European Surgical Research最新文献

{"title":"The application of platysma myocutaneous flap in tracheostomy after total laryngectomy: A novel surgical technique.","authors":"Chen Cao, Fanqin Wei, Jie Deng, Liping Chai, Zhangfeng Wang","doi":"10.1159/000550547","DOIUrl":"https://doi.org/10.1159/000550547","url":null,"abstract":"<p><p>Introduction Here we presented a new surgical technique for tracheostomy using the platysma myocutaneous flap after total laryngectomy and analyzed its results and follow-up data. Method In this innovative technique, longitudinal incisions are made on the posterior tracheal wall with a platysma myocutaneous flap for tracheostomy. The outcomes and analyses of 168 patients who underwent tracheostomy (from December 2006 to June 2021) were recorded. Result The incidence of post-tracheostomy tracheal stenosis was 2.38%, which is much lower than that of conventional surgery. Stoma size was not affected by body mass index, smoking, alcohol consumption, diabetes and number of resected tracheal cartilage rings (P>0.05). Patients who underwent this surgery had reduced psychological problems and increased physical appearance satisfaction. Conclusion This technique is easily reproducible and suitable for patients with lower incidence of tracheal stenosis and higher satisfaction.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766794","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":"New Perfusion- and Preservation Strategies for Donor Hearts.","authors":"Vincent Hendrik Hettlich, Hug Aubin, Maximilian Scherner, Bedri Ramadani, Artur Lichtenberg, Udo Boeken","doi":"10.1159/000551946","DOIUrl":"https://doi.org/10.1159/000551946","url":null,"abstract":"<p><p>Currently, there are several different systems and methods available for organ procurement and transportation in the context of heart transplantation. The hypothermic transport of the cardioplegic heart is certainly the most widely used method. Ultimately, this approach has been the global standard since the 1980s and the introduction of the brain death definition, i.e., the largely controlled heart procurement. The results of this procurement and transportation technique are very good and have been reproducible for decades. However, it should be emphasized that with this technique, there is still a critical limit for the organ's ischemic time of around 4-5 hours. The newer preservation and transport techniques are primarily characterized by their ability to extend ischemic tolerance. This has now been demonstrated in studies for all systems used. However, it is important to differentiate between hypothermic transport with current modifications (e.g., SherpaPak, Vitalpak) and so-called machine perfusion (e.g., OCS, XVIVO). A relevant criterion for selecting the appropriate system is undoubtedly the cost per use, as well as, particularly in Germany, the coverage by health insurance companies. While the currently standard technique of hypothermic transport in a Styrofoam box after cardioplegia is fully covered by insurance, the significantly higher costs of other systems are, to date, only covered within the framework of studies or must be covered by the users themselves. Currently, this issue (costs ranging from €10,000 to €65,000 per use, depending on the system) represents a significant limitation for the further and widespread adoption of these novel devices.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671683","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":"Use of Human Amnion/Chorion Membrane as a Protective Barrier in Complicated Diverticulitis Patients Undergoing Colorectal Resections.","authors":"Bidhan Das, Dennis Choat, Nezar Jrebi, Matthew Bardin","doi":"10.1159/000551652","DOIUrl":"https://doi.org/10.1159/000551652","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic leaks are a serious complication of colorectal surgery, particularly in patients undergoing colectomy for complicated diverticulitis. Dehydrated human amnion/chorion membrane (DHACM) allografts are FDA-regulated, non-viable cellular allografts derived from donated human placentas. This tissue is rich in cytokines and growth factors critical in wound healing and tissue growth. Animal models have demonstrated the benefits of these grafts for anastomotic healing in terms of increased bursting pressures, neoangiogenesis, fibroblast activity, collagenization, and epithelialization, as well as decreased inflammation. This study evaluated real-world outcomes associated with DHACM use as a protective barrier wrapped around the anastomotic site in patients undergoing colorectal resection for complicated diverticulitis.</p><p><strong>Methods: </strong>This retrospective, multi-center study analyzed consecutive adult patients undergoing left-sided colectomy with primary colorectal anastomosis and DHACM application, between January 2016 and June 2024. Patients with uncomplicated diverticulitis or receiving protective stoma were excluded. The primary outcome was anastomotic leak incidence within 30 days of surgery. Secondary outcomes included reoperation, readmission, length of stay, and mortality. Outcomes were summarized descriptively.</p><p><strong>Results: </strong>The study included 178 complicated diverticulitis patients with left-sided colectomy and no protective stoma. Three patients (1.7%) experienced an anastomotic leak, including two grade B leaks managed with antibiotics and one grade C leak requiring reoperation. The 30-day all-cause readmission rate was 3.9% (7/178), the median length of stay was 2 days and only 3 patients (1.7%) returned to surgery.