Advancing common bean (Phaseolus vulgaris L.) disease detection with YOLO driven deep learning to enhance agricultural AI.

Common beans (CB), a vital source for high protein content, plays a crucial role in ensuring both nutrition and economic stability in diverse communities, particularly in Africa and Latin America. However, CB cultivation poses a significant threat to diseases that can drastically reduce yield and quality. Detecting these diseases solely based on visual symptoms is challenging, due to the variability across different pathogens and similar symptoms caused by distinct pathogens, further complicating the detection process. Traditional methods relying solely on farmers' ability to detect diseases is inadequate, and while engaging expert pathologists and advanced laboratories is necessary, it can also be resource intensive. To address this challenge, we present a AI-driven system for rapid and cost-effective CB disease detection, leveraging state-of-the-art deep learning and object detection technologies. We utilized an extensive image dataset collected from disease hotspots in Africa and Colombia, focusing on five major diseases: Angular Leaf Spot (ALS), Common Bacterial Blight (CBB), Common Bean Mosaic Virus (CBMV), Bean Rust, and Anthracnose, covering both leaf and pod samples in real-field settings. However, pod images are only available for Angular Leaf Spot disease. The study employed data augmentation techniques and annotation at both whole and micro levels for comprehensive analysis. To train the model, we utilized three advanced YOLO architectures: YOLOv7, YOLOv8, and YOLO-NAS. Particularly for whole leaf annotations, the YOLO-NAS model achieves the highest mAP value of up to 97.9% and a recall of 98.8%, indicating superior detection accuracy. In contrast, for whole pod disease detection, YOLOv7 and YOLOv8 outperformed YOLO-NAS, with mAP values exceeding 95% and 93% recall. However, micro annotation consistently yields lower performance than whole annotation across all disease classes and plant parts, as examined by all YOLO models, highlighting an unexpected discrepancy in detection accuracy. Furthermore, we successfully deployed YOLO-NAS annotation models into an Android app, validating their effectiveness on unseen data from disease hotspots with high classification accuracy (90%). This accomplishment showcases the integration of deep learning into our production pipeline, a process known as DLOps. This innovative approach significantly reduces diagnosis time, enabling farmers to take prompt management interventions. The potential benefits extend beyond rapid diagnosis serving as an early warning system to enhance common bean productivity and quality.

Aortic Regurgitation: From Valvular to Myocardial Dysfunction.

Chronic aortic regurgitation (AR) leads to volume overload in the left ventricle (LV), which is well tolerated for years. In this condition, the LV usually dilates with minimal reduction in the ejection fraction (EF), even in the absence of symptoms. Echocardiography is the primary imaging test used to quantify AR. However, no single assessment of Doppler measures is accurate and precise in individual patients; therefore, the integration of multiple parameters is necessary. Recent guidelines recommend surgical treatment for severe AR in patients who are symptomatic or have an LVEF < 55% and an end-systolic diameter > 50 mm. Nevertheless, advances in imaging technology have improved the quantification of AR and the assessment of LV subclinical dysfunction. It is widely recognized that patients who undergo aortic valve replacement/repair (AVR) due to symptoms or a low LVEF experience worse outcomes than those undergoing AVR for non-Class I indications. In fact, subclinical irreversible myocardial damage may occur in clinically well-compensated and closely monitored patients while awaiting formal surgical indications. This condition could be prevented by the use of multimodal imaging parameters, in particular longitudinal LV strain and magnetic resonance imaging. In addition, better cut-off values for mortality predictors should be established. This review aims to identify simple models that integrate several echocardiographic and cardiac magnetic resonance-derived parameters to predict the optimal timing of surgical treatment in asymptomatic patients with chronic severe AR.

