Revista argentina de cirugia最新文献

{"title":"Trauma, emergencias, urgencias y cuidados críticos en tiempos de pandemia por COVID-19","authors":"R. D. Algieri, Asociación Argentina de Cirugía","doi":"10.25132/RAAC.V112.N3.EDRDA.ES","DOIUrl":"https://doi.org/10.25132/RAAC.V112.N3.EDRDA.ES","url":null,"abstract":"Los cirujanos de trauma, emergencias, urgencias y cuidados críticos en el contexto de la pandemia desempeñan un papel importante. Si bien la enfermedad COVID-19 no requiere intervención de la especialidad en forma esencial, la formación en habilidades no técnicas ‒como el trabajo en equipo y la experiencia en el manejo del proceso de toma de decisiones, así como la gestión, preparación y respuesta hospitalaria ante catástrofes y desastres‒ y fundamentalmente el liderazgo hacen que, en el contexto del manejo de la complejidad emergente en este escenario, sus aptitudes resulten necesarias para configurar el equipo de trabajo. La enfermedad COVID-19 es originada por un nuevo virus de la familia coronavirus, que puede causar muy escasos síntomas, como un resfrío, hasta enfermedades graves como el síndrome respiratorio de Oriente Medio (MERS-CoV) y el que origina el síndrome respiratorio agudo severo ( SARS-CoV). El SARS-CoV fue descubierto en noviembre de 2002, en Cantón, China. Luego apareció el virus SARSCoV-2 en Wuhan, Hubei, China, produciendo el primer caso el 08 de diciembre de 2019, según datos oficiales de las autoridades chinas, y originando la pandemia declarada por la Organización Mundial de la Salud (OMS) el 11 de marzo de 2020. En la Argentina había sido confirmado el primer caso el 03 de marzo de 2020, en un hombre de 43 años que arribó al país desde Milán, Italia. Este virus presenta una gran capacidad de transmisión y, aunque la mayoría de las personas se recuperan sin necesitar tratamiento hospitalario, aproximadamente 1 de cada 5 enfermos desarrolla un cuadro grave. Es extremadamente agresivo en adultos mayores y en quienes padecen enfermedades crónicas; sin embargo, cualquiera puede contraer COVID-19 y enfermar gravemente. Así, la alta incidencia de infección ha puesto a prueba los Sistemas de Salud a nivel mundial, desafiando las capacidades hospitalarias con número elevado de pacientes críticos en intervalos cortos de tiempo y con una severidad que no ha sido vista en los últimos 100 años, sobrecargando los Centros de Salud y específicamente las Unidades de Cuidados Intensivos (UCI) y haciendo imperiosa la necesidad de disponibilidad de Equipos de Bioseguridad para proteger a los profesionales de la salud, considerados una población altamente vulnerable. Tanto es así que varios documentos deRubén D. Algieri*","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":"45727077","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":"Tiroidectomía transoral endoscópica por abordaje vestibular","authors":"Alejandro M. Zalazar, J. Rossi, José M. Moreno Negri, Francisco Santucho Saravia","doi":"10.25132/raac.v112.n2.1439.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1439.es","url":null,"abstract":"Natural orifice transluminal endoscopic surgery (NOTES) was applied for the first time by K. Witzel in 2008, introducing the transoral endoscopic resection of the thyroid gland in human cadavers and living pigs. In 2016, A. Anuwong published the first case series using the vestibular approach in humans. We report the case of a 37-year-old female patient with a mass in the anterior aspect of the neck which appeared two months before consultation. The thyroid ultrasound reported multinodular goiter. The fine-needle aspiration (FNA) biopsy reported hyperplastic follicular nodule in both lobes. The patient underwent transoral endoscopic thyroidectomy by vestibular approach. Operative time was 180 minutes and blood loss was 20 mL. Pain was minimal and hospital stay was 36 hours. We report our first experience with total thyroidectomy in a patient with benign thyroid nodules.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45807946","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":"Tríada de Rigler radiológica en un caso de íleo biliar","authors":"Martín Varela Vega, Micaela Mandacen, Andrés Pouy","doi":"10.25132/raac.v112.n2.1469.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1469.es","url":null,"abstract":"Background: gallstone ileus is a rare complication of cholelithiasis. It is defined as a mechanical obstruction of the small bowel due to impaction of large gallstones into the gastrointestinal tract, generally though a cholecystoduodenal fistula. Rigler’s triad (pneumobilia, ectopic gallstone and mechanical obstruction) occurs in 30% of the patients. Surgery is indicated and includes enterotomy with gallstone extraction. Objective: we report a case of gallstone ileus with radiographic evidence of Rigler’s triad","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47530548","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":"Correlación diagnóstica de la escala RIPASA en pacientes intervenidos quirúrgicamente por apendicitis aguda","authors":"R. A. Gasque, Walter A. Moreno, Gabriel E Vigilante","doi":"10.25132/raac.v112.n2.1452.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1452.es","url":null,"abstract":"Background: Acute appendicitis (AA) is the most common surgical emergency worldwide. Its correct and early diagnosis is essential to avoid unnecessary surgeries and complications associated with its natural history. Objective: The aim of this study was to determine the diagnostic sensitivity and specificity of the RIPASA score in patients with suspected AA. Material and methods: This analytical, cross-sectional, observational and retrospective study included appendectomy specimens of patients of both sexes > 18 years operated on with clinical diagnosis of AA between January 1 and December 31, 2017. The histopathological examination of the appendectomy specimens was considered the gold standard diagnostic test. A score of 7.5 for the RIPASA score was chosen as cut-off value. