Jacob FL, Almeida NRC, Bentes LGB
… +5 more, Lemos RS, Barbosa JFS, Kietzer KS, Pinto LOAD, Yasojima EY
Rev Col Bras Cir
· 2024 · PMID 39607185
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Clitoral hypertrophy is a condition that has a negative impact on a womans intimate life and can cause embarrassment and impact on her sexual life. The article describes a surgical technique of clitoroplasty performed wi...Clitoral hypertrophy is a condition that has a negative impact on a womans intimate life and can cause embarrassment and impact on her sexual life. The article describes a surgical technique of clitoroplasty performed with a 360° circumferential subcoronal incision only in the skin and Dartos tunica to avoid neuronal damage, followed by degloving to the base of the clitoris, preserving the dorsal neurovascular bundle. The body of the clitoris was amputated, preserving 0.5 cm of the stump of the clitoral shaft, and the glans was sutured to the rest of the remaining spongy tissue. Finally, it is noteworthy that there were no complaints of loss of sensitivity or sexual dysfunctions post-operatively.
Campos ECR, Dalazoana Filho E, Kono PA
… +7 more, Souza MA, Proença NJ, Santos MD, Salina MVJ, Zanolla PS, Yamaoka LMM, Miyawaki LN
Rev Col Bras Cir
· 2024 · PMID 39607184
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OBJECTIVE: To evaluate the quality of life among patients with Soft Tissue Sarcomas treated at the Evangelic Mackenzie Hospital (HUEM) from 2018 to 2024 and undergoing surgical treatment. MATERIAL AND METHODS: descriptiv...OBJECTIVE: To evaluate the quality of life among patients with Soft Tissue Sarcomas treated at the Evangelic Mackenzie Hospital (HUEM) from 2018 to 2024 and undergoing surgical treatment. MATERIAL AND METHODS: descriptive and cross-sectional analysis of 23 patients with soft tissue neoplasia who underwent surgery and whether they underwent neoadjuvant or adjuvant clinical treatments. Epidemiological, clinical, and pathological data were considered. The EORTC 30 protocol was the instrument used for assessing the patients' quality of life. RESULTS: the main cases were located at extremity in females. Mean age at diagnosis was 47 years. All patients were symptomatic at diagnosis, with pain and a palpable mass being the most prevalent symptom and clinical sign, respectively. The mean time from the onset of symptoms to the date of diagnosis was 9 months. The mean tumor size was 11.68cm. Considering the functional scale, the items physical functioning, role performance and social function were the most affected in the assessment of quality of life. Fatigue and loss of appetite were the most common sign and symptom, respectively. A global measure of quality of life achieved high rates when 50% of patients rated as excellent. CONCLUSION: Continuous and multidisciplinary oncological care provided to the patient allows for better symptom control, resulting in higher quality of life, which positively impacts the patient's adherence to treatment, their progression, and possibly their survival.
Rev Col Bras Cir
· 2024 · PMID 39607183
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INTRODUCTION: The aim of this study was to conduct a scoping review on the efficacy of phosphodiesterase-5 inhibitors (PDE-5Is) in rehabilitating erectile function in patients undergoing cavernous nerve sparing radical p...INTRODUCTION: The aim of this study was to conduct a scoping review on the efficacy of phosphodiesterase-5 inhibitors (PDE-5Is) in rehabilitating erectile function in patients undergoing cavernous nerve sparing radical prostatectomy (NSRP). METHODS: The databases used were MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science. Systematic reviews with meta-analyses on the subject were included until March 5, 2024, with no language restrictions. Publications that did not address any of the aforementioned relationships were excluded. The data was organized into tables for descriptive analysis. The methodological quality of the included studies was assessed using the ROBIS tool. RESULTS: Eight studies were selected and all concluded that the use of PDE-5Is is effective in penile rehabilitation. Only one of the reviews found that use for more than six months was superior to short-term use, and another concluded that daily use was superior to on-demand use. In addition, the articles identified more adverse effects in the experimental group compared to the control group, but without compromising therapeutic adherence. Six of the studies were classified as low risk of bias, while the other two had uncertain risk. CONCLUSION: PDE-5Is are effective in restoring erectile function in patients undergoing NSRP, especially when used regularly and over the long term, and follow-up is not hampered by adverse effects. However, due to the scarcity of data, new studies should be carried out to determine the best form of use of these drugs.