Registro Nacional Argentino de Resonancia Cardíaca (RENAREC) / Argentine National Cardiac Magnetic Resonance Imaging Registry (RENAREC)

RESUMEN Introducción: La utilidad de la resonancia magnética cardíaca (RMC) ha crecido ampliamente en los últimos años, en los cuales se han publicado distintos registros internacionales sobre su uso e impacto clínico. Sin embargo, no contamos con este tipo de información en Argentina. Objetivo: Evaluar indicaciones, protocolos utilizados, seguridad y consecuencias terapéuticas de la RMC en la República Argentina. Material y métodos: Se diseñó un registro prospectivo a nivel nacional con recolección de datos demográficos, indicaciones de RMC, complicaciones asociadas, diagnósticos y consecuencias terapéuticas. Resultados: Participaron 34 centros de 10 provincias de Argentina (85% centros privados, 59% centros con internación). Se incluyeron 1131 pacientes (edad 54 ± 18 años, 61% varones). Las principales indicaciones para el estudio de RMC fueron la miocardiopatía hipertrófica (13,9%) y la arritmia ventricular (12,3%). El 99,7% de los estudios fueron reportados sin complicaciones. Los resultados más frecuentes de la RMC fueron: normal (31,2%), miocardiopatía no isquémica (14,7%), miocardiopatía isquémico-necrótica (11,6%) y miocardiopatía hipertrófica (8,9%). La sospecha clínica fue confirmada en el 23,6% de los casos y la RMC generó un diagnóstico nuevo no sospechado en el 48,7% de los casos. Las consecuencias terapéuticas más frecuentes fueron el alta hospitalaria (31,6%) seguida por el cambio en la medicación (28,1%). Conclusiones: La RMC es un estudio ampliamente utilizado en Argentina, principalmente en centros privados, con un número muy bajo de complicaciones. Las principales indicaciones son las miocardiopatías (hipertrófica y dilatada) y la arritmia ventricular, y provee un diagnóstico nuevo no sospechado en casi la mitad de los casos. Se requieren de otros estudios en el futuro para evaluar las implicancias clínicas y terapéuticas.

ABSTRACT Background: The usefulness of cardiac magnetic resonance imaging (MRI) has greatly increased in the last years. Different international registries have been published on its use; however, there is no data available from Argentina. Objective: The aim of this study was to evaluate different indications, protocols, safety and therapeutic consequences of cardiac MRI in Argentina. Methods: A prospective national registry was designed with collection of demographic data, indications for cardiac MRI, associated complications, diagnoses and therapeutic consequences. Results: A total of 34 centers from 10 provinces of Argentina (85% private and 59% with inpatient capacity) participated in the study, including 1131 patients (mean age 54±18 years and 61% males). The main indications for cardiac MRI were hypertrophic cardiomyopathy (13.9%), and ventricular arrhythmia (12.3%). In 99.7% of cases, no study complications were reported. The most frequent results of cardiac MRI were: normal (31.2%), non-ischemic cardiomyopathy (14.7%), ischemic-necrotic cardiomyopathy (11.6%) and hypertrophic cardiomyopathy (8.9%). Clinical suspicion was confirmed in 23.6% of cases and cardiac MRI generated an unsuspected new diagnosis in 48.7% of cases. The main therapeutic consequences were hospital discharge (31.6%) followed by change in medication (28.1%). Conclusions: Cardiac MRI is widely used in Argentina, mainly in private centers with a very low incidence of complications. Cardiomyopathies (hypertrophic and dilated) and ventricular arrhythmia are its main indication, and it provides a new unsuspected diagnosis in almost half of the cases. Further studies are required to assess its clinical and therapeutic impact.

Reacciones adversas del tratamiento antirretroviral / Adverse reactions of antiretroviral treatment

Se realizó un estudio descriptivo y transversal para analizar el comportamiento de las reacciones adversas al tratamiento antirretroviral en personas con VIH/SIDA, en la consulta municipal de Morón, entre el año 2000 y 2011; de un universo de 57 casos atendidos en la consulta hasta la fecha, se toma como muestra las 20 personas que asisten a la misma y se encuentran con tratamiento antirretroviral, donde el grupo de edad más afectado es el de 41-45 años, que representa el 30 por ciento. Además, predominaron los que llevan menos de 1 año con tratamiento (45 por ciento), y los que evolucionaron en menos de 1 año del diagnóstico de VIH, a SIDA. El 70 por ciento de los esquemas del tratamiento es a base de 3TC, AZT, NVP. El alcohol y el tabaco se encuentran entre los factores que están presentes en las personas con tratamiento antirretroviral con reacciones adversas. La criptosporidiasis, candidiasis orofaríngea y el herpes zoster, son las infecciones oportunistas que más aparecieron en pacientes con este tratamiento. La polifarmacia está presente en un 60 por ciento de las personas con tratamiento y de ellos el 100 por ciento tuvo reacción adversa a un medicamento; sin embargo, las reacciones adversas y el tratamiento antirretroviral se comportó al 60 por ciento.

