Objetivo.- Reportar nuestra experiencia en el tratamiento del insulinoma pancreático vía laparoscópica. Pacientes y métodos.- Entre enero del 2000 a septiembre del 2005, acudieron a nuestra institución cuatro pacientes con diagnóstico clínico y radiológico de Insulinoma. Resultados.- Todos fueron abordados vía laparoscópica con la intención de enuclear el tumor. En tres de ellos se pudo realizar la enucleación laparoscópica completa, y en el paciente restante se convirtió a laparotomía para realizar una resección de la porción central del páncreas. Una paciente presentó una fístula pancreática que cerró espontáneamente. El estudio anatomopatológico reveló en todos los casos un tumor benigno de los islotes del páncreas. La glicemia retornó a valores normales en todos los casos. Conclusión.- La enucleación laparoscópica del insulinoma pancreático es factible ...

Se presenta el caso de una paciente de 51 años con cuadro clínico de hipoglicemia por un probable insulinoma pancreático Los exámenes de laboratorio confirmaron la sospecha de insulinoma, pero los estudios por imágenes no pudieron demostrar el tumor. Bajo estas circunstancias, la paciente tuvo abordaje laparoscópico y con la ayuda del ultrasonido intraoperatorio se localizó el tumor en el proceso uncinado del páncreas y, finalmente, se procedió a la enucleación laparoscópica.

Objectives. To evaluate the payment mechanism for outpatient care of patients diagnosed with cervical and breast cancer at the national institute of neoplastic diseases (inem). Methods. It is an observational,  descriptive and croos-sectional study. the population was composed of patients diagnosed with cervical and breast cancer, affiliated with the integrated health insurance system (sis) in peru who received outpatient care at the inen, during the period 2014-2016. information was obtained from the insurance and information technology office. Results. There is no temporal relationship between the service provided by inen and the financial disbursement made by the peruvian army ́s health insurance fund administration institute (iafas). there is an annual increase in cervical and breast cancer care. by type of cancer: breast cancer presented a maximum consultation  concentrat...

Objectives. To evaluate the payment mechanism for outpatient care of patients diagnosed with cervical and breast cancer at the national institute of neoplastic diseases (inem). Methods. It is an observational, descriptive and croos-sectional study. the population was composed of patients diagnosed with cervical and breast cancer, affiliated with the integrated health insurance system (sis) in peru who received outpatient care at the inen, during the period 2014-2016. information was obtained from the insurance and information technology office. Results. There is no temporal relationship between the service provided by inen and the financial disbursement made by the peruvian army  health insurance fund administration institute (iafas). there is an annual increase in cervical and breast cancer care. by type of cancer: breast cancer presented a maximum consultation concentration of 8.74 in...

Introducción.- La pancreatectomía proximal o distal constituye el tratamiento estándar de los tumores benignos del páncreas que no pueden ser resecados. Estos procedimientos implican una resección radical así como una importante pérdida de tejido pancreático normal que puede resultar en insuficiencia pancreática endocrina y/o exocrina. Objetivo.- Reportar nuestra experiencia institucional con la pancreatectomía central para el tratamiento de tumores benignos y de bajo potencial maligno del cuello y cuerpo del páncreas enfatizando en las indicaciones y los resultados perioperatorios. Métodos.- Serie prospectiva de pacientes con sospecha de tumores benignos del cuerpo del páncreas. Técnica quirúrgica.- Resección del páncreas central con anastomosis pancreatoyeyunal en Y de Roux. Resultados.- Entre marzo de 1997 y mayo de 2005, 12 patientes tuvieron pancreatectomía central...

Objective: The study aimed to describe and compare minimally invasive surgery (MIS) and open surgery for rectal cancer in Peru. Material and methods: A retrospective single-center analysis was performed for all patients who underwent sphincter- sparing surgery for non-metastatic rectal cancer at Instituto Nacional de Enfermedades Neoplásicas in Peru between January 2016 and December 2020. Clinical, perioperative, pathological, and survival outcomes were compared between both groups. A propensity score matching method was used to minimize bias. Results: 162 patients were included in the final analysis. 124 had open surgery and 38 had MIS. Patients, clinical tumour, pathological characteristics, and perioperative were similar between groups after matching. Similar circumferential resection margin (CRM) with optimal quality of the mesorectum (p=1.000) but higher number of lymph nodes resec...

