Manometric comprobation of esophagogastric junction competence after Nissen fundoplication and its relation to the length of fundic wrap.

We present 98 patients operated on by two techniques of 360-degree fundoplication due to gastroesopagheal reflux disease and divided in two groups: Group I comprised those who were given a conventional valve 5 cm in length, and group II underwent a short fundoplication that did not surpass 1.5 cm. All were subjected to preoperative esophageal manometry, with determination of the pressure and length of the lower esophageal sphincter (LES) and the motor behavior of the esophageal body. The postoperative manometric results are analyzed, checking that after fundoplication there was a significant increase in tone and length of the LES (p < 0.00005); there were no differences between the two groups (p = 0.9920 and p = 0.2160, respectively). The motor function of the esophageal body did not change after surgery. We conclude that even the smallest length of the fundic wrap does not cause a reduction in the pressure and length of the manometric LES; that is, the antireflux effectiveness, measured by manometry, did not depend on the anterior length of the valvuloplasty.

[Reoperation after failure of gastroesophageal reflux surgery]. / Reintervenciones tras fracaso de la cirugía del reflujo gastroesofágico.

We present 28 patients who underwent surgery after failed procedures due to gastroesophageal reflux with an asymptomatic period over 2.6 years. The most frequent complications resulted in recurrent reflux (86%) and peptic strictures (36%). An abdominal approach was used on all the patients. Reoperation, using the Collis-Nissen gastroplasty (19 cases), Nissen 360 degrees (3 cases), duodenal diversion with Roux-en-Y (3 cases) and Angelchick prothesis (3 cases) gave excellent or good results in 84% of the patients and poor in 4 cases. There was one operative death. All patients were referred for 24 hour pH-monitoring. Sphincter pressure and length of the distal esophageal sphincter were significantly increased over the preoperative values. Our results suggest that the Collis Nissen procedure is a suitable form of treatment for complicated forms of peptic esophagitis after the failed antireflux operations.

[Splenic hydatidosis: presentation of 8 cases and review of the literature]. / Hidatidosis esplénica: presentación de 8 casos y revisión de la literatura.

A retrospective revision of 8 splenic hydatid cyst cases which underwent surgery in our Department over a period of 19 years is presented. Its rareness, clinical and diagnostic aspects, as well as the association to hydatidosis in other organs are pointed out presenting the results of surgical treatment and patients' evolution.

[Nonchromaffin neurogenic tumors of the intestinal tract. A report of 2 cases and their relation to von Recklinghausen's neurofibromatosis]. / Tumores neurogénicos no cromafines del tracto intestinal. Aportación de dos casos y estudio de su relación con la neurofibromatosis de von Recklinghausen.

Two patients with neurogenic gastrointestinal tumors are reported. One of them was a gangliocytic paraganglioma of the duodenum. The second one, a jejunal tumors in a patient with Von Recklinghausen's disease (ganglioneuroma). The neural crest origin of these tumours is discussed.

[Primary retroperitoneal tumors. Review of 34 cases]. / Tumores retroperitoneales primarios. Revisión de 34 casos.

Thirty four cases of primary retroperitoneal tumors treated in our hospital during a period of thirteen years are presented. The predominant clinical picture consisted of abdominal pain (57%) and paraneoplasic syndrome (42.8%) with palpable abdominal mass in 79.4% of patients. We highlight the diagnostic value of TAC and ultrasound in these lesions. Surgical treatment was performed in 33 patients, 19 patients underwent radical resection, 3 partial resection and a biopsy was performed in 12 patients. The relapse index after radical surgery was 68.4%. Chemotherapy and/or radiotherapy was given to 70.5% of the patients. The five year survival for solid tumors was 10%.

[Primary tumors of the small intestine]. / Tumores primarios del intestino delgado.

We made a retrospective analysis of 43 cases of primary tumor of the small intestine, 28 benign and 15 malignant, diagnosed and treated in our hospital over a period of 18 years. A preoperative diagnosis was reached in 13 cases (30%), while in 37.2% the tumor was a casual finding during operation by other methods. The remaining 32.5% debuted as acute abdomen and were an emergency surgical indication. Simple tumoral resection was practiced in 19 cases (44.1%) of benign tumor, intestinal resection with end-to-end anastomosis in 22 cases (51%) and only biopsy in two cases (4.6%). Coadjuvant chemotherapy was given to five patients (11.5%) and radiotherapy to one (2.3%). The one-year survival for malignant tumors was 73%, and only 18% (2 cases) survived more than 5 years after the operation).