Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction. In Uruguay, the start of the pandemic was decreed by Covid. 19 on March 13, 2020, In this context, the Maciel Hospital (HM) established guidelines and recommendations to face the disease that radically modified its usual benefits. The objective of this communication is to present the surgical experience developed in the care context of a sustained phase 2 of Covid infection.19 Material and methods The surgical activity of the HM is retrospectively analyzed from its record of Operative Descriptions, during the period between 13.3.2020 and 30.4.2020 (49 days) and performs a critical analysis from the governing documents of our surgical conduct. Results: 403 cases, 149 coordination and 254 emergency were operated. 287 patients with multiple etiologies, although predominantly oncological (27%) and infectious / inflammatory processes (19%), were operated by the general and specialty surgery services. Laparoscopy involved 62 cases, 43 of which were urgent, mostly due to infectious / inflammatory pathologies: appendicitis (35%), cholecystectomies (24%), and diagnostic laparoscopies (11%). 55% of the cases underwent surgery for cancer and the rest cholecystectomies and others. Conclusions: The HM operated three times more than the rest of the public system; Even so, with respect to its usual production, the number of surgeries decreased significantly (35%), especially coordination (59%). Covid.19 positive patients were not operated. A high number of justified operations were carried out in terms of quantity and type of pathology, using the protocol for maximum protection against Covid.19 rationally, within the established sanitary guidelines and without infectious impact by the coronavirus

Introduction: Since March 2020, COVID-19 infection was declared a pandemic with consequent impact on the health system. A particular case is the surgery service with the risk linked to transmission by microdrops or pneumoperitoneum. To reduce the risk of contagion, non-oncological coordination surgeries have been suspended. The objective of this study was to assess the proportion of asymptomatic patients at the time of surgery and who developed the disease after surgery. Materials and methods: This is an observational, descriptive and retrospective study. A search was made in the operative descriptions system of the Maciel Hospital, identifying the surgical procedures of all the specialties performed from March 16 to April 16, 2020. Demographic variables, variables related to surgery, complications and respiratory symptoms were recorded. Results: 128 patients were included, on which 165 procedures were performed. 42.2% of the coordination procedures, 52.1% of urgency and 5.5% of emergency were performed. It is highlighted that 73.4% of the patients did not present complications and a mortality of only 7.8% was found. 9 (7.0%) swabs were performed in the period, none of them was positive. Conclusions: COVID-19 infection is linked to an increase in postoperative mortality compared to pre-epidemic mortality, which requires strict triage to minimize risk. We highlight in our center the absence of surgery in asymptomatic patients with the infection.

The residual pleural space after lung resection associated with air leak is a frequent finding. It is reported that it can occur in up to 40% of patients in the first postoperative days. Treatment may require re-surgery or the use of less invasive procedures. In two patients, we performed cervical phrenic nerve block, pneumoperitoneum, and chemical pleurodesis by drainage tube.

  Obliteration or foreign body retention after a surgical procedure is a real, current, and preventable problem that affects the safety of the surgical patient. We present the case of a 42-year-old patient, who underwent an emergency laparotomy cholecystectomy 3 years ago, who consulted for a pain-free, progressing growth-free one-year central-abdominal tumor with no changes in transits. It is intra-abdominal, rounded 10 cm in diameter. A tomographic study was requested to confirm the finding, and the exploration was decided by means of a laparotomy that confirmed the presence of a surgical pad.The patient evolves favorably. It is important to adopt a culture of prevention, through the perioperative surveillance of the materials and instruments used during the surgical act.Oblite can occur in any procedure and provoke medico-legal actions against the treating team.

Introduction Ventral hernia management in patients undergoing surgery bari átrica is controversial, not there is consensus in the literature current about the optimal time of hernia repair in relationship to the procedure baric, as well as the choice of the repair method hernial. Every bariatric patient with a defect of the abdominal wall should be addressed individually, taking into account account for factors such as the presence of symptoms, size of the parietal defect and hernia reductibility. Description of contents In the video it exposes the realization of a laparoscopic gastric sleeve in a patient morbidly obese with a recurrence of an umbilical hernioplasty. In the same act it takes Perform parietal repair laparoscopically, highlighting the closure of the defect with extracorporeal stitches, ending with the intra-abdominal placement of a Composite mesh (polyester / collagen) with an overflap of 5cm.    

Few cases of nontraumatic rupture of the spleen in diffuse B-cell lymphoma have been reported.   We present a case of a 73-year-old man, multiple comorbidities that hours before biopsy puncture of the liver nodule installed abdominal pain and hypovolemic shock. An emergency operation was performed. A pathological spleen was found with a ruptured nodule, bleeding and moderate hemoperitoneum. Splenectomy was performed. At 96 hours, he installed abdominal pain and shock. The liver node and hemoperitoneum rupture and bleeding, hemodynamic instability and intraoperative death were reoperated and confirmed. The pathological anatomic study diagnosed diffuse large B-cell lymphoma.

Splenic abscess is a rare clinical entity that is most often associated with infective endocarditis. Heart valve replacement in the setting of an untreated splenic abscess is associated with a high incidence of prosthetic valve infection and death. A patient with infectious endocarditis and splenic abscess treated by laparoscopic splenectomy followed by valve replacement is described. 

The author reviews the clinico-pathological forms of peptic esophagitis, so as to avoid confusion when adopting a surgical procedure

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The authors use the fluorescence provoked by tetracycline, its analogy and permanency in the neoplasic tissues, to detect them, so, the diagnosis becomes easier.They point out the existence of a fluorescence at the ultraviolet light, a natural one, in the· urine of the neoplasics, and they suggest it could be provoked by the presence of the called substancia "E", described in the neoplasics serum, by Dr. Esculies.