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1.
Surg Innov ; 21(1): 39-42, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22410391

RESUMO

INTRODUCTION: Appendectomy is performed on almost 700 000 patients per year in the European Community, rendering it the most common acute surgical procedure. Since the introduction of laparoscopic surgery, there has been increased interest in carrying out procedures with fewer incisions and less ports. MATERIALS AND METHODS: After the inception of single-port access, it is possible to insert into the abdominal cavity multiple instruments through a single device. A total of 15 patients--mean age 22 years and mean body mass index 27 kg/m(2)--with acute appendicitis were included in this study. RESULTS: Mean operative time was 35 minutes with no conversions. Local suction drain was needed in 2 patients. Mean hospital stay was less than 24 hours with no complications. CONCLUSION: Single-port suprapubic appendectomy is feasible and safe, and can allow a more direct vision of the operating field depending on the position of the appendix and presents good cosmetic and postoperative outcomes.


Assuntos
Apendicectomia/métodos , Apendicite/cirurgia , Laparoscopia/métodos , Adolescente , Adulto , Drenagem , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Resultado do Tratamento
2.
Cir Esp ; 87(5): 293-8, 2010 May.
Artigo em Espanhol | MEDLINE | ID: mdl-20381796

RESUMO

INTRODUCTION: The appearance of single transumbilical incision surgery has opened a new era in the minimally invasive approach of cholecystectomy. Specific ports for this technique have made it easier to perform. We report our initial experience, from July 2008 to June 2009 and give an updated bibliographic review. PATIENTS AND METHODS: A prospective, longitudinal and interventional study that included 30 patients with symptomatic cholelithiasis, from 10 July 2008 to 30 June 2009, on whom a single transumbilical incision laparoscopic cholecystectomy was performed (LESS technique), without other minilaparoscopic ports or traction stitches. A gel port was used for all surgeries (R-Port, Tri-Port), as well as straight and roticulating laparoscopic graspers. Surgical time, analgesia requirements, postoperative hospital stay, conversions and complications were registered. RESULTS: The median age was 34.8 years (range, from 21 to 53), with a BMI between 21 kg/m(2) and 39.5 kg/m(2) (mean 25.8 kg/m(2)). Surgical time was 65.1 minutes (ranging from 40 to 150) and postoperative length stay was less than 24 hours. Postoperative pain was measured with the VAS scale, giving a low score. Up to now, two wound infections and a bile leak have been observed. CONCLUSIONS: LESS cholecystectomy is a safe and feasible technique performed by experienced surgeons in minimally invasive surgery, and requires a greater learning curve than that of the conventional laparoscopic cholecystectomy.


Assuntos
Colecistectomia Laparoscópica/métodos , Colelitíase/cirurgia , Cordão Umbilical/cirurgia , Géis , Humanos
3.
Medwave ; 17(6): e7007, 2017 Jul 31.
Artigo em Espanhol | MEDLINE | ID: mdl-28777782

RESUMO

There are no approved therapeutic regimes for adrenal carcinoma following progression to a first line of chemotherapy/mitotane although a high percentage of patients are candidates to receive them. In the present article we review the possible therapeutic alternatives after the progression to a first line of treatment in patients with adrenal carcinoma and we report a case in which a prolonged overall survival is achieved, much higher than expected, probably in relation to the multidisciplinary management of the case and the use of most of the therapeutic arsenal available.


En el carcinoma suprarrenal metastásico no existen esquemas de tratamiento aprobados tras la progresión a una primera línea de quimioterapia/mitotane, si bien un alto porcentaje de pacientes son candidatos a recibirlos. En este artículo realizamos una revisión sobre las posibles alternativas terapéuticas tras la progresión a una primera línea de tratamiento en pacientes con carcinoma suprarrenal metastásico. A propósito de la misma, se presenta un caso clínico en el que se consigue una prolongada supervivencia global, mucho mayor de la esperable, probablemente debido al manejo multidisciplinario del caso y a la utilización de la mayor parte del arsenal terapéutico disponible.


Assuntos
Neoplasias do Córtex Suprarrenal/tratamento farmacológico , Carcinoma Adrenocortical/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Córtex Suprarrenal/patologia , Carcinoma Adrenocortical/patologia , Adulto , Humanos , Masculino , Mitotano/administração & dosagem , Cuidados Paliativos/métodos , Equipe de Assistência ao Paciente/organização & administração , Taxa de Sobrevida
5.
Med. UIS ; 24(3): 297-300, sept.-dic.2011. ilus
Artigo em Espanhol | LILACS | ID: lil-684222

RESUMO

El tumor de células granulares es una neoplasia infrecuente, generalmente benigna, que suele afectar cara y cuello. Aparece entre la segunda y la sexta década, más frecuentemente en la raza negra y en mujeres. El 25% de los casos presenta lesiones múltiples. El único tratamiento es quirúrgico. Un varón de 17 años presentó una lesión nodular única epitroclear en el codo derecho. Se realizó una escisión amplia y el resultado anatomopatológico fue un tumor de células granulares. Tras un seguimiento de seis meses no hay evidencia de recidiva. La patogénesis debe ser claramente establecida, aunque la literatura sostiene la hipótesis de que tiene su origen en las células de Schwann. Los autores subrayan la peculiaridad de la localización epitroclear y discuten la clasifi cación, fi siopatología y el tratamiento del tumor con una revisión de la literatura.


Granular cell tumor is an infrequent neoplasm, benign in most of the cases, that usually affects head and neck. It develops between the second and sixth decades of life, more frequently among women and black people. 25% of the cases occur as multiple lesions. The only treatment is surgery. A 17- year old male presented a nodular, single and fi rm epithroclear lesion in his right elbow. A wide surgical excision was performed and the fi nal pathologic diagnosis was granular cell tumor. During follow-up of six months there is no evidence of tumour recurrence. The pathogenesis of the tumor has still to be clearly established, although literature sustains the hypothesis that it has origin in the Schwann ́s cells. The authors underscore the peculiarity of the epithroclear localization and discuss the classifi cation, pathophysiology and the treatment of Abrikossoff ́s tumor through a review of the literature.


Assuntos
Tumor de Células Granulares , Imuno-Histoquímica , Neoplasias
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