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Search Results: 1 - 10 of 111669 matches for " O.; Kerkebe "
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Resección laparoscópica de feocromocitoma y quiste pancreático en un paciente con enfermedad de Von Hippel-Lindau
Castillo,O.; Kerkebe,M.; Vitagliano,G.; Arellano,L.;
Actas Urológicas Espa?olas , 2007, DOI: 10.4321/S0210-48062007000300016
Abstract: introduction: von hippel-lindau disease is a dominant autosomic hereditary condition, characterized by cerebellar hemangioblastomas, retinal animas and visceral cysts and tumors. we report a case of a patient with von hippel-lindau in which we performed a single-stage laparoscopic adrenalectomy for a pheochromocytoma and pancreatic cyst excision. patient and method: a 20 year old male patient with von hippel lindau disease underwent laparoscopic adrenalectomy for a 5 cm left adrenal mass. a 3 cm cystic lesion was found of the tail of the pancreas and was resected completely laparoscopically during the same operative procedure. results: total operative time was 120 minutes. there were no operative or postoperative complications. blood loss was < 50 ml and hospital stay was 3 days. the histopathologic result was adrenal pheochromocytoma and pancreatic mucous microcystic cystoadenoma. conclusion: laparoscopy allows surgical approach of patients with simultaneous lesions in several abdominal solid viscera, like von hippel lindau disease. this case represents the first report of one-stage laparoscopic adrenalectomy and pancreatic cyst excision.
Cirugía laparoscópica en el tratamiento de enfermedades adrenales: experiencia en 200 casos
Castillo,O.; Cortés,O.; Kerkebe,M.; Pinto,I.; Arellano,L.; Contreras,M.;
Actas Urológicas Espa?olas , 2006, DOI: 10.4321/S0210-48062006000900010
Abstract: objective: we are presenting our experience in laparoscopic adrenalectomy, after adopting the laparoscopic technique for 10 years as a primary option for suprarenal surgery. methods: we included 200 laparoscopic adrenal surgeries performed in a consecutive manner in 183 patients with surgical suprarenal pathology between november 1994 and november 2005. sixty-seven (36.6%) patients were male and 116 (63.4%) were female, with an average age of 49.1 years (age range 8 months to 78 years). results: the most frequents clinical diagnosis were hyperaldosteronism (17.5%), metastatic cancer (15.8%), pheochromocytoma (15.3%), cushing syndrome (7.1%), adrenal cyst (4.9%) and myelolipoma (2.7%). a total of 164 total adrenalectomies, 29 partial adrenalectomies and 7 marsupializations of adrenal cysts were performed. mean surgical time was 82.6 minutes (range 25 to 240 minutes) and mean hospitalization time was 2.5 days (range 1-10 days). the size of the suprarenal gland and/or tumor varied between 1 and 14 cm (average 5.6 cm). the rate of complication was 6%. in 8 of the patients, there was another laparoscopic procedure besides the adrenal surgery: cholecystectomies (2), marsupialization of a renal cyst (2), block nephrectomy (2), partial nephrectomy for a tumor (1) and pancreatic cystectomy (1). one patient underwent a right laparoscopic adrenalectomy and an ipsilateral percutaneous nephrolithotomy. conclusion: the accumulated experience with 200 laparoscopic adrenal procedures has allowed the management of endocrine pathologies, such as, aldosteroma, pheochromocytoma, cushing syndrome and rare entities, such as, cysts, myelolipomas in a suitable manner. additionally, it has permitted us to extend the benefits of a minimally invasive procedure for large adrenal masses and selected oncology cases.
