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3.
Breast Dis ; 42(1): 305-313, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37807773

RESUMO

Breast cancer is the most incidental and deadly neoplasm worldwide; in Mexico, very few epidemiologic reports have analyzed the pathological features and its impact on their clinical outcome. Here, we studied the relation between pathological features and the clinical presentation at diagnosis and their impact on the overall and progression-free survival of patients with breast cancer. For this purpose, we collected 199 clinical records of female patients, aged at least 18 years old (y/o), with breast cancer diagnosis confirmed by biopsy. We excluded patients with incomplete or conflicting clinical records. Afterward, we performed an analysis of overall and progression-free survival and associated risks. Our results showed an average age at diagnosis of 52 y/o (24-85), the most common features were: upper outer quadrant tumor (32%), invasive ductal carcinoma (76.8%), moderately differentiated (44.3%), early clinical stages (40.8%), asymptomatic patients (47.8%), luminal A subtype (47.8%). Median overall survival was not reached, but median progression-free survival was 32.2 months (29.75-34.64, CI 95%) associated risk were: clinical stage (p < 0.0001) symptomatic presentation (p = 0.009) and histologic grade (p = 0.02). Therefore, we concluded that symptom presence at diagnosis impacts progression-free survival, and palpable symptoms are related to an increased risk for mortality.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Adulto , Feminino , Humanos , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , México/epidemiologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais
9.
Nutr. hosp ; 38(5)sep.-oct. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-224654

RESUMO

Introduction: after laparoscopic Roux-en-Y gastric bypass (LRYGBP) many patients complain of epigastric pain or food intolerance, leading to the performance of upper gastrointestinal (UGI) endoscopy. Objective: this study aims to assess which symptomatology as reported by LRYGBP patients during follow-up suggested correlation with pathological findings of endoscopy, and which factors might play a role, taking the timing of symptom presentation into account. Materials and methods: a retrospective cohort study was performed identifying LRYGBP patients presenting with food intolerance and/or epigastric pain who had undergone endoscopy. Primary outcomes were endoscopy findings, their association with patient characteristics, and timing of symptom presentation. Results: of the 514 patients complaining of epigastric pain and/or food intolerance, 81 (15.6 %) underwent endoscopy. A gastrojejunostomy complication was found in 58 % of cases. All patients who complained about food intolerance and epigastric pain presented pathological findings. The only preoperative factor associated with a gastrojejunostomy complication was being a smoker (p = 0.021). Time between surgery and endoscopy was also a predictive factor for endoscopic pathological findings (p = 0.007); in cases of epigastric pain, symptom onset during the first year (median: 10 months) was related to increased risk of gastrojejunal complications (p < 0.05). Conclusions: endoscopies performed within one year of surgery were significantly more likely to reveal pathological findings than endoscopies performed after the first postoperative year, especially in patients experiencing epigastric pain. (AU)


Introducción: tras un baipás gástrico laparoscópico en “Y de Roux” muchos pacientes refieren dolor epigástrico o intolerancia alimenticia, lo que motiva la realización de una endoscopia digestiva alta. Objetivos: el objetivo de este estudio es intentar establecer una relación entre la sintomatología referida por los pacientes sometidos a baipás gástrico con los hallazgos endoscópicos patológicos y conocer qué factores pueden estar implicados, considerando el momento de presentación. Material y métodos: estudio retrospectivo de cohortes, identificando a los pacientes sometidos a baipás gástrico laparoscópico que presentan dolor epigástrico o intolerancia alimenticia durante el seguimiento y a los que se realizó una endoscopia digestiva alta. El objetivo primario es relacionar los hallazgos endoscópicos con la sintomatología y el momento de aparición. Resultados: de los 514 pacientes que presentaban dolor epigástrico o intolerancia alimenticia, 81 (15,6 %) fueron sometidos a endoscopia digestiva alta. En un 58 % de los casos se encontraron complicaciones relacionadas con la gastroyeyunostomía. En todos los pacientes que presentaban simultáneamente dolor e intolerancia aparecieron hallazgos endoscópicos patológicos. El único factor preoperatorio relacionado con las complicaciones fue el hábito tabáquico (p = 0,021). El tiempo entre la cirugía y la realización de la endoscopia también fue un factor significativamente relacionado con los hallazgos endoscópicos (p = 0,007). En los casos de dolor epigástrico durante el primer año (media: 10 meses) existía un incremento del riesgo de aparición de complicaciones de la gastroyeyunostomía (p < 0,05). Conclusiones: las endoscopias realizadas durante el primer año postoperatorio tenían más probabilidades de presentar hallazgos patológicos, sobre todo en los pacientes afectos de dolor epigástrico. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fatores de Tempo , Complicações Pós-Operatórias/etiologia , Anastomose em-Y de Roux/normas , Anastomose em-Y de Roux/efeitos adversos , Anastomose em-Y de Roux/estatística & dados numéricos , Estudos Retrospectivos , Estudos de Coortes , Complicações Pós-Operatórias/epidemiologia , Dor Abdominal/cirurgia
11.
Clin Nucl Med ; 46(11): e543-e547, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183502

