Open Access
Intrathymic inoculation of donor bone marrow cells prior to xenotransplantation of pig pancreatic islets into diabetic rats
(Appleton & Lange, 1994) Villa, Vanessa H. de; Balén Rivera, Enrique; Torramadé, Jaime R.; Regueira, F.; Díez-Caballero, A.; Sierra, A.; Sáez, E.; Pardo, Fernando; Hernández, José Luis; Cienfuegos, Javier A.; Ciencias de la Salud; Osasun Zientziak
Open Access
Metabolic and immunohistochemical asessment of endocrine pancreatic function after orthotopic multivisceral transplantation
(Elsevier, 1998) Balén Rivera, Enrique; Montuenga, Luis M.; Pardo, Fernando ; Hernández, José Luis ; Herrera Cabezón, Javier; Lera, José Miguel; Cienfuegos, Javier A. ; Ciencias de la Salud; Osasun Zientziak
Open Access
Influence of cold ischemia time on oxidative stress after experimental pancreas transplantation
(Elsevier, 1999) Zazpe, Cruz; Balén Rivera, Enrique; Ferrer, J. V.; Sáez, M. J.; Guerrero, David; Herrera Cabezón, Javier; Lera, José Miguel; Ciencias de la Salud; Osasun Zientziak
Open Access
Enfermedad diverticular del colon sigmoideo: aspectos diagnósticos y terapéuticos
(Grutesa, 1991) Torramadé, Jaime R.; Cienfuegos, Javier A.; Pardo, Fernando; Hernández, José Luis; Benito, César; González, Jesús; Balén Rivera, Enrique; Villa, Vanessa H. de; Ciencias de la Salud; Osasun Zientziak
Open Access
Arteriodigestive fistula: a complication associated with intra-operative and external beam radiotherapy following surgery for gastric cancer
(Wiley, 1992) Villa, Vanessa H. de; Calvo, Felipe A.; Bilbao, Jose I.; Balén Rivera, Enrique; Hernández, José Luis ; Pardo, Fernando; Cienfuegos, Javier A.; Ciencias de la Salud; Osasun Zientziak
Intestinal hemorrhage due to arteriodigestive fistula is described to be a rare and serious complication of radiotherapy. Three cases of this type of fistula in gastric cancer patients treated with gastrectomy, intraoperative electron boost (15 Gy), and fractionated external beam irradiation (46 Gy) are reported. Selective angiography is most helpful in the diagnosis and immediate surgery could be lifesaving. An attempt to explain the etiopathogenesis is made.
Open Access
The Endo-GIA stapler for the side-to-side colorectal anastomosis in the Duhamel operation
(Springer, 1994) Balén Rivera, Enrique; Hernández, José Luis; Pardo, Fernando; Villa, Vanessa H. de; Cienfuegos, Javier A.; Ciencias de la Salud; Osasun Zientziak
A new technical modification of the Duhamel operation for construction of the side-to-side colorectal anastomosis is reported. A 21/2-year-old boy was duagnosed as having Hirschsprung's disease affecting the rectum and sigmoid colon. A Duhamel operation was performed with three modifications of the technique described by Lester W. Martin: the side-to-side colorectal anastomosis was performed with an Endo-GIA 30 stapler (Auto Suture; United States Surgical Corporation, Norwalk, Conn.) in an inverted V-shaped triangular manner; the remnant of the rectal stump was excited just above the Endo-GIA anastomosis, thus preserving only the rectal ampulla; and the rectal stump was left closed without being anstomosed to the descending colon. The postoperative functional results were excellent 6 months after the operation.
Open Access
Multivisceral abdominal transplantation: functional assesment of liver and pancreatic grafts
(Elsevier, 1992) Balén Rivera, Enrique; Cienfuegos, Javier A.; Pardo, Fernando; Hernández, José Luis; Benito, César; González, Jesús; Villa, Vanessa H. de; Torramadé, Jaime R.; Ciencias de la Salud; Osasun Zientziak
Open Access
The complications of central venous access systems: a study of 218 patients.
(Scandinavian University Press, 1993) Torramadé, Jaime R.; Cienfuegos, Javier A.; Hernández, José Luis; Pardo, Fernando; Benito, César; González, Jesús; Balén Rivera, Enrique; Villa, Vanessa H. de; Ciencias de la Salud; Osasun Zientziak
Objective: To evaluate the safety and usefulness of systems for obtaining central venous access. Design: Prospective open study. Setting: Clinica Universitaria de Navarra, Spain. Subjects: 218 consecutive patients who required long term venous access either for chemotherapy or for total parenteral nutrition, and who had no evidence of infection, a platelet count of over 40 x 10(9)/l, and a life expectancy of three months or more, had 234 devices inserted. Interventions: Insertion of either a silicone rubber (Port-A-Cath) or a polyurethane (Implantofix) catheter into the cephalic, jugular or subclavian vein, leaving the tip in the superior vena cava. Results: Between February 1985 and December 1990, 234 devices were implanted in 218 patients aged from 0.9 to 78 years. The median (range) length of time that the catheters functioned was 277 (7-1887) days. The overall incidence of complications was 0.09/100 days inserted, and the complication rates for infection and thrombosis were 0.02 and 0.03/100 days, respectively. Thirty two devices were removed because of complications, and 19 because the treatment had finished. Five of the 218 patients (2%) were lost to follow up. Conclusions: These devices have a long working life, and a low rate of complications, and are of great value to patients who require long term or cyclical intravenous treatment.
Open Access
Assessment of intestinal preservation injury and duodenal rejection in a multivisceral allotransplantation model in the pig
(Appleton & Lange, 1996) Balén Rivera, Enrique; Cienfuegos, Javier A.; Montuenga, Luis M.; Hernández, José Luis; Pardo, Fernando; Villa, Vanessa H. de; Torramadé, Jaime R.; Regueira, F. ; Ciencias de la Salud; Osasun Zientziak
Open Access
International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams
(Springer, 2010-08-12) Augestad, Knut M.; Lindsetmo, Rolv-Ole; Stulberg, Jonah; Reynolds, Harry; Senagore, Anthony; Champagne, Brad; Heriot, Alexander G.; Leblanc, Fabien; Delaney, Conor P.; International Rectal Cancer Study Group (IRCSG); Balén Rivera, Enrique; Ciencias de la Salud; Osasun Zientziak
Background Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates. Methods One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer. Results One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years¿ experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventy-four percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II + III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81). Conclusions There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods.