Metástasis pancreáticas por carcinoma renal. Nuestra casuística y revisión de la literatura / Pancreatic metastases due to renal carcinoma. Our cases and a literature review

Analizar los casos de metástasis pancreáticas por carcinoma renal intervenidos en nuestro hospital entre los años 2000 y 2011.Material y métodos Estudio retrospectivo donde se recogen diferentes variables de 8 pacientes con metástasis pancreáticas por carcinoma renal intervenidos. Comparación de nuestros datos con los de la literatura. Resultados La enfermedad metastásica del páncreas por carcinoma renal en nuestra serie ha sido de 1,2%. Todas las metástasis han sido metacrónicas. La afectación por sexo ha sido igual. El tiempo medio entre la resección del tumor renal y el diagnóstico de las metástasis ha sido de 12,42 años (rango: 1,62-30,13 años). La actitud terapéutica ante las lesiones pancreáticas ha sido quirúrgica en todos los casos. Hasta la fecha, 7 pacientes continúan vivos. Conclusión La enfermedad metastásica del páncreas por carcinoma renal es poco frecuente (1-2,8%). El intervalo entre la resección primaria y las metástasis puede ser bastante largo. Siempre debe sospecharse metástasis pancreática en los pacientes que presenten masa pancreática e historia de carcinoma renal. Se recomienda un tratamiento quirúrgico agresivo en casos seleccionados. La cirugía en estos casos mejora la supervivencia y la calidad de vida (AU)

Objective: To analyse the cases of pancreatic metastases due to renal carcinoma operated on in our hospital between the years 2000 and 2011.Material and methods: A retrospective study using the variables of 8 patients who were subjected to surgery of pancreatic metastases due to renal carcinoma, and a comparison of our data with those from the literature. Results: The incidence of metastatic disease of the pancreas due to renal carcinoma in our series was 1.2%. All the metastases were metachronous, with both sexes being affected equally. The mean time between resection of the renal tumour and the diagnosis of the metastasis was 12.42 years (range: 1.62-30.13 years). The therapeutic approach to the pancreatic lesions was surgical in all cases. Seven patients are currently still alive. Conclusion: Metastatic disease of the pancreas due to renal carcinoma is uncommon(1%-2.8%). The interval between the primary resection and the metastasis can be quite long. Pancreatic metastasis must always be suspected in patients who present with a pancreatic mass and a history of renal carcinoma. Aggressive surgical treatment is recommended in selected cases. The surgery in these cases improves survival and the quality of life (AU)

[Pancreatic metastases due to renal carcinoma. Our cases and a literature review]. / Metástasis pancreáticas por carcinoma renal. Nuestra casuística y revisión de la literatura.

OBJECTIVE: To analyse the cases of pancreatic metastases due to renal carcinoma operated on in our hospital between the years 2000 and 2011. MATERIAL AND METHODS: A retrospective study using the variables of 8 patients who were subjected to surgery of pancreatic metastases due to renal carcinoma, and a comparison of our data with those from the literature. RESULTS: The incidence of metastatic disease of the pancreas due to renal carcinoma in our series was 1.2%. All the metastases were metachronous, with both sexes being affected equally. The mean time between resection of the renal tumour and the diagnosis of the metastasis was 12.42 years (range: 1.62-30.13 years). The therapeutic approach to the pancreatic lesions was surgical in all cases. Seven patients are currently still alive. CONCLUSION: Metastatic disease of the pancreas due to renal carcinoma is uncommon (1%-2.8%). The interval between the primary resection and the metastasis can be quite long. Pancreatic metastasis must always be suspected in patients who present with a pancreatic mass and a history of renal carcinoma. Aggressive surgical treatment is recommended in selected cases. The surgery in these cases improves survival and the quality of life.

Ileítis tras colectomía por colitis ulcerosa / Ileitis after colectomy due to ulcerative colitis

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Dehiscencia anastomótica tardía en cáncer colorrectal avanzado tratado con Bevacizumab™ / Delayed anastomotic dehiscence in advanced colorectal cancer treated with Bevacizumab™

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Estenosis anastomóticas benignas en la cirugía radical del cáncer de recto. Resultados del tratamiento con dilatación hidrostática / Benign anastomotic strictures after oncologic rectal cancer surgery. Results of treatment with hydrostatic dilation