Rev Col Bras Cir
· 2024 · PMID 39607182
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INTRODUCTION: Peripheral Arterial Disease (PAD) is highly prevalent and the final stage of the disease is the Critical Ischemia (CI) of the Lower Limbs (LL), culminating, in most cases, with amputation of the limbs as pa...INTRODUCTION: Peripheral Arterial Disease (PAD) is highly prevalent and the final stage of the disease is the Critical Ischemia (CI) of the Lower Limbs (LL), culminating, in most cases, with amputation of the limbs as part of the proposed treatment. Infrared Thermography (IT) is an inexpensive method, painless, without emission of radiation and easy to manage, which aims to determine the temperature of the skin of the limb to be amputated, and could help the surgeon to evaluate the level of the lower limb amputation. OBJECTIVE: To Evaluate Whether IT is a useful method to determine the level of lower limb amputation in patients with PAD and CI. Method: Prospective cohort study performed from April 2023 to November 2023, at the Unit of vascular surgery - Hospital de Base do Distrito Federal (Brasília-DF). It evaluated patients with PAD and CI that were in the preoperative period for lower limb amputation. All Patients Underwent IT evaluation standards protocols. RESULTS: The results showed a wider longitudinal thermal gradient in PAD smoking (S) patients compared to non-smokers. It was also observed that (S) patients with wide thermal gradients were more likely to undergo an above the knee amputation. CONCLUSION: Infrared thermography was a useful method in discriminating thermal differences in patients with PAD and CI could be employed in preoperative evaluation to choose the level of lower limb amputation. Smoking patients with greater longitudinal thermal gradients are more likely to undergo an above the knee amputations.
Rev Col Bras Cir
· 2024 · PMID 39607181
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INTRODUCTION: The use of axillary marking prior to Neoadjuvant Systemic Therapy (NST) is a controversial matter regarding patients with positive Lymph Nodes (LN). Several methods were tested to make possible the decrease...INTRODUCTION: The use of axillary marking prior to Neoadjuvant Systemic Therapy (NST) is a controversial matter regarding patients with positive Lymph Nodes (LN). Several methods were tested to make possible the decrease of false negative rate in comparison to sentinel lymph node adding more accuracy to the results. This study aims to evaluate the oncological outcomes in patients who had undergone selective axillary dissection with 4% carbon marking before TSN. METHODS: A prospective study was performed with cT1-T4, cN1-N2 breast cancer patients classified as suspected LNs undergoing concomitant 4% carbon marking. After TSN, targeted LNs were identified and resected associated to the sentinel lymph node (SLN) biopsy. The oncological outcomes pointed out were overall survival (OS), causespecific survival (CSS), distant disease-free survival (DDFS), axillary recurrence (AR) and local recurrence (LR). RESULTS: A total of 168 patients were evaluated for a median period of 49 months. The axillary emptying was reached in 89 (50.6%) cases. Five of 168 patients (2.9%) had axillary recurrence (AR). There was a significant link between axillary emptying and AR (0 vs. 6% p = 0.012). The DDFS was 140/168 (83.3%), OS 158/168 (94%) and CSS 158/163 (96.9%). CONCLUSION: The use of carbon marking in selective axillary dissection is a reliable low-cost method with simple execution. Among the oncological outcomes AR may not be considered for post downstaging axillary evaluation analysis since it is a rare event and not necessarily related to OS or DDFS.
