<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992017000400221</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Técnica de apendicectomía en apendicitis complicada para preservación del ciego]]></article-title>
<article-title xml:lang="en"><![CDATA[Appendicetomy technique in complicated appendicitis for the preservation of the cecum]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas Ávila]]></surname>
<given-names><![CDATA[Arcenio Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Luna Jiménez]]></surname>
<given-names><![CDATA[Stephany de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palacio Vélez]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas Flores]]></surname>
<given-names><![CDATA[Julián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lombardini Tolentino]]></surname>
<given-names><![CDATA[Pedro Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Pacheco]]></surname>
<given-names><![CDATA[Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional General Ignacio Zaragoza ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional General Ignacio Zaragoza ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional General Ignacio Zaragoza ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>39</volume>
<numero>4</numero>
<fpage>221</fpage>
<lpage>225</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992017000400221&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992017000400221&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992017000400221&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción: La apendicitis aguda es una de las primeras causas de abdomen agudo quirúrgico en la mayor parte de los hospitales en México. La perforación del apéndice es una complicación frecuentemente asociada al tiempo de evolución.  Objetivo: Describir la técnica con punto transfictivo seromuscular para el manejo del muñón en apendicitis con perforación o necrosis del tercio proximal.  Material y métodos: Se ha diseñado una técnica que consiste en colocación de un punto transfictivo seromuscular en un solo sitio o dos de la base apendicular proximal a la zona de necrosis o perforación. Se diseñó un estudio de cohorte sobre una base de datos prospectiva en la que se evaluaron pacientes con perforación o necrosis de la base del apéndice.  Resultados: Se realizaron 20 apendicetomías, de las cuales 11 fueron por vía laparoscópica, nueve casos con técnica abierta con manejo del muñón con colocación de punto de anclaje transfictivo seromuscular en la base apendicular. En ningún caso se desarrolló complicación postquirúrgica.  Conclusiones: A pesar de los dispositivos modernos para el cierre del muñón apendicular, aún es difícil el cierre de perforaciones en la base del ciego. En apendicitis complicada con perforación a nivel del tercio proximal, la técnica que se utilizó para el abordaje del muñón es una opción eficaz y segura.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction: Acute appendicitis in Mexico is one of the leading causes of acute surgical abdomen in most of the country&#8217;s hospitals. The appendix perforation is a frequent complication associated to the time of evolution.  Objective: Describe the knotting technique with seromuscular transfixed point for the management of the stump in appendicitis with perforation or necrosis at the proximal third.  Material and methods: We designed a technique that consists in the placement of transfixed seromuscular suture in one or two places at the appendiceal base near to the perforation or necrosis area. It was designed a cohort study founded on a prospective database, in which we assess patients with perforation or necrosis at the appendiceal base.  Results: We realized 20 appendectomies, in which 11 were laparoscopy and 9 cases with open technique, with management of the stump with the placement of an anchorage transfixed seromuscular suture in the appendiceal base. No postoperative complications were developed.  Conclusions: Despite modern devices for the appendicular stump closure, it is still difficult to close perforations at the base of the cecum. In complicated appendicitis with perforation at the proximal third, the technique that we used for approaching the stump is an effective and safe option.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Apendicitis perforada]]></kwd>
<kwd lng="es"><![CDATA[muñón apendicular]]></kwd>
<kwd lng="es"><![CDATA[perforación cecal]]></kwd>
<kwd lng="es"><![CDATA[hemicolectomía derecha]]></kwd>
<kwd lng="en"><![CDATA[Perforated appendicitis]]></kwd>
<kwd lng="en"><![CDATA[appendiceal stump]]></kwd>
<kwd lng="en"><![CDATA[cecal perforation]]></kwd>
<kwd lng="en"><![CDATA[right hemicolectomy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rebollar]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Trejo]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apendicitis aguda: revisión de la literatura]]></article-title>
<source><![CDATA[Rev Hosp Jua Mex]]></source>
<year>2009</year>
<volume>76</volume>
<page-range>210-6</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Athié]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Guízar]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiología de la patología abdominal aguda en el servicio de urgencias del Hospital General de México. Análisis de 30 años]]></article-title>
<source><![CDATA[Cir Gen]]></source>
<year>1999</year>
<volume>21</volume>
<page-range>99-104</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Junior]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[Pde A]]></given-names>
</name>
<name>
<surname><![CDATA[de Faria]]></surname>
<given-names><![CDATA[CV]]></given-names>
</name>
<name>
<surname><![CDATA[Cangussu]]></surname>
<given-names><![CDATA[IV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lessons learned with laparoscopic management of complicated grades of acute appendicitis]]></article-title>
<source><![CDATA[J Clin Med Res]]></source>
<year>2014</year>
<volume>6</volume>
<page-range>261-6</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[OJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores asociados a la perforación apendicular en pacientes con apendicitis aguda. Experiencia en el Nuevo Sanatorio Durango]]></article-title>
