Objective: to demonstrate that the use of the portocath implantation technique without tunneling the catheter is not associated with a higher rate of complications in the short or long term. In addition, we aim to improve the implantation technique of the portocath device, with the presentation of a step-by-step guide for surgeons in training. Methods: this is a retrospective descriptive study, with analytical components. Data were analyzed using information extracted from electronic medical records linked to the National Health Care procedure code between the years 2019-2020. Results: none of the 94 procedures resulted in complications on the day they were performed. Complications were recorded seven days after the procedure in only two patients (2.13%). Intraoperative radioscopy had been performed in both cases. Thirty days afters the procedure, complications were observed in two patients among the remaining 92 (2.17%), both undergoing catheter implantation without tunneling. There were no complications in the six months after portocath implantation in 57.4% of patients and there is no information about the other 42.6%. Conclusion: the portocath insertion technique without tunneling is a safe outpatient procedure, with a low risk of complications, and can be adopted to shorten procedure time and patient discomfort, without functional or safety impairments. There was no association of not tunneling the catheter, laterality of the punctured vein and performing radioscopy in the transoperative period with the rate of complications.
INTRODUÇÃO: A Síndrome de Aarskog (SA) foi descrita pela primeira vez em 1970, como “uma síndrome familiar de baixa estatura associada à displasia facial e anomalias genitais”. A herança é ligada ao X (recessivo e semi-dominante), autossômico dominante (influenciado pelo sexo) ou autossômico recessivo. Não existe uma terapia específica para a SAS, no entanto, intervenções cirúrgicas podem ser feitas para correção das malformações. RELATO DE CASO: Masculino, 20 anos, portador de Síndrome de Aarskog, chega em serviço hospitalar terciário por quadro de vômitos, dor abdominal e constipação seguido por alteração de hábito intestinal há duas semanas. TC abdominal identificou grande massa centrada na raiz mesentérica, mal delimitada, deslocando as alças intestinais e englobando estruturas vasculares e em continuidade com lesão ovalada que se projetava para a luz de alça de íleo. Biópsia de epíplon, realizada por laparotomia, teve perfil imuno-histoquímico compatível com linfoma não-Hodgkin de imunofenótipo B, do tipo Burkitt. Paciente evoluiu a óbito poucos dias após o procedimento, por disfunção ventilatória. CONCLUSÃO: Linfoma de Burkitt é um tipo agressivo de Linfoma não-Hodgkin e possui uma apresentação clínica variável. A associação entre Síndrome de Aarskog e linfomas ainda não havia sido descrita na literatura. Espera-se contribuir com outros pacientes ao descrever este caso à comunidade científica.
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