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1. A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step

Author

Habeeb, Tamer A. A. M., Hussain, Abdulzahra, Shelat, Vishal, Chiaretti, Massimo, Bueno-Lledó, Jose, García Fadrique , Alfonso, Kalmoush, Abd-Elfattah, Elnemr, Mohamed, Safwat, Khaled, Raafat, Ahmed, Wasefy, Tamer, Heggy, Ibrahim A., Osman, Gamal, Abdelhady, Waleed A., Mawla, Walid A., Fiad, Alaa A., Elaidy, Mostafa M., Amr, Wessam, Abdelhamid, Mohamed I., Abdou, Ahmed Mahmoud, Ibrahim, Abdelaziz I. A., and Baghdadi, Muhammad Ali

Published
2023
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3. A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step

Author

Tamer A. A. M. Habeeb, Abdulzahra Hussain, Vishal Shelat, Massimo Chiaretti, Jose Bueno-Lledó, Alfonso García Fadrique, Abd-Elfattah Kalmoush, Mohamed Elnemr, Khaled Safwat, Ahmed Raafat, Tamer Wasefy, Ibrahim A. Heggy, Gamal Osman, Waleed A. Abdelhady, Walid A. Mawla, Alaa A. Fiad, Mostafa M. Elaidy, Wessam Amr, Mohamed I. Abdelhamid, Ahmed Mahmoud Abdou, Abdelaziz I. A. Ibrahim, and Muhammad Ali Baghdadi

Subjects
Abdominal wall dehiscence, Incisional hernia, Posterior component separation, Retro-muscular mesh, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh. Methods Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study. Results The mean age was 42 ± 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 ± 3 days. The mean vertical length of primary AWD was 16 ± 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 ± 1 days. The mean operative time of posterior CS + TAR was 95 ± 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level

Published
2023
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5. GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases

Author

Fernando Pereira, Angel Serrano, Israel Manzanedo, Estibalitz Pérez-Viejo, Santiago González-Moreno, Luis González-Bayón, Alvaro Arjona-Sánchez, Juan Torres, Isabel Ramos, Maria E. Barrios, Pedro Cascales, Rafael Morales, Enrique Boldó, Alfonso García-Fadrique, Xabier Arteaga, Alberto Gutierrez-Calvo, Susana Sánchez-García, Enrique Asensio, Cesar P. Ramírez, Manuel Artiles, Javier Vaqué, Pedro A. Parra, Pedro Villarejo, Cristóbal Muñoz-Casares, Estrella Turienzo, Alicia Calero, Isabel Jaén Torrejimeno, Isabel Prieto, Julio Galindo, Vicente Borrego, Manuel E. Marcello, Cristina Rihuete, Joaquin Carrasco, and Luis Gomez-Quiles

Subjects
HIPEC, Peritoneal carcinomatosis, Peritoneal metastases, Colon cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m2 (30 minutes) for the treatment of peritoneal metastases from colorectal cancer. However, several methodological flaws have been identified in PRODIGE 7, specially the HIPEC protocol or the choice of overall survival as the main endpoint, so its results have not been assumed as definitive, emphasizing the need for further research on HIPEC. It seems that the HIPEC protocol with high-dose mytomicin-C (35 mg/m2) is the preferred regime to evaluate in future clinical studies. Methods GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV clinical trial that aims to evaluate the effectiveness of HIPEC with high-dose mytomicin-C in preventing the development of peritoneal recurrence in patients with limited peritoneal metastasis from colon cancer (not rectal), after complete surgical cytoreduction. This study will be performed in 31 Spanish HIPEC centres, starting in March 2022. Additional international recruiting centres are under consideration. Two hundred sixteen patients with PCI ≤ 20, in which complete cytoreduction (CCS 0) has been obtained, will be randomized intraoperatively to arm 1 (with HIPEC) or arm 2 (without HIPEC). We will stratified randomization by surgical PCI (1–10; 11–15; 16–20). Patients in both arms will be treated with personalized systemic chemotherapy. Primary endpoint is peritoneal recurrence-free survival at 3 years. An ancillary study will evaluate the correlation between surgical and pathological PCI, comparing their respective prognostic values. Discussion HIPEC with high-dose mytomicin-C, in patients with limited (PCI ≤ 20) and completely resected (CCS 0) peritoneal metastases, is assumed to reduce the expected risk of peritoneal recurrence from 50 to 30% at 3 years. Trial registration EudraCT number: 2019–004679-37; Clinicaltrials.gov: NCT05250648 (registration date 02/22/2022, ).

