Browsing by Author "Zuniga, Alvaro"

Now showing 1 - 7 of 7
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    A novel surgical approach to slow-transit constipation: Report of two cases
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Pinedo, George; Leon, Francisca; Molina, Maria Elena; Soto, Gonzalo; Lopez, Francisco; Zuniga, Alvaro
    INTRODUCTION: Slow-transit constipation after proper diagnosis and extensive medical therapy may have a surgical solution. Total abdominal colectomy and ileorectal anastomosis, at our institution, is the surgical procedure of choice. Nonetheless, patients may reject this alternative because of morbidity.
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    Benefit of adjuvant 5-fluorouracil based chemotherapy for colon cancer: a retrospective cohort study
    (SOC MEDICA SANTIAGO, 2016) Mondaca, Sebastian; Villalon, Constanza; Luis Leal, Jose; Zuniga, Alvaro; Bellolio, Felipe; Padilla, Oslando; Palma, Silvia; Garrido, Marcelo; Nervi, Bruno
    Background: Multiple clinical trials have demonstrated the benefits of adjuvant 5-fluorouracil-based chemotherapy for patients with resectable colon cancer (CC), especially in stage III. Aim: To describe the clinical characteristics of a cohort of CC patients treated at a single university hospital in Chile since 2002, and to investigate if chemotherapy had an effect on survival rates. Material and Methods: Review of a tumor registry of the hospital. Medical records of patients with CC treated between 2002 and 2012 were reviewed. Death certificates from the National Identification Service were used to determine mortality. Overall survival was described using the Kaplan-Meier method. A multivariate Cox proportional hazard regression model was also used. Results: A total of 370 patients were treated during the study period (202 in stage II and 168 in stage III). Adjuvant chemotherapy was administered to 22 and 70% of patients in stage II and III respectively. The median follow-up period was 4.6 years. The 5-year survival rate for stage II patients was 79% and there was no benefit observed with adjuvant chemotherapy. For stage III patients, the 5-year survival rate was 81% for patients who received adjuvant chemotherapy, compared to 56% for those who did not receive chemotherapy (hazard ratio (HR): 0.29; 95% confidence interval (CI): 0.15-0.56). The benefit of chemotherapy was found to persist after adjustment for other prognostic variables (HR: 0.47; 95% CI: 0.23-0.94). Conclusions: Patients with colon cancer in stage III who received adjuvant chemotherapy had a better overall survival.
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    Clinical Presentation and Perioperative Management of Pheochromocytomas and Paragangliomas: A 4-Decade Experience
    (ENDOCRINE SOC, 2021) Uslar, Thomas; San Francisco, Ignacio F.; Olmos, Roberto; Macchiavelo, Stefano; Zuniga, Alvaro; Rojas, Pablo; Garrido, Marcelo; Huete, Alvaro; Mendez, Gonzalo P.; Cortinez, Ignacio; Zemelman, Jose Tomas; Cifuentes, Joaquin; Castro, Fernando; Olivari, Daniela; Dominguez, Jose Miguel; Arteaga, Eugenio; Fardella, Carlos E.; Valdes, Gloria; Tagle, Rodrigo; Baudrand, Rene
    Purpose: Latin American reports on pheochromocytomas and paragangliomas (PPGLs) are scarce. Recent studies demonstrate changes in clinical presentation and management of these patients. Herein, we assessed the main characteristics of PPGL patients in our academic center over the past 4 decades.
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    Diagnóstico y manejo de colitis ulcerosa grave. Una mirada actualizada
    (2017) Hernandez Rocha, Cristian; Ibanez, Patricio; Elena Molina, Maria; Klaassen, Julieta; Valenzuela, Andrea; Candia, Roberto; Bellolio, Felipe; Zuniga, Alvaro; Miguieles, Rodrigo; Francisco Miquel, Juan; Chianale, Jose; Alvarez Lobos, Manuel
    Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.
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    Insuficiencia intestinal secundaria a síndrome de intestino corto : resultados de un programa multidisciplinario de rehabilitación intestinal
    (2016) Elena Molina, Maria; Bellolio, Felipe; Klaassen, Julieta; Gomez, Javier; Villalon, Constanza; Francisco Guerra, Juan; Zuniga, Alvaro
    Background: In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. Aim: To report the results of our program in patients suffering intestinal failure. Patients and Methods: A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed. Initial work up included prior intestinal surgery, blood tests, endoscopic and imaging studies. Also demographic data, medical and surgical management as well as clinical follow-up, were registered. Results: Data from 14 consecutive patients aged 26 to 84 years (13 women) was reviewed. Mean length of remnant small bowel was 100 cm and they were on parenteral nutrition for a median of eight months. Seven of 14 patients had short bowel secondary to mesenteric vascular events (embolism/thrombosis). Medical management and autologous reconstruction of the bowel included jejuno-colic anastomosis in six, enterorraphies in three, entero-rectal anastomosis in two, lengthening procedures in two, ileo-colic anastomosis in one and reversal Roux-Y gastric bypass in one. Thirteen of 14 patients were weaned off parenteral nutrition. Conclusions: Our Multidisciplinary Intestinal Rehabilitation Program, allowed weaning most of the studied patients off parenteral nutrition.
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    Long-term survival in carcionoid tumour of the appendix. An analysis of 8903 appendectomies
    (ELSEVIER DOYMA SL, 2009) Michel Butte, Jean; Angelica Garcia Huidobro, Maria; Torres, Javiera; Duarte, Ignacio; Zuniga, Alvaro; Llanos, Osvaldo
    Introduction: Appendiceal carcinoids are the most frequent tumors of the appendix and are usually detected as an incidental finding in the final pathology report. The aim of this study was to evaluate the clinical and pathological characteristics, surgical treatment and long-term survival in patients with an appendiceal carcinoid tumor.
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    The Volume of Lactated Ringer's Solution Required to Maintain Preload and Cardiac Index During Open and Laparoscopic Surgery
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Concha, Mario R.; Mertz, Veronica F.; Cortinez, Luis I.; Gonzalez, Katya A.; Butte, Jean M.; Lopez, Francisco; Pinedo, George; Zuniga, Alvaro
    BACKGROUND: Recent studies have emphasized the importance of perioperative fluid restriction. However, fluid restriction regimens may increase the likelihood of insufficient perioperative fluid administration or may result in excess intravascular crystalloid replacement. We postulate that the use of transesophageal echocardiography may reduce the amount of crystalloid administered during open and laparoscopic colorectal surgery.