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Article ; Online: Use of thoracic fluid content for prediction of fluid balance and postoperative pulmonary complications after major abdominal surgery: an observational study.

Martín-Serrano, P / Alday-Muñoz, E / Planas-Roca, A / Martín-Pérez, E

Revista espanola de anestesiologia y reanimacion

2024

Abstract: Background and objectives: The harmful effects of excess fluids frequently manifest in the lungs. Thoracic fluid content (TFC) is a variable provided by the STARLINGTM bioreactance monitor, which represents the total volume of fluid in the chest. The ... ...

Abstract	Background and objectives: The harmful effects of excess fluids frequently manifest in the lungs. Thoracic fluid content (TFC) is a variable provided by the STARLINGTM bioreactance monitor, which represents the total volume of fluid in the chest. The objective is to analyse the association between the variation in TFC values (TFCd0%) at 24 h postoperatively, postoperative fluid balance, and postoperative pulmonary complications. Material and methods: Prospective and analytical observational study. Patients scheduled for major abdominal surgery at a tertiary teaching hospital were included. They were monitored during the intervention and the first 24 postoperative hours with the monitor. STARLINGTM, measuring TFC and its variation in different stages of the perioperative period. Serial lung ultrasounds were performed and postoperative pulmonary complications were recorded. Logistic regression was performed to predict the occurrence of atelectasis and pulmonary congestion. The Pearson correlation coefficient was calculated to verify the association between TFC and fluid balance. Results: 50 patients were analyzed. TFCd0% measured on the morning of the first postoperative day increased by a median of 27.1% [IQR: 20.3-37.5] and was correlated at r = 0.44 with the postoperative balance of 677 ml [IQR: 125.5-1,412]. Increased TFC was related to a higher risk of atelectasis (OR = 1.24) and pulmonary congestion (OR = 1.3). Conclusions: TFCd0% measured 24 h after surgery presents a moderate correlation with postoperative fluid balance. Its increase is a risk factor for the appearance of postoperative pulmonary complications.
Language	English
Publishing date	2024-03-05
Publishing country	Spain
Document type	Journal Article
ISSN	2341-1929
ISSN (online)	2341-1929
DOI	10.1016/j.redare.2024.03.005
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Article ; Online: Early diverting stoma closure is feasible and safe: results from a before-and-after study on the implementation of an early closure protocol at a tertiary referral center.

Blanco Terés, L / Cerdán Santacruz, C / Correa Bonito, A / Delgado Búrdalo, L / Rodríguez Sánchez, A / Bermejo Marcos, E / García Septiem, J / Martín Pérez, E

Techniques in coloproctology

2024 Volume 28, Issue 1, Page(s) 32

Abstract: Background: Evidence on early closure (EC) of defunctioning stoma (DS) after colorectal surgery shows a favorable effect when patients are carefully selected. Therefore, a clinical pathway adapted to the implementation of an EC strategy was developed in ...

Abstract	Background: Evidence on early closure (EC) of defunctioning stoma (DS) after colorectal surgery shows a favorable effect when patients are carefully selected. Therefore, a clinical pathway adapted to the implementation of an EC strategy was developed in our center. The aim of this study was to carry out a comparative analysis of time until DS closure and DS-related morbidity before and after the implementation of an EC protocol (ECP). Methods: This study is a before-and-after comparative analysis. Patients were divided into two cohorts according to the observational period: patients from the period before the ECP implementation (January 2015-December 2019) [Period 1] and those from the period after that (January 2020-December 2022) [Period 2]. All consecutive patients subjected to elective DS closure within both periods were eligible. Early closure was defined as the reversal within 30 days from DS creation. Patients excluded from EC or those not closed within 30 days since primary surgery were analyzed as late closure (LC). Baseline characteristics and DS-related morbidity were recorded. Results: A total of 145 patients were analyzed. Median time with DS was shorter in patients after ECP implementation [42 (21-193) days versus 233 (137-382) days, p < 0.001]. This reduction in time to closure did not impact the DS closure morbidity and resulted in less DS morbidity (68.8% versus 49.2%, p = 0.017) and fewer stoma nurse visits (p = 0.029). Conclusions: The ECP was able to significantly reduce intervals to restoration of bowel continuity in patients with DS, which in turn resulted in a direct impact on the reduction of DS morbidity without negatively affecting DS closure morbidity.
MeSH term(s)	Humans ; Colorectal Surgery ; Surgical Stomas/adverse effects ; Tertiary Care Centers
Language	English
Publishing date	2024-02-13
Publishing country	Italy
Document type	Comparative Study ; Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-023-02905-z
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Article ; Online: Percutaneous retroperitoneal debridement for the management of pseudocyst after acute necrotising pancreatitis (with video).

