Ejso最新文献

{"title":"Clinical impact of surgical energy device (Caiman®) IN elderly patients with Endometrial Cancer (protocol ID: Cineca)","authors":"Federica Perelli ,&nbsp;Martina Arcieri ,&nbsp;Stefano Restaino ,&nbsp;Alberto Mattei ,&nbsp;Salvatore Gueli Alletti ,&nbsp;Valerio Gallotta ,&nbsp;Giovanni Scambia ,&nbsp;Chiara Innocenzi ,&nbsp;Barbara Costantini ,&nbsp;Giuseppe Vizzielli","doi":"10.1016/j.ejso.2025.109982","DOIUrl":"10.1016/j.ejso.2025.109982","url":null,"abstract":"<div><h3>Study objective</h3><div>To investigate the clinical performance of the Caiman® energy device in class A radical laparoscopic hysterectomy (RLH) according to Querleu-Morrow classification, combined with bilateral salpingo-oophorectomy (BSO) and pelvic lymph node assessment in elderly patients with early-stage endometrial cancer (EC), specifically focusing on hemostatic effectiveness and safety.</div></div><div><h3>Design</h3><div>Single-institution, prospective observational study.</div></div><div><h3>Setting</h3><div>Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.</div></div><div><h3>Patients</h3><div>Forty-three women over 65 years with FIGO stage IA or IB endometrioid EC were enrolled from September 2021 to August 2023.</div></div><div><h3>Interventions</h3><div>Use of Caiman® energy device in RLH combined with BSO and pelvic lymph node assessment in elderly patients.</div></div><div><h3>Measurements</h3><div>The primary endpoint was operative time, with secondary endpoints including perioperative outcomes and postoperative complications.</div></div><div><h3>Main results</h3><div>Results demonstrated a median surgical time of 135 min, with no significant intraoperative complications attributed to the Caiman® device. Postoperative complications were minimal, with no severe complications (Grade 4 or 5) and a median hospital stay of two days.</div></div><div><h3>Conclusion</h3><div>The study highlights the advantages of the Caiman® in enhancing surgical efficiency while minimizing risks for elderly patients, suggesting its potential for improving resource allocation and patient outcomes in oncologic surgery. The findings of this study suggest the feasibility of using the Caiman® device for surgical procedures in elderly patients with early-stage endometrial cancer. Future prospective randomized trials are needed to establish its efficacy compared to traditional surgical methods.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109982"},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825543","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":"Safety of minimally invasive surgery in early-stage endometrial cancer: A systematic Retrospective analysis based on 2023 FIGO staging system☆","authors":"Yuzheng Gan ,&nbsp;Wei Xu ,&nbsp;Shuang Liang ,&nbsp;Chenyu Zhou,&nbsp;Lequn Li,&nbsp;Yincheng Teng,&nbsp;Xiaolu Zhu,&nbsp;Zhihong Ai","doi":"10.1016/j.ejso.2025.109997","DOIUrl":"10.1016/j.ejso.2025.109997","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of minimally invasive surgery in the management of early-stage endometrial cancer.</div></div><div><h3>Method</h3><div>This study involved a retrospective analysis of clinical data and prognosis for 382 patients diagnosed with early-stage endometrial cancer (stage I and II) who underwent either laparoscopy or laparotomy at Shanghai Sixth People's Hospital between June 2011 and November 2022. The postoperative pathological diagnoses were based on 2023 FIGO staging system.</div></div><div><h3>Results</h3><div>A total of 189 patients underwent laparotomy and 193 patients underwent laparoscopic surgery. The intraoperative blood loss and postoperative complications (pulmonary embolism, pulmonary infection, intestinal obstruction, suboptimal healing or infection of surgical incision) rates in laparoscopy group was significantly lower than that in laparotomy group (P &lt; 0.05). Regarding long-term prognosis (mean follow-up duration of 81.8 ± 41.1 months), there were no significant differences in DFS (Disease-Free Survival) and OS (Overall Survival) between two groups (P &gt; 0.05). By integrating the new FIGO staging with risk factors for stratified analysis, the results still indicated that there were no significant differences in DFS or OS between laparoscopy group and laparotomy group across all risk stratification (P &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>In the management of early-stage EC, laparoscopy significantly reduces intraoperative blood loss and postoperative complication rates, which facilitate patient recovery without adversely affecting recurrence or survival outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109997"},"PeriodicalIF":3.