Pharmacokinetics of tildipirosin in estuarine (Crocodylus porosus) and freshwater (Crocodylus siamensis) crocodiles.

Tildipirosin is a macrolide antimicrobial. It is authorised for the treatment and prevention of respiratory disease in cattle and pigs. There are no data on its administration in crocodiles. Therefore, this study evaluated the disposition kinetics of tildipirosin after intravenous (dose: 2mg/kg) and intramuscular (doses: 2 and 4mg/kg) administration in two crocodilian species (estuarine and freshwater; (n = 5). Tildipirosin plasma concentrations were quantified by a validated HPLC method. Plasma concentrations obtained at each extraction time were analysed by non-compartmental methods. In the estuarine and freshwater crocodiles, the apparent volumes of distribution of tildipirosin after intravenous administration were 0.36 ± 0.10 and 1.48 ± 0.26L/kg, respectively. These values, suggesting poorer tissue distribution, were much lower than those obtained in mammals. There was complete bioavailability of tildipirosin after intramuscular route at a dose of 2mg/kg; however, at a dose of 4mg/kg the bioavailability decreased by about 20-25%. Furthermore, the pharmacokinetics of tildipirosin were markedly different in the two crocodilian species. Considering a MIC of 0.5µg/mL, the surrogate marker AUC0→24/MIC indicates that TD would greatly exceed the value of 65h for both crocodile species and dose levels tested. This suggests that both doses (2 and 4mg/kg) may provide a bactericidal effect. Therefore, based on the absence of adverse reactions following the administration of tildipirosin in both crocodilian species, and considering its favourable pharmacokinetic properties, tildipirosin may be useful in treating infections in these reptiles.

[Microscopy vs. molecular biology in the diagnosis of intestinal protozoal infections, is it time for a change?] / Microscopía vs. biología molecular en el diagnóstico de infecciones protozoarias intestinales, ¿es el momento del cambio?

OBJECTIVE: Microscopic examination of the intestinal parasites, from the patient's concentrated feces, has a lower sensitivity when compared to molecular diagnostic techniques. Therefore, the objective of this study has been to compare both techniques, as well as to evaluate whether there is a correlation between the microscopic examination and the threshold cycles (Ct) obtained for Blastocystis hominis. METHODS: Retrospective study of the samples received in the Microbiology laboratory during September 2021. The MiniParasep SF® concentration test was performed for microscopic visualization and then PCR was performed with the Seegene AllplexTM Parasite Assay panel. RESULTS: A 27% (n=74) of the samples were positive by molecular diagnosis, with a total of 87 parasites detected. 53% (n=39) were women with a mean age of 47 ± 24 years. In 76% (n=56) of the cases the service of origin was Primary Care. The most frequently found parasite was B. hominis, 85% (n=64), followed by Dientamoeba fragilis 20% (n=15) and Giardia lamblia 11% (n=8). Co-infection by two parasites was detected in 13 cases (B. hominis + D. fragilis in 6 cases, and B. hominis + G. lamblia in 7 cases). In the microscopic diagnosis, 9.5% (n=26) positivity was obtained. The most frequently found parasite was B. hominis, 84% (n=23), followed by G. lamblia, which was seen in three cases by microscopy. D. fragilis was not seen in any case. Coinfection of B. hominis + G. lamblia was observed in one sample. CONCLUSIONS: Techniques for molecular diagnosis of intestinal parasites are fast, reliable and more sensitive than microscopic techniques, improving microbiological diagnosis and quality of care.

Empiema necessitatis por Mycobacterium tuberculosis en Pediatría: Reporte de caso / Empyema necessitatis due to mycobacterium tuberculosis in pediatrics: case report

El empiema necessitatis es una entidad clínica poco frecuente en la población pediátrica, la principal etiología está asociada a infección por Mycobacterium tuberculosis, en pacientes inmunocompetentes o inmunosuprimidos, el diagnóstico principal debe realizarse de manera oportuna, buscando evitar complicaciones o lesiones permanentes en los pacientes que la padecen.(AU)

Empyema necessitatis is a rare clinical entity in the pediatric population, the main etiology is associated with infection by Mycobacterium tuberculosis, in immunocompetent or immunosuppressed patients, the main diagnosis must be made in a timely manner, seeking to avoid complications or permanent injuries in the patients who suffer from it.(AU)

Metal and metalloid pollution in shelf sediments from the Gulf of Cádiz (Southwest Spain): Long-lasting effects of a historical mining area.

