Revista Chilena De Cirugia最新文献_第7页

Cirugía de contorno corporal en pacientes con pérdida masiva de peso en un hospital universitario. Estudio de frecuencias 在一所大学医院对体重大幅减轻的病人进行塑形手术。频率研究

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300257

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

{"title":"Cirugía de contorno corporal en pacientes con pérdida masiva de peso en un hospital universitario. Estudio de frecuencias","authors":"S. Danilla E., C. Domínguez C., José Tomas Ganz V., Ekaterina Troncoso O., M. Ríos V., Naomi Yamada T., S. Serra D, P. Andrades C., J. Cisternas V., C. Erazo C., S. Sepúlveda P.","doi":"10.4067/S0718-40262018000300257","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300257","url":null,"abstract":"Introduction: Massive weight loss in obese, has beneficial health effects, however patients usually presents excessive adiposity and redundant skin, that generates physical and psychological problems. The body contouring surgery helps to modify the contour of the body to achieve aesthetic harmony. There are few national studies that describe the epidemiology of body contour surgery in patients with massive weight loss. Objectives: Describes a series of patients with massive weight loss with body contour surgery and its complications. Materials and Methods: A prospective series of patients with body contouring surgery with a history of low body mass, between January 2013 and June 2016, in a university hospital. Patients with incomplete information or operated at another center were excluded. Descriptive statistics was used. Results: 120 patients with body contouring surgery and low weight mass were included. Age of 38.4 ± 10.4 years, 105 (87.5%) were women. 110 (91.67%) were bariatric patients. BMI of 26.56 ± 3.26 kg/m2 and a weight loss of 39.06 ± 14.17 Kg were reached previous the contouring surgery. The most frequent surgery was the standard abdominoplasty 79 (65.83%), followed by mastopexy with implants 21 (17.5%). 1 (0.83%) presented major complication and 33 (27.5%) had a minor complication during the postoperative period. Discussion: This series presents results similar to other authors, with a lower rate of postoperative complications. Conclusion: The Body contouring surgery are safe procedures, which provides a solution to the bodily sequels after massive weight loss according to our experience.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"138 1","pages":"257-265"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86529450","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

Trauma cervical transfixiante por clavo

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300205

C. Vergara, A. R. Olmos-de-Aguilera, D. Carrasco, A. Zagal, Z. Sanhueza

引用次数: 0

Mis primeros 100 colgajos libres 我的前100个自由皮瓣

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300245

C. Andrades, Carlos Domínguez, V. Cisternas, E. S. Danilla, Cristián Erazo, P. Sepúlveda

{"title":"Mis primeros 100 colgajos libres","authors":"C. Andrades, Carlos Domínguez, V. Cisternas, E. S. Danilla, Cristián Erazo, P. Sepúlveda","doi":"10.4067/S0718-40262018000300245","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300245","url":null,"abstract":"Introduction: Microsurgical techniques have been consolidated as a safe and reproducible reconstructive strategy with high success rates. They allow to successfully solve complex coverage defects. Its development has been driven by technological improvements, technical standardization and perioperative management. The development and implementation of microsurgery is a complex process, requiring a progressive work by the health team. Objective: Show experience accumulated by the main author in reconstructive surgery during his first 100 free flap and the technical changes due to the modernization. Material and Methods: Retrospective series of 100 free flaps performed by the lead author during the years 2010 to 2015. All patients submitted to reconstructive microsurgery with free flaps were included and no exclusion criteria were established. Clinical and surgical history were reviewed. Descriptive statistics were used to present the results. Results: 100 free flaps, 62% of male patients, mean age 58 ± 15 years. The most used fins were fasciocutaneous (77%), in particular the anterolateral flap of the thigh (47%). Head and neck defects (47%) were the most frequent defects. There were 10 vascular complications (6 arterial and 4 venous), with a failure rate of 7%. Discussion: Teamwork, the use of horse flaps and new technologies are the cornerstone of the microsurgery experience presented. This corresponds to the continuation of the line of work sustained over time.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"42 1","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79405606","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

Sutura laparoscópica frente a sutura por laparotomía en úlceras gastroduodenales perforadas 胃十二指肠穿孔溃疡的腹腔镜缝合与腹腔镜缝合

