bluuebunny/crossref_metadata_2025_split huggingface dataset:
REVIEW OF 5 YEARS RESULTS AFTER SURGERY FOR GASTRO-OESOPHAGEAL REFLUX DISEASE: NISSEN VS TOUPET
Authors: Alonso Batanero E , Rodríguez Uría R , Amoza Pais S , Rodicio Miravalles J L , Moreno Gijón M , Sanz Navarro S , Turienzo Santos E , Sanz Álvarez L 
Published: May 2021

Abstract

INTRODUCTION
Multiple studies attempt to demonstrate the superiority of Toupet fundoplication over the classic Nissen technique in the treatment of gastro- oesophageal reflux disease (GERD). In our study we compared the results of both techniques.

MATERIAL AND METHODS
A retrospective descriptive study of patients operated because of GERD using laparoscopic Nissen and Toupet fundoplication in our centre between January 1, 2015 and December 31, 2019.

RESULTS
80 patients were operated, 56 Nissen (70%) versus 24 Toupet (30%). Both groups are comparable in terms of mean age, distribution by sex, obesity, toxic habits, the prevalence of typical symptoms, DeMeester, and presurgical lower oesophagal sphincter pressure; although there are differences regarding the presence of associated hiatal hernia and within them the type. A similar surgical time (136.59 vs 132.71 minutes) and mean stay (4.02 vs 5 days) were observed. In the Nissen group, 12 patients (21.42%) presented initial postoperative dysphagia, requiring 2 endoscopic dilations and 5 reoperations, compared to 5 patients (20.83%) in the Toupet group, that did not require dilation and with 1 reoperation. The conversion and mortality rate was 0% in both groups, with a variable follow-up of 22.08 versus 14.45 months.

CONCLUSIONS
Both techniques present similar results, including the rate of postoperative dysphagia, which is one of the most feared complications. However, it would be necessary to increase the size and longer follow-up to establish long-term results.
ARE SYMMETRICAL BARBED SUTURES AN ADVANTAGE IN KNEE ARTHROPLASTIES? PROSPECTIVE ANALYSIS
Authors: Suárez-Anta Rodríguez P J , Lanuza Lagunilla L , Camblor Valladares A , Meneses Gutiérrez A , García Arias A , Cabria Fernández J , García Cuello L , Riera Campillo M 
Published: May 2021

Abstract

INTRODUCTION
The number of knee replacements has increased significantly, and is projected to increase further by 2030. Wound closure is one of the research areas. Arthroplasties require a large incision to achieve adequate exposure. This implies long closure and healing times. Barbed sutures are not new as they were introduced in 1964. Since then, multiple improvements have been made to these sutures and their use has expanded to various fields. Despite the potential advantages, barbed sutures are not commonly used in knee replacements. This may be due to the higher cost and uncertain clinical benefits. The objective is to determine the effect of barbed sutures compared to traditional braided sutures in knee arthroplasties by analyzing certain clinical results.

MATERIAL AND METHODS
A prospective observational study was carried out analyzing the arthroplasties operated during one year.
Those in which the barbed suture was used for the closure of the arthrotomy and/or subcutaneous cellular tissue were compared with those in which a traditional braided suture was used.

RESULTS
No statistically significant differences were observed between both sutures in terms of range of motion, functional status, and surgical complications. Regarding the time of surgery, a difference of 10 minutes was observed in favor of barbed sutures, the closure time being statistically significant.

CONCLUSIONS
Barbed sutures contribute to greater surgical effectiveness, cost savings, surgical time, and comparable complication rates.
MEDIUM-TERM PROGNOSIS OF THE CONTRALATERAL HIP AFTER A PRIMARY ARTHROPLASTY
Authors: Suárez-Anta Rodríguez P J , Climent Peris V , Suárez Vázquez A J , Lanuza Lagunilla L , Camblor Valladares A , Meneses Gutiérrez A , García Arias A , Cabria Fernández J 
Published: May 2021

Abstract

INTRODUCTION
Coxarthrosis is one of the most frequent and disabling pathologies. 20% of those over 60 years of age will develop symptomatic coxarthrosis and 10% end with a hip replacement. Hip arthroplasty is an alternative because it increases the quality of life. When we recommend arthroplasty in clinical practice, patients often ask about the prognosis of their other hip. Will it deteriorate in the same way? Will it be necessary to operate it? When? The objective is to determine if there is any variable or radiological sign that predicts the medium-term prognosis of the contralateral hip after total hip arthroplasty.

