European Surgical Research最新文献

{"title":"The utilisation, application and quality of videos of clinical interventions in peer-reviewed literature: a scoping review.","authors":"Henry Douglas Robb, Michael Fadel, Bibek Das, Laith Omar Khalaf Alghazawi, Olivia Ariarasa, Aksaan Arif, Ayda Alizadeh, Zohaib Arain, Matyas Fehervari, Hutan Ashrafian","doi":"10.1159/000545224","DOIUrl":"https://doi.org/10.1159/000545224","url":null,"abstract":"<p><strong>Background: </strong>Videos of clinical interventions (VoCI) demonstrating surgical and interventional procedures have become a mainstay in clinical practice and peer-reviewed academic literature. Despite the widespread availability of VoCI in the literature, there remains no established guidelines regarding the reporting of VoCI. We undertook a scoping review to investigate the current utilisation, application, and quality in VoCI reporting.</p><p><strong>Methods: </strong>A comprehensive literature search of MEDLINE, EMBASE, Emcare and CINAHL databases was performed to retrieve articles presenting VoCI, from January 2020 to December 2023. A customised data extraction tool assessed video characteristics (e.g. case presentation, outcomes), utility (e.g. target audience, reproducibility of procedure) and quality (subjective and objective).</p><p><strong>Results: </strong>Six hundred and twenty-four VoCI were included (mean length 06:06), with over 62 hours of VoCI reviewed. The most common VoCI perspectives were endoscopic (n = 153; 25%) and laparoscopic (n = 140; 22%). The clinical background and outcomes were described in 480 (76.9%) and 403 cases (64.6%), respectively, with disclosures (n = 23; 3.8%) rarely presented. VoCI primarily targeted trainees (n = 547; 87.7%) with most videos providing technical guidance (n = 394; 63.1%). Two hundred and forty-eight videos (40%) were rated as medium or low quality on subjective assessment.</p><p><strong>Conclusions: </strong>There is significant heterogeneity and notably poor quality control in VoCI reporting in peer-reviewed literature resulting in the omission of critical procedural steps and suboptimal visual quality. VoCI reporting guidelines are therefore urgently required to provide a set of minimum items that should be reported by clinicians when uploading VoCI.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendicolith as a Sign of Complicated Appendicitis: A Myth or Reality? A Retrospective Study.","authors":"Ceith Nikkolo, Mariliis Muuli, Ülle Kirsimägi, Urmas Lepner","doi":"10.1159/000543683","DOIUrl":"10.1159/000543683","url":null,"abstract":"<p><strong>Introduction: </strong>Appendicolith can be incidentally detected on abdominal computer tomography (CT) without any signs of appendicitis. However, it has also been found to be a risk factor for failure of nonoperative management in acute appendicitis. The present retrospective study aimed to evaluate whether appendicolith predicts complicated appendicitis in patients with any appendicitis.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for patients undergoing appendectomy from January 2016 to December 2018. Appendicolith was considered to be present when it was described in a CT scan.</p><p><strong>Results: </strong>Of the 267 patients, appendicolith was found in 120 cases, while there were no in 147 cases in preoperative CT scans. In the case of complicated appendicitis (gangrenous or gangrenous perforated appendicitis), appendicolith was visible in CT scans in 57.7% of the patients. Of the patients with uncomplicated appendicitis, 38.3% had appendicolith in CT scan (p = 0.002). In univariate logistic regression analysis, based on the finding of the histological specimen, appendicolith was associated with complicated appendicitis (OR: 2.12; 95% CI: 1.28-3.51; p = 0.004). When adjusting for sex, age group (age ≤50 vs. >50 years), and duration of symptoms (≤24 vs. >24 h), the odds ratio was 3.52 (95% CI: 1.88-6.58; p < 0.001).</p><p><strong>Conclusion: </strong>Our study found that appendicolith can be considered an independent risk factor for complicated appendicitis. Therefore, in the presence of appendicolith, surgical treatment should probably be preferred over nonsurgical treatment in acute appendicitis.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the C-REX LapAid and Circular Stapled Colorectal Anastomoses in an Experimental Model.","authors":"Dadi Thor Vilhjalmsson, Anders Grönberg, Ingvar Syk, Henrik Tobias Thorlacius","doi":"10.1159/000543069","DOIUrl":"10.1159/000543069","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The rate of colorectal anastomotic leakage has remained unchanged for the last decades. The limitations of current anastomotic methods have generated an interest in alternative anastomotic techniques, such as compression anastomosis. The aim of this experimental study was to evaluate the early mechanical strength in left colonic anastomoses, comparing C-REX LapAid and circular stapled anastomotic methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 48 pigs underwent open sigmoid resection with end-to-end colorectal anastomoses 15 cm above the anal verge, where 21 anastomoses were constructed with traditional circular staplers and 27 with the C-REX LapAid device. Bursting pressure was measured at different time intervals postoperatively through an attached anal plug while the upper limit of the bowel segment was closed with a bowel clamp. Early histological changes were assessed 6-24 h after the anastomotic formation with vascular CD31 and collagen Masson Trichrom staining.