ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Lipoma/pathology , Neoplasms, Fibrous Tissue/pathology , Neuralgia/diagnosis , Diagnosis, Differential , Lipoma/diagnostic imaging , Lipoma/surgery , Neoplasm Recurrence, Local , Neoplasms, Fibrous Tissue/diagnostic imaging , Neoplasms, Fibrous Tissue/surgery , Neuralgia/etiology , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Appendicitis/etiology , Appendix , Foreign Bodies/complications , Acute Disease , Appendicitis/surgery , Emergencies , Foreign Bodies/surgery , Gangrene/etiology , RadiographySubject(s)
Lipoma/pathology , Neoplasms, Fibrous Tissue/pathology , Neuralgia/diagnosis , Diagnosis, Differential , Humans , Lipoma/diagnostic imaging , Lipoma/surgery , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neoplasm Recurrence, Local , Neoplasms, Fibrous Tissue/diagnostic imaging , Neoplasms, Fibrous Tissue/surgery , Neuralgia/etiology , Treatment OutcomeSubject(s)
Appendicitis/etiology , Appendix , Foreign Bodies/complications , Acute Disease , Appendicitis/surgery , Emergencies , Foreign Bodies/surgery , Gangrene/etiology , Humans , Male , Middle Aged , RadiographyABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Streptococcus pyogenes , Streptococcus pyogenes/isolation & purification , Streptococcus pyogenes/pathogenicity , Peritonitis/complications , Peritonitis/therapy , Amoxicillin-Potassium Clavulanate Combination/administration & dosage , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Clindamycin/therapeutic use , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Hemoperitoneum/complications , Hemoperitoneum/surgery , Hemoperitoneum , Neoplasm Metastasis , Aneurysm/complications , Aneurysm , Adenocarcinoma, Papillary/complications , Adenocarcinoma, Papillary/surgery , Adenocarcinoma, Papillary , Nephrectomy/methods , Liver Neoplasms/complications , Liver Neoplasms , Microvessels/pathology , Microvessels , Carcinoma/surgery , Carcinoma , Hospice Care/methodsSubject(s)
Round Ligament of Liver , Hemoperitoneum , Humans , Liver Neoplasms , Rupture, SpontaneousABSTRACT
BACKGROUND: Roux-en-Y gastric bypass (RYGB) is considered the gold standard for the treatment of morbid obesity. There is no consensus over ideal limb length when the bypass is created and published studies do not take into account the influence of the common limb (CL) on weight loss. The objective was to study the influence of the common limb after RYGB. The setting was the Virgen de la Arrixaca University Clinical Hospital in Murcia, Spain. MATERIAL AND METHODS: This prospective study includes 151 patients undergoing laparoscopic RYGB surgery for morbid obesity. The patients were divided into 2 groups according to their body mass index. The small intestine (SI) was measured using micro forceps so that the percentage of common limb (%CL) could then be compared against the total SI in each patient. The percentage of excess weight loss (%EWL) in relation to the %CL was calculated at 3, 12, and 24 months. A series of tests was conducted simultaneously to analyze nutritional deficiencies and their relation to the %CL. RESULTS: The total jejunoileal segment and the %CL in the groups of both obese and super-obese patients had no influence on the %EWL in either group for any of the periods studied. The patients with a %CL<50% had greater nutritional deficiencies in the follow-up period and required supplements and more frequent laboratory tests. CONCLUSIONS: The %CL has no effect on weight loss in RYGB patients. A lower %CL is related to greater nutritional deficiencies.