Published
2022
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7. GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases

Author

Pereira, Fernando, Serrano, Angel, Manzanedo, Israel, Pérez-Viejo, Estibalitz, González-Moreno, Santiago, González-Bayón, Luis, Arjona-Sánchez, Alvaro, Torres, Juan, Ramos, Isabel, Barrios, Maria E., Cascales, Pedro, Morales, Rafael, Boldó, Enrique, García-Fadrique, Alfonso, Arteaga, Xabier, Gutierrez-Calvo, Alberto, Sánchez-García, Susana, Asensio, Enrique, Ramírez, Cesar P., Artiles, Manuel, Vaqué, Javier, Parra, Pedro A., Villarejo, Pedro, Muñoz-Casares, Cristóbal, Turienzo, Estrella, Calero, Alicia, Torrejimeno, Isabel Jaén, Prieto, Isabel, Galindo, Julio, Borrego, Vicente, Marcello, Manuel E., Rihuete, Cristina, Carrasco, Joaquin, and Gomez-Quiles, Luis

Published
2022
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9. RAS Mutation Decreases Overall Survival After Optimal Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy of Colorectal Peritoneal Metastasis: A Modification Proposal of the Peritoneal Surface Disease Severity Score

Author

Arjona-Sanchez, A., Rodriguez-Ortiz, L., Baratti, D., Schneider, M. A., Gutiérrez-Calvo, A., García-Fadrique, A., Tuynman, J. B., Cascales-Campos, P. A., Martín, V. Concepción, Morales, R., Salti, G. I., Arteaga, X., Pacheco, D., Alonso-Gomez, J., Yalkin, O., Villarejo-Campos, P., Sanchez-Hidalgo, J. M., Casado-Adam, A., Cosano-Alvarez, A., Rufian-Peña, S., and Briceño, J.

Published
2019
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10. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer with Peritoneal Carcinomatosis: Multicenter Study of Spanish Group of Peritoneal Oncologic Surgery (GECOP)

Author

Manzanedo, Israel, Pereira, Fernando, Rihuete Caro, Cristina, Pérez-Viejo, Estíbalitz, Serrano, Ángel, Gutiérrez Calvo, Alberto, Regueira, Fernando M., Casado-Adam, Ángela, Cascales-Campos, Pedro A., Arteaga, Xabier, García-Fadrique, Alfonso, Gómez Sanz, Remedios, López García, Adela, Zozaya, Gabriel, Arjona, Álvaro, and Gil Martínez, José

Published
2019
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11. HIPECT4: multicentre, randomized clinical trial to evaluate safety and efficacy of Hyperthermic intra-peritoneal chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma

Author

A. Arjona-Sánchez, P. Barrios, E. Boldo-Roda, B. Camps, J. Carrasco-Campos, V. Concepción Martín, A. García-Fadrique, A. Gutiérrez-Calvo, R. Morales, G. Ortega-Pérez, E. Pérez-Viejo, A. Prada-Villaverde, J. Torres-Melero, E. Vicente, P. Villarejo-Campos, J. M. Sánchez-Hidalgo, A. Casado-Adam, Ruben García-Martin, Manuel Medina, T. Caro, C. Villar, Enrique Aranda, M. T. Cano-Osuna, C. Díaz-López, E. Torres-Tordera, F. J. Briceño-Delgado, and S. Rufián-Peña

Subjects
Colon carcinoma, HIPEC, Peritoneal carcinomatosis, Chemoprophylaxis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Local relapse and peritoneal carcinomatosis (PC) for pT4 colon cancer is estimated in 15,6% and 36,7% for 12 months and 36 months from surgical resection respectively, achieving a 5 years overall survival of 6%. There are promising results using prophylactic HIPEC in this group of patients, and it is estimated that up to 26% of all T4 colon cancer could benefit from this treatment with a minimal morbidity. Adjuvant HIPEC is effective to avoid the possibility of peritoneal seeding after surgical resection. Taking into account these results and the cumulative experience in HIPEC use, we will lead a randomized controlled trial to determine the effectiveness and safety of adjuvant treatment with HIPEC vs. standard treatment in patients with colon cancer at high risk of peritoneal recurrence (pT4). Methods/Design The aim of this study is to determine the effectiveness and safety of adjuvant HIPEC in preventing the development of PC in patients with colon cancer with a high risk of peritoneal recurrence (cT4). This study will be carried out in 15 Spanish HIPEC centres. Eligible for inclusion are patients who underwent curative resection for cT4NxM0 stage colon cancer. After resection of the primary tumour, 200 patients will be randomized to adjuvant HIPEC followed by routine adjuvant systemic chemotherapy in the experimental arm, or to systemic chemotherapy only in the control arm. Adjuvant HIPEC will be performed simultaneously after the primary resection. Mitomycin C will be used as chemotherapeutic agent, for 60 min at 42–43 °C. Primary endpoint is loco-regional control (LC) in months and the rate of loco-regional control (%LC) at 12 months and 36 months after resection. Discussion We assumed that adjuvant HIPEC will reduce the expected absolute risk of peritoneal recurrence from 36% to 18% at 36 months for T4 colon-rectal carcinoma. Trial registration NCT02614534 (clinicaltrial.gov) Nov-2015.

