Browsing by Author "Santolaya, Raimundo"

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    Casos Clínicos Endometriosis diafragmática: a propósito de un caso
    (Sociedad Chilena de Obstetricia y Ginecología, 2016) Berrios, Raul; Bulboa, Constanza; Santolaya, Raimundo; Undurraga, Pedro; Perez, Pablo; Sandoval, Cesar
    Background: Endometriosis affects between 5 to 15% of women of reproductive age. Thoracic presentation entity is infrequent (less than 1% of all cases of endometriosis) and may be located in airway parenchyma, pleura or diaphragm. Its clinical manifestations usually occur within the first 72 hours of onset of menstruation and include chest pain, pneumothorax or hemoptysis. Better management consists of hormonal suppression and surgical management in refractory cases. Objective: To describe a case of diaphragmatic endometriosis, successfully treated by video-assisted thoracoscopic surgery (VATS). Case report: Woman of 27 years old, with a history of ovarian endometriosis operated by electrofulguration two years before. She present right omalgia and a history of pelvic endometriosis. Chest CT report a solid, ovoid formation, 30 mm x 13 mm, which captures contrast partially, located in the right sub diaphragmatic region. Image is interpreted as a possible focus of endometriosis, it is complemented by RNM that is consistent with the diagnosis. It is performed VATS right with diaphragmatic resection and primary repair. Pathology reports endometriosis with negative margins. The pleurostomy is removed after 48 hours, she was discharged after three days. A one year follow up, it is asymptomatic and without evidence of recurrence. Conclusion: Despite its low frequency, the thoracic endometriosis represents an important commitment to the quality of life. Cases with chest complications, and with fair or poor response to hormone therapy, benefit with minimally invasive surgical resolution.
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    Manejo conservador en múltiples heridas torácicas por bala
    (2013) Parra, Marcelo; Ortega, José; Berríos, Raúl; Santolaya, Raimundo; Schwember, Philipp
    El manejo conservador es una opción para los traumatismos torácicos por bala. Un seguimiento estricto es necesario, ya que algunas veces el manejo conservador falla. El Angio-TC de Tórax es una herramienta rápida y sensible, necesaria para realizar un manejo conservador en estos pacientes
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    Minimally invasive management of traumatic lung herniation
    (Oxford University Press, 2017) Pérez, Pablo; Undurraga, Felipe; Santolaya, Raimundo; Berrios, Raul; Rivera, Francisco
    Post-traumatic pulmonary hernia can occur immediately after thoracic trauma or it may also appear months or even years after the onset. We report a case of a seventeen year-old male patient with thoracic blunt trauma secondary to high energy bicycle accident. Chest CT shows moderate hemothorax and pneumothorax, displaced fracture of the fifth left rib, and protusion of pulmonary tissue through a chest wall defect. In the Emergency Room the patient presents with chest pain (7/10 in Visual Analog Scale) and respiratory distress. Video-assisted thoracic surgery approach was chosen. Hernia reduction, non-anatomic lingular resection and rib fracture external fixation using a titanium plate was performed. Traumatic pulmonary hernia is an uncommon complication of thoracic trauma which may constitute an emergency for the trauma or thoracic surgeon. The early management of this injury can be developed by minimally invasive approach with excellent results.
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    Regionalización de la cirugía oncológica torácica en Chile
    (2021) Santolaya, Raimundo; Berríos S., Raúl; Ortega S., José; Zink R., Manfred; Pérez Castro, Pablo
    La patología oncológica representa la segunda causa de muerte en Chile. Si bien se han realizado importantes avances como las garantías explicitas de salud para 17 patologías malignas, la Ley Ricarte Soto para enfermedades de alto costo y la Ley del Cáncer Dr. Claudio Mora, aun existen importantes diferencias de sobrevida basados en estrato socioeconómico y desgraciadamente no existen datos nacionales sobre diferencias en resultados clínicos entre centros de alto y bajo volumen. Para avanzar en un cuidado de pacientes con cáncer que permita a la población de Chile recibir una buena atención y optar a los mejores resultados oncológicos posibles, se hace necesario concentrar la experiencia en cáncer en un grupo mas reducido de centros regionales que puedan concentrar recursos y experiencia.
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    Resección traqueal y anastomosis primaria en traumatismo traqueo esofágico por arma de fuego
    (Sociedad de Cirujanos de Chile, 2013) Parra, Marcelo; Ortega, José; Berríos, Raúl; Santolaya, Raimundo; Santa María, Ángela
    Introduction: Even though tracheoesophagueal lesions due to cervicothoracic gunshot wound are infrecuent, they should always be considered in a lesion of this kind, based on the proximity of the structures in this area, as well as the rapid compromise and deterioration that can develop these patients if the air way or vascular structures are damaged. Clinical case: We present a patient with a tracheoesophageal gunshot trauma and the surgical repair.
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    Seguridad de equipos de procuramiento de órganos y tejidos en Chile. ¿Qué esperamos?
    (2024) Pérez, Pablo; Casanova. Carlos; Muñoz, Delia; Ortega Sepúlveda, José Ignacio; Antunez Riveros, Miguel; Santolaya, Raimundo
    La tasa de trasplantes en Chile es baja en comparación con otros países. Si bien se han hecho importantes avances para aumentar este número, existe poca claridad en cuanto a protocolos de seguridad de los equipos de procuramiento de órganos. A nivel internacional existen diferentes tragedias que han marcado este trabajo, la más conocida es la ocurrida en Michigan, donde un equipo médico perdió la vida al caer sobre el lago en un transporte por un trasplante de pulmón. Años después de la tragedia se conocieron los reiterados reclamos por parte del personal médico en relación a la falta de seguridad durante los traslados. Si bien el procuramiento de órganos tiene un riesgo asociado inherente, este se debe mantener al mínimo. Para avanzar en esto se confeccionó una guía de seguridad donde participaron las organizaciones de trasplante más importantes de Estados Unidos. Se emitieron recomendaciones, donde se regula el transporte aéreo, terrestre, seguros y el futuro de esta actividad. En Chile la orientación técnica que regula el procuramiento, no especifica ninguno de estos puntos y no existe información pública disponible, dejando la seguridad a disposición de las instituciones locales. Si bien es importante reconocer el esfuerzo nacional por mejorar el número de trasplantes año a año, es necesario avanzar en mejorar la seguridad de los equipos de procuramiento, y no esperar que ocurra una tragedia, para generar cambios necesarios, particularmente en un país con una geografía desafiante como Chile. The transplant rate in Chile is low compared to other countries. Although significant advances have been made to increase this number, there is little clarity regarding safety protocols for organ procurement teams. Internationally, various tragedies have marked this work, the most famous being the one that occurred in Michigan, where a medical team lost their lives when they crashed into a lake during transport for a lung transplant. Years after the tragedy, repeated complaints by medical personnel came to light concerning the lack of safety during transfers. Although organ procurement inherently carries associated risks, these should be kept to a minimum. In 2020, a safety guide was created to make progress with participation from the most crucial transplant organizations in the United States. Recommendations were issued regulating air and ground transportation, insurance, and the future of transplant activity. In Chile, technical guidelines that regulate procurement need to specify crucial safety metrics, and there is no publicly available information or recommendations, leaving safety to the discretion of local institutions. While it is essential to recognize the national effort to improve the number of transplants year after year, it is necessary to advance in improving the safety of procurement teams and not wait for a tragedy to occur to generate the required changes, particularly in a country with challenging geography like Chile

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