9 results on '"Flor, Blas"'
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2. A restrictive stoma policy after colorectal anastomosis in ovarian cancer based on ghost ileostomy use.
- Author
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Lago, Víctor, Albert, Manel Montesinos, Cruz, Marta Arnaez, Guijarro Campillo, Rafael Alberto, Padilla-Iserte, Pablo, Matute, Luis, Gurrea, Marta, Flor, Blas, and Domingo, Santiago
- Subjects
ILEOSTOMY ,OVARIAN cancer ,SURGICAL stomas ,SURGICAL anastomosis ,CYTOREDUCTIVE surgery ,COLORECTAL cancer - Abstract
The incidence of anastomotic leak after colorectal anastomosis in ovarian cancer has been reported to be much lower than that in colorectal cancer patients. Regarding the use of protective manoeuvres (diverting ileostomy) as suggested by clinical guidelines, the goal should be the implementation of a restrictive stoma policy for ovarian cancer patients, given the low rate of anastomotic leakage in this population. Patients who underwent cytoreduction surgery in a single centre (University Hospital La Fe, Valencia Spain) due to ovarian cancer between January 2010 and June 2023 were classified according to two groups: a non-restrictive stoma policy group (Group A) and a restrictive stoma policy group (Group B). A total of 256 patients were included in the analysis (group A 52 % vs group B 48 %). The use of protective diverting ileostomy was lower in the restrictive stoma policy group (14 % vs 6.6 %), and the use of ghost ileostomy was 32 % vs 87 % in groups A and B, respectively (p < 0.00001). No differences were found in the anastomotic leak rate, which was 5.2 % in the non-restrictive group and 3.2 % in the restrictive stoma policy group (p = 0.54). The use of a restrictive stoma policy based on the use of ghost ileostomy reduces the rate of diverting ileostomy in patients with ovarian cancer after colorectal resection and anastomosis. Furthermore, this policy is not associated with an increased rate of anastomotic leakage nor with an increased rate of morbi-mortality related to the leak. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
- Author
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Nepogodiev, Dmitri, Bhangu, Aneel, Glasbey, James C, Li, Elizabeth, Omar, Omar M, Simoes, Joana FF, Abbott, Tom EF, Alser, Osaid, Arnaud, Alexis P, Bankhead-Kendall, Brittany K, Breen, Kerry A, Cunha, Miguel F, Davidson, Giana H, Di Saverio, Salomone, Gallo, Gaetano, Griffiths, Ewen A, Gujjuri, Rohan R, Hutchinson, Peter J, Kaafarani, Haytham MA, Lederhuber, Hans, Löffler, Markus W, Mashbari, Hassan N, Minaya-Bravo, Ana, Morton, Dion G, Moszkowicz, David, Pata, Francesco, Tsoulfas, George, Venn, Mary L, Cox, Daniel, Roslani, April C, Alakaloko, Felix, de Vries, Jean-Paul PM, Aaraj, Mahmoud A, Abbott, Tom EF, Abbott, Sarah J, Abdalla, Mutwakil OM, Abdelaal, Ahmed S, Ademuyiwa, Adesoji O, Aherne, Thomas M, Ali, Osman M, Alkadeeki, Ghadah Z, Almeida, Ana C, Alrahawy, Mahmoud M, Ambler, Graeme K, Alameer, Ehab, Andreani, Stefano M, De Andrés-Asenjo, Beatriz, Antonanzas, Leyre Lopez, Aoun, Salah