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All animals recovered uneventfully after the surgical procedure. The circular stapled anastomoses exhibited a median bursting pressure of 36 mbar (28-64) at 1 h, 45 mbar (43-69) at 6 h, and 145 mbar (85-185) 12 h after surgery. In comparison, the C-REX LapAid anastomoses demonstrated a median bursting pressure of 195 mbar (180-240) at 1 h, 192 mbar (180-220) at 6 h, and 180 mbar (160-180) 12 h after surgery, representing a 2-5-fold higher median bursting pressure in the early anastomotic healing phase. Early microscopic architecture showed little evidence of vascular and collagen formation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The novel C-REX LapAid device demonstrated significantly higher bursting pressure values in the early phase of the anastomotic healing process compared to the circular stapled method. A clinical study to further verify the benefits of C-REX LapAid is warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The rate of colorectal anastomotic leakage has remained unchanged for the last decades. The limitations of current anastomotic methods have generated an interest in alternative anastomotic techniques, such as compression anastomosis. The aim of this experimental study was to evaluate the early mechanical strength in left colonic anastomoses, comparing C-REX LapAid and circular stapled anastomotic methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 48 pigs underwent open sigmoid resection with end-to-end colorectal anastomoses 15 cm above the anal verge, where 21 anastomoses were constructed with traditional circular staplers and 27 with the C-REX LapAid device. Bursting pressure was measured at different time intervals postoperatively through an attached anal plug while the upper limit of the bowel segment was closed with a bowel clamp. Early histological changes were assessed 6-24 h after the anastomotic formation with vascular CD31 and collagen Masson Trichrom staining.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/str","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"9-17"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal mucosal perfusion and integrity are maintained in hypotensive brain dead mice.","authors":"Mihai Oltean, Jasmine Bagge, Anna Casselbrant, Andreas Lundgren, Lucas Ferreira da Anunciação, Lucia de Miguel Gomez, Tomas Lorant, Mats Hellström, Michael Olausson","doi":"10.1159/000540020","DOIUrl":"https://doi.org/10.1159/000540020","url":null,"abstract":"<p><p>Brain death (BD) leads to complex hemodynamic and inflammatory alterations which may compromise organ perfusion and induce morphologic and functional damage in various organs. The intestine is particularly sensitive to hypoperfusion and donor hypotension usually precludes intestinal donation. Previous studies reported inflammatory intestinal changes following BD but information on mucosal integrity and perfusion are lacking. BD was induced in mice by inflating an epidural balloon catheter. Controls underwent only anesthesia and tracheostomy. Intestinal perfusion was assessed using laser Doppler flowmetry (LDF). Intestinal injury was assessed after 2h of BD by the Chiu-Park score and morphometry. Intestinal tight junction (TJ) proteins (claudin-1, claudin-3, occludin, tricellulin) as well as inflammatory activation (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukin-6) were also analysed and compared with a sham group. Although blood pressure decreased in BD mice, intestinal perfusion remained similar between BD and sham mice. Histologically, mucosal injury was absent/minimal and TJs appeared well maintained in both groups. BD may trigger intrinsic, autoregulatory mechanisms to preserve microvascular tissue perfusion and mucosal integrity in spite of mild hypotension.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and Trial Protocol for a Double-Blinded Randomized Controlled Trial to assess the Impact of a Concomitant Crural Repair during Laparoscopic Sleeve Gastrectomy in Patients with a Lax Gastroesophageal Junction without Frank Hiatal Hernia (REPAIR trial protocol).","authors":"Koy Min Chue, Bin Chet Toh, Lester Wei Lin Ong, Gamage Manisha Kariyawasam, Wai Keong Wong, Chin Hong Lim, Jeremy Tian Hui Tan, Baldwin Po Man Yeung","doi":"10.1159/000538043","DOIUrl":"https://doi.org/10.1159/000538043","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic sleeve gastrectomy (LSG) is associated with postoperative gastroesophageal reflux disease (GERD) and erosive esophagitis (EE). The role of crural repair during LSG is still controversial. The preoperative laxity of the gastroesophageal junction (GEJ), graded by the Hill's classification, is more predictive for postoperative GERD and EE after LSG than the presence of a hiatal hernia seen on endoscopy. Thus, the authors hypothesize that a concomitant crural repair in a specific subgroup of patients with a lax GEJ (Hill's III) may reduce the incidence of postoperative GERD and EE.</p><p><strong>Methods: </strong>A double-blinded, randomized controlled trial of patients with Hill's III GEJ undergoing LSG will be randomized to a concomitant crural repair (experimental) versus LSG alone (control). Primary outcome measures will be presence of EE at 1-year. Secondary outcome measures will include proton pump inhibitor use, postoperative complications, operative time, blood loss, quality of life, GERD and gastrointestinal symptoms.