Background: One of the mainstays in the treatment of locally advanced rectal cancer is neoadjuvant chemoradiotherapy. Neoadjuvant therapy have demonstrated to decrease local recurrence, also generating tumor downstaging, even leading to a pathological complete response (PCR), the latter related to better overall survival (OS) and disease-free survival (SLE). Aim: To report the anatomo-pathological results of treatment with chemoradiotherapy in rectal cancer, analyzing the relationship with OS and SLE. Material and Method: Prospective cohort study. A database of colorectal surgeries from the Clinical Hospital of the University of Chile between the years 2004-2019, including patients with locally advanced low and middle rectal cancer, who received neoadjuvant and later surgery. Survival analysis was made with the Kaplan-Meier method and the Log-rank test for comparison. A value of p < 0.05 was considered statistically significant. Results: 411 patients underwent surgery for rectal cancer, 143 patients received neoadjuvant therapy, 19% registered PCR. The OS of the group with PCR was 94% (95% CI; 59.79-79.41%) while that of the group without PCR was 71% (95% CI; 66.64-99.20%) (p = 0.018), the SLE in those patients with PCR reached 100%, while in those without PCR it was 74% (95% CI; 64.08-81.28) (p = 0.008). Conclusions: Patients with PCR have better long-term results than those without PCR. PCR could indicate a favorable biological tumor profile, with less tendency to recurrence and improved survival.

Resumen Antecedentes: La radioquimioterapia neoadyuvante es uno de los pilares del tratamiento del cáncer de recto localmente avanzado. La neoadyuvancia ha demostrado disminuir la recidiva local, generando también un downstaging tumoral, llegando incluso a una respuesta patológica completa (RPC), esta última relacionada con una mejor sobrevida global (SG) y sobrevida libre de enfermedad (SLE). Objetivo: Reportar los resultados anátomo-patológicos del tratamiento con radioquimioterapia en cáncer de recto, analizando su relación con la SG y la SLE. Material y Método: Estudio de cohorte prospectivo. Se analiza base de datos de cirugías coloproctológicas del Hospital Clínico de la Universidad de Chile, entre los años 20042019, incluyendo pacientes con cáncer de recto medio y bajo localmente avanzados, los cuales recibieron neoadyuvancia y posteriormente cirugía. Se realizó el análisis de sobrevida con el método de Kaplan-Meier y el test Log-rank para su comparación. Se consideró estadísticamente significativo un valor de p < 0,05. Resultados: 411 pacientes fueron operados por cáncer de recto, 143 pacientes recibieron neoadyuvancia, el 19% registró RPC. La SG del grupo con RPC fue 94% (IC 95%; 59,79-79,41%) mientras que la del grupo sin RPC fue 71% (IC 95%; 66,64-99,20%) (p = 0,018), la SLE en aquellos pacientes con RPC alcanzó un 100%, mientras que en aquellos sin RPC fue 74% (IC 95%; 64,08-81,28) (p = 0,008). Conclusiones: Los pacientes con RPC mostraron mejores resultados a largo plazo que aquellos sin RPC. La RPC podría indicar un perfil tumoral biológico favorable, con menos tendencia a la recurrencia y mejor supervivencia.

Abstract Writing takes part in the repertoire of knowledge and skills inherent to teacher education, as stated in teacher education policies and regulatory frameworks and in research on its formative role. However, there is little knowledge about the curricularization of writing in teachers’ educational experience. This multiple case study analyzes elementary teacher training programs in three certified Chilean universities. A purposeful sample of course syllabi was constructed and written pedagogical competencies and practices were identified to describe the presence of writing in the designed curriculum. These data were triangulated with focus groups of students and professors in each institution, which collected evidence of the experienced curriculum. The results show a significant presence of writing in the teacher education curriculum at all institutions, although mostly implicitly. The courses with the greatest potential for working on writing through the curriculum are not necessarily identified as such by teachers and students, since there is a high impact of each teacher’s implementation of the programs. These results highlight the need for crosscutting and sequencing the teaching of writing.

