Ejso最新文献

{"title":"The influence of physical post-operative rehabilitation interventions to improve upper limb strength in women undergoing breast cancer surgery: A Systematic Review of the literature","authors":"Zoe Chia ,&nbsp;Michael O'Brien ,&nbsp;Jessica Shortland ,&nbsp;Holly M. Holmes ,&nbsp;Dana Giza ,&nbsp;An Ngo-Huang ,&nbsp;Kwok Leung Cheung ,&nbsp;Ruth M. Parks","doi":"10.1016/j.ejso.2025.109983","DOIUrl":"10.1016/j.ejso.2025.109983","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most prevalent cancer globally. Primary treatment commonly involves surgery to the breast and axilla, which can potentially cause a variety of physical impairments, negatively affecting patients’ quality of life. Consequently, effective rehabilitation techniques may help patients recover their physical function following surgery. Therefore, this review aims to identify whether post-operative rehabilitation interventions improve upper limb strength in women following breast cancer surgery and to compare the efficacy of different approaches.</div></div><div><h3>Methods</h3><div>The literature search was completed in October 2023 using MEDLINE, EMBASE and Cochrane databases. Eligible studies included full-text English articles of studies performed in patients who have undergone breast cancer surgery and subsequent post-operative rehabilitation to assess the outcome on upper limb strength.</div></div><div><h3>Results</h3><div>Nine studies were included with 786 women who underwent breast cancer surgery and subsequent post-operative rehabilitation. Six studies were rated as level-I evidence, whilst three studies represented level-II evidence. Five studies reported an increase in upper limb strength following rehabilitation with multimodal therapy and proprioceptive neuromuscular facilitation. Findings regarding the optimal duration of intervention and the best time to commence rehabilitation following surgery were inconclusive.</div></div><div><h3>Conclusion</h3><div>This review has demonstrated heterogeneous findings regarding the impact of post-operative rehabilitation on upper limb strength. Furthermore, the ideal time point to initiate rehabilitation post-surgery, as well as the appropriate length of intervention needs further investigation. Therefore, additional research is necessary to better inform clinical practice in this area.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109983"},"PeriodicalIF":3.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684355","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":"Celiac ganglion resection as an intraoperative factor associated with delayed gastric emptying in retroperitoneal sarcoma surgery: A multicentric prospective cohort study","authors":"Luca Improta ,&nbsp;Toufik Mohammed Bouhadiba ,&nbsp;Marco Germanotta ,&nbsp;Alessandro Gronchi ,&nbsp;Dimitri Tzanis ,&nbsp;Marco Baia ,&nbsp;Chiara Pagnoni ,&nbsp;Sylvie Bonvalot ,&nbsp;Marco Fiore ,&nbsp;Sergio Valeri","doi":"10.1016/j.ejso.2025.109978","DOIUrl":"10.1016/j.ejso.2025.109978","url":null,"abstract":"<div><h3>Introduction</h3><div>Delayed gastric emptying (DGE) is a common but underexplored complication following retroperitoneal sarcoma surgery. The celiac ganglion, often excised during these procedures, plays a key role in gastric motility and its removal may contribute to DGE development.</div></div><div><h3>Materials and methods</h3><div>Data from 42 patients were prospectively collected at three referral centers. DGE was graded according to the International Study Group of Pancreatic Surgery (ISGPS) classification. Intraoperative celiac ganglion resection was categorized as none, partial, or complete. The primary endpoint was the effect of celiac ganglion resection on clinically relevant DGE (ISGPS grade B–C). The secondary endpoint was whether resection was an independent predictor of DGE.</div></div><div><h3>Results</h3><div>One patient was excluded due to early postoperative mortality. Among the remaining 41 patients, DGE occurred in 60.97 % of cases, with 26.83 % classified as clinically relevant. Partial celiac ganglion resection was performed in 31.7 % of patients, while complete resection occurred in 14.6 %. Univariate analysis showed that complete resection was associated with 22.5-fold increased risk of clinically relevant DGE (p = 0.011). Multivariate analysis confirmed this association, identifying complete resection as an independent risk factor (OR = 40.56, p = 0.013).</div></div><div><h3>Conclusions</h3><div>Clinically relevant DGE is frequent after retroperitoneal sarcoma surgery. Complete celiac ganglion resection significantly increases the risk of DGE, emphasizing the importance of careful surgical planning and comprehensive preoperative patient counselling. Implementing standardized perioperative protocols, including early nutritional support, may help mitigate its impact and improve postoperative recovery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109978"},"PeriodicalIF":3.