Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500444
A. Escobar, Juan Riquelme Contreras, G. Cumsille, Manuel Lizana Corvera
Introduccion: La enfermedad hemorroidaria puede ser tratada de multiples formas. Una alternativa es la ligadura de las ramas terminales de la arteria rectal y pexia de los paquetes guiados por Doppler (THD â ). Objetivo: Presentar nuestra experiencia inicial con esta tecnica. Material y metodo: serie prospectiva, consecutiva, no aleatoria. Incluye a los pacientes tratados por enfermedad hemorroidaria que no responde al manejo no quirurgico. Resultados: La serie corresponde a 11 pacientes, 7 de genero masculino. Todos fueron operados en forma ambulatoria. El tiempo quirurgico promedio fue de 35 minutos y la evaluacion del dolor pos operatorio inmediato no supero un EVA de 3 en todos los pacientes. El seguimiento promedio es de 12 meses y solo un paciente requirio una ligadura con banda elastica por sangrado hemorroidario. Conclusion: La tecnica de ligadura y pexia guiada por Doppler es sencilla, con buenos resultados iniciales y con minimo dolor pos operatorio.
{"title":"Tratamiento de la enfermedad hemorroidaria con desarterialización y pexia guiada por doppler (THD®). Experiencia inicial","authors":"A. Escobar, Juan Riquelme Contreras, G. Cumsille, Manuel Lizana Corvera","doi":"10.4067/S0718-40262018000500444","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500444","url":null,"abstract":"Introduccion: La enfermedad hemorroidaria puede ser tratada de multiples formas. Una alternativa es la ligadura de las ramas terminales de la arteria rectal y pexia de los paquetes guiados por Doppler (THD â ). Objetivo: Presentar nuestra experiencia inicial con esta tecnica. Material y metodo: serie prospectiva, consecutiva, no aleatoria. Incluye a los pacientes tratados por enfermedad hemorroidaria que no responde al manejo no quirurgico. Resultados: La serie corresponde a 11 pacientes, 7 de genero masculino. Todos fueron operados en forma ambulatoria. El tiempo quirurgico promedio fue de 35 minutos y la evaluacion del dolor pos operatorio inmediato no supero un EVA de 3 en todos los pacientes. El seguimiento promedio es de 12 meses y solo un paciente requirio una ligadura con banda elastica por sangrado hemorroidario. Conclusion: La tecnica de ligadura y pexia guiada por Doppler es sencilla, con buenos resultados iniciales y con minimo dolor pos operatorio.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"13 1","pages":"445-448"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89243037","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500409
A. Beltrán, S. Oyarzún, G. Castro, L. Andrade, R. Fernández
Introduction: Late presentation of traumatic diaphragmatic hernia constitutes a true surgical emergency. The purposes of this study were to describe the diagnostic characteristics, treatment and outcomes of late presentation diaphragmatic hernias and to identify a cutoff point from the onset of symptoms to necrosis development. Patients and Methods: A retrospective series of cases constituted by all patients subjected to emergency diaphragmatic hernia repair form 2006 to 2016 was studied. Categorical and continuous variables were measured and analyzed with descriptive statistics. Receiver Operating Characteristics (ROC) curves at 6 and 12 hours from the onset of symptoms were used to determine the cutoff point for organ resection. Once stablished the cutoff point, sensitivity, specificity, positive and negative predictive values and prevalence were calculated. Results: Clinical presentation, diagnostic study and surgical treatment were similar to what has been already described. The cutoff point was defined at 12 hours from the onset of symptoms with 80% sensitivity and 83% sensibility. Conclusions: The diagnosis and treatment of these cases should be carried on before the first 6 hours after the onset of symptoms. Even though the universe of this study was small, we may suggest that after 12 hours form the onset of symptoms, the implicated organs would be found necrotic requiring surgical resection.
