Hematological Alterations after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have benefits for survival in some cancers with peritoneal metastasis. Hematologic toxicity described rate is 2 to 38%.

Methods: Patients admitted to an intensive care unit (ICU) after CRS and HIPEC over 78 months.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer with Peritoneal Carcinomatosis: Multicenter Study of Spanish Group of Peritoneal Oncologic Surgery (GECOP).

Background: Gastric cancer (GC) with peritoneal carcinomatosis (PC) is traditionally considered a terminal stage of the disease. The use of a multimodal treatment, including cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), can benefit these patients. Our goal was to evaluate the morbidity and survival outcomes of these patients.

Central pancreatectomy for the treatment of a benign pancreatic lesion. Case report and literature review.

We present the case of a 45 year old female patient with an incidental diagnosis of a cystic pancreatic lesion corresponding to a serous cystadenoma of 14 mm. During a 5-year follow-up (CT and MRT) the lesion tripled in size and a surgical intervention was decided upon. The lesion was thought to have a benign pathology and, in an attempt to preserve the spleen and a major portion of pancreatic tissue, a central pancreatectomy with a diversion of the remaining distal pancreas was carried out.

First case reported of Bouveret´s syndrome associated to duodenal and biliary perforation to retroperitoneum.

We present the case of a 69 year old woman with a history of cholecystitis, who consulted for severe abdominal pain, nausea and vomiting. Abdominal CT showed duodenal obstruction caused by a gallstone, cholecystoduodenal fistula and pneumobilia, what is known as Bouveret's syndrome, a rare form of gallstone ileus. Additionally, she presented free duodenal and vesicular perforation to retroperitoneum at the same level of the cholecystoduodenal transit point.

Neuroendocrine tumor of the pancreas in a patient with tuberous sclerosis: a case report and review of the literature.

A rare case of pancreatic neuroendocrine neoplasm in a patient with tuberous sclerosis complex is described. The patient was a 31-year-old man who had multiple congenital subependymal nodules, bilateral cortical tubers, and seizures of difficult control. A 2.

The influence of immunosuppression switching in liver function in adult hepatic transplantation.

We evaluate the 5-year results of a single-centre prospective randomized trial that compared cyclosporine microemulsion (CyA-me) in triple therapy (plus steroids and azathioprine) and Tacrolimus (Tac) in double therapy (plus steroids) for primary immunosuppression. One hundred adult patients undergoing liver transplantation were randomized to receive Tac (n=51) or CyA-me (n=49). Ten patients in group A, and thirty-one patients in group B had their main immunosuppressive agent switched.

Incidence of de novo nonmelanoma skin tumors after liver transplantation for alcoholic and nonalcoholic liver diseases.

Introduction: Skin tumors are the most common malignancies after orthotopic liver transplantation (OLT). They have been related to sunlight exposure, tobacco consumption, and immunosuppression. The aim of this study was to compare the incidence of de novo skin tumors (nonmelanoma) in patients who underwent liver transplantation for alcoholic cirrhosis versus nonalcoholic diseases.

Hepatic allograft arterialization by means of the gastroduodenal bifurcation (branch patch) as a prognostic factor.

Introduction: Because of the current shortage of cadaveric organs, it is important to determine preoperatively those variables that are readily available, inexpensive, and noninvasive that can predict a higher incidence of hepatic artery thrombosis (HAT).

Material And Methods: From April 1986 to October 2001, 717 patients underwent 804 liver transplants. All the arterial reconstructions were performed with fine (7-0) monofilament sutures in an interrupted fashion.

Advantages of the piggy back technique on intraoperative transfusion, fluid compsumption, and vasoactive drugs requirements in liver transplantation: a comparative study.

Introduction: The piggyback technique was first described in adult liver transplantation in 1989, although it has been used in conjunction with venous bypass, with cross-clamping the vena cava, or both. In this study, the inferior vena cava was not occluded at any time during the liver transplant.

Objective: We compared the use of intraoperative blood products, fluid requirements, and vasoactive drugs among patients managed with bypass, without bypass, and with the piggyback technique.

Simultaneous liver-kidney transplant for combined renal and hepatic end-stage disease.

Introduction: After the first combined liver-kidney transplantation (CLKT) reported by Margreiter in 1984, it became clear that renal failure was no longer an absolute contraindication.

