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Biomedical subjects

C Vara-Thorbeck

Publications and source records attributed to C Vara-Thorbeck.

At least 19 recordsLinked to original sources
PubMed1994

Laparoscopic ileal-loop conduit.

We describe our experience with a laparoscopic ileal-loop conduit technique for an elderly high-risk patient with bladder cancer. Four ports were used. The ileal segment was sectioned and isolated, ileal continuity was restored, and the ureter was implanted into the ileal segment conduit, extracorporeally. Conduit stoma was formed in one port. Operating time: 4 h. Recovery uneventful. The patient was discharged on the sixth postoperative day and is symptom-free at present and under radiotherapy.

Aged↗
PubMed1994

Common bile duct stones after laparoscopic cholecystectomy and its treatment. The role of ultrasound and intravenous and intraoperative cholangiography.

In the present work we recount our experience in handling common bile duct stones (CBDS) in our first 100 cases of laparoscopic cholecystectomy. In the first 50 cases our diagnostic procedures involved the use of ultrasound exploration and intravenous cholangiotomography 48 h before laparoscopic surgery. We found three cases of residual CBDS. One of the cases was treated by means of ERCP. The other two cases were resolved by carrying out a transparietohepatic cholangiography after the ERCP procedure failed. After this experience, we changed our strategy, introducing the intraoperative cholangiography in the cases with an unclear diagnosis. With this new approach, no residual CBDS occurred in the following 50 cases. These findings demonstrate the following: (1) In our hands, intravenous cholangiography is not more effective than ultrasound exploration in resolving dubious cases. (2) These dubious cases are more effectively diagnosed by means of selective intraoperative cholangiography. (3) When CBDS is treated by transparietohepatic cholangiography it proves to be less uncomfortable for the patient than ERCP and, as we found, even more efficient in removing the stones, although our experience is based on only two cases.

Adolescent↗
PubMed1994

Histamine synthesis and content in benign and malignant breast tumours. Its effects on other host tissues.

We studied 100 patients: 40 with breast cancer, 41 with benign breast tumours and 19 non-cancer-bearing cholecystectomy patients, in order to measure the histidine decarboxylase activity and histamine content in benign and malignant breast tumours, and to determine whether the histamine metabolism affected skin and muscle tissue distant from the tumour. The HDC-activity of cancerous tissue was significantly higher (P < 0.01) than that registered in the healthy mammary gland tissue of the same patient, being even more pronounced in benign tumour tissue (P < 0.001). However, the histamine content was found to be significantly lower (P < 0.01) in malignant tumours, but higher in benign tumoural tissue as compared with the healthy tissue of the same patient. We also found that the histamine content in muscle tissue was significantly higher in cancer patients than in non-cancer patients. These findings highlight the fact that intracellular histamine metabolism varies in benign and malignant tumours, and that high histamine synthesis of malignant tumours affects other host tissue.

Breast↗
PubMed1994

Indications and advantages of laparoscopy-assisted colon resection for carcinoma in elderly patients.

The controversy about laparoscopy assisted colectomy for cancer is based on doubt about performing a radical resection and adequate histopathological staging. Therefore, we selected a group of patients who could profit from the accepted benefits of the technique, while avoiding its uncontrolled outcome. We operated on patients with colorectal cancer with distant metastasis and on patients over 70 years old and American Society of Anesthesia (ASA) III-IV with a high operative risk with standard surgery. The results for the first 18 patients demonstrated the following: (a) the size of the surgical specimen and the number of lymph nodes were similar to those in standard surgery; (b) no mortality and very low morbidity occurred despite the patients' advanced age, debilitated condition, and comorbid diseases; (c) minor postoperative complications occurred in five of 18 patients; (d) the hospital stay was 6-7 days for nonmetastatic patients and 9-12 days for metastatic patients; (e) the 1-year survey revealed a relapse in only one patient 9 months after the first operation.

Aged↗
PubMed1989

[Complications in bland struma surgery. A retrospective study based on 2,035 personal cases].

