Publications by authors named "Espin-Basany E"
Article Synopsis
- Organ preservation through the Watch and Wait (WW) approach in rectal cancer patients shows promise but poses a risk of local regrowth (LR), leading to higher rates of distant metastases (DM) compared to traditional surgery (TME).
- A study comparing 508 LR patients managed by WW and 893 near-complete pathologic response (nPCR) patients after TME found a significantly higher DM rate in the LR group (22.8% vs. 10.2%).
- The research concluded that patients with LR have poorer 3-year DM-free survival (75% vs. 87%) and highlight that leaving a primary undetectable tumor can result in worse overall outcomes.
Article Synopsis
- - The study investigates the occurrence of metachronous colorectal cancer in patients diagnosed with early-onset colorectal cancer (under 50 years old), finding an overall incidence of 2.6%.
- - It highlights that patients with Lynch syndrome have a significantly higher incidence of metachronous colorectal cancer at 18.43%, while those with a family history have a rate of 10.52%.
- - The findings suggest that although early-onset colorectal cancer patients have a similar risk as older patients, specific genetic and familial factors significantly increase their risk, indicating the need for personalized management strategies.
Article Synopsis
- - The study investigated the effectiveness of robotic right colectomy (RRC) compared to laparoscopic right colectomy (LRC) for nonmetastatic pT4 colon cancer, focusing on surgical outcomes like cancer removal success, complication rates, and recovery times.
- - Results showed similar cancer removal rates and lymph node retrieval between RRC and LRC, but RRC had advantages like fewer conversions to open surgery, less blood loss, and fewer postoperative complications.
- - Both surgical methods had comparable long-term survival rates, indicating that RRC is a viable option for treating pT4 right colon cancer with better short-term results than LRC.
Article Synopsis
- The study investigates an artificial intelligence (AI) platform designed to diagnose acute appendicitis, addressing the limitations of current scoring systems and CT scans, which have potential risks and resource constraints.
- The AI platform demonstrated impressive diagnostic capabilities, with a sensitivity of 92.2% and specificity of 97.2%, outperforming traditional CT scans in several metrics, including the area under the receiver curve and precision.
- The findings suggest that the AI tool can significantly enhance clinical decision-making, offering a valuable diagnostic alternative that minimizes unnecessary surgeries while maintaining accuracy.
Article Synopsis
- This study evaluates three minimally invasive surgical techniques for total mesorectal excision (TME) in treating low/mid locally advanced rectal cancer: laparoscopic, robotic, and transanal TME.
- An analysis of 468 patients revealed that robotic and transanal TME had lower complication and conversion rates compared to laparoscopic TME, with robotic TME showing fewer anastomotic leaks.
- The study concludes that robotic and transanal TME approaches can lead to quicker recovery times and fewer postoperative issues compared to laparoscopic TME, indicating their potential advantages for patient outcomes.
Background: The Catalan Cancer Plan (CCP) undertakes periodic audits of cancer treatment outcomes, including organ/space surgical site infections (O/S-SSI) rates, while the Catalan Healthcare-associated Infections Surveillance Programme (VINCat) carries out standardized prospective surveillance of surgical site infections (SSI) in colorectal surgery. This cohort study aimed to assess the concordance between these two monitoring systems for O/S-SSI following primary rectal cancer surgery.
Methods: The study compared O/S-SSI incidence data from CCP clinical audits versus the VINCat Programme in patients undergoing surgery for primary rectal cancer, in 2011-12 and 2015-16, in publicly funded centres in Spain.
Article Synopsis
- The text discusses two surgical techniques, Deloyers procedure and retro-ileal colorectal anastomosis, that are suitable for patients needing colorectal surgery without causing tension in the colon.
- It highlights the practicality of performing these techniques, sharing outcomes from 19 patients where surgeries were successful, although some faced complications.
- The conclusion notes that while both methods are effective and can be minimally invasive, they carry risks of postoperative complications, emphasizing the need for careful patient management and communication of potential risks.
Background: Sacral neuromodulation might be effective to palliate low anterior resection syndrome after rectal cancer surgery, but robust evidence is not available.
Objective: To assess the impact of sacral neuromodulation on low anterior resection syndrome symptoms as measured by validated scores and bowel diaries.