Di Martino, M / Brime Menéndez, R / Martín-Pérez, E

Journal of visceral surgery

2019 Volume 156, Issue 5, Page(s) 463–464

MeSH term(s)	Aged ; Debridement/methods ; Humans ; Male ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/surgery ; Pancreatitis, Acute Necrotizing/surgery ; Postoperative Complications/surgery ; Retroperitoneal Space
Language	English
Publishing date	2019-07-17
Publishing country	France
Document type	Case Reports ; Journal Article ; Video-Audio Media
ISSN	1878-7886
ISSN (online)	1878-7886
DOI	10.1016/j.jviscsurg.2019.06.009
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Article ; Online: Infecciones asociadas a enterobacterias productoras de carbapenemasas OXA-48 en pacientes quirúrgicos: consumo de antibióticos y evolución de sensibilidades.

Mora-Guzmán, I / Rubio-Perez, I / Domingo-Garcia, D / Martín-Pérez, E

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia

2020 Volume 33, Issue 6, Page(s) 448–452

Abstract: Objective: To assess antibiotic consumption, susceptibility patterns and targeted treatment for OXA-48 carbapenemase-producing Enterobacteriaceae (CPE) related infections in surgical patients in a General Surgery Department.: Methods: Retrospective ... ...

Title translation	Infections by OXA-48 carbapenemase-producing Enterobacteriaceae in surgical patients: antibiotic consumption and susceptibility patterns.
Abstract	Objective: To assess antibiotic consumption, susceptibility patterns and targeted treatment for OXA-48 carbapenemase-producing Enterobacteriaceae (CPE) related infections in surgical patients in a General Surgery Department. Methods: Retrospective review of patients with a positive culture for OXA-48 and associated clinical data of infection, while hospitalized in a General Surgery Department from January 2013 to December 2018. Results: Sixty-five patients with 66 isolations (OXA-48) were included: Klebsiella pneumoniae, 57 (86.5%); Enterobacter cloacae, 5 (7.6%); Escherichia coli, 3 (4.5%); Morganella morganii, 1 (1.5%). The most frequent source was intra-abdominal infection (n=39, 60%), and previous antibiotic consumption was: piperacillin-tazobactam (48%), meropenem (45%), ciprofloxacin (25.5%), ertapenem (16.5%), imipenem (12%), amikacin (12%), tigecycline (12%). Temporal trends (2013/14, 2015/16 and 2017/18) in susceptibility patterns were (percentages): ceftazidime-avibactam X-X-100; amikacin 100- 96-84 (p=0.518); tigecycline 100-92-80 (p=0.437); colistin 100-67-66 (p<0.001); meropenem 37-64-72 (p=0.214); imipenem 51-41-77 (p=0.109); gentamicin 13-19-18 (p=0.879); ertapenem 35-0-0 (p<0.001). Median duration of the targeted antibiotic therapy was 14 [IQR 9-20] days; antibiotics used were: tigecycline (57%); meropenem (40.5%); amikacin (37.5%); ceftazidime-avibactam (9%); imipenem (7.5%); colistin (7.5%). Global mortality rate at 30 days was 12% (8 patients). Targeted treatment was appropriate (antibiogram) in 87.7%, and targeted combination scheme was administered in 76.9%, which included a carbapenem in 49.2%. Conclusions: OXA-48-related-intra-abdominal infection is significant in surgical patients, with substantial broad-spectrum antibiotic consumption. Useful targeted therapy includes ceftazidime-avibactam, amikacin, tigecycline, meropenem, and imipenem.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Carbapenem-Resistant Enterobacteriaceae ; Enterobacteriaceae Infections/drug therapy ; Humans ; Klebsiella pneumoniae ; Microbial Sensitivity Tests ; Retrospective Studies ; beta-Lactamases
Chemical Substances	Anti-Bacterial Agents ; beta-Lactamases (EC 3.5.2.6)
Language	Spanish
Publishing date	2020-10-16
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1018135-0
ISSN	1988-9518 ; 0214-3429
ISSN (online)	1988-9518
ISSN	0214-3429
DOI	10.37201/req/081.2020
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Article ; Online: Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus.

