Gil, A. (Aurora)
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- Análisis de la morbilidad postoperatoria en pacientes con adenocarcinoma gástrico tratados según protocolo de quimiorradioterapia preoperatoria y cirugía(Elsevier, 2009-12) Valenti, V. (Víctor); Blasco-Blanco, M. (Manuel); Bueno, A. (Álvaro); Martinez-Regueira, F. (Fernando); Álvarez-Cienfuegos, J. (Javier); Zozaya-Larequi, G. (Gabriel); Hernandez-Lizoain, J.L. (Jose Luis); Gil, A. (Aurora); Marti-Cruchaga, P. (Pablo); Pedano, N. (Nicolás); Beorlegui, C. (Carmen)Introducción El impacto del tratamiento neoadyuvante sobre las complicaciones postoperatorias en el cáncer de estómago es motivo de controversia. El objetivo de este trabajo es analizar la morbilidad y la mortalidad postoperatoria en un grupo de pacientes a los que se les había aplicado un protocolo de quimiorradioterapia preoperatoria, así como identificar posibles factores de riesgo que se asocian al desarrollo de complicaciones. Material y métodos Entre junio de 2005 y junio de 2008, pacientes diagnosticados de adenocarcinoma gástrico localmente avanzado se intervinieron en nuestro Centro tras haber seguido un protocolo de quimiorradioterapia preoperatoria. Se recogieron prospectivamente los datos sobre morbilidad y mortalidad postoperatoria y se analizaron las variables dependientes relacionadas con los pacientes, con el tipo de intervención y las características tumorales. Resultados Se evaluaron 40 pacientes. La morbilidad y la mortalidad global fue del 32,5% (13 pacientes) y del 2,5% (un paciente), respectivamente. Las complicaciones más frecuentes fueron la neumonía en el 12,9% y la sepsis por catéter en el 9,7% de los pacientes. Los factores de riesgo para el desarrollo de complicaciones fueron el índice de masa corporal (>25 kg/m2) y la inclusión en la resección del páncreas o del bazo. Conclusiones El tratamiento preoperatorio con quimiorradioterapia en pacientes con cáncer de estómago localmente avanzado no incrementa la incidencia de complicaciones postoperatorias. La condición preoperatoria del paciente (índice de masa corporal) y la extensión de la cirugía del bazo y del páncreas son factores pronósticos de complicaciones postoperatorias precoces. Abstract Introduction The impact of neoadjuvant treatment on the postoperative complications in stomach cancer is a subject of controversy. The aim of this study is to analyse the post-surgical morbidity and mortality in a group of patients who were treated using a chemoradiotherapy protocol before surgery, as well as to identify the possible risk factors that may be associated with the development of complications. Material and methods Patients diagnosed with locally advanced gastric adenocarcinoma between June 2005 and June 2008 were operated on in our Centre after having followed a preoperative chemoradiotherapy protocol. Data on postoperative morbidity and mortality were collected retrospectively and the dependent variables associated with the patients, the type of intervention and the tumour characteristics were analysed. Results A total of 40 patients were evaluated. The overall morbidity and mortality was 32.5% (13 patients) and 2.5% (1 patient), respectively. The most frequent complications were pneumonia in 12.9% and sepsis due to the catheter in 9.7% of the patients. The risk factors for the development of complications were the body mass index (BMI 25 kg/m2) and the inclusion of the pancreas and/or spleen in the resection. Conclusions Preoperative treatment with chemoradiotherapy in patients with locally advanced stomach cancer does not increase the incidence of post-surgical complication. The preoperative condition of the patient (BMI) and extending the surgery to the spleen and pancreas are prognostic factors of early postoperative complications.
