Cristian Gallardo

• Place of Birth: Santiago, Chile
• Date of Birth: 03/06/82
• Nationality: Chilean

• Diversity bias in colorectal surgery: a global perspective, Updates in Surgery, 2022.
• The European Society of Coloproctology Collecting Opinions on Sustainable Surgery Study, Diseases of the Colon & Rectum, 2022. Garoufalia, Zoe; Cunha, Miguel; Dudi-Venkata, Nagendra N.; An, Yongbo; Bellato, Vittoria; Gallardo, Cristián; Zaaroni, Gloria; Christensen, Peter; Kenington, Cleo; Aytac, Erman; Brady, Richard RW; Pellino, Gianluca.
• Report from 'ESCP 2021 Virtual': the 16th Scientific and Annual Conference of the European Society of Coloproctology, 22-24 September 2021, Colorectal Disease, 2022, Miguel Cunha, Zoe Garoufalia, Vittoria Bellato, Yongbo An, Nagendra N. Dudi-Venkata, Cristián Gallardo.
• Report from 'Virtually Vilnius': the 15th Scientific and Annual Conference of the European Society of Coloproctology, 21-23 September 2020, Colorectal Disease, 2021, Gianluca Pellino, Miguel Cunha, Cristián Gallardo.
• Bascom operation for the treatment of abscessed pilonidal sacrococcygeal disease. Initial experience, Revista Chilena Cirugía, 06/2018, Alejandro Barrera E., Sebastián Pradenas B., Guillermo Bannura C., Felipe Illanes F., Cristian Gallardo V., URL, Introduction: One of the form of presentation of the sacral coccygeal pilonidal disease is the abscess, for this cases there are various treatment alternatives. Objective: We present our experience with Bascom technique for the treatment of pilonidal abscess. Material and Method: Prospective, consecutive, nonrandomized series. It includes all patients older than 15 years who have an abscess or mass discharge at the time of surgery. Results: The series consists of 10 patients, 7 males. They are not risk factors recognized in the literature as risk of pilonidal disease. Eight patients completely better within a maximum period of 18 days and two with persistent discharge by what is considered treatment failure. They were subjected to a second surgery treatment with another technique with good results. Conclusion: Bascom's technique is simple, safe and offers a 80% cure in a short period of healing. Key words: sacrococcygeal pilonidal disease; Bascom; pilonidal abscess.
• Primary neuroendocrine tumors of the colon and rectum, Rev Chil Cir, 2018, Guillermo Bannura, Alejandro Barrera, Carlos Melo, Felipe Illanes, Cristian Gallardo, URL, The nomenclature and staging classification of neuroendocrine tumors (NETs) has changed drastically in the past decade. Objective To do a critical analysis of management of colorectal NETs in our institution in the light of the new classification. Methods We retrospectively reviewed the records of consecutive patients operated on with radical intention due to a colorectal NET in the last 15 years. Results There were 10 patients, median age was 56 years (range 48-76), six of them located near the ileocecal valve, three in the rectum (2 of them polyps) and one polyp in the sigmoid colon. Surgical procedure included four anterior resections and six right colectomy (one with hepatic resection). The median follow up was 78.3 months (range 8-180). Two patients died due to metastatic disease. Conclusion NETs located near de ileocecal valve were diagnosed usually as a big tumor with obstructing symptoms, while NETs of the rectum and sigmoid colon more frequently were detected as polyps or submucosal lesions. Some low grade TENs may invade the colonic wall and/or have metastasis in the regional lymph nodes and those cases need radical resection and/or adjuvant therapy. Combine the grade (Ki-67 and number and/or number of mitosis) of 2010 WHO classification with TNM showed prognostic value for classification and staging colorectal NETs with important therapeutic implications.
• Surgical procedures for rectovaginal fistula: 25-years of experience, Revista Chilena de Cirugía, 2016, Bannura C., Guillermo, y Alejandro Barrera E., y Carlos Melo L., y Felipe Illanes F., y Cristian Gallardo V.., URL, Abstract Background: Rectovaginal fistula (RVF) is a distressing condition with no generally accepted standard surgical management. Aim: To assess results of surgery for RVF. Material and method: This is a descriptive retrospective analysis of 63 patients operated on consecutively for RVF in a period of 25 years. Results: Halve of the cases were secondary to a pelvic malignancy and 27% due to radiotherapy of pelvic tumors. RVFs were associated with local (obstetrical) trauma and postsurgical complications in 28% of the cases. High RVFs were approached through abdominal procedures in 26 patients (41%), including radical resection of the primary tumor in 11 cases and coloanal sleeve anastomosis procedure in 15 patients