{"title":"Hernia diafragmática secundaria a trauma: presentación tardía","authors":"A. Beltrán, S. Oyarzún, G. Castro, L. Andrade, R. Fernández","doi":"10.4067/S0718-40262018000500409","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500409","url":null,"abstract":"Introduction: Late presentation of traumatic diaphragmatic hernia constitutes a true surgical emergency. The purposes of this study were to describe the diagnostic characteristics, treatment and outcomes of late presentation diaphragmatic hernias and to identify a cutoff point from the onset of symptoms to necrosis development. Patients and Methods: A retrospective series of cases constituted by all patients subjected to emergency diaphragmatic hernia repair form 2006 to 2016 was studied. Categorical and continuous variables were measured and analyzed with descriptive statistics. Receiver Operating Characteristics (ROC) curves at 6 and 12 hours from the onset of symptoms were used to determine the cutoff point for organ resection. Once stablished the cutoff point, sensitivity, specificity, positive and negative predictive values and prevalence were calculated. Results: Clinical presentation, diagnostic study and surgical treatment were similar to what has been already described. The cutoff point was defined at 12 hours from the onset of symptoms with 80% sensitivity and 83% sensibility. Conclusions: The diagnosis and treatment of these cases should be carried on before the first 6 hours after the onset of symptoms. Even though the universe of this study was small, we may suggest that after 12 hours form the onset of symptoms, the implicated organs would be found necrotic requiring surgical resection.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"13 1","pages":"409-417"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73624863","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500438
N. Pérez, M. González, Alberto Pérez-Castilla, Nicolás Campaña Weitz, Gonzalo Alfredo Campaña Villegas
Introduccion: La filtracion anastomotica (FA) en cirugia colorrectal aumenta la morbimortalidad. La identificacion de factores de riesgo y la creacion de un modelo predictivo ayudaria en la decision de crear un ostoma desfuncionalizante, hecho que actualmente recae en el criterio del cirujano. Dekker creo el Colon Leakage Score (CLS) estableciendo criterios objetivos. Objetivo: Establecer el CLS en pacientes intervenidos por cancer de colon izquierdo y recto en Clinica INDISA, estableciendo valores de corte locales, su sensibilidad y especificidad. Pacientes y Metodo: Corresponde a un estudio de pruebas diagnosticas, cuya intervencion es la aplicacion del CLS comparandolo con la presencia de filtracion anastomotica (gold standard), definida por criterios clinicos y radiologicos. Se utilizo analisis de curvas ROC, indice de Youden y regresion logistica. Resultados: De 180 pacientes, hubo FA en 12 (6.6%). La media de CLS en quienes hubo FA fue de 11.5 y en quienes no hubo FA de 6.9 (p=0.0001). El area bajo la curva para prediccion de FA con el CLS fue de 0.829 (IC 95% 0.69-0.96), con un valor de corte de 11, sensibilidad de 67% y especificidad de 89%. En el analisis de regresion logistica, el OR para la prediccion de FA utilizando el CLS fue de 1.48 (IC 95% 1.22-1.79 p<0.001). Conclusion: El CLS es una herramienta que permite predecir el riesgo de FA en pacientes intervenidos por cancer colon izquierdo y recto. Ante un valor mayor o igual a 11 se deberia crear un ostoma protector, generando un cambio en la practica clinica.
前言:结肠直肠癌吻合口过滤(af)增加发病率和死亡率。风险因素的识别和预测模型的创建将有助于决定创建一个功能失调的造口，这一事实目前取决于外科医生的判断。Dekker通过建立客观标准来创建结肠泄漏评分(CLS)。摘要目的:建立印度临床左结肠癌和直肠癌患者的CLS，建立局部截止值、敏感性和特异性。患者和方法:对应于诊断试验的研究，其干预是CLS的应用，并将其与吻合滤过(金标准)的存在进行比较，由临床和放射学标准定义。采用ROC曲线分析、优登指数和logistic回归。结果:180例患者中有12例(6.6%)患有FA。有FA的患者CLS平均值为11.5，没有FA的患者CLS平均值为6.9 (p=0.0001)。使用CLS预测FA曲线下面积为0.829 (95% ci 0.69-0.96)，截止值为11，敏感性67%，特异性89%。在logistic回归分析中，使用CLS预测FA的OR为1.48 (95% ci 1.22-1.79 p<0.001)。结论:CLS是一种预测左结肠癌和直肠癌患者FA风险的工具。当值大于或等于11时，应该创建一个保护性的口孔，从而改变临床实践。
