Padilla L, Tapia-Jurado J, Goldberg J, Landero T, Carranza P, Di Silvio N

Language: Spanish
References: 19
Page: 196-202
PDF size: 121.30 Kb.

ABSTRACT

We describe 30 years of clinical, training and research activities in two Microsurgery Units. The Experimental Surgery Service of the National Medical Center “20 de Noviembre” from the ISSSTE (Mexican Health and Welfare Institute for government employees) and the Department of Surgery of the School of Medicine, UNAM (National Autonomous University of Mexico), both located in Mexico City, participating in 121 clinical cases resolved with microsurgical techniques in seven different specialties.
At the ISSSTE, from 1977 to 2007, 104 courses on “Vascular Microsurgery” have been given and 453 surgeons and residents have been trained in surgical techniques. At the UNAM, from 1984 to 2007, 364 students have been trained in 67 courses.
Since 1979, we have experimentally studied vascular microprostheses of biological or synthetic origin of 1 to 2 mm in diameter in substitution of aorta and cava vein segments in rats, giving rise to six publications. Since 1996, we have been studying the “angiogenesis” phenomenon as treatment for lower extremities with critical ischemia. Based on previous studies, the Ethics and Research Committee of the ISSSTE-Medical Center approved a research protocol in patients with that pathology, accumulating, until this date, 26 extremities with bone marrow-derived stem cells, applied through intramuscular injection and through distal venous route at the level of the saphenous vein. From 2004 to 2009, five extremities have been amputated and 21 have been saved; the results of the study are being evaluated for publication.
Hospitals with programs for the training of residents in surgical specialties must have a laboratory of microsurgery for the basic and continuous training and for the design of research protocols, to be able to offer solutions to the patients with microsurgical techniques.

REFERENCES

1. Lee SH, Fisher B. Portocaval shunt in the rat. Surgery 1961; 50: 668-672.

2. Padilla SL, Valle GA. Manual de microcirugía. Editorial Salvat. México, 1983.

3. Padilla SL, Valle GA, Sánchez CR. Trasplante en ratas de arterias bovinas pretratadas con enzimas proteolíticas Arch Inst Cardiol Méx 1983; 53: 91-98.

4. Padilla L, Sastre N, Chousleb A, Di Silvio M, Contreras M, Manzano B, et al. Polytetrafluoroethylene microprosthesis in the venous system of the rat. J Reconstr Microsurg 1987; 3: 159-163.

5. Padilla L, Valle A, Carrillo H, Di Silvio M, Contreras M, Viniegra F, et al. Polytetrafluoroethylene microprosthesis in the arterial system of the rat. J Reconstr Microsurg 1987; 4: 33-37.

6. Padilla SL, Chousleb KA, Di Silvio LM, Viniegra RF, Shultze RA, Sánchez CR, et al. Injertos vasculares biológicos para microcirugía. Rev Fac Med UNAM 1990; 33: 11-18.

7. Padilla SL, Chousleb KA, Rocha HG, Di Silvio LM, Viniegra RF, Vázquez CJ, et al. Microprótesis de politetrafluoroetileno de pared delgada. Rev Méx Angiol 1991; 19: 14-19.

8. Padilla SL, Carrillo-Soto IA, García GMV, Valdés GR. Angiogénesis inducida por túneles fibrocolágenos. Cir Gen 1996; 18: 123-128.

9. Pu LQ, Arekat Z, Brassard R, Symes JF. Demonstration of significantly enhanced neovascularitization by angiogenic stimulation in the ischemic limb. Surg Forum 1992; 43: 368-370.

10. Baffour R, Berman J, Garb JL, Rhee SW, Kaufman J, Friedman P. Enhanced angiogenesis and growth of collaterals by in vivo administration of recombinant basic fibroblast growth factor in a rabbit model of acute lower limb ischemia: dose-response effect of basic fibroblast growth factor. J Vasc Surg 1992; 16: 181-191.

11. Bauters C, Asahara T, Zheng LP, Takeshita S, Bunting S, Ferrara N, et al. Site-specific therapeutic angiogenesis after systemic administration of vascular endothelial growth factor. J Vasc Surg 1995; 21: 314-25.

12. Jackson CJ, Giles I, Knop A, Nethery A, Schrieber L. Sulfated polysaccharides are required for collagen. Induced vascular formation. Exp Cell Res 1994; 215: 294-302.

13. Padilla SL, Figueroa BS, De León D, Carrillo SI, King-MAC, Schalch LP, et al. Angiogénesis inducida por colágena polivinilpirrolidona y heparina en el músculo isquémico. Cir Cir 1999; 67: 59-65.

14. Asahara T, Murohara T, Sullivan A, Silver M, van der Zee R, Li T, et al. Isolation of putative. Progenitor endothelial cells for angiogenesis. Science 1997; 275: 964-967.

15. Padilla SL, Krötzsch E, Schalch LP, Figueroa BS, Miranda A, Rojas E, et al. Administration of bone marrow cells into surgically induced fibrocollagenous tunnels induces angiogenesis in ischemic rat hindlimb model. Microsurgery 2003; 23: 568-574.

16. Padilla L, Krötzsch E, De La Garza AJ, Figueroa S, Rodríguez-Trejo J, Avila G, et al. Bone marrow mononuclear cells stimulate angiogenesis when transplanted into surgically induced fibrocollagenous tunnels: results from a canine ischemic hindlimb model. Microsurgery 2007; 27: 91-97.

17. Goss JA, Soltes G, Goodpastor SE, Barth M, Lam R, Brunicardi FC, et al. Islet transplantation: the radiographic approach. Transplantation 2003; 76: 199-203.

18. Bartsch T, Falke T, Brehm M, Zeus T, Kögler G, Wernet P, Strauer BE. Intra-arterial and intramuscular transplantation of adult, autologous bone marrow stem cells. Novel treatment for therapy-refractory peripheral arterial occlusive disease. Dtsch Med Wochenschr 2006; 131: 79-83.

19. Padilla SL, Rodríguez-Trejo J, Escoto SJ, Flores CJDD, Rodríguez Ramírez N, Krötzsch GE, et al. Trasplante de células mononucleares progenitoras derivadas de médula ósea por vía endovenosa retrógrada distal para inducir angiogénesis en miembros inferiores con isquemia. Cir Gral 2009; 31: 213-218.