with a RVF due to pelvic radiation. Seventeen patients with persistent pelvic tumors after radiotherapy and/or surgery were handled with a colostomy or ileostomy to improve quality of life. Four of five cases with postsurgical RVF closed spontaneously with a proximal colostomy and, in seven patients with obstetrical RVF, an advancement flaps were performed, with success in 6. Conclusions: In this study local repair of RVF was employed in 12 cases, one third of the cases needed a permanent ostomy, and 40% of the complex cases of RVF were successfully repaired with sphincter preservation. Comparisons with other studies are precluded because of heterogeneity of published RVF series, probably due to different patterns of reference. Keywords: Rectovaginal fistula, Radiotherapy.
• Total pelvic exenteration for locally advanced rectal tumors: Experience in 10 patients, Revista Chilena de Cirugía, 2016, Bannura, Guillermo, y Alejandro Barrera, y Carlos Melo, y Felipe Illanes, y Cristián Gallardo., URL, Abstract. Aim: To report the results of total pelvic exenteration (TPE) in patients with locally advanced primary rectal tumors. Material and method: We report 10 patients with stage 4 rectal tumors subjected to a potentially curative TPE in a period of 16 years. Results: Six patients received also adjuvant chemoradiotherapy. A classic technique was used in 3 patients and a supra-elevator technique in 6. Mean hospitalization length was 36 days, and 80% of patients had complications. The pathological study of the surgical piece confirmed a T4 tumor in 6 patients, T3 in 3 and T0 in one. Among patients who received chemoradiotherapy, one was in stage ypT0N0M0, 2 in ypIIA, 2 in ypIIC, one in ypIIIB, 2 in pIIC and 2 in pIIIC. During follow up 3 patients survived between 30 and 180 months and three died due to distant metastases without local relapse. Conclusion: TPE requires long hospital stays and has a high rate of complications. Supra-elevator TPE protected with a transitory ileostomy avoided definitive colostomy in 6 of 10 cases. Urinary ileostomy had satisfactory long term functional results. The prolonged survival of half of the patients justifies the use of this surgical technique.
• Perineal rectosigmoidectomy for the treatment of rectal prolapse, Revista Chilena de Cirugía, 2016, Barrera, Alejandro, Sebastián Pradenas, Guillermo Bannura, Felipe Illanes, Cristian Gallardo, Baldo Rinaldi, Andrea Madariaga, Constanza Espinoza., URL, Abstract. Aim: We present our experience with perineal rectosigmoidectomy for the treatment of rectal prolapse. Material and method: It is a retrospective, consecutive series of 17 patients. Results: Predominantly female and the average age is 62 years. Morbidity reached 23%, but almost all less serious, with only one reoperation. Recurrence is 6%, and the improvement in continence is 88%. Conclusion: We conclude that it is a safe technique with a controlled morbidity and good results with low recurrence and improvement of continence in a high percentage of patients.
• Hospital readmission rates in complex colorrectal surgery, Revista Chilena de Cirugía, 2015, Bannura C., Guillermo, Cristián Gallardo V., Claudio Vargas R., Alejandro Barrera E., Carlos Melo L., Felipe Illanes F.., URL, Abstract Background: Non programmed hospital readmission rates are a quality indicator of colorectal surgery. Aim: To analyze the causes of readmission of patients subjected to surgical procedures including intestinal anastomoses. Material and Methods: Analysis of a database of patients subjected to elective intestinal anastomoses in a period of 10 years. All non-programmed readmissions that occurred within 30 days after patient discharge were analyzed. Results: Overall non-programmed readmission rate was 7% and it was due to medical causes in 55% of patients. Nine percent of readmitted patients required a new surgical intervention. The figure among patients readmitted due to surgical causes, was 20%. Sixty one percent of patients were admitted at less than six days after discharge and 84% at less than 10 days. A non-programmed readmission duplicated the total hospitalization lapse and triplicated the rates of new surgical procedures. Conclusions: In this series of patients, the only predictor of a non-programmed readmission was the need for reoperation during the first admission.
• Vacuum-assisted closure for open perineal wound after abdominoperineal resection, Revista Heridas y Ostomías, 2015, Sebastián Pradenas B., Cristián Gallardo V., Manuel Quiroz F., Guillermo Bannura C., Felipe Illanes F., Carlos Melo L., Alejandro Barrera E., URL, Publication Description
