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V Soria Aledo

Publications and source records attributed to V Soria Aledo.

11 recordsLinked to original sources
PubMed2002

Role of appendectomy in training for laparoscopic surgery.

BACKGROUND: This study aimed to evaluate a program of training in laparoscopic surgery based on clinical practice in the emergency room, in which laparoscopic appendectomy is the first technique that residents perform as surgeons. METHODS: A prospective nonrandomized study was conducted involving all the laparoscopies performed in emergencies with a diagnosis of acute abdomen, appendicular in origin, during the period between June 1991 and December 1997. RESULTS: There were no statistically significant differences between residents and assistants in terms of conversion rates (22/242 vs 15/158), mean hospital stay for each type of surgeon (5.2 days for residents and 5.1 days for assistants), and complications (12.8% for residents and 13.7% for assistants). Operating time, was significantly longer (p < 0.05) for residents (52.2 min) than for assistants (48 min). CONCLUSIONS: Apprenticeship in laparoscopic appendectomy can be accomplished with gradual clinical training and without the need for resort to animal experimentation laboratories.

Abdomen, Acute↗
PubMed2002

[Omental torsion: imaging techniques can prevent unnecessary surgical interventions].

INTRODUCTION: Segmentary infarction of the greater omentum produces a clinical profile of acute abdomen. To date, the cause has been discovered during surgery. Greater use of ultrasonography and computed tomography (CT) in the emergency department could lead to preoperative diagnosis. The aim of this study was to describe the advisability of avoiding surgery in selected patients. PATIENTS AND METHOD: A series of nine adult patients (six men and three women), aged between 18 and 50 years, with a final diagnosis of primary omental torsion were reviewed. The first three patients underwent surgery: two underwent laparotomy for suspected acute appendicitis and the third underwent laparoscopy with a diagnosis of non-specific acute abdomen. The six remaining patients, who received a diagnosis of primary omental torsion or infarction based on ultrasonography and CT, underwent conservative treatment. The patients who did not undergo surgery were subsequently evaluated with imaging techniques to confirm resolution. RESULTS: In the first three patients, symptoms were resolved by resection of the affected omental section. In the six remaining patients, a 3-6 cm mass of soft tissue in the paraumbilical region, between the rectal sheath and the transverse colon, was found. The lesions were hyperechoic or of mixed attenuation. These findings, together with the absence of other radiological and clinical signs, led to the preoperative diagnosis. Treatment was conservative and a fast recovery, observed both clinically and radiologically, was made. CONCLUSIONS: Surgery should be avoided in selected cases of acute abdomen diagnosed as primary omental torsion.

Abdomen, Acute↗
PubMed1994

Laparoscopic versus open appendicectomy: a prospective assessment.

A prospective study of 200 consecutive patients with suspected acute appendicitis was performed to compare open and laparoscopic appendicectomy. Formal randomization was precluded by instrument availability. Some 100 patients underwent laparoscopic appendicectomy (conversion to laparotomy was carried out in five) and 100 had conventional surgery. The groups were similar in sex ratio, age, degree of appendiceal inflammation and antibiotic treatment. The mean duration of open appendicectomy was 46 min and of the laparoscopic procedure 51 min (P not significant). Postoperative complications in patients who underwent laparoscopic appendicectomy included: intra-abdominal abscess (two patients), wound infection (one), early bowel obstruction (four; all resolved with medical treatment) and umbilical haematoma (two). There were no reoperations in the immediate or late postoperative period. Complications after open operation were: wound infection (seven patients) (P < 0.05), early bowel obstruction (five; three resolved with medical treatment, two required surgery) and haematoma of the surgical wound (one). The mean hospital stay was 4.8 days for laparoscopic appendicectomy and 6.0 days for the open operation (P < 0.05). There were no deaths.

Adolescent↗
PubMedDate not supplied

[Computed tomographic colonography: applications, advantages and disadvantages].

INTRODUCTION: Complete preoperative study of the colon is required in the management of colorectal cancer, due to the frequent association of primary colonic neoplasms with colonic adenomas (28%) and/or synchronous carcinomas (5%) of the colon. We present a series of patients who underwent computed tomographic colonography, the indications for this procedure, and the results. PATIENTS AND METHODS: We performed a descriptive prospective study. Between May 2003 and August 2004, 50 computed tomographic colonographies were performed in 50 patients with suspected stenosing colorectal cancer and incomplete conventional colonoscopy. RESULTS: Fifty computed tomographic colonographies were performed. The findings were as follows: three were normal (6%), and in the remainder, one was a false positive for a suspected neoplastic pelvic mass (3.125%) and two were false positives (11.7%) for colonic polyps. Fifty percent of the findings (n = 32) were related to peritoneal metastases and colonic neoplasms. There were 12 technical complications [lack of cleaning of the colon (5), lack of distension (2), little air insufflation (5)]. Patient complications included vegetative manifestations in one (vomiting) and rectal bleeding in another. The overall complication rate was 27.4% (23.4% corresponded to technical complications and the remaining 4% were patient-related). There was no mortality related to the procedure. CONCLUSION: Because computed tomographic colonography is safe, effective and well tolerated by the patient, it should be considered as a technical alternative in the study of stenosing neoplasms of the proximal colon with incomplete colonoscopy. In addition, it allows other associated findings, both intra- and extracolonic, to be obtained and improves the diagnostic and therapeutic management of the patient.

Adenocarcinoma↗