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Correa Bonito A, Cerdán Santacruz C, Pellino G, Fernández Miguel T, Bermejo Marcos E, Rodríguez Sánchez A, García Septiem J, Martín-Pérez E. Results of a national survey about the management of patients with acute uncomplicated diverticulitis. Cir Esp 2024; 102:202-208. [PMID: 38341091 DOI: 10.1016/j.cireng.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/19/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this study is to evaluate the adhesión among national centres to these and others recommendations related to this pathology. METHODS An online national survey, that has been broadcast by several applications, was performed. The results obtained were statistically analysed. RESULTS A total of 104 surgeons participated, representing 69 national hospitals. Of those, in 82.6% of the centres, outpatient management is performed for acute uncomplicated diverticulitis. 23.2% of the hospitals have a protocol stablished for treatment without antibiotherapy in selected patients. Centres that do not follow these protocols allege that the mean reasons are the logistic difficulties to set them up (49.3%) and the lack of current evidence for it (44.8%). Significative statistical differences have been found when comparing the establishment of such protocols between centres with advanced accredited units and those who are not, with higher rates of outpatient management and treatment without antibiotics in accredited units (p ≤ .05). CONCLUSIONS In spite that this a very common disease, there is a huge national heterogeneity in its treatment. This is why it would adviseable to unify diagnostic and treatment criteria by the collaboration of scientific societies and the simplification of the development of hospitalary protocols.
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Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
| | - Carlos Cerdán Santacruz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Gianluca Pellino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - Tamara Fernández Miguel
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Galdakao-Usansolo, Bilbao, Spain
| | - Elena Bermejo Marcos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Ana Rodríguez Sánchez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Blanco Terés L, Bermejo Marcos E, Cerdán Santacruz C, Correa Bonito A, Rodríguez Sanchez A, Chaparro M, Gisbert JP, García Septiem J, Martín-Pérez E. FiLaC® procedure for highly selected anal fistula patients: indications, safety and efficacy from an observational study at a tertiary referral center. Rev Esp Enferm Dig 2023; 115:700-706. [PMID: 37449475 DOI: 10.17235/reed.2023.9644/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND the ideal clinical profile of patients or fistula features for fistula laser closure (FiLaC®) technique remain to be established. The aim of this study was to analyze clinical outcomes and the safety profile of FiLaC® in search for an ideal setting for this technique. METHODS a retrospective observational study was performed from a prospective database including all consecutive patients who underwent surgery for anal fistula (AF) with FiLaC® in the coloproctology unit of a tertiary referral center, between October 2015 and December 2021. The FiLaC® procedure was offered to AF patients who were considered to be at risk of fecal incontinence. Fistulas were described according to Parks' classification and categorized as complex or simple according to the American Gastroenterological Association (AGA) guidelines. Healing was defined by the closure of the internal and external openings for at least six months. Predictive factors of AF healing were investigated. RESULTS a total of 36 patients were included, with a mean age of 48 ± 13.9 years. Twenty patients (55.6 %) were male and 13 patients (36 %) had Crohn's disease (CD). Fourteen patients (38.8 %) had a complex fistula. The primary and secondary healing rates were 55.6 % and 91.7 %, respectively, during a median follow-up time of 12 months (IQR 7-29). No fecal continence impairment was registered in any case. The proportion of patients with primary healing was significantly higher in CD patients (76.9 % vs 43.5 %, p = 0.048). CONCLUSIONS FiLaC® is a sphincter-preserving procedure with an excellent safety profile and reasonable success rate despite of the strict patient selection. This technique may be attractive for patients with CD due to its higher primary healing rate.
