Digestive Surgery最新文献

Non-colorectal liver metastases undergoing liver resection: the NONCOLMET study group. 非结直肠肝转移患者行肝切除术：non - colmet研究组。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-09-23 DOI: 10.1159/000548423

Marcello Di Martino, Giorgio Ercolani, Federica Cipriani, Gianluca Baiocchi, Roberto Bordonaro, Matteo Cescon, Antonio Frena, Felice Giuliante, Gianluca Grazi, Salvatore Gruttadauria, Giovanni Marchegiani, Riccardo Memeo, Fabrizio Panaro, Fabrizio Romano, Andrea Ruzzenente, Marcello Spampinato, Guido Alberto Tiberio, Guido Torzilli, Roberto Troisi, Matteo Donadon

{"title":"Non-colorectal liver metastases undergoing liver resection: the NONCOLMET study group.","authors":"Marcello Di Martino, Giorgio Ercolani, Federica Cipriani, Gianluca Baiocchi, Roberto Bordonaro, Matteo Cescon, Antonio Frena, Felice Giuliante, Gianluca Grazi, Salvatore Gruttadauria, Giovanni Marchegiani, Riccardo Memeo, Fabrizio Panaro, Fabrizio Romano, Andrea Ruzzenente, Marcello Spampinato, Guido Alberto Tiberio, Guido Torzilli, Roberto Troisi, Matteo Donadon","doi":"10.1159/000548423","DOIUrl":"https://doi.org/10.1159/000548423","url":null,"abstract":"Background: While the resection of colorectal liver metastases (CRLM) is a well-established procedure, with survival rates superior to chemotherapy alone, controversial data still exist on liver resection for non-colorectal liver metastases (NCRLM). These patients comprise a diverse and heterogeneous group usually excluded from surgery. To date, only few retrospective reports are available on the surgical treatment of NCRLM. The NONCOLMET study aims to build a comprehensive registry of patients undergoing liver resection for NCRLM, providing robust retrospective and prospective data to describe clinical practices, outcomes, and identify prognostic factors.Methods: The study consists of two phases: (1) retrospective collection of data from patients treated between 2010-2024 and (2) prospective enrolment from 2025. Patients aged ≥18 years with histologically confirmed NCRLM undergoing liver resection will be included. Data will be recorded via a standardized electronic case report form (eCRF) in the RedCap platform. The following endpoints will be evaluated: oncological outcomes including overall survival (OS), disease-free Survival (DFS) and disease relapse; post-operative mortality at 30 and 90 days with causes of death; post-procedural complications; predictor variables of short- and long-term outcomes. These outcomes will be used to elaborate a risk score models. The study protococol was registered on Clincaltrials.gov (NCT06542926).Conclusions: NONCOLMET will offer crucial insights into the surgical management of NCRLM, helping refine patient selection criteria and informing future clinical guidelines.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-8"},"PeriodicalIF":1.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Circulating Cell-Free DNA as a potential Diagnostic Tool in Pancreatic Cancer: A Comparative Analysis. 循环游离细胞DNA作为胰腺癌的潜在诊断工具：比较分析。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-09-23 DOI: 10.1159/000547870

Romualdas Riauka, Rita Kupcinskaite-Noreikiene, Ingrida Grabauskyte, Antanas Gulbinas, Giedrius Barauskas, Aldona Jasukaitiene, Vakare Gruodyte, Povilas Ignatavicius

{"title":"Circulating Cell-Free DNA as a potential Diagnostic Tool in Pancreatic Cancer: A Comparative Analysis.","authors":"Romualdas Riauka, Rita Kupcinskaite-Noreikiene, Ingrida Grabauskyte, Antanas Gulbinas, Giedrius Barauskas, Aldona Jasukaitiene, Vakare Gruodyte, Povilas Ignatavicius","doi":"10.1159/000547870","DOIUrl":"https://doi.org/10.1159/000547870","url":null,"abstract":"Introduction: Liquid biopsies enable non-invasive tumor material sampling in patients with pancreatic adenocarcinoma (PDAC). Genetic information, especially alterations in circulating free DNA (cfDNA) levels, might help to predict poorer tumor differentiation, disease progression and might be used as treatment efficacy evaluator. However, the data on this topic is insufficient.Methods: Newly diagnosed, PDAC patients without prior systemic treatment and chronic pancreatitis patients treated at the tertiary university hospital and healthy controls were included in this prospective study. Blood samples were collected pre-treatment, and cfDNA was extracted and measured using necessary equipment according to manufacturer's protocols.Results: 57 patients (47 PDAC and 10 chronic pancreatitis) and 8 healthy controls were included. cfDNA levels were significantly higher in cancer patients compared to chronic pancreatitis (p = 0,032) and healthy controls (p < 0.001). The determined cfDNA cut-off value for distinguishing PDAC from chronic pancreatitis was 23.65 ng/ml and for distinguishing PDAC from healthy controls - 22.9 ng/ml. However, no distinctions in cfDNA levels were noted concerning tumor characteristics or survival rates.Conclusion: Liquid biopsies and alterations in cfDNA levels could aid in distinguishing PDAC from benign inflammatory diseases or healthy patients. Nonetheless, further studies are necessary for more comprehensive validation.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-15"},"PeriodicalIF":1.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgery for multifocal intrahepatic cholangiocarcinoma. 多灶性肝内胆管癌的外科治疗。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-09-18 DOI: 10.1159/000548043

