Efecto de la inmunosupresión con azatioprina-prednisona sobre la anastomosis bronquial telescopiada en el trasplante pulmonar unilateral experimental / Effect of immunosuppresion with azatioprine-prednisone on bronchial anastomosis in experimental unilateal pulmonary transplant

El efecto de altas dosis de azatioprina - prednisona sobre la anastomosis bronquial en el transplante pulmonar fue investigada en el presente trabajo en diez perros. Se realizó un trasplante pulmonar unilateral con anastomosis realizada en forma telescopiada en todos los casos. No observamos complicaciones en el seguimiento de los animales hasta los 18 meses, a pesar de las altas dosis de inmunosupresión

[Prune belly syndrome associated with cystic adenomatoid malformation of the lung and pulmonary sequestration]. / Síndrome de "prune belly" asociado a malformación adenomatoide quística pulmonar y secuestro pulmonar.

The "prune belly" syndrome classically described in males, has also been described in female patients with a variable incidence. Associations with multiple respiratory tract malformations have been reported which together with urinary tract anomalies and renal failure are often the cause of early mortality. We report the case of a female patient with prune belly in association with cystic adenomatoid malformation of the lung and pulmonary sequestration with a favorable clinical evolution following medical and surgical treatment.

[Surgical treatment of pleuropulmonary infection in children]. / Tratamiento quirúrgico de la infección pleuropulmonar en el niño

Pleural empyema is most frequently seen in surgical pathology of the chest at the Hospital del Niño IMAN. Decortication has been necessary, with or without pulmonary resection, in 58% of the cases, contrasting with the limited number of cases in series published in countries with a high standard of life and where a conservative criterion for treatment is held by the authors and some national pediatric groups. Thus, a retrospective analysis is made with 118 patients who underwent surgery between 1971 and 1976 with ages ranging from 3 months to 17 years. The strict management procedure followed in all cases in mentioned, as well as the criterion to perform thoracotomy, to establish the irreversible nature of the anatomical lesions and to evaluate the results. 114 patients were discharged following recovery; 11 of these showed complications such as bronchopleural fistula, atelectasis and postoperative fever, which were treated with pleural drainage and bronchoscopy. Four patients died: one from upper gastrointestinal bleeding and three from sepsis. With the clinical and radiological, as well as the bronchoscopic evaluation, the destructive and irreversible nature of the lesions was determined. This was confirmed by the histopathological study of the resected parts. It is concluded that there should be no doubts or disagreements when surgical treatment is indicated.

[Surgical treatment of gastroesophageal reflux (hiatal hernia) in pediatric age]. / Tratamiento guirúrgico de la enfermedad por reflujo gastroesofágico (hernia hiatal) en edad pediátrica

Forty nine pediatric patients with gastroesophageal reflux were studied retrospectively; this is a 4 years experience of Hospital del Niño, IMAN. All of them were treated in the same manner, which included barium gastrointestinal series, esophagoscopy, gastric secretion test. Nissen's funduplication was performed in all of them, plus gastrostomy in those cases having esophageal stenosis. Preoperatively, eight out of every ten patients had stenosis. From the entire series, one patient died. All of them were relieved from their gastroesophageal reflux. By the ninth day following operation, one patient suffered a gastric perforation. The authors make special considerations concerning the high number of cases per year, as compared with other series. Nissen's funduplication proved very efficient to prevent gastroesophageal reflux.