Digestive Surgery最新文献_第3页

Perioperative Blood Product Transfusions in Gastric Cancer Surgery in Finland. 芬兰胃癌手术围手术期血液制品输注。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2025-12-26 DOI: 10.1159/000549881

Jukka-Pekka Lammi, Mika Ukkonen, Matti Eskelinen, Juha Saarnio, Pirjo Käkelä, Tuomo Rantanen

{"title":"Perioperative Blood Product Transfusions in Gastric Cancer Surgery in Finland.","authors":"Jukka-Pekka Lammi, Mika Ukkonen, Matti Eskelinen, Juha Saarnio, Pirjo Käkelä, Tuomo Rantanen","doi":"10.1159/000549881","DOIUrl":"10.1159/000549881","url":null,"abstract":"Introduction: Preoperative anaemia is common in gastric cancer patients. Although restrictive blood product transfusion strategies have been introduced, their use in standard practice is not well known. This national register study investigated the perioperative haemoglobin and platelet levels and the use of blood product transfusions in gastric cancer surgery.Methods: In order to improve and unify blood transfusion policies, the Finnish Red Cross Blood Service carried out a project concerning the optimal use of blood products (VOK project). These register data were used to form the patient population containing 70% of blood product transfusions in Finland. Patients undergoing open surgery for gastric cancers were included.Results: A total of 500 patients were included. Perioperative anaemia was observed in 75% of males and 52% of females. Fifty-one percent of patients received blood transfusions, with a median transfusion trigger point of 91 g/L [IQR 84-98 g/L] and a median 3 units transfused [IQR 2-4 units]. Seven percent received platelet transfusion (median trigger 77, IQR 15-146; median 4 units, IQR 2-8), and 6.5% received either fresh frozen plasma or pooled human plasma products. At discharge, the median haemoglobin level was 109 g/L in non-transfused patients and 114 g/L in transfused patients. If restrictive strategies had been applied, only 1.7% (n = 9) had required blood and 0.5% (n = 3) had a platelet transfusion.Conclusion: Anaemia is common among patients undergoing gastric cancer surgery. We encourage clinicians to follow restrictive transfusion policies in gastric cancer patients as Hb levels seem to recover after gastric surgery without blood transfusions.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"16-22"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843597","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

Response Rate Correlates with the Conversion Rate in Patients with Advanced Hepatocellular Carcinoma Treated with Systemic or Hepatic Artery Infusion Chemotherapy: A Systematic Review. 晚期肝癌患者接受全身或肝动脉输注化疗的应答率与转换率相关：一项系统综述

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2025-12-23 DOI: 10.1159/000550237

Masayuki Okuno, Hiroto Nishino, Keisuke Okura, Takamichi Ishii, Hiroki Hashida, Etsuro Hatano

{"title":"Response Rate Correlates with the Conversion Rate in Patients with Advanced Hepatocellular Carcinoma Treated with Systemic or Hepatic Artery Infusion Chemotherapy: A Systematic Review.","authors":"Masayuki Okuno, Hiroto Nishino, Keisuke Okura, Takamichi Ishii, Hiroki Hashida, Etsuro Hatano","doi":"10.1159/000550237","DOIUrl":"10.1159/000550237","url":null,"abstract":"Introduction: The appropriate regimen for induction therapy with the intent of conversion therapy for advanced hepatocellular carcinoma (HCC) is unknown. This study aimed to evaluate whether the overall response rate (ORR) of chemotherapy correlates with the conversion rate.Methods: The studies of phase 2/3 trials of systemic or hepatic artery infusion chemotherapy (HAIC) for patients with advanced HCC were searched. Spearman's correlation coefficient was calculated to measure the strength of the relationship between the conversion rate and the ORR.Results: A total of 42 patient groups from 32 trials were included in the analysis. The ORR and conversion rates in a total of 3,516 patients were 24.7% and 8.3%, respectively. The analysis of only the patient groups treated with 1st-line immune checkpoint inhibitors, tyrosine kinase inhibitors or HAIC revealed a strong correlation between the ORR and the conversion rate (ρ = 0.647, p = 0.0003). In addition, strong correlations between the ORR and median progression-free survival (PFS)/overall survival (OS) were observed (ρ = 0.772, p < 0.0001 and ρ = 0.754, p < 0.0001, respectively).Conclusion: Because of the strong correlations of the ORR with the conversion rate and PFS/OS, regimens with high ORRs may be used for patients with advanced HCC who are potential candidates for conversion therapy. .","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"23-34"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817970","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: 0

