<p>Oral 111-Indium-DTPA colonic scintigraphy was used to assess segmental transit in 23 patients with slow transit constipation (STC) and 13 controls. The transit time did not differ between patients and controls in the right colon, whereas the patients had a consistent delay from the transverse colon and distally (<i>P</i><0.05–0.001). Two individual patients had a delay in the right colon.</p><p>Twenty-eight patients underwent a left- (n=26) or a right (n=2) hemicolectomy for STC, after evaluation including colonic scintigraphy. Twenty-three patients (80%) were satisfied with the outcome after a median of 50 months. The median stool frequency increased from one to seven per week (<i>P</i><0.001). The number of patients with bloating, excessive straining and painful defecation decreased (<i>P</i><0.05). The laxative use decreased (<i>P</i><0.01) and faecal continence was unchanged. A blunted rectal sensation correlated to a poor outcome.</p><p>Fifty constipated patients with slow colonic transit and 28 controls were investigated with anorectal manovolumetry. Anal resting pressure was lower (<i>P</i><0.05), and squeeze pressure tended to be lower (<i>P</i>=0.09) in patients. Rectal sensation was not different between groups, although ten patients had a threshold for filling sensation above the 95^th percentile of controls. The rectal compliance was increased in patients (<i>P</i><0.05–0.01).</p><p>Total and segmental colonic transit was assessed with radio-opaque marker study and scintigraphy in 35 constipated patients, and related to normal values. Twenty-seven of 31 female patients had a prolonged total transit time on marker study, and 26 on scintigraphy. Of those 31 patients, 29 had prolonged segmental transit only in one or two segments on marker study. The two methods gave a similar result, except in the descending colon (<i>P</i><0.05). However, the results varied considerably for individual patients.</p><p>In conclusion, patients with STC often benefit from a segmental colonic resection, following assessment including scintigraphy. Anorectal physiology testing may predict surgical results.</p>

Oral 111-Indium-DTPA colonic scintigraphy was used to assess segmental transit in 23 patients with slow transit constipation (STC) and 13 controls. The transit time did not differ between patients and controls in the right colon, whereas the patients had a consistent delay from the transverse colon and distally (P&lt;0.05–0.001). Two individual patients had a delay in the right colon. Twenty-eight patients underwent a left- (n=26) or a right (n=2) hemicolectomy for STC, after evaluation including colonic scintigraphy. Twenty-three patients (80%) were satisfied with the outcome after a median of 50 months. The median stool frequency increased from one to seven per week (P&lt;0.001). The number of patients with bloating, excessive straining and painful defecation decreased (P&lt;0.05). The laxative use decreased (P&lt;0.01) and faecal continence was unchanged. A blunted rectal sensation correlated to a poor outcome. Fifty constipated patients with slow colonic transit and 28 controls were investigated with anorectal manovolumetry. Anal resting pressure was lower (P&lt;0.05), and squeeze pressure tended to be lower (P=0.09) in patients. Rectal sensation was not different between groups, although ten patients had a threshold for filling sensation above the 95th percentile of controls. The rectal compliance was increased in patients (P&lt;0.05–0.01). Total and segmental colonic transit was assessed with radio-opaque marker study and scintigraphy in 35 constipated patients, and related to normal values. Twenty-seven of 31 female patients had a prolonged total transit time on marker study, and 26 on scintigraphy. Of those 31 patients, 29 had prolonged segmental transit only in one or two segments on marker study. The two methods gave a similar result, except in the descending colon (P&lt;0.05). However, the results varied considerably for individual patients. In conclusion, patients with STC often benefit from a segmental colonic resection, following assessment including scintigraphy. Anorectal physiology testing may predict surgical results.

