Revistas
Revista:
TECHNIQUES IN COLOPROCTOLOGY
ISSN:
1123-6337
Año:
2023
Vol.:
27
N°:
12
Págs.:
1251 - 1256
PurposeA protective loop ileostomy is the most useful method to reduce sequelae in the event of an anastomotic leakage (AL) after rectal cancer surgery. However, it requires an additional stoma reversal surgery with its own potential complications. Postoperative ileus (POI) remains the most common complication after ileostomy reversal, which leads to an increase in morbidity, length of hospital stay (LOS) and overall healthcare costs. Several retrospective studies carried out in this field have concluded that there are insufficient evidence-based recommendations about the routine application of preoperative bowel stimulation in clinical practice. Here we discuss whether stimulation of the efferent limb before ileostomy reversal might reduce POI and improve postoperative outcomes.MethodsThis is a multicentre randomised controlled trial to determine whether mechanical stimulation of the efferent limb during the 2 weeks before the ileostomy reversal would help to reduce the development of POI after surgery. This study was registered on Clinicaltrials.gov (NCT05302557). Stimulation will consist of infusing a solution of 500 ml of saline chloride solution mixed with a thickening agent (Resource (c), Nestle Health Science; 6.4 g sachet) into the distal limb of the ileostomy loop. This will be performed within the 2 weeks before ileostomy reversal, in an outpatient clinic under the supervision of a trained stoma nurse.ConclusionThe results of this study could provide some insights into the preoperative management of these patients.
Revista:
COLORECTAL DISEASE
ISSN:
1462-8910
Año:
2023
Vol.:
25
N°:
5
Págs.:
1040 - 1041
Autores:
Tejedor, P. (Autor de correspondencia); Jiménez, L. M.; Simo, V.; et al.
Revista:
COLORECTAL DISEASE
ISSN:
1462-8910
Año:
2022
Vol.:
24
N°:
5
Págs.:
659 - 663
Aim The aim was to describe the range of possibilities and our group's clinical outcomes when performing different types of anastomosis during transanal total mesorectal excision (taTME). Method A retrospective analysis was performed based on four taTME series from 2016 to 2021. Inclusion criteria were patients with rectal cancer in whom a sphincter-saving low anterior resection by taTME was performed. Four different techniques were employed for the anastomosis construction: (A) abdominal view, (B) transanal view, (C) hand-sewn coloanal anastomosis and (D) pull-through. Intra-operative and postoperative data were collected and compared. Results A total of 161 patients were included. Tumour height was lower in groups C and D (4 [3-5] vs. 7 [6-8] group A vs. 6 [5-7] group B, P = 0.000), requiring a hand-sewn anastomosis. A transanal extraction of the specimen was more commonly performed in groups C and D (over 60% vs. 30% in groups A and B, P = 0.000). The rate of temporary stoma was similar between groups A, B and C (ranging from 84% to 98%) but was significantly lower in group D (P = 0.000). The overall rate of complications was similar between groups; however, group D had longer length of stay (15 days vs. 5-6 in groups A, B and C, P = 0.026). Conclusion Every type of anastomosis construction after a taTME procedure seems to be safe and feasible and should be chosen based on surgeon's experience, tumour height and the length of the rectal cuff after the rectal transection. Colorectal surgeons should be familiar with these techniques in order to choose the one that benefits each patient the most.
