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1.
ANZ J Surg ; 88(1-2): E11-E15, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27566595

RESUMO

BACKGROUND: Colon cancer is the second most frequent cause of death in both genders. Survival has increased since 1980, although this increase has been lower in patients ≥75 years old. We analyzed the results of surgical treatment for this pathology in this group of patients. METHODS: This retrospective, observational and descriptive study analyzed data relating to 315 patients undergoing colon cancer surgery between January 2010 and December 2011. Surgical results (surgical procedure, mean postoperative stay, isolated lymph nodes, postoperative morbidity and mortality) were compared between patients who were <75 and ≥75 years old. RESULTS: Statistical significance was observed in the percentages of hypertension (P = 0.001), cardiovascular disease (P = 0.006) and bronchopathy (P = 0.005) for the older group. No differences were found between the groups regarding surgical results, except higher postoperative morbidity and mortality in the ≥75 years old age group (P = 0.02 and P = 0.03, respectively). In the multivariate analysis, the factors associated with postoperative morbidity were age and preoperative albumin levels (P < 0.05). Cancer-specific survival (CSS) was lower in older patients (P < 0.05). The multivariate analysis of survival determined that age and tumour stage are independent predictive factors (P = 0.004 and P = 0.039, respectively), unlike American Society of Anesthesiologists score. CONCLUSIONS: Age does not influence the surgical results after colon cancer resection but is associated with increased postoperative morbidity and mortality. CSS is lower in patients who are ≥75 years old.


Assuntos
Colectomia/efeitos adversos , Neoplasias do Colo/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/mortalidade , Neoplasias do Colo/patologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
2.
World J Gastroenterol ; 23(9): 1712-1719, 2017 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-28321171

RESUMO

AIM: To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal cancer. METHODS: A review of the databases MEDLINE® and Embase™ was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were defined. RESULTS: This is a review of 58 published articles on presacral venous plexus injury during the mobilization of the rectum and on techniques used to treat presacral venous bleeding. Due to the lack of cases published in the literature, there is no consensus on which is the best technique to use if there is presacral bleeding during mobilization in surgery for rectal cancer. This review may provide a tool to help surgeons make decisions regarding how to resolve this serious complication. CONCLUSION: A series of alternative treatments are described; however, a conventional systematic review in which optimal treatment is identified could not be performed because few cases were analyzed in most publications.


Assuntos
Perda Sanguínea Cirúrgica , Hemostasia Cirúrgica/métodos , Neoplasias Retais/cirurgia , Tomada de Decisões , Eletrocoagulação , Hemostasia , Humanos , Hidrodinâmica , Metais , Pelve , Próteses e Implantes , Reto/cirurgia , Sacro/anatomia & histologia , Sacro/cirurgia , Veias
3.
Cir. Esp. (Ed. impr.) ; 92(9): 604-608, nov. 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-128893

RESUMO

INTRODUCCIÓN: La ileostomía derivativa temporal es utilizada frecuentemente para disminuir las consecuencias de una dehiscencia anastomótica distal tras la escisión total del mesorrecto en la cirugía del cáncer rectal. Esta técnica quirúrgica está asociada a una alta morbilidad y a una mortalidad no despreciable. El objetivo de este estudio es evaluar la morbilidad y la mortalidad asociadas a la ileostomía y su posterior cierre. MATERIAL Y MÉTODOS: Entre 2001 y 2012 fueron analizados retrospectivamente 96 pacientes con ileostomía derivativa temporal. Se analizó la morbimortalidad tras la creación de la ileostomía y posteriormente al cierre de la misma, incluyendo como variables la edad, sexo, comorbilidades, tiempo transcurrido hasta la reconstrucción del tránsito y tratamiento adyuvante. RESULTADOS: El estoma fue permanente en 5 pacientes y 5 fueron exitus. La morbimortalidad relacionada con el estoma mientras este estuvo presente fue del 21 y 1% respectivamente. Se realizó el cierre del estoma en 86 pacientes y el 57% había recibido previamente adyuvancia. No hubo mortalidad postoperatoria tras el cierre y la morbilidad fue del 24%. El tiempo medio entre la cirugía inicial y la reconstrucción intestinal fue de 152,2 días. Este intervalo fue significativamente superior en los pacientes que recibieron adyuvancia. No se encontró significación estadísticamente significativa entre las variables analizadas y las complicaciones. CONCLUSIONES: La ileostomía está asociada a una baja mortalidad y a una morbilidad alta antes y después de su cierre. La quimioterapia adyuvante retrasa significativamente la reconstrucción intestinal, aunque en este estudio no ha influido en el índice de complicaciones


