Analysis of potential risk factors in the survival of patients with primary retroperitoneal liposarcoma / Análisis de los potenciales factores de riesgo en la supervivencia de pacientes con liposarcoma retroperitoneal primario

Introduction: The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma.Methods: The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019.Results: The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02–19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50–8.86). Conclusion: Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival. (AU)

Introducción: El presente trabajo es un estudio observacional de una serie de variables relacionadas con la supervivencia global y la supervivencia libre de enfermedad en pacientes diagnosticados de liposarcoma primario. Métodos: Este es un estudio prospectivo con recolección de datos retrolectiva que incluye a todos los pacientes con liposarcoma primario remitidos al Hospital Son Espases en Palma de Mallorca, desde enero de 1990 hasta diciembre de 2019. Resultados: El estudio incluye 50 pacientes y la cirugía compartimental se realizó en 18 (36%) de ellos. La supervivencia global media de la muestra fue de 15,57 años (IC 95% 12,02-19,12) y la supervivencia libre de enfermedad media fue de 6,70 años (IC 95% 4,50-8,86). Conclusiones: La cirugía compartimental no ha mostrado beneficios en términos de supervivencia general y supervivencia libre de enfermedad. La clasificación ASA (≥3) predice un mal pronóstico tanto en la supervivencia global como en la supervivencia libre de enfermedad. La resección con márgenes libres, descrita en los resultados patológicos y definida en este trabajo como R0, muestra una mejor supervivencia libre de enfermedad. (AU)

Analysis of potential risk factors in the survival of patients with primary retroperitoneal liposarcoma.

INTRODUCTION: The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma. METHODS: The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019. RESULTS: The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02-19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50-8.86). CONCLUSION: Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival.

Long-term comparative study on open versus laparoscopic biliopancreatic diversion.

BACKGROUND: To date, bariatric surgery has been proposed as the most effective treatment to resolve morbid obesity, a multifactorial chronic disease with an epidemic and increasing tendency. The purpose of this study was to determinate the impact of the laparoscopy on weight loss parameters in morbid obese patients who underwent surgery according to Scopinaro's biliopancreatic diversion (BPD) and evaluate early and late complications related to the open and laparoscopic approach of this technique. MATERIALS AND METHODS: This is a longitudinal retrospective study in consecutive patients undergoing BPD due to morbid obesity between 1999 and 2015. From 2006 the laparoscopic technique was introduced in our group for obesity surgery. In both approaches, open and laparoscopic surgery, the procedure performed consists of a proximal gastric section with a long Roux-en-Y reconstruction. The following variables were assessed in the two groups: intervention duration (min), estimated blood loss (mL), conversions to open approach (%), preoperative stay, postoperative and global stay (days). Complications were divided into early and late postoperative complications. The early surgical complications were catalogued according to the Clavien-Dindo classification. RESULTS: Two hundred seventy-seven patients were consecutively enrolled and divided in two groups: open BPD and laparoscopic BPD. There were no significant differences in the comparison of the two groups and the mean age was 43.9 years (19-60) with a mean BMI of 52.5 kg/m2. A statistically significant reduction was observed in favor of the laparoscopic group with respect to the reduction in hospital stay and in the incidence of incisional hernia as a late complication. No statistically significant difference were found with respect to early postoperative complications. CONCLUSIONS: Laparoscopic BPD is a safe technique that allows a shorter hospital stay compared to open surgery and that allows a drastic reduction in the incidence of incisional hernias.

Analysis of potential risk factors in the survival of patients with primary retroperitoneal liposarcoma.

INTRODUCTION: The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma. METHODS: The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019. RESULTS: The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02-19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50-8.86). CONCLUSION: Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival.

Adenocarcinoma sobre quiste de duplicación yeyunal / Adenocarcinoma over a jejunal duplication cyst

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Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity: Long-Term Results and Metabolic Consequences.

PURPOSE: In the multidisciplinary therapeutic approach to obesity, bariatric surgery is considered the most effective treatment in weight reduction and the decrease in associated comorbidities. The objective of this work is to describe the long-term clinical and metabolic results in obese patients undergoing biliopancreatic diversion (BPD) according to Scopinaro's technique. MATERIALS AND METHODS: Patients undergoing surgery were followed by the same multidisciplinary team in a study period of 15 years (1999-2015). A retrospective study based on a prospective database was designed, where data on the evolution of obesity-related diseases and nutritional parameters were studied. RESULTS: Two hundred seventy-seven patients were collected; 75.5% were women. The preoperative body mass index (BMI) decreased from 52.5 kg/m2 to 34.9 kg/m2 10 years after surgery. A resolution or improvement of diabetes has been observed in 85.38% of the patients; a decrease in arterial hypertension and obstructive sleep apnea syndrome were in 65.61% and 89.14%, respectively. Throughout the monitoring of the sample, protein malnutrition increased, from 1.8% after the first year of surgery to 4.5% 10 years after the operation. CONCLUSION: Even if Scopinaro's technique is beginning to be replaced by other malabsorptive techniques, it can still be considered as an effective surgical procedure in terms of weight loss, quality of life, and evolution of obesity-related diseases. In order to avoid nutritional deficiencies, the operated patients need a strict follow-up and a supplementation adjusted to the technique.

Apendicectomía laparoscópica: nuestra vía de abordaje / Laparoscopic appendectomy. Our original approach

Objetivo: Presentar la experiencia con apendicectomía laparoscópica. Determinar la limitación de la técnica en relación al tipo de abordaje. Pacientes y método: Entre enero de 1999 y septiembre de 2002 se revisó una serie personal de 100 pacientes en quienes se realizó apendicectomía laparoscópica en 98 casos y abierta en dos. El diagnóstico se apoyó en la ecografía abdominal para descartar apendicitis complicada. Técnica quirúrgica: Se utilizó el trocar de Hasson umbilical y dos puertos, uno de 5 mm púbico para exposición del apéndice y otro en fosa iliaca izquierda de 10 mm sustituido por uno de 5 mm, al disponer de una óptica de 5 mm y cero grados. La extracción del apéndice siempre fue con bolsa por el acceso umbilical. Resultados: El tiempo de cirugía fue de 55 minutos. Como complicaciones se presentaron una infección de herida quirúrgica y una eventración. La tasa de apendicectomía en blanco fue 8/100. Conclusión: La apendicectomía laparoscópica es un tratamiento alternativo de la apendicitis aguda no complicada en nuestro medio; puede realizarse sin dificultades e independientemente de la disposición variable de los trocares de entrada

Técnica de Shouldice e interposición de malla de Prolene. Resultados preliminares / Shouldice's technique and interposition of prolene mesh

El tratamiento quirúrgico de la hernia inguinal ha sido objeto de múltiples controversias con el desarrollo de distintas técnicas. En la década de los ochenta esta controversia ha dado paso a la implantación de dos técnicas que por sus resultados se han distanciado claramente de otras formas de tratamiento. La herniorrafia de Shouldice y la interpretación de malla de prolene son en la actualidad dos técnicas compatibles y con unos resultados excelentes a largo plazo. Nuestro objetivo era determinar la capacidad de reproducción y los resultados en un mismo grupo de cirujanos. Concluimos que teniendo ambas resultados muy similares, el fácil desarrollo técnico de la malla de prolene desplaza a las demás técnicas