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Serradilla-Martín M, Villodre C, Falgueras-Verdaguer L, Zambudio-Carroll N, Castell-Gómez JT, Blas-Laina JL, Borrego-Estella V, Domingo-del-Pozo C, García-Plaza G, González-Rodríguez FJ, Montalvá-Orón EM, Moya-Herraiz Á, Paterna-López S, Suárez-Muñoz MA, Alkorta-Zuloaga M, Blanco-Fernández G, Dabán-Collado E, Gómez-Bravo MA, Miota-de-Llamas JI, Rotellar F, Sánchez-Pérez B, Sánchez-Cabús S, Pacheco-Sánchez D, Rodríguez-Sanjuan JC, Varona-Bosque MA, Carrión-Álvarez L, de la Serna-Esteban S, Dopazo C, Martín-Pérez E, Martínez-Cecilia D, Castro-Santiago MJ, Dorcaratto D, Gutiérrez-Díaz ML, Asencio-Pascual JM, Burdío-Pinilla F, Carracedo-Iglesias R, Escartín-Arias A, Ielpo B, Rodríguez-Laiz G, Valdivieso-López A, De-Vicente-López E, Alonso-Orduña V, Ramia JM. Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project). Cancers (Basel) 2024; 16:1676. [PMID: 38730631 PMCID: PMC11082946 DOI: 10.3390/cancers16091676] [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: 03/03/2024] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.
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Affiliation(s)
- Mario Serradilla-Martín
- Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Surgery, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Celia Villodre
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain
- Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain
| | | | | | | | | | | | | | - Gabriel García-Plaza
- Department of Surgery, Hospital Universitario Insular, 35016 Las Palmas de Gran Canaria, Spain;
| | | | - Eva M. Montalvá-Orón
- Department of Surgery, Hospital Universitario y Politécnico La Fe, IIS La Fe, Ciberehd ISCIII, 46026 Valencia, Spain;
| | - Ángel Moya-Herraiz
- Department of Surgery, Hospital Universitario de Castellón, 12004 Castelló de la Plana, Spain;
| | - Sandra Paterna-López
- Department of Surgery, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - Miguel A. Suárez-Muñoz
- Department of Surgery, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | | | | | | | - Miguel A. Gómez-Bravo
- Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | | | - Fernando Rotellar
- Department of Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Belinda Sánchez-Pérez
- Department of Surgery, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Santiago Sánchez-Cabús
- Department of Surgery, Hospital Universitario de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | | | | | - María A. Varona-Bosque
- Department of Surgery, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain;
| | | | | | - Cristina Dopazo
- Department of Surgery, Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain;
| | - Elena Martín-Pérez
- Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain; (E.M.-P.); (D.M.-C.)
| | - David Martínez-Cecilia
- Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain; (E.M.-P.); (D.M.-C.)
- Department of Surgery, Hospital Universitario Virgen de la Salud, 45004 Toledo, Spain
| | | | - Dimitri Dorcaratto
- Department of Surgery, Hospital Clínico Universitario, 46010 Valencia, Spain;
| | | | | | - Fernando Burdío-Pinilla
- Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain; (F.B.-P.); (B.I.)
| | | | | | - Benedetto Ielpo
- Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain; (F.B.-P.); (B.I.)