INTRODUCTION: A temporary diverting ileostomy is frequently used to reduce the consequences of a distal anastomotic leakage after total mesorectal excision in rectal cancer surgery. This surgical technique is associated with high morbidity and a not negligible mortality. The aim of this study is to evaluate the morbidity and mortality rate associated with an ileostomy and its posterior closure. MATERIAL AND METHODS: Between 2001 and 2012, 96 patients with temporary diverting ileostomy were retrospectively analyzed. Morbidity and mortality were analyzed before and after the stoma closure. The studied variables included age, sex, comorbidities, time to bowel continuity restoration and adjuvant chemotherapy. RESULTS: In 5 patients the stoma was permanent and another 5 died. The morbidity and mortality rates associated with the stoma while it was present were 21 and 1% respectively. We performed a stoma closure in 86 patients, 57% of whom had previously received adjuvant therapy. There was no postoperative mortality after closure and the morbidity rate was 24%. The average time between initial surgery and restoration of intestinal continuity was 152.2 days. This interval was significantly higher in patients who had received adjuvant therapy. No statistically significant difference was found between the variables analyzed and complications. CONCLUSIONS: Diverting ileostomy is associated with low mortality and high morbidity rates before and after closure. Adjuvant chemotherapy significantly delays bowel continuity restoration, although in this study did not influence in the rate of complications


Assuntos
Humanos , Neoplasias Retais/cirurgia , Ileostomia/métodos , Indicadores de Morbimortalidade , Estudos Retrospectivos , Fatores de Risco , Distribuição por Idade e Sexo , Complicações Pós-Operatórias/epidemiologia , Deiscência da Ferida Operatória/epidemiologia , Técnicas de Fechamento de Ferimentos Abdominais
4.
Cir Esp ; 92(9): 604-8, 2014 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24969349

RESUMO

INTRODUCTION: A temporary diverting ileostomy is frequently used to reduce the consequences of a distal anastomotic leakage after total mesorectal excision in rectal cancer surgery. This surgical technique is associated with high morbidity and a not negligible mortality. The aim of this study is to evaluate the morbidity and mortality rate associated with an ileostomy and its posterior closure. MATERIAL AND METHODS: Between 2001 and 2012, 96 patients with temporary diverting ileostomy were retrospectively analyzed. Morbidity and mortality were analyzed before and after the stoma closure. The studied variables included age, sex, comorbidities, time to bowel continuity restoration and adjuvant chemotherapy. RESULTS: In 5 patients the stoma was permanent and another 5 died. The morbidity and mortality rates associated with the stoma while it was present were 21 and 1% respectively. We performed a stoma closure in 86 patients, 57% of whom had previously received adjuvant therapy. There was no postoperative mortality after closure and the morbidity rate was 24%. The average time between initial surgery and restoration of intestinal continuity was 152.2 days. This interval was significantly higher in patients who had received adjuvant therapy. No statistically significant difference was found between the variables analyzed and complications. CONCLUSIONS: Diverting ileostomy is associated with low mortality and high morbidity rates before and after closure. Adjuvant chemotherapy significantly delays bowel continuity restoration, although in this study did not influence in the rate of complications.


Assuntos
Ileostomia/efeitos adversos , Ileostomia/mortalidade , Neoplasias Retais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Cir. Esp. (Ed. impr.) ; 90(8): 506-512, oct. 2012. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-103964

RESUMO

Introducción: Analizamos nuestra experiencia y los resultados obtenidos con el uso del vacuum assisted closure (VAC®, KCI Clinic Spain SL) en el manejo del abdomen abierto. Material y métodos Revisamos de forma retrospectiva las laparostomías realizadas entre junio de 2006 y marzo de 2011 usando la terapia VAC® en el Hospital Xeral-Cíes de Vigo. Resultados Incluimos a 23 pacientes consecutivos (18 varones y 5 mujeres) en los que se usó el VAC® en un abdomen abierto por distintas indicaciones (traumatismo abdominal, peritonitis, pancreatitis, patología isquémica o síndrome compartimental abdominal). El VAC® precisó recambio una media de 3,1 veces por paciente (1-7), con una duración total media de la terapia de 14,8 días (2-43) hasta el cierre, lográndose el cierre primario en 18 de 21 pacientes (86%). La estancia media hospitalaria fue de 110,1 días (8-163) y 6 pacientes (26%) fallecieron durante el ingreso por problemas relacionados con su proceso de base. Siete casos (30%) presentaron complicaciones durante la terapia VAC®: 3 abscesos intraabdominales (13%), 4 fístulas o dehiscencias de suturas (17%) y 1 evisceración (4%).Conclusiones La terapia VAC® es de manejo sencillo con una aceptable tasa de complicaciones, particularmente la de fístulas intestinales, y una mortalidad reducida. De los diversos sistemas disponibles para el cierre diferido de un abdomen, el VAC® supone un progreso considerable en estos últimos años gracias a su material adaptable y sus numerosas ventajas. Posiblemente su uso aumentará en el futuro (AU)


