surgical treatment of esophageal cancer. an updateEsophageal cancer surgery is a challenge despite the advances in surgical techniques and perioperative care. It continues to have high rates of complications and mortality, even in large volume centers. This paper revises the epidemiology, staging and therapeutic options for esophageal cancer, according to its stage and location. It also encompasses the digestive tract reconstruction options, according to our own experience and reports from abroad.Key words: Esophageal cancer, surgery, digestive tract reconstruction. resumenLa cirugía del cáncer de esófago ha sido y sigue siendo un desafío pese a los avances en técnica quirúrgica y cuidados peri operatorios y a pesar de que las complicaciones postoperatorias y la morbimortalidad sigue siendo alta, aún en centros con alto volumen de procedimientos y más aún en centros no dedicados a la atención de estos pacientes. En este artículo se revisarán algunos aspectos epidemiológicos, las herramientas diagnósticas actuales, su etapificación, y las opciones terapéuticas de acuerdo al estadío, sea en etapas precoces o avanzadas, la localización y tipo de tumor, opciones de reconstrucción del tránsito digestivo en base a lo reportado en la literatura internacional, la experiencia nacional y en base a nuestros propios resultados en

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Surgical treatment in type 2 diabetes and mild obesityIntroduction: In the last years, type 2 diabetes mellitus (T2DM) and obesity have become a serious public health problem, behaving as epidemic diseases. There is great interest in exploring different options for treatment of T2DM in non-morbidly obese patients. Objective: To report parameters of glicemic control in patients with T2DM and mild obesity who underwent laparoscopic Roux-en-Y Gastric Bypass (RYGBP). Material and Methods: Prospective clinical trial that includes patients with T2DM with a Body Mass Index (BMI) between 30 and 35 kg/mt 2 who underwent laparoscopic RYGBP from July 2008 through October 2010. Results: Thirty-one patients were included in the study, 15 men and 16 women, with an average age of 48.7 ± 8.6 years. The average time since onset of T2DM was 5.8 years. The average postoperative follow-up is 30.4 months. The average preoperative blood glucose and glycosylated hemoglobin was 152 ± 70 mg/dl and 7.7 ± 2.1%, respectively. All of them were using oral hypoglycemic agents, and 4 patients were insulin dependent. Only one patient had a postoperative complication (hemoperitoneum). At 36 months follow up the average BMI decreased to 24.7 Kg/mt