RESUMO

ABSTRACT: A 15-year-old adolescent girl diagnosed of interaortocaval paraganglioma with a positive 123I-MIGB SPECT/CT and 1 unsuccessful prior surgery was operated on with the assistance of a handheld gamma camera. Once the lesion was located and removed, 2 images were taken, one of the surgical field (without 123I-MIGB uptake) and another of the tumor ex vivo (with high 123I-MIGB uptake), confirming that the lesion had been satisfactorily excised. This case highlights the use of a portable gamma camera as a useful tool to locate this rare tumor, with a SPECT/CT positive for 123I-MIGB and a difficult anatomical location suspected.


Assuntos
Câmaras gama , Paraganglioma , Adolescente , Feminino , Humanos , Paraganglioma/diagnóstico por imagem , Paraganglioma/cirurgia , Cintilografia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
12.
Nutr Hosp ; 38(5): 978-982, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34036791

RESUMO

INTRODUCTION: Introduction: after laparoscopic Roux-en-Y gastric bypass (LRYGBP) many patients complain of epigastric pain or food intolerance, leading to the performance of upper gastrointestinal (UGI) endoscopy. Objective: this study aims to assess which symptomatology as reported by LRYGBP patients during follow-up suggested correlation with pathological findings of endoscopy, and which factors might play a role, taking the timing of symptom presentation into account. Materials and methods: a retrospective cohort study was performed identifying LRYGBP patients presenting with food intolerance and/or epigastric pain who had undergone endoscopy. Primary outcomes were endoscopy findings, their association with patient characteristics, and timing of symptom presentation. Results: of the 514 patients complaining of epigastric pain and/or food intolerance, 81 (15.6 %) underwent endoscopy. A gastrojejunostomy complication was found in 58 % of cases. All patients who complained about food intolerance and epigastric pain presented pathological findings. The only preoperative factor associated with a gastrojejunostomy complication was being a smoker (p = 0.021). Time between surgery and endoscopy was also a predictive factor for endoscopic pathological findings (p = 0.007); in cases of epigastric pain, symptom onset during the first year (median: 10 months) was related to increased risk of gastrojejunal complications (p < 0.05). Conclusions: endoscopies performed within one year of surgery were significantly more likely to reveal pathological findings than endoscopies performed after the first postoperative year, especially in patients experiencing epigastric pain.


INTRODUCCIÓN: Introducción: tras un baipás gástrico laparoscópico en "Y de Roux" muchos pacientes refieren dolor epigástrico o intolerancia alimenticia, lo que motiva la realización de una endoscopia digestiva alta. Objetivos: el objetivo de este estudio es intentar establecer una relación entre la sintomatología referida por los pacientes sometidos a baipás gástrico con los hallazgos endoscópicos patológicos y conocer qué factores pueden estar implicados, considerando el momento de presentación. Material y métodos: estudio retrospectivo de cohortes, identificando a los pacientes sometidos a baipás gástrico laparoscópico que presentan dolor epigástrico o intolerancia alimenticia durante el seguimiento y a los que se realizó una endoscopia digestiva alta. El objetivo primario es relacionar los hallazgos endoscópicos con la sintomatología y el momento de aparición. Resultados: de los 514 pacientes que presentaban dolor epigástrico o intolerancia alimenticia, 81 (15,6 %) fueron sometidos a endoscopia digestiva alta. En un 58 % de los casos se encontraron complicaciones relacionadas con la gastroyeyunostomía. En todos los pacientes que presentaban simultáneamente dolor e intolerancia aparecieron hallazgos endoscópicos patológicos. El único factor preoperatorio relacionado con las complicaciones fue el hábito tabáquico (p = 0,021). El tiempo entre la cirugía y la realización de la endoscopia también fue un factor significativamente relacionado con los hallazgos endoscópicos (p = 0,007). En los casos de dolor epigástrico durante el primer año (media: 10 meses) existía un incremento del riesgo de aparición de complicaciones de la gastroyeyunostomía (p < 0,05). Conclusiones: las endoscopias realizadas durante el primer año postoperatorio tenían más probabilidades de presentar hallazgos patológicos, sobre todo en los pacientes afectos de dolor epigástrico.