Introduction: We analyse our experience and the results obtained with the use of vacuumassisted closure (VAC1, KCI Clinic Spain SL) in the management of open abdomen.Material and methods: We retrospectively reviewed the la parostomies performed between June 2006 and March 2011 using VAC1treatment in the Hospital Xeral-Cíes, Vigo. Results: We included 23 consecutive patients (18 males and 5 females) on whom the VAC1was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischemic disease or abdominal compartmental syndrome). The VAC1neededchanging a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%).The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC1 therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%).Conclusions: VAC1therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC1has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future (AU)


Assuntos
Humanos , Técnicas de Fechamento de Ferimentos Abdominais , Laparotomia/métodos , Complicações Pós-Operatórias , Traumatismos Abdominais/cirurgia , Vácuo
6.
Cir Esp ; 90(8): 506-12, 2012 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-22652131

RESUMO

INTRODUCTION: We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen. MATERIAL AND METHODS: We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo. RESULTS: We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome). The VAC(®) needed changing a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of 14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%). The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC® therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%). CONCLUSIONS: VAC(®) therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC(®) has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future.


Assuntos
Abdome/cirurgia , Técnicas de Fechamento de Ferimentos Abdominais , Tratamento de Ferimentos com Pressão Negativa , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Cir. Esp. (Ed. impr.) ; 89(1): 31-36, ene. 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-95666

RESUMO

Introducción La resección abdominoperineal tras radioterapia se acompaña de una alta tasa de complicaciones de la herida perineal. El propósito de este estudio retrospectivo fue evaluar los resultados de la reconstrucción perineal con un colgajo miocutáneo de músculo recto abdominal en pacientes con cáncer anal recurrente o persistente. Pacientes y método Entre 2006 y 2010, 6 pacientes varones VIH+ fueron tratados después del fracaso del tratamiento inicial con quimio-radioterapia. Tras amputación abdominoperineal, se realizó un colgajo miocutáneo de recto anterior.Resultados La media de edad fue de 36,3 años (rango: 30-42). La curación primaria de la herida perineal se consiguió en los primeros treinta días. No hubo complicaciones mayores en el postoperatorio inmediato o tras un seguimiento medio de 26,5 meses. Hubo 2 complicaciones menores (33,3%) relacionadas con la herida perineal. No hubo complicaciones de la pared abdominal. Conclusión La utilización de un colgajo miocutáneo del recto anterior del abdomen, en pacientes con cáncer anal recurrente o persistente, se asoció con un bajo índice de complicaciones perineales (AU)


Introduction Abdominoperineal resection after radiotherapy has a high rate of perineal wound complications. The aim of this retrospective study was to evaluate the results of perineal reconstruction with a rectus abdominis muscle myocutaneous flap in patients with recurrent or persistent anal cancer. Patients and method Between 2006 and 2010, six male HIV+ patients were treated after initial treatment failure with chemotherapy. An anterior rectal myocutaneous flap was performed after abdominal-perineal excision. Results The mean age was 36.3 years (range: 30-42). Primary healing of the perineal wound was achieved in the first thirty days. There were no major complications in the immediate post-surgical period or after a mean follow up of 26.5 months. There were 2 (33.3%) minor complications associated with the perineal wound. There were no complications of the abdominal wall. Conclusion The use of an anterior rectus abdominis myocutaneous flap in patients with recurrent or persistent anal cancer is associated with a low rate of perineal complications (AU)


Assuntos
Humanos , Masculino , Adulto , Neoplasias do Ânus/cirurgia , Infecções por HIV/complicações , Períneo/cirurgia , Retalhos Cirúrgicos , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Recidiva Local de Neoplasia/cirurgia
8.
Cir. Esp. (Ed. impr.) ; 82(1): 32-36, jul. 2007. ilus, tab
Artigo em Es | IBECS | ID: ibc-054003

