Manuel Pera

Hospital Del Mar

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Document Type

Co-Authors

Luís Grande

Hospital Del Mar

José M. Ramón

Hospital Del Mar

John V. Reynolds

Trinity College Dublin

Gail Darling

Dalhousie University

Albert Goday

Hospital Del Mar

Giovanni De Manzoni

University of Verona

Riccardo Rosati

Istituti di Ricovero e Cura a Carattere Scientifico

Richard van Hillegersberg

University Medical Center Utrecht

Suzanne S. Gisbertz

Amsterdam University Medical Centers

Donald E. Low

Virginia Mason Medical Center

Cooperative Institutions

Queen Elizabeth Hospital Birmingham

230

American Gastroenterological Association

150

Universitat Autònoma de Barcelona

147

Universitat de Barcelona

144

Hospital Del Mar

131

University of Birmingham

119

Amsterdam University Medical Centers

111

Hospital del Mar Research Institute

101

Radboud University Nijmegen

100

Hospital Clínic de Barcelona

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AIDS AND SALMONELLA‐INFECTED ABDOMINAL AORTIC ANEURYSM

Australian and New Zealand Journal of Surgery (1990)

C.A. Mestres Salvador Pié i Ninot Antonio M. Lacy Marion Castel Pilar Iranzo

The case of a bisexual male patient with acquired immunodeficiency syndrome (AIDS) and an infected abdominal aortic aneurysm requiring surgery is presented. Attention is drawn to the fact that an unpredictable number of operations will be needed in AIDS patients in the next future.

Abdominal aneurysm

10.1111/ans.1990.60.3.225

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Citations (16)

Additional Metabolic Effects of Bariatric Surgery in Patients with a Poor Mid-Term Weight Loss Response: A 5-Year Follow-Up Study

Journal of Clinical Medicine (2020)

David Benaiges Maria Bisbe Juan Pedro‐Botet Aleix de Vargas‐Machuca José M. Ramón

To ascertain the 5-year metabolic effects of bariatric surgery in poor weight loss (WL) responders and establish associated factors.Retrospective analysis of a non-randomised prospective cohort of bariatric surgery patients completing a 5-year follow-up. Mid-term poor WL was considered when 5-year excess weight loss was <50%.Forty-three (20.3%) of the 212 included patients were mid-term poor WL responders. They showed an improvement in all metabolic markers at 2 years, except for total cholesterol. This improvement with respect to baseline was maintained at 5 years for plasma glucose, HbA1c, HOMA, HDL and diastolic blood pressure; however, LDL cholesterol, triglycerides and systolic blood pressure were similar to presurgical values. Comorbidity remission rates were comparable to those obtained in the good WL group except for hypercholesterolaemia (45.8% vs. poor WL, p = 0.005). On multivariate analysis, lower baseline HDL cholesterol levels, advanced age and lower preoperative weight loss were independently associated with poor mid-term WL.Although that 1 in 5 patients presented suboptimal WL 5 years after bariatric surgery, other important metabolic benefits were maintained.

Excess weight

10.3390/jcm9103193

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Citations (2)

Western European variation in the organization of surgical esophageal cancer care.

European Journal of Surgical Oncology (2023)

Maurits Visser Daan M. Voeten Suzanne S. Gisbertz Jelle P. Ruurda Lars Bo Svendsen

Variation (astronomy)

10.1016/j.ejso.2022.11.150

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Citations (0)

Western European Variation in the Organization of Esophageal Cancer Surgical Care

Diseases of the Esophagus (2024)

Maurits R. Visser Daan M. Voeten Suzanne S. Gisbertz Jelle P. Ruurda Michael Patrick Achiam

Abstract Reasons for structural and outcome differences in esophageal cancer surgery in Western Europe remain unclear. This questionnaire study aimed to identify differences in the organization of esophageal cancer surgical care in Western Europe. A cross-sectional international questionnaire study was conducted among upper gastrointestinal (GI) surgeons from Western Europe. One surgeon per country was selected based on scientific output and active membership in the European Society for Diseases of the Esophagus or (inter)national upper GI committee. The questionnaire consisted of 51 structured questions on the structural organization of esophageal cancer surgery, surgical training, and clinical audit processes. Between October 2021 and October 2022, 16 surgeons from 16 European countries participated in this study. In 5 countries (31%), a volume threshold was present ranging from 10 to 26 annual esophagectomies, in 7 (44%) care was centralized in designated centers, and in 4 (25%) no centralizing regulations were present. The number of centers performing esophageal cancer surgery per country differed from 4 to 400, representing 0.5–4.9 centers per million inhabitants. In 4 countries (25%), esophageal cancer surgery was part of general surgical training and 8 (50%) reported the availability of upper GI surgery fellowships. A national audit for upper GI surgery was present in 8 (50%) countries. If available, all countries use the audit to monitor the quality of care. Substantial differences exist in the organization and centralization of esophageal cancer surgical care in Western Europe. The exchange of experience in the organizational aspects of care could further improve the results of esophageal cancer surgical care in Europe.