Assuntos
Anastomose em-Y de Roux/normas , Complicações Pós-Operatórias/etiologia , Fatores de Tempo , Dor Abdominal/cirurgia , Adulto , Anastomose em-Y de Roux/efeitos adversos , Anastomose em-Y de Roux/estatística & dados numéricos , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
13.
Cir. Esp. (Ed. impr.) ; 99(4): 276-281, abr. 2021. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-217940

RESUMO

Introducción: La cirugía bariátrica es uno de los procedimientos quirúrgicos más realizados en España, sin embargo actualmente es la cirugía con mayor demora en la lista de espera quirúrgica (LEQ). Para disminuir la LEQ se pone en marcha un programa especial de autoconcertación, y se quiere valorar su utilidad, estudiando las repercusiones clínicas y económicas en una unidad de alto volumen de cirugía bariátrica. Métodos: Se realizó un estudio prospectivo de 3 meses comparando evolución, resultados y consumo de recursos perioperatorios de 45 pacientes operados de cirugía bariátrica, divididos en 2 grupos, pacientes operados en quirófano de forma estándar y pacientes operados en programación especial. Se tuvieron en cuenta factores epidemiológicos, asistenciales y económicos. Resultados: Se operaron 2 grupos homogéneos de pacientes, reduciendo con éxito la LEQ. La morbilidad fue similar en ambos grupos y el coste medio de las cirugías realizadas fue de 5.331,4euros, 5372,5±798,1euros para el grupo estándar y 5.290,3±685,1euros para el grupo de programación especial, sin diferencias significativas. Conclusiones: En centros hospitalarios donde se realiza alto volumen de cirugía bariátrica es factible incorporar programas especiales quirúrgicos que permiten la reducción en la demora de las listas de espera quirúrgica, manteniendo los criterios de calidad y sin suponer un mayor gasto al sistema sanitario. (AU)


Introduction: Bariatric surgery is one of the most common surgical practices in Spain. However, this procedure currently has longest delay on surgical waiting lists (SWL). We have developed a special surgical program that aims to reduce this waiting list and to assess the economic and clinical repercussions in a high-volume bariatric surgery unit. Methods: A three-month prospective study was carried out comparing outcomes, results and perioperative resources consumed for 45 patients who underwent bariatric surgery. The patients were divided into 2 groups: patients who underwent the standard procedure in the operating room, and patients treated in the special program. Epidemiological, healthcare and economic factors were taken into account. Results: Two homogeneous groups of patients were operated on, successfully reducing the SWL. Morbidity was similar in both groups and the average cost of the surgeries performed was €5,331.40; in the standard group, the cost was €5,372.50±€798.10, and the cost of the special program group was €5,290.30±€685.10, with no significant differences. Conclusions: In hospitals with a high volume of bariatric surgery, it is feasible to incorporate special surgical programs that are able to reduce surgical waiting lists, while maintaining quality criteria and without incurring a greater expense to the healthcare system. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Cirurgia Bariátrica , Saúde Pública , Listas de Espera , Estudos Prospectivos , Hospitais , Sobrepeso/cirurgia
14.
Cir Esp (Engl Ed) ; 99(4): 276-281, 2021 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32674840

RESUMO

INTRODUCTION: Bariatric surgery is one of the most common surgical practices in Spain. However, this procedure currently has longest delay on surgical waiting lists (SWL). We have developed a special surgical program that aims to reduce this waiting list and to assess the economic and clinical repercussions in a high-volume bariatric surgery unit. METHODS: A three-month prospective study was carried out comparing outcomes, results and perioperative resources consumed for 45 patients who underwent bariatric surgery. The patients were divided into 2 groups: patients who underwent the standard procedure in the operating room, and patients treated in the special program. Epidemiological, healthcare and economic factors were taken into account. RESULTS: Two homogeneous groups of patients were operated on, successfully reducing the SWL. Morbidity was similar in both groups and the average cost of the surgeries performed was €5,331.40; in the standard group, the cost was €5,372.50±€798.10, and the cost of the special program group was €5,290.30±€685.10, with no significant differences. CONCLUSIONS: In hospitals with a high volume of bariatric surgery, it is feasible to incorporate special surgical programs that are able to reduce surgical waiting lists, while maintaining quality criteria and without incurring a greater expense to the healthcare system.

