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  1. Article ; Online: Textbook Outcomes in Liver Surgery: a Systematic Review.

    Sweigert, Patrick J / Ramia, Jose M / Villodre, Celia / Carbonell-Morote, Silvia / De-la-Plaza, Roberto / Serradilla, Mario / Pawlik, Timothy M

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2023  Volume 27, Issue 6, Page(s) 1277–1289

    Abstract: Background: Assessment of the quality of care among patients undergoing hepatectomy may be inadequate using traditional "siloed" postoperative surgical outcome metrics. In turn, the combination of several quality metrics into a single composite Textbook ...

    Abstract Background: Assessment of the quality of care among patients undergoing hepatectomy may be inadequate using traditional "siloed" postoperative surgical outcome metrics. In turn, the combination of several quality metrics into a single composite Textbook Outcome in Liver Surgery (TOLS) may be more representative of "ideal" surgical care.
    Methods: Adhering to PRISMA guidelines, a search for primary articles on post-operative TOLS evaluation after hepatectomy was performed. Studies that did not present hepatectomy outcomes, pediatric or transplantation populations, duplicated series, and editorials were excluded. Studies were evaluated in aggregate for methodological variation, TOLS rates, factors associated with TOLS, hospital variation, and overall findings.
    Results: Among 207 identified publications, 32 observational cohort studies were selected for inclusion in the review. There was a total of 90,077 hepatic resections performed from 1993 to 2020 in the analytic cohort. While TOLS definitions varied widely, all studies used an "all-or-none" composite structure combining a median of 5 (range: 4-7) discrete parameters. Observed TOLS rates varied in the different reported populations from 11.2 to 77.0%. TOLS was associated with patient, hospital, and operative factors.
    Conclusions: This systematic review summarizes the contemporary international experience with TOLS to assess surgical performance following hepatobiliary surgery. TOLS is a single composite metric that may be more patient-centered, as well as better suited to quantify "optimal" care and compare performance among centers performing liver surgery.
    MeSH term(s) Humans ; Child ; Hepatectomy ; Cohort Studies ; Outcome Assessment, Health Care ; Liver ; Liver Neoplasms/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-023-05673-1
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  2. Article ; Online: Short- and long-term outcomes after distal pancreatectomy with radiologic infiltration of splenic vessels for pancreatic ductal adenocarcinoma.

    Blanco-Fernández, Gerardo / Serradilla-Martín, Mario / Rotellar, Fernando / Latorre, Raquel / Jaén-Torrejimeno, Isabel / Muñoz-Forner, Elena / Villodre, Celia / Carabias-Hernández, Alberto / Kälviäinen-Mejía, Helga K / Gordillo, Sara Esteban / de la Plaza, Roberto / Armas-Conde, Noelia De / Garcés-Albir, Marina / Morote, Silvia Carbonell / Manuel-Vázquez, Alba / Serrablo, Alejandro / Pardo, Fernando / Sabater, Luis / Muñoz, María Paloma Sanz /
    Ramia, Jose M

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2024  Volume 28, Issue 4, Page(s) 467–473

    Abstract: Background: The effect of radiologic splenic vessels involvement (RSVI) on the survival of patients with pancreatic adenocarcinoma (PAC) located in the body and tail of the pancreas is controversial, and its influence on postoperative morbidity after ... ...

