We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

Ana Marta PEREIRA

Centro Hospitalar Entre o Douro e Vouga
Santa Maria da Feira, Portugal
MD
298 likes
5.7K views
6 comments
Filter by
Clear filter Specialty
View more

Clear filter Media type
View more
Clear filter Category
View more
Laparoscopic total gastrectomy
A multimodality approach remains the only potential treatment for advanced gastric cancer. Oncological outcomes seem to be equivalent either in open surgery or in minimally invasive surgery. Therefore, laparoscopic gastric resection is expanding in expert centers.
The authors present a clinical case of a 70-year-old woman with no relevant clinical past. She presented with a 1-month complaint of epigastric pain and melena. She underwent an upper endoscopy, which showed an ulcerated gastric lesion at the lesser curvature. Biopsy revealed a poorly cohesive gastric carcinoma with signet ring cells. Thoraco-abdominal-pelvic CT-scan revealed a thickening of the gastric wall associated with multiple perigastric and celiac trunk lymph nodes. She was proposed for perioperative chemotherapy. On the restaging CT-scan, there was no evidence of disease progression and therefore she underwent a laparoscopic radical total gastrectomy.
The benefits of minimally invasive surgery, combined with the increasing evidence of oncological results overlapping with open surgery, have contributed to the progressive implementation of laparoscopic surgery in the treatment of malignant gastric pathology.
J Magalhães, C Osorio, L Frutuoso, AM Pereira, A Trovão, R Ferreira de Almeida, M Nora
Surgical intervention
1 month ago
1692 views
9 likes
3 comments
09:44
Laparoscopic total gastrectomy
A multimodality approach remains the only potential treatment for advanced gastric cancer. Oncological outcomes seem to be equivalent either in open surgery or in minimally invasive surgery. Therefore, laparoscopic gastric resection is expanding in expert centers.
The authors present a clinical case of a 70-year-old woman with no relevant clinical past. She presented with a 1-month complaint of epigastric pain and melena. She underwent an upper endoscopy, which showed an ulcerated gastric lesion at the lesser curvature. Biopsy revealed a poorly cohesive gastric carcinoma with signet ring cells. Thoraco-abdominal-pelvic CT-scan revealed a thickening of the gastric wall associated with multiple perigastric and celiac trunk lymph nodes. She was proposed for perioperative chemotherapy. On the restaging CT-scan, there was no evidence of disease progression and therefore she underwent a laparoscopic radical total gastrectomy.
The benefits of minimally invasive surgery, combined with the increasing evidence of oncological results overlapping with open surgery, have contributed to the progressive implementation of laparoscopic surgery in the treatment of malignant gastric pathology.
Laparoscopic revision of Nissen fundoplication to Roux-en-Y gastric bypass
Introduction: Obesity is a known etiological factor for gastroesophageal reflux disease (GERD) and is also a growing public health concern. Although Nissen fundoplication is a highly effective technique to treat GERD, it may fail in obese patients. Roux-en-Y gastric bypass provides excellent long-term control of GERD symptoms with the additional benefit of weight loss.
Clinical case: A 57-year-old woman underwent a laparoscopic Nissen fundoplication for GERD (BMI 30.0 Kg/m2) with excellent outcomes during the first postoperative year in 2011. Two years later, GERD symptoms recurred, and her weight increased progressively (BMI of 36.0 Kg/m2). The patient was proposed to a laparoscopic conversion of Nissen fundoplication to a Roux-en-Y gastric bypass. The procedure was uneventful, and the patient was discharged on postoperative day 4. One year later, she remained asymptomatic, off antacids medication, and with her weight decreased to 63.5Kg which corresponded to a BMI of 25.4 Kg/m2.
Discussion/conclusion: Roux-en-Y gastric bypass successfully reduces GERD symptoms by diverting bile away from the esophagus, decreasing acid production in the gastric pouch, therefore limiting the amount of acid reflux and by promoting weight loss decreases abdominal pressure over the lower esophageal sphincter and esophageal hiatus. In obese patients (BMI>35) with GERD, Roux-en-Y gastric bypass seems to be the most effective and advantageous treatment since it provides control of GERD symptoms with the additional benefit of weight loss. In patients who have previously undergone anti-reflux surgery, bariatric surgery can be technically demanding. However, if performed by high-volume surgeons in high-volume centers, it is perfectly feasible with low morbidity and excellent results.
J Magalhães, AM Pereira, T Fonseca, R Ferreira de Almeida, M Nora
Surgical intervention
3 months ago
1079 views
3 likes
1 comment
09:34
Laparoscopic revision of Nissen fundoplication to Roux-en-Y gastric bypass