Revista:
REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS
ISSN:
1130-0108
Año:
2018
Vol.:
110
N°:
3
Págs.:
138 - 144
Purpose: The objective of the study was to analyze the clinico-pathological differences and the oncologic outcomes between right and left-sided colon cancer. Patients and methods: The patients cohort was identified from a prospective register of colon cancer, 950 patients underwent surgery (stages I, II and III), of which 431 had right-sided colon cancer and 519 had left-sided colon cancer. Results: More laparoscopic resections were performed (101 vs 191; p < 0.001) and operating times were longer (146 min vs 165 min; p < 0.001) in the left-sided colon group. Patients with right-sided colon cancer more frequently received transfusions (18.8% vs 11.3%; p < 0.001) and experienced a greater number of complications (28.5% vs 20.9%, p = 0.004), although severity and operative mortality were similar in both groups (1.2% vs 0.2%). Mucinous adenocarcinomas and undifferentiated tumors were more frequent in the right-sided group (12% vs 6.5%; p < 0.001). Early stage was predominant in the left-sided colon tumors (28.2% vs 34.5%, p = 0.02). There were no differences in disease-free survival (DFS) in stages I and II after a median follow-up of 103 months. However, a greater survival at five and ten years in left-sided, stage III tumors was observed, with a trend towards statistical significance (p = 0.06). No differences were found with regard to the patterns of recurrence. Conclusions: Right-sided colon cancer exhibits phenotypical differences with regard to left-sided colon cancer. In stage III disease, left-sided colon cancer has a greater survival with a trend towards statistical significance. Overall, tumor location is a variable that should be taken into consideration in clinical studies of colon cancer.
Revista:
CLINICAL AND TRANSLATIONAL ONCOLOGY
ISSN:
1699-048X
Año:
2016
Vol.:
18
N°:
7
Págs.:
714-721
Our results suggest that cellular mucin pools are an indicator of an aggressive phenotype and harbingers of a worse prognosis.
Revista:
CLINICAL AND TRANSLATIONAL ONCOLOGY
ISSN:
1699-048X
Año:
2016
Vol.:
18
N°:
9
Págs.:
909-914
Combined treatment for LARC obtains a 5-year OS rounding 90 %. Follow-up based on thoracic-abdominal CT scan allows an early diagnosis of metastatic lesions. Surgical resection of metastases, regardless of their location, greatly increases the patient's survival rate.
Revista:
SURGERY TODAY
ISSN:
0941-1291
Año:
2015
Vol.:
45
N°:
3
Págs.:
374 - 377
A 75-year-old woman who had undergone pancreatoduodenectomy 19 years earlier was referred to us for investigation of progressive abdominal pain without conclusive preliminary complementary tests. Computed tomography enabled us to identify that the transanastomotic pancreatic stent had migrated distally, resulting in bowel perforation. She underwent surgery and the foreign body was removed.
Revista:
ANNALS OF SURGICAL ONCOLOGY
ISSN:
1068-9265
Año:
2015
Vol.:
22
N°:
3
Págs.:
916-923
The presence of PLVI is a more powerful prognostic factor than TRG in LARC patients treated with neoadjuvant CRT followed by surgery. PLVI denotes an aggressive phenotype, suggesting that these patients may benefit from adjuvant systemic therapy.
Revista:
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
ISSN:
0179-1958
Año:
2015
Vol.:
30
N°:
10
Págs.:
1427 - 1428
Revista:
REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS
ISSN:
1130-0108
Año:
2015
Vol.:
107
N°:
6
Págs.:
340-346
With a mean follow-up of 70.06 months, local recurrence was 4.8% and distant recurrence 25.5%. No differences were found in the histopathologic prognostic factors across the three groups studied depending on distance (cm) from the anal margin. Involvement of the circumferential resection margin (CRM+) was significantly greater in tumors in the distal third of the rectum (8.5%; p = 0.04). 67 patients (13.4%) showed a complete pathologic response. DSF at 5 and 10 years was significantly lower in patients with tumors affecting the distal third as compared to the middle third of the rectum (61.9% vs. 57.7%; p = 0.04). Tumors at this distal location resulted in a significantly higher incidence of lung metastases (p = 0.016).
Revista:
JOURNAL OF GASTROINTESTINAL ONCOLOGY
ISSN:
2078-6891
Año:
2014
Vol.:
5
N°:
2
Págs.:
148-153
Neoadjuvant chemotherapy as a systemic treatment for stage IV colon cancer does not indicate surgery contraindication nor increases postoperative morbimortality by a significant amount.
