Analgesia en cirugía abdominal laparoscópica / Analgesia in laparoscopic surgery

Resumen: El abordaje laparoscópico ha revolucionado la cirugía abdominal en los últimos 30 años, y ahora los cirujanos son capaces de realizar operaciones sin realizar grandes incisiones a la pared abdominal. Así como la colecistectomía, apendicectomía y los procedimientos tubo-ováricos fueron los abordajes iniciales, la laparoscopía ahora ha incrementado su aplicabilidad a procedimientos mayores como histerectomía, procedimientos bariátricos y varias resecciones gastrointestinales y urológicas de tipo oncológico. Los avances tecnológicos han generado el desarrollo de muchas variaciones sobre el abordaje laparoscópico «tradicional o estándar¼. Los aspectos en el cuidado perioperatorio multimodal fueron asignados para alcanzar una recuperación más rápida después del procedimiento quirúrgico. Esto dependerá del tipo de cirugía realizada, de factores propios del paciente y de la presencia de comorbilidades. La duración de la recuperación después de la cirugía laparoscópica dependerá del procedimiento realizado, pudiendo ser tan corta como de una a dos semanas en procedimientos de tipo ambulatorio (visita http://www.painoutmexico.com para obtener la versión completa del artículo y el diagrama de recomendaciones).

Abstract: Laparoscopy has revolutionized abdominal surgery over the past 30 years that enable surgeons to perform operations without making large abdominal incisions. As well as cholecystectomy, appendicectomy, and tubo-ovarian procedures, laparoscopy is now increasingly used for hysterectomy, bariatric procedures, and many gastrointestinal and urological cancer resections. Technological advances have resulted in the development of several variations on the «standard¼ laparoscopic approach. The multimodal perioperative care pathways were designed to achieve early recovery after surgical procedures. This depends upon the type of surgery that has been performed, and patient factors such as comorbidities. The duration of recovery after laparoscopic surgery depends on the procedure performed and can be as short as 1-2 weeks in day case procedures (visit http://www.painoutmexico.com to see the full article and recommendations).

Two Cases of Advanced Ovarian Serous Tumor of Borderline Malignancy / 대한부인종양콜포스코피학회잡지

Ovarian serous tumors of low malignant potential (borderline serous tumors) are intermediate in their clinical behavior between benign serous cystadenoma and malignant neoplasm, and are associated with 10 year survival rates in excess of 90%. Borderline ovarian serous tumors are characterized by absence of stromal invasion but presence of some characteristics of malignancy. Borderline ovarian tumors occur predominantly in premenopausal women, and associated with a very good prognosis. The principal treatment of borderline malignancy is surgical resection of the primary tumor. But approximatley 20% of patients with ovarian tumors of low malignant potential present with Stage III or IV disease at the time of diagnosis. The benefit of postsurgical therapy in this group of patients has not been well established. We report two cases of advanced ovarian serous borderline tumor, one of which was treated with 3 cycles of cisplatin-taxol chemotherpy.