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Introduction The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma. Methods The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019. Results The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02–19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50–8.86). Conclusion Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival.

Background Major concerns years after the sleeve gastrectomy (SG) include weight regain, development of hiatal hernia (HH) and gastro esophageal reflux disease (GERD), with esophagitis and Barrett's esophagus (BE). Both problems could be related, and the incidence of asymptomatic patients is troubling. Goal To study the incidence of reflux symptoms, esophagitis, BE, hiatal hernia and asymptomatic pathology and their relationship with weight regain in patients 5 years after undergoing SG at different bariatric centers in Spain. Setting Public and private hospitals with bariatric surgery units. Patients and method Prospective, multicenter, non-randomized study involving 13 Spanish hospitals with a cumulative experience of 4500 patients having undergone the SG procedure and patients who had been subjected to the procedure at least 5 years previously along with preoperative gastroscopy. The clinical history, preoperative gastroscopy, and technical details of the SG were recorded. A specific clinical questionnaire was given that recorded the intake volume, perception of satiety and gastroesophageal reflux (GER) symptoms. Gastroscopy, pH-metry and manometry studies were carried out, and the data analyzed statistically. The study has been authorized by the official Spanish ethics committee "CEI/CEIm Hospital Universitario Gran Canaria Dr Negrin", with the code 2019-216-1. Results 105 patients who underwent SG and who had with at least 5 years of follow-up were included. All procedures were performed laparoscopically. The mean age of patients was 51.1 years and 70.5% were women. The mean characteristics of the SG procedure were a 37.2 French probe, at 4.6 cm from the pylorus, and a crura closure was performed in 5 cases. There were no major complications (Clavien Dindo> 3) or deaths. The average preoperative Body Mass Index (BMI) was 46.3 kg/m2, the minimum reached was 20.6 kg/m2, while the average after 5 years was of 34.5 kg/m2. The presence of GER, hiatal hernia and esophagitis symptoms went from 17.1%, 28.6% and 5.7%, respectively, before the SG to 76%, 30,5% and 31,4% respectively, 5 years after the procedure. Symptoms persisted over the years in 37,1% of cases and presented de novo in 52,8% of cases. 53% of manometries (n=27, total 51) and 64% of pH-metries (n=32, total 53) (DeMeester average score was 65) were pathological 5 years after the procedure. Concerning gastroscopies, 5 years after the procedure, HH was found in 33 patients (30,5% of total) and esophagitis in 32 patients (31,4% of total). 80 patients (76%) had GER symptoms, and 25 patients (24%) were asymptomatics. Only one patient (0,9%) developed BE. Conclusion Our study has confirmed a high rate of both “persistent” and “de novo” esophagitis and hiatal hernia, many of which were asymptomatic, 5 years after SG had been performed. Weight regain and a striking increase in gastric capacity are risk factors indicative of esophagitis, even when patients are asymptomatic. We consider a control gastroscopy and the preventive use of proton pump inhibitors (PPIs) necessary in these cases, regardless of symptoms. We recommend a control gastroscopy should be performed in all cases, regardless of symptoms, 5 years after SG. Further studies are needed to validate these recommendations.

Resumen Introduccion La cirugia y la quimioterapia han aumentado la supervivencia de los pacientes con neoplasias pancreaticas. La disminucion de la morbimortalidad postoperatoria y el aumento de la esperanza de vida han ampliado las indicaciones de la duodenopancreatectomia cefalica (DPC), aunque sigue siendo controvertida en la poblacion geriatrica. Metodos Estudio observacional retrospectivo sobre una base de datos prospectiva, de pacientes con adenocarcinoma ductal de pancreas sometidos a una DPC entre 2007-2018. El objetivo principal fue analizar la morbimortalidad y supervivencia asociada a la DPC en pacientes ≥ 75 anos (ancianos). Resultados Se incluyeron 79 pacientes, 21 de ellos mayores de 75 anos (27%); dentro de este grupo el 23,9% tenian mas de 80 anos. El ASA de ambos grupos fue similar. Los pacientes ≥ 75anos requirieron mas transfusiones. No se observaron diferencias en el tiempo operatorio, aunque en los ancianos se realizaron mas resecciones vasculares (26 vs. 8,7%; p = 0,037). La morbilidad fue mayor en los ancianos (61,9 vs. 46,6%), aunque sin diferencias. Los ≥ 75anos presentaron mas complicaciones no quirurgicas (33,3%; p = 0,050) siendo la neumonia la mas frecuente. La mortalidad postoperatoria fue superior en los ≥ 75anos (9 vs. 0%; p = 0,017), constituyendo la reseccion venosa un factor de riesgo (p = 0,01). La supervivencia global y la supervivencia libre de enfermedad no mostraron diferencias significativas en ambos grupos. Conclusiones Los pacientes ancianos presentaron una mayor mortalidad postoperatoria y mas complicaciones no quirurgicas. La supervivencia no mostro diferencias, por lo que, con una adecuada seleccion de pacientes, la edad no debe constituirse por si misma como una contraindicacion para la DPC.

