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

Introduction: Auricle reconstruction is, nowadays, a difficult problem to solve. Several surgical techniques have been proposed and only those based on the use of autologous costal cartilage are accepted worldwide.Objective: To evaluate the effectiveness of the auricle reconstruction technique described by Burt Brent.Methods: A quantitative study with a cross-sectional descriptive design was carried out with 41 patients who presented congenital microtia or acquired loss of the ear and who were performed auricle reconstruction with autologous costal cartilage in the plastic surgery service at Hospital “William Soler”, Centro de Investigaciones Médico-Quirúrgicas and Clínica Central “Cira García”, from 1994 to 2019. The used technique described by Burt Brent was, in turn, described and documented. A 10-point scale based on the normal atrial anatomy was used to assess the outcomes.Results: Thirty-two patients with congenital microtia (78.04 %) and nine traumatic losses (21.95 %) were found, with a predominance of the female sex (56.09 %). The incidence was higher on the right side (68.75 %) in patients with congenital microtia. Favorable and satisfactory outcomes were achieved in 95 % of cases.Conclusions: Auricle reconstruction requires the use of a costal cartilage piece of enough size, shape and projection. The key is to sculpt a cartilaginous framework of the ear and to maintain these details through the skin as close as possible to the normal ear. A high level of specialization is required for a satisfactory outcome.Keywords: congenital microtia; auricle; auricle reconstruction.

Introduction: Facial rhytidectomy is the technique for correcting facial aging features, but they are becoming increasingly complex due to the incorporation of deeper planes in the process. The superficial musculoaponeurotic system techniques have the advantage of providing a greater degree of naturalness and permanence in time.Objective: To evaluate the effectiveness of the high-superficial musculoaponeurotic system technique for facial rejuvenation.Methods: A prospective and longitudinal case series study was carried out in the plastic surgery service of Hospital General Universitario “Vladimir Ilich Lenin” with patients who requested facial rejuvenation and were treated with the high-superficial musculoaponeurotic system technique, from January 1, 2018 to June 30, 2020. The variables age, sex, skin type, degree of aging, operative complications, patient satisfaction and aesthetic outcomes were studied.Results: The female sex predominated, together with the age group 50-59 years, the degrees of aging II and III, as well as white and light brown skin colors, while the most frequent operative complication was wound dehiscence of the suture line at the auricle root. The patients' satisfaction with the aesthetic outcomes of the surgical intervention was verified and the aesthetic outcomes was assessed as favorable in 100 % of the cases for the used surgical technique.Conclusions: The high-superficial musculoaponeurotic system surgical technique for rhytidectomy offers harmonic, long-lasting outcomes with a low percentage of complications, making it a valuable alternative for patients. Keywords: high-superficial musculoaponeurotic system; rhytidectomy; facial rejuvenation.

Introduction: The incidence of cholecystocutaneous fistula has decreased due to the early surgical managment of patients with vesicular lithiasis.Objective: To present a case of cholecystocutaneous fistula secondary to chronic lithiasic cholecystopathy.Clinical case: An 87-year-old female patient was attended in the emergency surgical services after having suffered, two weeks earlier, pain in the right hypochondrium accompanied by progressive increase in volume in that region. Physical examination revealed spontaneous discharge of dark bile continuously through a fistulous orifice. The patient was decided to be taken to the operating room, where she was performed a profound infundibulum cholecystectomy and transcystic cholangiography, lithiasis being visualized. The next considered step was choledochotomy for stone extraction with bile duct lavage, and a T-tube was placed. Evolution was satisfactory.Conclusions: The treatment combining surgery and antibiotic therapy is curative.Keywords: cholecystocutaneous fistula; cholecystectomy; perforation.

