ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Appendectomy , Appendicitis/surgery , Calculi/complications , Cecal Diseases/complications , Diverticulum/complications , Calculi/diagnosis , Cecal Diseases/diagnosis , Diverticulum/diagnosis , Incidental Findings , Intraoperative PeriodSubject(s)
Appendectomy/adverse effects , Appendicitis/surgery , Cholecystitis/etiology , Acute Disease , Child , Female , HumansABSTRACT
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Subject(s)
Humans , Female , Child , Appendectomy/adverse effects , Appendicitis/surgery , Cholecystitis/etiology , Acute DiseaseABSTRACT
Renal paratransplant hernia constitutes an unusual variant of internal hernia caused by entrapment of bowel through a defect in the peritoneum covering the transplanted kidney. Only three cases have been previously reported. We present three new cases of renal paratransplant hernia. Abdominal pain and vomiting were the main symptoms. Clinical diagnosis of bowel obstruction and paratransplant hernia was reached using abdominal CT scan. All patients underwent an emergency surgical procedure, and one patient needed resection of necrotic bowel. The three patients survived owing to early surgical intervention, and they were discharged asymptomatic. Paratransplant hernia represented 1.1% of our series of transplant patients. Early diagnosis and surgical treatment are esential in transplant patients with bowel obstruction to avoid high morbidity and mortality rates.
Subject(s)
Abdominal Pain/diagnosis , Hernia/etiology , Kidney Transplantation/adverse effects , Adult , Female , Humans , Male , Middle Aged , Postoperative Complications/diagnosisSubject(s)
Emphysema/chemically induced , Emphysema/pathology , Hallucinogens/adverse effects , Mediastinal Emphysema/chemically induced , Mediastinal Emphysema/pathology , N-Methyl-3,4-methylenedioxyamphetamine/adverse effects , Uterine Cervical Diseases/chemically induced , Uterine Cervical Diseases/pathology , Adult , Female , Humans , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Male , Female , Adult , Humans , Mediastinal Emphysema/etiology , 3,4-Methylenedioxyamphetamine/adverse effects , Subcutaneous Emphysema/etiology , Designer Drugs/adverse effects , Substance-Related Disorders/diagnosisABSTRACT
OBJECTIVE: Total gastrectomy for advanced gastric cancer is frequently combined with extended lymphadenectomy. This technique is easier when resection of distal pancreas and/or spleen is performed. We have tried to evaluate whether the resection of both structures and total gastrectomy in patients with advanced gastric cancer actually improve survival rates. PATIENTS: From 1991 to 1999, 140 patients with advanced gastric cancer underwent total gastrectomy at the General Hospital of Albacete: 43 with simple total gastrectomy, 57 with total gastrectomy plus splenectomy and 40 with total gastrectomy plus distal pancreaticosplenectomy. Univariate and multivariate analysis were conducted in order to evaluate different prognostic factors and survival curves among the groups. RESULTS: Survival rates of the three groups were compared for each factor, being only significant variables the degree of tumor infiltration in the gastric wall, the size of the tumor, the staging and the type of lymphatic infiltration. Neither splenectomy nor distal pancreaticosplenectomy improved the survival compared to simple total gastrectomy. Morbimortality rates increased with more aggressive surgical procedures, but differences were not significant. CONCLUSIONS: Resection of distal pancreas and/or spleen plus total gastrectomy for advanced gastric cancer is associated to a greater number of isolated lymph nodes, but do not improve the survival of patients.
