ABSTRACT
Introducción. La preservación de la mucosa intestinal ofrece resultados desalentadores que influyen en la viabilidad del injerto y supervivencia del paciente. El objetivo es valorar si la octreótida es capaz de prolongar el tiempo de preservación y mejorar la calidad del injerto intestinal. Material y métodos. Se han empleado 60 animales (ratas Wistar) distribuidos en dos grupos, octreótida y control, en cada uno de los cuales se ha practicado la extracción y preservación del injerto de intestino delgado (6, 12, 24 h). Posteriormente, se cuantificó el contenido de TNF-alfa intraluminal y se valoró el grado de daño histológico. Resultados. El grupo tratado con octreótida presentó un descenso significativamente estadístico del contenido de TNF intraluminal; asimismo, presenta de forma consistente un menor grado de daño histológico en todas las clasificaciones empleadas. Conclusiones. El efecto citoprotector de la octreótida, su capacidad de inhibir la liberación de proteasas luminales por parte del páncreas, así como su acción estabilizadora sobre el mastocito mesentérico pueden explicar que disminuya el daño total, ampliando la "ventana" terapéutica (AU)
Subject(s)
Organ Preservation/history , Intestine, Small , Intestine, Small/injuries , Intestine, Small/surgery , Tumor Necrosis Factor-alpha/historyABSTRACT
No disponible
Subject(s)
Hernia/complications , Hernia/surgery , Hernia/diagnosis , Polypropylenes/therapeutic use , Laparotomy , Hernia, Ventral/surgery , Hernia, Ventral/complications , Hernia, Ventral/diagnosis , Hernia, Ventral/etiology , Hernia, Ventral , Suture Techniques/trends , Suture Techniques , Surgical Mesh/trends , Surgical Mesh , Surgical Mesh/supply & distributionABSTRACT
En la experiencia de los cirujanos, las hernias de la pared abdominal constituyen una enfermedad cuyo diagnóstico es básicamente clínico. Sin embargo, la hernia de Spiegel, por su infrecuente presentación (0,2 por ciento), sintomatología inespecífica y exploración anodina, pasa fácilmente desapercibida. Presentamos nuestra experiencia en 7 pacientes (2 por ciento) con hernia de Spiegel, analizando las dificultades diagnósticas que aconsejan con frecuencia el empleo de pruebas diagnósticas complementarias (AU)
Subject(s)
Adult , Aged , Female , Male , Middle Aged , Humans , Laparotomy , Hernia, Ventral/diagnosis , Hernia, Ventral/epidemiology , Hernia, Ventral/complications , Hernia, Ventral , Hernia, Ventral/surgery , Tomography, X-Ray Computed , Polypropylenes , Polypropylenes/adverse effects , Diagnosis, Differential , Abnormalities, Multiple/surgery , Abnormalities, Multiple/diagnosisSubject(s)
Adenocarcinoma/complications , Cecal Neoplasms/complications , Ileal Diseases/etiology , Intussusception/etiology , Abdomen/diagnostic imaging , Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Aged , Aged, 80 and over , Cecal Neoplasms/diagnosis , Cecal Neoplasms/surgery , Humans , Ileal Diseases/diagnosis , Ileal Diseases/surgery , Intussusception/diagnosis , Intussusception/surgery , Male , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The case of a 22 year old male with massive faecal impaction and anorectal mechanical stenosis caused by multiples bone fractures and pelvic deformities secondary to imperfect osteogenesis is reported. The patient was treated with subtotal colectomy and permanent colostomy.
Subject(s)
Fecal Impaction/etiology , Osteogenesis Imperfecta/complications , Adult , Fecal Impaction/physiopathology , Humans , Male , ManometryABSTRACT
Between October 1987 and January 1989, a prospective study was performed on the nutritional state of 100 elderly patients aged 65 and over, with digestive neoplasia. We found that 47% were suffering from malnutrition. This was associated to greater postoperative complications and mortality, and prealbumin and weight-loss percentages were the nutritional parameters most often altered, and which showed better correlations to the development of postoperative complications. Based on these two parameters, we prepared a classification system for these patients, dividing them into three surgical risks groups from the nutritional standpoint, which enabled us to select those patients who would most benefit from preoperative nutritional support, and evaluate the effectiveness of this treatment in reducing postoperative complications and mortality, by means of a corresponding prospective study.
Subject(s)
Digestive System Neoplasms/complications , Nutrition Disorders/complications , Nutritional Status , Postoperative Complications/etiology , Preoperative Care , Aged , Aged, 80 and over , Digestive System Neoplasms/surgery , Humans , Prognosis , Prospective Studies , RiskABSTRACT
From 1980 to 1986, 569 patients with colonic disease underwent surgery in the General Surgery Service of "Nuestra Sra. de Aránzazu" Hospital, 131 of them over 75 and representing 23% of the total. In this group, neoplasms were the most common lesion, for a total of 108 cases (83.2%). Among nontumoral diseases, half corresponded to diverticula. Colonic surgery was practiced as an emergency in 35.87% of the cases and in 72.7% of the non-neoplastic lesions, with an overall operative mortality of 28 patients (21.37%). We analyze the distribution of the different lesions of the colon, the urgency of the operation and operative mortality as related to age, evaluating the limitations in elderly patients and their increased surgical risk.
Subject(s)
Colonic Diseases/surgery , Age Factors , Aged , Cause of Death , Colonic Diseases/mortality , Colonic Neoplasms/mortality , Colonic Neoplasms/surgery , Female , Humans , Male , Middle Aged , Risk FactorsABSTRACT
From 1979 to 1987, 5 patients with cholecystocolonic fistula were operated on in our service, which represents 25% of a total of 20 external biliodigestive fistulas complied over this period. Admission was as an emergency in 4 of the 5 patients (80%), and in one for elective programmed surgery. External biliodigestive fistula was suspected in 3 patients (60%) and biliocolonic fistula in one (20%), on observing aerobilia and leakage of contrast into the hepatic angle of the colon. On two occasions (40%) associated choledocholithiasis was detected, by means of echographic study in one case and intraoperative cholangiography in the other. Antecedents of biliary pathology were present in 3 of our 5 observations (60%), with a mean time of evolution of 12 years.