Cytoreductive surgery (CRS) provides a survival benefit when achieved without residual disease. As diaphragm is frequently affected in peritoneal malignancies, complete cytoreduction often requires surgical techniques over the diaphragm. The purpose of the study was to assess diaphragmatic resection impact on cytoreduction completeness, morbidity and mortality compared to less aggressive diaphragmatic peritonectomy in CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) settings.Patients with peritoneal carcinomatosis and supramesocolic disease undergoing CRS/HIPEC from 2011 to 2019 were included in a prospectively collected database. We compared patients who underwent full-thickness diaphragmatic resection (DR) and diaphragmatic peritonectomy (DP). Epidemiological and clinical data, morbidity, and mortality within 90 days of surgery were documented.232 patients were initially selected. Inclusion criteria were met by 88 procedures. DR was performed on 32 patients and DP on 56. Number of resected organs was 5.21 in the DR cohort vs. 3.57 in the DP cohort (p0.0001). Rate of Peritoneal Cancer Index (PCI) score14 was higher in the DR group (75%) than in the DP group (50.9%) (p=0.027). Tumor invasion of diaphragmatic muscle after DR was confirmed in 89.3% patients. Postoperative pleural effusion was observed in 28 patients (50%) in the DP group and in 17 (53.1%) in the DR group.CRS/HIPEC requires specific surgical techniques over the diaphragm to achieve complete cytoreduction. As diaphragmatic muscle invasion is frequent, full-thickness resection may allow a cytoreduction completeness increase without an increased morbidity. Pleural drains are not systematically required as these procedures show low incidence of major respiratory complications.

Introduction We distributed a survey in order to determine the current indications for the use of colonic stents to treat colonic obstruction in Spain and its compliance with international guidelines. Methods Descriptive study of a survey distributed by the Spanish Association of Surgeons (Asociacion Espanola de Cirujanos), the Catalan Society of Surgery (Societat Catalana de Cirurgia) and the Spanish Society of Digestive Endoscopy (Sociedad Espanola de Endoscopia Digestiva). Results 340 valid responses were received: 25% from gastrointestinal specialists, and 75% from general surgeons. During the last year, 44.4% of respondents assessed between 10 and 20 COC. Of these, 52.2% indicated less than 5 stents/year, 75% of which were indicated as a prior step to preferential surgery and only 25% were performed with palliative intent. 55.3% of the participants reported knowing the official guidelines, and 64% of respondents would use the stent as a step prior to surgery in elderly patients with localized disease. 75.9% would place stents as palliative therapy in young patients with carcinomatosis, and 61.8% would use them in stage IV malignancies under treatment with chemotherapy. Only 18.1% knew of the risk of colon perforation after stent placement in patients undergoing treatment with antiangiogenics. Conclusions In Spain, the indication for colonic stents is reserved for selected cases and varies according to the specialty and the years of experience of the respondent. The compliance with international guidelines of most respondents is moderate. It is important to insist on the high risk of perforation after angiogenics, which is unknown to most surgeons.

Resumen Introduccion Difundimos una encuesta con el objetivo de conocer las indicaciones actuales para la utilizacion del stent de colon para el tratamiento de la obstruccion colonica en Espana y su adecuacion a las guias internacionales. Metodos Estudio descriptivo de una encuesta distribuida por la Asociacion Espanola de Cirujanos, la Societat Catalana de Cirurgia y la Sociedad Espanola de Endoscopia Digestiva. Resultados Se recibieron 340 respuestas validas, un 25% de medicos digestologos, y el 75% de cirujanos generales. Durante el ultimo ano el 44,4% de los encuestados valoro entre 10 a 20 COC. Un 52,2% indico menos de 5 stents/ano, y de estos el 75% se indico como paso previo a una cirugia preferente y solo el 25% se realizo con intencion paliativa. Un 55,3% de los participantes refirio conocer las guias oficiales. El 64% de los encuestados utilizaria el stent como paso previo a cirugia en ancianos con enfermedad localizada. El 75,9% colocaria stent con fines paliativos en jovenes con carcinomatosis, y un 61,8% los utilizaria en neoplasias estadio iv en tratamiento con quimioterapia. Solo un 18,1% conocia el riesgo de perforacion de colon tras stent en pacientes en tratamiento con antiangiogenicos. Conclusiones En Espana la indicacion del stent de colon se reserva para casos seleccionados y varia segun la especialidad y los anos de experiencia del encuestado. La adecuacion a las guias internacionales para la mayoria de los encuestados es moderada. Es importante insistir en el alto riesgo de perforacion tras angiogenicos, pues la mayoria de profesionales lo desconocen.

Mesenteric fibromatosis is a benign locally-aggressive mesenchymal neoplasm that lacks the potential for metastasis. It is related to Gardner's Syndrome, previous trauma, abdominal surgery, and prolonged intake of oestrogen. Differentially diagnosing this from similar tumours is crucial in order for establishing the appropriate treatment and only immunohistochemical features can be used for a definitive diagnosis. Although medical therapies play a role in the treatment of mesenteric fibromatosis, surgical resection is the gold-standard procedure.Our case study is a 40-year-old male with a concomitant diagnosis of non-Hodgkin lymphoma and mesenteric fibromatosis, not associated with any of the risk factors mentioned above. We performed CT and PET scans and observed a vascularised and well-defined mesenteric centre-abdominal hypermetabolic solid mass in contact with the gastric body, duodenum, body and tail of the pancreas, transverse colon, and spleen. An ultrasound-guided tru-cut biopsy revealed features suggestive of mesenteric fibromatosis.An elective laparotomy was carried out and a giant mass, arising from mesentery, was excised, including a partial gastrectomy and segmental resection of the transverse colon. Distal pancreatectomy, small bowel resection and successive splenectomy were performed due to a large hypertensive component. The postoperative period was uneventful. The histopathology of the surgical pieces was compatible with intra-abdominal desmoid fibromatosis.As far as we know from the literature, this is the largest mesenteric fibromatosis tumour ever to be excised. We also noticed that this is the first reported case of the concomitant presence of mesenteric fibromatosis and non-Hodgkin lymphoma that is not related to any of the described risk factors. Further research is needed to establish what type of association this presentation may indicate.

The incidence of anal cancer has increased in recent years, making screening and early detection of anal intraepithelial neoplasia (AIN) a necessity in patients at risk.A descriptive observational study of homosexual patients (MSM) or women with CIN III, with human immunodeficiency virus (HIV) infection included in an AIN detection screening program was carried out between March 2016 and September 2019.We have performed 695 anal smears, 156 with results of LSIL (low-grade lesion) or HSIL (high-grade lesion) (22.4%), 116 high resolution anoscopy (HRA) 75.3% of patients with altered cytology. We have 403 biopsies being 84% pathological, 197 biopsies of AIN 1 (49%), 96 AIN II and III (24%), 44 were condylomas (11%) and the rest, 16%, normal mucosa.The high prevalence of premalignant lesions and the improvement in the staging of lesions after treatment recommend this protocol.

To the EditorBody packing (BP) is a method of drug trafficking in which smugglers ingest drug-filled packages before travelling, usually crossing international boundaries [1]. Drug packets usually ...

espanolEl tratamiento del cancer de esofago ha experimentado un cambio con el avance de la cirugia minimamente invasiva. Se reducen las tasas de morbi-mortalidad y complicaciones de los pacientes quienes son sometidos a esofagectomia minimamente invasiva. Presentamos el caso de un paciente de 60 anos con adenocarcinoma de esofago distal a quien se le realizo esofaguectomia total minimamente invasiva. https://www.youtube.com/watch?v=NYKf4vZk2UU EnglishThe treatment of oesophageal cancer has undergone a change with the progress of minimally invasive surgery. The morbidity and mortality rates of patients who undergo minimally invasive esophagectomy are dropping. We present the case of a 60-year-old patient with distal oesophageal adenocarcinoma who underwent minimally invasive total esophagectomy. Full video

Gastrointestinal melanoma metastases are not uncommon, with the jejunum and ileum being the most common locations (58 %), followed by the stomach (26 %), colon (22 %), duodenum (12 %), and rectum (5 %).

