Ejso最新文献

{"title":"Impact of minimal invasive surgery techniques on long-term health-related quality of life in rectal cancer: a Dutch cohort study","authors":"David M. Mens ,&nbsp;Jan M. van Rees ,&nbsp;Olga Husson ,&nbsp;Rogier M.P.H. Crolla ,&nbsp;Denise E. Hilling ,&nbsp;Cornelis Verhoef ,&nbsp;Esther J.C. Consten ,&nbsp;Robert R.J. Coebergh van den Braak ,&nbsp;PLCRC Study Group","doi":"10.1016/j.ejso.2025.110180","DOIUrl":"10.1016/j.ejso.2025.110180","url":null,"abstract":"<div><h3>Objective</h3><div>Limited data exists on health-related quality of life (HRQoL) after robot-assisted surgery (RAL) for rectal cancer beyond one-year post-surgery. This study compares long-term HRQoL following RAL total mesorectal excision (TME) to conventional laparoscopic (CL) TME.</div></div><div><h3>Methods</h3><div>All rectal carcinoma patients from the 63-center Prospective National CRC cohort (PLCRC) who completed pre- and post-operative HRQoL questionnaires (EQ-5D, QLQ-C30, and QLQ-CR29) were retrospectively included. Delta scores per parameter were calculated by subtracting pre-operative scores from scores at one year. Sensitivity analysis included all patients with beyond one-year post-operative questionnaires, regardless of a pre-operative questionnaire. Data were analyzed using multivariate linear regression.</div></div><div><h3>Results</h3><div>Patients undergoing RAL TME more often had low rectal tumors, more post-operative complications and more stomas. In patients with both pre- and post-operative questionnaires, no significant differences were found in the EQ-5D delta score (n = 591). The QLQ-C30 (n = 709) showed statistically significant and clinical relevant difference in fatigue favored CL TME (4.4 ± 1.9, p = 0.021). The QLQ-CR29 (n = 696) showed small, statistically significant differences favoring RAL in body image and stoma-related issues, but no clinical relevance. Sensitivity analysis EQ-5D (n = 1250), QLQ-C30 (n = 1423) or QLQ-CR29 (n = 1453) showed no clinically relevant differences.</div></div><div><h3>Conclusion</h3><div>This is the first study comparing long-term HRQoL between CL and RAL surgery for rectal cancer. Although several statistically significant differences were found, no clinically relevant differences were observed except for a small difference in the subdomain fatigue of the EORTC QLQ-C30 favoring CL surgery. Furthermore, the current study underlines the relevance of a pre-operative HRQoL assessment.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110180"},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Risk of distant metastasis after local excision for near-complete response versus salvage surgery for local regrowth in rectal cancer: Results from an international registry”","authors":"Jin Cheon Kim","doi":"10.1016/j.ejso.2025.110175","DOIUrl":"10.1016/j.ejso.2025.110175","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110175"},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Have technological advancements in PIPAC brought revolutionary changes in its clinical application? — Perspectives from surgical oncologists","authors":"Chaofan Guo ,&nbsp;Xiangyang Yu","doi":"10.1016/j.ejso.2025.110178","DOIUrl":"10.1016/j.ejso.2025.110178","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110178"},"PeriodicalIF":3.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Risk of recurrence following transanal endoscopic microsurgery without neoadjuvant or adjuvant treatment in T2 rectal cancer\"","authors":"Haoxun Mao,&nbsp;Chongjie Zhang","doi":"10.1016/j.ejso.2025.110169","DOIUrl":"10.1016/j.ejso.2025.110169","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 110169"},"PeriodicalIF":3.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted liver surgery reduces complication rates while maintaining equivalent outcome quality compared to open liver surgery","authors":"Alexander Wilk ,&nbsp;Methin Mazgaldzhi ,&nbsp;Thorsten Brechmann ,&nbsp;Benno Mann","doi":"10.1016/j.ejso.2025.110167","DOIUrl":"10.1016/j.ejso.2025.110167","url":null,"abstract":"<div><h3>Introduction</h3><div>Resecting liver surgery has been dominated by open surgical approaches (OLR). Minimal invasive procedures such as robotic liver surgery (RLR) are technically challenging but may reduce the surgical trauma and complication rates.