The understanding of the mesorectal spread in rectal cancer has lead to wide acceptance of total mesorectal excision (TME) as the surgical technique of choice for carcinoma in the lower and mid rectum. While oncological results and survival have improved with TME-surgery, morbidity and mortality remain important issues. The most feared complication is symptomatic anastomotic leakage. The aim of this thesis was to focus on the role of the defunctioning stoma, risk factors, and postoperative monitoring in regard to anastomotic leakage in sphincter saving resection of the rectum. Intraoperative adverse events were analysed in a retrospective population based case-control study in which all patients who underwent elective anterior resection in Sweden between 1987 and 1995, and who died within 30 days or during the initial hospital stay (n=140), were compared with patients chosen at random (n=423) who underwent the same operation during the same period, but survived the operation. Intraoperative adverse events were more frequent in those who died, and reconstruction of an anastomosis judged unsatisfactory by the surgeon improved the outcome. In a population based retrospective case-control study, risk factors for symptomatic anastomotic leakage were investigated in randomly chosen sample of patients who underwent anterior resection in Sweden between 1987 and 1995 (n=432). Twelve per cent of the patients developed symptomatic leakage, and 25% of the patients with leakage ended up with a permanent stoma. In multivariate regression analysis, low anastomosis, preoperative radiotherapy, male gender and intraoperative adverse events were independent riskfactors for anastomotic leakage. In a randomised multicentre trial patients operated with sphincter saving TME¨surgery for rectal cancer were randomised to a defunctioning stoma (n=116) or not (n=118). The overall rate symptomatic leakage was 19%. Patienst without a defunctioning stoma leaked in 28% and patients with a defunctioing stoma in 10%, a statistically significant difference (p&lt;0.001) not previously demonstrated in any randomised trial of adequate size. Postoperative monitoring with computed tomography scan (CT-scan) on postoperative day 2 and 7, and C-reactive protein (CRP) daily in 33 patients operated on with anterior resection of the rectum, demonstrated larger pelvic fluid collections in patients with leakage before the leakage was clinically diagnosed. CRP was increased from postoperative day 2 and onwards in patients in whom clinical leakage was diagnosed on median postoperative day 8. In 23 patients who underwent anterior resection of the rectum, intraperitoneal metabolism was investigated using microdialysis technique measuring the carbohydrate metabolites lactate, pyruvate and glucose. Intraperitoneal cytokines IL-6, IL-10 and TNF-α were collected through a pelvic drain and analysed. In patients who developed leakage, the latate/pyruvate ratio was increased near the anastomosis on postoperative day 5 and 6, as well as IL-6 and IL-10 which were increased postoperatively day 1 and 2, while TNF-α was higher on day 1.

Indlæggelsestiden i forbindelse med kirurgi er blevet kortere. Der er meget lidt viden om, hvordan den umiddelbare postoperative periode forløber. Formålet med undersøgelsen har været at vurdere om korte hospitalsforløb hos patienter, der er opereret for forstørret prostata, bevirker at de pårørende overtager en del af plejen, at undersøge om der kommer en øget belastning på andre dele af sundhedsvæsenet, samt at få en viden om hvordan patienterne har det i de første uger efter operationen. Der er foretaget kvalitative interviews med ti hustruer. Til analyse af interviewene er brugt den fænomenologiske metode, beskrevet af Giorgi og Karlsson. På baggrund af disse interviews er der udarbejdet et spørgeskema, som er udsendt til alle hustruer, hvis ægtefælle i perioden november 2004 til maj 2005 er blevet prostataopereret. Resultaterne fra spørgeskemaundersøgelsen blev sat ind i en access database. Resultatet viser at den første postoperative periode er præget af mange vandladningsgener så som inkontinens, hyppige vandladninger, blødning og urinstop. Gener som også belaster hustruerne. Hustruerne følte sig usikre på om efterforløbet var normalt, og de manglede viden om, hvor de kunne henvende sig med problemer. / The length of stay at hospital after surgery has shortened. Little is known about the immediate post-surgery period. The aim of this study is to assess whether spouses have to take active care of their husbands and to assess if the burden of other part of the health service increases as a result of early discharge after prostatic surgery. Furthermore, the study intends to increase the knowledge about how patients experience the first postoperative weeks. Initially qualitative interviews were conducted with ten spouses. The Phenomological method described by Giorgi and Karlsson was used for analysing the interviews. Based on the experience of this, a questionnaire was prepared and sent to all spouses of patients who had undergone prostatic surgery between November 2004 and May 2005. The results of the questionnaires were put into an access database. The principal finding is that many patients during the first postoperative period experience various urinary problems such as incontinence, frequency, haematuria, and urinary retention. Problems which negatively impacted on the spouses. Furthermore, the spouses were uncertain whether it was common to experience these problems, and they did not know whom to contact when in need of support / <p>ISBN 91-7997-152-0</p>

