Estadísticas

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      "titulo" => "¿Cómo publicamos los cirujanos en España? Análisis bibliométrico de las revistas Cirugía Española y Revista Española de Enfermedades Digestivas"
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    "titulo" => "Nuestra experiencia en el tratamiento de la hernia inguinofemoral reproducida del adulto. Estudio sobre 155 casos consecutivos y propuesta de un protocolo"
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        "titulo" => "OUR EXPERIENCE IN THE TREATMENT OF RECURRENT GROIN HERNIA IN ADULTS&#46; A STUDY OF 155 CONSECUTIVE CASES AND A PROPOSED PROTOCOL"
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        "resumen" => "<span class="elsevierStyleBold">Introducci&#243;n&#46;</span> Presentamos nuestra experiencia en 155 casos de hernias inguinofemorales reproducidas operadas en 15 ocasiones con t&#233;cnicas herniorr&#225;ficas y en 140 con t&#233;cnicas herniopl&#225;sticas&#44; utilizando en 114 casos un abordaje inguinal anterior y en 26 un abordaje preperitoneal&#46; Con un seguimiento protocolizado&#44; se realiza un estudio individual de recidivas y complicaciones&#44; introduciendo en el protocolo terap&#233;utico inicial las variaciones que ha sugerido la experiencia&#46; <br/> <span class="elsevierStyleBold">Pacientes y M&#233;todo&#46;</span> Han sido intervenidos 155 casos de recidivas herniarias en 131 pacientes&#44; 124 varones y 7 mujeres&#44; con un n&#250;mero de recidivas entre una y tres y con una media de edad de 57&#44;7 a&#241;os&#46; Fueron intervenidos por los autores&#44; utilizando&#44; en principio&#44; t&#233;cnicas herniorr&#225;ficas en los casos considerados de bajo riesgo de recidiva y prot&#233;sicas en el resto&#44; usando un anclaje prot&#233;sico al ligamento de Cooper cuando existi&#243; deterioro del plano superficial y abordaje preperitoneal si exist&#237;a cirug&#237;a prot&#233;sica inguinal previa y en algunos casos de bilateralidad&#46; <br/> <span class="elsevierStyleBold">Resultados&#46;</span> El &#237;ndice de recidiva en las t&#233;cnicas simples fue del 23&#37; y en las prot&#233;sicas del 7&#44;42&#37;&#46; Las recidivas ocurrieron durante los primeros 50 casos salvo tres ocurridas en procedimientos preperitoneales durante los 105 casos restantes&#59; el an&#225;lisis de todos los casos nos ha conducido a introducir cambios de procedimiento y material en nuestro protocolo inicial&#46; <br/>Conclusi&#243;n&#46; La alta frecuencia de recidiva en el tratamiento de la hernia inguinofemoral reproducida con el uso de procedimientos no prot&#233;sicos aconseja el uso de pr&#243;tesis en todos los casos&#46; En nuestra experiencia&#44; el uso de pr&#243;tesis de propilpropileno&#44; suturadas con id&#233;ntico material&#44; con adecuada protecci&#243;n del orificio inguinal profundo y con abordaje virgen en caso de inserci&#243;n prot&#233;sica previa&#44; ofrece los mejores resultados"
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        "resumen" => "<span class="elsevierStyleBold">Introduction&#46;</span> We present our experience in 155 cases of recurrent groin hernia&#46; Herniorrhaphy was performed in 15 cases and hernioplasty in 140&#59; of the latter&#44; 114 involved an anterior inguinal approach and 26 a preperitoneal approach&#46; The follow-up protocol included the individual study of recurrences and complications&#59; changes were introduced into the initial therapeutic protocol as indicated by experience&#46; <br/> <span class="elsevierStyleBold">Patients and method&#46;</span> One hundred thirty-one patients &#40;124 men and 7 women&#59; mean age&#58; 57&#46;7 years&#41; were treated surgically for 155 recurrent hernias&#46; Each patient presented between 1 and 3 recurrences&#46; Surgery was performed by the authors of this report&#44; who employed herniorrhaphy in those cases in which there appeared to be a low risk of recurrence&#44; and prostheses were placed in the remainder&#46; The prosthesis was attached to Cooper&#39;s ligament when the tissue plane was deteriorated and a preperitoneal approach was used when the patient had undergone previous inguinal prosthetic surgery and in certain cases of bilateral hernia&#46; <br/> <span class="elsevierStyleBold">Results&#46;</span> The rate of recurrence associated with herniorrhaphy was 23&#37; and that of prosthesis placement was 7&#46;42&#37;&#46; Recurrences developed in the first 50 cases&#59; among the remaining 105 cases&#44; there were only 3 recurrences&#44; all of them involving a preperitoneal approach&#46; The analysis of our series led us to introduce changes in the procedure and materials employed in our initial protocol&#46; <br/>Conclusion&#46; The high recurrence rate associated with groin hernia when not repaired by prosthesis placement suggests that prostheses should be employed in every case&#46; In our experience&#44; the use of propylpropylene prostheses sutured with the same material&#44; with proper protection of the deep inguinal ring and using a new approach in cases of previous prosthesis placement&#44; produces the best results&#46;"
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