Laparoscopic hemi-splenectomy: a valid option in selected cases such as epidermoid cyst.

Splenic cysts are a rare pathology, which can be classified as true (25%) or pseudocysts (75%). Total splenectomy has been the treatment of choice, particularly in recent times with the advent of the laparoscopic approach. However, as the spleen is an organ with multiple immunological functions, the laparoscopic partial splenectomy is an alternative, which is technically difficult but effective. We present a case of a 26-year-old woman with incidental evidence of a splenic cyst in an abdominal ultrasound scan. We performed a laparoscopic partial splenectomy to preserve the function of the spleen because of the patient's youth. Laparoscopic partial splenectomy allows the effective removal of lesions and preservation of splenic function. Although more research is needed to clarify the most effective approach, this case is further evidence that this surgical approach may be beneficial for selected patients.

Ileocecal intussusception extending to left colon due to endometriosis.

Bowel involvement in endometriosis is uncommon and is most frequently located in the sigmoid colon and the rectum. We present a case in a 37-year-old woman of a cecal endometrioid mass complicated with an ileocolic intussusception which extended beyond the splenic colon flexure. Careful manual extraction allowed a reduction of the intussusceptum, followed by an oncological right hemicolectomy. The patient suffered postoperative ileus, which was spontaneously solved. Intussusception is infrequent in the adult population and usually involves the small bowel. The great majority of ileocolic intussusceptions have a malignant origin (cecal adenocarcinoma). An endometriotic mass located at the cecum as the lead point for ileocolic intussusception is an extremely rare presentation. On reviewing the literature, we found only 13 reports with no other cases extending beyond the splenic flexure, as occurred in our patient.

Anestesia espinal y cirugía ambulatoria / Spinal anesthesia in Ambulatory Surgery

En los últimos años hemos asistido a un abandono de la anestesia espinal como técnica habitual en pacientes ambulatorios por el auge de la anestesia general. Esto se debe a los efectos adversos clásicamente asociados a su empleo y al retraso en el alta domiciliaria. Sin embargo, la irrupción en el mercado de los nuevos anestésicos locales de corta duración y la utilización de la anestesia subaracnoidea selectiva en procedimientos ortopédicos ha suscitado un interés creciente por esta técnica anestésica. Con este artículo pretendemos hacer una revisión de la anestesia espinal, de las indicaciones, contraindicaciones y de los efectos adversos asociados a la técnica. Finalmente, proponemos un resumen breve de los nuevos anestésicos locales de acción corta y unas recomendaciones para la cirugía proctológica y del miembro inferior (AU)

Recently, we have witnessed a drop of spinal anesthesia as a routine technique in outpatients by the rise of general anesthesia. This is due to the adverse effects typically associated with its employment and delayed discharge home. However, the introduction of new local anesthetics of short duration and the use of selective spinal anesthesia in orthopedic procedures has led to a growing interest in the anesthetic technique. We intend with this article to make a review of spinal anesthesia, including indications and contraindications and associated technical side effects. Finally, we provide a brief summary of the new short-acting local anesthetics and recommendations for the proctologic and lower limb surgery (AU)

Low condylectomy as the sole treatment for active condylar hyperplasia: facial, occlusal and skeletal changes. An observational study.

The purpose of this study was to measure the changes in facial, occlusal, and skeletal relationships in patients with active unilateral condylar hyperplasia whose sole treatment was a low condylectomy. A retrospective observational descriptive study was conducted. All patients had undergone a low condylectomy as the sole or initial surgical treatment. The size of the condylar segment removed was decided by matching the affected side with the healthy side, leaving them both like the healthy one. The length of the ramus was measured using panoramic X-ray (distance from the highest part of the condyle to the mandibular angle). Facial, occlusal, and skeletal changes were evaluated using clinical, photographic, and radiological records before and after surgery. Condylectomy as the sole treatment for patients with active condylar hyperplasia allowed improvements to the alterations produced by this pathology, such as chin deviation, tilted lip commissure plane, tilted occlusal plane, angle of facial convexity, unevenness of the mandibular angles, and length of the mandibular ramus. The occlusal relationship also improved with orthodontic and elastic therapy. To conclude, low condylectomy as a sole and aetiological treatment for patients with active condylar hyperplasia allowed improvements to alterations produced by this pathology.