Digestive Surgery最新文献_第10页

Letter to "Identification of Pre-Operative Risk Factors for Poor Survival in Patients with Resectable Pancreatic Cancer Treated with Upfront Surgery". 致 "可切除胰腺癌患者术前生存率低的风险因素识别 "的信

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2022-07-07 DOI: 10.1159/000525832

Harshit Verma, Ashesh Kumar Jha, Manoj Kumar, Prashant Kumar Singh, Anil Kumar, Shiv Shankar Paswan, Deepak Kumar

引用次数: 0

Intake of Acetylsalicylic Acid and High Age Are Risk Factors for Iron Deficiency Anemia in Patients with Large Diaphragmatic Hernias. 大膈疝患者缺铁性贫血的危险因素是乙酰水杨酸摄入和高龄。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000529326

Christoph G Dietrich, Tanja Kottmann, Annette Holtdirk, Joachim W Heise

{"title":"Intake of Acetylsalicylic Acid and High Age Are Risk Factors for Iron Deficiency Anemia in Patients with Large Diaphragmatic Hernias.","authors":"Christoph G Dietrich, Tanja Kottmann, Annette Holtdirk, Joachim W Heise","doi":"10.1159/000529326","DOIUrl":"https://doi.org/10.1159/000529326","url":null,"abstract":"Introduction: In 15% of patients with iron deficiency anemia, large diaphragmatic hernias are found as the cause of chronic iron loss. Conversely, iron deficiency anemia is present in 10-40% of diaphragmatic hernia patients. However, it is unclear why some patients with large diaphragmatic hernias develop anemia and others do not.Methods: We retrospectively analyzed 116 patients with diaphragmatic hernias larger than 5 cm for the presence of anemia and the effect of surgery on this anemia, dividing these patients into 4 groups (group A: 21 patients with anemia/surgery, group B: 27 patients without anemia but with surgery, group C: 34 patients with anemia but without surgery, and group D: 34 patients without anemia/surgery).Results: Women significantly predominated in the patient population (76%). Patients with iron deficiency anemia tended to be significantly older than patients without iron deficiency anemia (74.7 ± 12.2 vs. 69.6 ± 14.8 years, p = 0.08). The proportion of patients taking ASA was significantly higher in the anemia collective (41.8% vs. 9.8%, p < 0.001). Regression analysis further confirmed that higher age and ASA intake correlated significantly with lower hemoglobin in anemic patients. Performing hernia repair significantly decreased anemia rates and PPI use in the anemia patients, while both remained almost the same in the non-operated anemia patients.Conclusion: ASA use and advanced age are risk factors for the presence of iron deficiency anemia in patients with large diaphragmatic hernias. Surgical hernia repair is suitable to reduce anemia.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 5-6","pages":"250-254"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366653","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

Effect of the First Assistant on Anastomotic Leakage after Rectal Cancer Surgery with Double-Stapling Anastomosis: A Propensity Score Matching Analysis. 第一辅助对直肠癌双吻合器吻合术后吻合口漏的影响:倾向评分匹配分析。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000525909

Soo Young Lee, Sola Lee, Ook Song, Jaram Lee, Hyeong-Min Park, Chang Hyun Kim, Hyeong Rok Kim

{"title":"Effect of the First Assistant on Anastomotic Leakage after Rectal Cancer Surgery with Double-Stapling Anastomosis: A Propensity Score Matching Analysis.","authors":"Soo Young Lee, Sola Lee, Ook Song, Jaram Lee, Hyeong-Min Park, Chang Hyun Kim, Hyeong Rok Kim","doi":"10.1159/000525909","DOIUrl":"https://doi.org/10.1159/000525909","url":null,"abstract":"Introduction: Proper handling and firing of the circular stapler are important for secure anastomosis in rectal cancer surgery. This study aimed to investigate the association between the first assistant and anastomotic leakage (AL) after rectal cancer surgery with double-stapling anastomosis.Methods: Patients with primary rectal cancer who underwent low anterior resection with double-stapling anastomosis between January 2015 and September 2019 were included. Data on clinicopathological characteristics, including the first assistant's sex and experience level, were retrospectively reviewed, and the risk factors for AL were analyzed using propensity score matching analysis.Results: Among 758 rectal cancer surgeries, residents participated in 401 (52.9%) surgeries, and fellows participated in 357 (47.1%) surgeries as first assistants. After propensity score matching (n = 650), AL occurred in 5.4% (35/650). The first assistant's experience level (resident: 5.5% vs. fellow: 5.2%, p = 0.862) and sex (male: 5.4% vs. female: 4.9%, p = 0.849) were not associated with the occurrence of AL. Male sex in patients was the only significant predictive factor for AL (odds ratio = 2.804, 95% confidence interval 1.070-7.351, p = 0.036).Discussion/conclusion: The first assistant's sex and experience level were not associated with AL after rectal cancer surgery with double-stapling anastomosis. These findings may justify resident participation in rectal cancer surgeries in which circular staplers are used.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 4","pages":"176-182"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10568669","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

