Revista argentina de cirugia最新文献

{"title":"Linfomas extranodales de cabeza y cuello","authors":"M. Loccisano, María F. Montesinos, M. Montesinos","doi":"10.25132/RAAC.V113.N1.1529.EI","DOIUrl":"https://doi.org/10.25132/RAAC.V113.N1.1529.EI","url":null,"abstract":"Background: Extranodal lymphomas of the head and neck (ELHN) are rare neoplasms. The role of surgery for the diagnosis justifies thinking of these neoplasms among the differential diagnoses of the surgical disorders of the region. Objective: The aim of this study was to describe the clinical and pathological characteristics of ELHN, their location and association with systemic diseases in a series of patients undergoing surgery. Material and methods: The clinical records of 5489 patients undergoing surgery between June 2009 and June 2019 were retrospectively reviewed. Nineteen patients (0.35%) presented ELHN. Results: Mean age was 56 years (range: 17-84; SD 19.3) and 84% (n = 16) were women. The location of ELHN were the parotid gland (n =12, 63%), submaxillary gland (n = 3, 16%), salivary gland (n = 1, 5%), lacrimal gland (n = 1, 5%) and thyroid gland (n =1, 5%). All the tumors were non-Hodgkin lymphomas with the following subtypes: mucosa associated lymphoid tissue (MALT) lymphoma (n = 9, 48%), follicular lymphoma (n = 4, 21%), large B-cell lymphoma (n = 3, 16%), small B-cell lymphoma (n = 1, 5%), mantle cell lymphoma (n = 1, 5%), and anaplastic lymphoma (n =1, 5%). Four patients (21%) presented Sjögren syndrome at the moment of the diagnosis; three were MALT lymphomas and one patient had follicular lymphoma. The diagnosis was made with different surgical procedures. Conclusion: ELHN constitute a singular presentation of onco-hematology neoplasms. In our series, these tumors occurred within a wide age range and were more common in women. The parotid gland was more commonly affected. The diagnosis was made by surgical biopsy or resection of the area affected.","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":"46125855","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":"Revisión histórico - narrativa del ALPPS","authors":"José R. Oliver Guillén, José M. Ramia Ángel, Mario Serradilla Martín","doi":"10.25132/RAAC.V113.N1.1510.EI","DOIUrl":"https://doi.org/10.25132/RAAC.V113.N1.1510.EI","url":null,"abstract":"Two-stage liver resections were described to increase the resectability of liver tumors in patients with insufficient future liver remnant. The ALPPS procedure, described in 2011, has represented a breakthrough in the field of hepato-pancreato-biliary surgery. This technique accelerates the hypertrophy of the future liver remnant and reduces the interval between the two surgeries compared with previous techniques. ALPPS has gained popularity rapidly, with more than 1200 patients included in the world registry. Recommendations about indications, patient selection and surgical standardization have been discussed twice in international expert meetings. Although ALPPS has proven to be superior in terms of resectability (80-100% versus 60-90% of twostage hepatectomy), its rapid implementation has been punished with high morbidity and mortality reaching up to 40% and 9%, respectively, in the published series. The current evidence on the possible benefits and disadvantages is mainly based on observational studies. We present a historical review, describing the different technical modifications that have been carried out since its description, with a rigorous review in terms of morbidity, mortality, and oncological outcomes.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69522871","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":"Colecistitis aguda en vesícula biliar izquierda. Presentación de un caso resuelto en forma segura por vía laparoscópica","authors":"Agustín Virgili, Carlos Wendichansky, Rodrigo Maroni","doi":"10.25132/RAAC.V113.N1.1490.EI","DOIUrl":"https://doi.org/10.25132/RAAC.V113.N1.1490.EI","url":null,"abstract":"Left-sided gallbladder (LSGB) is a rare bile duct abnormality, usually found during a cholecystectomy. Symptoms usually do not differ from those of a normally positioned gallbladder, making the preoperative diagnosis extremely uncommon. We report the case of an acute cholecystitis in a patient whit LSGB, safely managed with laparoscopic surgery. A 24-year-old male patient was admitted to our institution with clinical and radiological signs of acute cholecystitis. The intraoperative finding of an acute cholecystitis in a LSGB made us modify ports positioning and a cholangiograhy was done by direct puncture of the gallbladder before hilum dissection. After the cystic duct was identified, a transcystic cholangiography was performed which confirmed a complete and clear bile duct anatomy and laparoscopic cholecystectomy was safely completed. The intraoperative finding of a LSGB makes the surgeon change some aspects of the usual technique to perform a safe cholecystectomy as LSGB significantly increases the risk of common bile duct injuries. Meticulous dissection of the gallbladder hilum to achieve a critical view of safety and the systematic use of intraoperative cholangiography are extremely important to perform a safe laparoscopic cholecystectomy.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49353020","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":"Manejo actualizado de las fracturas costales","authors":"Guillermo Carriquiry, J. Trostchansky","doi":"10.25132/RAAC.V112.N4.ANCAR","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N4.ANCAR","url":null,"abstract":"Rib fractures are the most common injuries in chest trauma. Fracture fixation has been traditionally performed in flail chest patients. Over the past years, the indication has been extended to multiple, severely displaced non-flail pattern fractures. Other less common indications for osteosynthesis have also been considered. Severe pneumonia and lung contusion requiring mechanical ventilation are considered contraindication for surgical fixation. The optimal timing for the intervention is the first week. Several devices have been developed for fracture fixation; titanium plates are the most commonly used. Rib fixation offers patients a more rapid recovery with shorter length of hospital stay and of intensive care unit stay with improved respiratory function and pain management in the short and long term.