Resumen La escritura se incluye en el repertorio de saberes y habilidades propios de la Formación Inicial Docente (FID), tal como manifiestan las políticas y marcos normativos FID y las investigaciones sobre su rol formativo. No obstante, es escaso el conocimiento sobre la instanciación curricular de la escritura en las trayectorias FID. Este estudio de casos múltiples analiza la carrera de Pedagogía en Educación Básica en tres universidades chilenas acreditadas. Se construyó una muestra intencionada de programas de curso y se identificaron competencias y prácticas pedagógicas escritas para describir la presencia de la escritura en el currículum diseñado. Estos datos fueron triangulados con grupos focales de estudiantes y profesores en cada institución, que recogieron evidencias del currículum experimentado. Los resultados dan cuenta de una importante presencia de la escritura en el currículum FID en todas las instituciones, aunque mayoritariamente de forma implícita. Los cursos con mayor potencial para trabajar la escritura a través del currículum no necesariamente son identificados como tales por docentes y estudiantes, ya que hay un alto impacto de la implementación que cada docente hace de los programas. Finalmente, se releva la necesidad de transversalizar y secuenciar la enseñanza de la escritura.

RESUMO O esporte é uma atividade praticada recreativa ou profissionalmente. Quem pratica profissionalmente às vezes recebe contribuições financeiras e consegue estudar uma carreira profissional, conhecida como carreira dupla. No entanto, há quem apresente essa atividade como trabalho. O objetivo do estudo foi analisar os argumentos de atletas chilenos para se referir ao esporte como atividade de trabalho. O objetivo específico foi refletir criticamente sobre o desenvolvimento da carreira dupla no Chile Para entender esses argumentos, foi realizado um estudo qualitativo, por meio de entrevistas ativas semiestruturadas com atletas de alto desempenho (DAR) e atletas recreativos, olímpicos e paralímpicos. Os resultados mostram que os atletas exigem reconhecimento como funcionários públicos por meio de três argumentos: econômico, subordinação e dependência e identidade. As conclusões e discussões sugerem debater seu reconhecimento como funcionários públicos.

ABSTRACT Sport is an activity practiced recreationally or professionally. Those who do it professionally occasions receive financial contributions and manage to study a professional career, which is known as a dual career. However, there are those who present this activity as their work. The objective of the study was to analyze the arguments of Chilean athletes to refer to sports as a work activity. The specific objective was to critically reflect on the development of the dual career in Chile To understand these arguments, a qualitative study was conducted through semi-structured active interviews with high performance athletes and recreational, Olympic and Paralympic athletes. The results show that athletes demand recognition as public workers through three arguments: economic, subordination and dependency, and identity. The conclusions and discussions suggest to debate their recognition as public workers.

RESUMEN El deporte es una actividad que se práctica de forma recreativa o profesional. Quienes lo hacen profesionalmente en ocasiones reciben aportes económicos y logran estudiar una carrera profesional, lo que se conoce como carrera dual. No obstante, hay quienes presentan esta actividad como su trabajo. El objetivo general del estudio fue analizar los argumentos de los deportistas chilenos para referirse a la práctica deportiva como una actividad laboral; el objetivo específico fue reflexionar críticamente sobre el desarrollo de la carrera dual en Chile. Para comprender estos argumentos, se realizó un estudio cualitativo por medio de entrevistas activas semiestructuradas a deportistas de alto rendimiento (DAR) y recreativos, olímpicos y paralímpicos. Los resultados muestran que los atletas demandan reconocimiento como trabajadores públicos por medio de tres argumentos: económico, subordinación y dependencia e identidad. Las conclusiones y discusiones sugieren debatir el reconocimiento de ellos y ellas como trabajadores públicos.

