PubMed Health⌕ Search

Biomedical subjects

R Romero-Torres

Publications and source records attributed to R Romero-Torres.

8 recordsLinked to original sources
PubMed1981

Hemostatic suture of the stomach for the treatment of massive hemorrhage due to esophageal varices.

Hemorrhage from esophagogastric varices has been treated in 15 patients by an interruption of the portal-azygous venous circulation. The venous pedicles of the stomach were ligated, and a hemostatic suture was placed around the circumference of the stomach at the level of its upper and middle thirds. The procedure was effective in controlling massive acute hemorrhage caused by portal hypertension. One operative death occurred. During follow-up observations of eight months to five years, only one patient had mild recurrent hemorrhage at the end of the second year. Four patients died late of liver failure. This method of the anatomic interruption between portal and azygous venous circulation was simple, rapidly performed and relatively safe in patients with massive bleeding gastroesophageal varices which had not responded to conservative therapy.

Adult↗
PubMed1979

Sacrofixation with Marlex mesh in massive prolapse of the rectum.

Rectal fixation to the sacrum is considered the most rational operation in the surgical treatment of massive or complete prolapse of the rectum, since it eliminates the anatomic defect which is fundamental in the pathogenesis of this disease. Many techniques have been used to join the posterior wall of the rectum to the sacrum, ranging from the use of simple sutures with nonabsorbable material to prosthetic materials, such as Teflon sheets or Ivalon, polyvinyl, sponges which are placed around the rectum and attached to the sacrum. A variant consists of using Marlex mesh instead of Teflon. In an experience with 24 patients, only one patient died postoperatively. In a follow-up period of ten years, no recurrences have been observed in any of the remaining patients.

Adolescent↗
PubMedDate not supplied

Long-term results of hemostatic gastric suture in the treatment of esophagogastric varices.

Portal azygos disconnection, using vein ligatures and a circumferential hemostatic suture of the gastric wall at the level of the upper pole, is a simple and a rapid technique that effectively controls bleeding from esophagogastric varices. Its low mortality rate in emergency cases or poor-risk patients can be of great benefit to patients who have not responded to conservative therapy, including tamponade and vein sclerosis. In this article, we conclude that the long-term results of this operation demonstrate that it can also be used in elective cases, especially in patients with Child's "C" classification. These patients with advanced cirrhosis have a very low survival rate (no more than 5 years) yet they can benefit from this portal disconnection since this procedure does not alter the portal hemodynamics and, consequently, does not induce chronic encephalopathy.

Adolescent↗
PubMedDate not supplied

A new surgical approach for the treatment of massive hemorrhage due to esophageal varices.

Experiments on dogs demonstrated that ligating the venous pedicles of the stomach, as well as placing a continuous hemostatic suture around the circumference of the stomach at the level of the upper and middle third, can be effective in stopping hemorrhage produced by induced esophagogastric varices. Subsequently, the operation was applied to ten patients with massive hemorrhage from varices resulting from severe portal hypertension. There were no operative deaths in follow-up of from six months to four years. Only one patient had minor recurrent hemorrhage at the end of the second year.

Adult↗
PubMedDate not supplied

The true splenic blood supply and its surgical applications.

BACKGROUND/AIMS: In 1981 we described a simple porta-azygous disconnection procedure to stop the bleeding in esophago-gastric varices. This surgical technique included ligature of the splenic artery and the short gastric vessels. In spite of the arterial ligatures, no alteration was seen in splenic circulation. METHODOLOGY: In 1988, Warshaw presented a study of twenty-two cases of distal pancreatectomy without splenectomy. Since then, we have studied our porta-azygous disconnected patients using radioactive substances and found, surprisingly, that there is a normal splenic blood supply. Simultaneously, we started an experimental study with dogs and human cadavers by placing acrylic fluid into the splenic arterial vessels. Solidification and corrosion of soft tissue showed the true arterial architecture of the vessels. RESULTS: Both the animal experiments and the results of injecting acrylic into the arterial splenic arteries of human cadavers demonstrated that in addition to the splenic artery and the short arteries there is another important artery which reaches the splenic hilum. Injecting acrylic into this artery showed that this was the left gastroepiploic artery. CONCLUSIONS: The spleen is irrigated by the splenic artery and the short vessels, but also by the left gastroepiploic artery. These findings suggest surgical applications such as distal pancreatectomy without splenectomy, and, more importantly, that in the portal-azygous disconnection previously described it may not be necessary to ligate the splenic artery.

Animals↗