Cisticercosis visceral por Cysticercus tenuicollis en ovinos de faena en la Provincia de Santa Cruz, Argentina

Durante la zafra 2014-2015 en todos los frigoríficos de la localidad de Río Gallegos, provincia de Santa Cruz, llamó la atención un aumento importante de decomisos de vísceras rojas en corderos, debido a la presencia de lesiones en hígado. Con el fin de cuantificar y determinar la etiología de las lesiones observadas en una planta frigorífica en la faena de 811 corderos correspondientes a 2 tropas provenientes de 2 establecimientos ovejeros, se analizaron 50 corderos de cada uno, tomándose muestras de tejidos con lesiones para estudios histopatológicos, parasitológicos y microbiológicos. El 54% de los corderos presentó lesiones macroscópicas a la faena que consistieron en surcos o estrías subcapsulares de 10 a 20 mm de largo por 2 mm de ancho en ocasiones de color rojo y hemorrágicas y en otras de color blanco y aspecto sólido al tacto. Microscópicamente, ambos tipos de lesiones se caracterizaron por tener un centro necrótico acompañado por abundante inflamación no supurativa mediada principalmente por células mononucleares. En el examen parasitológico se observó la presencia de Cysticercus tenuicollis, adheridos a la superficie del hígado. Se concluye que las lesiones causantes de los decomisos se deben al parasitismo de los corderos por metacestodes de Taenia hydatigena.During the 2014-2015 season at a the slaughterhouses in Rio Gallegos city, Santa Cruz province, Argentina, an increase in the red viscera condemnation in lambs due to the presence of lesions in liver was observed. With the aim to quantify and to determine the aetiology of the those lesions, from 811 lambs belonging to two sheep farms, 50 lambs from each one were studied and sampled for histopathological, parasitological and bacteriological studies. Fifty four percent of the lambs presented macroscopic lesions characterized as sub capsular streaks of 10-20 mm long and 2 mm wide, reddish or whitish color. Microscopically both lesions showed a necrotic core surrounded by a non suppurative mononuclear inflammatory infiltration. The presence of Cysticercus tenuicollis adhered to the liver surface was observed. It is concluded that the lesions that causes liver condemnation in lambs at the slaughterhouse were due to the parasitism by the metacestode of Taenia hydatigenaEEA BarilocheFil: Santana, Jorge Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia De Extensión Rural Río Gallegos; ArgentinaFil: Martínez, Agustín. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Grupo Salud Animal; ArgentinaFil: Soulés, Anabel. Servicio Nacional de Sanidad Animal (SENASA). Área de Inocuidad y Calidad Agroalimentaria; ArgentinaFil: Milicevic, Francisco. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia De Extensión Rural Río Gallegos; ArgentinaFil: Marcellino, Romanela. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Grupo Salud Animal; ArgentinaFil: Larroza, Marcela Patricia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Grupo Salud Animal; ArgentinaFil: Robles, Carlos Alejandro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Grupo Salud Animal; Argentin

Hepatitis parasitaria por Lamanema chavezi en guanacos (Lama guanicoe) faenados en la Provincia de Santa Cruz, Argentina