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300252

H. P. Ciriano, T. I. Grao, M. Ruiz, R. Seisdedos, M. Kayser, V. Rey, D. M. Pérez, F. Turégano

{"title":"Sutura laparoscópica frente a sutura por laparotomía en úlceras gastroduodenales perforadas","authors":"H. P. Ciriano, T. I. Grao, M. Ruiz, R. Seisdedos, M. Kayser, V. Rey, D. M. Pérez, F. Turégano","doi":"10.4067/S0718-40262018000300252","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300252","url":null,"abstract":"Introduction: Gastroduodenal perforation continues to be a relatively frequent surgical emergency, despite advances in the medical treatment of ulcer disease. Its laparoscopic approach has been increasing in the last years, although it has not been generalized. Objective: Was to analyze the postoperative results in patients with perforated ulcer treated with laparoscopic suture, and to compare them with a similar group with laparotomy suture. Our hypothesis was that laparoscopic suture is a safe option and with less morbidity than the laparotomy approach. Material and Methods: Comparative retrospective analysis of two patient cohorts: one treated with laparoscopic suture during 2014 and 2015, a period in which this approach was fully implanted in the emergency room in our hospital, and another comparable group treated by suture for open surgery during the period 2001-2003. Complications were analyzed according to Clavien-Dindo classification, conversion rate, mean stay and mortality. Results: The groups were comparable in age, sex, comorbidities and anesthetic risk. There was a trend towards superiority in favor of the laparoscopic approach in certain variables analyzed, with a conversion rate of 3%. The presence of early postoperative complications was greater in the laparotomy suture group: post-surgical septic shock (15.2% vs 6%) and wound infection (15.2% vs 3%), as well as medical complications, although not significantly. The group with laparoscopic suture had a longer surgical time, lower mean stay and lower mortality. Conclusion: The laparoscopic suture of the gastroduodenal ulcer in our center has had a very low conversion rate and a somewhat lower morbidity to the laparotomy suture, with a lower rate of reinterventions and a mean stay, despite a longer surgical time.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"33 1","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80559564","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

Aplicación de tres modelos pronósticos en cáncer de mama precoz 三种预后模型在早期乳腺癌中的应用

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300212

R. Sánchez, J. Maldonado, B. J. Jans, C. Domínguez, A. Galindo, A. Camus, B. D. Oddo, A. Medina, C. Acevedo

{"title":"Aplicación de tres modelos pronósticos en cáncer de mama precoz","authors":"R. Sánchez, J. Maldonado, B. J. Jans, C. Domínguez, A. Galindo, A. Camus, B. D. Oddo, A. Medina, C. Acevedo","doi":"10.4067/S0718-40262018000300212","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300212","url":null,"abstract":"Objective: Apply three prognostic models “online” (Nothingham index (NPI), Adjuvantonline! (AO) and PREDICT used in routine oncology practice in order to stratify patients and define the use of adjuvant therapies in patients with stage I breast cancer (BC) to evaluate its correlation and overall survival (OS) in our population. Methods: We obtained patients’ medical records data with invasive BC T1N0M0, treated at the Cancer Center of the Pontificia Universidad Catolica de Chile, Santiago, Chile, from January 1997 to December 2003. Results: We analyzed data from 125 patients. Median age was 55 years (3580). Most tumors were infiltrating ductal carcinoma (72.8%), estrogen receptor positive (88.8%), 80% received endocrine therapy (ET). The estimated ET and chemotherapy benefit was not significantly different according to the AO and PREDICT models (1.3% and 1% for CT, p = 0.13, 0.9% and 1% for ET p = 0.8, respectively). The estimated median OS on NPI (96%) was higher than calculated by AO (90.9%) and PREDICT (92.5%). Interestingly diseasespecific mortality estimated was 3%, similar to that observed (3.2%). While the estimated median OS by all models in the group of deceased patients was lower than in surviving, this difference did not reach statistical significance (p = 0.85). Conclusion: The prognostic models applied effectively predict OS in Chilean patients with T1N0M0 BC, but in this series, they do not sufficiently discriminate patients with poor prognosis. The addition of co- morbidities to AO does not alter the results.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"214 1","pages":"212-217"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73453934","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

La evolución de la enseñanza quirúrgica: un desafío permanente 外科教学的演变:一个持续的挑战

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300201

C. Martínez

引用次数: 1

Evaluación comparativa de efectividad y tolerabilidad con polietilenglicol y picosulfato de sodio-citrato de magnesio como agentes de preparación intestinal para colonoscopia 聚乙二醇和皮硫酸钠柠檬酸镁作为结肠镜检查肠道制剂的有效性和耐受性的比较评价

Revista Chilena De Cirugia Pub Date : 2018-07-17 DOI: 10.4067/S0718-40262018000300224

Nelson Muñoz P., M. Rodríguez G, Nicolás Campaña W., Solange Agar F., G. Campaña V.