The Gulf of Cádiz is an area historically affected by acid mine drainage and also by the discharge of two important rivers, the Guadiana and the Guadalquivir. Metal and metalloid (As, Cd, Hg, Pb, Zn, Cu, Cr, Ni, Mn, Fe, Al and Li) concentrations were measured in 33 surface sediment samples, collected in the continental shelf, inside the Ría de Huelva and the Bay of Cádiz, to assess the metal pollution status of this area. Geographical distribution was identified for different groups of metals: Cu, Cd, Zn, Hg and As were mainly associated with discharges of the Tinto and Odiel rivers, which have been historically affected by mining, into the Ría de Huelva. Sediments inside this Ría presented the highest concentrations of the whole area for these metals, and enrichment factors revealed that Hg and Cu pollution spread up to 20 km away from the mouth of this Ría, into the continental shelf. On the contrary, the distribution of Ni, Cr and Mn did not show a clear gradient with distance from a pollution source, and was mainly explained by geochemical factors, such as their association with fine materials. The comparison of metal concentrations with sediment quality guidelines, predicts that adverse ecological effects due to the metal pollution may be occurring in a group of stations located in the northwest corner of the studied area. Local background levels for metals in the Gulf of Cádiz were proposed and the information obtained will be useful to identify those areas where sampling must be intensified in ongoing Marine Strategy Framework Directive (MSFD) monitoring programs. These results corroborate that metal pollution is still a serious problem in the Gulf of Cádiz.

Terapia endovascular en trauma periférico: una alternativa a la cirugía abierta tradicional / Endovascular therapy in peripheral trauma: our experience

Resumen Introducción: La terapia endovascular ha demostrado ser una buena alternativa de tratamiento en las enfermedades arteriales y venosas. Asimismo, en trauma vascular periférico constituye una excelente opción, especialmente en sitios anatómicos difíciles de acceder y con lesiones complejas como seudoaneurismas, fístulas arteriovenosas (FAV) o la combinación de ambos, con numerosas ventajas. Objetivo: Evaluar los resultados del tratamiento endovascular en trauma vascular penetrante por agresiones y iatrogenias. Materiales y Método: Revisión retrospectiva de todos los pacientes con trauma vascular periférico sometidos a terapia endovascular. Resultados: Entre abril de 2011 y mayo de 2020 se trataron 30 pacientes, 28 hombres y 2 mujeres. Con edades fluctuantes entre 17 y 84 años. La causa del trauma fue 20 penetrantes y 10 iatrogenias. Los vasos afectados fueron arteria femoral superficial 6, femoral profunda 2, subclavia 9, axilar 1, poplítea 4, ilíacas 1, peronea 1, tibial anterior 5, tronco venoso braquiocefálico 1. Diecisiete pacientes fueron tratados con endoprótesis, 9 con embolización y 4 con cierre percutáneo en relación con catéteres arteriales en subclavia. No hubo mortalidad, pero dos pacientes requirieron reparación abierta: un seudoaneurisma poplíteo gigante y un seudoaneurisma de tibial anterior, en ambos se constató sección completa de ambas arterias. El seguimiento clínico ha sido entre 30 días y 3 años. Conclusiones: En esta serie de casos, la terapia endovascular en lesiones de trauma vascular periférico ofrece excelentes resultados con baja morbimortalidad y permeabilidad aceptable a corto y mediano plazo.

Introduction: Endovascular therapy has proven to be a good treatment alternative in arterial and venous diseases. Likewise, in peripheral vascular trauma it is an excellent option, especially in anatomical sites that are difficult to access and with complex lesions such as pseudoaneurysms, arteriovenous fistulas (AVFs) or the combination of both, with numerous advantages. Aim: To evaluate the results of endovascular treatment in trauma Penetrating vascular injury and iatrogenesis. Materials and Method: Retrospective review of all patients with peripheral vascular trauma undergoing endovascular therapy. Results: Between April 2011 and May 2020, 30 patients were treated, 28 men and 2 women. With fluctuating ages between 17 and 84 years. The cause of the trauma was 20 penetrating and 10 iatrogenic. The affected vessels were superficial femoral artery 6, deep femoral 2, subclavian 9, axillary 1, popliteal 4, iliac 1, peroneal 1, anterior tibial 5, brachiocephalic venous trunk 1. Seventeen patients were treated with endoprosthesis, 9 with embolization and 4 with percutaneous closure in relation to arterial catheters in the subclavian. There was no mortality but two patients required open repair: a giant popliteal pseudoaneurysm and an anterior tibial pseudoaneurysm in which both sections of both arteries were found to be complete. Clinical follow-up was between 30 days and 3 years. Conclusión: In this serie, endovascular therapy in peripheral vascular trauma lesions offers excellent results with low morbidity and mortality and acceptable patency in the short and medium term.