G, Ashoush, Fouad M, Augestad, Knut Magne, Avellana, Rocio B, Ayeni, Funbi A, Ayorinde, John OO, Babu, Bheemanakone H, Baig, Mirza MAS, Bajomo, Oreoluwa M, Baker, Olivia J, Baker, Markus P, Baldwin, Alexander J, Ban, Vin Shen, Baron, Ryan D, Barranquero, Alberto G, Barry, Conor P, DI Bartolomeo, Alessandro, Bass, Gary A, Bath, Michael F, Batjer, H Hunt, Beamish, Andrew J, Belgaumkar, Ajay P, Bence, Matthew N, Benson, Ruth A, Bernal-Sprekelsen, Juan Carlos, Bhama, Anuradha R, Bhavaraju, Avi V, Biffl, Walter L, Blundell, Chris M, Boddy, Alexander P, Borgstein, Alexander BJ, Bosanquet, David C, Bosch, Karen D, Bouhuwaish, Ahmad EM, Bozkurt, Mehmet A, Brathwaite, Collin EM, Brown, Benjamin C, Brown, Oliver D, Brown, Allison K, Buarque, Igor Lima, Bueno-Cañones, Alejandro D, Bulugma, Mustafa R, Burke, Joshua R, Byrne, Matthew HV, Cagigal-Ortega, Elima P, Callcut, Rachael A, DI Candido, Francesca, Canova, Michaela E, Carlos, William J, Caruana, Edward J, Cato, Liam D, Catton, Andrew B, Ceretti, Andrea Pisani, Chase, Thomas JG, Chiara, Francesco Di, Chowdhury, Abeed H, Chung, Eric A, Cicerchia, Pierfranco M, Clough, Ethan CS, Coleman, Natasha L, Collins, Chris G, Collins, Michelle L, Colonna, Emily T, Comini, Lara V, Coughlin, Patrick A, Cruzado, Laura Fernández-Gomez, Davidson, Brian R, Davies, Richard J, Davies, Emma J, Davis, Niall F, Dawson, Brett E, Dean, Benjamin JF, Delgado, Maria Garcia-Conde, Diaz, Jose J, Dickson, Kathryn E, Diez-Alonso, Manuel M, Dixon, Jan R, Doe, Matthew J, Drake, Thomas D, Drake, Frederick T, Duffy, John P, Dunne, Declan FJ, Dunne, Naomi JM, Durán-Muñoz-Cruzado, Virginia M, Durst, Alexander ZE, Eardley, Nicola J, Edwards, John G, Elfallal, Ahmed H, Elfiky, Mahmoud MA, Elliott, Jessie A, Emile, Sameh H, Emslie, Katy M, Endorf, Frederick W, Engel, Jamie L, Enjuto, Diego T, Etchill, Eric W, Evans, Jonathan P, Fahey, Brian A, Faria, Carlos S, Feo, Carlo V, Ferguson, Henry JM, Fernandez, Beatriz Dieguez, Fernandez, Andres Garcia, Fernández, Antonio J, Fernández-Pacheco, Borja Camacho, Fitzgerald, J Edward, Fonsi, Giovanni B, Font, Roser Farré, Fowler, Amy L, Fretwell, Kenneth R, Fructuoso, Lorena Sanchon, Fusai, Giuseppe K, Garcia, Miguel Hernandez, Garcia-Ureña, Miguel Angel, Gill, Charn K, Gisbertz, Suzanne S, Del Giudice, Roberto, Giuffrida, Maria Carmela, Di Giuseppe, Matteo, Gómez, María Fanjul, Griffiths, Ewen A, Guariglia, Claudio A, Hainsworth, Alison J, Hall, Bria J, Hall, James RW, Hammond, John S, Haqqani, Maha H, Harrison, Ewen M, Hazelton, Joshua P, van Heinsbergen, Maarten, Hill, Arnold DK, Hing, Caroline B, Hirji, Sameer A, Ho, Michael WS, Holbrook, Charlotte M, Holme, Thomas J, Hopkins, James C, Hopkinson, David N, Hossain, Fahad S, Hudson, Victoria E, Hughes, Jane L, Hwang, E. Shelley, Ibrahim, Mohamed AH, Isolani, Simone M, Jenkinson, Michael D, Jenny, Hillary E, Jeyaretna, Deva S, Jones, Robert P, Jones, Andrew P, Jonker, Pascal KC, Jönsson, Maria L, Joyce, Doireann P, Kalkwarf, Kyle J, Kamarajah, Sivesh K, El Kassas, Mohamed, Kavanagh, Dara O, Keatley, James M, Khalefa, Mohamed A, Khan, Jim