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Humans , Female , Aged , Colonic Neoplasms/diagnostic imaging , Colonic Neoplasms/surgery , Adenocarcinoma/pathology , Carcinoma, Neuroendocrine/pathology , Colonic Neoplasms/pathology , Anemia/complications , Colon, Transverse/pathology , Tomography, X-Ray Computed , Colectomy/methods , Cecal Neoplasms/diagnostic imaging , Cecal Neoplasms/pathology
Adenocarcinoma/secondary , Colonic Neoplasms/pathology , Liver Neoplasms/secondary , Neoplasms, Multiple Primary/pathology , Neuroendocrine Tumors/secondary , Adenocarcinoma/surgery , Aged , Anemia/etiology , Cecal Neoplasms/complications , Cecal Neoplasms/pathology , Cecal Neoplasms/surgery , Colectomy , Colonic Neoplasms/complications , Colonic Neoplasms/surgery , Female , Gastrointestinal Hemorrhage/etiology , Hepatectomy/methods , Humans , Liver Neoplasms/surgery , Neoplasms, Multiple Primary/surgery , Neuroendocrine Tumors/surgery
Introducción: El cáncer colorrectal (CCR) constituye un problema sanitario relevante, asociado a una morbimortalidad significativa. A lo largo de las últimas décadas se ha estudiado en profundidad el vínculo que existe entre el cáncer y el estado nutricional e inflamatorio de los pacientes oncológicos, y se han desarrollado múltiples escalas inmunonutricionales, relacionadas principalmente con el pronóstico oncológico de varios tipos de cáncer. Al generarse una interacción entre el tumor y el huésped, se desencadena una reacción inflamatoria sistémica que conduce a una serie de alteraciones neuroendocrinas. Dicha situación favorece una tendencia hacia la anorexia y el catabolismo. Nuestra hipótesis es que el estado nutricional e inflamatorio de los pacientes oncológicos se correlaciona con la morbilidad postoperatoria. Métodos: Este es un estudio observacional y prospectivo de cohortes, con pacientes tratados mediante la cirugía curativa para el CCR en nuestro centro, entre septiembre del 2015 y marzo del 2017. El estado nutricional e inflamatorio de los pacientes fue establecido mediante el uso del Prognostic Nutritional Index (PNI). Las complicaciones (globales, graves, infecciosas y fuga anastomótica) fueron cuidadosamente observadas y registradas durante los 30 primeros días del período postoperatorio. Resultados: Tras llevar a cabo el análisis multivariante, el PNI resultó ser un gran factor predictivo de complicaciones globales (RR: 0,279; IC 95%: 0,141-0,552), complicaciones graves (RR: 0,355; IC 95%: 0,130-0,965), complicaciones infecciosas (RR: 0,220; IC 95%: 0,099-0,489) y fuga anastomótica (RR: 0,151; IC 95%: 0,036-0,640). Conclusiones: Nuestro trabajo refleja que el INP es un factor predictivo independiente para el desarrollo de complicaciones tras la cirugía curativa del CCR
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
Humans , Male , Female , Aged , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Postoperative Care , Prognosis , Nutritional Status , Postoperative Complications , Prospective Studies , Multivariate Analysis , Anastomosis, Surgical , Logistic Models , Middle Aged
Perforation of the gastrointestinal tract caused by the ingested foreign bodies and subsequent hepatic abscess formation is uncommon. Early diagnosis is difficult and the treatment is mainly surgical.
Foreign Bodies/complications , Liver Abscess/etiology , Female , Foreign Bodies/diagnostic imaging , Humans , Liver Abscess/diagnostic imaging , Middle Aged , Pyloric Antrum/diagnostic imaging , Pyloric Antrum/injuries , Tomography, X-Ray Computed
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.
Colorectal Neoplasms/surgery , Nutrition Assessment , Postoperative Complications/epidemiology , Aged , Colorectal Neoplasms/complications , Female , Humans , Inflammation/complications , Male , Morbidity , Postoperative Complications/etiology , Prognosis , Prospective Studies
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Humans , Male , Middle Aged , Solitary Fibrous Tumors/diagnostic imaging , Gastroscopy/methods , Cardia/diagnostic imaging , Lymphadenopathy/diagnostic imaging , Esophagectomy/methods , Esophagogastric Junction/diagnostic imaging , Solitary Fibrous Tumors/pathology , Solitary Fibrous Tumors/surgery , Hematemesis/complications , Hematemesis/etiology , Cardia/pathology , Immunohistochemistry/methods , Lymphadenopathy/pathology , Anastomosis, Surgical/methods , Diagnosis, Differential
Esophagogastric Junction/diagnostic imaging , Solitary Fibrous Tumors/diagnostic imaging , Stomach Neoplasms/diagnostic imaging , Biomarkers, Tumor , Cardia/diagnostic imaging , Cardia/pathology , Cardia/surgery , Diagnosis, Differential , Esophagogastric Junction/pathology , Esophagogastric Junction/surgery , Gastrointestinal Stromal Tumors/diagnosis , Gastroscopy , Hematemesis/etiology , Humans , Male , Melena/etiology , Middle Aged , Solitary Fibrous Tumors/complications , Solitary Fibrous Tumors/pathology , Solitary Fibrous Tumors/surgery , Stomach Neoplasms/complications , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Tomography, X-Ray Computed
Testicular germ cell tumors, though rare (1%), represent the most common neoplasm among young men. Gastrointestinal involvement from these malignancies usually presents as bowel obstruction and digestive bleeding, but their frequency is low (5%). The patterns of this involvement are: infiltration from affected retroperitoneal lymph nodes or, less frequently, by peritoneal seeding and direct hematogenous spread. Particularly, infiltration of duodenum is also rare, though its real frequency is not well defined. Moreover, the affinity for GI tract differs among the histological types of GCT, being seminomatous tumors an exceedingly unfrequent cause of duodenal infiltration. We herein present a recent case in our institution of severe anemia due to gastrointestinal bleeding in the context of giant retroperitoneal bulky metastatic mass infiltrating duodenum as first manifestation of a testicular pure seminoma.
Duodenal Neoplasms/secondary , Neoplasms, Germ Cell and Embryonal/pathology , Seminoma/secondary , Testicular Neoplasms/pathology , Adult , Duodenal Neoplasms/diagnostic imaging , Duodenal Neoplasms/pathology , Gastrointestinal Hemorrhage/etiology , Gastroscopy , Humans , Male , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Neoplasms, Germ Cell and Embryonal/surgery , Seminoma/diagnostic imaging , Seminoma/pathology , Testicular Neoplasms/diagnostic imaging , Testicular Neoplasms/surgery , Tomography, X-Ray Computed
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Humans , Female , Aged , Shock, Septic/etiology , Echinococcosis, Hepatic/complications , Intestinal Fistula/complications , Rupture/complications , Risk Factors