RESUMO

Objetivo. Estudiar la enfermedad tiroidea encontrada en pacientes intervenidos por hiperparatiroidismo (HPT) comparando la frecuencia de carcinomas tiroideos bien diferenciados entre los distintos tipos de HPT. Pacientes y método. Revisión retrospectiva de las historias clínicas de 124 pacientes intervenidos de HPT de manera consecutiva en nuestro servicio por un mismo cirujano entre enero de 1998 y junio de 2006. Resultados. Se trata de 105 (84,7%) mujeres y 19 (15,3%) varones, con una media de edad de 59,7 ± 15,66 años. De ellos, 115 (92,7%) presentan HPT primario (HPTP) y 9 (7,3%), HPT renal (HPTR). En 3 (2,6%) HPTP y en ninguno de los HPTR hay antecedente de radioterapia cervical. En 43 (34,7%) pacientes se realizó simultáneamente algún tipo de cirugía del tiroides, 40 (34,8%) de los HPTP y 3 (33,3%) de los HPTR (p = 1,00). Entre los 115 pacientes intervenidos por HPTP, encontramos 6 (5,2%) carcinomas papilares y entre los 9 afectos de HPTR, 2 (22,2%), sin diferencias estadísticamente significativas entre ambos grupos (p = 0,105). Conclusiones. La afección tiroidea es frecuente en pacientes intervenidos por HPT, pero no más que en series de autopsias. No se encuentran diferencias significativas en la prevalencia de carcinoma papilar de tiroides entre los HPT primario y renal. La radioterapia cervical no parece ser en la actualidad un factor clínicamente relevante en el desarrollo de carcinoma papilar de tiroides en los pacientes afectos de HPTP. La prevalencia de enfermedad tiroidea en la población general justifica la realización de una ecografía preoperatoria de forma sistemática (AU)


Objective. To analyze thyroid gland disease incidentally found in patients undergoing surgery for hyperparathyroidism and to compare the frequency of nonmedullary thyroid carcinoma among different hyperparathyroidism varieties. Patients and method. We retrospectively reviewed 124 clinical records of patients who underwent surgery for hyperparathyroidism by a single surgeon from January 1998 to June 2006. Results. There were 105 women (84.7%) and 19 men (15.3%). The mean age was 59.7 ± 15.66 years old. Of these, 115 (92.7%) were diagnosed with primary hyperparathyroidism and 9 (7.3%) with renal hyperparathyroidism. In the primary hyperparathyroidism group, 3 patients (2.6%) had received neck irradiation compared with none in the renal hyperparathyroidism group. Thyroid gland surgery was performed simultaneously in 43 patients (34.7%), 40 (34.8%) of them belonging to the first group and three (33.3%) to the second group (p = 1.00). Among the 115 patients operated on for primary hyperparathyroidism, 6 papillary thyroid carcinomas (5.2%) were found and 2 (22.2%) were found among the 9 patients with renal hyperparathyroidism, but this difference was not statistically significant (p = 0.105). Conclusions. An incidental finding of thyroid disease in patients undergoing surgery for hyperparathyroidism is fairly frequent but no more so than that found in autopsy series. No statistically significant differences were found between primary and renal hyperparathyroidism in the prevalence of papillary thyroid carcinoma. Currently, neck irradiation does not seem to be a clinically significant factor in this issue. The high prevalence of thyroid disease in the general population warrants systematic neck ultrasound before hyperparathyroidism surgery (AU)


Assuntos
Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Hiperparatireoidismo/diagnóstico , Bócio/diagnóstico , Carcinoma/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Diagnóstico Diferencial , Estudos Retrospectivos , Hiperparatireoidismo/complicações , Hiperparatireoidismo/radioterapia , Hiperparatireoidismo/cirurgia , Carcinoma/etiologia , Tireoidectomia/métodos , Neoplasias da Glândula Tireoide/etiologia
9.
Cir Esp ; 82(1): 32-6, 2007 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-17580029