- Department of Surgery, Hospital Universitario de León, 24008 León, Spain
| | - Gonzalo Rodríguez-Laiz
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
| | | | | | - Vicente Alonso-Orduña
- Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - José M. Ramia
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain
- Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain
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López-Gómez JJ, Ramos-Bachiller B, Primo-Martín D, Calleja-Fernández A, Izaola-Jauregui O, Jiménez-Sahagún R, González-Gutiérrez J, López Andrés E, Pinto-Fuentes P, Pacheco-Sánchez D, De Luis-Román DA. Effect on Body Composition of a Meal-Replacement Progression Diet in Patients 1 Month after Bariatric Surgery. Nutrients 2023; 16:106. [PMID: 38201936 PMCID: PMC10780820 DOI: 10.3390/nu16010106] [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: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Progression diets after bariatric surgery (BS) are restricted in calories and protein, and they may induce a worsening of body composition. The aim of this study was to evaluate the effect of a modified diet with an oral nutritional supplement that is hyperproteic and normocaloric over the body composition. METHODS A two-arm ambispective observational cohort study was designed. Forty-four patients who underwent sleeve gastrectomy were included in the study. Thirty patients received a progression diet with a normocaloric, hyperproteic oral nutritional supplement during the first two weeks after surgery (820 kcal, 65.5 g protein). They were compared with a historical cohort of 14 patients treated with a standard progression diet (220 kcal, 11.5 g protein). Anthropometric and body composition (using electrical bioimpedanciometry) data were analyzed before BS and 1 month after the surgery. RESULTS The mean age was 47.35(10.22) years; 75% were women, and the average presurgical body mass index (BMI) was 45.98(6.13) kg/m2, with no differences between both arms of intervention. One month after surgery, no differences in the percentage of excess weight loss (%PEWL) were observed between patients in the high-protein-diet group (HP) and low-protein-diet group (LP) (HP: 21.86 (12.60)%; LP: 18.10 (13.49)%; p = 0.38). A lower loss of appendicular skeletal muscle mass index was observed in the HP (HP: -5.70 (8.79)%; LP: -10.54 (6.29)%; p < 0.05) and fat-free mass index (HP: 3.86 (8.50)%; LP:-9.44 (5.75)%; p = 0.03), while a higher loss of fat mass was observed in the HP (HP: -14.22 (10.09)%; LP: -5.26 (11.08)%; p < 0.01). CONCLUSIONS In patients undergoing gastric sleeve surgery, the addition of a normocaloric, hyperproteic formula managed to slow down the loss of muscle mass and increase the loss of fat mass with no differences on total weight loss.
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Affiliation(s)
- Juan J. López-Gómez
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Beatriz Ramos-Bachiller
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - David Primo-Martín
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Alicia Calleja-Fernández
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Olatz Izaola-Jauregui
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Rebeca Jiménez-Sahagún
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Jaime González-Gutiérrez
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Eva López Andrés
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Pilar Pinto-Fuentes
- General Surgery Department, Rio Hortega Universitary Hospital, 47012 Valladolid, Spain
| | - David Pacheco-Sánchez
- General Surgery Department, Rio Hortega Universitary Hospital, 47012 Valladolid, Spain
| | - Daniel A. De Luis-Román
- Endocrinology and Nutrition Department, Clinic Universitary Hospital of Valladolid, 47003 Valladolid, Spain
- Investigation Centre Endocrinology and Nutrition, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
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Plúa-Muñiz K, Bailón-Cuadrado M, Pérez-Saborido B, Pacheco-Sánchez D, Pinto P, Asensio-Díaz E. Survival analysis and identification of prognostic factors in colorectal liver metastasis after liver resection. Cir Esp 2023; 101:160-169. [PMID: 36108955 DOI: 10.1016/j.cireng.2022.09.023] [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: 08/29/2021] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Liver resection is the only curative treatment for colorectal liver metastasis. The identification of predictive factors leads to personalize patient management to enhance their long-term outcomes. This population-based study aimed to characterize factors associated with, and survival impact of patients who received hepatectomy for colorectal liver metastasis. METHODS A retrospective cohort study of all the hepatectomies for colorectal liver metastasis performed at third-level hospital of Spain (2010-2018) was conducted. The Kaplan-Meier method was used for survival analyses. Multivariable Cox and regression models were used to determine prognostic factors associated with overall survival. RESULTS The 5-year overall survival and disease-free survival were 42 and 33%, respectively. Survival analysis showed that metastasis features (number, largest size, distribution, and extrahepatic disease) and postsurgical factors (transfusion, major complications, and positive margin resection), as well as non-mutated KRAS, showed a significant association with survival. Otherwise, on multivariate analysis, only 5 independent risk factors were identified: major size metastasis >4 cm, RAS mutation, positive margin resection, intraoperative transfusion, and major complications. CONCLUSIONS According to our findings, major size metastasis >4 cm, intraoperative transfusion, and major postoperative complications continue to be traditional prognostic factors. Meanwhile, the KRAS biomarker has a powerful impact as a survival prognostic factor.