</div></div><div><h3>Objectives &amp; methods</h3><div>This study aims to compare the outcomes of RLR and OLR. A retrospective, single-centre analysis was conducted on 185 patients who underwent liver resection for benign or malign diseases (OLR: 86, RLR: 99). The primary objective was complication rates based on Clavien-Dindo classification, Secondary objectives included operative time, intraoperative blood loss, length of hospital stay, and resection outcomes.</div></div><div><h3>Results</h3><div>RLR was associated with significantly less major complications (23.1 % vs. 41.9 %, p = 0.011), lower blood loss (200 ml vs. 400 ml, p = 0.013) and shorter hospital stays (9.0 vs. 13.0 days, p &lt; 0.001). Primary oncological results were similar.</div></div><div><h3>Conclusion</h3><div>RLR provides equivalent resection quality to OLR, with fewer complications, less blood loss, and shorter hospital stays.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110167"},"PeriodicalIF":3.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal circulating tumor cells as prognostic markers in HCC Post-Transplantation: Sirolimus as a potential therapeutic Modulator","authors":"Jinyan Chen ,&nbsp;Rongsen Wang ,&nbsp;Huigang Li ,&nbsp;Jiancai Sun ,&nbsp;Ruijie Zhao ,&nbsp;Jianyong Zhuo ,&nbsp;Zuyuan Lin ,&nbsp;Chiyu He ,&nbsp;Xingzhu Chen ,&nbsp;Jun Li ,&nbsp;Leyi Chen ,&nbsp;Xudong Yang ,&nbsp;Xuyong Wei ,&nbsp;Shusen Zheng ,&nbsp;Xiao Xu ,&nbsp;Di Lu","doi":"10.1016/j.ejso.2025.110147","DOIUrl":"10.1016/j.ejso.2025.110147","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic value of CTCs for post-LT tumor recurrence remains insufficiently studied, and the associations between CTCs and immunosuppressants remain unclear.</div></div><div><h3>Methods</h3><div>This study analyzed 277 HCC patients undergoing liver transplantation. MCTC and ECTC levels were measured from the day of surgery to one month postoperatively. Prognostic outcomes were compared across patients with varying MCTC levels, with subgroup analysis based on the presence or absence of major portal vein tumor thrombus. Differences in MCTC dynamics and outcomes were further evaluated across immunosuppressant regimens.</div></div><div><h3>Results</h3><div>Patients with low MCTC levels demonstrated better recurrence-free survival (RFS) than those with high MCTC levels (p = 0.022), a trend observed in both the PVTT subgroup (p = 0.023) and the non-PVTT subgroup (p = 0.046). Patients with a reduction in MCTC levels at the second measurement had significantly better prognoses compared to those without a reduction (p = 0.03). The use of sirolimus was associated with a decrease in MCTC levels (p = 0.017), and patients receiving sirolimus exhibited improved survival compared to those not using sirolimus (p = 0.033). Sirolimus also extended post-recurrence survival (p = 0.0052).</div></div><div><h3>Conclusion</h3><div>MCTC levels serve as an effective predictor of tumor recurrence following liver transplantation for HCC. Sirolimus reduces MCTC levels and extends post-recurrence survival.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110147"},"PeriodicalIF":3.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a role for the sentinel lymph node in endometrial atypical hyperplasia? Insights from an ESGO-accredited Institution","authors":"Stefano Restaino ,&nbsp;Alice Poli ,&nbsp;Martina Arcieri ,&nbsp;Laura Mariuzzi ,&nbsp;Maria Orsaria ,&nbsp;Angelica Tulisso ,&nbsp;Federico Paparcura ,&nbsp;Giulia Pellecchia ,&nbsp;Marco Petrillo ,&nbsp;Giampiero Capobianco ,&nbsp;Guglielmo Stabile ,&nbsp;Giorgio Bogani ,&nbsp;Lorenza Driul ,&nbsp;Giovanni Scambia ,&nbsp;Giuseppe Vizzielli","doi":"10.1016/j.ejso.2025.110168","DOIUrl":"10.1016/j.ejso.2025.110168","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates the outcomes of patients with premalignant endometrial findings on biopsy who underwent hysterectomy with sentinel lymph node (SLN) excision and were subsequently diagnosed with endometrial cancer (EC). It aims to highlight the role of nodal assessment in guiding postoperative treatment strategies. Additionally, the study compares surgery complication rates between patients who underwent SLN mapping and those who did not.</div></div><div><h3>Methods</h3><div>This retrospective, observational, single-center study was conducted at Udine Hospital between April 2021 and July 2024. 63 patients diagnosed with atypical hyperplasia on endometrial biopsy who underwent hysterectomy and bilateral salpingo-oophorectomy, with or without SLN mapping, were included. All procedures were performed using minimally invasive surgery.