[Acute necrotizing pancreatitis by a foreign body. First worldwide report secondary to a match impactation]. / Pancreatitis Aguda Necrotizante por Cuerpo Extraño. Primer caso Reportado SecundariO a un Palillo de Fósforos.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Pancreatitis aguda necrotizante por cuerpo extraño. Primer caso reportado secundario a un palillo de fósforos / Acute necrotizing pancreatitis by a foreign body. First reported case secondary to a match stick

Cuadros de pancreatitis causada por cuerpo extraño son excepcionalmente raros. Se han descrito: agujas, clips quirúrgicos, suturas, hebillas de cinturón, mondadientes, espinas de pescado, plumas de pollo y bezoares. Este es el primer caso reportado en la literatura mundial causado de un palito de fósforo (cerillo). Se trata de una mujer de 73 años con diagnóstico de pancreatitis aguda necrotizante, puntaje Apache en 12, que desarrollo en las siguientes 36 horas de la admisión, hipotensión refractaria, falla renal aguda y muerte. La autopsia mostró necrosis extensa que comprometía todo el páncreas y un cerillo impactado en el conducto de Wirsung. Microscópicamente se evidenció necrosis coagulativa parenquimal, micro_abscesos y un denso infiltrado inflamatorio agudo rodeando al cerillo.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Enfoque interdisciplinario en el tratamiento del Síndrome de Marfan: resultados a 17 años / Interdisciplinary approach of Marfan Syndrome: a 17-year experience

Introducción: el Síndrome de Marfan (SM) es una enfermedad genética de baja prevalencia (1/5.000) individuos). Esta entidad posee características cardiovasculares, esqueléticas y oculares bien definidas. El pronóstico depende fundamentalmente de la dilatación de la raíz aórtica que provoca disección y/o ruptura de la misma. Hay gran desconocimiento sobre este síndrome por parte de los médicos de todas las especialidades. Con la formación de un equipo interdisciplinario diseñamos un registro sobre esta patología, relevando el comportamiento clínico y quirúrgico. Objetivo: registrar la información clínica y evolutiva de los pacientes con SM derivados de diversos lugares de nuestro país a nuestro centro con el fin de lograr una mejor atención de esta patología y detectar la presencia de dilatación de la raíz aórtica. Material y métodos: entre 1992 y 2009 se incluyeron pacientes con diagnóstico de SM de acuerdo a los criterios internacionales establecidos en Ghent. Fueron evaluados por traumatólogos, cardiólogos, cirujanos cardiovasculares, oftalmólogos, nutricionistas, neumonólogos y psicólogos y controlados periódicamente con un programa preestablecido recibiendo tratamiento preventivo médico y/o quirúrgico. Resultados: se evaluaron 273 pacientes, 145 de sexo masculino (53,5%). La edad promedio fue de 25,7 años (2 a 70 años). Las manifestaciones diagnósticas cardiovasculares correspondieron en orden decreciente a: aneurisma de aorta torácica 84 p (30,7%), insuficiencia valvular aórtica 47 p (17,2%), prolapso de válvula mitral 30 sujetos (10,9%) e insuficiencia mitral en 28 (10,2%). 63 % (90 pacientes) requirió cirugía de reemplazo de aorta ascendente. 76 pacientes en nuestro Hospital, el 84 % de las cirugías fueron programadas. Conclusión: la constitución de un equipo interdisciplinario permitió controlar un importante número de pacientes con SM con la detección de un número significativo de casos pasibles de tratamiento preventivo del aneurisma de aorta torácica.

