Publications by authors named "Daniel Aparicio-Lopez"

Male breast cancer (MBC) is a rare condition with unique characteristics compared to female breast cancer (FBC). Despite its scarceness, there is growing evidence that MBC should not be studied and treated as FBC due to factors like later diagnosis stage and distinct genetic makeup. Retrospective observational study in the EpiChron Cohort, selecting all the prevalent patients with breast cancer between 2010 and 2019.

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Introduction: Male breast cancer accounts for 1% of all breast cancers. Its low frequency leads to a lack of awareness, resulting in significant diagnostic delays. Additionally, this limits the available evidence, which primarily uses diagnostic-therapeutic algorithms based on women.

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Colorectal cancer is the most frequently diagnosed neoplasm in the population worldwide, regardless of sex. Its presentation is variable, from asymptomatic cases that are diagnosed in the population screening programme, to perforation or intestinal obstruction that appear urgently. The location of the neoplasia inside an inguinal hernia, although it is described in the literature, is uncommon and may increase the risk of incarceration or strangulation with the need for urgent surgery.

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Background: Improving the quality of care is a priority for health systems to obtain better care and reduce costs. One of the tools for measuring quality is benchmarking (BM). We presented a 1-country prospective study of distal pancreatectomies (DPs) and determined BM.

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Article Synopsis
  • Surgical hemostasis is crucial in surgery, but the lack of a standardized bleeding classification makes it difficult to choose the best hemostatic agent for individual cases.
  • This study aims to evaluate the VIBe (Validated Intraoperative Bleeding) scale in a clinical setting, particularly focusing on liver surgeries and its relationship with bleeding severity and postoperative complications.
  • Conducted across 10 Spanish centers, this prospective study involves 259 liver resection patients and seeks to validate the VIBe scale for potential integration into everyday surgical practice.
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Background: Colorectal anastomosis leak (AL) is the most feared complication of rectal cancer surgery (1-19%) as it increases morbidity and mortality and worsens oncological outcomes in terms of local recurrence and survival. The publication of the REAL-score index makes it possible to predict the risk of AL and compare the expected results with those obtained.

Method: Observational, descriptive, longitudinal and retrospective study of patients operated on for rectal cancer at the Miguel Servet University Hospital, in Zaragoza, Spain, in 2019.

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Article Synopsis
  • A 34-year-old man experienced daily vomiting and significant weight loss, leading to a gastroduodenoscopy that revealed dilatation and inflammation in his duodenum, causing narrowing of the passageway.
  • A biopsy confirmed he had Crohn's disease, for which he initially received treatments including Prednisone, Adalimumab, and Ustekinumab.
  • After 9 months of ineffective treatment and reliance on corticosteroids, he underwent surgery to remove part of his duodenum and had a successful recovery, remaining symptom-free a year later while on Ustekinumab.
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Article Synopsis
  • It is often discovered incidentally during endoscopies or imaging since most cases are small and do not cause symptoms, but larger or symptomatic lesions may need surgical removal.
  • A patient who experienced vomiting and lack of appetite ultimately required surgery for peptic ulcer perforation, and further complications led to a decision for antrectomy, revealing Brunner's gland hyperplasia through pathology results.
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Aortoesophageal fistula (AEF) secondary to thoracic endovascular aortic repair (TEVAR) is a rare clinical entity that poses a threat to life as it causes massive digestive bleeding, and it is estimated that 60% of patients who suffer from it could die within within 6 months of the onset of their symptoms. It requires a high clinical suspicion to establish an early multidisciplinary surgical treatment. We present the cases of two patients diagnosed with aortoesophageal fistulas after TEVAR in the last 5 years (January 2018-December 2022) while reviewing the existing scientific literature on the matter.

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Intracholecystic papillary neoplasia (IPN) is a rare entity rarely described in the literature, of incidental anatomopathological diagnosis in a cholecystectomy specimen that presents a premalignant behavior, with progression to carcinoma in more than 50% of cases. In the absence of an invasive component, clinical follow-up is recommended, without associating another surgical gesture, with a 5-year prognosis (90% survival). We present a case of a patient with an incidental diagnosis of NPIC after laparoscopic cholecystectomy due to presenting a gallbladder polyp.

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Article Synopsis
  • Colonoscopy is a common procedure used to diagnose, treat, and prevent colorectal cancer, but it can have complications.
  • The main risks include bleeding and perforation, with splenic rupture being rare but very serious.
  • A case is presented where a patient experienced a splenic rupture during a routine screening colonoscopy, resulting in the need for emergency surgery due to severe bleeding.
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Article Synopsis
  • The study evaluated the effectiveness of a standardized clinician-reported bleeding severity scale specifically for liver surgery, aiming to determine its reproducibility and clinical value.
  • Conducted with 47 surgeons across 10 hospitals in Spain, the research found high agreement scores for both intraobserver (0.985) and interobserver (0.929) reliability, indicating the consistency of the scale's use regardless of the surgeon's experience level or the number of surgeries performed.
  • The findings support the utility of this bleeding severity scale as a valuable tool for assessing intraoperative bleeding in liver surgery, emphasizing its practicality in diverse clinical settings.
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Background: Hepatobiliary mucinous cystic neoplasms (MCN) harbor an invasive carcinoma in 16% of the cases, mainly tubular type, but occasionally sarcomatoid or undifferentiated, these entities being frankly rare.

Methods: We present the case of a liver MCN with an invasive component and sarcomatous degeneration.

Results: The patient was treated surgically with subsequent adjuvant chemotherapy (capecitabine), presenting tumor progression after three months with peritoneal carcinomatosis and liver recurrence.

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