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2. P-053 LAPAROSCOPIC APPROACH WITH EXTRAPERITONEAL PREFERENCE AS A STANDARD INDICATION FOR PATIENTS WITH INGUINAL HERNIA. OUR FIRST RESULTS

Author

D W Silva Cano, E López-Negrete Cueto, J L Rodicio Miravalles, B Carrasco Aguilera, M Moreno Gijón, R Rodríguez Uria, S Sanz Navarro, L Sanz Álvarez, and J E Granero Trancón

Subjects
Surgery
Abstract

Aim Laparoscopic inguinal repair originated in the early 80's, but despite the time elapsed its use is not generalized, although more groups are adopting it as the technique of choice. With this wordk we seek to analyze our results after generalizing the laparoscopic approach. Material & Methods Descriptive and retrospective study of patients electively operated by Totally Extraperitoneal (TEP) or Transabdominal Preperitoneal (TAPP) repair, between January 2020 and December 2022, for primary or recurrent inguinal hernia. Results A total of 138 patients underwent surgery, 92.8% male, mean age 60.7 (SD 11.9) years. Of these, 113 had unilateral hernia and 25 bilateral. In 115 (83.3%) the hernia was primary. The mean operative duration was 61.3 (SD 24.3) minutes, and 2 complications (1 right inferior epigastric artery injury on postoperative day 10 and 1 intraoperative ligament bleeding). There were 3 TEP to TAPP conversions and 3 recurrrences (1 no surgery due to patient refusal, 1 repair by anterior approach and another reoperated by TAPP). At one month possoperatively, 87.7% reported no or mild pain, 113 patients being discharged. The average follow-up wa 83.1 (SD 129.2) days. When analyzing the specific approach, TEP was predominant: 110 (79.7%) with similar postoperative results of pain vs TAPP although with significantly shorter operative duration: 53.1 vs 68.9 minutes (p Conclusions Inguinal laparoscopy in our setting is safe and effective in the short term for primary repair. Our results support laparoscopic repair with TEP as the first choice and TAPP as an alternative.

Published
2023

3. RANDOMIZED STUDY ON THE EFFICACY OF NEGATIVE PRESSURE WOUND THERAPY (NPWT) IN THE PREVENTION OF SURGICAL SITE COMPLICATIONS

Author

A Suárez Sánchez, I de Santiago Álvarez, M García Munar, L A García González, I Cifrian Canales, T Díaz Vico, M Moreno Gijón, and L Sanz Álvarez

Subjects
Surgery
Abstract

Introduction The secondary consequences of SSC worsen patient's quality of life, while increasing healthcare costs considerably. Applying preventive measures to reduce this complication rate should be one of the priorities of improving healthcare. Methods We conducted a prospective randomized study between March 2019 and March 2021 in a General Surgery Department of a tertiary hospital. Operated patients with risk factors for developing (SSC) were included according to the established protocol, and were randomized to the use of NPWT or conventional dressing (CD). The aim of our study was to compare SSC (skin dehiscence, seroma, hematoma, edge necrosis, and wound infection) in both groups, and to assess the benefit of NPWT. Results We studied 267 patients, 124 (46.4%) in the NPWT group and 143 (53.6%) in the CD group, with a mean age of 68 (±12.9) years. 96.2% of the patients corresponded to the ASA II or III classification. A total of 72 (27%) SSC were observed, being significantly lower in the NPWT group (odds ratio [OR] 0.49; confidence interval [CI] 0.28–0.85; p Relative risk reduction (RRR) was 41.5% and absolute risk reduction (ARR) was 14%, with a number needed to treat (NNT) of 6.9. Conclusion NPWT decreases the risk of SSC, so its use should be considered in patients with risk factors.

Published
2023

4. CORRELATION BETWEEN RADIOLOGICAL (PCIR) AND SURGICAL (PCIS) PERITONEAL CARCINOMATOSIS INDEX (PCI)

Author

C Ramos Montes, A Cernuda García, M Moreno Gijón, S Amoza Pais, A Mesa Álvarez, A A Suárez, L Sanz Álvarez, and E O Turienzo Santos

Subjects
Surgery
Abstract

Introduction The Peritoneal Carcinomatosis Index (PCI) is used for the selection of candidates for cytoreductive surgery (CRS)+HIPEC and as a prognostic for resectability. The accuracy of MDCT (Multidetector Computed Tomography) is evaluated by analyzing the degree of correlation between preoperative PCIr and surgical PCIs. Methods We conducted an observational, longitudinal, single-center and retrospective study between May 2014 and 2018 on patients operated upon for peritoneal carcinomatosis. Preoperative TCDM were interpreted by an expert radiologist and PCIs were calculated intraoperatively. Comparison was performed using the Concordance Correlation Coefficient (CCC). The Bland-Altman method was used to represent the difference between observations, with a 95% confidence interval (CI). The sensitivity and specificity of PCIr Results Mean PCIs of the 50 patients undergoing CRS+HIPEC was 11.8 (9.5), and mean PCIr was 11.0 (10.1). The CCC between both was 0.94 (95% CI 0.91–0.97). Sensitivity of PCIr was 0.82 (95%CI 0.68–0.92), being resectable 37/40 patients with PCIr Conclusions MDCT interpreted by an expert radiologist is an indispensable tool for the selection of patients who are candidates for CRS+HIPEC. A PCIr ≥20 is not synonymous with unresectability.

Published
2023

5. RETROSPECTIVE STUDY OF THE LAPAROSCOPIC APPROACH TO SMALL BOWEL OBSTRUCTION

Author

B Carrasco Aguilera, E López-Negrete Cueto, G Martínez Izquierdo, J L Rodicio Miravalles, M Moreno Gijón, T Díaz Vico, L Sanz Álvarez, and J E Granero Trancón

Subjects
Surgery
Abstract

Introduction Exploratory laparotomy has classically been the treatment for adhesive small bowel obstruction (ASBO). Laparoscopic approaches have proven to be a beneficial technique in selected patients. Despite being minimally invasive and associated with low morbidity it is still not a widespread technique. Methods Descriptive, retrospective study from January 2011 to April 2022, of 43 patients with ASBO operated by laparoscopy in a tertiary hospital. Demographic, surgical and evolutionary variables were analysed. Descriptive statistics using non-parametric tests. Univariate logistic regression. Results The median age was 67 years (44–77.5), 65% women and 63.3% had previous surgery. In CT (93%) mean loop dilatation was 37.2±6mm and reported as single adhesive band in 62.7%. Time to surgery After surgery 43% had oral tolerance Median follow-up of 48.7 months with 6.9% reoperation, 4.6% readmission, Clavien-Dindo There was a relation (p Conclusions Laparoscopy is a safe approach in patients with OIB in our setting. Our series reflects effective results, in a prolonged mean follow-up, with a low readmission rate and a conversion to open surgery similar to previous series, with only an association between the degree of obstruction and the operative time with the obstruction.

