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Search Results: 1 - 10 of 602610 matches for " OCTAVIO A CASTILLO C "
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Linfadenectomía retroperitoneal lumboaórtica laparoscópica por vía extraperitoneal en cáncer testicular no seminoma Extraperitoneal laparoscopic retroperitoneal lymph node dissection in non-seminomatous testicular cancer
Octavio A Castillo C
Revista Chilena de Cirugía , 2013,
Abstract: Objetivo: Mostrar la experiencia en la técnica de disección lumboaórtica por vía totalmente extra-peritoneal, en un grupo de pacientes con cáncer testicular en estadio A. Material y Métodos: La serie está formada por 5 pacientes, portadores de un tumor testicular no seminoma, en estadio A. En ellos se planteó como alternativa la linfadenectomía retroperitoneal lumboaórtica laparoscópica. La técnica quirúrgica consistió en la formación de un espacio extraperitoneal, con rechazo de peritoneo, exposición del retroperitoneo y disección linfática clásica. Se analizaron los datos demográficos, histología, complicaciones del acceso y la técnica quirúrgica, tiempo operatorio, sangrado estimado y seguimiento a largo plazo. Resultados: El tiempo operatorio medio fue de 144 min, con un sangrado medio estimado en 42,5 ml (20-150 ml). No hubo complicaciones intra ni postoperatorias. El tiempo medio de hospitalización fue de 33,6 h. El número medio de nodos linfáticos resecados fue de 27,4 (24 a 32). Con un promedio de seguimiento de 134 meses, no ha habido recurrencia retroperitoneal ni diseminación a distancia. Discusión: La vía extraperitoneal es una alternativa de acceso para la disección linfática retroperitoneal en pacientes con cáncer testicular. Permite evitar potenciales lesiones intestinales y es factible de realizar en pacientes con cirugía abdominal previa. Objective: The aim is to describe the technique of extraperitoneal laparoscopic access for retroperitoneal lymph node dissection in a series of patients with testis cancer stage A. Material and Methods: The extraperitoneal approach was performed in 5 patients with stage A testicular cancer. The technique includes the creation of a totally extraperitoneal space, full exposition of the retroperitoneum and classic retroperito-neal lymph node dissection. We analyzed demographic data, histology, access and surgical complications, estimated blood loss and follow up. Results: The average age was 29.4 years old (22-41). The mean operative time was 144 minutes, with an estimated blood loss of 42.4 ml. There were no surgical complications. The average hospital stay was 33.6 hr, and mean number of lymph nodes was 27.4 (24 -32). In long-term follow up there was no recurrence. Discussion: The extraperitoneal approach is an alternative access for retroperitoneal lymph node dissection in testis cancer patients. It allows avoiding potential intestinal lesions and there is no contraindication in patients with prior abdominal surgery.
Cirugía robótica Robotic surgery
Octavio A Castillo C,Ivar Vidal M
Revista Chilena de Cirugía , 2012,
Abstract:
Bazo accesorio simulando tumor suprarrenal Aberrant spleen simulating an adrenal mass
Octavio A Castillo C,Pablo Pizzi L
Revista Chilena de Cirugía , 2013,
Abstract: Introducción: El diagnóstico de los así llamados "incidentalomas" suprarrenales, cada vez más frecuente en la práctica clínica, plantea un diagnóstico diferencial importante. Caso clínico: Se presenta el caso clínico de una paciente de 69 a os, hipertensa, con el hallazgo de una masa suprarrenal izquierda aparentemente funcionante, operada por vía laparoscópica y que resultó ser un bazo aberrante. Se discute el diagnóstico diferencial entre masa suprarrenal y pseudo-tumores adrenales y la embriología y presentación clínica del bazo aberrante. Introduction: The diagnosis of adrenal incidentalomas is common in current clinical practice. Clinical case: We report a 69 years-old female patient with hypertension, who underwent an abdominal CAT Scan, finding a left adrenal mass of 8 cm diameter. Subsequent studies showed elevated urinary metanephrine levels. With the suspicion of a pheochromocytoma, a laparoscopic surgery was performed. The mass resulted to be an aberrant spleen.