</p><p><strong>Conclusions: </strong>In this real-world cohort of complicated diverticulitis patients undergoing colectomy, low rates of anastomotic leak, readmission, and reoperation were observed following application of DHACM around the anastomosis. These findings suggest DHACM may be a promising adjunct to support anastomotic healing in this high-risk population. Controlled prospective studies are warranted to confirm these observations.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"1-19"},"PeriodicalIF":1.9,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490948","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":"Simultaneous Liver-Kidney Transplantation versus Liver Transplantation in End-Stage Liver Disease Patients with Kidney Dysfunction.","authors":"Sarah Bouari, Yitian Fang, Jacqueline van de Wetering, Vincent E de Meijer, Robert A Pol, Stefan P Berger, Wojciech G Polak, Hans Blokzijl, Aiko P J de Vries, Minneke J Coenraad, Hwai-Ding Lam, Dorottya K de Vries, Robert J Porte, Caroline M den Hoed, Jan N M IJzermans, Robert C Minnee","doi":"10.1159/000550008","DOIUrl":"10.1159/000550008","url":null,"abstract":"<p><strong>Introduction: </strong>The role of simultaneous liver-kidney transplantation (SLKT) in end-stage liver disease patients with varying kidney dysfunction remains unclear. This study aims to compare clinical outcomes of SLKT recipients with those undergoing liver transplant alone (LTA) with comparable kidney dysfunction.</p><p><strong>Methods: </strong>This retrospective cohort study included the SLKT cohort (n = 52) from the Dutch Organ Transplantation Registration and the LTA cohort (n = 829) from Erasmus Medical Center between 2000 and 2020. Patients were stratified by pretransplant renal function (chronic kidney disease [CKD] stages 3b-5) and pretransplant renal replacement therapy (RRT) status. Patient and graft survival, and renal function were compared across renal function strata.</p><p><strong>Results: </strong>Across CKD stages 3b and 4, there was no statistically significant difference in overall survival rates (p = 0.59 and p = 0.23, respectively). For patients with CKD stage 5 or RRT, patient survival rates at 1, 3, and 5 years posttransplant were significantly lower in the LTA group (60.3%, 51.7%, and 51.7%, respectively) compared to the SLKT group (90.0%, 90.0%, and 80.8%, p = 0.048). Death-censored liver graft survival rates at 1, 3, and 5 years were also significantly lower in the LTA group (59.8%, 49.9%, and 49.9%) versus SLKT group (86.4%, 86.4%, and 77.0%, p = 0.048). Cox proportional hazards model confirmed the association between SLKT and improved patient survival (HR 0.31, 95% CI: 0.10-0.98, p = 0.046).</p><p><strong>Conclusion: </strong>For patients with CKD stage 5 or those on pretransplant RRT, SLKT was associated with better survival outcomes compared to LTA. Primary etiology of liver disease and severity of kidney dysfunction should be considered when determining SLKT eligibility. Due to the limited group size, these findings should be interpreted with caution and further validated.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"46-55"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12845520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762583","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":"Brachial Plexus Blockage versus General Anesthesia for Upper Extremity Surgery: A Systematic Review and Meta-Analysis.","authors":"Rafael Llombart-Blanco, María Benlloch, Gonzalo Mariscal, Pablo Vera, Egor Polevoi, Ali Dway, Carlos Barrios, Rafael Llombart-Ais","doi":"10.1159/000550121","DOIUrl":"10.1159/000550121","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis investigated differences in rebound pain and opioid consumption when using brachial plexus blockade (BPB) versus general anesthesia (GA) for upper limb surgery.</p><p><strong>Methods: </strong>Four databases were searched. Odds ratios (OR), mean differences (MD), and standard mean differences (SMD) with 95% confidence intervals (CIs) were calculated. Outcomes included were pain, opioid consumption, adverse events, and discharge time. The risk of bias was assessed.</p><p><strong>Results: </strong>Nine clinical trials involving 487 patients were included. BPB resulted in significantly lower pain scores within 2 h postoperatively (MD -4.57, 95% CI -5.76 to 3.38; participants = 263; studies = 5; I2 = 0%; p < 0.00001) but not from 6 to 24 h. Opioid consumption (mg) was lower in the BPB group in the first 24 h (SMD -0.85, 95% CI -1.41 to -0.29; participants = 188; studies = 3; I2 = 67%; p < 0.003). BPB was associated with fewer postoperative nausea/vomiting events (OR 0.19, 95% CI 0.10-0.33; participants = 326; studies = 6; I2 = 45%; p < 0.00001) and shorter hospital stay (SMD -1.20, 95% CI -1.73 to -0.66; participants = 213; studies = 4; I2 = 69%; p < 0.0001). There was no difference in the number of patients not requiring opioids from 24 to 48 h.</p><p><strong>Conclusions: </strong>BPB provided superior pain control at 2 h postoperatively and was associated with reduced opioid use, fewer adverse events, and shorter discharge time. No significant differences in pain scores were observed at 6-24 h or beyond 24 h, likely due to block wear-off. Despite this limitation, BPB still offered perioperative advantages over GA.