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L Morales Fochs

Publications and source records attributed to L Morales Fochs.

At least 19 recordsLinked to original sources
PubMed2003

[Utility of octyl 2-cyanoacrylate in pediatric surgery].

OBJECTIVE: The aim this study was to demonstrate the utility and suitability of octyl-2-cianocrylate in cutaneus repair of different conditions in the pediatric population. Octyl-2-cianocrylate is a topical tissular adhesive which can be used on skin and which has been tested in surgical practice as a wound sealant, avoiding the use of conventional sutures. MATERIAL AND METHODS: We applied octyl-2-cianocrylate in 100 patients with skin wounds smaller than 5 cm. The patients were distributed as follows: Emergency department: simple sharp wounds in the face and extremities (20 patients); surgical block: surgical wounds in 80 patients with the following conditions: inguinal hernia (20 patients), cryptorchidism (20 patients), umbilical hernia (10 patients), hypospadias (17 patients), post-hypospadias fistula repair (8 patients) and cleft lip (5 patients). The results were analyzed in terms of efficacy, cosmetic result, procedure time, material used, and patient comfort. CONCLUSIONS: Octyl-2-cianocrylate was easier to use than conventional sutures in all its applications, requiring less time than conventional sutures and therefore lowering the cost per procedure.

Child↗
PubMed2001

[Urofacial Ochoa's syndrome: a clinical case].

An 11 year-old girl had an urinary diversion because of a complex uropathy with vesical sphincter dyssinergism. Her inexpressive face with lost eyes and forced gestures, especially when smiling--her smile looking rather like weeping--was the clue to the diagnosis of Ochoa's syndrome. She underwent psoic bladder fixation, right ureteral reimplantation, bladder neck loosening and cystostomy undiversion. At follow-up, renal function deteriorated. She has recently received a kidney transplantation in another institution, and is now symptom-free.

Child↗
PubMed2001

[Focal nodular hyperplasia of the liver].

Focal nodular hyperplasia (FNH) of the liver is an uncommon benign lesion that usually occurs in young or middle-aged women. Although it has been associated with oral contraceptive use, no evidence supports this hypothesis. Most patients with this lesion are asymptomatic. We report the case of a 10-year-old boy with a history of transient epigastric abdominal pain over several days. Physical examination revealed a tender mass in the upper left quadrant. Abdominal ultrasonography revealed an 85 3 45 mm mass located in the left lobe of the liver. Computed tomography-guided biopsy showed histological changes consistent with FNH. Left hepatectomy was performed and the diagnosis was confirmed by histological study. FNH of the liver is extremely rare in children, especially in boys. Unlike adenoma, malignant transformation of FNH has not been described and consequently patients can be periodically followed-up with imaging tests, without need of surgery. The differential diagnosis includes other benign hepatic lesions such as hemangioma and hepatocellular adenoma. Surgical resection is indicated in symptomatic patients, usually with abdominal pain, cholestasis or palpable abdominal mass, and when the differential diagnosis, especially with hepatic adenoma, is unclear.

Child↗
PubMed2000

[Ectopic ureter as cause of urinary incontinence in girls].

Continuous urine dripping together with normal micturition is the classical picture of ectopic ureter in girls. During the years 1982 to 1996, eleven girls with such abnormality have been treated at our department. The diagnostic work-up included: intravenous pyelogram (IP), ultrasonography (US), renal scintiscan, cystogram, cystoscopy and/or vaginoscopy, as well as a thorough exam of the external genitalia under general anesthesia. Ten girls had a double renal system, one of them being bilateral; one girl had simple kidneys with renal ectopia. Treatment was heminephrectomy with ureterectomy in 9 cases, ureteroureterostomy with preservation of the hemikidney in one case, and nephrectomy with ureterectomy in the case with a simple system. Urinary incontinence in girls due to ectopic ureter is an uncommon disease. Eigthty-five% of the cases are associated to renal duplication. IP is highly sensible to defect renal duplication; direct vision of the ectopic ureter meatus, canalization and roentgenologic confirmation of the suspected diagnosis are required prior to surgery. Heminephrectomy has been the most common treatment; however, early diagnosis by means of US will promote more conservative surgical approaches.

Adolescent↗
PubMed2000

[Treatment with triamcinolone cetonide (trigon-depot) for stenosis after surgery of severe hypospadias].