Published
2023

6. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit

Author

S.K. Kamarajah, R.P.T. Evans, D. Nepogodiev, J. Hodson, J.R. Bundred, I. Gockel, J.A. Gossage, A. Isik, B. Kidane, H.A. Mahendran, I. Negoi, K.E. Okonta, R. Sayyed, R. van Hillegersberg, R.S. Vohra, B.P.L. Wijnhoven, P. Singh, E.A. Griffiths, D. Alderson, J. Bundred, J. Gossage, B. Jefferies, S. McKay, I. Mohamed, K. Siaw-Acheampong, R. Vohra, K. Wanigasooriya, T. Whitehouse, A. Gjata, J.I. Moreno, F.R. Takeda, R. Guevara Castro, T. Harustiak, A. Bekele, A. Kechagias, A. Kennedy, A. Da Roit, A. Bagajevas, J.S. Azagra, L. Mejía-Fernández, J. El Kafsi, R.H. Sayyed, M. Sousa, A.S. Sampaio, R. Blanco, B. Wallner, P.M. Schneider, P.K. Hsu, S. Gananadha, V. Wills, M. Devadas, C. Duong, M. Talbot, M.W. Hii, R. Jacobs, N.A. Andreollo, B. Johnston, G. Darling, A. Isaza-Restrepo, G. Rosero, F. Arias-Amézquita, D. Raptis, J. Gaedcke, D. Reim, J. Izbicki, J.H. Egberts, S. Dikinis, D.W. Kjaer, M.H. Larsen, M.P. Achiam, J. Saarnio, D. Theodorou, T. Liakakos, D.P. Korkolis, W.B. Robb, C. Collins, T. Murphy, J. Reynolds, V. Tonini, M. Migliore, L. Bonavina, M. Valmasoni, R. Bardini, J. Weindelmayer, M. Terashima, R.E. White, E. Alghunaim, M. Elhadi, A.M. Leon-Takahashi, H. Medina-Franco, P.C. Lau, J. Heisterkamp, C. Rosman, G. Beban, R. Babor, A. Gordon, J.I. Rossaak, K.M.I. Pal, A.U. Qureshi, S.A. Naqi, A.A. Syed, J. Barbosa, C.S. Vicente, J. Leite, J. Freire, R. Casaca, R.C.T. Costa, R.R. Scurtu, S.S. Mogoanta, C. Bolca, S. Constantinoiu, D. Sekhniaidze, M. Bjelović, J.B.Y. So, G. Gačevski, C. Loureiro, M. Pera, A. Bianchi, M. Moreno Gijón, J. Martín Fernández, M.S. Trugeda Carrera, M. Vallve-Bernal, M.A. Cítores Pascual, S. Elmahi, I. Halldestam, J. Hedberg, S. Mönig, S. Gutknecht, M. Tez, A. Guner, M.B. Tirnaksiz, E. Colak, B. Sevinç, A. Hindmarsh, I. Khan, D. Khoo, R. Byrom, J. Gokhale, P. Wilkerson, P. Jain, D. Chan, K. Robertson, S. Iftikhar, R. Skipworth, M. Forshaw, S. Higgs, R. Nijjar, Y.K.S. Viswanath, P. Turner, S. Dexter, A. Boddy, W.H. Allum, S. Oglesby, E. Cheong, D. Beardsmore, N. Maynard, R. Berrisford, S. Mercer, S. Puig, R. Melhado, C. Kelty, T. Underwood, K. Dawas, W. Lewis, A. Al-Bahrani, G. Bryce, M. Thomas, A.T. Arndt, F. Palazzo, R.A. Meguid, J. Fergusson, E. Beenen, C. Mosse, J. Salim, S. Cheah, T. Wright, M.P. Cerdeira, P. McQuillan, M. Richardson, H. Liem, J. Spillane, M. Yacob, F. Albadawi, T. Thorpe, A. Dingle, C. Cabalag, K. Loi, O.M. Fisher, S. Ward, M. Read, M. Johnson, R. Bassari, H. Bui, I. Cecconello, R.A.A. Sallum, J.R.M. da Rocha, L.R. Lopes, V. Tercioti, J.D.S. Coelho, J.A.P. Ferrer, G. Buduhan, L. Tan, S. Srinathan, P. Shea, J. Yeung, F. Allison, P. Carroll, F. Vargas-Barato, F. Gonzalez, J. Ortega, L. Nino-Torres, T.C. Beltrán-García, L. Castilla, M. Pineda, A. Bastidas, J. Gómez-Mayorga, N. Cortés, C. Cetares, S. Caceres, S. Duarte, A. Pazdro, M. Snajdauf, H. Faltova, M. Sevcikova, P.B. Mortensen, N. Katballe, T. Ingemann, B. Morten, I. Kruhlikava, A.P. Ainswort, N.M. Stilling, J. Eckardt, J. Holm, M. Thorsteinsson, M. Siemsen, B. Brandt, B. Nega, E. Teferra, A. Tizazu, J.H. Kauppila, V. Koivukangas, S. Meriläinen, R. Gruetzmann, C. Krautz, G. Weber, H. Golcher, G. Emons, A. Azizian, M. Ebeling, S. Niebisch, N. Kreuser, G. Albanese, J. Hesse, L. Volovnik, U. Boecher, M. Reeh, S. Triantafyllou, D. Schizas, A. Michalinos, E. Balli, M. Mpoura, A. Charalabopoulos, D.K. Manatakis, D. Balalis, J. Bolger, C. Baban, A. Mastrosimone, O. McAnena, A. Quinn, C.B. Ó Súilleabháin, M.M. Hennessy, I. Ivanovski, H. Khizer, N. Ravi, N. Donlon, M. Cervellera, S. Vaccari, S. Bianchini, l. Sartarelli, E. Asti, D. Bernardi, S. Merigliano, L. Provenzano, M. Scarpa, L. Saadeh, B. Salmaso, G. De Manzoni, S. Giacopuzzi, R. La Mendola, C.A. De Pasqual, Y. Tsubosa, M. Niihara, T. Irino, R. Makuuchi, K. Ishii, M. Mwachiro, A. Fekadu, A. Odera, E. Mwachiro, D. AlShehab, H.A. Ahmed, A.O. Shebani, A. Elhadi, F.A. Elnagar, H.F. Elnagar, S.T. Makkai-Popa, L.F. Wong, Y.R. Tan, S. Thannimalai, C.A. Ho, W.S. Pang, J.H. Tan, H.N.L. Basave, R. Cortés-González, S.M. Lagarde, J.J.B. van Lanschot, C. Cords, W.A. Jansen, I. Martijnse, R. Matthijsen, S. Bouwense, B. Klarenbeek, M. Verstegen, F. van Workum, J.P. Ruurda, P.C. van der Sluis, M. de Maat, N. Evenett, P. Johnston, R. Patel, A. MacCormick, M. Young, B. Smith, C. Ekwunife, A.H. Memon, K. Shaikh, A. Wajid, N. Khalil, M. Haris, Z.U. Mirza, S.B.A. Qudus, M.Z. Sarwar, A. Shehzadi, A. Raza, M.H. Jhanzaib, J. Farmanali, Z. Zakir, O. Shakeel, I. Nasir, S. Khattak, M. Baig, Noor MA, H.H. Ahmed, A. Naeem, A.C. Pinho, R. da Silva, A. Bernardes, J.C. Campos, H. Matos, T. Braga, C. Monteiro, P. Ramos, F. Cabral, M.P. Gomes, P.C. Martins, A.M. Correia, J.F. Videira, C. Ciuce, R. Drasovean, R. Apostu, S. Paitici, A.E. Racu, C.V. Obleaga, M. Beuran, B. Stoica, C. Ciubotaru, V. Negoita, I. Cordos, R.D. Birla, D. Predescu, P.A. Hoara, R. Tomsa, V. Shneider, M. Agasiev, I. Ganjara, D. Gunjić, M. Veselinović, T. Babič, T.S. Chin, A. Shabbir, G. Kim, A. Crnjac, H. Samo, I. Díez del Val, S. Leturio, J.M. Ramón, M. Dal Cero, S. Rifá, M. Rico, A. Pagan Pomar, J.A. Martinez Corcoles, J.L. Rodicio Miravalles, S.A. Pais, S.A. Turienzo, L.S. Alvarez, P.V. Campos, A.G. Rendo, S.S. García, E.P.G. Santos, E.T. Martínez, M.J. Fernández Díaz, C. Magadán Álvarez, V. Concepción Martín, C. Díaz López, A. Rosat Rodrigo, L.E. Pérez Sánchez, M. Bailón Cuadrado, C. Tinoco Carrasco, E. Choolani Bhojwani, D.P. Sánchez, M.E. Ahmed, T. Dzhendov, F. Lindberg, M. Rutegård, M. Sundbom, C. Mickael, N. Colucci, A. Schnider, S. Er, E. Kurnaz, S. Turkyilmaz, A. Turkyilmaz, R. Yildirim, B.E. Baki, N. Akkapulu, O. Karahan, N. Damburaci, R. Hardwick, P. Safranek, V. Sujendran, J. Bennett, Z. Afzal, M. Shrotri, B. Chan, K. Exarchou, T. Gilbert, T. Amalesh, D. Mukherjee, S. Mukherjee, T.H. Wiggins, R. Kennedy, S. McCain, A. Harris, G. Dobson, N. Davies, I. Wilson, D. Mayo, D. Bennett, R. Young, P. Manby, N. Blencowe, M. Schiller, B. Byrne, D. Mitton, V. Wong, A. Elshaer, M. Cowen, V. Menon, L.C. Tan, E. McLaughlin, R. Koshy, C. Sharp, H. Brewer, N. Das, M. Cox, W. Al Khyatt, D. Worku, R. Iqbal, L. Walls, R. McGregor, G. Fullarton, A. Macdonald, C. MacKay, C. Craig, S. Dwerryhouse, S. Hornby, S. Jaunoo, M. Wadley, C. Baker, M. Saad, M. Kelly, A. Davies, F. Di Maggio, P. Mistry, R. Singhal, O. Tucker, S. Kapoulas, S. Powell-Brett, P. Davis, G. Bromley, L. Watson, R. Verma, J. Ward, V. Shetty, C. Ball, K. Pursnani, A. Sarela, H. Sue Ling, S. Mehta, J. Hayden, N. To, T. Palser, D. Hunter, K. Supramaniam, Z. Butt, A. Ahmed, S. Kumar, A. Chaudry, O. Moussa, A. Kordzadeh, B. Lorenzi, M. Wilson, P. Patil, I. Noaman, J. Willem, G. Bouras, R. Evans, M. Singh, H. Warrilow, A. Ahmad, N. Tewari, F. Yanni, J. Couch, E. Theophilidou, J.J. Reilly, null van Boxel Gijs, K. Akbari, D. Zanotti, B. Sgromo, G. Sanders, T. Wheatley, A. Ariyarathenam, A. Reece-Smith, L. Humphreys, C. Choh, N. Carter, B. Knight, P. Pucher, A. Athanasiou, B. Tan, M. Abdulrahman, J. Vickers, K. Akhtar, R. Chaparala, R. Brown, M.M.A. Alasmar, R. Ackroyd, K. Patel, A. Tamhankar, A. Wyman, R. Walker, B. Grace, N. Abbassi, N. Slim, L. Ioannidi, G. Blackshaw, T. Havard, X. Escofet, A. Powell, A. Owera, F. Rashid, P. Jambulingam, J. Padickakudi, H. Ben-Younes, K. Mccormack, I.A. Makey, M.K. Karush, C.W. Seder, M.J. Liptay, G. Chmielewski, E.L. Rosato, A.C. Berger, R. Zheng, E. Okolo, A. Singh, C.D. Scott, M.J. Weyant, J.D. Mitchell, Surgery, Intensive Care, Radiotherapy, Oral and Maxillofacial Surgery, Rheumatology, Medical Microbiology & Infectious Diseases, Erasmus MC other, Hematology, Gastroenterology & Hepatology, Public Health, Medical Informatics, Internal Medicine, Public Administration, Epidemiology, Erasmus School of Economics, Cell biology, Pathology, Health Services Management & Organisation (HSMO), and Molecular Genetics

Subjects
Pulmonary and Respiratory Medicine, Esophageal Neoplasms, Anastomosis, Anastomotic Leak, outcomes, Esophageal Neoplasms/surgery, surgical techniques, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Necrosis, Postoperative Complications, Esophagectomy/adverse effects, SDG 3 - Good Health and Well-being, Surgical, Surgical Stapling, anastomotic leak, esophageal cancer, esophagectomy, Anastomosis, Surgical, Esophagectomy, Humans, Suture Techniques, Anastomosis, Surgical/adverse effects, Suture Techniques/adverse effects, Surgical Stapling/adverse effects, Surgery, Postoperative Complications/etiology, Necrosis/surgery, Cardiology and Cardiovascular Medicine, Anastomotic Leak/etiology
Abstract

BACKGROUND: The optimal anastomotic techniques in esophagectomy to minimize rates of anastomotic leakage and conduit necrosis are not known. The aim of this study was to assess whether the anastomotic technique was associated with anastomotic failure after esophagectomy in the international Oesophago-Gastric Anastomosis Audit cohort.METHODS: This prospective observational multicenter cohort study included patients undergoing esophagectomy for esophageal cancer over 9 months during 2018. The primary exposure was the anastomotic technique, classified as handsewn, linear stapled, or circular stapled. The primary outcome was anastomotic failure, namely a composite of anastomotic leakage and conduit necrosis, as defined by the Esophageal Complications Consensus Group. Multivariable logistic regression modeling was used to identify the association between anastomotic techniques and anastomotic failure, after adjustment for confounders.RESULTS: Of the 2238 esophagectomies, the anastomosis was handsewn in 27.1%, linear stapled in 21.0%, and circular stapled in 51.9%. Anastomotic techniques differed significantly by the anastomosis sites (P < .001), with the majority of neck anastomoses being handsewn (69.9%), whereas most chest anastomoses were stapled (66.3% circular stapled and 19.3% linear stapled). Rates of anastomotic failure differed significantly among the anastomotic techniques (P < .001), from 19.3% in handsewn anastomoses, to 14.0% in linear stapled anastomoses, and 12.1% in circular stapled anastomoses. This effect remained significant after adjustment for confounding factors on multivariable analysis, with an odds ratio of 0.63 (95% CI, 0.46-0.86; P = .004) for circular stapled versus handsewn anastomosis. However, subgroup analysis by anastomosis site suggested that this effect was predominantly present in neck anastomoses, with anastomotic failure rates of 23.2% versus 14.6% versus 5.9% for handsewn versus linear stapled anastomoses versus circular stapled neck anastomoses, compared with 13.7% versus 13.8% versus 12.2% for chest anastomoses.CONCLUSIONS: Handsewn anastomoses appear to be independently associated with higher rates of anastomotic failure compared with stapled anastomoses. However, this effect seems to be largely confined to neck anastomoses, with minimal differences between techniques observed for chest anastomoses. Further research into standardization of anastomotic approach and techniques may further improve outcomes.