Introduction: Obesity is a known etiological factor for gastroesophageal reflux disease (GERD) and is also a growing public health concern. Although Nissen fundoplication is a highly effective technique to treat GERD, it may fail in obese patients. Roux-en-Y gastric bypass provides excellent long-term control of GERD symptoms with the additional benefit of weight loss.
Clinical case: A 57-year-old woman underwent a laparoscopic Nissen fundoplication for GERD (BMI 30.0 Kg/m2) with excellent outcomes during the first postoperative year in 2011. Two years later, GERD symptoms recurred, and her weight increased progressively (BMI of 36.0 Kg/m2). The patient was proposed to a laparoscopic conversion of Nissen fundoplication to a Roux-en-Y gastric bypass. The procedure was uneventful, and the patient was discharged on postoperative day 4. One year later, she remained asymptomatic, off antacids medication, and with her weight decreased to 63.5Kg which corresponded to a BMI of 25.4 Kg/m2.
Discussion/conclusion: Roux-en-Y gastric bypass successfully reduces GERD symptoms by diverting bile away from the esophagus, decreasing acid production in the gastric pouch, therefore limiting the amount of acid reflux and by promoting weight loss decreases abdominal pressure over the lower esophageal sphincter and esophageal hiatus. In obese patients (BMI>35) with GERD, Roux-en-Y gastric bypass seems to be the most effective and advantageous treatment since it provides control of GERD symptoms with the additional benefit of weight loss. In patients who have previously undergone anti-reflux surgery, bariatric surgery can be technically demanding. However, if performed by high-volume surgeons in high-volume centers, it is perfectly feasible with low morbidity and excellent results.
Laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction for a terminal achalasia
Introduction: Idiopathic achalasia is the most frequent esophageal motility disorder. Generally, treatment is the "palliation" of symptoms and improvement in quality of life. Although Heller myotomy is the standard treatment, achieving good results in 90 to 95% of cases, esophagectomy is required in 5 to 10% of cases.
The authors present a case of a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction in a woman with long-term achalasia and megaesophagus.
Clinical case: A 54-year-old woman, with a previous history of a "psychological eating disorder", was referred to the Emergency Department. She complained of epigastric pain and dysphagia. A thoraco-abdominal CT-scan was requested and revealed a dilated, tortuous, sigmoid esophagus, filled with food content, with no identifiable mass causing obstruction. The patient was admitted to hospital and further study was performed --esophagogastroscopy and esophageal manometry - which confirmed the diagnosis of achalasia with esophageal aperistalses.
The patient was proposed a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction.
No complications were reported in the postoperative period, and discharge was possible on postoperative day 7. Six months later, an esophagram showed adequate contrast passage and progression.
Discussion/Conclusion: Esophagectomy as a primary treatment of achalasia might be considered if severe symptomatic (dysphagia, regurgitation), anatomical (megaesophagus) or functional (esophagus aperistalses) disorders are contraindications to a more conservative approach.
AM Pereira, J Magalhães, R Ferreira de Almeida, G Gonçalves, M Nora
Surgical intervention
1 year ago
2905 views
286 likes
2 comments
09:29
Laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction for a terminal achalasia
Introduction: Idiopathic achalasia is the most frequent esophageal motility disorder. Generally, treatment is the "palliation" of symptoms and improvement in quality of life. Although Heller myotomy is the standard treatment, achieving good results in 90 to 95% of cases, esophagectomy is required in 5 to 10% of cases.
The authors present a case of a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction in a woman with long-term achalasia and megaesophagus.
Clinical case: A 54-year-old woman, with a previous history of a "psychological eating disorder", was referred to the Emergency Department. She complained of epigastric pain and dysphagia. A thoraco-abdominal CT-scan was requested and revealed a dilated, tortuous, sigmoid esophagus, filled with food content, with no identifiable mass causing obstruction. The patient was admitted to hospital and further study was performed --esophagogastroscopy and esophageal manometry - which confirmed the diagnosis of achalasia with esophageal aperistalses.
The patient was proposed a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction.
No complications were reported in the postoperative period, and discharge was possible on postoperative day 7. Six months later, an esophagram showed adequate contrast passage and progression.
Discussion/Conclusion: Esophagectomy as a primary treatment of achalasia might be considered if severe symptomatic (dysphagia, regurgitation), anatomical (megaesophagus) or functional (esophagus aperistalses) disorders are contraindications to a more conservative approach.