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short-term outcomes of robotic liver resection: An initial singleinstitution experience

World Journal of Hepatology 2022年第1期14卷 224-233页

作者： manuel Durán Javier Briceño Ana Padial Ferdinando Massimiliano Anelli juan manuel sánchez-hidalgo María Dolores Ayllón Rafael Calleja-Lozano Carmen García-Gaitan Unit of Hepatobiliary surgery and Liver Transplantation General and Digestive Surgery DepartmentReina Sofia University HospitalCordoba 14004Spain GC18 Translational Research in surgery of solid Organ Transplantation Maimonides Biomedical Research InstituteCórdoba 14004Spain GE09 Research in Peritoneal and Retroperitoneal Oncological surgery Maimonides Biomedical Research InstituteCórdoba 14004Spain Department of Anesthesiology and Resuscitation Reina Sofia University HospitalCordoba 14004Spain

BACKGROUND Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced *** robotic approach has gradually been introduced in liver surgery and has increased notably in recent ***,few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic *** To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary *** A total of forty consecutive patients underwent robotic liver resection(da Vinci Xi,***,United states)between June 2019 and January *** were prospectively followed and retrospectively *** characteristics and perioperative and short-term outcomes were *** are expressed as mean and standard *** study was approved by the Institutional Review *** The mean age of patients was 59.55 years,of which 18(45%)were *** mean body mass index was 29.41 kg/m^(2).Nine patients(22.5%)were *** were divided by type of resection as follows:Ten segmentectomies,three wedge resections,ten left lateral sectionectomies,six bisegmentectomies(two VVI bisegmentectomies and four IVb-V bisegmentectomies),two right anterior sectionectomies,five left hepatectomies and two right *** lesions occurred in twenty-nine(72.5%)of the *** mean operative time was 258.11 min and two patients were transfused intraoperatively(5%).Inflow occlusion was used in thirty cases(75%)and the mean total clamping time was 32.62 *** was a single conversion due to uncontrollable *** postoperative complications(Clavien–Dindo>Ⅲb)occurred in three patients(7.5%)and mortality in one(2.5%).No patient required readmission to the *** mean hospital stay was 5.6 *** Althou

关键词： Robotics Hepatectomy Minimally invasive surgery Liver surgery Da vinci

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Back-table surgery pancreas allograft for transplantation:Implications in complications

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World Journal of Transplantation 2021年第1期11卷 1-6页

作者： Javier Briceño juan manuel sánchez-hidalgo Alvaro Arjona-sanchez Department of General and Digestive surgery Reina Sofia University HospitalCordoba 14004Spain

To describe the main aspects of back-table surgery in pancreatic graft and the problems arising from poor ***-table surgery for pancreatic graft is a complex,meticulous and laborious technique on which the success of implant surgery and perioperative results *** technique can be described in the following steps:Preparation of the sterile table,ex-situ inspection of the pancreasspleen block,management of the duodenum,identification of the bile duct,preparation of the portal vein,preparation of the own graft arteries and anastomosis to the arterial graft,spleen management and graft preservation prior to implantation in the recipient.A careful inspection of the pancreas-spleen block should be *** is important to identify the stump of the main bile duct,the portal vein cuff,and the arrangement of the superior mesenteric artery and splenic *** redundant duodenum must be *** availability of a good venous cuff facilitates the portal vein anastomosis and the positioning of the graft,two key points to prevent *** section line of the arteries must be clean,without atherosclerosis,to prevent arterial *** superior and splenic mesenteric arteries are generally separated by dense fibrolymphatic *** artery can be reconstructed by interposing a"Y"graft from the donor iliac artery;or with an end-to-end anastomosis between the splenic artery and the superior mesenteric *** exquisite technique of bench work helps to prevent the most feared complications of pancreas transplantation:Thrombosis and graft pancreatitis.

