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R Trullenque Peris

Publications and source records attributed to R Trullenque Peris.

At least 19 recordsLinked to original sources
PubMed2005

Rubber-band ligation for hemorrhoids in a colorectal unit. A prospective study.

INTRODUCTION: Nowadays the rubber band ligation technique is one of the most worldwide used and effective treatment of the hemorrhoidal disease. OBJECTIVES: Our study has as a goal to analyze the success or failure of the rubber band ligation in hemorrhoids grade 1,2 and 3, to analyze their complications and to see if all symptomatic hemorrhoids should be treated with ligation at the first visit. PATIENTS AND METHOD: A prospective and descriptive study was designed for patients who came to the Colorectal Unit with hemorrhoidal disease from September 1997 to December 2001. First, second and third degree patients were treated according to the classification of hemorrhoids of St. Mark's Hospital. The technique of ligation after Barron was applied. RESULTS: From 261 patients with a mean age of 48.3 (range: 16-86), 181 (99 M/82 W) have been treated with Barron's method and 80 with rich fiber diet and water. Rectal bleeding was the most common symptom (91.16%). Anuscopy showed hemorrhoidal disease in all the cases. From 181 patients, 19.33% were hemorrhoids degree I, 51.93% degree II and 29.83% degree III. Two hundred and eighty-seven ligation sessions were done and the balance of ligations per patient was 2.45 and 1.5 rubber band per session. The 32% of the patients referred pain after ligation. A 13.81% of cases were operated due to persistent rectal bleeding or hemorrhoidal prolapse. CONCLUSIONS: Symptomatic hemorrhoids degree I and II with a short clinical history should be treated initially with a rich fiber and water diet. The technique of Barron is an effective therapy to treat the hemorrhoids degree 1, 2 and in 74% of success in cases with degree 3.

Adolescent↗
PubMed2005

Surgery for gastroesophageal reflux disease: a comparative study between the open and laparoscopic approaches.

OBJECTIVE: Given the demonstrated effectiveness of medical treatment together with the eminent acceptance of the laparoscopic approach, the indications of surgery in the treatment of gastroesophageal reflux disease (GERD) are currently subject to continuous controversy. To participate in this debate, we have the following work hypothesis: "The results of the 360 masculine short and floppy laparoscopic fundoplication are superior to those of open surgery". CLINICAL DESIGN: Prospective, clinical, non-randomized study. PATIENTS: Our work was developed between November 1991 and December 1998 by means of a prospective, non-randomized clinical rehearsal with two groups of patients: Group I (n = 75): 360 degree short and floppy laparoscopic fundoplication in Hospital Dr. Peset, Valencia (Spain). Group II (n = 28): 360 degree short and floppy, open fundoplication in Hospital General, Valencia (Spain). We evaluated the preoperative parameters and found no differences, which allows us to know that both groups were comparable. RESULTS: The analysis of peroperative results (morbidity and surgical time) and of clinical follow-up (every three months and later annually) and instrumental follow-up (TEGD, upper digestive endoscopy, pHmetry and manometry) show no differences, while the postoperative analysis shows statistically significant (s.s.) differences regarding recovery (pain, oral intake, hospital stay and return to previous activities). CONCLUSIONS: The results of the 360 degree short and floppy laparoscopic fundoplication are similar to those of the open approach, but favor the former approach with a better postoperative tolerance.

Digestive System Surgical Procedures↗
PubMed1997

Multiple colon tumors. Diagnosis and follow-up of 450 patients with colorectal carcinoma.

OBJECTIVE: Failure to diagnose synchronous tumors leads to errors in patient treatment and prognosis. The existence of metachronous tumors requires strict patient follow-up to ensure early identification of the second tumor. The present study evaluates the results obtained in the application of a structured procedure for the diagnosis and follow-up of multiple colorectal carcinoma. MATERIALS AND METHODS: A structured procedure was used to follow for 5 years a group of 12 patients with multiple colorectal tumors (7 synchronous and 5 metachronous) of a series of 450 colorectal neoplasms. RESULTS: Six synchronous tumors were diagnosed preoperatively and one intraoperative. Of the 5 metachronous neoplasms, 4 strictly adhered to the follow-up protocol, as a result of which the second tumor was detected at an early stage. The remaining case involved no follow-up, and the second tumor was diagnosed in an advanced stage as a result of bowel occlusion. The left colon was predominantly involved; polyps were detected in 9 cases, while two patients had 3 malignancies detected by histopathological study. COMMENTS: We emphasize the need for a full evaluation of the colon in all patients with colorectal carcinoma. In the case of incomplete preoperative evaluation, intraoperative colonoscopy is to be considered; if this is not feasible it should be performed one month after surgery. A structured follow-up procedure permits the early detection of these tumors, there by improving patient prognosis.