Augustė Andzelytė, Ieva Tveragaitė, Povilas Ignatavicius

{"title":"Surgery for multifocal intrahepatic cholangiocarcinoma.","authors":"Augustė Andzelytė, Ieva Tveragaitė, Povilas Ignatavicius","doi":"10.1159/000548043","DOIUrl":"https://doi.org/10.1159/000548043","url":null,"abstract":"Background Multifocal intrahepatic cholangiocarcinoma (m-ICC) is an aggressive form of primary liver cancer, often associated with poor outcomes. Although surgical resection is considered the only curative treatment for ICC, multifocality is frequently regarded as a contraindication due to the high risk of recurrence and limited survival benefits. Aim To perform a systematic literature review on the outcomes of surgical treatment of m-iCCA. Methods This systematic review was performed according to PRISMA statement. A study protocol for the review was registered in the International Prospective Register of Systematic Reviews database. Databases were systematically searched for studies analysing surgical treatment outcomes for m-iCCA. Results Ten articles with 2392 patients who had m-ICCA were included in our review. The reviewed studies reported extensive surgical procedures with median survival ranging from 18.9 to 27 months. Recurrence rates were higher in m-iCCA patients (67.8-74.3%) compared to solitary ICC cases (52.4-60.5%), with recurrence-free survival as short as 4.5 months. One study reported a 5-year survival rate of 12.9% for surgical patients compared to 0% for non-operated patients. Survival outcomes were influenced by adverse prognostic indicators. Conclusions Surgical resection for multifocal intrahepatic cholangiocarcinoma is a challenging treatment option due to the high likelihood of recurrence and the aggressive nature of the disease. Despite these challenges, surgery may offer survival benefits for carefully selected patients.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-16"},"PeriodicalIF":1.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between textbook outcomes of liver surgery (TOLS) and overall survival in gallbladder cancer patients treated with curative-intent resection: A multicenter study. 一项多中心研究：胆囊癌患者肝手术预后（TOLS）与治疗目的切除的总生存率之间的关系

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-09-11 DOI: 10.1159/000548351

Zi-Mu Li, Hui-Ying Ouyang, Yi Gong, Hai-Su Dai, Jie Bai, Yan Jiang, Xian-Yu Yin, Zhi-Yu Chen, Shu-Guo Zheng, Yun-Feng Li, Chao Yu, Fan Huang, Zhao-Ping Wu, Jin-Xue Zhou, Da-Long Yin, Rui Ding, Wei Guo, Yi Zhu, Wei Chen, Ke-Can Lin, Ping Yue, Yao Cheng, Dong Zhang, Yan-Qi Zhang, Zhi-Peng Liu, Tao Qin

