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

Anterolateral thoracotomy is the technique of choice in the emergency: chest wounds, hemopericardium to tension, cardiac arrest. In the surgery of choice, it has more limited indications, preferring approaches that offer greater operative exposure. The operative times of this technique are described.

The vertical sternotomy (S.V.) is one of the incisions that has seen its indications expanded in recent years.

Two cases of cervical carotid arterial aneurisms were operated successfully. One of the patients was a young woman and the aneurism was located in the interna! carotid artery; itwas impossible to establish its ethiology. The other case was a traumatic arteriovenous aneurism of the common carotid-internal jugular vein. In the former, by re.ason of the inaccessibility of the upper end of the aneurism which lay on the basis of the skull, it was found necess"ary to performan the proximal and distal ligature of the interna! carotidartery. The latter was re.sected and arterial continuity was restablished through plastic protesis. Selective carotid arteriography clearly showed the arteriovenous fistula and the cervical aneurismatic pouch. Stress is laid on. the need f9r a detail study of collateral circulation of the brain, on the possibility of carotid ligature as sole treatment of this malformation, or in the temporary interruption over a relatively long period, of carotid blood flow during surgery .

The paper describes a case of intestinal invagination in a child on whom surgery was successfully performed in spite of hemophilia. The hemotherapeutic treatment is discussed.

In one patient mecanic occusion of the colon was caused by a submucous lipoma. They are rare in this location, and this type of complication is even more so.

By means of serious renal interlography, the aim is to find a non-invasive means to elucidate the problem of ureteral occlusion and acute arterial obstruction.

Serious digestive hemmorrhage was caused by the perforation of a gastric ulcer in the. parenchima of the spleen. Surgical tactics and techniques employed are \ discussed.This disease is extremely rare and there are no precedents to be found in national medica! literature.

The paper stresses the importance of deep phlebography in the study of postphlebitic syndromes and discusses the physiopathology of this disease.

The characteristics of herniation of the esophageal foramen of the diaphragm are discussed. Stress is laid on· the importance of esophagitis due to backflow regurgitation in the. ascending type. The author Iists the elements considered necessary in deciding whether surgery jr necessary, since this therapy does not apply to all cases. This is followed by an analysis of 64 cases treated by surgery. The decision for applying this therapy was based on the following elements: symptomatic manifestations, anemia, backflow regurgitation, esophagitis, complications or associated pathology (bi!iary or _gratoduodenal). Cases not requiring surgery are analyzed. ( symptornatic, without backflow isolated radiological findings), vointing out however, that they should be carefully observed, because surgery rnay eventually become necessary in the course of their evolution. The conclusion arrived at is that backflow and esophagitis should be stopped befare they cause serious morphological alterations which are difficult to treat. A high percentage of herniations of the esophageal foramen require surgery and this therapy is more widelyapplied as a result of better knowledge of pathology and surgical tactics.

The authors have undertaken a study of 100 cases of single lung nodes treated by thoracotomy and anatomopathologicalcontrol; their findings are compared ·with those of other authors. Stress is laid on their site and on the predóminance,in this series, of hydatid cysts or their sequella ( 53 % ) . As a result of this study it appears that the. best ¡method of diagnosis is exploratory thoracotomy, which ,has low risk (1 %') and should consequently be em; ployed without delay. Cancer incidence is high in this type of lesion ( 44 % ). especially in patients over 50 years of age, and resection at this stage is the procedure which affords greater possibility of longterm survival.