Assessment of postoperative morbidity in Spanish hospitals: Results from a national survey.

Background: The methodology used for recording, evaluating and reporting postoperative complications (PC) is unknown. The aim of the present study was to determine how PC are recorded, evaluated, and reported in General and Digestive Surgery Services (GDSS) in Spain, and to assess their stance on morbidity audits.

Methods: Using a cross-sectional study design, an anonymous survey of 50 questions was sent to all the heads of GDSS at hospitals in Spain.

Diagnostic value of ascites immunohistochemistry in carcinomatosis of unknown origin.

We present the case of a patient diagnosed with carcinomatosis when admitted urgently for an occlusive condition. It is the immunohistochemistry that clarifies which is the primary tumor. Sigma neoplasia was initially suspected to recur due to operative findings.

When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement.

Background & Aims: There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on the indications and appropriate techniques for colonic tattoo through a modified Delphi process.

Methods: The baseline questionnaire was classified into 3 areas: where tattooing should not be used (1 domain, 6 questions), where tattooing should be used (4 domains, 20 questions), and how to perform tattooing (1 domain 20 questions).

Photodynamic Therapy for the Treatment of Complex Anal Fistula.

Background And Objectives: To validate and analyze the results of intralesional photodynamic therapy in the treatment of complex anal fistula.

Study Design/materials And Methods: This prospective multicentric observational study enrolled patients treated for complex anal fistula who underwent intralesional photodynamic therapy (i-PDT). The included patients were treated from January 2016 to December 2018 with a minimum follow-up of 1 year to evaluate recurrence, continence and postoperative morbidity.

Standard outcome indicators after colon cancer resection. Creation of a nomogram for autoevaluation.

Introduction: Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset.

Methods: Data from the prospective national study ANACO were used.

Recommendations of «not-to-do»: Proposals of the Spanish Association of Surgeons to the project «Commitment to quality of scientific societies».

Introduction: The initiative of the Spanish Ministry of Health «Commitment to quality of scientific societies», aims to reduce unnecessary interventions of healthcare professionals.

Methods: The Spanish Association of Surgeons has selected 22 experts from the different sections that have participated in the identification of 26 proposals «do not do» to be ordered by the expected impact its implementation would have according to the GRADE methodology. From these proposals, the Delphi technique was used to select 5 recommendations presented in more detail in this article.

Analysis of the quality of care in surgical treatment of colorectal cancer: national study. Follow-up results.

Objectives: Using the cases included in the Study on the quality of care in colorectal cancer conducted by the Spanish Association of Surgeons in 2008, we present follow-up data.

Method: Multicenter, descriptive, longitudinal and prospective study of patients operated on a scheduled basis of colorectal cancer. 35 hospitals have contributed data on 334 patients.

[Safety of a multiperforated catheter implanted in the surgical wound for the continuous infusion of local anaesthetics in post-operative analgesia].

Objective: To evaluate the incidence of infection at the surgical site in patients who have a multiperforated catheter implant for continuous infusion of a local anaesthetic as a local analgesic.

Patients And Method: An observational, descriptive and prospective study, of one month duration. It included 50 patients subjected to selective laparotomy in whom a multiperforated pre-peritoneal catheter was implanted for analgesia purposes (Painfusor®.

[Analysis of the quality of surgical treatment of colorectal cancer, in 2008. A national study].

Objective: A national study conducted for the Spanish Association of Surgeons with the aim of analysing the surgical treatment of colorectal cancer (CRC) in Spain and to compare it with scientific literature.

Material And Methods: A multicentre, descriptive, prospective and longitudinal study of patients with CRC who were treated by elective surgery. A total of 50 hospitals in 15 Autonomous Regions took part, with 496 treated cases in 2008.

[Major ambulatory surgery and clinical pathways: a stimulating combination].

The success of major ambulatory surgery (MAS) in Spain is due to the need to shorten the surgical waiting list for procedures of low to medium complexity, and the efficiency, satisfaction and safety that it can obtain. Clinical Pathways (CP) are defined health care plans, supported by scientific evidence, prepared for specific environments, on "Clinical Processes" with, a predictable clinical course, high prevalence and variability. The sequence of all the activities are set out in detail in them, as well as checking the performance of the professionals involved.

[Guidelines and clinical pathways. Is there really a difference?].

Quality Design Activities of Good Clinical Practice guidelines or protocols and clinical pathways (CP) include those clinical plans intended for the patients with a particular disease. They must be based on the clinical evidence, the analysis of the process, and the consensus of the professionals involved in the care of the patient. When these are introduced to surgical professionals, they usually say that they do not understand the the difference between CP and protocols or guidelines.

[Comparison of the quality of two clinical practice guides in colorectal cancer using the AGREE System].

Introduction: Clinical practice guidelines (CPG) must be adapted to the population in which we apply them, therefore it is important that their quality is validated. AGREE Collaboration is a tool mainly designed for helping CPG providers and users in the evaluation of their methodological quality.

Material And Method: We have compared two colorectal cancer CPG (the original guidelines were prepared by Royal Collage of Surgeons of England (RCSE) and the other by the Valencian Society of Surgery (SVC).