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: A total of 68 appendectomies were included; 57 (83.82%) specimens were positive for acute appendicitis. Mean age was 43.32 years. The histological diagnosis of AA was present in 32 (84.21%) men and in 25 (83.33%) women. For the RIPASA score, 54 patients had a true positive result (cut-off point ≥ 7.5 and positive histology for AA) with a sensitivity of 93%, specificity of 40%, PPV of 90%, NPV of 50%, positive likelihood ratio of 1.55 and negative likelihood ratio of 0.175. Conclusion: The RIPASA score has demonstrated excellent sensitivity and specificity for the clinical diagnosis of AA in a fast, simple and non-invasive fashion.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42448025","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":"Fístula perianal compleja. Tratamiento con plasma rico en plaquetas","authors":"Bruno M. Moroni, J. Muñoz, Camila C. Battú, Pedro E. Straini, Gustavo C. Theiler, Rosana Valentini","doi":"10.25132/raac.v112.n2.1430.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1430.es","url":null,"abstract":"A male patient with a diagnosis of steroid dependent inflammatory bowel disease (ulcerative colitis) sought medical care due to complex perianal fistula with extended chronic inflammation of the perianal region that was successfully treated with platelet-rich plasma as a single therapy. The benefits of autologous platelet-rich plasma for the treatment of this type of fistulas are presented. In this way, there is no need to perform surgery in a chronic inflammatory territory with high rate of complications and recurrence affecting patients’ quality of life.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46199679","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 enfisematosa: presentación de tres casos","authors":"Jorge A. Obeid, Alejandro García Hevia, Aída V. Canga, Pablo M. Fernández","doi":"10.25132/raac.v112.n1.1441.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n1.1441.es","url":null,"abstract":"Background: Emphysematous cholecystitis (EC) is a rare presentation of acute cholecystitis. Material and methods: We report three cases of EC in two men and one woman between 55 and 79 years. One of the patients was otherwise healthy while the other two were diabetics. A computed tomography (CT) scan was performed in all the cases. Two patients underwent video-assisted laparoscopic cholecystectomy with favorable outcome and one patient underwent percutaneous cholecystostomy. Discussion: Emphysematous cholecystitis is characterized by the presence of gas in the gallbladder lumen or wall. Mortality rate is 50%. Most patients are diabetics, but EC may present in younger patients without risk factors. Computed tomography scan is the method of choice for the diagnosis. Cholecystectomy is indicated as definite treatment, but percutaneous cholecystostomy may be a valid option. Conclusions: Laparoscopic cholecystectomy and antibiotics are effective and safe to treat. Palabras clave: colecistitis enfisematosa, colecistectomía laparoscópica, colecistostomía percutánea, tomografía computarizada.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48801160","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":"Esofagitis por píldoras","authors":"G. M. Rodríguez, A. M. Prieto","doi":"10.25132/raac.v112.n1.1419.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n1.1419.es","url":null,"abstract":"","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44821905","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":"Editorial","authors":"Roberto A. Cerutti","doi":"10.25132/raac.v112.n1.edrac.esin","DOIUrl":"https://doi.org/10.25132/raac.v112.n1.edrac.esin","url":null,"abstract":"","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47354713","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":"Reducción de la exposición en residentes de Cirugía frente al brote de COVID-19","authors":"A. Morales, Mora Achával, J. C. López Meyer, Carla Vega, Gerónimo Faillace, Guadalupe Iudica, Ezequiel Verde, Carina Chwat","doi":"10.25132/raac.v112.n2.1492.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1492.es","url":null,"abstract":"The worldwide outbreak of COVID-19 during the first quarter of 2020 constitutes an unprecedented challenge for the health system. The aim is to describe the strategies adopted by residents of General Surgery of a university hospital of Argentina, to safeguard the health of residents, reduce the risk of exposure of surgical patients, maintain continuous academic training and promote teamwork. Minimize resident exposure by dividing the group into two teams that work by fortnights; divide activities, hours within hospital, and shifts equally among residents; use telemedicine for postoperative / ambulatory controls; suspend office activity; organize daily online classes and reviews of published articles. In the context of the COVID-19 pandemic, all means should be used to minimize the risk of exposure in order to optimize human resources. Although these strategies can easily be applied to other residencies, more research is needed to assess their impact on disease transmission, and on the physical and emotional health of health professionals","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69521325","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":"Liderazgo en Cirugía en la era COVID-19","authors":"Juan Pekolj","doi":"10.25132/raac.v112.n2.1509.es","DOIUrl":"https://doi.org/10.25132/raac.v112.n2.1509.es","url":null,"abstract":"The advent of the COVID-19 pandemic has shattered the paradigms through which the various societies worldwide moved over a short period of time. There is no area or activity that has not been affected by this reality, which has no geographic or temporal limits in the short term. The vertiginous nature of the development of the pandemic has created enormous uncertainty about how to act in the present and how the future outlook will be.","PeriodicalId":78597,"journal":{"name":"Revista argentina de cirugia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69521451","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}