Revista Chilena De Cirugia最新文献_第3页

Cirugía mayor ambulatoria de la glándula tiroides y paratiroides. Resultados tras 6 años de experiencia 甲状腺和甲状旁腺的门诊大手术。6年经验后的结果

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/s0718-40262018000600557

Alejandra de Andrés Gómez, F. V. Ferrer, A. M. Abellán, A. Ismail, Ramón Gómez Contreras, Carla Navarro Moratalla, Javier Precioso Estiguin, C. Fernández

{"title":"Cirugía mayor ambulatoria de la glándula tiroides y paratiroides. Resultados tras 6 años de experiencia","authors":"Alejandra de Andrés Gómez, F. V. Ferrer, A. M. Abellán, A. Ismail, Ramón Gómez Contreras, Carla Navarro Moratalla, Javier Precioso Estiguin, C. Fernández","doi":"10.4067/s0718-40262018000600557","DOIUrl":"https://doi.org/10.4067/s0718-40262018000600557","url":null,"abstract":"Objetive: Ambulatory or overnight stay surgery have been consolidated in many different procedures. However, its use in thyroid and parathyroid surgery is still controversial. The aim of this report is to present the results of 6 years of ambulatory patients undergoing surgery of the thyroid or parathyroid glands. Material and Methods: Prospective observational study of patients who underwent hemithyroidectomy or selective parathyroidectomy in the ambulatory program from January 2011 to December 2016. All patients included met the general criteria of ambulatory surgery. During the first years nodules bigger than 3cm and patients classified as ASA III were excluded. Patients arrive at hospital the morning of surgery. After the operation, patients pass to the post-anesthesia care unit and then to the hospitalization room. 8 hours after surgery patients are discharged home if they meet the criteria. Results: 270 patients were operated, 159 of them met the inclusion criteria. The overall applicability rate was 59%. The acceptance rate was 83.6% and the substitution index was 49.2%. The unwanted hospital admission was 10.4% for the parathyroidectomy and 17.6% for the hemithyroidectomy. Any patient presented major complications at home. The satisfaction rate was high or very high for 94% of the patients. Conclusion : Selective parathyroidectomy and hemithyroidectomy performed by experienced surgeons in selected patients can be safely and effectively carried out in ambulatory surgery (outpatient). It would be possible to improve the substitution index by increasing the application and acceptability ratios.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4067/s0718-40262018000600557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47233494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consideraciones perioperatorias en el paciente obeso 肥胖患者的围手术期考虑

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/s0718-40262018000600580

C. Nazar J., R. Coloma D., José Ignacio Contreras C., Ian Molina P., R. Fuentes H

引用次数: 0

Úlceras del pie diabético: importancia del manejo multidisciplinario y salvataje microquirúrgico de la extremidad 糖尿病足溃疡：多学科管理和肢体显微外科挽救的重要性

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/S0718-40262018000600535

Nicolás Pereira C., H. Suh, Joon Pio Hong

引用次数: 2

Linfoma no Hodgkin y carcinomatosis peritoneal: una imagen a recordar 非霍奇金淋巴瘤与腹膜癌：一种值得回忆的图像

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/S0718-40262018000600501

J. F. Reoyo-Pascual, C. Cartón-Hernández, Guillermo Cabriada-García, Raquel León-Miranda, Gregorio Moral-Moral, Francisco Javier Sánchez-Manuel

引用次数: 0

Signo del remolino: cirugía de urgencia o falacia ad populum 漩涡的迹象：紧急手术或AD大众谬论

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/S0718-40262018000600551

Lucas N. Pina, C. Villa, María Laprovitta, Gonzalo Carles

{"title":"Signo del remolino: cirugía de urgencia o falacia ad populum","authors":"Lucas N. Pina, C. Villa, María Laprovitta, Gonzalo Carles","doi":"10.4067/S0718-40262018000600551","DOIUrl":"https://doi.org/10.4067/S0718-40262018000600551","url":null,"abstract":"Introduction: The imaging test have become an important piece on the diagnosis of the acute abdomen in emergency, nevertheless medical conduct should be based on contextualized iconographic findings. The tomographic “whirlpool sign” establishes a surgical paradigm for its association with the bowel volvulus. Objetive: To register patients with diagnosis of acute abdomen looking for the “whirlpool sign” in the computed tomography and identify who needed surgical intervention. Methods: Analytical cross-sectional study. 115 tomographies of acute obstructive abdomen have being evaluated. Results: 15 tomographies were excluded. The prevalence of the whirlpool sign was 5%. Diagnoses were intestinal malrotation (2%), midgut volvulus (1%), sigmoid volvulus (1%) and enterocolitis (1%). Only 60% of the patients required surgery. Discussion: The presence of the “whirlpool sign” not always determines a surgical resolution. It is not a pathognomonic sign of a punctual entity; it could represent an ordinary finding in the context of several pathologies. To apply the correct treatment, surgical or medical, for these patients it was important to recognize “whirlpool sign” variants.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44400294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hepatectomía en 2 tiempos con técnica de ALPPS (Asociación de bipartición hepática con ligadura portal para hepatectomía en 2 tiempos). Experiencia y resultados iniciales del Hospital Regional de Talca 采用ALPPS技术进行2次肝切除术(肝双分区结合门端结扎进行2次肝切除术)。塔尔卡地区医院的经验和初步结果

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/s0718-40262018000600571

C. Muñoz C., G. Sepulveda D., Alvaro Tapia V., Gloria Vergara A., Marcelo Santelices B., Rodrigo Vega F., Hernán Araya M.

