RESUMO
INTRODUCTION: We analyzed the Uruguayan experience with cryopreserved arterial homografts. We studied 55 medical records in the period from June 9, 2000 to April 7, 2007, including 41 from males and 14 from females, ranging from 36-78 years of age. The clinical indications were as follows: Group 1, revascularization of infrainguinal atherosclerotic occlusive disease by bypass due to the lack of availability of a suitable vein (n = 35); Group 2, substitution of an infected prosthetic grafts (n = 15); and Group 3, arteriovenous fistula (AVF) after failure of previous prosthetic loops by repeated thrombosis and/or infection in the absence of a vein (n = 5). RESULTS: Among Group 1, primary and secondary patency rates were 61% and 71%, respectively at 1 year with 15 complications, 3 infections, 8 thromboses, 2 aneurysms, 1 homograft degradation, and 1 death related to surgery. Among Group 2, the primary and secondary patency rates were 71% and 79%, respectively, at 1 year with 6 patients experiencing complications. Group 3 did not have complications with a primary patency rate of 67% at 1 year. CONCLUSIONS: The use of cryopreserved arterial homografts is a valid, accessible, and safe alternative in complicated vascular situations. In our country, it is a technology to consider for patients with critical limb ischemia, when the risk of a major amputation is high and it is not possible to have a suitable vein or prosthetic bypass. It can be an excellent alternative for the substitution of infected synthetic bypasses, especially to substitute in situ for an infected aortic graft.
Assuntos
Arteriopatias Oclusivas/cirurgia , Artérias/transplante , Criopreservação/métodos , Transplante Homólogo/estatística & dados numéricos , Adulto , Idoso , Procedimentos Cirúrgicos Cardiovasculares/estatística & dados numéricos , Ponte de Artéria Coronária/estatística & dados numéricos , Feminino , Humanos , Artéria Ilíaca/cirurgia , Masculino , Pessoa de Meia-Idade , Politetrafluoretileno , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Uruguai , Grau de Desobstrução Vascular/fisiologiaRESUMO
Luego de analizar una experiencia de 80 casos, revisando la bibliografia, los autores subrayan la necesidad del diagnostico de fisura anal idiopatica descartando patologias asociada, sobre todo el absceso posterior. Prefierem como tratamiento de eleccion la esfinterotomia lateral interna subcutanea, considerando que se obtiene un mayor porcentaje de curaciones com menores complicaciones y secuelas. En la serie presentada hubo una sola recidiva (1,25%) por error diagnostico, sin secuelas, por lo cual los autores recomiendan el procedimiento precisando sus indicaciones y contraindicaciones
Assuntos
Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Fissura Anal , Procedimentos Cirúrgicos OperatóriosRESUMO
Con motivo de un caso clinico, se hace una puesta al dia, de una entidad clinica, poco difundida en nuestro medio. Se insiste, por un lado, en el incremento de su frecuencia en paralelo, con el de la patologia traumatica y por otro lado, de que si pensamos en esta afeccion, es posible el diagnostico, antes de instaurarse, el tratamiento. Damos las pautas terapeuticas, destacandose que la tendencia actual es la de instaurar en primer lugar, el tratamiento medico, el cual resulta efectivo, en un 35 a 40% de los casos