Lowering of central venous pressure in hepatic surgery is nowadays widely recommended and used procedure. Low central venous pressure anesthesia is associated with decreased blood loss and improved clinical outcome. There are several approaches how to reach low central venous pressure. Till now none of them is recommended as superior in terms of patient safety and clinical outcome. Concurrently there is still debate if to use the low central venous pressure anesthesia principle or if it could be replaced with a principle of anesthesia with high stroke volume variation (or another dynamic preload parameter) with the use of a more sophisticated hemodynamic monitoring method. Results of our study didn't show any significant difference between two approaches used for reduction of central venous pressure, but suggest that the principle of low central venous pressure anesthesia could be possibly replaced by the principle of high stroke volume variation anesthesia which presumes the use of advanced hemodynamic monitoring. KEYWORDS Hepatic resection, central venous pressure, Pringle maneuver, hemodynamics, hemodynamic monitoring, fluid therapy, anesthesia

O câncer de pulmão tem alto grau de letalidade. O tabagismo é considerado o principal fator de risco associado ao carcinoma de pulmão não pequenas células. O tratamento que oferece as maiores possibilidades de cura é a cirurgia. A ressecção pulmonar associada atoracectomia é a cirurgia preconizada nos tumores T3 invadindo a parede torácica. A ressecção em Gaiola de Passarinho pode ser considerada uma técnica alternativa. Foram analisados retrospectivamente, de janeiro de 1990 à dezembro de 2009, 13 pacientes portadores de câncer de pulmão aderidos a parede torácica. Eles foram submetidos à ressecção extramusculoperiostal em Gaiola de Passarinho no Hospital Universitário Pedro Ernesto. A avaliação do grau de invasão à parede torácica foi feita no pré-operatório por métodos de imagem; e sua comprovação baseada nos achados histopatológicos dos fragmentos de tecidos enviados para a biópsia de congelação, assim como nos laudos definitivos das peças ressecadas. Os pacientes com tumores de Pancoast ou que abandonaram o acompanhamento foram excluídos do estudo. A avaliação da sobrevida global foi feita a partir dos dados de seguimento pós operatório a nível ambulatorial. A análise estatística foi composta pela curva de sobrevida ou livre de eventos ajustada pelo método de Kaplan-Meier. Complicações pós operatórias, intervalo livre de doença, recidiva local, e uso de terapia complementar também foram incluídos na análise. A idade média em anos foi de 59,6. Todos os pacientes eram tabagistas. O tipo histológico mais encontrado foi o carcinoma escamoso. A média de intervalo livre de doença foi de 44,7 meses. A sobrevida global em cinco anos foi de 60% e o índice de complicações pós-operatórias foi de 69,2%. Não houve mortalidade operatória. O estágio Ib foi encontrado em 80 %. A ressecção extramusculoperiostal demonstrou ser uma alternativa segura de tratamento cirúrgico dos tumores que não invadiram efetivamente o gradil costal. Porém novos estudos tornam-se necessários. Esta dissertação pode servir de base para futuras pesquisas sobre o tratamento cirúrgico do câncer de pulmão. / Lung cancer has high level of lethality. Smoking is considered the main risk factor associated with non small-cell lung cancer. The treatment that offers better opportunity for cure is surgery. Lung resection with thoracectomy is the procedure performed in T3 tumours invading chest wall. The bird cage resection can be considered an alternative approach. Between january 1990 and december 2009, 13 pacients with non-small cell lung cancer invading chest wall were retrospectively analyzed. They underwent resection in bird cage in Pedro Ernesto Hospital of State of Rio de Janeiro University. Preoperative evaluation of chest wall invasion was performed with imaging methods and based on histopathological findings of tissue fragments sent for frozen biopsy, as well as the final reports of surgical specimens. Pacients with Pancoasttumours and whose abandoned treatment was excluded. Overall survival evaluation was done from follow-up outpacients. Statistics analysis was performed using cumulative survival and cumulative metastasis-free survival curves, adjusted by Kaplan-Meier method. Postoperative complications, disease-free interval, local disease recurrence and complementary therapy were also included in the study. Median age was 56,9 years. Median free-disease interval was 44,7 months. All pacients were smokers. Carcinoma squamous cell was the main histological type founded. Overall long-term survival was 60% in five years and the rate of postoperative complications was 69,2%. There was no operative mortality. Stage Ib was present in 80%. The extramusculoperiosteal in bird cage resection has demonstrated to be a safe alternative in surgical treatment of tumours that effectively doesnt violate the chest wall. However, new studies are necessary. This dissertation can be used as basis for future researches in surgical treatment of lung cancer.

