Dolor inguinal crónico posquirúrgico. Una revisión narrativa / Chronic postoperative inguinal pain: A narrative review

El dolor inguinal crónico posquirúrgico constituye una complicación de incidencia variable entre los pacientes intervenidos de hernia inguinal. La tendencia actual de medición de resultados en términos de calidad de vida (patient reported outcome measurment) ha puesto de manifiesto la importancia de esta complicación, debido a las limitaciones de actividad diaria e implicaciones socioeconómicas que genera. En este artículo se realiza una revisión narrativa de la literatura disponible en las plataformas PUBMED, EMBASE y Cochrane Library y se discuten los principales aspectos concernientes a la epidemiología, etiología, prevención, diagnóstico y tratamiento del dolor inguinal crónico posquirúrgico, proponiéndose un algoritmo para su manejo. Los pacientes que padecen dolor inguinal crónico posquirúrgico presentan un amplio espectro de manifestaciones clínicas y su diagnóstico supone un auténtico desafío. No existe un tratamiento estándar y el éxito del mismo radica en un adecuado diagnóstico etiológico para poner a disposición del paciente el amplio abanico de medidas terapéuticas de las que se dispone de forma individualizada

Inguinodynia or chronic postoperative inguinal pain is a growing problem between patients who undergo surgical repair of an inguinal hernia. The change in results measurement proposed by many authors towards Patient Reported Outcome Measurement has underlined the importance of chronic postoperative inguinal pain, because of the great limitations in everyday life and the huge socioeconomic impact that it causes. In this article a narrative review of the available literature in PUBMED, EMBASE and Cochrane Library is performed and the most relevant aspects about epidemiology, etiology prevention, diagnosis and treatment of chronic postoperative inguinal pain are discussed. A new management algorithm is also proposed. The variability in its incidence and clinical presentation makes diagnosis of chronic postoperative inguinal pain a very challenging issue. There is no standardized therapy and an adequate etiological diagnosis is key point for a successful treatment. There are many treatment options that have to be sequentially used and adjusted to each patient and their clinical features

Chronic postoperative inguinal pain: A narrative review. / Dolor inguinal crónico posquirúrgico. Una revisión narrativa.

Inguinodynia or chronic postoperative inguinal pain is a growing problem between patients who undergo surgical repair of an inguinal hernia. The change in results measurement proposed by many authors towards Patient Reported Outcome Measurement has underlined the importance of chronic postoperative inguinal pain, because of the great limitations in everyday life and the huge socioeconomic impact that it causes. In this article a narrative review of the available literature in PUBMED, EMBASE and Cochrane Library is performed and the most relevant aspects about epidemiology, etiology prevention, diagnosis and treatment of chronic postoperative inguinal pain are discussed. A new management algorithm is also proposed. The variability in its incidence and clinical presentation makes diagnosis of chronic postoperative inguinal pain a very challenging issue. There is no standardized therapy and an adequate etiological diagnosis is key point for a successful treatment. There are many treatment options that have to be sequentially used and adjusted to each patient and their clinical features.

Cirugía mayor ambulatoria del cáncer de mama: factores relacionados con la conversión a hospitalización convencional / Major ambulatory surgery for the treatment of breast cancer: Factors conditioning conversion to conventional hospitalization

