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Cirugía Española 03/2011; 90(1):e2. · 0.87 Impact Factor
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ABSTRACT: In cancer of the colon, the number of lymph nodes that should be analysed before a patient is classified as free of lymph node involvement has been widely discussed. A mathematical model is proposed which is based on the Bayes Theorem for calculating the probability of error (PE) similar to that normally used to evaluate a diagnostic test, but adapted to a quantitative variable, the lymph node count.
The clinical histories of 480 patients routinely operated on in attempt to cure cancer of the colon were reviewed. Cases with any kind of metastasis were excluded. The proposed formula based on the Bayes Theorem was applied with the aim of calculating the PEs for the complete series and for different patient sub-groups (T2, T3, and T4 tumours).
For the probabilities of error of classifying a patient as N negative, which varied between 5% and 1% (near or practically 0), the minimum number of negative lymph nodes required for analysis fluctuated between 7 and 17, respectively, for the complete series. This minimum figure was also variable for the different sub-groups (T2, T3, and T4 tumours) studied. These numbers mainly depended on the case characteristics of a specific study group as regards the prevalence of the N+ cases that they dealt with, and of its historically demonstrated ability to collect and identify positive lymph nodes in those patients that had them.
From a mathematical point of view, the minimum number of lymph nodes that have to be analysed in cancer of the colon in order to classify a patient as N negative is not a constant. This depends on the error that is prepared to be assumed for that diagnosis, possibly depending on certain tumour traits, and also may be adapted to the cases of each study group.
Cirugía Española 10/2010; 88(6):383-9. · 0.87 Impact Factor
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Cirugía Española 02/2009; 85(1):64; author reply 65. · 0.87 Impact Factor
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ABSTRACT: The assessment and interpretation of the results of a clinical study are a real challenge for the clinicians. In this paper we establish a general basis for a critical and reserved assessment of these, from the fundamental aspects of the design and statistics, as well as the application of the results to our own patients according to risk and benefit criteria. Main errors and the traps that should be avoided are emphasised.
Cirugía Española 01/2009; 84(6):307-12. · 0.87 Impact Factor
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ABSTRACT: Obesity has been proven to be a significant independent risk factor for hiatal hernia. In morbidly obese patients, the usual techniques to improve gastroesophageal reflux after hiatal hernia repair could have poorer outcomes than in the general population. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to be an effective procedure in controlling symptoms and complications of gastroesophageal reflux in these patients. Therefore, LRYGBP is one of the most frequent procedures performed in bariatric surgery. The authors report a case of a 41-year-old man with a body mass index (BMI) of 44.6 kg/m(2) who was diagnosed with giant type III hiatal hernia. A laparoscopic approach for both hiatal hernia repair and LRYGBP was performed. At 6 months follow-up, the patient has lost 30% of excess body weight (BMI 34.4), and there is no evidence of recurrence of the esophageal hernia.
Obesity Surgery 10/2008; 20(6):801-3. · 3.29 Impact Factor
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ABSTRACT: To report a brucellar orchiepididymitis case and to review the diagnosis and treatment of this pathology.
We present the case of a 62 year old man presenting with fever, testicular pain and constitutional syndrome. The diagnosis was made after ultrasound, blood cultures and anamnesis.
The treatment was Doxiciclin six weeks and teicoplanin, the second one was replaced with ciprofloxacin.
It is important to make a correct anamnesis to the patient with orchiepididymitis to identify any risk factor for brucellosis. The diagnosis is confirmed with blood cultures. The oral antibiotics are enough to cure patients.
Archivos españoles de urología 05/2008; 61(3):442-4.
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ABSTRACT: Metastasis to regional lymph nodes, after distant metastasis, is the most important prognostic factor of colorectal carcinomas. It is also of primary importance in decisions related to the administration of adjuvant treatments. Most scientific associations recommend the examination of at least 12 lymph nodes for the reliable determination of the absence of nodal metastases. We performed a literature review on lymph node recovery in order to determine whether 12 is the minimum and optimal number of lymph nodes to be examined after colorrectal cancer surgery. The differences between authors suggest that an optimal number of lymph nodes to be examined after colorectal cancer surgery probably does not exist and depends on many factors. Thus, recovering as many lymph nodes as possible seems to be a good option.
Cirugía Española 04/2008; 83(3):108-17. · 0.87 Impact Factor
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ABSTRACT: We analyze the reasons why the use of confidence intervals is highly advisable. Among these reasons, confidence intervals provide an approach to knowledge of the real importance of a result, independently of statistical significance, as well as equivalence assessment between two variables.
Cirugía Española 04/2007; 81(3):121-5. · 0.87 Impact Factor