Introducción Las estenosis anastomóticas tras cirugía de cáncer de recto son frecuentes y precisan tratamientos desde medidas conservadoras hasta cirugía de resección Pacientes y método De marzo de 2001 a agosto de 2008 se intervinieron 422 carcinomas de recto, en el 83,8% se realizó anastomosis. Se definió la estenosis como la incapacidad de pasar el colonoscopio. Se realizó tratamiento mediante dilatación hidrostática. Se analizaron las diferencias entre los tratamientos con y sin éxito. Resultados Serie de 26 pacientes con estenosis de anastomosis (7,34%). Dieciséis varones y 10 mujeres, con una mediana de 66 años (57–74). Las intervenciones fueron 26 resecciones anteriores: 10 anastomosis término-terminales, 10 lateroterminales, 4 reservorios en J y 2 coloplastias . La mediana de altura de la estenosis fue de 10 cm (4–12). Trece pacientes recibieron radioterapia (RT) preoperatoria (50%). Nueve pacientes portaban ileostomía (34,7%). La mediana de diagnóstico fue 6 meses (3–10). El diagnóstico se realizó: por tacto rectal en 19,2%, por colonoscopia 23,1% y por clínica en 57,7%. Se realizaron una mediana de 2 (1–4) sesiones de dilatación. La mediana de seguimiento fue de 39 meses (23 a 49). El resultado fue bueno en el 88,5% y fracasó en 11,5%. La morbilidad fue del 3,8% (una perforación tras la dilatación). No existió mortalidad. ConclusionesLas estenosis anastomóticas tras cirugía de cáncer de recto son frecuentes (7,05%), suelen originar clínica (52,9%) y pueden tratarse con éxito mediante dilatación en más del 88% de los pacientes (AU)

Introduction Benign anastomotic strictures after rectal cancer surgery are common and their treatment can vary from conservative measures to surgical resection. Patients and methods Between March 2001 and August 2008, 422 patients with rectal cancer underwent anterior resection and 83.8% were treated with primary anastomosis. Anastomotic stricture has been defined as the inability to pass a colonoscope. Hydrostatic balloon dilation was performed. Results of success and failure dilation were assessed. Results Twenty-six patients (7.34%) with anastomotic stricture were treated; 16 men and 10 women, with a median age of 66 years (57–74). A total of 26 anterior resections were performed, as well as 10 end-to-end anastomosis, 10 side-to-end, 4 j-pouch and 2 pouch coloplasties. The median stricture height was 10cms (4–12). Thirteen patients had preoperative radiotherapy (50%), and 9 patients had an ileostomy (34.7%). The median time of diagnosis was 6 months (3–10). The diagnosis was made by: rectal digital examination in 19.2%, colonoscopy 23.1% and clinical symptoms in 57.7%. The median number of dilation sessions required was 2 (1–4). The median of follow-up was 39 months (23 to 49). Results were successful 88.5,% and unsuccessful in 11.5%. Morbidity was 3.8% (one perforation after dilation). There was no mortality. Conclusions Benign anastomotic strictures after rectal cancer surgery are frequent (7.05%), develop symptoms (52.9%) and can be successfully treated by hydrostatic dilation in more than 88% patients (AU)

[Benign anastomotic strictures after oncologic rectal cancer surgery. Results of treatment with hydrostatic dilation]. / Estenosis anastomóticas benignas en la cirugía radical del cáncer de recto. Resultados del tratamiento con dilatación hidrostática.

INTRODUCTION: Benign anastomotic strictures after rectal cancer surgery are common and their treatment can vary from conservative measures to surgical resection. PATIENTS AND METHODS: Between March 2001 and August 2008, 422 patients with rectal cancer underwent anterior resection and 83.8% were treated with primary anastomosis. Anastomotic stricture has been defined as the inability to pass a colonoscope. Hydrostatic balloon dilation was performed. Results of success and failure dilation were assessed. RESULTS: Twenty-six patients (7.34%) with anastomotic stricture were treated; 16 men and 10 women, with a median age of 66 years (57-74). A total of 26 anterior resections were performed, as well as 10 end-to-end anastomosis, 10 side-to-end, 4 j-pouch and 2 pouch coloplasties. The median stricture height was 10cms (4-12). Thirteen patients had preoperative radiotherapy (50%), and 9 patients had an ileostomy (34.7%). The median time of diagnosis was 6 months (3-10). The diagnosis was made by: rectal digital examination in 19.2%, colonoscopy 23.1% and clinical symptoms in 57.7%. The median number of dilation sessions required was 2 (1-4). The median of follow-up was 39 months (23 to 49). Results were successful 88.5,% and unsuccessful in 11.5%. Morbidity was 3.8% (one perforation after dilation). There was no mortality. CONCLUSIONS: Benign anastomotic strictures after rectal cancer surgery are frequent (7.05%), develop symptoms (52.9%) and can be successfully treated by hydrostatic dilation in more than 88% patients.