¿Es la apendicectomía un tratamiento válido en las neoplasias mucinosas apendiculares de bajo grado? / Is appendectomy a valid treatment in low-grade appendiceal mucinous neoplasms (lamn)?

Introducción: las neoplasias mucinosas apendiculares de bajo grado son una patología infrecuente, cuyo manejo quirúrgico ha variado en los últimos anos. Métodos: estudio retrospectivo de pacientes con diagnostico anatomopatologico de neoplasias mucinosas apendiculares de bajo grado. Resultados: se incluyeron 28 pacientes con una edad mediana de 63 años. La clínica predominante de presentación fue la apendicitis aguda en 11 pacientes (39,3%). El 35,7% se abordaron mediante laparoscopia. En el 39,3% se describe perforación apendicular y el 25% presentan moco libre en la cavidad abdominal. En el 60,7% se realizo de inicio una apendicectomia, presentando el estudio anatomopatologico afectación de los bordes en 5 pacientes. En 4 de los 5 se amplió la resección, sin evidencia de enfermedad residual. Conclusiones: la apendicetomía es el tratamiento recomendado en las neoplasias mucinosas de bajo grado. Si existen márgenes afectos se debe individualizar el tratamiento, valorando el seguimiento como una opción a considerar

Introduction: low-grade appendiceal mucinous neoplasms are an infrequent pathology, whose surgical management has varied in recent years. Methods: retrospective study of patients with anatomopathological diagnosis of low grade appendiceal mucinous neoplasms. Results: twenty-eight patients with a median age of 63 years were included. The main clinical presentation was acute appendicitis in 11 patients (39.3%). 35.7% were approached by laparoscopy. In 39,3% patients is described appendicular perforation and 25% present free mucus in the abdominal cavity. In 60,7% patients was performed an appendectomy, presenting the pathological study the border affected in 5 patients. In 4 of the 5 resection was extended, without evidence of residual disease. Conclusions: appendectomy is the recommended treatment in low grade mucinous neoplasms. If there borders are affected, treatmentshould be individualized, assessing follow-up as an option to be considered

[Assessment of antibiotic prophylaxis adequacy in rectal surgery]. / Evaluación de la adecuación de la profilaxis antibiótica en la cirugía de recto.

OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection (SSI), so the development of guidelines and assessment of its monitoring is essential. In this study protocol compliance of antibiotic prophylaxis in rectal surgery and the effect of its adequacy in terms of pre-ention of SSI was assessed. METHODS: Prospective cohort study was conducted from 1 January 2009 to 30 December 2015. The degree of compliance with antibiotic prophylaxis and causes of non-compliance in rectal surgery was evaluated. The incidence of SSI was studied after a maximum period of 30 days of incubation. To assess the effect of prophylaxis non-compliance on SSI the relative risk (RR) adjusted with the aid of a logistic regression model was used. RESULTS: The study covered a total of 244 patients. The patients infected reached 20 cases with a SSI cumulative incidence of 8.2% (CI95%: 4.8-11.6). Antibiotic prophylaxis was indicated in all patients and was administered in 98% of cases, with an overall protocol compliance 92.5%. The principal cause of non-compliance was the choice of antibiotic 55.6% (n=10). The effect of inadequacy of antibiotic prophylaxis on surgical infection was RR=0.58, CI95%: 0.10-4.10 (P>0.05). CONCLUSIONS: Compliance with antibiotic prophylaxis was high. No relationship between the adequacy of prophylaxis and incidence of surgical site infection in rectal surgery was found.

Leiomiosarcoma de vena cava: A propósito de un caso / Leiomyosarcoma of the vena cava: a case report

Los sarcomas de grandes vasos son tumores raros, siendo el de cava uno de los más frecuentes. Presentamos un caso de una mujer de 50 años con un leiomiosarcoma de vena cava infrahepatica con afectación de la vena renal derecha. Se efectuó una resección en bloque incluyendo la vena cava desde la vena renal derecha con el riñón derecho hasta casi la bifurcación. Se realizó una reconstrucción con una prótesis de PTFE anillada. El resultado del estudio anatomopatológico fue de leiomiosarcoma de vena cava inferior. Este tipo de tumores precisan de un manejo multidisciplinar debido a su rareza y complejidad

Large vessel sarcomas are very rare, one of the most common is originated from the cava. We present a 50 year-old woman with a leiomyosarcoma of the infrahepatic vena cava encompassed the right renal vein. Excision of the tumor was performed in block, from the right renal vein to the bifurcation of the vena cava. A vascular reconstruction was performed with ringed PTFE prosthesis. The anatomopathological study revealed a leiomyosarcoma of the inferior vena cava. This tumors require a multidisciplinary approach due to they are very rare and complex

Leiomiosarcoma de vena ovárica izquierda: a propósito de un caso / Leiomyosarcoma of the ovarian vein: Presentation of a case

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