Carrato, A / Cerezo, L / Feliu, J / Macarulla, T / Martín-Pérez, E / Vera, R / Álvarez, J / Botella-Carretero, J I

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2021 Volume 24, Issue 1, Page(s) 112–126

Abstract: Purpose: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) ... ...

Abstract	Purpose: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. Methods: A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. Results: The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. Conclusions: There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients.
MeSH term(s)	Critical Pathways ; Humans ; Malnutrition/diet therapy ; Malnutrition/etiology ; Nutrition Therapy ; Nutritional Status ; Pancreatic Neoplasms/complications
Language	English
Publishing date	2021-08-07
Publishing country	Italy
Document type	Consensus Development Conference ; Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-021-02674-x
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Article ; Online: Cystic artery pseudoaneurism secondary to acute cholecystitis.

Tovar Pérez, Rodrigo / Di Martino, Marcello / Blanco Terés, Lara / Martín-Pérez, Elena

Cirugia espanola

2022 Volume 100, Issue 3, Page(s) 171

MeSH term(s)	Arteries ; Cholecystitis/complications ; Cholecystitis/surgery ; Cholecystitis, Acute/complications ; Cholecystitis, Acute/surgery ; Gallbladder Diseases ; Humans
Language	English
Publishing date	2022-02-23
Publishing country	Spain
Document type	Journal Article ; Comment
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.cireng.2022.02.009
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Article ; Online: Left-sided portal hypertension due to retroperitoneal fibrosis treated with an oesophagus preserving, modified Sugiura procedure.

Di Martino, M / de la Hoz Rodríguez, A / Real Martínez, Y / Martín-Pérez, E

Annals of the Royal College of Surgeons of England

2019 Volume 102, Issue 2, Page(s) e48–e50

Abstract: Left-sided portal hypertension is a very uncommon condition and retroperitoneal fibrosis has rarely been reported as a cause. We present the case of a 77-year-old man with retroperitoneal fibrosis obstructing the splenic vein and causing recurrent ... ...

Abstract	Left-sided portal hypertension is a very uncommon condition and retroperitoneal fibrosis has rarely been reported as a cause. We present the case of a 77-year-old man with retroperitoneal fibrosis obstructing the splenic vein and causing recurrent episodes of upper gastrointestinal bleeding. Computed tomography showed a retroperitoneal mass as being responsible for the obstruction of the splenic vein, splenomegaly, and diffuse varices around the gastrosplenic and gastrohepatic ligaments. An oesophagus preserving, modified Sugiura procedure was performed with disconnection of the gastric vessels on the lesser curve of the stomach, preserving the pylorus branches of the nerves of Latarjet.
MeSH term(s)	Aged ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/surgery ; Esophagus/blood supply ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/surgery ; Humans ; Male ; Organ Sparing Treatments ; Retroperitoneal Fibrosis/complications ; Retroperitoneal Fibrosis/diagnosis ; Retroperitoneal Space/diagnostic imaging ; Splenectomy ; Stomach/blood supply ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular Surgical Procedures
Language	English
Publishing date	2019-10-29
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2019.0138
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Article ; Online: Results of a national survey about the management of patients with acute uncomplicated diverticulitis.