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758948","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":"Hyperbilirubinemia does not impair induced liver hypertrophy after portal vein Embolization—a retrospective scandinavian cohort study","authors":"Dennis Björk ,&nbsp;Ulrik Carling ,&nbsp;Stefan Gilg ,&nbsp;Kristina Hasselgren ,&nbsp;Peter N. Larsen ,&nbsp;Gert Lindell ,&nbsp;Bård I. Røsok ,&nbsp;Per Sandström ,&nbsp;Christian Sturesson ,&nbsp;Christoph Tschuor ,&nbsp;Ernesto Sparrelid ,&nbsp;Bergthor Björnsson","doi":"10.1016/j.ejso.2025.109995","DOIUrl":"10.1016/j.ejso.2025.109995","url":null,"abstract":"<div><h3>Background</h3><div>Portal vein embolization (PVE) may be used to induce hypertrophy of the future liver remnant (FLR) before major hepatectomy. The influence of hyperbilirubinemia on FLR hypertrophy after PVE is controversial. The aim of this study was to compare FLR hypertrophy after PVE between patients with and without elevated P-bilirubin.</div></div><div><h3>Materials/methods</h3><div>This is a Scandinavian retrospective cohort study of patients from five hepatobiliary centres. This study included patients who underwent right-sided PVE from 2013 to 2023. Data were collected from electronic medical records. FLR growth was analysed with respect to normal or elevated P-bilirubin.</div></div><div><h3>Results</h3><div>In total, 410 patients were included in this study. Among the total cohort, 105 patients had elevated P-bilirubin levels (≥26 μmol/L) at the time of PVE. Elevated P-bilirubin levels were not associated with impaired FLR hypertrophy after PVE, as determined by absolute growth (p &lt; 0.001), relative growth (p = 0.008), degree of hypertrophy (p &lt; 0.001) and kinetic growth rate (p = 0.002). Multivariable analysis revealed that elevated P-bilirubin levels at the time of PVE (p = 0.002) together with the use of N-butyl cyanoacrylate (NBCA) as an embolizing material (p = 0.009) were associated with increased FLR hypertrophy. A larger estimated total liver volume was associated with reduced FLR hypertrophy (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this multicentre, retrospective cohort study, we were unable to show any negative effect of elevated P-bilirubin on FLR hypertrophy at the time of PVE. There is no need for P-bilirubin levels to normalize before PVE. This study supports the ongoing shift towards NBCA as an embolizing material.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109995"},"PeriodicalIF":3.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and donor-site morbidity outcomes of muscle-sparing latissimus dorsi flap in sarcoma defects reconstruction: A single-center cohort study","authors":"Bassel Hoteit ,&nbsp;Anais Delgove ,&nbsp;Diane Adam ,&nbsp;Magali Fau ,&nbsp;Raphael Blaquiere ,&nbsp;Audrey Michot","doi":"10.1016/j.ejso.2025.109994","DOIUrl":"10.1016/j.ejso.2025.109994","url":null,"abstract":"<div><h3>Introduction</h3><div>The latissimus dorsi musculocutaneous flap (LD) is widely used in trunk and limb reconstruction after soft tissue sarcoma excision. The muscle-sparing technique (MSLD) appears to reduce donor site morbidity. The main objective of this study was to assess functional morbidity after reconstruction with LD and MSLD using the QuickDash score. Secondary objectives aimed to evaluate postoperative complications and hospital length of stay.</div></div><div><h3>Patients and method</h3><div>This was a prospective single-center study including adult patients undergoing reconstruction with LD or MSLD flaps after resection of a soft tissue sarcoma, who completed a QuickDash questionnaire preoperatively and postoperatively between 2018 and 2024.