S, Kirmani, Bilal H, Kisiel, Aaron P, Kouris, Spyros Marinos, Kowal, Mikolaj R, Labib, Peter L, Larkin, John O, Lauscher, Johannes C, Leclercq, Wouter KG, Ledesma, Frances SJ, Leite-Moreira, André M, Leung, Elaine YL, Lewis, Sophia E, Lima, Maria João, Lin, Daniel J, Liu, Helen H, Lowery, Aoife J, Lozano, Saida Martel, Luney, Catriona R, Maia, Mariana Magalhães, Mariani, Nicolò M, Marino, Marco V, Marra, Angelo A, Marsh, Christopher L, Martin, Robert CG, McCluney, Simon J, McIntyre, Robert C, Mckay, Siobhan C, McKevitt, Kevin L, Meagher, Ashley D, Mehdi, Mohammad Q, Mehigan, Brian J, Gonzalez-De Miguel, Melania, De Miguel-Ardevines, Maria-Carmen, Mills, Sarah J, Mohan, Helen M, Moir, John AG, Monson, John RT, Monteiro, Joana M, Montella, Maria T, Montesinos, Cristina Soto, Morgom, Marwa M, Moura, Francisco S, Muguerza, Jose M, Murphy, Suzanne H, De Nardi, Paola, Naumann, David N, Neary, Paul C, Neely, David TA, Ng-Kamstra, Joshua S, Ngu, Albert WT, Nguyen, Truong A, Nita, George E, Nunes, Quentin M, Nygaard, Rachel M, O'Meara, Lindsay B, O'Neill, John R, Okafor, Barbara U, Olson, Steven A, Oo, Aung Y, Ormazabal, Pablo Collera, Osorio, Alexander L, Pachl, Max J, Parry, James T, Patel, Panna K, Pérez-Sánchez, Luis E, Pevidal, Ana Nogues, Pezzuto, Anna P, Philp, Matthew M, Pinkney, Thomas D, Pollok, Joerg M, Povey, Meical G, Poza, Alfredo Alonso, Rajgor, Amarkumar D, Rao, Jagan N, Raptis, Dimitri A, Rice, Henry E, Ridgway, Paul F, Rivas, Ana Munoz, Rodriguez-Sanjuan, Juan C, Rogers, Luke J, Da Roit, Anna, Rollett, Rebecca A, Romera, Jose L, Rooney, Siobhan M, Roxo, Vanessa I, Le Roy, Bertrand, Rubio, Eduardo E, Ruiz, Carolina Castro, Ruiz, Manuel Losada, Ryan, Éanna J, Saad, Abdel Rahman, Saeed, Samerah A, Salama, Hiba A, Salamah, Abdulrauf A, Sampietro, Gianluca M, Sarma, Diwakar R, Schaffer, Kathryn B, Schnitzbauer, Andreas A, Scurrah, Rachel J, Serevina, Olivia L, Serralheiro, Pedro A, Sewards, Joseph M, Shackcloth, Michael J, Shaw, Abigail V, Sheel, Andrea RG, Sica, Giuseppe S, De Simone, Veronica, Singh, Aminder A, Singh, Rabindra P, Skelly, Brendan L, Smith, Henry G, Sohail, Amir H, Spalding, Duncan R, Springford, Laurie R, Ssentongo, Anna E, Steinkamp, Pieter J, Stevens, Kent A, Stewart, Grant D, Stylianides, Nicholas A, Sullivan, Tom BB, Taher, Ahmed SA, Tamimy, Muhammad S, Tang, Alethea M, Tebala, Giovanni D, Tejero-Pintor, Francisco J, Thaha, Mohamed A, Thomas, Amy J, De Toma, Giorgio, La Torre, Filippo, Torres, Antonio J, Townshend, David N, Trout, Isobel M, Tucker, Sarah C, Ubhi, Harmony K, Vega, Viviana A, Velmahos, George C, Velopulos, Catherine G, Viswanath, Yirupaiahgari KS, Vivas, Alfredo A, Wade, Ryckie G, Wadley, Martin S, Wall, Joshua JS, Walters, Andrew M, Warren, Oliver J, Weerasinghe, Chamindri K, Wilkin, Richard JW, Williams, Katherine J, Winter, Stuart C, Wormald, Justin CR, Wright, Franklin L, Xyda, Souzana E, Young, Alastair L, Youssef, Mina MG, Yousuf, Farhat B, El Youzouri, Hanan, Zappa, Marco