[Non-functioning retroperitoneal paraganglioma. Clinical case].
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Biomedical subjects
F Martín Acebes
Publications and source records attributed to F Martín Acebes.
Acute diverticulitis and diverticular disease of the colon: a safe indication for laparoscopic surgery.
AIM: We analyzed our experience with a laparoscopic method for the treatment of acute diverticular disease. METHODS: Between January 1994 and October 1999 a group of 52 patients who fulfilled the criteria for symptomatic diverticular disease in the descending and sigmoid colon underwent laparoscopy with resection of an average of 40 cm of the bowel. Intraabdominal mechanical anastomosis completed the procedure. RESULTS: The use of ultrasonic scissors made the laparoscopic technique easier and shortened operative time. Operative morbidity was 15%. Two patients with acute diverticulitis and associated sepsis were reconverted to open surgery, and 4 patients presented postoperative rectal bleeding which ceased spontaneously. No long-term complications were found except in 1 patient who developed an incisional hernia through an entry port. Oral intake began between the second and third day. Postoperative hospitalization was 3-8 days (mean: 5.5 days) and mean operative time was 130 min (range: 70-240 min). CONCLUSIONS: Despite the steep learning curve for this type of surgery, the good morbidity and mortality rates with the laparoscopic method, especially with high-risk groups of patients (age > 65 years, high blood pressure, etc.) suggest that this surgical option can be used efficiently and safely, and that it achieves better results than with open surgery. However, we feel that the treatment of patients with acute complications of diverticular colon disease requires extensive experience with laparoscopic colorectal surgery.
Adult↗
Vertical ring gastroplasty (VRG) in the treatment of the serious clinical obesity. Results and complications.
OBJECTIVE: The morbid obesity is a serious polysystematic disease to which it is necessary to offer a surgical solution when the conservative alternatives fail. METHODS: In a period of five years, 50 patients with vertical ring gastroplasty (VRG) have been evaluated and protocolized in the program of surgery of the morbid obesity, with an average weight of 134.3 kg corresponding to an overweight and body mass index (BMI) average respectively, of 69.7 kg and 49.8 kg/m2. RESULTS: The early morbidity has been scarce and the postoperative average stay of 7 days. The decrease of the percentage of weight, overweight and BMI was maximum 2 years later, with losses of 52 kg, with a percentage of loss of average overweight of 76.8% and a fall of 21 points in the BMI; however there was a partial recovery of the indexes in the following years. The accompanying pathology was solved in the period of studied time, although 84% of the patients referred vomits and practically 100% dietary limitations. CONCLUSIONS: The gastroplasty is a quick, simple technique and of scare morbimortality, although it is being subjected to criticism for the restrictions in the diet, quality of life and disruptions of the line of clamped. However, nowadays there is not a consensus on the ideal bariatric solution, and as a surgical alternative, the vertical gastroplasty can represent one of the techniques of choice for certain selected types of serious obesity.
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[Nonelective colorectal surgery. Does age determine the results?].
OBJECTIVE: To evaluate the influence of age on the morbi-mortality after non-elective colorectal surgery. DESIGN: Retrospective analysis. SUBJECTS: 150 consecutive patients who underwent non-elective colorectal surgery between 1986 and 1992 [65 patients aged under 70 years (Group I)] and 85 patients aged 70 years or over (Group II)]. RESULTS: Using multiple regression analysis we have found: 1) Mortality is determined by the presence of associated risk factors (p < 0.001 tv = 4.11), the presence of peritonitis (p < 0.05 tv = 2.08) and by the admission-operation interval (p < 0.05 tv = 2.10). 2) Overall morbidity increases with age (p < 0.01, tv = 3.22) and the benign nature of the colorectal disease (p < 0.05, tv = 2.00). CONCLUSION: Age does not influence mortality in non-elective colorectal surgery even though it is a determinant risk factor in morbidity increase.
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