- Angiomiolipoma epitelioide hepático(Elsevier España, 2002) Rotellar, F. (Fernando); Rodriguez-Spiteri, N. (Natalia); Pardo, F. (Fernando); Olea, J. (J.); Toledo, G. (Gemma); Álvarez-Cienfuegos, J. (Javier); Sola, J. (Josu); Gil, A. (Aurora); Cervera, M. (María)Abstract: We describe the case of a hepatic epithelioid angiomyolipoma in a 50-year-old woman with epigastric pain and well-circumscribed 47 mm hepatic mass detected by ultrasonography. Angiomyolipoma is a rare benign mesenchymal tumor of the liver, composed of variable amounts of smooth muscle cells, abnormal blood vessels and adipose tissue. Preoperative diagnosis is difficult. Immunoreactivity with HMB-45 antibody helps to distinguish this tumor from other benign and malignant tumors of the liver.
- Pancreatectomía central en tumores benignos del cuello del páncreas(Elsevier España, 2005) Valenti, V. (Víctor); Pastor, C. (Carlos); Rotellar, F. (Fernando); Poveda, I. (Ignacio); Pardo, F. (Fernando); Álvarez-Cienfuegos, J. (Javier); Beunza, J.J. (Juan José); Gil, A. (Aurora); Cervera, M. (María)The surgical treatment of benign tumors of the neck of the pancreas usually consists of enucleation or formal pancreatectomy. Central pancreatectomy has been put forward because it has fewer major complications and can preserve endocrine and exocrine function. Between January 1999 and march 2003, three patients with benign tumors of the neck of the pancreas underwent central pancreatectomy. all patients underwent computed tomography scans, intraoperative ultrasound and frozen-section analysis. pathologic examination showed two mucinous cystadenomas and one serous cystadenoma. after a mean follow-up of 34 months, none of the patients has shown major complications or local recurrence, or has developed diabetes. In conclusion, central pancreatectomy is a useful technique for selected benign or low-grade malignant pancreatic tumors of the neck of the pancreas.
- Adenoma velloso hipersecretor de recto. Diagnóstico y tratamiento(Arán Ediciones, 2005) Valenti, V. (Víctor); Pastor, C. (Carlos); Poveda, I. (Ignacio); Álvarez-Cienfuegos, J. (Javier); Hernandez-Lizoain, J.L. (Jose Luis); Moncada, R. (Rafael); Gil, A. (Aurora); Cervera, M. (María)
- Cirugía bariátrica laparoscópica: bypass gástrico proximal(Gobierno de Navarra. Departamento de Salud, 2005) Valenti, V. (Víctor); Pastor, C. (Carlos); Rotellar, F. (Fernando); Poveda, I. (Ignacio); Baixauli-Fons, J. (Jorge); Gil, A. (Aurora); Marti-Cruchaga, P. (Pablo)The spectacular increase in the prevalence of obesity in our society and the significant complications and comorbidities that it gives rise to have stimulated the interest of scientists and public in this pathology. Surgical treatment is at present the only efficient and lasting treatment for morbid obesity and in many cases it appreciably improves, and even definitively cures, associated complications such as the case of diabetes or hypertension. Amongst the different techniques of bariatric surgery, the gastric bypass (GBP) seems to be definitively establishing itself, since it offers an excellent balance between loss of weight (>70% of the excess), surgical risk and subsequent quality of life. The possibility of carrying out this technique employing a laparoscopic approach has improved its acceptance by doctors and patients while it has made it possible to reduce morbidity and mortality, length of hospital stay and costs. Proximal GBP is carried on those patients with an BMI <60 Kg/m2; for BMI >60 Kg/m2 the GBP employed is denominated distal. Between October 2003 and November 2005, our centre performed 55 laparoscopic proximal Roux-en-Y gastric bypasses via laparoscopy. These involved 42 women and 13 males with an average age of 44 years. The average BMI was 43.5 (35-55.8). The average basal weight was 116.15 Kg. There was no peroperative mortality, nor reinterventions. The BMI after 12 months was 28.4. The average basal weight was 74.2 Kg. Laparoscopic Roux-en-Y proximal gastric bypass is a safe and efficient technique for the treatment of morbid obesity.