{"title":"Association between textbook outcomes of liver surgery (TOLS) and overall survival in gallbladder cancer patients treated with curative-intent resection: A multicenter study.","authors":"Zi-Mu Li, Hui-Ying Ouyang, Yi Gong, Hai-Su Dai, Jie Bai, Yan Jiang, Xian-Yu Yin, Zhi-Yu Chen, Shu-Guo Zheng, Yun-Feng Li, Chao Yu, Fan Huang, Zhao-Ping Wu, Jin-Xue Zhou, Da-Long Yin, Rui Ding, Wei Guo, Yi Zhu, Wei Chen, Ke-Can Lin, Ping Yue, Yao Cheng, Dong Zhang, Yan-Qi Zhang, Zhi-Peng Liu, Tao Qin","doi":"10.1159/000548351","DOIUrl":"https://doi.org/10.1159/000548351","url":null,"abstract":"Background This study investigated the relationship between textbook outcomes of liver surgery (TOLS) and overall survival (OS) in patients who underwent curative-intent resection of GBC. Method Patients with GBC who underwent curative-intent resection between 2014 and 2021 were selected from 16 hospitals. Patients were divided into either the TOLS group or the non-TOLS group according to whether TOLS were observed. Patients who died within 90 days of surgery were excluded prior to the survival analysis. Log-rank test was used to compare the difference in the OS rate between TOLS and non-TOLS groups. Univariate and multivariate analyses were performed using Cox regression analysis to identify factors independently associated with OS. Results A total of 913 patients were selected, 565 (61.9%) exhibited TOLS. The 5-year OS rate in the TOLS group was significantly higher than that in the non-TOLS group (45.4% vs. 21.9%; P<0.001). Multivariate Cox regression analysis confirmed TOLS, TB level> 54 µmol/ml, CEA level> 5 µg/ml, CA19-9 level> 37 U/L, poor differentiation, stages T2 and T3/4 according to the 8th edition AJCC T staging manual, N1 and N2 according to the 8th edition AJCC N staging manual, and adjuvant chemotherapy as independent risk factors that affect OS after curative-intent resection of GBC. Conclusion Among patients who undergo curative-intent resection of GBC, approximately 61.9% experience TOLS. TOLS are not only the optimal short-term outcome but also associated with long-term survival.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-21"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of Intestinal Fatty Acid Binding Protein in Diagnosing Adhesive Small Bowel Obstruction: A Pilot Study. 肠脂肪酸结合蛋白在粘连性小肠梗阻诊断中的作用：一项初步研究。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-08-14 DOI: 10.1159/000547989

Juliette S van Dam, Claire A J I Leenarts, Thijs R van Oudheusden, Joep P M Derikx, Misha Luyer

{"title":"Role of Intestinal Fatty Acid Binding Protein in Diagnosing Adhesive Small Bowel Obstruction: A Pilot Study.","authors":"Juliette S van Dam, Claire A J I Leenarts, Thijs R van Oudheusden, Joep P M Derikx, Misha Luyer","doi":"10.1159/000547989","DOIUrl":"10.1159/000547989","url":null,"abstract":"Introduction: The incidence of adhesive small bowel obstruction (ASBO) after abdominal surgery is 2.4%. Delay in surgery increases morbidity and mortality. Plasma intestinal fatty acid binding protein (I-FABP) levels indicate intestinal damage and may guide treatment. The aim of this study was to investigate whether plasma I-FABP levels may optimize selection of patients requiring surgery presenting with ASBO.Methods: Patients with suspected ASBO underwent a contrast swallow. If bowel transit was absent after 8 h, surgery was performed. I-FABP levels were assessed at several moments. Data were analyzed by comparing groups based on bowel transit, ischemia, and positive or negative laparotomies. Furthermore, a true operative group (patients with mechanical obstruction during surgery and patients needing operative treatment who deceased due to non-operative treatment) was compared to a true non-operative group (patients with negative laparotomies and patients successfully treated with non-operative treatment).Results: Median I-FABP levels were higher in patients without bowel transit (1,207 pg/mL) than in patients with bowel transit (589 pg/mL, p = 0.01). Median I-FABP levels in the negative laparotomy group (301 pg/mL) showed a trend to significance compared to the positive laparotomy group (1,177 pg/mL, p = 0.05). There was no significant difference between the true operative group (1,150 pg/mL) and the true non-operative group (664 pg/mL) or between proven ischemia (975 pg/mL) and no ischemia (921 pg/mL).Conclusion: I-FABP might help identify ASBO patients in whom surgery can be postponed.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are There Any Differences in Clinical Outcome after the Surgical Management of Patients with Stomach versus Duodenal Perforation? 胃穿孔与十二指肠穿孔手术治疗后的临床结果有什么不同？

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-08-08 DOI: 10.1159/000547869

