1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
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.
Collapse
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
| | | |
Collapse
|
4
|
Tovar Pérez R, Di Martino M, Blanco Terés L, Martín-Pérez E. Cystic artery pseudoaneurism secondary to acute cholecystitis. Cir Esp 2022; 100:171. [PMID: 35216912 DOI: 10.1016/j.cireng.2022.02.009] [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: 10/05/2020] [Accepted: 01/17/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Rodrigo Tovar 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.
| | - Marcello Di Martino
- 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
| | - Lara Blanco Terés
- 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
| |
Collapse
|
5
|
Pérez de la Fuente T, Blanco Terés L, Viamontes Ugalde F, Gimeno A. Unusual technical resource in an urgent abdominal panniculectomy in a super-obese patient. Cir Esp 2021; 99:763-764. [PMID: 34764062 DOI: 10.1016/j.cireng.2021.10.006] [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: 04/18/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Teresa Pérez de la Fuente
- Unidad de Cirugía Plástica, Estética y Reparadora, Hospital Universitario de La Princesa, Madrid, Spain.
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
| | - Francisco Viamontes Ugalde
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alberto Gimeno
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
| |
Collapse
|
6
|
Maqueda Gonzalez R, Cerdán Santacruz C, García Septiem J, Blanco Terés L, Lopesino González JM, Fernández Jiménez G, Martín-Pérez E. Proctologic emergency consultation during COVID-19: Comparative cross-sectional cohort study. Cir Esp 2021; 99:660-665. [PMID: 34749925 DOI: 10.1016/j.cireng.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/13/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Proctologic issues entail a frequent reason for consultation in the emergency department (ED). We aim to analyze how the SARS-COV-2 pandemic has impacted in the demand for proctological consultations. MATERIAL AND METHOD Descriptive comparative retrospective study of cross-sectional cohorts of patients attending the ED for proctological complaints from March to April in 2020 and 2019. Demographic variables, comorbidities, reasons for consultation and diagnosis, treatment and readmission were included. Four periods were analyzed according to the different stages of the pandemic derived limitations. RESULTS A total of 191 patients were reviewed, 58 in 2020 and 133 in 2019 with an average age of 48 years (SD 20.1) and 112 (58.6%) males. The average number of daily consultations was 2.18 patients in 2019 versus 0.95 in 2020 (p=0.025) meaning a 56% reduction in consultations for proctological reasons. This difference in average consultations was significant in both periods of lockout (p=0.001) and previous de-escalation (p=0.014). The diagnosis distribution was similar between both periods; however, perianal abscesses doubled their rate in 2020, 22.4% versus 11.3% (p=0.045). There was an increasing need for surgery, 31% vs 15% (p=0.011) with no difference in outpatients regimen after emergency surgery (12.5% vs 7.5%, p=0.201). Three patients in 2020 required readmission to the ED (5.2% vs 12.9%, p=0.086). CONCLUSION There was a decrease of a 56% in proctologic emergency consultation, however, the need for surgery was twice more frequent during the study period. Reflection on the use of emergencies for proctological reasons is warranted.
Collapse
Affiliation(s)
- Rocío Maqueda Gonzalez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain.
| | - Carlos Cerdán Santacruz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Guillermo Fernández Jiménez
- Unidad de Información Clínico-Asistencial, Servicio de Admisión y Documentación Clínica, Hospital Universitario La Princesa, Madrid, Spain
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| |
Collapse
|
7
|
de la Fuente Añó A, Valdés de Anca Á, Milián Goicoechea H, Rofso Raboso P, Blanco Terés L. Iatrogenic pneumothorax after preoperative progressive pneumoperitoneum. Cir Esp 2021; 99:693-694. [PMID: 34629310 DOI: 10.1016/j.cireng.2021.09.003] [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: 05/18/2020] [Accepted: 08/30/2020] [Indexed: 10/20/2022]
Affiliation(s)
| | - Álvaro Valdés de Anca
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Paloma Rofso Raboso
- Servicio de Cirugía Torácica, Hospital Universitario de La Princesa, Madrid, Spain
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
| |
Collapse
|
8
|
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
| |
Collapse
|
9
|
Barranquero AG, Muñoz de Nova JL, Gómez-Ramírez J, Valdés de Anca Á, Porrero B, Blanco Terés L, Corral S, Martín-Pérez E. Effect of preoperative potassium iodide administration on Graves' disease surgery: a propensity score analysis. Am J Surg 2021; 222:959-963. [PMID: 33941360 DOI: 10.1016/j.amjsurg.2021.04.023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preoperative administration of a saturated solution of potassium iodide (SSKI) is recommended in the guidelines for the management of hyperthyroidism due to Graves' disease. Studies addressing its effect on complications after thyroidectomy are inconclusive. METHODS Retrospective multicenter Propensity Score study of patients undergoing total thyroidectomy for Graves' disease, from January 2013 to September 2019 in two tertiary centers in Madrid, Spain. Patients were given SSKI prior to surgery or not according to surgeons' preferences. Electronic clinical records were reviewed searching: baseline characteristics surgical variables, pathological findings, and postoperative complications. RESULTS Ninety patients were analyzed: 44 received SSKI and 46 were not given SSKI. No significant differences were found in the main postoperative complications with or without SSKI: transient hypoparathyroidism (40.9% vs. 50%), permanent hypoparathyroidism (6.8% vs. 13%), transient recurrent laryngeal nerve (RLN) palsy (2.3% vs. 8.7%), definitive RLN palsy (2.3% vs. 2.2%), or cervical hematoma (2.3% vs. 4.3%). CONCLUSION Preoperative administration of SSKI had no impact on postoperative complications after thyroidectomy for Graves' disease.
