Fanny Rodríguez Santos, E. González Salazar, C. Roni, Clara Facioni, Agustina Mutchinick, Virginia M. Cano Busnelli, A. Beskow, J. Pekolj, M. de Santibañes, A. Dietrich
{"title":"Perceptions of general surgeons in training in the initial phase of COVID-19 pandemic","authors":"Fanny Rodríguez Santos, E. González Salazar, C. Roni, Clara Facioni, Agustina Mutchinick, Virginia M. Cano Busnelli, A. Beskow, J. Pekolj, M. de Santibañes, A. Dietrich","doi":"10.25132/raac.v113.n3.1585","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1585","url":null,"abstract":"Objective: The aim of this study is to describe the perceptions of surgeons in training during the initial phase of the COVID-19 pandemic. Material and methods: A 51-question survey was conducted among physicians in training from a department of surgery in an Argentine hospital. Five domains were explored: institutional, healthcare, academic, domestic and emotional. Results: The survey was completed by 55 physicians (91.7%): 35 residents and 20 fellows. Among the respondents, 98.1% considered the information provided by the hospital and the department about the measures implemented in the COVID-19 stetting was sufficient. 98.1% considered that the instructions about personal protective equipment were satisfactory, but 38% reported difficulties to use them. 92.5% of the residents agreed with the system implemented for on-call shifts, 94.5% increased the time dedicated to academic activities, 75% considered the virtual class schedule implemented as very useful and 72.72% perceived that they had spaces to express their concerns. The supervision was considered adequate by 60%; 81.81% were worried to lose manual dexterity; 53% felt frustrated and 54% were afraid of infecting their family/partner. Conclusion: Understanding the perceptions of surgeons in training in the initial phase of the COVID-19 pandemic made it possible to detect opportunities for improvement and incorporate modifications to address the following phases, ensuring learning and prioritizing their physical and psychosocial wellbeing.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44447142","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}
I. A. Gemio del Rey, Aylhin J. López Marcano, A. M. Medina Velasco, R. de la Plaza Llamas, J. Ramia
{"title":"Giant ischiorectal lipoma as a cause of anal pain, fecal incontinence and dyspareunia. An exceptional association","authors":"I. A. Gemio del Rey, Aylhin J. López Marcano, A. M. Medina Velasco, R. de la Plaza Llamas, J. Ramia","doi":"10.25132/raac.v113.n3.1476","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1476","url":null,"abstract":"Lipomas account for 50% of soft-tissue tumors and may compress adjacent structures. We report the case of a 49-year-old female patient with intense anal pain associated with defecation urgency, tenesmus, incontinence and dyspareunia. A soft tumor was present in the right buttock suggestive of lipoma. On magnetic resonance imaging an apparently encapsulated mass with a size of 15.7 × 9 × 6 cm was identified extending through the ischioanal fossa and ischiorectal fossa, displacing the levator ani muscle and rectum. The lesion was excised en bloc and the patient was discharged 48 hours later without complications. The pathology report concluded that the lesion corresponded to a lipoma. We performed a bibliographic search in PubMed to assess the association between lipoma and fecal incontinence; Of the 87 articles retrieved, none of them responded to the subject of the study. These symptoms are exceptional in the literature. The diagnosis is made mainly with magnetic resonance imaging and endoscopic ultrasound. An excellent functional outcome was achieved with surgical excision.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41401630","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}
Obeid Jorge A., Alejandro García Hevia, Aída V. Canga, P. M. Fernández, José Brizuela Saluzo
{"title":"Percutaneous transgluteal drainage","authors":"Obeid Jorge A., Alejandro García Hevia, Aída V. Canga, P. M. Fernández, José Brizuela Saluzo","doi":"10.25132/raac.v113.n3.1484","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1484","url":null,"abstract":"Background: Percutaneous drainage is an alternative to surgery in the management of pelvic abscesses. The aim of this study is to evaluate the safety and efficacy of the transgluteal approach. Material and methods: Transgluteal percutaneous drainages were performed by 3 surgeons using computed tomography guidance. The Seldinger technique was used with 8 Fr and 10 Fr catheters under local anesthesia. Drainage was considered successful if the abscess regressed and did not recur. Results: Mean age was 49.2 years. Escherichia coli was the most common microorganism identified. In 50% of the cases, the abscesses occurred postoperatively. Mean duration of drainage was 9.2 days. Drainage was successful in all the cases and there were no major complications. Conclusion: Transgluteal computed tomography-guided approach is safe and well-tolerated for the treatment of deep pelvic abscesses","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43718560","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}