Introduction: Marfan syndrome is a genetic disorder of low prevalence (1/5,000 subjects). This disorder has well defined cardiovascular, skeletal and ocular features. Its prognosis depends mainly on the aortic root dilation leading to its disection and/or rupture. This Syndrome is not well known among physicians of all specialties. In order to study the clinical and surgical characteristics of this disorder, we form an interdisciplinary team and design a registry. Objective: To register the clinical information and evolution of patients with Marfan Syndrome referred from different areas of our country to our Hospital in order to get a better attention of this disorder and to detect the presence of thoracic aorta dilation. Methods: Between 1992 and 2009, patients with Marfan Syndrome were included according to the international criteria established in Ghent. An interdisciplinary team formed by: traumatologists, cardiologists, cardiovascular surgeons, oftalmologists, specialists in nutrition, neumonologists and psychologists, evaluated and controlled the patients periodically with a pre set program receiving medical and/or surgical treatment. Results: it were evaluated 273 patients, 146 male (53,5%). Average age was 25.7 years (2-70 years old). Cardiovascular manifestations were in decreasing order: thoracic aorta aneurysms 84 p (30.7%), aortic valve regurgitation 47p (17.2%), mitral valve prolapse 30p (10.9%) and mitral regurgitation 28 p (10.2%), 90 patients (63%) required replacement of the ascending aorta, 76 were performed in our Hospital, and 84% of the procedures were scheduled. Conclusions: the formation of an interdisciplinary team allowed to control an important number of patients with Marfan Syndrome detecting a significant amount of cases which could be treated with preventive surgery of the thoracic aorta aneurysms, main cause of early mortality.

[An unusual presentation of liver involvement in hereditary hemorrhagic telangiectasia biliary disease]. / Una presentacion inusual de compromiso hepatico en telangiectasia hemorragica hereditaria: enfermedad biliar.

Hereditary Hemorrhagic Telangiectasia is a relatively common, under-recognized autosomal dominant disorder characterized by angiodysplastic lesions that affect multiple organs, like liver. This is a case of a 76 years old woman with history of pain in the lower third of right hemithorax, presence of tiny telangiectases in fingers, lips and tongue, in addition to pain on palpation of right hypochondrium; the initial abdominal ultrasound assessment showed biliary intrahepatic dilation. Patient meets The Diagnostic Criteria of Curacao for Hereditary Hemorrhagic Telangiectasia. The presence of liver arteriovenous malformations was confirmed by DOPPLER-ECHO and CT scan.

Una presentación inusual de compromiso hepático en telangiectasia hemorrágica hereditaria: enfermedad biliar / An unusual presentation of liver involvement in hereditary hemorrhagic telangiectasia biliary disease

Telangiectasia Hemorrágica Hereditaria es un desorden autosómico dominante sub reconocido y relativamente común caracterizado por lesiones angiodisplásicas que afectan múltiples órganos, entre ellos el hígado. Reportamos el caso de una mujer de 76 años de edad con historia de dolor en el tercio inferior del hemitórax derecho, presencia de tenues telangiectasias en pulpejos de dedos de manos, labios y lengua además de dolor a la palpación del hipocondrio derecho; la ecografía abdominal inicial de esta paciente fue compatible con dilatación de la vía biliar intrahepática. La paciente cumple el criterio diagnóstico de Curacao para Telangiectasia Hemorrágica Hereditaria. La presencia de malformaciones arteriovenosas en hígado fue confirmada por ECO-DOPPLER y Tomografía Espiral Multicorte.

Hereditary Hemorrhagic Telangiectasia is a relatively common, under-recognized autosomal dominant disorder characterized by angiodysplastic lesions that affect multiple organs, like liver. This is a case of a 76 years old woman with history of pain in the lower third of right hemithorax, presence of tiny telangiectases in fingers, lips and tongue, in additionto pain on palpation of right hypochondrium; the initial abdominal ultrasound assessment showed biliary intrahepatic dilation. Patient meets The Diagnostic Criteria of Curacao for Hereditary Hemorrhagic Telangiectasia. The presence of liver arteriovenous malformations was confirmed by DOPPLER-ECHO and CT scan.

Surgical treatment of ascending aortic complications in Marfan syndrome: early and long-term outcomes.