{"title":"Aplicabilidad del Colon Leakage Score como predictor de filtración anastomótica en cirugía de cáncer colorrectal","authors":"N. Pérez, M. González, Alberto Pérez-Castilla, Nicolás Campaña Weitz, Gonzalo Alfredo Campaña Villegas","doi":"10.4067/S0718-40262018000500438","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500438","url":null,"abstract":"Introduccion: La filtracion anastomotica (FA) en cirugia colorrectal aumenta la morbimortalidad. La identificacion de factores de riesgo y la creacion de un modelo predictivo ayudaria en la decision de crear un ostoma desfuncionalizante, hecho que actualmente recae en el criterio del cirujano. Dekker creo el Colon Leakage Score (CLS) estableciendo criterios objetivos. Objetivo: Establecer el CLS en pacientes intervenidos por cancer de colon izquierdo y recto en Clinica INDISA, estableciendo valores de corte locales, su sensibilidad y especificidad. Pacientes y Metodo: Corresponde a un estudio de pruebas diagnosticas, cuya intervencion es la aplicacion del CLS comparandolo con la presencia de filtracion anastomotica (gold standard), definida por criterios clinicos y radiologicos. Se utilizo analisis de curvas ROC, indice de Youden y regresion logistica. Resultados: De 180 pacientes, hubo FA en 12 (6.6%). La media de CLS en quienes hubo FA fue de 11.5 y en quienes no hubo FA de 6.9 (p=0.0001). El area bajo la curva para prediccion de FA con el CLS fue de 0.829 (IC 95% 0.69-0.96), con un valor de corte de 11, sensibilidad de 67% y especificidad de 89%. En el analisis de regresion logistica, el OR para la prediccion de FA utilizando el CLS fue de 1.48 (IC 95% 1.22-1.79 p<0.001). Conclusion: El CLS es una herramienta que permite predecir el riesgo de FA en pacientes intervenidos por cancer colon izquierdo y recto. Ante un valor mayor o igual a 11 se deberia crear un ostoma protector, generando un cambio en la practica clinica.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"39 1","pages":"439-444"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80601644","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500459
Jaime Ruíz-Tovar, M. Jiménez-Fuertes, G. Díaz, J. M. Gonzalez, César Lévano-Linares, M. Durán
Introduction: Esophageal perforation is a possible complication after anterior cervical fusion. However, these complications usually appear intraoperatively or in the early postoperative course. Case report: A 35-years-old females, who underwent a C3-C5 anterior cervical fusion 3 years ago, after suffering a mild cervical trauma, she complained of dysphagia. A retroesophageal abscess was observed, caused by esophageal perforation, secondary to plaque rupture and screw extrusion.
{"title":"Perforación esofágica cervical tardía por rotura y desplazamiento de placa de artrodesis cervical anterior","authors":"Jaime Ruíz-Tovar, M. Jiménez-Fuertes, G. Díaz, J. M. Gonzalez, César Lévano-Linares, M. Durán","doi":"10.4067/S0718-40262018000500459","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500459","url":null,"abstract":"Introduction: Esophageal perforation is a possible complication after anterior cervical fusion. However, these complications usually appear intraoperatively or in the early postoperative course. Case report: A 35-years-old females, who underwent a C3-C5 anterior cervical fusion 3 years ago, after suffering a mild cervical trauma, she complained of dysphagia. A retroesophageal abscess was observed, caused by esophageal perforation, secondary to plaque rupture and screw extrusion.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"10 1","pages":"460-463"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75106959","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500397
G. A. Campos
{"title":"Comité de Educación Médica de la Sociedad de Cirujanos de Chile. Siguiendo el rumbo","authors":"G. A. Campos","doi":"10.4067/S0718-40262018000500397","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500397","url":null,"abstract":"","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"78 1","pages":"397-397"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77421551","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500425
F. Quiroz, S. F. N. Drolett, P. Aguirre, J. Cifuentes, S. Mancilla, M. A. Pumarino, Z. J. Labbé
Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted “No touch” (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceina. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences. Key words: saphenous vein; coronary artery bypass; pedicled ‘no-touch’; vascular damage.
