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Background: satisfaction with healthcare is focused on the patient and is known as “patient-centered care”. However, user satisfaction is not always synonymous with good care. Healthcare practitioners should determine and understand what patients need and expect in order to improve the quality of care. Aims: the main objective of this study was to determine the perceived quality of care of patients diagnosed with colorectal cancer in our unit. Methods: a cross-sectional study was performed in all patients diagnosed with colorectal cancer (CRC) that underwent staging studies and were hospitalized in the Gastroenterology Department from May 2013 to October 2013. Furthermore, outpatients with rapid consultations for CRC staging from November 2013 to November 2014 were also included. Two questionnaires were administered: a) a survey of 20 questions with closed responses regarding the competence of treating physicians and nurses, the information received and the waiting time; b) the European Organization for Research and Treatment of Cancer (EORTC) QLQ-INFO25: information on the disease, medical tests, treatment and other services, with eight single items. Results: there were no differences in the perceived healthcare quality, delays in starting treatment, the tumor stage, symptoms (performance status) or the time spent studying the disease. In-patients and those with advanced disease started treatment earlier than outpatients and those with disease stage I or II. Likewise, outpatients perceived a better psychological support. Conclusions: outpatient study did not reduce the quality of care and did not delay treatment.

Aim: to describe the management of acute calculous cholecystitis in a tertiary teaching hospital and the outcomes obtained. Material and methods: a retrospective single tertiary center cohort study. Results: medical records of 487 patients were analyzed. The mean follow-up was 44.5 ± 17.0 months. Treatment alternatives were cholecystectomy (64.3%), conservative treatment (23.0%), endoscopic retrograde cholangiopancreatography (17.4%), percutaneous cholecystostomy (10.7%) and endoscopic ultrasound-guided gallbladder drainage (0.8%). Most cholecystectomies were delayed (88.8%). Recurrences occurred in 38.2% of patients. Although cholecystectomy was the therapeutic approach with the lowest recurrence rate once performed, 44.6% of patients that underwent delayed surgery had pre-surgical recurrences. Conclusions: delayed cholecystectomy is still commonly performed, even though it is related with a high frequency of preoperative recurrences

espanolntroduccion: existe controversia respecto a los riesgos asociados a las protesis de aposicion luminal (PAL), con importantes variaciones entre los trabajos disponibles. Objetivos: describir el tipo y la proporcion de complicaciones durante la permanencia y retirada de PAL tipo Axios™. Describir la relacion entre tiempo de permeabilidad, diana terapeutica y presencia de complicaciones. Metodos: serie de casos retrospectiva y multicentrica que incluyo todos los pacientes consecutivos a los que se les coloco una PAL para acceder a estructuras extraluminales durante el ano 2017. Se registraron unicamente aquellos casos que alcanzaron exito tecnico. Resultados: se incluyeron 179 pacientes de siete centros (rango 4-68 casos/centro) con edad media de 64,3 anos (DE: 15,8, rango 24,6-98,8 anos), 122 (68,2%) de ellos varones. Las indicaciones mas frecuentes fueron las necrosis encapsuladas (58, 32,4%), seguidas de pseudoquistes (31, 17,3%) y drenajes vesiculares (26, 14,5%). Durante la permanencia de la PAL se documentaron complicaciones en 19 pacientes (10,9%), siendo las mas frecuentes las obstrucciones de la luz protesica o del marco gastroduodenal en ocho (4,5%) casos y las hemorragias en siete (3,9%) pacientes. Las PAL no se retiraron en 86 pacientes (48%) por los siguientes motivos: intencion permanente de la PAL en 46 (53,5%), perdida del seguimiento en 18 (20,9%), fallecimiento del paciente en 16 (18,6%) y migracion en seis (7%). Durante la retirada se observaron cinco complicaciones (5,4%), tres casos de hemorragia y dos perforaciones. No observamos una asociacion entre el tiempo de permanencia y las complicaciones (p = 0,67). Conclusion: la aparicion de complicaciones secundarias a la insercion de PAL es poco frecuente, aunque pueden ser graves. En este estudio no se ha observado una asociacion entre la aparicion de complicaciones y el tiempo de permanencia de la protesis. EnglishIntroduction: there is controversy with regard to the risks associated with lumen-apposing metal stents (LAMSs), with significant variations between available reports. Objectives: to describe the types and proportions of complications that arise during the permanence time and removal of Axios™ LAMS. Furthermore, the relationship between patency time, therapeutic target and the presence of complications was also described. Methods: a retrospective, multicenter case series study was performed of all patients with an implanted LAMS to access extra-luminal structures during 2017. Only technically successful cases were recorded. Results: a total of 179 patients from seven sites (range, 4-68 cases/site) were included in the study, with a mean age of 64.3 years (SD: 15.8; range: 24.6-98.8 years) and 122 (68.2%) were male. Most common indications included encapsulated necrosis (58, 32.4%), pseudocysts (31, 17.3%) and gallbladder drains (26, 14.5%). Complications during LAMS stay were reported in 19 patients (10.9%); stent lumen or gastroduodenal obstruction (8, 4.5%) and bleeding (7, 3.9%) were the most common. LAMS were not removed in 86 (48%) patients due to the following reasons: a permanent stent was used (46, 53.5%), loss to follow-up (18, 20.9%), patient demise (16, 18.6%) and stent migration (6, 7%). Five (5.4%) complications were reported during stent removal, which were three bleeds and two perforations. No association was found between stent duration and complications (p = 0.67). Conclusion: complications secondary to LAMS insertion are uncommon but may be serious. This study found no association between complications and stent duration.

Las metastasis que por via hematogena asientan en el estomago son infrecuentes, y entre estas destacan las secundarias a melanomas y tumores de mama. Clinicamente suelen ser asintomaticas y se encuentran en tumores avanzado