Impact of the laparoscopic approach, early closure and preoperative stimulation on outcomes of ileostomy closure after rectal resection.

AIM: To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach. METHODS: We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission. RESULTS: Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57-113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5-7). Readmission was needed in 6.8% (n = 7) of patients. CONCLUSION: A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.

Uso de las redes sociales por parte de los cirujanos generales. Resultados de la encuesta nacional de la Asociación Española de Cirujanos / Use of social networks by general surgeons. Results of the national survey of the Spanish Association of Surgeons

Introducción: Se desconoce el uso y utilidad de las redes sociales (RR.SS.) entre los cirujanos generales españoles. Métodos: Entre octubre y diciembre de 2017 se realizó una encuesta online a los socios de la Asociación Española de Cirujanos, en la que se recogieron datos de perfil de uso y de opinión sobre RR. SS. Resultados: Se obtuvo respuesta de 360 cirujanos, de los cuales 310 tenían presencia en RR.SS. Las redes más populares fueron: Facebook (86%), LinkedIn (61.6%), YouTube (60,6%) y Twitter (54,2%). LinkedIn y Twitter destacaron como las RR.SS. más empleadas con fines profesionales. Los cirujanos con presencia en RR.SS. eran más jóvenes (42,4 ± 11 años frente a 51,6 ± 8 años; p < 0,001), existiendo a menor edad mayor frecuencia de acceso a las mismas. El género no mostró influencia sobre la presencia en RR.SS. La mayoría de los encuestados tiene perfil en más de una red (3,6 ± 1 cuentas) y el 73,5% comunicó acceder a ellas diariamente. El 19,7% de los servicios de cirugía al que pertenecen los encuestados tiene perfil en RR. SS. Entre las utilidades profesionales destacan las actividades formativas (87%) y el contacto con otros profesionales (84%). El 14,1% de los encuestados utilizan RR. SS. para relacionarse con los pacientes. Conclusiones: Las RR.SS. son útiles para la divulgación de información sobre eventos científicos y actividades formativas, la actualización y adquisición de conocimientos y la comunicación entre profesionales. Aspectos como la privacidad o la relación con los pacientes representan una barrera en el uso de RR. SS

Introduction: The use and utility of social media (SM) among Spanish general surgeons is unknown. Methods: Between October and December 2017 an online survey was carried out to the members of the Spanish Association of Surgeons, in which data on the profile of use and opinion on the usefulness of SM were collected. Results: 360 valid responses were obtained, 310 from surgeons who had an active SM profile. The most popular networks were: Facebook (86%), LinkedIn (61,6%), YouTube (60,6%) and Twitter (54,2%). LinkedIn and Twitter stood out as the most used SM for professional purposes. Surgeons with a SM profile were younger (42.4 ± 11 years versus 51.6 ± 8 years; P < .001). Gender did not show influence on presence in SM. The majority of respondents have profiles in more than one network (3.6 ± 1 accounts) and 73.5% reported daily access to them; 19.7% of the surgery departments to which the respondents belong have a SM account. Among SM utilities in the professional field, training activities (87%) and connectivity among professionals (84%) were the most outstanding; 14.1% of respondents use SM to interact with patients. Conclusions: SM is useful as a tool for the acquisition, updating and dissemination of scientific knowledge, also proving valuable as a new form of interaction among surgeons. Other issues such as privacy or surgeon-patient relationship represent a barrier to its use

Use of social networks by general surgeons. Results of the national survey of the Spanish Association of Surgeons. / Uso de las redes sociales por parte de los cirujanos generales. Resultados de la encuesta nacional de la Asociación Española de Cirujanos.

INTRODUCTION: The use and utility of social media (SM) among Spanish general surgeons is unknown. METHODS: Between October and December 2017 an online survey was carried out to the members of the Spanish Association of Surgeons, in which data on the profile of use and opinion on the usefulness of SM were collected. RESULTS: 360 valid responses were obtained, 310 from surgeons who had an active SM profile. The most popular networks were: Facebook (86%), LinkedIn (61,6%), YouTube (60,6%) and Twitter (54,2%). LinkedIn and Twitter stood out as the most used SM for professional purposes. Surgeons with a SM profile were younger (42.4±11 years versus 51.6±8 years; P<.001). Gender did not show influence on presence in SM. The majority of respondents have profiles in more than one network (3.6±1 accounts) and 73.5% reported daily access to them; 19.7% of the surgery departments to which the respondents belong have a SM account. Among SM utilities in the professional field, training activities (87%) and connectivity among professionals (84%) were the most outstanding; 14.1% of respondents use SM to interact with patients. CONCLUSIONS: SM is useful as a tool for the acquisition, updating and dissemination of scientific knowledge, also proving valuable as a new form of interaction among surgeons. Other issues such as privacy or surgeon-patient relationship represent a barrier to its use.

Tratamiento mediante microcirugía endoscópica transanal de un hamartoma quístico retrorrectal birrecidivado / Transanal endoscopic microsurgery treatment of twice recurred tail-gut

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Reparación laparoscópica de una hernia de Morgagni y hemicolectomía derecha ampliada por neoplasia de colon / Laparoscopic assisted repair of Morgagni hernia and extended right colectomy for colon cancer

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