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F Delgado Gomis

Publications and source records attributed to F Delgado Gomis.

12 recordsLinked to original sources
PubMed2005

Surgery for gastroesophageal reflux disease: a comparative study between the open and laparoscopic approaches.

OBJECTIVE: Given the demonstrated effectiveness of medical treatment together with the eminent acceptance of the laparoscopic approach, the indications of surgery in the treatment of gastroesophageal reflux disease (GERD) are currently subject to continuous controversy. To participate in this debate, we have the following work hypothesis: "The results of the 360 masculine short and floppy laparoscopic fundoplication are superior to those of open surgery". CLINICAL DESIGN: Prospective, clinical, non-randomized study. PATIENTS: Our work was developed between November 1991 and December 1998 by means of a prospective, non-randomized clinical rehearsal with two groups of patients: Group I (n = 75): 360 degree short and floppy laparoscopic fundoplication in Hospital Dr. Peset, Valencia (Spain). Group II (n = 28): 360 degree short and floppy, open fundoplication in Hospital General, Valencia (Spain). We evaluated the preoperative parameters and found no differences, which allows us to know that both groups were comparable. RESULTS: The analysis of peroperative results (morbidity and surgical time) and of clinical follow-up (every three months and later annually) and instrumental follow-up (TEGD, upper digestive endoscopy, pHmetry and manometry) show no differences, while the postoperative analysis shows statistically significant (s.s.) differences regarding recovery (pain, oral intake, hospital stay and return to previous activities). CONCLUSIONS: The results of the 360 degree short and floppy laparoscopic fundoplication are similar to those of the open approach, but favor the former approach with a better postoperative tolerance.

Digestive System Surgical Procedures↗
PubMed1999

Laparoscopic choledochotomy in the management of choledocholithiasis. A report of 32 cases.

OBJECTIVE: we describe a choledochotomy technique for the laparoscopic removal of calculi in the management of choledocholithiasis, with an analysis of the results obtained in our first 32 patients. METHODS: a prospective study was made of all patients who underwent laparoscopic choledochotomy in our surgical service in the period between December 1993 and December 1996. A total of 112 patients diagnosed as having choledocholithiasis were operated on in our service in the course of the study. Of the 54 patients who initially underwent laparoscopic surgery, 32 underwent cholecystectomy, choledochotomy, extraction of stones and laparoscopic choledochorrhaphy. RESULTS: in 30 patients (93.75%) laparoscopic surgery could be completed without resorting to open surgery; in 5 of these patients primary choledochorrhaphy was performed, and in the remaining patients suturing was performed on a Kehr T-tube. Mean surgical time was 176 min. Two slight complications (one acute gastric dilatation and one small biliary fistula) and one severe complication (bowel fistula) were recorded. Mean hospital stay was 7 days. CONCLUSIONS: choledocholithiasis was successfully managed with laparoscopic choledochotomy and the extraction of stones, with no increase in morbidity or mortality in comparison to other therapeutic modalities.

Adolescent↗
PubMed1998

Early results of laparoscopic resection of colorectal cancer.

OBJECTIVE: To study the immediate and early postoperative results obtained in patients subjected to laparoscopic resection of colorectal cancer. PATIENTS AND METHOD: A prospective, observational cohort study was initiated in January 1993, involving 50 patients subjected to laparoscopic resection for colorectal adenocarcinoma (rectal amputation in 10 cases, lower rectal resection in 13, recto-sigmoidectomy in 18, and miscellaneous colectomies in 9 cases). Seventy-percent of the tumors were in IUCC stages II and III. Mean follow-up was 21 months. RESULTS: Conversion to open surgery was required in 18 cases (36%). Intraoperative problems were limited to a single urethral lesion, while postoperative complications were recorded in 11 patients (22%), and were managed conservatively: a urinary fistula secondary to the aforementioned urethral lesion; subclinical dehiscence of the anastomosis (2 cases); phlebitis (1 case); infection of the surgical wound (4 cases), and urinary and pulmonary infection (1 case each). There were no differences between converted surgery (i.e., conventional laparotomy) and those operations completed endoscopically (with a final assisted or combined minilaparotomy) in terms of the length of the surgical resection piece, the length of the distal margin of the specimen or the number of lymph nodes. Global hospital stay ranged from 9-12 days, versus 5-7 in the group without complications. Global survival is 78% at 42 months, with a disease-free interval of 53% at this time. CONCLUSIONS: Laparoscopic colorectal resection presents an incidence of intra- and postoperative complications characteristic of major surgery, with no differences in surgical specimen size with respect to those operations converted to laparotomy. Global survival is similar to that reported in the literature for open surgery.