Lesión diafragmática durante la laparoscopia urológica transperitoneal
CASTILLO C,OCTAVIO A; VITAGLIANO,GONZALO; VIDAL M,IVAR;
Revista chilena de cirugía , 2010, DOI: 10.4067/S0718-40262010000300008
Abstract: introduction: capnothorax is a rare complication of urologic laparoscopy. however with the increasing use of this technique in a variety of urological procedures, this rare complication is a potential risk. material and methods: we analyzed a total of 786 urological procedures performed by transperitoneal laparoscopy in our center. all procedures were performed by the same surgeon: 213 adrenalectomy, 181 simple nephrec-tomies, 143 lymphadenectomies, 118 radical nephrectomies, 107 partial nephrectomies and 24 nephroure-terectomy. results: a total of 6 patients (0.7%) present diaphragmatic lesions. the diaphragmatic repair was performed totally intracorporeal. one patient required the placement of a pleural drainage. no patient presented complications associated with diaphragmatic injury. conclusion: repair of diaphragmatic injury during transperitoneal laparoscopy can be performed successfully by this route. this technique is feasible, reproducible and reliable. this is the largest series reported by a single center.
Cistectomía radical laparoscópica: técnica y resultados en 100 pacientes consecutivos Radical laparoscopic cystectomy: Experience in 100 patients
Octavio A Castillo C,Ivar Vidal-Mora
Revista Chilena de Cirugía , 2013,
Abstract: Objetivo: Presentar nuestra serie de cistectomía radical laparoscópica, su técnica, resultados y complicaciones. Material y Métodos: En un período de 10 a os, se efectuaron un total de 100 cistectomías lapa-roscópicas en forma consecutiva por un solo cirujano, cuya indicación fue por cáncer vesical. Se realizaron 57 cistoprostatectomías radicales, 22 exanteraciones anteriores, 14 cistectomías con preservación prostática y 7 cistectomías radicales. La derivación urinaria fue efectuada por vía extracorpórea en el 92% de los casos. Se analizan los resultados peri operatorios y a largo plazo obtenidos con esta técnica. Resultados: Los 100 procedimientos se completaron por vía laparoscópica sin conversión. La relación hombre mujer fue de 3:1. La edad promedio fue de 63 a os (29-83). El índice de masa corporal promedio (IMC) fue de 28 kg/m2 (20-47). La derivación urinaria empleada fue una Neovejiga ortotópica en 49 pacientes, Conducto ileal incontinente en 32, Reservorios urinario-continente tipo Indiana en 10 y Neovejiga recto-sigmoidea (Mainz II) intracorpórea en 9 pacientes. El tiempo operatorio promedio fue de 271 min (180-375) y el sangrado estimado promedio de 459 ml (50-1.500). Hubo 8 pacientes (11%) con complicaciones intra o peri operatorias. Hubo 7 complicaciones tardías (9%). El tiempo promedio de hospitalización fue de 8,8 días (4-28). Hubo un fallecido. El seguimiento promedio fue de 48 meses. Diez pacientes (13%) presentaron muerte por progresión de la enfermedad. Conclusión: Los resultados a mediano plazo son prometedores, se requiere de un seguimiento más prolongado para consolidar su validez oncológica. Background: Laparoscopic cystectomy is a less invasive alternative than traditional surgery. Aim: To report our experience with laparoscopic radical cystectomy, the