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Request PDF on ResearchGate | Sutures and the operating room nurse: criteria in forecasting the need for sutures and Operações fundamentais In: Goffi FS. Técnica Cirúrgica: bases anatômicas, fisiopatológicas e técnicas cirúrgicas. Free download Goffi tecnica cirurgica pdf, O sistema Apache II e o progn stico de pacientes submetidos s opera es de grande e pequeno porte. Apache II scores. Goffi FS, Tolosa EMC. Técnica cirúrgica: Bases anatô- micas, fisiopatológicas e técnica cirúrgica. 4a ed. São. Paulo: Atheneu; 6. Lima GJS, Silva AL, Leite .
The purpose of this meta-analysis and merged data analysis was therefore to obtain a comprehensive assessment of recurrence and to ascertain determinants of recurrence of PSD with respect to specific surgical procedures and follow-up time.
We thus assembled a database with sources from the first description of PSD in on, that included reported recurrence, year of publication, timeframes of follow-up, type of study, and patient- and procedure-specific factors. Using this dataset, we assessed the efficacy of common surgical procedures employed in treating PSD as a function of recurrence. We found that the recurrence in PSD varied depending on the surgical procedure and on the length of follow-up.
While naturally, an increase of recurrence could be observed with longer follow-up, the rate of this increase was varying among the different procedures. This indicates that a thorough evaluation of a procedure in view of recurrence has to include the specific relation of recurrence to follow-up time and cannot just be based on comparisons at one single follow-up time.
The strength of our conclusions is substantially buttressed by the extensive analysis of a large database pertaining to particular therapeutic procedures. Table 1 Grouping of therapeutic strategies for analysis of recurrence rates in pilonidal sinus disease. Full size table Results Our search criteria retrieved 5, studies and book chapters across all databases. After excluding duplicates, 5, studies were screened.
Reports on PSD in other than the classical presacral intergluteal location, studies in embryonic development, in carcinomas, etc. Following exclusion, 1, articles on PSD at classical anatomical location with specific surgical treatment remained for analysis.
Of these, lacked detailed data on recurrence or follow-up time or both. Finally, studies published from to were analysed.
A flow chart describing the selection of literature sources, based on the Preferred reporting items for systematic reviews and meta-analysis PRISMA 8 , is illustrated in Fig. Figure 1 Flow diagram based on Preferred reporting items for systematic reviews and meta-analysis PRISMA 8 illustrating the systematic search for evidence regarding recurrence and long term follow-up data associated with common surgical procedures in PSD.
How are the stones calculi? The number, size, shape and color of gallstones are quite variable. Some people only have one stone, while others have several. They can also vary in size from tiny, as a grain of sand, to large as an orange. Who can have stone calculus in the gallbladder? Stone or calculus of the gallbladder is a very common disease. Over 10 million Brazilians have this problem. Anyone can have gallstones, but some are more likely, according to certain variables such as: 1 age the disease can affect even children, but its frequency increases with age and is more common in adults and elderly ; 2 woman the gallstones are more common in women than in men, especially in already became pregnant ; 3 obesity fatter, greater is the possibility of having gallstones; however, lean people can also have calculi ; 4 heredity the people who have family members with calculi have more chances of having this disease than those without.
Symptoms and complications caused by gallstones Many individuals who have gallstones have no symptoms. Whether a person has no symptoms or complications depends on the number or size of the stones. Sometimes a single small stone can cause serious complications, as, for example, acute pancreatitis. The presence of gallstones may cause mild, serious or intense symptoms, the most common being : 1 severe pain in the abdomen belly , usually on the right side or in the region in the stomach; it lasts for minutes to hours, but when longer may indicate complication; in this case, you should seek medical attention urgently; 2 nausea feeling sick and vomiting, especially when eating certain foods fat, eggs, banana, etc.
Diagnosis The best method for diagnosing gallstones is an ultrasound of the abdomen. The scan may not show the stones in many patients. Treatment The only form of effective treatment for gallstone or calculus is the surgical removal of the gallbladder cholecystectomy.
Same is said to magic recipes, teas, feeding recommendation done by lay people based on personal experiences, popular beliefs and feeding restriction as they will only delay definitive diagnosis and treatment, which is surgical removal of the gallbladder. Initially, gas is injected carbon dioxide into the abdomen belly to create a space where the surgeon can perform the operation safely.