16.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1353888

RESUMO

Introducción: La enfermedad de Parkinson afecta principalmente a personas >65 años. El cuadro degenerativo lumbar en el contexto de un canal estrecho sumado a la alteración neuromuscular y la mala calidad ósea, favorece al desequilibrio sagital y coronal. Los pacientes que necesitan cirugía tienen altas tasas de revisión y reoperación con técnicas instrumentadas y no ins-trumentadas. El objetivo de este estudio fue evaluar la técnica quirúrgica de descompresión mínimamente invasiva en pacientes con enfermedad de Parkinson y dolor radicular o claudicación neurogénica en los miembros inferiores. materiales y métodos: Se evaluó a pacientes con diagnóstico de canal lumbar estrecho y enfermedad de Parkinson tratados quirúrgicamente. El procedimiento se indicó por síntomas de canal estrecho o estenosis foraminal de causa degenerativa. Todos fueron tratados con una cirugía descompresiva a través de una hemilaminectomía mínimamente invasiva mediante retracción tubular y asistencia con microscopia. Resultados: De enero de 2015 a diciembre de 2017, se trató a 6 pacientes con enfermedad de Parkinson y canal lumbar estrecho. Se descomprimieron 12 niveles en total, todos estuvieron internados <24 h. No se necesitaron transfusiones, no hubo complicaciones asociadas, el tiempo promedio de cirugía fue de 120 minutos. El seguimiento mínimo fue de 12 meses, los síntomas no reaparecieron. Conclusiones: La elevada tasa de complicaciones en pacientes operados con enfermedad de Parkinson y la disminución de las complicaciones en este estudio sugieren que la cirugía mínimamente invasiva de columna lumbar debería ser una alternativa quirúrgica en estos pacientes. Nivel de Evidencia: IV


Introduction: Parkinson's disease mainly affects patients aged 65 and older. The degenerative condition at the lumbar spine in the context of a narrow canal added to the neuromuscular disorder and poor bone quality favors sagittal and coronal imbalance. Patients who need surgery have high rates of revision and reoperation with instrumented and non-instrumented techniques. The objective of this study was to evaluate the minimally invasive surgical decompression technique in patients with Parkinson's disease and radicular pain or neurogenic claudication in the lower limbs. Materials and Methods: Surgically treated patients with a diagnosis of lumbar spinal stenosis and Parkinson's disease were evaluated. The indication for the procedure was due to symptoms of the lumbar or foraminal stenosis of degenerative cause. All the patients were treated with decompressive surgery through a minimally invasive hemilaminectomy using tubular retraction and assistance with microscopy. Results: From January 2015 to December 2017, 6 patients with Parkinson's disease and lumbar spinal stenosis were treated. A total of 12 segments were decompressed, all patients were hospitalized for less than 24 hours. They did not require a transfusion nor suffered associated complications, with an average surgery time of 120 minutes. All with a minimum follow-up of 12 months and no relapse of the symptoms. Conclusion: The high rate of surgical complications in patients with Parkinson's disease, in contrast to the low rate of complications in the present study, suggests that minimally invasive surgery of the lumbar spine should be a surgical alternative in these patients. Level of Evidence: IV


Assuntos
Idoso , Doença de Parkinson , Procedimentos Cirúrgicos Minimamente Invasivos , Descompressão Cirúrgica
17.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1353908

RESUMO

Introducción: La laminectomía unilateral para descompresión bilateral por abordaje único ha tomado relevancia en pacientes con estenosis multinivel. Cuando se realiza en más de un nivel por un abordaje único, de manera alterna y de forma cruzada, al abordaje anterior es conocida como técnica de "slalom". Elobjetivode este artículo es presentar una serie de casos tratados con la técnica de "slalom" con asistencia endoscópica y microscópica bilateral, simultánea, en pacientes con estenosis de canal lumbar multinivel.materiales y métodos: Análisis retrospectivo de pacientes tratados de forma simultánea, entre enero de 2017 y enero de 2018, todos operados por el mismo equipo quirúrgico con separadores tubulares, y asistencia endoscópica y micros-cópica simultánea.Resultados: Se incluyó a 4 hombres, con una edad promedio de 73.5 años y patología lumbar multinivel. Se descomprimieron 10 segmentos (2,5 media de niveles por paciente), con un tiempo quirúrgico promedio de 107 minutos. No hubo complicaciones asociadas y los pacientes recibieron el alta hospitalaria el día de la cirugía.Conclusiones:La técnica de "slalom" mínimamente invasiva resulta ser un procedimiento muy eficaz para resolver síntomas de estenosis multinivel asociada a una técnica combinada bilateral con dos equipos quirúrgicos para el tratamiento de este tipo de pacientes. Nivel de Evidencia: IV