• Clinical and anatomical features of fissure-associated anal fistulae, Revista Chilena de Cirugía, 2014, Drs. Cristóbal Suazo L., Guillermo Bannura C., Cristián Gallardo V., URL, Background: Fissure-associated anal fistulae are not recognized in Parks classification and are probable underdiagnosed. Aim: To characterize these types of fistulae and describe their surgical management and long term results. Material and Methods: Review of medical records of a proctology surgical team. Identified patients were contacted by telephone to know their long term fate. Results: Twenty patients aged 29 to 59 years (70% males), with fissure-associated anal fistulae were operated between 1998 and 2011. These corresponded to 4% of all ano-rectal fistulae operated in the period. A fistulectomy was performed in 65% of patients and a fistulotomy in the rest. In 50% of patients, internal lateral sphicterotomy was also performed. Follow-up information was obtained in 80% of patients, 71 months (range 7-169) after surgery. No relapses or reoperations were recorded. Two female patients referred occasional gas incontinence, not affecting their quality of life. Conclusions: Considering the trajectory of fissure-associated anal fistulae, they do not affect the sphincter. The usual surgical treatment has a good long term prognosis, except in patients with active fissures, sphincter hypertonia or stenosis.
• Neo-adjuvant treatment with imatinib for a rectal gastrointestinal stromal tumor, Revista Chilena de Cirugía, 2014, Guillermo Bannura, y Cristián Gallardo., y Valeria Cornejo C.., URL, Abstract. Background: Rectal gastrointestinal stromal tumors (GIST) are rare. Neo-adjuvant therapy with imatinib is recommended for locally advanced or non-resectable tumors. Case report: We report a 63 years old woman with a malignant GIST located in the recto-vaginal septum which was initially considered non-resectable. The patient was treated with imatinib as induction therapy for three months. After this lapse the tumor was successfully excised using an endo-anal approach. Due to a tumor size over 5 cm and the presence of 13 mitoses per 50 high power fields, two bad prognostic factors, treatment with imatinib was maintained for 15 months after surgery. After 20 months of follow up, the patient is free of disease with complete fecal continence and with an adequate sexual life. Secondary effects of imatinib are gradually subsiding. Palabras clave: GIST, imatinib, endo-anal excision.
• Enlarged cecostomy as an alternative for the protection of low colorrectal anastomoses, Revista Chilena de Cirugía, 2014, Bannura C., Guillermo, y Alejandro Barrera E., y Carlos Melo L., y Felipe Illanes F., y Cristian Gallardo V., y Cristóbal Suazo L.., URL, Abstract. Background: Loop ileostomy, usually used as protection for low colorrectal anastomoses, has a significant number of complications. Aim: To assess the results of a new technique, called enlarged cecostomy for anastomotic protection. Material and Methods: The enlarged cecostomy technique, described herein, was applied to 12 consecutive patients, subjected to a radical resection for a low rectal cancer. Most procedures were performed after a neoadjuvant therapy. The results obtained in these patients were compared with similar series of patients in whom a loop ileostomy was performed. Results: 4 low anterior resections and 8 ultra-low anterior resections were performed among patients subjected to enlarged cecostomy (11 laparoscopic). Among patients subjected to loop ileostomy, 8 low anterior resections and 4 ultra-low anterior resections were performed (4 laparoscopic). The execution lapse for enlarged cecostomy was 15 minutes and for loop ileostomy, 25 minutes. Patients subjected to cecostomy had a lower hospitalization time. This was because 4 patients had a dysfunction of the loop ileostomy. The degree of diversion was complete in 11 patients subjected to enlarged cecostomy. The ostomy was closed in 7 patients subjected to loop ileostomy and the same number of patients subjected to enlarged cecostomy. Conclusions: Enlarged cecostomy is a valid protection alternative for patients operated for low rectal cancer. It is easier to perform than loop ileostomy.

• Prof Dr Alejandro Barrera, Colorectal Surgeon, Chief of Surgical Service, Hospital Clínico San Borja Arriarán, Universidad de Chile, alejandro.barrera@redsalud.gob.cl
• Cristóbal Suazo, Chief of Colorectal Surgery Unit, Redsalud Center, cristobalsuazolopez@gmail.com

• ATLS, 2022
• ACLS, 2022
• HIGH RESOLUTION ANOSCOPY, ASCRS BOSTON, 2015
• TaTME - Transanal Total Mesorectal Excision, Unité de Chirurgie Colorectale, Hôpital Haut Lévèque, CHU de Bordeaux, France, 2019
• TAMIS, Clínica Alemana de Santiago, 2016

European Society of Coloproctology

Chilean Society of Coloproctology

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