    Abstract Background: The effect of radiologic splenic vessels involvement (RSVI) on the survival of patients with pancreatic adenocarcinoma (PAC) located in the body and tail of the pancreas is controversial, and its influence on postoperative morbidity after distal pancreatectomy (DP) is unknown. This study aimed to determine the influence of RSVI on postoperative complications, overall survival (OS), and disease-free survival (DFS) in patients undergoing DP for PAC.
    Methods: A multicenter retrospective study of DP was conducted at 7 hepatopancreatobiliary units between January 2008 and December 2018. Patients were classified according to the presence of RSVI. A Clavien-Dindo grade of >II was considered to represent a major complication.
    Results: A total of 95 patients were included in the analysis. Moreover, 47 patients had vascular infiltration: 4 had arterial involvement, 10 had venous involvement, and 33 had both arterial and venous involvements. The rates of major complications were 20.8% in patients without RSVI, 40.0% in those with venous RSVI, 25.0% in those with arterial RSVI, and 30.3% in those with both arterial and venous RSVIs (P = .024). The DFS rates at 3 years were 56% in the group without RSVI, 50% in the group with arterial RSVI, and 16% in the group with both arterial and venous RSVIs (P = .003). The OS rates at 3 years were 66% in the group without RSVI, 50% in the group with arterial RSVI, and 29% in the group with both arterial and venous RSVIs (P < .0001).
    Conclusion: RSVI increased the major complication rates after DP and reduced the OS and DFS. Therefore, it may be a useful prognostic marker in patients with PAC scheduled to undergo DP and may help to select patients likely to benefit from neoadjuvant treatment.
    MeSH term(s) Humans ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery ; Pancreatectomy/adverse effects ; Retrospective Studies ; Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/surgery ; Carcinoma, Pancreatic Ductal/diagnostic imaging ; Carcinoma, Pancreatic Ductal/surgery ; Postoperative Complications/etiology
    Language English
    Publishing date 2024-01-23
    Publishing country Netherlands
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1016/j.gassur.2024.01.018
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  3. Article ; Online: Reaching a consensus on the definition of "difficult" cholecystectomy among Spanish experts. A Delphi project. A qualitative study.

    Manuel-Vázquez, Alba / Latorre-Fragua, Raquel / Alcázar, Cándido / Requena, Paola Melgar / de la Plaza, Roberto / Blanco Fernández, Gerardo / Serradilla-Martín, Mario / Ramia, J M

    International journal of surgery (London, England)

    2022  Volume 102, Page(s) 106649

    Abstract: Background: Being able to predict preoperatively the difficulty of a cholecystectomy can increase safety and improve results. However, there is a need to reach a consensus on the definition of a cholecystectomy as "difficult". The aim of this study is ... ...

    Abstract Background: Being able to predict preoperatively the difficulty of a cholecystectomy can increase safety and improve results. However, there is a need to reach a consensus on the definition of a cholecystectomy as "difficult". The aim of this study is to achieve a national expert consensus on this issue.
    Methods: A two-round Delphi study was performed. Based on the previous literature, history of biliary pathology, preoperative clinical, analytical, and radiological data, and intraoperative findings were selected as variables of interest and rated on a Likert scale. Inter-rater agreement was defined as "unanimous" when 100% of the participants gave an item the same rating on the Likert scale; as "consensus" when ≥80% agreed; as "majority" when the agreement was ≥70%. The delta of change between the two rounds was calculated.
    Results: After the two rounds, the criteria that reached "consensus" were bile duct injury (96.77%), non-evident anatomy (93.55%), Mirizzi syndrome (93.55%), severe inflammation of Calot's triangle (90.32%), conversion to laparotomy (87.10%), time since last acute cholecystitis (83.87%), scleroatrophic gallbladder (80.65%) and pericholecystic abscess (80.65%).
    Conclusion: The ability to predict difficulty in cholecystectomy offers important advantages in terms of surgical safety. As a preliminary step, the items that define a surgical procedure as difficult should be established. Standardization of the criteria can provide scores to predict difficulty both preoperatively and intraoperatively, and thus allow the comparison of groups of similar difficulty.
    MeSH term(s) Cholecystectomy/methods ; Cholecystectomy, Laparoscopic/methods ; Cholecystitis, Acute/surgery ; Consensus ; Delphi Technique ; Humans
    Language English
    Publishing date 2022-05-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2022.106649
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  4. Article ; Online: Clinical decisions in pancreatic cancer surgery: a national survey and case-vignette study.