Adrenalectomía laparoscópica: lecciones aprendidas en 110 procedimientos consecutivos Lapararoscopic adrenalectomy: lessons learned from 110 consecutive procedures
OCTAVIO CASTILLO C,OSCAR CORTéS O,MARCELO KERKEBE L,IVáN PINTO
Revista Chilena de Cirugía , 2006,
Abstract: Objetivo: Se presenta una serie personal de 110 adrenalectomías laparoscópicas efectuadas en forma consecutiva, destacando las indicaciones, técnica quirúrgica, complicaciones y resultados. Material y Método: Entre Junio de 1993 y Junio del 2003, se realizaron 110 adrenalectomías laparoscópicas en 102 pacientes, 62 mujeres y 40 hombres con una edad promedio de 47,2 a os (8-78 a os). Las indicaciones más frecuentes fueron: incidentaloma 23,6%, cáncer metastásico 22,7%, hiperaldosteronismo 17,3%, feocromocitoma 15,5%, síndrome de Cushing 7,3%, quiste adrenal 6,4%, mielolipoma 3,6% y teratoma 1,8%. Resultados: El tiempo operatorio promedio fue 94.2 minutos (25-240 minutos), el sangrado intraoperatorio fue de 116,9 mL (0-2500 mL), la conversión a cirugía abierta fue necesaria en 1 paciente (0,9%) debido a sangrado. La estadía hospitalaria fue de 2,5 días (1-10 días). Se registró complicación en 3 pacientes (2,7%) y hubo una muerte (0,9%) durante la cirugía. El tama o promedio fue de 4,2 cm (1,5-14 cm) y los diagnósticos anatomopatológicos más frecuentes fueron: adenoma 27,3%, hiperplasia nodular 18,2%, cáncer metastático 17,3% y feocromocitoma 14,5%. Conclusiones: La adrenalectomía laparoscópica evolucionó durante la década pasada hasta establecerse como la técnica de elección para la cirugía adrenal. Basado tanto en la experiencia personal como en los artículos aparecidos en la literatura, este abordaje reporta resultados quirúrgicos comparables a cirugía abierta, pero con claras ventajas para la cirugía laparoscópica en lo que se refiere a complicaciones, estadía hospitalaria, período de convalecencia y resultado cosmético Background: Laparoscopic adrenalectomy has clear advantages over the open procedure. Aim: To report a series of 110 laparoscopic adrenalectomies performed by one surgeon. The operative indications, surgical technique, results and complications are presented. Material and methods: Between June 1993 and June 2003, 110 laparoscopic adrenalectomies were performed in 102 patients (62 females), aged 8 to 78 years. Results: The operative indications were incidentaloma in 24%, metastatic adrenal carcinoma in 23%, hyperaldosteronism in 17%, pheochromocytoma in 16%, Cushing syndrome in 7%, adrenal cyst in 6%, myelolipoma in 4% and teratoma in 1.8%. Mean operative time was 94.2 minutes (range 25-240). Mean blood loss was 116.9 mL (range 0-2500). Mean hospital stay was 2.5 days (range 1-10). Conversion rate to open surgery was 0.9%. There were 3 complications (2.7%) and mortality rate was 0.9%. Mean adrenal tumor size was 4.2 cm (range 1.5-14). The
Adrenalectomía laparoscópica: lecciones aprendidas en 110 procedimientos consecutivos
CASTILLO C,OCTAVIO; CORTéS O,OSCAR; KERKEBE L,MARCELO; PINTO,IVáN; ARELLANO,LEONARDO; RUSSO,MOISéS;
Revista chilena de cirugía , 2006, DOI: 10.4067/S0718-40262006000300003
Abstract: background: laparoscopic adrenalectomy has clear advantages over the open procedure. aim: to report a series of 110 laparoscopic adrenalectomies performed by one surgeon. the operative indications, surgical technique, results and complications are presented. material and methods: between june 1993 and june 2003, 110 laparoscopic adrenalectomies were performed in 102 patients (62 females), aged 8 to 78 years. results: the operative indications were incidentaloma in 24%, metastatic adrenal carcinoma in 23%, hyperaldosteronism in 17%, pheochromocytoma in 16%, cushing syndrome in 7%, adrenal cyst in 6%, myelolipoma in 4% and teratoma in 1.8%. mean operative time was 94.2 minutes (range 25-240). mean blood loss was 116.9 ml (range 0-2500). mean hospital stay was 2.5 days (range 1-10). conversion rate to open surgery was 0.9%. there were 3 complications (2.7%) and mortality rate was 0.9%. mean adrenal tumor size was 4.2 cm (range 1.5-14). the pathological results showed an adenoma in 27%, nodular hyperplasia in 18%, metastatic carcinoma in 17% and pheochromocytoma in 14%. conclusions: laparoscopic adrenalectomy shares the operative results of open adrenalectomy and adds the advantages of a short hospital stay, less complications, shorter convalescence period and better cosmetic results
