Subject(s)
Humans , Male , Aged , Hernia, Diaphragmatic/diagnostic imaging , Carcinoma, Hepatocellular/surgery , HepatectomySubject(s)
Cysts , Liver Diseases , Cysts/diagnostic imaging , Cysts/surgery , Humans , Liver Diseases/diagnostic imagingABSTRACT
INTRODUCTION: Of the possible complications after a cephalic duodenopancreatectomy (CPD), the clinically relevant postoperative pancreatic fistula (PPF) is the most important, especially in patients with pancreas of a soft consistency. The main objective of this work is to analyze the different postsurgical complications, with special emphasis on the rate of PPF on soft pancreas with a risk of moderate/high PPF, and its incidence between the two different types of sutures used by our group (classic vs reinforced duct-mucosa anastomosis [REDMA]). METHODS: Retrospective observational study, between January 2017 and March 2020, of patients undergoing CPD in our unit after applying the inclusion and exclusion criteria. Analysis of preoperative, intraoperative factors and postoperative complications observed during follow-up. RESULTS: Sample of 34 patients; 67.6% (n = 23) of them under the classic protocol and 32.4% (n = 11) with REDMA. The only post-surgical complication in which we obtained statistical repercussion, without differences between cases and controls in terms of the risk of FPP, in favor of the REDMA anastomosis is that of FPP. Thanks to this surgical innovation, both the complications from stage IIIb, according to the Clavien-Dindo classification, and the mean hospital stay have also been reduced with statistical significance. CONCLUSIONS: When REDMA reduces the rate of PPF in patients with moderate/high surgical risk of it, we consider it to be a useful alternative to consider in the reconstruction of transit after CPD.
Subject(s)
Pancreatic Fistula , Pancreaticoduodenectomy , Anastomosis, Surgical/adverse effects , Humans , Mucous Membrane , Pancreas/surgery , Pancreatic Fistula/etiology , Pancreaticoduodenectomy/adverse effectsSubject(s)
Humans , Male , Female , Aged , Pancreaticoduodenectomy/adverse effects , Pancreatic Fistula/prevention & control , Anastomosis, Surgical/methods , Pancreatic Diseases/surgery , Pancreatic Fistula/etiology , Retrospective Studies , Surgical Procedures, Operative/methods , Postoperative ComplicationsABSTRACT
INTRODUCTION: Of the possible complications after a cephalic duodenopancreatectomy (CPD), the clinically relevant postoperative pancreatic fistula (PPF) is the most important, especially in patients with pancreas of a soft consistency. The main objective of this work is to analyze the different postsurgical complications, with special emphasis on the rate of PPF on soft pancreas with a risk of moderate/high PPF, and its incidence between the two different types of sutures used by our group (classic vs reinforced duct-mucosa anastomosis [REDMA]). METHODS: Retrospective observational study, between January 2017 and March 2020, of patients undergoing CPD in our unit after applying the inclusion and exclusion criteria. Analysis of preoperative, intraoperative factors and postoperative complications observed during follow-up. RESULTS: Sample of 34 patients; 67.6% (n = 23) of them under the classic protocol and 32.4% (n = 11) with REDMA. The only post-surgical complication in which we obtained statistical repercussion, without differences between cases and controls in terms of the risk of FPP, in favor of the REDMA anastomosis is that of FPP. Thanks to this surgical innovation, both the complications from stage IIIb, according to the Clavien-Dindo classification, and the mean hospital stay have also been reduced with statistical significance. CONCLUSIONS: When REDMA reduces the rate of PPF in patients with moderate/high surgical risk of it, we consider it to be a useful alternative to consider in the reconstruction of transit after CPD.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pancreatitis/complications , Pancreatitis/surgery , Pancreatitis , Jaundice, Obstructive/complications , Jaundice, Obstructive , Tomography, Emission-Computed/methods , Tomography, Emission-Computed/trends , Immunosuppressive Agents/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Pancreatitis/pathology , Endoscopy/methods , Endoscopy , Constriction, Pathologic/surgery , Constriction, Pathologic , Common Bile Duct/pathology , Common Bile Duct/surgery , Common Bile Duct , Biomarkers, Tumor/analysisABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Liver/physiopathology , Brucellosis/physiopathology , Liver Neoplasms/physiopathology , Liver Neoplasms/surgery , Brucellosis/complications , Brucellosis/drug therapy , Liver/injuries , Diagnosis, Differential , C-Reactive Protein/therapeutic use , Drainage/methodsABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Aneurysm, False/complications , Aneurysm, False/surgery , Aneurysm, False , Internal Mammary-Coronary Artery Anastomosis/methods , Internal Mammary-Coronary Artery Anastomosis/trends , Internal Mammary-Coronary Artery Anastomosis , Mammary Arteries/pathology , Mammary Arteries , Sentinel Lymph Node Biopsy/methods , Sentinel Lymph Node Biopsy , Aneurysm, False/physiopathology , Axillary Artery/pathology , Axillary Artery , Anticoagulants/therapeutic use , Neoplasms, Ductal, Lobular, and Medullary/complications , Neoplasms, Ductal, Lobular, and Medullary/surgery , Neoplasms, Ductal, Lobular, and Medullary , Carcinoma, Ductal, Breast/complicationsSubject(s)
Aneurysm, False/etiology , Mammary Arteries , Sentinel Lymph Node Biopsy/adverse effects , Aged , Humans , MaleABSTRACT
Objetivo: La analgesia postoperatoria en cirugía de la mama sigue siendo un reto. Presentamos la técnica de colocación de un catéter para la perfusión continua de anestésicos locales en cirugía de mama como alternativa a los métodos analgésicos actuales. Casos clínicos: Caso 1. Mujer de 59 años con un carcinoma en la mama derecha con ganglios axilares negativos. Se realizó mastectomía derecha y se colocó catéter de analgesia interpectoral. Caso 2. Mujer de 52 años con un carcinoma en la mama derecha y ganglios axilares positivos. Se realizó mastectomía tipo Madden y se colocó catéter de analgesia interpectoral y axilar derecho. Se retiró el catéter a las 48 horas sin complicaciones. Conclusiones: El uso de perfusión continua de anestésico local en la herida quirúrgica mediante catéter multiperforado es una alternativa eficaz para el control del dolor postoperatorio en cirugía de la mama, lo cual disminuye los requerimientos y los efectos secundarios de antiinflamatorios sistémicos y opioides(AU)
Introduction: Postoperative analgesia in breast surgery is still a challenge. We present a technique for continuous perfusion of anaesthetics through an "in situ" placed catheter, as an alternative to the current analgesic methods in breast surgery. Case reports: Case 1. A 59 year old woman with carcinoma in the right breast and negative axillary nodes had a right mastectomy and an interpectoral analgesia catheter was inserted. Case 2. A 52 year old woman with carcinoma in the right breast and positive axillary nodes. A right Madden mastectomy was performed and an interpectoral and right axillary analgesia catheter was inserted. The catheter was removed 48 hours later with no complications. Conclusions: The use of continuous perfusion in surgical wounds by means of a multiperforated catheter is an effective option for the treatment of post-surgical pain in breast surgery. This technique reduces the requirements, and potential side effects, of systemic anti-inflammatory drugs and opioids(AU)