关键词： Pancreas transplantation Back-bench work Pancreas thrombosis Graft pancreatitis Arterial reconstruction Pancreas allograft

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Colorectal peritoneal metastases:Optimal management review

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World Journal of Gastroenterology 2019年第27期25卷 3484-3502页

作者： juan manuel sánchez-hidalgo Lidia Rodríguez-Ortiz Alvaro Arjona-sánchez sebastián Rufián-Pena Angela Casado-Adam Antonio Cosano-Alvarez Javier Briceno-Delgado Department of General and Digestive surgery Reina Sofia University HospitalCordoba 14004Spain

The peritoneum is a common site of dissemination for colorrectal cancer, with a poorer prognosis than other sites of metastases. In the last two decades, it has been considered as a locoregional disease progression and treated as such with curative intention treatments. Cytoreductive surgery(CRs) and hyperthermic intraperitoneal chemotherapy(HIPEC) is the actual reference treatment for these patients as better survival results have been reached as compared to systemic chemotherapy alone, but its therapeutic efficacy is still under debate. Actual guidelines recommend that the management of colorectal cancer with peritoneal metastases should be led by a multidisciplinary team carried out in experienced centers and consider CRs + HIPEC for selected patients. Accumulative evidence in the last three years suggests that this is a curative treatment that may improve patients disease-free survival, decrease the risk of recurrence, and does not increase the risk of treatment-related mortality. In this review we aim to gather the latest results from referral centers and opinions from experts about the effectiveness and feasibility of CRs + HIPEC for treating peritoneal disease from colorectal malignancies.

关键词： Peritoneal metastases Colorectal cancer Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis

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Improved organs at risk segmentation based on modified U‐Net with self‐attention and consistency regularisation

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CAAI Transactions on Intelligence Technology 2024年第4期9卷 850-865页

作者： Maksym Manko Anton Popov juan manuel Gorriz Javier Ramirez Electronic Engineering Department Igor Sikorsky Kyiv Polytechnic InstituteKyivUkraine Department of signal Theory Telematics and CommunicationsUniversity of GranadaGranadaSpain

Cancer is one of the leading causes of death in the world,with radiotherapy as one of the treatment *** planning starts with delineating the affected area from healthy organs,called organs at risk(OAR).A new approach to automatic OAR seg-mentation in the chest cavity in Computed Tomography(CT)images is *** proposed approach is based on the modified U‐Net architecture with the ResNet‐34 encoder,which is the baseline adopted in this *** new two‐branch Cs‐sA U‐Net architecture is proposed,which consists of two parallel U‐Net models in which self‐attention blocks with cosine similarity as query‐key similarity function(Cs‐sA)blocks are inserted between the encoder and decoder,which enabled the use of con-sistency *** proposed solution demonstrates state‐of‐the‐art performance for the problem of OAR segmentation in CT images on the publicly available segTHOR benchmark dataset in terms of a Dice coefficient(oesophagus-0.8714,heart-0.9516,trachea-0.9286,aorta-0.9510)and Hausdorff distance(oesophagus-0.2541,heart-0.1514,trachea-0.1722,aorta-0.1114)and significantly outperforms the *** current approach is demonstrated to be viable for improving the quality of OAR segmentation for radiotherapy planning.

关键词： 3‐D computer vision deep learning deep neural networks image segmentation medical image processing object segmentation

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Guest Editorial:Knowledge‐based deep learning system in bio‐medicine

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CAAI Transactions on Intelligence Technology 2024年第4期9卷 787-789页

作者： Yu‐Dong Zhang juan manuel Górriz University of Leicester LeicesterUK University of Granada GranadaSpain

Numerous healthcare procedures can be viewed as medical sector *** the modern era,computers have become indispensable in the realm of medical decision‐***-ever,the common view of computers in the medical field typically extends only to applications that support doctors in diagnosing *** more tightly intertwine computers with the biomedical sciences,professionals are now more frequently utilising knowledge‐driven deep learning systems(KDLs)and their foundational technologies,especially in the domain of neuroimaging(NI).

关键词： learning computer doctor

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GAN‐MD:A myocarditis detection using multi‐channel convolutional neural networks and generative adversarial network‐based data augmentation

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CAAI Transactions on Intelligence Technology 2024年第4期9卷 866-878页

作者： Hengame Ahmadi Golilarz Alireza Azadbar Roohallah Alizadehsani juan manuel Gorriz Department of Medical Radiation Engineering Faculty of EngineeringLahijan BranchIslamic Azad UniversityLahijanIran Department of Medical Radiation Engineering Lahijan BranchIslamic Azad UniversityLahijanIran Institute for Intelligent systems Research and Innovation(IIsRI) Deakin UniversityWaurn PondsVictoriaAustralia Data science and Computational Intelligence Institute University of GranadaGranadaSpain