RESUMO Racional: A identificação de fatores prognósticos do câncer de esôfago permitiu prever a evolução dos pacientes. Objetivo: Avaliar diferentes fatores prognósticos da sobrevida em longo prazo do câncer de esôfago e avaliar um novo fator prognóstico da sobrevida em longo prazo chamado índice linfoparietal (N+/T). Método: Estudo prospectivo do Hospital Clínico da Universidade do Chile, entre janeiro de 2004 e dezembro de 2013. Incluiu todas as operações de câncer de esôfago com intenção curativa e anastomose cervical. Os critérios de exclusão incluíram: câncer em estágio 4, ressecções R1, procedimentos paliativos e operações de emergência. Resultados: Cinquenta e oito pacientes foram incluídos, 62,1% eram homens, a idade média foi de 63,3 anos. Um total de 48,3% eram escamosos, 88% eram cânceres avançados, a colheita média de linfonodos foi de 17,1. A morbidade cirúrgica pós-operatória foi de 75%, com 17,2% de reoperações e 3,4% de mortalidade. A sobrevida global média foi de 41,3 meses, a sobrevida em três anos foi de 31%. A análise multivariada dos fatores prognósticos mostrou que variáveis significativas foram elevação pelo mediastinal anterior (p=0,01, OR: 6,7 [1,43-31,6]), fístula anastomótica (p=0,03, OR: 0,21 [0,05-0,87]), classificação N (p=0,02, OR: 3,8 [1,16-12,73]), estágio TNM (p=0,04, OR: 2,8 [1,01-9,26]) e índice linfoparietal (p=0,04, RR: 3,9 [1,01-15,17]. As curvas ROC do índice linfoparietal, classificação N e estádio TNM apresentam áreas abaixo da curva de 0,71, 0,63 e 0,64, respectivamente, com diferença estatística significativa (p=0,01). Conclusão: Os fatores prognósticos independentes de sobrevida em longo prazo no câncer de esôfago são a elevação mediastinal anterior, fístula anastomótica, classificação N, estágio TNM e índice linfoparietal. No câncer de esôfago, o novo índice linfoparietal é mais forte que o estágio TNM no prognóstico de sobrevida em longo prazo.

ABSTRACT Background: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. Aim: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal index (N+/T). Method: Prospective study of the Universidad de Chile Clinical Hospital, between January 2004 and December 2013. Included all esophageal cancer surgeries with curative intent and cervical anastomosis. Exclusion criteria included: stage 4 cancers, R1 resections, palliative procedures and emergency surgeries. Results: Fifty-eight patients were included, 62.1% were men, the average age was 63.3 years. A total of 48.3% were squamous, 88% were advanced cancers, the average lymph node harvest was 17.1. Post-operative surgical morbidity was 75%, with a 17.2% of reoperations and 3.4% of mortality. The average overall survival was 41.3 months, the 3-year survival was 31%. Multivariate analysis of the prognostic factors showed that significant variables were anterior mediastinal ascent (p=0.01, OR: 6.7 [1.43-31.6]), anastomotic fistula (p=0.03, OR: 0.21 [0.05-0.87]), N classification (p=0.02, OR: 3.8 [1.16-12.73]), TNM stage (p=0.04, OR: 2.8 [1.01-9.26]), and lymphoparietal index (p=0.04, RR: 3.9 [1.01-15.17]. The ROC curves of lymphoparietal index, N classification and TNM stage have areas under the curve of 0.71, 0.63 and 0.64 respectively, with significant statistical difference (p=0.01). Conclusion: The independent prognostic factors of long-term survival in esophageal cancer are anterior mediastinal ascent, anastomotic fistula, N classification, TNM stage and lymphoparietal index. In esophageal cancer the new lymphoparietal index is stronger than TNM stage in long-term survival prognosis.

Resumo: A construção da identidade dos atletas é um tema de interesse no campo dos estudos socioculturais do esporte. O objetivo deste estudo foi analisar a identidade esportiva do atleta chileno para compreender melhor este tópico. O tipo de estudo foi qualitativo, por meio de 17 entrevistas semiestruturadas com atletas de alto desempenho e recreativos nas modalidades convencional e adaptada. Os resultados mostram que existem duas categorias para construir a identidade esportiva chilena: condições socioculturais e condições materiais, marcadas por construir histórias alternativas para contestar o individualismo e a competição como valores presentes no esporte chileno.

Abstract: Construction of sports identity is an interesting topic in the field of sociocultural studies of sport. This study analysed identity construction in Chilean athletes in order to gain a deeper understanding on the topic and its associated issues. Our qualitative study involved 17 semi-structured interviews with high-performance and recreational athletes who practise conventional and adaptive sports. The results reveal that there are two categories of conditions involved in the construction of Chilean sports identity - sociocultural conditions and material conditions - and that these are influenced by neoliberal logics and values. We conclude that gender is one dimension that can potentially generate alternatives to individualism and competition discourses present in current Chilean sports identity.