Esophagectomy

10.1093/dote/doae033

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Citations (3)

Epithelial Cell Hyperproliferation After Biliopancreatic Reflux Into the Esophagus of Rats

The Annals of Thoracic Surgery (1998)

Manuel Pera Luís Grande Marisa Gelabert X. Figueras Miguél Pera

10.1016/s0003-4975(97)01382-9

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Citations (33)

O161 LASTING SYMPTOMS AFTER ESOPHAGEAL RESECTION (LASER) – EUROPEAN MULTI-CENTER CROSS-SECTIONAL STUDY

Diseases of the Esophagus (2019)

Sheraz R. Markar Giovanni Zaninotto Carlo Castoro Asif Johar Pernilla Lagergren

Abstract Aim Long-term functional outcomes and the associations to health-related quality of life (HRQOL) after esophagectomy is largely unknown. LASER is a multi-center European study aimed to identify the most prevalent symptoms, and those with the greatest impact upon HRQOL among patients surviving more than one-year after esophagectomy for cancer, and to develop a clinically relevant symptom-based tool to measure HRQOL. Background & Methods Between 2010 and 2016, patients from 20 European Centers who underwent esophagectomy for esophageal cancer, and were disease-free at least one year postoperatively were invited to complete the LASER questionnaire, EORTC-QLQ30 and OG25. Specific symptom questionnaire items that were associated with a poor HRQOL as identified by EORTC-QLQC30 and OG25 were identified by multivariable linear and logistic regression analysis and combined to form a tool, which was tested using receiver operating characteristics curve analysis. Results A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had had symptoms associated with their esophagectomy and 52.4% of patients had sought medical treatment for their symptoms. Ongoing weight loss was reported by 10.4% of patients while 32.4% were struggling to maintain their body weight, and 18.8% of patients required supplemental oral nutrition. Only 13.8% of patients had returned to work with the same activities as before. Three LASER symptoms in multivariate analysis were correlated with poor HRQOL; pain on scars on chest (Odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81±0.02 and 0.82±0.09 respectively. Conclusions Two-thirds of patients experience symptoms related to their esophagectomy more than one year after surgery. The three key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased long-term term support.

Esophagectomy

Cross-sectional study

10.1093/dote/doz092.161

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Citations (2)

Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus

Diseases of the Esophagus (2020)

Philip C. Müller Joshua R. Kapp Diana Vetter Luigi Bonavina Wendy A. Brown

Summary There are no internationally recognized criteria available to determine preparedness for hospital discharge after esophagectomy. This study aims to achieve international consensus using Delphi methodology. The expert panel consisted of 40 esophageal surgeons spanning 16 countries and 4 continents. During a 3-round, web-based Delphi process, experts voted for discharge criteria using 5-point Likert scales. Data were analyzed using descriptive statistics. Consensus was reached if agreement was ≥75% in round 3. Consensus was achieved for the following basic criteria: nutritional requirements are met by oral intake of at least liquids with optional supplementary nutrition via jejunal feeding tube. The patient should have passed flatus and does not require oxygen during mobilization or at rest. Central venous catheters should be removed. Adequate analgesia at rest and during mobilization is achieved using both oral opioid and non-opioid analgesics. All vital signs should be normal unless abnormal preoperatively. Inflammatory parameters should be trending down and close to normal (leucocyte count ≤12G/l and C-reactive protein ≤80 mg/dl). This multinational Delphi survey represents the first expert-led process for consensus criteria to determine ‘fit-for-discharge’ status after esophagectomy. Results of this Delphi survey may be applied to clinical outcomes research as an objective measure of short-term recovery. Furthermore, standardized endpoints identified through this process may be used in clinical practice to guide decisions regarding patient discharge and may help to reduce the risk of premature discharge or prolonged admission.

Delphi Method

Esophagectomy

Delphi

Preparedness

10.1093/dote/doaa101

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Citations (8)

Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA)

European Journal of Surgical Oncology (2024)

Ewen A. Griffiths James Halle‐Smith Sivesh K. Kamarajah R.P.T. Evans Dmitri Nepogodiev

Esophagectomy

10.1016/j.ejso.2024.107983