A, Abate, Emmanuele, Abdalaziz, Hossam, Abdelkarim, Mostafa, Abdou, Hossam, Aboelkassem-Ibrahim, Ahmad, Abuown, Ala, Acebes-Garcia, Fernando, Acharya, Metesh, Adamina, Michel, Addae-Boateng, Emmanuel, Aftab, Raiyyan, Agarwal, Arnav, Aguilar, José, Ahmed, Yousra, Aitken, Emma, Al-Azzawi, Marwa, Al-Embideen, Somya, Al-Masri, Mahmoud, Al-Najjar, Hani, Al-Sukaini, Ahmad, Alam, Ruhina, Alderson, Derek, Aliyeva, Zumrud, Aljanadi, Firas, Almasri, Murad, Alonso-Ortuño, Paula, Altintoprak, Fatih, Amira, Gamal, Amjad, Rabbia, Anania, Gabriele, Andabaka, Tatjana, Angelou, Dimitrios, Annamalai, Seethalakshmi, Annessi, Valerio, Anthoney, James, Anwar, Sibtain, Anwer, Mariyah, Aragon-Chamizo, Juan, Ardito, Antonella, Arigoni, Michele, Armao, Teodora, Arminio, Armando, Armstrong, Lara, Arnaud, Alexis, Asaad, Peter, Ashcroft, James, Ashmore, Christopher, Asqalan, Ahmad, Asti, Emanuele, Aubry, Emmanuelle, Aytac, Erman, Ayuso-Herrera, Esther, Baeza, Melody, Bailon-Cuadrado, Martin, Bakmaz, Bernarda, Baldi, Caterina, Baldini, Edoardo, Baldo, Stefano, Ballabio, Michele, Baloyiannis, Ioannis, Baltazar, Gerard, Bàmbina, Fabrizio, Bandiera, Alessandro, Barlow, Emma, Barmasse, Roberto, Barmpagianni, Christina, Baronio, Gianluca, Barra, Fabio, Bartsch, Anne-Marie, Basgaran, Amedra, Basha, Amr, Bashkirova, Varvara, Bastazza, Marco, Baumber, Rachel, Belcher, Elizabeth, Belvedere, Angela, Benítez-Linero, Inmaculada, Bergeat, Damien, Bernasconi, Matteo, Bhalla, Ashish, Bhutiani, Neal, Bianco, Federica, Bisagni, Pietro, Blake, Iain, Blanco-Colino, Ruth, Blazquez-Martin, Alma, Boal, Matthew, Bonavina, Luigi, Bonavina, Giulia, Bond-Smith, Giles, Booth, Karen, Borges, Filipe, Borghi, Felice, Bouchagier, Konstantinos, Bourke, Grainne, Boyle, Emily, Brachini, Gioia, Brain, Jessie, Brar, Amanpreet, Breckles, Lisa, Bretagnol, Frédéric, Brixton, Genevieve, Bruzzaniti, Placido, Bueser, Teofila, Burnside, Nathan, Caballero, Albert, Calcerrada-Alises, Enrique, Callahan, Miriam, Camarero, Enrique, Campagnaro, Tommaso, Campanelli, Michela, Candiani, Massimo, Cantalejo-Diaz, Miguel, Cao, Han, Capelli, Patrizio, Capizzi, Vita, Carcano, Giulio, Carissimi, Francesca, Carlini, Massimo, Carlucci, Michele, Carmichael, Heather, Carrasco, Milagros, Carrillo, Mariana, Carvello, Michele, Casati, Massimiliano, Castoro, Carlo, Catalan, Vanesa, Cavaleiro, Salomé, Cellerino, Paola, Centinaio, Giovanna, Cernei, Cristina, Cerro, Cristina, Cervellera, Maurizio, Chakrabortee, Sohini, Chamberlain, Stephanie, Chan, Jeffrey, Chang, Grace, Chaudhry, Dauod, Chebaro, Alexandre, Chen, David, Chetty, Govind, Chia, Zoe, Chiappini, Ambra, Chiarugi, Massimo, Chidambaram, Swathikan, Chiozza, Matteo, Cholewa, Hanna, Chong, Clara, Choolani-Bhojwani, Ekta, Christoforidis, Dimitri, Chui, Karen, Chung, Choyin, Cirillo, Bruno, Citterio, Davide, Clermidi, Pauline, Coccolini, Federico, Colletti, Gaia, Compagnoni, Bruno, Concepción-Martín, Vanesa, Confalonieri, Marco, Connolly, Hannah, Conso, Christel, Conti, Luigi, Cooper, Zara, Cordera, Fernando, Corral, Javier, Costa, Marta, Costanzi, Andrea, Cotsoglou, Christian, Cozza, Valerio, Cuming, Tamzin, Curtis, Miles, Cuschieri, Joseph, D'Agruma, Michele, D'Andrea, Giancarlo