Biomedical subjects

J A Alvarez Zapico

Publications and source records attributed to J A Alvarez Zapico.

6 recordsLinked to original sources

PubMed2006

[Endoscopic treatment of ureterocele in children: is a long term effective technique?].

INTRODUCTION: The endoscopic treatment of the ureterocele is a less invasive procedure. Currently, there are only a few published articles regarding the long-term outcomes of this treatment. MATERIAL AND METHODS: We have introduced this technique in our practice since 1995, and have been tracking 15 pediatric patients for long-term evaluation. RESULTS: The average operative age for endoscopic treatment is 19.40 months (1 week-8 years). In 53% of the cases, the diagnosis was made during prenatal screening. In 27% of the cases, the ureterocele was bilateral, and 47% of the patients have a double system. The indication for endoscopic treatment is 66% ureteric obstruction and 34% vesicoureteric reflux. We perform "uncapping" and incision in the two first cases and puncture in the subsequent procedure. The patients were followed for 4 years (7 months-7 years). During this time, two ureteroceles needed a second perforation, out of the seven that continued having reflux, two were treated with quimioprofilaxis and two were treated endoscopically for anti-reflux. Two patients continued to have reflux, and two were diagnosed with renal atrophy and hemiatrophy. DISCUSSION: The endoscopic treatment avoided an open surgical procedure in almost all cases. The need for anti-reflux puncture occurred in 33% of the cases.

Child↗

PubMed2005

[Retroperitoneoscopic heminephrectomy].

The practice of minimally invasive surgery techniques in the retro-peritoneal space presents additional difficulties. Due to the absence of a real cavity and the presence of a dense fat tissue involving the structures, the need for an artificial space to work in is necessary. We present three cases of the retro-peritoneal superior heminephrectomy present in a 3-months, 6-months and a 6-year old children. In all cases a 1 centimeter port for the optique and two 0.5 centimeter ports for the instruments were situated, and the use of harmonic scalpel was satisfactory to remove renal tissue without bleeding. Drainages were unnecessary and all of the children left the hospital within the first 48 post-operative hours. Since 1994, when Figenhans and Clayman communicated the first laparoscopic nephrectomy in children, the technique has been used generally and their forward advances in conventional surgery are now universally accepted. Furthermore, the practice of polar retro-peritoneoscopic heminephrectomy allowed a very precise renal hiliar dissection and an excellent differentiation of each hemirenal tissue, separating the ill kidney and preserving the maximum function possible for the other half-kidney and the adrenal gland.

Humans↗

PubMed2004

[Usefulness of video-assisted thoracic surgery techniques in intra-thoracic mass resection in children].

The progressive advances in Minimally Invasive Surgical Procedures, are applied presently to the surgical treatment of intra-thoracic injuries in children by way of Video-Assisted Thoracic Surgery (VATS) techniques. We present the complete findings of two intra-thoracic masses, in an infant and in a school-aged child, with the use of the VATS technique. The operative technique is detailed in each case. We conclude that the lack of invasiveness and cost-efficiency of VATS the technique, constitute it as being the first choice in the treatment of intra-thoracic masses in children.

Age Factors↗

PubMed2001

[Fascia lata transplant from cadaveric donor in the reconstruction of abdominal wall defects in children].

INTRODUCTION: Abdominal wall closure is not possible in large congenital defects, even after extensively stretching in to enlarge its capacity. The skin coverage is usually adequate but the aponeurotic defect has to be closed temporally using synthetic patches. The use of these materials leads to increase complication such as infection, fistula formation and extrusion. In addition a second operation is required to remove the material and to perform a definitive closure. The role of fascia lata in reconstruction of abdominal wall is well established as free grafts, pedicled flaps or free flaps. Bank cadaveric fascia lata is used extensively in neurosurgical, ophtalmological, orthopaedic and urogynecological procedures. This is the first description of the use of cadaveric fascia lata for the closure of large abdominal wall defects. CASE REPORTS: We present two cases of congenital diaphragmatic hernia. The first patient was a newborn who presented the impossibility to close the fascia, that was salvaged by a teflón patch. Five months later the wound opened, leaving the mesh exposed that had to be removed. A cadaveric fascia lata patch was used to cover the defect, closing the skin satisfactorily. The second case was a two days newborn. We performed the diaphragmatic closure, and the aponeurotic defect was closed using cadaveric fascia lata. RESULTS: Cosmetic and functional appearance are satisfactory in both cases and no complications have been seen. CONCLUSION: Fascia lata patches are revascularized in the abdominal wall and incorporates into receptor tissue. They have the following advantages with respect to synthetic materials: First, the risk of complications is lower. Second, their removal is not necessary. Finally, no intraperitoneal adhesions occur. The risks of disease transmission and rejection are minimized by the Centro Comunitario de Transfusiones donor selection and processing of the cadaveric fascia lata.

Abdominal Muscles↗

PubMed2001

[Current aspects in the treatment of vesicoureteral reflux. Analysis of our experience].

We have evaluated 465 patients diagnosed as having vesicoureteral reflux between 1975 and 2000 in our Department. Three hundred cases were treated surgically and 165 received submucosal injection of Teflon as endoscopic procedure. Since 1991, when we introduced the endoscopic technique in our Department, 31 patients required open surgery. The work includes the study of the diagnostic procedures performed in the patients, such as ultrasonography, voiding cystouretrography and renal isotopic gammagraphy. We focused on these patients treated endoscopically. The overall success rate was 97.6% with surgical techniques. Reflux was resolved using the endoscopic procedure in 76% after first injection, 93% after second and 96% after third. We conclude that the submucosal injection of Teflon is an appropriate treatment for most cases of vesicoureteral reflux. The non-invasive procedure requirement, lack of adverse effects and minimal morbidity make it an alternative to medical treatment and open surgery. The future is the search for new biocompatible materials with tissue-augmenting properties as Teflon.

Adolescent↗

PubMed2000

[Crossed testicular ectopia. Report of a case].

Crossed testicular ectopia is a rare congenital malformation in which both testis are located in the same hemiscrotum, and is related to an anomaly in normal testicular descent. This entity was first described by Lenhossek in 1886 and posteriorly by Halstead in 1907. Since then, there have been described less than a hundred of cases of this rare congenital malformation. Several ethiopathogenic theories have been proposed, including testicular adherence to mullerian structures, fusion of the wolffian ducts or defective gubemacular development, although none of them has been widely accepted. Usually, clinical sign is an inguinal hernia with empty contralateral hemiscrotum, and sometimes both testis in ipsilateral hemiscrotum. A new case of this pathology is presented.

Child, Preschool↗