O câncer de pulmão tem alto grau de letalidade. O tabagismo é considerado o principal fator de risco associado ao carcinoma de pulmão não pequenas células. O tratamento que oferece as maiores possibilidades de cura é a cirurgia. A ressecção pulmonar associada atoracectomia é a cirurgia preconizada nos tumores T3 invadindo a parede torácica. A ressecção em Gaiola de Passarinho pode ser considerada uma técnica alternativa. Foram analisados retrospectivamente, de janeiro de 1990 à dezembro de 2009, 13 pacientes portadores de câncer de pulmão aderidos a parede torácica. Eles foram submetidos à ressecção extramusculoperiostal em Gaiola de Passarinho no Hospital Universitário Pedro Ernesto. A avaliação do grau de invasão à parede torácica foi feita no pré-operatório por métodos de imagem; e sua comprovação baseada nos achados histopatológicos dos fragmentos de tecidos enviados para a biópsia de congelação, assim como nos laudos definitivos das peças ressecadas. Os pacientes com tumores de Pancoast ou que abandonaram o acompanhamento foram excluídos do estudo. A avaliação da sobrevida global foi feita a partir dos dados de seguimento pós operatório a nível ambulatorial. A análise estatística foi composta pela curva de sobrevida ou livre de eventos ajustada pelo método de Kaplan-Meier. Complicações pós operatórias, intervalo livre de doença, recidiva local, e uso de terapia complementar também foram incluídos na análise. A idade média em anos foi de 59,6. Todos os pacientes eram tabagistas. O tipo histológico mais encontrado foi o carcinoma escamoso. A média de intervalo livre de doença foi de 44,7 meses. A sobrevida global em cinco anos foi de 60% e o índice de complicações pós-operatórias foi de 69,2%. Não houve mortalidade operatória. O estágio Ib foi encontrado em 80 %. A ressecção extramusculoperiostal demonstrou ser uma alternativa segura de tratamento cirúrgico dos tumores que não invadiram efetivamente o gradil costal. Porém novos estudos tornam-se necessários. Esta dissertação pode servir de base para futuras pesquisas sobre o tratamento cirúrgico do câncer de pulmão. / Lung cancer has high level of lethality. Smoking is considered the main risk factor associated with non small-cell lung cancer. The treatment that offers better opportunity for cure is surgery. Lung resection with thoracectomy is the procedure performed in T3 tumours invading chest wall. The bird cage resection can be considered an alternative approach. Between january 1990 and december 2009, 13 pacients with non-small cell lung cancer invading chest wall were retrospectively analyzed. They underwent resection in bird cage in Pedro Ernesto Hospital of State of Rio de Janeiro University. Preoperative evaluation of chest wall invasion was performed with imaging methods and based on histopathological findings of tissue fragments sent for frozen biopsy, as well as the final reports of surgical specimens. Pacients with Pancoasttumours and whose abandoned treatment was excluded. Overall survival evaluation was done from follow-up outpacients. Statistics analysis was performed using cumulative survival and cumulative metastasis-free survival curves, adjusted by Kaplan-Meier method. Postoperative complications, disease-free interval, local disease recurrence and complementary therapy were also included in the study. Median age was 56,9 years. Median free-disease interval was 44,7 months. All pacients were smokers. Carcinoma squamous cell was the main histological type founded. Overall long-term survival was 60% in five years and the rate of postoperative complications was 69,2%. There was no operative mortality. Stage Ib was present in 80%. The extramusculoperiosteal in bird cage resection has demonstrated to be a safe alternative in surgical treatment of tumours that effectively doesnt violate the chest wall. However, new studies are necessary. This dissertation can be used as basis for future researches in surgical treatment of lung cancer.

