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Herrera A, Herrera M, Guerra-Perez N, Galindo-Pumariño C, Larriba MJ, García-Barberán V, Gil B, Giménez-Moyano S, Ferreiro-Monteagudo R, Veguillas P, Candia A, Peña R, Pinto J, García-Bermejo ML, Muñoz A, García de Herreros A, Bonilla F, Carrato A, Peña C. Endothelial cell activation on 3D-matrices derived from PDGF-BB-stimulated fibroblasts is mediated by Snail1. Oncogenesis 2018; 7:76. [PMID: 30250018 PMCID: PMC6155204 DOI: 10.1038/s41389-018-0085-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 08/26/2018] [Indexed: 01/26/2023] Open
Abstract
Carcinomas, such as colon cancer, initiate their invasion by rescuing the innate plasticity of both epithelial cells and stromal cells. Although Snail is a transcriptional factor involved in the Epithelial-Mesenchymal Transition, in recent years, many studies have also identified the major role of Snail in the activation of Cancer-Associated Fibroblast (CAF) cells and the remodeling of the extracellular matrix. In CAFs, Platelet-derived growth factor (PDGF) receptor signaling is a major functional determinant. High expression of both SNAI1 and PDGF receptors is associated with poor prognosis in cancer patients, but the mechanism(s) that underlie these connections are not understood. In this study, we demonstrate that PDGF-activated fibroblasts stimulate extracellular matrix (ECM) fiber remodeling and deposition. Furthermore, we describe how SNAI1, through the FAK pathway, is a necessary factor for ECM fiber organization. The parallel-oriented fibers are used by endothelial cells as “tracks”, facilitating their activation and the creation of tubular structures mimicking in vivo capillary formation. Accordingly, Snail1 expression in fibroblasts was required for the co-adjuvant effect of these cells on matrix remodeling and neoangiogenesis when co-xenografted in nude mice. Finally, in tumor samples from colorectal cancer patients a direct association between stromal SNAI1 expression and the endothelial marker CD34 was observed. In summary, our results advance the understanding of PDGF/SNAI1-activated CAFs in matrix remodeling and angiogenesis stimulation.
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Affiliation(s)
- Alberto Herrera
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain
| | - Mercedes Herrera
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain.,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Natalia Guerra-Perez
- Medical Oncology Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Cristina Galindo-Pumariño
- Medical Oncology Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - María Jesús Larriba
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, CIBERONC, Madrid, Spain
| | - Vanesa García-Barberán
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain.,Laboratory of Molecular Oncology, IIS Hospital Clínico San Carlos, CIBERONC, Madrid, Spain
| | - Beatriz Gil
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain.,Laboratorio de Oncología Traslacional y Nuevas Terapias. Instituto de Investigación i+12, Madrid, Spain
| | - Sara Giménez-Moyano
- Biomarkers and Therapeutic Targets Lab, Pathology Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Reyes Ferreiro-Monteagudo
- Medical Oncology Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Pilar Veguillas
- Surgery Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Antonio Candia
- Pathology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Raúl Peña
- Programa de Recerca en Càncer, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Jesús Pinto
- Pathology Department, Virgen de la Concha Hospital, Zamora, Castilla y León, Spain
| | - Mª Laura García-Bermejo
- Laboratorio de Oncología Traslacional y Nuevas Terapias. Instituto de Investigación i+12, Madrid, Spain
| | - Alberto Muñoz
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, CIBERONC, Madrid, Spain
| | | | | | - Alfredo Carrato
- Medical Oncology Department, Ramon y Cajal University Hospital, IRYCIS, CIBERONC, Alcala University, Madrid, Spain
| | - Cristina Peña
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain. .,Medical Oncology Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERONC, Madrid, Spain.
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Ramia JM, Adel F, de La Plaza R, Veguillas P, García-Parreño J. Laparoscopic first stage in a two-stage hepatectomy. Cir Esp 2015; 93:125-7. [PMID: 24094926 DOI: 10.1016/j.ciresp.2013.05.013] [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: 03/24/2013] [Revised: 05/09/2013] [Accepted: 05/23/2013] [Indexed: 02/07/2023]
Affiliation(s)
- José Manuel Ramia
- Unidad de Cirugía Hepatobiliopancreática. Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España.
