Cirugia y cirujanos最新文献

Objective: To organize the experience and international knowledge in the surgical management and staging of colorectal endometriosis, with a management proposal in stages.

Method: An extensive non-systematic review of the literature was carried to organize the disease in stages (limited, intermediate and advanced) according to a scoring system, which considers the characteristics of the endometrioma, the personal history and surgical findings. We tested the proposed staging in a retrospective group of patients.

Results: From January 2017 to April 2023, we collected 19 patients with a confirmed diagnosis of colorectal endometriosis, treated laparoscopically, by the same group of surgeons, in whom we found a strong correlation between the stage of the disease and the presence of complications that required reinterventions.

Conclusions: We suggest a sequence of colorectal surgical management in stages according to the staging of the disease and we hope that this work will be followed by joint efforts to test it prospectively in order to compare results between hospital centers and make planned decisions.

Objective: This study aims to compare the effects of microscopic microdiscectomy and microendoscopic discectomy on pain, disability, fear of falling, kinesiophobia, anxiety, quality of life in patients with lumbar disc herniation (LDH).

Methods: A total of 90 patients who underwent microscopic microdiscectomy (n = 40) and microendoscopic discectomy (n = 50) for LDH were included in this study. The patients' pain, disability, fear of falling, kinesiophobia, anxiety, and quality of life were evaluated before the surgery, in the early postoperative period and three months after.

Results: In patients who underwent microendoscopic discectomy, the results of pain, disability, fear of falling, kinesiophobia and anxiety were statistically decreased compared with the microscopic microdiscectomy in the early postoperative period and three months later (p < 0.05). Also, a statistically higher increase was observed in the general health perception of patients who underwent microendoscopic discectomy three months after the operation (p < 0.01).

Conclusion: Microendoscopic microdiscectomy, remains the most effective and widely applied method with advantages on pain, quality of life, and improved physical functions.

Objective: Determine the life expectancy in the covered population of the Institute of Security and Social Services of State Workers in México for 2021.

Method: We used the abrogated method from Reed-Merrel, for calculate the life expectancy in age groups.

Results: By 2021, life expectancy general was 79.51 years; 81.40 years and 78.91 years for woman and men, respectively.

Conclusions: The calculated life expectancy not show a reduction in the population of federal and State employees in Mexico.

Objective: This study aimed to evaluate the value of platelet activation markers in predicting preeclampsia and its severity. Preeclampsia is a serious pregnancy complication that affects 3-5% of pregnancies and can lead to significant morbidity and mortality for both the mother and the fetus.

Methods: The study included 99 patients diagnosed with preeclampsia and 60 healthy pregnant women as a control group. Platelet activation markers such as mean platelet volume (MPV), platelet distribution width (PDW), platelet count, and plateletcrit were evaluated along with other clinical parameters.

Results: The results of the study showed that platelet activation markers, particularly PDW and MPV, are valuable in the diagnosis and follow-up of preeclampsia. However, they are not sufficient to predict the severity of the disease.

Conclusion: The study suggests that platelet activation markers could aid in predicting, diagnosing, and managing preeclampsia. However, further research is needed to determine the role of these markers in predicting the severity of the disease. The findings of this study could contribute to the development of more effective strategies for the prevention and management of preeclampsia, which could ultimately improve maternal and fetal outcomes.

Objective: The aim of this study is to describe the effectiveness and safety of a magistral formulation of diltiazem 2% rectal gel as a treatment for chronic anal fissure.

Material and methods: A retrospective observational study of all patients that began treatment with diltiazem 2% gel during 2019. The primary endpoint of the study was anal fissure healing. We also looked for differences in effectiveness between those initiating treatment and those who had been previously treated, long-term effectiveness through a 2-year follow-up and frequency of adverse effects.

Results: Of the 166 patients included in the study, anal fissure healed in 72.9%. We detected adverse effects in 12 patients, the most common was local irritation. After 2 years of follow-up, 88% of patients did not relapse.

Conclusion: In this study, use of topical diltiazem 2% has been shown to be effective and safe in the treatment of anal fissure and should be considered as the first line of therapy.

Wernicke encephalopathy, which is caused by a thiamine deficiency, occurs in 0.8-2% of the population. Only 16% present the typical triad of this disease: nystagmus, confusion and ataxia. We present the case of a postoperative patient with a one anastomosis gastric bypass with reoperation undergoing a Roux-en-Y gastric bypass that begins with confusion and nystagmus on her third postoperative day. The diagnosis of Wernicke encephalopathy is made by imaging, and vitamin B1 is administered with total improvement of nystagmus and altered state of consciousness (lethargy, bradypsychia, bradylalia).

Introduction: Gastrointestinal stromal tumors (GIST) are rare, reported incidence is between 10 to 15 cases per million of habitants. They are usually located in the stomach (56%), small intestine (32%), colon-rectum (6%), and esophagus (<1%). Its symptoms include nausea, vomiting and abdominal fullness; 30% are asymptomatic. Incidental finding during abdominal surgery or imaging studies is common. Resection with negative margins is the standard treatment.

Case report: A 69-year-old female patient who debuted with massive digestive tract bleeding, requiring surgical treatment. A tumor was detected at jejunum compatible with a GIST.

Objective: The objective of the study is to evaluate combined hyperbaric oxygen therapy (HBOT) and steroids on hearing in sudden sensorineural hearing loss (SSNHL) patients.

Method: A total of 50 patients with sudden hearing loss that started within 1 week and who received a combination of intravenous steroid therapy and HBOT in their medical treatment were assigned to the otolaryngology department for 1 week, followed by intravenous steroid therapy at 1 mg/kg/day and then reduced doses for 1 week. They were treated once in a hyperbaric chamber where they breathed 100% oxygen at 2.5 atm pressure for 60 min, for a total of 20 sessions.

Results: Hearing loss was observed in 54% of participants in the right ear. Significant improvements were observed in hearing thresholds across all tested frequencies after treatment with a specific intervention (p < 0.001 for each comparison). Combined steroid and HBOT significantly improved hearing across low and high frequencies (p < 0.001). Improvement in hearing at low frequencies was significantly greater than at high frequencies (p < 0.01). Post hoc analysis showed greater hearing improvement at lower frequencies compared to higher ones.

Conclusions: This study demonstrated that combined steroid and HBOT significantly improves hearing thresholds in patients with idiopathic SSNHL, especially at lower frequencies.