Revista Chilena De Cirugia最新文献_第6页

Revista Chilena De Cirugia Pub Date : 2018-08-01 DOI: 10.4067/s0718-40262018000300389

Cristian Zárate B., Obren Drazic B., L. Mariné m., F. valdÉs e.

引用次数: 0

Lower Body Lift: Manejo integral del tronco inferior en pacientes con baja masiva de peso. Serie de casos y descripción de la técnica quirúrgica 下体提升:对体重大幅下降患者的下躯干进行整体处理。病例系列及手术技术描述

Revista Chilena De Cirugia Pub Date : 2018-08-01 DOI: 10.4067/s0718-40262018000300336

S. Danilla E., C. Domínguez C., José Tomas Ganz V., Ekaterina Troncoso O., M. Ríos V., P. Andrades C., J. Cisternas V., C. Erazo C., S. Sepúlveda P.

引用次数: 0

Divertículo de Meckel volvulado asociado a brida como causa de obstrucción en intestino delgado 与法兰相关的膨化梅克尔憩室是小肠梗阻的原因

Revista Chilena De Cirugia Pub Date : 2018-08-01 DOI: 10.4067/s0718-40262018000300358

J. Morales G., Romina Olmos-de-Aguilera A., Cristóbal Sánchez T., Diego Sáez Q.

引用次数: 2

Faringo-íleo-colo anastomosis con suplemento vascular microquirúrgico en reconstrucción del tracto digestivo superior

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300266

M. Í. Braghetto, Manuel Figueroa-Giralt, P. Sanhueza, S. Lanzarini, P. Sepúlveda, Cristián Erazo, C. Gonzalez

引用次数: 0

Seis años de experiencia en cirugía digestiva asistida por robot 6年机器人辅助消化手术经验

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300207

S. Hamilton, C. Onetto, P. P. Marín, E. Orellana

{"title":"Seis años de experiencia en cirugía digestiva asistida por robot","authors":"S. Hamilton, C. Onetto, P. P. Marín, E. Orellana","doi":"10.4067/S0718-40262018000300207","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300207","url":null,"abstract":"Background: Since its approval, robotic surgery has been growing as a useful, promising and probably superior technique for many surgeries. The aim of this study is to expose and evaluate the results of a 6-year experience, of a single surgeon, with robotic assisted surgery, used for different gastrointestinal procedures throughout this years. Study Design: We conducted a retrospective revision of all consecutive robotic assisted gastrointestinal cases performed by a single gastrointestinal laparoscopic surgeon of the Bariatric Surgery Department and Robotics Surgery Department of Clinica Santa Maria of Santiago, Chile, between September 2011 and May 2017. Results: A total of 290 patients underwent robotic gastrointestinal surgery during 6 years. All cases were performed by the same gastrointestinal surgeon. Primary procedures performed were totally hand sewn Roux-en-Y gastric bypass, sleeve gastrectomy, revisional bariatric and non-bariatric surgery, Nissen fundoplication, single port cholecystectomy, Heller myotomy with Dor fundoplication, hernia repairs, and other exceptional cases. A total of 512 procedures were performed in 290 patients. The majority of secondary procedures were cholecystectomies, hiatal hernia repairs and adhesiolysis. Average length of hospital stay was 3 days. Postoperative complications were observed in 27 (9.3%) patients. According to Clavien Dindo classification of surgical complications, 4 (1.4%) complications were Clavien I, 5 (1.7%) Clavien II, 18 (6.2%) Clavien III, 0 Clavien IV, 0 Clavien V. There were no deaths in this group. Mean operative time was 76 minutes. Mean surgical time was 64 minutes. Conclusion: Robot assisted upper gastrointestinal surgery is a reliable and effective technique, that can be used in many diseases.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"16 1","pages":"207-211"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73553763","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

Manejo perioperatorio de pacientes usuarios de antiagregantes plaquetarios 血小板抗聚集剂患者的围手术期管理

