http://repositorio.ufc.br/handle/riufc/417 Wed, 10 Jun 2026 21:00:04 GMT 2026-06-10T21:00:04Z http://repositorio.ufc.br/handle/riufc/86620 Título: Correlação da incontinência fecal com parâmetros clínicos, funcionais e anatômicos de pacientes do sexo feminino submetidas à secção da musculatura esfincteriana lisa pós fistulotomia anal e esfincterotomia anal Autor(es): Mont’Alverne, Ricardo Everton Dias Abstract: Introduction: Anal fistula and anal fissure are benign diseases affecting the anal canal; however, surgical treatment may be required, often involving division of the internal sphincter muscle. As a consequence, patients may experience sequelae that significantly impact their quality of life, such as fecal incontinence, with female patients being particularly susceptible. Methodology: Sixty-three female patients who underwent internal sphincter muscle division through anal fistulotomy (30 patients) or anal sphincterotomy (33 patients) were evaluated. Clinical assessment was performed using a fecal incontinence score, functional assessment by anorectal manometry, and anatomical assessment by 3D endoanal ultrasound. Results: Overall, 46% (29/63) of patients reported symptoms of fecal incontinence after internal anal sphincter division, with 18 (60%) in group I and 16 (48%) in group II. However, the severity of symptoms was similar between groups, with mean scores of 1.6 (0–8) in group I and 2 (0–7) in group II. Resting pressure decreased in both groups and was similar between them postoperatively. The longitudinal length and percentage of the internal sphincter muscle divided were greater in group I. The longitudinal length of the anterior external anal sphincter and the distance between the external anal sphincter and puborectalis muscle were similar in both groups. However, the gap length—the distance between the proximal edge of the external anal sphincter and the distal edge of the puborectalis—was significantly greater in group II. Conclusion: Sphincter division surgery, regardless of the operative technique, is associated with a high rate of fecal incontinence, although the symptom severity remains low. The length and percentage of smooth muscle divided were smaller in patients who underwent anal sphincterotomy. Nevertheless, the rate of fecal incontinence was similar between the two groups. This finding may be explained by the longer gap observed in this group, leading to greater asymmetry of the anal canal. Tipo: Dissertação Wed, 01 Jan 2025 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86620 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86542 Título: Nódulos tireoidianos e carcinoma papilífero na infância e adolescência: preditores clínico patológicos de malignidade e metástase cervical Autor(es): Macedo, Mário Sérgio Rocha Abstract: The incidence of thyroid nodules and differentiated thyroid carcinomas in children and adolescents has increased in recent decades, with a biological behavior distinct from that observed in adults and a higher frequency of lymph node metastasis. This study had three objectives: (1) to describe the clinical, laboratory, ultrasonographic, cytological, and histopathological profile of children and adolescents undergoing thyroidectomy; (2) to identify predictors of benignity and malignancy in thyroid nodules; and (3) to investigate clinicopathological predictors of cervical metastasis in patients with papillary thyroid carcinoma. A retrospective study was conducted including patients younger than 18 years who underwent thyroid surgery between January 2013 and May 2023. Surgical indications, ultrasonography findings, and fine-needle aspiration biopsy results were analyzed, along with histopathological findings standardized according to the 5th edition of the World Health Organization (WHO) classification and the College of American Pathologists (CAP) protocol, staging based on the 8th edition of the American Joint Committee on Cancer (AJCC), risk stratification according to the American Thyroid Association pediatric guidelines (ATA, 2015), use of radioiodine therapy, and oncological outcomes. Factors associated with outcomes were evaluated using bivariate analyses, multivariate logistic regression, and Firth’s penalized regression. Among 91 patients, 40.6% had malignant neoplasms, predominantly papillary thyroid carcinoma, with cervical lymph node involvement in 78.1% of cases (25/32). Ultrasonographic microcalcifications (OR 28.64; 95%CI 3.29–249.31; p = 0.002) and age ≤ 10 years (OR 5.69; 95%CI 1.21–26.75; p = 0.028) were independent predictors of malignancy. In the subcohort of 32 papillary thyroid carcinomas, only extrathyroidal extension remained an independent predictor of cervical metastasis after multivariate adjustment (OR 14.29; 95%CI 1.28–2028.82; p = 0.028). These findings reinforce the high rate of locoregional dissemination of papillary thyroid carcinoma and highlight the role of structured ultrasonographic assessment and detailed histopathological analysis in risk stratification and surgical planning. Tipo: Dissertação Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86542 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86138 Título: Estudo prospectivo da resposta a quimioterapia neoadjuvante na determinação do tratamento cirúrgico conservador em pacientes com câncer de mama Autor(es): Machado, Francisco Heine Ferreira Abstract: This present prospective study mtended to evaluate the contribution of neoadjuvant chemotherapy upon the reduction of breast malignant tumors with views to perform