MATERIAL AND METHODS
A retrospective study of patients who underwent Total Hip Arthroplasty in our hospital during 2011 and 2012 was carried out, with a total of 543 patients.
The degree of coxarthrosis was determined at the time of the first arthroplasty and at regular intervals during follow-up, according to the JOA and Tónnis classifications, analyzing each of the items included in these classifications.

RESULTS
A progression of osteoarthritis of the contralateral hip could be expected in the next 3 years in 10% of patients. This progression will be greater and faster in those with grade II-III and, especially, in those with greater joint narrowing and greater alteration of the femoral head, and can reach between 25 and 30% of patients.

CONCLUSIONS
The degree of initial JOA is a predictive factor for requiring a hip replacement on the contralateral side.
TELEMENTORING IN TIMES OF COVID-19 FOR TRAINING IN GENERAL SURGERY
Authors: Suárez Sánchez A , Diaz Vico T , Fernández Hevia M , García Munar M , Ramos Montes C , Rodríguez García I , Otero Diez J l , García Florez l J 
Published: May 2021

Abstract

INTRODUCTION
Telemedicine applied to surgery is called telementorization (TM). It allows remote assistance by expert surgeons to others with less experience in certain techniques, thus guaranteeing learning that overcomes the barriers of time and location without being associated with a higher rate of complications. The objective is to publicize the use of this type of technology in our surgical department, particularly needed with the current restrictions.

MATERIAL AND METHODS
In our center, the Proximie platform (www.proximie.com) is used as a tool for TM. It allows to remotely broadcast live procedures performed by expert surgeons, as well as to create a virtual library of our own procedures that can be used as study and teaching tool by residents. This platform transmits not only bidirectional image and sound, but it also allows the active participation of a remote assistant with interactive features that are projected directly on the screen of the local surgeon.

RESULTS
The Proximie platform is being used frequently (and more intensively during this time of greatest restrictions) in advanced colorectal surgeries, with TM by remote experts and in our department for the continuing training program for residents. It also offers the possibility of conducting multidisciplinary sessions and webinars with subsequent availability control online.

CONCLUSIONS
TM and digital platforms such as Proximie provide important benefits in the practical learning and training of surgeons, especially with the current restrictions, being a safe technique and a teaching tool to be exploited.
SURGICAL AND PROGNOSTIC IMPLICATIONS IN GASTRIC ADENOCARCINOMA BY THE INTEGRATION OF PROTEOMIC MOLECULAR ANALYSIS
Authors: Ugarte Sierra B , Losada J , Losada I , Sarria R , Losada M A , Grandes P 
Published: May 2021

Abstract

INTRODUCTION
Despite a steady decline in the incidence of gastric cancer (GC) over recent decades, the prognosis remains poor with 5-year survival rates of 21.9% in Europe. The AJCC Cancer Staging Manual (8th Edition) establishes the necessity to evaluate personalized survival models. These models would help in the decision-making process. Proteomic and genomic molecular analyses have provided a more in-depth knowledge of GC.

MATERIAL AND METHODS
19 patients affected by 21 tumors operated between 2012-2014 were prospectively included. Healthy tissue and tumor samples were taken from each case and deposited in a tissue biobank for subsequent proteomic analysis by Proteomics Department.

RESULTS
The following histopathological types were identified: (73.69%) intestinal, (10.52%) diffuse, and (15.78%) undetermined, poorly differentiated, and mixed neuroendocrine of the classification WHO. According to the size and extent of tumor invasion, the percentages of the sample were T1 or T2 (26.31%) and T3 or T4 (73.68%). Furthermore, 57.89% of the patients were found to have lymph-node metastases (N 1, 2, 3 +). After the differences in protein intensities in healthy tissue and tumor tissue were analyzed, it was found that in the healthy tissue, EGFR1, MAPK1 and MAPK3 were predictive variables of overall survival when the tumor stage was T3 or T4

CONCLUSIONS
It would be convenient to redefine the classification and treatment plan in gastric cancer by integrating the study at a molecular level.
EVALUATION OF THE RELEASE RATE OF A CHEMOTHERAPEUTIC AGENT INCORPORATED AS A COATING ON A BIODEGRADABLE URETERAL STENT. IN VITRO STUDY
Authors: Soto Gallardo M , de la Cruz Conty J E , Aznar Cervantes S D , Cenis Anadón J L , Sánchez Margallo F M , Rioja Zuazu J , Soria Gálvez F 
Published: May 2021

Abstract

INTRODUCTION
To assess the release rate of Mitomycin C (MMC) after its adherence to a biodegradable ureteral stent (BraidStent™-MMC) by dip coating in order to evaluate its potential application as an adjuvant treatment for upper tract urothelial carcinoma.

MATERIAL AND METHODS
The dip coating technique is applied to a total of 10 fragments of the BraidStent™ catheter which has a polymeric matrix as a coating. Each 3 cm fragment is immersed 10 times in pure MMC crystallising in methanol and finally obtaining the formation of microlayers on its surface. After drying, each fraction of the stent is immersed in 5 ml of artificial urine to study its interaction with this medium. The samples remain in an orbital shaker at 36ºC and the medium is exchanged under sterile conditions after 12, 24, 48, 48, 72, 96 and 120h. At each replacement, the remaining urine is analysed by HPLC-DAD to quantify the presence of the cytotoxic agent.

RESULTS
During the first 12h, MMC is completely released reaching a mean concentration of 52.22 mg/L. Comparing this result with those previously obtained with the first BraidStent ™ -MMC formulation (10.82mg/L), it is determined that this technique allows to increase the release rate up to 5 times.

CONCLUSIONS
The release rate of Mitomycin C from a biodegradable ureteral stent is increased by integrating a polymeric matrix with microlayers in its coating. Further trials are needed to achieve the therapeutic dose for clinical application in oncology patients.
CYTOREDUCTION SURGERY WITH HIPEC IN PERITONEAL CARCINOMATOSIS OF GASTRIC ORIGIN: A HOPEFUL TREATMENT?
Authors: García Munar M , Merayo Álvarez M , Moreno Gijón M , Rodríguez Uría R , Rodicio Miravalles J L , Suárez Sánchez A , Turienzo Santos E , Sanz Álvarez L 
Published: May 2021

Abstract

INTRODUCTION
The incidence of peritoneal metastases in gastric cancer are frequent and are associated with very poor median survival rates. The multimodal treatment of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could offer a better prognosis in selected cases although it is not currently contemplated in clinical practice guidelines.

MATERIAL AND METHODS
Of the 100 patients operated on for peritoneal carcinomatosis in our centre between May 2014 and December 2020, we selected those of gastric origin. Multidisciplinary CRS treatment with HIPEC was indicated in those patients with positive cytology and/or preoperative PCI &lt;7.

RESULTS
Four men and one woman with a mean age of 63 years underwent surgery. The mean preoperative PCI was 2 and complete cytoreduction was achieved in all cases (CC-0). Complications included a biliary leak, a postoperative collection and a bronchoaspirative pneumonia. One patient died at 34 months. The other four are still alive: one with recurrence at 18 months and the rest without disease with a mean follow-up of 25 months. In one of the cases CRS surgery with HIPEC was performed as surgical salvage after initial surgery and in the rest as the only treatment.

CONCLUSIONS
Palliative systemic chemotherapy is considered the treatment of gastric cancer with peritoneal involvement, however, treatment based on CRS and HIPEC in selected cases could improve survival rates, disease-free interval and even be considered as salvage treatment in resectable oligometastatic recurrences.
IS CONSERVATIVE AND MINIMALLY INVASIVE LIVER SURGERY SAFE IN THE APPROACH TO HEPATOCARCINOMA? ANALYSIS OF THE RESULTS IN OUR CENTER
Authors: Camarero E , García-Botella A , Avellana R , Pizarro M J , de la Serna S , Otero J , Díez-Valladares L , Torres A J 
Published: May 2021

Abstract

INTRODUCTION
We present the results of liver resection surgery for hepatocarcinoma (HCC), comparing morbidity, mortality, and survival data based on the type of surgical approach (open vs. laparoscopic) and the type of liver resection (anatomical vs. limited).