</div></div><div><h3>Results</h3><div>Of the 63 patients, 35 (55.6 %) had confirmed atypical hyperplasia on uterine pathology, while 23 (36.5 %) were diagnosed with EC on final pathology. Of the patients who underwent SLN mapping, 18 (43 %) received a final diagnosis of EC and were accurately staged and treated accordingly. In contrast, within the group of patients treated without SLN mapping, 5 (24 %) were diagnosed with EC on final pathology and didn't receive proper staging. No nodal metastases were found in both groups. There was no statistically significant difference in operating time and complication rates between the two groups (with or without SLN mapping), further supporting the procedure's safety.</div></div><div><h3>Conclusions</h3><div>This study's findings underscore the significance of incorporating SLN mapping into hysterectomy and bilateral salpingo-oophorectomy for patients with atypical hyperplasia. This approach enhances accurate staging for patients diagnosed with endometrial cancer on final pathology.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110168"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced recovery for cytoreductive surgery and hyperthermic intraperitoneal Chemotherapy: An international survey to assess acceptance and feasibility","authors":"Amaniel Kefleyesus ,&nbsp;Naoual Bakrin ,&nbsp;Vahan Kepenekian ,&nbsp;Chloé Gerbaud-Coulas ,&nbsp;Anne Li ,&nbsp;Olivia Vassal ,&nbsp;Clarisse Eveno ,&nbsp;Olivia Sgarbura ,&nbsp;Gregg Nelson ,&nbsp;Antoine Bouchard-Fortier ,&nbsp;Lloyd Mack ,&nbsp;Justin Rivard ,&nbsp;Anna Fagotti ,&nbsp;Shigeki Kusamura ,&nbsp;Manuela Robella ,&nbsp;Pompiliu Piso ,&nbsp;Miklos Acs ,&nbsp;Fernando Arias ,&nbsp;Beate Rau ,&nbsp;Laura A. Lambert ,&nbsp;Martin Hübner","doi":"10.1016/j.ejso.2025.110150","DOIUrl":"10.1016/j.ejso.2025.110150","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols have markedly improved outcomes after colorectal and other major surgery, suggesting benefits also for complex surgeries like Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC). This study investigates the adoption and acceptance of the recent ERAS recommendations for CRS-HIPEC within expert centers.</div></div><div><h3>Methods</h3><div>Clinicians from 16 expert centers across 9 countries were invited to answer an online survey inquiring about current clinical practice. Adoption of the 72 ERAS items from the recent dedicated guidelines were evaluated using a Likert-type scale with focus on preoperative, perioperative, and postoperative phases.</div></div><div><h3>Results</h3><div>Overall, 27 clinicians (11 female, 21 surgeons, 2 gynecologists and 4 anesthesiologists/intensivists) participated, with high adoption of ERAS protocols at baseline (67 %). More than half of the guideline items (54 %) were widely adopted. However, despite nearly 18 % intending to change their practices, there remains substantial resistance to further adoption, such as for measures like alcohol cessation programs, mechanical bowel preparation, and oral antibiotic decontamination. Barriers identified include resource limitations(20 %), perceived irrelevance (17 %) for specific patient groups, unclear benefits (59 %), and restrictive policies (5 %).</div></div><div><h3>Conclusion</h3><div>The study shows that most ERAS principles are routinely implemented in CRS-HIPEC surgeries, despite significant challenges with specific components and complex processes. Future research will focus on generating additional evidence and streamlining ERAS guidelines to prioritize essential elements.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110150"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of cerebral hyper-perfusion syndrome like symptoms after resection of carotid body tumours","authors":"Jianfeng Gao ,&nbsp;Guangchao Gu ,&nbsp;Rong Zeng ,&nbsp;Yuexin Chen ,&nbsp;Wei Ye ,&nbsp;Yuehong Zheng","doi":"10.1016/j.ejso.2025.110153","DOIUrl":"10.1016/j.ejso.2025.110153","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral hyper-perfusion syndrome (CHS) is a rare but severe complication after surgery of carotid artery related disease (with a varied incidence range of 0–25.7 %), while its association with carotid body tumour (CBT) surgery is unknown. This study aimed to investigate the incidence and risk factors of CHS-like symptoms after resection of CBTs.</div></div><div><h3>Methods</h3><div>This retrospective study included 152 CBT patients (165 operated tumours) who received surgery at Peking Union Medical College Hospital from March 2013 to December 2021 and had fully-available clinical records. Surgeries were performed by the several operation teams (around 4–5 teams during the study period) from the department of vascular surgery, of which the team leaders were all senior vascular surgeons who had full experience on CBT surgery. CHS-like symptom was determined based on clinical manifestation and its risk factors were identified by univariate and multivariate regression analyses.