Revista Chilena De Cirugia最新文献_第9页

Experiencia inicial con esofagectomia mínimamente invasiva transtorácica en posición semiprono por cáncer esofágico 食管癌半前位经胸微创食管切除术的初步经验

Revista Chilena De Cirugia Pub Date : 2018-01-15 DOI: 10.4067/S0718-40262018000100027

Enrique Norero, Marco Ceroni, A. Ramírez, R. Mejía, Cristian Martínez, R. Muñoz, F. Araos, Paulina González, Alfonso Díaz

{"title":"Experiencia inicial con esofagectomia mínimamente invasiva transtorácica en posición semiprono por cáncer esofágico","authors":"Enrique Norero, Marco Ceroni, A. Ramírez, R. Mejía, Cristian Martínez, R. Muñoz, F. Araos, Paulina González, Alfonso Díaz","doi":"10.4067/S0718-40262018000100027","DOIUrl":"https://doi.org/10.4067/S0718-40262018000100027","url":null,"abstract":"Introduction: Surgical treatment of esophageal cancer is associated with high morbidity and mortality. The minimally invasive approach has been introduced with the aim of reducing postoperative morbidity. Aim: To describe the surgical technique and the results of transthoracic minimally invasive esophagectomy (MIE) in semiprone position. Material and Methods: Descriptive cohort study. Patients with an elective MIE for cancer were included between April 2013 and May 2017. Demographic, perioperative, pathology and survival variables were recorded. Results: We included 33 patients (24 men, age 69 years, 91% with comorbidities). The predominant location of the tumor was in the middle and lower thirds of the esophagus (90%). Fifteen (45%) patients received neoadjuvant treatment. There were no cases of conversion to thoracotomy. The reconstruction was performed with stomach in 93%. Cervical anastomosis was performed in 66% and thoracic anastomosis in 30%. The operative time was 420 (330-570) minutes and bleeding 200 (20-700) cc. The 90-day mortality rate was 0%. Overall morbidity was 78%, there was a 15% occurrence of pneumonia and 9% required a reoperation. The hospital stay was 23 (11-81) days. The histology was squamous carcinoma in 51% and adenocarcinoma in 45%. Margins were RO at 87%. The lymph node count reached 30 (9-45) lymph nodes. Overall 2-year survival is 68%. Conclusion: The preliminary results of this technique are favorable, without any case of postoperative mortality. The oncological results demonstrate a high percentage of RO surgery and adequate lymph node count.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"41 1","pages":"27-34"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88549614","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

Evolución y pronóstico oncológico de fístulas anastomóticas esofágicas en el tratamiento del cáncer de esófago. Estudio comparativo según vía de ascenso de tubo gástrico 这篇文章是我们2011年拉丁美洲和加勒比研究的一部分。根据胃管上升路径进行比较研究

Revista Chilena De Cirugia Pub Date : 2018-01-15 DOI: 10.4067/S0718-40262018000100019