, Daliya, Prita, Dare, Oliver, Darko, Ebenezer, Day, Andrew, Dehal, Ahmed, Dehart, Dustin, Delgado-Oliver, Eduardo, Denning, Max, Desai, Anant, Desender, Liesbeth, Dester, Sara, Díaz-García, Alberto, Diaz-Peña, Patricia, Dousset, Bertrand, Doussot, Alexandre, Duchateau, Nicolas, Duff, Sarah, Dunning, Joel, Duque-Mallen, Victoria, Dziakova, Jana, Egan, Bridget, Egan, Richard, El-Ali, Abess, Elfeki, Hossam, Elhadi, Muhammed, Eljareh, Mohammed, Elkady, Ramy, Elkhafeefi, Fatimah, Elmore, 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Melissa, Rojo, Mikel, Rolli, Luigi, Romano, Silvio, Ross, Elizabeth, Ross, Howard, Rossborough, Catherine, Rottoli, Matteo, Ruiz-Grande, Fernando, Ruiz-Martin, Irene, Ruiz-Soriano, María, Ruzzenente, Andrea, Ryska, Ondrej, Saez, Carlos, Sagnotta, Andrea, Sahnan, Kapil, Sahni, Arun, Salim, Ali, Sallam, Ibrahim, Salvia, Roberto, Samadov, Elgun, Sammarco, Giuseppe, Sampaio-Alves, Mafalda, Sánchez-Arteaga, Alejandro, Sanchez-Fuentes, Maria-Nieves, Sanchez-Pelaez, Daniel, Sanchez-Perez, Coral, Sanchez-Rubio, Maria, Sancho-Muriel, Jorge, Sanders, Julie, Santero-Ramirez, Maria-Pilar, Santora, Thomas, Santoro, Antonio, Santos, Irene, Santos-Sousa, Hugo, Sapienza, Paolo, Sartarelli, Lodovico, Sarveswaran, Janahan, Sasia, Diego, Saudemont, Alain, Saudi-Moro, Sef, Saxena, Shobhit, Saxena, Dolly, Sayasneh, Ahmad, Scalabre, Aurelien, Schache, Andrew, Schiavina, Riccardo, Schineis, Christian, Schreckenbach, Teresa, Scorza, Antonella, Scott, Lucy, Seegert, Sara, Seguin-Givelet, Agathe, Senent-Boza, Ana, Seymour, Keith, Shabana, Amanda, Shah, Karishma, Shah, Jigar, Shah, Preena, Shah, Sujay, Shakir, Taner, Shalaby, Mostafa, Shankar, Sushma, Shaw, Richard, Shehata, Sameh, Shenfine, Amy, Sheridan, Kelda, Sherief, Ahmed, Sherief, Mohamed, Sherif, Mohamed, Shinkwin, Michael, Shu, Sebastian, Siaw-Acheampong, Kwabena, Sileri, Pierpaolo, Singh, Abhinav, Singh, Shailendra, Sinha, Sanjay, Sinha, Deepti, Siragusa, Leandro, Sivaprakasam, Rajesh, Sivayoganathan, Sriharan, Smillie, Robert, Smith, Claire, Smith, Andrew, Smith, Christopher, Sochorova, Dana, Soggiu, Fiammetta, Sohrabi, Catrin, Sohrabi, Catrin, Sohrabi, Catrin, Solari, Francesca, Solli, Piergiorgio, Soreide, Kjetil, Spinelli, Antonino, Spoletini, Domenico, Spriano, Giuseppe, Sravanam, Sanskrithi, Ssentongo, Paddy, Stanger, Sophie, Stavroulias, Dionisios, Steel, Ben, Stella, Marco, Stewart, Robbie, Stringer, Sally, Sulen, Nina, Sundar, Sudha, Sundhu, Matthew, Suri, Avni, Syed, Arooj, Szatmary, Peter, Tabiri, Stephen, Tadross, Daniel, Taglietti, Lucio, Tansey, Rosamond, Tartaglia, Dario, Tawheed, Ahmed, Tayeh, Salim, Teles, Tobias, Testa, Valentina, Tewari, Nilanjana, Thoenissen, Philipp, Thomas, Kane, Thomin, Anne, Thrush, Jessica, Tierney, Sean, Tiwari, Abhinav, Toh, Simon, Toledo, Enrique, Tonini, Valeria, Torkington, Jared, Torquati, Alfonso, Torzilli, Guido, Totty, Joshua, Tourountzi, Paraskevi, Tousidonis, Manuel, Townend, Philip, Townsend, Catherine, Trompeter, Alex, Trotta, Francesco, Truant, Stéphanie, Trujillo-Díaz, Jeancarlos, Tsoulfas, Georgios, Turco, Celia, Turrado-Rodriguez, Victor, Turri, Giulia, Tustin, Harry, Tyler, Jayne, Tzedakis, Stylianos, Tzovaras, George, Uittenbogaart, Martine, Ullah, Ramzan, Urban, Shane, Urbani, Alessia, Usai, Antonella, Vaccarella, Gianpaolo, Valdes-Hernandez, Javier, Valsecchi, Luca, Vashisht, Rajiv, Vázquez-Fernández, Andrea, Venn, Mary, Vera-Mansilla, Cristina, Vergari, Roberto, Vescio, Giuseppina, Vidya, Raghavan, Vieira, Paula, Vijay, Vardhini, Vimalachandran, Dale, Violante, Tommaso, Volpe, Anita, Vovola, Fernanda, Vulliamy, Paul, Wall, Rosemary, Wallwork, Kate, Ward, Alex, Warwick, David, Waseem, Saima, Weaver, Helen, Wells, Fiona, Wen, Jiaxin, West, Raha, Whitehall, Emma, Wild, Laura, Wilkins, Alex, Williams, Gethin, Williams, Matthew, Winnand, Philipp, Wong, Ken, Worku, Dawit, Wright, Naomi, Yalamanchili, Seema, Yershov, Danylo, Yildiz, Alp, Young, Richard, Yurttas, Can, Zadegan, Frederic, Zafar, Noman, Zakaria, Rasheed, Zambon, Martina, Zanini, Nicola, Zarate, Alba, Zerbib, Philippe, Zizzo, Maurizio, Zmora, Oded, Zonta, Sandro, van Berge Henegouwen, Mark I, van der Plas, Willemijn Y, Ali, Inthekab Ali Mohamed, Bakri, Nur Amalina Che, Bauset, Juan Carlos Catalá, Abou Chaar, Mohamad K, Marino Cosentino, Luigi MP, Gómez Díaz, Carlos J, Garcia Galocha, Jose L, de Gheldere, Charles A, Ataíde Gomes, Gustavo Mendonça, Beltrán de Heredia, Juan, Blazer III, Dan G, Nugent III, William C, Ali karar, Ali A, Borja De Lacy, F, Blas Laina, Juan luis, Shane Lester, Madan Jha, Liyanage, Aloka S D, Al Maadany, Faraj S, De Marchi, Joshua A, Ramos-De la Medina, Antonio, Mithany, Reda H M, Sanchez del Pueblo, Cristina, van Ramshorst, Gabrielle H, De Salas, Maria Marqueta, De Souza, Anthony C, Dolores Del Toro, M, Archer, James E, Odeh, Abdulrahman, Erridge, Simon, Salem, Hosni Khairy, Jones, Gareth P, Gardner, Anne, Tripathi, Shiva S, Gregg, Anne, Jeganathan, Reuben, Siddique, Muhammad Harris, Lombardi, Celestino P, Martin, Benjamin, Leo, Cosimo Alex, Dass, Debashis, Di Franco, Gregorio, Jiao, Long R, Mari, Giulio Maria, Capitan-Morales, Luis-Cristobal, Connelly, Tara M, Alanbuki, Ammar, De Virgilio, Armando, Schilling, Clare, San Miguel Mendez, Carlos, Kulkarni, Gauri, Nizami, Kulsoom, Walsh, Stewart, Dean, Harry, Ruiz-Marin, Miguel, Houston, Rory, Trompetto, Mario, Chrastek, David, Kouritas, Vasileios, Cannoletta, Maria, Rosato, Francesco, Kaushal, Manish V, Costa, Paulo Matos, Elkadi, Hannah H, Johnstone, Jack R, Irvine, Esmee, Alvarez, Maria R, Corbellini, Carlo, Venkatesan, Gowtham S, Mateo-Sierra, Olga, Martínez-Pérez, Carolina, Serrano González, Javier, Hernández Bartolomé, Miguel Ángel, Díaz Pérez, David, Gutiérrez Samaniego, María, Galindo Jara, Pablo, Sharma, Neil, Smart, Neil J, and Keller, Deborah S
- Abstract
The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection.
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- 2020
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4. Comparative study of three different managements after colorectal anastomosis in ovarian cancer: conservative management, diverting ileostomy, and ghost ileostomy.