Objective: Our goal was to assess our results with combined liver-kidney transplant. Among 875 liver transplants performed between May 1986 and October 2002, there were 17 cases (1.

Liver transplantation for hepatocellular carcinoma: our experience from 1986.

Unlabelled: Currently liver transplantation is the treatment of choice for early hepatocellular carcinoma and end-stage liver disease. We analyzed our experience to identify factors that could be used to select patients who will benefit from liver transplantation.

Patients And Methods: From April 1986 to December 2001, 71 (8.

[Role of anatomic variations and methods of hepatic artery reconstruction in the incidence of thrombosis following liver transplantation].

Aim: The aim of this study was to investigate the incidence of anatomic variations of hepatic artery (HA) in order to evaluate if anatomical anomalies may be associated with an increased incidence of hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT). Moreover, we focused on arterial reconstructive technique associated with a low incidence of HAT.

Methods: We reported a consecutive series of 687 OLT in 601 patients (1986-1999).

[Assessment of risk factors in the incidence of hepatic artery thrombosis in a consecutive series of 687 liver transplantations].

Aim: The aim of this retrospective study was to characterize the risk factors of hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT) in a consecutive series of 687 OLT, comparing the branch patch anastomosis (BPA) with the end-to-end anastomosis (EEA), in order to investigate, moreover, which technique may be statistically associated with a reduced incidence of HAT.

Methods: Between 1986-1999 we performed 687 OLT in 601 patients, of which 592 were adult and 95 pediatric. Preservation of all donor livers was accomplished with the University of Wisconsin solution since OLT No.

[Diagnosis and treatment of hepatic artery thrombosis after liver transplantation].

The aim of this study was to examine the clinical presentation and time of hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT), stressing the role of imaging modalities. Therapeutic options are described, such as retransplantation (Re-OLT), hepatic resections and revascularization procedures, focusing on complications and outcome in a consecutive series of 687 OLT. Over the period from 1986 to 1999, 687 OLT were carried out in 601 patients, 592 of whom were adults and 95 pediatric subjects.

Anesthetic support in synchronous liver and kidney transplantation.

Background/aims: We performed a retrospective evaluation of 11 patients in the final stages of hepatic disease with chronic kidney failure, in whom simultaneous double liver-kidney transplantation was performed.

Methodology: In the immediate pre-, intra- and postoperative periods, we assessed metabolic, hemodynamic and coagulation parameters; bicarbonate, calcium and inotropic drug requirements; the incidences during reperfusion of the graft; the surgical technique employed; the need for hemodialysis and/or ultrafiltration; and the survival rate of the patients.

Results: Of the 11 cases studied, four patients needed hemodialysis, while only one patient needed ultrafiltration; three patients required both techniques, and no dialysis or ultrafiltration was performed in three patients.

Hepatic steatosis in liver transplant donors: common feature of donor population?

Fatty change in donor livers is a risk factor for poor function after orthotopic liver transplantation. Various prevalences of steatosis have been reported in time 0 biopsies. The aim of this research was to determine, in a longitudinal study, the degree (percent of hepatocytes involved) and type (size of vacuoles) of fatty change shown by various histologic techniques.

Graft mass and volume calculation in living related donors for liver transplantation.

Living related liver transplantation is one of the strategies currently used to increase the donor pool. A preoperative and non-invasive estimate of the donor's liver volume is needed to ensure sufficient functional liver reserve for survival after resection, and to obtain a graft of adequate volume to suit the recipient's features. A method based on a preoperative abdominal computerised axial tomography of the donor, that enables the volume and mass of the whole liver, and the graft, to be calculated is herein described.

Diagnostic and treatment of Zenker's diverticulum: review of our series pharyngo-esophageal diverticula.

Background/aims: Clinical aspects and preneoplastic potential of Zenker's diverticulum justify its surgery. The clinical signs of the patients and the size of the diverticulum determine the surgical technique.

Methodology: Between January 1974 and December 1995, 32 patients underwent surgery in our department.

Lipoprotein abnormalities in long-term stable liver and renal transplanted patients. A comparative study.

Hyperlipidemia is a common feature after organ transplantation. Most studies have evaluated the lipid profile in recipients of a particular graft, usually renal. In the present work, we studied the lipid profiles of 30 long-term stable liver transplant patients (LTP) and compared their pattern with 40 long-term stable renal transplant patients (RTP) matched for gender, age, and time from transplantation.