RESUMEN
The vast majority of ingested foreign bodies (FB) can pass through the digestive tract without major incidences. In some cases, they accumulate in large amounts in the stomach. They can also perforate the gastrointestinal wall and migrate to extraluminal sites, remaining quiescent for many years. We report a case of a psychiatric patient with more than 100 ingested FB in the stomach.
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In an attempt to find the ideal surgical technique for mesh fixation during laparoscopic total extraperitoneal inguinal hernia repair, we evaluate the use of a synthetic surgical glue (N-butyl-cyanoacrylate-Glubran 2) in an effort to reduce postoperative pain and the complications associated with the use of staples. We have prospectively evaluated 61 consecutive patients (73 hernias) with a minimum follow-up period of 18 months and an average of 29.7 months, without any significant complications present. The majority (59%) only required low dosages of painkillers during the first 24 hours after surgery and have not experienced any cases of chronic pain or recurring hernias in the time period described. On the basis of this initial experience, the use of the surgical glue used to repair inguinal hernias with the laparoscopic total extraperitoneal technique has been proved to be a simple and effective surgical method for mesh fixation.
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Cianoacrilatos/farmacología , Hernia Inguinal/cirugía , Herniorrafia/métodos , Laparoscopía/métodos , Mallas Quirúrgicas , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Cicatrización de Heridas , Adulto JovenRESUMEN
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Asunto(s)
Humanos , Equinococosis Hepática/cirugía , Laparoscopía/métodosRESUMEN
Introducción Análisis de nuestra experiencia en la intervención de quistes hidatídicos hepáticos mediante cirugía laparoscópica con criterios similares a los de la cirugía abierta. Material y métodos Estudio retrospectivo de 8 pacientes operados y de las complicaciones intraoperatorias y postoperatorias. Resultados En 7 pacientes se completó la intervención planificada por laparoscopia, en uno fue necesaria reconversión por hemorragia. Se realizaron 4 quistoperiquistectomías, 3 resecciones de cúpula saliente y 1 resección hepática. Dos pacientes sufrieron fístulas biliares: una de ellas (externa) necesitó una esfinterectomía endoscópica y la otra desarrolló un absceso que fue necesario reintervenir y drenar. En esta paciente se observó una trombosis de vena suprahepática derecha que se resolvió espontáneamente; 3 enfermos desarrollaron hipernatremia sin repercusión clínica. Conclusiones Muchas de las técnicas descritas en cirugía abierta son realizables por laparoscopia, sin necesidad de instrumentación específica para los quistes hidatídicos. Las complicaciones encontradas son similares a las de la cirugía abierta (AU)
Introduction We evaluate our experience in the surgical laparoscopic treatment of hepatic hydatid cysts with the same criteria that we use in open surgery. Material and methods A retrospective study of 8 operated patients and their intra- and postoperative complications. Results We performed the scheduled surgery on 7 patients; bleeding was the reason for conversion to open surgery in the remaining one. We made 4 complete peri-cystectomies, 3 de-roofing and 1 hepatic resection. Two patients had postoperative bile leaks: the first one had an external leak that needed an endoscopic sphincterotomy and the other developed an abscess that needed reintervention for drainage. This patient also had a right hepatic vein thrombosis that disappeared spontaneously. Finally, 3 patients had hypernatremia without clinical symptoms. Conclusions Many of the open surgery techniques for hepatic hydatid cysts can be performed laparoscopically, without any specific instruments. Our complications with laparoscopic treatment of hepatic hydatid cysts were similar to those of open surgery(AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Equinococosis Hepática/cirugía , Laparoscopía/métodos , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
INTRODUCTION: We evaluate our experience in the surgical laparoscopic treatment of hepatic hydatid cysts with the same criteria that we use in open surgery. MATERIAL AND METHODS: A retrospective study of 8 operated patients and their intra- and postoperative complications. RESULTS: We performed the scheduled surgery on 7 patients; bleeding was the reason for conversion to open surgery in the remaining one. We made 4 complete peri-cystectomies, 3 de-roofing and 1 hepatic resection. Two patients had postoperative bile leaks: the first one had an external leak that needed an endoscopic sphincterotomy and the other developed an abscess that needed reintervention for drainage. This patient also had a right hepatic vein thrombosis that disappeared spontaneously. Finally, 3 patients had hypernatremia without clinical symptoms. CONCLUSIONS: Many of the open surgery techniques for hepatic hydatid cysts can be performed laparoscopically, without any specific instruments. Our complications with laparoscopic treatment of hepatic hydatid cysts were similar to those of open surgery.