</div></div><div><h3>Results</h3><div>30 patients were included in the study: 17 in the MSLD group and 13 in the LD group. There was no significant difference between the ΔQuickDash in the MSLD group (13.1) and the LD group (9.7) (p = 0.729). The MSLD group had a shorter average hospitalization length (5.9 days) compared to the LD group (9.3 days) (p &lt; 0.05). The seroma rate was higher in the LD group (46.2 %) than in the MSLD group (17.6 %) without statistically significant difference (p = 0.2).</div></div><div><h3>Conclusion</h3><div>This study does not show a reduction in functional morbidity of the donor site in MSLD compared to LD in oncoplastic surgery of sarcoma. MSLD presents the advantage of a shorter hospitalization duration, probably related to a lower complication rate. MSLD and LD seem to have different indications.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109994"},"PeriodicalIF":3.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704759","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":"Corrigendum to \"Prime suspect or collective responsibility: Impact of specific lymph node station dissection on short- and long-term outcomes among locally advanced gastric cancer patients after neoadjuvant chemotherapy\" [Eur J Surg Oncol 51 (2025) 109545].","authors":"Katarzyna Sędłak, Marcin Kubiak, Zuzanna Pelc, Radosław Mlak, Sebastian Kobiałka, Magdalena Leśniewska, Katarzyna Mielniczek, Katarzyna Chawrylak, Andrew Gumbs, S Vincent Grasso, Timothy M Pawlik, Wojciech P Polkowski, Karol Rawicz-Pruszyński","doi":"10.1016/j.ejso.2025.109975","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.109975","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109975"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691583","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":"Short-term outcomes of transanal endoscopic intersphincteric resection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: A single-center retrospective cohort study","authors":"Naijipu Abuduaini ,&nbsp;Xiaohan Wang ,&nbsp;Abe Fingerhut ,&nbsp;Minhua Zheng ,&nbsp;Jianwen Li ,&nbsp;Xiao Yang ,&nbsp;Haiqin Song ,&nbsp;Sen Zhang ,&nbsp;Xi Cheng ,&nbsp;Ximo Xu ,&nbsp;Hao Zhong ,&nbsp;Batuer Aikemu ,&nbsp;Chengsheng Ding ,&nbsp;Mengqin Yu ,&nbsp;Jingyi Liu ,&nbsp;Yi Zhang ,&nbsp;Wanyu Wang ,&nbsp;Lih Shyuan Kong ,&nbsp;Zhenghao Cai ,&nbsp;Bo Feng","doi":"10.1016/j.ejso.2025.109984","DOIUrl":"10.1016/j.ejso.2025.109984","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the perioperative safety and specimen characteristics after transanal endoscopic intersphincteric resection (taE-ISR) versus classical intersphincteric resection (cISR) in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT).</div></div><div><h3>Methods</h3><div>Clinicopathological data of 145 patients (75 undergoing taE-ISR and 70 undergoing cISR after nCRT) were retrospectively analyzed. Baseline characteristics, perioperative details, and pathological specimen quality of the two groups were compared.</div></div><div><h3>Results</h3><div>Intraoperative blood loss was lower in the taE-ISR group compared to cISR (50.0 (40.0–100.0) ml <em>vs.</em> 70.0 (50.0–100.0) ml, P = 0.034). Two patients (2.6 %) in the taE-ISR group and eight patients (11.4 %) in the cISR group sustained adjacent organ injury (P = 0.037). There was no statistically significant difference in the prevalence of postoperative complications between the two groups (17.3 % <em>vs.</em> 30.0 %, P = 0.072). However, pelvic abscess (1.3 % <em>vs.</em> 8.6 %, P = 0.042) and rectovaginal fistula (0.0 % <em>vs.</em> 5.7 %, P = 0.036) occurred less often in taE-ISR compared to cISR. The complete resection rate was higher in taE-ISR compared to cISR (98.7 % <em>vs.</em> 91.4 %, P = 0.042). No patients in taE-ISR had positive distal resection margins (DRM), while four patients in cISR had positive DRM (0.0 % <em>vs.</em> 5.7 %, P = 0.036).