Durante la zafra 2017-18 en un frigorífico de la localidad de Río Gallegos, Argentina, se detectaron lesiones en hígados de guanacos (Lama guanicoe) a la faena. Con el fin de caracterizar y determinar la causa de las lesiones se tomaron muestras de tejidos para histopatología y de materia fecal para análisis coproparasitológicos de 10 animales. Macroscópicamente se observaron nódulos esféricos, blanco-amarillentos, firmes al tacto de diversos tamaños. Estas lesiones estaban demarcadas por una cápsula fibrosa con infiltración de neutrófilos y macrófagos. Además, se detectaron lesiones más pequeñas, sin cápsula fibrosa, algunas hemorrágicas y otras con infiltrado celular linfocitario. En los cortes histológicos del hígado de un guanaco se observaron secciones de parásitos. En el examen coproparasitológico se observaron huevos de Lamanema chavezi, Nematodirus spp., Capillaria spp. y Trichuris spp. No se observaron huevos de Fasciola hepatica. Los coprocultivos confirmaron el desarrollo de larvas de 680-800 μm, con colas con terminación roma y presencia de ocho células intestinales coincidentes con lo descripto para L. chavezi. Se concluye que las lesiones hepáticas observadas se deben a la migración de las formas larvarias de L. chavezi, siendo este el primer reporte de esta patología en poblaciones silvestres de guanacos en la Patagonia Argentina.During the 2017-18 season in a slaughterhouse in Rio Gallegos, Argentina, macroscopic lesions in the liver of wild guanacos (Lama guanicoe) were detected. With the aim to characterize and to determine de cause of the lesions, tissues samples for histopathological studies and faeces for copro-parasitological analysis were collected from 10 animals. Macroscopically, spherical, various sizes, white-yellowish of firm consistency nodules were detected. These lesions were demarcated by a fibrous capsule with a cellular infiltration including degenerated neutrophils and macrophages. In addition, smaller focal lesions were also detected, without fibrous capsule, some haemorrhagic and others with mainly lymphocyte infiltration. In liver sections of one animal, several structures of parasites were observed. Eggs of Lamanema chavezi, Nematodirus spp., Capillaria spp. and Trichuris spp. were observed during the parasitological examination of faeces. No eggs of Fasciola hepatica were detected. It is concluded that the lesions observed were due to the migration of the larval forms of L. chavezi, being this the first report of this pathology in wild populations of guanacos in the Argentine Patagonia.Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad AnimalFil: Santana, Jorge Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia de Extensión Rural Rio Gallegos; ArgentinaFil: Martinez, Agustin. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad Animal; ArgentinaFil: Soulés, Anabel. Servicio Nacional de Sanidad Animal. Área de Inocuidad y Calidad Agroalimentaria; ArgentinaFil: Milicevic, Francisco. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia de Extensión Rural Rio Gallegos; ArgentinaFil: Cafrune Wierna, María Mercedes. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Salta. Área Salud Animal; ArgentinaFil: Larroza, Marcela Patricia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad Animal; ArgentinaFil: Robles, Carlos Alejandro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Area de Produccion Animal. Grupo de Sanidad Animal; Argentin

Urban Biodiversity: Economic and Environmental Management Strategies in Urban Environments of Colombia

El presente estudio tuvo como objetivo analizar la percepción y la opinión de 250 personas en relación con la biodiversidad urbana y las estrategias de gestión económica y ambiental en entornos urbanos. Se implementó un cuestionario estructurado que abordó temas clave, incluida la importancia de la biodiversidad urbana, las especies comunes, los desafíos y amenazas, las estrategias de gestión económica, las políticas necesarias y la viabilidad económica de las estrategias de conservación. Los resultados revelaron que la mayoría de los encuestados considera que la biodiversidad urbana es de "Alta" o "Muy alta" importancia. Las "Plantas autóctonas" fueron identificadas como las especies más comunes, mientras que la "Pérdida de hábitat" se destacó como el principal desafío. La estrategia más efectiva fue "Implementar programas de conservación financiados por el gobierno", y las "Restricciones a la tala de árboles" se consideraron políticas necesarias. La mayoría considera que las estrategias de conservación son "Viables" o "Muy viables". Estos resultados respaldan la importancia de la biodiversidad urbana y la necesidad de estrategias de gestión efectivas para promover ciudades sostenibles. Las conclusiones se alinean con la literatura científica existente, destacando la relevancia de abordar estos temas de manera integral en la planificación urbana y la conservación.The objective of this study was to analyze the perception and opinion of 250 people in relation to urban biodiversity and economic and environmental management strategies in urban environments. A structured questionnaire was implemented that addressed key topics, including the importance of urban biodiversity, common species, challenges and threats, economic management strategies, necessary policies, and economic viability of conservation strategies. The results revealed that the majority of respondents consider urban biodiversity to be of "High" or "Very high" importance. “Native Plants” were identified as the most common species, while “Habitat Loss” was highlighted as the main challenge. The most effective strategy was “Implement government-funded conservation programs,” and “Restrictions on logging” were considered necessary policies. Most consider conservation strategies to be "Viable" or "Very Viable." These results support the importance of urban biodiversity and the need for effective management strategies to promote sustainable cities. The conclusions align with existing scientific literature, highlighting the relevance of addressing these issues comprehensively in urban planning and conservation