导读:延长冠状动脉旁路移植术中移植物的通透性一直是一个挑战。目的:比较人隐静脉(VSH)“无接触”(NT)技术与常规技术(TC)在解剖和功能上的差异。材料与方法:实验研究。在安托法加斯塔地区医院心脏外科病房用CT和NT解剖VSH。VSH样品被切成3mm的环状，用克雷布斯-林格溶液保存在离体器官室中。为了评估血管舒缩活性，给予去甲肾上腺素(10-6M)、罂粟碱(10-4M)、乙酰胆碱(10-6M)和硝普钠(10-5M)。将一段样品固定在10%福尔马林中，用苏木精-伊红、Verhoeff和orceina光镜技术对其进行处理和组织学分析。采用Prism软件graphhad进行统计分析。结果:血管反应性:去甲肾上腺素诱导的血管收缩在NT组明显高于TC组(p < 0.0001)。NT组罂粟碱和乙酰胆碱的血管舒张作用分别高于对照组(p < 0.004)和对照组(p < 0.0003)。形态学研究:NT组肌层厚度(0.755 vs 0.680 mm)、非固定肌层厚度(0.5600 vs 0.4663 mm)、总壁厚度(1.344 vs 0.962 mm)均较TC组厚。血管数目无显著差异。结论:NT组血管收缩剂和血管舒张剂疗效显著。结果与形态学差异相关。关键词:隐静脉;冠状动脉搭桥术;有蒂的“出手”;血管损伤。
{"title":"Reactividad vascular in vitro y estudio morfométrico de venas safenas utilizadas como bypass coronario: técnica “no-touch” versus convencional.","authors":"F. Quiroz, S. F. N. Drolett, P. Aguirre, J. Cifuentes, S. Mancilla, M. A. Pumarino, Z. J. Labbé","doi":"10.4067/S0718-40262018000500425","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500425","url":null,"abstract":"Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted “No touch” (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceina. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences. Key words: saphenous vein; coronary artery bypass; pedicled ‘no-touch’; vascular damage.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"26 1","pages":"425-431"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87303882","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500473
Alejandro González, H. Zamora, C. Contreras, F. M. Ibacache
Postoperative recovery and post discharge surveillance and support are essential in outpatient surgery success. The postoperative recovery process is divided into Phase I and Phase II, in which predefined clinical criteria are used to decide whether a patient can be moved to the next phase or be discharged to home, respectively. At discharge, postoperative indications are given in writing and an adult must accompany the patient. After discharge, the patient is monitored during the first few days, usually through a telephone call and predefined clinical parameters are evaluated. Outpatient surgery outcome evaluation is performed through specific indicators such as prolonged postoperative stay, unanticipated hospital admission, and return to hospital and readmission.
{"title":"Cirugía ambulatoria: ¿Qué hacer en el período posoperatorio? Desde el término de la cirugía hasta el control domiciliario","authors":"Alejandro González, H. Zamora, C. Contreras, F. M. Ibacache","doi":"10.4067/S0718-40262018000500473","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500473","url":null,"abstract":"Postoperative recovery and post discharge surveillance and support are essential in outpatient surgery success. The postoperative recovery process is divided into Phase I and Phase II, in which predefined clinical criteria are used to decide whether a patient can be moved to the next phase or be discharged to home, respectively. At discharge, postoperative indications are given in writing and an adult must accompany the patient. After discharge, the patient is monitored during the first few days, usually through a telephone call and predefined clinical parameters are evaluated. Outpatient surgery outcome evaluation is performed through specific indicators such as prolonged postoperative stay, unanticipated hospital admission, and return to hospital and readmission.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"128 1","pages":"474-479"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88706592","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500479
M. Í. Braghetto
La gastrectomia vertical tubular (GVT) o en manga ha sido validada como un procedimiento bariatrico efectivo para tratar pacientes con obesidad morbida. Se han descrito modificaciones anatomicas y fisiopatologicas en la union esofago-gastrica que pueden estar relacionados con patogenesis de la enfermedad por reflujo gastroesofagico. En este articulo se muestran los resultados de nuestra propia experiencia y de la literatura respecto de los cambios en la funcion esofagica y gastrica, la prueba de reflujo acido, los estudios endoscopicos y radiologicos en pacientes sometidos a GVT. Se concluye que la GVT puede presentar cambios anatomicos y fisiopatologicos que se asocian a la aparicion de enfermedad por reflujo gastroesofagico.