</div></div><div><h3>Conclusion</h3><div>taE-ISR after nCRT was associated with higher-quality specimens, reduced intraoperative blood loss, and fewer perioperative complications, attesting to the feasibility and safety of taE-ISR In low-LARC patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109984"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791245","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":"Contact X-ray brachytherapy in rectal cancer: A systematic review and meta-analysis","authors":"Simon G. Powell ,&nbsp;James N.R. Wyatt ,&nbsp;Christopher Rao ,&nbsp;Amandeep Dhadda ,&nbsp;Muneeb Ul Haq ,&nbsp;Ngu Wah Than ,&nbsp;Ahsan Javed ,&nbsp;Shakil Ahmed ,&nbsp;D.M. Pritchard ,&nbsp;Jamie Mills ,&nbsp;Alexandra Stewart ,&nbsp;Timothy S. Maughan ,&nbsp;Jean-Piere Gerard ,&nbsp;Arthur Sun Myint","doi":"10.1016/j.ejso.2025.109976","DOIUrl":"10.1016/j.ejso.2025.109976","url":null,"abstract":"<div><div>Rectal cancer is a highly prevalent disease. Evidence presented in the 2025 phase-III OPERA randomised trial suggests that Contact X-ray Brachytherapy (CXB), with external beam chemoradiotherapy, is a viable organ-preserving alternative to radical surgery. We conducted a systematic review and meta-analysis to assess the clinical effectiveness of CXB in the treatment of rectal cancer.</div><div>This systematic review was prospectively registered (CRD42021284969) and reported following PRISMA guidelines. Multiple electronic databases were interrogated using the search terms “Rectal cancer”, “Contact Brachytherapy”, and synonym terms. Clinical complete response (cCR) was the primary outcome. Proportional meta-analyses were conducted and presented as forest plots with summary proportions and 95 % confidence intervals.</div><div>The literature search identified 973 studies, of which 52 studies encompassing 5447 patients met the inclusion and exclusion criteria and were included in the meta-analysis. Pooled estimates of outcomes were as follows: cCR rate = 82 % (95 % CI 76–88 %), Local Regrowth rate = 20 % (95 % CI 15–25 %), regional metastasis rate = 3 % (95 % CI 2–4 %), salvage surgery rate = 14 % (95 % CI 11–18 %), long-term disease control post-salvage surgery rate = 88 % (95 % CI 78–96 %) and organ preservation = 81 % (95 % CI 74–88 %).</div><div>CXB in the appropriately selected patient population can achieve long-term disease control and organ preservation whilst avoiding major surgery. Salvage surgery remains a viable option for patients who experience disease regrowth with excellent long-term disease control. Clinicians should discuss CXB with rectal cancer patients, presenting it as a viable and safe alternative to radical surgery. This is particularly pertinent for patients who are stoma-averse or older patients in frail health.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109976"},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative diagnostic failure in gallbladder cancer: Influence of tumor location and size on imaging precision","authors":"Miho Akabane ,&nbsp;Jun Kawashima ,&nbsp;Abdullah Altaf ,&nbsp;Selamawit Woldesenbet ,&nbsp;Federico Aucejo ,&nbsp;Minoru Kitago ,&nbsp;Yuki Imaoka ,&nbsp;Andrea Ruzzenente ,&nbsp;Itaru Endo ,&nbsp;Hugo P. Marques ,&nbsp;Vincent Lam ,&nbsp;Shishir K. Maithel ,&nbsp;Tom Hugh ,&nbsp;Nazim Bhimani ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.ejso.2025.109979","DOIUrl":"10.1016/j.ejso.2025.109979","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative imaging diagnosis of early-stage gallbladder cancer (GBC) remains challenging. The effectiveness of different imaging modalities and clinical factors to diagnose GBC have not been fully investigated. We identified risk factors for preoperative diagnostic failure of GBC, including tumor location (hepatic vs. peritoneal) and size relative to different imaging approaches.</div></div><div><h3>Methods</h3><div>Patients undergoing curative-intent GBC resection (2000–2023) were identified from an international, multi-institutional database. The primary outcome was successful preoperative GBC diagnosis based solely on imaging without biopsy. Multivariable logistic regression identified risk factors associated with diagnostic failure, and the impact of different imaging modalities was assessed.</div></div><div><h3>Results</h3><div>Among 293 patients, preoperative GBC diagnosis was successfully made in 164 (56.0 %) patients. Hepatic-sided tumors were less common among undiagnosed versus diagnosed patients (18.6 % vs. 44.5 %; p = 0.033). On multivariable analysis, hepatic-sided location (OR:0.13 [0.02–0.76]; p = 0.025, ref:peritoneal-sided) and tumor size ≥2.0 cm (OR:0.11 [0.01–0.88]; p = 0.035) were associated with lower odds of preoperative imaging diagnostic failure. Among tumors &lt;2.0 cm, peritoneal-sided lesions had a higher risk of diagnostic failure than hepatic-sided, with the risk gap widening as size decreased. MRI/MRCP (39.5 % vs. 65.2 %) and EUS (5.4 % vs. 16.5 %) were used less often among undiagnosed patients compared to diagnosed ones (both p &lt; 0.001), while CT use was similar (84.5 % vs. 85.4 %; p = 0.993). The failure of preoperative imaging diagnosis decreased as more imaging modalities were combined compared with CT alone: 65.1 % for CT only versus 17.4 % for CT plus MRI/MRCP or EUS.