Objetivo: El objetivo del estudio fue evaluar el valor pronóstico de la razón de ganglios metastásicos (LNR) en los pacientes con cáncer gástrico operados de gastrectomía radical D2. Materiales y métodos: Se revisaron retrospectivamente las historias clínicas de 498 pacientes del Instituto Nacional de Enfermedades Neoplásicas (INEN) entre los años 2008 y 2011 que cumplían los criterios de inclusión y exclusión. Se dividieron en 4 grupos de acuerdo a su LNR; LNR0: 0, LNR1: 0-0,13, LNR2: 0,14-0,4 y LNR3: ≥ 0,4. Resultados: La mediana de ganglios resecados fue de 42 [rango 8-153] y 494 (99,2%) pacientes tuvieron más de 15 ganglios resecados. 340 (68,5%) pacientes presentaron compromiso ganglionar y 175 (35,1%) fueron clasificados como pN3, 94 (18,5%) pN2 y 72 (14,5%) como pN1. 285 (57,2%) pacientes tuvieron estadío III. Hubo diferencias significativas entre los grupo...

Background: The standard treatment for ampullary adenocarcinoma is pancreaticoduodenectomy. Identification of preoperative risk factors might help the clinician to select patients fit for resection and potentially decrease morbidity and mortality after PD. We conducted a cohort study to determine the preoperative factors related to 90-day severe morbidity and mortality after PD.Methods: We conducted a retrospective cohort study in patients with a diagnosis of ampullary adenocarcinoma who underwent an open PD between January 2010 and December 2019 at our tertiary centre.Results: Independent preoperative predictors of mortality were the albumin-bilirubin (ALBI) grade 3 (OR: 21.7; CI 95: 2.1-226.9; p=0.01) and the estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 (OR: 17.7; CI 95: 1.8-172.6; p=0.013). The eGFR <90 mL/min/1.73 m2 (OR = 6.6; CI 95: 1.9-23.4; p=0.003) and prothrom...

Aim: Describe and analyze the safety of the “Enhanced Recovery After Surgery” (ERAS) protocol in elective procedures for colorectal cancer. Materials and Methods: Observational study of 272 patients with colorectal cancer who underwent elective surgery from January 2019 to September 2020 at the “Instituto Nacional de Enfermedades Neoplásicas”, Peru, were retrospectively collected. U Mann-Whitney test, Pearson chi-square test and odds ratios (OR) were used for statistical analysis. Results: 90 patients were included in the ERAS program with a median postoperative hospital stay of 3 days (range 3-19). Laparoscopic surgery was performed in 53% of the patients with significantly shorter postoperative hospital stay in comparison with the patients who had open surgery (p=0,035). Oral food intake less than 24 hours postoperatively was 91%, and early mobilization in 89% of the cases. Th...

Aim: Describe and analyze the safety of the “Enhanced Recovery After Surgery” (ERAS) protocol in elective procedures for colorectal cancer. Materials and Methods: Observational study of 272 patients with colorectal cancer who underwent elective surgery from January 2019 to September 2020 at the “Instituto Nacional de Enfermedades Neoplásicas”, Peru, were retrospectively collected. U Mann-Whitney test, Pearson chi-square test and odds ratios (OR) were used for statistical analysis. Results: 90 patients were included in the ERAS program with a median postoperative hospital stay of 3 days (range 3-19). Laparoscopic surgery was performed in 53% of the patients with significantly shorter postoperative hospital stay in comparison with the patients who had open surgery (p=0,035). Oral food intake less than 24 hours postoperatively was 91%, and early mobilization in 89% of the cases. Th...