Published
2022

7. STUDY OF THE QUALITY OF LIFE AND COSTS OF PATIENTS ON THE WAITING LIST AGAINST PATIENTS UNDERTAKEN FOR BARIATRIC SURGERY

Author

M Moreno Gijón, E López Negrete Cueto, T Diaz Vico, L Sanz Álvarez, B Carrasco Aguilera, G García Santos, J L Rodicio Miravalles, and J Llosa Pérez

Subjects
medicine.medical_specialty, Waiting list, business.industry, General surgery, Medicine, Surgery, business
Abstract

INTRODUCTION Bariatric surgery is the only effective long-term treatment for patients with morbid obesity, being the deterioration of the quality of life of these patients one of the main reasons for surgery. In this work, we prospectively analyze the impact of health-related quality of life (HRQoL) and comorbidities among patients who underwent bariatric surgery versus those on the waiting list. MATERIAL AND METHODS Between January and December 2017 139 patients (70 operated on and 69 on waiting list) were included in the study, with a 2-year follow-up. Quality of life was measured using the SF-12v2 and IWQoL-Lite questionnaires. Sociodemographic, clinical, and surgical variables were collected. The cost was evaluated through analytical accounting of Diagnosis-Related Groups. RESULTS 12 and 24 months follow-up showed statistically significant improvement in all areas of the HRQoL in the surgical group (p CONCLUSIONS Bariatric surgery significantly improves both quality of life and patients’ comorbidities. This, along with the fact that the surgical cost of 3.558€ pays for itself in just two years, could justify a greater investment in these types of procedures as a suitable healthcare strategy.

Published
2021

8. REVIEW OF 5 YEARS RESULTS AFTER SURGERY FOR GASTRO-OESOPHAGEAL REFLUX DISEASE: NISSEN VS TOUPET

Author

S Sanz Navarro, E Alonso Batanero, R Rodríguez Uría, J L Rodicio Miravalles, S Amoza Pais, L Sanz Álvarez, E Turienzo Santos, and M Moreno Gijón

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Reflux, Disease, Repeat Surgery, Surgery, Endoscopy, medicine.anatomical_structure, Gastro, medicine, Sphincter, Age distribution, Laparoscopy, business
Abstract

INTRODUCTION Multiple studies attempt to demonstrate the superiority of Toupet fundoplication over the classic Nissen technique in the treatment of gastro- oesophageal reflux disease (GERD). In our study we compared the results of both techniques. MATERIAL AND METHODS A retrospective descriptive study of patients operated because of GERD using laparoscopic Nissen and Toupet fundoplication in our centre between January 1, 2015 and December 31, 2019. RESULTS 80 patients were operated, 56 Nissen (70%) versus 24 Toupet (30%). Both groups are comparable in terms of mean age, distribution by sex, obesity, toxic habits, the prevalence of typical symptoms, DeMeester, and presurgical lower oesophagal sphincter pressure; although there are differences regarding the presence of associated hiatal hernia and within them the type. A similar surgical time (136.59 vs 132.71 minutes) and mean stay (4.02 vs 5 days) were observed. In the Nissen group, 12 patients (21.42%) presented initial postoperative dysphagia, requiring 2 endoscopic dilations and 5 reoperations, compared to 5 patients (20.83%) in the Toupet group, that did not require dilation and with 1 reoperation. The conversion and mortality rate was 0% in both groups, with a variable follow-up of 22.08 versus 14.45 months. CONCLUSIONS Both techniques present similar results, including the rate of postoperative dysphagia, which is one of the most feared complications. However, it would be necessary to increase the size and longer follow-up to establish long-term results.

Published
2021

9. RESULTS OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY AND CYTOREDUCTIVE SURGERY FOR PERITONEAL CARCINOMATOSIS OF COLORECTAL ORIGIN

Author

M Moreno Gijón, I. Cifrián Canales, J L Rodicio Miravalles, M Merayo Álvarez, L Sanz Álvarez, M García Munar, and E Turienzo Santos

Subjects
medicine.medical_specialty, business.industry, Debulking, medicine.disease, Preoperative care, Peritoneal carcinomatosis, Surgery, medicine.anatomical_structure, Hematoma, Peritoneum, Peritonectomy, Medicine, Hyperthermic intraperitoneal chemotherapy, business, Cytoreductive surgery
Abstract

INTRODUCTION Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is supported by clinical practice and published series as a fundamental treatment for increasing survival of selected patients with colorectal peritoneal carcinomatosis. The results were evaluated since having implemented a peritoneal oncological surgery program five years ago. MATERIAL AND METHODS Descriptive analysis was conducted to patients who had been diagnosed with peritoneal carcinomatosis from May 2014 to December 2020. 36 out of 100 patients who had undergone surgery were included in the CRS and HIPEC assessment and 6 patients without HIPEC, were excluded. RESULTS The mean preoperative PCI was 7.81±6.61 accomplishing complete cytoreduction CC 0-CC-1 in the 36 cases. An average of 1.86±1.22 peritonectomies were performed. Among procedures, complete pelviperitonectomy (11 patients) and liver metastasis resection (6 patients) should be noticed. Complications were presented in 16 patients (8 patients over Clavien Dindo>III) and 6 required reinterventions due to hematoma (2) or anastomotic leak (2) mostly. The 4-year overall survival is 76.2% and the disease-free interval is 34 months within an average follow-up of 23 months. CONCLUSIONS The overall survival and disease-free interval rates are above the standards. Currently, peritoneal carcinomatosis might be considered a curative disease. The multidisciplinary assessment allows selecting patients who will benefit from surgery.

Published
2021

10. CYTOREDUCTION SURGERY WITH HIPEC IN PERITONEAL CARCINOMATOSIS OF GASTRIC ORIGIN: A HOPEFUL TREATMENT?

Author

R Rodríguez Uría, J L Rodicio Miravalles, M García Munar, M Merayo Álvarez, E Turienzo Santos, M Moreno Gijón, L Sanz Álvarez, and A Suárez Sánchez

Subjects
medicine.medical_specialty, Palliative care, business.industry, Debulking, Preoperative care, Chemotherapy regimen, Peritoneal carcinomatosis, Surgery, Medicine, Combined Modality Therapy, Hyperthermic intraperitoneal chemotherapy, business, Survival rate
Abstract

INTRODUCTION The incidence of peritoneal metastases in gastric cancer are frequent and are associated with very poor median survival rates. The multimodal treatment of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could offer a better prognosis in selected cases although it is not currently contemplated in clinical practice guidelines. MATERIAL AND METHODS Of the 100 patients operated on for peritoneal carcinomatosis in our centre between May 2014 and December 2020, we selected those of gastric origin. Multidisciplinary CRS treatment with HIPEC was indicated in those patients with positive cytology and/or preoperative PCI RESULTS Four men and one woman with a mean age of 63 years underwent surgery. The mean preoperative PCI was 2 and complete cytoreduction was achieved in all cases (CC-0). Complications included a biliary leak, a postoperative collection and a bronchoaspirative pneumonia. One patient died at 34 months. The other four are still alive: one with recurrence at 18 months and the rest without disease with a mean follow-up of 25 months. In one of the cases CRS surgery with HIPEC was performed as surgical salvage after initial surgery and in the rest as the only treatment. CONCLUSIONS Palliative systemic chemotherapy is considered the treatment of gastric cancer with peritoneal involvement, however, treatment based on CRS and HIPEC in selected cases could improve survival rates, disease-free interval and even be considered as salvage treatment in resectable oligometastatic recurrences.