technique, results and complications. Material and Methods: During a 10-year period, 100 consecutive laparoscopic cystectomies for bladder cancer were carried out. The procedures performed were 57 radical cystoprostatectomies, 27 pelvic exenterations, 14 cystectomies with prostate preservation and seven radical cystectomies. An extracorporeal urinary diversion was performed in 92% of cases. Results: The age of patients ranged from 29 to 83 years and the male/female ratio was 3:1. As urinary diversion, an orthotopic reservoir was used in 49 patients, and ileal conduit in 32, Indiana continent reservoir in 10 and intracorporeal Sigma-rectum pouch (Mainz pouch II) in 9 patients. All Mainz II pouches were constructed laparoscopically. Mean operative time and blood loss were 279 minutes
Lesión diafragmática durante la laparoscopia urológica transperitoneal Diaphragmatic injury during transperitoneal urological laparoscopic surgery
OCTAVIO A CASTILLO C,GONZALO VITAGLIANO,IVAR VIDAL M
Revista Chilena de Cirugía , 2010,
Abstract: Introducción: El capnotórax es una complicación infrecuente de la laparoscopía urológica. No obstante, con el uso cada vez mayor de esta técnica en una gran variedad de procedimientos urológicos, esta infrecuente complicación se presenta como un riesgo potencial. Material y Métodos: Se analizaron un total de 786 procedimientos urológicos realizados en forma laparoscópica por vía transperitoneal en nuestro centro. Todos los procedimientos fueron realizados por el mismo cirujano: 213 adrenalectomías, 181 nefrectomías simples, 143 linfadenectomías, 118 nefrectomías radicales, 107 nefrectomías parciales y 24 nefroureterectomías. Resultados: Un total de 6 pacientes (0,7%) presentaron lesiones diafragmáticas. La reparación diafragmática fue efectuada totalmente en forma intracorpórea. Un solo paciente requirió de la colocación de un drenaje pleural. Ningún paciente presentó complicaciones asociadas a la lesión diafragmática. Conclusión: La reparación de las lesiones diafragmáticas ocurridas durante la laparoscopía transperitoneal puede ser efectuada exitosamente por esta misma vía. Esta técnica es factible, reproducible y confiable. Esta es la serie más grande reportada por un solo centro. Introduction: Capnothorax is a rare complication of urologic laparoscopy. However with the increasing use of this technique in a variety of urological procedures, this rare complication is a potential risk. Material and Methods: We analyzed a total of 786 urological procedures performed by transperitoneal laparoscopy in our center. All procedures were performed by the same surgeon: 213 adrenalectomy, 181 simple nephrec-tomies, 143 lymphadenectomies, 118 radical nephrectomies, 107 partial nephrectomies and 24 nephroure-terectomy. Results: A total of 6 patients (0.7%) present diaphragmatic lesions. The diaphragmatic repair was performed totally intracorporeal. One patient required the placement of a pleural drainage. No patient presented complications associated with diaphragmatic injury. Conclusion: Repair of diaphragmatic injury during transperitoneal laparoscopy can be performed successfully by this route. This technique is feasible, reproducible and reliable. This is the largest series reported by a single center.