Risk Factors for Conversion in Laparoscopic Appendicectomy: A Cross-Sectional Study in a Middle-Income Country. 腹腔镜阑尾切除术转换的危险因素：一项中等收入国家的横断面研究。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-03-13 DOI: 10.1159/000550991

Edith Rodriguez-Prado, Flavia Rioja-Torres, Gabriel De La Cruz-Ku, César Razuri-Bustamante

{"title":"Risk Factors for Conversion in Laparoscopic Appendicectomy: A Cross-Sectional Study in a Middle-Income Country.","authors":"Edith Rodriguez-Prado, Flavia Rioja-Torres, Gabriel De La Cruz-Ku, César Razuri-Bustamante","doi":"10.1159/000550991","DOIUrl":"10.1159/000550991","url":null,"abstract":"Introduction: Acute appendicitis is a common surgical emergency. Laparoscopic appendicectomy is preferred for faster recovery and less pain, but conversion to open surgery remains necessary in some cases. Most evidence on conversion comes from high-income countries, while data from low- and middle-income settings (LMIC), where resource limitations may influence surgical decisions, are scarce. This study aimed to identify factors associated with conversion in a public, resource-limited Peruvian hospital.Methods: We conducted a retrospective cross-sectional study of patients undergoing laparoscopic appendicectomy at a public hospital in Lima, Peru, between 2022 and 2023. Variables were compared between patients requiring conversion and those completing the procedure laparoscopically. Multivariate analyses were performed to identify risk factors.Results: A total of 523 patients were included. Conversion to open appendicectomy occurred in 4 patients (0.76%), primarily due to difficult dissection from severe adhesions, intraoperative hemorrhage associated with equipment malfunction. Multivariate analysis identified adhesions (OR = 8.91, 95% CI: 1.48-53.42, p = 0.017), appendicolith (OR = 11.49, 95% CI: 1.74-75.69, p = 0.001), and intraoperative complications (OR = 45.74, 95% CI: 6.71-311.55, p < 0.001) as significant factors of conversion.Conclusions: Laparoscopic appendicectomy is safe and effective in public hospitals, even in low-resource settings. Conversion was rare and mainly driven by adhesions, appendicoliths, or intraoperative complications. These findings reinforce that laparoscopic appendicectomy can be reliably performed in LMIC.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"69-80"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455578","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

Robotically Assisted Gastric Resections Using the hinotori™: A Cadaveric Feasibility Study. 机器人辅助胃切除使用hinotori™：尸体可行性研究。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2025-11-28 DOI: 10.1159/000548938

Christoph Wandhöfer, Franco Roviello, Vladimir J Lozanovski, Evangelos Tagkalos, Peter P Grimminger, Hauke Lang, Suzanne S Gisbertz

{"title":"Robotically Assisted Gastric Resections Using the hinotori™: A Cadaveric Feasibility Study.","authors":"Christoph Wandhöfer, Franco Roviello, Vladimir J Lozanovski, Evangelos Tagkalos, Peter P Grimminger, Hauke Lang, Suzanne S Gisbertz","doi":"10.1159/000548938","DOIUrl":"10.1159/000548938","url":null,"abstract":"Introduction: In this first preclinical evaluation study of the hinotori™ system in gastric resection procedure, its capabilities to perform distal and total gastrectomy while using human cadaver models were evaluated.Methods: Three robotic distal gastrectomies (RADGs) and one total gastrectomy were performed in human cadavers using the same setup. A delta-shaped anastomosis in the RADG procedures were performed with a manual stapler.Results: The mean operative time for three distal gastrectomies was 118 min, while the total gastrectomy procedure focused on the resection only. The dissection could be made up to pulmonary veins, while the entire setup was kept. The procedures were done safely according to the surgical standards with smooth instrument and overall performance without any complications seen. An ergonomic surgeon cockpit and head rest supported the outcome.Conclusion: Docking-free design and human arm-like movement with a high degree of operation arm mobility showed a wide range of motion of the wristed robotic instruments. This could be beneficial for multiquadrant procedures resulting in potential shorter procedures times with smother performance, which should be evaluated in further studies. .","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"10-15"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631167","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: 0

Erratum. 勘误表。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-03-19 DOI: 10.1159/000551164

引用次数: 0

Prognostic Significance of Nutritional and Inflammatory Factors in Gastric Cancer Surgery. 营养和炎症因子在胃癌手术中的预后意义。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-05-20 DOI: 10.1159/000552039

