A pilot study was done to address the efficacy of a General Packet Radio Service mobile phone-based telemedicine system used to improve follow-up after ambulatory surgery. The method involves sending images of surgical wounds or other areas from the patient's home, to assess local complications and avoid unnecessary hospital visits. Ninety-six (N = 96) patients were enrolled in the study. The phone used was a Nokia 6600, which provides images in Joint Photographic Experts Group format. These images were sent via e-mail and visualized on a standard 17-inch screen of a personal computer. After the follow-up period, self-reported patient satisfaction was assessed by analyzing the replies to a 9-item questionnaire. Thirty of the 96 patients (31.3%) reported local problems including: hematoma in 20 (66.7%) patients, surgical bandage blood-stained in 7 (23.3%), exudates in 1 (3.3%), allergic skin reactions in 1 (3.3%), and bandage too tight in 1 (3.3%). In total, 225 photographs were evaluated by 3 physicians. In all cases, it was possible to identify and assess the postoperative problem with consensus among the 3 physicians. Images served to resolve patients' concerns in 20 individuals (66.7%). In 10 patients (33.3%), concerns were satisfied but it was suggested that follow-up images be sent in the following days. Only 1 patient (3.3%) was asked to visit the hospital. The telemedicine system proposed increases the efficiency of home follow-up to ambulatory surgery, avoids unnecessary hospital visits, and clearly improves patient satisfaction.

PurposeThe Spanish Early-onset Colorectal Cancer (SECOC) study is a multicentre prospective cohort established in Spain to investigate the molecular basis of early-onset colorectal cancer (EOCRC), including metabolic alterations.Participants220 patients with EOCRC have been enrolled since January 2019 through 18 centres across Spain. Individual-level data were collected by questionnaire, including lifestyle and other colorectal cancer-related factors. Medical record review was performed to capture clinical, histopathological and familial cancer history data. Biospecimen collection (blood, stool, tissue) at diagnosis and at various time points across treatment, as applicable, is also completed.Findings to dateParticipants had a median age of 44 years (range 14–49), and the majority are men (60%), with individuals age 40–49 years at EOCRC diagnosis being over-represented. Forty-three per cent of participants were diagnosed with a tumour in the rectosigmoid junction/rectum. Nearly two-thirds of EOCRC cases (64%) were diagnosed with advanced stage (III–IV) disease, and 28% of cases had no reported familial history of cancer.Future plansWe are actively recruiting and observing participants; we plan to administer follow-up questionnaires and perform additional biospecimen collection. This prospective cohort offers a unique, rich resource for research on EOCRC aetiologies and will contribute to larger international efforts to disentangle the rising disease burden.

Because of its feasibility, acceptability, and cost-efficiency, the direct referral system has the potential to improve relations between primary and specialized care and enhance the quality of care by shortening the delay to treatment.

Introducción: La progresiva implantación en nuestro pais de la Cirugía Mayor Ambulatoria (CMA) puede afectar a la enseñanza de la cirugía, si consideramos el desplazamiento presente y futuro hacia las Unidades de CMA de intervenciones quirúrgicas muy frecuentes, de riesgo medio y bajo, que constituyen la base del aprendizaje quirúrgico. El objetivo del presente trabajo es 1º) conocer la opinión de los residentes de especialidades quirúrgicas sobre la repercusión que la CMA puede tener en su formación quirúrgica y 2º) conocer las posibles soluciones que aportan en este sentido.Material y Métodos: Se ha realizado una encuesta de 17 preguntas (13 cerradas, 2 abiertas y 1 mixta) a 72 residentes pertenecientes a 7 de las especialidades quirúrgicas que participan en la Unidad de CMA del Hospital Clínico San Carlos de Madrid.Resultados: La encuesta ha sido cumplimentada por el 36,1% de los residentes. De ellos, el 100% considera que: 1) es importante conocer y formarse en este tipo de cirugía. 2) las técnicas quirúrgicas que se realizan en la UCMA del Hospital son fundamentales para la formación del residente. 3) la Cirugía Mayor Ambulatoria debe incluirse en la formación de su especialidad durante el periodo de residencia. El 80,8% considera que tener formación en CMA contribuye a mejorar las expectativas laborales una vez finalizada la residencia.Conclusiones: Los residentes consideran que es necesaria su participación en la actividad de las Unidades de CMA, necesitándose, en este sentido, la creación de programas bien estructurados, elaborados Encuesta de opinión sobre la cirugía mayor ambulatoria en la formación del residente de especialidades quirúrgicas y coordinados. Estos han de estar consensuados por todas las partes afectadas y se han de adaptar a las características de cada especialidad. Palabras claves: Cirugía Mayor Ambulatoria; Formación quirúrgica; Formación del Residente de Especialidades Quirúrgicas; Residencia en cirugía; Enseñanza de la Cirugía Mayor Ambulatoria.