Saleh Lahes, Gudrun Wagenpfeil, Matthias Glanemann

{"title":"Are There Any Differences in Clinical Outcome after the Surgical Management of Patients with Stomach versus Duodenal Perforation?","authors":"Saleh Lahes, Gudrun Wagenpfeil, Matthias Glanemann","doi":"10.1159/000547869","DOIUrl":"10.1159/000547869","url":null,"abstract":"Introduction: Free perforation of the stomach or the duodenum usually requires emergency surgery. In fact, perforation is associated with short-term mortality and morbidity in up to 30 and 50% of patients, respectively, due to secondary peritonitis and sepsis. We hypothesized that postoperative clinical outcomes with duodenal perforation (DP) are worse than those with stomach perforation (SP). This retrospective study aimed to compare the early postoperative clinical outcomes of patients with SP and DP, focusing on morbidity and mortality, to identify differences that could indicate potential changes in surgical management.Methods: A total of 110 patients underwent emergency surgery between 2012 and 2022 for free SP or DP. We compared the demographic, intra-, and postoperative data, including morbidity and mortality during primary hospitalization in the two groups of patients. One group consisted of patients with SP and the second group consisted of patients with DP.Results: The incidence of any postoperative complication, the rate of planned reoperation, median operation time, as well as the median hospital stay after surgery were significantly increased in patients with DP compared to those with SP. In addition, surgical and nonsurgical complications, as well as mortality were common in the total patient population, and higher in DP than in SP patients; however, these differences were not statistically significant.Conclusion: Common postoperative problems occurring after surgery for DP or SP are similar and often life-threatening in both situations. However, patients with DP experienced these problems significantly more often, indicating a more complex injury that required considerably more medical intervention and extended treatment.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Organ-Sparing Approach after Neoadjuvant Treatment in Oesophageal Cancer. 食管癌新辅助治疗后保留器官入路。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-07-29 DOI: 10.1159/000547632

Matteo Pittacolo, Oleksandr Khoma, Sjoerd M Lagarde, Bianca Mostert, Bas P L Wijnhoven

{"title":"Organ-Sparing Approach after Neoadjuvant Treatment in Oesophageal Cancer.","authors":"Matteo Pittacolo, Oleksandr Khoma, Sjoerd M Lagarde, Bianca Mostert, Bas P L Wijnhoven","doi":"10.1159/000547632","DOIUrl":"10.1159/000547632","url":null,"abstract":"Background: Neoadjuvant chemoradiotherapy (nCRT) or perioperative chemotherapy followed by surgical resection is the standard of care for oesophageal and gastroesophageal junction cancer. Up to a third of patients will have a pathological complete response to neoadjuvant treatment. Given the significant morbidity associated with surgery, active surveillance is considered as a potential alternative for patients with clinical complete response post-nCRT.Summary: The preSANO and preSINO trials have validated a multimodal diagnostic strategy combining oesophagogastroduodenoscopy with bite-on-bite biopsies, endoscopic ultrasonography with fine-needle aspiration of suspicious lymph nodes, and PET-CT to detect residual disease. The SANO trial is assessing whether active surveillance leads to non-inferior overall survival compared to planned surgery. Early results of randomized studies support previous retrospective reports of comparable oncological outcomes, with improved quality of life in the surveillance group. Despite concerns of increased morbidity of postponed surgery upon recurrence, recent data indicate comparable surgical outcomes of delayed oesophagectomy. Ongoing trials, including SANO-2, CELEAC, and NEEDS, aim to rationalize surveillance protocols, while SANO-3 is investigating the role of adding immunotherapy in improving response durability.Key messages: Active surveillance represents a promising alternative to surgery for oesophageal cancer patients achieving complete clinical response after neoadjuvant therapy. While it can spare patients the morbidity of oesophagectomy and significantly improve quality of life, it requires accurate response assessment and structured follow-up. Future developments, including immunotherapy and non-invasive diagnostics, may further refine this approach and expand its safe applicability.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retrospective Analysis of Risk Factors Associated with Incidental Appendiceal Neoplasms in Patients with Acute Appendicitis. 急性阑尾炎患者偶发阑尾肿瘤相关危险因素回顾性分析。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-07-29 DOI: 10.1159/000547699

Susumu Doita, Fumitaka Taniguchi, Kengo Mouri, Eiki Miyake, Toshihiro Ogawa, Megumi Watanabe, Takashi Arata, Kou Katsuda, Kohji Tanakaya, Hideki Aoki

{"title":"Retrospective Analysis of Risk Factors Associated with Incidental Appendiceal Neoplasms in Patients with Acute Appendicitis.","authors":"Susumu Doita, Fumitaka Taniguchi, Kengo Mouri, Eiki Miyake, Toshihiro Ogawa, Megumi Watanabe, Takashi Arata, Kou Katsuda, Kohji Tanakaya, Hideki Aoki","doi":"10.1159/000547699","DOIUrl":"10.1159/000547699","url":null,"abstract":"Introduction: As the nonoperative management of acute appendicitis becomes more widespread, identifying patients at high risk of appendiceal tumors is increasingly important. This study aimed to clarify the predictive factors of appendiceal tumors before appendectomy.Methods: We retrospectively analyzed 434 patients diagnosed with acute appendicitis who underwent emergency or interval appendectomy.Results: Appendiceal neoplasms were found in 3.9% of patients. Patients with tumors were significantly older (64.4 vs. 49.6 years, p < 0.001). The tumor group exhibited a lower appendicolith incidence (48% vs. 12%, p = 0.011) and larger appendiceal diameters (18.0 vs. 12.3 mm, p < 0.001). Multivariate analysis demonstrated that age ≥60 years, absence of appendicolith, and an appendiceal diameter ≥12 mm were independent risk factors of appendiceal tumors. Among patients who underwent interval appendectomy, only the non-tumor group exhibited significant improvement in appendiceal diameter after nonoperative management (tumor, +1.6 mm vs. no tumor, -3.5 mm, p < 0.001).Conclusions: Advanced age, absence of appendicolith, and an enlarged appendiceal diameter may be significant predictive factors of appendiceal tumors. These factors will aid in the selection of appropriate appendicitis treatment strategies.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Approaches to Diagnosis and Management of Acute Mesenteric Ischaemia: A Scoping Review. 急性肠系膜缺血的当前诊断和治疗方法-范围综述。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2025-07-15 DOI: 10.1159/000547297