[Developmental care of premature newborns: Fundamentals and main characteristics]. / Cuidados del desarrollo en recién nacidos prematuros: Fundamentos y características principales.

Premature newborns, especially the extreme ones, need to be cared for in the different units in the neonatal services. In addition to ensuring the survival of these newborns, these services have gra dually incorporated interventions to promote their development. This review provides an updated synthesis of developmental-focused neonatal care. First, it describes the neurobiological theoretical foundations that explain how the so-called "neonatal stress" can affect the development of a prema ture child. Later, it reviews the Synactive Theory, which is one of the theoretical models that contri bute to understanding the characteristics of the care focused on development. Regarding this care, the evidence and challenges for implementing are described and addressed from a critical perspective, pointing out the strengths and weaknesses. This article highlights the importance of improving the quality of care that preterm newborns received in NICUs, promoting resilience and/or the best pos sible developmental potential in these children, in addition to strengthening the role of parents in neonatal care.

K-12 Health Education, Health Communication, and Health Literacy: Strategies to Improve Lifelong Health.

To promote a health literate K-12 population, this chapter focuses on intersections of Health Literacy (HL), Health Education (HE) and Health Communication (HC) and urges collaborations among professionals from these disciplines as well as with stakeholders who share their interests and concerns. Core definitions and evolutionary highlights of these disciplines are presented, as well as their intersection and promise of impact on student academic and health outcomes. The Whole School, Whole Community, Whole Child (WSCC) model is used as an example of a framework embraced by education and health experts to help students become health literate. Internal and external stakeholders, models of what works, resources and strategies for developing or strengthening school health and health communication practice are presented. Selected contemporary threats to the social and emotional health and safety of youth are reviewed; as are successful, evidence-based, collaborative HE, HC, and HL programs and strategies. Finally, recommendations for future research and strategic actions in combining HE and HC for HL are discussed to empower, build resilience, and improve the lifelong health of children and adolescents as they become adults.

Detection of Approximal Caries Lesions in Adults: A Cross-sectional Study.

Detection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.

Eficacia de la intervención psicológica grupal en atención primaria / Effectiveness of psychological intervention by groups in Primary Care

OBJETIVO: El objetivo del presente estudio es analizar la eficacia de la aplicación de un tratamiento psicológico grupal, realizado en el servicio de atención primaria por psicología clínica, dirigido a reducir sintomatología ansiosa siguiendo un modelo transdiagnóstico. MATERIAL Y MÉTODOS: La evaluación se realizó mediante el cuestionario Clinical Outcomes in Routine Evaluation-Short Form A (CORE-SFA). Se aplicó un tratamiento cognitivo-conductual grupal de 4 sesiones de duración, con una frecuencia semanal, que incluía como componentes psicoeducación, reestructuración cognitiva, entrenamiento en asertividad, higiene del sueño, solución de problemas, técnicas de relajación y manejo del tiempo. Los datos del estudio fueron recabados entre enero de 2015 y octubre de 2016, con una muestra total de 48 pacientes. RESULTADOS: Con la intervención, como se evidencia en la evaluación pretest-postest, se consiguió una reducción estadísticamente significativa de la sintomatología ansiosa. Además, un 79,2% de los pacientes recibieron el alta tras la intervención grupal. CONCLUSIONES: Se discuten las implicaciones de los resultados del estudio, que apoyan la eficacia de la terapia cognitivo-conductual transdiagnóstica grupal en atención primaria para el tratamiento de la sintomatología ansiosa y depresiva subclínica

OBJECTIVE: The aim of this study is to analyse the efficacy of a trans-diagnostic psychological therapy group aimed at reducing anxiety symptomatology. This was delivered within a Primary Care setting by clinical psychology. MATERIAL AND METHODS: The assessment was completed through the outcome measure Clinical Outcomes in Routine Evaluation-Short Form A (CORE-SFA). The intervention consisted of a Cognitive Behavioural Therapy group that delivered one session a week for 4 weeks. Components of this therapy included: psycho-education, cognitive restructuring, assertiveness training, sleep hygiene, problem solving, relaxation techniques, and time management. The data for this study was collected between January 2015 and October 2016, with a sample of 48 patients. RESULTS: Results from the data collected demonstrated a statistically significant reduction of the anxiety symptomatology. Moreover, 79.2% of the sample was discharged from services following this group intervention. CONCLUSIONS: The clinical implications of this study are discussed, supporting the efficacy of a trans-diagnostic Cognitive Behavioural Therapy group in a Primary Care setting for the treatment of symptoms of sub-clinical anxiety and depression

[Effectiveness of psychological intervention by groups in Primary Care]. / Eficacia de la intervención psicológica grupal en atención primaria.