Published
2021

11. POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE

Author

T Diaz Vico, G Martínez Izquierdo, E Turienzo Santos, P del Val Ruiz, L Sanz Álvarez, S Amoza Pais, M Moreno Gijón, and B Carrasco Aguilera

Subjects
medicine.medical_specialty, business.industry, Treatment outcome, Reflux, Disease, medicine.disease, Comorbidity, Surgery, Postoperative dysphagia, Quality of life, Barrett's esophagus, medicine, business
Abstract

INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

Published
2021

12. Pylephlebitis as a complication of acute appendicitis

Author

M Moreno Gijón, J J González González, P Granero Castro, A. Prieto Fernández, J Granero Trancón, L. Raposo Rodríguez, and L Barneo Serra

Subjects
medicine.medical_specialty, Pylephlebitis, business.industry, Gastroenterology, MEDLINE, General Medicine, medicine.disease, Thrombosis, Mesenteric Vein, Tratamiento farmacologico, Internal medicine, Acute appendicitis, Medicine, business
Published
2010

13. Tumor de células granulares apendicular

Author

J J González González, M Moreno Gijón, M S Fernández García, L Vázquez Velasco, and P Granero Castro

Subjects
Granular cell tumor, Pathology, medicine.medical_specialty, Text mining, medicine.anatomical_structure, business.industry, Gastroenterology, medicine, MEDLINE, General Medicine, medicine.disease, business, Appendix
Published
2009

15. Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices

Author

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I., Contreras, E., Boerma, E. -J., Cianchi, F., Marino, F., Uggeri, F., Han, F., Calculli, F., Falaschi, F., Ghignone, F., Perrone, F., Borghi, F., Garcia, F., Agresta, F., Cananzi, F. C. M., Mendoza-Moreno, F., Cengiz, F., Almeida, F. M., Baracchi, F., Carannante, F., la Torre, F., Fernandes, F., Friedmacher, F., Grama, F., Carissimi, F., Pecchini, F., Bianco, F., Colombo, F., Ferrara, F., Litta, F., Carrano, F. M., Martignoni, F., Tasselli, F. M., Milone, F., Pata, F., Sammartino, F., Zambianchi, F., Barragan, F., Herrero, F., Schlottmann, F., Den Boer, F. C., Pfeffer, F., Fujita, F., Navarra, G., Herrera-Almario, G., Pozzo, G., Capolupo, G. T., van Ramshorst, G. H., Liscia, G., Gallo, G., Asawa, G., Wang, G., Raiyani, G., Beets, G., Naval, G. S., Jin, G., Chang, G. J., Saakian, G., Kahane, G., Borroni, G., Lo Secco, G., Baiocchi, G. L., Baronio, G., Pagano, G., Pattacini, G. C., Lisi, G., Milito, G., Sinibaldi, G., Serrao, G., Bagaglini, G., Sarro, G., Brisinda, G., Candilio, G., Mangiameli, G., Giuliani, G., Martin-Martin, G. P., Bodzin, G., Leon, G., Mackay, G., Vasil, G., Palmisano, G., Giovanna, G. M., Fernandez, G. C., Steingel, G. B., Zhang, G., Choi, G. S., Chen, H., Hirose, H., Kayano, H., Ulgur, H. S., Impellizzeri, H., Ariola, H., Liu, H., Medina, H., Miyauchi, H., Takahashi, H., Hayashi, H., Ishikawa, H., Ishida, H., de Vries, H., Ulman, H., Kon, H., Ota, H., Akamatsu, H., Tamagawa, H., Shoji, H., Egi, H., Matsubara, H., Miki, H., Elfeki, H., Lin, H. -H., Giani, I., Caravaca-Garcia, I., Takemasa, I., Angriman, I., Negoi, I., Volkova, I., Russo, I., Kronberger, I. E., Shageev, I., Aydin, I., Mora-Guzman, I., Novak, I., Giuliano, I., Rachmuth, J., Ngu, J. C. -Y., Glasbey, J., Stoot, J., Zatecky, J., Melenhorst, J., van der Wal, J. B. C., Leijtens, J., Bogach, J., Elliott, J., de Wilt, J. H. W., Han, J., Cui, J., Liu, J., Khan, J., Wirawan, J. P., Zhang, J., Manyari, J. D. O., Doerner, J., Bock, J., Konsten, J., Castro, J. M., Grobas, J. P., Pinto, J. P., Juloski, J., Laina, J. L. B., Solorzano, J. J., Lopez, J. R. G., Li, J., Watanabe, J., Kwak, J. -M., Hasegawa, J., Hiro, J., Sergey, K., Zhang, K., Nagahori, K., Martinez, K., Tokuhara, K., Danno, K., Uehara, K., Yoshimatsu, K., Ehara, K., Ueda, K., Suda, K., Yamamoto, K., Ishimaru, K., Kimura, K., Hirata, K., Deen, K., Imaizumi, K., Yamada, J., Tanakura, K., Rida, K., Sugimoto, K., Kotaro, K., Shi, K., Okabayashi, K., Hida, K., Kataoka, K., Hongo, K., Xia, K., Tseng, L., Reime, L., Lorenzon, L., Ruano, L. M., Zhou, L., de Nes, L., Brandariz, L., Morini, L., Petagna, L., Ripamonti, L., Martinez, L. H., Pio, L., Sacco, L., Carvalho, L., Zorcolo, L., Perez-Sanchez, L. E., Esparza, L. H. R., Aguilar, L. T., Garner, M., Sugimoto, M., Nagashima, M., Shiozawa, M., Simone, M., Ferrer-Marquez, M., Carvalho, M., Alifano, M., Arganini, M., Calussi, M., Catarci, M., Allaix, M. E., Forlin, M., Milone, M., Paci, M., Fodor, M., Antipova, M., Martos, M. B., Giuffrida, M. C., Tabernilla, M. D., Quiros, M. J. A., Lemma, M., Correo, M. L. R. D., Malowiecka, M., Bellomo, M. P., Fernandez, M. R., Socias, M., Rizk, M., Aurora, M., Antolinez, M. A., Ninkovic, M., Giuffrida, M., Leeuwenburgh, M. M. N., de Roos, M. A. J., Lara, M. C., Agustin, M. C., Cuadrado, M., Pascual, M., Lemmerer, M., Carlos, R., Okamoto, M., Miyo, M., Inomata, M., Ikenaga, M., Tsujie, M., Yasuno, M., Kotake, M., Sato, M., Yasui, M., Lavazza, M., Rottoli, M., Zuin, M., Zuluaga, M., Cervellera, M., Cesari, M., Zizzo, M., Garino, M., Ghirardi, M., Montuori, M., Podda, M., Santarelli, M., Koc, M. A., Baini, M., de Cillia, M., de Rosa, M., Manigrasso, M., Zuolo, M., Cunha, M. F., Misca, M., Slavchev, M., Danilov, M., Shigaev, M., Martens, M., Kobayashi, M., Ren, M., Ishizuka, M., Hassan, M. M., Siblini, M., Sahloul, M., Keramati, M. R., Karunakaran, M., Markel, M., Majeed, M., Younis, M. U., Akin, M. I., Laraibe, M., Derebey, M., Kendirci, M., Fukunaga, M., Matsubara, N., Ordaz, N. E. C., Samalavicius, N. E., Keeratibharat, N., de Angelis, N., Gica, N., Mariani, N. M., Ramino, N., Falco, N., Smart, N., de Korte, N., Kok, N. F. M., Jamieson, N. B., Aberyasev, N., Bruklich, N., Ichikawa, N., Miyoshi, N., de Palma, N., Figueiredo, N., Torrecilla, N. O., Dybov, O. G., Yudin, O., Crepin, O., Gomez, O., Sert, O. Z., Lominchar, P. L., Menendez, P., de Nardi, P., Tejedor, P., Jordan, P., Tan, P., Marsanic, P., Natalya, P., Banos, P. P., Rebasa, P., Neary, P. M., Tanis, P., Giustacchini, P., Anoldo, P., Concejo, P., Cao, P., Chandrasinghe, P., Abeyratne, P., Wang, Q., Klicks, R. J., Mukai, R., Riquelme, R. F., de Luca, R., Galli, R., Gianesini, R., Moorjani, R. G., Deshpande, R. K., Gorter, R., Ledesma, R. L., Ruslan, R. -G., Chhabra, R., Talreja-Pelaez, R., Suzuki, R., Balestri, R., Rosati, R., Kiblawi, R., Martins, R., Angelico, R., Tutino, R., Persiani, R., Pollastri, R., Lopez, R. G., Perez, R. O., Hompes, R., Lukanin, R., Roser Termes, S. R., Brunaccino, R., Nakanishi, R., Stefan, S., Hernandez, S. P. S., Di Carlo, S., Ingallinella, S., Domoto, S., Ikeda, S., Mikalauskas, S., Kim, S. H., Mantova, S., Barbuta, S., Li, S., Yamaguchi, S., Yam-Agishi, S., Homma, S., Tsujinaka, S., Yoshioka, S., Mori, S., Tewari, S., Rayman, S., Horiuchi, S., Matoba, S., Morita, S., Yaman, S., Vigna, S., Testa, S., Ng, S., Deidda, S., Cicconi, S., Di Maria, S., Sibio, S., Ersoz, S., Pejkova, S., Altarifi, S., He, S., Malakorn, S., Meindert, S., Sumikawa, S., Parmar, S., Uranitsch, S., D'Ugo, S., Giuliani, S., Breukink, S., Lee, S. -H., Hata, T., Ishikawa, T., Akiyoshi, T., Azuma, T., Kobatake, T., Fukuzaki, T., Aiyama, T., Yamada, T., Garmanova, T., Gomez-Sanchez, T., Yamaguchi, T., de Jesus Flores, T., Usub, T., Tsuruma, T., Shimizu, T., Hristov, T. G., van Loon, T., Funakoshi, T., Manzia, T. M., Kiyomatsu, T., Katayama, T., Akagi, T., Mizushima, T., Kazuhito, U., Elmore, U., Grossi, U., Trucha, V. A., Rodriguez, V. S., Testa, V., Tonini, V., Celentano, V., Nekoval, V. M., Bettencourt, V., Mammadov, V., Leyva, V. A. G., Mariscal, V. G. O., Seid, V. E., Klemann, V., Turrado-Rodriguez, V., Papagni, V., Vento, V., Frering, V., Vigorita, V., Petrove, V. V., Lyadov, V., Fu, W., Mi, W., Jeong, W. K., Leclercq, W. K. G., de Sousa, X., Zhao, X., Li, X., Wang, X., Yang, X., Zhang, X., Zhen, Y., Dong, Y., Erushevich, Y., Takii, Y., Sumi, Y., Loli, Y. T., Yifat, Y. L., Shimada, Y., Nabeya, Y., Ide, Y., Wu, Y., Tsukada, Y., Miyamoto, Y., Toiyama, Y., Fujie, Y., Kaneko, Y., Mokutani, Y., Fujii, Y., Kanemitsu, Y., Medkova, Y., Chen, Y., Ruiz, Y. G., Kinugasa, Y., Sow, Z., Razzaq, Z., Wang, Z., Liu, Z., Han, Z., Tai, Z., Lai, Z., Ng, Z. Q., Dambrauskas, Z., Bellato, V, Konishi, T, Pellino, G, An, Y, Piciocchi, A, Sensi, B, Siragusa, L, Khanna, K, P, Bm, Franceschilli, M, Campanelli, M, Efetov, S, S Sica, G, Uggeri, F, Bellato V., Konishi T., Pellino G., An Y., Piciocchi A., Sensi B., Siragusa L., Khanna K., Pirozzi B.M., Franceschilli M., Rottoli M., Campanelli M., Efetov S., Sica G.S., on behalf of S-COVID Collaborative Group [ .., Tonini V., ], Bellato, Vittoria, Konishi, Tsuyoshi, Pellino, Gianluca, An, Yongbo, Piciocchi, Alfonso, Sensi, Bruno, Siragusa, Leandro, Khanna, Krishn, Pirozzi, Brunella Maria, Franceschilli, Marzia, Campanelli, Michela, Efetov, Sergey, Sica, Giuseppe S, Center of Experimental and Molecular Medicine, Graduate School, ACS - Pulmonary hypertension & thrombosis, AII - Infectious diseases, Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Surgery, Amsterdam Reproduction & Development (AR&D), and ​Robotics and image-guided minimally-invasive surgery (ROBOTICS)