a cross-sectional study

Objectives We determined the seroprevalence and correlates of Toxoplasma gondii infection in pregnant women in Aguascalientes City, Mexico. Design A cross-sectional survey. Setting Pregnant women were enrolled in the central Mexican city of Aguascalientes. Participants We studied 338 pregnant women who attended prenatal care in 3 public health centres. Primary and secondary outcome measures Women were examined for IgG/IgM antibodies to T. gondii by using commercially available enzyme immunoassays, and an avidity test. Multiple analyses were used to determine the association of T. gondii seropositivity with the characteristics of the pregnant women. Results Of the 338 pregnant women studied, 21 (6.2%) had IgG antibodies to T. gondii, and 1 (4.8%) of them was also positive for IgM antibodies to T. gondii. Avidity of IgG antibodies to T. gondii was high in the IgM-positive sample. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that T. gondii seropositivity was associated with white ethnicity (OR=149.4; 95% CI 10.8 to 2054.1; p<0.01), not washing hands before eating (OR=6.41; 95% CI 1.73 to 23.6; p=0.005) and use of latrine (OR=37.6; 95% CI 4.63 to 306.31; p=0.001). Conclusions Results demonstrate that pregnant women in Aguascalientes City have a low seroprevalence of T. gondii infection. However, this low prevalence indicates that most pregnant women are at risk for a primary infection. Factors associated with T. gondii exposure found in this study, including food hygiene, may be useful to determine preventive measures against T. gondii infection and its sequelae

Artificial Intelligence on FDG PET Images Identifies Mild Cognitive Impairment Patients with Neurodegenerative Disease

[EN] The purpose of this project is to develop and validate a Deep Learning (DL) FDG PET imaging algorithm able to identify patients with any neurodegenerative diseases (Alzheimer's Disease (AD), Frontotemporal Degeneration (FTD) or Dementia with Lewy Bodies (DLB)) among patients with Mild Cognitive Impairment (MCI). A 3D Convolutional neural network was trained using images from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The ADNI dataset used for the model training and testing consisted of 822 subjects (472 AD and 350 MCI). The validation was performed on an independent dataset from La Fe University and Polytechnic Hospital. This dataset contained 90 subjects with MCI, 71 of them developed a neurodegenerative disease (64 AD, 4 FTD and 3 DLB) while 19 did not associate any neurodegenerative disease. The model had 79% accuracy, 88% sensitivity and 71% specificity in the identification of patients with neurodegenerative diseases tested on the 10% ADNI dataset, achieving an area under the receiver operating characteristic curve (AUC) of 0.90. On the external validation, the model preserved 80% balanced accuracy, 75% sensitivity, 84% specificity and 0.86 AUC. This binary classifier model based on FDG PET images allows the early prediction of neurodegenerative diseases in MCI patients in standard clinical settings with an overall 80% classification balanced accuracy.This work was financially supported by INBIO 2019 (DEEPBRAIN), INNVA1/2020/83(DEEPPET) funded by Generalitat Valenciana, and PID2019-107790RB-C22 funded by MCIN/AEI/10.13039/501100011033/. Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org).The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California.Prats-Climent, J.; Gandia-Ferrero, MT.; Torres-Espallardo, I.; Álvarez-Sanchez, L.; Martinez-Sanchis, B.; Cháfer-Pericás, C.; Gómez-Rico, I.... (2022). Artificial Intelligence on FDG PET Images Identifies Mild Cognitive Impairment Patients with Neurodegenerative Disease. Journal of Medical Systems. 46(8):1-13. https://doi.org/10.1007/s10916-022-01836-w11346

Evaluación de la eficacia de antisárnicos contra Psoroptes ovis en ovinos

En el presente informe técnico se describen los principales resultados obtenidos en estudios de eficacia de formulaciones inyectables de ivermectina (IVM) y doramectina (DRM) contra Psoroptes ovis en ovinos infestados experimentalmente, su relación con la farmacocinética, y las recomendaciones prácticas que se sugieren para el uso de estos productos a partir de los resultados encontrados. Los estudios en los que se basa este informe fueron realizados por el Grupo de Salud Animal de la EEA INTA Bariloche y el Laboratorio de Farmacología del Centro de Investigación Veterinaria de Tandil (CIVETAN).Estación Experimental Agropecuaria BarilocheFil: Larroza, Marcela Patricia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad Animal; ArgentinaFil: Soler, Paula. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad Animal; ArgentinaFil: Robles, Carlos Alejandro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Area de Produccion Animal. Grupo de Sanidad Animal; ArgentinaFil: Martinez, Agustin. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Producción Animal. Grupo Sanidad Animal; ArgentinaFil: Cabrera, Francisco Raúl. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Area de Produccion Animal. Grupo de Sanidad Animal; ArgentinaFil: Canton, Candela. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Laboratorio de Farmacología; ArgentinaFil: Ballent, Mariana. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Laboratorio de Farmacología; ArgentinaFil: Lanusse, Carlos Edmundo. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Laboratorio de Farmacología; ArgentinaFil: Lifschitz, Adrián Luis. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Laboratorio de Farmacología; Argentin

