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M Lomas Espadas

Publications and source records attributed to M Lomas Espadas.

16 recordsLinked to original sources

Complete rectal prolapse clinical and functional outcome with Delorme's procedure.

INTRODUCTION: Many surgical techniques -both through the perineal and abdominal routes- have been described for the treatment of rectal prolapse. The aim of this work is to evaluate the clinical and functional outcome with Delorme's perineal procedure. PATIENTS AND METHODS: Twenty-one patients with complete rectal prolapse were studied from July 2000 to October 2005. Age, gender, anesthetic risk, and accompanying symptoms were all assessed. Diagnostic tests performed included: colonoscopy, anorectal manometry before and after surgery, and 360 masculine endoanal ultrasonography. Delorme's procedures were carried out by only one surgical team. RESULTS: No mortality occurred, and morbidity was minimal. Prolapse relapse rate was 9.52% with a mean follow-up of 34 months. Anal continence improved in 87.5% of patients, and no surgery-associated constipation ensued. Mean hospital stay was 2 (range 1-4) days. During the postoperative period no pain developed in 17 patients, and 4 patients had mild pain. Satisfaction with surgery was high in 16 cases (76.19%), moderate in 3 (14.28%), and low in 2 (9.52%). CONCLUSIONS: Delorme's procedure for the management of complete rectal prolapse is associated with low morbidity, improves anal continence, gives rise to no postsurgical constipation, and has an acceptable relapse rate. Patient satisfaction with this procedure is high because of its high comfortability (intradural anesthesia, short hospital stay, and little postoperative pain) and optimal results.

Adult↗

[Is the introduction and realization of the Japanese system of staging and surgical treatment for stomach cancer possible in Spain?].

Discrepancies in the five-year survival rates after treatment of gastric cancer between the West and the East have been attributed to differences in the biological behavior of the tumor or in the incidence of early cancer. Alternatively, the better staging system and the national standardization of the diagnosis and treatment used in the East may explain their findings. Poor definition of stages and curability, scarce interest in standardization of techniques, and lack of basic information in many pathological reports are frequent in Western countries. Between May 1988 and April 1991 a prospective study on a consecutive series of 89 patients diagnosed of gastric carcinoma in the Hospital "Príncipe de Asturias" using the directions given by the Japanese Research Society for Gastric Cancer has been made. Our results support the use of the Japanese system in a General Hospital of our country and confirm its accuracy in defining the type of surgery performed, the later being its main advantage over the TNM staging system.

Adult↗

[Acute pancreatitis and afferent loop syndrome].

A new case of afferent loop obstruction presenting as acute pancreatitis is described. It is an uncommon manifestation of the afferent loop syndrome: less than 20 cases found in the literature. The diagnosis of afferent loop obstruction should be suspected in any patient with acute pancreatitis and a previous Billroth II gastrectomy. Duodenopancreatic reflux seems to play an important role in the pathogenesis of acute pancreatitis in this situation. The "closed duodenal loop" experimental model of acute pancreatitis simulates quite closely this clinical situation. The physiopathological principles, diagnosis and treatment of this syndrome is reviewed.

Acute Disease↗

[Spontaneous and simultaneous external and internal double biliary fistula].

An exceptional case is presented of double biliary fistula, internal (to duodenum) and external (to the abdominal wall) in a patient with cholelithiasis of long evolution. The diagnosis of suspicion was made by CAT and was confirmed in the surgical act. Treatment was cholecystectomy, closure of the duodenal communication and external drainage of the parietal abscess. The postoperative evolution coursed without complications.

Abdominal Muscles↗

Angiosarcoma in the small intestine. Apropos of a particular case.

Presentation of a case of small intestine primary angiosarcoma in a 70-year-old male. There is question of an extremely rare tumor in the gastrointestinal tract. Its symptomatology is similar to that of other tumors in the small intestine. An immunohistochemical study is usually essential for its anatomopathological diagnosis. The diagnosis is generally arrived at in its advanced stages, and that makes for a bad prognosis. The bibliography has been revised from this case on.

Aged↗

Subcutaneous venous reservoir implant: our experience in 1200 cases.

We present our experience in subcutaneous venous reservoir (SVR) implanting, laying emphasis on the surgical technique, the protocol followed for assessing difficulty, implant care and per- and post-implant complications and their management. Between March 1996 and December 2002 we installed 1200 SVRs on an outpatient basis, with subsequent result follow-up. The reservoir was successfully installed by the standard procedure in 99.33% of cases (1194), while in the remaining six patients (0.67%) the participation of the Intervention Radiology Department was required for correct implantation. Results were excellent with a morbidity of 3.3% and we had to single out two cases of immediate infection (0.16%), nine of tardive infection (over three months); twelve cases of pneumothorax (1%); seven episodes of venous thrombosis (0.58%) and four cases of catheter migration (0.3%). SVR implanting is possible on an outpatient basis but requires strict measures of asepsis and an experienced team and personnel responsible for its handling and maintenance, although there are a small number of complications inherent in the patient's general state.

Catheterization, Central Venous↗