<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1727-897X</journal-id>
<journal-title><![CDATA[MediSur]]></journal-title>
<abbrev-journal-title><![CDATA[Medisur]]></abbrev-journal-title>
<issn>1727-897X</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas, Provincia de Cienfuegos.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1727-897X2023000200471</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estrategia quirúrgica en un paciente con tumor agresivo del tracto gastrointestinal en cuarta porción de duodeno]]></article-title>
<article-title xml:lang="en"><![CDATA[Surgical strategy in a patient with an aggressive tumor of the gastrointestinal tract in the fourth portion of the duodenum]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lombardo Vaillant]]></surname>
<given-names><![CDATA[Tomás Ariel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Militar Principal de Luanda.  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>República de Angola</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<volume>21</volume>
<numero>2</numero>
<fpage>471</fpage>
<lpage>481</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1727-897X2023000200471&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1727-897X2023000200471&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1727-897X2023000200471&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Los tumores del estroma gastrointestinal son tumores infrecuentes y se corresponden con un 1 % de todas las neoplasias gastrointestinales; la localización duodenal solo representa entre 3-5 %. Se realizó este reporte de caso con el propósito de divulgar la estrategia quirúrgica seguida con un paciente portador de tumor invasivo del estroma gastrointestinal (&gt;10 cm) de localización atípica, en cuarta porción del duodeno. El internamiento fue por tumor abdominal y anemia. El ejercicio clínico consistió en identificar una masa abdominal izquierda con contacto lumbar. Las pruebas diagnósticas realizadas fueron: pruebas de química sanguínea, ultrasonido abdominal, tomografía axial computadorizada y endoscopia digestiva con biopsia que confirmó el diagnóstico. El procedimiento quirúrgico fue resección de la cuarta porción de duodeno y primeras asas yeyunales, con restablecimiento de la funcionabilidad intestinal mediante duodeno (segunda porción)-yeyunostomía latero-lateral. La cirugía fue interrumpida por inestabilidad hemodinámica del paciente y cuatro días después fue llevado otra vez al salón de operaciones por presentar peritonitis, con salida de pus por los drenajes abdominales, que fue solucionada con lavado de la cavidad. La morbilidad estuvo acompañada por una fístula pancreática. En el tercer tiempo quirúrgico se realizó resección del tumor residual, nefrectomía izquierda y control de la fístula pancreática. Después de un año el paciente se encuentra libre de enfermedad tumoral. Se puede concluir que la estrategia de manejo en pacientes con tumores del estroma gastrointestinal de localización atípica representa un reto para el cirujano como miembro del grupo multidisciplinar y depende de la extensión del tumor, el estado del paciente y el manejo oportuno del equipo quirúrgico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ Gastrointestinal stromal tumors are rare tumors and correspond to 1% of all gastrointestinal neoplasms; duodenal location only represents between 3-5%. This case report was made for disclosing the surgical strategy followed in a patient with invasive gastrointestinal stromal tumors (&gt;10 cm) of atypical location in the duodenum fourth portion. Hospitalization was due to abdominal tumor and anemia. The clinical exercise consisted of identifying a left abdominal mass with lumbar contact. The diagnostic tests performed were: blood chemistry tests, abdominal ultrasound, computerized axial tomography, and digestive endoscopy with biopsy that confirmed the diagnosis. The surgical procedure was resection of the duodenum fourth portion and the first jejunal loops, with restoration of intestinal function through duodenum (second portion) lateral jejunostomy. The surgery was interrupted due to the patient's hemodynamic instability, and four days later he was taken back to the operating room due to peritonitis, with pus coming out of the abdominal drains, which was resolved by washing the cavity. Morbidity was accompanied by a pancreatic fistula. In the third surgical time, resection of the residual tumor, left nephrectomy, and control of the pancreatic fistula were performed. After one year the patient is free of tumor disease. The management strategy in patients with atypically located gastrointestinal stromal tumors represents a challenge for the surgeon as a member of the multidisciplinary group and depends on the extent of the tumor, the patient's condition, and the surgical team timely management.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[tumores del estroma gastrointestinal]]></kwd>
<kwd lng="es"><![CDATA[cirugía general]]></kwd>
<kwd lng="en"><![CDATA[gastrointestinal stromal tumors]]></kwd>
<kwd lng="en"><![CDATA[general surgery]]></kwd>
</kwd-group>
</article-meta>
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<article-title xml:lang=""><![CDATA[Association between R1 resection and oncological outcome in resectable gastrointestinal stromal tumors without tumor rupture A systematic review and meta-analysis]]></article-title>
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