FHP care is more effective than is non-FHP care at preventing death from secondary stroke and myocardial infarction.
Introduction Since the 1960s, mortality in Crohn's disease and Ulcerative Colitis patients had a significant decrease due to advances in medical and surgical therapy. An important proportion of these patients are submitted to surgical procedures during their disease course, with postoperative mortality between 4 and 10%. Methods 157 inflammatory bowel disease patients submitted to surgical therapy were retrospectively identified and allocated in 2 groups (Crohn's and colitis). Deaths were individually discriminated in detail. Results 281 surgical procedures were performed. In the colitis group, 43 operations were performed in 24 patients; in the abdominal Crohn's subgroup, 127 procedures in 90 patients and in the perineal Crohn's subgroup, 115 in 64 patients, respectively. Nine postoperative deaths were observed (3 in the colitis and 6 in the Crohn's groups). Overall postoperative mortality was 5.7% (4.5% for Crohn's; 6.6% in abdominal Crohn's and 12.5% for Colitis). Most of deaths were related to emergency procedures and previous use of corticosteroids. The cause of death in all patients was sepsis. Conclusions Overall postoperative mortality in inflammatory bowel disease was 5.7%, and it was attributed to the severity of the cases referred.
- [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. The band was withdrawn in 13 patients (68.42%), including seven by erosion, four for unsatisfactory weight loss and two for gastroesophageal reflux. The gastric bypass was conducted in ten patients and Scopinaro operation in one. Two patients had not been reoperated till nowadays and four were lost in late follow-up. Conclusion:The gastric band is technically unsatisfactory in long-term evaluation, have high withdrawal rate due to migration or unsatisfactory weight loss. RESUMO -Racional -A banda gástrica ajustável por via laparoscópica é técnica segura,potencialmente reversível e alternativa eficaz ao by-pass gástrico em Y-de-Roux. Porém, ela tem taxa elevada de reoperação e perda de peso insatisfatória. ObjetivoApresentar uma série de casos com o uso da banda gástrica em seguimento de longo prazo analisando o índice de retirada, suas causas e as conversões cirúrgicas efetuadas. Métodos: Estudo retrospectivo baseado na análise de 19 pacientes submetidos ao procedimento no período de novembro de 1999 a novembro de 2002, e revisados com seguimento clínico tardio até fevereiro de 2011. Os pacientes foram analisados nos seguintes aspectos: sexo, idade, peso pré-operatório, IMC pré-operatório, tempo de seguimento, motivos de retirada da banda gástrica, necessidade de conversão para outra modalidade cirúrgica e índice de falha do método cirúrgico. Resultados: Dezenove pacientes foram submetidos ao procedimento, sendo quatro mulheres e 15 homens. O IMC médio pré-operatório foi de 41,95 kg/m 2 (36-54). A banda foi retirada em 13 pacientes (68,42%), dos quais sete por erosão, quatro por perda de peso insatisfatório e dois por refluxo gastroesofágico. O bypass gástrico foi realizado em dez pacientes e operação de Scopinaro em um. Duas pacientes ainda não tinham sido reoperadas e quatro perderam o seguimento. Conclusão: A banda gástrica é técnica insatisfatória a longo prazo, com alto índice de retirada por migração ou por perda de peso insatisfatória.
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