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

Introduction: The mortality rate of malignant tumors of the trachea, bronchi and lung ranks second in men and first in women. According to the Health Statistics Yearbook, there were 5,580 deaths from this cause in 2020, with a general mortality rate for men of 61.6 and 38.1 for women per 100,000 inhabitants. For the treatment of lung cancer in early stages, video-assisted thoracic surgery has demonstrated its safety and effectiveness, with low morbidity and a shorter postoperative stay.Objective: To show the results of video-assisted thoracic surgery lobectomy at the National Center for Minimal Invasive Surgery.Methods: A prospective study was carried out in a consecutive series of 29 patients operated on with a diagnosis of pulmonary nodule. A collection form was prepared to obtain the information and the informed consent of the patients was obtained at all times. The variables were evaluated during the pre, intra and postoperative period.Results: Fifty seven (57) cases with pulmonary nodules formed the total of this study.  Twenty nine of them (29) underwent lobectomy by video-assisted thoracic surgery (50.9%). 80% were in stages I and II according to pTNM. There were 31% complications and the conversion rate was 20.7%.Conclusions: Video-assisted thoracic surgery lobectomy is a safe and proven technique, which is feasible to generalize in our setting.Keywords: lobectomy; video-assisted thoracic surgery; video thoracoscopy.

Introduction: Blunt abdominal trauma can cause severe organ injury with hemorrhage demanding emergent surgical treatment. It is the leading cause of preventable death among all age groups.Objective: To assess the clinical-surgical characteristics of patients with blunt abdominal trauma.Methods: A descriptive and retrospective observational study was carried out to assess the characteristics of blunt abdominal trauma in 81 patients treated at Roberto Rodríguez Fernández General Provincial Teaching Hospital of Morón from January 2014 to December 2019.Results: Young adults represented the predominant age group (34.6%), together with the male sex (19.8%). Traffic accident (48.1%) was the main cause. Hemorrhagic symptoms (39.5%) was the most relevant clinical symptoms, followed by abdominal pain (38.3%). Positive results in complementary tests were represented by abdominal ultrasound (74.1%), followed by abdominal puncture (9.9%). Hepatic lesions (27.0%) was the most affected solid viscera, followed by splenic lesions (19.0%). 77.8% of cases were operated on and hepatic surgical techniques were the most frequently used, accounting for 17 cases (26.9%). Hypovolemic shock (12.7%) was the most frequent postoperative complication. A death rate of 12.3% was reported.Conclusions: The patient with blunt abdominal trauma should always be considered polytraumatized, in which case the initial treatment is aimed at rapid stabilization and identification of life-threatening injuries.

Introduction: Thyroid nodules are a frequent problem; they should be studied, especially because of the possibility that they may be malignant.Objective: To characterize patients with thyroid surgical conditions in Cienfuegos Province, from January 1, 2015 to December 31, 2017.Methods: A descriptive and retrospective study of 225 patients with thyroid surgical affections was carried out in the surgery service of Dr. Gustavo Aldereguía Lima General University Hospital, in Cienfuegos Province, during a three-year period. The variables analyzed were age, sex, affected lobe, physical and ultrasound nodular characteristics of nodules, used biopsy modalities and their correlation, surgical technique, histological variety and postoperative complications. A data collection model was used with the variables of interest, presented in tables of frequency, numbers and percentages.Results: Females predominated (87.1 %), together with the age group 41-50 years (34.7 %) and the left lobe (45.3 %). Single, mobile, refractory and echogenic nodules prevailed. Papillary carcinoma (59.6 %) and multinodular goiter (25.3 %) predominated. Hemithyroidectomy was the most employed surgical procedure (44.9 %) and transient dysphonia (4.9 %) was the most frequent complication.Conclusions: The daily clinical practice of thyroid conditions evidences the necessary interrelation between endocrinologists, surgical doctors, oncologists, imaginologists and pathologists, among others, for the multi- and interdisciplinary approach in the diagnosis and managment of these patients.

