What guidelines tell us about acute pancreatitis. A review of the last international guidelines
Background Since the Atlanta Symposium several guidelines and consensus conferences have been published to improve the management and understanding of patients with acute pancreatitis. Herein, a review of the most recent guidelines on acute pancreatitis is carried out, trying to find differences and similarities.
Commentary on “A Standard Approach to Expose the Recurrent Laryngeal Nerve During Endoscopic Thyroidectomy”
Multiple small bowel perforations during the treatment of primary intestinal extranodal natural killer/T‐cell lymphoma, nasal type
Effectiveness and efficiency of a special program to reduce the bariatric surgery waiting list at a tertiary hospital
Graphical abstract
Eficacia y eficiencia de un programa especial para la disminución de la lista de espera de cirugía bariátrica en un hospital terciario
Resumen Introduccion La cirugia bariatrica es uno de los procedimientos quirurgicos mas realizados en Espana, sin embargo actualmente es la cirugia con mayor demora en la lista de espera quirurgica (LEQ). Para disminuir la LEQ se pone en marcha un programa especial de autoconcertacion, y se quiere valorar su utilidad, estudiando las repercusiones clinicas y economicas en una unidad de alto volumen de cirugia bariatrica. Metodos Se realizo un estudio prospectivo de 3 meses comparando evolucion, resultados y consumo de recursos perioperatorios de 45 pacientes operados de cirugia bariatrica, divididos en 2 grupos, pacientes operados en quirofano de forma estandar y pacientes operados en progra…
Efficacy and safety of preoperative with Lugol's iodine solution euthyroid patients with Graves' disease (LIGRADIS Trial): study protocol for a multicenter randomized trial
"Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM"
Myocardial Protection by Retrograde Cardioplegic Perfusion in the Presence of Acute Coronary Artery Obstruction: An Experimental Study
To investigate retrograde delivery of cardioplegic solutions as a means of enhancing myocardial protection in the presence of coronary artery occlusion, a two-part experimental model was devised. In part 1 (in vitro) the possibility of retroperfusing the entire myocardium during acute occlusion of the left anterior descending artery (LAD) was assessed. In part 2 (in vivo) acute LAD occlusion was performed in dogs, and during 2 hours of aortic cross-clamping crystalline cardioplegic solution was infused at 20-minute intervals. In group I the infusion was antegrade, via the aortic root, and in group II it was retrograde, via the coronary sinus. Thereafter the LAD snare was released and the do…
Anthropometric parameters and permanent remission of comorbidities 10 years after open gastric bypass in a cohort with high prevalence of super-obesity
Abstract Background and aim Roux-en-Y gastric bypass (RYGB) is an effective treatment for weight loss in patients with morbid obesity. However, few studies have assessed its long-term efficacy in super-obese patients. The study objective was to analyse the long-term effectiveness of RYGB and its effect on improvement of comorbidities after 10 years of follow-up, and to compare the results depending on baseline BMI ( 2 vs ≥50 kg/m 2 ). Patients and methods A retrospective study was conducted in 63 patients referred for RYGB with a 10-year or longer follow-up period. Mean BMI before surgery was 55 kg/m 2 . Results Mean BMI decreased to 38.1 kg/m 2 at 10 years of follow-up. The success rates a…
Recurrence of esophageal cancer after R0 surgery: risk factors and evolution
Introduction despite advances in surgical and adjuvant therapy, recurrence in esophageal cancer submitted to R0 surgery remains high. The aim is to define risk factors and recurrence patterns. Additionally, to show the management carried out and the outcome of patients showing recurrence. Material and methods observational and prospective study that included 61 patients. Neoadjuvancy therapy was indicated on T3, T4 and N+ tumors and every lymph node dissection was performed in two fields. Recurrence is defined at distance, regional or local, when, recurrence is detected after six months. According to clinical features and the recurrences, a palliative, chemotherapeutic or surgical managemen…
Locking Y Lateral Canthopexy as a Treatment for Dry Eye Disease Caused by Eyelid Malposition
PURPOSE The signs and symptoms of dry eye disease (DED) can affect the quality of life of patients. This study analyzes whether locking Y lateral canthopexy improves patients' quality of life and in what way it does so (based on the ocular surface disease index questionnaire) and DED signs (measured by the fluorescein breakup time, tear osmolarity, Schirmer test, and corneal staining) in patients with DED caused by a eyelid malposition or impaired blink dynamics. METHODS This was a case-control study. Forty eyes of 20 patients with DED and lateral canthal disinsertion examined at the University Hospital La Ribera during a 1-year period from November 2016 to November 2017. The 40 eyes were d…
Roux-en-Y Gastric Bypass as an Effective Bariatric Revisional Surgery after Restrictive Procedures
<b><i>Introduction:</i></b> Revisional surgery must be considered when insufficient weight loss is attained or weight is subsequently regained. This study aimed to investigate the value of Roux-en-Y gastric bypass (RYGB) as a revisional procedure after restrictive surgery. <b><i>Materials and Methods:</i></b> An observational, retrospective study including patients initially operated on for morbid obesity with restrictive techniques (vertical-banded gastroplasty [VBG], adjustable gastric band [AGB], and sleeve gastrectomy) and reoperated with RYGB in our centre between December 1994 and January 2019. Demographic and anthropometric data, associ…
Intraoperative Scintigraphy With Portable Gamma Camera for the Localization of Interaortocaval Paraganglioma
A 15-year-old adolescent girl diagnosed of interaortocaval paraganglioma with a positive 123I-MIGB SPECT/CT and 1 unsuccessful prior surgery was operated on with the assistance of a handheld gamma camera. Once the lesion was located and removed, 2 images were taken, one of the surgical field (without 123I-MIGB uptake) and another of the tumor ex vivo (with high 123I-MIGB uptake), confirming that the lesion had been satisfactorily excised. This case highlights the use of a portable gamma camera as a useful tool to locate this rare tumor, with a SPECT/CT positive for 123I-MIGB and a difficult anatomical location suspected.
Randomized clinical trial of pancreaticogastrostomy versus pancreaticojejunostomy on the rate and severity of pancreatic fistula after pancreaticoduodenectomy
Abstract Background Anastomotic leakage of pancreaticojejunostomy (PJ) remains the single most important source of morbidity after pancreaticoduodenectomy (PD). The primary aim of this randomized clinical trial comparing PG with PJ after PD was to test the hypothesis that invaginated PG would result in a lower rate and severity of pancreatic fistula. Methods Patients undergoing PD were randomized to receive either a duct-to-duct PJ or a double-layer invaginated PG. The primary endpoint was the rate of pancreatic fistula, using the definition of the International Study Group on Pancreatic Fistula. Secondary endpoints were the evaluation of severe abdominal complications (Clavien–Dindo grade …