Rev Col Bras Cir
· 2024 · PMID 39319975
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This is a letter to the editor praising the editorial published in the Revista do Colégio Brasileiro de Cirurgiões which details the process of granting specialist titles in the field of surgery. At the same time, howeve...This is a letter to the editor praising the editorial published in the Revista do Colégio Brasileiro de Cirurgiões which details the process of granting specialist titles in the field of surgery. At the same time, however, the issuance of these titles to doctors who have not completed medical residency is questioned.
Rev Col Bras Cir
· 2024 · PMID 39258627
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The role of the burn surgeon in Burn Treatment Centers (BTCs) is crucial for complementing the multidisciplinary approach in the treatment of burn patients. Globally, the areas of General Surgery and Plastic Surgery are...The role of the burn surgeon in Burn Treatment Centers (BTCs) is crucial for complementing the multidisciplinary approach in the treatment of burn patients. Globally, the areas of General Surgery and Plastic Surgery are the primary surgical specialties dedicated to this function. The structuring of the Burn Patient Care Line in Minas Gerais highlighted the need to expand the "Burn Care" Field of Expertise, extending it to General Surgery. With the inevitable expansion of the Care Line, pioneered by the state of Minas Gerais, to the federal level, the need for specialized surgical training encompasses both the state context and anticipates the national scenario in the short term. Therefore, the expansion of the "Burn Care" Field of Expertise is fundamental to meeting specific demands and improving the quality of care offered to burn patients, in accordance with international standarts.
Gomes Neto A, Oliveira LC, Alves FM
… +4 more, Nogueira LFA, Oliveira VF, Medeiros IL, Mariani AW
Rev Col Bras Cir
· 2024 · PMID 39258626
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OBJECTIVES: To evaluate the early and late results of surgical treatment of patients with bronchiectasis, comparing the Video-Assisted Thoracic Surgery (VATS) vs. the open thoracotomy (OT). METHODS: Observational retrosp...OBJECTIVES: To evaluate the early and late results of surgical treatment of patients with bronchiectasis, comparing the Video-Assisted Thoracic Surgery (VATS) vs. the open thoracotomy (OT). METHODS: Observational retrospective study of patients who underwent surgery for bronchiectasis. Patients were divided into two groups according to surgical access OT/VATS. Variables collected included gender, age, preoperative symptoms, etiology, segments involved, FVC and FEV1, type of surgical resection, complications, mortality, and length of hospital stay. Late surgical results were classified as excellent, complete remission of symptoms; good, significative improvement; and poor, little/no improvement. RESULTS: 108 surgical resections (103 patients). OT group 54 patients (52.4%) vs. VATS 49 (47.6%). A high percentage of complications was observed, but no difference between the OT (29.6%) and VATS (24.5%) groups was found. Post-operative hospital stay was shorter in the VATS group (5.4 days) vs. the OT group (8.7 days (p=0.029). 75% of the patients had a late follow-up; the results were considered excellent in 71.4%, good in 26%, and poor in 2.6%. Regarding bronchiectasis distribution, an excellent percentage was obtained at 82.1% in patients with localized bronchiectasis and 47.5% with non-localized bronchiectasis, p=0.003. CONCLUSIONS: VATS leads to similar results regarding morbidity, compared to OT. However, VATS was related to shorter hospital stays, reflecting the early recovery. Late results were excellent in most patients, being better in patients with localized bronchiectasis. VATS should be considered a preferable approach for bronchiectasis lung resection whenever possible.
