Fundoplication with extensive dissection of the esophagogastric junction: Lessons learned and outcomes from 178 consecutives patients.

Introduction: Antireflux surgery is commonly associated with significant recurrence and complication rates, and several surgical techniques have been proposed to minimize them. The aim of this study is to evaluate the results of a fundoplication with extensive dissection of the esophagogastric junction 1 and 3 years after the procedure.

Methods: Retrospective observational study including 178 patients with gastroesophageal reflux disease or hiatal hernia who underwent fundoplication with extensive dissection of the esophagogastric junction between 2015 and 2020.

Implication of stem cells from adipose tissue in wound healing in obese and cancer patients.

Objective: Certain diseases such as obesity and cancer can cause impaired wound healing. Adipose tissue derived stem cells (ASCs) are a novel field of research. Many studies have evidenced their high degree of safety and potential for wound repair due to their immunomodulatory and tissue-regeneration properties.

Core outcome set for surgical trials in gastric cancer (GASTROS study): international patient and healthcare professional consensus.

Background: Surgery is the primary treatment that can offer potential cure for gastric cancer, but is associated with significant risks. Identifying optimal surgical approaches should be based on comparing outcomes from well designed trials. Currently, trials report different outcomes, making synthesis of evidence difficult.

Methods for conducting international Delphi surveys to optimise global participation in core outcome set development: a case study in gastric cancer informed by a comprehensive literature review.

Background: Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations.

Impact of Biliopancreatic Limb Length (70 cm vs 120 cm), with Constant 150 cm Alimentary Limb, on Long-Term Weight Loss, Remission of Comorbidities and Supplementation Needs After Roux-En-Y Gastric Bypass: a Prospective Randomized Clinical Trial.

Background: The best alimentary and biliopancreatic limb (BPL) lengths in the Roux-en-Y gastric bypass (RYGB) still remain unclear. The aim of this study was to compare the effect of a BPL of 70 vs 120 cm, with a constant AL of 150 cm on long-term weight loss, remission of comorbidities, and supplementation needs after RYGB.

Patients And Methods: A prospective randomized study of morbidly obese patients undergoing RYGB was performed.

Laparoscopic Toupet Fundoplication After Roux-en-Y Gastric Bypass in Patient with Severe GERD.

Background: Up to 22% of the patients, after laparoscopic Roux-en-Y gastric bypass (LRYGB) can complain about gastroesophageal reflux disease (GERD) symptoms, there is little evidence about the most effective treatment of this situation.

Materials And Method: This video shows a laparoscopic reintervention after a LRYGB in a 42-year-old woman presenting with untreatable GERD. GERD was treated with maximum doses of PPIs with no effect on the symptoms; the patient had a 24-h pH and impedance manometry that showed an acid and non-acid reflux, and for that reason, we decided to perform a laparoscopic fundoplication.

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.

Histopathological factors predicting response to neoadjuvant therapy in gastric carcinoma.

Background: Neoadjuvant therapy (NAT) is a useful therapeutic option. However, some patients respond poorly to it and can even show tumor progression. It is important to define factors that can predict response to NAT.

Laparoscopic Roux-en-Y Gastric Bypass After Open Vertical Banded Gastroplasty in Patient with Severe GERD.

This video shows a laparoscopic reintervention after an open, vertical banded gastroplasty in a 39-year-old woman presenting with untreatable GERD.

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.

CDX2 expression can predict response to neoadjuvant therapy in gastric carcinoma.

Purpose: Caudal-related homeobox transcription factor 2 (CDX2) has recently been proposed as a prognostic factor for gastric carcinoma. However and to the best of our knowledge, no previous report has analyzed CDX2 expression in patients with gastric adenocarcinoma receiving neoadjuvant therapy (NAT).

Patients, Materials And Methods: This is a retrospective cohort study to analyze the potential role of CDX2 expression to predict response to NAT and prognosis.

Biliobronchial fistula after liver surgery for giant hydatid cyst.

Background. Biliobronchial fistula (BBF) is a rare complication in the natural history of liver hydatid disease by Echinococcus granulosus. We present a case of BBF after resection of a giant liver hydatid cyst in a 72-year-old woman.

Wnt signaling requires sequestration of glycogen synthase kinase 3 inside multivesicular endosomes.

Canonical Wnt signaling requires inhibition of Glycogen Synthase Kinase 3 (GSK3) activity, but the molecular mechanism by which this is achieved remains unclear. Here, we report that Wnt signaling triggers the sequestration of GSK3 from the cytosol into multivesicular bodies (MVBs), so that this enzyme becomes separated from its many cytosolic substrates. Endocytosed Wnt colocalized with GSK3 in acidic vesicles positive for endosomal markers.

Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty.

Study Design: Systematic review of published incidence of radiographic adjacent segment degeneration (ASDeg) and symptomatic adjacent segment disease (ASDis) after arthrodesis or total disc replacement.

Objective: Assess impact of surgery method and other factors on the incidence of ASDeg and ASDis.

Summary Of Background Data: Twenty-seven articles, none of which were class I or II, met the inclusion criteria.

[First non-autologous vascular access for hemodialysis: PTFE fistula].

Introduction: Since 1999 to 2003 we have tried to perform an antebraquial "loop" PTFE fistula (PTFEa) as first vascular access for hemodialysis in patients without suitable superficial venous system.

Material And Methods: We have performed a prospective study to analyze the results (permeability and complications) with this approach.

Results: We could perform 44 PTFEa in 46 consecutive patients (in two cases we used the axillary vein as return vessel).

Liver transplantation for the treatment of fulminant hepatic failure induced by the ingestion of ecstasy.

Methylenedimethoxymethamphetamine (MDMA), more commonly known as ecstasy, is a synthetic amphetamine derivative used by teenagers and young adults in the United States as well as in Western Europe as a "dance drug". Though a number of complications associated with this drug have been reported, there is little information pertaining to hepatoxity as a result of MDMA ingestion. This case report is about an 18-year-old female patient who regularly used ecstasy on weekends over a 2-month period.

Orthotopic liver transplantation in primary liver tumors.

Among 283 orthotopic liver transplantations made during the last 6 years at our institution, 22 (7.77%) were done on 19 patients with unresectable hepatic malignant tumors [hepatocellular carcinoma (17), angiosarcoma (1), and cholangiocarcinoma (1)]. None of them showed extrahepatic invasion, and only one had lymph node involvement.

A single technique for polypropylene mesh hernioplasty of inguinal and femoral hernias.

The main factor in the repair of groin hernias is the reinforcement of posterior wall defects of the inguinal canal, including the femoral ring, because the normal insertion of the transversalis fascia and transversus abdominis muscle is on Cooper's ligament and not Poupart's ligament. In approximately one-half of primary femoral hernia repairs in men, a coincidental ipsilateral inguinal hernia existed. Recurrence after inguinal herniorrhaphy is usually femoral.

Liver transplantation in malignant primary hepatic neoplasms.

Between April 1986 and August 1990, 151 liver transplantations were performed at our institution, 16 (11%) of them in 14 patients with primary hepatic tumors. There were 12 hepatocellular carcinomas, 1 angiosarcoma, and 1 Klatskin tumor. None of the tumors was resectable, and there was no preoperative evidence of extrahepatic tumoral extension.

Recurrent acute pancreatitis as a complication of cystic fibrosis: report of one case treated surgically.

We present the case of a young woman previously diagnosed with cystic fibrosis (CF) manifested primarily by respiratory symptoms and pancreatic exocrine insufficiency. Only 0.5% of these patients suffer from episodes of recurrent acute pancreatitis, the majority of which respond to conservative treatment.