Perforación traqueal diferida tras cirugía tiroidea en un paciente con radioterapia cervical.

Tracheal perforation is a rare complication of thyroid surgery. A 36-year-old man with previous neck radiotherapy due to a nasopharyngeal cancer. After right hemithyoidectomy and isthmusectomy, the patient presented a tracheal perforation.

Parkinsonism as presenting symptom of primary hyperparathyroidism: Improvement after surgery.

Introduction: Hypercalcemia can cause different neurological disorders, depending on the calcium level. We report an exceptional case of primary hyperparathyroidism presenting as neurological alteration and it has favourable outcome after parathyroidectomy.

Case Report: A 74-year-old woman presented with progressive cognitive deterioration and impaired motor function.

[Tumores neuroendocrinos pancreáticos. Nuestra experiencia].

Pancreatic neuroendocrine tumors are rare. It is a heterogeneous group of neoplasms with very different behavior and prognosis. They can appear sporadically or associated with genetic syndromes.

[Metástasis en el lóbulo frontal como primera manifestación clínica de un carcinoma folicular de tiroides].

Antecedentes: El carcinoma folicular de tiroides puede producir metástasis a distancia, siendo las localizaciones más habituales el pulmón y el hueso. Las metástasis cerebrales son inusuales, y es poco habitual que aparezcan como primera manifestación de cáncer.

Caso ClÍnico: Paciente varón de 80 años, que tras una caída al suelo comenzó con alteración del comportamiento, desorientación y pérdida del control de esfínteres.

[Parkinsonism as presenting symptom of primary hyperparathyroidism: Improvement after surgery].

Introduction: Hypercalcemia can cause different neurological disorders, depending on the calcium level. We report an exceptional case of primary hyperparathyroidism presenting as neurological alteration and it has favourable outcome after parathyroidectomy.

Case Report: A 74-year-old woman presented with progressive cognitive deterioration and impaired motor function.

[Laparoscopic cleavage in splenic symptomatic cyst].

Background: Splenic cysts are rare diseases that are diagnosed incidentally during imaging studies. When cysts are recognized, surgical treatment is recommended adapted to the particular case, depending on the size and location of the cyst and the age of the patient in order to avoid dangerous complications such as spleen rupture or cyst infection with abscess.

Clinical Case: We report 2patients with symptomatic splenic epidermoid cyst treated by laparoscopic cleavage.

Intestinal endometriosis. Our experience.

Intestinal endometriosis is defined as a bowel infiltration by ectopic endometrial tissue. The prevalence is 3-37% of all women affected by endometriosis. Rectosigmoid colon is the most frequent location (70-93%), followed to ileocecal region, appendix and other colon and small bowel segments.

Short-term outcome of percutaneous posterior tibial nerve stimulation (PTNS) for the treatment of faecal incontinence.

Background: The aim of the present study was to establish the efficacy of percutaneous posterior tibial nerve stimulation (PTNS) in treating flatal, urge and passive faecal incontinence (FI).

Methods: A prospective study with 55 patients with FI was carried out. Clinical anamnesis, physical examination, a reverse visual analogue scale (VAS) score, Wexner score and the American Society of Colon and Rectal Surgeons quality of life score were recorded at baseline and 6 months, along with an incontinence diary.

[Psoas abscess as a differential diagnosis in emergency department].

Background: A psoas (or iliopsoas) abscess is a rare clinical entity with a wide etiological range. It is defined as a collection of pus that begins and extends through the iliopsoas muscle and can reach up to the inguinal region.

Methods: We performed a retrospective descriptive study by reviewing medical records from the General Surgery department of Reina Sofía's General University Hospital.

Adrenalectomy for solid tumor metastases: results of a multicenter European study.

Background: We assessed the results of adrenalectomy for solid tumor metastases in 317 patients recruited from 30 European centers.

Methods: Patients with histologically proven adrenal metastatic disease and undergoing complete removal(s) of the affected gland(s) were eligible.

Results: Non-small cell lung cancer (NSCLC) was the most frequent tumor type followed by colorectal and renal cell carcinoma.

[Laparoscopic adrenalectomy: the best surgical option].

Background: Laparoscopic approach has become the gold standard for the surgical treatment of suprarenal gland. Nevertheless there is still controversy about the laparoscopic treatment of adrenal carcinoma.

Material And Methods: From April 2005 to April 2012, 37 laparoscopic adrenalectomies were performed.

[Quality assessment and improvement in the indication and management of parenteral nutrition in a general surgery unit].

Objective: To analyze the degree of compliance with a variety of internationally accepted standards defined for Total Parenteral Nutrition (TPN) quality control in our Surgery Department.

Patients And Method: Prospective study of patients treated with TPN over two years in the department of surgery of a university teaching hospital (n = 72). Assessment of quality was performed by measurements of compliance using 19 criteria.

Evaluation and monitoring of the clinical pathway for thyroidectomy.

The aim of this study is to present the evaluation and monitoring of a clinical pathway for thyroidectomy 1 year after its implementation and after 4 years' follow up. We compare the results of an evaluation and monitoring indicators series before and after the establishment of the clinical pathway for thyroidectomy in the Surgery Department of Morales Meseguer Hospital, a general university hospital in Murcia, Spain. Implementation of the clinical pathway led to a reduction in length of hospital stay for all the surgery patients (4.

[The POSSUM scoring system: an instrument for measuring quality in surgical patients].

Introduction: The POSSUM scale (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) is a scoring system that is used to predict risk-adjusted mortality and morbidity rates in a wide variety of surgical procedures. In this prospective study, the validity of the POSSUM scale was evaluated in patients undergoing laparotomy in a general surgery department.

Patients And Methods: The POSSUM scale was prospectively applied in all patients undergoing elective and emergency laparotomy in the general surgery department of a level II hospital over 8 months.