Introducción: La realización de cirugía oncológica mamaria en régimen ambulatorio se está convirtiendo en una práctica estándar entre los centros públicos por los distintos beneficios que aporta. En este estudio se analizan los resultados obtenidos con esta modalidad asistencial y se identifican los factores relacionados con su fracaso. Métodos: Se analizaron retrospectivamente los datos de las 206 pacientes intervenidas por cáncer de mama en el año 2016 bajo 3 tipos de régimen: ambulatorio puro, ambulatorio-23 h y hospitalario convencional. Se describen los índices de ambulatorización, éxito y conversión, tanto de forma global como distinguiendo entre cirugía conservadora, mastectomía ± reconstrucción inmediata y cirugía axilar. Se realiza un análisis univariante para hallar aquellos factores relacionados con la conversión a régimen hospitalario. Resultados: Para la muestra global se obtuvo un índice de ambulatorización del 61,2%, con un 16,5% de conversiones y un éxito del 83,4%. Para cirugía conservadora, ambulatorización, éxito y conversión fueron del 78,8, el 88,6 y el 11,4%, respectivamente. En las mastectomías la ambulatorización fue del 28,6%, con un 37,1% de conversión y un éxito del 62,9%. Las 11 cirugías axilares culminaron en régimen ambulatorio. Los factores asociados a una mayor probabilidad de conversión fueron la realización de mastectomía frente a cirugía conservadora y la aparición de complicaciones postoperatorias. Conclusiones: La cirugía del cáncer de mama en régimen ambulatorio es factible y segura. Para la optimización de resultados resultan imprescindibles la cuidadosa selección de las candidatas y el desarrollo de una técnica quirúrgica cuidadosa y lo más conservadora posible

Introduction: The main step in curative treatment for breast cancer is surgery. Its use in an ambulatory setting can contribute towards more efficient healthcare, providing additional benefits for patients. In this study, we analyze the results obtained with this treatment method and identify factors related with conversion to hospitalization.Methods: Results were analyzed from the 206 surgeries performed for breast cancer in 2016, using three different methods: day surgery, overnight ambulatory (23h) and conventional hospitalization. The ambulatory success and conversion rates were calculated for the global sample and stratified, distinguishing between conservative surgery, mastectomy and axillary surgery. A univariate analysis was performed to identify the factors involved in conversion. Results: For the global sample, the ambulatory surgery rate was 61.2%, 16.5% conversions and a success rate of 83.4%. For conservative surgery, ambulatory, success and conversion rates were 78.8%, 88.6 and 11.4%, respectively. For mastectomies, the ambulatory rate was 28.6%, with 62.9% success and 37.1% conversions. The 11 axillary surgeries were performed as day surgeries. Factors associated with conversion were mastectomy vs. vs. conservative surgery and the appearance of postoperative complications. Conclusions: Ambulatory surgery for the surgical treatment of breast cancer should be standard care. Optimized results require adequate patient selection and the performance of surgical technique that needs to be as careful and as conservative as possible

Major ambulatory surgery for the treatment of breast cancer: Factors conditioning conversion to conventional hospitalization. / Cirugía mayor ambulatoria del cáncer de mama: factores relacionados con la conversión a hospitalización convencional.

INTRODUCTION: The main step in curative treatment for breast cancer is surgery. Its use in an ambulatory setting can contribute towards more efficient healthcare, providing additional benefits for patients. In this study, we analyze the results obtained with this treatment method and identify factors related with conversion to hospitalization. METHODS: Results were analyzed from the 206 surgeries performed for breast cancer in 2016, using three different methods: day surgery, overnight ambulatory (23h) and conventional hospitalization. The ambulatory success and conversion rates were calculated for the global sample and stratified, distinguishing between conservative surgery, mastectomy and axillary surgery. A univariate analysis was performed to identify the factors involved in conversion. RESULTS: For the global sample, the ambulatory surgery rate was 61.2%, 16.5% conversions and a success rate of 83.4%. For conservative surgery, ambulatory, success and conversion rates were 78.8%, 88.6 and 11.4%, respectively. For mastectomies, the ambulatory rate was 28.6%, with 62.9% success and 37.1% conversions. The 11 axillary surgeries were performed as day surgeries. Factors associated with conversion were mastectomy vs. vs. conservative surgery and the appearance of postoperative complications. CONCLUSIONS: Ambulatory surgery for the surgical treatment of breast cancer should be standard care. Optimized results require adequate patient selection and the performance of surgical technique that needs to be as careful and as conservative as possible.

Pseudoaneurisma no traumático de la arteria cística como causa de hemobilia / Non traumatic pseudoaneurysm of the cystic artery as a cause of haemobilia

No disponible

Disfagia tras artrodesis cervical por migración del material protésico / Dysphagia after cervical spine fusion caused by migration of the prosthetic material

No disponible