OBJECTIVE: The aim of this study is to analyse the efficacy of a trans-diagnostic psychological therapy group aimed at reducing anxiety symptomatology. This was delivered within a Primary Care setting by clinical psychology. MATERIAL AND METHODS: The assessment was completed through the outcome measure Clinical Outcomes in Routine Evaluation-Short Form A (CORE-SFA). The intervention consisted of a Cognitive Behavioural Therapy group that delivered one session a week for 4 weeks. Components of this therapy included: psycho-education, cognitive restructuring, assertiveness training, sleep hygiene, problem solving, relaxation techniques, and time management. The data for this study was collected between January 2015 and October 2016, with a sample of 48 patients. RESULTS: Results from the data collected demonstrated a statistically significant reduction of the anxiety symptomatology. Moreover, 79.2% of the sample was discharged from services following this group intervention. CONCLUSIONS: The clinical implications of this study are discussed, supporting the efficacy of a trans-diagnostic Cognitive Behavioural Therapy group in a Primary Care setting for the treatment of symptoms of sub-clinical anxiety and depression.

Self-assembly of iron oxide precursor micelles driven by magnetic stirring time in sol-gel coatings.

The purpose of this work is to fabricate self-assembled microstructures by the sol-gel method and study the morphological, structural and compositional dependence of ε-Fe2O3 nanoparticles embedded in silica when glycerol (GLY) and cetyl-trimethylammonium bromide (CTAB) are added as steric agents simultaneously. The combined action of a polyalcohol and a surfactant significantly modifies the morphology of the sample giving rise to a different microstructure in each of the studied cases (1, 3 and 7 days of magnetic stirring time). This is due to the fact that the addition of these two compounds leads to a considerable increase in gelation time as GLY can interact with the alkoxide group on the surface of the iron oxide precursor micelle and/or be incorporated into the hydrophilic chains of CTAB. This last effect causes the iron oxide precursor micelles to be interconnected forming aggregates whose size and structure depend on the magnetic stirring time of the sol-gel synthetic route. In this paper, crystalline structure, composition, purity and morphology of the sol-gel coatings densified at 960 °C are examined. Emphasis is placed on the nominal percentage of the different iron oxides found in the samples and on the morphological and structural differences. This work implies the possibility of patterning ε-Fe2O3 nanoparticles in coatings and controlling their purity by an easy one-pot sol-gel method.

Pharmacokinetics and effects of alfaxalone after intravenous and intramuscular administration to cats.

AIMS: To determine the pharmacokinetics, and anaesthetic and sedative effects of alfaxalone after I/V and I/M administration to cats. METHODS: Six European shorthair cats, three males and three females, with a mean weight of 4.21 (SD 0.53) kg and aged 3.8 (SD 0.9) years were enrolled in this crossover, two-treatment, two-period study. Alfaxalone at a dose of 5 mg/kg was administered either I/V or I/M. Blood samples were collected between 2-480 minutes after drug administration and analysed for concentrations of alfaxalone by HPLC. The plasma concentration-time curves were analysed by non-compartmental analysis. Sedation scores were evaluated between 5-120 minutes after drug administration using a numerical rating scale (from 0-18). Intervals from drug administration to sit, sternal and lateral recumbency during the induction phase, and to head-lift, sternal recumbency and standing position during recovery were recorded. RESULTS: The mean half-life and mean residence time of alfaxalone were longer after I/M (1.28 (SD 0.21) and 2.09 (SD 0.36) hours, respectively) than after I/V (0.49 (SD 0.07) and 0.66 (SD 0.16) hours, respectively) administration (p<0.05). Bioavailability after I/M injection of alfaxalone was 94.7 (SD 19.8)%. The mean intervals to sternal and lateral recumbency were longer in the I/M (3.73 (SD 1.99) and 6.12 (SD 0.90) minutes, respectively) compared to I/V (0 minutes for all animals) treated cats (p<0.01). Sedation scores indicative of general anaesthesia (scores >15) were recorded from 5-15 minutes after I/V administration and deep sedation (scores 11-15) at 20 and 30 minutes. Deep sedation was observed from 10-45 minutes after I/M administration. One cat from each group showed hyperkinesia during recovery, and the remainder had an uneventful recovery. CONCLUSIONS AND CLINICAL RELEVANCE: Alfaxalone administered I/V in cats provides rapid and smooth induction of anaesthesia. After I/M administration, a longer exposure to the drug and an extended half life were obtained compared to I/V administration. Therefore I/M administration of alfaxalone could be a reliable, suitable and easy route in cats, taking into account that alfaxalone has a slower onset of sedation than when given I/V and achieves deep sedation rather than general anaesthesia.