| | - Farah Adel
- Unidad de Cirugía Hepatobiliopancreática. Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Roberto de La Plaza
- Unidad de Cirugía Hepatobiliopancreática. Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Pilar Veguillas
- Unidad de Cirugía Hepatobiliopancreática. Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Jorge García-Parreño
- Unidad de Cirugía Hepatobiliopancreática. Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
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Ramia JM, de la Plaza R, Quiñones JE, Veguillas P, Adel F, García-Parreño J. [Gastroenteric reconstruction route after pancreaticoduodenectomy: antecolic versus retrocolic]. Cir Esp 2013; 91:211-6. [PMID: 23452819 DOI: 10.1016/j.ciresp.2013.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 12/20/2012] [Accepted: 01/11/2013] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Delayed gastric emptying (DGE) is a relatively common complication after cephalic pancreaticoduodenectomy (CPD). Its origin is not very clear, and it is believed that its appearance is due to multiple factors (hormones, appearance of other complications, particularly pancreatic fistulas, and the surgical technique). Among the technical aspects associated with DGE, it has been proposed that the route of gastroenteric reconstruction (antecolic or retrocolic) could have an effect on its incidence. MATERIAL AND METHODS A systemic review was made of the literature, searching for articles that compared both reconstruction routes after CPD, finding only 11 articles: 4 randomised clinical trials, one prospective study, and 6 retrospective studies. A meta-analysis could not be performed on them, due to the large methodological differences between them. RESULTS In the 4 randomised studies, 2 were in favour of the antecolic route, and 2 did not observe any differences between either of them. The antecolic route obtained a much lower DGE rate than the retrocolic one in the only prospective study. In 4 of the retrospective studies the antecolic route obtained a very low rate. The results of both routes were similar in another 2 retrospective studies, with the retrocolic route slightly better in one of them. CONCLUSIONS Using the published literature, the gastric reconstruction route associated with less DGE after CPD cannot currently be determined.
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Affiliation(s)
- José M Ramia
- Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, Spain.
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Ramia JM, De la Plaza R, Garcia I, Perna C, Veguillas P, García-Parreño J. Liver metastasis of endometrial stromal sarcoma. World J Hepatol 2012; 4:415-8. [PMID: 23355923 PMCID: PMC3554809 DOI: 10.4254/wjh.v4.i12.415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 11/07/2011] [Accepted: 11/14/2012] [Indexed: 02/06/2023] Open
Abstract
Resection of liver metastases from gynaecological tumours is uncommon. Endometrial stromal sarcomas (ESS) are low incidence gynecological tumours which can originate in previous sites of endometriosis or following metaplasia of the pelvic peritoneal wall, and which are exceptionally associated with liver metastasis. We present a 68-year-old woman with a ESS and metachronic liver metastasis treated by liver resection. There is very little literature on clinical management about liver metastasis from ESS, but extrapolating the data obtained with liver metastasis from sarcomas and uterine tumours, we should recommend resection as this is considered a resectable extrauterine metastasis. In cases with more sites of extrauterine disease, liver resection should also be performed if the other sites are resectable.
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Affiliation(s)
- Jose M Ramia
- Jose M Ramia, Roberto De la Plaza, Pilar Veguillas, Jorge García-Parreño, Department of Surgery, Hepatopancreatobiliary Surgical Unit, Hospital Universitario de Guadalajara, Guadalajara, 28020 Madrid, Spain
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Ramia JM, De La Plaza R, Quiñones JE, Veguillas P, García-Parreño J. [Minor liver resections and fenestrations using three-trocar laparoscopy]. Cir Esp 2012; 90:670-2. [PMID: 22029929 DOI: 10.1016/j.ciresp.2011.06.011] [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: 04/05/2011] [Revised: 05/23/2011] [Accepted: 06/04/2011] [Indexed: 02/07/2023]
Affiliation(s)
- Jose M Ramia
- Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, España.
