Biomedical subjects

L Gramática

Publications and source records attributed to L Gramática.

At least 19 recordsLinked to original sources

PubMed2001

[Jejunostomy for enteral feeding in surgery. Technical contribution and experience].

UNLABELLED: The necessity to maintain the nutritional integrity in patients subjected to major surgery of the superior digestive tract has been broadly accepted. The enteral nutrition for yeyunostomy is accepted as more physiologic, sure and effective than the parenteral one. MATERIALS AND METHOD: 171 yeyunostomies were indicated in: 151 patients with malignant neoplasm of the superior digestive tract, 15 with infected pancreatic necrosis, 3 bile-duodenum-pancreatic traumatisms and in 1 stenosis for gastroesophagic reflux. Depending on the pathological type, a yeyunostomy using the Witzell technique was carried out with either local or general anesthesia at a 15 to 20 cm. of the Treitz angle. To facilitate the fixation of the catheter and to avoid the stenosis of the jejunum we have incorporated, as an original technical detail, the proximal serous section with cold scalpel in about 4 cm, that is to say in the sector to be tunneled. RESULTS: There was not mortality in relation to the yeyunostomy. Among the minor complications we emphasize the abdominal distension, colic pain and diarrhea, situations that were reverted, controlling the debit and the feeding characteristics. This approach could be maintained for period of 2 months and in some cases at home. CONCLUSIONS: We emphasize the great importance of the enteral feeding for yeyunostomy, for its of easy handling, security and low cost that, together with the suggested technical detail, has allowed us to obtain a deeding road almost without inherent complications.

Digestive System Surgical Procedures↗

PubMed1999

[Amplifying right colectomy: place in the treatment of obstructive proximal left colon cancer].

The results obtained about nineteen (19) patients operated by left colon cancer with variable grade obstruction have been analysed. Seventeen (17) patients operated due to obstructive left colon cancer situated: five (5) in distal transverse colon, other five (5) at splenic flexure and seven (7) in proximal descending colon but three of them with right synchronic neoplasias. The remaining two (2) that showed a cancer located at splenic flexure and the other one in proximal descending colon were reoperated three weeks later than a transverse colostomy had been performed owing to an obstructive condition. One patient had to be reoperated because a generalised peritonitis from a fistula with partial disruption on end to end ileo-colic anastomosis. Exteriorization of both ends was carried out with favourable evolution and subsequent reanastomosis. An exteriorized patient by splenic flexure cancer also had to be drained ten days later for a retroperitoneal abscess through a percutaneous puncture and a lesion grade 1 in lower pole of spleen was resolved with electrofulguration. No patient has showed invalidating diarrhea and all themselves have been stabilised with two or three stools daily about two month after surgery. Amplifying right colectomy is a safe procedure with low surgical morbimortality and take privileged place in the treatment of the patients undergoing synchronical neoplasias and/or carcinomas associated with polyps, specially in all those cases when a variable grade of obstruction have occurred.

Aged↗

PubMed1999

[Value of the nuclear magnetic cholangio resonance in the study of the patient with jaundice].

This report analyse the results about forty three (43) patients, thirty six (36) of which showed an extrahepatic obstructive biliary Syndrome was made evident by ultrasonography, five (5) with a cholecistolithiasis and doubtful history of jaundice were evaluated to carry out a video-surgery procedure and two (2) patients whom hepatic-yeyunostomy had been practiced, a control of anastomosis in postoperative period was required. Nuclear Magnetic Resonance and Operative Cholangiography findings were correlated and afterward with the anatomopathological studies when they arrived. In all cases the Nuclear Magnetic Cholangio Resonance (NMCR) let us prove the diagnosis of extrahepatic biliary obstruction determining with precision furthermore the topographical site of the lesion. Respecting the aetiology of obstruction, NMCR was accurate in 34 out of 36 cases (94.4%). In conclusion Cholangio-Resonance is an excellent diagnostic method to evaluate biliary ductal system including anatomic changes. However, there are some limitations yet in order to determine the aetiology of lesions about extrahepatic biliary via extremes. We emphasize its features such as non-invasive, little operating dependent, and without morbimortality that become it as a method of choice to study the biliary via from a diagnostic viewpoint.

Cholangiography↗

PubMed1999

[Zenker diverticulum: therapeutic approach].