Myocarditis is a significant public health concern because of its potential to cause heart failure and sudden *** standard invasive diagnostic method,endomyocardial bi-opsy,is typically reserved for cases with severe complications,limiting its widespread ***,non‐invasive cardiac magnetic resonance(CMR)imaging presents a promising alternative for detecting and monitoring myocarditis,because of its high signal contrast that reveals myocardial *** assist medical professionals via artificial intelligence,the authors introduce generative adversarial networks‐multi discriminator(GAN‐MD),a deep learning model that uses binary classification to diagnose myocarditis from CMR *** approach employs a series of convolutional neural networks(CNNs)that extract and combine feature vectors for accurate *** authors suggest a novel technique for improving the classification precision of *** generative adversarial networks(GANs)to create synthetic images for data augmentation,the authors address challenges such as mode collapse and unstable *** a reconstruction loss into the GAN loss function requires the generator to produce images reflecting the discriminator features,thus enhancing the generated images'quality to more accurately replicate authentic data ***,combining this loss function with other reg-ularisation methods,such as gradient penalty,has proven to further improve the perfor-mance of diverse GAN models.A significant challenge in myocarditis diagnosis is the imbalance of classification,where one class dominates over the *** mitigate this,the authors introduce a focal loss‐based training method that effectively trains the model on the minority class *** GAN‐MD approach,evaluated on the Z‐Alizadeh sani myocarditis dataset,achieves superior results(F‐measure 86.2%;geometric mean 91.0%)compared with other deep learning models and traditional machine learning methods.

关键词： 2‐D 3‐D

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Brent *** Texas Intermediate in the Us petro derivatives price formation

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Petroleum science 2024年第1期21卷 729-739页

作者： Alejandro Almeida Antonio A.Golpe juan manuel Martín-Alvarez Jose Carlos Vides Universidad Internacional de La Rioja Department of Quantitative Methods for Economics and BusinessLa RiojaSpain University of Huelva Department of Economics and Centro de Estudios Avanzados en FisicaMatematicas y Computacion and ICEIHuelvaSpain Complutense University of Madrid Department of Applied and Structural Economics and History and ICEIMadridSpain

In this paper,we apply the spatial panel model to explore the relationship between the dynamic of two types of crude oil prices(WTI and Brent crude oil)and their refined products over *** the turbulent months of 2011,when Cushing Oklahoma had reached capacity and the crude oil export ban removal in 2015 as breakpoints,we apply this method both in the full sample and the three resultant ***,results suggest our results show that both WTI and Brent display very similar behaviour with the refined ***,when attending to each regime,results derived from the first and third regimes are quite similar to the full sample ***,during the second regime,Brent crude oil became the benchmark in the petrol market,and it influenced the distillate ***,our model can let us determine the price-setters and price-followers in the price formation mechanism through refined *** results possess important considerations to policymakers and the market participants and the price formation.

关键词： Crude oil prices spatial panel model Refined products Price formation

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Late hepatic artery pseudoaneurysm:A rare complication after resection of hilar cholangiocarcinoma

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World Journal of Gastroenterology 2008年第38期14卷 5920-5923页

作者： Javier Briceńo lvaro Naranjo Rubén Ciria juan manuel sánchez-hidalgo Luis Zurera Pedro López-Cillero Hepatobiliary surgery and Liver Transplantation Unit Department of Surgery Hospital Universitario Reina SofíaCórdoba 14004 Spain Interventional Radiology Unit Department of Surgery Hospital Universitario Reina SofíaCórdoba 14004 Spain

We report an unusual pathological entity of a pseudoaneurysm of the right hepatic artery, which developed two years after the resection of a type Ⅱ hilar cholangiocarcinoma and secondary to an excessive skeletonization for regional lymphadenectomy and neoadjuvant external-beam radiotherapy. After a sudden and massive hematemesis, a multidetector computed tomographic angiography (MDCTA) showed a hepatic artery pseudoaneurysm. Angiography with embolization of the pseudoaneurysm was attempted using microcoils with adequate patency of the hepatic artery and the occlusion of the pseudoaneurysm. A new episode of hematemesis 3 wk later revealed a partial revascularization of the pseudoaneurysm. A definitive interventional radiological treatment consisting of transarterial embolization (TAE) of the right hepatic artery with stainless steel coils and polyvinyl alcohol particles was effective and well-tolerated with normal liver function tests and without signs of liver infarction.

