Roberto de la Plaza Llamas

• M.D. Ph.D. MSc. FACS
• Professor (Associate) at Hospital Universitario de Guadalajara

BACKGROUND The quality-adjusted life year (QALY) is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures. Surgical waiting lists (SWLs) represent a pressing problem in public healthcare. The QALY measure has rarely been used in the context of surgery. It would...

EAGLE is an international study bringing together surgeons, anaesthetists and theatre teams around the world to share best practice. The common goal is to reduce the global anastomotic leak rate after right colectomy and ileocaecal resection. Feel free to join ESCP Safe-anastomosis programme.

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-devel...

Simple Summary Most of the existing data on the resection of liver metastases with inferior vena cava infiltration come from case reports or small case series. This systematic review on the subject found postoperative morbidity and mortality rates and overall survival to be acceptable, offering a surgical alternative to these patients previously co...

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 Adher...

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 po...

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 perform...

Objective: Bull-horn injuries (BHI) are unique and there is reduced published literature about it. We present an analysis of a 11-year BHI case series. Method: Study of 138 cases developed during a 11-year period with hospitalization admission greater than 24 hours with diagnosis of BHI/contusion. We classified patients in two groups: group A, p...

Resumen En el presente manuscrito, se ha recogido un caso de absceso hepático posiblemente causado por una colecistitis evolucionada, en la que está implicado un germen anaerobio, fusobacterium mortiferum, no descrito en la literatura como agente causal de este tipo de infecciones. Al tener una infección por la presencia de una bacteria infrecuente...

Lipomas account for 50% of soft-tissue tumors and may compress adjacent structures. We report the case of a 49-year-old female patient with intense anal pain associated with defecation urgency, tenesmus, incontinence and dyspareunia. A soft tumor was present in the right buttock suggestive of lipoma. On magnetic resonance imaging an apparently enca...

Background To analyze whether clinical and analytical parameters differ according to histopathology in cases of acute appendicitis (AA). Methods This is a retrospective, observational study including patients (>14 years of age) admitted for suspicion of AA from 1 April 2014 to 31 July 2016. Histopathology was divided into complicated (including pe...

Postoperative complications represent a basic quality indicator of outcomes, but are not systematically measured. This situation has negative consequences that are ignored. An accurate assessment could help to evaluate the real morbidity, establish measures for improvement, increase efficiency and identify benchmark services. I present a personal r...

Resumen Introducción: la intususcepción es el deslizamiento de un segmento de tracto gastrointestinal hacia otro distalmente adyacente, pudiendo alterar el transito gastrointestinal y su vascularización. Es más frecuente en niños y raro en adultos (5-16%), representando en estos últimos 1-5% de los casos de obstrucción intestinal. Una rara causa de...

BACKGROUND Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver no...

Introduction: Recently, some surgical teams have used a laparoscopic vertical clip gastroplasty to treat morbid obesity. This approach mimics the principle of laparoscopic sleeve gastrectomy, but using a completely reversible mechanism. Displacement of the device has been reported in 7.7% of cases. The manner of its withdrawal has not been describ...

Resumen Introducción Los parámetros clínicos y analíticos de la apendicitis aguda (AA) son la base diagnóstica. Se analiza la diferencia de sus valores según la histología para distinguir las AA simples de las complicadas. Métodos Análisis observacional retrospectivo que incluye pacientes (> 14 años) que ingresan con diagnóstico de AA desde el 1...

Postoperative complications (PC) are a basic health outcome, but no surgery service in the world records and/or audits the PC associated with all the surgical procedures it performs. Most studies that have assessed the cost of PC suffer from poor quality and a lack of transparency and consistency. The payment system in place often rewards the volum...

Introduction: radical surgery in hepatic hydatidosis is associated with less morbidity and recurrence than conservative surgery. Material and methods: a retrospective observational study of patients with liver hydatid cyst surgery was performed. Seventy-one patients with 90 cysts were included between 2007 and 2017, and radical surgery was perfo...

Post-operative morbidity of pancreatectomies occurs in up to 40–50% of patients, even in modern series. There is a need to find a simple scale in order to identify patients with increased risk of developing major post-operative complications after pancreatic resections. Many studies have been published on sarcopenia and surgical outcomes. Aspects o...

Resumen Introducción: la intususcepción es el deslizamiento de un segmento de tracto gastrointestinal hacia otro distalmente adyacente, pudiendo alterar el tránsito gastrointestinal y su vascularización. Es más frecuente en niños y raro en adultos (5-16%), representando en estos últimos 1-5% de los casos de obstrucción intestinal. Una rara causa de...

Post-operative morbidity of pancreatectomies occurs in up to 40–50% of patients, even in modern series. There is a need to find a simple scale in order to identify patients with increased risk of developing major post-operative complications after pancreatic resections. Many studies have been published on sarcopenia and surgical outcomes. Aspects o...

Perforation in colorectal cancer is an uncommon condition, and neoplastic invasion of the abdominal wall with local infection is even rarer. Our objective is to present the case of an 84-year-old male with right colon cancer that manifested as an inguinal abscess, and also to perform a systematic review of the literature in PubMed, EMBASE, and Web...

Background: Hepatocellular carcinoma is the most common type of primary liver cancer and is the third cause of cancer related deaths; 80% of the HCC are associated with cirrhotic livers or chronic liver diseases, which constitute the main risk factor. Chronic inflammation, necrosis and regeneration due to these conditions produce genetic mutation a...

Resumen La evaluación y el diagnóstico del paciente con dolor abdominal agudo en los Servicios de Urgencias muchas veces puede ser un reto. Existen factores que plantean dificultades en el momento de realizar la historia clínica, retrasar el diagnóstico correcto o definir un tratamiento adecuado, todo ello teniendo como consecuencia resultados adve...

Resumen El dolor en la fosa ilíaca derecha es una consulta frecuente en los Servicios de Urgencias, la cual plantea una elevada complejidad debido a los diversos diagnósticos diferenciales, muchos de ellos de causa urgente. En este trabajo, realizamos una revisión de la literatura y proponemos un algoritmo diagnóstico que pueda facilitar el manejo...