Design: Randomized, double-blind, 2-phased, controlled, multicenter crossover trial (NCT02517853).
Aim: Management of diverticulitis with abscess formation in immunosuppressed patients (IMS) remains unclear. The main objective of the study was to assess short- and long-term outcomes between IMS and immunocompetent patients (IC). The secondary aim was to identify risk factors for emergency surgery.
View Article and Find Full Text PDFObjective: To assess the effect of high inferior mesenteric artery tie on defecatory, urinary, and sexual function after surgery for sigmoid colon cancer. Performing a sigmoidectomy poses a notable risk of causing injury to the preaortic sympathetic nerves during the high ligation of the inferior mesenteric artery, as well as to the superior hypogastric plexus during dissection at the level of the sacral promontory. Postoperative defecatory and genitourinary dysfunction after sigmoid colon resection are often underestimated and underreported.
View Article and Find Full Text PDF"Long-term oncologic outcomes and risk factors for distant recurrence after pathologic complete response following neoadjuvant treatment for locally advanced rectal cancer. A nationwide, multicentre study".
Eur J Surg Oncol
October 2023
Background: Pathologic complete response (pCR) after multimodal treatment for locally advanced rectal cancer (LARC) is used as surrogate marker of success as it is assumed to correlate with improved oncologic outcome. However, long-term oncologic data are scarce.
Methods: This retrospective, multicentre study updated the oncologic follow-up of prospectively collected data from the Spanish Rectal Cancer Project database.
Background: The impact of method of anastomosis and minimally invasive surgical technique on surgical and clinical outcomes after right hemicolectomy is uncertain. The aim of the MIRCAST study was to compare intracorporeal and extracorporeal anastomosis (ICA and ECA respectively), each using either a laparoscopic approach or robot-assisted surgery during right hemicolectomies for benign or malignant tumours.
Methods: This was an international, multicentre, prospective, observational, monitored, non-randomized, parallel, four-cohort study (laparoscopic ECA; laparoscopic ICA; robot-assisted ECA; robot-assisted ICA).
Article Synopsis
- Robotic surgery is becoming more popular for pelvic floor reconstruction, but it's unclear if it's better than traditional methods, so this study aimed to clarify its role using expert opinions.* -
- An international group of 26 experienced surgeons from various specialties conducted a two-round Delphi process to evaluate the use of robotics in pelvic floor surgeries, discussing numerous aspects from surgeon characteristics to future implications.* -
- The consensus among experts was that robotic surgery offers significant technical advantages and is safe and effective for pelvic floor reconstruction, with the increased costs justified by improved surgical effectiveness.*
Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS.
Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology.
Background: Colorectal cancer management may require an ostomy formation; however, a stoma may negatively impact health-related quality of life (HRQoL). This study aimed to compare generic and stoma-specific HRQoL in patients with a permanent colostomy after rectal cancer across different countries.
Method: A cross-sectional cohorts of patients with a colostomy after rectal cancer in Denmark, Sweden, Spain, the Netherlands, China, Portugal, Australia, Lithuania, Egypt, and Israel were invited to complete questionnaires regarding demographic and socioeconomic factors along with the Colostomy Impact (CI) score, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and five anchor questions assessing colostomy impact on HRQoL.
Article Synopsis
- The study looked at why surgeons decide to do a protective ileostomy after a certain type of surgery for rectal cancer.
- Most surgeons (76%) agreed on doing the ileostomy, and many (88%) considered certain risk factors before deciding.
- The study found that emotions and personal experiences played a big role in the decisions surgeons made, but there aren't clear guidelines on when to perform this procedure yet.
Background: Anastomotic leaks represent one of the most significant complications of colorectal surgery and are the primary cause of postoperative mortality and morbidity. Sponge-assisted endoluminal vacuum therapy (EVT) has emerged as a minimally invasive technique for the management of anastomotic leaks; however, there are questions regarding patient selection due to the heterogeneous nature of anastomotic leaks and the application of sponge-assisted EVT by surgeons.
Method: Seven colorectal surgical experts participated in a modified nominal group technique to establish consensus regarding key questions that arose from existing gaps in scientific evidence and the variability in clinical practice.