Biomedical subjects

J A Garcia Marcilla

Publications and source records attributed to J A Garcia Marcilla.

4 recordsLinked to original sources

PubMed1994

Primary small bowel malignant tumors.

We reviewed 69 patients who underwent surgery for primary malignant tumors of the small bowel over a 15-year period. Patients with periampullary lesions were excluded, as were those with known adenocarcinomas in other sites. There were 46 males (67%) and 23 females (33%) with an average age at presentation of 52.6 years (range 4-92). Of the 69 patients, four (6%) were asymptomatic. The mean duration of symptoms before diagnosis, in the remaining 65 symptomatic patients, was 3.6 months (range 1 day 1.2 years). The most frequent symptom was abdominal pain (83%), followed by nausea and/or vomiting (54%), and weight loss (43%). Abdominal mass was the most common finding on physical examination (29%), followed by abdominal distension (24%) and abdominal guarding and rigidity (14%). Laboratory examinations were normal in 26 patients (40%). Radiographic study of the duodenum and small bowel was abnormal in 87%. The diagnosis was suspected preoperatively in 51%. Lymphoma was the most common tumor (42%), followed by adenocarcinoma (38%), carcinoid (10%) and leyomiosarcomas (10%). In 41% the neoplasm was located in the jejunum, in 33% in the ileum, in 22% in the duodenum and in 4% multiple sites were found. Lymph node metastases were found in 45% and vascular invasion was found in 19%. Of the 65 symptomatic patients 43% presented as surgical emergencies, the rest had elective surgery. 61% had a curative resection, the rest were palliative or a bypass. The operative mortality rate was 10% and the morbidity rate was 24%. Ten patients underwent emergency surgery, developed a complication, giving a morbidity rate of 32% in this group. The 5-year overall survival was 43.25%. The 5-year survival for carcinoid tumors was 60% while the 5-year survival for small bowel malignant lymphoma and adenocarcinoma was 40 and 34.28% respectively.

Adenocarcinoma↗

PubMed1993

Results of surgical treatment of epidermoid carcinoma of the thoracic esophagus.

During 1979 to 1991, 125 patients with epidermoid carcinoma of the thoracic esophagus were admitted to our General Surgery unit. The average age was 60.1 years; 94.4 percent of the patients were male. The mean duration of symptoms was 3.65 months. The most frequent symptom was dysphagia in 97.19 percent, followed by weight loss in 64.48 percent. The most frequent location was the middle one-third in 58.4 percent. The tumor was well differentiated in 27.2 percent, moderately well differentiated in 41.6 percent and poorly differentiated in 31.2 percent. By preoperative staging, 1 patient was stage I, 24 were stage II, 86 were stage III and 14 were stage IV. The operability rate was 76 percent and the resectability rate was 48.8 percent. Resection was "curative" in 42.62 percent and palliative in 57.37 percent. Radiation therapy and chemotherapy were used only in those patients who did not undergo resection. All of the patients in whom resection was possible underwent a single-stage esophagogastrectomy. The postoperative mortality rate was 20 percent, but only 11.54 percent if we only consider those patients who underwent "curative" resection. The most frequent causes of mortality were respiratory complications and anastomotic leakage. The five year overall survival rate was 5.99 percent. In the resected group, the five year survival rate was 8.82 percent and in patients in whom resection was considered "curative," the rate was 20.86 percent.

Carcinoma, Squamous Cell↗

PubMed1992

Long-term results of Nissen fundoplication in reflux esophagitis without strictures. Clinical, endoscopic, and pH-metric evaluation.

The present paper evaluates the efficiency of Nissen fundoplication as an antireflux technique in a series of 51 patients with different grades of esophagitis. Follow-up time averaged 6.6 years. The evaluation includes a clinical assessment, endoscopic study, and 24-hr pH monitoring. The results reveal an acceptable rate of recurrences, with clinical (9.8%) being less frequent than endoscopic (13.7%) or pH-metric (19.6%) recurrences. Side effects appeared in 37.3% of the patients (mainly inability to belch or vomit, and postprandial fullness), which were mild and transitory in most cases. Nissen fundoplication proved effective in controlling long-term gastroesophageal reflux, as over 80% of the patients presented an excellent-to-good clinical situation, without or with minimal digestive consequences.

Adult↗

PubMed1991

Surgery improves defective oesophageal peristalsis in patients with gastro-oesophageal reflux.

Postoperative manometry was carried out in 12 patients with gastro-oesophageal reflux associated with hypomotility of the oesophageal body. A Nissen fundoplication was carried out in all patients. After a median follow-up of 3.5 years, patients underwent clinical, endoscopic, radiological, manometric and pH-metric evaluation. Manometric results revealed an overall improvement in oesophageal motor function with an increase in the amplitude of deglutition waves and a decrease in the percentage of deglutitions without response. Six of the patients (one with complete motor failure) recovered normal peristaltic function. Non-specific oesophageal motor disorders may be secondary to gastro-oesophageal reflux and are reversible in nature.

Adult↗