Published
2018
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19. Laparoscopy may decrease morbidity and length of stay after elective colon cancer resection, especially in frail patients: results from an observational real-life study

Author

Cerdán Santacruz, Carlos, Frasson, Matteo, Flor-Lorente, Blas, Ramos Rodríguez, José Luis, Trallero Anoro, Marta, Millán Scheiding, Mónica, Maseda Díaz, Olga, Dujovne Lindenbaum, Paula, Monzón Abad, Andrés, García-Granero Ximenez, Eduardo, Alvarez Rico, Miguel Angel, García Brao, Maria Jesus, Sanchez Gonzalez, Juan Manuel, Braithwaite, Mariela, Martí Martínez, Eva, Álvarez Pérez, José Antonio, Espí, Alejandro, Romero Simó, Manuel, Escoll Rufino, Jordi, Santamaría Olabarrieta, Marta, Viñas Martínez, José, López Bañeres, Manolo, Blesa Sierra, Isabel, Feliú Villaró, Francesc, Aguiló Lucía, Javier, Bargallo Berzosa, José, Alonso Hernández, Natalia, Labrador Vallverdú, Francisco Javier, Parra Baños, Pedro Antonio, Ais Conde, Guillermo, Codina Cazador, Antonio, Hernandis Villalba, Juan, Álvarez Laso, Carlos, Martínez Alcaide, Sonia, Cáceres Alvarado, María Nieves, Rey Simó, Ignacio, Montero García, Josep, García Fadrique, Alfonso, Aguilella Diago, Vicente, García Septiem, Javier, García García, Jacinto, Ponchietti, Luca, Carceller Navarro, María Soledad, Ramos Fernández, María, Conde Muiño, Raquel, Huerga Álvarez, Daniel, Menéndez Sánchez, Pablo, Maristany Bienert, Carlos, García Martínez, María Teresa, Moreno Muzas, Celia, Pastor Idoate, Carlos, Andicoechea, Alejandro, Alonso Casado, Adolfo Pedro, Roig Vila, José Vicente, Goded Broto, Ignacio, Collera, Pablo, Arroyo Sebastián, Antonio, and The ANACO Study Group

Published
2017
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20. Tratamiento quirúrgico urgente de la hernia paraestomal incarcerada asociada a urostomía: revisión y experiencia personal.

Author

Trallero Anoro, Marta, Carbonell Tatay, Fernando, Carreño Sáenz, Omar, Campos Máñez, Jorge, García Fadrique, Alfonso, Caballero Soto, María, and Estevan Estevan, Rafael

Subjects
SURGICAL emergencies, HERNIA, OPERATIVE surgery, IMPRISONMENT, CANCER patients, HERNIA surgery
Abstract

Copyright of Revista Hispanoamericana de Hernia is the property of Aran Ediciones S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2023
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21. Efficacy and Safety of Intraoperative Hyperthermic Intraperitoneal Chemotherapy for Locally Advanced Colon Cancer: A Phase 3 Randomized Clinical Trial.

Author

Arjona-Sánchez, Alvaro, Espinosa-Redondo, Esther, Gutiérrez-Calvo, Alberto, Segura-Sampedro, Juan J., Pérez-Viejo, Estibalitz, Concepción-Martín, Vanessa, Sánchez-García, Susana, García-Fadrique, Alfonso, Prieto-Nieto, Isabel, Barrios-Sanchez, Pedro, Torres-Melero, Juan, Ramírez Faraco, Maria, Prada-Villaverde, Arancha, Carrasco-Campos, Joaquin, Artiles-Armas, Manuel, Villarejo-Campos, Pedro, Ortega-Pérez, Gloria, Boldo-Roda, Emrique, Sánchez-Hidalgo, Juan-Manuel, and Casado-Adam, Angela

Published
2023
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22. HIPECT4: multicentre, randomized clinical trial to evaluate safety and efficacy of Hyperthermic intra-peritoneal chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma

Author

Arjona-Sánchez, A., Barrios, P., Boldo-Roda, E., Camps, B., Carrasco-Campos, J., Concepción Martín, V., García-Fadrique, A., Gutiérrez-Calvo, A., Morales, R., Ortega-Pérez, G., Pérez-Viejo, E., Prada-Villaverde, A., Torres-Melero, J., Vicente, E., Villarejo-Campos, P., Sánchez-Hidalgo, J. M., Casado-Adam, A., García-Martin, Ruben, Medina, Manuel, Caro, T., Villar, C., Aranda, Enrique, Cano-Osuna, M. T., Díaz-López, C., Torres-Tordera, E., Briceño-Delgado, F. J., and Rufián-Peña, S.