Subjects
Cross Infection/prevention & control, Cross-sectional study, Settore MED/18 - CHIRURGIA GENERALE, Coronavirus Infections/prevention & control, Practice Patterns, 0302 clinical medicine, Betacoronavirus, COVID-19, Coronavirus Infections, Cross Infection, Cross-Sectional Studies, Hospitals, Humans, Infection Control, Mass Screening, Pandemics, Pneumonia, Viral, Policy, Practice Patterns, Physicians, SARS-CoV-2, Surgical Procedures, Operative, Surveys and Questionnaires, Pandemic, Hospitals/standards, Infection control, 030212 general & internal medicine, Viral, Pandemics/prevention & control, Practice Patterns, Physicians', Research Theme 1: COVID-19 Pandemic, Pneumonia, Viral/prevention & control, Mass Screening/standards, Health Policy, Operative/adverse effects, Operative, screening policies, preventive measures, Human, Surgical Procedures, Operative/adverse effects, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 030231 tropical medicine, MEDLINE, NO, Physicians'/standards, Hospital, 03 medical and health sciences, Physicians, medicine, Practice Patterns, Physicians'/standards, Mass screening, Cross-Sectional Studie, Physicians', Surgical Procedures, Betacoronaviru, Coronavirus Infection, business.industry, Preoperative screening, Public Health, Environmental and Occupational Health, Viral/prevention & control, Perioperative, Pneumonia, Settore MED/18, COVID-19, Coronavirus Infections, Cross Infection, Cross-Sectional Studies, Hospitals, Humans, Infection Control, Mass Screening, Pandemics, Pneumonia, Viral, Policy, Practice Patterns, Physicians', SARS-CoV-2, Surgical Procedures, Operative, Surveys and Questionnaires, coronavirus Infections, cross infection, cross-sectional studies, hospitals, humans, infection control, mass screening, pandemics, pneumonia, viral, policy, practice patterns, physicians', surgical procedures, operative, surveys and questionnaires, Family medicine, Infection Control/standards, business
Abstract

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide.Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions.Study registration: Registered in ClinicalTrials.gov: NCT04344197.

17. Short-term outcomes of a multicentre prospective study using a "visible" polyvinylidene fluoride onlay mesh for the prevention of midline incisional hernia.

Author

Rodicio Miravalles JL, Méndez CSM, Lopez-Monclus J, Moreno Gijón M, López Quindós P, Amoza Pais S, López López A, García Bear I, Menendez de Llano Ortega R, Díez Pérez de Las Vacas MI, and Garcia-Urena MA

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors, Treatment Outcome, Young Adult, Aged, 80 and over, Fluorocarbon Polymers, Incisional Hernia prevention & control, Magnetic Resonance Imaging, Polyvinyls, Surgical Mesh
Abstract

Introduction: Prophylactic meshes in high-risk patients prevent incisional hernias, although there are still some concerns about the best layer to place them in, the type of fixation, the mesh material, the significance of the level of contamination, and surgical complications. We aimed to provide answers to these questions and information about how the implanted material behaves based on its visibility under magnetic resonance imaging (MRI)., Method: This is a prospective multicentre observational cohort study. Preliminary results from the first 3 months are presented. We included general surgical patients who had at least two risk factors for developing an incisional hernia. Multivariate logistic regression was used. A polyvinylidene fluoride (PVDF) mesh loaded with iron particles was used in an onlay position. MRIs were performed 6 weeks after treatment., Results: Between July 2016 and June 2022, 185 patients were enrolled in the study. Surgery was emergent in 30.3% of cases, contaminated in 10.7% and dirty in 11.8%. A total of 5.6% of cases had postoperative wound infections, with the requirement of stoma being the only significant risk factor (OR = 7.59, p = 0.03). The formation of a seroma at 6 weeks detected by MRI, was associated with body mass index (OR = 1.13, p = 0.02)., Conclusions: The prophylactic use of onlay PVDF mesh in midline laparotomies in high-risk patients was safe and effective in the short term, regardless of the type of surgery or the level of contamination. MRI allowed us to detect asymptomatic seromas during the early process of integration., Study Registration:  This protocol was registered at ClinicalTrials.gov (NCT03105895)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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19. Prophylactic use of incisional negative pressure wound therapy for the prevention of surgical site occurrences in general surgery: Consensus document.

Author

Bueno-Lledó J, Rubio-Pérez I, Moreno-Gijón M, Olona-Casas C, Barbosa E, Molina JM, and Castellanos G

Subjects
Humans, Surgical Wound Infection epidemiology, Consensus, Risk Factors, Negative-Pressure Wound Therapy adverse effects, Surgical Wound complications
Abstract

Background: Surgical site occurrences pose a threat to patient health, potentially resulting in significant increases in health care spending caused by using additional resources. The objective of this study was to reach a consensus among a group of experts in incisional negative pressure wound therapy to determine the indications for using this type of treatment prophylactically and to analyze the associated risk factors of surgical site occurrences in abdominal surgery., Methods: A group of experts in incisional negative pressure wound therapy from Spain and Portugal was formed among general surgery specialists who frequently perform colorectal, esophagogastric, or abdominal wall surgery. The Coordinating Committee performed a bibliographic search to identify the most relevant publications and to create a summary table to serve as a decision-making protocol regarding the use of prophylactic incisional negative pressure wound therapy based on factors related to the patient and type of procedure., Results: The patient risk factors associated with surgical site occurrence development such as age, immunosuppression, anticoagulation, hypoalbuminemia, smoking, American Society of Anesthesiologists classification, diabetes, obesity, and malnutrition were analyzed. For surgical procedure factors, surgical time, repeated surgeries, organ transplantation, need for blood transfusion, complex abdominal wall reconstruction, surgery at a contaminated site, open abdomen closure, emergency surgery, and hyperthermic intraperitoneal chemotherapy were analyzed., Conclusion: In our experience, this consensus has been achieved on a tailored set of recommendations on patient and surgical aspects that should be considered to reduce the risk of surgical site occurrences with the use of prophylactic incisional negative pressure wound therapy, particularly in areas where the evidence base is controversial or lacking., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2023
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22. Prospective Analysis Regarding Health-Related Quality of Life (HR-QOL) between Morbid Obese Patients Following Bariatric Surgery Versus on a Waiting List.

Author

Moreno Gijón M, Díaz Vico T, Rodicio Miravalles JL, López-Negrete Cueto E, Suárez Sánchez A, Amoza Pais S, Sanz Navarro S, Valdés Arias C, Turienzo Santos EO, and Sanz Álvarez LM

Subjects
Female, Humans, Male, Prospective Studies, Quality of Life, Surveys and Questionnaires, Waiting Lists, Bariatric Surgery, Obesity, Morbid surgery
Abstract

Background: Major impairment of health-related quality of life (HRQoL) is one of the main reasons why obese patients request surgical treatment., Objective: To prospectively analyze the impact of HRQoL between obese patients who underwent surgery and those who were wait-listed., Methods: Between April 2017 and March 2018, 70 surgical and 69 wait-listed patients were interviewed twice, at baseline and at the 12-month follow-up. Quality of life was measured by the SF-12v2 and the Impact of Weight on Quality of Life-Lite (IWQoL-Lite) questionnaires. Sociodemographic-, clinical-, and surgical-related variables were collected., Results: One hundred thirty-nine patients were analyzed, showing similar baseline characteristics but differences in HRQoL. Performing more qualified work improved scores on some aspects of the SF-12 survey. In contrast, women scored worse on the self-esteem domain, and men scored worse on the mental health domain. By group, at the 12-month follow-up, statistically significant differences were found among all aspects of the questionnaires between both groups (P < 0.001) and between baseline and postoperative 12-month follow-up in the surgical group (P < 0.001). Furthermore, scores were lower in all domains in the evolution of wait-listed patients, with statistically significant differences among the Bodily Pain, Emotional Role, Mental Health, and Mental Component Summary Domains (P < 0.05)., Conclusion: HRQoL is a multimodal concept that allows the identification of factors impacting obese patients' quality of life. It promotes the benefit of surgery against waiting list delays, which can take up to 4 years in our hospital. Therefore, HRQoL is an important pillar to justify more resources for reducing unacceptable surgical delays.