EDS Society News EDS社新闻

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000520690

引用次数: 0

The Effect of Celiac Neurolysis and Splanchnicectomy on Survival in Unresectable Pancreatic Cancer: A Systematic Review and Meta-Analysis. 腹腔神经松解术和胰切除术对不可切除胰腺癌患者生存的影响:系统回顾和荟萃分析。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2021-12-10 DOI: 10.1159/000520456

Linhan Ye, Stephan Schorn, Ilaria Pergolini, Okan Safak, Elke Demir, Rouzanna Istvanffy, Helmut Friess, Güralp O Ceyhan, Ihsan Ekin Demir

{"title":"The Effect of Celiac Neurolysis and Splanchnicectomy on Survival in Unresectable Pancreatic Cancer: A Systematic Review and Meta-Analysis.","authors":"Linhan Ye, Stephan Schorn, Ilaria Pergolini, Okan Safak, Elke Demir, Rouzanna Istvanffy, Helmut Friess, Güralp O Ceyhan, Ihsan Ekin Demir","doi":"10.1159/000520456","DOIUrl":"https://doi.org/10.1159/000520456","url":null,"abstract":"Background: Intractable pancreatic pain is one of the most common symptoms of patients with pancreatic ductal adenocarcinoma (PDAC). Celiac neurolysis (CN) and splanchnicectomy were already described as effective methods to manage abdominal pain in unresectable PDAC, but their impact on overall survival (OS) has not yet been established.Objective: We aimed to investigate the impact of CN and splanchnicectomy on the survival of patients with unresectable pancreatic cancer.Methods: A systematic review of PubMed and Cochrane Library according to predefined searching terms was conducted in March 2020. Hazard ratios (HR) of OS data were calculated using the Mantel-Haenszel model for random effects or fixed effects.Result: Four randomized-controlled trials (RCTs) and 2 non-RCTs with a total of 2,507 patients were identified. The overall pooled HR did not reveal any relevant effect of CN and splanchnicectomy on OS (HR: 1.03; 95% CI: 0.81-1.32), which was also underlined by the sensitivity analysis of RCTs (HR: 1.0; 95% CI: 0.72-1.39) and non-RCTs (HR: 1.07; 95% CI: 0.71-1.63). However, subgroup analyses depending on tumor stage revealed that CN or splanchnicectomy was associated with a worsened OS in AJCC (American Joint Committee on Cancer) stage III patients with unresectable PDAC (HR: 1.22; 95% CI: 1.03-1.45), but nor for AJCC stage IV patients (HR: 1.27; 95% CI: 0.9-1.80).Conclusion: Although only few data are currently available, this systematic review with meta-analysis showed that in unresectable PDAC, CN or splanchnicectomy is associated with a worsened survival in stage III PDAC patients, with no effect on stage IV PDAC patients. These data call for caution in the usage of CN or splanchnicectomy in stage III PDAC and for further studies addressing this observation.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 1","pages":"51-59"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599589","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 in Autoimmune Pancreatitis. 自身免疫性胰腺炎的手术治疗

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2021-12-15 DOI: 10.1159/000521490

Sara Nikolic, Poya Ghorbani, Raffaella Pozzi Mucelli, Sam Ghazi, Francisco Baldaque-Silva, Marco Del Chiaro, Ernesto Sparrelid, Caroline S Verbeke, J-Matthias Löhr, Miroslav Vujasinovic

