Status of the management of hypertension and diabetes in rural Kenya: a multi-institutional joint intervention of cross-sectional surveys.

Introduction: the aim of this study was to analyze the status of the management of vascular risk factors (hypertension and diabetes) at hospital level (3, 4 and 5) in Murang'a County (Kenya) health system.

Methods: between July and December 2018 we performed a joint intervention about the strategies for improving care management of hypertension and diabetic patients in Murang'a (Kenya). A survey based on the recommendations from WHO about management of diabetes and hypertension was completed for 9 health-care centers.

Goiter surgery recommendations in sub-Saharan Africa in humanitarian cooperation.

Background: The standard treatment for endemic goiter is usually total thyroidectomy. In low- and middle-income countries, the management of thyroid disease, which is commonplace in fully developed countries, is not always possible. The purpose of this study is to establish a treatment algorithm to calculate the extent of thyroidectomy based on the risk factors of each patient.

Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting.

Background: Since the declaration of the pandemic, humanitarian medicine has been discontinued. Until now, there have been no general recommendations on how humanitarian surgical missions should be organized.

Methods: Based on our experience in the field of humanitarian surgical missions to Sub-Saharan Africa, a panel of recommendations in times of COVID-19 was developed.

Isoperistaltic versus antiperistaltic ileocolic anastomosis. Does it really matter? Results from a randomised clinical trial (ISOVANTI).

Background: Right hemicolectomy is a very common surgery. Many studies compare different options for laparoscopic ileocolic anastomoses: intra- or extracorporeal; handsewn or stapled; side-to-side or end-to-side. However, there are no studies about the influence that peristalsis could have on this anastomosis.

V-Y advancement flaps for extensive perianal defect repair.

Objectives: Some perianal pathologies require aggressive surgery that will need techniques to allow to re-establish the integrity of the perianal region. The purpose is to analyze short and long term results after perineal reconstruction with V-Y flaps.

Methods: A retrospective review of prospectively collected database was conducted at Virgen de la Arrixaca's Hospital in Murcia (España) between January 2000 and December 2013.

Utility of rectoscopy in the assessment of response to neoadjuvant treatment for locally advanced rectal cancer.

Background/aims: The management of locally advanced rectal cancer has changed substantially over the last few decades with neoadjuvant chemoradiotherapy. The aim of the present study is to compare the results between neoadjuvant post-treatment rectoscopy and the anatomopathological findings of the surgical specimen.

Patients And Methods: We conducted a prospective study of 67 patients with locally advanced adenocarcinoma of the rectum (stages II and III).

The influence of the percentage of the common limb in weight loss and nutritional alterations after laparoscopic gastric bypass.

Background: Roux-en-Y gastric bypass (RYGB) is considered the gold standard for the treatment of morbid obesity. There is no consensus over ideal limb length when the bypass is created and published studies do not take into account the influence of the common limb (CL) on weight loss. The objective was to study the influence of the common limb after RYGB.

The learning curve of laparoscopic treatment of rectal cancer does not increase morbidity.

Introduction: The treatment of rectal cancer via laparoscopy is controversial due to its technical complexity. Several randomized prospective studies have demonstrated clear advantages for the patient with similar oncological results to those of open surgery, although during the learning of this surgical technique there may be an increase in complications and a worse prognosis.

Objective: Our aim is to analyze how the learning curve for rectal cancer via laparoscopy influences intra- and postoperative results and oncological markers.

[Single incision transumbilical laparoscopic appendectomy: initial experience].

Introduction: Appendicitis is the most common abdominal emergency. The treatment is surgical and single incision laparoscopic surgery (SILS) involves performing laparoscopic surgery through a single transumbilical point, in an attempt to improve the results of laparoscopic surgery.

Material And Method: A total of 73 patients with suspected acute appendicitis were operated on using the SILS technique between June 2009 and August 2010.

Screening for the effectiveness of conservative treatment in chronic anal fissure patients using anorectal manometry.

Purpose: Chemical sphincterotomy (CS) is routinely applied in order to avoid the irreversible anal incontinence associated with the surgical treatment of chronic anal fissure (CAF). However, CS has a lower cure rate than surgery. We developed a screening test (using anal manometry) to separate those patients that are unlikely to benefit from CS and should undergo a more aggressive treatment.