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Affiliation(s)
- Katherine Plúa-Muñiz
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain.
| | - Martín Bailón-Cuadrado
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Baltasar Pérez-Saborido
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain
| | - David Pacheco-Sánchez
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Pilar Pinto
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Enrique Asensio-Díaz
- Unidad de Cirugía Hepatobiliopancréatica, Hospital Universitario Río Hortega, Valladolid, Spain
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Bueno-Cañones AD, Blanco-Álvarez JI, Sarmentero-Prieto JC, Pacheco-Sánchez D. Orbital metastasis as the first manifestation of advanced rectal cancer. Cir Esp 2022; 100:242. [PMID: 35469991 DOI: 10.1016/j.cireng.2022.03.008] [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: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | | | | | - David Pacheco-Sánchez
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, Spain
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5
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Plúa-Muñiz K, Bailón-Cuadrado M, Pérez-Saborido B, Pacheco-Sánchez D, Pinto P, Asensio-Díaz E. Análisis de supervivencia e identificación de factores pronósticos de metástasis hepáticas de cáncer colorrectal tras resección hepática. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Bueno-Cañones AD, Blanco-Álvarez JI, Sarmentero-Prieto JC, Pacheco-Sánchez D. Orbital metastasis as the first manifestation of advanced rectal cancer. Cir Esp 2021; 100:S0009-739X(21)00047-6. [PMID: 33715830 DOI: 10.1016/j.ciresp.2021.02.004] [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: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | - David Pacheco-Sánchez
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
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7
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Tejero-Pintor FJ, Sarmentero-Prieto JC, Bailón-Cuadrado M, Blanco-Álvarez JI, Sánchez-González J, Velasco-López R, Rodriguez-Vielba P, Pacheco-Sánchez D. Double hepatic metastasis of double colon neoplasia: Adenocarcinoma and neuroendocrine tumour. Gastroenterol Hepatol 2019; 42:624-625. [PMID: 31324463 DOI: 10.1016/j.gastrohep.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 01/17/2023]
Affiliation(s)
| | | | - Martín Bailón-Cuadrado
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - José I Blanco-Álvarez
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Javier Sánchez-González
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Rosalía Velasco-López
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Paloma Rodriguez-Vielba
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - David Pacheco-Sánchez
- Servicio de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
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8
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Bailón-Cuadrado M, Pérez-Saborido B, Sánchez-González J, Rodríguez-López M, Velasco-López R, C Sarmentero-Prieto J, I Blanco-Álvarez J, Pacheco-Sánchez D. Prognostic Nutritional Index predicts morbidity after curative surgery for colorectal cancer. Cir Esp 2018; 97:71-80. [PMID: 30583791 DOI: 10.1016/j.ciresp.2018.08.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 01/09/2018] [Revised: 07/12/2018] [Accepted: 08/30/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) is a major health concern and it is associated with significant morbidity and mortality. Over the last decades, the relationship between cancer and nutritional and inflammatory status in oncologic patients was studied thoroughly and multiple immunonutritional scores were developed. These scores have been mainly related to the prognosis of several cancers. An interaction between the tumour and the host is generated, triggering a systemic inflammatory reaction leading to several neuroendocrine changes. This situation favours a tendency towards anorexia and catabolism. Our hypothesis is that nutritional and inflammatory status of oncologic patients is correlated to postoperative morbidity. METHODS This is a prospective observational cohort study with those patients undergoing curative surgery for CRC at our institution between September 2015 and March 2017. Nutritional and inflammatory status was established using Onodera's Prognostic Nutritional Index (PNI). Complications (overall, severe, infectious and anastomotic leakage) were carefully collected during the first 30 days of the postoperative period. RESULTS After carrying out the multivariate analysis, PNI turned out to be a great predictive and protective factor for overall complications (RR: 0.279; 95% CI: 0.141-0.552), severe complications (RR: 0.355; 95% CI: 0.130-0.965), infectious complications (RR: 0.220; 95% CI: 0.099-0.489) and anastomotic leakage (RR: 0.151; 95% CI: 0.036-0.640). CONCLUSION Our work reports that PNI is an independent predictive factor for the development of postoperative complications following curative surgery for CRC.