Adenocarcinoma↗
PubMed1998

Laparoscopic reconstruction of intestinal continuity following Hartmann's procedure.

Laparoscopy-guided reversal of Hartmann's procedure was performed in eleven patients who had been treated surgically for inflammatory disease or cancer of the colon. Restoration of intestinal continuity was achieved in ten of them. There were no postoperative complications. The mean surgical time was 144 minutes and the mean duration of postoperative ileus was 48 hours (range: 30 to 60 hours). The mean hospital stay was 7 days. Our results suggest that laparoscopic reversal of Hartmann's procedure is safer than and as effective as open surgery.

Adult↗
PubMed1989

[Surgical treatment of cancer of the colon: a review of 175 cases].

We present a review of 175 cases of carcinoma of the colon out of 270 cases of colorectal cancer operated in our service during the period 1980-1986. It is noteworthy that 46.8% of the patients underwent emergency surgery for occlusion and/or diastasic tumoral perforation, and that they presented an advanced average age (48.5% were over 70 years). In emergency surgery there was a predominance of bypass operations (73%) versus tumoral resection (27%). In programmed surgery the index of resectability was 83%. The global operative mortality was 12.5%, but separately it was greater for emergency surgery (18%) than for elective surgery (7.5%). Wound infection occurred in 35% of emergency operations and in 11.8% of programmed operations. An anastomotic fistula appeared in 6.9% of cases, with a similar incidence for mechanical and manual anastomoses. It is concluded that early detection of the disease is necessary to reduce the percentage of urgent operations, and consequently the rates of operative morbi-mortality, and improve long-term survival.

Aged↗
PubMedDate not supplied

[Surgical trauma from laparoscopic cholecystectomy].

UNLABELLED: The authors present a prospective study whose objective is to estimate the degree of injury from laparoscopic cholecystectomy, by means of the determination of the neuroendocrine response to the surgical aggression. By means of a simple randomization, two study groups are established: group A, consisting of 17 patients subjected to laparoscopic cholecystectomy, and group B, consisting of 18 patients subjected to different techniques of open surgery. EXCLUSION CRITERIA: transfusion of blood derivatives or therapy with corticosteroids. The groups are homogeneous with regard to age, sex, Quetelet index, duration of the intervention, and anaesthetic drugs. A postoperative increase of plasma ACTH, growth hormone, insulin, cortisol and T3 was found in both groups (p < 0.05), and a significant postoperative increase of cortisol and catecholamines in 24 hour urine was found especially in group B. It can be concluded that even though there is an increase of the contraregulatory hormones in the postoperative phase of both groups, the neuroendocrine response is lower after laparoscopic cholecystectomy.

Adult↗
PubMedDate not supplied

[Venous reservoirs: the late complications according to the route of implantation. The Interhospital Group of Valencia (GIHV)].

UNLABELLED: The aim of the study which we present is to analyze the incidence of late complications, clinical and sub-clinical, of venous reservoirs implanted through two access routes, subclavian (group A), and brachial (group B). It is a multi-centric clinical study, initiated in 1992, in which the general surgery departments of three general hospitals of the Valencian Community were involved. It is made up of 87 patients, 48 men and 39 women, with a mean age (SD) of 57.1 (12.6) years, of whom we made a late review of 41 patients (29 from group A and 12 from group B). They were subjected to a physical examination, bacterial cultures of the entrance, and phlebograms of the upper extremities through the dorsal veins of the hands. RESULTS: The incidence of clinical complications was 39% in group A and 77% in group B (p = 0.0507). The main clinical complications were minimally symptomatic venous thrombosis, catheter thrombosis, infection, and miscellaneous (migration, paresthesias, articular movement alterations, etc.). And the prevalence of phlebographic venous thrombosis was 18% in group A and 40% in group B (p = 0.051). CONCLUSIONS: The subclavian access for the implantation of venous reservoirs has a lower incidence (with a tendency towards clinical significance) of clinical complications and subclinical venous thrombosis (Phlebogram) than the brachial access.

Analysis of Variance↗