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Biomedical subjects

L Lassaletta

Publications and source records attributed to L Lassaletta.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Tissue adhesives in closing of fistulas after surgery of esophageal atresia].

AIMS: Recurrent tracheoesophageal fistula is a severe postoperative complication after esophageal atresia repair. Endoscopic obliteration with tissue adhesives has been used as an alternative to reoperation. The aim of this study is to review our experience with such procedure. MATERIAL AND METHODS: The medical records of 415 esophageal atresia patients were retrospectively reviewed in order to analyze the incidence of complications and the outcome of patients in whom tissue adhesives were used to close a recurrent tracheoesophageal fistula. RESULTS: 334 patients underwent an esophageal anastomosis and fistula closure or fistula division alone, 41 (12.3%) of them had recurrent tracheoesophageal fistula. In eight of these patients and one having an H type tracheoesophageal fistula, endoscopic obliteration using tissue adhesives was attempted. None of these nine children cured after this procedure and all required an open procedure for their recurrent tracheoesophageal fistula. CONCLUSIONS: Contrary to some published cases, we have not succeeded with endoscopic obliteration of recurrent tracheoesophageal fistula using tissue adhesives; therefore, we do not recommend this treatment.

Endoscopy↗
PubMed1998

Synchronous glottic granular cell tumor and subglottic spindle cell carcinoma.

We report the clinicopathologic findings in a case of coexistent glottic granular cell tumor and subglottic spindle cell carcinoma. There is no evidence in this case that suggests malignant transition of the granular cell tumor to malignant tumor. To our knowledge, this is the first report of synchronous granular cell tumor and subglottic spindle cell carcinoma.

Carcinoma↗
PubMed1997

Pediatric tonsillectomy: post-operative morbidity comparing microsurgical bipolar dissection versus cold sharp dissection.

A prospective single-blinded study was conducted to compare pediatric tonsillectomy using the traditional cold sharp dissection with ligation for securing hemostasis (CSDL) versus microsurgical bipolar dissection technique (MBCT). Sixty children aged between 2 and 14 years were sequentially assigned to each group. Blood loss and postoperative pain in the first hour were markedly decreased in the MBCT group (P < 0.0001 and P < 0.05, respectively). Average surgical time was slightly decreased in diathermy tonsillectomy (15'30") compared with the cold technique (16'30"). Return to normal diet was significantly earlier in the CSDL group (P < 0.05). Late postoperative pain measured on the tenth day showed a moderate increase in children who underwent MBCT. There was no difference between the two techniques in the incidence of postoperative hemorrhage. No major complications occurred. We believe MBCT is a fast and safe technique which may be useful in children with known bleeding disorders. However, it increases late postoperative pain and, therefore, delay in patients' return to normal activities. Consequently, it does not represent a significant advantage over the traditional CSDL procedure.

Adolescent↗
PubMed1995

Gastric somatostatin content and binding in children with hypertrophic pyloric stenosis: a long-term follow-up study.

Because somatostatin (SS) inhibits basal and stimulated gastric acid secretion and gastrin release, it is conceivable that decreased gastric SS concentration may be one of the factors responsible for hypergastrinemia found in patients formerly operated on for hypertrophic pyloric stenosis (HPS). To investigate this issue, the SS-like immunoreactivity (SLI) concentration was estimated in antral and fundic mucosal samples from control and HPS children. In addition, SS binding to cytosol from gastric mucosa (fundus and antrum), fasting serum gastrin levels, and serum gastrin response to a standard breakfast were studied. The mean fundic and antral SLI concentrations were significantly lower in HPS children than in controls. The depletion of fundic and antral SLI content was associated with an increase in the number of gastric SS binding sites. The fasting serum gastrin levels and serum gastrin responses to the standard breakfast (after 60 minutes) of HPS children were significantly higher than those of controls. Since, together with the increase of SS binding to gastric mucosa, there is an increase in the gastrin serum levels, despite the inhibitor effect of SS on gastrin release, the binding capacity cannot be the main factor determining the response to SS in children with HPS. The present results suggest that both SS and gastrin have a role in the pathogenesis of HPS.