{"title":"Consecuencias fisiopatológicas y anatómicas posgastrectomía vertical tubular como posibles causas de enfermedad por reflujo gastroesofágico","authors":"M. Í. Braghetto","doi":"10.4067/S0718-40262018000500479","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500479","url":null,"abstract":"La gastrectomia vertical tubular (GVT) o en manga ha sido validada como un procedimiento bariatrico efectivo para tratar pacientes con obesidad morbida. Se han descrito modificaciones anatomicas y fisiopatologicas en la union esofago-gastrica que pueden estar relacionados con patogenesis de la enfermedad por reflujo gastroesofagico. En este articulo se muestran los resultados de nuestra propia experiencia y de la literatura respecto de los cambios en la funcion esofagica y gastrica, la prueba de reflujo acido, los estudios endoscopicos y radiologicos en pacientes sometidos a GVT. Se concluye que la GVT puede presentar cambios anatomicos y fisiopatologicos que se asocian a la aparicion de enfermedad por reflujo gastroesofagico.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"7 1","pages":"480-487"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78531538","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}
Pub Date : 2018-09-20DOI: 10.4067/S0718-40262018000500399
Marta González-Andaluz, M. Fernández-Díaz, María Soledad Trugeda-Carrera
{"title":"Divertículo esofágico secundario a peristalsis hipertensiva severa","authors":"Marta González-Andaluz, M. Fernández-Díaz, María Soledad Trugeda-Carrera","doi":"10.4067/S0718-40262018000500399","DOIUrl":"https://doi.org/10.4067/S0718-40262018000500399","url":null,"abstract":"","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"55 1","pages":"399-399"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83860352","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}
Pub Date : 2018-09-20DOI: 10.4067/s0718-40262018000500456
Jesús Morales Maza, Ó. Santes, U. Clemente-Gutiérrez, R. Cortés
Aim: To report a clinical case of metastatic fibrolamellar hepatocarcinoma and its multidisciplinary management. Case report: 24 year-old patient with abdominal pain, bloating and fever. A computed tomography of the abdomen was performed; an irregular hepatic tumor was found. A laparotomy was performed with evidence of multiple implants in the abdominal cavity and the histopathology report was metastatic fibrolamellar hepatocarcinoma. It was decided to perform cytoreductive surgery plus HIPEC. The patient´s survival was 11 months. Discussion: Fibrolamellar hepatocarcinoma is a rare tumor. There is still no consensus on the treatment of choice in patients with metastases with good functionality status. Current management is based on systemic chemotherapy and surgical resection in localized cases. In the case of our patient, cytoreductive surgery plus HIPEC was performed with the intention of improving survival. More evidence is needed to define this strategy as standard treatment.
{"title":"Mujer joven con hepatocarcinoma fibrolamelar metastásico; citorreducción y HIPEC. A propósito de un caso","authors":"Jesús Morales Maza, Ó. Santes, U. Clemente-Gutiérrez, R. Cortés","doi":"10.4067/s0718-40262018000500456","DOIUrl":"https://doi.org/10.4067/s0718-40262018000500456","url":null,"abstract":"Aim: To report a clinical case of metastatic fibrolamellar hepatocarcinoma and its multidisciplinary management. Case report: 24 year-old patient with abdominal pain, bloating and fever. A computed tomography of the abdomen was performed; an irregular hepatic tumor was found. A laparotomy was performed with evidence of multiple implants in the abdominal cavity and the histopathology report was metastatic fibrolamellar hepatocarcinoma. It was decided to perform cytoreductive surgery plus HIPEC. The patient´s survival was 11 months. Discussion: Fibrolamellar hepatocarcinoma is a rare tumor. There is still no consensus on the treatment of choice in patients with metastases with good functionality status. Current management is based on systemic chemotherapy and surgical resection in localized cases. In the case of our patient, cytoreductive surgery plus HIPEC was performed with the intention of improving survival. More evidence is needed to define this strategy as standard treatment.","PeriodicalId":49615,"journal":{"name":"Revista Chilena De Cirugia","volume":"1 1","pages":"457-459"},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76247912","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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