Distribución Topográfica y Manejo de Tumores Neuroendocrinos del Tubo Digestivo / Topographic Distribution and Management of Neuroendocrine Tumors of the Digestive Tube

Introducción: Los tumores neuroendocrinos (TNE) son un grupo de neoplasias que se originan a partir de células enterocromafínicas, especialmente ubicadas en el tubo digestivo. El objetivo del presente estudio es escribir la distribución topográfica, el manejo multidisciplinario y diagnóstico patológico según la OMS de los tumores neuroendocrinos del tubo digestivo. Métodos: El presente es un estudio descriptivo, retrospectivo de los casos con diagnóstico anatomopatológico confirmado de tumor neuroendocrino localizados en el tubo digestivo entre enero del 2011 a diciembre del 2018 en el Instituto Oncológico Nacional del Ecuador- SOLCA de Guayaquil. Se describe topografía y tipo de tratamiento establecido con frecuencias y porcentajes. Resultados: Ingresaron al estudio 21 casos. La localización más frecuente fue el apéndice cecal n = 8 (38 %), en estómago n=4 (19 %), intestino delgado n=3 (14 %). El diagnóstico patológico en estadio G1 (65 %); G2 (24%) y G3 (12%). La primera línea de tratamiento fue la cirugía con intención curativa n=19 (90.5 %) y tratamiento endoscópico n=2 (9.5 %). Los pacientes sometidos a cirugía, n=16/19; (84 %) obtuvieron niveles de resección 0 (R0) y permanecieron en observación clínica, los demás sujetos en el estudio recibieron tratamiento adyuvante con somatostatina sola n=1 (4.8 %) o combinación de somatostatina y radioterapia n=2 (9.5 %). Conclusión: El diagnóstico de tumor neuroendocrino de tubo digestivo es una etiología oncológica poco frecuente. El tratamiento quirúrgico en esta serie de casos está enfocada en una acción curativa de tipo quirúrgico.

Introduction: Neuroendocrine tumors (NETs) are a group of neoplasms that originate from enterochromaffin cells, especially located in the digestive tract. The objective of the present study is to write the topographic distribution, the multidisciplinary management and pathological diagnosis according to the WHO of the neuroendocrine tumors of the digestive tract. Methods: This is a descriptive, retrospective study of the cases with a confirmed anatomopathological diagnosis of neuroendocrine tumor located in the digestive tract between January 2011 to December 2018 at the National Oncology Institute of Ecuador- SOLCA of Guayaquil. The topography and type of treatment established with frequencies and percentages are described. Results: 21 cases were entered into the study. The most frequent location was the cecal appendix n = 8 (38%), stomach n = 4 (19%), small intestine n = 3 (14%). The pathological diagnosis in stage G1 (65%); G2 (24%) and G3 (12%). The first line of treatment was surgery with curative intent n = 19 (90.5%) and endoscopic treatment n = 2 (9.5%). Patients undergoing surgery, n = 16/19; (84%) obtained resection levels 0 (R0) and remained under clinical observation, the other subjects in the study received adjuvant treatment with somatostatin alone n = 1 (4.8%) or combination of somatostatin and radiotherapy n = 2 (9.5%). Conclusion: The diagnosis of neuroendocrine tumor of the digestive tract is a rare oncological etiology. The surgical treatment in this series of cases is focused on a surgical action of a surgical type.

Heterotopía Gástrica Rectal. Reporte de un Caso / Rectal Gastric Heterotopia. A Case Report

La mucosa gástrica heterotópica es una alteración caracterizada por la presencia de mucosa gástrica fuera del estómago siendo la ubicación más frecuente en esófago. La heterotopía gástrica del recto es un hallazgo infrecuente, con sólo 50 casos reportados hasta el momento, descripta por primera vez en 1939. A continuación, describimos un caso de heterotopía gástrica en recto haciendo una breve actualización de las manifestaciones, posibles etiologías y opciones terapéuticas.

Heterotopic gastric mucosa is an anomaly that is characterized by the appearance of gastric mucosa out of the stomach, usually in the esophagus. The gastric heterotopia in rectum is a rare finding -of which only 50 cases reported so far- that was first described in 1939. Below, we describe a case of gastric heterotopia in rectum briefly updating the manifestations, possible causes and therapeutic options.

Expression of P53, HER2 and Ki67 proteins in rats subjected to bladder augmentation with stomach, colon and ileum

PURPOSE: To study the expression of HER2, p53 and Ki67 proteins in cystoplasties. METHODS: Sixty rats were distributed randomly into three groups of 20 animals. Bladder augmentation was held to increase with ileum (Group I), colon (Group II) and stomach (Group III). Tissue samples of neobladder was collected from each rat to its own control. The animals were sacrificed after 12 weeks. The neobladder was withdrawn for immunohistochemitry analysis of p53, HER2 and Ki67 expression. Wilcoxon and Mann-Whitney tests were used for statistical study. RESULTS: There were no significant changes in the expression of p53 and HER2 proteins. It was observed significant increase (p<0.0001) in Ki67 expression in all groups, when compared with their respective controls. When the study groups were compared with each other, there was increase of cell proliferation in the largest gastrocystoplasties in respect of ileocystoplasties (p=0.004) and colocystoplasties (p=0.003). CONCLUSION: We observed significant increase of cell proliferation characterized by Ki67 protein in the digestive tract of the ileocystoplasties, the colocystoplasties and the gastrocystoplasties and this increase was significantly greater in gastrocystoplasties.

Historia de la coloproctología: con especial referencia en Tucumán / History coloproctology: with particular reference in Tucumán

En este trabajo, en la primera parte se hacen algunas referencias sobre la Proctología o Coloproctología, como se la designa actualmente, a lo largo de la historia del hombre y a continuación tras una breve síntesis del desarrollo de la misma en Argentina realizamos un análisis del inicio y progreso de la especialidad en Tucumán destacando la figura del Dr. Julio U. Leites a quien consideramos el iniciador de la especialidad en Tucumán, objetivo principal de este trabajo. Finalizamos el mismo describiendo el posterior desarrollo de la coloproctología en la Sala 1 del Hospital Ángel C. Padilla.

In the first section of this report some facts about the history of Coloproctology are been referred. Afterwards through the story of mankind, a brief summary of the development in Argentine of the specialization and its competences is done. We have mentioned and analyze the beginning and progress of this branch of the surgery in Tucuman, remarking of Dr. Julio U. Leites figure, who is the very first surgeon in practice Proctology seriously and professionally. The last part of the article is to describe the beginning of Coloproctology at Angel C. Padilla Hospital.

Doenças do trato gastrintestinal / Gastrointestinal diseases

O trato gastrintestinal é um tubo que está em continuidade com o meio ambiente externo em ambas as extremidades. Essa via mede de 7 a 8 metros de comprimento. Ela se estende desde a boca passando através do esôfago, do estômago e dos intestinos, vai até o ânus. Com o processo de envelhecimento, começam a ocorrer alterações que vão influenciar o processo digestivo