Revista:
SURGERY TODAY
ISSN:
0941-1291
Año:
2014
Vol.:
44
N°:
12
Págs.:
2318-2323
If longer-term follow-up is achieved, definitive conclusions may be obtained. However, the present results suggest that the cleft lift procedure may become the gold standard technique for the surgical management of non-acute pilonidal disease.
Revista:
REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS
ISSN:
1130-0108
Año:
2014
Vol.:
106
N°:
7
Págs.:
497 - 499
A 36-year-old woman without previous medical history presented at the emergency room with recent onset of diffuse, continuous abdominal pain associated to nausea without vomiting.On examination, her abdomen was soft, very distended and tender with guarding over the left iliac fossa.
Her blood tests were normal apart from a white cell count of 17,2x109/L. Abdominal radiograph findings showed suggestive images of CV, confirmed on computerized tomography (CT) (Fig. 1). We decided to perform a colonoscopy to decompress the colon before surgery. After that, her abdomen became non-distended and was taken to the operating room.Under laparoscopic approach (three 5 mm trocars), we found a soft but not dilated ascending colon that lacked retroperitoneal fixation. It was fixed in its proper place with three running sutures
Revista:
JOURNAL OF GASTROINTESTINAL ONCOLOGY
ISSN:
2078-6891
Año:
2014
Vol.:
5
N°:
2
Págs.:
104-111
Oxaliplatin/fluorpyrimidine neoadjuvant chemotherapy induces major tumour shrinkage at both the pathological and radiological levels. The CT scan shows a high accuracy and a low overstaged rate in LACC patients treated by means of a neoadjuvant approach.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2013
Vol.:
36
N°:
1
Págs.:
141 - 144
Background. Curettage mastectomy is indicated as a palliative treatment in locally advanced breast cancer. We present our experience with the use of a DIEP flap reconstruction following extensive mastectomy. Methods. We report the case of a patient with very advanced local breast cancer that was subsidiary to aggressive palliative surgery after chemotherapy. Results. It was considered that the closure that could be performed with the latissimus dorsi muscle was unsuitable, therefore a DIEP flap was performed. The patient was discharged uneventfully. Conclusion. The DIEP reconstruction offers great cutaneous extension. It can be a resource in highly selected cases of locally advanced breast cancer in which surgery becomes the main treatment.
Revista:
CIRUGIA ESPAÑOLA
ISSN:
0009-739X
Año:
2013
Vol.:
91
N°:
8
Págs.:
490 - 495
Introduction: Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. Method: Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. Results: Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123. min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11. mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. Conclusions: APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients.
Revista:
CIRUGIA ESPAÑOLA
ISSN:
0009-739X
Año:
2013
Vol.:
91
N°:
1
Págs.:
e5
Revista:
CIRUGIA ESPAÑOLA
ISSN:
0009-739X
Año:
2013
Vol.:
91
N°:
10
Págs.:
659 - 663
Introduction: There is currently no effective medical therapy for polycystic liver (PCL). Cyst puncture and sclerotherapy, cyst fenestration, or partial hepatic resections have been used as palliative treatments. Orthotopic liver transplantation (OLT) has become the treatment of choice for terminal PCL, being indicated in patients with limiting symptoms not susceptible to any other medical treatment. It is also difficult to determine the priority on the waiting list using the Model for End-Stage Liver Disease (MELD).
Methods: A retrospective analysis of OLT for PCL was conducted in our centre. Inclusion criteria were patients with limiting symptoms, bilateral cysts liver, and insufficient remaining liver. In all cases a deceased donor liver transplantation with piggy-back technique without veno-venous bypass was performed.