Published
2018
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36. Evolución de los parámetros sanguíneos tras cirugía de la obesidad mórbida mediante la técnica del cruce duodenal Evolution of the blood parameters after morbid obesity surgery with the duodenal crossing technique

Author

A. Vázquez Prado, A. García Fadrique, and E. M.ª Montalvá Orón

Subjects
Obesidad mórbida, Cirugía, Cruce duodenal, Seguimiento, Malnutrición, Morbid obesity, Surgery, Duodenal crossing, Follow-up, Malnourishment, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Objetivo: Valorar la evolución de los parámetros sanguíneos en pacientes obesos mórbidos que han sido sometidos a cirugía mediante la técnica del cruce duodenal. Métodos: Se estudian 110 pacientes, a los que tras la cirugía se les ha realizado controles ponderales y de los parámetros analíticos más influenciados por este tipo de cirugía (hematocrito, hemoglobina, glucosa, proteínas totales, albúmina, calcio, PTH, ALT, índice de Quick, bilirrubina total, colesterol y triglicéridos, hierro, ferritina, ácido fólico y vitamina B12). El control postoperatorio se ha realizado a los 3, 6, 12, 18, 24, 36, 48 y 60 meses. El seguimiento mínimo es de un año. Resultados: La pérdida de peso es superior al 50% del sobrepeso y mantenida a lo largo del estudio, alcanzando a más del 75% de los pacientes. En el seguimiento postoperatorio existe un claro déficit de hierro que condiciona la existencia de anemia, así como una elevación evidente de la PTH. La normalización de las cifras de glucemia, colesterol y triglicéridos alcanza cifras cercanas al 100%. Conclusiones: Las alteraciones de los parámetros sanguíneos que presentan los pacientes obesos mórbidos sometidos a la técnica del cruce duodenal, indicadores de complicaciones nutricionales, afectan aproximadamente a un 10% de los pacientes (excepto el déficit de Fe y la alteración de la PTH) y son fácilmente corregidos en su mayoría con suplementos farmacológicos y nutricionales, adaptándose el organismo a estos déficits, sin que existan alteraciones clínico-biológicas severas y con tendencia a la normalización.Objective: To assess the course of blood parameters from patients with morbid obesity submitted to the duodenal crossing surgical technique. Methods: 110 patients were studied in whom post-surgical monitoring of ponderal and laboratory parameters (the ones most influenced by this type of surgery such as hematocrit, hemoglobin, glucose, total proteins, albumin, calcium, PTH, ALT, Quick's index, total bilirubin, cholesterol and triglycerides, iron, ferritin, folic acid, and vitamin B12) has been carried out. Postsurgical monitoring has been carried out at months 3, 6, 12, 18, 24, 36, 48, and 60. The shortest follow-up time has been one year. Results: Weight loss is higher than 50% of the weight in excess and is maintained throughout the study, comprising more than 75% of the patients. During the postsurgical follow-up, there is a clear iron deficiency concurrent with the presence of anemia, as well as an evident increase in PTH. Normalization of glycemia, cholesterol, and triglyceride levels reaches almost 100%. Conclusions: changes in blood parameters presented by patients with morbid obesity submitted to the duodenal crossing technique, indicators of nutritional complications, affect about 10% of the patients (with the exception of iron deficiency and PTH impairment), and most of them are easily corrected with pharmacological and nutritional supplements, the body getting adapted to these deficits, without any severe clinical-biological impairment and with a trend towards normalization.

