[Microsurgery applied to surgery of Vater's ampulla]. / La microchirurgie appliquée à la chirurgie de la papille de Vater.

Microsurgery, applied to surgery of Vater's papilla, does not represent a new development in surgical technique, but rather propounds the possibility of a new view of infundibular papilla which is of great diagnostic value of biliar disease. We see it as being indicated in all those cases in which surgery of papilla is undertaken. In papilla microsurgery technique exists a first period of diagnosis in which a study is made of the infundibula mucous membrane, allowing one to ascertain the state of the wall and possible affectation of the distal parts of the choledochus and of Wirsung ducts. In the second period, or the strictly surgical, microsurgery constantly achieves control of the papilla and its elements, at the same time being antitraumatic and more objective.

[Prognosis of stage II and III breast cancer in women and critique of various aspects of the TNM system]. / Estudio pronóstico de los estadios II y III del cáncer de mama en la mujer y crítica de algunos aspectos del sistema TNM.

A five-year survival study has been made on 383 patients with breast cancer belonging to the stages II and III of the TNM classification. After the results we consider advisable making a subdivision of these stages forming groups of patients having a similar prognosis in order to apply a statistical treatment to a more homogeneous group and set the treatment on a prognosis basis. In addition it has been considered convenient to transfer the patients classified as T3N0M0 of stage III to stage II attending to their prognosis. Finally, a TNM classification including said concepts is proposed.

[Results of surgical treatment of breast cancer]. / Resultados del tratamiento quirúrgico del cáncer de mama.

The authors make a survival study of 645 patients with breast cancer, giving the per cent survival for stages I, II, III and IV after 5 and 10 years. They indicate that the survival rate may improve taking into consideration the screening of increased risk women, the use of adjuvant operatory chemotherapy, and the application of chemoprophylaxis.