Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista

Detalhes bibliográficos
Ano de defesa: 2019
Autor(a) principal: Monte, Hipólito Monte
Orientador(a): Moraes, Maria Elisabete Amaral de
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/55755
Resumo: Hipólito Souza Monte. Dissertation presented in 28/08/2019 to the Post-Graduate Program in Clinical Pharmacology of theFederal University of Ceará, as a partial requirement to obtain the title of Master. In Clinical Pharmacology.This retrospective study analyzed 5,021 cases of laparoscopic appendicectomy for complicated and uncomplicated acute appendicitis performed by the same surgeon during the period from 2001 to 2018, observing the methods of appendiceal closure, the most used technique and its consequences. The most representative parameters for the study were: hospitalization time, operative time, incidence of wall infection, incidence of intra-abdominal abscess, need for conversion, use of antibiotic therapy, introduction of oral diet, abdominal wall intercurrences, reexploration of abdominal cavity and the most important parameter evaluated was the use of a titanium metal clip to close the appendicular stump. The following results were found: mean hospital stay time of 24.08 hours; mean operative time of 15.19 min; absence of wall infection; absence of intra-abdominal abscess; zero conversion rate; antibiotic therapy with predominance of Sulbactam with Ampicillin and Metronidazole; introduction of oral diet with an average of 4 hours postoperatively; observed two umbilical scar seromas and two abdominal wall ecchymoses/bruise; intestinal obstruction diagnosed in the 5th and 12th postoperative days, respectively, with laparoscopic re-inspection; Metallic titanium clip used in 5,006 cases. After compiling all the data, an analysis of the results was carried out with similar national and international studies in order to verify the most effective and efficient method for appendicular stump closure. After conducting the study, it was observed that in face of a clinical case of diagnosed acute appendicitis, even with a few days of evolution, the laparoscopic method should be used as the initial treatment, as the best option and to perform the closing of the cut appendicular with titanium clip.
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spelling Monte, Hipólito MonteMoraes, Maria Elisabete Amaral de2020-12-18T21:15:21Z2020-12-18T21:15:21Z2019MONTE, H. S. Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista. 2019. 85 f. Dissertação (Mestrado Profissional em Farmacologia Clínica) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.http://www.repositorio.ufc.br/handle/riufc/55755Hipólito Souza Monte. Dissertation presented in 28/08/2019 to the Post-Graduate Program in Clinical Pharmacology of theFederal University of Ceará, as a partial requirement to obtain the title of Master. In Clinical Pharmacology.This retrospective study analyzed 5,021 cases of laparoscopic appendicectomy for complicated and uncomplicated acute appendicitis performed by the same surgeon during the period from 2001 to 2018, observing the methods of appendiceal closure, the most used technique and its consequences. The most representative parameters for the study were: hospitalization time, operative time, incidence of wall infection, incidence of intra-abdominal abscess, need for conversion, use of antibiotic therapy, introduction of oral diet, abdominal wall intercurrences, reexploration of abdominal cavity and the most important parameter evaluated was the use of a titanium metal clip to close the appendicular stump. The following results were found: mean hospital stay time of 24.08 hours; mean operative time of 15.19 min; absence of wall infection; absence of intra-abdominal abscess; zero conversion rate; antibiotic therapy with predominance of Sulbactam with Ampicillin and Metronidazole; introduction of oral diet with an average of 4 hours postoperatively; observed two umbilical scar seromas and two abdominal wall ecchymoses/bruise; intestinal obstruction diagnosed in the 5th and 12th postoperative days, respectively, with laparoscopic re-inspection; Metallic titanium clip used in 5,006 cases. After compiling all the data, an analysis of the results was carried out with similar national and international studies in order to verify the most effective and efficient method for appendicular stump closure. After conducting the study, it was observed that in face of a clinical case of diagnosed acute appendicitis, even with a few days of evolution, the laparoscopic method should be used as the initial treatment, as the best option and to perform the closing of the cut appendicular with titanium clip.Hipólito Souza Monte. Dissertação de Mestrado Profissional apresentada em 28/08/2019 ao Programa de Pós-Graduação em Farmacologia Clínica da Universidade Federal do Ceará, como requisito parcial para obtenção do título de Mestre em Farmacologia Clínica. Esse estudo retrospectivo analisou 5.021 casos de apendicectomia laparoscópica por apendicite aguda complicada e não complicada realizadas pelo mesmo médico cirurgião durante o período de 2001 a 2018 na cidade de Fortaleza, Ceará, Brasil em hospital privado observando os métodos de fechamento do côto apendicular, a técnica mais utilizada e suas consequências. Foram avaliados os parâmetros mais representativos para o estudo: tempo de internação, tempo operatório, incidência de infecção de parede, incidência de abscesso intra-abdominal, necessidade de conversão, uso de antibioticoterapia, tipo de analgesia