Hydatidosis is a zoonosis caused by Echinococcus in the larval stage. Humans are accidental intermediary hosts where cystic lesions develop, primarily in the liver and the lungs. It is usually asymptomatic, hence it often represents an incidental finding. Symptoms result from cyst expansion and/or host inflammatory reaction. Hepatomegaly is the most common sign. Hydatidosis induces no specific changes in lab tests but immunodiagnostics are available that may complement its study, with antibody detection being the modality of choice. While ultrasound is the main diagnostic technique, tomography offers more accurate information regarding both characteristics and anatomical relations. A number of therapy options are presently available. Treatment with albendazole, whether combined or not with praziquantel, is useful for smaller, uncomplicated cysts (5 cm). Only 30 % of cysts disappear with medical treatment alone. Surgery is indicated for bigger liver cysts (10 cm), and cysts at risk of rupture and/or complicated cysts. The laparoscopic approach is scarcely widespread. The radical technique (total cystopericystectomy) is preferable because of its lower risk for postoperative abdominal infection, biliary fistula, and overall morbidity. Conservative techniques are appropriate in endemic areas where surgery is performed by nonspecialist surgeons. PAIR (puncture-aspiration-injection-reaspiration) is an innovative technique representing an alternative to surgery. It is indicated for inoperable cases and/or patients who reject surgery, for recurrence after surgery, and for lack of response to medical treatment. Active surveillance without treatment may be indicated for quiescent or inactive, uncomplicated liver cysts.

La combinación de anestesia general con analgesia epidural se considera como el gold-estándar para la cirugía abdominal por vía laparotómica. Ante la aparición de síntomas neurológicos en el postoperatorio inmediato de pacientes portadores de catéter epidural es preciso sospechar de complicaciones relacionadas con el mismo.En caso de presentar un hematoma epidural, es fundamental un diagnóstico precoz con prueba de imagen y la realización de una cirugía descompresiva urgente.

Surgery and chemotherapy have increased the survival of pancreatic cancer. The decrease in postoperative morbidity and mortality and increase in life expectancy, has expanded the indications por cephalic pancreaticoduodenectomy (PDC), although it remains controversial in the geriatric population.Retrospective study on a prospective database of patients with ductal adenocarcinoma of pancreas who underwent PDC between 2007-2018. The main objective was to analyse the morbidity-mortality and survival associated with PDC in patients ≥75 years (elderly).79 patients were included, 21 of them older than 75 years (27%); within this group, 23'9% were over 80 years old. The ASA of both groups was similar. Patients ≥75 years required more transfusions. No differences in operating time were observed, although more vascular resection were performed in the elderly (26 vs. 8.7%; P = .037). Morbidity was higher in the elderly (61.9% vs. 46.6%), although without differences. Patients aged ≥75 years had more non-surgical complications (33.3%, P = .050), being pneumonia the most frequent. Postoperative mortality was higher in the ≥75 years (9 vs. 0%; P = .017). The overall survival and disease-free survival did not show significant differences in both groups.Elderly patients had higher postoperative mortality and more non-surgical complications. Survival did not show differences, so with an adequate selection of patients, age should not be considered itself as a contraindication for PDC.

To date, bariatric surgery has been proposed as the most effective treatment to resolve morbid obesity, a multifactorial chronic disease with an epidemic and increasing tendency. The purpose of this study was to determinate the impact of the laparoscopy on weight loss parameters in morbid obese patients who underwent surgery according to Scopinaro’s biliopancreatic diversion (BPD) and evaluate early and late complications related to the open and laparoscopic approach of this technique. This is a longitudinal retrospective study in consecutive patients undergoing BPD due to morbid obesity between 1999 and 2015. From 2006 the laparoscopic technique was introduced in our group for obesity surgery. In both approaches, open and laparoscopic surgery, the procedure performed consists of a proximal gastric section with a long Roux-en-Y reconstruction. The following variables were assessed in the two groups: intervention duration (min), estimated blood loss (mL), conversions to open approach (%), preoperative stay, postoperative and global stay (days). Complications were divided into early and late postoperative complications. The early surgical complications were catalogued according to the Clavien–Dindo classification. Two hundred seventy-seven patients were consecutively enrolled and divided in two groups: open BPD and laparoscopic BPD. There were no significant differences in the comparison of the two groups and the mean age was 43.9 years (19–60) with a mean BMI of 52.5 kg/m2. A statistically significant reduction was observed in favor of the laparoscopic group with respect to the reduction in hospital stay and in the incidence of incisional hernia as a late complication. No statistically significant difference were found with respect to early postoperative complications. Laparoscopic BPD is a safe technique that allows a shorter hospital stay compared to open surgery and that allows a drastic reduction in the incidence of incisional hernias.

