Revisiones_bibliográficas TyO

viernes, 10 de marzo de 2017

Resección de Hemivertebra con fusión instrumentada con abordaje posterior en niños

http://www.columnavertebralpediatricaygeriatrica.com.mx/academia/reseccion-de-hemivertebra-con-fusion-instrumentada-con-abordaje-posterior-en-ninos/

Hemivertebra Resection With Instrumented Fusion by Posterior Approach in Children

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27927556

http://www.sciencedirect.com/science/article/pii/S2212134X1500115X

De:

Piantoni L1,Francheri Wilson IA2,Tello CA2,Noel MA2,Galaretto E2,

Remondino RG2,Bersusky ES2.

Spine Deform.

2015 Nov;3(6):541-548. doi: 10.1016/j.jspd.2015.04.008. Epub 2015 Oct 28.

We conducted a retrospective study of patients with congenital scoliosis due to hemivertebra (HV) and performed resection with instrumentation through posterior approach-only with long term follow-up.

OBJECTIVES:

The objective of this study was to assess results of HV resection by posterior approach-only with instrumentation between 2002 and 2011.

SUMMARY AND BACKGROUND DATA:

Hemiepiphysiodesis, arthrodesis in situ and resection without instrumentation had been performed in the past with different results. Hemivertebra resection with spinal instrumentation through anterior and posteriorapproach has been advocated as the treatment of choice.

CONCLUSIONS:

We concluded that HV resection by posterior approach-only with instrumentation is a simple, secure, reliable, less invasive and well tolerated technique that can successfully resolve this kind of congenital scoliosis in children.

KEYWORDS:

Congenital scoliosis; Early-onset scoliosis; Hemivertebra resection; Pediatric spine surgery; Vertebrae malformation

PMID: 27927556 DOI:

10.1016/j.jspd.2015.04.008

Resumen

DISEÑO DEL ESTUDIO:
Se realizó un estudio retrospectivo de pacientes con escoliosis congénita por hemivertebra (HV) y se realizó resección con instrumentación mediante abordaje posterior, sólo con seguimiento a largo plazo.

OBJETIVOS:
El objetivo de este estudio fue evaluar los resultados de la resección de HV por vía posterior, sólo con instrumentación entre 2002 y 2011.

RESUMEN Y ANTECEDEN:
hemiepifisiodesis, artrodesis in situ y resección sin instrumentación se había realizado en el pasado con diferentes resultados. La resección de Hemivertebra con instrumentación de columna mediante el abordaje anterior y posterior se ha defendido como el tratamiento de elección.

CONCLUSIONES:
Llegamos a la conclusión de que la resección HV por vía posterior-sólo con la instrumentación es una técnica simple, segura, fiable, menos invasiva y bien tolerada que puede resolver con éxito este tipo de escoliosis congénita en los niños.
Copyright © 2015 Sociedad de Investigación de Escoliosis. Publicado por Elsevier Inc. Todos los derechos reservados.

PALABRAS CLAVE:
Escoliosis congénita; Escoliosis de inicio temprano; Resección de Hemivertebra; Cirugía de columna vertebral pediátrica; Malformación de las vértebras

PMID: 27927556 DOI: 10.1016 / j.jspd.2015.04.008

#Escoliosis congénita #Resección de Hemivertebra #Malformación de las vértebras #niños

Transplante con riñon marginal / Transplantation with marginal kidney

Marzo 9, 2017. No. 2623

¿Es un abuelo de 87 años de edad demasiado marginal para ser un donante de riñón? La visión de los anestesiólogos

Is an 87-Year-Old Grandfather Too Marginal for Being a Kidney Donor? The View of Anesthesiologists.

Kesimci E1, Erkilic E1, Kilinc I2, Kilic M3.

J Clin Med Res. 2016 Sep;8(9):680-2. doi: 10.14740/jocmr2629w. Epub 2016 Jul 30.

Abstract

Living kidney donation has been accepted increasingly as a result of growth in the number of end-stage renal disease patients awaiting organ. In this aspect using grafts from marginal donors such as with advanced age is increasing in worldwide practice and also in Turkey. Therefore, anesthetic management of donors is particularly important. We herein report the anesthetic management of an 87-year-old grandfather donating his kidney to her granddaughter and review the current anesthetic strategies in a geriatric patient.

KEYWORDS: Anesthesia; Elderly donor; Geriatrics; Kidney; Transplantation

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¿Cuándo es Justificable el Trasplante con un "Riñón Marginal"?

When is Transplantation with a "Marginal Kidney" Justifiable?

Rouchi AH1, Mahdavi-Mazdeh M1.

Ann Transplant. 2016 Jul 26;21:463-8.

Abstract

The ability of kidney transplantation to improve quality of life has made this therapeutic modality the treatment of choice among renal replacement therapies; however, the continuing organ shortage has forced the use of marginal kidneys as a supplementary source of allografts. It has been repeatedly suggested that failed kidney transplant recipients have greater morbidity and mortality compared with dialysis patients with no renal transplant history. Achieving an optimal balance between the advantages of kidney transplant and disadvantages of allografts with marginal quality is a topic of controversy in transplant medicine. The major and potentially life-threatening complications of immunosuppressive therapies and shorter lifespan following graft failure necessitate a reappraisal of kidney transplant programs from expanded-criteria deceased donors, which can neither necessarily give dialysis patients a better quality of life nor a significant survival benefit, especially in settings with additional diminished graft survival due to HLA-mismatch. It should be offered just to those with short life expectancy and with HLA-matching. The last item is very important in countries without mandatory HLA-matching protocols for kidney transplantation programs.

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