Resumen: La construcción de la identidad de los y las deportistas es un tema de interés en el campo de estudios socioculturales del deporte. El objetivo de este estudio fue analizar la construcción de la identidad deportiva en Chile para comprender mejor este tema. El tipo de estudio realizado fue de carácter cualitativo, a través de 17 entrevistas semiestructuradas a deportistas recreativos y de alto rendimiento de modalidad convencional y adaptado. Los resultados demuestran que existen dos categorías para construir la identidad deportiva chilena: condiciones socioculturales y las condiciones materiales, las cuales están marcadas por lógicas y valores neoliberales. Se concluye expresando que el género es una dimensión que genera relatos alternativos para disputar el individualismo y la competencia en tanto valores presentes en la identidad deportiva chilena.

RESUMO Racional: A identificação de fatores prognósticos do câncer gástrico (GC) permitiu predizer a evolução dos pacientes. Objetivo: Avaliar a confiabilidade do índice linfoparietal na predição de sobrevida em longo prazo em pacientes tratados com intenção curativa. Método: Estudo prospectivo do Hospital das Clínicas da Universidade de Chile, entre maio de 2004 e maio de 2012. Todas as operações de câncer gástrico foram com intenção curativa. Os critérios de exclusão foram: gastrectomia por lesões benignas, cânceres estágio 4, ressecções R1, procedimentos paliativos, esofagogastrectomias completas e operações de emergência. Resultados: Foi incluído um total de 284 pacientes; da amostra 65,4% eram homens, com média de idade de 64,5 anos, 75% eram cânceres avançados, 72,5% necessitaram de gastrectomia total e 30 coletas de linfonodos. A morbimortalidade cirúrgica foi de 17,2% e 1,7%. Sobrevida em cinco anos foi de 56,9%. O índice N +/T pôde predizer a sobrevida em longo prazo em todos os subgrupos (p<0,0001), embora tivesse previsão confiável em GC precoce (p=0,005), GC avançado (p<0,0001), célula GC de anel de sinete (p< 0,0001), GC proximal (p<0,0001) e GC distal (p<0,0001). As curvas ROC N +/T, LNR e T apresentaram áreas abaixo da curva de 0,789, 0,786 e 0,790, respectivamente, sem diferença estatística significativa (p=0,96 ). Conclusão: O índice N +/T é um quociente confiável no prognóstico na avaliação de pacientes com adenocarcinoma gástrico que foram ressecados com intenção curativa.

ABSTRACT Background: The identification of prognostic factors of gastric cancer (GC) has allowed to predict the evolution of patients. Aim: Assess the reliability of the lymphoparietal index in the prediction of long-term survival in GC treated with curative intent. Method: Prospective study of the Universidad de Chile Clinical Hospital, between May 2004 and May 2012. Included all gastric cancer surgeries with curative intent. Exclusion criteria were: gastrectomies due to benign lesions, stage 4 cancers, R1 resections, palliative procedures, complete esophagogastrectomies and emergency surgeries. Results: A total of 284 patients were included; of the sample 65.4% were male,mean age of 64.5 years,75% were advanced cancers, 72.5% required a total gastrectomy, 30 lymph nodes harvest. Surgical morbidity and mortality were 17.2% and 1.7%. 5-year survival was 56.9%. The N+/T index could predict long-term survival in all de subgrups (p<0.0001), although had a reliable prediction in early GC (p=0.005), advanced GC (p<0.0001), signet ring cell GC (p<0.0001), proximal GC (p<0.0001) and distal GC (p<0.0001). The ROC curves N+/T index, LNR and T classification presented areas below the curve of 0.789, 0.786 and 0,790 respectively, without a significant statistical difference (p=0.96). Conclusion: The N+/T index is a reliable quotient in the prognostic evaluation of gastric adenocarcinoma patients who have been resected with curative intent.

Introduction Post operative leaks of esophageal anastomosis after esophagectomy is a risky event associated with poor postoperative evolution. Its frequency and severity will depend mainly on surgical technical aspects. Objectives To analyze the frequency, management and prognosis of leakage of esophageal anastomosis after esophagectomy for esophageal cancer. Material and Method Analysis of our prospective oncologic database of patients with esophageal cancers submmitted to esofagectomy. Statistical analysis with Fisher's exact test. Results 34 out of 37 esophageal cancer patients were included submitted to completely invasive mini esophagectomy. Cervical anastomosis was performed in 79.4% of patients, in the remaining 20.6%, a distal esophagectomy with intrathoracic anastomosis was performed. The leak rate was 38.2% (13/34), of these, 69.2% (9/13) correspond to grade Clavien - Dindo I - II complications. The leak rate was 54.5% (6/11) for retro-sternal gastric ascensus and 43.7% (7/16) for mediastinal route, without significative difference (p = 1.0). The reoperation rate was 11.7%, being a 100% secondary to mediastinal ascensus, 3 of them were submitted to thoracoscopic toilets and an innominate vein repair. Postoperative mortality rate was 5.8%, all concentrated in the group of patients with posterior mediastinal ascensus, but without statistical difference (p = 0.26). Conclusion Leaks are frequent in patients operated on for esophageal cancer, especially after cervical esophago-gastro-anastomosis with anterior route for ascensus. However, retro-sternal ascensus did not require re-operations, nor postoperative mortality compared to gastric ascensus through posterior mediastinum