</div></div><div><h3>Results</h3><div>The mean age of this cohort was 44.2 ± 10.9 years and female patients represented 67.1 % (102/152). There were 13 (13/152, 10.5 %) cases receiving bilateral CBT resections, generating a total of 165 operated tumours. The median maximum diameter of the tumours was 3.5 cm (IQR: 2.5–4.8 cm), with 37 (22.4 %), 40 (24.2 %) and 88 (53.3 %) lesions being classified as Shamblin I, II and III, respectively. All CBTs were completely resected under general anaesthesia, with 51 patients undergoing balloon occlusion tests (51/152, 33.6 %) preoperatively and no preoperative embolization was performed. During surgery, 34 cases (34/165, 20.6 %) underwent intervention for internal carotid artery (ICA) and 43 cases (43/165, 26.1 %) underwent external carotid artery ligation. Among the 165 operations, 43 cases developed CHS-like symptoms after surgery (26.1 %, 43/165), of which 26 cases received dehydrant therapy due to severe symptoms (60.5 %, 26/43) and most cases developed symptoms within 48 h after surgery (90.7 %,39/43). Univariate analysis revealed that occurrence of CHS-like symptoms is significantly related with elevated post-operation immediate heart rate (HR) (P = 0.006), post-operation day 1 morning HR (P = 0.004), ICA intervention (P = 0.002) and postoperative new-onset hypertension (P = 0.02). Furthermore, ICA intervention (P = 0.008) and new-onset hypertension (P = 0.017) remained the independent risk factors for development of CHS-like symptoms in multivariate regression analysis.</div></div><div><h3>Conclusion</h3><div>CBT excision is related to a significant incidence of postoperative CHS-like symptoms, of which intraoperative ICA intervention and post-operative new-onset hypertension are the independent risk factors, thus more attention and closer monitoring should be given on such patients so as to prevent life-threatening CHS-related cerebral complications.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110153"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing matters: A comparative analysis of synchronous and metachronous mammoplasty techniques","authors":"Jude Geldart ,&nbsp;Emma Barrett ,&nbsp;Ahmed Morad ,&nbsp;James Harvey","doi":"10.1016/j.ejso.2025.110109","DOIUrl":"10.1016/j.ejso.2025.110109","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic mammoplasty (TM) is a Level 2 oncoplastic procedure that improves cosmetic outcome in patients undergoing breast conserving surgery (BCS) for breast cancer. The contralateral reduction may be performed at the same time as the index procedure (synchronous) or later (metachronous); commonly cited reasons for the latter include fewer complications, reduced need for revisional surgery and less delay to adjuvant therapies. This study aims to compare synchronous and metachronous approaches to therapeutic mammoplasty.</div></div><div><h3>Materials and methods</h3><div>A database between 2010 and 2019 was hand searched. The primary outcome measure was the trend of synchronous vs unilateral operating by year. Secondary outcome measures included demographic variables, type of mammoplasty, tumour biology, revisional surgery rate, type and timing of planned revisional surgery, complications, type and time to adjuvant therapy, type of axillary surgery, and tumour trends by year.</div></div><div><h3>Results</h3><div>155 patients had synchronous mammoplasties and 107 patients had unilateral procedures, of which 26 had delayed contralateral symmetrising surgery. There was a significant increase in the total number of TMs (p &lt; 0.03) and synchronous TMs (p &lt; 0.02) over time. There were no differences in time to chemotherapy (p &gt; 0.05), time to radiotherapy (p &gt; 0.05) or time till re-excision of margins/revision mastectomies (p &gt; 0.05). In the unilateral group, mean time to contralateral symmetrising surgery was 14 months.</div></div><div><h3>Conclusions</h3><div>Synchronous TMs are increasingly popular and appear safe for patients undergoing BCS for breast cancer. Further work is necessary to establish patient preferences between the two groups.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110109"},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}