Nefrectomía radical laparoscópica en el tratamiento del carcinoma de células renales: análisis de los primeros 50 casos Laparoscopic radical nephrectomy for renal cell carcinoma: Report of 50 cases
Marcelo Kerkebe L,Rubén Olivares G,Nelson Orellana S,Carlos Iturriaga V
Revista Chilena de Cirugía , 2006,
Abstract: Introducción: Desde que Clayman describió la primera nefrectomía laparoscópica a principios de los noventa se han publicado numerosos reportes se alando los beneficios de esta técnica mínimamente invasiva sobre la nefrectomía radical abierta. Se presenta el análisis de la experiencia personal en los primeros 50 casos. Material y Método: Entre Julio de 2001 y Agosto de 2004, se realizaron 50 Nefrectomías radicales laparoscópicas (NRL) en 13 mujeres y 37 hombres, de las cuales 35 fueron totalmente laparoscópicas y 15 fueron con asistencia manual. La edad promedio fue de 61,4 a os (Rango 40-78 a os). Se realizaron 24 NRL del lado derecho y 26 NRL del lado izquierdo, todas por vía transperitoneal. En las NRL mano asistidas se realizó una incisión en fosa iliaca izquierda o derecha según el caso, sin utilización de ningún dispositivo adicional. Resultados: El tiempo operatorio promedio fue de 143 minutos con un rango de 45 a 300 min. El sangrado operatorio promedio fue de 176 ml. (Rango 20-2000 ml.) Cuatro pacientes (8%) requirieron transfusiones sanguíneas.. Hubo tres (6%) complicaciones mayores. El tiempo de hospitalización promedio fue de 2,7 días. Hubo una (2%) conversión. Conclusión: La NRL es una técnica quirúrgica mínimamente invasiva, reproducible y segura. Presenta menor morbilidad, tiempo de hospitalización y requerimientos analgésicos que la Nefrectomía radical convencional, con similares resultados oncológicos. Esta serie presenta los resultados preliminares necesitando mayor seguimiento para evaluar resultados oncológicos a largo plazo Background: The minimally invasive laparoscopic radical nephrectomy has several benefits over the open procedure. Aim: To report the experience with 50 laparoscopic radical nephrectomies. Material and methods: Prospective analysis of the first 50 laparoscopic nephrectomies, performed between July 2001 and August 2004 in patients with renal cell carcinoma. Operative time and intraoperative bleeding was assessed by the anesthesiologist. Results: The age range of patients was 40 to 78 years and 37 were male. The size of tumors on CAT scan ranged from 1.8 to 10 cm Twenty four procedures were on the right side and the rest on the left. Thirty five procedures were totally laparoscopic and in 15, manual assistance through an incision in the costovertebral angle, was required. Operative time ranged from 45 to 300 min and intraoperative bleeding ranged from 20 to 2000 ml. Four patients required blood transfusion. Three patients had minor complications (two hematomas in the puncture site and one prolonged ileus). The conver
REPARACIóN LAPAROSCóPICA DE FíSTULA VESICOVAGINAL MEDIANTE TéCNICA RETROVESICAL: UNA SERIE DE 6 PACIENTES
Marcelo Kerkebe L,Enrique Bley V,Pablo Pizzi L,Cristian Falcón B
Revista Chilena de Obstetricia y Ginecología , 2009,