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724878","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":"Letter to the editor regarding the article “learning curve for robot-assisted Mckeown esophagectomy in patients with thoracic esophageal cancer”","authors":"Akshaya Viswanathan,&nbsp;Pitchaipillai Sankar Ganesh,&nbsp;Rajesh Kanna Gopal","doi":"10.1016/j.ejso.2025.109977","DOIUrl":"10.1016/j.ejso.2025.109977","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109977"},"PeriodicalIF":3.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737890","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":"Influence of lung metastases on outcomes of curative management of peritoneal metastases from colorectal cancer","authors":"Ajinkya Pawar ,&nbsp;Vahan Kepenekian ,&nbsp;Alhadeedi Omar ,&nbsp;Nicolas Bel ,&nbsp;Laurent Villeneuve ,&nbsp;Gabrielle Drevet ,&nbsp;Jean Michel Maury ,&nbsp;Guillaume Passot ,&nbsp;Olivier Glehen","doi":"10.1016/j.ejso.2025.109650","DOIUrl":"10.1016/j.ejso.2025.109650","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally there has been a nihilistic approach towards patients with pulmonary metastases arising from colorectal cancer. However, emerging evidence highlights the benefit of curative intent treatment. Given the established individual roles of pulmonary metastectomy and CRS/HIPEC in the treatment of colorectal pulmonary and peritoneal metastases, respectively, we decided to combine these modalities and determine whether pulmonary metastases really influence the outcomes of curative intent treatment in CRC patients with peritoneal metastases.</div></div><div><h3>Methods</h3><div>This was a retrospective study of a prospectively maintained database of CRC patients with peritoneal metastases undergoing CRS and HIPEC with curative intent from Jan 1, 2005 to Aug 1, 2018. Patients were divided into two groups of without pulmonary metastases and with pulmonary metastases. Patients were followed up for a median 40.8 months.</div></div><div><h3>Results</h3><div>Of total 455 patients 19 had pulmonary metastases. The median RFS and OS of all patients was 14.26 months (95 % CI:12.71–16.2) and 56.96 months (95 % CI: 47.73–77.79) respectively. Median RFS and OS of patients with and without pulmonary metastases was 12 &amp; 49.8 months and 14.4 &amp; 57.9 months, respectively. On multivariate analysis, PCI, CC-0 rate, CEA, signet ring histology and retroperitoneal lymph node metastases significantly affected the OS. Presence of pulmonary metastases did not significantly affect the RFS or OS.</div></div><div><h3>Conclusion</h3><div>There has always been a skepticism in the management CRC with PM and extraperitoneal disease, especially pulmonary metastases with curative intent. Our study demonstrates that CRS and HIPEC improves OS in such patients and pulmonary metastases per se do not influence the outcomes of disease. Nevertheless, further prospective and multi centric studies are required to validate these findings.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109650"},"PeriodicalIF":3.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684372","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":"Comments on: The efficacy of immediate lymphatic reconstruction after axillary lymph node dissection – A meta-analysis. Wong AW, Sim NHS, Zhan SJ, Huang JJ","authors":"Henrique Jose Pereira de Godoy ,&nbsp;Jose Maria Pereira de Godoy","doi":"10.1016/j.ejso.2025.109698","DOIUrl":"10.1016/j.ejso.2025.109698","url":null,"abstract":"<div><div>On analyzing the important article published in this journal “<strong>The efficacy of immediate lymphatic reconstruction after axillary lymph node dissection – A meta-analysis</strong>” ¹, I would like to make some comments that are important in the management of these patients, in particular, the best time to indicate the procedure.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 109698"},"PeriodicalIF":3.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847870","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":"Enhancing feature importance analysis with Spearman's correlation with p-values: Recommendations for improving PHLF prediction","authors":"Haoqian Pan,&nbsp;Yoshiyasu Takefuji","doi":"10.1016/j.ejso.2025.109687","DOIUrl":"10.1016/j.ejso.2025.109687","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109687"},"PeriodicalIF":3.