Short-and long-term results with Karydaki's technique for sacrococcygeal pilonidal diseaseIntroduction: Sacrococcygeal pilonidal cyst or sinus is a common condition in young people. There is still discussion about which of the many existing techniques is best suited to resolve this condition. Objective: To analyze the short-and long-term use of Karydaki's technique in our Hospital. Material and Methods: We analyzed prospective protocols from patients with pilonidal cyst with Karydaki's technique from June 2005 to August 2010. Clinical and telephonic follow-up was done to all patients and a satisfaction survey done to a random sample of the series. Results: We analyzed 62 patients with mean age of 24.5 years (15-45), being 33 men (53%). Cysts were previously relapsed in 20.9% of cases. The average hospital stay was 2.5 days (1-3). Early complications occurred in 14.3% of patients being the most common seroma in 8% and dehiscence in 6.4%. At a mean follow up of 38 months (12-62), relapse occurred in two patients (3.2%), one at 6 months and the other at 3 years, being resolved one by a new Karydaki's technique and the other with marsupialization. Among the group surveyed for satisfaction, 75% found the technique satisfactory or very satisfactory in terms of aesthetics and 95% would recommend this technique. Conclusions: Karydaki's operation achieves with a simple and aesthetic technic a low recurrence and morbidity and a complete recovery after 15 days in most patients.
Laparoscopic colorectal surgery in ChileThe development of laparoscopic colorectal surgery began 20 years ago; however it took several years before gaining its acceptance by the international surgical community. The fi rst report in Chile was published in 1995. However, were necessary many years, until the middle of this decade, to know the fi rst prospective series experiences. Out of these reports, no reliable data exist regarding the development of laparoscopic colorectal surgery in Chile, related to the number of centers performing laparoscopic colorectal surgery or the number of procedures performed. For record these data, a standardized questionnaire was send to colorectal chairmans of all hospitals that had reported to be developing laparoscopic colorectal surgery in our country. Ten of 15 hospitals responded to the survey. Most of the procedures performed were hemicolectomies, principally for cancer and diverticular disease. The average conversion rate was 7% and hospital stay was 5 days. Morbidity and mortality rates were 12% and 0.4% respectively. In the last year was seen an increase in the number of laparoscopic procedures in relation to the previous period. In conclusion, laparoscopic colorectal surgery is a recent technique in Chile, which is being implemented progressively, with good overall results. ResumenEl desarrollo de la cirugía laparoscópica colorrectal (CLCR) se inició en la década de los 90, sin embargo, pasaron varios años antes de lograr su aceptación por la comunidad quirúrgica internacional. En Chile, los primeros relatos en congresos datan del año 1995 y las primeras experiencias de series prospectivas fueron Rev.
Single-port access right laparoscopic hemicolectomy for colon cancerA new laparoscopic technique allows a peritoneal access through a single umbilical port with less abdominal wall trauma and pain. We report a 64 years old male with a right colon adenocarcinoma, detected during a routine colonoscopy. The patient was subjected to a right laparoscopic hemicolectomy through a single SILS ® Multiple Instrument Access Port, that can accommodate up to three instruments introduced through a 3 cm paraumbilical incision. The surgical procedure was uneventful and the patient had a good postoperative evolution. The pathological study of the surgical piece confirmed the presence of an adenocarcinoma with invasion of the submucosa and without lymph node involvement.Key words: Single port, laparoscopic surgery, hemicolectomy. ResumenLa tendencia a una menor invasión en el acto quirúrgico ha sido un objetivo desde los inicios de la cirugía y en la actualidad se buscan continuamente caminos que cumplan este principio. En el último año han surgido publicaciones de una nueva técnica laparoscópica a través de un acceso umbilical único que permitiría disminuir el trauma de la pared abdominal, el dolor postoperatorio y además, mejorar el resultado cosmético. El objetivo de este reporte es dar a conocer nuestra experiencia con la primera hemicolectomía derecha laparoscópica (HCDL) reportada a través de un puerto único para una neoplasia maligna de colon. Se trata de un paciente con un adenocarcinoma cecal originado en un pólipo (< 2 cm) abordado por vía laparoscópica introduciendo el puerto único SILS (SILS™ Port, Covidien, Autosuture) con lugar para trabajar con 3 trócares a través de una incisión paraumbilical de 3 cm, por la cual se realizó toda la disección y extracción de la pieza operatoria. La cirugía se llevó a cabo sin incidentes, respetando todos los principios oncológicos y el paciente evolucionó en forma satisfactoria. La pieza operatoria confirmó un adenocarcinoma con invasión de submucosa (SM3) sin metástasis en 30 ganglios examinados. Se concluye que la realización de una HCDL con puerto único es factible y pudiera ser segura desde el punto de vista oncológico. Tiene ventajas cosméticas evidentes y además podría disminuir la morbilidad de la pared abdominal, los costos totales quirúrgicos y eventualmente las tasas de conversión.Palabras clave: Hemicolectomía derecha, laparoscopía, un puerto.