Rectal adenocarcinoma usually metastasizes to the liver and lungs and when it has bone spread, it more frequently involves the vertebrae and pelvis. Thus, aberrant metastasis from a rectal adenocarcinoma to upper extremities with preservation of intra-abdominal organs is very uncommon. We present the case of an 80-year-old male patient with a diagnosis of adenocarcinoma of the rectum T4N1M1 with non-axial single bone metastases and with preservation of visceral organs. Anterior resection of rectum after neoadjuvant chemotherapy and radiotherapy were made. The bone metastasis received palliative radiotherapy and was not resected. The patient died 10 months after diagnosis. This clinical situation generally has a poor prognosis. When the patient complains of unusual bone pain it is necessary to suspect a malignant disease and even if extraordinarily rare, rectal cancer must be considered as a possible cause.

Resumen El uso de la fluorescencia en cirugia se ha ampliado y difundido en los ultimos anos, lo que ha constituido un autentico fenomeno tecnologico ligado a la aparicion de dispositivos adaptados a su utilizacion en los abordajes laparoscopicos y roboticos. La cirugia guiada por fluorescencia en el campo de la cirugia endocrina esta igualmente en auge. Cada vez son mas los articulos que describen su uso en la cirugia de las glandulas tiroides, paratiroides y suprarrenal, aunque con series aun modestas y con protocolos diversos no estandarizados. Existen actualmente diversas areas de desarrollo de la aplicacion de la fluorescencia en cirugia endocrina. Cabe destacar el uso de la fluorescencia con verde de indocianina en cirugia suprarrenal, la identificacion y prediccion de la perfusion paratiroidea con verde de indocianina, y la autofluorescencia de las glandulas paratiroides. El objetivo de este articulo es revisar las actuales aplicaciones de la fluorescencia en cirugia endocrina.

The use of fluorescence in surgery has expanded and become widespread in recent years, which has led to a real technological phenomenon with the emergence of devices adapted for use in laparoscopic and robotic approaches. Fluorescence-guided surgery in the field of endocrine surgery is also on the rise. More and more articles describe its use in surgery of the thyroid, parathyroid and adrenal glands, although the series are still modest in size and protocols have not been standardized. There are currently several developing areas for the application of fluorescence in endocrine surgery, including the use of fluorescence with indocyanine green in adrenal gland surgery, the identification and prediction of parathyroid perfusion with indocyanine green, and autofluorescence of the parathyroid glands. The objective of this article is to review the current applications of fluorescence in endocrine surgery.

Introduction Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (HIPEC) has recently been established as the treatment of choice for selected patients with peritoneal carcinomatosis of colonic origin. Until recently, the simultaneous presence of peritoneal and hepatic dissemination has been considered a contraindication for surgery. The aim of this paper is to analyze the morbidity, mortality and survival of patients with simultaneous peritoneal and hepatic resection with HIPEC for peritoneal carcinomatosis secondary to colon cancer. Methods Between January 2010 and January 2015, 61 patients were operated on, 16 had simultaneous peritoneal and hepatic dissemination (group RH+), and 45 presented only peritoneal dissemination (group RH−). Results There were no differences between the groups in terms of demographic data, length of surgery and extension of peritoneal disease. Postoperative grade III–V complications were significantly higher in the RH+ group (56.3 vs 26.6%; P =0.032). For the whole group, mortality rate was 3.2% (two patients in group RH−, and none in group RH+). Patients with liver resection had a longer postoperative stay (14.4 vs 23.1 days) ( P =.027). Median overall survival was 33 months for RH−, and 36 for RH+ group. Median disease-free survival was 16 months for RH−, and 24 months for RH+ group. Conclusions Simultaneous peritoneal cytoreduction and hepatic resection resulted in a significantly higher Clavien grade III–V morbidity and a longer hospital stay, although the results are similar to other major abdominal interventions. The application of multimodal oncological and surgical treatment may obtain similar long-term survival results in both groups.

