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Id: biblio-986330
Autor: Molinares, Beatriz; García, Vanessa; Llamas, Rafael; Osorio, Germán.
Título: Papilomatosis biliar: presentación de un caso con trasplante hepático / Biliary Papillomatosis: A Case Report
Fonte: Rev. colomb. radiol;29(1):4887-4881, 2018. ilus.
Idioma: es.
Resumo: Las neoplasias papilares intraductales de los ductos biliares (NPIB), tradicionalmente llamadas "papilomatosis biliar", son raras y se caracterizan por una apariencia macroscópica papilar y, en muchos casos, secreción visible de mucina. Ocurren con mayor frecuencia en pacientes con antecedente de litiasis biliar. Presentamos el caso de una paciente de 47 años de edad, a quien se le realizó un trasplante hepático por cirrosis biliar secundaria a litiasis intra y extrahepática, quien presentó durante muchos años episodios de colangitis recurrente, los cuales fueron manejados entre otros, con una anastomosis bilioentérica. En los estudios de imagen previos al trasplante, además de los cambios por cirrosis, se encontró una importante dilatación de la vía biliar intra y extrahepática, con cálculos de la vía biliar. La patología del explante mostró papilomatosis de la vía biliar. La paciente desarrolló recurrencia temprana en la vía biliar extrahepática nativa. Ha recibido manejo conservador hasta este momento.

Intraductal papillary neoplasias of the bile ducts (IPNB), traditionally called "biliary papillomatosis", is a rare entity characterized by macroscopic papillary appearance and in many cases visible secretion of mucin. It occurs more frequently in patients with history of biliary lithiasis. We present the case of a 47 years old patient who underwent liver transplantation due to biliary cirrhosis secondary to intra- and extrahepatic lithiasis, which suffered for many years episodes of recurrent cholangitis managed among others, with a bilioenteric anastomosis. At pre-transplant imaging studies, in addition to changes due to cirrhosis, a significant intra- and extra- hepatic biliary tract dilation was found with multiple calculi within. Pathology results reported the presence of bile duct papillomatosis. The patient developed early recurrence into the native extrahepatic bile duct. She has so far received conservative management.
Descritores: Dilatação
-Papiloma
Ductos Biliares
Imagem por Ressonância Magnética
Transplante de Fígado
Limites: Seres Humanos
Responsável: CO371.9


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Id: biblio-900696
Autor: Garzón, Martín; Hernández, Geovanny; Pérez, Oscar; Martínez, Julián David; Molano, Juan Carlos; Marulanda, Juan Carlos; Lizarazo, Jorge Iván; Hormaza, Natan; Rey, Mario Humberto.
Título: Factores asociados con el uso de litotripsia mecánica en pacientes con cálculos gigantes de la vía biliar: ¿puede la dilatación papilar con balón grande disminuir su requerimiento? / Can Endoscopic Papillary Large Balloon Dilation (EPLBD) Decrease the Need for Mechanical Lithotripsy in Patients with Giant Biliary Stones?