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Affiliation(s)
- Lara Blanco Terés
- General and Digestive Surgery, Hospital Universitario La Princesa, España
| | | | | | - Alba Correa Bonito
- General and Digestive Surgery, Hospital Universitario de La Princesa, España
| | | | - María Chaparro
- General and Digestive Surgery, Hospital Universitario de La Princesa, España
| | - Javier P Gisbert
- General and Digestive Surgery, Hospital Universitario de La Princesa, España
| | | | - Elena Martín-Pérez
- General and Digestive Surgery, Hospital Universitario de La Princesa, España
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Cerdán-Santacruz C, Cano-Valderrama Ó, Santos Rancaño R, Terés LB, Vigorita V, Pérez TP, Rosciano Paganelli JG, Paredes Cotoré JP, Carre MK, Flor-Lorente B, Antona FB, Martín EY, Tebar JC, Cao IA, Coltell ZB, Alonso MG, Paredes Cotoré JP, Prada López BL, Riesco AB, Cánovas NI, Sánchez CM, Serrat DR, Conde GA, Toscano MJ, Aira AC, Pérez MR, Petit NM, Espín Basany E, Carré MK, Pellino G, Retuerta JM, Saldaña AG, Laso CÁ, Allende IA, Álvarez DH, Cazador AC, Sánchez Bautista WM, Torres Sánchez MT, Bonito AC, Velázquez MC, Díaz OM, Fuentes NS, Olías MDCDLV, Pérez TP, Rosciano Paganelli JG, Lorente BF, Valderrama ÓC, Santos Rancaño R, Terés LB, Santacruz CC. "Long-term oncologic outcomes and risk factors for distant recurrence after pathologic complete response following neoadjuvant treatment for locally advanced rectal cancer. A nationwide, multicentre study". Eur J Surg Oncol 2023; 49:106962. [PMID: 37414628 DOI: 10.1016/j.ejso.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/09/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Pathologic complete response (pCR) after multimodal treatment for locally advanced rectal cancer (LARC) is used as surrogate marker of success as it is assumed to correlate with improved oncologic outcome. However, long-term oncologic data are scarce. METHODS This retrospective, multicentre study updated the oncologic follow-up of prospectively collected data from the Spanish Rectal Cancer Project database. pCR was described as no evidence of tumour cells in the specimen. Endpoints were distant metastases-free survival (DMFS) and overall survival (OS). Multivariate regression analyses were run to identify factors associated with survival. RESULTS Overall, 32 different hospitals were involved, providing data on 815 patients with pCR. At a median follow-up of 73.4 (IQR 57.7-99.5) months, distant metastases occurred in 6.4% of patients. Abdominoperineal excision (APE) (HR 2.2, 95%CI 1.2-4.1, p = 0.008) and elevated CEA levels (HR = 1.9, 95% CI 1.0-3.7, p = 0.049) were independent risk factors for distant recurrence. Age (years) (HR 1.1; 95%-CI 1.05-41.09; p < 0.001) and ASA III-IV (HR = 2.0; 95%-CI 1.4-2.9; p < 0.001), were the only factors associated with OS. The estimated 12, 36 and 60-months DMFS rates were 96.9%, 91.3%, and 86.8%. The estimated 12, 36 and 60-months OS rates were 99.1%, 94.9% and 89.3%. CONCLUSIONS The incidence of metachronous distant metastases is low after pCR, with high rates of both DMFS and OS. The oncologic prognosis in LARC patients that achieve pCR after neoadjuvant chemo-radiotherapy is excellent in the long term.
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Affiliation(s)
| | | | | | - Lara Blanco Terés
- Colorectal Surgery Department, Hospital de la Princesa, Madrid, Spain
| | - Vicenzo Vigorita
- Colorectal Surgery Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | - Jesús Pedro Paredes Cotoré
- Colorectal Surgery Department, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | | | - Blas Flor-Lorente
- Colorectal Surgery Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | | | | | - Inés Aldrey Cao
- Complejo Hospitalario Universitario de Ourense, Orense, Spain
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Correa Bonito A, Cerdán Santacruz C, Di Martino M, Blanco Terés L, Gancedo Quintana Á, Martín-Pérez E, Biondo S, García Septiem J. Treatment for acute uncomplicated diverticulitis without antibiotherapy: systematic review and meta-analysis of randomized clinical trials. Int J Surg 2023; 109:1412-1419. [PMID: 37026842 PMCID: PMC10389615 DOI: 10.1097/js9.0000000000000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/15/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Use of antibiotics in selected cases of acute uncomplicated diverticulitis (AUD) has recently been questioned. OBJECTIVE The aim of this study is to examine the safety and efficacy of treatment regimens without antibiotics compared with that of traditional treatments with antibiotics in selected patients with AUD. DATA SOURCES PubMed, Medline, Embase, Web of Science, and the Cochrane Library. METHODS A systematic review was performed according to PRISMA and AMSTAR guidelines by searching through Medline, Embase, Web of Science, and the Cochrane Library for randomized clinical trials (RCTs) published before December 2022. The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis. STUDY SELECTION RCTs on treating AUD without antibiotics published in English before December 2022 were included. INTERVENTION Treatments without antibiotics were compared with treatments with antibiotics. MAIN OUTCOME MEASURES The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis. RESULTS The search yielded 1163 studies. Four RCTs with 1809 patients were included in the review. Among these patients, 50.1% were treated conservatively without antibiotics. The meta-analysis showed no significant differences between nonantibiotic and antibiotic treatment groups with respect to rates of readmission [odds ratio (OR)=1.39; 95% CI: 0.93-2.06; P =0.11; I2 =0%], change in strategy (OR=1.03; 95% CI: 0.52-2,02; P =0.94; I2 =44%), emergency surgery (OR=0.43; 95% CI: 0.12-1.53; P =0.19; I2 =0%), worsening (OR=0.91; 95% CI: 0.48-1.73; P =0.78; I2 =0%), and persistent diverticulitis (OR=1.54; 95% CI: 0.63-3.26; P =0.26; I2 =0%). LIMITATIONS Heterogeneity and a limited number of RCTs. CONCLUSIONS Treatment for AUD without antibiotic therapy is safe and effective in selected patients. Further RTCs should confirm the present findings.