Collapse
Affiliation(s)
- Alberto G Barranquero
- General and Digestive Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - José Luis Muñoz de Nova
- General and Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Joaquín Gómez-Ramírez
- General and Digestive Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Álvaro Valdés de Anca
- General and Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Belén Porrero
- General and Digestive Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Lara Blanco Terés
- General and Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Sara Corral
- General and Digestive Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Elena Martín-Pérez
- General and Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain
| |
Collapse
|
10
|
Blanco Terés L, García Sanz Í, Marín Campos C, Gancedo Quintana Á, Martín-Pérez E. Bowel obstruction secondary to transdiaphragmatic intercostal hernia. Gastroenterol Hepatol 2021; 45:557-558. [PMID: 33872618 DOI: 10.1016/j.gastrohep.2021.02.012] [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] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España.
| | - Íñigo García Sanz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Cristina Marín Campos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Álvaro Gancedo Quintana
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario 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 La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, España
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Tovar Pérez R, Di Martino M, Blanco Terés L, Martín-Pérez E. Cystic artery pseudoaneurism secondary to acute cholecystitis. Cir Esp 2021; 100:S0009-739X(21)00028-2. [PMID: 33745718 DOI: 10.1016/j.ciresp.2021.01.006] [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: 10/05/2020] [Revised: 01/05/2021] [Accepted: 01/17/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Rodrigo Tovar 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.
| | - Marcello Di Martino
- 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
| | - Lara Blanco Terés
- 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
| |
Collapse
|
13
|
Pérez de la Fuente T, Blanco Terés L, Viamontes Ugalde F, Gimeno A. Unusual technical resource in an urgent abdominal panniculectomy in a super-obese patient. Cir Esp 2020; 99:S0009-739X(20)30302-X. [PMID: 33127049 DOI: 10.1016/j.ciresp.2020.09.002] [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: 04/18/2020] [Revised: 07/04/2020] [Accepted: 09/06/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Teresa Pérez de la Fuente
- Unidad de Cirugía Plástica, Estética y Reparadora, Hospital Universitario de La Princesa, Madrid, España.
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Francisco Viamontes Ugalde
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | - Alberto Gimeno
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| |
Collapse
|
14
|
Maqueda Gonzalez R, Cerdán Santacruz C, García Septiem J, Blanco Terés L, Lopesino González JM, Fernández Jiménez G, Martín-Pérez E. Proctologic emergency consultation during COVID-19: Comparative cross-sectional cohort study. Cir Esp 2020; 99:S0009-739X(20)30317-1. [PMID: 33218670 PMCID: PMC7584434 DOI: 10.1016/j.ciresp.2020.10.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Proctologic issues entail a frequent reason for consultation in the emergency department (ED). We aim to analyze how the SARS-COV-2 pandemic has impacted in the demand for proctological consultations. MATERIAL AND METHOD Descriptive comparative retrospective study of cross-sectional cohorts of patients attending the ED for proctological complaints from March to April in 2020 and 2019. Demographic variables, comorbidities, reasons for consultation and diagnosis, treatment and readmission were included. Four periods were analyzed according to the different stages of the pandemic derived limitations. RESULTS A total of 191 patients were reviewed, 58 in 2020 and 133 in 2019 with an average age of 48 years (SD 20.1) and 112 (58.6%) males. The average number of daily consultations was 2.18 patients in 2019 versus 0.95 in 2020 (p=0.025) meaning a 56% reduction in consultations for proctological reasons. This difference in average consultations was significant in both periods of lockout (p=0.001) and previous de-escalation (p=0.014). The diagnosis distribution was similar between both periods; however, perianal abscesses doubled their rate in 2020, 22.4% versus 11.3% (p=0.045). There was an increasing need for surgery, 31% vs 15% (p=0.011) with no difference in outpatients regimen after emergency surgery (12.5% vs 7.5%, p=0.201). Three patients in 2020 required readmission to the ED (5.2% vs 12.9%, p=0.086). CONCLUSION There was a decrease of a 56% in proctologic emergency consultation, however, the need for surgery was twice more frequent during the study period. Reflection on the use of emergencies for proctological reasons is warranted.
Collapse
Affiliation(s)
- Rocío Maqueda Gonzalez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain.
| | - Carlos Cerdán Santacruz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Guillermo Fernández Jiménez
- Unidad de Información Clínico-Asistencial, Servicio de Admisión y Documentación Clínica, Hospital Universitario La Princesa, Madrid, Spain
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, Spain
| |
Collapse
|
15
|
de la Fuente Añó A, Valdés de Anca Á, Milián Goicoechea H, Rofso Raboso P, Blanco Terés L. Iatrogenic pneumothorax after preoperative progressive pneumoperitoneum. Cir Esp 2020; 99:S0009-739X(20)30278-5. [PMID: 33040974 DOI: 10.1016/j.ciresp.2020.08.010] [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: 05/18/2020] [Revised: 06/23/2020] [Accepted: 08/30/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Álvaro Valdés de Anca
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| | | | - Paloma Rofso Raboso
- Servicio de Cirugía Torácica, Hospital Universitario de La Princesa, Madrid, España
| | - Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, España
| |
Collapse
|
16
|
Blanco Terés L, Di Martino M, Rodríguez ÁDLH, Martín-Pérez E. Hepatic granuloma mimicking an intrahepatic cholangiocarcinoma: An unusual presentation. Cir Esp 2020; 99:383. [PMID: 32682513 DOI: 10.1016/j.ciresp.2020.06.006] [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: 03/10/2020] [Revised: 04/21/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Lara Blanco Terés
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España.
| | - Marcello Di Martino
- 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
| |
Collapse
|
17
|
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
| |
Collapse
|
18
|
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
| |
Collapse
|