Published
2008

37. Colaboradores

Author

Abad Carratalà, Guillem, Abella Serra, Arnau, Acosta Reveles, Marco Antonio, Alapont Alacreu, José Miguel, Alonso Isa, Manuel, Alonso Mediavilla, Eneko, Luis Álvarez-Ossorio, José, Angerri Feu, Oriol, Arlandis Guzmán, Salvador, Bahilo Mateu, Pilar, Balañà Lucena, Josep, Bolón Marset, Jaime, Bonillo García, Miguel Ángel, Briones Mardones, Gabriel, Calleja Hermosa, Paola, Campos-Juanatey, Félix, Cansino Alcaide, Ramón, Castelló Porcar, Ana, Casu Jarca, Vasile Cristian, Cepeda Delgado, Marcos, Conca Baenas, María de los Ángeles, Costa-Roig, Adrià, Cuevas Garro, Ainhoa, Cruz Ruiz, Marta de la, de Pablos Rodríguez, Pedro, del Peral Samaniego, María Pilar, Delgado Oliva, Francisco, Diéguez Hernández-Vaquero, Irene, Duarte Añez, Juan Carlos, Eguibar González, Aritz, Emiliani Sanz, Esteban, Margarita Fernández-Ávila, Cristina, Fernández Pascual, Esáu, Garau Perelló, Carmen, García de Paredes, Rodrigo García-Baquero, García Fadrique, Gonzalo, García Gómez, Borja, García Ibáñez, Joan, García Reboll, Luis, García Rojo, Esther, Gil Azkárate, Maitane, Gómez-Ferrer Lozano, Álvaro, Gómez Palomo, Francisco, Guldris García, Ricardo, Gutiérrez Baños, José Luis, Herranz Yagüe, José Antonio, Kanashiro Azabache, Andrés, López Alcina, Emilio, López-Fando Lavalle, Luis, Mainez Rodríguez, Juan Antonio, Manso Aparicio, Coral, March Villalba, José Antonio, Martínez Cuenca, Esther, Martínez Jabaloyas, José María, Ignacio Martínez-Salamanca, Juan, Martínez Sarmiento, Manuel, Mima, Mahmoud, Monserrat Monfor, Juan José, Morán Pascual, Eduardo, Niederberger, Craig, Ohlander, Samuel, Ordaz Jurado, Domingo de Guzmán, Osca García, José Manuel, Pabón Cruz, Rebeca, Pacheco Bru, Juan José, Pagani, Rodrigo, Panach Navarrete, Jorge, Pascual Mateo, Carlos, Peinado Ibarra, Francois, Perán Teruel, Miguel, Pérez-Carral García, José Ramón, Pérez-Lanzac, Alberto, Pérez Reggeti, José Ignacio, Pieras Ayala, Enrique, Polo Alonso, Elvira, Polo Rodrigo, Alba, Pontones Moreno, José Luís, Portilla Mediavilla, Leire, Povo Martín, Iván, Quereda Flores, Francisco, Ramírez Backhaus, Miguel, Ramos Cebrián, María, Reig Ruiz, Carlos, Rodríguez Caravallo, Lucía, Rodrigo Aliaga, Miguel, Romero-Otero, Javier, Rubio Briones, José, Luis Ruiz-Cerdá, José, Ruiz Guerrero, Estefanía, Salas Trigo, Eva, Serrano Durbá, Agustín, Ruiz de Velasco, Antonio Servera, Simón Rodríguez, Carlos, Suárez Broto, Miguel Ángel, Teba del Pino, Fernando, Torremadé Barreda, Josep, and Tubau Vidaña, Valentí

Published
2024
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39. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer with Peritoneal Carcinomatosis: Multicenter Study of Spanish Group of Peritoneal Oncologic Surgery (GECOP)

Author

José Gil Martínez, Ángela Casado-Adam, Fernando Pereira, Cristina Rihuete Caro, Ángel Serrano, Estíbalitz Pérez-Viejo, Israel Manzanedo, Gabriel Zozaya, Alfonso García-Fadrique, Xabier Arteaga, Alberto José Gutiérrez Calvo, Adela Petra López García, Álvaro Arjona, P.A. Cascales-Campos, Fernando Martínez Regueira, and Remedios Gómez Sanz

Subjects
Adult, Male, medicine.medical_specialty, Gastroenterology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Prospective Studies, Prospective cohort study, Survival rate, Peritoneal Neoplasms, Aged, Retrospective Studies, business.industry, Hazard ratio, Cancer, Retrospective cohort study, Cytoreduction Surgical Procedures, Hyperthermia, Induced, Middle Aged, Prognosis, medicine.disease, Combined Modality Therapy, Oxaliplatin, Survival Rate, Oncology, Spain, Chemotherapy, Cancer, Regional Perfusion, 030220 oncology & carcinogenesis, Peritoneal Cancer Index, Female, 030211 gastroenterology & hepatology, Surgery, Hyperthermic intraperitoneal chemotherapy, Neoplasm Recurrence, Local, business, Follow-Up Studies, medicine.drug
Abstract

Gastric cancer (GC) with peritoneal carcinomatosis (PC) is traditionally considered a terminal stage of the disease. The use of a multimodal treatment, including cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), can benefit these patients. Our goal was to evaluate the morbidity and survival outcomes of these patients. This is a retrospective, multicenter study from a prospective national database of patients diagnosed with PC secondary to GC treated with CRS and HIPEC from June 2006 to October 2017. Eighty-eight patients from seven specialized Spanish institutions were treated with CRS and HIPEC, with median age of 53 years; 51% were women. Median Peritoneal Cancer Index (PCI) was 6, and complete cytoreduction was achieved in 80 patients (90.9%). HIPEC was administered in 85 cases with 4 different regimens (Cisplatin + Doxorubicin, Mitomycin-C + Cisplatin, Mitomycin-C and Oxaliplatin). Twenty-seven cases (31%) had severe morbidity (grade III–IV) and 3 patients died in the postoperative period (3.4%). Median follow-up was 32 months. Median overall survival (OS) was 21.2 months, with 1-year OS of 79.9% and 3-year OS of 30.9%. Median disease-free survival (DFS) was 11.6 months, with 1-year DFS of 46.1% and 3-year DFS of 21.7%. After multivariate analysis, the extent of peritoneal disease (PCI ≥ 7) was identified as the only independent factor that influenced OS (hazard ratio [HR] 2.37, 95% confidence interval [CI] 1.26–4.46, p = 0.007). The multimodal treatment, including CRS and HIPEC, for GC with PC can improve the survival results in selected patients (PCI

