RESUMEN
PURPOSE: Although there is a high incidence of inguinal hernia in developed countries, few studies have been conducted to describe the symptoms, and these few only address the local symptoms, not those presenting at other levels. The aim of the present study is to conduct a detailed review of the symptoms, both inguinal and otherwise, of patients with inguinal hernia. METHODS: A case-control study was designed to compare the symptoms presented by 231 patients diagnosed with inguinal hernia with those of a second group of 231 randomly-selected subjects. In the hernia group, the symptoms were also evaluated according to the location of the hernia (right, left, bilateral). RESULTS: Significant differences (more symptomatology in patients with hernia) were found for the following items: groin pain, genital pain, urinary symptoms, abdominal pain, increased peristalsis and tenesmus. On the contrary, the control patients presented greater symptomatology with respect to back pain and diaphragm pain. CONCLUSIONS: Patients with inguinal hernia present a wide variety of symptoms, and these are not restricted to the inguinal area. It is important to be aware of this fact to convey accurate information to the patient, especially with regard to postoperative expectations.
Asunto(s)
Hernia Inguinal/complicaciones , Hernia Inguinal/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Ingle , Hernia Inguinal/cirugía , Herniorrafia , Humanos , Masculino , Persona de Mediana Edad , Dolor/etiología , Evaluación de Síntomas , Tiempo de Tratamiento , Adulto JovenRESUMEN
Covering a large hiatal hernia with a mesh has become a basic procedure in the last few years. However, mesh implants are associated with high complication rates (esophageal erosion, perforation, fistula, etc.). We propose using a synthetic resorbable mesh supported with an omental flap as a possible solution to this problem. A 54-year-old female patient with a large hiatal defect (9 cm) was laparoscopically implanted with a synthetic resorbable mesh supported with an omental flap. The surgical procedure was successful and the patient was discharged on postoperative day 2. On a follow-up examination 6 months after surgery, she remained free of relapse or complication signs. Supporting an implanted resorbable mesh with an omental flap may be a solution to the problems posed by large esophageal hiatus defects. However, more studies based on larger patient samples and longer follow-up periods are necessary.
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Hernia Hiatal/cirugía , Herniorrafia/métodos , Colgajos Quirúrgicos , Mallas Quirúrgicas , Femenino , Humanos , Laparoscopía , Persona de Mediana Edad , Epiplón , Resultado del TratamientoAsunto(s)
Hernia Diafragmática/complicaciones , Hernia Hiatal/complicaciones , Adulto , Diafragma/anomalías , Diafragma/cirugía , Gastroscopía , Hernia Diafragmática/diagnóstico , Hernia Diafragmática/cirugía , Hernia Hiatal/diagnóstico , Hernia Hiatal/cirugía , Humanos , Laparoscopía/métodos , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
INTRODUCTION: We assessed the results of laparoscopic cholecystectomy in 176 patients over the age of 70 years. PATIENTS AND METHODS: The study included all patients older than 70 years of age who underwent laparoscopic surgery cholelithiasis during the previous ten years. Variables studied included age, sex, type of operation (programmed/emergency), comorbidity, anesthetic risk, intraoperative cholangiography, conversion to open surgery, number of trocars, reoperation, residual choledocholithiasis, postoperative hospital stay, morbidity and mortality. RESULTS: The study included 176 patients (23.29% men and 76.71% women). The mean age was 74.86 years. The mean hospital stay was 1.27 days, with 16.98% morbidity and 0.56% mortality. CONCLUSIONS: Laparoscopic cholecystectomy is a safe procedure in older patients. It results in faster recovery, a shorter postoperative stay and lower rates of morbidity and mortality than open bile duct surgery.
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Colecistectomía Laparoscópica , Anciano , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
OBJECTIVES: Given the increasing concern about the physical, psychological, and social welfare of patients surgically treated for rectal cancer, we designed a study of the factors influencing quality of life in these patients. EXPERIMENTAL DESIGN: We prospectively analyzed factors related to quality of life in a cohort of patients using the Nottingham Health Profile and the EORTC questionnaire (QLQ-CR 38). PATIENTS: A total of 116 patients with locally advanced rectal cancer surgically treated in our hospital from 1994 to 1999. RESULTS: Quality of life scores for the various factors studied showed that quality of life was worse in women, in patients with tumors in the middle third of the rectum, and in patients undergoing low anterior resection. CONCLUSIONS: Factors influencing quality of life in patients surgically treated for locally advanced rectal cancer included sex, tumor site, and surgical technique. Since only this latter factor is modifiable, we suggest that the surgical technique be individualized in persons with mid-lower and lower-third tumors of the rectum, bearing in mind that quality of life in amputated patients is, in many respects, better than that of patients with preserved sphincters.
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Calidad de Vida , Neoplasias del Recto/psicología , Neoplasias del Recto/cirugía , Adulto , Anciano , Estudios de Cohortes , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Morbilidad , Análisis Multivariante , Invasividad Neoplásica , Estadificación de Neoplasias , Estudios Prospectivos , Neoplasias del Recto/epidemiología , Encuestas y CuestionariosRESUMEN
We report the case of a patients with a metachronous cystic pancreatic metastasis from an undifferentiated large cell lung carcinoma two years after the primary tumor had been surgically removed. Clinically, he presented with epigastric pain, fever, weakness and anorexia. The patient was operated and a palliative cystogastrostomy was performed after an intraoperative biopsy had been informed as positive for carcinoma. Six months later the patient died. Pancreatic metastases from lung carcinoma are found in approximately 7-9% of patients deceased of this neoplasm. Clinical and radiological findings simulate primary pancreatic tumors, being epigastric pain, jaundice and upper digestive bleeding the most frequent symptoms. They represent stages of advanced systemic disseminated tumoral disease, and because of this reason total or partial surgical curative resections will only be performed in a few cases of patients with isolated metastasis, criteria of resectability and without evidence of extended disease to other organs or systems. In the most of the cases, the treatment will only be palliative, even medical or surgical.