Digestive Surgery最新文献

{"title":"Anatomical Variants of the Jejunal Veins and Their Technical Implications in Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.","authors":"Roberto Cirocchi, Matteo Matteucci, Justus Randolph, Carlo Boselli, Justin Davies, Gabriele Scarselletti, Alessandro Gemini, Antonia Rizzuto, Giovanni Domenico Tebala","doi":"10.1159/000541417","DOIUrl":"10.1159/000541417","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most common causes of bleeding during pancreaticoduodenectomy is a dissection of the pancreatic head from the superior mesenteric vein and superior mesenteric artery. Knowledge of the anatomical variants of the veins draining the proximal jejunum may allow better control of bleeding during detachment of the uncinate process and pancreatic head from the mesenteric pedicle and division of the mesopancreas. The aim of this systematic review and meta-analysis was to evaluate the anatomical variations of the first jejunal vein (FJV) and jejunal trunk (FJT).</p><p><strong>Methods: </strong>Fourteen studies (1,888 patients) were included. We performed a systematic review of the available literature according to PRISMA guidelines.</p><p><strong>Results: </strong>The analysis has shown that the posterior course of the FJT and FJV represents the most frequent topographical location (pooled prevalence estimate [PPE] 79.6%) with the anterior jejunal trunk having a lower rate (PPE 20.4%). Few articles reported the variations with separate trunks for the first and second jejunal veins.</p><p><strong>Conclusions: </strong>A thorough preoperative radiological assessment of the anatomical variation of FJT and FJV may confer some advantage to establish the best therapeutic strategy and the best surgical approach in case of pancreatic head carcinoma as it can allow a better estimate of the extent of the neoplasm and improve the accuracy of surgical dissection with potential for reduced bleeding.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"245-255"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460367","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}

{"title":"Liver Resection in Synchronous Bilobar versus Unilobar Colorectal Liver Metastases: A Retrospective Analysis of Oncological Outcomes and Patient Survival.","authors":"Christian Stoess, Benjamin Mirschinka, Johanna Ollesky, Marcella Steffani, Nick Seyfried, Benedikt Kaufmann, Helmut Friess, Norbert Hüser, Ulrich Nitsche, Daniel Hartmann","doi":"10.1159/000538359","DOIUrl":"10.1159/000538359","url":null,"abstract":"<p><strong>Introduction: </strong>Resection of colorectal liver metastasis has emerged as the standard treatment. Our study compares oncological outcomes of patients with resected synchronous bilobar versus unilobar colorectal liver metastasis.</p><p><strong>Methods: </strong>This retrospective study presents long-term follow-up data of 105 consecutive patients with primary colorectal cancer and synchronous liver metastasis. All patients underwent primary tumor and metastasis resections between 2007 and 2019.</p><p><strong>Results: </strong>Fifty-five patients with bilobar and 50 patients with unilobar colorectal liver metastases were included. No significant difference in overall, tumor-specific, or recurrence-free survival was observed between patients with bilobar and unilobar metastases. After case-control matching, the results were confirmed in patients with similar tumor burdens. In the multivariate analysis, chemotherapy following liver metastasis resection was a significant prognostic factor associated with improved overall survival (hazard ratio 0.518, 95% confidence interval: 0.302-0.888, p = 0.017).</p><p><strong>Conclusion: </strong>Overall survival, as well as tumor-specific and recurrence-free survival, did not differ between patients with unilobar and bilobar liver metastasis. These findings contribute to the understanding that primary tumor and metastasis resection in eligible patients improve long-term outcomes.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"103-110"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861377","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}

{"title":"Intracorporeal versus Extracorporeal Anastomosis in Laparoscopic Right Hemicolectomy: An Updated Systematic Review and Meta-Analysis of Randomized Control Trials.","authors":"Pengyu Wei, Yang Li, Jiale Gao, Si Wu, Wenlong Shu, Hongwei Yao, Zhongtao Zhang","doi":"10.1159/000541373","DOIUrl":"10.1159/000541373","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic right hemicolectomy has become the standard surgical procedure for the treatment of right colon disease; however, the choice of anastomosis remains controversial. This study aimed to compare the safety and efficacy of intracorporeal anastomosis and extracorporeal anastomosis in laparoscopic right hemicolectomy.</p><p><strong>Methods: </strong>A systematic literature search was performed in PubMed, Embase, Web of Science, and Cochrane Library. Randomized controlled trials that compared intracorporeal anastomosis with extracorporeal anastomosis in patients with laparoscopic right hemicolectomy until June 4, 2023, are selected. The primary outcomes measured were incidence of anastomotic leakage within 30 days post-operation. Statistical analyses were performed using Review Manager (version 5.4.1).</p><p><strong>Results: </strong>Seven RCTs, including 720 patients, were eligible for the meta-analysis. The incidence of anastomotic leakage showed no significant difference between the intracorporeal anastomosis group and the extracorporeal anastomosis group (RR 0.93, 95% CI: 0.49, 1.76, p = 0.83, and I2 = 0%). However, the intracorporeal anastomosis group had significantly lower rates of postoperative ileus (RR 0.67, 95% CI: 0.45-0.99, p = 0.04, I2 = 46%) and surgical site infections (RR 0.34, 95% CI: 0.16-0.74, p = 0.007, I2 = 0%) compared to the extracorporeal anastomosis group. Additionally, patients in the intracorporeal anastomosis group experienced earlier postoperative passage of gas and stool (WMD -0.39, 95% CI: -0.60, -0.19, p = 0.0002, and I2 = 67%; WMD -0.53, 95% CI: -0.85, -0.21, p = 0.001, and I2 = 75%), as well as shorter hospital stays (WMD -0.46, 95% CI: -0.74, -0.18, p = 0.001, and I2 = 34%).</p><p><strong>Conclusion: </strong>In laparoscopic right hemicolectomy, intracorporeal anastomosis does not increase the incidence of anastomotic leakage within 30 days post-operation compared to extracorporeal anastomosis. In addition, intracorporeal anastomosis resulted in faster recovery of bowel function. This suggests that intracorporeal anastomosis is safe and effective.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"224-244"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343559","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}