Published
2019
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40. Quality Standards for Surgery of Colorectal Peritoneal Metastasis After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Author

Luis Sabater Ortí, Alfonso García-Fadrique, and Rafael Estevan

Subjects
Peritoneal metastasis, medicine.medical_specialty, business.industry, media_common.quotation_subject, Fistula, Cytoreduction Surgical Procedures, Hyperthermic Intraperitoneal Chemotherapy, Reference Standards, medicine.disease, Surgery, Clinical trial, Oncology, Anastomotic leakage, Surgical oncology, medicine, Humans, Quality (business), Hyperthermic intraperitoneal chemotherapy, business, Cytoreductive surgery, Colorectal Neoplasms, Peritoneal Neoplasms, media_common
Abstract

The standardization of surgical outcomes throughout surgical procedures is mandatory. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) should provide proficient oncological and surgical outcomes.The aim of this study was to identify clinically relevant quality indicators and their quality standard, and to determine their acceptable quality limit. A systematic review on cytoreductive results from 2000 to 2018 was performed focusing on clinical guidelines, consensus conferences, and publications. After the selection of quality indicators, a systematic review of indexed references was performed in order to calculate the quality standard for each indicator.Unicentric/multicentric series, comparative studies, and clinical trials. Studies were to include outcomes after cytoreduction of colorectal origin and series with more than 50 patients. Quality indicators with at least 10 series were mandatory and objective measurements were also mandatory for inclusion.Quality indicators selected were 1- to 5-year survival, overall disease-free survival, 1- to 5-year disease-free survival, complete surgical resection, duration of surgery, length of stay, overall morbimortality, major morbidity, re-intervention, postoperative hemorrhage, intestinal fistula, anastomotic leakage, wound infection, postoperative medical complications, overall recurrence, and failure to rescue.The most relevant quality indicators and critical quality limits were overall disease-free survival and 5-year overall disease-free survival (14 months and10 months, and 14% and4%, respectively), completeness of surgical resection (89% and80%, respectively), overall mortality (3% and8%, respectively), overall morbidity (47% and63%, respectively), failure to rescue (12% and30%, respectively), reintervention (13 and22%, respectively), anastomotic leakage (6% and13%, respectively), and overall recurrence (60% and74%, respectively).This is the first study to assess quality standards in CRS + HIPEC for colorectal peritoneal metastases. The current data are of particular relevance for future studies to control the variability of this surgery.

Published
2021

43. 595P The DUREC trial: Durvalumab plus total neoadjuvant therapy in locally advanced rectal cancer - a multicenter, single-arm, phase II study (GEMCAD-1703)

Author

Capdevila Castillon, J., Alonso, V., Macias Declara, I., Melian, M., Gallego Plazas, J., Vera, R., Riesco Martinez, M.C., Maurel, J., Grana Suarez, B., Hernando, J., Garcia Alvarez, A., Navalpotro, B., Soler Gonzalez, G., Polo, E., Garcia Fadrique, A., Espin, E., Fernandez Martos, C., Villacampa Javierre, G., and Losa, F.

Published
2023
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48. Estudio epidemiológico de incidencia estimada de la enfermedad litiásica candidata a tratamiento activo en la Comunidad Valenciana

Author

García Fadrique, Gonzalo Damián, Vera Donoso, César David, and Budía Alba, Alberto

Subjects
Litiasis renal, 3202 Epidemiología, Cálculos renales, Cálculos ureterales, 3213.16 Urología
Abstract

El objetivo principal del estudio es la estimación de la incidencia de la enfermedad litiásica renoureteral candidata a un tratamiento activo en la Comunidad Valenciana y su comparación con otros datos epidemiológicos a nivel nacional. Medicina Ciencias de la Salud