引用次数: 0

¿Permiten la citología, el genotipado y la anoscopia de alta resolución establecer un protocolo para la detección precoz del carcinoma epidermoide de canal anal en población de riesgo? 细胞学、基因分型和高分辨率肛门镜是否可以建立一种早期检测高危人群肛管表皮样癌的方案？

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/S0718-40262018000600523

R. Franco-Herrera, Marta Cuadrado-Ayuso, Alejandro Sánchez-Arteaga, David Alías-Jiménez, Jaime Ruíz-Tovar, Jesús Lago-Oliver

{"title":"¿Permiten la citología, el genotipado y la anoscopia de alta resolución establecer un protocolo para la detección precoz del carcinoma epidermoide de canal anal en población de riesgo?","authors":"R. Franco-Herrera, Marta Cuadrado-Ayuso, Alejandro Sánchez-Arteaga, David Alías-Jiménez, Jaime Ruíz-Tovar, Jesús Lago-Oliver","doi":"10.4067/S0718-40262018000600523","DOIUrl":"https://doi.org/10.4067/S0718-40262018000600523","url":null,"abstract":"Introduction: The incidence of anal cancer has increased in recent years. It is mediated by HPV and preceded by precancerous changes, raising the possibility of directing preventive efforts towards high-risk groups. The indication of screening remains controversial and which methods would be the ideal ones. Objective: To validate the screening tests established actually, comparing it with the biopsy considered as the “gold standard”. Materials and Methods: A cross-sectional study was performed, with prospective data collection in a cohort of VIH+ patients, who have male homosexual anal relations, belonging to Gregorio Marañón and Infanta Leonor Hospitals in a period of 2 years. Results: A total of 179 patients were selected with 286 visits to the screening Outpatient Clinic in which 3 parallel screening tests were performed (anal cytology, HPV genotyping and high resolution anoscopy (AAR) with a biopsy directed on a suspicious or random area). The sensitivity and specificity for the detection of high-grade dysplasia and cancer and their degree of agreement with the biopsy was as follows: cytology 3.23%/94.43% (k: 0.03), high HPV genotyping. risk 90.32%/27.45% (k: 0.05), AAR 32.26%/87.45 (k: 0, 17), the diagnostic accuracy of the three tests being very low. Conclusion: Cytology shows a very low diagnostic accuracy compared to the genotype that represents the highest one. In light of our results, clinical protocols as they are currently being developed should be abandoned.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4067/S0718-40262018000600523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44258676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Linfedema: actualización en el diagnóstico y tratamiento quirúrgico 淋巴水肿：诊断和外科治疗的最新进展

Revista Chilena De Cirugia Pub Date : 2018-12-01 DOI: 10.4067/S0718-40262018000600589

C. Pereira, Isao Koshima

引用次数: 10

Esplenectomía laparoscópica por quiste hidatídico primario de bazo 原发性脾积水囊肿腹腔镜脾切除术

Revista Chilena De Cirugia Pub Date : 2018-09-20 DOI: 10.4067/S0718-40262018000500448

F. L. Begliardo, Milagros Corpacci, R. H. Gil, Fernando Martínez-Lascano

引用次数: 0

Análisis de variables relacionadas con la morbimortalidad de la anastomosis ileocólica después de hemicolectomía derecha 右半结肠切开术后回肠吻合的发病率和死亡率相关变量分析

Revista Chilena De Cirugia Pub Date : 2018-09-20 DOI: 10.4067/S0718-40262018000500432

N. Pérez, M. González, Alberto Pérez-Castilla, Nicolás Campaña Weitz, Gonzalo Alfredo Campaña Villegas

{"title":"Análisis de variables relacionadas con la morbimortalidad de la anastomosis ileocólica después de hemicolectomía derecha","authors":"N. Pérez, M. González, Alberto Pérez-Castilla, Nicolás Campaña Weitz, Gonzalo Alfredo Campaña Villegas","doi":"10.4067/S0718-40262018000500432","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500432","url":null,"abstract":"Introduction: Right hemicolectomy with ileocolic anastomosis is a frequent surgery with many ways to perform it. Objective: To evaluate which is the best ileocolic anastomosis in terms of morbidity and mortality and to make a comparative evaluation of the postoperative clinical evolution according to the type of anastomosis. Patients and Method: Analytical observational study, with defined inclusion and exclusion criteria. The variables to be studied are divided into two groups, those related to the surgical technique and its anastomotic configuration, and the variables related to the results of the surgical intervention, creating a contingency table that crosses the data. Data analysis with STATA 13.0. Results: 216 patients with ileocolic anastomosis, highlighting statistical significance when crossing: A) reoperation and type of suture (p = 0.044), with UN or 3.4 (95% CI 0.94 to 18.6), being of greater risk the mechanics; B) mortality and urgency (p = 0.001) with an OR 7.76 (95% CI 1.56-49.29), with emergency surgery being of greater risk. Isoperistaltic anastomosis with gas elimination (p < 0.001), intestinal transit (p = 0.009) and solid intake (p = 0.005) earlier. There is earlier expulsion of gases in the laparoscopic approach, manual suture, end-to-side and isoperistaltic of the anastomosis and elective surgery. Conclusion: There is great variability of techniques to perform the ileocolic anastomosis. Manual anastomosis is less likely to require surgical reoperation, elective surgery has a lower mortality than that of emergency surgery. We suggest performing it laparoscopically, with manual suture, lateral term, isoperistaltic and electively, for having a shorter recovery.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"11 1","pages":"432-438"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86661408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0