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O estado da arte da cirurgia do ba?o, no início do século XXI

机译:21世纪初的脾外科技术水平

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In the last fifty years evolution of scientific knowledge on the spleen provoked an entirely new approach to splenic surgery. It was shown that virulence may emerge as a significant consequence of environmental and evolutionary changes of some microbial communities, and devastating pathogenetic results of these changes become visible in human hosts without the splenic function. In other words: the spleen plays a pivotal role in the dynamic balance between biodiversity, microorganisms and immunogenecity in human hosts. Therefore, to preserve the "splenic immunologic repertoire" became an increasing commitment among surgeons. Understanding the integration of these multiple information on spleen, seems central to understand the new splenic surgery. Partial splenectomies (Réglées) - based on anatomical, experimental and clinical studies, developed at the University of Minas Gerais since the fifties - were successfully applied initially to treat the traumatic injuries of the spleen; in a following step, partial splenectomy were used to control hematological diseases. "Réglées" techniques on the spleen have conquered "ethical support, consilience status and clinical governance" to give birth to surgical therapeutic decisions on the spleen, in order to spare the structural integrity of the immune system. Splenic réglées procedures became a seminal achievement of splenic surgical practice. Initial results of "Partial splenectomies" - with conventional surgical armamentaria and techniques - were confirmed and improved by the introduction of techniques based on laparoscopic and endovascular approaches. And current usage of surgical splenic saving procedures propitiated the emergence of an appropriate lexicon for medical communication and became an "end point" of a "long-standing surgical inhibition" over the spleen.
机译:在过去的五十年中,脾脏科学知识的发展激发了一种全新的脾外科手术方法。结果表明,某些微生物群落环境和进化变化的重要结果可能是致病力,而这些变化的破坏性致病结果在没有脾功能的人类宿主中变得可见。换句话说:脾脏在人类宿主生物多样性,微生物和免疫原性之间的动态平衡中起着关键作用。因此,保存“脾脏免疫组库”成为外科医生越来越多的承诺。了解脾脏这些多种信息的整合,对于理解新的脾脏手术至关重要。自五十年代以来在米纳斯吉拉斯大学开发的基于解剖,实验和临床研究的部分脾切除术(Réglées)最初已成功用于治疗脾脏的创伤;在接下来的步骤中,使用部分脾切除术来控制血液学疾病。脾脏的“Réglées”技术已征服“伦理支持,适应性状况和临床治理”,从而在脾脏上产生了外科治疗决定,从而免除了免疫系统的结构完整性。脾脏regglées手术成为脾外科实践的开创性成果。通过采用基于腹腔镜和血管内方法的技术,证实并改进了“部分脾切除术”的初步结果-包括常规手术武器和技术。目前,外科手术保存脾脏程序的使用促使出现了用于医学交流的适当词典,并成为脾脏“长期手术抑制”的“终点”。

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