[Leiomyosarcoma of the small intestine]. / Leiomiosarcomas del intestino delgado.

Leiomyosarcoma of the small intestine is a rare neoplasm that has a difficult, and normally late, diagnosis. We present two cases operated in our service and discuss the different forms of clinical presentation, the surgical strategy and the controversial aspects of benignity and malignancy aspects. The survival is emphasized.

A randomized trial on the effect of isotonic amino acid infusion on postoperative complications and short life plasma protein concentrations.

In a randomized clinical study 30 patients with high risk surgical procedures were distributed to receive either standard fluid-therapy (n = 14) or an isotonic amino acid solution (n = 16) during five days. The patients were evaluated pre- and postoperatively using: anthropometric parameters: body weight, biceps and triceps skinfold thickness, and mid arm circumference; biochemical parameters: albumin, prealbumin, transferrin, retinol-binding protein, total iron-binding capacity, and cholesterol; and delayed cutaneous hypersensitivity. Clinical outcome and complications were also recorded. Positive ketonuria was obtained soon in the treatment group after 24 h. Mean daily nitrogen balance was better in the protein sparing group (-3.8 g vs -9.3 g) p less than 0.02. No differences were observed between both groups in the postoperative plasma protein levels. There were no significant differences in delayed cutaneous reactivity nor anthropometric parameters between both groups; and mortality and morbidity were similar. The present study lends little support for substituting the routine D5W and saline postoperative fluid regime. No clinical advantage of amino acids over standard fluids could be appreciated indicating that the much less expensive conventional solutions should not be replaced by amino acids, at least in routine postoperative cases.