RESUMO

OBJECTIVE: To analyze thyroid gland disease incidentally found in patients undergoing surgery for hyperparathyroidism and to compare the frequency of nonmedullary thyroid carcinoma among different hyperparathyroidism varieties. PATIENTS AND METHOD: We retrospectively reviewed 124 clinical records of patients who underwent surgery for hyperparathyroidism by a single surgeon from January 1998 to June 2006. RESULTS: There were 105 women (84.7%) and 19 men (15.3%). The mean age was 59.7 +/- 15.66 years old. Of these, 115 (92.7%) were diagnosed with primary hyperparathyroidism and 9 (7.3%) with renal hyperparathyroidism. In the primary hyperparathyroidism group, 3 patients (2.6%) had received neck irradiation compared with none in the renal hyperparathyroidism group. Thyroid gland surgery was performed simultaneously in 43 patients (34.7%), 40 (34.8%) of them belonging to the first group and three (33.3%) to the second group (p = 1.00). Among the 115 patients operated on for primary hyperparathyroidism, 6 papillary thyroid carcinomas (5.2%) were found and 2 (22.2%) were found among the 9 patients with renal hyperparathyroidism, but this difference was not statistically significant (p = 0.105). CONCLUSIONS: An incidental finding of thyroid disease in patients undergoing surgery for hyperparathyroidism is fairly frequent but no more so than that found in autopsy series. No statistically significant differences were found between primary and renal hyperparathyroidism in the prevalence of papillary thyroid carcinoma. Currently, neck irradiation does not seem to be a clinically significant factor in this issue. The high prevalence of thyroid disease in the general population warrants systematic neck ultrasound before hyperparathyroidism surgery.


Assuntos
Bócio/etiologia , Hiperparatireoidismo/etiologia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Cir Esp ; 80(5): 331-3, 2006 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-17192209

RESUMO

Spontaneous pneumomediastinum is an uncommon benign disorder that usually occurs in young men. Because of its clinical features and physiopathologic mechanism, other, more serious disorders that could require urgent treatment, such as Boerhaave's syndrome or spontaneous esophageal rupture, must be ruled out. We report the case of a 19-year-old man with no relevant history, who presented mediastinal emphysema after an episode of repeated vomiting in the context of alcohol abuse. Imaging techniques help to assess esophageal involvement.


Assuntos
Doenças do Esôfago/diagnóstico por imagem , Enfisema Mediastínico/diagnóstico por imagem , Ruptura Espontânea/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Doenças do Esôfago/terapia , Esôfago/diagnóstico por imagem , Humanos , Masculino , Enfisema Mediastínico/terapia , Mediastino/diagnóstico por imagem , Radiografia Torácica , Ruptura Espontânea/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Gastroenterol. hepatol. (Ed. impr.) ; 29(10): 622-624, dic. 2006. ilus
Artigo em Es | IBECS | ID: ibc-052311

RESUMO

La endoscopia convencional valora de forma deficitaria las lesiones submucosas del tracto digestivo por la imposibilidad de su observación directa, ya que no permite determinar su tamaño adecuadamente, establecer un diagnóstico etiológico en la mayoría de los casos ni valorar la capa de origen del tumor. Sin embargo, la ultrasonografía endoscópica permite, en la mayoría de las ocasiones, solucionar estos problemas: logra diferenciar con cierta seguridad las lesiones malignas de las benignas, puede medir su tamaño y establecer su capa de origen. Es la técnica de elección para establecer la presencia y las características de un tumor submucoso y si éste es subsidiario de tratamiento; además, permite seleccionar los casos que pueden ser extirpados endoscópicamente sin excesivos riesgos. La ecografía hidrogástrica puede ser una buena alternativa a la ecoendoscopia para el estudio de las lesiones submucosas y la estadificación de tumores situados en el antro gástrico en los pacientes en que no se pueda disponer de esta técnica o no se pueda realizar. Es una técnica muy fiable, poco costosa, y muy bien tolerada por los pacientes. Presentamos a continuación el caso de una paciente que presentaba un tumor estromal gastrointestinal que pudo estudiarse mediante ecografía hidrogástrica, estableciéndose con precisión el tamaño, la capa de origen y la naturaleza maligna de la lesión