Adolescent↗
PubMed1995

[Partial splenic embolization in the treatment of hypersplenism. Long-term results].

In order to assess long term evolution of partial splenic embolization (PSE), 21 patients with hypersplenism treated by this technique from January 1984 to December 1992 have been reviewed. Between 50 and 90% of the splenic parenchyma was embolized in these patients. The follow-up period ranged between 12 and 103 months (mean = 32 months). Remaining splenic tissue was evaluated through sequential hematologic, ultrasonic and gammagraphic studies. After one year post-embolization white blood cells and platelets showed normal values. Five years later the mean values for these two parameters was lower but within the normal range. The mean reduction of splenic mass as estimated by ultrasound and gamma graphic studies was of 40% at one year and 17% at five years. Our results show that SPE can control hypersplenism, specially during the first years, but there is a tendency to a decrease in the leucocyte and platelet counts after five years. A regeneration of the splenic mass occurs in the long run after embolization. In our patients a relation between splenic regeneration and hypersplenism could not be demonstrated.

Adolescent↗
PubMed1994

[Acute renal failure after major surgery: effectiveness of continuous arterio-venous hemofiltration (CAVH)].

Thirteen patients with acute renal failure after mayor surgery were treated with CAVH, 6 children after liver transplantation (OLT) and 7 after extracorporeal cardiac surgery (ECS). The ages ranged from 4 months to 19 years, with filters from 0.16 m2 to 0.5 m2, according to the weights. CAVH was initiated 19 hours (mean) after OLT and 10.5 hours (mean) after ECS. Mean creatinine clearance was 6.3 ml/min/1.73 m2 (ECS) and 10.1 ml/min/1.73 m2 (OLT). Serum creatinine remained under acceptable values (mean 2.1 mg.%) in both groups. Mean fluid removal was 5.7 L/day (242 ml/kg/day), which allowed plasma administration despite oligoanuria in the OLT group. Fluid removal decreased central venous pressure (p < 0.001) and increased mean arterial pressure (p < 0.01) in the ECS group, and inotropic support could be diminished. CAVH was well tolerated and it was maintained for 79 hours (ECS) and 105 hours (OLT).

Acute Kidney Injury↗
PubMed1993

[Neonatal tracheomalacia. Study of 3 cases treated with aortopexy+].

Neonatal tracheomalacia is a disease in which there is a softening of the tracheal wall with lost of this consistency. This cause expiratory collapse cough and respiratory difficulty it is generally associated with Esophageal atresia and Vascular Rings. Exceptionally is a primary disease. In this paper we present three cases of neonatal tracheomalacia treated by aortopexy who is at the moment the best treatment that we have in severe cases. Soft cases will remit with conservative treatment.

Aorta↗
PubMed1993

[Gastroschisis: study of teratogenic factors].

The medical and surgical treatment of gastroschisis has improved in the last decades leading to better survival rates. Since in our institution there were the same cyclic variations in the incidence as in other large series in the literature, we have reviewed the epidemiological factors that can be at the origin of such variations. We studied 20 different variables in our patients in a case-control basis. Only five of them were significantly different between cases and controls. (Birth weight, gestational age, infection, drugs during the first three months of gestation and maternal age). The results point to the role of environmental factors more relevant in the etiology of gastroschisis than genetic ones.

Abdominal Muscles↗
PubMed1992

[Nuclear magnetic resonance of anorectal malformations and persistent postoperative fecal incontinence].

