RESUMO
This study assessed the feasibility, safety, and reliability of open mesh plug hernioplasty under local anesthesia on an ambulatory basis. We retrospectively evaluated results using the open mesh plug technique in a series of 398 patients with 413 inguinal hernias (378 primary, 35 recurrent). Local anesthesia with sedation was used in 91% of procedures, locoregional anesthesia in 8%, and general anesthesia in 1%. Median operative time was 45 min. Only 1% of patients operated on in ambulatory surgery required hospitalization. There were only mild complications, all of which were managed on an outpatient basis. Median time of return to work was 8 days. Recurrence rate was 0.83% at a minimal follow-up of 12 months. Open mesh plug hernioplasty is a reliable technique feasible in an outpatient basis.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/métodos , Hérnia Inguinal/cirurgia , Telas Cirúrgicas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Anestesia Local , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Results of laparoscopic fenestration in patients with a highly symptomatic solitary liver cyst (17 patients) or polycystic liver disease (PLD) (9 patients) were prospectively evaluated in a multicenter practice of general surgeons. Conversion to laparotomy was required in two patients because of inaccessible deep liver cyst in one and a diffuse form of PLD in the other. There was no mortality or major morbidity. Mean postoperative hospital stay was 4.6 days after successful laparoscopic procedures. During a mean follow-up of 9 months, 23% of the patients had recurrence of symptoms and 38% had radiographic reappearance of cysts. Factors predicting failure included previous surgical treatment, deepsited cysts, incomplete deroofing technique, location in the right posterior segments of the liver, and a diffuse form of PLD with small cysts. Adequate selection of patients and type of cystic liver disease and meticulous and aggressive surgical technique are recommended.
Assuntos
Cistos/cirurgia , Laparoscopia , Hepatopatias/cirurgia , Seleção de Pacientes , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Resultado do TratamentoAssuntos
Infecções Bacterianas/tratamento farmacológico , Ceftazidima/administração & dosagem , Ciclopropanos/administração & dosagem , Dipeptidases/antagonistas & inibidores , Tienamicinas/administração & dosagem , Cilastatina , Doenças do Sistema Digestório/tratamento farmacológico , Avaliação de Medicamentos , Quimioterapia Combinada , Humanos , Imipenem , Metronidazol/administração & dosagem , Distribuição AleatóriaRESUMO
Use of the EEA stapler for oesophageal anastomoses. Since december 1980 we performed with the EEA stapler 25 oesophago-jejunostomies after total gastrectomy for gastric cancer. Operative mortality was 8%. No anastomitic leak was observed. Three patients presented anastomotic stenosis: 2 of these were due to neoplastic recurrence. No particular technical difficulties occurred during the operations. The use of the EEA stapler improves the safety of oesophageal anastomoses and facilitates their realisation.