- Author
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Lago, Victor, Sanchez-Migallón, Amalia, Flor, Blas, Padilla-Iserte, Pablo, Matute, Luis, García-Granero, Álvaro, Bustamante, Marcos, and Domingo, Santiago
- Subjects
COMPARATIVE studies ,SURGICAL anastomosis ,OVARIAN cancer ,ILEOSTOMY ,COLOSTOMY - Abstract
Objective: Anastomotic leak remains the main concern after colorectal anastomosis in ovarian cancer. Our objective was to compare the use of three different management approaches after colorectal resection and anastomosis in patients with ovarian cancer. Methods: Between January 2010 and June 2018, a total of 133 patients with International Federation of Gynecology and Obstetrics (FIGO) stage II–IV ovarian cancer who underwent colorectal resection and anastomosis were included. According to the approach followed after colorectal anastomosis and during the post-operative period, patients were stratified into three groups: conservative management and observation, diverting ileostomy, or ghost ileostomy technique. Univariate analyses were performed for quantitative variables by applying Student's t test or Mann-Whitney U test and for qualitative variables by using the χ
2 test (or Fisher's test according to the sample size). Results: A total of 145 patients underwent colorectal resection during cytoreduction for FIGO stage II–IV ovarian cancer. Twelve patients were excluded because a colostomy was required. Thus, 133 patients were included in the final analysis. Modified posterior pelvic exenteration was performed in 121 (91%) patients and recto-sigmoid resection in 12 (9%) patients with relapse. The approach after anastomosis was wait-and-see in 72 patients (54.1%), diverting ileostomy in 19 patients (14.4%), and ghost ileostomy in 42 patients (31.5%). There were no differences in diagnosis, age, body mass index, ECOG (Eastern Cooperative Oncology Group), histology, tumor grade, FIGO stage, or type of surgery between the groups. No differences were found regarding the anastomosis leak related factors or the rate of anastomotic leak between the three groups (5.6% vs 5.3% vs 4.8%; p=0.98). Two patients died because of the anastomotic leak in the wait-and-see group, and none died in the diverting ileostomy or ghost ileostomy group. In the diverting ileostomy group, a higher number of patients had complications compared with the ghost ileostomy group (78.9% vs 7.1%; p<0.01). Four patients (21.1%) developed dehydration due to high output stoma (>1500 mL) causing electrolyte imbalance in the diverting ileostomy group, and one patient (2.4%) in the ghost ileostomy group (p=0.03). The stoma reversal rate was 73.7% for the diverting ileostomy group and 100% for the ghost ileostomy group. Conclusions: There were no differences found in the rate of anastomotic leak among the three groups of patients. The use of ghost ileostomy avoids the drawbacks of diverting ileostomy and seems to have advantages over routine diverting ileostomy and wait-and-see approaches for ovarian cancer patients undergoing colorectal anastomosis. Rates of stoma reversal are lower after diverting ileostomy when compared with ghost ileostomy. [ABSTRACT FROM AUTHOR]- Published
- 2019
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5. Ghost Ileostomy in Advanced Ovarian Cancer: A Reliable Option.
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Lago, Víctor, Flor, Blas, Matute, Luis, Padilla-Iserte, Pablo, García-Granero, Alvaro, Bustamante, Marco, and Domingo, Santiago
- Abstract
Objective: Diverting ileostomy (DI) has been proposed to reduce the incidence and consequences anastomotic leakage after bowel resection. In colorectal cancer treatment, ghost ileostomy (GI) has been proposed as an alternative to DI. Our objective was to report the results of GI associated with colorectal resection in the treatment of ovarian cancer. Materials and Methods: This is an observational pilot study performed in a single institution. The main objective sought was to report the results of GI associated with colorectal resection in the treatment of ovarian cancer: 26 patients were included. Results: Modified posterior exenteration was performed in 24 cases (92.3%) and rectum resection in the 2 cases of relapse (7.7%). After the main procedure GI was created, to check up the anastomosis status, a sequential postoperative rectoscopy was performed on postoperative day 5 ± 1 (range, 4–7). Serum levels were monitored in first and third postoperative days just with a descriptive intention to establish its relationship with the rectoscopy findings. In 2 cases, rectoscopy demonstrated a leakage. During postoperative course, no other complication related with the GI or DI was observed. No case of clinical anastomotic leakage was found. Conclusions: To the extent of our knowledge, this is the first study in which GI has been performed for the treatment of patients with ovarian cancer. Ghost ileostomy represents a real option that may reduce the number of ileostomies performed in ovarian cancer without increasing the morbimortality. Ghost ileostomy presents the advantages of DI while avoiding its drawbacks. It also seems to be a safe, feasible, and reproducible technique that does not add significant costs to the surgery. [ABSTRACT FROM AUTHOR]
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- 2018
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6. Early Prediction of Anastomotic Leak in Colorectal Cancer Surgery by Intramucosal pH.
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Millan, Monica, García-Granero, Eduardo, Flor, Blas, García-Botello, Stephanie, and Lledo, Salvador
- Abstract
PURPOSE: Adequate oxygenation is necessary for anastomotic healing, and ischemia has been found to be one of the most important factors in anastomotic leakage. This study was designed to assess the value of early postoperative intramucosal pH measurements for the prediction of anastomotic leakage in patients with colorectal anastomosis. METHODS: A prospective study of 90 patients with rectal or sigmoid cancer with primary anastomosis was conducted. In all patients intramucosal pH was determined by using tonometry at the anastomotic and gastric levels during the first 24 and 48 hours postoperatively. Seven other variables also were tested by univariate and multivariate analysis for any association with anastomotic leakage. RESULTS: The rate of clinical anastomotic leakage was 6.6 percent. Multivariate analysis showed that only the intramucosal pH at the anastomosis was an independent factor for the development of anastomotic leakage. The risk of leakage was 22 times higher in patients with an anastomotic intramucosal pH < 7.28 in the first 24 hours after surgery. CONCLUSIONS: Measurement of anastomotic intramucosal pH in the early postoperative period can more accurately predict the risk of anastomotic leakage and benefit those patients who would need additional measures to improve the viability of the anastomosis. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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7. Prognostic Heterogeneity of Endosonographic T3 Rectal Cancer
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Esclapez, Pedro, Garcia-Granero, Eduardo, Flor, Blas, García-Botello, Stephanie, Cervantes, Andres, Navarro, Samuel, and Lledó, Salvador
- Abstract
This study aimed to assess the prognostic implications of uT3 rectal carcinomas according to the tumor thickness and to analyze the correlation between this ultrasound-based parameter and other prognostic factors.