Cholinergic regulation of proliferation of the urothelium in response to E. coli lipopolysaccharide exposition.

How the proliferation of the urothelium is regulated is known to a little degree. E. coli lipopolysaccharide (LPS) activates the innate immune response of the urinary bladder via the Toll-like receptor 4 (TLR4) on the urothelium but induces also urothelial proliferation. We wanted to assess whether muscarinic receptors are involved in the regulation of urothelial proliferation triggered by LPS stimulation. Female Fischer 344 rats were instilled with LPS or saline (control) in the urinary bladder in the absence or presence of muscarinic receptor blockade with atropine and regeneration of the urothelium was assessed 4h and 24h later. In the Fischer 344 bladder, urothelial thinning and urothelial caspase 3 up-regulation occurred at 4h after LPS urinary bladder instillation, which were totally blocked in rats pre-treated with atropine. TLR4 was only expressed in blood vessels in the Fischer 344 bladder, while it was also expressed in umbrella cells in the Sprague-Dawley bladder. Proliferation (Ki67 incorporation) of the human urothelial cell line UROtsa was reduced in the presence of the muscarinic receptor antagonists methoctramine (M2/M4-selective) and pirenzepine (M1/M4-selective), while proliferation instead was enhanced in the presence of atropine. In UROtsa cells exposed to LPS for 24h, 4-DAMP (M3/M1/M5-selective) inhibited instead proliferation. In conclusion, muscarinic receptors regulate urothelial proliferation and LPS may induce urothelial apoptosis via muscarinic receptor-dependent pathways. Our findings also suggest that species differences exist in the expressional pattern of TLR4 in the urothelium.

Pharmacokinetics of deflazacort in rabbits after intravenous and oral administration and its interaction with erythromycin.

The pharmacokinetic of deflazacort after intravenous and oral administration and the effect of erythromycin on the disposition of deflazacort in rabbits were investigated. A parallel study was carried out in twelve rabbits. The plasma concentration-time profiles of deflazacort were determined after intravenous and oral administration of single dosages of 5 mg/kg in the presence and absence (baseline) of multiple dose erythromycin regimens. Plasma concentrations of 21-desacetyldeflazacort were determined by HPLC. Plasma concentration-time curves were analysed by compartmental pharmacokinetic and noncompartmental methods. The t½λz values following intravenous and oral administration were 3.67 and 4.96 hr, respectively. The apparent volume of distribution at steady-state (Vss ) was 4.08 ± 0.31 L/kg, this value indicates that deflazacort is widely distributed into the extravascular tissues. Moreover, bioavailability after oral administration of deflazacort (F = 87.48%) was high. Pharmacokinetic analysis after both routes of administration revealed a significant reduction in total body clearance, a significant increase in mean residence time, half-life and plasma concentrations of the steroid in the presence of multiple dose erythromycin. The results indicated the influence of the erythromycin on deflazacort disposition, which is consistent with a pharmacokinetic-type interaction in the elimination of the drug from the body. Moreover, this interaction should be considered to avoid adverse effects when using both drugs concomitantly.

Pharmacokinetics of norfloxacin after intravenous, intramuscular and subcutaneous administration to rabbits.

