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Introduction Acute appendicitis (AA) is the most frequent surgical emergency. Clinical and analytical parameters are the diagnostic basis. We analyze the predictive value of inflammatory markers (IM) and their relationship with complicated appendicitis (cAA), identifying a predictive SCORE. Methods Retrospective observational analysis of 484 patients > 14 years operated on for AA at a tertiary center between 2017–2019. 2 groups according to intraoperative findings in complicated and uncomplicated appendicitis (ncAA). Univariate logistic regression analysis was performed to evaluate the predictive ability of leukocyte count (LC), percentage of neutrophils (PN), CRP and polyglobulia) creating a multivariable predictive model. Results 83.7% <65 years, with ultrasonography being the most frequent diagnostic study and laparoscopy the preferred route of approach. 43.30% (207) complicated vs 54.81% (262) uncomplicated. Both LC and PN and CRP present statistically significant associations with complicated appendicitis, with a cut-off point of LC >18,990, PN >61.8% and CRP >5.05 respectively, while polyglobulia is related to less complication OR 0.63% (p 0.01402). According to the multivariable model 1/ [1 + e - (- 4.45–0.000003 * leukocytes + 0.043 * neutrophil percentage + 0.138 * CRP - 0.028 (if red series anemia) - 1.031 (if red series polyglobulia))] good predictive capacity is evidenced. Harrel's C corrected index of 0.743 CI95% (0.69%-0.78%). Conclusions Elevation of IM is associated with cAA. The predictive ability of the described SCORE is acceptable, and useful in surgical planning. Prospective validation is needed.

Introduction Soft tissue leiomyosarcomas represents 0.7% of all malignant tumors. The most common location is the retroperitoneum, and the appearance of local or distant recurrences after resection is not uncommon. Pathological study is important to establish the confirmatory diagnosis and the prognosis of this type of lesion. Clinical case We present the clinical case of a patient with retroperitoneal leiomyosarcoma that was resected associated with ipsilateral nephrectomy. An 11-month follow-up revealed a hepatic lesion in segment 5, suggestive of metastasis. We decided on surgical resection of this lesion. Liver segmentectomy was performed by laparoscopic approach. The pathological study of the liver lesion showed a tumor of about 5 centimeters, compatible with leiomyosarcoma metastasis, presenting abundant mitoses (8/10), 15% necrosis in the central area and a Ki67 of 20%. Discussion Leiomyosarcoma is a very aggressive tumor. Its treatment is fundamentally based on the surgical resection of the primary and its possible metastases. The pathological study of the piece, with special emphasis on the number of mitoses, as well as the Ki- 67%, are indicators of the aggressiveness of the tumor and the prognosis. Given the low incidence of these tumors, it is recommended that the approach of these tumors be done in multidisciplinary teams and in specialized centers.

INTRODUCTION Peritoneal dialysis is one of the renal replacement therapy options for patients with advanced chronic kidney disease. It provides an improvement in quality of life since it is practiced at home once a previous training has been completed, waiting for kidney transplant or if the patient is not a candidate for it. MATERIAL AND METHODS Between January 2014 and December 2017, an observational, descriptive, longitudinal and retrospective study was performed with 211 patients treated with peritoneal dialysis in a tertiary level hospital. In a 2-year follow-up, the complications, results and situation of peritoneal dialysis were analyzed, providing solutions for a better quality of patient care. Clinical and surgical variables were collected. RESULTS Survival of the first and second catheters was greater than 12 months in 79.5% and 86.2% of the patients, respectively. In the first 30 days after catheter placement, 4.7% of the patients had peritonitis. In no case was there visceral damage during surgery, nor was a reoperation required during the immediate postoperative period. Neither postoperative transfusions were needed nor were there leaks. The most important cause of end of technique (34.1%) was receiving a kidney transplant. CONCLUSIONS The peritoneal dialysis technique can be considered a good medical-surgical collaboration, since, in addition to complying with the established quality standards regarding this treatment, it is self-sufficient and effective as a renal replacement treatment in patients with advanced chronic kidney disease.