Urethral stenosis is, after the fistula, the most frequent complication in patients undergoing hypospadias repair. Incidence ranges between 6% and 10% depending on the surgical technique. Treatment of this complication with simple dilation of the narrowed segment is enough in most cases. However, dilation of the stricture may be difficult in patients with severe hypospadias that required wide dissection and excision of fibrotic tissue to repair a large deviation and also in patients who had previously multiple operations. We report 3 patients with severe hypospadias (scrotal and perineal) with history of multiple operations for that condition and postoperative urethral stenosis at different sites. All patients had periodical dilations for several months without any improvement. Surgical treatment was indicated to enlarge the stenotic segment. Enlargement was performed using oral mucosa graft in two cases and a local flap in the third one. Urethral stricture recurred in all cases very soon after the plasty and repeated dilations did not improve the symptoms. In the presence of hard scar tissue it was decided to inject triamcinolone DCI acetoide (Trigon depot), a long acting steroid, into the segment where the fibrotic narrowing was more severe, in an effort to obtain the same results reported in the treatment of hypertrophic scars and keloids. All the patients had repeated triamcinolone injections of hypertrophic scars and keloids. All the patients had repeated triamcinolone injections every 2-3 months. Follow-up ranges between 5 and 20 months and all of them are free of symptoms.

Adolescent↗
PubMed1998

[Nasal congenital cysts and fistulas: clinical and surgical aspects].

Eight patients affected with cysts or fistulae on the midline at the nose bridge (back of the nose) have been treated at the Pediatric Surgery Service of the Hospital Sant Joan de Dèu in Barcelona from march 1995 to october 1996. Six patients had a cystic mass (four of them having an intranasal prolongation) and two had a fistulous orifice (one of them also having intranasal prolongation). The test with the highest diagnostic sensibility was the CT-scan, which showed a bifid crista galli and intranasal prolongation in 5 of the patients. Pathologic exam confirmed the diagnosis of dermoid cyst. At follow-up, all patients were doing well. Congenital cysts and fistulae at the nose bridge (back of the nose) may appear as a trivial condition; the possibility of them being the only clinical feature of an intranasal or intracranial prolongation is the reason for a deeper study in order to determine the extension of the lesion. The treatment is always surgical removal of the cyst and the fistulous pathway at the time of diagnosis, regardless of the patient's age, thus avoiding possible infectious complications.

Child↗
PubMed1996

[Cystic lymphangioma: treatment with adhesive fibrin tissue. Follow-up study].

We present twelve cases of cystic lymphangioma in the neck and one in the leg, treated with fibrina adhesive injected into the lesion, during the periode 1991-1994. Two cases had been surgically treated and experimental recurrence of the tumor previous to our treatment. In the other ten the punction was the only therapy applied. Four cases needed two punctions and only one of then after two failed punctions, had be treated with surgical extripation. The follow up was between 3 and 42 months, with a mean of 26.5 months. No complications appeared. The ecografic follow up demonstrated a complete remission in the ten cases treated only with punction. We believe that our results support the fact that the punction-aspiration and posterior Tissucol infection is the first choice in the surgical treatment of the cystic lymphangioma.

Adolescent↗
PubMed1995

[Course of the urinary lithiasis treatment in the Surgery Department of a Children's Hospital].

Records of 90 urolithiasis patients (50 boys and 40 girls) of 5 months to 18 years old (medium 8.7 yr) treated in our department from 1975 to 1993 were reviewed. Family history was found in 25 (27.7%), concomitant uropathy in 9 and predisposing factors to lithogenesis in 35 patients. The most frequent clinical manifestations were hematuria, lumbalgia, dysuria and calculus elimination. Urinary tract infection was found in 26 cases. Treatment modalities used were: medical in 31, extracorporeal shock wave lithotripsy (ESWL) in 12 surgery en 28, endoscopy en 1 and instrumental in 1. Six of 28 surgically treated patients presented residual urolithiasis and another 6 relapsed. Three complications were registered. Recovery from hydronephrosis and/or vesicoureteral reflux was seen in all patients with these lesions.

Adolescent↗
PubMed1995

[Complications in hypospadias repair: 20 years of experience].

We report a comparative study of the complications in hypospadias repair of 1185 patients treated in our hospital in the last 20 years. They are divided in three well-defined groups: from 1974 to 1981 (265 p.); from 1982 to 1986 (281 p.) and from 1987 to 1993 (624 p.). These were the more frequent complications seen: a) Early as cutaneous necrosis, a severe complication that had an incidence of 3% in the first period. In the second and third period this percentage diminished to 1.9% and 1.1%, respectively. Only one patient developed a total necrosis of the cutaneous island flap that required a new urethroplasty. b) Late: Persistent chordee. It was present in 10% of the children in the first period and it was secondary to an inadequate release of the chordee and cutaneous necrosis. The incidence of the second period was 3.5% and only 2% of patients of the third group suffered it because of a non appropriate selection of the surgical technique. Fistula. It was the most common complication and it was present in 18%, 10% and 7.3% of the patients of each period. We think that the introduction of the cutaneous island flap procedure helped to the improvement in the rate of fistulas. Urethral structure. The incidence was 12% in the first period, 6.5% in the second one and it fall down to 4.4% in the third group due to the triangular flap of the glans. Megaurethra. The incidence was of 6.8% in the first period, 6.5% in the second one and only the 2.9% in the last years.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1995

[Urinary tract repercussions in patients with lipomeningocele: a review of 20 cases].