INTRODUÇÃO: O tratamento padrão do Carcinoma Epidermoide do Ânus (CEDA) é a quimiorradioterapia ou radioterapia exclusiva. Os pacientes em que a terapêutica conservadora falha são tratados com Ressecção Abdominoperineal do Reto (RAP) de resgate. OBJETIVOS: Avaliar a sobrevivência com a RAP de resgate no CEDA, identificando os descritores favoráveis para sobrevivência maior e as características do agrupamento de variáveis relacionadas a descritores independentes de risco para mortalidade. MÉTODOS: Foram levantados dados através de 111 prontuários de portadores de CEDA, tratados inicialmente com quimiorradioterapia combinada ou radioterapia exclusiva e submetidos à RAP no período de outubro de 1982 a janeiro de 2011. RESULTADOS: A média de idade foi de 58 anos, 93 (83,8%) pacientes eram do sexo feminino e 80 (72,1%) da raça branca. O estadio cT3-4 compôs 66,7% e cN0 39,6% da casuística. A RAP foi indicada por persistência da doença (PD) em 61 (55%) pacientes e por recidiva (RD) em 50 (45%) pacientes. A ressecção cirúrgica sem resíduos tumorais (R0) foi realizada em 86 (77,5%) pacientes. O tempo médio de permanência hospitalar pós-operatório foi de 14 dias. A morbidade cirúrgica foi de 64,9%, sendo 78,3% dela devida às complicações da região perineal. Recidiva após RAP ocorreu em 68 (61,2%) pacientes, sendo 40 (58,8%) no primeiro ano do pós-operatório, a maioria locorregional (78%; 53/68). A mediana do seguimento foi de 16 meses (1,2-60 meses). Na análise multivariada, cirurgia R0 (p<0,001), invasão perineural vascular e/ou linfática negativa (p<0,0001) e linfonodo negativo na peça cirúrgica (p=0,03) foram estatisticamente associados à maior sobrevivência. CONCLUSÕES: A taxa de sobrevivência global estimada em cinco anos foi de 24,5%, com mediana de sobrevivência de 32 meses. O subgrupo de pacientes submetidos a cirurgias R0 em cujas peças cirúrgicas não foram encontrados invasão perineural vascular e/ou linfática nem linfonodos comprometidos apresentou taxa de sobrevivência estimada em três e cinco anos de 74,4% e 55,0%, respectivamente, com mediana de sobrevivência de 87 meses. Não houve diferença significativa entre pacientes que evoluíram com PD ou RD. Identificou-se a cirurgia R1-2, invasão perineural vascular e/ou linfática e linfonodo positivo na peça cirúrgica como fatores preditivos independentes de mortalidade / INTRODUCTION: The standard treatment for epidermoid carcinoma of the anus (ECA) is the association of chemotherapy (QT) and radiotherapy or exclusive radiotherapy (RT). When conservative treatment fails, patients are submitted to abdominoperineal resection of the rectum (APR). OBJECTIVES: To assess survival with salvage APR in ECA, identifying the most favorable independent descriptors for longer survival and the characteristics of the group of independent variables for mortality risk. METHODS: Data were collected from the medical records of 111 patients with ECA, initially treated with QT/RT or exclusive RT and later submitted to APR, from October 1982 to January 2011. RESULTS: Their mean age was 58 years, 93 (83.8%) patients were female, and 80 (72.1%) were Caucasian. The cT3-4 stage represented 66.7% of the case series and cN0, 39.6%. The APR was indicated due to persistence of disease (PD) in 61 (55%) patients and recurrence of disease (RD) in 50 (45%) patients. Surgical resection without residual tumor (R0) was performed in 86 (77.5%) patients. The mean postoperative hospital length of stay was 14 days. Surgical morbidity was 64.9%, of which, 78.3% related to perineal infection. Recurrence after APR was observed in 68 (61.2%) patients, 40 (58,8%; 40/68) of whom in the first postoperative year, mostly locoregional (78%; 53/68). The median follow-up was 16 months (1.2 - 60 months). On multivariate analysis, R0 surgery (p<0.001), absence of perineural and/or lymphovascular invasion (p<0.0001) and negative lymph node status