Liam Costello, William P Duggan, Michael Flanagan, Conor Toale, Dara O Kavanagh

{"title":"Current Approaches to Diagnosis and Management of Acute Mesenteric Ischaemia: A Scoping Review.","authors":"Liam Costello, William P Duggan, Michael Flanagan, Conor Toale, Dara O Kavanagh","doi":"10.1159/000547297","DOIUrl":"10.1159/000547297","url":null,"abstract":"Background: Acute mesenteric ischaemia (AMI) is a life-threatening condition with mortality exceeding 50%. This scoping review evaluates current diagnostic and management strategies, comparing endovascular and open surgical approaches.Summary: Following Arksey and O'Malley's framework, a systematic search was conducted in OVID MEDLINE, Embase, and Web of Science (2005-2024). English-language studies on AMI were included. Data on diagnostic methods, mortality, hospital/ICU stay, and surgical outcomes were extracted. Thirty-nine studies (20,991 patients) were analysed. CT angiography was the primary diagnostic tool, with diagnostic delays ranging from 13.9 to 48 h. Endovascular interventions demonstrated lower 30-day mortality (0%-53.8%) versus open surgery (21%-81%). Hospital (5-15.35 vs. 5.7-27.26 days) and ICU stays (0-5.35 vs. 2-13 days) were shorter with endovascular management. Bowel resection and re-laparotomy rates were also reduced.Key messages: Endovascular management is associated with improved outcomes, including reduced mortality and shorter hospital stays. Timely diagnosis and patient selection remain critical. A multidisciplinary approach is essential, though further prospective studies are needed to standardise protocols.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-18"},"PeriodicalIF":1.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis. 早期口服喂养对择期结直肠手术术后效果的影响：系统综述和荟萃分析。

IF 1.8 3区医学

Digestive Surgery Pub Date : 2025-01-01 Epub Date: 2024-11-18 DOI: 10.1159/000542595

Soo Young Lee, Eon Chul Han

{"title":"Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis.","authors":"Soo Young Lee, Eon Chul Han","doi":"10.1159/000542595","DOIUrl":"10.1159/000542595","url":null,"abstract":"Introduction: This study aimed to evaluate the influence of early oral feeding (EOF), a key component of enhanced recovery after surgery protocols, on postoperative outcomes in patients undergoing elective colorectal surgery.Methods: We searched the MEDLINE, Embase, Cochrane Library, and KoreaMed databases to include randomized clinical trials comparing EOF that started on postoperative day 1 and conventional oral feeding that commenced after first flatus. Two authors independently screened the retrieved records and extracted data. The primary outcome was total complications. Data were pooled, and the overall effect size was calculated using a fixed-effect model.Results: We screened 13 studies, and 1,556 patients were included in the analysis. The EOF group exhibited fewer total complications (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.38-0.65). Anastomotic leakage was also reduced in the EOF group (OR: 0.40; 95% CI: 0.19-0.83); however, an increased incidence of vomiting (OR: 1.58; 95% CI: 1.11-2.26) as well as a tendency of higher rate of nasogastric tube reinsertion (OR: 1.49; 95% CI: 0.96-2.31) were observed. The EOF group demonstrated a decreased time to flatus (mean difference [MD] -0.87; 95% CI: -1.00 to -0.74) and shortened hospital stay (MD: -0.76; 95% CI: -0.89 to -0.6). No significant difference in mortality was observed between the two groups (OR: 0.54; 95% CI: 0.15-2.01).Conclusion: EOF proved to be a safe and effective practice for patients undergoing elective colorectal surgery. However, the increased incidence of vomiting necessitates careful consideration.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"26-35"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0