Resumen Introduccion La citorreduccion con quimioterapia intraperitoneal hipertermica (HIPEC) se ha postulado como tratamiento de eleccion en pacientes seleccionados con carcinomatosis peritoneal por cancer de colon. La presencia simultanea de diseminacion peritoneal y hepatica ha sido considerada una contraindicacion para esta cirugia. El objetivo del presente estudio es analizar la morbimortalidad y supervivencia de los pacientes con carcinomatosis peritoneal por cancer de colon, intervenidos mediante una citorreduccion peritoneal y reseccion hepatica simultanea con HIPEC. Metodos Entre enero de 2010 y enero de 2015 se intervinieron 61 pacientes, 45 pacientes con carcinomatosis peritoneal (grupo RH−) y 16 con carcinomatosis peritoneal y metastasis hepaticas (grupo RH+). Resultados No hubo diferencias significativas entre los 2 grupos en los datos demograficos, ASA, duracion de la intervencion, ni extension de la enfermedad peritoneal. Las complicaciones postoperatorias Clavien III-V fueron significativamente superiores en el grupo RH+ (56,3 vs. 26,6%; p = 0,03). La mortalidad global de la serie fue del 3,2% (2 pacientes en el grupo RH− y ninguno en el grupo RH+). Los pacientes con reseccion hepatica presentaron una estancia hospitalaria significativamente mas larga (14,4 vs. 23,1 dias; p = 0,027). La mediana estimada de supervivencia global fue de 33 meses para RH− y de 36 meses para RH+, y la de supervivencia libre de enfermedad fue de 16 meses para RH− y de 24 para RH+. Conclusiones La citorreduccion peritoneal con reseccion hepatica simultanea presenta una morbilidad postoperatoria y una estancia hospitalaria significativamente mayores, aunque las cifras son similares a las de otras cirugias abdominales mayores. La aplicacion de un tratamiento oncologico y quirurgico multimodal permite obtener resultados de supervivencia similares en ambos grupos.

In the multidisciplinary therapeutic approach to obesity, bariatric surgery is considered the most effective treatment in weight reduction and the decrease in associated comorbidities. The objective of this work is to describe the long-term clinical and metabolic results in obese patients undergoing biliopancreatic diversion (BPD) according to Scopinaro’s technique. Patients undergoing surgery were followed by the same multidisciplinary team in a study period of 15 years (1999–2015). A retrospective study based on a prospective database was designed, where data on the evolution of obesity-related diseases and nutritional parameters were studied. Two hundred seventy-seven patients were collected; 75.5% were women. The preoperative body mass index (BMI) decreased from 52.5 kg/m2 to 34.9 kg/m2 10 years after surgery. A resolution or improvement of diabetes has been observed in 85.38% of the patients; a decrease in arterial hypertension and obstructive sleep apnea syndrome were in 65.61% and 89.14%, respectively. Throughout the monitoring of the sample, protein malnutrition increased, from 1.8% after the first year of surgery to 4.5% 10 years after the operation. Even if Scopinaro’s technique is beginning to be replaced by other malabsorptive techniques, it can still be considered as an effective surgical procedure in terms of weight loss, quality of life, and evolution of obesity-related diseases. In order to avoid nutritional deficiencies, the operated patients need a strict follow-up and a supplementation adjusted to the technique.

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective but complex treatment for peritoneal metastasis (PM). Our objective was to identify risk factors for postoperative morbidity and mortality following CRS-HIPEC. Retrospective study of prospectively collected data of patients undergoing CRS-HIPEC for PM arises from colorectal cancer between January 2008 and December 2017. Perioperative variables were correlated with morbidity outcomes using a logistic regression model. Sixty-seven patients underwent CRS-HIPEC, and overall morbidity and mortality were 31.3% and 4.5% respectively. Major morbidity rate was 19.4%; 7.5% of patients were re-operated. Intraoperative blood transfusion (p = 0.01), liver resection (p