MATERIAL AND METHODS
Descriptive, prospective, and comparative study of 49 patients who underwent liver resection for HCC during the period 2013-2018 in our centre.

RESULTS
16 laparoscopic resections were performed (32.7%) compared to 33 open surgeries (67.3%). Morbidity and mortality results according to the Clavien-Dindo classification (I 38 (77.6%); II 9 (18.4%), III 1 (2%), IV 1 (2%).
Among the risk factors, the relationship between the preoperative Apri Index and the observed survival has been studied in our population, without observing statistically significant differences (p = 0.915).
No statistically significant differences have been found between the laparoscopic versus the open approach (p = 0.78) or in anatomical surgery versus limited resections (p = 0.26) in terms of time to tumor recurrence.
In our series, no significant differences in survival were found depending on the type of surgery (open vs laparoscopic, p = 0.57).

CONCLUSIONS
In our study, we have not been able to demonstrate the greater oncological safety of performing limited versus anatomic resections. The results of the laparoscopic approach are comparable, in terms of overall survival and time to recurrence, to the results of open surgery.
POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE
Authors: Carrasco Aguilera B , Amoza Pais S , Diaz Vico T , Turienzo Santos E O , Moreno Gijon M , Del Val Ruiz P , Martínez Izquierdo G , Sanz Álvarez L 
Published: May 2021

Abstract

INTRODUCTION
Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center.

MATERIAL AND METHODS
Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019.

RESULTS
248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively.

CONCLUSION
No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.
IMPACT OF A STATE OF EMERGENCY IN TRAUMATOLOGY EMERGENCIES
Authors: Lanuza Lagunilla L , Suárez-Anta Rodríguez P , Camblor Valladares A , Meneses Gutiérrez A , García Arias A , Cabria Fernández J , Riera Campillo M , García Cuello L 
Published: May 2021

Abstract

INTRODUCTION
In March 2020 the Government of Spain imposed a strict national closure to suppress the COVID-19 outbreak. The implementation of various measures during the different phases of confinement and de-escalating, led to a significant decrease in public mobility, modifying the daily life and activities of citizens.

MATERIAL AND METHODS
A retrospective cohort study was carried out including patients evaluated and diagnosed in the Traumatology Emergency Department of our centre during that period, and compared with 2019. The profile of the patients and the injuries treated based on the established diagnoses were analyzed. The weeks considered were divided into total confinement, de-escalation phase 0, 1, 2 and 3. 8511 patients were reviewed.

RESULTS
The measures established during the first wave of the Covid-19 outbreak showed a tremendous impact on the activity of the Traumatology Emergency Department. The number of patients cared for decreased by 59% in 2020. Despite a significant reduction compared to the previous year, the only fractures that remained constant were those of the femur. The cases of minor trauma and pain that do not necessarily require access to an emergency room are progressively reduced to 71% and 61%, respectively.

CONCLUSIONS
The study findings could help in future pandemics to formulate a protocol for patient management, identify areas for improvement and resource planning. It is important to understand which presentations are less common during a state of emergency and which presentations occur with it, or even more frequently.
ADIPOFASCIAL FLAP FOR BONE DEFECTS COVERAGE IN COMPLEX HAND INJURIES: A CASE REPORT AND LITERATURE REVIEW
Authors: Fernández Ortega , Camporro Lara , Daniel Fernández 
Published: May 2021

Abstract

INTRODUCTION
Hand injuries are often accompanied by defects in bone, tendon, and neurovascular structures that require complex repairs and an adequate skin coverage. Occasionally, this requires using different reconstructive techniques. Reverse flow adipofascial flaps are an option for the coverage of dorsal defects of the hand and fingers, basically. Its vascular supply allows to prevent, in case of fractures or bone defects, subsequent complications (osteomyelitis, pseudoarthrosis or adhesions).

MATERIAL AND METHODS
We present a patient with complex saw wounds in hand with extensor tendons injuries of the 4th and 5th fingers and an intercalary bone defect measuring 1.3cm x 0.9cm at the base of the proximal phalanx of the 4th finger, which is stabilized with Kirschner wires and cement.
This structure is covered by an adipofascial flap based on 2nd, 3rd and 4th intermetacarpal dorsal perforators. Additionally, literature review was conducted in PubMed database with the search terms "Adipofascial flap AND ostheosynthesis".