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684375","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":"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":"Constance Jehaes ,&nbsp;Yves Panis ,&nbsp;Laura Fernandez ,&nbsp;Bernard Lelong ,&nbsp;Guilherme Sao Julião ,&nbsp;Bruna Vailati ,&nbsp;Jeremie H. Lefevre ,&nbsp;Jean-Jacques Tuech ,&nbsp;José Azevedo ,&nbsp;Stéphane Benoist ,&nbsp;Amjad Parvaiz ,&nbsp;Mege Diane ,&nbsp;Angelita Habr- Gama ,&nbsp;Rodrigo Perez ,&nbsp;Quentin Denost ,&nbsp;GRECCAR Group","doi":"10.1016/j.ejso.2025.109761","DOIUrl":"10.1016/j.ejso.2025.109761","url":null,"abstract":"<div><h3>Aim</h3><div>Watch and Wait (WW) strategy is currently used for mid/low rectal adenocarcinoma after neoadjuvant treatment (NAT). Local regrowth (LR) is a well-known risk, but its impact on distant metastasis (DM) is increasingly debated. This study aimed to assess the rate of DM after local excision (LE) for near-complete clinical response (ncCR) at restaging versus salvage surgery for regrowth following WW.</div></div><div><h3>Method</h3><div>Retrospective analysis of DM rates from a prospective international registry, comparing patients with ncCR after NAT who underwent LE and patients with initial complete clinical response (cCR) and WW strategy, who underwent salvage surgery for regrowth. The primary endpoint was the 5-year distant metastasis-free survival (5y-DMFS). Univariate/Multivariate analysis were performed to identify risk factors of DM.</div></div><div><h3>Results</h3><div>Among 138 patients included, 59 had LE for ncCR and 79 had salvage surgery after regrowth including TME (n = 23), APR (n = 30) and LE (n = 26). The 5y-DMFS was lower in patients with surgery at regrowth, 71 % <em>vs.</em> 93 % (p = 0.006). LR was the only independent risk factor associated with DM (OR:3.89; 95 % CI:1.34–11.25; p = 0.012). When only patients managed by salvage LE for LR are considered, 5y-DMFS was equivalent to LE at restaging (87 <em>vs.</em> 93; p = 0.442).</div></div><div><h3>Conclusion</h3><div>Patients with rectal cancer undergoing LE for ncCR after NAT have a significantly lower rate of DM compared to patients undergoing salvage surgery after LR within WW approach. Patients managed by LE for regrowth may represent a distinct subgroup where the risk of subsequent DM is equivalent to patients managed by LE at restage.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109761"},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684373","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":"Sentinel lymph node biopsy in gynecological malignancies: A modern approach to surgical staging - A narrative review.","authors":"Aleksandar Celebic, Mirjana Miladinovic, Marina Jakimovska Stefanovska, Jean Calleja Agius, Kristina Drusany Staric","doi":"10.1016/j.ejso.2025.109757","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.109757","url":null,"abstract":"<p><p>Sentinel lymph node biopsy (SLNB) has emerged as a valuable alternative to traditional lymphadenectomy in the surgical management of gynecological cancers. This narrative review delves into the advantages, practical applications, and future research directions of SLNB in this context. Compared to the more extensive lymphadenectomy, SLNB offers a minimally invasive approach to lymph node staging, leading to reduced surgical morbidity, faster recovery times, and improved quality of life for the patients involved. This narrative review highlights the high detection rates and accuracy of SLNB in predicting lymph node metastasis, particularly in early-stage endometrial, cervical and vulvar cancers. By accurately assessing lymph node status, SLNB provides crucial information for treatment planning, potentially guiding decisions regarding adjuvant therapies and assessing the need for further lymph node dissection. From clinical practice guidelines, prospective studies, and relevant research articles, this review provides a thorough understanding the evolving role of SLNB in managing gynecological malignancies. The findings presented underscore the potential of SLNB to improve patient outcomes by providing accurate staging while minimizing surgical complications.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109757"},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673627","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":"Rare gynaecological cancers in Malta - An analysis of incidence between 2010 and 2021.","authors":"Miriam J Azzopardi, Jean Calleja-Agius, Neville Calleja, Darren Galea, Bridget Ellul, Rita Micallef, Sharon A O'Toole, Charles Savona Ventura","doi":"10.1016/j.ejso.2025.109971","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.109971","url":null,"abstract":"<p><strong>Introduction: </strong>Whilst about 18 % of all cancers in females are gynaecological cancers, more than 50 % of these can be classified as rare tumours (defined as an annual incidence of <6 per 100,000). Such cancers represent an important challenge for small countries like Malta where the small caseload may limit the expertise of clinicians in the diagnosis and treatment of such cancers.