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Introduction: major abdomino-pelvic surgery includes a series of procedures that carry a high percentage of postoperative complications. Our objective is to identify the factors related to post-surgical complications, classified according to Clavien-Dindo classification, with special attention to nutritional factors in patients who undergo major abdomino-pelvic surgery., Material and Method: retrospective observational study between July 2012 and December 2013. A total of 255 patients undergoing major abdomino-pelvic surgery (colorectal, gastric, obesity or total cystectomy) were selected on a scheduled basis. Four types of variables were collected: sociodemographic, baseline, diagnostic and outcome variables, including perioperative complications that were classified in 5 grades according to the Clavien-Dindo scale, and for the analysis of results, two groups of patients were separated: The group with complications grade 0 and I and group 2 with complications III to V. The statistical analysis was performed using IBM SPSS version 22.0., Results: patients had a mean age of 65 years. Twenty patients (7.8%) returned in the first 30 days after surgery and 8 patients (3.1%) died. 152 cases (59.6%) were classified in group 1 and 103 cases (40.4%) in group 2. When analyzing both groups, we found significant differences in the operative variables: type of surgery and laparoscopic or open approach. Regarding the physiological and nutritional parameters, we observed significant differences in the following factors: preoperative BMI, preoperative albumin, preoperative hemoglobin and day of onset of postoperative tolerance., Conclusion: in our study we have identified modifiable factors, such as hemoglobin and preoperative albumin, BMI and early onset of oral tolerance, related to postoperative morbidity. Preoperative nutritional status is related to postoperative complications in major abdomino-pelvic surgery.

Introduction: This study was aimed to assess the main clinical, pathological and therapeutic characteristics of a cohort of gastrointestinal stromal tumors (GIST)., Methods: Observational study including 66 patients diagnosed with GIST admitted to our hospital between 2002 and 2015. Parameters related to medical history, clinical manifestations, medical and surgical treatment, histopathology, and morbi-mortality were studied. A review of the literature was included to correlate with the results., Results: The most frequent location of GIST in our patients was the stomach (65.2%), in which the gastric fondo was the predominant region. The most common clinical manifestation was gastrointestinal hemorrhage (45.5%), followed by incidental finding after imaging or invasive procedures (33.3%). 58 patients underwent surgery (90.6%), 15.5% were urgent. A total of 69% of the GISTs had a size between 2 and 10cm. The one-year mortality was 7.9%, all cases related to local or remote extension, or surgical complications., Conclusion: There is a large clinical variability among GIST cases. The first choice of treatment is surgery, which is feasible in most cases and should be as conservative as possible. The prognosis varies depending on the size and proliferation index, thus close follow-up should be performed. No tumor marker is clearly associated with a poor prognosis. New molecular biology studies are needed in order to find therapeutic targets., (Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background and Objective: Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors., Methods: A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves' disease were compared to those with multinodular goiter., Results: Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves' disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery., Conclusions: Early stage thyroid cancer has better survival and prognosis after surgical treatment., (Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)