Laparoscopic gastrectomy for gastric adenocarcinoma. Long-term results.

BACKGROUND: The objective of our paper is to report on the long-term results of patients with gastric cancer treated by mini-invasive surgery with "intention-to-treat" laparoscopy. PATIENTS AND METHODS: Between June 1993 and January 2006, 130 patients comprising 94 men and 36 women with gastric adenocarcinoma were prospectively selected by two surgical teams in three hospitals based on a prior agreement (CHU Charleroi, Belgium, Centre Hospitalier de Luxembourg and Zumárraga Hospital, Spain). Patients with adenocarcinoma of the cardia were excluded. Mean age of patients was 68 years (range, 37-85 years). RESULTS: Post-operative mortality within 60 days of operation was 6 patients; 109 patients were therefore properly followed up for an average of 49 months (range, 2-153 months).Average survival time for 10 non-resected patients was 4.5 months. Average survival rate for all 14 palliatively resected patients was 6.9 months. Actuarial 5-year survival rate for R0-type surgery was 35%. Global actuarial 5-year survival rate after resective surgery was 31%. CONCLUSIONS: Laparoscopic gastrectomy with any kind of lymphadenectomy is a major but safe operation with acceptable mortality and morbility rates in patients with advanced gastric cancer, usually in poor general condition. Laparoscopic gastrectomy for locally advanced cancers is equivalent to laparotomy as far as long-term oncological results are concerned.

Sodium and chlorine concentrations in mixed saliva of healthy and cystic fibrosis children.

Sodium and chlorine concentrations in mixed saliva were simultaneously measured by neutron activation analysis in nine normal children and in nine patients with cystic fibrosis. Sodium levels showed a significant difference (P < 0.01) between patients and control. The concentration of chlorine was similar in both the control and the cystic fibrosis groups.

[Neoplasm invasion of the renal vein by transitional cell carcinoma of the kidney pelvis]. / Invasión neoplásica de la vena renal por Ca. de células transicionales de pelvis renal.

We present two cases of renal pelvis transitional cell carcinoma with invasion of the renal vein. We emphasize the importance of preoperative diagnosis and review the diagnostic methods available for revealing this uncommon eventuality. Owing to the prognostic importance and subsequent surgical treatment, this possibility should be evaluated in those cases of renal pelvis transitional cell carcinoma with extensive parenchymatous invasion or in those cases in which kidney function cancellation occurs in the excretory urograph.

[Ectopic gas as a complication of surgical kidney biopsy]. / Gas ectópico como complicaciones de la biopsia renal quirúrgica.

Since the complications herewith presented as a consequence of surgical renal biopsy are really exceptional and references found in the existing literature rare, we have considered that the contribution of these two cases which developed a pneumomediastinum-pneumoperitoneum and pneumocele prespectively during the immediate post-surgical period would be of interest. Evolution was favourable in both cases, with spontaneous resolution of the process.

[Evolution of pharmaceutical provision in the National Health System (1984-1994)]. / Evolución de la prestación farmacéutica en el Sistema Nacional de Salud (período 1984-1994).

OBJECTIVES: To analyse the free pharmaceutical provision of the National Health Service, using the customary indicators. DESIGN: Longitudinal, retrospective and observational study, embracing the years 1984 to 1994. SETTING: The provision, using official National Health Service prescriptions, of pharmaceutical products via dispensaries. PARTICIPANTS: Prescriptions of the period under study. MEASUREMENTS AND MAIN RESULTS: The measurements for the evolutionary analysis of free pharmaceutical provision were carried out in absolute and relative values. Within the absolutes, public health expenditure on drugs went from 178,348 million pesetas in 1984 to 643,701 million in 1994; and prescriptions from 432 million in 1984 to 494 million in 1994. Beneficiaries' contributions for drugs, as a percentage of overall consumption, went down from 15.75% in 1984 to 9.16% in 1994. The indicators of pharmaceutical prescription placed the cost of sale to the public per prescription in 1994 at 1,446 pesetas, an increase of 195% over 1984, whereas the average expenditure per prescription (1,303 pesetas in 1994) went up by 215%. Expenditure per protected pensioner went from 18,180 pesetas in 1984 to 56,784 in 1994, with an average number of prescriptions per pensioner of 38.04. In this last year the tendency for consumption to fall, begun in 1993. The profiles of the therapeutical sub-groups, which were most consumed in cost terms, displayed large variations. CONCLUSIONS: The structural management measures adopted during the period under study, especially those for 1993 (new VAT on drugs, Royal Decree on Selective Financing of Medicines) and 1994 (average fall of 3% in the free sale price of drugs, collaboration of Dispensaries) are, in our view, those which have most affected the evolution of this free provision.