The results obtained in our surgical unit in terms of morbidity, mortality and five-year actuarial survival rates are comparable to those of other units at large institutions, which are currently considered the standards of quality.

simultaneous or sequential treatment of liver metastases of colon cancer? experience in 76 patientsBackground: Synchronous liver metastases of colon cancer can be managed with sequential or simultaneous surgical management of the primary tumor and the metastases. aim: To compare the evolution of patients whose liver metastases were treated sequentially or simultaneously. Material and Methods: Retrospective analysis of 76 patients aged 63 ± 11 years (67% males). In 25, metastases were managed simultaneously and in 51 there were treated sequentially after a period of chemotherapy. All interventions were performed by the same surgeon. results: Patients treated sequentially had a higher number of metastases and more lymph nodes involved than their counterparts treated simultaneously. The overall resectability index was 78%. Eighteen major and 28 minor hepatic resections were carried out. Significantly more major resections were carried out in the sequential treatment group. Mean hospital stay was 11 days and 20% of patients had complications, with no differences between groups. Survival at one, three and five years was 75, 45 and 36% in the simultaneous treatment and 76, 49 and 29% in the sequential treatment group (with no significant differences between groups). conclusions: In this group of patients no differences in complications or survival were observed when liver metastases were treated simultaneously or sequentially. However groups were not homogeneous.

Duodenal intramural haematoma secondary to chronic pancreatitis is rare, although the diagnosis should be made with imaging and, if suspected, start conservative treatment and surgery only in complicated cases.

Objective: The purpose of this study was to assess the resectability and effectiveness of repeat hepatectomy for relapsing liver metastases of colorectal origin in terms of morbidity, mortality, overall survival, and disease-free survival.Methods: A retrospective study was performed on a prospective cohort of patients with colorectal liver metastases who underwent repeat surgery at Hospital Universitario San Cecilio, Granada (Spain), from March 2003 to June 2013. Primary outcome variables included survival and morbidity within 30 days post-surgery.Results: A total of 147 patients with colorectal liver metastases underwent surgical excision during the study period; 61 patients had liver recurrence, and 34 of these received repeat surgery. The overall survival rate at 5 and 10 years for resected patients (n = 27/34) was 48% and 48%. Mean hospital stay was 8.9 ± 3.5 days, morbidity was 9%, and mortality was 0%.Conclusion: Repeat liver resection for colorectal liver metastases is a safe, effective surgical procedure whose results are similar to those obtained after initial liver resection.

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