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Ramia-Ángel JM, De la Plaza R, Quiñones-Sampedro J, Veguillas P, García-Parreño J. Education and Imaging. Gastrointestinal: gastric incarceration in parastomal hernia. J Gastroenterol Hepatol 2012; 27:1405. [PMID: 22823916 DOI: 10.1111/j.1440-1746.2012.07181.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- J M Ramia-Ángel
- Hepato-Bilio-Pancreatic Surgery Unit, General Surgery and Digestive Diseases, University Hospital of Guadalajara, Guadalajara, Spain
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Silva J, Garcia V, Rodriguez M, Compte M, Cisneros E, Veguillas P, Garcia JM, Dominguez G, Campos-Martin Y, Cuevas J, Peña C, Herrera M, Diaz R, Mohammed N, Bonilla F. Analysis of exosome release and its prognostic value in human colorectal cancer. Genes Chromosomes Cancer 2012; 51:409-18. [PMID: 22420032 DOI: 10.1002/gcc.21926] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A significant proportion of extracellular nucleic acids in plasma circulate highly protected in tumor-specific exosomes, but it is unclear how the release of exosomes is modulated in carcinogenesis. We quantified by cytometry exosomes in plasma of 91 colorectal cancer patients to evaluate their potential as a tumor indicator and their repercussions on diagnosis and prognosis. We examined the involvement of TSAP6, a TP53-regulated gene involved in the regulation of vesicular secretion, in levels of circulating exosomes in plasma of colorectal patients and in HCT116 TP53-(wild-type and null) human colorectal cancer cell lines. The fraction of exosomes in cancer patients was statistically higher than in healthy controls (mean rank ¼ 53.93 vs. 24.35). High levels of exosomes in plasma of patients correlated with high levels of carcino-embryonic antigen (P ¼ 0.029) and with poorly differentiated tumors (P ¼ 0.039) and tended to have shorter overall survival than patients with low levels (P ¼ 0.056). Release of exosomes did not correlate with TSAP6 expression; and regulation of TSAP6 by TP53 was not shown either in tumor samples or in HCT116 cell lines. Although it was not suggested that the TP53/TSAP6 pathway regulates the release of exosomes into the plasma of colorectal cancer patients, the level of circulating exosomes may be used as a tumor indicator, because it correlates with poor prognosis parameters and shorter survival.
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Affiliation(s)
- J Silva
- Departmentof MedicalOncology, University Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
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Ramia JM, de la Plaza R, Quiñones-Sampedro JE, Ramiro C, Veguillas P, García-Parreño J. Walled-off pancreatic necrosis. Neth J Med 2012; 70:168-71. [PMID: 22641624 DOI: pmid/22641624] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Acute severe pancreatitits may be complicated by the development of 'walled-off pancreatic necrosis' (WOPN), which is characterised by a mixture of solid components and fluids on imaging studies as a consequence of organised pancreatic tissue necrosis. We present here an overview of the definition, clinical features, and diagnostic and therapeutic management of this clinical condition, which is mostly based on consensus as adequate clinical trials are lacking.
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Affiliation(s)
- J M Ramia
- Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Hospital of Guadalajar, Guadalajara, Spain.
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Ramia JM, Ruiz-Gomez F, Plaza RDL, Veguillas P, Quiñones J, García-Parreño J. Ambispective comparative study of two surgical strategies for liver hydatidosis. World J Gastroenterol 2012; 18:546-50. [PMID: 22363121 PMCID: PMC3280400 DOI: 10.3748/wjg.v18.i6.546] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 11/12/2011] [Accepted: 11/19/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the morbidity, mortality, recurrence and technical aspects of two distinct surgical strategies that were implemented in successive periods.
METHODS: Ninty-two patients with 113 cysts underwent surgical procedures. The study was divided into 2 periods. Data from first period (P1) were compiled retrospectively. The surgical strategy was conservative surgery. The second period (P2) included a prospective study conducted according to a protocol following the criterion that radical procedures should be performed whenever it is technically feasible.
RESULTS: Patients of both periods showed no statistically significant differences in age, gender, cyst location or mortality. Among the P2 group, patients exhibited more preoperative jaundice, and cyst size was smaller (P < 0.05). Changes in surgical strategy increased the rate of radical surgery, decreases morbidity and in-hospital stay (P < 0.001). A negative result in P2 was the death of two old patients (4.8%) who had undergone conservative treatments. The rate of radical surgery in P2 was around 75%.
CONCLUSION: Radical surgery should be the technique of choice whenever it is feasible, because it diminishes morbidity and in-hospital stay. Conservative surgery must be employed only in selected cases.
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Ramia JM, De la Plaza R, Quiñones J, Veguillas P, Garcia-Parreño J. Extremely high values of CA 19-9 in liver hydatidosis and frank biliary rupture. Turk J Gastroenterol 2011; 22:548-50. [PMID: 22234767 DOI: 10.4318/tjg.2011.0272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Elevation of carbohydrate antigen 19-9 has been observed in jaundiced patients with benign biliary tract diseases. No clear answer has explained that relationship. Patients with liver hydatidosis and frank intrabiliary rupture could present obstructive jaundice due to the presence of liver cyst material in the bile duct. We present two cases of huge elevation of carbohydrate antigen 19-9 in jaundiced patients with liver hydatidosis and biliocystic communication, and we assess the different theories presented in the medical literature today.
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Affiliation(s)
- Jose M Ramia
- Hospital De Guadalajara, Department of Surgery, Madrid, Spain.
