[Extracorporeal shockwave lithotripsy in patients with coagulation disorders]. / Litotricia extracorpórea por ondas de choque en pacientes con trastornos de coagulación.

During treatment of renal lithiasis with extracorporeal shock wave lithotripsy (ESWL) hemorrhagic events, especially renal hematoma, may present. A coagulation study is warranted in order to institute hemotherapy for blood factor deficiencies. We reviewed the records of 4,000 patients that had undergone ESWL. Of these, 17 (12 males, 5 females) presented coagulation disorders. The bleeding diatheses were due to platelet deficiency in 6 cases, plasma defects in 5, platelet and plasma disorders in 2, and capillary wall defects in 5 cases. The underlying cause was hepatosplenic disease in 12 cases, iatrogenic in 1, connectivopathy and corticoids in 2, and capillary purpura of unknown cause in 2 cases. Due to this protocol, no patient presented hemorrhage or hematoma from shock wave-induced lesions. These results show that a complete coagulation study must be performed in order to institute the necessary measures in patients with disorders of hemostasis due to the high risk of hematoma repeatedly reported in the literature.

[New ultrasonic images in patients with lithiasis after undergoing extracorporeal shock wave lithotripsy]. / Neuvas imágenes ecográficas en los litiásicos sometidos a litotricia extracorpórea por ondas de choque.

Evaluation and follow-up of patients submitted to extracorporeal shock wave lithotripsy (ESWL) by ultrasonography is a good adjunct to radiology. Plain x-ray and ultrasound imaging permit following the course of stone patients submitted to treatment by ESWL without recurring to IVP in most of the cases. One-thousand kidney units corresponding to 931 stone patients were submitted to ESWL. Patient evaluation by ultrasound was performed prior to and 24 hours after treatment. Ultrasonographic evaluation is important because it permits: 1. Detection of changes in size, number, and site of the hyperechogenic image. 2. Evaluation and follow-up of urinary tract dilatation. 3. Control of radiolucent calculi thereby avoiding repeated explorations using contrast medium. 4. Detection of possible perirenal hematoma post-ESWL. 5. Diagnosis of other renal or extrarenal disorders.

Nuevas aportaciones de la mascarilla laríngea en cirugía ambulatoria. Contribución de la mascarilla laríngea Supreme / No disponible

Desde la introducción de la mascarilla laríngea, su uso se ha expandido especialmente en el contexto de la cirugía ambulatoria. La mascarilla laríngea representa el “patrón oro” de los dispositivos supraglóticos, y es la referencia con la que los nuevos dispositivos deben ser comparados. La presente revisión es una actualización de las principales indicaciones de la mascarilla laríngea en usos avanzados, incluyendo el abordaje de la vía aérea difícil en el paciente intervenido de forma ambulatoria. Así mismo se incluye una revisión de las indicaciones, aportaciones, y ventajas de la mascarilla laríngea Supreme aplicadas al contexto de la cirugía sin ingreso (AU)

Since the introduction of the original laryngeal mask airway(LMA) in the nineties in our country, its use has expanded especially in the context of outpatient surgery. The LMA remains the “gold standard” of the supraglotic devices and the standard by which all other devices should be compared. This review is an update of the main indications of the LMA in advanced applications, including addressing the difficult airway in the patient operated on an outpatient basis. Also includes a review of the information, contributions, and advantages of the LMA supreme applied to the context of day surgery (AU)