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300291

J. Contreras, I. Molina

{"title":"Manejo perioperatorio de pacientes usuarios de antiagregantes plaquetarios","authors":"J. Contreras, I. Molina","doi":"10.4067/S0718-40262018000300291","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300291","url":null,"abstract":"The use of antiplatelet drugs for primary and secondary prevention of cardiovascular disease events is a common clinical practice. Antiplatelet therapy significantly decreases the incidence of cardiovascular disease events, including acute myocardial infarction and cerebrovascular accident. It is increasingly common to face patients on antiplatelet therapy who will undergo some surgical procedure, so it is essential to know the perioperative management of these drugs, to reduce the risks and complications associated with the suspension or maintenance of these therapies in the perioperative period. The most common antiplatelet agents used in Chile are acetylsalicylic acid and thienopyridines, of which clopidogrel is the most frequent one. The perioperative management of these drugs has to be based on the individual thrombotic risk of each patient and the risk of hemorrhage of each surgery. In noncardiac surgeries, it is suggested to maintain acetylsalicylic acid, except in patients with low to moderate thrombotic risk who will undergo surgeries with a high risk of bleeding, in which case it is recommended to suspend it 5 to 7 days before surgery. Clopidogrel is suggested to be discontinued 5 days before surgery, except in patients with high thrombotic risk who will undergo surgical procedures with low to moderate risk of hemorrhage. In myocardial revascularization surgeries, it is recommended to maintain acetylsalicylic acid and to suspend clopidogrel 5 days before the procedure. Once assuring adequate surgical hemostasis, it is suggested to reinitiate acetylsalicylic acid 6 hours after surgery and to reinitiate clopidogrel during the first 24 postoperative hours.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"5 1","pages":"291-299"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85403579","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: 1

La presencia de células en anillo de sello en la biopsia endoscópica no es un buen predictor para el diagnóstico de carcinoma gástrico de células en anillo de sello 内镜活检中密封环细胞的存在并不能很好地预测密封环细胞胃癌的诊断

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300218

M. Ceroni V, E. Norero M, C. Martínez B., R. Mejia M., Rodrigo Muñoz C., Gloria Aguayo B., Paulina González C., A. Díaz F.

{"title":"La presencia de células en anillo de sello en la biopsia endoscópica no es un buen predictor para el diagnóstico de carcinoma gástrico de células en anillo de sello","authors":"M. Ceroni V, E. Norero M, C. Martínez B., R. Mejia M., Rodrigo Muñoz C., Gloria Aguayo B., Paulina González C., A. Díaz F.","doi":"10.4067/S0718-40262018000300218","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300218","url":null,"abstract":"Introduction: Signet-ring cell carcinoma (SRCC) of the stomach is a histopathological type that has less response to chemotherapy and worse prognosis in patients with advanced gastric cancer, than other types of gastric carcinomas. Diagnostic value of the presence of signet-ring cells (SRC) in the endoscopic biopsy for the diagnosis of SRCC of the stomach, are unknown. Objectives: To calculate the diagnostic values of the presence of SRC in endoscopic biopsy for the diagnosis of SRCC of the stomach in a definitive surgical specimen biopsy. Materials and Methods: Retrospective diagnostic test study to determine the value of the presence of SRC in the endoscopic biopsy for the diagnosis of SRCC of the stomach in the surgical specimen biopsy. Inclusion criteria: Patients who underwent gastric surgery between 1996-2016. We calculated positive and negative predictive values (PPV and NPV), sensitivity, specificity, and positive and negative likelihood ratio (LR+ and LR-) of the presence of SRC in the endoscopic biopsy that predicts the diagnosis of SRCC of the stomach in the definitive biopsy. Confidence intervals (CI) of 95% were defined. Results: The diagnostic values of the presence of SRC in endoscopic biopsy to diagnose SRCC of the stomach in the surgical specimen biopsy were: PPV of 56.1% (95% CI, 47.8-64.1%), NPV of 91.3% (95% CI, 89-93.1%), sensitivity of 55.7% (95% CI, 47.4-63.7%), specificity of 91.4% (95% CI, 89.1-93.3%), LR+ of 6.5 (95% CI, 4.9-8.6) and LR- of 0.48 (95% CI, 0.4-0.6), a positive post-test probability of 56.1% (95% CI, 47.8-64.1%), and a negative post-test probability of 8.7% (95% CI, 6.9-11%). Conclusions: The presence of SRC in the endoscopic biopsy is not sufficient to diagnose SRCC of the stomach. The absence of SRC in the endoscopic biopsy has a high negative predictive value.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"14 1","pages":"218-223"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86889079","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