{"title":"Evaluación comparativa de efectividad y tolerabilidad con polietilenglicol y picosulfato de sodio-citrato de magnesio como agentes de preparación intestinal para colonoscopia","authors":"Nelson Muñoz P., M. Rodríguez G, Nicolás Campaña W., Solange Agar F., G. Campaña V.","doi":"10.4067/S0718-40262018000300224","DOIUrl":"https://doi.org/10.4067/S0718-40262018000300224","url":null,"abstract":"Introduction: The effectiveness of colonoscopy depends on multiple factors, being two of the most important ones an adequate bowel preparation and the patient’s tolerability to the preparation. Objectives: Compare effectiveness and tolerability of two bowel preparation agents, polyethylene glycol (PEG) and sodium picosulfate/magnesium citrate (SPMC). Patients and Methods: Randomized clinical trial on outpatients that went into colonoscopy in INDISA Clinic. We evaluated effectiveness and tolerability with Boston Bowel Preparation Score (BBPS) and Lawrence questionnaire [composed by Likert scale, two qualitative questions and Visual Analogue Scale (VAS) for pain], respectively. Results: 189 patients, 123 were randomized to PEG and 66 to SPMC. BBPS average in patients in the PEG branch was 7.51 (SD 1.66) and for SPMC 7.12 (SD 1.71) (p = 0.111). Likert scale for evaluating tolerability average for PEG was 0.94 (SD 0.68) and for SPMC 0.63 (SD 0.61) (p = 0.0004). VAS scale for PEG had an average of 7.68 (SD 2.4) and for PSCM 9.04 (SD 1.59) (p < 0.0001). When we asked for workplace absenteeism, there were no significant differences between both groups and when we asked about using the same intestinal preparation in a future colonoscopy there was statistical significance in favor to SPMC (p = 0.026). Conclusions: No differences were noted on effectiveness between the PEG and SPMC bowel preparations. Nevertheless, SPMC appeared to be better tolerated by patients.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"64 1","pages":"224-232"},"PeriodicalIF":0.0,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84827094","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

Técnicas quirúrgicas para la preservación de esfínter en cáncer de recto bajo: revisión histórica y estado actual 直肠癌括约肌保存的外科技术:历史回顾和现状

Revista Chilena De Cirugia Pub Date : 2018-04-19 DOI: 10.4067/S0718-40262018000200178

G. Carrillo, M. Abedrapo, M. R. Azolas

{"title":"Técnicas quirúrgicas para la preservación de esfínter en cáncer de recto bajo: revisión histórica y estado actual","authors":"G. Carrillo, M. Abedrapo, M. R. Azolas","doi":"10.4067/S0718-40262018000200178","DOIUrl":"https://doi.org/10.4067/S0718-40262018000200178","url":null,"abstract":"After multiple attempts to achieve appropriate results in the surgical resection for rectal cancer, Sir William Ernest Miles develops the technique that would carry his name, and is, without modifications, currently referred as abdominoperineal resection. This technique, considered gold standard for rectal tumors for many years, has been gradually replaced by sphincter preserving surgery. Low anterior resection allowed sphincter-preservation in patients with low rectal tumors within 5 cm from the anal verge. Technical developments (double stapling technique), better understanding of oncological principles (total mesorectal excision) and the introduction of neoadyuvant treatment with chemoradiotherapy, allowed further lowering of the adequate distal resection margin and to carry out ultralow colorectal and coloanal anastomoses. Ultralow intersphincteric resection removes the internal anal sphincter (partial, subtotal or total resection) avoiding permanent colostomy in a subset of patients. This technique has been broadly studied with published oncological outcomes that are better or similar to those of abdominoperineal resection. Currently, evaluation of response after neoadyuvant therapy has led some working groups to propose organ preservation; either by strict follow up for complete clinical response, or by local excision techniques for incomplete clinical response.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"1 1","pages":"178-184"},"PeriodicalIF":0.0,"publicationDate":"2018-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76172358","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: 2

Resultados del uso de stent metálico autoexpandible como terapia puente en cáncer de colon izquierdo obstructivo 使用自扩张金属支架作为桥接治疗左阻塞性结肠癌的结果

