Preoperative management of patients with oesophageal cancer: expert recommendations.

The aim of this work is to establish recommendations for the preoperative evaluation and selection of patients with malignant oesophageal neoplasms, who are candidates for surgical resection with curative intent, based on the consensus established by a group of experts. Using the Delphi methodolgy and after 2 rounds of evaluation, responses were obtained from 37 experts to 47 questions about the preoperative management of oesophageal cancer, considering consensus if there was a mean score greater than 8 (range between 0 to 10). Of the respondents, 54% were women, with a mean age of 50.

PROFUGO study protocol: Predictive model for the early diagnosis of anastomotic leak after esophagectomy and gastrectomy.

In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications.

Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study.

Introduction: The effectiveness of the Enhanced Recovery After Surgery (ERAS) protocols in gastric cancer surgery remains controversial.

Methods: Multicentre prospective cohort study of adult patients undergoing surgery for gastric cancer. Adherence with 22 individual components of ERAS pathways were assessed in all patients, regardless of whether they were treated in a self-designed ERAS centre.

The utility of intraoperative endoscopy in esophagogastric surgery.

Flexible endoscopy (FE) plays a major role in the diagnosis and treatment of gastrointestinal disease. Although its intraoperative use has spread over the years, its use by surgeons is still limited in our setting. FE training opportunities are different among many institutions, specialties, and countries.

The Impact of Sleeve Gastrectomy on Gastroesophageal Reflux Disease in Patients with Morbid Obesity.

Introduction: The impact of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) has not been widely quantified, and the data in the literature remain controversial.

Materials And Methods: Candidates for LSG underwent barium swallow, esophageal manometry, ambulatory 24-h esophageal pH monitoring (APM), and gastric emptying scintigraphy before and after surgery (1 and 18 months). Symptoms were evaluated using a gastroesophageal reflux disease questionnaire (GERDq).

Enhanced recovery after esophageal resection.

ERAS is a multimodal perioperative care program which replaces traditional practices concerning analgesia, intravenous fluids, nutrition, mobilization as well as a number of other perioperative items, whose implementation is supported by evidence-based best practices. According to the RICA guidelines published in 2015, a review of the literature and the consensus established at a multidisciplinary meeting in 2015, we present a protocol that contains the basic procedures of an ERAS pathway for resective esophageal surgery. The measures involved in this ERAS pathway are structured into 3areas: preoperative, perioperative and postoperative.

Enhanced recovery after surgery in gastric resections.

Introduction: Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery.

Methods: According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery.

[Prospective randomized trial of long-term results of inguinal hernia repair using autoadhesive mesh compared to classic Lichtenstein technique with sutures and polypropylene mesh].

Introduction: The use of autoadhesive meshes with hooks that allow fixation without sutures is a therapeutic alternative to decrease recurrence and chronic pain after inguinal hernia repair. The aim of this study was to evaluate if this kind of mesh has any advantage in long term results in comparison with the classic Lichtenstein technique with sutures and polypropylene mesh.

Material And Methods: We report a prospective and randomized study of patients who have been operated on for inguinal hernia between march of 2009 to march 2010, divided into 2 groups of 45 patients.

[Relationship of oxidative stress and weight loss achieved in morbid obese patients by means of bariatric surgery using the duodenal switch technique].

Introduction: Oxidative stress (OS), which is overtly present in morbid obesity, is an indicator of a chronic inflammatory state associated to obesity and possibly related with the associated comorbidities, some of which represent an important risk factor for the occurrence of cardiovascular diseases, so that decreasing its intensity has become a treatment priority.

Materials And Methods: he have consecutively performed the duodenal crossing surgical technique in 28 patients suffering from morbid obesity, assessing the level of oxidative stress by the determination of the products of molecular oxidation and antioxidants before the surgery and throughout one year after the surgery. Weight evolution and the progression of the comorbidities already present were assessed.

[Metabolic changes after morbid obesity surgery using the duodenal switch technique. Long term follow-up].

Introduction: The duodenal switch (DS) technique is considered to be complex surgery with a series of metabolic complications due to its malabsorptive character. For these reasons, it has not been extensively used by bariatric surgeons. Despite this, we consider it to be a suitable technique for the grossly obese.

[Use of adhesive mesh in hernioplasty compared to the conventional technique. Results of a randomised prospective study].

Introduction: The use of meshes made with reabsorbable materials and structures that allow them to be fixed to the tissue without sutures, is considered as a therapeutic possibility in inguinal hernioplasty, reducing surgical times and supposedly improving pain and post-operative recovery.

Material And Methods: A prospective randomised study of patients intervened for inguinal hernia between March 2009 and March 2010. Those patients subjected to hernia repair with a self-adhesive mesh (Parietene Progrip(®)) were placed in the in the SA (self-adhesive) group, and those subjected to hernia repair with a polypropylene mesh fixed with a monofilament suture in the CL (Classic Lichenstein) group.

[Operating position in colorectal surgery. The importance of the basics].

Intra-operative positioning in colorectal surgery is very important from three points of view: the proper surgical approach and exposure, adequate anaesthetic requirements with maintenance of the airway, and the potential complications related to the position. In the present study, we analyse the indications, positioning, advantages and disadvantages of each operative position, their potential complications and how to avoid them. These complications can be of a diverse nature, the most common being injuries related to stretching or compression of peripheral nerves, followed by thromboembolic, haemodynamic, and ischaemic or compartmental syndromes related to ischaemia-reperfusion after a long time in the Trendelenburg position.

[Donors yesterday and today: have the characteristics of liver donors changed over the last 15 years?].

Introduction: The social, medical and demographic changes of our population and the increase in the number of patients on waiting lists have led to some changes in the selection criteria of organ donors.

Material And Method: A retrospective, descriptive and comparative study of the liver cadaveric donors features accepted in the Liver Transplant Unit in La Fe University Hospital of Valencia (Spain) in 2 different periods. We distributed the cases into 2 groups, including in group A the first 200 first donors (from January 1991 to June 1995) and in group B the last 200 donors (from February 2004 to December 2005).