{"title":"Surgery in Autoimmune Pancreatitis.","authors":"Sara Nikolic, Poya Ghorbani, Raffaella Pozzi Mucelli, Sam Ghazi, Francisco Baldaque-Silva, Marco Del Chiaro, Ernesto Sparrelid, Caroline S Verbeke, J-Matthias Löhr, Miroslav Vujasinovic","doi":"10.1159/000521490","DOIUrl":"https://doi.org/10.1159/000521490","url":null,"abstract":"Introduction: Autoimmune pancreatitis (AIP) is a disease that may mimic malignant pancreatic lesions both in terms of symptomatology and imaging appearance. The aim of the present study is to analyze experiences of surgery in patients with AIP in one of the largest European cohorts.Patients and methods: We performed a single-center retrospective study of patients diagnosed with AIP at the Department of Abdominal Diseases at Karolinska University Hospital in Stockholm, Sweden, between January 2001 and October 2020.Results: There were 159 patients diagnosed with AIP, and among them, 35 (22.0%) patients had surgery: 20 (57.1%) males and 15 (42.9%) females; median age at surgery was 59 years (range 37-81). Median follow-up period after surgery was 50 months (range 1-235). AIP type 1 was diagnosed in 28 (80%) patients and AIP type 2 in 7 (20%) patients. Malignant and premalignant lesions were diagnosed in 8 (22.9%) patients for whom AIP was not the primary differential diagnosis, but in all cases, it was described as a simultaneous finding and recorded in retrospective analysis in histological reports of surgical specimens.Conclusions: Diagnosis of AIP is not always straightforward, and in some cases, it is not easy to differentiate it from the malignancy. Surgery is generally not indicated for AIP but might be considered in patients when suspicion of malignant/premalignant lesions cannot be excluded after complete diagnostic workup.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 1","pages":"32-41"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39608479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Endoscopic Stenting for Malignant Left-Sided Large-Bowel Obstruction in Patients with Colorectal Cancer: Evaluation according to Pathological Stage. 内镜下支架置入术治疗大肠癌左侧恶性大肠梗阻:病理分期评价。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000528181

Yoon Oh, Sunseok Yoon, Sun Gyo Lim, Seung Yeop Oh

{"title":"Endoscopic Stenting for Malignant Left-Sided Large-Bowel Obstruction in Patients with Colorectal Cancer: Evaluation according to Pathological Stage.","authors":"Yoon Oh, Sunseok Yoon, Sun Gyo Lim, Seung Yeop Oh","doi":"10.1159/000528181","DOIUrl":"https://doi.org/10.1159/000528181","url":null,"abstract":"Introduction: Self-expandable metallic stents (SEMSs) are widely used in patients with malignant left-sided large-bowel obstruction (MLLO) to convert an emergency situation into an elective one. However, the effects of endoscopic stenting on oncological outcomes remain unclear. This study aimed to analyze the oncological outcomes of SEMS placement in patients with MLLO stratified by pathological stage.Methods: We reviewed the data of patients with MLLO that were prospectively collected between January 2005 and December 2016. Patients were divided into those who underwent SEMS placement as a bridge to surgery and those who underwent emergency surgery. Disease-free survival (DFS) and overall survival (OS) were compared between groups, and their prognostic factors were determined by pathological stage.Results: SEMS placement and emergency surgery were performed in 130 and 45 patients, respectively. There was no difference in the 5-year DFS and OS rate between two groups. Subgroup analysis revealed a significant difference in the 5-year DFS and OS rate in patients with stage III MLLO, but was not observed in patients with stage II MLLO. Multivariate Cox regression analysis for stage III MLLO revealed endoscopic stenting (hazard ratio [HR], 2.051; 95% confidence interval [CI], 1.018-4.131; p = 0.044) as the only prognostic factor for DFS. Age, tumor differentiation, perineural invasion, and endoscopic stenting (HR, 3.189; 95% CI, 1.346-7.556; p = 0.008) were prognostic factors for OS.Conclusion: In terms of oncologic outcomes, endoscopic stenting might be more beneficial than ES in patients with stage III MLLO.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 5-6","pages":"242-249"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366793","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

Lower Incidence of Postoperative Urinary Retention in Robotic Total Mesorectal Excision for Low Rectal Cancer Compared with Laparoscopic Surgery. 与腹腔镜手术相比，低位直肠癌机器人全肠系膜切除术术后尿潴留发生率较低。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2022-02-07 DOI: 10.1159/000522229

