¿Tiene utilidad el recuento cellular en el cáncer de colon? / In the cell count useful in colon cáncer?

Introducción: Proponemos valorar la utilidad del recuento celular en el cáncer de colon en nuestro medio. Material y Métodos. Realizamos un estudio observacional, analítico, longitudinal y retrospectivo, basado en un esquema de cohortes. Se reclutan a 47 pacientes intervenidos de cáncer de colon en 2015. Se establecieron dos grupos según estadio anato-mopatológico final (grupo 1: estadios 0 y I y grupo 2: estadios II, III y IV) y se recogen sus datos analíticos en distintos momentos. Con los recuentos celulares se calcularon las curvas ROC para varias ratios, para establecer el punto de corte a partir del cual la probabilidad de pertenecer al grupo 1 es más alta. Se forman dos grupos, A y B, según sus valores de ratio y tomando el punto de corte para dividirlos y se comparan factores anatomopatológicos de mal pronóstico, datos quirúrgicos y clínicos. Se describe también el valor de la NLR en pacientes con mala evolución de la enfermedad. Resultados: No encontramos diferencias estadísticamente significativas en la evolución de ambos grupos, A y B, tampoco en cuanto a su relación con factores de mal pronóstico anatomopatológicos o clínicos. Se realiza también un seguimiento de los valores del NLR en pacientes que presentaron recidiva o metástasis, exponiendo resultados descriptivos. Conclusiones. Se trata de una medida sencilla de determinar, por lo que a pesar de no haber encontrado diferencias significativas, valoramos su utilidad cómo elemento informativo y consideramos su interés en demostrar la significancia estadística aumentando tamaño muestral y periodo de seguimiento en trabajos posteriores

Introduction. We propose to evaluate the utility of cell counts in colon cancer in our environment. Material and Methods. We conducted an observational, analytical, longitudinal and retrospective study, based on a cohort scheme. 47 patients were recruited who underwent colon cancer in 2015. Two groups were established according to the final anato-mopathological stage (group 1: stages 0 and I and group 2: stages II, III and IV) and their analytical data were collected at different times. With the cell counts the ROC curves were calculated for several ratios, to establish the cut-off point from which the probability of belonging to group 1 is higher. Two groups are formed, A and B, according to their ratio values and taking the cut-off point to divide them and comparing anatomopathological factors of poor prognosis, surgical and clinical data. The value of the NLR is also described in patients with poor evolution of the disease. Results. We did not find statistically significant differences in the evolution of both groups, A and B, neither in relation to their relationship with poor pathological or clinical prognostic factors. The NLR values were also monitored in patients with recurrence or metastasis, with descriptive results. Conclusions. This is a simple measure to determine, so despite not having found significant differences, we value its usefulness as an informative element and we consider its interest in demonstrating statistical significance by increasing sample size and follow-up period in subsequent studies

El desarrollo de seroma poslinfadenectomía axilar por cáncer de mama y su relación con determinados parámetros del drenaje aspirativo / Development of axillary seroma after lymphadenectomy for breast cancer and its relationship with several parameters of suction drainage

Objetivos. La aparición de seromas axilares es la complicación más frecuente tras la linfadenectomía axilar. En este trabajo estudiamos algunos parámetros relacionados con el uso de drenajes quirúrgicos que podrían resultar predictivos del desarrollo de dichos seromas. Pacientes y método. Se han estudiado, de forma prospectiva, 100 pacientes intervenidas de manera consecutiva por cáncer de mama y en las que se realizó linfadenectomía axilar de los tres niveles como parte de su tratamiento. En todas se colocó en la intervención un drenaje axilar, y se registraron datos sobre el débito y duración de dicho drenaje en el postoperatorio. Estos parámetros se compararon según desarrollaran las pacientes seromas que precisasen punciones evacuadoras. Resultados. Sólo se encontraron diferencias significativas en el débito medio de los tres últimos días de drenaje, encontrándose una relación entre el desarrollo de seromas y más de 50 ml del citado débito. No encontramos diferencias en el resto de parámetros, incluyendo la técnica utilizada. Conclusiones. La retirada del drenaje axilar cuando el débito medio de los tres últimos días es menor de 50 ml, es una medida eficaz a la hora de tratar de evitar el desarrollo de seromas axilares postoperatorios tras linfadenectomías por cáncer de mama (AU)

Tumores carcinoides del apéndice. Análisis clinicopatológico de 58 casos / Carcinoid tumors of the appendix. Clinic-pathologic analysis of 58 cases

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[Intestinal invagination in the adult]. / Invaginación intestinal en el adulto.