    Ramia, Jose M / Cugat, Esteban / De la Plaza, Roberto / Gomez-Bravo, Miguel A / Martín, Elena / Muñoz-Bellvis, Luis / Padillo, Francisco J / Sabater, Luis / Serradilla-Martín, Mario

    Updates in surgery

    2022  Volume 75, Issue 1, Page(s) 115–131

    Abstract: Very few surveys have been carried out of oncosurgical decisions made in patients with pancreatic cancer (PC), or of the possible differences in therapeutic approaches between low/medium and high-volume centers. A survey was sent out to centers ... ...

    Abstract Very few surveys have been carried out of oncosurgical decisions made in patients with pancreatic cancer (PC), or of the possible differences in therapeutic approaches between low/medium and high-volume centers. A survey was sent out to centers affiliated to the Spanish Group of Pancreatic Surgery (GECP) asking about their usual pre-, intra- and post-operative management of PC patients and describing five imaginary cases of PC corresponding to common scenarios that surgeons regularly assess in oncosurgical meetings. A consensus was considered to have been reached when 80% of the answers coincided. We received 69 responses from the 72 GECP centers (response rate 96%). Pre-operative management: consensus was obtained on 7/16 questions (43.75%) with no significant differences between low- vs high-volume centers. Intra-operative: consensus was obtained on 11/28 questions (39.3%). D2 lymphadenectomy, biliary culture, intra-operative biliary margin study, pancreatojejunostomy, and two loops were significantly more frequent in high-volume hospitals (p < 0.05). Post-operative: consensus was obtained on 2/8 questions (25%). No significant differences were found between low-/medium- vs high-volume hospitals. Of the 41 questions asked regarding the cases, consensus was reached on 22 (53.7%). No differences in the responses were found according to the type of hospital. Management and cases: consensus was reached in 42/93 questions (45.2%). At GECP centers, consensus was obtained on 45% of the questions. Only 5% of the answers differed between low/medium and high-volume centers (all intra-operative). A more specific assessment of why high-volume centers obtain the best results would require the design of complex prospective studies able to measure the therapeutic decisions made and the effectiveness of their execution. Clinicaltrials.gov identifier: NCT04755036.
    MeSH term(s) Humans ; Prospective Studies ; Pancreatic Neoplasms/surgery ; Pancreas ; Hospitals, High-Volume ; Pancreatic Neoplasms
    Language English
    Publishing date 2022-11-14
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-022-01415-1
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  5. Article: Adrenal uptake in PET/CT in a patient with pancreatic neoplasm: not always metastasis.

    Manuel Vázquez, Alba / Latorre Fragua, Raquel / Gijón de la Santa, Luis / de la Plaza, Roberto / Ramia, José Manuel

    Gastroenterologia y hepatologia

    2020  Volume 44, Issue 6, Page(s) 425–427

    Title translation Captación adrenal en PET/TC en paciente con neoplasia de páncreas: No siempre metástasis.
    MeSH term(s) Adenoma/diagnostic imaging ; Adenoma/pathology ; Adrenal Gland Neoplasms/diagnostic imaging ; Adrenal Gland Neoplasms/pathology ; Adrenal Glands/diagnostic imaging ; Ampulla of Vater/diagnostic imaging ; Carcinoma, Signet Ring Cell/diagnostic imaging ; Carcinoma, Signet Ring Cell/pathology ; Endosonography ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pancreatic Neoplasms/diagnostic imaging ; Positron Emission Tomography Computed Tomography
    Language Spanish
    Publishing date 2020-11-02
    Publishing country Spain
    Document type Case Reports
    ZDB-ID 632502-6
    ISSN 0210-5705
    ISSN 0210-5705
    DOI 10.1016/j.gastrohep.2020.07.007
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  6. Article ; Online: Garengeot’s hernia

    Garcia-Amador Cristina / De la Plaza Roberto / Arteaga Vladimir / Lopez-Marcano Aylhin / Ramia Jose

    Open Medicine, Vol 11, Iss 1, Pp 354-

    two case reports with CT diagnosis and literature review

    2016  Volume 360

    Abstract: Garengeot’s hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review ... ...