Pseudoaneurisma arteria renal postnefrectomía parcial: Tratamiento exitoso con embolización selectiva Renal artery pseudo aneurism after partial nephrectomy: Report of one case successfully treated with selective embolization
OCTAVIO CASTILLO C,JORGE DíAZ M,EDUARDO CAFFARENA A,MANUEL DíAZ C
Revista Chilena de Cirugía , 2006,
Abstract: La cirugía renal conservadora ha llegado a ser el estándar en el tratamiento de lesiones tumorales renales de menos de 4 cm. El pseudoaneurisma de la arteria renal es una complicación rara de la nefrectomía parcial, sin embargo puede ser un cuadro grave y de difícil diagnóstico si no se tiene un alto índice de sospecha. El manejo dependerá de las condiciones del paciente, pudiendo llegar incluso a la nefrectomía de necesidad. A continuación presentamos un caso clínico de pseudoaneurisma post nefrectomía parcial manejado en forma exitosa con embolización selectiva Renal artery pseudo aneurism is an uncommon, severe and difficult to diagnose complication of partial nephrectomy. We report a 72 years old male subjected to a partial left nephrectomy to excise a 6 cm. diameter tumor. The patient was discharged four days after surgery, but was admitted again due to persistent hematuria. An ultrasound showed a cystic lesion in the kidney and clots in the ureter. A selective renal angiography showed a 4 cm diameter pseudo aneurism of the renal artery and a high flow arteriovenous fistula. Afferent branches were embolized and the fistula was completely occluded. A double catheter was installed in the ureter to resolve a hydronephrosis and the patient was discharged without symptoms, four days after admission
Drenaje Percutáneo de Absceso Renal en Ni?os: Caso Clínico
CASTILLO C,OCTAVIO A; RUBIO L,GONZALO; VIDAL M,IVAR; PORTALIER F,PAULO;
Revista chilena de pediatría , 2010, DOI: 10.4067/S0370-41062010000200008
Abstract: introduction: renal abscesses in children are rare. percutaneous draining is a useful tool, frequently used among adults. the objective of this presentation is to present a pediatric case of a percutaneous-drained renal abscess. patients and methods: a 9 year old girl with a history of recurring acute left pyelonephritis was admitted for a new episode, which evolved into a 4.6 cm renal abscess, detected on a sonogram. antibiotic treatment was effective, resulting in clinical and image resolution. ten days post treatment, the abscess recurred, this time it was treated with an aspiration punction and antibiotics, with a good clinical response. follow up image showed resolution. again, followup showed a recurrence of the abscess. this time a percutaneous drain was utilized, with complete clinical and image resolution. various therapeutic alternatives, and the use of drains in children are discussed.
Nefrectomía simple por puerto único (LESS) asistida por robot (da Vinci)
CASTILLO C,OCTAVIO A; VIDAL M,IVAR; SEPúLVEDA T,FRANCISCO;
Revista chilena de cirugía , 2011, DOI: 10.4067/S0718-40262011000500011
Abstract: introduction: minimally invasive surgery in urology is rapidly advancing and laparo-endoscopic single-site surgery (less) is not the exception. such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. the benefit of the da vinci surgical system has recently introduced to less. we present two cases of robotic less nephrectomy. matherials and methods: two patients, a female of 23 years old, diagnosed with right renal atrophy secondary to chronic pyelonephritis and one male patient with diagnosis of left staghorn calculi and renal atrophy. both underwent to a total nephrectomy assisted by the da vinci s surgical system through a single port incision using the gelpoint? access system. results: the first surgery was performed without incidents or conversion. the second patient required the installation of an additional robotic port for triangulation. the dock time and the mean operative time was 18 and 110 min. the mean estimated blood loss was 100 cc and the hospital stay was 27 hours. there were no complications. conclusions: less robotic surgery is feasible using current robotic systems. however, there are several limitations. the design of specific technology for the use of the robot through single incision can solve this problem.
Ureteroscopia flexible: Experiencia inicial
CASTILLO C,OCTAVIO A; FONERON V,ALEJANDRO; SEPúLVEDA T,FRANCISCO;
Revista chilena de cirugía , 2011, DOI: 10.4067/S0718-40262011000100012
Abstract: background: flexible ureteroscopy is an increasingly used diagnostic and therapeutic tool for the upper urinary tract. aim: to report our experience with flexible ureteroscopy. material and methods: analysis of 13 procedures performed to seven males and 6 women aged 30 to 72 years. results: the indications for flexible ureteroscopy were urinary lithiasis in six patients, a filling defect found in a cat scan in five, proximal displacement of a double j catheter in one patient and unilateral hematuria in one patient. lithiasis was managed with extracorporeal lithotripsy using a holmium laser. biopsies were obtained from the sites with filling defects; the catheter was extracted using a dormia basket. in the patient with hematuria, a hemangioma was found and managed with laser excision. no complications were registered. conclusions: flexible ureteroscopy is safe and effective.
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