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46047965","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":"Tratamiento quirúrgico de la apendicitis aguda durante la pandemia: el daño colateral del COVID-19","authors":"M. C. Barreiro, Tomás Lanceloti, Roberto Salgado, David Solinas, Manuela Rodríguez Olivieri, Micaela Goya, Milena Napolitano, R. Oddi","doi":"10.25132/RAAC.V112.N4.1570.EI","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N4.1570.EI","url":null,"abstract":"Background: COVID-19 pandemic has generated changes regarding the management of patients with all kind of pathologies. Here we show the experience concerning the surgical treatment of acute appendicitis (AA) in a teaching hospital in the city of Buenos Aires during the lockdown, and its comparison with the same period of 2019 in order to assess the differences between the timing for consultation, intraoperative findings and the treatment outcome. Material and methods: A prospective database was retrospectively analyzed. We compared patients undergoing surgical treatment for AA in March-July of 2019 v. March-July 2020, taking into account the preoperative period and comparing the outcome regarding the surgical intervention and the impact in the postoperative period between the two groups. Results: 127 patients were included, 46 treated during the pandemic. Patients undergoing surgical treatment during the pandemic had a higher incidence of peritonitis (61.7% vs. 76.1%; p = 0.09) and higher requirement of abdominal drainage (9.9% vs. 23.9%; p = 0.03). There was an increase in the incidence of complications (10.9 vs. 4.9%; p: 0.21), reoperations (8.7 vs. 1.23%, p: 0.03), readmissions (6.5 vs. 0%, p: 0.02) and need for out-patient intravenous antibiotics (6.5 vs. 0%; p: 0.02). The average hospital length was of 1.89 (SD 2.04) and 3.24 (SD 7.31) for the groups operated before and during pandemic, respectively. Conclusions: During the COVID-19 pandemic, the number of patients undergoing surgical intervention because of AA decreased compared to the previous year, with increased complications in the postoperative period, higher compromise of the appendix, and longer hospital stay.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47338955","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":"Recomendaciones para la realización de procedimientos quirúrgicos de urgencia, emergencia, trauma y cuidados críticos ante la situación de pandemia por COVID-19","authors":"R. D. Algieri, Asociación Argentina de Cirugía, Ernesto Donelly","doi":"10.25132/RAAC.V112.N3.1531.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.1531.ES","url":null,"abstract":"Conditions requiring emergency surgery and trauma care are still common in emergency systems and require immediate evaluation and timely resolution even during a pandemic as is currently happening with COVID-19, a scenario that threatens to affect their capacity to provide care5,8. In these cases, certain measures must be taken for the special care of health care workers and their patients, who are often admitted in critical condition and require an immediate surgical intervention that does not allow for any delay. For this purpose, an algorithm should be developed with recommendations which include a checklist to guide surgeons working in emergency and trauma systems about the issues to consider for the appropriate management and treatment of these conditions and for preparation of perioperative environments during the COVID-19 pandemic. The ultimate goal is to maintain adequate care with the necessary and required protection in each case5,8,11, raising awareness of the importance of preserving capacity to respond to these conditions that routinely occur in our community.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42492938","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":"Recomendaciones para la cirugía videoendoscópica y mininvasiva en contexto de pandemia COVID-19","authors":"Fabio Leiro, Asociación Argentina de Cirugía, B. Quesada","doi":"10.25132/RAAC.V112.N3.1544.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.1544.ES","url":null,"abstract":"In the scenario of the COVID-19 pandemic, planning of surgical interventions needs to be FO Leiro y col. Recomendaciones COVID-19: videoendoscópica y mininvasiva. Rev Argent Cirug 2020;112(3):239-248 244 adapted and could be modified depending on the new information and on the dynamics of the pandemic phase each region is going through. The situation of human resources and hospital supplies, and the availability of general ward and intensive care unit (ICU) beds should be considered in the decisions. Given the continuous changes in the knowledge of a completely new entity, it is worth mentioning that these recommendations are mainly based on expert recommendations and are subject to modification in view of new scientific evidence of higher quality.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44777111","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":"Seguridad y entrenamiento de las colonoscopias por cirujanos. Estudio multicéntrico","authors":"H. Amarillo, Pablo Tacchi, Martín García, Alejandro Sanchez Ruiz, Vicente Borquez, J. Baistrocchi, H. Baistrocchi, Luis Díaz, G. Rodriguez, C. Funes, H. Ruíz","doi":"10.25132/RAAC.V112.N3.1454.