</p><p><strong>Conclusion: </strong>Conflicting crural repair results may be explained by differences in preoperative GEJ laxity. Patients with a frank hiatal hernia and patulous GEJ (Hill's IV) have a very high, while patients with an apposed GEJ (Hill's I, Hill's II) have a low incidence of postoperative GERD and EE respectively. Thus, the authors hypothesize that patients with a lax GEJ without frank hiatal hernia (Hill's III), might benefit from a crural repair. This study results can potentially highlight the clinical importance of preoperative endoscopic evaluation of the GEJ in all patients planned for LSG, to determine which subgroup patients may benefit from a crural repair. (Clinicaltrials.gov: NCT05330910, Registered 15-April-2022).</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recycling transplanted organs: An exceptional case and literature review.","authors":"Titas Bera, Puneet Sindhwani, Michael Rees, John Rabets, Obinna Ekwenna, Deepak Malhotra, Dinkar Kaw, Shobha Ratnam, Amira Gohara, Dalia Ibrahim, John Fisher, Kunal Yadav","doi":"10.1159/000537821","DOIUrl":"https://doi.org/10.1159/000537821","url":null,"abstract":"<p><strong>Background: </strong>Recycling transplant kidneys, in other words using an allograft which has previously been transplanted in one recipient for transplant in a second recipient, can be a source of opportunity for expanding the pool of available grafts in the United States and beyond.</p><p><strong>Summary: </strong>We describe a case of renal transplantation from a donor who had undergone a kidney transplant 3 years prior and had good graft function at the time of procurement. The recipient underwent transplantation uneventfully and to date has demonstrated excellent graft function. We also include a literature review of reported cases of recycled/retransplanted kidneys.</p><p><strong>Key messages: </strong>-Recycling transplanted kidneys is a largely untapped resource which could help decrease the transplant waitlist. -Utilizing such kidneys does need special considerations in terms of procurement technique, backtable, crossmatch, recipient selection and follow-up.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Surgery: The Future is Now.","authors":"Ahmad Guni, Piyush Varma, Joe Zhang, Matyas Fehervari, Hutan Ashrafian","doi":"10.1159/000536393","DOIUrl":"https://doi.org/10.1159/000536393","url":null,"abstract":"<p><p>Background Clinical Artificial intelligence (AI) has reached a critical inflection point. Advances in algorithmic science and increased understanding of operational considerations in AI deployment are opening the door to widespread clinical pathway transformation. For surgery in particular, the application of machine learning algorithms in fields such as computer vision and operative robotics are poised to radically change how we screen, diagnose, risk-stratify, treat and follow-up patients, in both pre- and post-operative stages, and within operating theatres. Summary In this paper, we summarise the current landscape of existing and emerging integrations within complex surgical care pathways. We investigate effective methods for practical use of AI throughout the patient pathway, from early screening and accurate diagnosis to intraoperative robotics, post-operative monitoring and follow-up. Horizon scanning of AI technologies in surgery is used to identify novel innovations that can enhance surgical practice today, with potential for paradigm shifts across core domains of surgical practice in the future. Any AI-driven future must be built on responsible and ethical usage, reinforced by effective oversight of data governance, and of risks to patient safety in deployment. Implementation is additionally bound to considerations of usability and pathway feasibility, and the need for robust healthcare technology assessment and evidence generation. While these factors are traditionally seen as barriers to translating AI into practice, we discuss how holistic implementation practices can create a solid foundation for scaling AI across pathways. Key Messages The next decade will see rapid translation of experimental development into real-world impact. AI will require evolution of work practices, but will also enhance patient safety, enhance surgical quality outcomes, and provide significant value for surgeons and health systems. Surgical practice has always sat on a bedrock of technological innovation. For those that follow this tradition, the future of AI in surgery starts now.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixation of Skin Flaps after Mastectomy Using Running or Interrupted Sutures for Combatting Seroma: A Protocol for a Randomised Controlled Trial (ANNIE).","authors":"Merel A Spiekerman van Weezelenburg, Loeki Aldenhoven, Sander M J van Kuijk, Elisabeth R M van Haaren, Alfred Janssen, Yvonne L J Vissers, Geerard L Beets, James van Bastelaar","doi":"10.1159/000542233","DOIUrl":"10.1159/000542233","url":null,"abstract":"<p><strong>Introduction: </strong>Flap fixation significantly reduces the incidence of seroma formation after mastectomy. Previous studies have compared running sutures, interrupted sutures, and tissue glue application with conventional wound closure. A recent systematic review with network meta-analysis showed running sutures to be the most optimal technique; however, direct comparisons and high adequate scientific evidence are lacking. This prospective trial aimed to directly compare running sutures with interrupted sutures to determine which technique of flap fixation using sutures is superior.