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Minimally Invasive Surgery for Necrotizing Pancreatitis: A Case Report

Surgical Science 2024年第9期15卷 514-521页

作者： Néstor Veriel Méndez Huerta Luis Fernando Zorrilla Núñez Noelia Obregón Gaxiola César Jair Treviño arizmendi Gerardo Iván Muñoz Morales marco alejandro arizmendi villarreal Pamela Denisse Valdez Navarro marco Antonio Hernández Guedea Gerardo Enrique Muñoz Maldonado Service of General Surgery Hospital Universitario Dr. Jos Eleuterio Gonzlez Universidad Autnoma de Nuevo Len Monterrey Mxico

Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].

关键词： Necrotizing Transgastric Pancreatic Necrosectomy Pancreatitis Case Report

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Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

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Journal of Biosciences and Medicines 2022年第8期10卷 201-209页

作者： Jesús Ricardo García-Corral José Martínez-Lopez Rodrigo Davila-Diaz Blanca Arambula-Sanchez marco Cuervo-Vergara Fernando Barbosa-villarreal Daniel De Luna Ana Priscila Campollo Lopez Fernando Isaac Recio Espana Alfredo Chama Naranjo Jaime García alejandro Costa David Flores-Soto Selina Marioni-Manriquez Patricia Lopez-Medellin Erika Barlandas-Quintana Edgar Guillen-Martinez Steve Rodriguez-Alanis Cuahutemoc Marquez Departamento de Cirugía Plástica y Reconstructiva Hospital Central Sur de Alta Especialidad PEMEX Mexico City Mexico

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psych

关键词： BREAST-Q Breast Reconstruction Satisfaction Index Quality of Life Breast Cancer Patient’s Decision Making

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Surgical Complications in Breast Reconstruction: Assessment and Associations

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Journal of Biosciences and Medicines 2023年第6期11卷 171-181页

作者： Daniel De-Luna-Gallardo Jaime Aron García-Espinoza Cuahútemoc Márquez-Espriella Blanca Yadira Arámbula-Sánchez marco Antonio Cuervo-Vergara Rodrigo Dávila-Diaz Ricardo García-Corral Fernando Barbosa-villarreal Fernando Isaac Recio-España Alberto Ignacio Cahuana-Quispe Plastic and Reconstructive Surgery Department Central South High Specialty Hospital of Petróleos Mexicanos Mexico City Mexico Plastic and Reconstructive Surgery Department Petróleos Mexicanos North Central Hospital Mexico City Mexico

Introduction: Breast cancer represents a pathology that generates catastrophic impact and has recently increased its incidence and survival due to timely diagnosis and treatment. Therefore, improving the quality of life of cancer survivors has become a priority, offering reconstructive procedures that reduce complications, costs, hospital stay, and optimize resources. Material and methods: 264 patients reconstructed with autologous tissue (TRAM flap and latissimus dorsi) and alloplastic (breast tissue expander—breast implant and direct breast implant) were included. Variables such as demographic, anthropometric, and histologic type were collected. Results: 62% were reconstructed through the use of alloplastics and 38% with autologous tissue. The risk factors related to a greater probability of immediate postoperative complications (surgical site infection, surgical wound dehiscence and reconstruction failure) were obesity (OR: 2.1, CI: 1.5 - 2.7), preoperative radiation (OR: 1.89, CI: 1.75 - 1.92), arterial hypertension (OR: 1.2), Diabetes Mellitus (OR: 1.78) and smoking (OR: 1.31). Conclusions: The reconstructive process is complex and influenced by patient factors, surgeon experience and the hospital center. However, when choosing the reconstructive strategy, risk factors present in each patient must be considered, since radiation and obesity present a greater probability of postoperative complications.

关键词： Breast Cancer Breast Reconstruction Obesity Radiotherapy TRAM

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Description of the Factors Associated with Trigger Finger in Patients Treated at Petroleos Mexicanos “Pemex”

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Journal of Biosciences and Medicines 2023年第7期11卷 151-159页