In the present retrospective study we examine the complications arising from simple goiter operations based on the analysis of 2,035 cases. The mortality rate is extremely low (0.3%). The most typical intraoperative complications - such as unilateral vocal cord paralysis (1.6%) and permanent parathyroprival hypocalcemia (0.4%) were observed to occur much more frequently in cases of subtotal thyroidectomy than in those of partial resection. - As a result of the introduction of synthetic reabsorbent sewing materials, healing problems have been drastically reduced (0.4%). Hypothyreosis and goiter recurrence can be avoided in cases of subtotal thyroidectomy by life-long and individually adjusted administration of thyroid hormones (rate of incidence in our study 3.1%). - In our view a subtotal thyroidectomy is indicate in cases where malignity is suspected (one or more cold nodules).

Adult↗
PubMed1989

Villous adenoma of the duodenum. Case report.

Two rare cases of villous adenoma of the duodenum are described. Obstructive jaundice was the presenting clinical feature. Histologically the tumour was benign in both cases. Local excision was performed. One year later both patients were free from recurrence, but one was treated for gastric adenocarcinoma after 2 years. The literature is reviewed.

Adenoma↗
PubMed1988

Increased histidine decarboxylase (HDC) activity in human colorectal cancer: results of a study on ten patients.

Following numerous reports of high histidine decarboxylase (HDC) activity in tumour-bearing animals, the present work was designed to determine the activity of this enzyme in normal and tumour tissues in a series of ten surgical patients with colorectal carcinoma. Significantly increased HDC activity, almost double that of normal tissues, was found in specimens from extirpated human tumours. These results, obtained under reliable sampling and measurement conditions indicated that changes in the enzymic activity of HDC may have a significant role in the development of colorectal tumour cells. Inhibition of the enzyme activity in human cancer subjects may retard or impede tumour growth and perhaps limit the spread of metastases.

Adult↗
PubMed1988

[Preoperative hemodilution for the prevention of postoperative deep venous thrombosis and early infectious complications in colorectal resections].

The effectiveness of heparin DHE and preoperative haemodilution (M.N.H.) for prophylaxis against deep venous thrombosis (D.V.T.) and against early septic complications was investigated in a prospective controlled study on two comparable groups of patients who had undergone colorectal resections for malignant tumours. The results clearly suggested that there was no significant difference between heparin DHE and preoperative haemodilution for prophylactic effectiveness on D.V.T. yet, the percentage of postoperative septic early complications, that is insufficiency of anastomosis and abdominal wall infections, was much lower (p less than 0.001) in patients with moderate normovolaemic haemodilution (haematocrit = 30 per cent). While the number of cases reviewed was as low as 62, the point can be made that less postoperative septic complications occurred to patients with low haematocrit (30 per cent).

Clinical Trials as Topic↗
PubMed1988

[Surgical treatment of echinococcosis of the lung based on 575 personal cases and a study of the literature].

Echinococcosis has continued to be a worrying problem in endemic zones. An account is given in this paper of 25 years of experience in echinococcosis treatment. Reported are 575 patients on whom operations had been performed at the Surgical Clinic of Malaga University under the supervision of Professor Vara López. Fifty-six per cent of these patients were males and the remainder females. The disease was found to occur with regularity to all age groups. Cough, pain, lung bleeding, and geographic origin were characteristic phenomena of the disease and its anamnestic background. Diagnosis was confirmed by these parameters together with eosinophilia, complement fixation reaction according to Weinberg, intracutaneous testing according to Casoni, and radiography. Surgical approaches were pericystectomy in 415 cases, cystectomy in 57 cases, segmentectomy in 64, lobectomy in 34, and pneumectomy in five cases. Postoperative complications occurred to seven per cent of the patients, and the lethality rate amounted to 1.5 per cent. The absence of clinical information in publications is discussed together with lack of analyses of clinical situations, modes of treatment, and complications.

Adolescent↗
PubMed1986

[Effect of glucagon on intestinal microcirculation].

Examinations in rats were carried out for investigating the glucagon effect on the bowel microcirculation. After intramuscular injection of glucagon an increase of the pO2, a decrease of the pCO2, and a consistent pH value were observed in the mesenteric vein. The results showed that by means of glucagon arteriovenous shunts of the bowel mucosa were opened. This leads to the exclusion of the capillary network in the villi.