Published
2020
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23. Economic evaluation of surgical treatment of obesity.

Author

Rodicio Miravalles JL, Alonso Fernández J, Moreno Gijón M, Rizzo Ramos A, Turienzo Santos E, Sanz Álvarez L, Rodríguez García JI, and González González JJ

Subjects
Adult, Comorbidity, Cost-Benefit Analysis, Diagnosis-Related Groups standards, Female, Follow-Up Studies, Gastric Bypass methods, Humans, Laparoscopy methods, Longitudinal Studies, Male, Middle Aged, Obesity epidemiology, Retrospective Studies, Spain epidemiology, Weight Loss, Drug Costs statistics & numerical data, Gastric Bypass economics, Obesity economics, Obesity surgery
Abstract

Introduction: Obesity surgery is the best treatment for extreme obesity, with demonstrated long-term positive outcomes. The potential cost-savings generated by the improvement of comorbidities after surgery can justify the allocation of more resources in the surgical treatment of obesity., Methods: This was an observational, descriptive, longitudinal and retrospective study. Eligible patients underwent Roux-en-Y gastric bypass surgery at the Hospital Universitario Central de Asturias between 2003 and 2012. The established minimum follow-up period was two years. We calculated the individualized cost per patient treated (bottom-up) as well as per Diagnosis-Related Group (DRG) codes (top-down)., Results: Our study included 307 patients. The average cost per hospitalization calculated by DRG codes was €6,545.90, and the average cost per patient was €10,572.20. DRG 288 represented 91% of the series, with a value of €4,631. The number of medications also decreased during this period, from 2.86 to 0.78 per medically treated patient, representing a cost reduction of €4,433 per patient with all the obesity-related comorbidities analyzed., Conclusions: Two years after Roux-en-Y gastric bypass conducted at Hospital Universitario Central de Asturias, the savings in drug costs for patients with multiple pathologies would compensate the inherent costs of the surgical treatment itself. Our results showed that DRG-related costs was insufficient to make a correct economic evaluation, so we recommend an individualized cost calculating method., (Copyright © 2020 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2020
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24. Evidence in follow-up and prognosis of esophagogastric junction cancer.

Author

Sanz Álvarez L, Turienzo Santos E, Rodicio Miravalles JL, Moreno Gijón M, Amoza Pais S, Sanz Navarro S, and Rizzo Ramos A

Subjects
Barrett Esophagus complications, Cardia, Esophageal Neoplasms therapy, Follow-Up Studies, Humans, Neoplasm Recurrence, Local therapy, Prognosis, Stomach Neoplasms therapy, Time Factors, Adenocarcinoma mortality, Esophageal Neoplasms mortality, Esophagogastric Junction, Neoplasm Recurrence, Local mortality, Stomach Neoplasms mortality
Abstract

Five-year survival of tumors of the esophagogastric junction is 50%, in the most favourable stages and with the most effective adjuvant treatments. More than 40% of patients will have recurrences within a short period, usually the first year after potentially curative surgery. Survival after this recurrence is usually less than 6 months because treatment is not very effective, be it palliative chemotherapy, radiotherapy or surgical excision of single recurrences. As the detection of asymptomatic recurrences allows for earlier and more effective treatments to be used, the type and frequency of follow-up has an influence on survival., (Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2019
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25. Laparoscopic treatment of large bowel obstruction due to a self-locating peritoneal dialysis catheter.

Author

Díaz Vico T, Rodicio Miravalles JL, Sánchez Álvarez E, Moreno Gijón M, Rizzo Ramos A, Turienzo Santos EO, and Sanz Álvarez L

Abstract

Introduction: Peritoneal dialysis has been used in the treatment of end-stage renal disease for a long time. The development of continuous ambulatory peritoneal dialysis (CAPD) has achieved an acceptable device of renal replacement therapy., Presentation of Case: We report a 55 year-old patient who was initiated on CAPD in February 2016. Three months later, the Tenckhoff catheter was removed due to its malfunction, and a new self-locating peritoneal dialysis catheter was placed in the left side of the abdomen. In September 2016, the patient presented with symptoms of intestinal obstruction. A CT scan revealed a collapsed sigmoid colon with the tungsten tip of the catheter supported on the mesosigmoid as the cause of the occlusion., Discussion: Herein, a rare but clinically important case of mechanical large bowel obstruction due to self-locating peritoneal dialysis catheter is presented. The weight added to the tip of the self-locating catheter for the purpose of stretching it, can be dangerous if a displacement takes place. A laparoscopic procedure was performed, resolving the obstruction by reinserting the peritoneal catheter in its right position., Conclusion: The weight added to the tip of self-locating catheters is a matter of concern, since intimate contact between the peritoneal catheter and the intestinal wall can result in perforation or intestinal occlusion., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2018
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26. Emergency surgery in chronic intestinal pseudo-obstruction due to mitochondrial neurogastrointestinal encephalomyopathy: case reports.

Author

Granero Castro P, Fernández Arias S, Moreno Gijón M, Alvarez Martínez P, Granero Trancón J, Álvarez Pérez JA, Lamamie Clairac E, and González González JJ

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a syndrome characterized by recurrent clinical episodes of intestinal obstruction in the absence of any mechanical cause occluding the gut. There are multiple causes related to this rare syndrome. Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is one of the causes related to primary CIPO. MNGIE is caused by mutations in the gene encoding thymidine phosphorylase. These mutations lead to an accumulation of thymidine and deoxyuridine in blood and tissues of these patients. Toxic levels of these nucleosides induce mitochondrial DNA abnormalities leading to an abnormal intestinal motility.Herein, we described two rare cases of MNGIE syndrome associated with CIPO, which needed surgical treatment for gastrointestinal complications. In one patient, intra-abdominal hypertension and compartment syndrome generated as a result of the colonic distension forced to perform emergency surgery. In the other patient, a perforated duodenal diverticulum was the cause that forced to perform surgery. There is not a definitive treatment for MNGIE syndrome and survival does not exceed 40 years of age. Surgery only should be considered in some selected patients.

Published
2010
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27. [Pseudo-carcinoma of the colon].

Author

Granero Castro P, Moreno Gijón M, Granero Trancón J, Llaneza Folgueras A, and González González JJ

Subjects
Aged, Colonic Neoplasms diagnosis, Diagnostic Errors, Humans, Male, Colon blood supply, Ischemia diagnosis
Published
2010
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28. Pylephlebitis as a complication of acute appendicitis.

Author

Granero Castro P, Raposo Rodríguez L, Moreno Gijón M, Prieto Fernández A, Granero Trancón J, González González JJ, and Barneo Serra L

Subjects
Adolescent, Humans, Male, Mesenteric Veins, Appendicitis complications, Mesenteric Vascular Occlusion etiology, Phlebitis etiology, Venous Thrombosis etiology
Published
2010
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29. [Granular cell tumor of the appendix].

Author

Moreno Gijón M, Granero Castro P, Fernández García MS, Vázquez Velasco L, and González González JJ

Subjects
Adult, Female, Humans, Appendiceal Neoplasms pathology, Appendiceal Neoplasms surgery, Granular Cell Tumor pathology, Granular Cell Tumor surgery
Published
2009
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