</p><p><strong>Methodology: </strong>The study uses data from the Maltese population-based cancer registry to examine trends in incidence rate of the rare gynaecological cancers for the 12-year period between 2010 and 2021. It employs the RARECAREnet list to identify the rare gynaecological cancers by major rare gynaecological cancer categories and histological types and analyses the number of cases and incidence rates in Malta to monitor trends and provide an insight of the burden of such cancers.</p><p><strong>Results: </strong>A total of 709 new cases of rare gynaecological cancers were discovered during the 12-year period. Globally, these rare gynae cancers, constituted 42.6 % of all the gynae cancers that occurred during this period. Most of these rare cancers were ovarian (399 cases, 56.3 %), followed by rare cancers of the vulva and vagina (122 cases, 17.21 %), rare cancers of the corpus uteri (93 cases, 13.12 %) and rare cancers of the cervix uteri (73 cases, 10.3 %). Other rare gynaecological cancers (10 cases, 1.41 %) and cancers of the placenta (2 cases, 0.04 %) were much rarer. The outcomes in terms of 5-year survival was worse for the rare cancers compared with the commoner types of gynae cancers with an overall 5-year survival of 45.10 % and 45.48 % for rare gynae cancers for the 2010-2014 and 2015-2019 cohorts respectively and an overall 5-year survival of 69.94 % and 73.44 % for the common gynae cancers for the 2010-2014 and 2015-2019 cohorts respectively.</p><p><strong>Conclusion: </strong>The study shows that globally rare gynaecological cancers in a small state like Malta are in fact not so rare - with a total of 709 rare gynaecological cancers in 12 years for Malta. These cases are however few when considering that they are divided into over 30 different histopathological groups. Numbers are also small when it comes to accumulating statistical power for analysis. The caseload for the individual sub-categories is small and will often be shared amongst the different individual gynaecologists and/or their clinical team. Thus, it might be difficult for these specialists to gather enough technical expertise that is crucial for early diagnosis and the treatment of these rare cancers. This study provides a rationale for international collaboration where there is scope for joint research and sharing of expertise. Establishment of common databases for the various types of rare gynaecological tumours will provide statistical power, enabling analysis of outcomes for these rare cancers and establishment of guidelines.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109971"},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729159","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":"Risk of recurrence following transanal endoscopic microsurgery without neoadjuvant or adjuvant treatment in T2 rectal cancer","authors":"Erik Wetterholm,&nbsp;Carl-Fredrik Rönnow,&nbsp;Henrik Thorlacius","doi":"10.1016/j.ejso.2025.109974","DOIUrl":"10.1016/j.ejso.2025.109974","url":null,"abstract":"<div><h3>Background</h3><div>Transanal endoscopic microsurgery (TEM) is only curative treatment for T1 rectal cancer with low-risk features. In T2 cancer, TEM is not recommended but could be used as a palliative procedure and/or in patients unfit for surgery. Few studies exist investigating recurrence after TEM for T2 rectal cancer.</div></div><div><h3>Method</h3><div>Retrospective, population-based study using the Swedish Colorectal Cancer Registry. Included patients had T2 rectal adenocarcinoma treated with TEM or surgery without neoadjuvant or adjuvant therapy between 2009 and 2021. Patients lost to follow-up, with syn/metachronous tumours or unknown recurrence status were excluded. Patient characteristics, perioperative morbidity, local and distant recurrence were compared.</div></div><div><h3>Results</h3><div>63 patients treated with TEM and 894 with surgery. Median age was 81 and 70 (<em>p</em> &lt; 0.01). 59 % and 23 % respectively were ASA III-IV (<em>p</em> &lt; 0.01). TEM tumours were more distal, 37 % vs 16 % in the lower third of the rectum (<em>p</em> &lt; 0.01). There were no severe complications after TEM compared to 6 % following surgery (<em>p</em> = 0.04). 5-year local recurrence was 33 % after TEM and 2 % after surgery (HR = 25.58, (<em>p</em> &lt; 0.01). 5-year distant recurrence rate was 9 % after TEM and 7 % after surgery (HR = 0.49, (<em>p</em> = 0.27). Mean time to local recurrence was 16 months after TEM, 34 months after surgery, time to distant recurrence 22 months after both.</div></div><div><h3>Conclusion</h3><div>TEM for T2 rectal cancer has high risk of local recurrence and cannot be recommended when intent is curative. TEM could be an option for patients unfit for surgery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109974"},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684374","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}