Fonte: Rev. colomb. gastroenterol;32(3):202-208, 2017. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: cerca del 10% al 15% de los pacientes con coledocolitiasis presentan cálculos gigantes, definidos como aquellos que miden más de 10 mm a 15 mm. La extracción de estos puede ser problemática, aun para endoscopistas experimentados. Casi todos los pacientes con esta patología pueden ser tratados endoscópicamente, y la mayoría de los cálculos son removidos con la realización de esfinterotomía (EFT), litotripsia mecánica (LM) o dilatación papilar con balón grande (DPBG). La DPBG ha demostrado ser efectiva en el manejo del cálculo gigante y disminuye la necesidad de LM. Objetivos: determinar la prevalencia de coledocolitiasis gigante en el Hospital Universitario de la Samaritana (HUS) entre el 2009 y el 2014, la frecuencia de éxito endoscópico y la necesidad de manejo quirúrgico, además de evaluar los factores asociados con el uso de litotripsia en casos de cálculos gigantes de la vía biliar. Materiales y métodos: el presente es un estudio de casos y controles de pacientes con cálculos gigantes, definidos como cálculos mayores de 10 mm en pacientes llevados a colangiopancreatografía retrógrada endoscópica (CPRE) en el HUS entre 2009 y 2014. Los casos fueron los pacientes a quienes se les realizó litotripsia y, los controles, quienes no requirieron este procedimiento. Los resultados se presentan como medias o medianas, y se indican sus respectivas medidas de dispersión para las variables continuas, según pruebas de normalidad o como frecuencias y porcentajes para las variables categóricas. Se realizó un análisis de regresión logística con el principal objetivo de determinar los factores asociados con litotripsia, en el que se incluyeron las variables biológicamente plausibles o que, estadísticamente, mostraron diferencias en el análisis bivariado (p<0,200). Los resultados se presentan como odds ratios (oportunidad relativa) ajustados (ORA). Resultados: entre 2009 y 2014, se realizaron un total de 1403 CPRE, de las cuales 198 (14,1%) tuvieron presencia de cálculos gigantes. Fue más frecuente la coledocolitiasis gigante en el sexo femenino que en el masculino. La edad promedio de los pacientes fue de 66,6 años. El diámetro promedio del colédoco fue de 18 mm, y el diámetro promedio de los cálculos fue de 18 mm. Al 99% de los pacientes se les realizo EFT, el 28% requirió LM, al 48% se les realizo DPBG, el 5,5% requirió LM y DPBG, y el 30,8% requirió el avance de prótesis biliar y más de una CPRE para la resolución de la coledocolitiasis. En el 89,9% de los casos, el manejo endoscópico fue exitoso. El 10,1% requirió cirugía. En el 9,0% de los casos, se presentaron complicaciones (6 pancreatitis, 7 sangrados, 2 impactaciones de canastilla y 1 perforación). En el análisis bivariado, la DPBG fue un factor protector del requerimiento de LM (ORA 0,07-IC del 95% 0,025-0,194), y el tamaño del colédoco es un predictor del requerimiento de LM (p<0,05). Conclusiones: en nuestra serie, la prevalencia de coledocolitiasis gigante y el éxito del manejo endoscópico es similar a la reportada en la literatura. La EFT, la LM y la DPBG fueron efectivas en el manejo de los cálculos gigantes. El tamaño del colédoco es un predictor de requerimiento de LM y la DPBG disminuyó el requerimiento de LM.

Abstract Introduction: About 10% to 15% of patients with choledocholithiasis develop a giant calculus, defined as one that measures more than 10 mm to 15 mm. Removal of these stones can be problematic even for experienced endoscopists. Almost all patients with this pathology can be treated endoscopically: most are removed with sphincterotomies, mechanical lithotripsy (ML) or large balloon papillary dilatation (LBPD). LBPD has been shown to be effective in handling giant calculi and decreases the need for ML. Objectives: The aim of this study was to determine the prevalence of giant choledocholithiasis at HUS between 2009 and 2014, the frequency of successful endoscopic treatment, and the frequency of surgery in these cases. We also evaluated factors associated with the use of lithotripsy to remove giant biliary calculi. Materials and Methods: This study is a case-control study of patients who had giant calculi and underwent ERCP at the HUS between 2009 and 2014. Calculi larger than 10 mm were defined as giant. Cases were patients who underwent lithotripsy while controls were those who did not require lithotripsy. The results for continuous variables are presented as means or medians and their respective measures of dispersion while results for categorical variables are presented according to tests of normality or as frequencies and percentages. A logistic regression analysis was used to determine factors associated with lithotripsy. Biologically plausible variables and those that had statistically significant differences in the bivariate analysis (p <0.200) were included. The results are presented as adjusted odds ratios (ORA). Results: Between 2009 and 2014, a total of 1403 ERCPs were performed. Giant calculi were found in 198 (14.1%) of these procedures. Giant choledocholithiasis was more common in female patients than in male patients. The patients' mean age was 66.6 years. The average diameter of the common bile duct was 18 mm, and the average diameter of the stones was 18 mm. Ninety-nine percent of these patients underwent sphincterotomies, 28% required ML, 48% underwent LBPD, 5.5% required ML and LBPD, and 30.8% required biliary stents and more than one ERCP for the resolution of choledocholithiasis. In 89.9% of cases, endoscopic management was successful. Only 10.1% of the total number of patients required surgery. Complications occurred in 9.0% of the cases: 6 cases of pancreatitis, 7 cases of bleeding, 2 impacted cannula and 1 perforation. In the bivariate analysis, LBPD was a protective factor against the need for ML (ORA 0.07-IC 95% 0.025-0.194) and choledochal size was a predictor a need for MM (p <0.05). Conclusions: In our series the prevalence of giant choledocholithiasis and the success of endoscopic management are similar to those reported in the literature. Sphincterotomies, ML and LBPD were effective for managing giant calculi. Choledochal size is a predictor of a need for ML while performance of LBPD decreased the need for ML.