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Ramia JM, de-la-Plaza R, Casares M, Ramiro C, Veguillas P, Quiñones J, García-Parreño J. Profile of patients with hepatic hydatid disease not treated surgically. Rev Esp Enferm Dig 2011; 103:448-52. [PMID: 21951112 DOI: 10.4321/s1130-01082011000900002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND hepatic hydatid disease (HHD) is still an important health problem in certain areas of Spain where it is endemic. The treatment of HHD is usually surgical but certain patients are found to be ineligible after assessment for surgery (asymptomatic disease, comorbidity, patient refusal, or other). MATERIAL AND METHODS description of patients assessed in the Department of Surgery for hepatic hydatid disease. RESULTS in a group of 70 patients with HHD, 27 patients were not treated surgically (mean age: 72.7 years [range: 47-97], 14 women [51.8%]). The number of cysts presented by these patients was 33, with 1.22 cyst/patient (range: 1-4). The cyst size was 5.5 cm (range: 2.1-12.5 cm). The cysts, according to the WHO classification, were CE1: 3 patients, CE3B: 5 patients, CE4: 10 patients and CE5: 9 patients. The form of presentation was: symptomatic in 9 patients, although only 6 were attributable to HHD (22%) and asymptomatic in 18 patients. In these cases, imaging was performed for study of tumor extension in 6 patients and diverse medical reasons in 12. Only two therapeutic interventions were performed: endoscopic retrograde cholangiopancreatography (ERCP) with insertion of a bile duct stent, and puncture-aspiration-injection-re-aspiration (PAIR), both in patients who did not wish to undergo surgery.Ten patients had surgical indications: CE1 (3 patients), CE3B (5 patients), CE4 (1 patient), and CE5 (1 patient). The reasons why the patients did not undergo surgical treatment were: refusal (9 patients) and advanced neoplasm (1 patient). Surgery was judged necessary in 5 patients. In the mean follow-up period of 17 months (range: 1-37), no surgery was performed. CONCLUSIONS there were various causes for not performing surgical intervention of HHD after medical evaluation: asymptomatic patients, older patients, patients with multiple pathologies and oncologic patients. Usually, they were patients who voluntarily chose not to undergo surgery.
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Affiliation(s)
- José Manuel Ramia
- Unit of Hepato-Bilio-Pancreatic Surgery, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, C/ Donante de Sangre s/n, Guadalajara, Spain
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Ramia JM, De la Plaza R, Quiñones J, Sanchez-Tembleque MD, Caminoa A, Veguillas P, García Parreño J. Three trocars laparoscopic resection of angiomyolipoma of the liver. Int J Hepatol 2011; 2011:150691. [PMID: 22135749 PMCID: PMC3226358 DOI: 10.4061/2011/150691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 01/03/2011] [Accepted: 01/18/2011] [Indexed: 01/22/2023] Open
Abstract
Angiomyolipoma of the liver (AML) is an infrequent neoplasm composed of three tissues (adipose, muscle and vessels). In spite of advances in radiology, preoperative correct diagnosis is difficult. Clasically, a conservative management strategy was adopted in patients with asymptomatic tumors less than 5 cm with undoubtful diagnosis. But after publishing some few cases of malignant angiomyolipoma a more radical has been advocated. Laparoscopic resection of liver tumors is becoming a excellent approach for operating on benign liver tumors. Usually is performed using five trocars but in some cases a less invasive technique with three trocars could be used. We present a laparoscopic resection of liver angiomyolipoma in a 65 year-old male using only three trocars and also discuss the optimal management of AML and technical tips of three-trocar technique.
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Affiliation(s)
- J. M. Ramia
- Hepatopancreatobiliary Unit, Department of Surgery, Guadalajara University Hospital, 19002 Guadalajara, Spain,*J. M. Ramia:
| | - R. De la Plaza
- Hepatopancreatobiliary Unit, Department of Surgery, Guadalajara University Hospital, 19002 Guadalajara, Spain
| | - J. Quiñones
- Hepatopancreatobiliary Unit, Department of Surgery, Guadalajara University Hospital, 19002 Guadalajara, Spain
| | - M. D. Sanchez-Tembleque
- Department of Gastroenterology and Hepatology, Guadalajara University Hospital, 19002 Guadalajara, Spain
| | - A. Caminoa
- Department of Pathology, Guadalajara University Hospital, 19002 Guadalajara, Spain
| | - P. Veguillas
- Hepatopancreatobiliary Unit, Department of Surgery, Guadalajara University Hospital, 19002 Guadalajara, Spain
| | - J. García Parreño
- Hepatopancreatobiliary Unit, Department of Surgery, Guadalajara University Hospital, 19002 Guadalajara, Spain
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