Published
2020

49. Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Author

Gianluca Pellino, Rafael Alós, Sebastiano Biondo, Antonio Codina-Cazador, José María Enríquez-Navascues, Eloy Espín-Basany, José Vicente Roig-Vila, Andrés Cervantes, Eduardo García-Granero, Raúl Adell Carceller, Juan Guillermo Ais Conde, Evelio Alonso Alonso, Antonio Amaya Cortijo, Antonio Arroyo Sebastian, Pedro Barra Baños, Ricard Batlle Solé, Juan C. Bernal Sprekelsen, Francisco J. Blanco Gonzalez, Santiago Blanco, J. Bollo, Nieves Cáceres Alvarado, Ignasi Camps Ausas, Ramon Cantero Cid, José Antonio Carmona Saez, Enrique Casal Nuñez, Luis Cristobal Capitán Morales, Guillermo Carreño Villarreal, Jesús Cifuentes Tebar, Miguel Á. Ciga Lozano, Antonio Codina Cazador, Juan de Dios Franco Osorio, María de la Vega Olías, Mario de Miguel Velasco, Sergio Rodrigo del Valle, José G. Díaz Mejías, José M. Díaz Pavón, Javier Die Trill, José L. Dominguez Tristancho, Paula Dujovne Lindenbaum, José Errasti Alustiza, Alejandro Espí Macias, Eloy Espín Basany, Rafael Estévan Estévan, Alfredo M. Estevez Diz, Luis Flores, Domenico Fraccalvieri, Alessandro Garcea, Mauricio García Alonso, Miguel Garcia Botella, Maria José García Coret, Alfonso García Fadrique, José M. García García, Jacinto García García, Jesús Á. Garijo Alvarez, José Gomez Barbadillo, Fernando Gris, Verónica Gumbau, Javier Gutierrez, Pilar Hernandez Casanovas, Daniel Huerga Alvarez, Ana M. Huidobro Piriz, Francisco Javier Jimenez Miramón, Ana Lage Laredo, Alberto Lamiquiz Vallejo, Félix Lluis Casajuana, Manuel López Lara, Juan A. Lujan Mompean, María Victoria Maestre, Eva Martí Martínez, M. Martinez, Javier Martinez Alegre, Gabriel Martínez Gallego, Roberto Martinez Pardavila, Olga Maseda Díaz, Mónica Millan Schedling, Benito Mirón, José Monzón Abad, José A. Múgica Martinera, Francisco Olivet Pujol, Mónica Orelogio Orozco, Luis Ortiz de Zarate, Rosana Palasí Gimenez, Natividad Palencia García, Pablo Palma Carazo, Alberto Parajo Calvo, Jesús Paredes Cotore, Carlos Pastor Idoate, Miguel Pera Roman, Francisco Pérez Benítez, José A. Pérez García, Marta Piñol Pascual, Isabel Prieto Nieto, Ricardo Rada Morgades, Mónica Reig Pérez, Ángel Reina Duarte, Didac Ribé Serrat, Xavier Rodamilans, María D. Ruiz Carmona, Marcos Rodriguez Martin, Francisco Romero Aceituno, Jesús Salas Martínez, Ginés Sánchez de la Villa, Inmaculada Segura Jimenez, José Enrique Sierra Grañon, Amparo Solana Bueno, Albert Sueiras Gil, Teresa Torres Sanchez, Natalia Uribe Quintana, Javier Valdés Hernández, Fancesc Vallribera, Vicent Viciano Pascual, Pellino, G., Alos, R., Biondo, S., Codina-Cazador, A., Enriquez-Navascues, J. M., Espin-Basany, E., Roig-Vila, J. V., Cervantes, A., Garcia-Granero, E., Carceller, R. A., Ais Conde, J. G., Alonso, E. A., Cortijo, A. A., Sebastian, A. A., Banos, P. B., Sole, R. B., Bernal Sprekelsen, J. C., Blanco Gonzalez, F. J., Blanco, S., Bollo, J., Alvarado, N. C., Ausas, I. C., Cid, R. C., Carmona Saez, J. A., Nunez, E. C., Capitan Morales, L. C., Villarreal, G. C., Tebar, J. C., Ciga Lozano, M. A., Cazador, A. C., de Dios Franco Osorio, J., Olias, M. D. L. V., de Miguel Velasco, M., Rodrigo del Valle, S., Diaz Mejias, J. G., Diaz Pavon, J. M., Trill, J. D., Dominguez Tristancho, J. L., Lindenbaum, P. D., Alustiza, J. E., Macias, A. E., Basany, E. E., Estevan, R. E., Estevez Diz, A. M., Flores, L., Fraccalvieri, D., Garcea, A., Alonso, M. G., Botella, M. G., Garcia Coret, M. J., Fadrique, A. G., Garcia Garcia, J. M., Garcia, J. G., Garijo Alvarez, J. A., Barbadillo, J. G., Gris, F., Gumbau, V., Gutierrez, J., Casanovas, P. H., Alvarez, D. H., Huidobro Piriz, A. M., Jimenez Miramon, F. J., Laredo, A. L., Vallejo, A. L., Casajuana, F. L., Lara, M. L., Lujan Mompean, J. A., Maestre, M. V., Martinez, E. M., Martinez, M., Alegre, J. M., Gallego, G. M., Pardavila, R. M., Diaz, O. M., Schedling, M. M., Miron, B., Abad, J. M., Mugica Martinera, J. A., Pujol, F. O., Orozco, M. O., Ortiz de Zarate, L., Gimenez, R. P., Garcia, N. P., Carazo, P. P., Calvo, A. P., Cotore, J. P., Idoate, C. P., Roman, M. P., Benitez, F. P., Perez Garcia, J. A., Pascual, M. P., Nieto, I. P., Morgades, R. R., Perez, M. R., Duarte, A. R., Serrat, D. R., Rodamilans, X., Ruiz Carmona, M. D., Martin, M. R., Aceituno, F. R., Martinez, J. S., Sanchez de la Villa, G., Jimenez, I. S., Sierra Granon, J. E., Bueno, A. S., Gil, A. S., Sanchez, T. T., Quintana, N. U., Hernandez, J. V., Vallribera, F., and Pascual, V. V.