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"66-76"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809912","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":"Erratum.","authors":"","doi":"10.1159/000551130","DOIUrl":"10.1159/000551130","url":null,"abstract":"<p><p>The article \"Desensitization Strategies in Immunized Heart Transplant Recipients\" [Eur Surg Res. 2026;67:1-9; https://doi.org/10.1159/000549669] by Goerler et al. was published with the wrong open access license. The correct license of the article is CC-BY.The original article has been updated.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":"67 1","pages":"78"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480140","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":"Efficacy of Platelet-Rich Plasma and Polyvinyl Alcohol Wound Dressing in Open Wound Healing: First Results from an Experimental Rat Model.","authors":"Umit Akin Dere, Fatma Altintas, Baris Albuz, Nazli Çil, Pelin Kuzucu, Esin Avci, Hande Senol, Ahmet Koluman, Mehmet Erdal Coskun","doi":"10.1159/000550016","DOIUrl":"10.1159/000550016","url":null,"abstract":"<p><strong>Introduction: </strong>Wound healing is a complex biological process involving hemostasis, inflammation, proliferation, and tissue remodeling. Despite promising results with platelet-rich plasma (PRP) and synthetic scaffolds used separately, their combined in vivo effects remain insufficiently investigated. This experimental study presents the first results on a composite wound dressing integrating PRP, rich in growth factors, with electrospun polyvinyl alcohol (PVA) nanofibers, a biocompatible and stable polymer.</p><p><strong>Methods: </strong>Full-thickness skin defects (1 × 1 cm2) were created in 21 adult female Sprague-Dawley rats and divided into three groups: control, PVA, and PRP/PVA. Wound healing was assessed histologically and biochemically on days 7 and 14, including fibroblast growth factor-2 (FGF-2) measurement.</p><p><strong>Results: </strong>The PRP/PVA group showed enhanced epithelialization and angiogenesis compared to other groups (p < 0.05), along with higher FGF-2 levels.</p><p><strong>Conclusion: </strong>The relatively small sample size, absence of a PRP-only group, and short observation period limit the generalizability of these findings. Within these constraints, the results indicate a potential synergistic role of PRP and PVA scaffolds in promoting wound repair, supporting further studies with larger cohorts and standardized PRP preparation before clinical translation.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"56-65"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877988","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":"Exploring the Impact of an Artificial Intelligence-Based Intraoperative Image Navigation System in Laparoscopic Surgery on Clinical Outcomes: A Protocol for a Multicenter Randomized Controlled Trial.","authors":"Daichi Kitaguchi, Nozomu Fuse, Masashi Wakabayashi, Norihito Kosugi, Yuto Ishikawa, Kazuyuki Hayashi, Hiro Hasegawa, Nobuyoshi Takeshita, Masaaki Ito","doi":"10.1159/000549894","DOIUrl":"10.1159/000549894","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI), particularly deep learning-based computer vision technology, has been used in surgery as real-time intraoperative navigation; however, its clinical relevance remains unclear. To address this gap, well-designed randomized controlled trials (RCTs) are necessary to evaluate the effects of these systems by comparing surgical outcomes with and without their use. In this study, we will investigate a deep learning-based intraoperative image navigation system that operates in real time and uses semantic segmentation to help identify the ureter and autonomic nerves during laparoscopic colorectal surgery. We propose a multicenter RCT to compare the procedure of using this system against those that do not.</p><p><strong>Methods: </strong>The ImNavi trial is a Japanese multicenter RCT involving 1:1 randomization between the use and nonuse of the deep learning-based intraoperative image navigation system. The participating institutions will include three high-volume centers with sufficient laparoscopic colorectal surgery caseloads (>100 cases/year), including one national cancer center and two university hospitals in Japan. All patients will provide written informed consent. Patients aged between 18 and 80 years scheduled to undergo laparoscopic left-sided colorectal resection will be included in the study. The primary outcome is the time required for each target organ, including the ureter and autonomic nerves, to be recognized by the surgeon after its initial appearance on the monitor. Secondary outcomes include intraoperative target organ injuries, intraoperative complications, operation time, blood loss, duration of postoperative hospital stay, postoperative complications within 30 days, postoperative male erectile and ejaculatory dysfunction 1 month post surgery, surgeon's confidence in recognizing each target organ, and the postoperative fatigue of the primary surgeon.</p><p><strong>Conclusion: </strong>The impact of AI-based surgical applications on clinical outcomes beyond numerical expression will be explored from diverse viewpoints while evaluating quantitative items, including intraoperative complications and operation time, as secondary endpoints. The findings of this RCT can contribute to advancing research in the domain of AI in surgery.