Papers by Patricio Herrera
Revista chilena de pediatría, Apr 22, 2020
Objetivo: Describir dos casos de lipoblastoma mediastínico, patología de baja incidencia y poco c... more Objetivo: Describir dos casos de lipoblastoma mediastínico, patología de baja incidencia y poco conocida, siendo aún más infrecuente en mediastino, sin haber reportes descritos en nuestro país. Casos Clínicos: 2 pacientes, ambos de sexo masculino, menores de 3 años, en los que se encontró como hallazgo incidental una masa mediastínica en una radiografía de tórax. El estudio se complementó con una tomografía computada y en uno de los pacientes con una biopsia toracoscópica. En ambos se logró extirpación completa de la lesión vía toracotomía, siendo apoyado vía toracoscópica previa a la extracción de la lesión en uno de ellos. Uno de los pacientes evolucionó con Síndrome de Claude Bernard Horner el cual resolvió de manera espontánea luego de dos años y el segundo caso no presentó complicaciones. Conclusiones: el lipoblastoma mediastínico es una patología muy poco frecuente, las descripciones de la literatura se asemejan a los casos expuestos en este artículo, concluyendo que presentan un patrón muy similar entre ellos. Teniendo un pronóstico favorable si se logra la resección completa y siendo fundamental diferenciarlo de sus diagnósticos diferenciales para descartar malignidad.
Journal of Pediatric Surgery
Pediatric surgery international, 2007
Congenital tracheal stenosis (CTS) is an uncommon condition that has challenged pediatric surgeon... more Congenital tracheal stenosis (CTS) is an uncommon condition that has challenged pediatric surgeons for decades. Patients with CTS can present with a wide spectrum of symptoms and varying degrees of severity. In addition, a variety of techniques have been devised to repair this malformation. A review of these procedures and our suggestions for clinical standards and practice guidelines will be presented in this paper. A retrospective review of the literature on CTS from 1964 to 31 March, 2006. There is not one standard technique for the repair of CTS, as individualized approach to each patient and airway lesion is necessary to optimize patient management; nevertheless there is a consensus about segmental resection and anastomosis being best for short segment stenosis while slide tracheoplasty is most effective for the long-segment ones. Conservative management is also an option for select group of patients with careful and close follow up. Survival following surgery over the years ha...
Medwave, 2009
Este texto completo es la transcripción editada y revisada de una conferencia dictada en el marco... more Este texto completo es la transcripción editada y revisada de una conferencia dictada en el marco de las reuniones clínicas de la Unidad General de Cuidados del Niño del Hospital Padre Hurtado. La publicación de estas actas científicas ha sido posible gracias a una colaboración editorial entre Medwave y la Unidad. El jefe de la UGCN es el Dr. Alejandro Donoso y el Encargado de las Reuniones Clínicas es el Dr. Mario Vildoso.
Pediatric Emergency Care, 2009
The ingestion or accidental insertion of foreign bodies is extremely rare before 6 months of age.... more The ingestion or accidental insertion of foreign bodies is extremely rare before 6 months of age. We report the case of a 3-month-old infant with a sewing needle into the right hepatic lobe, without symptoms. The extraction was performed through laparotomy. The issue is revisited, and the decision making tree is discussed.
Journal of Pediatric Surgery, 2007
The purpose of the study was to compare the outcomes in children undergoing thoracoscopic versus ... more The purpose of the study was to compare the outcomes in children undergoing thoracoscopic versus open resection of congenital lung lesions. Methods: Retrospective review of 12 consecutive children (b3 years of age) undergoing thoracoscopic resection of a congenital lung lesion between 2004 and 2005 was performed. Intraoperative and early postoperative results were compared with randomly selected age-and sex-matched (2:1) patients undergoing thoracotomy between 2000 and 2005. Results: Twelve children underwent thoracoscopic resection and were compared with 24 that underwent thoracotomy. Seventy five percent of the lesions in both groups were congenital cystic adenomatoid malformations. There were no major intraoperative complications. Two thoracoscopic procedures were converted to a thoracotomy. Perioperative outcomes including operative time, length of stay, duration and volume of chest tube drainage, and dose and duration of intravenous opioids were similar for the procedures. However, children undergoing thoracoscopic procedures were less likely (odds ratio = 0.07) to have received adjunctive regional anesthesia. Overall morbidity was 33% thoracoscopic and 25% open (P = .70). Conclusion: Thoracoscopic resection is a safe and feasible alternative to open resection of congenital lung lesions. Examination of long-term advantages of the thoracoscopic approach such as decreased risk of chest wall deformity and scoliosis and improved cosmesis will require longer follow-up.
Journal of Pediatric Surgery, 2003
The percutaneous endoscopic gastrostomy (PEG) is contested on the ground that it could cause gast... more The percutaneous endoscopic gastrostomy (PEG) is contested on the ground that it could cause gastroesophageal reflux (GER). The authors studied the complications of PEG to ponder the validity of this contraindication. Methods: The authors followed up with a group of 81 patients subjected to PEG to assess their complications, GER in particular. Results: In half of the patients, PEG was performed under deep sedation in the intensive care unit and the other half under general anesthesia. The procedure lasted about 12 minutes in both subgroups. Early complications were not observed. Late complications relating to the care of the tube were similar to those reported for other techniques. GER appeared in 8%, but surgical treatment was unnecessary, whereas in patients that presented GER before surgery, it subsided in 38%. A colocutaneous fistula observed in one patient was a consequence of previous interventions. Conclusions: PEG is minimally invasive, general anesthesia may be avoided, the procedure is rapid, major complications are conspicuously absent, and the incidence of GER is smaller than that associated with alternative techniques. In addition, the cost is low. The authors consider PEG the technique of choice because it has important advantages compared with open or laparoscopic techniques.
The Annals of Thoracic Surgery, 2008
We describe a case of "topsy-turvy heart" that necessitated simultaneous left tracheobronchial re... more We describe a case of "topsy-turvy heart" that necessitated simultaneous left tracheobronchial repair, aortic arch reconstruction, and bronchial stenting in an 11month-old girl. This case highlights the significant therapeutic dilemmas clinicians are faced with when dealing with conditions having an unknown natural history and unpredictable surgical outcomes, and reinforces the need for these patients to be managed by a multidisciplinary team approach.
Revista chilena de pediatría, 1996
Tc contribute to the idenllocation of children with unary tract infection |UT.] at increased risk... more Tc contribute to the idenllocation of children with unary tract infection |UT.] at increased risk of -ecurrences or abnormal f : ndings at imcge workup sljdies (ccrnp'ications;, associations oeKveen these and red blood cells markers erithrocyle I.ABO, MNSs. Rh, Lewis, PI) distribution were studied ir 309 childrer with LJTI. Ko associations were found between cny particular pC'lynorfism and complications, except for PI blood merger with E. coli i-fection (OR = 3.07; 1C 95% ~ 1 .1 3 a 8.6; p < 0 02) and the absence of other than E. coli agents in B positive patients [0/26). Aosence of "on t. coli isolations in phenotype B salients with UT, allhojgn net stct'stically significant, might sugest indepence-t and additive influence or B and PI on de'errnining the increased risk, as it has ceen shown fo r other markers in LJTI. This associct'on seems biologically plausible, since both phenotypes have aeen separctely rented to LJTI through uroepithelial coherence phenotypcal specificity.
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Papers by Patricio Herrera