Introducción: El cáncer de esófago y cardias es una enfermedad grave, en el que más de tres cuartos de los enfermos que se tratan están en fase avanzada. En Cuba existe experiencia con las prótesis esofágicas originales o construidas en el país.Objetivo: Evaluar los resultados de la experiencia de los hospitales universitarios “Comandante Manuel Fajardo” y “Miguel Enríquez” con las prótesis transtumorales en el cáncer de esófago no resecable.Métodos: Se realizó un estudio observacional, descriptivo, retrospectivo, tipo serie de casos, con una muestra de 197 enfermos con cáncer avanzado del esófago en los Hospitales Universitarios “Comandante Manuel Fajardo” y “Miguel Enríquez” tratados con prótesis por presentar un cáncer avanzado del esófago en el período 1995-2020.Resultados: Predominó el sexo masculino, las edades más afectadas fueron la sexta y séptima década. La localización más frecuente del tumor fue en tercio inferior del esófago y cardias y el tipo histológico el carcinoma epidermoide. En el 71 % se utilizaron prótesis rígidas de tubos endotraqueales; en el 20,8 % prótesis de Heering y en el 8,2 % prótesis autoexpansible. En el Hospital Manuel Fajardo la prótesis que más se utilizó fue la rígida de construcción artesanal y en el Hospital Miguel Enríquez la de Heering. La menos utilizada fue la autoexpansible. Se presentó un 10,1 % de complicaciones, sin mortalidad quirúrgica. Conclusiones: Aunque las prótesis autoexpansible son de fácil colocación por endoscopia, es un método ideal pero costoso. La prótesis plástica rígida industrial o artesanal también puede ofrecer calidad de vida sin disfagia, evitan que el enfermo fallezca con una ostomía abdominal.

Introduction: Iatrogenic bile duct lesions represent a serious surgical complication of cholecystectomy.Objective: To determine the morbility of bile duct lesions in the surgical service of Hospital Universitario “Manuel Ascunce Domenech”.Methods: A descriptive, prospective and observational study was carried out with patients admitted to the surgery service of Hospital Universitario “Manuel Ascunce Domenech” with a diagnosis of bile duct lesion, from September 2018 to January 2022. The study universe consisted of twelve patients who met the inclusion criteria. Descriptive statistical methods and calculations with percentage values were used.Results: The highest incidence of patients corresponded to the female sex and the white skin, accounting for 61.4 % and 85.7%, respectively. Conventional surgery and intraoperative diagnosis predominated, accounting for 66.7 % and 50 %, respectively. Types E1 and E2 according to the Strasberg classification, together with hepaticojejunostomy, was the most frequent surgery type, accounting for 66.7 %. Biliary bleeding was the predominant complication, accounting for 70 %.Conclusions: Most of the patients belong to the female sex and have white skin, in which cases conventional surgery and intraoperative diagnosis are the most frequent findings. More than half of the patients are classified as types E1 or E2 according to the Strasberg classification. Transmesocolic Braun loop and Roux-en-Y hepaticojejunostomy is the procedure performed in almost all patients. Biliary leakage is the most frequent complication.Keywords: bile duct lesion; morbility; bile duct iatrogenesis; biliary bleeding; postoperative stenosis.

Introduction: The interdisciplinary model in the oncological field has permitted connection between different disciplines, allowing to offer solutions for raising the quality of life of patients and provide excellent care.Objective: To explore the scientific evidence on interdisciplinary collaboration in the treatment of colon cancer.Methods: A systematic research was carried out. A digital search was carried out in the Web of Science, Lilacs, SciELO, Latindex, Elsevier, PubMed, Medline and Google databases, in view of identifying updated publications in English and Spanish.Development: The interdisciplinary approach in the treatment of oncologic diseases, including colon cancer, has been described for some time. The design allows connecting different specialties during interconsultation or the surgical act itself, which results in the formulation of research problems that require, for their solution, the exchange of knowledge and technologies from one specialty to another, allowing to offer solutions for raising the quality of life of patients and provide excellent care.Conclusions: Cancer is a disease that requires care for the patient, not only within the biological sphere, but also in the psychological, social and spiritual aspect. Interdisciplinary teams, made up of professionals from different disciplines, are a tool that can help, to a great extent, achieve better care.Keywords: interdisciplinarity; colon cancer; multidisciplinarity.

Introduction: Garengeot's hernia is one of the most uncommon abdominal wall hernias worldwide.Objective: To present the case of a patient with a diagnosis of crural hernia, with cecal appendix, definitely being Garengeot's hernia.Clinical case: A female patient of white skin color, aged 56 years old, with a family history of disease, was admitted to the surgery service of Hospital Universitario “Manuel Ascunce Domenech” with the diagnosis of incarcerated crural hernia. He presented pain in the root of the right thigh, nausea and an irreducible tumor below the Malgaigne's line, irreducible.Conclusions: Garengeot's hernia is a unique surgical entity, difficult to distinguish from an irreducible crural hernia. Therefore, its diagnosis is an intraoperative finding and herniorrhaphy is the most commonly used surgical procedure.Keywords: hernia; appendicitis; femoral; Garengeot's hernia.