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Affiliation(s)
- Martín Bailón-Cuadrado
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España.
| | - Baltasar Pérez-Saborido
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Javier Sánchez-González
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Mario Rodríguez-López
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - Rosalía Velasco-López
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - José C Sarmentero-Prieto
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - José I Blanco-Álvarez
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
| | - David Pacheco-Sánchez
- Departamento de Cirugía General y Digestiva, Hospital Universitario Río Hortega, Valladolid, España
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Tejero-Pintor FJ, Cuesta-De la Llave C, Rodriguez-Lopez M, Bailon-Cuadrado M, Pacheco-Sánchez D. Laparoscopic hemi-splenectomy: a valid option in selected cases such as epidermoid cyst. Ann R Coll Surg Engl 2018; 101:e73-e75. [PMID: 30482035 DOI: 10.1308/rcsann.2018.0205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Splenic cysts are a rare pathology, which can be classified as true (25%) or pseudocysts (75%). Total splenectomy has been the treatment of choice, particularly in recent times with the advent of the laparoscopic approach. However, as the spleen is an organ with multiple immunological functions, the laparoscopic partial splenectomy is an alternative, which is technically difficult but effective. We present a case of a 26-year-old woman with incidental evidence of a splenic cyst in an abdominal ultrasound scan. We performed a laparoscopic partial splenectomy to preserve the function of the spleen because of the patient's youth. Laparoscopic partial splenectomy allows the effective removal of lesions and preservation of splenic function. Although more research is needed to clarify the most effective approach, this case is further evidence that this surgical approach may be beneficial for selected patients.
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Affiliation(s)
- F J Tejero-Pintor
- General and Digestive Surgery Department, Rio-Hortega University Hospital , Valladolid , Spain
| | - C Cuesta-De la Llave
- General and Digestive Surgery Department, Rio-Hortega University Hospital , Valladolid , Spain
| | - M Rodriguez-Lopez
- General and Digestive Surgery Department, Rio-Hortega University Hospital , Valladolid , Spain
| | - M Bailon-Cuadrado
- General and Digestive Surgery Department, Rio-Hortega University Hospital , Valladolid , Spain
| | - D Pacheco-Sánchez
- General and Digestive Surgery Department, Rio-Hortega University Hospital , Valladolid , Spain
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Morales-Soriano R, Esteve-Pérez N, Segura-Sampedro JJ, Cascales-Campos P, Barrios P, Alonso-Gómez J, García-Fadrique A, Arjona-Sánchez A, Arteaga-Martín X, Bretcha-Boix P, Camps-Vilata B, Concepción- Martin V, García-Olmo D, Gil-Martínez J, Gómez Portilla A, González-Bayón L, González-Moreno S, Gutiérrez-Calvo A, Martínez-Regueira F, Mayol-Oltra A, Muñoz-Casares C, Padilla-Valverde D, Pacheco-Sánchez D, Parra-Baños P, Pereira-Pérez F, Pérez-Celada J, Ramírez-Plaza C, Ramos-Bernadó I, Torres-Meleroad J, Vaqué-Urbaneja J. Current practice in cytoreductive surgery and HIPEC for metastatic peritoneal disease: Spanish multicentric survey. Eur J Surg Oncol 2018; 44:228-236. [PMID: 29242018 DOI: 10.1016/j.ejso.2017.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/23/2017] [Accepted: 11/16/2017] [Indexed: 01/20/2023] Open
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11
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Pérez-Saborido B, Asensio-Díaz E, Barrera-Rebollo A, Rodríguez-López M, Gonzalo-Martín M, Madrigal-Rubiales B, García-Pajares F, Pacheco-Sánchez D. Graft versus host disease as a complication after liver transplantation: A rare but serious association. Rev Esp Enferm Dig 2016; 108:49-50. [PMID: 26765238] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED The graft versus host disease after liver transplant is rare, with an incidence less than 1%, but with a high mortality (75-85%), especially due to infectious complications. It usually affects gastrointestinal tract, skin and blood system in the context of a normal liver graft function. There is no consensus on the most appropriate treatment: some articles support a reduction or even elimination of immunosuppressive drugs, while others published success with a dose increase. CLINICAL CASE We report a case of a 68 year-old liver transplant recipient with a graft retrieved from an ABO identical cadaveric donor. After an uneventful postoperative period, he was readmitted presenting these symptoms: skin lesions, diarrhea and kidney failure. After ruling out infectious causes or drug toxicity, skin, duodenum and colon biopsies demonstrated characteristic histological changes of graft versus host disease grade III. Initially, supportive treatment along with methylprednisolone bolus were administered with good response. However, as the doses of corticosteroids decreased, the patient worsened again, requiring basiliximab. In spite of that, the patient progressively worsened with hematological involvement and, finally, an alteration of liver function tests prior to decease. The autopsy showed CMV and Herpes virus superinfection. DISCUSSION We report a new case of graft-versus-host disease after liver transplantation with fatal evolution due to viral superinfection despite the employed measures.