Descritores: Coledocolitíase
Litotripsia
-Ductos Biliares
Dilatação
Responsável: CO304.1 - Biblioteca Arturo Aparicio Jaramillo


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Id: biblio-829978
Autor: Farahat, Hassan Gamal El-Din; Ibrahim, Asmaa Muhammed; Ali, Ahmed Abdelwahab.
Título: The effect of intracameral epinephrine on pupil size during phacoemulsification and its postoperative effect on specular findings and macular thickness
Fonte: Rev. bras. oftalmol;75(6):425-431, nov.-dez. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate pupillary size and vital signs following intraoperative intracameral adrenaline during phacoemulsification and postoperative effect of on co specular microscopy findings and macular thickness by OCT. Methods: A prospective interventional study carried out from December 2014 to December 2015 on 90 eyes. They were divided randomly into further 6 groups (15 each). The inclusion criteria consisted of no history of ocular pathologic conditions, trauma, previous ocular surgery, or recent ocular medication use. All patients were dilated preoperatively by phenylephrine 10% and operated under local peribulbar anesthesia. Then systemic monitoring regarding (pulse rate, blood pressure) and measurement of the horizontal pupil diameter by a caliper to the nearest 0.25mm pre and post intracameral adrenaline injection. Results: In our study there were great effect for intracameral epinephrine, with concentrations used, in dilatation and maintainance of papillary dilatation, The mean pre intracameral epinephrine was 4.53± 1.27 mm.The mean post epinephrine papillary diameter was 6.46± 1.00 mm. Three cases from group 1/10000 weren't dilated properly. Also three cases from group 1/9000 weren't dilated properly after intracameral epinephrine. Conclusion: Intracameral epinephrine even in higher concentrations is effective in papillary dilatation especially in cases with long duration and poorly dilated cases by usual topical mydriatics.
Descritores: Dilatação
Epinefrina/administração & dosagem
Facoemulsificação
Pupila/efeitos dos fármacos
Tomografia de Coerência Óptica
-Ensaio Clínico
Estudos Prospectivos
Limites: Seres Humanos
Masculino
Feminino
Responsável: BR1.1 - BIREME


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Id: lil-783095
Autor: Sarabia Salazar, Daniel; Olivar, Freddy Ángel; Peña Carpio, Indira Elena; González Blanco, Mireya.
Título: Misoprostol en la conducta activa en el tercer período del parto: dosis mínima efectiva / Misoprostol in the active conduct in the third stage of labor: minimum effective dose
Fonte: Rev. obstet. ginecol. Venezuela;75(3):155-163, sep. 2015. tab.
Idioma: es.