ABSTRACTIntroduction: Colorectal and anal cancer is a disease with high incidence and intestinal obstruction is its most frequent complication.Objective: To describe the incidence and mortality of patients with colorectal and anal cancer and mechanical intestinal occlusion due to this cause.Methods: A descriptive case series revision was carried out including patients diagnosed with intestinal occlusion due to colorectal cancer in Sancti Spíritus, Cuba, from January 1, 2014 to December 31, 2018. Living patients and deceased were studied.Results: The incidence of colorectal and anal cancer had the highest rate in 2016, that is, 28.73 per 100,000 inhabitants. The highest number of occluded patients was in 2017 with 52.Conclusions: The incidence of colorectal and anal cancer and occlusion because of this reason is above Cuban reports, similar to what occurs in countries in the region. Mortality due to occlusion is above international investigations.Keywords: colorectal cancer; intestinal occlusion; incidence; mortality.

Introducción: El hidradenoma nodular maligno es un tumor maligno de glándula sudorípara ecrinas, poco común, considerada una lesión de diferenciación anexial ecrinas, que generalmente surge de nuevo, aunque se han descrito unos pocos casos surgidos sobre un hidradenoma nodular. Es decir, representa la contrapartida maligna del hidradenoma nodular.Objetivo: Dar a conocer la presentación de un caso, dada la inusual aparición de esta entidad, con revisión de los criterios para su diagnóstico.Caso clínico: Se informa el caso de un hombre de 74 años de edad con una neo formación en la región parietal derecha del cuero cabelludo.Conclusiones: Debemos pensar en un hidradenoma nodular maligno ante un tumor solitario, firme o fluctuante, infrecuente en el cuero cabelludo, con curso agresivo, recurrencias y metástasis ganglionares y confirmar su diagnóstico con el estudio inmunohistoquímico.

Introduction: With the introduction of the accelerated recovery program in the general surgery service of Dr. Mario Muñoz Monroy Military Hospital of the Army (Matanzas, Cuba), changes have occurred in the perioperative care of the patient with elective surgery for colon cancer. It is of vital importance to know its benefits with respect to the traditional procedure from the moment the surgical intervention is decided.Objective: To assess the benefits of accelerated recovery in patients undergoing elective colon surgery.Methods: An analytical case-control study was carried out during the period from January 2015 to December 2019. The case group completed 12 perioperative actions defined by the accelerated recovery program, while the control group followed the traditional procedure. A bivariate analysis of chi-square and odds ratio (OR) with 95% confidence interval was performed.Results: With the implementation of the accelerated recovery program from the preoperative period, patients arrived at surgery with adequate functional capacity and compensation of their comorbidities. This behavior favored postoperative evolution, reduced complications by 33% (OR: 0.05) and hospital stay by 5.67 days (OR: 2) [10.4-5.1].Conclusions: With the accelerated recovery procedure in their preoperative period, patients received benefits associated with reduced surgical stress, greater physiological reserves and better postoperative recovery. Hospital stay is significantly associated with patient age, comorbidities and number of comorbidities.

Introduction: Physiological responses to hemorrhage, such as hypotension and tachycardia, are not always proportional to the state of shock, which has led to the need to use other predictors.Objective: To analyze the characteristics of base deficit, lactate and severe shock index as predictors of mortality in multiply injured patients.Methods: An analytical, observational and retrospective study was carried out in the anesthesiology and resuscitation service of General Calixto García University Hospital, between August 2018 and August 2020. The sample was made up of 50 patients, according to nonprobabilistic selection criteria of the researcher.Results: Patients who suffered cranial trauma were seven times more likely to die. The index of severe shock at three hours tripled the risk of death. Lactate and baseline deficit correlated significantly with shock index greater than one. Blood transfusion doubled the risk of death, while amine requirements were not shown to be poor prognostic factors. Among complications, systemic inflammatory response was shown to have nine times higher risk of dying and multiple organ dysfunction seven times, but the presence of pneumonia did not influence death.Conclusions: The severe shock index was considered a prognostic factor for mortality in polytraumatized patients, as far as it tripled the risk of dying and was related to elevated lactate and altered base deficit values.