Animals↗
PubMed1986

[Echinococcosis of the liver. Its surgical treatment based on 178 personal cases].

Reported in this paper are 178 patients who had received surgical treatment for echinococciasis of the liver, among them 144 at the Surgical Hospital of Madrid University, between 1962 and 1970, and another 34 at the Surgical Hospital of Granada University, between 1971 and 1982. All of them had been carriers of Echinococcus cysticus. Echinococciasis of the liver usually is not diagnosed until the hydatid cyst begins to cause conspicuous symptoms or complications on account of its own growth. Diagnostic clues are obtainable from laboratory findings (eosinophilia in excess of four per cent), immune reaction, complement fixation reaction according to Weinberg, and intracutaneous test according to Casoni. Diagnosis of the authors' cases had been preceded by scintiscanning. Surgical removal of echinococcus cysts from the liver calls for an undogmatic approach. From among all surgical methods applicable to cyst removal the authors have most frequently used closed marsupialisation, according to Posadas-Dew (65.8 per cent of all cases). Drainage marsupialisation was applied to 25.8 per cent of all cases. The postoperative lethality amounted to 2.3 per cent. Morbidity was low.

Adolescent↗
PubMed1986

[Cysts of the parathyroid glands].

Cysts of epithelial bodies are rare causes of hyperparathyroidism. Reported in this paper are 2 patients with clinical symptoms of hyperparathyroidism, high blood calcium levels and established hormones in their epithelial bodies. Cysts of epithelial bodies were diagnosed by means of angiography, computed tomography, and sonography. Various aetiological factors behind cyst formation in epithelial bodies are discussed.

Adenoma↗
PubMed1986

[Peritoneal echinococcosis].

Secondary peritoneal echinococcosis was recorded from 50 in 312 patients (16 per cent) who had been hospitalised for liver echinococcosis. Hydatido and peritoneal hydatidiosis were recorded from 34 of these patients and thus accounted for the two most common pathological forms of secondary peritoneal echinococcosis, according to Dévè. Peritoneal echinococcosis usually is not diagnosed until conspicuous symptoms grow manifest due to cyst growth or other complications. Positive responses were recorded from all the above cases to laboratory tests (eosinophilia in over five to nine per cent) and were also established on the basis of immune reactions, including the complement fixation reaction according to Weinberg, the intracutaneous test by Casoni, and latex echinococcus reaction. Surgery, at present, is the only promising therapeutic approach to the problem. Surgical intervention could not even be avoided by application of mebendazol. Postoperative lethality amounted to four per cent and morbidity to ten per cent. They were comparatively low, measured by the generally poor prognosis of the disease.

Adolescent↗
PubMed1986

[Entero-gastric reflux after distal stomach resection--an animal experiment study].

UNLABELLED: The experiments were carried out in 125 Wistar rats. The entero-gastric reflux was estimated quantitatively with reference to the bilirubin and the cholic acid (radiolabeled by C 14). The animals were submitted to distal partial gastrectomy in groups after Billroth I operation, after Billroth II operation with and without enteroanastomosis, as well as Billroth II operation with enteroanastomosis and vagotomy. RESULTS: The statistical difference was significant between Billroth I and Billroth II operation with clear smaller reflux in Billroth I. The added enteroanastomosis decreased or increased the reflux of some animals at a time. The additional vagotomy reduced the number of the anastomotic ulcer.

Animals↗
PubMed1984

[Increase of bile acid reabsorption following total small intestine resection in the rat].

Bile salts undergo an enterohepatic circulation. The relative distribution of labelled cholic acid in portal blood, enterocytes, intestinal contents and feces, following intravenous injection of (carboxylic-14C) cholic acid, can be considered as an indication of the absorptive capacity of the epithelium cells. Seven days after a massive small intestinal resection (60-80 cm), the animal weight and the bile salt absorption were significantly decreased. Nevertheless, thirty days after the operation, weight and radioactivities reached the values found in the controls: in portal and cava blood, liver, intestinal contents and feces. An increase of the absorptive capacity of the intestinal epithelial cells was also observed.

Animals↗