Resumo: OBJETIVO: Comparar los efectos del uso de misoprostol sublingual en dosis de 200 µg, 400 µg o 600 µg en la conducta activa del tercer período del parto. MÉTODOS: Se incluyeron 350 pacientes con embarazos a término, que presentaron parto vaginal. Fueron distribuidas al azar en 3 grupos (A, B y C) las cuales recibieron dosis respectivamente de 200 µg, 400 µg y 600 µg de misoprostol sublingual como parte de la conducta activa durante el alumbramiento. Se registró el tiempo entre la expulsión del recién nacido y el alumbramiento completo, la pérdida hemática durante este período, y la presencia de efectos adversos hasta el momento de su egreso. RESULTADOS: La media del tiempo del alumbramiento fue de 3 ± 0,9 minutos para el grupo de 200 µg, 2,8 ± 0,7 minutos para el grupo de 400 µg y 2,8 ± 0,6 para el grupo de 600 µg (P=0,172). Se reportaron cuatro casos de hipotonía uterina, 1 en el grupo A, 2 en el B y 1 en el C y tres casos de retención de restos, uno en cada grupo. Se presentaron náuseas, vómitos, temblores, evacuaciones líquidas y fiebre en bajo porcentaje (menos de 5 %) sin relación con la dosis (P>0,05) CONCLUSIONES: El misoprostol en dosis de 200 µg es igual de efectivo que dosis mayores, en la conducta activa del alumbramiento, con una incidencia menor al 1 % de hemorragias posparto y escasos efectos secundarios adversos.

OBJECTIVE: To compare the effects of the use of sublingual misoprostol in doses of 200 µg, 400 µg or 600 µg in the active of the third period of confinement conduct. METHODS: 350 patients with pregnancies to term, showing vaginal birth were included. They were distributed randomly in 3 groups (A, B and C) which received doses 200 µg, 400 µg and 600 µg of sublingual misoprostol respectively as part of conduct active during childbirth. Is recorded time between the expulsion of the newly born and full delivery, lost blood during this period, and the presence of adverse effects until the time of his graduation. RESULTS: The average delivery time was 3 ± 0.9 minutes for the Group of 200 µg, 2.8 ± 0.7 minutes for the Group of 400 µg and 2.8 ± 0.6 for the Group of 600 µg (P = 0, 172). Reported four cases of uterine hypotonia, 1 in group A, 2 in group B and 1 in group C, and three cases of retention of remains, one in each group. Were nausea, vomiting, tremors, liquid evacuations, and fever in low percentage (less than 5 %) unrelated to the dose (P > 0.05). CONCLUSIONS: In doses of 200 µg misoprostol is as effective as doses above, conduct active birth, with one incidence of less than 1 % of postpartum haemorrhage and few adverse side effects.
Descritores: Dilatação
Misoprostol
Ocitocina
Parto
Complicações na Gravidez
Hemorragia Uterina
-Genitália
Membranas
Hipotonia Muscular
Limites: Seres Humanos
Feminino
Tipo de Publ: Estudos de Avaliação
Responsável: VE1.1 - Biblioteca Humberto Garcia Arocha


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Id: lil-780367
Autor: López Á., Alexo; Román F., Adriana; Vilanova V., Vanesa; Corujeira R., María del Carmen; Areán G., Iván; Barreiro C., José Luis.
Título: Neumoperitoneo a tensión tras dilatación endoscópica en paciente intervenida de by-pass gástrico laparoscópico / Pneumoperitoneum tension following endoscopic dilatation in patient underwent laparoscopic gastric bypass
Fonte: Rev. chil. anest;42(2):180-182, ago.2013. ilus.
Idioma: es.
Descritores: Cirurgia Bariátrica/efeitos adversos
Endoscopia/métodos
Pneumoperitônio/cirurgia
Pneumoperitônio/etiologia
-Anastomose Cirúrgica/efeitos adversos
Dilatação
Evolução Fatal
Hipertensão Intra-Abdominal/cirurgia
Hipertensão Intra-Abdominal/etiologia
Doença Iatrogênica
Laparoscopia/efeitos adversos
Limites: Seres Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-776757
Autor: Artifon, Everson L. A; Couto Junior, Décio S; Baracat, Renato; Furuya junior, Carlos K; Brabo, Alexandre M; Sakai, Christiano M; Rodrigues, Airton Z; Elias, Messias; Paione, José Luiz B.
