Browsing by Tema "Abdominal surgery"

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Appendiceal Phlegmon as an intraoperative finding: A retrospective analysis
(Research Square (United States), 2023) Danny Conde; Lina Rodríguez; David Venegas; C. Rey; Ricardo E. Núñez-Rocha; Ricardo Nassar; Marco Vanegas; Catalina Monsalve; Pablo Pinzón; Felipe Girón
Abstract Background Emergency procedures due to acute surgical abdomen correspond to a great part of emergency surgeries. Appendicitis is the most common abdominal surgical emergency in the world. Intraoperative findings can represent a challenging scenario for the surgical team and its decisions. Appendiceal phlegmon/plastron presents in 3.8-7% of patients with appendicitis and can be considered as a challenging surgical scenario where expertise may gain a fundamental value in terms of decision-making process. Therefore, we present clinical courses and outcomes of 40 patients that underwent emergency surgery with these intraoperative findings from 2016 to 2018. Methods Retrospective study with a prospective database in which we described patients with emergent need for surgical procedure due to peritoneal signs with surgical findings of appendiceal phlegmon. Multivariate analysis was performed to prove the relationship between obesity, diabetes, and surgeon experience with any complication and colonic resection. Results 40 patients underwent surgical procedure due to peritoneal signs with intraoperative findings of appendiceal phlegmon. Mean age was 51.9 (± 20.4). Procedures were performed based on intraoperative findings being appendectomy the most frequent (85%), followed by right hemicolectomy (10%) and partial cecum resection (5%). Three patients required reintervention. No mortalities were documented. Surgeries performed by junior surgeons have a higher probability to require colonic resections (P = 0.05, OR 4.05 ,95% CI), also obesity is associated with complications (P = 0.04, OR 1.44, 95% CI). Conclusion Finding of appendiceal phlegmon constitute a challenging surgical scenario in daily practice. Our patient’s complication rates are similar to those described in literature despite its emergent circumstances. Surgeons' expertise appears to be associated with outcomes. Further studies are needed to give clear recommendations.
Factores predictores para apéndice blanca y apendicitis aguda en pacientes sometidos a apendicectomía. Experiencia de dos años en una institución privada
(2015) Ricardo Ray Huacuja-Blanco; Miguel Ruiz-Campos; Ramón Ignacio Lemus-Ramírez; Eduardo Villegas-Tovar; Mario Andrés González-Chávez; Alejandro Díaz-Girón-Gidi; Carlos Amir Carmona-González; José Manuel Correa-Rovelo
Introduction.Acute appendicitis (AA) is the most common indication for emergency abdominal surgery, 10-20% of these are reported as negative appendectomy (NA). It has been attempted to reduce this incidence with new imaging studies and clinical diagnosis criteria. There are several pathologies that can mimic AA as well as many factors that are associated to an increased in the incidence of a NA. Objective.Define the frequency of NA in patients undergoing appendectomy from any cause in a private hospital and the variables that suggest or not the presence of AA. Material and Material and Material and Material and Material and methods. A retrospective study was conducted in 683 patients who underwent appendectomy during 2009 and 2010 at a private hospital in Mexico City. Age, gender, use of preoperative TAC, leukocytosis, associated diseases, phase of appendicitis reported by the surgeon and correlation with pathology report were analyzed. For categorical and discrete variables an univariate, bivariate and binary logistic regression model analysis was performed in order to identify risk factors associated with the presence or absence of AA and NA. Results.From the 683 patients analyzed, 51.5% were female. Mean age was 31.0 ± 17.1 years. From all patients, 87.2% were positive and 12.9% were reported as NA. 77.7% had leukocytosis. Preoperative TAC was performed to 66% of patients with diagnosis of AA, in contrast, only 43.2% with NA had preoperative TAC (p < 0.0001). Conclusions.Male, age less than 30 years, presence of leukocytosis and the use of preoperative TAC are suggestive factors of AA in clinically suspected patients.
Iliopsoas Abscess: A Narrative Review
(Springer Science+Business Media, 2026) Romulo Armenta‐Flores; Diego Armenta‐Villalobos; Luis G. Domínguez‐Carrillo
Since the description of IPA with isolated cases, then small series, and recently large retrospective reviews from major hospitals worldwide, the diagnosis and treatment of IPA have improved. With modern imaging techniques (US, CAT scan, and MRI), the diagnosis of IPA has increased, but sequential use of the aforementioned methods is not standardized; besides, there is no uniform treatment for IPA so far. Current management of IPA entails broad-spectrum antibiotics plus percutaneous or surgical drainage.
Invited commentary
(Springer Science+Business Media, 1983) José Patino; Julio Portocarrero
Lessons learned during the COVID-19 pandemic using virtual basic laparoscopic training in Santa Cruz de la Sierra, Bolivia: effects on confidence, knowledge, and skill
(Springer Science+Business Media, 2022) Constance S. Harrell; Alexandra Reitz; Erica Ludi; Raúl Rojas Aban; Lorena Jáuregui Paravicini; Federico Serrot
Long-Term Results After Laparoscopic Pericystectomy in Patients with Hepatic Echinococcosis: Case Series with Follow-up
(Springer Science+Business Media, 2022) Carlos Manterola; Nataniel Claros
[Parental perception of their child's pain tolerance and abdominal postoperative analgesic requirements].
(National Institutes of Health, 2014) Eugenio Larragoiti-Correa; Mario Enrique Rendón‐Macías
it is important to identify children perceived as poorly tolerant or not tolerant to pain before a painful procedure, in order to plan an efficient strategy for pain control.
Postoperative Complications and Recurrence of Abdominal Echinococcosis Rupture: Case Series with Follow-up
(Springer Science+Business Media, 2022) Carlos Manterola; Nataniel Claros; Luís Grande
Prevention of postoperative abdominal adhesions using systemic enoxaparin and local diclofenac. An experimental study
(Wiley, 2019) Gilberto Guzmán‐Valdivia Gómez; Eduardo Antonio Linares-Rivera; Eduardo Tena‐Betancourt; G. Castillo; Lukas Reipen
Abstract Introduction Postoperative abdominal adhesions (PAA) are a cause of morbidities, generating higher health care costs for patients and institutions responsible for health procurement. PAAs occur due to an imbalance between the enzymatic linkage in favour of fibrinogenesis in the cascade of coagulation, which encompasses a pathological process initiated by injury to the peritoneum amid the additional activation of inflammatory processes under tissue hypoxia. The objective of this study was to test the potential benefits of the use of subcutaneous enoxaparin plus intraperitoneal diclofenac in a porcine model. Material and Methods Using 32 hybrid female pigs, surgical adhesions were induced by open conventional splenectomy. The animals were divided into four groups: (I) control, irrigation with saline solution; (II) subcutaneous enoxaparine was applied; (III) intraperitoneal diclofenac; and (IV) combination of both. Results By far, the greater degree of formation of abdominal adhesions occurs in the non‐treated control group I ( P < .01). In contrast, in the macroscopic and histopathological report in terms of the degree of abdominal adhesion formation encountered in our assessments, the comparison among the treated groups showed no statistically significant differences among them, but asserted the preventive formation of PAA after the systemic application of enoxaparin and local diclofenac. Conclusions Subcutaneous enoxaparine and intraperitoneal diclofenac reduced the formation of PAA significantly, but we found no synergic action in their combination.
Successfully establishing laparoscopic surgery programs in developing countries
(Springer Science+Business Media, 1996) Horacio J. Asbun; Ramón Berguer; RENE ALTAMIRANO; H. Castellanos