Yoshinori Fujiwara, Shunji Endo, Masaharu Higashida, Yoko Endo, Ryoko Makieda, Hisako Kubota, Masaaki Hori, Toshimasa Okada, Kazuhiko Yoshimatsu, Tomio Ueno

{"title":"Prognostic Significance of Nutritional and Inflammatory Factors in Gastric Cancer Surgery.","authors":"Yoshinori Fujiwara, Shunji Endo, Masaharu Higashida, Yoko Endo, Ryoko Makieda, Hisako Kubota, Masaaki Hori, Toshimasa Okada, Kazuhiko Yoshimatsu, Tomio Ueno","doi":"10.1159/000552039","DOIUrl":"10.1159/000552039","url":null,"abstract":"Introduction: Various nutritional and inflammatory biomarkers have been proposed to predict prognosis in cancer patients. This study aimed to identify the most significant of these, along with clinical features, in gastric cancer patients who underwent gastrectomy.Methods: We retrospectively analyzed gastric cancer patients who underwent gastrectomy. Preoperative markers included mGPS (modified Glasgow Prognostic Score), neutrophil-to-lymphocyte ratio, C-reactive protein-to-albumin ratio, prognostic nutritional index, and Controlling Nutrition Status score. Postoperative markers were CRPmax, postoperative complications, and operative procedures. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS). Survival was analyzed with the Kaplan-Meier method. Key prognostic factors were identified using stepwise univariate and multivariable Cox regression.Results: 360 patients were analyzed. Stepwise Cox analysis showed mGPS as the strongest preoperative predictor of OS and RFS. When including both pre- and postoperative variables, age, pathological stage, and surgical procedure were independent prognostic factors. In a model limited to modifiable factors, mGPS and postoperative complications independently predicted both OS and RFS, while surgical procedure independently predicted RFS only.Conclusions: Improving preoperative mGPS and minimizing postoperative complications may enhance survival after gastrectomy. When appropriate, stomach-preserving procedures (e.g., subtotal distal gastrectomy) should be favored over total gastrectomy.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"126-134"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980791","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

PIPAC for Malignant Peritoneal Mesothelioma: Current Insights and Future Directions. 恶性腹膜间皮瘤的PIPAC：目前的见解和未来的方向。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-05-12 DOI: 10.1159/000552426

Arianna Castagna, Aphrodite Fotiadou, Ali Ramouz, Preslava Gesheva, Niall Brindl, Wiebke Solass, Andreas Brandl

{"title":"PIPAC for Malignant Peritoneal Mesothelioma: Current Insights and Future Directions.","authors":"Arianna Castagna, Aphrodite Fotiadou, Ali Ramouz, Preslava Gesheva, Niall Brindl, Wiebke Solass, Andreas Brandl","doi":"10.1159/000552426","DOIUrl":"10.1159/000552426","url":null,"abstract":"Background: Malignant peritoneal mesothelioma (MPM) is a rare and aggressive tumour with poor prognosis, often diagnosed late due to nonspecific symptoms. Current standard treatment involves systemic chemotherapy and cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, but this approach is limited to selected patients.Summary: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel technique improving drug delivery and penetration in the peritoneal cavity. This narrative review evaluates the role of PIPAC in the treatment of MPM, analysing data from clinical studies on its feasibility, safety, and efficacy. Evidence suggests that PIPAC is a well-tolerated procedure, with a manageable safety profile and potential to improve survival and tumour response in patients with unresectable or recurrent disease. Limitations in current studies include small cohorts and heterogeneous patient populations, underscoring the need for further research.Key message: PIPAC represents a promising therapeutic option, offering enhanced intraperitoneal chemotherapy delivery with minimal systemic toxicity. Future investigations should focus on optimizing treatment protocols and evaluating long-term benefits to better define PIPAC's role in clinical practice.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"151-162"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927408","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

Development of a Basic Robotic Training Course for Residents in General Surgery in the Netherlands. 荷兰普通外科住院医师基本机器人培训课程的开发。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-06-13 DOI: 10.1159/000553002

Frank Jan Voskens, Johannes Peter Maarten Burbach, Femke Julie Amelung, Daan Lips, George van der Schelling, Marc J van Det, Theo J Aufenacker, Werner A Draaisma, Jeroen Hagendoorn, Koen J Hartemink, Bart P L Witteman, Ivo Broeders, Jelle P Ruurda