Título: Fistulopapilotomia por sobre balão transpapilar em pacientes com Billroth II: uma nova técnica / Fistulotomy over transpapillary balloon in patientes with Billroth II: a new technique
Fonte: GED gastroenterol. endosc. dig;28(4):109-114, jul.-set. 2009.
Idioma: pt.
Resumo: Introdução: A CPRE diagnóstica e terapêutica, em pacientes com gastrectomia à Billroth 11, é mais difícil devido às alterações anatômicas. Acessórios e técnicas têm sido desenvolvidos para minimizar estas adversidades. Objetivo: Nova técnica de acesso biliar em pacientes gastrectomizados à Billroth 11. Pacientes: No período de fevereiro de 2003 a agosto de 2007, foram realizadas 157 CPRE em pacientes gastrectomizados à Billroth 11, por coledocolitíase. Em 37 desses pacientes, não foi possível cateterização pela técnica convencional, sendo submetidos a nova técnica. Métodos: Após fistulopapilotomia para acessar via biliar principal, passava-se fio-guia de 0,035mm, seguido por balão dilatador de 8mm, que se mantinha transpapilar. Pelo canal de trabalho, passava-se o estilete; ao posicionar em frente à papila, procedia-se secção do esfíncter por sobre balão insuflado com contraste até desaparecimento da cintura na radioscopia. Resultados: Dos 37 pacientes submetidos ao novo procedimento, seis foram excluídos. Dezesseis pacientes (51,6%) eram do sexo feminino e quinze (48,4%) do masculino. A idade variou de 29 a 89 anos, com média de 62,3 anos. Todos tinham icterícia clínica e laboratorial. O tempo do procedimento variou de 18 a 48 minutos (30 minutos). O diâmetro da via biliar foi de 4,5 a 12,8mm (7,7mm), apresentando de um a quatro cálculos. Ocorreram seis (19,3%) complicações relacionadas ao procedimento, sendo três (9,7%) pancreatites, duas (6,4%) hemorragias e uma (3,2%) perfuração. Não houve óbitos relacionados ao procedimento. Conclusão: O sucesso desta técnica foi de 83,8% (31 dos 37 casos), sendo 88,6% (31 de 35 casos) se considerarmos apenas a canulação da via biliar, portanto método seguro e eficaz em pacientes com Billroth 11 e papila duodenal difícil.
Descritores: Esfinterotomia Endoscópica/efeitos adversos
Colangiopancreatografia Retrógrada Endoscópica/métodos
-Fístula Biliar
Dilatação
Gastrectomia
Balão Gástrico
Limites: Seres Humanos
Masculino
Feminino
Adulto Jovem
Meia-Idade
Idoso de 80 Anos ou mais
Responsável: BR9.1 - Biblioteca de Ciências da Saúde Profa. Susana Schimidt


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Id: lil-767041
Autor: Javali, Tarun; Pathade, Amey; Nagaraj, H. K..
Título: A Novel method of ensuring safe and accurate dilatation during percutaneous nephrolithotomy
Fonte: Int. braz. j. urol;41(5):1014-1019, Sept.-Oct. 2015. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To report our technique that helps locate the guidewire into the ureter enabling safe dilatation during PCNL. Materials and Methods: Cases in which the guidewire failed to pass into the ureter following successful puncture of the desired calyx were subjected to this technique. A second guidewire was passed through the outer sheath of a 9 Fr. metallic dilator cannula, passed over the first guidewire. The cannula and outer sheath were removed, followed by percutaneous passage of a 6/7.5 Fr ureteroscope between the two guidewires, monitoring its progress through both the endoscopic and fluoroscopic monitors. Once the stone was visualized in the calyx a guidewire was passed through the working channel and maneuvered past the stone into the pelvis and ureter under direct endoscopic vision. This was followed by routine tract dilatation. Results: This technique was employed in 85 out of 675 cases of PCNL carried out at our institute between Jan 2010 to June 2014. The mean time required for our technique, calculated from the point of introduction of the ureteroscope untill the successful passage of the guidewire down into the ureter was 95 seconds. There were no intraoperative or postoperative complications as a result of this technique. Guidewire could be successfully passed into the ureter in 82 out of 85 cases. Conclusions: Use of the ureteroscope introduced percutaneously through the puncture site in PCNL, is a safe and effective technique that helps in maneuvering the guidewire down into the ureter, which subsequently enables safe dilatation.