Gastrojejunal anastomotic stenosis in laparoscopic gastric bypass with a circular stapler (21 mm): incidence, treatment and long-term follow-up.

Background: One of the keys to the long-term success of laparoscopic gastric bypass (LGBP) is performing a small-diameter gastrojejunal anastomosis, which occasionally involves an increased incidence of stenosis.

Methods: Between May 2000 and October 2008, 676 patients underwent LGBP with a no. 21 circular stapler to create the gastrojejunoanastomosis (GJA).

[Long-term results of laparoscopic gastric bypass in patients with morbid obesity. a prospective study of 508 cases].

Introduction: Although there are publications on the short-medium term results of gastric bypass, publications of long-term results are very limited and the results are less documented.

Patients And Method: In this article we present the experience of the same surgical team with laparoscopic gastric bypass over 7 years, with a follow-up of 97% of the patients. From March 2000 until May 2007, 508 laparoscopic gastric bypasses were performed by the same surgical team.

Clinical pathway for laparoscopic gastric bypass.

Background: Patients undergoing bariatric surgery are ideal candidates for a clinical pathway, as it is a standardized, common, and elective procedure and most patients have a predictable clinical course.

Objective: The aim of developing this clinical pathway is the result of a wide consolidated experience with patients undergoing laparoscopic Roux-en-Y gastric bypass, the purpose of which is to minimize complications without affecting patient care or the outcome of the procedure.

Patients And Method: The clinical pathway was applied to the 311 patients that received a laparoscopic Roux-en-Y gastric bypass.

Intragastric balloon reduces liver volume in super-obese patients, facilitating subsequent laparoscopic gastric bypass.

Background: Surgery in patients with super-obesity (BMI > or = 50) involves technical difficulties that are related, among other factors, to increased liver volume. Although the intragastric balloon is not a definitive alternative to surgery, it has been used in these patients as a primary therapeutic means of reducing excess weight and the risks of subsequent surgery. It has also been reported to considerably diminish liver volume to facilitate technical aspects of the operation.

Results of laparoscopic gastric bypass in patients > or =55 years old.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a commonly performed surgical intervention for morbid obesity. Some authors considered age > or =55 years as a relative contraindication to bariatric surgery. We examined the operative outcomes, weight loss, hospital stay and resolution of co-morbidities in patients > or =55 years old compared with those <55 years old undergoing LRYGBP.

[Influence of the surgeon as a factor in the surgical treatment of rectal cancer with preoperative radiochemotherapy. A comparative study].

Introduction: In the last few years, changes have been introduced in rectal cancer surgery that have improved its results. These changes include autosuture devices, total mesorectal excision, and neoadjuvant treatment. The aim of the present study was to determine whether the surgeon influences the results of surgical treatment for rectal cancer.

Experience with the circular stapler for the gastrojejunostomy in laparoscopic gastric bypass (350 cases).

Background: The increased incidence of morbid obesity has resulted in an increase in bariatric surgery. The gastrojejunostomy performed during Roux-en-Y gastric bypass (RYGBP) operations has technical variability with different outcomes and complication-rates immediate postoperatively and at long-term follow-up.

Methods: Between Jan 2000 and Feb 2005, 350 laparoscopic RYGBP procedures were performed.

Eversion thromboendovenectomy in organized portal vein thrombosis during liver transplantation.

Portal thrombosis is no longer considered a contraindication for transplantation because of the technical experience acquired in the field of liver transplantation and the development of various surgical techniques. All the same, the results obtained in portal thrombosis patients are at times suboptimal, and the surgical technique used (thromboendovenectomy or veno-venous bypass) is also controversial. Between May 1988 and December 2001, 455 liver transplants were performed, of which 32 (7%) presented portal vein thrombosis.

Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective study.

Objective: The objective of the study was to compare the results of open versus laparoscopic gastric bypass in the treatment of morbid obesity.

Summary Background Data: Gastric bypass is one of the most commonly acknowledged surgical techniques for the management of morbid obesity. It is usually performed as an open surgery procedure, although now some groups perform it via the laparoscopic approach.