Tae Hoon Lee, Jung-Myun Kwak, Da Young Yu, Kyung-Sook Yang, Se Jin Baek, Jin Kim, Seon Hahn Kim

{"title":"Lower Incidence of Postoperative Urinary Retention in Robotic Total Mesorectal Excision for Low Rectal Cancer Compared with Laparoscopic Surgery.","authors":"Tae Hoon Lee, Jung-Myun Kwak, Da Young Yu, Kyung-Sook Yang, Se Jin Baek, Jin Kim, Seon Hahn Kim","doi":"10.1159/000522229","DOIUrl":"https://doi.org/10.1159/000522229","url":null,"abstract":"Introduction: The incidence and clinical significance of postoperative urinary retention (POUR) remain high. This study aimed to evaluate the incidence of POUR and related risk factors in patients who underwent total mesorectal excision (TMR) for low rectal cancer.Methods: This study is a retrospective review of a prospectively collected colorectal database from a single center. Data from patients who underwent surgery for low rectal cancer between September 2006 and May 2017 were analyzed to assess the risk factors of POUR. POUR was considered inability to void after urinary catheter removal requiring catheter reinsertion and difficulty in bladder emptying requiring intermittent catheterization.Results: Of 555 patients with low rectal cancer, 78 (14.1%) developed POUR. Based on multivariate logistic regression analysis, laparoscopic TMR (odds ratio [OR]; 2.114, 95% confidence interval [CI]; 1.212-3.689, p = 0.008) and postoperative ileus (OR; 2.389, 95% CI; 1.282-4.450, p = 0.006) were independent risk factors of POUR. Male gender, advanced age, neoadjuvant chemoradiation, longer operative time, abdominoperineal resection, and lateral pelvic lymph node dissection were not associated with POUR. Advanced age over 65 years also failed to show statistical significance (OR; 1.604, 95% CI; 0.965-2.668, p = 0.068).Conclusion: Laparoscopic approach and postoperative ileus are risk factors for POUR after low rectal cancer surgery. We postulate that the benefits of robotic surgical systems compared to a laparoscopic approach may reduce the incidence of POUR.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 2-3","pages":"75-82"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39773510","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: 1

Laparoscopic versus Open Approach for Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis. 腹腔镜与开放入路治疗食管胃交界处Siewert II/III型腺癌:一项系统综述和meta分析

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000528912

Ming Wu, Wei Zhang, Yan-Yang Song

{"title":"Laparoscopic versus Open Approach for Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis.","authors":"Ming Wu, Wei Zhang, Yan-Yang Song","doi":"10.1159/000528912","DOIUrl":"https://doi.org/10.1159/000528912","url":null,"abstract":"Introduction: Due to the specific location, the potential advantages of laparoscopic gastrectomy (LG) compared with open gastrectomy (OG) for Siewert II/III adenocarcinoma of the esophagogastric junction (AEG) remain uncertain. The current study aimed to compare the short- and long-term outcomes of LG versus OG in treating Siewert type II/III adenocarcinoma.Methods: We searched PubMed, Embase, Web of Science, MEDLINE (hosted by Ovid), and the Cochrane Library for publications till July 2022 and then used the RevMan 5.3 software for statistical analysis.Results: Ten publications from 10 medical centers were included, with 1,516 cases from the LG group and 1,219 from the OG group. Meta-analysis results showed that the LG group was superior to the OG group in intraoperative blood loss, hospital stay, lymph nodes retrieved, time to ambulation, time to first flatus, time to diet, 5-year overall survival, and 5-year disease-free survival. There was no significant difference between the two groups in operative time, overall complications, proximal margin, distal margin, pulmonary infection, anastomotic leakage, mortality, ileus, or absolute infection.Conclusions: Compared with OG, LG is associated with better surgical and long-term outcomes in Siewert type II/III AEG. LG is a safe and feasible option for treating Siewert type II/III AEG. However, studies with large sample sizes, long follow-up periods, and rigorous designs are needed for verification.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 5-6","pages":"210-223"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366173","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: 1

EDS Society News. EDS社会新闻。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000528742

引用次数: 0