Lymphoepithelioma-like carcinoma of the large intestine: a case report and literature review / Carcinoma tipo linfoepitelioma de intestino grueso: descripción de un caso y revisión de la literatura

Lymphoepithelioma like carcinoma (LELC) is a well-known neoplastic lesion that mainly involves the stomach and which has been linked to Epstein Barr virus infection. There are exceptional cases of intestinal involvement by LELC, with 7 reported cases to date. We report a new case of LELC affecting the right colon and review the literature on this rare disorder, with special emphasis on pathogenesis, molecular features and differential diagnosis (AU)

El carcinoma tipo linfoepitelioma es una entidad conocida que suele afectar al estómago y se ha relacionado con infección por el virus de Epstein-Barr. La afectación intestinal es mucho más infrecuente, y en la literatura en inglés se han publicado solo 7 casos hasta la fecha. Describimos un caso de carcinoma tipo linfoepitelioma que afectó al colon derecho y realizamos una revisión de la literatura con especial énfasis en su patogenia, características moleculares y diagnóstico diferencial (AU)

Lymphoepithelioma-like carcinoma of the large intestine: A case report and literature review.

Lymphoepithelioma like carcinoma (LELC) is a well-known neoplastic lesion that mainly involves the stomach and which has been linked to Epstein Barr virus infection. There are exceptional cases of intestinal involvement by LELC, with 7 reported cases to date. We report a new case of LELC affecting the right colon and review the literature on this rare disorder, with special emphasis on pathogenesis, molecular features and differential diagnosis.

Schwannomas gastrointestinales: revisión de la literatura a propósito de 5 casos en intestino / Gastrointestinal schwannomas: report of five intestinal cases and a review of the literature

Se han documentado menos de 300 schwannomas en el tracto gastrointestinal, la mayor parte de ellos en el estómago, siendo muy raros en intestino delgado y recto. Tienen características clínicas, histológicas, inmunohistoquímicas y moleculares distintas de las de los schwannomas de partes blandas. Realizamos una revisión de 5 casos de schwannomas intestinales diagnosticados en el Hospital Clínico San Carlos en el periodo 2005-2015. La media de edad fue de 74 años y 4 de los pacientes eran mujeres. Tres se localizaban en el ciego, uno en el yeyuno distal y uno en el íleon. El tamaño variaba entre 0,5 y 4,5cm. El estudio microscópico mostró 5 lesiones no encapsuladas, con células fusiformes en haces sin clara empalizada ni cuerpos de Verocay. En 4 de los casos se observó infiltrado linfocitario periférico, con infiltrado linfoplasmocitario difuso asociado. S100 mostró positividad difusa y el índice Ki-67 fue menor al 10%. No se observó recidiva en ningún paciente (AU)

Less than 300 cases of gastrointestinal schwannoma have been reported to date. They occur most commonly in the stomach, being rare in the small bowel and rectum, and show characteristic clinical, histological, immunohistochemical and molecular features. We reviewed five cases of gastrointestinal schwannoma diagnosed between 2005 and 2015 in our hospital (Hospital Clínico San Carlos, Madrid). The patients were four women and one man, with a median age of 74 years. Three tumours were located in the caecum, one in the jejunum and one in the ileum. Tumour size ranged from 0.5 to 4.5cm. Microscopically, all were composed of monotonous benign-appearing spindle cells, without well-formed palisades or Verocay bodies. In all cases, except one, peripheral cuff-like lymphoid aggregates and/or diffuse lymphoplasmacytic infiltrate were present. S100 was diffusely positive and Ki-67 index was lower than 10%. None of the patients had recurrences or metastases (AU)

Resultados de la implantación de un protocolo de fast-track en una unidad de cirugía colorrectal: estudio comparativo / Results of applying a fast-track protocol in a colorectal surgery unit: comparative study