conservative operation as oposed to a more aggressive radical surgical procedure. Thirty two patients with mfiiltrating carcinoma of the breast stages I, IIa, lib, DIa and DIb eligible to underço radical inastectomy were included in this work. All patients studied were submited to fisical examination with measure of tumor size using tumorimeter, mammography, mammary ltrasonography, citology and core biopsy of the tuinor using tru-cut needle. With confirmed carcinoma of the breast upon results either from citology or core biopsy, aU patients received combmed neoadjuvant chemotherapy with 5- fluorouracü SOOmg/m , epirrubicine 50mg/m and cyclophophamide 500mg/m (FEC), every 21 days for three consecutive cycles as their initial therapy. After tree cycles of chemotherapy, patients were subjected again to the previous applied set of investigations including fisical examination with new measure of the tumor, mammography, mammary ultrasonography, citology and core biopsy of remaining tumor. Surçical local treatment m the form of either radical mastectomy (Madden operation) or quadrantectomy plus axilary clearence was performed. The mean tumor volumes before and after adjuvant chemotherapy were according to dsical exammatíon 24.23cm and 7.53cm , measured by mammography 10.81cm and 5.93cm3 and evaluated through mammary ultrasonography 5.70cm3 and 2.67 Objective response (OR) based on results from the above performed investigations was considered when patients presented either complete tumor size reduction (100%) or tumor size reduction equal or superior to 50%. Objective response (OR) based on fisical examination was observed m 84.5% of patients. When mammography was applied as the anaUzing method 81.2% of patients also presented objective response (OR). Accordmg mammary ultrasonography 80.0% of patients presented objective response (OR). These results were therefore very simuar irrespective of the method of evaluation applied. The rate of breast sakage was 81.2% which means that twenty six out of thirty two patients previously etígible to radical mastectomy underwent conservative surçery. The esthetic results obtained from conseryative surçery were considered good and excellent. The neoadjuvant Qt was efective to promove significance response, without stimulate important agressive m the pacients. The toxicity induced by neoadjuvant chemotherapy caused a high percentage of alopecia and a moderate incidence of nausea and vomits. These resuhs indicate that neoadjuvant chemotherapy can modify the use of radical mastectomy to a nnore conservative surçical treatment in the majority of patients studied. Futhermore, neoadjuvant chemotherapy response may be used to select patients with aggresive non-responsive breast tumors to receive other combmations of chemotherapy drugs which may be more efifective during post operative chemotherapy. Tipo: Dissertação Mon, 01 Jan 1996 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86138 1996-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86061 Título: Prevalência das disfunções do assoalho pélvico utilizando ultrassom 3D dinâmico em mulheres com sintomas de evacuação obstruída e sua relação com idade, paridade e parto vaginal Autor(es): Vilarinho, Adjra da Silva Abstract: Considerable controversy remains regarding the prevalence of pelvic floor disorders and their associated risk factors, largely due to biases related to the study populations and methodologies used. Few studies have employed dynamic three-dimensional imaging to identify pelvic floor dysfunctions and correlate them with factors such as mode of delivery, parity, or patient age. Therefore, this study aimed to determine the prevalence of pelvic floor disorders in female patients with obstructed defecation and to assess their association with age, mode of delivery, and parity using dynamic three-dimensional anorectal ultrasound (3D-US). This cohort study was conducted in the colorectal surgery unit of a tertiary hospital. Female patients presenting with symptoms of obstructed defecation who, despite increased dietary fiber intake, maintained a Cleveland Clinic Florida Constipation Score greater than 6 underwent echodefecography (EDF) to evaluate the presence of posterior pelvic floor dysfunction. The findings were then correlated with history of vaginal delivery, parity, and age. A total of 889 women were included: 552 (62%) had a history of vaginal delivery, and 337 (38%) were nulliparous. The mean age was significantly higher among women with a history of vaginal delivery. Previous anorectal surgeries were more frequent among nulliparous women (p = 0.043). The prevalence of posterior pelvic floor disorders—including rectocele, intussusception, enterocele/sigmoidocele, and anismus—was similar between the two groups and was not associated with the number of vaginal deliveries or with age. However, the prevalence of sphincter defects was higher in the vaginal delivery group and was positively associated with parity. In conclusion, the prevalence of obstructed defecation disorders such as rectocele, intussusception, and enterocele/sigmoidocele, as assessed by EDF, was not associated with vaginal delivery, number of deliveries, or age. Nevertheless, symptoms of fecal incontinence and obstructed evacuation were more prevalent among older women, regardless of prior vaginal deliveries. No association was found between age and the prevalence of sphincter defects in nulliparous women. Tipo: Tese Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86061 2026-01-01T00:00:00Z