Intususcepción colónica causada por lipoma de colon 结肠脂肪瘤引起的结肠肠套叠

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/s0718-40262018000300203

M. D. Daroch, M. D. Espínola

引用次数: 0

Evolución de síntomas a corto plazo y grado de satisfacción del paciente tras hemorroidectomía convencional 常规痔切除术后短期症状的演变及患者满意度

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300233

C. Fulle, L. Moreno, D. Quezada, G. Carvajal, N. Briones, B. R. Kusanovich, R. Castillo

{"title":"Evolución de síntomas a corto plazo y grado de satisfacción del paciente tras hemorroidectomía convencional","authors":"C. Fulle, L. Moreno, D. Quezada, G. Carvajal, N. Briones, B. R. Kusanovich, R. Castillo","doi":"10.4067/S0718-40262018000300233","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300233","url":null,"abstract":"Background: Hemorrhoidectomy is the treatment of choice for symptomatic hemorrhoids, reserved for patients with grade III or IV hemorrhoids or no response to conservative treatment. There are several surgical techniques, whose degree of resolution of symptoms and patient satisfaction has varied results. Objectives: To evaluate in the short term the symptomatology and degree of satisfaction of patients undergoing conventional hemorrhoidectomy in Complejo Asistencial Dr. Sotero del Rio. Material and Methods: A retrospective telephone survey was applied to patients undergoing conventional hemorrhoidectomy from June 2015 to January 2016. The survey includes questions about symptoms in the pre-operative, at the month and at 6 or more months post-operated. Bleeding, pruritus, pain, prolapsed sensation and incontinence were evaluated. The statistical analysis considered the results according to the 5 symptoms evaluated in the survey and then dichotomized according to clinical relevance. A significant p value < 0.01 was considered. Results: 43 patients answered the survey, with a median age of 55 years (17-80). The median evaluation was 8 months (6-12). Considering the symptoms: bleeding, pruritus, pain and prolapse, 35 patients (79%) had 3 or more preoperative symptoms considered significant. Persistent follow-up ranges from 9 to 28%. In the statistical analysis with dichotomized symptoms, there is a statistically significant decrease at one month and at 6 or more months post-surgery. Conclusion: Conventional hemorrhoidectomy is well evaluated by patients in relation to a significant resolution of hemorrhoidal disease symptoms.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"53 1","pages":"233-240"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75773450","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

Experiencia inicial con cirugía revisional bariátrica asistida por robot 有机器人辅助减肥修正手术的初步经验

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300241

S. Hamilton, C. Onetto, E. Orellana, P. P. Marín

{"title":"Experiencia inicial con cirugía revisional bariátrica asistida por robot","authors":"S. Hamilton, C. Onetto, E. Orellana, P. P. Marín","doi":"10.4067/S0718-40262018000300241","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300241","url":null,"abstract":"Background: Robotics in bariatric surgery is a novel development in medical institutions in Chile. Revisional bariatric procedures have increased during the last years. There are no publications in our country related to the initial experience and results in robotic revisional bariatric surgery. The aim of this study is to describe the initial experience and short term outcomes with robotic revisional bariatric surgery. Study Design: We conducted a retrospective study of all consecutive robotic revisional bariatric surgeries performed by a single surgeon in Clinica Santa Maria in Santiago, Chile. We analyzed demographic characteristics and surgical outcomes, morbidity, mortality and length of hospital stay. Results: 59 revisional bariatric surgeries were performed, 11 reshaping of sleeve gastrectomy, 34 Roux in Y gastric bypass, 1 pouch reshaping of Roux in Y gastric bypass, 3 extractions of laparoscopic adjustable gastric banding, 1 of them with simultaneous sleeve gastrectomy, 5 laparoscopic adjustable gastric banding to patients with previous Roux in Y gastric bypass, 3 total gastrectomy, 1 resection of gastro-gastric fistula and 1 gastro enteral anastomosis. Mean age was 47.8 years. Average preoperative body mass index was 33.86 kg/m2. Mean surgical time was 101.63 minutes. Postoperative complications were observed in 3 patients (5.08%). In 2 (3.39%) of this patient, reoperation was required. There were no deaths in this group. Average length of hospital stay was 3.6 days. Conclusion: Robotic revisional bariatric surgery is a novel technique that appears to be safe and effective.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"1 1","pages":"241-244"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90482317","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