Revista Chilena De Cirugia Pub Date : 2018-04-19 DOI: 10.4067/S0718-40262018000200127

T. E. Melkonian, Z. E. Mordojovich, R. Rollán, R. Navarro, B. Jensen, Z. A. Cuneo, S. Espíndola, M. D. Espínola, R. Romagnolli, B. Pradenas, M. Villalón, F. Sáenz

{"title":"Resultados del uso de stent metálico autoexpandible como terapia puente en cáncer de colon izquierdo obstructivo","authors":"T. E. Melkonian, Z. E. Mordojovich, R. Rollán, R. Navarro, B. Jensen, Z. A. Cuneo, S. Espíndola, M. D. Espínola, R. Romagnolli, B. Pradenas, M. Villalón, F. Sáenz","doi":"10.4067/S0718-40262018000200127","DOIUrl":"https://doi.org/10.4067/S0718-40262018000200127","url":null,"abstract":"Objetive: To analyze the results of the use of stent as bridge therapy for surgery in obstructive left colon cancer in our center. Material and Method: We performed a retrospective analysis of patients with obstructive left colon cancer undergoing metallic stenting as a bridge therapy for definitive surgery between January 2008 and December 2016. Demographic data, procedural success, complications, surgical approach, pathological anatomy and follow-up were analyzed. Results: Ten patients. The procedure was technically and clinically successful in all 10 patients, with no complications in any of them. All patients went to resective surgery, achieving primary anastomosis in 9 of them. In 3 of them, a laparoscopic approach was performed. A median of lymph nodes of 41 it was obtained in the surgical specimen. With a median follow-up of 34 months, 2 presented distant recurrence, which were patients diagnosed at a more advanced stage of their disease. Discussion: The stent as bridge therapy to an elective surgery, allows to obtain a low rate of colostomies, low morbidity, offer a laparoscopic surgery and an optimal cancer surgery. Conclusion: The use of the stent as a bridge therapy in obstructive left colon cancer appears as a good alternative to solve this pathology in patients of greater surgical risk.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"99 1","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2018-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81429367","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

El papel de los mastocitos en la evaluación de la respuesta inflamatoria posoperatoria, al implantar mallas protésicas para la reparación de defectos de la pared abdominal en biomodelos rata Wistar 在Wistar大鼠生物模型中，肥大细胞在植入假网修复腹壁缺损时评价术后炎症反应的作用

Revista Chilena De Cirugia Pub Date : 2018-04-19 DOI: 10.4067/S0718-40262018000200104

C. Arboleda, A. Franco, T. Valladares

{"title":"El papel de los mastocitos en la evaluación de la respuesta inflamatoria posoperatoria, al implantar mallas protésicas para la reparación de defectos de la pared abdominal en biomodelos rata Wistar","authors":"C. Arboleda, A. Franco, T. Valladares","doi":"10.4067/S0718-40262018000200104","DOIUrl":"https://doi.org/10.4067/S0718-40262018000200104","url":null,"abstract":"Objective: The objective of this study was to evaluate the role of mast cells in the postoperative inflammatory response after implantation of prosthetic mesh to repair abdominal wall defects in Wistar rat. Materials and Methods: An abdominal wall defect (30 x 20 mm) was created in the anterior abdominal wall of 25 adult male Wistar rats. The anatomical defect was then repaired with one of the two type’s meshes. Fibroin and monocryl ultrapo prolene meshes. Fibroin meshes were manufactured by weaving its threads, the polypropylene mesh was bought to Johnson & Johnson-Ethicon. After 28 days of implantation Wistar rats were sacrificed and the mesh with abdominal tissue was extracted. Subsequently the samples were treated with histochemical techniques for histological analysis. Results: The study reported adherence to omentum in both types of meshes used, however, the polypropylene mesh showed widely adhesions to colon, slight to intestine and liver, also in a very lower amount, adhesions to omentum. It was found that mast cells were presented in all the studied regions for the polypropylene mesh (dermis, perimysium, and visceral serosa). Discussion: Studies indicate that mast cells and their products such as histamine, serotonin, and others play a key role in controlling local inflammation, wound healing, adhesions, and reactions to foreign bodies in vivo. Conclusion: We can conclude that this study is a good step to show the possible role of mast cells in the abdominal wall repair process.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"5 1","pages":"104-111"},"PeriodicalIF":0.0,"publicationDate":"2018-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75503435","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