作者： Fernando Barbosa-villarreal Cuahutémoc Márquez-Espriella Rodrigo Dávila-Díaz marco A. Cuervo-Vergara Blanca Y. Arambula-Sánchez Alberto I. Cahuana-Quispe Victor A. Esquivel-Chávez Carlos E. García-Córdova Ana P. Campollo-López Mauricio Gutierrez-Alvarez Jesus R. García-Corral Alfredo Chama-Naranjo Daniel de Luna-Gallardo Ricardo A. Pulido-López Isaac F. Recio-España Esteban I. Campos-Serna Carlos I. Navarro-Delgadillo José C. Martínez-López Victor H. Avalos-Gómez alejandro Cruz-Zarate Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The trigger finger, also known as stenosing tenosynovitis of the flexor tendon, is a common cause of hand disability;This can result in significant limitations in certain daily living activities. It is possible to treat this condition with conservative or surgical methods. Methods: This is a retrospective, observational, cross-sectional and descriptive study. The source population consisted of all patients with a diagnosis of trigger finger who had been treated in the department of plastic and reconstructive surgery of our institution between 2020 and 2023. The primary objective of this study is to determine the prevalence and characterize the clinical and surgical characteristics of the population affected by trigger finger in our hospital. Results: The total population was 237 patients, of which 165 were women (70%) and 72 men (30%). The most affected hand was the right hand, with a total of 158 patients (67%). In the right hand, the middle finger was the most affected (45%). Of the 237 patients, 80 of them had obesity (34%), 86 had type 2 diabetes mellitus (36%), 95 had systemic arterial hypertension (40%). Open technique was performed in 190 (80%) patients, while percutaneous technique was performed in 47 (20%) of them. Conclusion: The female sex was twice as frequent, and the middle finger and thumb were the most affected. Most of the patients received surgical treatment with open approach and percutaneous approach in 20% of them.

关键词： Trigger Finger Tendinopathy

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Managament Wound Healing: The Importance of a Wound Clinic in Hospital Centers

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Modern Plastic Surgery 2023年第4期13卷 118-125页

作者： Alfredo Chama Naranjo Cuahutémoc Márquez Espriella Alberto Ignacio Cahuana Quispe Barbosa villarreal Fernando Ana Priscila Campollo López Mauricio Gutiérrez Álvarez Carlos Emiliano García Córdova Jesús Ricardo García Corral Cuervo Vergara marco Antonio Jorge Luis Rosales Becerra Dávila Díaz Rodrigo Edgar Alan Guillen Martínez Marín Canto Miguel Eduardo Luis Arturo Herrera Lozano Ochoa Contreras Erick Cesar Martinez Villalobos Claudia Nallely Cruz Soto Randall Camacho Rodriguez Hayah Ricardo Alberto Pulido López Edwing Michel Jaimes Durán Department of Plastic and Restrictive Surgery Hospital Central Sur de Alta Especialidad Pemex Mexico City Mexico

Background: In clinical practice, acute and chronic wounds continue to be a challenge. Unfortunately, wound care is often inadequate or inappropriate. The implementation of wound clinics involving an interdisciplinary team for wound care and treatment yields favorable clinical outcomes as well as a reduction in economic expenses due to a higher rate of healing, a decrease in hospital stays, and a reduction in the number of readmissions. The establishment of wound clinics enhances the utilization of diagnostic, preventive, and therapeutic resources, improving the quality of life of patients and facilitating their reintegration into their normal lives. The objective is solely to describe the importance of wound clinics in the medical profession. Methods: A retrospective literature search was conducted to include articles no more than 10 years old that reported measures or results of the study in order to perform a literature review and describe the importance of wound clinics in medical practice. Results: A total of 7 articles were obtained with the inclusion criteria, the most recent being from the year 2023 and the oldest from 2013. Conclusion: An important area for improvement in the healthcare industry is the management and treatment of complex wounds. The establishment of wound clinics offers comprehensive and specialized care for both acute and chronic complex wounds with the goal of enhancing secondary illness patients’ prevention, treatment, and rehabilitation.

关键词： Wound Clinic Pressure Ulcer Chronic Wound Wound Healing Quality of Life

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Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

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Modern Plastic Surgery 2023年第4期13卷 95-105页

作者： Cuahutémoc Márquez Espriella Ruiz Garza Jorge Gerardo Barbosa villarreal Fernando Dávila Díaz Rodrigo Cuervo Vergara marco Antonio Campollo López Ana Priscila Gutierrez Alvarez Mauricio Chama Naranjo Alfredo García Corral Jesús Ricardo Pérez Benítez Omar Alberto Pulido López Ricardo Alberto Jaimes Duran Edwing Michel Garibaldi Bernot Mauro Cortes Aguilar Carlos Manuel García Córdova Carlos Emiliano Camacho Rodriguez Hayah Camacho Rodriguez Hayah Martinez Villalobos Claudia Nallely Ochoa Contreras Erick Cesar Randall Cruz Soto Herrera Lozano Luis Arturo Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

关键词： Negative Pressure Wound Therapy Complex Wound Dermal Matrix Wound Therapy

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