</div></div><div><h3>Conclusion</h3><div>Peritoneal-sided tumors and lesions &lt;2.0 cm were associated with higher preoperative diagnostic failure risk among patients with GBC, especially when a single imaging modality was utilized. Combining different imaging modalities may improve preoperative diagnosis among this subset of patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109979"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684451","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":"Factors associated with bilateral sentinel lymph node mapping failure using indocyanine green in patients with apparent early-stage cervical cancer: An Italian retrospective multi-center study","authors":"Nicolò Bizzarri ,&nbsp;Gabriella Schivardi ,&nbsp;Giampaolo Di Martino ,&nbsp;Alessia Antonacci ,&nbsp;Denis Querleu ,&nbsp;Luigi Pedone Anchora ,&nbsp;Gabriella Ferrandina ,&nbsp;Camilla Fedele ,&nbsp;Vittoria Carbone ,&nbsp;Jvan Casarin ,&nbsp;Alessandro Buda ,&nbsp;Vanna Zanagnolo ,&nbsp;Francesco Multinu ,&nbsp;Filippo Testa ,&nbsp;Fabio Landoni ,&nbsp;Giovanni Scambia ,&nbsp;Francesco Fanfani","doi":"10.1016/j.ejso.2025.109981","DOIUrl":"10.1016/j.ejso.2025.109981","url":null,"abstract":"<div><h3>Objective</h3><div>The primary aim of this study was to assess the factors associated with bilateral mapping failure in patients with apparent early-stage cervical cancer undergoing sentinel lymph node (SLN) biopsy using indocyanine green (ICG). Secondary aims were sensitivity, negative predictive value and lymph node recurrence.</div></div><div><h3>Methods</h3><div>Retrospective multi-center study. Patients with cervical cancer apparent FIGO stage IA1 to IIA2, treated with primary surgery between 04/2015 and 12/2023 and undergoing SLN mapping attempt with ICG injection, were included. Appropriate statistical analysis was performed to assess study endpoints. Timeframe was divided in first period 04/2015–12/2019 and second period 01/2020–12/2023.</div></div><div><h3>Results</h3><div>618 patients were included. Bilateral SLN mapping was achieved in 531 (85.9 %) women (36 of them, 5.8 %, underwent cervical re-injection of ICG). SLN unilateral mapping and mapping failure was observed in 71 (11.5 %) and 16 (2.6 %), respectively. The sensitivity, negative predictive value and accuracy were 85.9 %, 98.1 % and 98.3 %, respectively. False negative rate was 4/68 (5.9 %) in patients with unilateral mapping versus 6/316 (1.9 %) in those with bilateral mapping (p = 0.061). BMI&gt;30 (p = 0.001) and pathologic tumor diameter &gt;20 mm (p = 0.023) were the only factors independently associated with bilateral SLN mapping failure. ICG re-injection increased the rate of bilateral SLN detection from 81.3 % to 85.9 %. The rate of bilateral detection was 82.8 % versus 88.3 % in the first versus second study period, respectively (p = 0.061). 3-year DFS and OS in all patients were 89.7 % and 98.2 %, respectively. Seven patients (1.2 %) had lymph node recurrence in the group of any SLN mapping versus 1 (6.3 %) in no mapping group (p = 0.190).</div></div><div><h3>Conclusion</h3><div>High BMI and larger tumors were associated with bilateral SLN mapping failure using ICG. The ICG cervical re-injection increased the rate of bilateral mapping. No lymph node recurrence difference was found in patients undergoing SLN mapping versus patients with mapping failure.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109981"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of robotic- and endoscopic-assisted breast surgeries","authors":"Han-Byoel Lee","doi":"10.1016/j.ejso.2025.109980","DOIUrl":"10.1016/j.ejso.2025.109980","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 109980"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847879","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}