BACKGROUND: Pharyngoesophageal or Zenker diverticula are a few frequent pathology that could represent between 1 and 3% of the patients with dysphagia and their physiopathology even at present is scarcity clear. OBJECTIVE: Therapeutic procedures results about this pathology were analyzed. SETTING: Caraffa and Sucre Clinic. DESIGN: Retrospective observational study. METHOD: It analyzed 13 patients operated by Zenker diverticula 9 of which were male and 4 were female sex with an average age of 55.6 years. Dysphagia occurred in 100% of the cases. Besides clinical finding the diagnosis was made evident by esophageal X-ray with contrast medium and endoscopy. Diverticulectomy by one stage through a left cervicotomy was the surgical procedure of choice. RESULTS: There was no surgical mortality. Related with morbility 2 patients presented fistulas managed medically and in other 2 patients abscesses of surgical wound occurred. The follow-up was carried on 6 months, 4 and 7 years respectively without relapses and with a good posterior evolution. CONCLUSIONS: Based on our short experience and the results attained we think the treatment of Zenker or pharyngoesophageal diverticulum by diverticulectomy through a left cervicotomy is safe and effective procedure to control this pathology.

Adult↗

PubMed1997

[Latent carcinoma of the thyroid in surgical samples].

We present 23 cases of latent thyroid carcinoma which were examined in 356 surgical specimens (incidence: 6.4%), having found a sclerosing variant predominance. Of the total cases that were under study, twenty of them belonged to women (86%), and three to men (14%). Due to the fact that the concepts of latent thyroid carcinoma and occult thyroid carcinoma are often misused as synonyms, regarding both pathologies, we have carefully examined the available literature and therefore, we have made a critic analysis of both entities. We also made a detailed microscopic study of the surgical specimens and included a slice for histopathologic examination, which was evaluated every 5 g of tissue. The purpose of this last study responded to our consideration on the real incidence of latent thyroid carcinoma, which cannot be found in routine studies.

Adolescent↗

PubMed1994

[Temporary muco-cutaneous transversal colostomy. Technical contribution].

The cases of 49 patients on whom a primary temporary muco-cutaneous transversal colostomy were practiced for different pathologies, are presented and the results obtained analysed. From our point of view, certain technical aspects explain the excellent results obtained. Within these aspects we call to attention the place where the colostomy was practiced, divulsioning the rectum muscle, the total absence of colo-parietal fixation and the early removal of the glass rod-all of which as we see it, simplifies enormously the healing process of this type of ostomy, thus permitting the systematic use of local anaesthesia. This procedure allows this type of surgery to be practiced on ambulatory patients, reducing the operating costs.

Colostomy↗

PubMed1994

[Anorectal malignant melanoma].

The cases of four patients who are carriers of primitive anorectal malignant melanoma are presented, reviewing at the same time the medical literature available. The clinic of all these patients was similar: pain, proctorrhagia, tumors, tenesmus, hemorrhoids and changes in the intestinal rhythm. One of these cases was similar to thrombosed hemorrhoids, and for this reason we believe that all of the parts that are removed should be biopsied. The prognosis of this pathology is in general adverse, notwithstanding the treatment received. There are very few cases on record that have survived more than 5 years, with early diagnosis and treatment with an abdominal-perineal resection. Radiotherapy and chemotherapy can reduce the size of the lesion but it is acknowledged that the prognosis will not change.

Aged↗

PubMed1993

[Infected pancreatic necrosis. Reexaminations planned with locoregional anesthesia].

Eleven patients with infected pancreatic necrosis are presented. They were treated with necrosectomy and lavage with programmed reexploration and peridural anesthesia. Nine of these patients, had biliary stone disease as associated pathology and two were chronic alcoholics. We used the contrast computerized tomography and CT-guided percutaneous aspiration to obtain fluid for Gram stains and culture, as a diagnostic method. The patients were reoperated 3 to 5 times each 48-72 hs., with a mortality of 18.2%.

Aged↗

PubMed1990

[Congenital pancreatic cyst].

A case of a congenital cyst of the pancreas occurring in an adult woman and successfully treated by resection, is reported. The presence of cylindrical epithelium in the cystic cavity, the high amylase contents of the cyst and the ERCP examination made the diagnosis.

Female↗

PubMed1989

[Experimental peritonitis: sequential bacteriologic study of the lymph and blood].

In 7 dogs with fecal peritonitis, induced by incision of the cecum, and in the same number of control animals the thoracic duct was cannulized at the neck level together with a femoral vein for the purpose of sequential study of the routes of bacterial dissemination. The findings show: a) rapid appearance of germs in lymph and then in blood in animals with peritonitis, b) a progressive increase in the number of species isolated in each sample, and c) that the lymphatic flow and drainage of bacterias lasted throughout the 12 hours that the experiment lasted. The microbes isolated in lymph and blood were related to the flora of the intestinal segment where the infection originated, with development of a large number of anaerobic species.

Animals↗

PubMed1986