{"title":"Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?","authors":"Leena-Mari Mäntymäki, Juha Grönroos, Anu Aronen, Jukka Karvonen, Mika Ukkonen","doi":"10.1159/000536158","DOIUrl":"10.1159/000536158","url":null,"abstract":"<p><strong>Introduction: </strong>Since the assessment of the disease severity in acute diverticulitis (AD) is of utmost importance to determine the optimal treatment and the need for follow-up investigations, we wanted to investigate whether the first CT report is compatible with daytime reassessment report and whether the value of initial report changes according to the experience of the radiologist.</p><p><strong>Methods: </strong>Consecutive patients from tertiary referral centre with AD were included. CT images done in the emergency department were initially analysed by either resident radiologists or consultant radiologists and then later reanalysed by consultant abdominal radiologists. Discrepancies between reports were noted.</p><p><strong>Results: </strong>Of total of 562 patients with AD, CT images were reanalysed in 439 cases. In 22 reports (5.0%) the final report was significantly different from the initial report and management changed in 20 cases. In reports of uncomplicated acute diverticulitis, reanalysis changed initial assessment in 4.0% of the cases and in complicated acute diverticulitis (CAD) in 9.1%. When consultant and resident radiologists were compared, there was no significant difference.</p><p><strong>Conclusion: </strong>Although no statistical difference could be noted between residents and consultants, the final report was significantly different in overall 5% of the cases when reanalysed at normal working hours by an experienced consultant abdominal radiologist. Therefore, we conclude that reassessment of CT reports is worthwhile in AD.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"37-41"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416652","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}

{"title":"Colonic Diverticulosis at Colonoscopy in Africa: A Systematic Review and Meta-Analysis of Pooled Estimates.","authors":"Emeka Ray-Offor, Stella-Maris Egboh, Rex F O A Ijah, Sameh Hany Emile, Steven D Wexner","doi":"10.1159/000536587","DOIUrl":"10.1159/000536587","url":null,"abstract":"<p><strong>Introduction: </strong>There is need to ascertain any epidemiologic shift of diverticulosis among Africans with traditionally high fiber diet consumption patterns and rare diverticulosis prevalence.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, Cochrane Library, African Journal Online (AJOL), and Google Scholar. Eligibility criteria included full-text observational and experimental human colonoscopy studies on asymptomatic and symptomatic African population from 1985 to 2022. Case reports, conference abstracts, dissertations, systematic reviews, and studies lacking colonoscopy findings were excluded. NIH quality assessment tool for observational cohort and cross-sectional studies was used to assess risk of bias. Meta-analysis was performed using the random-effect model. Heterogeneity was assessed using inconsistency (I2) statistics.</p><p><strong>Results: </strong>Thirty studies were included. Pooled prevalence rate of colonic diverticulosis in the last decade (2012-2022) has increased to 9.7% (95% CI 6.5-13.4; I2 = 97.3%) from 3.5% (95% CI 1.4-6.4; I2 = 62.7%). The highest regional prevalence rate was in West African studies at 11.3% (95% CI 7.6-14.9; I2 = 96.2%). Proportion of individuals with diverticulosis ≥50 years and male sex were 86.9% (95% CI 80.5-92.1) and 65.2% (95% CI 55.0-74.8), respectively. The left colon had the highest diverticulosis frequency (37% [148/400]). Bleeding/inflammation complications were sparingly detected (OR 0.2 [95% CI 0.03-0.75; p &lt; 0.0001]).</p><p><strong>Conclusion: </strong>An increasing utilization of colonoscopy revealed approximately a threefold increase in the prevalence rate of colonic diverticulosis in Africa. This pathology was most common in males aged &gt;50. Left colon was predominantly affected. Further studies are needed to demonstrate the effect of westernization of diet.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"63-78"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912333","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}

{"title":"Contents Vol. 40, 2023","authors":"De Pastena, S. Brozzetti, M. Carati, A. V. Sterpetti, Rome, S. R. Henriksen, J. Rosenberg, S. Fonnes, Herlev, G. Mendez-Rico, D. Reyes-Ruiz, P. I. J.M. Moreno-Ley","doi":"10.1159/000535458","DOIUrl":"https://doi.org/10.1159/000535458","url":null,"abstract":"","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"43 7","pages":"I - VI"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018188","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}

{"title":"Contents Vol. 39, 2022","authors":"","doi":"10.1159/000530198","DOIUrl":"https://doi.org/10.1159/000530198","url":null,"abstract":"<br />Dig Surg 2022;39:I–VI","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"138 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138508430","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}

{"title":"Front & Back Matter","authors":"","doi":"10.1159/000530871","DOIUrl":"https://doi.org/10.1159/000530871","url":null,"abstract":"","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43475758","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}

{"title":"Society News","authors":"","doi":"10.1159/000530303","DOIUrl":"https://doi.org/10.1159/000530303","url":null,"abstract":"<br />Dig Surg","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"136 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138508431","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}

{"title":"Society News","authors":"","doi":"10.1159/000531190","DOIUrl":"https://doi.org/10.1159/000531190","url":null,"abstract":"","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135052526","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}