Rev Col Bras Cir
· 2024 · PMID 39166610
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INTRODUCTION: Appendectomy is the standard treatment for appendicitis, with the laparoscopic technique offering benefits like lower infection rates and quicker recovery. However, residents often have their first practica...INTRODUCTION: Appendectomy is the standard treatment for appendicitis, with the laparoscopic technique offering benefits like lower infection rates and quicker recovery. However, residents often have their first practical experience with the procedure on real patients, increasing surgical risks. In this context, medical simulation emerges as a crucial methodology, allowing professionals to experience a variety of scenarios while preventing harm to patients. The objective of this study is to describe the production of an "ex-vivo" simulation model for laparoscopic appendectomy. METHODOLOGY: Cold ceramic structures were used to manually shape the anatomical model of the appendix, ensuring its rigidity. On this model, we poured materials to create a flexible mold using acetic silicone. Once the mold was made, we filled it with thermo-moldable styrene polymer rubber, along with dye, and fused it at a specific temperature. RESULTS: This process resulted in the manufacture of a piece that simulates the appendix, being tear-resistant and suturable, faithfully replicating the structure and characteristics of a human organ. The low weight of the materials facilitates transport, allowing them to be reproduced and used in various situations, from training in hospital settings to universities. The model is applicable in didactic simulations with medical students, residents, and surgeons. Its ease of production and low cost contribute to the practices being repeatable, ensuring a better development of surgical skills. CONCLUSION: This work not only contributes to the advancement of medical simulation but also highlights the importance of innovative and collaborative solutions in improving medical education and promoting patient safety.
Silva AILFD, Shehadeh I, Knaut EF
… +2 more, Bertolino EP, Fontes CER
Rev Col Bras Cir
· 2024 · PMID 39166609
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INTRODUCTION: The technique of open abdomen refers to a surgical procedure that intentionally involves leaving an opening in the abdominal wall. This study aimed to evaluate the clinical outcomes, mortality, and morbidit...INTRODUCTION: The technique of open abdomen refers to a surgical procedure that intentionally involves leaving an opening in the abdominal wall. This study aimed to evaluate the clinical outcomes, mortality, and morbidity of patients undergoing open abdomen in a public hospital in Brazil and investigate associated risk factors associated with the outcome. METHODS: Data from electronic medical records were collected from 2017 to 2022. The variables were used for descriptive analyses, association analysis, and survival analysis using the Kaplan-Meier curve. RESULTS: The sample included 104 patients, with 84 presenting with acute abdomen and 20 with trauma, having highly variable ages and comorbidities. Peritonitis and the need for early reoperation were the most common indication for the procedure, each accounting for 34%, and negative pressure wound therapy was the most commonly used technique. Fistula was the most frequent complication, with the majority forming in the early days after the surgery. The number of interventions and open abdomen time obtained statistical significance in comparison with the outcome. The overall mortality rate was 62,5%. CONCLUSION: Despite open abdomen being a technique that can have benefits in controlling intraabdominal contamination and preventing abdominal compartment syndrome, its implementation is associated with complications. The mortality and complication rates were high in this sample. The decision to use the technique should be individualized and based on several factors, including the indications and the patient's clinical status.
Menegozzo CAM, Oliveira CPDR, Rasslan R
… +5 more, Kfouri F, Bitran A, Leal RS, Damous SHB, Utiyama EM
Rev Col Bras Cir
· 2024 · PMID 39045921
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The role of wound protectors in laparoscopic surgeries is highly controversial in the literature. Some studies demonstrate their benefit in reducing the rate of surgical site infections; however, these results are not re...The role of wound protectors in laparoscopic surgeries is highly controversial in the literature. Some studies demonstrate their benefit in reducing the rate of surgical site infections; however, these results are not reproducible across all procedures. In addition to protecting the operative wound, these devices can be used at sites of surgical specimen extraction in laparoscopic procedures. Several commercially available devices serve this purpose but are scarcely available in resource-limited settings. One of the reasons for this limitation is the cost of the device. In this technical note, we aim to provide a cost-effective option utilizing materials readily available in the operating room and with a simple fabrication process.
