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    "titulo" => "Video-assisted Thoracoscopic Sympathectomy for the Treatment of Facial Blushing&#58; Ultrasonic Scalpel Versus Diathermy"
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            0 => "Facial blushing"
            1 => "Video-assisted thoracoscopic sympathectomy and sympatholysis"
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            0 => "Rubor facial"
            1 => "Simpaticotom&#237;a y simpatic&#243;lisis tor&#225;cica por videotoracoscopia"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate the advantages of the ultrasonic scalpel compared to electrocoagulation in patients undergoing video-assisted thoracoscopic sympatholysis or sympathectomy for uncontrolled facial blushing&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Two hundred bilateral video-assisted thoracoscopic procedures to interrupt transmission in the thoracic sympathetic nerve were performed in 100 patients with incapacitating facial blushing&#46; In 2 cases&#44; the video-assisted approach was chosen because of pleural symphysis&#46; The mean age of patients was 34 years &#40;range&#58; 15 to 67&#41;&#46; The sympathetic chain was interrupted from the lower portion of the first thoracic ganglion through the third&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">All patients were discharged within 24 hours with the exception of one on whom an emergency thoracotomy had been performed&#46; No complications were reported in the group in which a harmonic scalpel was used&#46; One case of temporary Horner syndrome &#40;4 months&#41; and 3 cases of persistent chest pain &#40;more than 2 weeks&#41; were reported in the diathermy group&#46; There were 9 cases of partial and asymptomatic pneumothorax that resolved without treatment or prolonged hospital stays&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">Dissection of the sympathetic nerve is accomplished more reliably and with better visualization with the ultrasonic scalpel&#46; Peripheral lesions in lung parenchyma and adjacent tissues &#40;intercostal vessels and nerves&#41; are avoided&#44; as is Horner syndrome&#44; which can be caused by dispersion of heat&#46; Use of the ultrasonic scalpel would also lead to a lower incidence of postoperative neuralgia&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar las ventajas de la utilizaci&#243;n del bistur&#237; ultras&#243;nico frente a la electrocoagulaci&#243;n&#44; en los pacientes operados de rubor facial incontrolable mediante simpatic&#243;lisis o simpaticotom&#237;a tor&#225;cica por videotoracoscopia&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se han realizado 200 interrupciones del simp&#225;tico tor&#225;cico bilaterales por videotoracoscopia en 100 pacientes afectados de rubor facial invalidante&#46; Dos de ellas se realizaron mediante cirug&#237;a videoasistida por presentar s&#237;nfisis pleural&#46; La edad media de los pacientes fue de 34 a&#241;os &#40;rango&#58; 15-67&#41;&#46; La cadena simp&#225;tica fue interrumpida desde la porci&#243;n inferior de T1 hasta T3 inclusives&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes fueron dados de alta en 24 h&#44; a excepci&#243;n del paciente en el que se realiz&#243; toracotom&#237;a de asistencia&#46; En el grupo en que se utiliz&#243; el bistur&#237; arm&#243;nico no hubo complicaciones&#46; En el grupo de diatermia hubo un caso de s&#237;ndrome de Horner transitorio &#40;4 meses&#41; y tres casos de dolor tor&#225;cico persistente &#40;superior a dos semanas&#41;&#46; En total&#44; hubo 9 neumot&#243;rax parcelarios y asintom&#225;ticos que no requirieron tratamiento ni prolongaron la estancia hospitalaria&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">El bistur&#237; ultras&#243;nico permite una secci&#243;n del simp&#225;tico m&#225;s firme y con mejor visualizaci&#243;n&#46; Evita lesiones perif&#233;ricas en el par&#233;nquima pulmonar y tejidos adyacentes &#40;vasos y nervios intercostales&#41;&#44; as&#237; como el s&#237;ndrome de Horner que se puede producir por efecto calor&#237;fico&#46; Producir&#237;a tambi&#233;n una menor incidencia de neuralgias posquir&#250;rgicas&#46;</p>"
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