{"title":"Development of a Basic Robotic Training Course for Residents in General Surgery in the Netherlands.","authors":"Frank Jan Voskens, Johannes Peter Maarten Burbach, Femke Julie Amelung, Daan Lips, George van der Schelling, Marc J van Det, Theo J Aufenacker, Werner A Draaisma, Jeroen Hagendoorn, Koen J Hartemink, Bart P L Witteman, Ivo Broeders, Jelle P Ruurda","doi":"10.1159/000553002","DOIUrl":"10.1159/000553002","url":null,"abstract":"Introduction: The continued adoption of robotic-assisted surgery (RAS) in digestive surgery has created an increasing demand for structured training of surgical residents. However, standardized basic RAS training programs specifically designed for residents remain limited, resulting in variable exposure and skill acquisition. This study describes the development and evaluation of a structured basic RAS training course, to standardize education and improve residents' robotic surgery skills.Methods: A 2-day, on-site basic RAS training course was developed by the Dutch Robotic Surgery Working Group and implemented at the OLV Robotic Surgery Institute (ORSI) academy between June 2021 and October 2023. The curriculum included lectures, interactive didactic sessions, simulation-based training, and both dry and wet laboratory exercises. The impact of the course on skill enhancement was assessed using pre- and post-course assessments.Results: Seventy-five senior surgical residents with a specific interest in RAS participated. Simulator assessments showed significant improvements in overall score, task completion time, and economy of motion across all three exercises following course completion: exercise 1 (p < 0.001), exercise 2 (p < 0.001), exercise 3 (p < 0.001).Conclusion: This 2-day basic robot training course significantly improved basic robotic skills of general surgery residents. The program provides essential preparation for safe clinical utilization of robotic surgery and may serve as a scalable model for future basic robotic training courses within surgical residency programs.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"135-145"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249642","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

Accuracy and Methodological Considerations of Steep Ramp Test-Estimated Oxygen Uptake at Peak Exercise in Preoperative Risk Assessment for Esophagectomy. 致编辑的信：食管切除术术前风险评估中陡斜坡试验-估计峰值运动时摄氧量的准确性和方法学考虑。

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2026-01-26 DOI: 10.1159/000550637

Jersey Lotz, Bart C Bongers, Maryska Janssen-Heijnen, Ruud Franssen

引用次数: 0

Long-Limb Roux-en-Y Reconstruction for Glycemic Control in Patients with Gastric Cancer and Type 2 Diabetes: One-Year Outcomes of Oncometabolic Surgery. 长肢Roux-en-Y重建用于胃癌和2型糖尿病患者的血糖控制：肿瘤代谢手术的1年结果

IF 1.2 3区医学

Digestive Surgery Pub Date : 2026-01-01 Epub Date: 2025-10-27 DOI: 10.1159/000549195

Yeongkeun Kwon, Hayun Kim, Dohyang Kim, Chang Min Lee, Jong-Han Kim, Sungsoo Park

{"title":"Long-Limb Roux-en-Y Reconstruction for Glycemic Control in Patients with Gastric Cancer and Type 2 Diabetes: One-Year Outcomes of Oncometabolic Surgery.","authors":"Yeongkeun Kwon, Hayun Kim, Dohyang Kim, Chang Min Lee, Jong-Han Kim, Sungsoo Park","doi":"10.1159/000549195","DOIUrl":"10.1159/000549195","url":null,"abstract":"Background: Long-limb Roux-en-Y (LLRY) reconstruction has recently been implemented as an oncometabolic surgery to improve glycemic control following surgery for gastric cancer (GC); however, data on its feasibility are insufficient. We investigated the 1-year outcomes of LLRY reconstruction for glycemic control in patients with type 2 diabetes (T2D).Methods: We reviewed the records of 15 patients with GC and T2D who underwent LLRY reconstruction after gastrectomy, with biliopancreatic and Roux limb lengths of 130-250 cm, to improve postoperative glycemic control. The primary outcome was the T2D remission (glycated hemoglobin <6.5% without antidiabetic medication) rate at 12 months postoperatively. The diabetes prediction (DP) score and Korean nationwide average T2D remission rates following GC surgery were compared.Results: The mean patient age was 66.5 years (standard deviation [SD] 9.6), mean body mass index was 26.4 kg/m2 (SD 4.4), and mean glycated hemoglobin level was 7.7% (SD 1.5). The overall T2D remission rate was 46.7%. The postoperative T2D remission rate was 12.9% higher than the DP score estimate (33.8%) and 25.7% higher than the Korean national average rate (21%) of T2D remission following GC surgery.Conclusion: Our results show that LLRY reconstruction after gastrectomy is an effective oncometabolic surgery for treating T2D and GC. .","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376355","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: 0