RESUMEN
BACKGROUND: Textile materials of surgical origin are found in the abdominal cavity in between 1/1300 and 1/1500 laparotomies, in spite of preventive measures. It is very difficult to ascertain the exact incidence due to the lack of descriptions in the literature. METHODS: Fourteen cases of postoperative foreign bodies or textilomas are reported. The cases were collected from two hospital centers between 1985 and 1997. RESULTS: There were 12 intra-abdominal cases, 1 thoracic and 1 paravertebral. In 8 (57.1%) diagnosis was made preoperatively by radiological techniques. The mortality rate was 14.2% with 2 deaths due to multiorganic failure in one case and sepsis in the other. Both patients were over 70, with malignant pathology. The morbidity rate was 21.4%, wall abscesses which evolved favorably being the most frequent cause of complications. CONCLUSIONS: Prevention of this complication is the best treatment. It is advisable to use textile material with radiopaque contrast, to count the pieces of material to be used and perform an X-ray before the laparotomy is closed specially in emergency (bleeding and trauma patients) because in these complex cases the possibility of material being left behind is more advisable.
Asunto(s)
Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/cirugía , Complicaciones Posoperatorias/etiología , Textiles , Adulto , Anciano , Femenino , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/mortalidad , Humanos , Enfermedad Iatrogénica , Laparoscopía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Resumen. Pese a las preocupaciones e incertidumbres iniciales respecto a las resecciones pulmonares mayores por cirugía torácica videoasistida, esta técnica ha demostrado ser una opción válida en el tratamiento del carcinoma broncogénico de células no pequeñas en estadios iniciales. Tanto la lobectomía como la linfadenectomía mediastínica por cirugía mínimamente invasiva son técnicamente factibles y seguras. No se aprecia un aumento de las tasas de morbi-mortalidad. Asimismo, la técnica permite mantener los principios oncológicos, logrando buenos resultados reflejados en supervivencias similares o incluso superiores a las alcanzadas por cirugía abierta. Pese a estos resultados, aún está muy poco extendida en la práctica quirúrgica habitual de los servicios de Cirugía Torácica. Por lo tanto, dado que se trata de una técnica factible, segura y con buenos resultados oncológicos, debería comenzar a ser una práctica rutinaria en aquellos centros en que pueda iniciar un programa de lobectomía por cirugía mínimamente invasiva (AU)
Abstract. In spite of the initial concerns and uncertainty regarding major lung resections by video-assisted thoracic surgery, this technique has been demonstrated to be a valid option in the treatment of non-small cell bronchogenic carcinoma in initial stages. Both the lobectomy and the mediastinic lymphadectomy by minimally invasive surgery are technically feasible and safe. No increase in the rates of morbidity-mortality is observed. Furthermore, the technique makes it possible to maintain the oncological principles, achieving good results reflected in similar or even greater survivals than those reached by open surgery. In spite of these results, it is still not very extended in the usual surgical practice of the Thoracic Surgery services. Therefore, given that it is a feasible and safe technique with good oncological results, it should begin to become a route practice in those sites that can initiate a program of lobectomy by minimally invasive surgery (AU)