RESUMEN
Laparoscopic ventral hernia repair is currently the subject of intense debate, even though it provides a series of advantages over open surgery and is feasible and safe. Various studies have shown this technique to be as effective as open repair with a lower recurrence rate. Despite the excellent results of laparoscopic repair of ventral hernias, there are numerous controversies associated with this procedure. These controversies concern the indications and contraindications of the procedure, and technical aspects such as how to create the pneumoperitoneum, perform adhesiolysis, manage the hernia sac, and insert and fix the mesh to the anterior abdominal wall. Also controversial are outcome, complications related to postoperative seroma, and which type and size of mesh should be used. The present article aims primarily to address many of these issues, based on the experience of distinct surgeons with expertise in this approach, in order to provide data to establish a consensus on how laparoscopic ventral hernia repair should be performed.
Asunto(s)
Hernia Ventral/cirugía , Laparoscopía/métodos , Humanos , Cuidados PosoperatoriosRESUMEN
Los sarcomas de mama son raros, aparecen con una frecuencia de 1-3 por ciento de todos los tumores mamarios malignos. El liposarcoma mamario supone el 3-24 por ciento de estos sarcomas primarios. Es un tumor de muy difícil diagnóstico preoperatorio ya que la PAAF es inconcluyente en casi todos los casos. Los tratamientos propuestos son múltiples; desde escisión local, mastectomía simple, quimioterapia y radioterapia complementaria o tratamiento conservador más radioterapia. Los resultados de estos tratamientos son poco concluyentes por el escaso número de casos. No así la linfadenectomía rutinaria que es innecesaria. Aportamos el caso de un liposarcoma gigante mamario en una mujer de 65 años. La exploración, la mamografía y ecografía detectaron un tumor liso, redondeado y regular. La PAAF no fue concluyente. El liposarcoma de mama es un tumor raro, de difícil diagnóstico, cuyo tratamiento no está claramente establecido (AU)
Asunto(s)
Anciano , Femenino , Humanos , Liposarcoma/patología , Neoplasias de la Mama/patología , Biopsia con Aguja , Liposarcoma/terapiaRESUMEN
PURPOSE: A study was made to assess the effect of oral calcium supplementation on colorectal carcinogenesis at the colocolic suture line and in the rest of the colon following administration of a carcinogen. METHODS: Fifty-nine rats were randomly divided into two groups: control (given a standard diet for rats and mice containing 0.8 percent calcium) and treatment (given the same diet as before but with 2 percent calcium). Carcinogenesis was induced by 26 weekly injections of 1,2-dimethylhydrazine. All animals were subjected to an end-to-end colonic anastomosis at the beginning of the experiment using five stitches of steel wire. RESULTS: The control group developed significantly more tumors per animal at both the anastomosis (P < 0.001) and in the rest of the colon (P < 0.001). In addition, the percentage of rats with tumors was significantly higher in the control group at both the anastomosis (chi-squared = 12; df = 1, P < 0.001) and in the rest of the colon (chi-squared = 7.12; df = 1, P < 0.01). The mean surface of tumors was likewise greater in the control group at the anastomosis (P < 0.001) and throughout the rest of the colon (P < 0.001). Finally, there were significantly more small-bowel tumors (excluding the duodenum) in the control group (P < 0.05). CONCLUSIONS: It is concluded that calcium supplementation decreases the tumor yield at the site of end-to-end colonic anastomosis and in the rest of the colon and small bowel (excluding the duodenum).
Asunto(s)
Adenocarcinoma/prevención & control , Calcio de la Dieta/farmacología , Colon/cirugía , Neoplasias del Colon/prevención & control , Adenocarcinoma/etiología , Anastomosis Quirúrgica , Animales , Colon/efectos de los fármacos , Neoplasias del Colon/etiología , Modelos Animales de Enfermedad , Humanos , Masculino , Ratas , Ratas Sprague-Dawley , Acero Inoxidable , SuturasRESUMEN
Intestinal tuberculosis has been a clinical rarity in the western world since the tuberculostatic agents were discovered. The most common location of these lesions is usually the ileocecal region, lesions of the transverse colon being much less frequent and perforation of this viscus being exceptional. The etiological diagnosis is usually difficult because there are no specific radiological signs and false negatives are often found in biopsy material obtained by colonoscopy since the process is mainly submucous. This disease is often diagnosed during operation so treatment is usually resection. Should a preoperative diagnosis be made, the picture generally responds to tuberculostatics.