The disposition kinetics of norfloxacin, after intravenous, intramuscular and subcutaneous administration was determined in rabbits at a single dose of 10 mg/kg. Six New Zealand white rabbits of both sexes were treated with aqueous solution of norfloxacin (2%). A cross-over design was used in three phases (2 × 2 × 2), with two washout periods of 15 days. Plasma samples were collected up to 72 hr after treatment, snap-frozen at -45°C and analysed for norfloxacin concentrations using high-performance liquid chromatography. The terminal half-life for i.v., i.m. and s.c. routes was 3.18, 4.90 and 4.16 hr, respectively. Clearance value after i.v. dosing was 0.80 L/h·kg. After i.m. administration, the absolute bioavailability was (mean ± SD) 108.25 ± 12.98% and the Cmax was 3.68 mg/L. After s.c. administration, the absolute bioavailability was (mean ± SD) 84.08 ± 10.36% and the Cmax was 4.28 mg/L. As general adverse reactions were not observed in any rabbit and favourable pharmacokinetics were found, norfloxacin at 10 mg/kg after i.m. and s.c. dose could be effective in rabbits against micro-organisms with MIC ≤0.14 or 0.11 µg/mL, respectively.

Seis años de experiencia en cirugía digestiva asistida por robot / 6 years of experience with robotic assisted gastrointestinal surgery

Resumen Introducción Desde su aprobación, la cirugía robótica ha crecido como una técnica útil, prometedora y probablemente superior en muchas cirugías. El objetivo de este estudio es exponer y evaluar los resultados de 6 años de experiencia, en cirugía digestiva asistida por robot, utilizada en diferentes procedimientos gastrointestinales, a lo largo de estos años. Material y Método Realizamos una revisión retrospectiva de todos los pacientes consecutivos sometidos a cirugía asistida por robot, realizada por un cirujano digestivo del Departamento de Cirugía Bariátrica y Departamento de Cirugía Robótica de la Clínica Santa María, de Santiago de Chile, entre septiembre de 2011 y mayo de 2017. Resultados Un total de 290 pacientes fueron sometidos a cirugía digestiva asistida por robot durante 6 años. Todos los pacientes fueron operados por el mismo cirujano digestivo. Los procedimientos primarios realizados fueron bypass gástrico en Y-Roux con anastomosis manual, gastrectomía en manga, cirugía revisional bariátrica y no bariátrica, fundoplicatura de Nissen, colecistectomía con puerto único, miotomía de Heller con fundoplicatura de Dor, hernioplastías, y otros casos excepcionales. La mayoría de los procedimientos secundarios fueron colecistectomías, hernioplastías hiatales y adherenciolisis. La estadía hospitalaria promedio fue de 3 días. Se observaron complicaciones postoperatorias en 27 (9,3%) pacientes. De acuerdo a la clasificación de Clavien Dindo, 4 (1,4%) complicaciones fueron Clavien I, 5 (1,7%) Clavien II, 18 (6,2%) Clavien III, 0 Clavien IV, 0 Clavien V. No hubo mortalidad en este grupo. El tiempo total promedio de los procedimientos fue de 76 min. El tiempo quirúrgico promedio fue de 64 min. Conclusión La cirugía digestiva asistida por robot es una técnica confiable y segura, que se puede utilizar para muchas enfermedades.

Background Since its approval, robotic surgery has been growing as a useful, promising and probably superior technique for many surgeries. The aim of this study is to expose and evaluate the results of a 6-year experience, of a single surgeon, with robotic assisted surgery, used for different gastrointestinal procedures throughout this years. Study Design We conducted a retrospective revision of all consecutive robotic assisted gastrointestinal cases performed by a single gastrointestinal laparoscopic surgeon of the Bariatric Surgery Department and Robotics Surgery Department of Clínica Santa María of Santiago, Chile, between September 2011 and May 2017. Results A total of 290 patients underwent robotic gastrointestinal surgery during 6 years. All cases were performed by the same gastrointestinal surgeon. Primary procedures performed were totally hand sewn Roux-en-Y gastric bypass, sleeve gastrectomy, revisional bariatric and non-bariatric surgery, Nissen fundoplication, single port cholecystectomy, Heller myotomy with Dor fundoplication, hernia repairs, and other exceptional cases. A total of 512 procedures were performed in 290 patients. The majority of secondary procedures were cholecystectomies, hiatal hernia repairs and adhesiolysis. Average length of hospital stay was 3 days. Postoperative complications were observed in 27 (9.3%) patients. According to Clavien Dindo classification of surgical complications, 4 (1.4%) complications were Clavien I, 5 (1.7%) Clavien II, 18 (6.2%) Clavien III, 0 Clavien IV, 0 Clavien V. There were no deaths in this group. Mean operative time was 76 minutes. Mean surgical time was 64 minutes. Conclusion Robot assisted upper gastrointestinal surgery is a reliable and effective technique, that can be used in many diseases.