Results: Six patients underwent liver transplantation for PCL between April 1992 and April 2010, one of them a combined liver-kidney transplantation. The mean intraoperative packed red blood cell transfusion was 3.25 L and fresh frozen plasma was 1.200 cc. Mean operation time was 299 min, and 498 min in the liver-kidney transplantation. There was no peri-operative mortality. The mean hospital stay was 6.5 days. All patients are healthy after a mean follow-up of 71 months.
Conclusion: OLT offers an excellent overall survival. Results are better when OLT is performed early; thus these patients should receive additional points to be able to use the MELD score as a valid prioritisation system for waiting lists.
Keywords: Enfermedad poliquística hepática; Liver transplantation; MELD en la poliquistosis hepática; MELD score for polycystic liver disease; Polycystic liver disease; Trasplante hepático.
Revista:
COLORECTAL DISEASE
ISSN:
1462-8910
Año:
2013
Vol.:
15
N°:
5
Págs.:
552-27
Neoadjuvant chemotherapy followed by surgery and chemotherapy for LACC is safe without apparent increase of early and medium-term complications
Revista:
DISEASES OF THE COLON AND RECTUM
ISSN:
0012-3706
Año:
2013
Vol.:
56
N°:
4
Págs.:
416-421
Patients with low third locally advanced rectal cancer with a poor response to neoadjuvant chemoradiotherapy (high y-pathological stage or low tumor regression grade) are at high risk of recurrence. Intense surveillance and the design of alternative therapeutic approaches aimed to lower the distant failure rate seem warranted.
Revista:
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
ISSN:
0179-1958
Año:
2013
Vol.:
28
N°:
5
Págs.:
671 - 677
Revista:
Transplantation Proceedings
ISSN:
0041-1345
Año:
2012
Vol.:
44
N°:
6
Págs.:
1560 - 1561
Revista:
ENDOSCOPY
ISSN:
0013-726X
Año:
2012
Vol.:
44
N°:
Suppl. 2
Págs.:
UCTN:E366-7
Revista:
REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS
ISSN:
1130-0108
Año:
2012
Vol.:
104
N°:
8
Págs.:
436-439
the duodenal defect repair with a patch of the remant antrum, represents a valid alternative in similar circumstances. To our knowledge, it appears to be the first clinical description of this technique.
Revista:
CIRUGIA ESPAÑOLA
ISSN:
0009-739X
Año:
2011
Vol.:
89
N°:
1
Págs.:
24-30
La anastomosis intracorpórea frente a la extracorpórea en la hemicolectomía derecha laparoscópica permite obtener un mayor número de ganglios resecados y un inicio más precoz de la tolerancia oral y del tránsito intestinal.
Revista:
REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS
ISSN:
1130-0108
Año:
2010
Vol.:
102
N°:
12
Págs.:
722 - 728
Solid pseudo-papillary tumor (SPPT) is a rare cystic tumor of the pancreas (1-3% of exocrine tumors of the pancreas) which shows an "enigmatic" behavior on the clinical and molecular pattern. A retrospective analysis of the cytological studies and resected specimens of pancreatic cystic tumors from May 1996 to February 2010 was carried out. Three cases of SPPT were found, which are the objective of this study. The diagnosis was established upon occasional finding in the abdominal CT, in spite of sizing between 3 and 6 cm of diameter. In the three cases the preoperative diagnosis was confirmed by cytology and specific immunohistochemical staining. Cases 2 and 3 showed strong immunoreactivity for Beta-Catenin and E-Cadherin staining. Radical resection (R0) was carried out in the three cases. A young male -21 years of age (case 1)- who had duodenal infiltration and two lymph nodes metastases died of hepatic and peritoneal recurrence 20 months following surgery. The other two cases are free of disease. The current review of the literature reports roughly 800 cases since the first report in 1959, and shows the enigmatic character of this tumor regarding the cellular origin, molecular pathways, prognostic factors and clinical behavior.
Revista:
Revista española de enfermedades digestivas
ISSN:
1130-0108
Año:
2010
Vol.:
102
N°:
3
Págs.:
193 - 201