RESULTS
Bone stabilization and coverage is achieved without any problems. Subsequently, bone cement and wires are replaced by an autologous radial graft and by plate and screws. Six articles are reviewed that reported the capability of these flaps to prevent bone infections, adhesions and nonunions.

CONCLUSION
Adipofascial flaps are a safe, low-morbidity and versatile reconstructive option to take into account for urgent or delayed reconstruction of complex dorsal hand defects.
These dońt require microsurgical techniques and resources that may not be available in many centers and dońt sacrifice main vascular axis or future reconstructive options.
BARBED SUTURE FOR LAPAROTOMY CLOUSURE IN URGENCY PROCEDURES. RETROSPECTIVE ANALYSIS
Authors: Bosch-Ramírez M , Lillo-García C , Sánchez-Guillén L , Fernández-Candela A , Curtis-Martínez C , Lario-Pérez S , Oller-Navarro I , Arroyo A 
Published: May 2021

Abstract

INTRODUCTION
Urgency surgeries are often performed in a stressful setting, out of hours and with critical patient involved. In this context, laparotomy closure can sometimes be deficient.
Suture recommended by European Hernia Society is slowly absorbable monofilament continuous suture with a “small bites” technique. Barbed sutures appear as an alternative to conventional suture, frequently used in laparoscopic procedures due to its’ intrinsic maintenance of traction.
The aim of this study is to describe the results in terms of short and mid-term rate of incisional hernia after urgency midline laparotomy, according to the suture utilized.

MATERIAL AND METHODS
A single-center retrospective cohort study was performed including patients with urgency midline laparotomy during 2018. Group A was represented by patients with slowly absorbable monofilament continuous suture. Group B included patients with barbed suture laparotomy closure.
Main variables were hernia rates one month and one year after surgery, diagnosed by physical exploration and/or imaging.

RESULTS
A total of 68 of patients (36 on group A; 32 Group B) were included.
On Group A, 13.9% (5) patients presented incisional hernia on the month follow-up, whereas none did on Group B. After a year, Group A only had 1 new case, but 12.5% of patients did herniate on group B; with no significantly relation with obesity neither underlying neoplasm.

CONCLUSIONS
Midline laparotomy closure must be performed within quality standards, as “small bites” technique with the ratio at least 4/1. Barbed suture appears as a promising closure option, especially in emergency procedures, but needs further study.
INFLUENCE OF THE PERITUMORAL MATRIX ON COLON CANCER
Authors: Fernando Macías E , Rodriguez Uría R , Sanz Navarro S , Porrero Guerrero B , González del Rey Rodríguez M C , Vázquez Villa J F , Barneo Caragol C , Barneo Serra L 
Published: May 2021

Abstract

INTRODUCTION
Several publications have highlighted the importance of the peritumoral matrix in various epithelial tumors. Our team has pointed out the value of ColXIα1 in the stroma of breast, colon and pancreatic cancer. The possible prognostic factor of the stroma in colon cancer is debated. Our aim is to analyze the prognostic role of the stroma and ColXIα1 in colon adenocarcinoma.

MATERIAL AND METHODS
Samples of 189 patients with colon cancer were studied by image analysis. The matrix was stained with Gomori green trichrome and the CAFs with the mouse monoclonal anti-proColXIα1 antibody. The samples were evaluated with an optical microscope, obtaining data from the area stained with proColXIα1, the area stained with Gomori and the number of pro ColXIα1 positive cells. 35 Gb of images were analyzed with Image J-FIJI, which measures the number of cells and the total area of marked regions, and also quantifies the number and area of unlabeled cells. Statistical analysis by MedCalc v1o and SpSS v15.

RESULTS
Colon cancer stages (%): I, 13; II, 40; III, 29; IV, 18. Recurrences (%), 32; by stages: I, 0; II, 21; III, 44; IV, 86. Global survival: median, 28 months; S5, 33%. Total stromal cells, number of CAFs and its area: higher in early stages. Gomori area, smaller in early stages and in cases without recurrences.

CONCLUSIONS
The number of CAFs and the extension of the stromal area could have influence in the development of the cancer colon, and may be related to the prognosis of disease.