PubMed Health⌕ Search

Biomedical subjects

J Hebrero

Publications and source records attributed to J Hebrero.

At least 19 recordsLinked to original sources

[The biological aftereffects of preoperative and palliative percutaneous biliary drainage].

Biological repercussions in 78 patients with malignant obstructive jaundice in whom percutaneous biliary drainage was performed, are reported. In 37 cases drainage was done during operation while 41 were palliative. Biochemistry, proteinogram, hematological studies, renal function and immunology were assessed 15.7 +/- 3.4 days postoperatively and 25.2 +/- 4.7 days in palliative drainage. Results show a significant improvement of all parameters, more important in preoperative drainages especially in those combining percutaneous and internal drainage techniques.

Aged↗

[Evaluation of transparietal hepatic cholangiography in the diagnosis of cholestatic syndrome].

Three hundred and thirty-two percutaneous cholangiograms were done in 313 patients. The etiology was benign in 137 cases and malignant in 152 instances. The level of obstruction was correctly localized in 97.8% of cases. The total sensitivity was 88.5% and specificity 95.9%. Positive predictive value 95.4% and negative predictive value 89.6%. Major complications occurred in 3.3% of cases. Complications occurred more frequently when the bile ducts were dilated. They were not related to the number of attempts to puncture ther biliary tree or the experience of the physician.

Aged↗

[Adenocarcinoma of the cardia: results of distal esophagectomy and total enlarged gastrectomy using left thoracophrenolaparotomy].

An analysis was made of the results obtained in terms of postoperative complications, mortality and the 5-year survival rate in a series of 23 patients diagnosed as adenocarcinoma of the cardias who underwent total gastrectomy with distal esophagectomy via left thoracophrenolaparotomy, with esophagojejunostomy on a Roux-en-Y loop. We consider the results as favorable and conclude that this procedure has an application in adequately selected patients.

Adenocarcinoma↗

[Carcinoma of the colon in La Rioja. Study of incidence in the period 1978-87].

A study was made of the incidence of colonorectal tumors in the Autonomous Community of La Rioja (Spain) over 10-year period between 1978 and 1987, inclusive. An increased incidence of these tumors is confirmed, with no decline in the age of presentation or in the frequency of detection of early tumors, which suggests that this disease is on the rise. In view of these results, measures leading to the early diagnosis of colonic tumors are needed, such as screening of the general population, particularly groups at risk.

Aged↗

[Results of extended resections in colorectal cancer].

We present 50 cases of super-radical surgery in cancer of the colon and rectum with tumoral spread. In the same period of time a total of 426 colorectal neoplasms were operated on, which represents 11% of the total. The mean age was 65.7 years, with a predominance of females (29/21). In every case the primitive tumor and contiguous organ affected were excised with an oncologic criterion; the principal location was the rectum, with 14 cases, and the viscus most affected was the female genital tract. The mean hospital stay was slightly longer than that of the general series (20.9/14); the mortality was 4%, a figure similar to that of the general series; the index of morbidity did not rise, survival was comparable and the patient's comfort was enhanced. In our opinion, this technique is indicated in all cases in which the tumor invades contiguous regions when local and/or general conditions permit.

Adult↗

[Immediate prognosis factors in total gastrectomy in cancer].

We present a series of 76 patients operated over a period of nine years, diagnosed as gastric cancer (CG), in whom radical oncologic total gastrectomy (GT) with esophago-jejunal anastomosis (EY) on a Roux-en-Y loop (Y-R) was performed. The tumor was located in the cardias in 27 patients, body in 37, fornix in 3, gastric stump in 7 and over plastic linitis in 2. We performed total gastrectomy enlarged to the spleen in 63 patients, to the pancreas in 28, to the colon in 5 and to the liver in 4. We describe the most salient technical details of the surgical intervention. Twenty-six percent of the patients presented postoperative complications, which we divided into two groups: anastomosis failures, among which are emphasized 4 severe esophagojejunal fistulas, a fistula of the duodenal stump (MD) and respiratory complications. The mortality was 7.8%, corresponding to 4 esophago-jejunal fistulas, 1 fistula of the duodenal stump and 1 bilateral bronchopneumonia. We analyzed various parameters that we consider important prognostic indicators of postoperative morbi-mortality. Applying the Fischer test, we attempted to assign statistical significance to these parameters. Age over 60 years increased postoperative mortality. Super-radical surgery did not increase mortality. On the other hand, patients in stages IIIb and IV have a worse prognosis, with a mortality in the first 30 days of 28.5%. Esophago-jejunal anastomosis on a Roux-en-Y loop is the procedure of choice used by our center after total gastrectomy for gastric cancer, yielding the most acceptable morbi-mortality figures.

Adult↗

[Non-excisional treatment of spontaneous rupture of the esophagus].

We present 7 personal cases of Boerhaave syndrome, 6 treated surgically and one managed with conservative measures. Boerhaave's syndrome is one of the most serious gastro-intestinal perforation pictures. Although its frequency is scant, because of its seriousness it is important to be aware of it for early diagnosis. While a prompt diagnosis is important in any pathology, it is even more so in this syndrome since there is a clear relationship between the time lapse from perforation to the onset of treatment and the rate of survival. Although we present one case cured medically, this is exceptional and treatment is eminently surgical and should be as early as possible. The technique that provides the best results and an excellent morbimortality rate in relation to efficacy is primary suture followed by a fundal patch. In delayed cases with patients in deteriorated condition, other techniques can be considered. Due to its initial severity and a tendency to postoperative complications, the patient should be closely controlled, and correct antibiotic therapy and complete parenteral support nutrition are very important in treatment.

Adult↗