Subject(s)
Deficiency Diseases/etiology , Gastric Bypass/methods , Intestine, Small/pathology , Laparoscopy/methods , Obesity, Morbid/surgery , Postoperative Complications/etiology , Adult , Aged , Albumins/deficiency , Avitaminosis/etiology , Calcium/deficiency , Deficiency Diseases/pathology , Folic Acid Deficiency/etiology , Humans , Male , Middle Aged , Obesity, Morbid/pathology , Organ Size , Postoperative Complications/pathology , Prospective Studies , Weight Loss , Young AdultABSTRACT
INTRODUCCIÓN: El tratamiento del cáncer de recto por laparoscopia es controvertido por su complejidad técnica. Estudios prospectivos aleatorizados han demostrado claras ventajas para el paciente, con resultados oncológicos equiparables a la cirugía abierta, aunque durante el aprendizaje de esta cirugía puede existir un aumento de las complicaciones y peor pronóstico. OBJETIVO: Nuestro objetivo es analizar cómo influye la curva de aprendizaje del cáncer de recto por vía laparoscópica en los resultados intra y postoperatorios, así como en los marcadores oncológicos. PACIENTES Y MÉTODOS: Se realizó una revisión retrospectiva de los 120 primeros pacientes intervenidos de neoplasia de recto por vía laparoscópica. La población a estudio se ordenó cronológicamente por fecha de intervención y se dividió en un primer grupo que contenía las 40 primeras intervenciones, y un segundo grupo que contenía las 80 siguientes. Las intervenciones fueron realizadas por el mismo equipo quirúrgico con una amplia experiencia en el tratamiento del cáncer colorrectal abierto, además de estar capacitados para realizar cirugía laparoscópica avanzada. Se analizaron sexo, ASA, localización del tumor, neoadyuvancia, técnica quirúrgica, tiempo operatorio, conversión, complicaciones postoperatorias, estancia hospitalaria, número de ganglios, estadio y afectación de márgenes. RESULTADOS: Se observaron diferencias significativas en cuanto a tiempo quirúrgico (224 min en el primer grupo, 204 min en el segundo grupo), con una mayor tasa de conversión en el primer grupo (22,5%) frente al segundo (11,3%). No se apreciaron diferencias significativas en cuanto a la tasa de cirugía conservadora de esfínteres, estancia hospitalaria, complicaciones posquirúrgicas, número de ganglios afectos/aislados ni márgenes circunferencial y distal afectos. CONCLUSIÓN: Es posible realizar el aprendizaje de esta compleja cirugía sin comprometer la seguridad y resultado oncológico del paciente
INTRODUCTION: The treatment of rectal cancer via laparoscopy is controversial due to its technical complexity. Several randomized prospective studies have demonstrated clear advantages for the patient with similar oncological results to those of open surgery, although during the learning of this surgical technique there may be an increase in complications and a worse prognosis. OBJECTIVE: Our aim is to analyze how the learning curve for rectal cancer via laparoscopy influences intra- and postoperative results and oncological markers. A retrospective review was conducted of the first 120 patients undergoing laparoscopic surgery for rectal neoplasia. The operations were performed by the same surgical team with a wide experience in the treatment of open colorectal cancer and qualified to perform advanced laparoscopic surgery. We analyzed sex, ASA, tumor location, neoadjuvant treatment, surgical technique, operating time, conversion, postoperative complications, length of hospital stay, number of lymph nodes, stage and involvement of margins. RESULTS: Significant differences were observed with regard to surgical time (224 min in the first group, 204 min in the second group), with a higher rate of conversion in the first group (22.5%) than in the second (11.3%). No significant differences were noted for rate of conservative sphincter surgery, length of hospital stay, post-surgical complications, number of affected/isolated lymph nodes or affected circumferential and distal margins. CONCLUSIONS: It is possible to learn this complex surgical technique without compromising the patient's safety and oncological outcome
Subject(s)
Humans , Rectal Diseases/surgery , Rectum/surgery , Digestive System Surgical Procedures/methods , Laparoscopy/methods , Retrospective Studies , Digestive System Surgical Procedures/education , Professional Training , Postoperative Complications/epidemiologyABSTRACT
INTRODUCTION: The treatment of rectal cancer via laparoscopy is controversial due to its technical complexity. Several randomized prospective studies have demonstrated clear advantages for the patient with similar oncological results to those of open surgery, although during the learning of this surgical technique there may be an increase in complications and a worse prognosis. OBJECTIVE: Our aim is to analyze how the learning curve for rectal cancer via laparoscopy influences intra- and postoperative results and oncological markers. A retrospective review was conducted of the first 120 patients undergoing laparoscopic surgery for rectal neoplasia. The operations were performed by the same surgical team with a wide experience in the treatment of open colorectal cancer and qualified to perform advanced laparoscopic surgery. We analyzed sex, ASA, tumour location, neoadjuvant treatment, surgical technique, operating time, conversion, postoperative complications, length of hospital stay, number of lymph nodes, stage and involvement of margins. RESULTS: Significant differences were observed with regard to surgical time (224 min in the first group, 204 min in the second group), with a higher rate of conversion in the first group (22.5%) than in the second (11.3%). No significant differences were noted for rate of conservative sphincter surgery, length of hospital stay, post-surgical complications, number of affected/isolated lymph nodes or affected circumferential and distal margins. CONCLUSIONS: It is possible to learn this complex surgical technique without compromising the patient's safety and oncological outcome.