Findings in 54 patients (mean age 39 years, range 18-66 years, 25% female) were analyzed. Of these patients, 21 had dissection of the ascending aorta (15 acute and six chronic) and 33 had aneurysm of the ascending aorta. Surgery was classified as emergency surgery in three cases, as urgent in 15, and as scheduled surgery in 36. The Bentall-De Bono procedure was performed in 39 patients, aortic valve reimplantation was carried out in nine, Cabrol's operation was performed in three, and a homograft was used in three. The mean diameter of the ascending aorta was 66.6 mm. Overall, in-hospital mortality was 3.7% (33.3% for emergency surgery vs. 2.8% for scheduled surgery; P< .001). During the mean follow-up period of 4 years (range, 2 months-14 years), seven patients died, including four who died due to type-B aortic dissection. The actuarial survival rate at 2, 5 and 10 years was 94%, 83% and 75%, respectively, with 88%, 67% and 43% of patients, respectively, not requiring reoperation. Elective aortic root replacement was associated with a low risk and a good survival rate.

Immunotherapy for patients with persistent allergic rhinitis unsatisfied with free chronic pharmacotherapy.

BACKGROUND: Chronic pharmacotherapy is recommended to patients with persistent moderate-severe (PM-S) allergic rhinitis (AR). The cost of pharmacotherapy is the main barrier to achieve symptoms control. AIMS OF THE STUDY: To determine the benefits of mite subcutaneous immunotherapy (SIT) in patients with PM-S AR not satisfied with chronic pharmacotherapy received free of charge. METHODS: Open study with seven (7) patients with PM-S AR not satisfied with chronic pharmacotherapy. Prior to enrollment patients had received monthly for more than five months and free of charge, optimal pharmacotherapy. We compared, off pharmacotherapy, symptoms and quality of life (QOL) before and during SIT. RESULTS: Mite SIT improved nasal symptoms, non nasal symptoms and QOL. Off pharmacotherapy patients reported adequate control of symptoms and were satisfied. CONCLUSIONS: Not all patients with PM-S AR are satisfied with chronic pharmacotherapy, even if medication is received free of charge. SIT control symptoms and satisfies patients with PM-S AR unsatisfied with free chronic pharmacotherapy.

Interfacial properties of a synthetic peptide derived from hepatitis G virus E2 protein: interaction with lipid monolayers.

A useful approach to get information about the potential fusogenic ability of virus synthetic peptides is the study of its interfacial properties and subsequent study in mono- and bilayers. In this work, we have characterized by means of physicochemical tools (i.e. compression isotherms and surface activity) the sequence 267-284, LLGTEVSEVLGGAGLTGG, derived from the E2 structural protein of HGV/GBV-C. The adsorption of the peptide at the air/water interface was monitored by following the increase in surface pressure as a function of time at two different pH values: 5 and 7. Parameters such as surface excess or molecular area were calculated from the equation of Gibbs. The peptide showed a tendency to migrate to the surface of a saline-buffered solution. It formed stable monolayers at the air/water interface giving a compression isotherm with a shape consistent with that of some alpha-helical peptide conformations. Brewster angle microscopy (BAM) showed that through compression the peptide formed multilayers. The studies with lipid monolayers (DPMC, DMPC/DMPG, and DMPC/DMTAP) showed that the peptide interacts with all the lipids assayed producing a marked disrupting effect upon them. In these effects electrostatic interactions seem to have some participation.

Perturbations induced by synthetic peptides from hepatitis G virus structural proteins in lipid model membranes: a fluorescent approach.

The name HGV/GBV-C remains as an acronym for hepatitis G virus (HGV) and GB virus-C (GBV-C), strain variants of this enveloped RNA virus independently but simultaneously discovered in 1995. Nowadays there is no evidence that it causes hepatitis in humans either during initial infection or after long-term carriage, but it has been recently related with HIV regarding the inhibition of progression to AIDS. The overall genomic organization of HGV/GBV-C is similar to that of hepatitis C virus (HCV) and other members of the Flavivirus family in Hepacivirus genus. Although a stretch of conserved, hydrophobic amino acids within the envelop glycoprotein of HCV has been proposed as the virus fusion peptide, the mode of entry of GBV-C/HGV into target cells is at present unknown. In the present work, sequences derived from the structural E2-protein of HGV/GBV-C have been selected by means of semiempirical methods and then synthesized manually following solid-phase methodologies. Their ability to induce perturbations in model membranes has been analysed by measuring the penetration of such peptides in lipid monolayers and by a series of experiments based on tryptophan peptide fluorescence emission spectra. Besides, release of vesicular contents to the medium was monitored by the ANTS/DPX assay. The membrane destabilization properties of these peptides was found very related with the length of the sequence.