Rev Col Bras Cir
· 2024 · PMID 39045920
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INTRODUCTION: Tranexamic acid (TA) has attracted increased attention among surgical specialties, but its use in plastic surgery is limited. The aim of this study was to assess the efficacy and safety of topical administr...INTRODUCTION: Tranexamic acid (TA) has attracted increased attention among surgical specialties, but its use in plastic surgery is limited. The aim of this study was to assess the efficacy and safety of topical administration of 3% TA solution in reconstructive surgery of the face and scalp after excision of skin cancers. METHODS: a randomized, double-blind, parallel-group clinical trial was conducted in patients aged 18 years or older with malignant skin neoplasms in the face or scalp region (ICD-10 C44.9). The primary outcome was volume of blood loss in the intraoperative and immediate postoperative period. Secondary outcomes included difficult-to-control intraoperative haemorrhage, hematoma, ecchymosis, and other adverse events. RESULTS: of the 54 included patients, 26 were randomised to TA group and 28 to placebo group. The mean blood loss was 11.42ml (SD 6.40, range 8.83-14.01) in the TA group, and 17.6ml (SD 6.22, range 15.19-20.01) in the placebo group, representing a mean decrease of 6.18ml (35.11%) (p=0.001). TA significantly reduced the risk of ecchymosis (RR = 0.046; 95% CI: 0.007-0.323). Only two patients in the placebo group experienced ischemia in the flaps, and one patient in the placebo group experienced tissue necrosis requiring surgical reintervention. There were no surgical wound infections, thromboembolic phenomena, or other adverse events related to TA. CONCLUSIONS: topical TA may reduce intraoperative and immediate postoperative bleeding, with a significantly decreased risk of ecchymosis. There is no evidence of ischemic damage of flaps, systemic thromboembolic complications, or other adverse events.
Frogeri FG, Bustorff-Silva J, Oliveira Filho AG
… +3 more, Silva MACP, Mitsunaga TM, Sarti L
Rev Col Bras Cir
· 2024 · PMID 39045919
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INTRODUCTION: esophageal replacement in children is indicated when it is impossible to maintain the native esophagus, which in the pediatric population includes patients with esophageal atresia and esophageal caustic ste...INTRODUCTION: esophageal replacement in children is indicated when it is impossible to maintain the native esophagus, which in the pediatric population includes patients with esophageal atresia and esophageal caustic stenosis. The objective of this communication is to report the experience of a university service with two techniques of esophageal replacement. METHODS: this is a retrospective study based on the revision of hospital files. The study population consisted of patients who underwent esophageal replacement from 1995 to 2022, at the Hospital de Clínicas of the State University of Campinas. The analyzed data were age, sex, underlying disease, technical aspects, complications, and long-term results. RESULTS: during the study period, 30 patients underwent esophageal replacement. The most common underlying diseases were esophageal atresia (73.33%) and caustic stenosis (26.67%). Twenty-one patients underwent gastric transposition (70%), and nine underwent esophagocoloplasty (30%). The most frequent postoperative complication was fistula of the proximal anastomosis, which occurred in 14 patients. Most of the patients with fistulas had a spontaneous recovery. There were three deaths. Of the 27 survivors, 24 can feed exclusively by mouth. CONCLUSION: esophageal replacement in children is a procedure with high morbidity and mortality. Esophagocoloplasty and gastric transposition have similar results and complications, with the exception of proximal anastomotic fistulas, which are generally self-resolving and are more common in esophagocoloplasty. The choice of the best surgical technique must be individualized according to the patients characteristics and the surgeons experience, as both techniques offer the ability to feed orally in the short or medium term.