    Abstract Garengeot’s hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations.
    Keywords hernia ; inguinal ; femoral ; amyand’s hernia ; garengeot’s hernia ; appendix ; appendicitis ; Medicine ; R
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher De Gruyter
    Document type Article ; Online
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  7. Article: Garengeot's hernia: two case reports with CT diagnosis and literature review.

    Garcia-Amador, Cristina / De la Plaza, Roberto / Arteaga, Vladimir / Lopez-Marcano, Aylhin / Ramia, Jose

    Open medicine (Warsaw, Poland)

    2016  Volume 11, Issue 1, Page(s) 354–360

    Abstract: Garengeot's hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review ... ...

    Abstract Garengeot's hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations. We report two cases diagnosed preoperatively by contrast-enhanced computed tomography (CT) and discuss the treatment options based on a review of the literature published in PubMed updated on 1 December, 2015. Fifty articles reporting 64 patients (50 women, mean age 70 years) with GH were included in the analysis. Diagnosis was performed by preoperative CT in only 24 cases, including our two. The treatment of GH is emergency surgery. Several options are available laparoscopic or open approach: insertion of a mesh or simple herniorrhaphy, with or without appendectomy.
    Conslusion: The preoperative diagnosis with CT can guide the choice of treatment. Appendectomy and hernioplasty should be performed via inguinotomy, if there is no perforation or abscess formation.
    Language English
    Publishing date 2016-10-07
    Publishing country Poland
    Document type Journal Article ; Review
    ZDB-ID 2829380-0
    ISSN 2391-5463
    ISSN 2391-5463
    DOI 10.1515/med-2016-0065
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  8. Article ; Online: "Ancient" schwannoma in the psoas muscle.

    Ramia, José Manuel / de la Plaza, Roberto / Alonso, Soledad / Gijón, Luis / Valenzuela, José

    Cirugia espanola

    2016  Volume 94, Issue 2, Page(s) e37–9

    MeSH term(s) Humans ; Muscle Neoplasms ; Neurilemmoma ; Psoas Muscles
    Language Spanish
    Publishing date 2016-02
    Publishing country Spain
    Document type Letter
    ZDB-ID 730701-9
    ISSN 1578-147X ; 0009-739X
    ISSN (online) 1578-147X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2015.01.008
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  9. Article ; Online: Tuberculous periportal lymphadenitis: A diagnostic challenge.

    Ramia, Jose Manuel / Diaz-Morfa, Miguel / Caminoa, Alejandra / Gijón, Luis / de la Plaza, Roberto

    Cirugia espanola

    2016  Volume 94, Issue 3, Page(s) 194–196

    MeSH term(s) Humans ; Tuberculosis, Lymph Node
    Language Spanish
    Publishing date 2016-03
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 730701-9
    ISSN 1578-147X ; 0009-739X
    ISSN (online) 1578-147X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2015.05.009
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  10. Article ; Online: Regenerative multiple hepatic nodular hyperplasia associated with oxalyplatin.

    Ramia, Jose Manuel / de la Plaza, Roberto / Perna, Cristian / Adel, Farah / Kuhnhardt, Andree

    Cirugia espanola

    2016  Volume 94, Issue 1, Page(s) 52–54

    MeSH term(s) Humans ; Hyperplasia ; Liver ; Liver Diseases ; Organoplatinum Compounds
    Chemical Substances Organoplatinum Compounds ; oxaliplatin (04ZR38536J)
    Language Spanish
    Publishing date 2016-01
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 730701-9
    ISSN 1578-147X ; 0009-739X
    ISSN (online) 1578-147X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2015.02.009
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