After conducting four few millimeters holes, a television camera is placed inside the abdomen through one of the holes so that the surgeon and his team can view the entire abdomen on a TV. The tools to perform the operation forceps, scissors, suture materials, etc.
People who already have symptoms should be operated, due to frequency of complications that in these situations is very high.
The people who have yet life expectancy of many years have higher risk of complications, even without symptoms. The elderly and other associated diseases diabetes, high blood pressure, heart complications the surgeon and the clinical need to assess the risks and discuss with the patient to make the decision about the operation. Even people who have other diseases, and if they are well controlled, the risk of complications is small.
However, under conditions of acute inflammation and infection of the gallbladder cholecystitis operation becomes imperative in emergency.
After removal of the gall bladder, will I have any restrictions in my diet? You do not need to modify your diet after the operation, because the gallbladder have little important function in the body, which is to store bile.
It do not produces bile, only helps in storage. The production of bile by the liver remains normal after removal of the gallbladder. No sequel or consequence to the organism exists after removal of the gallbladder.
Thus, most people who had intolerance to certain foods, nausea , vomiting, discomfort or pain after eating, with the removal of the gallbladder these symptoms disappear or greatly improve.
Surgical treatment Postoperative recovery: Most patients stay in the hospital only one day and can return to work and to all activities, including sports, in a week or two. Complete and final resolution of the disease: In some people the symptoms remain.
Minimal surgical scar: Are performed only four holes whose scars may disappear after sometime Risk of infection and complications: When the operation is done on a scheduled basis elective , the risk of infection and other complications is small, around 0.
Risk of death: It is very low. Even in elderly individuals the risk of death related to the transaction is less than 0. Although the results of surgical treatment are excellent, some patients may have complications, as with any surgical procedure. The most common are: viscera injury, infection, bleeding and anesthetic risk low. The risks of the operation are more common in patients who have severe disease or complications such as inflammation of the gallbladder, jaundice, acute pancreatitis at the time of operation.
In these situations, the operation is generally more difficult to achieve and should be done as emergency. Comorbidities accompanying diseases As the disease affects more frequently the older people and some of them favor the formation of gallstones, there are common associated diseases.
Among them the most common are obesity, diabetes and dyslipidemia high cholesterol. But also high blood pressure, heart problems and osteoarthrosis are common diseases in the elderly.
All these associated diseases should be adequately controlled before surgery. In these cases, the set of a clinical medical care with the surgeon and the anesthesiologist will ensure good control of associated diseases before operation, ensuring maximum patient safety. Anesthesia and pre-anesthetic evaluation Many people are afraid or apprehensive and anxious before the anesthesia. Most of the time it is generated by ignorance of the subject, bad reports of relatives, friends or even by the press and broadcast media.
Long time anesthesia is procedure completely safe for the patient; the medications and anesthetics had advances. Your whole body is monitored during the anesthetic doctors team, nurses and technicians.
Pressure, breath and heart rate are carefully monitored by the team and devices with automatic alarms. Furthermore, some believe which during anesthesia dreams, nightmares and unpleasant memories occur is fantasy. None of this happens.
You sleep relaxed and wake-up as if nothing had happened, rested. An appropriate pre -anesthetic assessment will bring peace and security to you, to surgical and anesthesia teams. In this pre-anesthetic consultation, you can talk with the anesthesiologist, explain your fears and concerns and he will know guide you, answer your question and everyone will be safer during the procedure.
Of all these, the only real risk is having to allergic reaction to the medication, but that is very rare and can happen to any medication you use. The difference is that by being in the presence of a medical team and all their vital signs monitored, you will have chance to be attended to immediately and with less risk.
Cholecystectomy, the operation you need to do, requires general anesthesia. Before entering the operating room, you may have already received slee -inducing drug that has fast action.
General anesthesia prevents you from feeling pain. After the operation you receive another medicine that makes you wake-up and everything goes like you slept peacefully in that period.
Postoperative guidance The recovery is usually very fast and most people return to their normal activities within a few days. The guidelines should be followed so that you have little discomfort and recovery occurs uneventfully. It has no special diet.