[Neonatal stage IV and IVs neuroblastoma: surgical treatment with silo and liver reduction]. / Neuroblastoma neonatal estadio IV y IVs: Tratamiento quirúrgico con silo y reducción hepática.

UNLABELLED: Hepatic metastases of neonatal neuroblastoma can cause multiple organ failure due to rapid growth and severe hepatomegaly. The objective of this work is to present two infants with neuroblastoma stage IV and IVs in a critical situation that needed a decompressive abdominal silo and surgical liver reduction for definitive abdominal closure. Currently both children are 6 years old and they are free from disease. CONCLUSION: The placement of a silo for abdominal decompression is still an indication for salvage. Surgical hepatic reduction is an alternative for the early closure of the abdomen avoiding complications due to infection or dehiscence of the silo.

Inguinal cordopexy: a simple and effective new technique for securing the testes in reoperative orchiopexy.

BACKGROUND/PURPOSE: A new procedure is described for securing the testis in the scrotum in patients with a past history of inguinal sugery and testes in an unsatisfactory position. METHODS: Twenty-seven patients with 29 abnormally positioned testes (two bilateral) were evaluated. All patients had a past history of inguinal surgery, and ages ranged between 4 and 16 years (mean, 7.2). Previous surgical procedures included 23 orchiopexies, 4 inguinal herniorrhaphies, and 2 testicular detorsions of undescended testis. In all reoperations an attempt was made to fix a strip (two nonabsorbable stitches) of the fascia attached to the cord, to the pubic bone, or to the tendinosous part of the gracilis muscles (cordopexy), so that the distal part of the cord and the testis lay freely in the scrotum without tension. Patients underwent follow-up every 6 months after the operation with physical and ultrasound examinations. RESULTS: Cordopexy was possible in 11 (38%) of the 29 inguinal reoperations. In all cases, orchiopexy was the previous surgical procedure. One hundred percent of the testes remain within the scrotum after a mean follow-up of 21 months (range, 8 to 38). CONCLUSION: When feasible, inguinal cordopexy is a simple and effective technique for securing testicles in reoperative orchiopexy procedures.

[Achalasia of the esophagus]. / Acalasia del esófago.

Thirty-two cases of achalasia of the esophagus are studied in retrospect. The evolution was carried on from different standpoints: clinical, radiological, endoscopic, and motility studies. Patients were treated by dilatation (either pneumatic or mercury bougies) or surgery. The result of treatment was evaluated from the clinical standpoint correlating it with the remaining studies in order to establish wether or not they were related.

[Benign stenosis of the esophagus]. / Estenosis benigna de esófago.

In the present study 39 patients with benign esphageal stenosis were studied (average age 59,9 years). The most common etiology was refux esofagitis, and the most common associated pathology was esophageal hiatus hernia. Thirty one patients received medical treatment (diet. antireflux drugs and dilatations.) Twenty four were dilated with the slow continuous method, six with metalic bougies. One patient was not dilated. Seven patients were not treated since the stenosis was due to extrinsec compression. One patient was surgically treated from the onset. Seventy percent of the patients had goods results with esophageal dilatation. We propose that patients with benign esophageal stenosis should be treated by the slow continuous dilatation method.

[Cimetidine in the treatment of the active duodenal ulcer]. / Cimetidina en el tratamiento de la úlcera duodenal activa.

Thirty six patients with active duodenal ulcers were studied in this double blind work. 19 received placebo and 17 Cimetidine: 1 gr./day. The endoscopic control after 21 days, showed healing in 81,2% of the cases treated with Cimetidine and in 22,2% of those with placebo. After 42 days of continous treatment with Cimetidine the healing of duodenal ulcers was 82,3% against 50% with placebo; the difference being highly statestically significant; p less than 0.01. The symptoms improved with Cimetidine revealing less diurnal and nocturnal pain complete disappearance of nausea and vomit and a significant decreased ingestion of alkali tablets.

Cordopexias en reintervenciones por criptorquidia / Cordopexy in reoperation for cryptorchidia

Se presenta la técnica de cordopexia para la fijación testicular en reintervenciones por criptorquidia.Se indica el procedimiento cuando existen firmes adherencias entre la aponeurosis del oblicuo mayor y el cordón espermático.En un período de 2 años se realizaron 11 intervenciones de las cuales en 4 se utilizó esta técnica.En los cuatro pacientes los controles mostraron que el testículo permanecía en escroto