Manejo laparoscópico de los quistes hepáticos simples

Aim: To describe the clinical features, surgical, and long-term follow-up outcomes of patients with symptomatic simple hepatic cysts who underwent laparoscopic deroofing or fenestration. Materials and methods: Retrospective and descriptive series of patients with symptomatic simple hepatic cysts treated with laparoscopic deroofing or fenestration between January 2013 to December 2021. Results: Eight patients were included, seven (88%) were females and one (12%) male. The average age was 57 years (range 45–86 years). Pain was the most frequent symptom in seven patients (88%), followed by early fullness in one patient (12%). The average size of the dominant cyst was 12.8 cm (range 6–20 cm) and liver segment IV was the most frequently involved. The length of hospital stay was 2 days. One patient (12%) had major morbidity and required reoperation. There was not postoperative mortality. One patient developed symptomatic recurrence ten months after the first surgery and required a new laparoscopic deroofing. Conclusions: L paroscopic fenestration or deroofing is a safe and effective procedure for the treatment of symptomatic simple hepatic cysts.Objetivo: Describir las características clínicas, resultados quirúrgicos y seguimiento a largo plazo de los pacientes con diagnóstico de quiste hepático simple, sintomáticos y tratados con fenestración o destechamiento laparoscópico. Materiales y métodos: Serie retrospectiva y descriptiva de quistes hepáticos simples tratados con fenestración o destechamiento laparoscópico, desde enero de 2013 a diciembre de 2021. Resultados: Se incluyeron ocho pacientes sintomáticos, siete (88%) de sexo femenino y un varón (12%). La mediana de la edad fue 57 años (rango 45–86 años). El dolor fue el síntoma más frecuente en siete pacientes (88%), seguido de la llenura precoz en un paciente (12%). La mediana del diámetro mayor del quiste dominante fue de 12.8 cm (rango de 6–20 cm) y el segmento hepático más frecuentemente afectado fue el VI, en 4 pacientes (50%). La mediana de la estancia hospitalaria fue de 2 días. Un paciente (12%) presentó complicación mayor, necesitando una re-operación en el post operatorio inmediato. No hubo mortalidad post operatoria. Un paciente (12%) hizo recurrencia sintomática a los diez meses de la primera cirugía y requirió un nuevo destechamiento laparoscópico. Conclusiones: La fenestración o destechamiento por laparoscopía para el tratamiento de los quistes hepáticos simples os es un procedimiento seguro y efectivo

Island Invasion by a Threatened Tree Species: Evidence for Natural Enemy Release of Mahogany (Swietenia macrophylla) on Dominica, Lesser Antilles

Despite its appeal to explain plant invasions, the enemy release hypothesis (ERH) remains largely unexplored for tropical forest trees. Even scarcer are ERH studies conducted on the same host species at both the community and biogeographical scale, irrespective of the system or plant life form. In Cabrits National Park, Dominica, we observed patterns consistent with enemy release of two introduced, congeneric mahogany species, Swietenia macrophylla and S. mahagoni, planted almost 50 years ago. Swietenia populations at Cabrits have reproduced, with S. macrophylla juveniles established in and out of plantation areas at densities much higher than observed in its native range. Swietenia macrophylla juveniles also experienced significantly lower leaf-level herbivory (∼3.0%) than nine co-occurring species native to Dominica (8.4–21.8%), and far lower than conspecific herbivory observed in its native range (11%–43%, on average). These complimentary findings at multiple scales support ERH, and confirm that Swietenia has naturalized at Cabrits. However, Swietenia abundance was positively correlated with native plant diversity at the seedling stage, and only marginally negatively correlated with native plant abundance for stems ≥1-cm dbh. Taken together, these descriptive patterns point to relaxed enemy pressure from specialized enemies, specifically the defoliator Steniscadia poliophaea and the shoot-borer Hypsipyla grandella, as a leading explanation for the enhanced recruitment of Swietenia trees documented at Cabrits