in the surgical specimen (p=0.03) were associated with increased survival. CONCLUSION: Estimated overall survival rate in 5 years was 24.5%, with median survival of 32 months. There was no significant difference in survival after APR in patients who had PD or RD after conservative treatment. The subgroup of patients who underwent R0 and whose surgical specimen showed absence perineural and/or lymphovascular invasion and negative lymph nodes had an estimated survival rate at 3 and 5 years of 74,4% and 55,0%, respectively, with a median survival of 87 months. The following were identified as independent predictors of mortality: R1-2 surgery; presence perineural and/or lymphovascular invasion; and positive lymph node in the surgical specimen

Introdução: As grandes perdas de maxila condicionam grande defeito oral que afetam a qualidade de vida do paciente em diversos domínios. Porém, não há na literatura um questionário específico para esta condição. Proposição: Desenvolver e validar um instrumento de qualidade de vida para as grandes perdas de maxila sem envolvimento facial. Material e Método: Elaboração de um questionário piloto baseado nos achados de outros estudos e seleção de perguntas de instrumentos já existentes que trabalham com domínios semelhantes. Em seguida, clínicos avaliaram estas questões, que poderiam sugerir a inclusão e exclusão de questões. A seguir, pacientes pontuaram os itens gerados numa escala de 0 a 10 segundo a relevância e importância para redução de itens segundo o método de impacto. Por fim, dois pesquisadores agruparam os itens em domínios e se determinou a consistência interna pelo coeficiente alfa de Cronbach. Resultados e Discussão: O questionário preliminar contou inicialmente com 60 questões que, após a entrevista com pacientes, foi reduzido a 33. O alfa de Cronbach foi de 0,92 e os itens foram separados em oito domínios: relações sociais; fala e voz; alimentação; emocional; bem estar material; dor; estética; e halitose. Apenas uma questão, que não obteve índice de impacto suficiente, foi incluída devido aos achados de outros estudos e falta de outra pergunta similar. O instrumento gerado necessita de um processo de validação final. Conclusões: Obtenção de um questionário preliminar sobre qualidade de vida nas grandes perdas de maxila sem envolvimento facial com validade de conteúdo. / Introduction: Maxilla defects affect patients quality of life on several domains. There is not a specific instrument to this condition. Proposition: Develop and validate a disease-specific health related quality of life questionnaire for acquired maxilla defect. Materials and Methods: To elaborate a pilot questionnaire based on other studies results and select questions using instruments that deal with similar domains. Then, experts assessed these items and could suggest including or excluding questions. After that, patients scored the items according to relevance and importance in order to reduce the number of questions using the impact method. At last, two researchers grouped the questions into domains and the internal consistency was calculated using the Cronbachs alpha coefficient. Results and Discussion: The pilot questionnaire contained 60 questions and after we performed the impact method it was reduced to 33 items. The Cronbachs alpha coefficient was 0,92. The researchers compiled the items into eight domains: social relationships; speech and voice; feeding; emotional; material wellbeing; pain; aesthetics ;and halitosis. Only one question did not reach the minimum impact score was included in the questionnaire due to findings in others studies and lack of a similar items. The preliminary instrument presented here needs to undergo a complete validation process in to assess the psychometric properties and to decide on the final version. Conclusions: A preliminary version of the instrument with content validity was obtained.