M. Í. Braghetto, G. Figueroa, P. Sanhueza, Héctor Valladares, H. G. Cardemil, L. SolangeCortés, B. Contreras

{"title":"Evolución y pronóstico oncológico de fístulas anastomóticas esofágicas en el tratamiento del cáncer de esófago. Estudio comparativo según vía de ascenso de tubo gástrico","authors":"M. Í. Braghetto, G. Figueroa, P. Sanhueza, Héctor Valladares, H. G. Cardemil, L. SolangeCortés, B. Contreras","doi":"10.4067/S0718-40262018000100019","DOIUrl":"https://doi.org/10.4067/S0718-40262018000100019","url":null,"abstract":"Introduction: Post operative leaks of esophageal anastomosis after esophagectomy is a risky event associated with poor postoperative evolution. Its frequency and severity will depend mainly on surgical technical aspects. Objectives: To analyze the frequency, management and prognosis of leakage of esophageal anastomosis after esophagectomy for esophageal cancer. Material and Method: Analysis of our prospective oncologic database of patients with esophageal cancers submmitted to esofagectomy. Statistical analysis with Fisher’s exact test. Results: 34 out of 37 esophageal cancer patients were included submitted to completely invasive mini esophagectomy. Cervical anastomosis was performed in 79.4% of patients, in the remaining 20.6%, a distal esophagectomy with intrathoracic anastomosis was performed. The leak rate was 38.2% (13/34), of these, 69.2% (9/13) correspond to grade Clavien - Dindo I - II complications. The leak rate was 54.5% (6/11) for retro-sternal gastric ascensus and 43.7% (7/16) for mediastinal route, without significative difference (p = 1.0). The reoperation rate was 11.7%, being a 100% secondary to mediastinal ascensus, 3 of them were submitted to thoracoscopic toilets and an innominate vein repair. Postoperative mortality rate was 5.8%, all concentrated in the group of patients with posterior mediastinal ascensus, but without statistical difference (p = 0.26). Conclusion: Leaks are frequent in patients operated on for esophageal cancer, especially after cervical esophago-gastro-anastomosis with anterior route for ascensus. However, retro-sternal ascensus did not require re-operations, nor postoperative mortality compared to gastric ascensus through posterior mediastinum","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"85 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75888974","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

Tumores neuroendocrinos primarios de colon y recto

Revista Chilena De Cirugia Pub Date : 2018-01-15 DOI: 10.4067/S0718-40262018000100053

Guillermo Bannura, Alejandro Barrera, Carlos Melo, Felipe Illanes, V. CristiánGallardo

{"title":"Tumores neuroendocrinos primarios de colon y recto","authors":"Guillermo Bannura, Alejandro Barrera, Carlos Melo, Felipe Illanes, V. CristiánGallardo","doi":"10.4067/S0718-40262018000100053","DOIUrl":"https://doi.org/10.4067/S0718-40262018000100053","url":null,"abstract":"Introduccion: La clasificacion y el manejo de los tumores neuroendocrinos (TNEs) han cambiado drasticamente en la ultima decada. Se realiza un analisis critico del manejo de los TENs colorrectales primarios intervenidos en nuestro centro a la luz de la nueva clasificacion. Material y Metodo: Analisis retrospectivo de los resultados del tratamiento quirurgico radical de este tipo de lesiones en un periodo de 15 anos. Resultados: Se trata de 10 pacientes, con un promedio de 56 anos (extremos 48-76), 6 ubicados cercanos a la valvula ileocecal (VIC) que se presentaron con un cuadro de obstruccion intestinal incompleto y tres en el recto (2 polipos) y un polipo en colon sigmoides. La cirugia efectuada incluye cuatro resecciones anteriores y seis colectomias derechas (con reseccion de una metastasis hepatica en 1 caso). La mediana de seguimiento fue de 78,3 meses (extremos 8-180), durante el cual dos pacientes fallecen por metastasis a distancia. Conclusion: Los TNEs ubicados en el colon habitualmente se presentaron como grandes masas tumorales cercanos a la VIC, lo que proporcionalmente no ocurre con las lesiones del rectosigmoides que son diagnosticados mas precozmente como polipos o lesiones submucosas. Algunos tumores de bajo grado muestran un compromiso avanzado en la pared y/o los linfonodos regionales lo que justifica la reseccion radical y/o la quimioterapia adyuvante. A la luz de esta experiencia, es necesario complementar el grado del tumor OMS 2010 (Ki-67 y numero de mitosis) con el estadio TNM para caracterizar adecuadamente los TNEs, lo que influye en el manejo multidisciplinario.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"82 1","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77533148","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: 3

Análisis de susceptibilidad antimicrobiana y hallazgos microbiológicos: perfil en cirugía abdominal de urgencia 抗菌敏感性分析和微生物学发现:紧急腹部手术概况

Revista Chilena De Cirugia Pub Date : 2018-01-15 DOI: 10.4067/S0718-40262018000100013

Katya Carrillo, Sebastian Pedraza Lopez, Gunther Bocic, Mario Luppi, Fernanda Ávila, Roberto Olivares, Felipe Bocic, M. Abedrapo, Rodrigo Azolas, Antonella Sanguineti, M. Díaz, J. L. Llanos

引用次数: 1

Hernia umbilical en pacientes cirróticos con ascitis. ¿Tratamiento conservador o quirúrgico? 肝硬化腹水患者脐疝。保守治疗还是手术治疗?