Descritores: Dilatação/métodos
Cálices Renais/cirurgia
Nefrostomia Percutânea/métodos
Ureter/cirurgia
-Dilatação/instrumentação
Cálculos Renais/cirurgia
Nefrostomia Percutânea/instrumentação
Punções/instrumentação
Punções/métodos
Reprodutibilidade dos Testes
Fatores de Tempo
Resultado do Tratamento
Ureteroscópios
Limites: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: lil-763436
Autor: Ortega R., Juan Pablo; Cuellar G., María Carolina; Cisternas C., Daniel; Parra B., Adolfo; Nunes A., Vitor; Riquelme P., Arnoldo.
Título: Imagen del mes / Image of the month
Fonte: Gastroenterol. latinoam;24(1):34-37, 2013. ilus.
Idioma: es.
Resumo: Reportamos un caso de un paciente joven que ingresó para estudio y manejo de una hipocalcemia grave. Durante su evolución el paciente presentó dolor abdominal (cólico vesicular) relacionado con la presencia de un ejemplar de Ascaris lumbricoides en la vesícula biliar, que respondió a terapia médica conservadora.

We report a case of a young patient who was admitted for study and management of severe hypocalcemia. During evolution of the condition the patient presents abdominal pain (biliary colic) related to the presence of Ascaris lumbricoides in the gallbladder, responding to conservative medical therapy.
Descritores: Esofagoscopia/métodos
Estenose Esofágica/cirurgia
Estenose Esofágica/diagnóstico
-Dilatação
Limites: Seres Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-763063
Autor: Wishahi, Mohamed; Elganzoury, Hossam; Elkhouly, Amr.
Título: Detour technique, Dipping technique, or IIeal bladder flap technique for surgical correction of uretero-ileal anastomotic stricture in orthotopic ileal neobladder
Fonte: Int. braz. j. urol;41(4):796-803, July-Aug. 2015. graf.
Idioma: en.
Resumo: ABSTRACTBackground:Uretero-ileal anastomotic stricture (UIAS) is a urological complication after ileal neobladder, the initial management being endourological intervention. If this fails or stricture recurs, surgical intervention will be indicated.Design and Participants:From 1994 to 2013, 129 patients were treated for UIAS after unsuccessful endourological intervention. Unilateral UIAS was present in 101 patients, and bilateral in 28 patients; total procedures were 157. The previous ileal neobladder techniques were Hautmann neobladder, detubularized U shape, or spherical shape neobladder.Surgical procedures:Dipping technique was performed in 74 UIAS. Detour technique was done in 60 renal units. Ileal Bladder flap was indicated in 23 renal units. Each procedure ended with insertion of double J, abdominal drain, and indwelling catheter.Results:Follow-up was done for 12 to 36 months. Patency of the anastomosis was found in 91.7 % of cases. Thirteen patients (8.3%) underwent antegrade dilatation and insertion of double J.Conclusion:After endourological treatment for uretero-ileal anastomotic failure, basically three techniques may be indicated: dipping technique, detour technique, and ileal bladder flap. The indications are dependent on the length of the stenotic/dilated ureteral segment. Better results for long length of stenotic ureter are obtained with detour technique; for short length stenotic ureter dipping technique; when the stenotic segment is 5 cm or more with a short ureter, the ileal tube flap is indicated. The use of double J stent is mandatory in the majority of cases. Early intervention is the rule for protecting renal units from progressive loss of function.