Introduction: Unilateral laminectomy for bilateral decompression (ULBD) by single approach has become relevant in patients with multilevel stenosis, when it is performed at more than one level with single approach, alternately and crosswise to the previous approach is known as a slalom technique.The objective of the following work is to present a series of cases treated with the slalom technique with bilateral endoscopic and microscopic assistance, simultaneous in patients with multilevel lumbar canal stenosis. Materials and Methods: Retrospective analysis of patients treated simultaneously between the months of January 2017 to January 2018, all operated by the same surgical team with tubular separators and simultaneous endoscopic and microscopic assistance. Results: Four patients, all male, with an average age of 73.5 years with multilevel lumbar pathology, were included. In total 10 segments were decompressed (2.5 average level for patients), with an average surgery of 107 minutes. No associated complications, with hospital discharge within the day of surgery. Conclusions: The minimally invasive Slalom technique turns out to be a very effective procedure to resolve symptoms of multilevel stenosis associated with a bilateral combined technique with two surgical teams, resulting in a viable option for the treatment of this type of patient. Level of Evidence: IV


Assuntos
Idoso , Estenose Espinal , Procedimentos Cirúrgicos Minimamente Invasivos , Descompressão Cirúrgica , Vértebras Lombares
18.
Sensors (Basel) ; 20(22)2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33182756

RESUMO

The integrity, comfort, and energy demand of a building can be negatively affected by the presence of moisture in its walls. Therefore, it is essential to identify and characterise this building pathology with the most appropriate technologies to perform the required prevention and maintenance tasks. This paper proposes the joint application of InfraRed Thermography (IRT) and Ground-Penetrating Radar (GPR) for the detection and classification of moisture in interior walls of a building according to its severity level. The IRT method is based on the study of the temperature distribution of the thermal images acquired without an application of artificial thermal excitation for the detection of superficial moisture (less than 15 mm deep in plaster with passive IRT). Additionally, in order to characterise the level of moisture severity, the Evaporative Thermal Index (ETI) was obtained for each of the moisture areas. As for GPR, with measuring capacity from 10 mm up to 30 cm depth with a 2300 MHz antenna, several algorithms were developed based on the amplitude and spectrum of the received signals for the detection and classification of moisture through the inner layers of the wall. In this work, the complementarity of both methods has proven to be an effective approach to investigate both superficial and internal moisture and their severity. Specifically, IRT allowed estimating superficial water movement, whereas GPR allowed detecting points of internal water accumulation. Thus, through the combination of both techniques, it was possible to provide an interpretation of the water displacement from the exterior surface to the interior surface of the wall, and to give a relative depth of water inside the wall. Therefore, it was concluded that more information and greater reliability can be gained by using complementary IRT-GPR, showing the benefits of combining both techniques in the building sector.

19.
Rev. argent. neurocir ; 34(3): 235-239, sept. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1120967

RESUMO

Introducción: Las lesiones durales son complicaciones frecuentes en la cirugía de columna. La fuga de liquidocefalorraquideo (LCR) puede originar hemorragia en todos los compartimientos del cerebro. La mayoría ocurre en venas ubicadas en región cerebelosa.Material y método: Se presenta un caso de hemorragia subaracnoidea posterior a una descompresión lumbar mínimamente invasiva asociada a desgarro dural. Resultados: Evoluciona en el postoperatorio con síntomas neurológicos de cefaleas y trastornos del sensorio por lo que se decide evaluarlo con estudios por imágenes vasculares cerebrales identificándose sangrado subaracnoideo.Discusión: El sitio más frecuente de hemorragia intracraneal posterior a una cirugía de columna es el cerebelo. El mecanismo de acción de este tipo de sangrados es desconocido y controversial, hay algunos reportes que sugieren que se trataría de un sangrado venoso. El síntoma más característico de este síndrome es la cefalea. Aunque se desconoce la etiología exacta, se postula que la pérdida de volumen de LCR causa una caída en la presión intracraneal, lo que lleva a un agrandamiento de los senos venosos durales que predisponen al paciente a un hematoma subdural espontáneoConclusión: La fuga de LCR, las alteraciones asociadas al edema cerebral en la hipotensión cerebral podría ser llave del mecanismo que desencadena una hemorragia subaracnoidea.