Epilepsia, un problema de salud pública internacional / Epilepsy: an international public health problem

La epilepsia es el desorden neurológico serio más común y es una de las enfermedades no-comunicables y más prevaleciente en el mundo. Las proporciones de incidencia edad-ajustadas del primer rango de epilépticos son, de 18.9 a 190 por 1000,000 habitantes, mientras el predominio perpetuo global va de 3.5 a 10.7. Las personas con epilepsia tienen un riesgo mayor de muerte comparado con aquellos que no tienen epilepsia. El programa the WHO - Global Burden of Disease estima al agregado de carga debido a la epilepsia a 1 por ciento de la carga de la enfermedad total en el mundo. Aunque la mayoría de los pacientes con epilepsia puede lograr controlar la enfermedad con medicinas, aproximadamente 85 por ciento de la carga global de epilepsia está en los países en vías de desarrollo, donde la mayoría de las personas con epilepsia no logran la atención médica en absoluto. A pesar de los programas del lanzamiento por las organizaciones internacionales, la epilepsia sigue siendo no sólo un problema para el desarrollo sino también para los países en vías de desarrollo. La educación de la comunidad así como el entrenamiento de obreros del cuidado de salud es esencial. La campaña lanzada por las organizaciones mundiales, incluyendo al ILAE,IBE y WHO, da una ventana de oportunidad con indescriptibles características para intervenir.

Carcinoma folicular del tiroides minimamente invasor / Minimally invasive follicular thyroid carcinoma

Se analiza el problema del tratamiento del carcinoma folicular encapsulado mínimamente invasor realizandose la correlación con los grupos de riesgo. Se destaca el excelente pronóstico de los pacientes con este tipo de carcinoma y en situaciones de bajo riesgo. El estudio de una serie personal de 16 casos en la que predominaron los pacientes de bajo riesgo (81,2 por ciento); en ellos se realizo tiroidectomías conservadoras en 92 por ciento y radioyodo ablativo solamente en 46 por ciento. Se logró un seguimiento de 62,5 por ciento de los operados con 70 por ciento mayor a los 5 años, no hubieron en la serie recidivas, metástasis ni muertes. Se propone como tratamiento de elección la lobectomía en situaciones de bajo riesgo (salvo patología del otro lóbulo) y la tiroidectomía casi total en los de alto riesgo. La tiroidectomía total y el radioyodo se reservan para los carcinomas invasores o con rotura capsular extensa o angioinvasión o ambas, sobre todo en los enfermos de alto riesgo

Bisfosfonatos: aplicaciones actuales en osteoporosis y cáncer / Bisphosphonates: current applications in osteoporosis and cancer therapy

Los bisfosfonatos son compuestos antirresortivos con alta afinidad por los cristales de hidroxiapatita y no son degradados por las pirofosfatasas. Sus principales indicaciones son el tratamiento de la osteoporosis posmenopáusica, la inducida por corticoides, enfermedad de Paget, hipercalcemia asociada a neoplasias y la enfermedad osteolítica del hueso por cáncer.

Esofagectomía transhiatal. Experiencia del Hospital Pasteur en su aplicación en el cáncer de esófago inferior / Transhiatal esophagectomy. Experience at Hospital Pasteur in applying it for cancer of the lower esophagus

Se expone la experiencia del Hospital Pasteur en el tratamiento de pacientes portadores de cáncer de tercio inferior de esófago mediante esofagectomía transhiatal. Para ello, se realizó un estudio retrospectivo sobre un total de 24 pacientes a los que se realizó dicho procedimiento. Se analizó la presentación clínica, el tipo histológico y en especial el procedimiento quirúrgico, señalando algunas características distintivas del procedimiento. Se analizaron las complicaciones intra y posoperatorias y la mortalidad del procedimiento, comparándolas con la morbimortalidad que aparece en la bibliografía. Se concluye que la esofagectomía transhiatal es una alternativa válida para el tratamiento del cáncer de tercio inferior de esófago, con claras ventajas frente a la esofagectomía transtorácica por su baja morbimortalidad, similar a la señalada en la literatura