</p><p><strong>Methods: </strong>This trial will combine a retrospective cohort of patients undergoing flap fixation using interrupted sutures from a previous trial, with a randomised prospective cohort with patients undergoing flap fixation using running sutures or flap fixation using interrupted sutures. This study design was chosen to acquire a sample size with sufficient power and the ability to conduct this study in an acceptable time frame. The primary endpoint is the incidence of complications requiring interventions, including clinically significant seroma, infections and haemorrhagic complications. Secondarily, the length of the procedure and cosmetic results will be compared.</p><p><strong>Conclusions: </strong>This is the first trial comparing two suturing techniques for flap fixation after mastectomy. Results will be used to optimise flap fixation techniques for these patients to prevent seroma formation.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"130-136"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Basic Research in Normothermic Machine Perfusion.","authors":"Sarah A Hosgood, Michael L Nicholson","doi":"10.1159/000542290","DOIUrl":"10.1159/000542290","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) is gradually being introduced into clinical transplantation to improve the quality of organs and increase utilisation. This review details current understanding of the underlying mechanistic effects of NMP in the heart, lung, liver, and kidney. It also considers recent advancements to extend the perfusion interval in these organs and the use of NMP to introduce novel therapeutic interventions, with a focus on organ modulation.</p><p><strong>Summary: </strong>The re-establishment of circulation during NMP leads to the upregulation of inflammatory and immune mediators, similar to an ischaemia-reperfusion injury response. The level of injury is determined by the condition of the organ, but inflammation may also be exacerbated by the passenger leucocytes that emerge from the organ during perfusion. There is evidence that damaged organs can recover and that prolonged NMP may be advantageous. In the liver, successful 7-day NMP has been achieved. The delivery of therapeutic agents to an organ can aid repair and be used to modify the organ to reduce immunogenicity or change the structure of the blood group antigens to create a universal donor blood group organ.</p><p><strong>Key messages: </strong>The application of NMP in organ transplantation is a growing area of research and is increasingly being used in the clinic. In the future, NMP may offer the opportunity to change practice. If organs can be preserved for days on an NMP system, transplantation may become an elective rather than an emergency procedure. The ability to introduce therapies during NMP is an effective way to treat an organ and avoid the complexity of treating the recipient.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"137-145"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Renal Artery Aneurysm by ex situ Repair and Autotransplantation: A Nationwide Cohort Study.","authors":"Yitian Fang, Hendrikus J A N Kimenai, Ron W F de Bruin, Dorottya K de Vries, Bart-Jeroen Petri, Michiel C Warlé, Ignace F J Tielliu, Jorinde van Laanen, Mirza M Idu, Robert A Pol, Robert C Minnee","doi":"10.1159/000541814","DOIUrl":"10.1159/000541814","url":null,"abstract":"<p><strong>Introduction: </strong>Renal artery aneurysm (RAA) is a rare vascular disease with a mortality rate of up to 80% upon rupture. This study aimed to investigate the safety and efficacy of ex situ repair and autotransplantation for endovascularly untreatable RAA.</p><p><strong>Methods: </strong>A retrospective nationwide cohort study was conducted in RAA patients undergoing ex situ repair and autotransplantation in the Netherlands. Surgical techniques, postoperative complications, and graft outcomes were assessed.</p><p><strong>Results: </strong>Ex situ repair was performed in 9 patients with 11 RAAs. Eight RAAs were located at the first bifurcation, one on the main trunk, one on the first branch, and one on the second branch. Nephrectomy was performed via laparoscopy (n = 7), robotic-assisted laparoscopy (n = 1), and laparotomy (n = 1). Postoperative complications were recorded in 4 patients, including bowel obstruction, delirium, pneumonia, and hydronephrosis due to double-J dislocation. The median estimated glomerular filtration rate was 83 mL/min/1.73 m2 pretransplant and 88 mL/min/1.73 m2 posttransplant. By an average follow-up of 32 months, 2 patients had died due to lung adenocarcinoma and stroke, while all autotransplanted kidneys had good patency and remained functional.</p><p><strong>Conclusions: </strong>Ex situ repair and autotransplantation are safe and feasible for endovascularly untreatable RAA cases. Larger cohorts with longer follow-up periods are necessary to further evaluate the role of this surgical approach.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"123-129"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}