Evaluation of submucosal lesions of the digestive tract with conventional endoscopy is unsatisfactory since this technique does not allow direct observation or correct evaluation of the size and layer of origin of the tumor; therefore, in most patients an etiological diagnosis cannot be established with this procedure. However, in most patients, endoscopic ultrasonography can resolve these problems: to a fair degree of certainty, this technique can differentiate malignant from benign lesions, measure their size, and establish their layer of origin. Endoscopic ultrasonography is the technique of choice to establish the presence and characteristics of submucosal tumors and their suitability for treatment. Moreover, this procedure can identify tumors that can be removed endoscopically without excessive risk. Hydrogastric ultrasonography can be an effective substitute for echoendoscopy when evaluating submucosal lesions and for staging tumors of the gastric antrum when echoendoscopy is not available or in patients in whom it cannot be performed. Hydrogastric ultrasonography is safe, inexpensive and very well tolerated by patients. We present the case of a female patient with a gastric GIST that was evaluated using hydrogastric ultrasonography. The size, layer of origin, and malignancy of the tumor were accurately established


Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Ultrassonografia/métodos , Antro Pilórico/patologia , Neoplasias Gástricas , Reprodutibilidade dos Testes , Antro Pilórico , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
12.
Cir. Esp. (Ed. impr.) ; 80(5): 331-333, nov. 2006. ilus, tab
Artigo em Es | IBECS | ID: ibc-049169

RESUMO

El neumomediastino espontáneo es una entidad clínica benigna que suele manifestarse en varones jóvenes. Tanto sus manifestaciones clínicas como el mecanismo por el que se produce obligan a descartar otras afecciones de mayor gravedad que puedan requerir un tratamiento inmediato, como el síndrome de Boerhaave o la rotura esofágica espontánea. Aportamos el caso de un varón de 19 años de edad sin antecedentes significativos que presentó un enfisema mediastínico espontáneo tras un episodio de vómitos de repetición en el contexto de una ingesta etílica. Las exploraciones radiológicas practicadas ayudaron a descartar la afección esofágica (AU)


Spontaneous pneumomediastinum is an uncommon benign disorder that usually occurs in young men. Because of its clinical features and physiopathologic mechanism, other, more serious disorders that could require urgent treatment, such as Boerhaave's syndrome or spontaneous esophageal rupture, must be ruled out. We report the case of a 19-year-old man with no relevant history, who presented mediastinal emphysema after an episode of repeated vomiting in the context of alcohol abuse. Imaging techniques help to assess esophageal involvement (AU)


Assuntos
Masculino , Adulto , Humanos , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/cirurgia , Tomografia Computadorizada de Emissão/métodos , Ruptura Espontânea/cirurgia , Radiografia Torácica/métodos , Diagnóstico Diferencial , Ruptura Gástrica/cirurgia , Esôfago/patologia , Esôfago/cirurgia , Esôfago , Diagnóstico de Pneumomediastino/métodos , Diagnóstico de Pneumomediastino , Enfisema Mediastínico/etiologia
13.
Gastroenterol Hepatol ; 29(10): 622-4, 2006 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-17198640

RESUMO

Evaluation of submucosal lesions of the digestive tract with conventional endoscopy is unsatisfactory since this technique does not allow direct observation or correct evaluation of the size and layer of origin of the tumor; therefore, in most patients an etiological diagnosis cannot be established with this procedure. However, in most patients, endoscopic ultrasonography can resolve these problems: to a fair degree of certainty, this technique can differentiate malignant from benign lesions, measure their size, and establish their layer of origin. Endoscopic ultrasonography is the technique of choice to establish the presence and characteristics of submucosal tumors and their suitability for treatment. Moreover, this procedure can identify tumors that can be removed endoscopically without excessive risk. Hydrogastric ultrasonography can be an effective substitute for echoendoscopy when evaluating submucosal lesions and for staging tumors of the gastric antrum when echoendoscopy is not available or in patients in whom it cannot be performed. Hydrogastric ultrasonography is safe, inexpensive and very well tolerated by patients. We present the case of a female patient with a gastric GIST that was evaluated using hydrogastric ultrasonography. The size, layer of origin, and malignancy of the tumor were accurately established.


Assuntos
Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Ultrassonografia/métodos
14.
Am J Kidney Dis ; 44(2): e28-30, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15264210

RESUMO

Peritoneal catheter malfunction is commonly related to omental wrapping, although entrapment owing to other different intraperitoneal structures is possible but rare. The authors report a case of catheter obstruction owing to fallopian tube wrapping, diagnosed and resolved by laparoscopic surgery. A brief review of this rare problem is presented.


Assuntos
Tubas Uterinas , Diálise Peritoneal Ambulatorial Contínua/instrumentação , Cateteres de Demora , Nefropatias Diabéticas/terapia , Falha de Equipamento , Tubas Uterinas/cirurgia , Feminino , Humanos , Laparoscopia , Pessoa de Meia-Idade
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