<source><![CDATA[Rev Fac Med (Méx.)]]></source>
<year>2013</year>
<volume>56</volume>
<page-range>21-5</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Vega]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Osorio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Serna]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bermúdez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tiempo de evolución de la apendicitis y riesgo de perforación]]></article-title>
<source><![CDATA[Rev Colomb Cir]]></source>
<year>2013</year>
<volume>28</volume>
<page-range>24-30</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Busch]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gutzwiller]]></surname>
<given-names><![CDATA[FS]]></given-names>
</name>
<name>
<surname><![CDATA[Aellig]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kuettel]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Metzger]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Zingg]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[In-hospital delay increases the risk of perforation in adults with appendicitis]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>2011</year>
<volume>35</volume>
<page-range>1626-33</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bickell]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Aufses]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bodian]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How time affects the risk of rupture in appendicitis]]></article-title>
<source><![CDATA[J Am Surg Coll Surg]]></source>
<year>2006</year>
<volume>202</volume>
<page-range>401-6</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Drake]]></surname>
<given-names><![CDATA[FT]]></given-names>
</name>
<name>
<surname><![CDATA[Mottey]]></surname>
<given-names><![CDATA[NE]]></given-names>
</name>
<name>
<surname><![CDATA[Farrokhi]]></surname>
<given-names><![CDATA[ET]]></given-names>
</name>
<name>
<surname><![CDATA[Florence]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Mock]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Time to appendectomy and risk of perforation in acute appendicitis]]></article-title>
<source><![CDATA[JAMA Surg]]></source>
<year>2014</year>
<volume>149</volume>
<page-range>837-44</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kearney]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Cahill]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[O&#8217;Brien]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kirwan]]></surname>
<given-names><![CDATA[WO]]></given-names>
</name>
<name>
<surname><![CDATA[Redmond]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Influence of delays on perforation risk in adults with acute appendicitis]]></article-title>
<source><![CDATA[Dis Colon Rectum]]></source>
<year>2008</year>
<volume>51</volume>
<page-range>1823-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lane]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Schmit]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Chandler]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Bennion]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ileocecectomy is definitive treatment for advanced appendicitis]]></article-title>
<source><![CDATA[Am Surg]]></source>
<year>2001</year>
<volume>67</volume>
<page-range>1117-22</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Bennion]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Schmit]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hiyama]]></surname>
<given-names><![CDATA[DT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cecectomy for complicated appendicitis]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>1994</year>
<volume>179</volume>
<page-range>135-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shiryajev]]></surname>
<given-names><![CDATA[YN]]></given-names>
</name>
<name>
<surname><![CDATA[Volkov]]></surname>
<given-names><![CDATA[NN]]></given-names>
</name>
<name>
<surname><![CDATA[Kashintsev]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Chalenko]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Radionov]]></surname>
<given-names><![CDATA[YV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Appendectomy and resection of the terminal ileum with secondary severe necrotic changes in acute perforated appendicitis]]></article-title>
<source><![CDATA[Am J Case Rep]]></source>
<year>2015</year>
<volume>16</volume>
<page-range>37-40</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ligadura simple versus invaginación del muñón después de la apendicectomía: Una revisión sistemática de estudios aleatorizados]]></article-title>
<source><![CDATA[Cir Gen]]></source>
<year>2007</year>
<volume>29</volume>
<page-range>42-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Minhas]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Siddique]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Mirza]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Malik]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Post-operative complications of stump ligation alone versus stump ligation with invagination in appendicectomy]]></article-title>
<source><![CDATA[Int J Surg]]></source>
<year>2010</year>
<volume>22</volume>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Naqvi]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Appendicular perforation at the base of the caecum, a rare operative challenge in acute appendicitis, a literature review]]></article-title>
<source><![CDATA[World J Emerg Surg]]></source>
<year>2011</year>
<volume>6</volume>
<page-range>36</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Granados]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tapia]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Valderrama]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
<name>
<surname><![CDATA[Sevilla]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Acuña]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cierre de la base apendicular en apendicectomías laparoscópicas utilizando endoloop o engrapadora lineal]]></article-title>
<source><![CDATA[Rev Mex Cir Endoscop]]></source>
<year>2013</year>
<volume>14</volume>
<page-range>60-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