Subject(s)
Gastrectomy/methods , Pancreatectomy/methods , Splenectomy/methods , Stomach Neoplasms/surgery , Aged , Analysis of Variance , Female , Gastrectomy/mortality , Humans , Lymph Node Excision/mortality , Male , Middle Aged , Pancreatectomy/mortality , Splenectomy/mortality , Stomach Neoplasms/mortality , Survival RateABSTRACT
Objetivo: la gastrectomía total en el cáncer gástrico avanzado, es asociada a una linfadenectomía extendida en gran parte de los casos. Esta técnica se ve facilitada si se practica una resección del páncreas distal y/o del bazo. Intentamos analizar si la resección de una o ambas estructuras junto a la gastrectomía total en el cáncer gástrico avanzado, mejoraba realmente el pronóstico de los pacientes. Pacientes: desde 1991 a 1999 se han realizado 140 gastrectomías totales por cáncer gástrico avanzado en el Hospital General de Albacete: 43 mediante gastrectomía total simple, 57 mediante gastrectomía total con esplenectomía y 40 mediante gastrectomía total con pancreatectomía distal y esplenectomía. Un análisis univariante y multivariante permitió analizar los diferentes factores pronósticos y las curvas de supervivencia entre los grupos. Resultados: se comparó la supervivencia de cada grupo para cada factor analizado resultando sólo variables significativas el grado de infiltración tumoral en la pared gástrica, el tamaño del tumor, el estadiaje y el tipo de infiltración linfática. Ni la esplenectomía ni la pancreaticoesplenectomía distal mejoró la supervivencia con respecto a la gastrectomía total simple. La morbi-mortalidad fue mayor en los pacientes con cirugía más agresiva pero sin valor significativo. Conclusiones: la resección de bazo y/o páncreas distal en la gastrectomía total por cáncer gástrico avanzado conlleva un mayor número de ganglios aislados pero no influye en la supervivencia de los enfermos (AU)
Subject(s)
Middle Aged , Aged , Male , Female , Humans , Splenectomy , Survival Rate , Pancreatectomy , Analysis of Variance , Lymph Node Excision , Gastrectomy , Stomach NeoplasmsABSTRACT
OBJECTIVE: Many different hepatobiliary diseases have been related with ulcerative colitis. In this retrospective study we tried to determine whether colectomy involves a greater risk of postoperative cholecystitis in these patients than in other patients who undergo colectomy. METHODS: From 1990 to 1998 a total of 53 subtotal or total colectomies were carried out in our hospital. 35.8% of the operations were done for ulcerative colitis (group I), 58% for cancer, 1.8% for aganglionic megacolon, and 3.6% for volvular disorders (group II). RESULTS: In group I, 21% of the patients required reoperation because of postoperative acute cholecystitis. In group II there were no cases of acute cholecystitis. Neither parenteral nutrition nor diabetes were influential factors. 94.5% of the patients in group I had emergency surgery, while emergency surgery was necessary in only 38.2% of the patients in group II. CONCLUSIONS: Acute cholecystitis after colectomy for ulcerative colitis, especially when the latter arises in an emergency situation, is a common complication. Although the sample was small, the results show that in view of the mortality from cholecystitis, prophylactic cholecystectomy may be necessary.
Subject(s)
Cholecystitis/etiology , Colectomy/adverse effects , Colitis, Ulcerative/surgery , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk FactorsABSTRACT
OBJETIVO: una gran variedad de enfermedades hepatobiliares han sido relacionadas con la colitis ulcerosa. En este estudio retrospectivo intentamos demostrar si en estos pacientes la colectomía conlleva un mayor riesgo de desencadenar colecistitis aguda en el postoperatorio que en otro tipo de pacientes colectomizados. PACIENTES: en el período de 1990 a 1998 hemos realizado en nuestro hospital un total de 53 colectomías subtotales o totales, de las cuales el 35,8 por ciento corresponden a colitis ulcerosa (grupo l), el 58,5 por ciento a cirugía neoplásica, el 1,8 por ciento a megacolon agangliónico y un 3,6 por ciento a patología volvular, completando estos tres últimos el grupo II. RESULTADOS: en el grupo 1 encontramos que el 21 por ciento tuvieron que ser reintervenidos por colecistitis aguda en el postoperatorio; por el contrario, en el grupo Il no se encontró ningún caso de colecistitis aguda. Ni el factor nutrición parenteral ni la diabetes fueron factores influyentes. El 94,5 por ciento de los pacientes del grupo I se operaron de forma urgente por sólo 38,2 por ciento de los enfermos del grupo II. CONCLUSIONES: la colecistitis aguda tras colectomía por colitis ulcerosa, sobre todo si se efectúa de forma urgente, es una complicación frecuente. Aunque la muestra es pequeña, los resultados indican, dada su mortalidad, que puede ser necesaria la colecistectomía profiláctica (AU)