G. Nari, Alesio E. López, Ana D. Mariot, José L. Layún
{"title":"Programa de recuperación mejorada en cirugía hepática","authors":"G. Nari, Alesio E. López, Ana D. Mariot, José L. Layún","doi":"10.25132/raac.v113.n3.1640","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1640","url":null,"abstract":"Since the development of fast-track programs in colorectal surgery with promising results, many centers started with these programs, and improved them. These programs were applied to different organs with the same results observed in colorectal surgery. Liver resections were not excluded from enhanced recovery programs, with a significant reduction in length of hospital stay and costs. Adequate patient information and commitment, multimodal analgesia, fluid therapy and early oral intake are the most important items of these programs.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44966023","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}
Alvar G. Rivera Romero, Sebastián A. Romero Núñez, M. Bulacio, Fernando D. Craievich
{"title":"Solitary cecal ulcer as a rare cause of acute surgical abdomen","authors":"Alvar G. Rivera Romero, Sebastián A. Romero Núñez, M. Bulacio, Fernando D. Craievich","doi":"10.25132/raac.v113.n3.1542","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1542","url":null,"abstract":"Solitary cecal ulcers (SCUs) are rare and no cases have been published in Argentina. Few cases or series have been reported in other countries. The etiology is unknown and many other diseases must be ruled out before making the diagnosis. This case was solved with selective right hemicolectomy through laparotomy in an emergency basis.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49538894","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}
Ignacio Sastre, L. Moulin, Camila Battu, Gustavo C. Theiler, Bruno M. Moroni, Héctor Francia
{"title":"Post-traumatic pleurobiliary fistula: a case series of a rare complication","authors":"Ignacio Sastre, L. Moulin, Camila Battu, Gustavo C. Theiler, Bruno M. Moroni, Héctor Francia","doi":"10.25132/raac.v113.n3.1588","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1588","url":null,"abstract":"Background: Pleurobiliary fistula is a rare complication of thoraco-abdominal trauma that is confirmed by the presence of bilirubin in pleural fluid. Objective: The aim of this study is to analyze the management and treatment performed to patients with pleurobiliary fistula due to penetrating thoracoabdominal injury and their results, compare them with the published literature, and propose a treatment algorithm. Material and methods: For this descriptive and retrospective study, we reviewed 5688 medical records of patients admitted to Hospital José María Cullen, Santa Fe, Argentina, Centro de Trauma Nivel 1 between January 2010 and January 2016; 614 had involvement of the thoracic and abdominal region. The demographic data, kinematics of trauma, diagnosis, treatment and patient progress were analyzed. Results: Seven cases of pleurobiliary fistula were found. All the patients were men with penetrating trauma. Pleural drainage was the initial treatment in 4 cases, 2 patients underwent pleural drainage and exploratory laparotomy and 1 patient underwent urgent thoracotomy. Two cases resolved with pleural drainage alone. Five patients require biliary drainage through endoscopic retrograde cholangiopancreatography with sphincterotomy. Two of these patients also required biliary stenting and 2 also underwent percutaneous drainage. Finally, 2 patients required thoracotomy, 1 of them with open pleurostomy. The fistulae resolved in all the cases with acceptable morbidity. None of them died. Conclusion: In current surgical practice, the wide availability of interventional endoscopy has improved the minimally invasive approach for the management of PBF. Surgical management should be limited to fistulae not responding lo less invasive treatments or to complicated fistulae.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49451149","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}
P. Barros Schelotto, E. Ortiz, Leonardo Montes, P. Romero, S. Almanzo, P. Farinelli, D. Ramisch, G. Gondolesi