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Affiliation(s)
| | | | | | - Lara Blanco Terés
- General and Digestive Surgery Service, Hospital Universitario de La Princesa, Madrid
| | | | - Elena Martín-Pérez
- General and Digestive Surgery Service, Hospital Universitario de La Princesa, Madrid
| | - Sebastiano Biondo
- General and Digestive Surgery – Colorectal Unit, Bellvitge University Hospital, Barcelona, Spain
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Correa Bonito A, Muñoz-Hernández P, de la Hoz Rodríguez Á, Delgado Valdueza J, Martín Pérez E. Doege-Potter syndrome due to a hepatic solitary fibrous tumour. Cir Esp 2022; 100:108-110. [PMID: 34973916 DOI: 10.1016/j.cireng.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/22/2020] [Indexed: 06/14/2023]
Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
| | | | - Ángela de la Hoz Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Jesús Delgado Valdueza
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Elena Martín Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Correa Bonito A, Cuartero Desviat B, Martínez Negro E, Acedo Fernández de Pedro F, Rodríguez Marín D, Marcello Fernández ME, Ochando Cerdán F, Martínez Cortijo S. Ampullary GIST tumour as an incidental finding after a cephalic duodenopancreatectomy due to a suspect of a nonfunctional neuroendocrine tumour. Rev Esp Enferm Dig 2022; 114:495-496. [DOI: 10.17235/reed.2022.8748/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Correa Bonito A, Maqueda González R, Rodríguez Sánchez A, Bermejo Marcos E, Blanco Terés L, García Septiem J, Martín Pérez E. Presacral neuroendocrine tumour in a patient diagnosed with Currarino's syndrome. Gastroenterol Hepatol 2021; 45 Suppl 1:62-63. [PMID: 34023472 DOI: 10.1016/j.gastrohep.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/20/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España.
| | | | - Ana Rodríguez Sánchez
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Elena Bermejo Marcos
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Lara Blanco Terés
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Javier García Septiem
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Elena Martín Pérez
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
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Blanco Terés L, Cerdán Santacruz C, García Septiem J, Maqueda González R, Lopesino González JM, Correa Bonito A, Martín-Pérez E. Patients' Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department. Surg Innov 2021; 29:35-43. [PMID: 33848218 DOI: 10.1177/15533506211008053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest (P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.
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Affiliation(s)
- Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Carlos Cerdán Santacruz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Rocío Maqueda González
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - José María Lopesino González
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 16517Universidad Autónoma de Madrid (UAM), Madrid, España
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Correa Bonito A, Muñoz-Hernández P, de la Hoz Rodríguez Á, Delgado Valdueza J, Martín Pérez E. Doege-Potter syndrome due to a hepatic solitary fibrous tumour. Cir Esp 2020; 100:S0009-739X(20)30358-4. [PMID: 33309282 DOI: 10.1016/j.ciresp.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/07/2020] [Accepted: 10/22/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España.
