Cirugía mayor ambulatoria ginecológica en el Hospital San José de Parral / Major outpatient gynecological surgery at the San Jose de Parral Hospital

OBJECTIVE: Evaluate initial results of a ambulatory major surgery program in Gynecology. MATERIAL AND METHODS: Retrospective, descriptive study of the period March 2018 to June 2019. The interventions included were: surgical sterilizations via vaginal, minilap and laparoscopic, diagnostic laparoscopy, laparoscopic cyst or anexectomy, hysteroscopy, TOT, vaginal plasty, biopsy curettage, polypectomy, extraction of IUD under anesthesia, labiaplasty, and removal of transobsturatrix tape. Quality indicators such as suspension, readmissions and systemic and surgical complications have been analyzed. RESULTS: 136 patients were operated by CMA of which 43 were laparoscopic (31.6%), 55 patients vaginally (40.4%), 34 histeroscopy (25%) and 4 patients by minilap (3%)There were 4 minor and late complications (2.9%) that corresponded to operative wound infection in vaginal plasty and nymphoplasty, a dysfunctional TOT tape that had to be removed in a mediated manner and a PIP post surgical sterilization via vaginal route. CONCLUSIONS: Gynecological ambulatory major surgery is feasible to perform in a hospital of medium complexity with a low percentage of minor complications in this study.

Is the buccal compartment a masticatory space extension or an anatomic space in itself? Evidence based on medical images and human cadaver dissection.

OBJECTIVES: According to some authors, the buccal space is incompletely closed with no real anatomical separation from the masticator space, and also has no fascial limit toward the cranial and caudal regions. However, several other authors consider this anatomic area to be a separated space. The goal of this study was to provide a detailed description of the normal anatomy using medical images and human cadaveric head material dissection of this facial anatomic region, to precisely clarify its condition as an extension of the masticator space or an independent space. METHODS: The buccomasseteric area in 25 male and female patients aged 14-68 years, who were referred for various head and neck disorders that did not compromise the masticatory and buccal area, was analyzed by magnetic resonance imaging on the axial and coronal planes. The region was further examined by dissection of the buccomasseteric area in four heads of fresh adult male and female human cadavers aged 30-65 years. RESULTS: The findings demonstrated that the buccal compartment should be considered part of the masticator space, rather than a space in itself. This was mainly because a corridor was positioned medially to the tendon of the masseter muscle that communicated the infratemporal region of the masticator space with the buccal region, with no fascial barrier at this level that could separate it from the masticator space. CONCLUSIONS: The present study suggests that the buccal compartment is part of the masticator space, rather than a space in itself.