{"title":"Initial experience in laparoscopic liver resections","authors":"P. Barros Schelotto, E. Ortiz, Leonardo Montes, P. Romero, S. Almanzo, P. Farinelli, D. Ramisch, G. Gondolesi","doi":"10.25132/raac.v113.n3.1582","DOIUrl":"https://doi.org/10.25132/raac.v113.n3.1582","url":null,"abstract":"Background: Despite laparoscopic liver resection has significantly evolved, most hepatectomies are performed by the conventional approach. Objective: The aim of this study is to present the initial experience and applicability of laparoscopic liver resections. Material and methods: We conducted a retrospective analysis of patients undergoing liver resection between August 2010 and December 2019. Perioperative, intraoperative and postoperative variables were analyzed. To evaluate applicability, the sample was divided into 3 stages: stage 1, from August 2010 to December 2013; stage 2, from January 2014 to December 2016; and stage 3, from January 2017 to December 2019. Results: Of 385 liver resections performed, 119 were laparoscopic procedures: 53 (44%) were pure laparoscopic procedures, 64 (54%) were hand-assisted (64 patients) and 2 corresponded to hybrid procedures. Global applicability was 31%. In stage 1 1: 23%, in 2: 30% and in 3: 44% (p < 0.05). Malignant lesions: stage 1: 36%, stage 2: 67% and stage 3: 72% (p < 0.05). Major liver resections: 13%, 31% and 32% in stages 1, 2, and 3, respectively (p < 0.05). Conversion rate was 12%, 0% and 11%, respectively (p NS). Hepatic pedicle clamping was used in 6%, 5% and 45%; (p < 0.05). Complications in stage 1 were 30%, in stage 2: 28% and in stage 3: 17%, and Clavien-Dindo complications grade 3 or greater were 6%, 13% and 5%, respectively, p NS. Conclusions: Laparoscopic liver resections are complex procedures but technically reproducible. Applicability increases with the acquisition of experience, not only in malignant lesions but also in complex lesions ensuring safety for the patient.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44689792","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}
{"title":"In memoriam: Dr. Raúl A. Borracci","authors":"M. Montesinos, Asociaciòn Argentina de Cirugía","doi":"10.25132/RAAC.V113.N2.IMRAB","DOIUrl":"https://doi.org/10.25132/RAAC.V113.N2.IMRAB","url":null,"abstract":"Such was my feeling when I learned, on March 19, that Raul Alfredo Borracci had passed away at the age of 62","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43558168","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}
{"title":"Optimización perioperatoria","authors":"Santiago Mc Loughlin, U. Fraidenraij, A. Álvarez","doi":"10.25132/raac.v113.n2.ederas.es","DOIUrl":"https://doi.org/10.25132/raac.v113.n2.ederas.es","url":null,"abstract":"We are honored to have received the invitation to be the editors of this special issue of the Revista Argentina de Cirugía entirely devoted to perioperative enhanced recovery. This new paradigm of surgical care is continually becoming more widely accepted worldwide and its cornerstones are elements that do not require major technological advances, funding, or special talents","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47458406","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}
Martín Galvarini Recabarren, Francisco Schlottmann, C. A. Angeramo, Javier Kerman Cabo, M. A. Casas, J. Mella, Rudolf Baron Bouxhoeveden, D. Cimmino, G. Bugari
{"title":"Ecoendoscopia en la estadificación del cáncer de esófago y de estómago","authors":"Martín Galvarini Recabarren, Francisco Schlottmann, C. A. Angeramo, Javier Kerman Cabo, M. A. Casas, J. Mella, Rudolf Baron Bouxhoeveden, D. Cimmino, G. Bugari","doi":"10.25132/RAAC.V113.N1.1524.EI","DOIUrl":"https://doi.org/10.25132/RAAC.V113.N1.1524.EI","url":null,"abstract":"Background: Gastric adenocarcinoma (GAC) and esophageal adenocarcinoma (EAC) are one of the leading causes of mortality from gastrointestinal cancer worldwide. Endoscopic ultrasound (EUS) has proved to be a valuable tool for preoperative staging of GAC and EAC in selected cases. Objective: The aim of this study was to evaluate the usefulness of EUS for staging of EAC and GAC and selecting patients who are candidates for neoadjuvant therapy, as compared with the previous stage before the implementation of EUS, in a surgical center in Argentina. Material and methods: Consecutive patients with EAC and GAC between 2013-2019 were included. Patients with criteria of unresectable cancer or who underwent emergency surgery were excluded. The sample was divided into four groups G1 and G2 (EAC with and without EUS, respectively) and G3 and G4 (GAC with and without EUS, respectively). The clinical and anatomopathological variables and survival were evaluated in all the groups. Results: A total of 89 patients were included, 40 with EAC (30 in G1 and 10 in G2, and 49 with GAC, 20 in G3 and 29 in G4. Of the patients undergoing EUS staging in G1, 23 (75%) received neoadjuvant therapy vs. 2 patients in G2 (20%) (P ≤ 0.005). Eight patients (40%) in G3 and 2 (7%) in G4 received perioperative chemotherapy (P ≤ 0.005). Lymph node metastases were observed in 9 (30%) of surgical specimens of EAC in G1 and in 60% in G2 (P ≤ 0.005), and in 45% in G3 and G4. After a mean follow-up of 36 months (6-72), we observed a non-significant trend toward higher overall survival and disease-free survival in patients undergoing EUS staging. Conclusion: EUS for preoperative staging pf EAC and GAC is a useful tool. Although the use of EUS use may be a challenging task in many centers in Argentina, future efforts are needed to include this test in selected cases for staging patients with these types of cancers","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48179422","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}
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