Cirugia Espanola最新文献

{"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":"102 8","pages":"Pages 426-432"},"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}

{"title":"¿Se ha acabado la indicación quirúrgica en los tumores desmoides?","authors":"","doi":"10.1016/j.ciresp.2024.03.012","DOIUrl":"10.1016/j.ciresp.2024.03.012","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 8","pages":"Pages 464-465"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132416","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}

{"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":"102 8","pages":"Pages 408-416"},"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}

{"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":"Francisco Cristóbal Muñoz Casares ,&nbsp;Francisco Javier Padillo Ruiz ,&nbsp;Carlos González de Pedro ,&nbsp;José Gómez Barbadillo ,&nbsp;Javier Martín Broto ,&nbsp;Francisco Almoguera González ,&nbsp;Daniel Díaz Gómez ,&nbsp;Juan Ángel Fernández-Hernández ,&nbsp;José Antonio González López ,&nbsp;José Manuel Asencio Pascual","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":"102 8","pages":"Pages 433-442"},"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}

{"title":"Herramientas y recursos para la realización de revisiones sistemáticas y meta-análisis","authors":"Roser Bono ,&nbsp;Maria J. Blanca","doi":"10.1016/j.ciresp.2024.07.001","DOIUrl":"10.1016/j.ciresp.2024.07.001","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 8","pages":"Pages 444-445"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951515","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}

{"title":"Análisis de moderadoras en metaanálisis: metarregresión y análisis de subgrupos","authors":"Julio Sánchez-Meca ,&nbsp;Juan Botella","doi":"10.1016/j.ciresp.2024.03.006","DOIUrl":"10.1016/j.ciresp.2024.03.006","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 8","pages":"Pages 446-447"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951516","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}

{"title":"Prolapso gastroesofágico intermitente después de una funduplicatura de Nissen tratada con gastropexia de Hill","authors":"Camilo José Castellón Pavón ,&nbsp;Alejandro García Muñoz-Najar ,&nbsp;Flor María Fernández Gordon Sánchez ,&nbsp;Silvia Sánchez Infante Carriches ,&nbsp;Manuel Durán Poveda","doi":"10.1016/j.ciresp.2024.05.007","DOIUrl":"10.1016/j.ciresp.2024.05.007","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 8","pages":"Pages 461-463"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951520","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}

{"title":"Conformidad: El actor oculto en las decisiones quirúrgicas","authors":"Alvaro Sanabria ,&nbsp;Carlos Betancourt ,&nbsp;Luis Carlos Domínguez","doi":"10.1016/j.ciresp.2024.04.010","DOIUrl":"10.1016/j.ciresp.2024.04.010","url":null,"abstract":"<div><p>Conformity in decision making has a relevant impact in surgical environments. This manuscript reveals how group opinions can distort the surgeon's individual judgment, even in critical situations. Two key phenomena are analyzed: communication cascades and group polarization, which amplify conformity and lead to extreme and sometimes harmful decisions.</p><p>It is important to highlight the importance of evidence-based education, critical thinking, and diversification of information sources to counteract the negative effects of conformity. Self-identifying conformist tendencies, encouraging open debate, and implementing constructive dissent strategies can help mitigate the effects of conformity on decision making. Reviewing authority models and promoting diversity in surgical settings can improve decision making and the quality of patient care.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 7","pages":"Pages 381-384"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138481","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}

{"title":"Cirugía digital","authors":"Miguel Toledano Trincado ,&nbsp;Salvador Morales-Conde ,&nbsp;Juan Bellido-Luque ,&nbsp;Mario Álvarez Gallego","doi":"10.1016/j.ciresp.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.ciresp.2024.06.001","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 ","pages":"Pages S1-S2"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582651","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}

{"title":"The surgical metaverse","authors":"Kabir Matwala ,&nbsp;Taner Shakir ,&nbsp;Chetan Bhan ,&nbsp;Manish Chand","doi":"10.1016/j.ciresp.2023.10.004","DOIUrl":"https://doi.org/10.1016/j.ciresp.2023.10.004","url":null,"abstract":"<div><p>Recent developments have seen acceleration in the development of virtual reality (VR) and augmented reality (AR) technology. Through these developments, the metaverse has emerged. Within the metaverse, users create an avatar to experience an immersive, interactive extended reality. Current front-runners in its implementation are the financial, communication and entertainment sectors. This technology, however, is receiving greater recognition in the medical world, with national and international surgical bodies acknowledging the benefits that VR and the metaverse will have on surgical training and patient care. Its versatility means that we are likely to see VR related technology become intimately woven into the fabric of surgery in the next two decade. In this article, the impact of the metaverse on the surgical field will be discussed.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 ","pages":"Pages S61-S65"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0009739X23002312/pdfft?md5=e8ed4ffc5b1d90e85ad9ac7c86fd756a&pid=1-s2.0-S0009739X23002312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141583228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}