Machine Learning-Based Analysis in the Management of Iatrogenic Bile Duct Injury During Cholecystectomy: a Nationwide Multicenter Study

Background Iatrogenic bile duct injury (IBDI) is a challenging surgical complication. IBDI management can be guided by artificial intelligence models. Our study identified the factors associated with successful initial repair of IBDI and predicted the success of definitive repair based on patient risk levels. Methods This is a retrospective multi-institution cohort of patients with IBDI after cholecystectomy conducted between 1990 and 2020. We implemented a decision tree analysis to determine the factors that contribute to successful initial repair and developed a risk-scoring model based on the Comprehensive Complication Index. Results We analyzed 748 patients across 22 hospitals. Our decision tree model was 82.8% accurate in predicting the success of the initial repair. Non-type E (p < 0.01), treatment in specialized centers (p < 0.01), and surgical repair (p < 0.001) were associated with better prognosis. The risk-scoring model was 82.3% (79.0-85.3%, 95% confidence interval [CI]) and 71.7% (63.8-78.7%, 95% CI) accurate in predicting success in the development and validation cohorts, respectively. Surgical repair, successful initial repair, and repair between 2 and 6 weeks were associated with better outcomes. Discussion Machine learning algorithms for IBDI are a novel tool may help to improve the decision-making process and guide management of these patients

Resource recovery from sulphate-rich sewage through an innovative anaerobic-based water resource recovery facility (WRRF)

[EN] This research work proposes an innovative water resource recovery facility (WRRF) for the recovery of energy, nutrients and reclaimed water from sewage, which represents a promising approach towards enhanced circular economy scenarios. To this aim, anaerobic technology, microalgae cultivation, and membrane technology were combined in a dedicated platform. The proposed platform produces a high-quality solid- and coliform-free effluent that can be directly discharged to receiving water bodies identified as sensitive areas. Specifically, the content of organic matter, nitrogen and phosphorus in the effluent was 45 mg COD.L-1 , 14.9 mg N.L-1 and 0.5 mg P.L-1 , respectively. Harvested solar energy and carbon dioxide biofixation in the form of microalgae biomass allowed remarkable methane yields (399 STP L CH 4.kg(-1) CODinf ) to be achieved, equivalent to theoretical electricity productions of around 0.52 kWh per m 3 of wastewater entering the WRRF. Furthermore, 26.6% of total nitrogen influent load was recovered as ammonium sulphate, while nitrogen and phosphorus were recovered in the biosolids produced (650 +/- 77 mg N.L-1 and 121.0 +/- 7.2 mg P.L-1).This research was supported by the Spanish Ministry of Economy and Competitiveness (MINECO, Projects CTM2014-54980-C2-1-R and CTM2014-54980-C2-2-R) jointly with the European Regional Development Fund (ERDF), which are gratefully acknowledged. This research was also supported by the Spanish Ministry of Education, Culture and Sport via two pre-doctoral FPU fellowships (FPU14/05082 and FPU15/02595) and by the Spanish Ministry of Economy and Competitiveness via two pre-doctoral FPI fellowships (BES-2015-071884, BES-2015-073403) and one Juan de la Cierva contract (FJCI-2014-21616). The authors would also like to acknowledge the support received from Generalitat Valenciana via two VALithornd post-doctoral grants (APOSTD/2014/049 and APOSTD/2016/104) and via the fellowships APOTI/2016/059 and CPI-16-155, as well as the financial aid received from the European Climate KIC association for the 'MAB 2.0' Project (APIN0057_ 2015-3.6-230_ P066-05) and Universitat Politecnica de Valencia via a pre-doctoral FPI fellowship to the seventh author.Seco Torrecillas, A.; Aparicio Antón, SE.; Gonzalez-Camejo, J.; Jiménez Benítez, AL.; Mateo-Llosa, O.; Mora-Sánchez, JF.; Noriega-Hevia, G.... (2018). Resource recovery from sulphate-rich sewage through an innovative anaerobic-based water resource recovery facility (WRRF). Water Science & Technology. 78(9):1925-1936. https://doi.org/10.2166/wst.2018.492S19251936789Bair, R. A., Ozcan, O. O., Calabria, J. L., Dick, G. H., & Yeh, D. H. (2015). Feasibility of anaerobic membrane bioreactors (AnMBR) for onsite sanitation and resource recovery (nutrients, energy and water) in urban slums. Water Science and Technology, 72(9), 1543-1551. doi:10.2166/wst.2015.349Barat, R., Serralta, J., Ruano, M. V., Jiménez, E., Ribes, J., Seco, A., & Ferrer, J. (2013). Biological Nutrient Removal Model No. 2 (BNRM2): a general model for wastewater treatment plants. Water Science and Technology, 67(7), 1481-1489. doi:10.2166/wst.2013.004Batstone, D. J., Hülsen, T., Mehta, C. M., & Keller, J. (2015). Platforms for energy and nutrient recovery from domestic wastewater: A review. Chemosphere, 140, 2-11. doi:10.1016/j.chemosphere.2014.10.021Bilad, M. R., Arafat, H. A., & Vankelecom, I. F. J. (2014). Membrane technology in microalgae cultivation and harvesting: A review. Biotechnology Advances, 32(7), 1283-1300. doi:10.1016/j.biotechadv.2014.07.008Carrington E.-G. 2001 Evaluation of Sludge Treatments for Pathogen Reduction. http://europa.eu.int/comm/environment/pubs/home.htm.Cookney, J., Mcleod, A., Mathioudakis, V., Ncube, P., Soares, A., Jefferson, B., & McAdam, E. J. (2016). Dissolved methane recovery from anaerobic effluents using hollow fibre membrane contactors. Journal of Membrane Science, 502, 141-150. doi:10.1016/j.memsci.2015.12.037De Morais, M. G., & Costa, J. A. V. (2007). Biofixation of carbon dioxide by Spirulina sp. and Scenedesmus obliquus cultivated in a three-stage serial tubular photobioreactor. Journal of Biotechnology, 129(3), 439-445. doi:10.1016/j.jbiotec.2007.01.009Giménez, J. B., Robles, A., Carretero, L., Durán, F., Ruano, M. V., Gatti, M. N., … Seco, A. (2011). Experimental study of the anaerobic urban wastewater treatment in a submerged hollow-fibre membrane bioreactor at pilot scale. 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Surgical treatment for colorectal cancer: Analysis of the influence of an enhanced recovery programme on long-term oncological outcomes-a study protocol for a prospective, multicentre, observational cohort study

