Browsing by Author "Iglesias, Andres"

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    Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile
    (2024) Silva, Felipe; Bustamante, Miguel; Latorre, Gonzalo; Flandez, Jorge; Montero, Isabella; Dukes, Eitan; Gandara, Vicente; Robles, Camila; Uribe, Javier; Iglesias, Andres; Bellolio, Felipe; Molina, Maria Elena; Migueles, Rodrigo; Urrejola, Gonzalo; Larach, Tomas; Besser, Nicolas; Sharp, Allan; Aguero, Carlos; Riquelme, Arnoldo; Vargas, Jose Ignacio; Candia, Roberto; Monrroy, Hugo; De Simone, Federico; Espino, Alberto
    Background: Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America. Aim: To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs. Methods: Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile. Results: A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n = 38), gastrointestinal stromal tumors (GIST) (21.8%, n = 19), lymphoma (17.2%, n = 15) and adenocarcinoma (AC) (11.5%, n = 10). GIST was more frequent in duodenum (50%; n = 12) and NET in the ileum (65.8%; n = 25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC ( p = 0.035), as well as gastrointestinal bleeding in GIST ( p = 0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5 -year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1 - 99.2), 82.2% (95%CI: 57.6 - 93.3), 40.0% (95%CI: 16.5 - 82.8) and 25.9% (95%CI: 4.5 - 55.7%), respectively. NET (HR 6.1; 95%CI: 2.1 - 17.2) and GIST (HR 24.4; 95%CI: 3.0 - 19.8) were independently associated with higher survival compared to AC, adjusted for age and sex. Conclusions: Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes. (c) 2024 Elsevier Espana, S.L.U. All rights reserved.
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    Earlier surgery is associated to re duce d postoperative morbidity in ileocaecal Crohn's disease: Results from SURGICROHN-LATAM study
    (2023) Avellaneda, Nicolas; Coy, Claudio Saddy Rodrigues; Fillmann, Henrique Sarubbi; Saad-Hossne, Rogerio; Munoz, Juan Pablo; Garcia-Duperly, Rafael; Bellolio, Felipe; Rotholtz, Nicolas; Rossi, Gustavo; Marquez, Juan Ricardo; Cillo, Mariano; Lacerda-Filho, Antonio; Carrie, Augusto; Maruyama, Beatriz Yuki; Fillmann, Lucio Sarubbi; Ferro, Ezequiel; Londono-Schimmer, Eduardo; Iglesias, Andres; Harriott, Camila Bras; Campana, Juan Pablo; Estrada, Daniel Londono; Balachandran, Rogini; Kontze, Paulo Gustavo
    Background: Early surgical resection is an emerging concept for patients with ileocaecal Crohn's disease (CD). The aim of this study was to compare postoperative outcomes after ileocaecal resections between patients with luminal and complicated CD.Methods: A retrospective analysis of patients operated for ileocaecal CD during an 8-year period in ten tertiary referral academic centres from Latin America was performed. Patients were allocated into 2 groups: those operated for early (luminal) disease (Early Crohn's Disease-ECD-) and for complications of CD (Complicated Crohn's disease-CCD-). A comparative analysis was performed regarding short-term outcomes of surgery, considering overall postoperative complications as main outcome. Results: 337 patients were included in the analysis, 60 (17.80%) in the ECD group. Smoking and ex-posure to perioperative biologic drugs were more prevalent in CCD group. CCD patients had increased requirement of urgent surgery (26.71 vs. 15%, p = 0.056), longer operative time (164.25 vs. 90.53 min, p < 0.01), lower rates of primary anastomosis (90.23 vs. 100%, p = 0.012), increased rate of overall postopera-tive complications (33.21 vs. 16.67%, p = 0.013), more reoperations (13.36 vs. 3.33%, p = 0.026), and higher rates of major anastomotic fistulas and hospital stay. On multivariable analysis, smoking ( p = 0.001,95%CI: 2.59-32.11), operative time ( p = 0.022,95%CI:1-1.02), associated procedures ( p = 0.036,95%CI:1.09-15.72) and intraoperative complications ( p = 0.021,95%CI:1.45-92.31) were independently related to presenting postoperative complications.
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    Risk factors for major complications after surgical treatment of primary ileocecal Crohn's disease. A multicenter Latin American experience
    (2023) Avellaneda, Nicolas; Coy, Claudio Saddy Rodrigues; Fillmann, Henrique Sarubbi; Saad-hossne, Rogerio; Mun, Juan Pablo; Garcia-duperly, Rafael; Bellolio, Felipe; Rotholtz, Nicolas; Rossi, Gustavo; Marquez, Juan Ricardo; Cillo, Mariano; Lacerda-filho, Antonio; Carrie, Augusto; Maruyama, Beatriz Yuki; Fillmann, Lucio Sarubbi; Craveiro, Marcela Maria Silvino; Ferro, Ezequiel; Londono-schimmer, Eduardo; Iglesias, Andres; Harriott, Camila Bras; Campana, Juan Pablo; Estrada, Daniel London; Balachandran, Rogini; Kotze, Paulo Gustavo
    Introduction: Complications after ileocecal resection for Crohn's disease (CD) are frequent. The aim of this study was to analyze risk factors for postoperative complications after these procedures.