Introduction: Postsurgical infections are present in every worldwide institution with surgical services. These infections are preventable causes of serious adverse events in hospitalized patients.Objective: To characterize morbimortality due to healthcare-associated infection in patients in a surgical service.Methods: A descriptive, observational and retrospective study was conducted from 2017 to 2019 in the general surgery service of Hospital Militar “Mario Muñoz Monroy”. The sample was 114 patients who presented postsurgical infection according to the reports from the surgical rooms or the intermediate and intensive care units. Demographic variables were gathered, at the same time with type of infection, risk factors and lethality, all of them grouped in tables for processing and analysis.Results: The global incidence rate of healthcare-associated infections between 2017 and 2019 was 2.3 %. The female sex accounted for 67.5 % of the total. The predominant age groups were above sixty years old and under eighty years old, accounting for 56.1 %. Superficial surgical site infection predominated in 70.1 % of the patients. The degree of surgical contamination was the main risk factor, accounting for 85.0 % of the cases. Comorbilities were present in 79.8 % of all the patients with infections. Overall lethality of patients with infections was 12.2 %.Conclusions: The global rates of associated infections are demonstrative of efficient care management. Surgical site infections are the most frequent nosocomial infections, with a predominance of superficial surgical site infection. The main risk factors are comorbilities, age above sixty years, emergency surgery, and smoking.Keywords: infection; surgery; healthcare; risk factors; mortality.

Introduction: Nowadays, conservative surgery, rather than an option for the surgical treatment of breast cancer, is the surgical technique of choice.Objective: To characterize the survival of patients with breast cancer operated on with conservative surgery.Methods: A multicenter, retrospective, descriptive and longitudinal study was carried out at Hospital Universitario Clínico Quirúrgico “Arnaldo Milián Castro” and "Celestino Hernández Robau" oncologic hospital, both in the city of Santa Clara, Villa Clara Province, in the period from January 2011 to December 2020.Results: The overall survival of patients with breast cancer and conservative surgery in those who presented events (died) was higher in those with infiltrating ductal carcinoma, accounting for 9.3 years. In the case of tumor stage, survival was predominant in those patients with stages IA and IIA, accounting for 9.8 and 9.1 years, respectively. Concerning immunohistochemistry, the molecular subtype with the best overall survival was Luminal B, accounting for 9.2 years. Regarding the applied definitive treatment, those patients who received chemotherapy-radiotherapy-hormone therapy and chemotherapy-radiotherapy schemes presented better overall survival, accounting for 9.4 and 8.8 years, respectively.Conclusions: Overall survival is higher in patients with infiltrating ductal carcinoma (not otherwise specified), tumor stages IA and IIA, molecular subtype Luminal B according to immunohistochemistry, and definitive treatments with chemotherapy, radiotherapy, hormone therapy scheme.Keywords: breast cancer; conservative surgery; overall survival

Introduction: Numerous women have contributed to the development of stomatology in Cuba and in Cienfuegos. However, in this sense, few local sources broach the lives of these women.Objective: To deepen in the life and work of Dr. María Narcisa Isacia Agramonte Jiménez, so that elements of the historical evolution of Cienfuegos stomatology can be rescued.Methods: A historical-biographical research was carried out from October 2016 to December 2020. Memoirs were used as a way of reviewing the history. The methods used were analytical-synthetic and deductive-inductive; and the sub-methods employed were chronological, numismatic, diplomatic and iconographic. Historical research techniques were used to collect data: documentary review and interviews. As primary sources of the research, historical-legal documents were consulted at the Civil Status Registry (2), and at the University of Havana (1), as well as oral interviews (13), with testimonies of key informants. A bibliographic search was carried out, with four references of articles and books.Results: María Narcisa Isacia Agramonte Jiménez was the first middle class female dentist from Lajas -also black-, graduated in 1944. She had an active revolutionary presence, after 1959. The donation of all her dental equipment to the “Manuel Piti Fajardo” polyclinic in Cruces, of which she was the founding dentist, stands out.Conclusions: The vocation of the first dentist from La Paz for pedagogy and her commitment to the revolutionary cause were elements of vital importance in the development of stomatology in Cruces.