Resumen Introducción La filtración de anastomosis esofágica es un evento que se asocia a mala evolución postoperatoria Su frecuencia y gravedad dependerá principalmente de aspectos técnicos quirúrgicos. Objetivos Analizar la frecuencia, manejo y pronóstico de las filtraciones de anastomosis esofágicas en esofagectomías por cáncer comparando la vía de ascenso del tubo gástrico y sitio de anastomosis. Material y Método Análisis de base prospectiva de pacientes con cáncer esofágico sometidos a esofagectomía. Análisis estadístico con test exacto de Fisher. Resultados De un total de 37 pacientes con cáncer esofágico tratados en nuestra institución en el período de estudio (5 años), se incluyeron 34 esofagectomías totalmente mini invasivas secundarias a cáncer de esófago. Un 79,4% correspondieron a esofagectomías totales con anastomosis cervical, en el 20,6% restante se realizó esofagectomía distal con anastomosis intratorácica. La tasa de filtración de la anastomosis esofágica fue de un 38,2% (13/34), todas fueron secundarias a esofagectomías totales. De estas un 69,2% (9/13) se clasificaron como Clavien - Dindo I-II. La tasa de filtración fue de 54,5% (6/11) para ascenso retroesternal y 43,7% (7/16) para ascenso mediastínico, sin ser estadísticamente diferente (p = 1,0). La tasa de reoperaciones fue de un 11,7%, siendo en todas secundario a ascensos mediastínicos posteriores, de estas fueron 3 casos de aseos vídeo-toracoscópicos y una reparación de vena innominada. No existió diferencia estadística entre las vías de ascenso y la tasa de reoperaciones (p = 0,26). La serie presentó una mortalidad quirúrgica de 5,8% concentrados todos en el grupo de pacientes con esofagectomías totales con ascenso mediastínico posterior. Conclusión Las filtraciones en anastomosis esofágicas son frecuentes en pacientes operados con intención curativa de cáncer esofágico. Las filtraciones de anastomosis esofágicas cervicales con ascenso retroesternal no requirieron reoperaciones, ni presentaron mortalidad postoperatoria.

Background: Most patients with gastric cancer consult when the tumor is an advanced stage. Aim: To assess the survival of patients with gastric cancer in stage IIIc or IV subjected to surgery. Patients and Methods: Prospective study of patients with gastric cancer in stages IIIc (spreading to nearby organs or serosa) or IV (spreading to distant organs), who consulted between 2004 and 2012. A surgical exploration was carried out in all patients performing a palliative total or subtotal gastrectomy, a gastrojejunal anastomosis or only an exploration. Twenty five patients received adjuvant chemotherapy. All were followed until their death. Results: A surgical resection was performed in 61 patients (64%) with an operative mortality of 5 and 0% for total and subtotal gastrectomy, respectively. The mortality of non-resected patients was 6.4% with a maximal survival of 15 months after surgery. No significant differences in survival were observed between patients with hepatic or peritoneal metastases. Adjuvant chemotherapy significantly improved survival among patients subjected to gastric resection. Conclusions: Among patients with gastric cancer, palliative gastrectomy may improve quality of life and adjuvant chemotherapy apparently improves survival.

