http://repositorio.ufc.br/handle/riufc/422 Thu, 11 Jun 2026 14:36:42 GMT 2026-06-11T14:36:42Z 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/85968 Título: Mastectomia radical modificada com drenagem por sucção contínua versus sem drenagem Autor(es): Juaçaba, Ricardo Carvalho Abstract: This research was conducted in order to analyze the results of seroma formation after modified radical mastectomy using suction drain versus no suction drain with a wound closure tecnique. This prospective study included seventy-two (72) patients who had operable breast cancer. All patients underwent modified radical mastectomy (Madden surgery) followed by wound closure using inabsorvent stitch between the skin and the chest wall musculature. The axila was also closed and the suction drains were placed beneath the skin and in the axila. The drains were removed 24 hours after surgery. Of the seventy-two (72) patients in the study, thirty-seven underwent the surgery and had drains placed. Thirty-five patients had no drains place following surgery. Evaluations factors included: age, weigth, clinical stage, number of axillary lymph nodes removed and positive lymph nodes. Complications (thus are of study) in both groups of patients included: seroma, infected seroma, skin necroses, hematoma and wound infection. The results of these seventy-two patients showed no significant statistical difference between the two groups in relation to: age (p=0.59), weight (p=0.25), height (p=0.83), clinical stage (p=0.44), lymph nodes removed (p=0.63) and positive lymph nodes (p=0.94). Surgical complications occurred in 10 patients (27%) in the first group (with drains) and in 12 patients (34,3%) in group two (without drains). Seroma formation was present in 8 patients in group 1 (21,6%) and in 10 patients in group 2 (28,6%). No significant statistical difference was noted between the two groups in relationship to the total number of complications (p=0.50) and seroma (p=0.49). The author concluded that modified radical mastectomy (associated with wound closure) and without drains can be safely performed without increasing surgical complications Tipo: Dissertação Mon, 01 Jan 2001 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/85968 2001-01-01T00:00:00Z