utilizada, introdução da dieta oral, intercorrências de parede abdominal, reexplorarão de cavidade abdominal e o mais importante parâmetro avaliado foi o emprego de clip metálico de titanium para fechamento do côto apendicular. Como resultados, foram encontrados: tempo de permanência hospitalar médio de 24,08 horas; tempo operatório médio de 15,19min; ausência de infecção de parede; ausência de abscesso intra-abdominal; taxa zero de conversão; esquema terapêutico antibiótico com predominância do Sulbactam com Ampicilina e Metronidazol; esquema de analgesia, introdução de dieta oral com média de 4h de pós-operatório; observados dois casos de seroma de cicatriz umbilical e dois casos de equimoses de parede abdominal; obstrução intestinal diagnosticada no 5º e 12º pós-operatório respectivamente com reabordagem laparoscópica; clip metálico de titanium utilizado em 5.006 casos. Após compilação de todos os dados foi realizado uma análise dos resultados com estudos similares nacionais e internacionais com o intuito de constatar o método mais eficaz e eficiente para o fechamento do côto apendicular. Após a realização do estudo observou-se que em face de um quadro clínico de apendicite aguda diagnosticada, mesmo com alguns dias de evolução, deve-se ter o método laparoscópico como tratamento inicial, como a melhor opção e realizar a confecção do fechamento do côto apendicular com clip de titanium.ApendiciteLaparoscopiaCotoApendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionistainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/55755/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52ORIGINAL2019_dis_hsmonte.pdf2019_dis_hsmonte.pdfapplication/pdf1722385http://repositorio.ufc.br/bitstream/riufc/55755/1/2019_dis_hsmonte.pdf92be923c604f1c5be3eff6d91e65a5feMD51riufc/557552020-12-18 18:15:21.635oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2020-12-18T21:15:21Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
title Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
spellingShingle Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
Monte, Hipólito Monte
Apendicite
Laparoscopia
Coto
title_short Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
title_full Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
title_fullStr Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
title_full_unstemmed Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
title_sort Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista
author Monte, Hipólito Monte
author_facet Monte, Hipólito Monte
author_role author
dc.contributor.author.fl_str_mv Monte, Hipólito Monte
dc.contributor.advisor1.fl_str_mv Moraes, Maria Elisabete Amaral de
contributor_str_mv Moraes, Maria Elisabete Amaral de
dc.subject.por.fl_str_mv Apendicite
Laparoscopia
Coto
topic Apendicite
Laparoscopia
Coto
description Hipólito Souza Monte. Dissertation presented in 28/08/2019 to the Post-Graduate Program in Clinical Pharmacology of theFederal University of Ceará, as a partial requirement to obtain the title of Master. In Clinical Pharmacology.This retrospective study analyzed 5,021 cases of laparoscopic appendicectomy for complicated and uncomplicated acute appendicitis performed by the same surgeon during the period from 2001 to 2018, observing the methods of appendiceal closure, the most used technique and its consequences. The most representative parameters for the study were: hospitalization time, operative time, incidence of wall infection, incidence of intra-abdominal abscess, need for conversion, use of antibiotic therapy, introduction of oral diet, abdominal wall intercurrences, reexploration of abdominal cavity and the most important parameter evaluated was the use of a titanium metal clip to close the appendicular stump. The following results were found: mean hospital stay time of 24.08 hours; mean operative time of 15.19 min; absence of wall infection; absence of intra-abdominal abscess; zero conversion rate; antibiotic therapy with predominance of Sulbactam with Ampicillin and Metronidazole; introduction of oral diet with an average of 4 hours postoperatively; observed two umbilical scar seromas and two abdominal wall ecchymoses/bruise; intestinal obstruction diagnosed in the 5th and 12th postoperative days, respectively, with laparoscopic re-inspection; Metallic titanium clip used in 5,006 cases. After compiling all the data, an analysis of the results was carried out with similar national and international studies in order to verify the most effective and efficient method for appendicular stump closure. After conducting the study, it was observed that in face of a clinical case of diagnosed acute appendicitis, even with a few days of evolution, the laparoscopic method should be used as the initial treatment, as the best option and to perform the closing of the cut appendicular with titanium clip.
publishDate 2019
dc.date.issued.fl_str_mv 2019
dc.date.accessioned.fl_str_mv 2020-12-18T21:15:21Z
dc.date.available.fl_str_mv 2020-12-18T21:15:21Z
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dc.identifier.citation.fl_str_mv MONTE, H. S. Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista. 2019. 85 f. Dissertação (Mestrado Profissional em Farmacologia Clínica) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/55755
identifier_str_mv MONTE, H. S. Apendicite aguda e laparoscopia com clipagem do côto apendicular e análise intervencionista. 2019. 85 f. Dissertação (Mestrado Profissional em Farmacologia Clínica) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.
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