RESUMEN
The authors consider the various causes of ascites and they also develop the concept of refractory ascites. They consider the various possibilities of medical and dietary therapy whose failure constitutes the basis for a surgical approach. In the latter case it is being considered the Peritoneo Venous Shunt (PVS) that employs different types of valves. In the light of their personal experience, matured over a period of 15 years, in which 75 valves were positioned in 64 patients and precisely: 55 valves of Le Veen, 15 Hakim and 5 Denver, it is emphasized that the best results, as for as mortality and morbidity goes, were obtained through careful attention in the preoperative stage and during surgery itself with the privileged use of a Le Veen's valve. For such motives, since in a high percentage of these patients there persists a poor prognosis a year away from the onset of refractory ascites, a PVS seems proposable anyway and even though this will not alter the pathological outcome, there's a clear improvement in the quality of life without precluding any other surgical approach. Finally, the authors outline the possibilities offered by the Transjugular Intrahepatic Portosystemic Shunt (TIPS), as a new original approach for the resolution of refractory ascites.
Asunto(s)
Ascitis/cirugía , Derivación Peritoneovenosa , Adulto , Anciano , Anciano de 80 o más Años , Ascitis/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Derivación Peritoneovenosa/efectos adversosAsunto(s)
Enfermedades del Sistema Digestivo/cirugía , Fallo Renal Crónico/terapia , Complicaciones Posoperatorias/epidemiología , Diálisis Renal , Uremia/terapia , Adulto , Anciano , Femenino , Humanos , Enfermedades Renales/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidadAsunto(s)
Equinococosis Hepática/cirugía , Adolescente , Adulto , Anciano , Hepatectomía , Humanos , Métodos , Persona de Mediana EdadRESUMEN
The need for continuous control of the parameters that may influence cerebral homeostasis has made it advisable to use general anaesthesia for cerebral angiography. A combination of propanidide and neuroleptanalgesia, with controlled ventilation, was employed in a group of 66 patients with various cerebral diseases. The stability of narcosis and the absence of significant changes in the cardiocirculatory and respiratory parameters prevented alterations in cerebral flow and intracranial pressure during the examination. Prompt reawakening enabled the patient's neurological state at the end of the examination to be immediately evaluated. In addition, the angiograms were of better quality.
Asunto(s)
Anestesia General , Angiografía Cerebral , Humanos , Neuroleptanalgesia , Medicación Preanestésica , Propanidida , Respiración ArtificialRESUMEN
Authors have studied the incidence of septic complications due to subclavian vein catheterization, According to literature, have considered that this is generally connected to the operating ability. Septic contamination, though of high incidence, only exceptionally is reason of a septic clinical condition.