Introdução: A memória prospectiva (MP) refere-se a um conjunto de habilidades cognitivas que permitem lembrar-se de uma intenção a desempenhar no futuro, no momento adequado. Essa função é pouco avaliada em baterias neuropsicológicas que avaliam pessoas com epilepsia. Objetivo: Estudamos o impacto da cirurgia para epilepsia sobre a MP, componente prospectivo, em pessoas submetidas a lobectomia temporal unilateral para controle de epilepsia refratária ao tratamento clínico. Métodos: Comparamos o desempenho de MP em pessoas com epilepsia associada à esclerose mesial temporal à esquerda (EMTE) ou direita (EMTD) com dois grupos controles. Um grupo foi composto por indivíduos sem epilepsia (controles normais), e o outro por pessoas com epilepsia secundária à EMT, submetidos a avaliação e reavaliação neuropsicológica, sem intervenção cirúrgica (grupo clínico para controle teste/reteste). Resultados: Avaliamos 42 indivíduos sem epilepsia, 20 do grupo clínico (controle teste/reteste) e 39 do grupo cirúrgico (pré e pósoperatório). Comparamos o desempenho entre grupos e também a variação de desempenho individual, pelo índice de mudança confiável. Os grupos não diferiram em idade, escolaridade e quociente de inteligência. Na avaliação inicial, observou-se rebaixamento no desempenho em MP nos grupos clínico e cirúrgico (p < 0,01) (efeito lesão), sem diferença entre os grupos EMTE ou EMTD (efeito lateralidade). Para o grupo cirúrgico, observamos acentuada (p < 0,01) redução de crises e leve, porém significativa, redução de carga de drogas antiepilépticas pós-operatória. Observamos estabilidade em reteste de MP, declínio de memória verbal para o grupo EMTE e estabilidade de memória verbal e visual para o grupo EMTD. Conclusão: Embora exista um sistema de evocação compartilhado entre a MP e a memória episódica, a ressecção de estruturas temporais mesiais acometidas patologicamente não provoca declínio adicional em MP, mesmo quando se observou declínio de memória verbal no grupo EMTE. O comportamento dissociado de declínio de memória verbal para o grupo EMTE e preservação de MP após cirurgia de epilepsia sugere diferentes papeis das estruturas temporais mesiais nestes sistemas de memória. O papel do acometimento de estruturas extratemporais e de estruturas temporais não mesiais na MP em pacientes com EMT deverá ser melhor elucidado em estudos futuros / Introduction: Prospective memory (PM) refers to a set of cognitive abilities that allow recall of a previous intention to perform in the future, in the appropriate setting. This function is not usually evaluated in neuropsychological batteries used to evaluate people with epilepsy. Objective: We evaluated the impact of epilepsy surgery on the prospective component of PM, in people undergoing unilateral temporal lobectomy to treat medically refractory epilepsy. Methods: We compared performance in PM in people with left or right mesial temporal sclerosis (MTS) in the pre and postoperative periods with that of two control groups. One group was composed of people without epilepsy (normal controls), and another group was composed of people with epilepsy associated with mesial temporal sclerosis that underwent neuropsychological testing and retesting without undergoing surgery (clinical test/retest control group). Results: We studied 42 people without epilepsy, 20 clinical controls (test/retest group), and 39 patients that underwent epilepsy surgery (pre and postoperative testing). We compared groups performances and changes in individual performances with the reliable change index. Groups did not differ in age, education, and intelligence quotient. We found decreased preoperative PM performance for the clinical and surgical groups (p < 0.01) (lesion effect), without a difference between right and left groups (laterality effect). Postoperatively, there was a significant (p < 0.01) decrease in number of seizures, a small, but significant reduction in antiepileptic drug load, stable prospective memory, verbal and visual memory for right mesial temporal sclerosis, and decreased verbal memory in the left mesial temporal sclerosis group. Conclusion: In spite of a shared evocation system for episodic and prospective memory, resection of pathologically involved mesial temporal structures does not impact on prospective memory performance, even in the setting verbal memory decline in the left MTS group.The finding of dissociated verbal memory decline and PM stability after epilepsy surgery suggests a different role of mesial temporal lobe structures in these memory systems. The role of extratemporal and nonmesial temporal lobe structures in prospective memory in MTS patients should be evaluated in future studies