Subjects
Male, Survival, Colorectal cancer, medicine.medical_treatment, T stage, 030230 surgery, TNM, 0302 clinical medicine, Registries, Stage (cooking), Rectal cancer, Aged, 80 and over, Margins of Excision, General Medicine, Middle Aged, Neoadjuvant Therapy, Survival Rate, medicine.anatomical_structure, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, Adult, medicine.medical_specialty, Neoadjuvant treatment, Prognosi, Rectum, 03 medical and health sciences, Young Adult, medicine, Adjuvant therapy, Humans, Chemotherapy, Aged, Neoplasm Staging, Retrospective Studies, Radiotherapy, business.industry, Rectal Neoplasms, Cancer, Chemoradiotherapy, Adjuvant, medicine.disease, Surgery, Radiation therapy, Spain, T-stage, business, Follow-Up Studies, Forecasting
Abstract

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most.

Published
2020

50. Estándares de calidad en la cirugía de carcinomatosis peritoneal de origen colorectal mediante citorreducción y quimioterapia intraperitoneal hipertermia (HIPEC)

Author

García Fadrique, Alfonso Luis, Sabater Ortí, Luis, Escrig Sos, Javier, Estevan Estevan, Rafael, and Departament de Cirurgia

Subjects
cirugia oncológica, calidad asistencial, UNESCO::CIENCIAS MÉDICAS, quimioterapia intraperitoneal, cirugía, CIENCIAS MÉDICAS [UNESCO], estándares de calidad
Abstract

El mayor conocimiento de la historia natural de la carcinomatosis peritoneal ha permitido su valoración como una progresión locorregional. Tras los trabajos publicados por Sugarbaker tanto a nivel quirúrgico, con la descripción de las técnicas de peritonectomía como a nivel farmacológico experimental para la aplicación de la quimioterapia intraperitoneal hipertérmica (HIPEC), se considera un tratamiento locorregional de la enfermedad confinada al abdomen. Así, una cirugía radical de citorreducción con extirpación de la enfermedad macroscópica y la aplicación posterior de HIPEC para control de la enfermedad microscópica residual, ha obtenido resultados muy superiores a la quimioterapia aislada. En todo tratamiento quirúrgico, y más en aquellos de mayor complejidad como la cirugía de citorreducción y HIPEC (CRS+HIPEC), se debe garantizar una atención sanitaria óptima que ofrezca una adecuada calidad en la asistencia y disminuya la variabilidad en los tratamientos y en los resultados. Esta gestión de la calidad viene determinada por una serie de indicadores y estándares, medibles, reproducibles y que garantizan los cambios y mejoras en la asistencia si fuera necesario. En los últimos años se han evaluado estándares de calidad en varios procesos asistenciales relacionados con el cáncer, sin embargo, Carecemos de estándares de ca en el ámbito del tratamiento multidisciplinar de la cirugía oncológica peritoneal. Hipótesis Mediante la aplicación de los métodos de análisis y la utilización de las gráficas de control de procesos, es posible determinar los estándares de calidad en los resultados de la cirugía de carcinomatosis peritoneal de origen colorrectal, a partir de datos objetivos y estadísticamente robustos publicados en la literatura. Objetivos 1. Determinar cuáles son los indicadores de calidad y su valor correspondiente, clínicamente relevantes 2. Establecer escalas o intervalos con los límites de variabilidad o límites de calidad aceptables para cada indicador, de fácil medición, que sirvan de herramienta a las unidades de cirugía oncológica peritoneal y permitan auditar los resultados de forma sencilla y objetiva Resultados y conclusiones 1. Se han determinado 20 indicadores de calidad: media de supervivencia global, media de supervivencia global a 1 año y a 5 años, media de supervivencia libre de enfermedad global, a 1 año y a 5 años, supervivencia libre de enfermedad global, a 1 año y a 5 años, tasa de resecciones completas, duración media de la cirugía, estancia media hospitalaria, tasa de mortalidad global, tasa de morbilidad global, tasa de morbilidad mayor, tasa de reintervenciones, tasa de hemorragias postoperatorias, tasa de fístulas intestinales, tasa de dehiscencia de anastomosis, tasa de infecciones de herida, tasa de complicaciones médicas, tasa de recurrencia global y tasa de fallo de rescate.

Published
2020

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