Subject(s)
Digestive System Surgical Procedures/education , Digestive System Surgical Procedures/methods , Laparoscopy/education , Learning Curve , Postoperative Complications/epidemiology , Rectal Neoplasms/surgery , Aged , Female , Humans , Male , Retrospective Studies , Time FactorsABSTRACT
No disponible
Subject(s)
Humans , Cardiac Surgical Procedures , Cholecystitis, Acute/complications , Emphysematous Cholecystitis/complications , Postoperative ComplicationsSubject(s)
Humans , Male , Adult , Appendicitis/parasitology , Dysentery, Amebic/complications , Appendectomy , Emigrants and Immigrants , Risk FactorsABSTRACT
INTRODUCTION: The use of single-incision laparoscopic surgery may represent an improvement over conventional laparoscopic surgery. In recent years, more and more articles have been published demonstrating the feasibility of this approach. Hence, for this reason, we present this randomized prospective study to compare the 2 techniques. METHODS: Between September 2009 and December 2010, a total of 184 patients with a diagnosis of acute appendicitis and indicated for surgery were included in the study, of whom, 91 received an appendectomy via a single umbilical incision and 93 via conventional laparoscopy. The study protocol was approved by the ethical committee of the Virgen de la Arrixaca University Hospital (Murcia). The study was registered on ClinicalTrials.gov with inscription number NCT0151529. All the operations were performed by the same team of surgeons. RESULTS: As far as the demographical results of the study population are concerned, there were no significant differences between the 2 groups for age, weight, sex, body mass index, and removed appendix type. Operating time was longer with the single-port approach: 38.13 ± 13.49 versus 32.12 ± 12.44 minutes (P = 0.02). Significant differences were observed for postoperative pain, which was measured on the visual analog scale, with less pain reported in the single-incision group: 2.76 ± 1.64 versus 3.78 ± 1.76 (P < 0.001). There were no significant differences between the 2 groups for early and late complications and lengths of hospital stay measured in postoperative hours. CONCLUSIONS: The transumbilical single-port approach is seen as a feasible technique for performing appendectomy. It does not increase the rate of complications and represents a possible alternative to conventional laparoscopic appendectomy.
Subject(s)
Appendectomy/methods , Appendicitis/surgery , Laparoscopy/methods , Laparotomy/methods , Umbilicus/surgery , Acute Disease , Adolescent , Adult , Aged , Body Mass Index , Child , Female , Follow-Up Studies , Humans , Length of Stay , Male , Middle Aged , Pain Measurement , Pain, Postoperative/diagnosis , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
El número de complicaciones tras el cierre de ileostomía es del 17%. El íleo paralítico es la complicación más frecuente. Con el objetivo de disminuir esta complicación, en las 2 semanas previas al cierre del estoma, se realizó una estimulación diaria a través del asa eferente (AU)
There is a 17% complications rate after ileostomy closure, with paralytic ileus being the most common. With the aim of reducing this complication, stimulation via the afferent loop was performed daily for the 2 weeks prior to the stoma (AU)
Subject(s)
Humans , Ileostomy/rehabilitation , Efferent Pathways , Transcutaneous Electric Nerve Stimulation/methods , Intestinal Pseudo-Obstruction/prevention & control , Postoperative Complications/prevention & controlSubject(s)
Amebiasis , Appendicitis/parasitology , Adult , Amebiasis/diagnosis , Amebiasis/surgery , Appendicitis/diagnosis , Appendicitis/surgery , Humans , MaleABSTRACT
There is a 17% complications rate after ileostomy closure, with paralytic ileus being the most common. With the aim of reducing this complication, stimulation via the afferent loop was performed daily for the 2 weeks prior to the stoma.