We review our experience with Magnetic Resonance Imaging (MRI) in the evaluation of 6 patients showing anorectal malformation, and 4 more with persistent postoperative fecal incontinence. Preoperative sagittal, axial and coronal planes were studied with special consideration to the pelvic and vertebral structures. The excellent resolution of MRI allowed accurate identification of the pelvic musculature in all patients, including those with bizarre sacral abnormalities. MRI revealed structural anomalies not detected previously, such as teathering cord, intraspinal lipoma, presacral mass and renal malformation. In our institution, MRI has replaced the CT scan in the study of patients suffering of persistent fecal incontinence. In non operated on cases of anorectal malformations, MRI determines with extraordinary accuracy the location of the rectal atretic pouch, the actual pelvic muscular quality, and the detection of previously unsuspected associated anomalies.

Anal Canal↗
PubMed1991

[A case of total intestinal aganglionosis. 2 years of survival].

A two-year-old male is presented. Small bowel aganglionosis was proved to extend to 3 cm below ligament of Treitz. Gastrostomy and ileostomy was done. He received his caloric intake by cyclic home parenteral nutrition trough implantable venous system. At eighteen months of age, intestinal transplantation was refused and reoperation was done. The child underwent Ziegler's miotomymiectomy on 60 cm of aganglionic jejunum. Now at twenty seven months of age he receives cyclic parenteral nutrition, and enteral feedings are being increased slowly. The weight/height was at 91 per 100 standard, intestinal motility appears much better on contrast study and he is developmentally a normal child.

Biopsy↗
PubMed1990

Association of juvenile and adenomatous polyposis with pulmonary arteriovenous malformation and hypertrophic osteoarthropathy.

The juvenile form is the usual type of colonic polyp seen during childhood. However, mixed forms associating juvenile and adenomatous polyps have been reported. A syndrome including the association of generalized juvenile polyposis, pulmonary arteriovenous malformation, and hypertrophic osteoarthropathy has been described in three cases; however, this is the first report of the association of mixed juvenile and adenomatous polyposis, pulmonary arteriovenous malformation, and hypertrophic osteoarthropathy.

Animals↗
PubMed1990

Abdominal mass: "fetus in fetu".

A female newborn presented a mass in the left upper abdominal quadrant. It was removed by surgery and contained two independent fetuses. Dissection and radiological study of the fetuses showed an axial skeleton and long bones. It corresponds to the generally recognized diagnostic criteria of fetus in fetu.

Abdomen↗
PubMed1989

[Effect of prostaglandin (PGE2) in biliary atresia].

We studied the choleretic effect of Prostaglandin E2 (PGE2) in patients with biliary atresia. In the last four years PGE2 was used in ten cases with extrahepatic biliary atresia. All of them were treated by Kasai technique and temporary exteriorization of the bilioenteric conduit, permitting analyses of the postoperative bile flow. Mean age al operation was 50 days (range 30-70 days). The histology studies of liver and porta hepatis showed severe hepatic fibrosis in three patients, moderate in seven, bile ducts less than 100 mu in five and more than 100 mu in another five. The mean postoperative bile flow was 15 c.c./day (range 0-30 c.c.). We used PGE2 during postoperative period because the bile excretion was partial or total stopped (PGE2 0.125 mgr./kgr./day). In six cases the bile flow increase until 90 c.c./day (range 40-160 c.c./day) and four patients no response. Eight patients are alive, four without jaundice with normal hepatic function (serum bilirubin 1.04 mgr./dl) and four are waiting for liver transplantation. Two have died 7 and 30 months after Kasai procedure. The long-term follow-up was between 6 to 53 months. In conclusion the PGE2 has choleretic action in biliary atresia and could be a coadjuvant treatment to improve the bile flow.

Biliary Atresia↗
PubMed1988

Partial splenic embolization in hypersplenism.

Four patients with portal hypertension, oesophageal varices and severe hypersplenism were treated by partial splenic embolization. All showed improvement of blood and platelet counts early in the postoperative period. Three months after embolization IgA and C3 levels increased significantly. All patients had a decrease in the incidence of variceal bleeding and this procedure provides an acceptable alternative to splenectomy.

Child↗