Gastrosquisis: nueva técnica quirúrgica mediante el procedimiento simil exit experiencia en Hospital Universitario Japonés, clínica foianini y UDIME / Gastroschisis: new surgical technique using the exit procedure similar experience in Japanese University Hospital, clinic foianini and UDIME

Se denomina gastrosquisis al prolapso prenatal del intestino hacia la cavidad amniótica a través de un pequeño defecto de todos los planos de la pared abdominal, ubicado generalmente a la derecha del cordón umbilical. Su prevalencia está incrementándose progresivamente en las últimas décadas, desde un caso por cada 10.000 nacidos vivos en los años setenta, hasta uno por cada 2.500 en la actualidad. La gastrosquisis suele presentarse de forma aislada y esporádica y asociada a malformaciones congénitas...

[How I do it: myelomeningocele in bolivia]. / Como Lo Hago Yo: Mielomeningocele En Bolivia.

INTRODUCTION: Neural Tube Defects (NTD) are the second congenital malformation, second only to cardiac malformations. Myelomeningocele (MMCL) is the most frequent NTD and the more complex. In Bolivia, like in many countries in South America, the low socio economical level of the population increases its incidences and complicates its management. MATERIALS AND METHODS: Retrospective study of 70 cases of MMC at Hospital Universitario Japonés (HUJ), Santa Cruz de la Sierra, between 2008-2011. Sixty had surgery. RESULTS: Prenatal care in 27 women (38.6%), positive diagnosis for spinal disraphism in 2 (7.4%). The child arrived after 24 hours of birth (65.5%). Lumbosacral lesion (64.3%). Of those 67.2% were open, with 32.9% evidencing partial motor lesion in contrast with 47.1% who were paraplegic bellow the level of the lesion. Three children were not operated because they had complex and severe malformations associated to the MMCL. The most common surgical complications were; wound dehiscence or infection (16.6%), CSF fistula (10%) CNS infection (11.7%). Mortality and specifically postoperative mortality were 7.1% y 3.3%, respectively. Hydrocephalus wass evident in 80% of the patients who were operated, they received a VP shunt medium pressure. Nine patients who had long term follow up presented with tethered cord. CONCLUSIONS: A characteristic, delayed referral. No gender predominance. Majority of cases were lumbar or lumbar sacral. Mortality similar to what is reported in the literature. Few patients came for follow up. MMCL is a pathology that requires concentrated attention by the national authorities. A multi center and multi national study will improve our management of these patients.

Tratamiento endoscópico con deflux en flujo vesicoureteral / Endoscopic treatment with deflux in flux vesicoureteral

El tratamiento del reflujo vesicoureteral (RVU) ha pasado por varias etapas, desde la conducta clínica hasta la quirúrgica.

Abordaje laporoscopico transanal en el manejo de atresia rectal / Laparoscopic transanal rectal atresia management

La atresia rectal es una malformación anorectal rara y donde se han descrito varios procedimientos quirúrgicos para resolverlos. El propósito del presente trabajo es presentar experiencia y seguimiento en un paciente varón con atresia anal que fue operado, utilizando un abordaje laparoscópico y trans-anal, sin complicacionesintraoperatorias y post-operatorias.