OBJECTIVES: To analyze the urinary repercussions in patients with lipomyelomeningocele. METHODS: From 1976 to 1993, 20 patients (11 males and 9 females), aged 12-17 years had been referred to our department. All patients were evaluated clinically and analytically, urodynamically and by imaging techniques (cystography, US or IVP). RESULTS: Neurogenic bladder dysfunction was observed in 13 patients (65%); 4 of these patients had vesicoureteric reflux and 2 had residual pyelonephritic lesions. These 13 patients with neurogenic bladder were incontinent: 4 were on intermittent bladder catheterization, 2 patient were receiving oxybutinine, 3 were on intermittent catheterization+oxybutinine, and one patient has an artificial sphincter. Four male patients under 7 years will be starting intermittent catheterization. Of the patients with vesicoureteric reflux, 3 were treated with medication and one was submitted to surgery. CONCLUSIONS: Urinary tract involvement is not uncommon in these patients. However, it is not inevitable and the degree of severity is variable. Early diagnosis of neurogenic bladder dysfunction is fundamental for management.

Adolescent↗
PubMed1995

[Evolution of hypospadias surgery. Comparative study of the various techniques used for 20 years].

With the purpose of studying the long-term results of the different surgical techniques used for the treatment of hypospadias, we have examined 1186 patients treated in our centre over the last 20 years. To facilitate the comparative study, three well-defined periods have been established: 1974-1981 (165 pts.). Treatment was done in several operative times. Denis Browne and Mathieu's urethroplasties were the techniques more frequently used. Their long-term evolution show keratosis and hairiness of the neourethra, which in 17 patients required a new urethroplasty with vesicle mucosa, as the most serious complication. 1982-1986 (281 pts.). Restoration was done in one single operative time. Magpi, Mathieu and Duckett's techniques were the most frequently used during this period. 1987-1993 (624 pts.). An island flap is added as cutaneous plasty after urethroplasty has been performed. Fistulae were the most frequent complications in all the above time-periods (18, 10 and 7.3%, respectively), followed by stenosis (12, 6.5 and 4.4%) and megaurethra (6.8, 6.7 and 2.9%). The remarkable decrease both in number and seriousness of the complications is due to the island cutaneous flap, hormonal stimulation, use of slow reabsorption materials , silicone probes, silastic foam dressings, caudal anaesthetics and, above all, a better indication for the surgical technique in each case.

Follow-Up Studies↗
PubMed1994

[Hypospadias. Onlay technique].

The "onlay" urethroplasty is based technically on the following principles: movilization of the urethral plate without dividing it, complete exeresis of chordee beneath it and use of a double faced mucocutaneous vascularized flap from the dorsal aspect rotated to the ventral aspect of penis. Several advantages over other technical modalities make its applicability possible in almost all varieties of hypospadias even in those with severe incurvature. Up to date we have used this technique in 9 patients between 2 and 3 years of age with proximal and middle hypospadias and in one with a considerable middle third fistula, without complications.

Child, Preschool↗
PubMed1994

[Videothoracoscopy, laparoscopy and minimal-access surgery].

Since we start our way in endoscopic surgery, a total of 101 procedures (93 by laparoscopy and 8 by thoracoscopy) have been performed. In two cases (splenectomy, lobectomy) the combination with a minimal enlargement of the wall incision let us remove the entire piece and reduce the operatory time. This is the review of our experience. While the 51.5% of the cases concern to the genitourinary system, the 40.5% of the pathology was digestive and only the 8% was thoracic. The age of the patients ranged between 20 days and 17 years with a clear predominance of the boys. Absence of complications and a high grade of success should do laparoscopy and thoracoscopy frequent surgical procedures in any department of pediatric surgery.

Adolescent↗
PubMed1990

[The behavior of a striated muscle implant in contact with the intestinal wall. An experimental study].

Based on the experiences of Thompson and Hakelius, we wanted to study the behaviour of a previously denervated skeletal muscle, in close contact with the intestinal wall, as a possible high pressure mechanism. We used 60 Sprague-Dawley rats. Two surgical procedures were performed: sciatic nerve section and a plantaris muscle transplant at the ileum, the interval between these two procedures was zero, two and four weeks. The implant area was studied by histochemical and histological techniques at different posttransplant times. Live muscle fibers were seen in all implants. The best results were seen in those implants that has been denervated 4 weeks prior to the seconds procedure. During the first phase, there was considerable postimplant inflammation. In the later phases, healthy muscle fiber remained, but with partial fibrous substitution. An implant of skeletal muscle, prior denervated, in contact with the intestinal wall, survive the posttransplant ischemia. The implant showed live muscle fibers with structural capacity for contraction. This experimental model, that is described for the first time, allows for the functional study of pre- and postimplant behaviour.

Animals↗