OBJECTIVE: To show the various arrangements of the saphenofemoral junction and its tributaries. MATERIAL AND METHODS: Between January 1996 and January 2001, 136 saphenofemoral junctions were dissected and classified according to Blanchemaison and Santos Gaston models in 121 patients undergoing surgery for primary varicose veins. RESULTS: One hundred and nineteen variants were assessed in 62 anatomic examinations (46%), 45 samples with one anomaly, 23 with 2 and 6 with 3 or more anomalies. CONCLUSION: Almost a half of cases showed anatomical variation. The accurate knowledge of the saphenofemoral junction and its variant anatomy may help the surgeon to avoid intraoperative accidents and prevent recurrence of varicose veins.

The purpose of this article is to show our experience on the dissection of short saphenous vein during surgical interventions due to essential varicose veins. Between January 1990 and January 2001 forty-seven sapheno-popliteal junctions were dissected in 41 patients. Moreover, we reviewed a broad bibliography regarding the anatomy of sapheno-popliteal junction. We explain both our operative findings and how important the preoperative examination and surgical technique are. One relevant point is to outline the influence of echo-Doppler (ultrasound scan, 1998) and the implementation of standard operative protocols in the quality of anatomical intraoperative diagnoses since 1996.

OBJECTIVE: The absence of an universal classification for hyperthyroidisms (HT), give rise to inadequate interpretation of series and trials, and prevents decision making. We offer a tentative classification based on gammagrafic and functional findings. MATERIAL AND METHODS: Clinical records from patients who underwent thyroidectomy in our Department since 1967 to 1997 were reviewed. Those with functional measurements of hyperthyroidism were considered. All were managed according to the same preestablished guidelines. RESULTS: HT was the surgical indication in 694 (27,1%) of the 2559 thyroidectomies. Based on gammagraphic studies, we classified HTs in: Parenchymatous Increased-Uptake, which could be Diffuse, Diffuse with Cold Nodules or Diffuse with at least one Nodule, and Nodular Increased-Uptake (Autonomous Functioning Thyroid Nodes [AFTN]), divided into Solitary AFTN or Toxic Adenoma...

OBJETIVE: To determine the incidence of Marine-Lenhart syndrome (MLS) in the previously thyroidectomies reported and describe its epidemiology, symptoms, diagnosis methods and compare with Plummer syndrome (PS). MATERIALS AND METHODS: Medical records of 694 hyperthyroid patients were reviewed and ANOVA was perform to compare age of patients, time of disease and thyroid's weight between MLS (diffuse hyperthyroidism with at least 1 node with increased uptake and with or without cold nodes) and PS. RESULTS: The MLS was reported in 4,3% of hyperthyroidisins and 1,2% of the total. Patients age, time of disease and thyroids weight were significantly different between MLS and PS. MLS produced pressure symptoms in two thirds of the patients and functional sings and symptoms in the most of them. In fotir of our patients we fotind exoplitalmos and orily one developed thyroid carcinoma. Total thyro...

OBJECTIVE: To compare the morbidity of total thyroidectomy (TT) and subtotal thyoidectomy (ST) in the management of hyperthyroidism. MATERIAL AND METHODS: A retrospective study of 350 cases of thyroidectomies performed at the Service B of Surgery at the Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, from 1975 to 1996. Clinical diagnosis was always "hyperthyroidism". The main outcome measures were parathyroid morbidity (recurrent laryngeal nerve palsy, infections and hemorrhages), length of hospital stay, relapses and re-operations. RESULTS: Among 350 thyroidectomies done, 71 were TST and 279 were TT. Both techniques exhibited similar results, except for a higher incidence of recurrent laryngeal nerve palsy in the early postoperative period. CONCLUSIONS: TT was a good approach for hyperthyroidism because it prevented recurrences and had a low morbidity, with a minimal risk...

La peritonitis por vernix caseosa (PVC) es una complicación ocasionada por la respuesta inflamatoria al líquido amniótico que se vierte en el abdomen materno durante la cesárea. Los mecanismos fisiopatológicos no están del todo claros, aunque la queratina procedente de las células fetales contenidas en la vernix puede inducir una reacción granulomatosa del peritoneo. Pese a su rareza, debe ser considerada como un posible diagnóstico diferencial ante un dolor abdominal o abdomen agudo puerperal tras realizar una cesárea. En el presente artículo, presentamos un caso de PVC, y discutimos las características clínicas e histopatológicas que la diferencian, permitiendo identificarla y orientar correctamente la conducta quirúrgica y terapéutica.

INTRODUCCIÓN. La colecistitis aguda (CA) en el anciano es una entidad clínica frecuente, caracterizada por la elevada tasa de complicaciones y mortalidad. La elección entre cirugía urgente o tratamiento conservador más cirugía diferida es un motivo de controversia. MATERIAL Y MÉTODOS. Estudio de una cohorte retrospectiva sobre pacientes con edad igual o superior a 70 años tratados de colecistitis aguda entre 2003 y 2009. Se analizaron parámetros epidemiológicos, clínicos, diagnósticos, quirúrgicos y de coste-efectividad. Método estadístico: utilizamos los test Chi-2, “t” de Student y ANOVA. El nivel de significación se estableció para valores p < 0.05. RESULTADOS. Durante los 6 años estudiados fueron tratados 173 episodios de CA en 147 pacientes (52% mujeres), con una edad media de 80.6 años (máximo 101). En 103 episodios (77 pacientes) se adoptó tratamiento m...

INTRODUCCIÓN: El síndrome de Mirizzi es una variante poco frecuente de colelitiasis en la que un cálculo impactado en la bolsa de Hartmann comprime la vía biliar desencadenando una ictericia obstructiva, frecuentemente seguida de fenómenos inflamatorios y diversas complicaciones. OBJETIVO: Establecer la frecuencia del síndrome de Mirizzi en la colelitiasis complicada del anciano y analizar las opciones diagnósticas y terapéuticas más adecuadas. PACIENTES Y MÉTODOS: Se seleccionaron los síndromes de Mirizzi entre las litiasis bilares sintomáticas en mayores de 70 años intervenidos de urgencia durante un periodo de 5 años. Se analizaron epidemiología, clínica, diagnóstico, variables operatorias, morbilidad y hospitalización. RESULTADOS: Se detectaron 12 pacientes con Mirizzi, con una edad media 77.2 años en 197 colelitiasis complicadas. Se realizó un abordaje laparoscó...