Descritores: Doenças do Íleo/cirurgia
Obstrução Ureteral/cirurgia
Ureterostomia/métodos
Procedimentos Cirúrgicos Urológicos/métodos
-Anastomose Cirúrgica/efeitos adversos
Anastomose Cirúrgica/métodos
Constrição Patológica/cirurgia
Cistectomia/efeitos adversos
Dilatação
Seguimentos
Doenças do Íleo/etiologia
Cuidados Pós-Operatórios
Retalhos Cirúrgicos/cirurgia
Obstrução Ureteral/etiologia
Bexiga Urinária/cirurgia
Limites: Feminino
Seres Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-745614
Autor: Quitral C, Ricardo; Caulier F, Carolina; Rubio V, Pilar; Aguayo Z, Carlos.
Título: Traqueostomía percutánea con técnica Ciaglia Blue Rhino: experiencia en Hospital Clínico FUSAT de Rancagua / Percutaneous tracheostomy Ciaglia Blue Rhino technique: revision 2 years of experience
Fonte: Rev. otorrinolaringol. cir. cabeza cuello;75(1):13-20, abr. 2015. ilus, graf, tab.
Idioma: es.
Resumo: Introducción: La traqueostomía descrita ya hacia el 1500 AC, en las últimas décadas ha evolucionado al desarrollo de sistemas de abordaje mínimamente invasivos o percutáneos, de los cuales la técnica de Ciaglia Blue Rhino (dilatador único), es la más utilizada en la actualidad. Objetivo: Se realizó un estudio retrospectivo descriptivo de las traqueostomías realizadas en el Hospital Clínico FUSAT de Rancagua, entre los años 2006 y 2012, con el fin de evaluar ventajas, desventajas e incidencia de complicaciones de la técnica abierta versus la técnica percutánea en nuestras manos. Material y método: Se incluyeron 64 traqueostomías consecutivas de las cuales 42 fueron percutáneas con técnica de Ciaglia Blue Rhino y el resto con técnica abierta clásica. Resultados: Al analizar los resultados encontramos ventajas de la técnica percutánea como un importante acortamiento del tiempo quirúrgico (de 45,27 minutos en la técnica clásica a 15,28 minutos promedio en la técnica percutánea), una menor incidencia de complicaciones (14% en procedimiento percutáneo versus 27% en procedimiento abierto) y una curva de aprendizaje relativamente rápida que permitió que la indicación para el procedimiento percutáneo pasara desde 68% en la primera mitad de la serie al 92% en la segunda mitad de ésta. Conclusión: Creemos que la técnica es segura en manos de otorrinolaringólogos y debería incorporarse como una herramienta más al arsenal quirúrgico de la especialidad.

Introduction: The tracheostomy described as about 1500 BC, only in recent decades has seen the development of systems for minimally invasive or percutaneous, of which the Ciaglia Blue Rhino technique (single dilator), is most often used today. Aim: We performed a retrospective study of tracheostomies performed at the FUSAT Clinical Hospital from Rancagua, between 2006 and 2012, in order to evaluate advantages, disadvantages and incidence of complications of open surgery versus percutaneous technique in our hands. Material and methods: Included 64 tracheostomies of which 42 were percutaneous Ciaglia Blue Rhino technique. Results: In analyzing the results highlights shortening surgical time from 45.27 minutes for classical technique to 15.28 minutes for percutaneous (statistically significant) in relation to complications, they showed a lower incidence in the group with percutaneous technique, the learning curve of the procedure is quick, reaching its indication in our series more than 90% of cases once acquired experience. Conclusion: We believe that the technique is safe in the hands of Otolaryngologists and should be incorporated as another tool to the arsenal surgical specialty.
Descritores: Dilatação/métodos
Traqueostomia/métodos
Traqueostomia/estatística & dados numéricos
-Duração da Cirurgia
Complicações Pós-Operatórias
Estudos Retrospectivos
Limites: Seres Humanos
Masculino
Feminino
Adulto
Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central



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