关键词：假动脉瘤栓塞肝动脉假动脉瘤胆管癌

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Peritoneal metastases of colorectal origin treated by cytoreduction and HIPEC: An overview

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World Journal of Gastrointestinal Oncology 2014年第10期6卷 407-412页

作者： Alvaro Arjona-sánchez Francisco Javier Medina-Fernández Francisco Cristobal Mu?oz-Casares Angela Casado-Adam juan manuel sánchez-hidalgo sebastián Rufián-Pe?a Unit of Oncological and Pancreatic surgery Department of General and Digestive Surgery University Hospital Reina Sofia 14004 Cordoba Spain

Colorectal peritoneal carcinomatosis was considered a terminal condition with a merely palliative treatment that included only supportive care, palliative surgery and the best systemic chemotherapy. since the birth of a new approach, cytoreductive surgery with peritonectomy procedures together with hyperthermic intraperitoneal chemotherapy and/or early postoperative intraperitoneal chemotherapy to treat peritoneal carcinomatosis, many research groups contributed with promising results using this procedure being up to date this strategy the only one that has shown curative benefits on colorectal peritoneal carcinomatosis achieving reported overall survival rates up to 64 mo and fiveyear survival rates up to 51%. The aim of this paper is to expose an updated overview of the therapeutic possibilities of these procedures in colorectal peritoneal metastases in the same way that our Unit of Oncologic surgery has performed since 1997 with more than four hundred procedures.

关键词： Carcinomatosis peritoneal Colon cancer Intraperitoneal chemotherapy Cytoreduction Perito-nectomy

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Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study

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Journal of Geriatric Cardiology 2024年第7期21卷 723-732页

作者： Francisco Marín manuel Anguita sánchez Iñaki Lekuona Marcelo sanmartín Fernán-dez Vivencio Barrios Carlos Perez Muñoz juan Cosín-sales Alejandro IPérez Cabeza Vanesa Roldán schilling Carles Rafols Priu Esteban Orenes-Piñero María Asunción Es-teve-Pastor Department of Cardiology Hospital Clínico Universitario Virgen de la ArrixacaIMIB-ArrixacaUniversity of MurciaCIBERCVMurciaSpain Department of Cardiology Hospital Reina Sofía CórdobaIMIBICUniversity of CordobaCIBERCVCórdobaSpain Hospital Galdakao-Usansolo BizkaiaSpain Department of Cardiology Hospital Uni-versitario Ramony CajalCIBERCVMadridSpain Department of Cardiology University Hospital Ramóny CajalAl-caláUniversityMadridSpain Medical Center La Capillita Sanlúcar de Barrameda.Private cardiology clinicJerez de la FronteraSpain Department of Cardiology Hospital Arnau de VilanovaValenciaSpain Department of Car-diology Virgen de la Victoria University HospitalCIBERCV.MalagaSpain Department of Haematology Hospital Clínico Universitario Virgen de la ArrixacaUniversity of MurciaMurciaSpain Department of Medical Affairs Bayer HispaniaBarcelonaSpain Department of Biochemistry and Molecular Biology-A University of MurciaMurciaSpain

Objectives To analyze the clinical profile,adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial(AF),taking rivaroxaban in clinical *** Out of 1433 patients,453(31.6%)were octogenarians at *** to younger patients,octogenarians had more comorbidities,higher CHA2Ds2-VAsc(4.5±1.3vs.3.0±1.4;Ps-BLED scores(2.0±1.0vs.1.4±1.0;Pse of rivaroxaban was adequately prescribed in 83.4%of patients,but more frequently in the younger population(71.1%vs.89.1%;P=0.039).After a mean follow-up of 2.2±0.6 years,annual rates of stroke+systemic embolism+transient ische-mic attack,MACE,cardiovascular death and major bleeding were 1.03%,1.24%,1.03%and 1.75%,respectively,in octogenarian *** for progressive heart failure death and major bleeding,rates of outcomes in octogenarians were similar com-pared to younger *** octogenarians,the concomitant use of antiplatelet agents and non-severe dementia were independ-ently associated with the development of ischemic stroke,whereas previous coronary revascularization and heart failure with and higher HAs-BLED score with major ***,Conclusions In clinical practice,around one third of patients taking rivaroxaban are *** patients have many comorbidities and a high thromboembolic *** that,rates of adverse events remain *** is adequately pre-scribed in the majority of octogenarians.

关键词： patients atrial bleeding

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