| | | | - Ángela de la Hoz Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Jesús Delgado Valdueza
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Elena Martín Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
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Di Martino M, García Septiem J, Maqueda González R, Muñoz de Nova JL, de la Hoz Rodríguez Á, Correa Bonito A, Martín-Pérez E. [Elective surgery during the SARS-CoV-2 pandemic (COVID-19): a morbimortality analysis and recommendations on patient prioritisation and security measures]. Cir Esp 2020; 98:525-532. [PMID: 32408995 PMCID: PMC7188649 DOI: 10.1016/j.ciresp.2020.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The spread of the SARS-CoV-2 infection (COVID-19) has required adaptation by hospitals affected by the pandemic, which has caused a reduction in elective surgical activity. METHODS Retrospective study of patients operated on in the previous month and during the peak of the pandemic. We analysed the COVID-19 infection rate, the severity of respiratory infection according to the Brescia respiratory COVID-19 severity scale, the adopted therapeutic measures and the overall postoperative complications. RESULTS From 17th February to 31st March 2020, there was a progressive decrease in surgical activity, with only 213 patients operated on. This comprised 59 (27.8%) elective operations for oncological diseases, 97 (45.5%) elective operations for benign diseases and 57 (26.7%) as urgent procedures.There was a progressive increase in the rate of infection by COVID-19, with a total of 15 cases (7%). This included 10 patients (16.9%) in the elective group for oncological disease, 1 (1%) in the elective surgery group for benign disease and 4 (7%) in the urgent surgery group (p < 0.001). Five patients presented with a severe respiratory infection, of which 4 were affected by oncological disease. There were 3 deaths (1.4%), which were all due to the worsening of a respiratory infection. CONCLUSIONS The patients undergoing the surgical procedures showed high rates of COVID-19 infection and postoperative complications, especially the patients with oncological diseases. Local resumption of surgical activity must be based on the prioritisation of the cases to be operated on, respecting certain premises of security and optimisation of the available resources.
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Affiliation(s)
- Marcello Di Martino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España.
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Rocío Maqueda González
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Jose Luis Muñoz de Nova
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | | | - Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
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Di Martino M, Blanco Terés L, Correa Bonito A, Martín-Pérez E. Image-guided laparoscopic anatomic liver resection. Cir Esp 2020; 98:555. [PMID: 32600645 DOI: 10.1016/j.ciresp.2020.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Marcello Di Martino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España.
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
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Correa Bonito A, de la Hoz Rodríguez Á, Marín Campos C, Doblado Cardellach B, Martín Pérez E. Porocarcinoma Located in the Breast: A Case Report. Cir Esp 2020; 98:561-563. [PMID: 31992443 DOI: 10.1016/j.ciresp.2019.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España.
| | - Ángela de la Hoz Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Cristina Marín Campos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Beatriz Doblado Cardellach
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Elena Martín Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
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Blanco Terés L, Valdés de Anca Á, Correa Bonito A, Gancedo Quintana Á, Martín Pérez E. Flood syndrome: A severe complication of umbilical hernia. Cir Esp 2020; 98:490-491. [PMID: 31980151 DOI: 10.1016/j.ciresp.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España.
| | - Álvaro Valdés de Anca
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Álvaro Gancedo Quintana
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Elena Martín Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
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Mora-Guzmán I, Di Martino M, Bonito AC, Jodra VV, Hernández SG, Martin-Perez E. Conservative Management of Gallstone Disease in the Elderly Population: Outcomes and Recurrence. Scand J Surg 2019; 109:205-210. [PMID: 30791835 DOI: 10.1177/1457496919832147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS The prevalence of gallstone disease increases with age, being early cholecystectomy the most accepted treatment in the vast majority of patients in order to prevent complications and recurrence. The aim of this study is to determine the recurrence rate and its possible predictors after initial non-operative management. MATERIALS AND METHODS We reviewed a consecutive series of patients, older than 65 years, admitted for a gallstone-related disease and treated with a non-operative management between January 2010 and December 2013. We analyzed comorbidities, clinical data, diagnosis, management, recurrence, and its treatment. Median follow-up after the discharge was 2 years. Recurrence was analyzed by a Kaplan-Meier survival curve. Possible recurrence's predictors were analyzed. RESULTS The study included 226 patients. Mean age was 80.4 ± 7.2 years, 127 (56%) were female. The main causes of index hospitalization were acute cholecystitis (58%) and biliary pancreatitis (18.1%). After 2 years of follow-up, the recurrence rate was 39.8%; mean time to recurrence was 255.2 ± 42.1 days, 81% of patients recurred within 1 year. Bile duct disease implied a higher recurrence rate than the gallbladder disease group (52% vs 33%, p < 0.001). Subjects with two or more diagnoses during index admission presented higher recurrence rate (32% vs 49%, p < 0.001). CONCLUSION More than a third of elderly patients could present a recurrence within 2 years after initial non-operative management. Early cholecystectomy should be considered at index admission in order to prevent recurrence.
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Affiliation(s)
- I Mora-Guzmán
- Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain
| | - M Di Martino
- Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain
| | - A C Bonito
- Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain
| | - V V Jodra
- Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S G Hernández
- Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Martin-Perez
- Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain
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