Objetivo: Implantar un protocolo de fast-track (FT) en una unidad de cirugía colorrectal, comprobando la seguridad de aplicación del mismo, en pacientes sometidos a cirugía colorrectal electiva, mediante la evaluación de las diferencias de morbilidad y estancia hospitalaria con respecto a un grupo control (GC) con cuidados tradicionales. Analizamos también la recuperación funcional del grupo FT. Material y método Se compararon mediante un estudio de cohorte prospectivo con control no concurrente, un grupo de 108 pacientes intervenidos por cáncer colorrectal entre 2008 y 2009, a los que se les aplicó el protocolo FT y un GC de 147 pacientes intervenidos entre 2005 y 2007 de similares características, con cuidados postoperatorios tradicionales. Resultados Fueron similares en ambos grupos las características demográficas, el riesgo anestésico y los procedimientos quirúrgicos realizados, con un mayor número de pacientes con abordaje laparoscópico en el grupo FT. El cumplimiento de los ítems incluidos en nuestro protocolo FT fue elevado (72,2-92,6%).Se observaron complicaciones en 77 pacientes (52%) del GC frente a 30 (27,8%) en el grupo FT (p<0,001), debido fundamentalmente a la disminución de la infección de la herida quirúrgica (p<0,001). Mortalidad y número de reingresos fueron menores en el grupo FT, sin diferencias estadísticamente significativas. La mediana de estancia hospitalaria fue de 14 días en el GC y de 8 en el FT (p<0,001).Conclusiones La aplicación de un programa de FT en cirugía colorrectal es segura, permitiendo una disminución significativa de la morbilidad y la estancia hospitalaria, sin aumentar el número de reingresos (AU)

Objective: To implement a fast-track (FT) protocol in a colorectal surgery unit, checking its safety when applied to patients subjected to elective colorectal surgery, by evaluating the differences in morbidity and hospital stay compared to a control group with traditional care. We also analyse the functional recovery of the FT group. Material and method: A prospective cohort study with non-concurrent control, was conducted on a group of 108 patients operated on for colorectal cancer between 2008 and 2009,to which the FT protocol was applied, and a control group (CG) of 147 patients subjected to surgery between 2005 and 2007 with similar characteristics, with traditional postoperative care. Results: The demographic characteristics, anaesthetic risk, and the surgical procedures performed were similar, with a higher number of patients with laparoscopic approach in the FT group. The compliance with the items in our FT protocol was high (72.2-92.6%).Complications were observed in 77 patients (52%) in the GC compared to 30 (27.8%) in the FT group (P<.001), mainly due to the decrease in surgical wound infection (P<.001). Mortality and the number of readmissions were less in the FT group, with no statistically significant differences. The median hospital stay was 14 days in the CG and 8 in the FT group (P<.001).Conclusions: The applying of an FT program in colorectal surgery is safe, leading to a significant decrease in morbidity and hospital stay, without increasing the number of readmissions (AU)

[Results of applying a fast-track protocol in a colorectal surgery unit: comparative study]. / Resultados de la implantación de un protocolo de fast-track en una unidad de cirugía colorrectal: estudio comparativo.

OBJECTIVE: To implement a fast-track (FT) protocol in a colorectal surgery unit, checking its safety when applied to patients subjected to elective colorectal surgery, by evaluating the differences in morbidity and hospital stay compared to a control group with traditional care. We also analyse the functional recovery of the FT group. MATERIAL AND METHOD: A prospective cohort study with non-concurrent control, was conducted on a group of 108 patients operated on for colorectal cancer between 2008 and 2009, to which the FT protocol was applied, and a control group (CG) of 147 patients subjected to surgery between 2005 and 2007 with similar characteristics, with traditional postoperative care. RESULTS: The demographic characteristics, anaesthetic risk, and the surgical procedures performed were similar, with a higher number of patients with laparoscopic approach in the FT group. The compliance with the items in our FT protocol was high (72.2-92.6%). Complications were observed in 77 patients (52%) in the GC compared to 30 (27.8%) in the FT group (P<.001), mainly due to the decrease in surgical wound infection (P<.001). Mortality and the number of readmissions were less in the FT group, with no statistically significant differences. The median hospital stay was 14 days in the CG and 8 in the FT group (P<.001). CONCLUSIONS: The applying of an FT program in colorectal surgery is safe, leading to a significant decrease in morbidity and hospital stay, without increasing the number of readmissions.