Abstract: Antecedentes: La fístula vesicovaginal (FVV) es una enfermedad frecuente en países no desarrollados y afecta la calidad de vida de mujeres en edad media, siendo la causa más habitual la histerectomía previa. Las técnicas quirúrgicas disponibles para su reparación presentan resultados variables. Objetivos: Presentar nuestra experiencia en la reparación de FVV por vía laparoscópica con abordaje retrovesical, en una serie consecutiva de 6 pacientes. Método: análisis prospectivo descriptivo de 6 pacientes sometidos a reparación laparoscópica retrovesical de FVV supratrigonales secundarias a histerectomías. Resultados: El tiempo operatorio promedio fue de 191 minutos. Ningún paciente requirió transfusiones y el tiempo de hospitalización promedio fue de 2,5 días. No se presentaron complicaciones ni recidivas, con un seguimiento promedio de 15 meses. Conclusión: La reparación laparoscópica de FVV mediante técnica retrovesical es una técnica segura, poco invasiva y reproducible en manos entrenadas, que podría convertirse en la técnica de elección a futuro. De acuerdo a nuestra revisión, esta comunicación es la primera serie de reparación laparoscópica de FVV publicada en Chile. Background: Vesicovaginal fistula (VVF) is a fairly common condition in underdeveloped countries affecting mainly young women. Its most prevalent cause is prior hysterectomy. Surgical techniques for repairing VVF have widespread results. Objective: To present our results with a retrovesical laparoscopical repair of VVF in a 6 consecutive patient case series. Method: It is a descriptive prospective analysis of 6 consecutive patients with a retrovesical laparoscopical repair of supratrigonal VVF after hysterectomy. Results: Average surgical time was 191 minutes. No blood transfusion was required. Average hospital stay was 2.5 days. None of them had postoperatory complications nor relapse whatsoever, after a minimum of 15 months follow-up. Conclusion: Retrovesical laparoscopic repair of VVF is a feasible, simple, reproducible and less invasive technique. In trained hands it is the election technique for this condition. To the best of our knowledge this is the first publication of laparoscopic management for VVF in Chile.
Estudio prospectivo no randomizado comparando los resultados funcionales y oncológicos entre la prostatectomía radical retropúbica y laparoscópica
Kerkebe Lama,Marcelo; Orellana Salinas,Nelson R.; Flores Martínez,José M.; Olivares Gribbell,Rubén A.; Storme Cabrera,Oscar; Fuentealba Sudy,Cynthia A.;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000200012
Abstract: introduction: radical prostatectomy (rp) is a potentially healing surgical procedure. objective: we evaluate and compare the surgical and oncologic outcomes between laparoscopic and retropubical radical prostatectomy in the urology department in dipreca hospital. method: we constructed a nonrandomised, prospective study between january 2003 and march 2007. a total of 115 patients, 56 operated laparoscopically and 59 by retropubical rp. functional and oncologic results were compared according to standardized variables and their corresponding statistical analysis, for which we used spss 12.0 program. results: mean operation time was 202,5 minutes for laparoscopic rp and 150,5 for retropubical rp (p<0.0001). retropubical rp required more blood transfusions (p<0.0001), longer hospital stay (p=0,0073) and longer need for vesical catheter (p=0,0001) than laparoscopic rp. there were 23 complications, 15 attributable to laparoscopic rp. we found no significant differences in postsurgical sexual function and urinary continence. in respect to the oncologic variables, we found no statistically relevant differences in positive surgical margins nor biochemical relapse during follow up. conclusion: we found no significant differences between retropubical and laparoscopic rp in the oncologic and functional variables analyzed. nevertheless, our experience shows a distinct benefit in favour of the laparoscopic approach in relation to bleeding and recovery rate. though retropubical rp has a shorter operating time, we believe this variable depends on the learning curve still developing for laparoscopic rp. according to our literary review, this is the first publication in chile that compares both techniques.
