Cirugía española
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To determine the incidence of incisional hernia in patients subjected to colorectal cancer surgery. To analyse the individual risk factors and to determine which patients would benefit more from the use of prophylactic measures. ⋯ The prevalence of incisional hernia after colorectal cancer resection is higher than expected (39,9%). Patients with a BMI greater than 25 kg/m(2), and those who require further surgery are candidates to receive a prophylactic mesh.
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Practice Guideline
[Recommendations for the peri-operative management of bariatric surgery patients: results of a national survey].
To standardise possible peri-operative bariatric surgery protocols, a survey was prepared to be filled in by members of the Spanish Society for Obesity (Sociedad Española de Cirugía de la Obesidad) (SECO), and to approve it at the XII National Congress. A total of 47 members of SECO from 14 autonomous communities responded, and it unanimously approved by the Congress. As highly recommended peri-operative procedures, were proposed: full laboratory analysis (98%) with an endocrine study (90%), ECG (96%), chest x-ray (98%), an oesophageal-gastric imaging test (endoscopy or gastro-duodenal transit study (98%), antibiotic prophylaxis (92%) and use of low molecular weight heparins pre-operatively (96%), and for 2 weeks (83%). Pre-surgical, abdominal ultrasound (86%), spirometry (80%), diet (88%) and psychological study (76%), and during surgery, use of elastic stockings (76%), leak tests (92%) and drainages (90%), were established as advisable procedures.
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Surgical wound infection in colorectal surgery has incidence rate of up to 26%. Peri-operative factors and those of the patients themselves play a part in these infections. The correct administration of the antibiotic, a normal temperature, and hyperoxygenation are a commonly applied triad. The primary aim of the study was to evaluate the incidence of surgical wound infection in patients subjective to colorectal surgery where a surgical infection prevention protocol was applied. The second objective was the relationship between surgical infection and peri-operative factors. ⋯ The prevention protocol did not have an impact on the incidence of surgical wound infection.
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Classically, a sub-hepatic drain was inserted routinely in a cholecystectomy to prevent intra-abdominal abscesses, possible post-surgical bleeding, and biliary fistulas. Over the years, it has been demonstrated that the systematic use of a drain does not have any benefits, and many studies conclude that, in special circumstances (bleeding, signs of gallbladder inflammation, incidental opening, or suspected bile leak), and depending on the experience of the individual surgeon, the insertion of a drain may be of use. ⋯ The insertion of a sub-hepatic drain after elective laparoscopic cholecystectomy increases post-surgical pain and prolongs hospital stay, and does not prevent the occurrence of intra-abdominal abscesses.
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Letter Case Reports
[Hereditary angioedema: a rare cause of abdominal pain].