Correa Bonito, Alba / Cerdán Santacruz, Carlos / Pellino, Gianluca / Fernández Miguel, Tamara / Bermejo Marcos, Elena / Rodríguez Sánchez, Ana / García Septiem, Javier / Martín-Pérez, Elena

Cirugia espanola

2024 Volume 102, Issue 4, Page(s) 202–208

Abstract: Introduction: Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this ... ...

Abstract	Introduction: Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this study is to evaluate the adhesión among national centres to these and others recommendations related to this pathology. Methods: An online national survey, that has been broadcast by several applications, was performed. The results obtained were statistically analysed. Results: A total of 104 surgeons participated, representing 69 national hospitals. Of those, in 82.6% of the centres, outpatient management is performed for acute uncomplicated diverticulitis. 23.2% of the hospitals have a protocol stablished for treatment without antibiotherapy in selected patients. Centres that do not follow these protocols allege that the mean reasons are the logistic difficulties to set them up (49.3%) and the lack of current evidence for it (44.8%). Significative statistical differences have been found when comparing the establishment of such protocols between centres with advanced accredited units and those who are not, with higher rates of outpatient management and treatment without antibiotics in accredited units (p ≤ .05). Conclusions: In spite that this a very common disease, there is a huge national heterogeneity in its treatment. This is why it would adviseable to unify diagnostic and treatment criteria by the collaboration of scientific societies and the simplification of the development of hospitalary protocols.
MeSH term(s)	Humans ; Diverticulitis/therapy ; Anti-Bacterial Agents/therapeutic use ; Ambulatory Care/methods
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-02-08
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.cireng.2023.11.023
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Article ; Online: Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer.

Martin-Perez, E / Domínguez-Muñoz, J E / Botella-Romero, F / Cerezo, L / Matute Teresa, F / Serrano, T / Vera, R

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2020 Volume 22, Issue 11, Page(s) 1963–1975

Abstract: Pancreatic cancer (PC) remains one of the most aggressive tumors with an increasing incidence rate and reduced survival. Although surgical resection is the only potentially curative treatment for PC, only 15-20% of patients are resectable at diagnosis. ... ...

Abstract	Pancreatic cancer (PC) remains one of the most aggressive tumors with an increasing incidence rate and reduced survival. Although surgical resection is the only potentially curative treatment for PC, only 15-20% of patients are resectable at diagnosis. To select the most appropriate treatment and thus improve outcomes, the diagnostic and therapeutic strategy for each patient with PC should be discussed within a multidisciplinary expert team. Clinical decision-making should be evidence-based, considering the staging of the tumor, the performance status and preferences of the patient. The aim of this guideline is to provide practical and evidence-based recommendations for the management of PC.
MeSH term(s)	Consensus ; Endosonography ; Humans ; Neoplasm Staging ; Nutritional Support ; Palliative Care ; Pancreatectomy ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/therapy
Language	English
Publishing date	2020-04-21
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-020-02350-6
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Article ; Online: Surgical Site Infections by OXA-48 Carbapenemase-Producing

Mora-Guzmán, Ismael / Rubio-Perez, Inés / Martín-Pérez, Elena

Surgical infections

2020 Volume 21, Issue 5, Page(s) 473

MeSH term(s)	Carbapenem-Resistant Enterobacteriaceae ; Enterobacteriaceae ; Enterobacteriaceae Infections ; Humans ; Surgical Wound Infection
Language	English
Publishing date	2020-03-11
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1440120-4
ISSN	1557-8674 ; 1096-2964
ISSN (online)	1557-8674
ISSN	1096-2964
DOI	10.1089/sur.2020.028
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