Rev Col Bras Cir
· 2024 · PMID 39045918
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INTRODUCTION: The concept of safe care permeates health institutions around the world, however, it is necessary to understand the safety culture of an institution to improve the provision of safety to patients and profes...INTRODUCTION: The concept of safe care permeates health institutions around the world, however, it is necessary to understand the safety culture of an institution to improve the provision of safety to patients and professionals. METHODOLOGY: Cross-sectional study with a quantitative approach. The sample was made up of 119 health professionals who made up the multidisciplinary team at the surgical center from August to September 2021, where data collection took place. The Hospital Survey on Patient Safety Culture (HSOPSC) instrument was used to evaluate the twelve dimensions that make up patient safety culture. Data analysis was carried out using descriptive statistics, to evaluate the reliability of the responses to the HSOPSC instrument, the Cronbachs Alpha test was used. RESULTS: Of the twelve dimensions evaluated, there was no dimension considered strong for patient safety in the unit. The dimensions with potential for patient safety were "Expectations and actions of the supervisor/manager to promote patient safety"; "Teamwork within units" and "Organizational learning - continuous improvement", while all other dimensions were evaluated as weak for patient safety. 39.50% of participants consider patient safety in the unit to be regular, despite this, 89.91% of participants reported not having made any event notifications in the last 12 months. CONCLUSION: The study highlighted the need to strengthen all dimensions of the patient safety culture by the team at the hospital studied, as none of them were identified as strong.
Santos MMCJD, Lima SF, Slullitel A
… +5 more, Oliveira NG, Santos ECN, Araújo EC, Bruginski D, Pereira Júnior GA
Rev Col Bras Cir
· 2024 · PMID 39045917
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OBJECTIVE: describe the process of translation and cross-cultural adaptation of the Mayo High Performance Team Scale into Brazilian Portuguese. METHOD: descriptive study of validation and cross-cultural adaptation of the...OBJECTIVE: describe the process of translation and cross-cultural adaptation of the Mayo High Performance Team Scale into Brazilian Portuguese. METHOD: descriptive study of validation and cross-cultural adaptation of the scale, carried out virtually, following assumptions proposed by Beaton and collaborators. It had a sample of 40 experts, and carried out two rounds, one for validation and one for final assessment. RESULTS: after following all translation steps, the scale was presented to the committee of experts who reached a consensus (IVC between 0.9 and 1.0) that there was no discrepancy, after evaluating the semantic, idiomatic, experiential and conceptual equivalences between the original scale and the translated version. CONCLUSION: The Brazilian Portuguese version of the MHPTS was adequately translated and validated, revealing excellent potential for use in clinical simulation contexts for multidisciplinary scenarios.
Santos MMCJD, Lima SF, Slullitel A
… +5 more, Giovanazzi RSD, Lopes Neto FDN, Lima MAVP, Santos Neto RSD, Pereira Júnior GA
Rev Col Bras Cir
· 2024 · PMID 39045916
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INTRODUCTION: sedation and analgesia are fundamental procedures for children undergoing invasive interventions, and complications must be avoided during their implementation. In situ simulation allows, in turn, training...INTRODUCTION: sedation and analgesia are fundamental procedures for children undergoing invasive interventions, and complications must be avoided during their implementation. In situ simulation allows, in turn, training in real practice environments to improve the technical and non-technical skills of professionals for such procedures. Although it is a very useful tool, it is often not used due to lack of preparation for its planning and application. OBJECTIVE: develop and validate an in situ simulation scenario in pediatric emergency care using sedation to perform an invasive procedure. METHOD: descriptive study of construction and content validation of an in situ simulation scenario, using the Delphi method, following the following steps: 1) definition of the problem and selection of experts; 2) development of the initial document; 3) rounds for validation with analysis of responses and feedback (until consensus is reached by the Content Validation Index); 4) final report. Results: The experts indicated suggestions that were duly used and the scenario obtained, in all items, a CVI greater than 80.0%, demonstrating its high validity and reliability. By using experts to validate the scenario, their insights guarantee greater precision and reliability in scenario construction engineering. CONCLUSION: It is expected that this study will allow the replication of the scenario in different training contexts, facilitating and encouraging professional training based on a scenario model based on best evidence and practices.
