ABSTRACT
INTRODUCTION: Subtotal cholecystectomy has been employed in cases of tecnically difficult cholecystectomy to prevent common bile duct injury. Given that there are few reports in Mexico on the theme, we consider it important to present the 18-year experience of a surgical group in the South-Southeast of Mexico. AIM: To determine the safety of laparoscopic subtotal cholecystectomy in patients with acute cholecystitis. MATERIALS AND METHODS: A retrospective, observational, and comparative study was conducted on patients with gallstones that underwent laparoscopic cholecystectomy. The variables analyzed were: anthropometric characteristics, comorbidities, conversion rate, surgery duration, hospital stay, and morbidity and mortality. STATISTICAL ANALYSIS: Descriptive statistics were applied through measures of central tendency and dispersion and standard deviation, utilizing the SPSS v22 program. RESULTS: A total of 1,101 medical records of patients with gallstones were reviewed. Of those patients, 223 presented with acute cholecystitis (20.25%) and they were divided into 2 groups: A) total cholecystectomy (82.95%) and B) subtotal cholecystectomy (17.05%). The anthropometric characteristics, risk factors, conversion rate, and hospital stay were similar in both groups. Only surgery duration was longer in the subtotal cholecystectomy group. Complications were more frequent, there was 1 death, and there was no bile duct injury in the subtotal cholecystectomy group. Those results were not statistically significant between the two groups. CONCLUSIONS: Subtotal cholecystectomy is a valuable resource in patients with acute cholecystitis. In our case series, it was a safe and reliable procedure for preventing bile duct injury. A larger number of cases are needed to corroborate those results.
Subject(s)
Cholecystectomy, Laparoscopic/methods , Cholecystitis, Acute/surgery , Adult , Aged , Aged, 80 and over , Cholecystectomy, Laparoscopic/adverse effects , Female , Humans , Male , Mexico , Middle Aged , Retrospective StudiesSubject(s)
Laryngeal Neoplasms/surgery , Sarcoma/surgery , Adult , Aged , Aged, 80 and over , Cohort Studies , Disease-Free Survival , Female , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/pathology , Male , Mexico , Middle Aged , Sarcoma/mortality , Sarcoma/pathology , Survival Rate , Treatment Outcome , Young AdultABSTRACT
Objetivos: (1) diseñar y evaluar una técnica de angiorresonancia 3D contrastada (ARM 3D) para el diagnóstico de la estenosis carotídea y compararla con la ecografía triplex (eco triplex) y la arteriografía por sustracción digital (ASD), esta última como estándar de referencia. (2) Evaluar la factibilidad de adicionar a la técnica anterior secuencias anatómicas y angiográficas del cerebro. Materiales y métodos: en 39 pacientes (78 carótidas) se estudió la bifurcación carotídea con ASD, angiorresonancia 3D con doble inyección y eco triplex. Se utilizó el método descrito en el estudio NASCET para cuantificar el grado de estenosis. Cada examen fue evaluado por observadores diferentes que no conocían el resultado de los otros métodos. Adicionalmente, se obtuvieron imágenes del cerebro y se describieron dichos hallazgos. Resultados: la angiorresonancia 3D con técnica de doble inyección detectó el 98 por ciento del grupo de carótidas clasificadas como normal-leves, el 83 por ciento de las estenosis moderadas, el 88 por ciento de las estenosis graves y el 100 por ciento de las oclusiones. Adicionalmente, dos errores diagnósticos (oclusiones falsas) de la ASD fueron identificados efectivamente por la ARM 3D. La eco triplex detectó el 92 por ciento del grupo normal-leve, el 33 por ciento de las estenosis moderadas, el 86 por ciento de las graves y todas las oclusiones encontradas con la ASD, pero la ecografía sobrestimó una estenosis leve a oclusión (falsa oclusión). La correlación estadística entre el estándar de referencia ASD y la ARM 3D fue buena a excelente, para los diferentes grados de estenosis (K>0,7 y K>0,9, respectivamente). En todos los pacientes se logró una evaluación adecuada del cerebro con resonancia. Conclusión: esta investigación sugiere que la ARM 3D con técnica de doble inyección tiene el potencial para remplazar la ASD en el diagnóstico y seguimiento de la enfermedad carotídea
Subject(s)
Magnetic Resonance Spectroscopy/methods , Magnetic Resonance Spectroscopy , Carotid Artery Thrombosis/diagnosis , Carotid Artery ThrombosisABSTRACT
The increasing application of light in new medical treatments has led to the need for optical characterization of tissues in order to obtain correct dosimetry. This study presents the results of measurements of the optical penetration depth of different human tissues based on the diffusion approximation of the transport theory of light.
Subject(s)
Light , HumansABSTRACT
A toughened hydroxyapatite (HA) ceramic has been obtained through the incorporation of magnesia partially stabilized zirconia (Mg-PSZ) under uniaxial pressing and sintering in wet oxygen at 1250 degrees C for 4 h. The powder X-ray diffraction (XRD) patterns and infrared spectra (FT-IR) show that HA is the only calcium phosphate phase present. The composite (MgPSZ-HA) has a density of 94% the theoretical value. The bending strength and the fracture toughness are around 50% higher for Mg-PSZ reinforced than for HA. The grain size and the fracture surface were studied by scanning electron microscopy (SEM). The influence of the Mg-PSZ particles on the fracture mechanism of the HA ceramic is discussed.
ABSTRACT
A classical abdominal Semm hysterectomy (CASH) morcellation laparoscopic hysterectomy was performed without bilateral salpingo-oophorectomy in 17 patients using 4 punctures with intracorporeal and extracorporeal suturing in 13 patients and in 4 patients with stapler of 35 mm. Removal of endocervical and endometrial canal through vaginal morcellation, the advantages of this procedure are its reduced blood loss, minimum possibility of ureter or bladder injury and decreased risk of infection through vaginal contamination, as well as a fast recovery period and minimum of pain.
Subject(s)
Hysterectomy/methods , Laparoscopy , Adult , Evaluation Studies as Topic , Female , Humans , Middle Aged , Pain, Postoperative/prevention & control , Surgical Staplers , Suture TechniquesABSTRACT
Laparoscopy was performed on patients with dysmenorrhea, sterility and pelvic pain in order to evaluate the prevalence of endometriosis in our environment therefore considering the population of female beneficiary patients of reproductive age of the ISSSTE hospital in the city of Veracruz, Ver. in México. The percentages of endometriosis were similar to the reports published in the international journals with the exception of the dysmenorrhea where our results were higher. In all the cases the same variables were analyzed; age, active sexual life (V.S.A.), birth control method, menarche (men), menstrual cycle, childbirths and abortions, as well as other laparoscopic detections. Each of the endometriosis cases were classified according to the revised American Fertility Society classification of 1985 (R.A.F.S.) for endometriosis.