Aged↗
PubMed1995

[The diagnosis of aorticomesenteric duodenal compression by magnetic resonance angiography].

The syndrome of duodenal obstruction by the mesenteric artery is an infrequent condition that nevertheless was too often diagnosed in the past. The development of modern imaging techniques has presently restricted the diagnosis of this syndrome. We report the case of a 21-year-old patient with superior mesenteric artery-induced duodenal compression syndrome secondary to malnutrition and loss of weight. Diagnosis was confirmed by the evaluation of bowel transit, CT Scan, NMR and angio-MR. Conservative treatment with total parenteral nutrition proved ineffective. Surgical sectioning of the ligament of Treitz and extensive mobilization of the duodenum (Strong's operation) was performed; outcome was unsatisfactory, however. A duodenojejunostomy was performed later, which finally solved the condition. We emphasize the diagnostic usefulness of CT Scan and angio-MR, and the favorable results afforded by duodenojejunostomy.

Adult↗
PubMed1985

[The 1978 TNM system for cancer of the breast: proposal for a modification].

The authors study the 5 and 10 years survival of 1.058 cases of breast carcinoma treated between 1963 and 1981, classified according to the pTNM system. They suggest the convenience of eliminating some of the combinations in order to obtain a good correlation with prognostic criteria. The authors propose a modification of the TNM system with closer clinical significance.

Breast Neoplasms↗
PubMedDate not supplied

[Experimental study of the immunomodulator effect of pentoxifylline in bacterial translocation produced by lipid-free parenteral nutrition].

INTRODUCTION: Bacterial translocation (BT) leads to sepsis of intestinal origin and, despite current advances, there is a high level of mortality and morbidity as a result of this. We have attempted to investigate whether such an immunity modulating substance as Pentoxiphylline (PX) might diminish or inhibit BT. We have chosen PX because it has immunity modulation actions and inhibits the synthesis and action of TNF-alpha, which seems to be linked to the progress of these conditions towards multiple organ failures. MATERIAL AND METHOD: An experimental study was performed with 4 groups of 20 Wistar rats subjected to lipid-free parenteral nutrition (PN) over 7 days. Group A: PN; group B: PN + 50 mg/kg of PX; group C: PN + 100 mg/kg; and group D: PN + 134 mg/kg. On day 7, a sterile extraction was effected to remove the mesenteric ganglial chain, liver, blood and intestine, and these samples were processed for the quantitative and qualitative microbiological study, the histological study of the intestinal mucosa and the quantification of TNF-alpha. The data obtained were subsequently analyzed statistically. RESULTS: The quantitative microbiological study revealed that, with statistically significant differences, more colonies grew in the lymphatic ganglion, liver and blood of animals belonging to group A. The germ most frequently identified was E. Coli. In the study of TNF-alpha, the greatest value corresponded to group A, again with statistically significant differences. In the histological study, it was observed that group A showed the greatest atrophy. CONCLUSIONS: Our experimental model is valid as a model of BT, in group A, without PX, a total of 16 BT occurred while in the groups with PX the number of BT fell, as did the serum figures for TNF-alpha.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Low-residue diets supplemented with fermentable fiber. Effect on experimental colonic anastomosis].

Presentation of an experimental study comparing the scarring of colic anastomoses performed in Wistar rats fed with three different types of diet: a standard laboratory diet, an enteral low-residue diet and a low-residue diet supplemented with fermentable fibre in short chain fatty acids (pectin). Scarring in the group fed with the standard laboratory diet showed greater anastomotic complications, and the microscopic appearance was more inflamed. The administration of low-residue diets reduced the level of complications, but also reduced the concentration of collagen and the parietal rupture tension. The addition of pectin to a low-residue diet maintained the complications at a low level, and also significantly increased the pressure parameters and the collagen concentration.

Anastomosis, Surgical↗