REPARACIóN LAPAROSCóPICA DE FíSTULA VESICOVAGINAL MEDIANTE TéCNICA RETROVESICAL: UNA SERIE DE 6 PACIENTES
Kerkebe L,Marcelo; Bley V,Enrique; Pizzi L,Pablo; Falcón B,Cristian; Iturriaga V,Carlos; Candia G,Walter; Heredia M,Fernando;
Revista chilena de obstetricia y ginecología , 2009, DOI: 10.4067/S0717-75262009000100005
Abstract: background: vesicovaginal fistula (vvf) is a fairly common condition in underdeveloped countries affecting mainly young women. its most prevalent cause is prior hysterectomy. surgical techniques for repairing vvf have widespread results. objective: to present our results with a retrovesical laparoscopical repair of vvf in a 6 consecutive patient case series. method: it is a descriptive prospective analysis of 6 consecutive patients with a retrovesical laparoscopical repair of supratrigonal vvf after hysterectomy. results: average surgical time was 191 minutes. no blood transfusion was required. average hospital stay was 2.5 days. none of them had postoperatory complications nor relapse whatsoever, after a minimum of 15 months follow-up. conclusion: retrovesical laparoscopic repair of vvf is a feasible, simple, reproducible and less invasive technique. in trained hands it is the election technique for this condition. to the best of our knowledge this is the first publication of laparoscopic management for vvf in chile.
Nefrectomía radical laparoscópica en el tratamiento del carcinoma de células renales: análisis de los primeros 50 casos
Kerkebe L,Marcelo; Olivares G,Rubén; Orellana S,Nelson; Iturriaga V,Carlos; Gutierrez M,Egidio; Vallejos A,Tucapel; Pantoja S,César; Schmidt A,Felix; Uma?a F,Miguel; Wilckens V,Johannes; Salgado B,Gustavo;
Revista chilena de cirugía , 2006, DOI: 10.4067/S0718-40262006000200009
Abstract: background: the minimally invasive laparoscopic radical nephrectomy has several benefits over the open procedure. aim: to report the experience with 50 laparoscopic radical nephrectomies. material and methods: prospective analysis of the first 50 laparoscopic nephrectomies, performed between july 2001 and august 2004 in patients with renal cell carcinoma. operative time and intraoperative bleeding was assessed by the anesthesiologist. results: the age range of patients was 40 to 78 years and 37 were male. the size of tumors on cat scan ranged from 1.8 to 10 cm twenty four procedures were on the right side and the rest on the left. thirty five procedures were totally laparoscopic and in 15, manual assistance through an incision in the costovertebral angle, was required. operative time ranged from 45 to 300 min and intraoperative bleeding ranged from 20 to 2000 ml. four patients required blood transfusion. three patients had minor complications (two hematomas in the puncture site and one prolonged ileus). the conversion rate was 2% and mean hospital stay was 2.7 days. conclusions: laparoscopic radical nephrectomy has a low rate of complications and requires a shorter hospital stay
Stress Loops Effect in Ductile Failure of Mild Steel  [PDF]
O.O. Oluwole
Journal of Minerals and Materials Characterization and Engineering (JMMCE) , 2009, DOI: 10.4236/jmmce.2009.84026
Abstract: A simulation study of effect of stress on mild steel microstructure has revealed stress loops at areas of stress application which are believed to be the root cause of the ductile failure morphology (cup and cone) in ductile alloys under plane strain conditions. The areas of concentration of these stress loops were observed to be that of subsequent instability (or necking) observed in mild steel and other materials of low friction (flow) stress. Shear stress loops with angular bearing of 450 to the tensile axis were observed to instigate both the failure site and shear morphology in these materials. In plane stress conditions, shear was seen to be that of a wave shape running obliquely to area of stress application resulting in oblique necking observed in thin mild steel sheets.
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