Publications by authors named "Guadalajara H"

This manuscript offers a detailed description of our successful tips for mastering transanal robotic surgery. It covers various aspects, including patient positioning, management of abdominal pressures to maintain a stable pneumorectum, platform positioning, camera alignment, trocar positioning to minimize collisions, instruments used, and approaches to tumor resection.

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Background: Empty Pelvis Syndrome, subsequent to the removal of pelvic organs, results in the descent of the small bowel into an inflamed pelvic cavity, leading to the formation of adhesions and subsequent small bowel obstruction. However, no effective measures have been previously described.

Objective: Describe a simple and autologous solution to prevent "Empty Pelvis Syndrome," small bowel obstruction, and adhesions by utilizing the cecum to occlude the pelvis.

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Article Synopsis
  • Sepsis from peritonitis triggers an inflammatory response, and mesenchymal stromal cells (MSCs) might help modulate the immune system as a new treatment option.
  • In a mouse study, researchers compared the effects of human adipose mesenchymal stem cells (hASCs) and modified hASCs (enhanced for better inflammation targeting) to see their impact on inflammation during peritonitis.
  • Ultimately, the study found that both standard and genetically modified hASCs were safe and effective treatments, showing no significant differences in anti-inflammatory effects between the two groups when administered directly into the peritoneum.
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Background: The term sepsis refers to a complex and heterogeneous syndrome. Although great progress has been made in improving the diagnosis and treatment of this condition, it continues to have a huge impact on morbidity and mortality worldwide. Mesenchymal stem cells are a population of multipotent cells that have immunomodulatory properties, anti-apoptotic effects, and antimicrobial activity.

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Background Aims: Peritoneal carcinomatosis (PC) from colorectal cancer (CRC) is a highly challenging disease to treat. Systemic chimeric antigen receptor (CAR) T cells have shown impressive efficacy in hematologic malignancies but have been less effective in solid tumors. We explored whether intraperitoneal (i.

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Background: Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between specialties and financial systems and provide a representation of existing SSI preventative measures to help improve the standardization of SSI prevention practices.

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Pseudomyxoma peritonei (PMP) is a rare malignant growth characterized by the production of mucin and the potential for peritoneal relapse. This study aimed to investigate the immunohistochemical and biological characteristics of mucin in patients with cellular and acellular PMP. We prospectively analyzed mucin specimens obtained from our patient cohort and described the composition and type of mucin present in each sample.

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Ovarian cancer is the seventh most common cancer worldwide in women and the most lethal gynecologic malignancy due to the lack of accurate screening tools for early detection and late symptom onset. The absence of early-onset symptoms often delays diagnosis until the disease has progressed to advanced stages, frequently when there is peritoneal involvement. Although ovarian cancer is a heterogeneous malignancy with different histopathologic types, treatment for advanced tumors is usually based on chemotherapy and cytoreduction surgery.

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Aim: Achieve an international consensus on how to recover lost training opportunities. The results of this study will help inform future EAES guidelines about the recovery of surgical training before and after the pandemic.

Background: A global survey conducted by our team demonstrated significant disruption in surgical training during the COVID-19 pandemic.

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(1) Background: Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2) Methods: We generated an adhesion model with intraperitoneal polypropylene meshes.

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Article Synopsis
  • - The Septin 9 test detects hypermethylation of the SEPT9 gene, which is associated with colorectal cancer (CRC), and is validated for screening and monitoring disease post-surgery.
  • - In a study with 28 patients and 4 healthy donors, preoperative sensitivity for CRC detection was 55.6%, while post-surgical tests showed high sensitivity (100%) for recurrence at 5-7 days, and maintained strong results up to one month after surgery.
  • - The findings suggest that analyzing Septin 9 gene methylation in blood could be a promising non-invasive method for identifying minimal residual disease and predicting tumor recurrences, though further research with a larger sample size is needed.
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Latest advances in the field of cancer immunotherapy have developed the (Chimeric Antigen Receptor) CAR-T cell therapy. This therapy was first used in hematological malignancies which obtained promising results; therefore, the use of CAR-T cells has become a popular approach for treating non-solid tumors. CAR-T cells consist of T-lymphocytes that are engineered to express an artificial receptor against any surface antigen of our choice giving us the capacity of offering precise and personalized treatment.

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Background: This study aimed to measure the toxicity resulting from collagenase administration to the peritoneal cavity in a pig model as a preliminary step to break down the stroma surrounding tumors.

Methods: Eight pigs were treated with 2 different collagenase concentrations previously tested in rats by our group. Time and temperature were controlled using a peritoneal lavage system (PRS System, Combat Medical Ltd.

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Article Synopsis
  • Surgeons and cancer patients are discussing how shared decision-making (SDM) can enhance personalised medicine, focusing on balancing personal and clinical aspects to improve care quality.
  • Personalised precision medicine (PPM) has mainly relied on genomic data for treatment decisions but lacks sufficient guidance for clinicians on effectively communicating treatment consequences to patients and engaging them in the decision-making process.
  • The paper examines the ethical aspects of SDM, especially for vulnerable patients, through four clinical cases, highlighting the need for better training and resources for both clinicians and patients in the context of colorectal cancer care.
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Background: Oncological outcomes of self-expanding metallic stent used as a bridge to surgery in potential curative patients with left-sided colonic cancer obstruction remain unclear. The aim of this study was to investigate perioperative and mid-term oncological outcomes of 2 of the currently most commonly performed treatments in left-sided colonic cancer obstruction.

Methods: This is a retrospective multicenter study including patients with left-sided colonic cancer obstruction treated with curative intent between 2013 and 2017.

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Background: Digestive tract resections are usually followed by an anastomosis. Anastomotic leakage, normally due to failed healing, is the most feared complication in digestive surgery because it is associated with high morbidity and mortality. Despite technical and technological advances and focused research, its rates have remained almost unchanged the last decades.

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Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP-appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed.

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Background: Can we create a technological solution to flexibly self-manage undergraduate General Surgery practices within hospitals? Before the pandemic, the management of clerkships was starting to depend less on checkerboards. This study aims to explore undergraduates' perceptions of doing rotations in teaching hospitals using different teaching styles and elicit their views regarding the options of managing practices to design a mobile app that substitutes for checkerboards.

Methods: In this sequential exploratory mixed methods study, 38 semi-structured interviews at a teaching hospital were conducted.

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Article Synopsis
  • The study investigates compliance differences in Enhanced Recovery After Surgery (ERAS) protocols for colon versus rectal cancer surgeries and identifies obstacles in implementing ERAS for rectal surgeries.
  • Among the 434 patients analyzed, rectal surgeries had a significantly lower compliance rate (73%) compared to colonic procedures (82%), indicating challenges in applying ERAS effectively to rectal surgeries.
  • Key factors contributing to lower compliance in rectal surgeries included an open surgical approach, use of an epidural catheter, and postoperative ileus, suggesting a need for tailored ERAS protocols for rectal procedures.
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