Caracterización de pacientes con tumores esofágicos atendidos en el Hospital Celestino Hernández Robau (2016-2017)

Fundamento: el cáncer de esófago es una de las neoplasias más agresivas del tubo digestivo, y se asocia a alta morbilidad y mortalidad; similar al cáncer de pulmón, hígado, páncreas y estómago. Su incidencia presenta grandes variaciones geográficas. La supervivencia es individualizada y depende del estadio de la enfermedad.Objetivo: caracterizar los pacientes con diagnóstico de tumores de esófago registrados en la consulta multidisciplinaria de vías digestivas.Métodos: estudio descriptivo longitudinal y de seguimiento prospectivo de una serie de pacientes adultos con diagnóstico de cáncer de esófago registrados en la consulta multidisciplinaria de vías digestivas (N=57), del Hospital Universitario Celestino Hernández Robau, de Villa Clara, en el período enero/2016 a diciembre/2017. Las variables analizadas fueron: edad, sexo, color de piel, factores de riesgo, tipo histológico, localización anatómica del tumor y tiempo del padecimiento.Resultados: existió predominio de pacientes masculinos con diagnóstico de cáncer de esófago (89,5 %); así como de los mayores de 60 años (63,2 %) y color blanco de la piel. Los factores de riesgo más frecuentes fueron el tabaquismo y alcoholismo, con 85,9 % y 66,6 % respectivamente. La variedad histológica más observada fue el carcinoma epidermoide, siendo la principal localización el tercio medio del esófago. En el 71,9 % de los casos transcurrieron más de tres meses desde el inicio de los síntomas hasta el diagnóstico.Conclusión: el diagnóstico de cáncer de esófago no se realiza de manera inmediata a la aparición de los síntomas, lo que limita las opciones terapéuticas y la supervivencia de los pacientes.</p

Characterization of relaparotomies performed at the Dr. Gustavo Aldereguía Lima General University Hospital (2015-2017)

Background: Relaparotomies are associated with a considerable percentage of morbidity and mortality in patients who require intensive care; and around this procedure it is complex to decide when and how to do it, so that it is effective in every way. For this reason, the study of its results through the analysis of specific variables is of interest.Objective: to characterize the behavior of relaparotomies in a General Surgery service.Methods: descriptive, longitudinal and prospective observational study, which included patients who required relaparotomies, which were performed in the Surgery service of the Dr. Gustavo Aldereguía Lima General University Hospital General, in Cienfuegos, from January/2015 to December / 2017. The variables analyzed were: operative diagnosis at reintervention, surgical strategy, number of reintervention, and time elapsed from initial surgery to reintervention, among others.Results: a relaparotomy index of 2.7 was obtained. The group over 60 years old and the male sex predominated; peritonitis and postoperative eviscerations were the main causes. The clinical criteria were the most used for reintervention; On-demand relaparotomy was applied to a greater number of patients, compared to the other surgical strategies. Mortality increased in reoperated patients in the first 72 hours.Conclusion: In the series analyzed, the number of reoperations and mortality showed a direct proportionality relationship. Multiple organ dysfunctions were the cause of death most associated with the relaparotomy procedure.</p

Reconstructive surgery in the Maxillofacial Surgery service. Cienfuegos, 2015-2019

Background: Reconstructive surgery of the different parts of the face is a challenge for the surgeons who perform it. Despite its current rise, studies of series of patients treated by these procedures are few.Objective: to characterize the face repair surgery in patients seen in a repair surgery consulting room.Methods: descriptive study, of a series of cases, at the Dr. Gustavo Aldereguía Lima Hospital, in Cienfuegos. Patients who received reconstructive surgery of different facial structures, in the period January 2015 to December 2019 (N = 21) attended in the repair surgery consultation were studied. For this series, age, sex, skin color, diagnosis, cause, type of anesthesia and surgical technique were analyzed.Results: men and white skin color predominated. The auricle was the most frequently affected structure; consequently, the most commonly used techniques were the Filatov tube and Dieffenbach retroauricular, combined. Local anesthesia was used in almost all cases. The largest age group was 18-35 years (13 patients), with more than 50% of the total. Patients aged 60 and over were affected by lesions derived from carcinomas.Conclusion: The series presented shows that reconstructive surgery can solve different health and aesthetic situations, sometimes both in the same patient, with techniques of minimal surgical risk, a short time and favorable results.</p