Cirugia Espanola最新文献_第3页

Comparación y combinación de tres fuentes de datos de la historia clínica para determinar la cuantificación óptima de la morbilidad posoperatoria según la Clasificación de Clavien Dindo y el Comprehensive Complication Index. Estudio prospectivo 根据克拉维恩-丁多分类法和综合并发症指数，比较并结合三种病历数据来源，确定术后发病率的最佳量化方法。前瞻性研究

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.03.013

{"title":"Comparación y combinación de tres fuentes de datos de la historia clínica para determinar la cuantificación óptima de la morbilidad posoperatoria según la Clasificación de Clavien Dindo y el Comprehensive Complication Index. Estudio prospectivo","authors":"","doi":"10.1016/j.ciresp.2024.03.013","DOIUrl":"10.1016/j.ciresp.2024.03.013","url":null,"abstract":"<div><h3>Introduction</h3><p>It is currently unknown which data sources from the clinical history, or combination thereof, should be evaluated to achieve the most complete calculation of postoperative complications (PC).</p></div><div><h3>Objective</h3><p>To analyze the morbidity and mortality of 200 consecutive patients undergoing major surgery, to determine which data sources or combination collect the maximum morbidity, and to determine the accuracy of the morbidity reflected in the discharge report.</p></div><div><h3>Methods</h3><p>Observational and prospective cohort study. The sum of all PC found in the combined review of medical notes, nursing notes, and a specific form was considered the gold standard. PC were classified according to the Clavien Dindo Classification and the Comprehensive Complication Index (CCI).</p></div><div><h3>Results</h3><p>The percentage of patients who presented PC according to the gold standard, medical notes, nursing notes and form were: 43.5%, 37.5%, 35% and 18.7% respectively.</p><p>The combination of sources improved CCI agreement by 8%-40% in the overall series and 39.1-89.7% in patients with PC. The correct recording of PC was inversely proportional to the complexity of the surgery, and the combination of sources increased the degree of agreement with the gold standard by 35%-67.5% in operations of greater complexity.</p><p>The CDC and CCI of the discharge report coincided with the <em>gold-standard</em> values in patients with PC by 46.8% and 18.2%, respectively.</p></div><div><h3>Conclusions</h3><p>The combination of data sources, particularly medical and nursing notes, considerably increases the quantification of PC in general, most notably in complex interventions.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

La elección MIR de cirugía general y del aparato digestivo se ha retrasado: análisis del periodo 2018-2022 普通外科和消化道外科 MIR 选举推迟：2018-2022 年期间分析

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2023.08.003

{"title":"La elección MIR de cirugía general y del aparato digestivo se ha retrasado: análisis del periodo 2018-2022","authors":"","doi":"10.1016/j.ciresp.2023.08.003","DOIUrl":"10.1016/j.ciresp.2023.08.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Every year hundreds of medical residents choose their specialization in various surgical fields. However, these numbers have been poorly analyzed. The objective of this study was to evaluate the selection of General and Digestive Surgery by medical residents and compare these results with the selection of other surgical specialties.</p></div><div><h3>Methods</h3><p>Cross-sectional observational study. The data from the selection of the medical residents from surgical specialties and the top 10 most demanded specialties between the years 2018 and 2022 were included. An analysis of adjusted ranking numbers based on the number of available positions was also conducted.</p></div><div><h3>Results</h3><p>The number of available positions in General and Digestive Surgery increased by 17.7% during the study period. However, the selection of our specialty has been delayed, with a median ranking number of 2419 (IQR: 1621–3284) in 2018, and 3484 (IQR: 2306–4156) in 2022 (<em>P</em> = .000). These differences remained significant after adjusting for the number of available positions (<em>P</em> = .000).</p><p>The choice of Urology, Thoracic Surgery, Cardiovascular Surgery, Gastroenterology, and Pediatrics also declined during this period, while plastic surgery, dermatology, ophthalmology, anesthesiology, and endocrinology improved their numbers.</p></div><div><h3>Conclusion</h3><p>The choice of General and Digestive Surgery has been delayed according to the data from the MIR selection of 2018–2022. The increase in the number of available positions has not been associated with a proportional increase in demand.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138613475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

¿Se ha acabado la indicación quirúrgica en los tumores desmoides? 蝶形细胞瘤的手术适应症是否已经结束？

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.03.012

引用次数: 0

Cirugía citorreductora radical y quimioterapia intraperitoneal hipertérmica en el tratamiento de la sarcomatosis peritoneal: resultados de un centro referente y reflexiones sobre la evidencia actual 治疗腹膜肉瘤病的根治性细胞切除手术和腹腔内热化疗：一家转诊中心的结果和对现有证据的反思

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.05.006

{"title":"Cirugía citorreductora radical y quimioterapia intraperitoneal hipertérmica en el tratamiento de la sarcomatosis peritoneal: resultados de un centro referente y reflexiones sobre la evidencia actual","authors":"","doi":"10.1016/j.ciresp.2024.05.006","DOIUrl":"10.1016/j.ciresp.2024.05.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Peritoneal sarcomatosis is a rare disease, with multiple histological origins and poor overall prognosis. The option of radical cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is controversial. The results of a surgical team experienced in these procedures are analyzed and discussed based on the available evidence.</p></div><div><h3>Methods</h3><p>Study on a prospective database of patients with peritoneal sarcomatosis who underwent CRS and HIPEC, from 2016 to 2022, in a national reference center for sarcomas and peritoneal oncological surgery, who met the established inclusion/exclusion criteria.</p></div><div><h3>Results</h3><p>Twenty-three patients were included in the study, with a median age of 53 years (6-68). Recurrent/persistent clinical presentation predominated (78.3%). Visceral origin (including GIST and non-GIST peritoneal) accounted for 47.8% of patients, compared to 43.5% uterine and 8.7% retroperitoneal. The median PCI was 17 (3-36), with CC0 cytoreduction of 87%. Postoperative morbidity (Dindo Clavien III-IV) of 13%, with no postoperative mortality in the series. Overall survival and disease-free survival at 5 years were 64.6% and 34.5%, respectively. Histological grade was the most influential prognostic factor for survival.</p></div><div><h3>Conclusions</h3><p>The results of the series, with low morbidity, support the benefit of radical peritoneal oncological surgery in patients with peritoneal sarcomatosis after adequate selection, as long as it is performed in high-volume centers, experienced surgeons and expert multidisciplinary teams. However, the role of HIPEC remains to be demonstrated and pending future studies.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Herramientas y recursos para la realización de revisiones sistemáticas y meta-análisis 进行系统综述和荟萃分析的工具和资源

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.07.001

引用次数: 0

Análisis de moderadoras en metaanálisis: metarregresión y análisis de subgrupos 荟萃分析中的调节分析：荟萃回归和亚组分析

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.03.006

引用次数: 0

Prolapso gastroesofágico intermitente después de una funduplicatura de Nissen tratada con gastropexia de Hill 采用希尔胃切除术治疗尼森胃底折叠术后间歇性胃食管脱垂

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2024-08-01 DOI: 10.1016/j.ciresp.2024.05.007