Introduction The evidence currently available from enhanced recovery after surgery (ERAS) programmes concerns their benefits in the immediate postoperative period, but there is still very little evidence as to whether their correct implementation benefits patients in the long term. The working hypothesis here is that, due to the lower response to surgical aggression and lower rates of postoperative complications, ERAS protocols can reduce colorectal cancer-related mortality. The main objective of this study is to analyse the impact of an ERAS programme for colorectal cancer on 5-year survival. As secondary objectives, we propose to analyse the weight of each of the predefined items in the oncological results as well as the quality of life. Methods and analysis A multicentre prospective cohort study was conducted in patients older than 18 years of age who are scheduled to undergo surgery for colorectal cancer. The study involved 12 hospitals with an implemented enhanced recovery protocol according to the guidelines published by the Spanish National Health Service. The intervention group includes patients with a minimum implementation level of 70%, and the control group includes those who fail to reach this level. Compliance will be studied using 18 key performance indicators, and the results will be analysed using cancer survival indicators, including overall survival, cancer-specific survival and relapse-free survival. The time to recurrence, perioperative morbidity and mortality, hospital stay and quality of life will also be studied, the latter using the validated EuroQol Five questionnaire. The propensity index method will be used to create comparable treatment and control groups, and a multivariate regression will be used to study each variable. The Kaplan-Meier estimator will be used to estimate survival and the log-rank test to make comparisons. A p value of less than 0.05 (two-tailed) will be considered to be significant. Ethics and dissemination Ethical approval for this study was obtained from the Aragon Ethical Committee (C.P.-C.I. PI20/086) on 4 March 2020. The findings of this study will be submitted to peer-reviewed journals (BMJ Open, JAMA Surgery, Annals of Surgery, British Journal of Surgery). Abstracts will be submitted to relevant national and international meetings.The present research study was awarded a Ministerio de Ciencia e Innovación health research project grant (PI19/00291) from the Carlos III Institute of the Spanish National Health Service as part of the 2019 call for Strategic Action in Health