Distal intestinal obstruction syndrome. Report of two cases with cystic fibrosis Distal Intestinal Obstruction Syndrome (DIOS) has a 16% incidence among patients with Cystic Fibrosis (CF). It is characterized by an intestinal obstruction secondary to fecal impaction in distal ileum or cecum. We report two adult patients with DIOS. A female with CF and subjected to a lung transplantation at the age of 13 years. Five years later, she consulted for an intestinal obstruction. She was treated conservatively with a good clinical evolution. She had a new episode of DIOS eight months later, that was also treated conservatively. A 31 year-old male, subjected to bilateral lung transplantation nine years before, that was admitted to the hospital for a bronchiolitis. Three days after admission he started with a intestinal obstruction, that was diagnosed as a DIOS. He was managed conservatively with a good clinical response.
La incontinencia anal o fecal se define como la incapacidad de postergar la defecación en forma voluntaria, produciéndose una pérdida recurrente e involuntaria de las heces (líquidas y/o sólidas) y/o gases a través del canal anal. Incluso en los casos leves, donde sólo se produce pérdida ocasional de gases y/o escurrimiento menor ("soiling"), esta patología se asocia en mayor o menor grado con compromiso en la calidad de vida de los pacientes en todos los ámbitos de su quehacer 1 . La incontinencia anal es una patología multicausal que está presente en un porcentaje cada vez más importante de nuestra sociedad, debido al sostenido envejecimiento de la población. En series internacionales y nacionales, se estima que el 2 al 7% de los mayores de 18 años pueden presentar incontinencia anal, cifra que se eleva hasta el 35% en pacientes de la tercera edad, especialmente en casas de reposo y hogares de ancianos 2 . Los principales factores de riesgo son: edad, menopausia, cirugías previas, parto traumático, fórceps, enfermedades del aparato conectivo, alteraciones neurológicas degenerativas y obesidad 3,4 . El estudio de esta patología incluye una completa anamnesis para evaluar factores de riesgo y antecedentes mórbidos, evaluación del tipo de tránsi-to intestinal y consistencia de las heces, alimentación y medicamentos de uso habitual.Dentro del algoritmo de estudio, se debe evaluar la integridad anatómica y funcional del aparato esfinteriano, lo cual se logra con endosonografía anorrectal y manometría anal. Asimismo se puede complementar con estudio neurológico y electromiografía anal y tiempo de latencia de nervios pudendos. Debe descartarse además patologías como enfermedades inflamatorias intestinales, presencia de diarreas crónicas y pólipos o tumores secretores de moco realizando una colonoscopia completa.En los pacientes en que se demuestra una alteración anatómica (sección) del esfínter externo en la endosonografia anal, la esfinteroplastía (plastia muscular) anal es hoy en día una de las mejores alternativas de tratamiento. Sin embargo, esta cirugía presenta un porcentaje de recurrencia, no menor al 40% a largo plazo 5 . Los pacientes que no presentan daño esfinteriano, o quienes han sido reparados sin éxito, pueden verse beneficiados con la implantación de un esfínter artificial, uso de neuromodulación sacra, o en casos muy adversos, con una ostomia definitiva. Lamentablemente la im-
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.