Barbosa LM, Sirqueira BPC, Carvalho JTO
… +2 more, Barros ANB, Lima AB
Rev Col Bras Cir
· 2024 · PMID 39045915
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INTRODUCTION: the obesity is defined as the excessive accumulation of fat in different areas of the body, a condition that causes damage to health and is a critical risk factor for various comorbidities. Bariatric surger...INTRODUCTION: the obesity is defined as the excessive accumulation of fat in different areas of the body, a condition that causes damage to health and is a critical risk factor for various comorbidities. Bariatric surgery is the therapeutic option with the best results. METHODS: this is a retrospective descriptive study using data obtained from medical records from January 2018 to December 2020 on patients undergoing bariatric surgery. Statistical analysis used a significance level of p<0.05. RESULTS: 178 medical records were included, 77.5% of which were women. The average age was 35.7 years (± 9.5), 63.8% of the patients were from Imperatriz, 98.3% reported a sedentary lifestyle, 38.7% regular alcohol consumption and 13% smoking. The prevalence of Class III obesity (BMI≥40 kg/m²) was 53.3%. The most common comorbidities were hepatic steatosis (64.6%), type 2 diabetes mellitus (DM2) (40.5%) and hypertension (38.7%). The main type of surgery performed was Roux-en-Y gastric bypass (RYGB) (89.3%). There was an association between median BMI and gender (p=0.008), with women showing higher values [43.4 (IQR 39.1 - 48.8)]. The mean BMI of patients who underwent RYGB was significantly higher compared to those who underwent vertical gastrectomy (VG) (p=0.009). There was a statistical association between DM2 (p=0.033) and depression (p=0.018) and the type of surgery performed. CONCLUSION: the clinical and epidemiological profile found showed a higher prevalence of females and individuals with Class III obesity. RYGB was the most commonly performed procedure, establishing an association with BMI and some of the patients' comorbidities.
Rev Col Bras Cir
· 2024 · PMID 38985039
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In its 20th anniversary, laparoscopic pancreatoduodenectomy, while feasible and safe in the hands of experienced surgeons, has not seen the anticipated popularity observed in other digestive surgery procedures. The prima...In its 20th anniversary, laparoscopic pancreatoduodenectomy, while feasible and safe in the hands of experienced surgeons, has not seen the anticipated popularity observed in other digestive surgery procedures. The primary hurdle remains the absence of a clear advantage over traditional open surgery, paired with the procedures complexity and a consequent steep learning curve. In regions with limited pancreatic surgery services, conducting this procedure without adequate training can have serious repercussions. Given the advent of robotic platforms and the anticipation of prospective and randomized studies on this new technology, it is imperative to engage in comprehensive discussions, endorsed by surgical societies, on the value, application, and implementation strategies for various minimally invasive pancreatoduodenectomy techniques. Such dialogue is crucial for advancing the field and ensuring optimal patient outcomes.
Motta FJTRAD, Luna ICG, Fabiani IM
… +3 more, Souza JCDS, Amorim VEM, Sá JZ
Rev Col Bras Cir
· 2024 · PMID 38985038
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INTRODUCTION: Vitamin D plays a crucial role in various biological processes, including the well-known regulation of the immune system and calcium metabolism. While its involvement in the surgical outcomes of various med...INTRODUCTION: Vitamin D plays a crucial role in various biological processes, including the well-known regulation of the immune system and calcium metabolism. While its involvement in the surgical outcomes of various medical specialties is recognized, there is a lack of consistent data regarding plastic surgery. This study aimed to assess preoperative serum levels of 25-hydroxyvitamin D and its relationship with complications in patients undergoing reconstructive and aesthetic plastic surgeries. METHODS: prospective and observational cohort study, conducted from October 2021 to August 2023 at the Hospital das Clínicas, Universidade Federal de Pernambuco, involving 83 patients. RESULTS: vitamin D levels were deemed deficient in 7 (8,4%) patients, insufficient in 36 (43,4%), and sufficient in 40 (48,2%). No direct association was demonstrated between deficient or insufficient serum levels of 25-hydroxyvitamin D and the incidence of complications in plastic surgery, even when considering comorbidities. CONCLUSION: preoperative hypovitaminosis D was not associated with complications in plastic surgery.