Surg Endosc 2013 Mar 6;27(3):1009-15. Epub 2012 Oct 6.

Department of General Surgery, Universidade Federal do Estado do Rio de Janeiro, Rua Mariz e Barros 775, Tijuca, Rio de Janeiro, RJ 20270-901, Brazil.

Background: Laparoendoscopic single-site surgery (LESS) has emerged as a technique that uses a natural scar, the umbilicus, within which a multiple-entry portal is placed into a 3.0-4.0-cm single incision to perform operations. The objective of this study was to compare incision size, wound complications, and postoperative pain of LESS compared with those of laparoscopic cholecystectomy (LC).

Methods: A prospective randomized controlled study was conducted between January and June 2011 at two university hospitals in Rio de Janeiro, Brazil. Fifty-seven patients were randomly assigned to undergo laparoscopic or LESS cholecystectomy. Skin and aponeurosis wound sizes were recorded. A 10-point visual analog scale (VAS) was used to assess pain at postoperative hours 3 and 24. Healing and wound complications were assessed at follow-up.

Results: A total of 57 patients, 53 women and 4 men with a mean age of 48.7 years, were randomly assigned to undergo LESS (n = 28) or LC (n = 29). The mean length of the umbilical skin incision was 4.0 cm (range = 2.1-5.8) in LESS and 2.7 cm (1.5-5.1) in LC (p < .0001). The mean internal aponeurosis diameter was 3.5 cm (2.0-5.5) in LESS and 2.3 cm (1.2-3.5) in LC (p < .0001). The mean operative time was 60.3 min (32-128) for LESS and 51.3 min (25-120) for LC (p = 0.11). Gallbladder perforation at detachment occurred in 15.69 % of the LESS cases and in 5.88 % of the LC cases (p = 0.028). The mean VAS score for pain at hour 3 was 2.0 points (0-7) for the LESS group and 4.0 (0-10) for the LC group (p = 0.07), and at postoperative hour 24 it was 0.3 points (0-6) for LESS and 2.3 (0-10) for LC (p = 0.03). There were no significant differences in wound complications. Incisional hernias were not found in either group.

Conclusions: The LESS single-port (SP) operations demand a bigger incision than LC surgery. However, there were no differences in healing, wound infections, and hernia development. We found a tendency of less postoperative pain associated with LESS/SP than with LC.
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http://dx.doi.org/10.1007/s00464-012-2556-1DOI Listing
March 2013

Multivisceral radical en bloc resection with spleen preservation in T4 gastric cancer.

BMJ Case Rep 2010 Dec 6;2010. Epub 2010 Dec 6.

Department of Surgery, Gaffrée & Guinle Univesity Hospital, Rio de Janeiro, Brazil.

Gastric cancers are the second most common cause of cancer death worldwide. In the majority of countries, gastric tumours are diagnosed at advanced stages. The authors present the case of a patient with a T4 gastric tumour who underwent a multivisceral en bloc resection (liver segmentectomy, total gastrectomy, partial pancreatectomy) and D2 lymphadenectomy with spleen preservation. The aim of this report was to confirm that, for T4 gastric tumours, radical resection can be performed without splenectomy with minimal morbidity, and this procedure can improve long-term survival.
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http://dx.doi.org/10.1136/bcr.02.2010.2782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028166PMC
December 2010

[Effects of intrinsic denervation of the jejunum after extensive enterectomy in the rat bowel syndrome].

Acta Cir Bras 2006 Jan-Feb;21(1):43-6. Epub 2006 Feb 13.

Departamento de Patologia, Faculdade de Medicina de Ribeirão, USP.

Purpose: To investigate the effects of intrinsic denervation of the jejunum after the extensive intestinal resection in rats.

Methods: Thirty male Wistar rats were distributed into three groups, depending on the experimental procedure: Group C (control), Group R (resection) and Group D (resection plus denervation). The body weight gain and a histomorphometric study of the jejunal mucosa were performed.

Results: The mean body weight of the group D animals showed a higher increase when compared to group R (D=312.2+/-21 g and R=196.7+/-36.2g). The number of jejunum myenteric neurons was smaller in group D (344.8+/-34.8 neurons/mm) when compared to other groups (R=909.0+/-55.5 and C=898.5+/-73.3). A hyperplasia of the jejunum mucosal epithelium was observed in the group D but also in the group R (R=7.3+/-3.9 mm2 and D=10.8+/-4.3 mm2), when compared to group C (C=5.8+/-3.0 mm2). The epithelial cell proliferation of the jejunum was higher in group D animals (48.7%) when compared to the other groups (R=31.9% and C=23.6%).

Conclusions: The denervated animals presented an increase the body weight gain and mucosal cell proliferation responses when compared to the control group. This experimental model may provide new strategies for the surgical treatment of the short bowel syndrome.
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http://dx.doi.org/10.1590/s0102-86502006000100010DOI Listing
August 2006