Idiopathic intestinal invagination is a relatively frequent process in children in comparison with cases of intestinal obstruction/subocclusion by invagination secondary to a tumor in adults which is unusual and more often observed in patients over the age of 60 years. Two clinical cases of intestinal obstruction in young adult males due to intestinal invagination by a tumor of the small intestine are presented. One case was due to a submucosal lipoma which lead to ileo-ileal intussusception and an ileo-cecal invagination by a terminal ileum lymphoma. The clinical and diagnostic aspects of this infrequent disease are discussed.

[Results of surgical treatment of esophageal cancer (209 cases)]. / Resultados del tratamiento quirúrgico del cáncer de esófago (209 casos).

We present a series of 209 patients with cancer of the esophagus over a 13-year period. Average age was 61.99 years and 87.56% of the patients were male. As for histological type, 59.8% of cases were epidermoid carcinomas and the remaining adenocarcinomas. In 76.55% of cases tumor stage was III or IV. Operability rate was 81.8% and resectability 57.89%. The most frequent resective procedure was oesophagogastrectomy through a right thoracotomy and laparotomy. Reconstruction of digestive continuity was achieved in 86.77% with the stomach; 53.72 of resections were judged to be "radical". Overall postoperative morbidity was 45.61%. Respiratory failure and anastomotic leakage accounted for most of morbidity. Anastomotic leakage was more frequent in patients undergoing bypass, with cervical anastomosis, and when the reconstruction was performed with the colon. Mortality rate was 14.04%, but fell to 7.69% in patients undergoing "radical" resection. Overall 5-year survival was 7.83% and 11.81% in patients undergoing resection. The more relevant prognostic factor was tumour stage; 5-years survival of patients with tumor stage I-II was 27.53%, and 0% for patients with tumour stage II or IV.

Results of surgical treatment of epidermoid carcinoma of the thoracic esophagus.

During 1979 to 1991, 125 patients with epidermoid carcinoma of the thoracic esophagus were admitted to our General Surgery unit. The average age was 60.1 years; 94.4 percent of the patients were male. The mean duration of symptoms was 3.65 months. The most frequent symptom was dysphagia in 97.19 percent, followed by weight loss in 64.48 percent. The most frequent location was the middle one-third in 58.4 percent. The tumor was well differentiated in 27.2 percent, moderately well differentiated in 41.6 percent and poorly differentiated in 31.2 percent. By preoperative staging, 1 patient was stage I, 24 were stage II, 86 were stage III and 14 were stage IV. The operability rate was 76 percent and the resectability rate was 48.8 percent. Resection was "curative" in 42.62 percent and palliative in 57.37 percent. Radiation therapy and chemotherapy were used only in those patients who did not undergo resection. All of the patients in whom resection was possible underwent a single-stage esophagogastrectomy. The postoperative mortality rate was 20 percent, but only 11.54 percent if we only consider those patients who underwent "curative" resection. The most frequent causes of mortality were respiratory complications and anastomotic leakage. The five year overall survival rate was 5.99 percent. In the resected group, the five year survival rate was 8.82 percent and in patients in whom resection was considered "curative," the rate was 20.86 percent.

[Does the ingestion of caustics produce irreversible motor changes in the esophagus? Manometric study of 17 cases]. / Produce la ingesta de cáusticos alteraciones motoras esofágicas irreversibles? Estudio manométrico de 17 casos.

During the acute period of caustic esophagitis, important alterations in esophageal motor function appear. However, it is not known if these alterations persist later. To determine whether motor disorders persist (after the aggression) in the esophagus that has suffered caustic aggression, a manometric study was made in two groups of patients classified as mild (9 cases) or severe esophagitis (8 cases), and results were compared with those of a control group. Patients who had developed stenosis or suffered the caustic aggression less than a year earlier were excluded. The probable existence of motor anomalies could determine the appearance of dysphagia or reduce the effectiveness of motor clearance of the esophageal body, thus conditioning a situation of esophageal defenselessness against physiological or eventual abnormal episodes of gastroesophageal reflux (RGE). Our results indicate that in a variable percentage of cases some peristaltic dysfunctions can persist in the esophageal body in relation to the severity of the initial lesion.