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"38-45"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843601","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":"Predictive Factors for Infectious Complications after Robotic Gastrectomy for Gastric or Esophagogastric Junction Cancer.","authors":"Sachiko Kaida, Katsushi Takebayashi, Reiko Otake, Asuka Fukuo, Nobuhito Nitta, Haruki Mori, Hiromitsu Maehira, Masatsugu Kojima, Toru Miyake, Masaji Tani","doi":"10.1159/000549841","DOIUrl":"10.1159/000549841","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic gastrectomy offers perioperative advantages such as reduced blood loss and faster recovery; however, infectious complications remain a significant concern. In this study, we aimed to identify the predictive factors for postoperative infectious complications following radical robotic gastrectomy in patients with gastric or esophagogastric junctional cancer.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed data from 155 patients with gastric or esophagogastric junction cancer who underwent curative robotic gastrectomy between December 2017 and April 2025 to identify predictive factors for postoperative infectious complications. Twenty-two variables, including nutritional indices and surgical factors, were evaluated.</p><p><strong>Results: </strong>A total of 18 patients developed Clavien-Dindo grade II-IIIa infectious complications. Infectious complications included pneumonia (n = 5, 3.2%), intra-abdominal abscess (n = 5, 3.2%), anastomotic leakage (n = 3, 1.9%), cholecystitis (n = 2, 1.2%), nonocclusive mesenteric ischemia (n = 1, 0.6%), bile leakage (n = 1, 0.6%), and sepsis (n = 1, 0.6%). The number of patients with complications and American Society of Anesthesiologists Physical Status (ASA-PS) class ≥3 (p = 0.006) and preoperative smoking (p = 0.012) was higher than that among patients without complications. Although hemoglobin levels (p = 0.041) and lymphocyte-to-monocyte ratios (p = 0.017) were lower in patients with complications, the platelet-to-lymphocyte ratios (p = 0.034) were higher. Multivariate analysis revealed that current smoking (odds ratio, 3.21; 95% confidence interval, 1.24-18.21) and ASA-PS class of ≥3 (odds ratio, 3.8; 95% confidence interval, 1.18-7.52) were identified as predictors of infectious complications.</p><p><strong>Conclusion: </strong>Robotic gastrectomy offers technical advantages, but optimizing patient-specific risk is essential for the best outcomes. Preoperative smoking and a high ASA-PS class were independent predictors of infectious complications following robotic gastrectomy. Enhanced perioperative management targeting these risk factors may reduce postoperative morbidity.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"10-20"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707886","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":"Immunotherapy for Solid Tumours: Current Clinical Landscape and Future Directions.","authors":"Aniek E van Diepen, Songul Kucukcelebi, Judith de Vos-Geelen, Nigel G Kooreman","doi":"10.1159/000549862","DOIUrl":"10.1159/000549862","url":null,"abstract":"<p><strong>Background: </strong>Cancer immunotherapy has transformed the therapeutic landscape of oncology by harnessing the body's immune system to recognise and eliminate malignant cells. In certain tumour types, such as melanoma and non-small cell lung cancer, immune-based therapies have led to durable clinical responses and significantly improved survival. These successes have fuelled the rapid integration of immunotherapeutic approaches into standard treatment regimens. However, their effectiveness in the majority of solid tumours remains limited. Several biological and physical barriers underlie this limited efficacy. A major challenge is the immunosuppressive nature of the tumour microenvironment (TME), which hampers effective immune cell infiltration and function. In many solid tumours, chronic inflammation, poor antigen presentation, a low mutational burden, and the presence of suppressive myeloid and stromal cells create an environment resistant to immune activation. In addition, high intra-tumoral pressure and abnormal vasculature further restrict drug delivery and immune cell trafficking, particularly in desmoplastic cancers such as pancreatic and prostate cancer.</p><p><strong>Summary: </strong>Recent advances in immuno-oncology have focused on strategies to overcome these barriers and convert \"cold\" tumours, those lacking immune cell infiltration, into \"hot,\" immune-inflamed tumours. Despite this progress, clinical translation has proven to be complex, with mixed results across various tumour types. While some patients derive long-term benefit from immunotherapy, others exhibit primary or acquired resistance, underscoring the need for better patient stratification and predictive biomarkers.</p><p><strong>Key messages: </strong>This review provides a comprehensive overview of the evolving field of immunotherapy for solid tumours, discussing key mechanisms of immune resistance, the role of the TME, and the multifactorial nature of therapeutic failure. It highlights the importance of understanding tumour-immune interactions in their full biological context, and explores current thinking on how to reshape the immune landscape of solid tumours. By addressing both immunological and physical barriers, future approaches may broaden the benefit of immunotherapy beyond its current scope, ultimately improving outcomes for patients with traditionally treatment-resistant cancers.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"21-29"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12807497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741777","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}