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.1454.ES","url":null,"abstract":"Introduction: The safety of colonoscopies performed by surgeons and the management of their complications has not been analyzed in depth in the low number of national publications. Objective: The primary endpoint of this study was to analyze the outcomes of colonoscopies performed by colorectal surgeons, in terms of complications. and their resolution. The secondary endpoint was to compare the results between a university hospital and different centers nationwide staffed with colorectal surgeons who had received formal training during a residency program in the surgical subspecialty. Material and methods: We conducted a multicenter, prospective and consecutive national study. The colonscopies performed between 2011 and 2016 were included. The variables analyzed included complications, age, sex, type of endoscopy, diagnosis, treatment, location were the procedure was performed and surgeon’s training. The results were expressed as mean, percentage and range. The statistical analysis was performed using Fisher’s exact test. A p value < 0.05 was considered statistically significant. Results: A total of 24,907 procedures were performed, 17,283 corresponded to diagnostic colonoscopies and 17,202 were made in provincial centers. Forty-four complications were recorded (0.17%), of which 35 were procedure-related complications: 19 perforations, 8 bleeding events, 5 post-polypectomy syndromes and three related with the technique; all were diagnosed and solved by the same team without morbidity and mortality. There were no differences in the incidence of complications and how they were treated according to the center or type of colonoscopy. All the surgeons received colonoscopy training during a residency program in the surgical subspecialty. Conclusions: The results obtained in colonoscopies performed by surgeons trained in institutions with residency programs in surgical subspecialties are similar t Safe colonoscopies can be performed by surgeons who have been trained in institutions with a residency program in a surgical subspecialty and with a formal training program in colonoscopy.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41649437","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":"Impacto de la pandemia COVID-19 en la cirugía pancreática. Análisis en dos instituciones, una pública y otra privada","authors":"C. Ocampo, H. Zandalazini, F. Alonso","doi":"10.25132/RAAC.V112.N3.1538.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.1538.ES","url":null,"abstract":"ABSTRACT Background: The COVID-19 pandemic has introduced dramatic changes in the health system. Elective surgeries are the surgical activities with greater decline during the pandemic. Objective: The aim of this paper is to analyze the impact of the COVID-19 pandemic in pancreatic surgery in a public and a private institution. The number of surgeries performed in each institution was compared with those performed in same period of the previous year. Material and methods: Data from a prospective database of all the patients who underwent pancreatic surgery between March 10, 2020, and June 3, 2020, were analyzed. The epidemiological data, type of pancreatic resection, pathology diagnosis, morbidity and mortality were determined in each institution and compared with patients who underwent pancreatic surgery in both institutions between March 3, 2019, and June 24, 2019. Results: 23 pancreatic resections were performed during the pandemic (13 cephalic pancreaticoduodenectomies, 9 left pancreatectomies and 1 total pancreatectomy); 70% (16/23) were adenocarcinomas. There were 34.7% complications and no deaths were reported. None of the patients was infected with coronavirus. The pandemic had no impact on the number of pancreatic resections in the private institution (22 vs. 20, p = 0.88), while the number of pancreatic surgeries was significantly lower in the public center (14 vs. 3, p = 0.009). Conclusion: Pancreatic surgery can be safely performed during the pandemic. The number of pancreatic surgeries did not decline during the pandemic. The priority for treating patients with COVID-19 at the public center resulted in a significant decrease in pancreatic surgeries. Keywords: pandemic, COVID 19, surgery, pancreas, pancreatic surgery, private center, public center, pancreaticoduodenectomy, left pancreatectomy.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43131063","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":"Recomendaciones generales de atención de la patología quirúrgica en el contexto de la pandemia por COVID-19 (SARS COV-2)","authors":"E. Ortíz, Asociación Argentina de Cirugía, R. D. Algieri, J. L. Tortosa","doi":"10.25132/RAAC.V112.N3.1543.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.1543.ES","url":null,"abstract":"Establish a communication channel between the department of surgery and the hospital board of directors, with daily reports about the department and the hospital. 2. Consider a 14-day shift followed by a 14-day break period according to the incubation period of the disease. 3. The usual work of the department will be lower due to the decrease in the normal activity. The surgeon without an assigned activity or who has finished it should remain at home to reduce exposure and infection and should be available for any emergency. This distribution should be coordinated by the person designated to such task. 4. All the staff members should receive practical training in donning and doffing of personal protective equipment (PPE) as established in each center. Recomendaciones para equipos de salud | Argentina.gob.ar 5. Working areas, offices and lecture halls must be well ventilated, keeping the safe distance between doctors and with the rest of the hospital staff.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49637850","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}