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Affiliation(s)
| | - Enrique Asensio-Díaz
- Unidad de Trasplante Hepático/Servicio de Cirugía , Hospital Universitario Rio Hortega, España
| | | | | | - Marta Gonzalo-Martín
- Servicio de Cirugía General y Digestiva, Hospital Universitario Rio Hortega, Valladolid, España
| | | | - Félix García-Pajares
- Servicio de Aparato Digestivo. Unidad de Hepatolog, Hospital Universitario Rio Hortega, España
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Rodríguez-López M, Pacheco-Sánchez D, Gonzalo-Martín M, Velasco-López R, Mambrilla-Herrero S, Bailón-Cuadrado M. Septic shock secondary to colonic fistula as clinical debut of liver hydatid cyst. Rev Esp Enferm Dig 2015; 107:245-246. [PMID: 25824930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Pérez-Saborido B, Pacheco-Sánchez D, Barrera Rebollo A, Pinto Fuentes P, Asensio Díaz E, Labarga Rodriguez F, Sarmentero Prieto J, Martínez Díez R, Rodríguez Vielba P, Gonzálo Martín M, Rodríguez López M, de Anta Román A. Incidence of Hepatic Artery Variations in Liver Transplantation: Does It Really Influence Short- and Long-Term Results? Transplant Proc 2012; 44:2606-8. [DOI: 10.1016/j.transproceed.2012.09.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Pérez-Saborido B, Pacheco-Sánchez D, Barrera-Rebollo A, Sarmentero-Prieto JC, Pinto-Fuentes P, Rodríguez-Vielba P, Asensio-Díaz E, Labarga-Rodríguez F, Sánchez-Antolín G, Anta-Román A. Eight years experience with liver transplantation in Rio Hortega hospital. Transplant Proc 2011; 43:729-31. [PMID: 21486584 DOI: 10.1016/j.transproceed.2011.02.038] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We sought to evaluate our transplant series in light of the parameters outlined in the quality criteria established by the Spanish Hepatic Transplant Society (Sociedad Española de Trasplante Hepático [SETH]). METHODS We retrospectively analyzed 240 hepatic transplantations performed in 223 patients from November 2001 to December 2009. RESULTS Among the series, 57% were in Child class C, 50% had cirrhosis without hepatocellular carcinoma, and 32% had this neoplasm. The most common cause for the illness was alcohol, followed by a virus, namely hepatitis C virus in 76% of cases. The average waiting list time was 45.14 days. The total graft ischemia averaged 460 minutes (range, 265-937). The 4.1% (n = 10), incidence of an urgent retransplantation was mainly due to primary graft failure or arterial thrombosis. During the perioperative period the mortality rate was 2.5% (n = 6) and the 1-month mortality rate was 6.6% (n = 16). The raw survival rates at 1, 3, and 5 years after the operation are 85%, 78%, and 72%, respectively. CONCLUSION Our perioperative as well as the long-term results fall within the quality standards established by SETH.
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Affiliation(s)
- B Pérez-Saborido
- Unit Liver Transplant, Universitary Río Hortega Hospital, Valladolid, Spain
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