Revista Chilena De Cirugia Pub Date : 2018-01-15 DOI: 10.4067/s0718-40262018000100079

Doyler Cubas-García, J. Galvez-Olortegui, José Caballero-Alvarado, P. Delgado-Guillena, Edward Chávez-Cruzado

{"title":"Hernia umbilical en pacientes cirróticos con ascitis. ¿Tratamiento conservador o quirúrgico?","authors":"Doyler Cubas-García, J. Galvez-Olortegui, José Caballero-Alvarado, P. Delgado-Guillena, Edward Chávez-Cruzado","doi":"10.4067/s0718-40262018000100079","DOIUrl":"https://doi.org/10.4067/s0718-40262018000100079","url":null,"abstract":"Ascites is the most common complication in patients with liver cirrhosis. Umbilical hernias (HU) occur in 20% of these patients and 40% in those with severe ascites. HU occurs due to increased intra-abdominal pressure, weakening of the abdominal fascia and loss of muscle mass. In addition, they have a tendency to enlarge rapidly and present high risk of complications that threaten the patient’s life. The treatment of the uncomplicated HU is controversial, both the surgical management (herniorrhaphy) and the conservative management (control of ascites) present high rate of complications, consequently high morbidity and mortality. Currently, umbilical herniorrhaphy is recommended with prior control of ascites in uncomplicated HU management, it reduces the risk of surgical wound infection, evisceration, ascites drainage, peritonitis, and it reduces up to 41% of HU recurrence. The success of this approach also depends on the degree of liver dysfunction. The treatment of complicated HU is surgical (herniorrhaphy without mesh), with lower mortality rate compared to conservative management. Studies reveal advantages of umbilical herniorrhaphy laparoscopy (minimally invasive and stress-free) compared to open surgery; however there is still no evidence about it.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"32 1","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82956216","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

Comité Científico de la Sociedad de Cirujanos de Chile. Enmendando el rumbo 智利外科医生协会科学委员会。改变航向

Revista Chilena De Cirugia Pub Date : 2018-01-01 DOI: 10.4067/S0718-40262018000100007

Mario Uribe

引用次数: 0

El recuperador celular y necesidad transfusional en pacientes intervenidos de cirugía cardíaca 心脏手术患者的细胞恢复和输血需求

Revista Chilena De Cirugia Pub Date : 2018-01-01 DOI: 10.4067/s0718-40262018000100040

M. Luque-Oliveros

引用次数: 0

Incidencia de tromboembolismo venoso en cirugía ortognática 正颌手术中静脉血栓栓塞的发生率

Revista Chilena De Cirugia Pub Date : 2018-01-01 DOI: 10.4067/S0718-40262018000500418

G. A. Campolo, I. T. Rioseco, E. Goñi, D. Vargas, S. Ramírez

引用次数: 1

Apendicectomía laparoscópica por sistema «glove port»: nuestros primeros 100 casos 腹腔镜阑尾切除术“手套端口”系统:我们的前100例病例

Revista Chilena De Cirugia Pub Date : 2017-12-01 DOI: 10.1016/J.RCHIC.2017.05.004

José Felipe Reoyo Pascual, Raquel León Miranda, Carlos Cartón Hernández, E. A. Alonso, R. Castro, J. Manuel

引用次数: 0

Biopsia videotoracoscópica de nódulo pulmonar guiada por imágenes con arpón

Revista Chilena De Cirugia Pub Date : 2017-12-01 DOI: 10.1016/J.RCHIC.2017.03.002

N. Parra, S. Ortega, M. Cáceres, C. Pérez

引用次数: 0