Introducción: El cáncer gástrico constituye un problema de salud pública por su alta incidencia. Muchos pacientes consultan en etapas muy avanzadas. Objetivo: Evaluar la sobrevida de pacientes con cáncer gástrico etapa IIIc y IV sometidos a cirugía. Material y Método: Estudio prospectivo y descriptivo de pacientes en dichas etapas, que consultaron entre mayo de 2004 y diciembre de 2012, divididos en 4 grupos según ubicación de metástasis. Todos sometidos a exploración quirúrgica realizando una gastrectomía total o subtotal paliativa, gastroyeyuno-anastomosis o sólo laparotomía. Quimioterapia adyuvante se realizó en 25 pacientes. Se realizó un seguimiento hasta la fecha de fallecimiento en un 100% de los casos. Resultados: La resección quirúrgica se realizó en 61 pacientes (64,3%), con una mortalidad operatoria de 4,6% para la gastrectomía total y 0% para la gastrectomía subtotal. La mortalidad de los pacientes no resecados fue de 6,4%, con sobrevida máxima de 15 meses después de operado. Entre los casos con resección gástrica, se observó una mayor pero no significativa sobrevida en pacientes con metástasis hepáticas comparadas con las peritoneales. La quimioterapia adyuvante mostró una sobrevida significativamente mayor en los resecados comparado a los pacientes en los que no se la empleó. Conclusión: La gastrectomía paliativa para mejorar la calidad de vida en pacientes con cáncer gástrico metastásico es factible, en grupos entrenados. El efecto beneficioso de la quimioterapia adyuvante debe ser evaluado en futuros estudios randomizados.

Background: The incidence of esophageal carcinoma has increased notoriously worldwide. Aim: To assess clinical features, immediate surgical results and long term survival of patients with esophageal carcinoma and Barrett esophagus. Material and Methods: Retrospective review of medical records of all patients operated for esophageal carcinoma, between 1996 y 2011. Results: The records of 53 patients aged 58 ± 9 years (45 males) were analyzed. The number of operated patients increased from 7 in the period 1968-1983 to 31 in the period 2004-2011. Peritoneal metastases were found in two patients, precluding a resection. Video assisted trans-hiatal approach was the most commonly used technique followed by minimally invasive thoracoscopic and laparoscopic surgery. Transit reconstruction was performed ascending the stomach to the neck in 90% of patients. The average length of Barrett esophagus was 7.4 cm and the mean number of excised lymph nodes was 19. Ten patients had an incipient cancer and their five years survival was 80%. The survival of those with tumors involving the muscular layer and those with transmural cancer was 25 and 5%, respectively. Conclusions: There is an increase in the incidence of esophageal cancer in the last 10 years. The survival after surgery is highly dependent on the invasiveness of the tumor.

Background: Surgery for gastric cancer may have high rates of complications and mortality. Aim: To analyze operative mortality of total and subtotal gastrectomy in the period 2004-2010. Material and Methods: Prospective study 345 patients with gastric cancer, mean age 62 years, 64% males, subjected to a total or subtotal R0, R1 or R2 gastrectomy. All patients were assessed in the postoperative period and all complications were recorded. Results: Total and subtotal gastrectomies were performed in 224 and 69 patients respectively. Postoperative complications consisted in anastomotic leaks, duodenal stump leaks, hemoperi-toneum, pulmonary infections and intestinal obstruction. Mortality of total gastrectomy R1 or R2 was 2.1% whereas palliative gastrectomy, to improve quality of life, had 15% mortality. Subtotal gastrectomy had 1.4% mortality. Conclusions: There has been a reduction in operative mortality of gastrectomy for gastric cancer, however the rate of complications has not changed.

Objetivos: Analizar la morbilidad y mortalidad operatoria de la gastrectomía total y subtotal en el período 2004-2010 y compararlo con las cifras publicadas en los últimos 40 años. Material y Método: El presente estudio prospectivo incluye a los pacientes sometidos a gastrectomía total o subtotal R0 R1 o R2 entre mayo de 2004 y diciembre de 2010. Se evaluaron la morbilidad y la mortalidad postoperatoria. Resultados: La gastrectomía total se realizó en 244 pacientes y la subtotal en 69 pacientes. La morbilidad postoperatoria correspondió a filtración de la anastomosis, filtración del muñón duodenal, hemoperitoneo, infecciones pulmonares y obstrucción intestinal. La mortalidad de la gastrectomía total R0 o R1 fue de 2,1%, mientras que la gastrectomía de aseo tuvo un 15% de mortalidad. La gastrectomía subtotal presentó una mortalidad de 1,4%. Conclusiones: Como consecuencia de todos los adelantos técnicos y materiales en la cirugía del cáncer gástrico, que significó una baja muy importante en la mortalidad operatoria, las complicaciones postoperatorias no han variado estos últimos 40 años.