Influence of simultaneous liver and peritoneal resection on postoperative morbi-mortality and survival in patients with colon cancer treated with surgical cytoreduction and intraperitoneal hyperthermic chemotherapy. / Influencia de la resección hepática y peritoneal simultánea, en la morbimortalidad y supervivencia de los pacientes con cáncer de colon intervenidos mediante cirugía citorreductora con quimioterapia intraperitoneal hipertérmica.

INTRODUCTION: Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (HIPEC) has recently been established as the treatment of choice for selected patients with peritoneal carcinomatosis of colonic origin. Until recently, the simultaneous presence of peritoneal and hepatic dissemination has been considered a contraindication for surgery. The aim of this paper is to analyze the morbidity, mortality and survival of patients with simultaneous peritoneal and hepatic resection with HIPEC for peritoneal carcinomatosis secondary to colon cancer. METHODS: Between January 2010 and January 2015, 61 patients were operated on, 16 had simultaneous peritoneal and hepatic dissemination (group RH+), and 45 presented only peritoneal dissemination (group RH-). RESULTS: There were no differences between the groups in terms of demographic data, length of surgery and extension of peritoneal disease. Postoperative grade III-V complications were significantly higher in the RH+ group (56.3 vs. 26.6%; P=.032). For the whole group, mortality rate was 3.2% (two patients in group RH-, and none in group RH+). Patients with liver resection had a longer postoperative stay (14.4 vs. 23.1 days) (P=.027). Median overall survival was 33 months for RH-, and 36 for RH+ group. Median disease-free survival was 16 months for RH-, and 24 months for RH+ group. CONCLUSIONS: Simultaneous peritoneal cytoreduction and hepatic resection resulted in a significantly higher Clavien grade III-V morbidity and a longer hospital stay, although the results are similar to other major abdominal interventions. The application of multimodal oncological and surgical treatment may obtain similar long-term survival results in both groups.

Balconing: An alcohol-induced craze that injures tourists. Characterization of the phenomenon.

BACKGROUND: Balconing is the term that has been given to consciously jumping into a swimming pool from a balcony or falling from height while climbing from one balcony to another in hotels during holidays METHOD: A 5 years retrospective study was conducted in a tertiary referral centre for severe trauma in the Balearic Islands, where balconing is endemic. Demographic data such as age, sex, nationality, personal records, alcohol or drug consumption, height of the fall and season of the year were collected. Scales of trauma severity and mortality rates were also included. RESULTS: Most of the patients were males, 45 (97.83%), aged 24.20±5.98years, 28 of them of British nationality (60.87%). In 44 (95.65%) cases, alcohol consumption was present accompanied by other drugs in 17 (36.96%) cases. The mean height of the fall was approximately 3 floors. Only 6 (13.04%) were intentional jumpers whereas 40 (86.96%) fell while trying to reach another balcony. CONCLUSION: Balconing is a new injury mechanism for alcohol-related falls from heights. Alcohol and other drug consumption are almost always involved, so balconing could be addressed as another consequence of alcohol abuse and binge drinking.