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

The current state of surgery for benign esophageal strictures is characterized by significant progress.

Introduction: Limb-sparing surgery is the standard treatment in the management of musculoskeletal tumors. The problem that the surgeon faces is reconstruction after a wide resection. There are various techniques such as endoprostheses, allografts and autografts, among others.In 1999 in Japan, Tsuchiya, et al developed the biological reconstruction technique using liquid nitrogen (LN). The objective of the following work is to present the first cohort of patients treated with this technique in our country. Also, analyze the following parameters: local recurrence, consolidation times, autograft survival, and functional evaluation at the end of follow-up.Methodology: A retrospective study was conducted from August 2015 to June 2019 of patients treated with frozen autograft in LN. All were evaluated in a multidisciplinary team and treated by the same surgical team. A total of 19 cases were registered, 13 were included for evaluation, the rest being excluded because they had less than 6 months of follow-up. The technique consists of tumor resection with wide margins, exposing the tumor to an immersion cycle in NL at -196 degrees Celcius for 20 minutes, then progressive heating for 15 minutes at room temperature and 10 minutes in distilled water. Achieving eradication of tumor cells by cryotherapy. Followed by reimplantation of the frozen bone and fixation with osteosynthesis material.In the evaluation, the local recurrence was evaluated clinically and imaging. Consolidation was assessed as defined by Zekry et al: patient without pain when ambulating and osteotomy lines are not visible or there is an obvious callus in 3 of the cortices in the anteroposterior and lateral approaches. The survival of the autograft was evaluated according to whether or not it was necessary to remove it.Results: At the end of the follow-up, all the patients were alive, none of the patients with localized disease had developed distant metastases. A patient with local recurrence in soft tissues was registered. Consolidation was achieved in 83% of the patients, with a mean of 6.7 months. It was necessary to remove the graft in 3 cases, two due to deep infection and the other due to joint collapse. The functional evaluation according to the average MSTS-ISOLS score was 73.8% (range 13-100%). This average was 89.9% (63-100%) in the 10 patients who kept the autograft.Conclusions: The frozen autograft technique in LN is a very good reconstruction option in musculoskeletal tumors. It is a technique that is easy to access, low in cost and maintains the properties of osteoconduction and osteoinduction. Our series presents similar results to published studies in terms of local recurrence, consolidation and functional score.

1) A nview of the opera ti ve technics utilized in 58 cases of hydatid cysts opened into the biliary tract ( H.C.O.B.T.) is presented. 2) The concept of H.C.O.B.T. is defined according to pathological criteria, considering as such all those cysts that have partially evacuated their contents into the biliary tract with no obstruction of tlie common bile duct. When this obstruction is present then the H.C.O.B.T. is considered both clinically and pathological ly as a biliohepatic disease. 3) The three. differents procedures available for the treatment of the H.C.O.B.T. are discussed: a) Cyst drainage. Hepatic monopolar operation. Minimal but fundamental procedure. b) Cyst drainage plus surgical exploration -and drainage- of the comm:on hile duct. Bipolar (complete) operation. e) Exploration and drainage of the common hile duct alone .. Biliary monopolar operation. This is an incomplete operation, not to be used as a rule, except under very special circunstances.

  IntroductionLaparoscopic oncological gastrectomy has increased in recent years due to postoperative benefits, maintaining oncological principles.We describe the main technical aspects of laparoscopic total oncological gastrectomy. Description of contentsPatient with advanced subcardial gastric adenocarcinoma.We started with peritoneal lavage, opening of the greater omentum, resecting the nodes of group 4 and 5, section of the right gastroepiploic pedicle, resecting group 6. Section of the duodenum and lymphadenectomy of group 8, 9 and 11.Stomachic coronary artery section (group 7). Resection of the lesser omentum to the esophageal hiatus and resection of ganglion groups 1, 2 and 3.We section the esophagus, extract the piece and resect the greater omentum. Reconstruction of the Roux-en-Y digestive transit.ConclusionsLaparoscopic oncological gastrectomy is a feasible and safe technique. Its performance requires experience in esophagogastric cancer surgery and advanced laparoscopic surgery.

The authors wake a remarkable stress, in · a keen and correct diagnostic in the diseases of the biliary tracts. This brings as a consequence, the rational choice of the treatment to be done. They proclaim in a special way, the denervation of the hepatic pedicle, with pyloroplasty,associated or not, to the cholecystectomy. They present a casuistical that confirms this kind of behaviour.

Gastroesophageal reflux always occurs under pathological conditions and creates a pathology at the same time when it fills conditions ofaggressiveness. Call it "reflux esophagitis", "is, peptic opgitis", "peptic disease of the esophagus" or "reflux disease", the entitynosological origin that originates in the lower esophagus as a consequence of the aggressive action of the secretions of the upper digestive sector, is, for its pathological polymorphism, a complex condition in the anatomo-functional field, in its clinical expression and in its treatment ...

1) A report is carried out of a case of suppurative calcified giant hepatic hydatid cyst, with severe aero-anaerobiac infection and very poor general state. Treatment involved plain evacuation, external drainage -but not drainage of the main bile duct- and antibiotic therapy. The course was fully satisfactory. 2) The chronic external hepato-cystic fistula was treated by a Y-shaped anastómosis the cystic residual cavity to the 4th jejunal loop, with excellent results.

Various features of bile duct-digestive anastomosis with dysfunctionalized loop, aimed at suppression of blackflow regarded as causing angiocholitis, are considered. Different types of dysfunctionalized anastomoseis,· with their advantag,e-s and shortcomings, are discussed.A series of 29 cases is surveyed.

A case of biliary ileus with pneumatosis of the bile ducts, is reported. Pre-operative preparation and surgical approach, are discussed.

Gall bladder volvulus are of rare occurrence, its difference with recurrence torsions being noteworthy. Two recent surgical cases of the conditionare reported upon; one was a partial volvulus, the other total.