compartments of the brain. Most occur in veins located in the cerebellar region.Material and method: A case of subarachnoid hemorrhage after a minimally invasive lumbar decompression associated with dural tear is presented.Results: It evolves in the postoperative period with neurological symptoms of headaches and sensory disorders, so it is decided to evaluate it with studies by cerebral vascular images identifying subarachnoid bleeding.Discussion: The most frequent site of intracranial hemorrhage after spinal surgery is the cerebellum. The mechanism of action of this type of bleeding is unknown and controversial, there are some reports that suggest that it would be a venous bleeding. The most characteristic symptom of this syndrome is headache. Although the exact etiology is unknown, it is postulated that the loss of CSF volume causes a drop in intracranial pressure, which leads to an enlargement of the dural venous sinuses that predispose the patient to a spontaneous subdural hematomaConclusion: CSF leakage, alterations associated with cerebral edema in cerebral hypotension could be key to the mechanism that triggers a subarachnoid hemorrhage.


Assuntos
Humanos , Masculino , Hemorragia Subaracnóidea , Cirurgia Geral , Edema Encefálico , Hemorragias Intracranianas , Hematoma Subdural
20.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(3): 192-196, ago. 2020.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1340619

RESUMO

Introducción: Las infecciones del sitio quirúrgico pueden requerir tratamientos prolongados con antibióticos, una estancia hospitalaria más prolongada y operaciones repetidas. Las incisiones pequeñas y la posibilidad de evitar la disección subperióstica en la cirugía mininvasiva pueden reducir, al mínimo, el riesgo de infecciones posoperatorias. Sin embargo, los estudios publicados sobre infecciones después de procedimientos mininvasivos son escasos. El objetivo de este estudio fue evaluar retrospectivamente una serie de pacientes operados, de manera consecutiva, con una técnica mininvasiva y la incidencia de infección posoperatoria. Materiales y Métodos: Se incluyó a los pacientes sometidos a cirugía lumbar posterior con retractores tubulares y microscopio, en nuestro Servicio, entre enero de 2015 y enero de 2018. Los procedimientos realizados fueron discectomías tubulares, descompresiones para la estenosis de canal y resecciones de quistes sinoviales. La incidencia de infección del sitio quirúrgico se calculó y comparó con el rango de tasas de infección del sitio quirúrgico publicado. Resultados: Se realizaron cirugías no instrumentadas (discectomías, descompresiones) en 212 pacientes. La media de la edad era de 62.4 años y la relación hombre:mujer, de 1,27:1. Solo un paciente sufrió una infección del sitio quirúrgico, diagnosticada el día 9 poscirugía, que fue tratada mediante lavado y limpieza de la herida. Conclusión: La tasa de infección fue del 0,47%. La cirugía mininvasiva puede disminuir notablemente la tasa de infección del sitio quirúrgico y puede ser una herramienta eficaz para reducir, al mínimo, los costos hospitalarios. Nivel de Evidencia: IV


Introduction: Surgical site infections (SSI) can lead to prolonged antibiotic treatments, increased hospital stays, and repeated operations. Small incisions and the possibility of avoiding subperiosteal dissection in minimally invasive surgery can minimize the risk of postoperative infections. However, there is a shortage of literature on infections after mini-invasive procedures. Objective: To evaluate retrospectively a series of patients consecutively operated on with minimally invasive technique and the incidence of postoperative infection. Materials and Methods: All patients undergoing posterior lumbar surgery with tubular retractors and microscope in our department from January 2015 to January 2018 were included. The procedures performed included tubular discectomies, lumbar stenosis decompressions, and synovial cyst resections. The incidence of postoperative SSIs was calculated and compared with the literature range for SSI rates. Results: A total of 212 patients underwent non-instrumented surgeries (discectomies, decompressions). The mean age was 62.4 years with a male:female ratio of 1.27:1. Only one patient had SSI, which was diagnosed on day 9 and treated by reoperation, surgical toilet of the wound, and antibiotic therapy. Conclusion: The infection rate was 0.47%. Minimally invasive surgery can significantly reduce the SSI rate and can be an effective tool in minimizing hospital costs. Level of Evidence: IV


Assuntos
Adulto , Pessoa de Meia-Idade , Infecção da Ferida Cirúrgica , Discotomia , Procedimentos Cirúrgicos Minimamente Invasivos , Vértebras Lombares
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