- Published
- 2009
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8. Outcome of Esophageal Function and 24-hour Esophageal pH Monitoring after Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass
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Ortega, Joaquin, Escudero, Maria, Mora, Francisco, Sala, Carlos, Flor, Blas, Martinez-Valls, Jose, Sanchiz, Vicente, Martinez-Alzamora, Nieves, Benages, Adolfo, and Lledo, Salvador
- Abstract
Background: One of the co-morbidities frequently associated with morbid obesity is gastro-esophageal reflux disease (GERD), present in >50 % of morbidly obese individuals. We compared the anti-reflux effect of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP), and their effect on esophageal function. Methods: 10 patients underwent VBG and 40 patients underwent RYGBP. Anthropometric parameters, symptomatology of GERD, esophageal manometry (EM), isotopic esophageal emptying (IEE) and 24hr esophageal pH monitoring were recorded in all patients preoperatively, and at 3 months and 1 year postoperatively. Results: Preoperatively, there was a high prevalence of GERD, symptomatic and pH-metric in both groups (57% and 80% respectively). The preoperative values of EM and IEE parameters were within the normal range in most patients. After surgery, there was an improvement at 3 months postoperatively in both groups. 1 year after surgery, the VBG group presented symptomatic GERD in 30% and pH-metric reflux in 60% of patients while the RYGBP group presented symptomatic GERD and pH-metric reflux in 12.5% and 15% of patients, respectively. There was an increase in postoperative sensation of dysphagia in both groups (70% VBG, 30% RYGBP) one year after operation. After surgery, differences in all EM parameters were minimal, and never reached statistical significance for any group (VBG and RYGBP). The IEE showed a significantly higher percentage of esophageal retention after surgery, but this retention was always within the normal range. Both groups had an improvement in anthropometric parameters, but 1 year after surgery the results were significantly better in RYGBP patients (70% excess weight loss) than in VBG patients (46% excess weight loss). Conclusion: >50% of morbidly obese individuals suffer from GERD. We did not find changes in esophageal function of morbidly obese patients to explain their gastroesophageal reflux preoperatively and postoperatively. EM and IEE studies are not indicated as standard preoperative tests, except in patients with significant symptoms of gastroesophageal reflux. RYGBP is significantly better than VBG as an anti-reflux procedure, and had better weight loss.
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- 2004
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9. Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass: Little Impact on Nutritional Status after 5-Year Follow-up
- Author
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Ortega, Joaquin, Sala, Carlos, Flor, Blas, Jiménez, Elsa, Escudero, Maria, Martinezvalls, Jose, and Lledo, Salvador
- Abstract
Background: Conversion to a Roux-en-Y gastric bypass (RYGBP) has been advocated after the failure of vertical banded gastroplasty (VBG). The aim of this study was to analyze the differences in anthropometric and nutritional parameters between patients with VBG and those converted to RYGBP. Methods: 45 patients initially underwent VBG. 22 of these patients have maintained this operation for more than 5 years (Group A) and 23 have been converted to RYGBP (Group B), after 2 years of follow-up. We analyzed anthropometric and nutritional parameters (macronutrients,micronutrients and lipid profile), and postoperative morbidity after both procedures. Data were recorded before the first operation and at 6 months, 1, 2 and 5 years follow-up. Results: VBG failure rate was 51%. The 23 patients converted to RYGBP have maintained an excess weight loss (EWL) of 70% 3 years after the revision, and all the complications related to VBG disappeared. Anthropometric parameters were significantly better after RYGBP. We found no significant differences in nutritional status between both groups except for levels of iron, vitamin B
12 and transferrin saturation index, which significantly decreased in converted patients. The redo procedure had a low morbidity rate, with no mortality. Conclusion: More than 50% of VBGs failed after 2-year follow-up. Patients converted to RYGBP maintained mean EWL 73% at 5 years. The only significant nutritional deficiencies were iron and vitamin B12 , in patients converted to RYGBP.- Published
- 2004
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