European Surgery最新文献

{"title":"Quality assurance in surgery—a moral obligation","authors":"Dietmar Öfner","doi":"10.1007/s10353-023-00825-8","DOIUrl":"https://doi.org/10.1007/s10353-023-00825-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Quality assurance (QA) in surgery is crucial, ensuring patient safety, improving outcomes, and maintaining the highest standards of care. Structured medical documentation is a key component in generating valid data that can be used to achieve QA goals. Unfortunately, digital systems for surgical documentation that are simultaneously clinically oriented, appropriately comprehensive, and user friendly are currently lacking.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>For this reason, the Department of Visceral, Transplant, and Thoracic Surgery at the Medical University of Innsbruck has established its medical documentation platform as a quality-controlled registry (qcRegistry).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>This paper gives an overview of quality assurance measures in medicine, especially in surgery. It describes the essential requirements for the data of a registry, the tools to achieve quality-controlled data, and its implementation in routine without significantly disturbing the daily clinical routine.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Despite complex conditions inherent to medical quality-controlled documentation, it has been shown that a quality-controlled, audit-capable registry (qcRegistry) can be successfully implemented across all aspects of surgical practice in a tertiary care surgery department.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139408320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional status, depression, and quality of life in female patients with postmastectomy lymphedema","authors":"Büşra Varman, Halim Yılmaz, Mehmet Ali Eryılmaz, Yurdagül Bahran Muştu, Alper Varman","doi":"10.1007/s10353-023-00821-y","DOIUrl":"https://doi.org/10.1007/s10353-023-00821-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>This study aimed to evaluate QOL in female patients who had developed lymphedema (LE) following unilateral breast cancer surgery and investigate its relationship to shoulder pain, sleep and depression.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A total of 69 female patients who had undergone unilateral mastectomy because of breast cancer and had been diagnosed with LE and 69 healthy controls were included in the study. While the QOL of participants was evaluated by the Short Form-36 (SF-36), depression levels were determined by the Beck Depression Inventory (BDI) and quality of sleep was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Shoulder pain on the operated side in the patient group was appraised by the visual analogue scale (VAS).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>This study revealed that LE patients had increased levels of depression, sleep disorders, and arm pain, while a decrease was found in the level of upper extremity functions and QOL. Therefore QOL, depression, and sleep disorders should be investigated in detail alongside upper extremity problems in the diagnosis and follow-up of patients with postmastectomy LE.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Postmastectomy LE causes chronic pain and depression and impairs patients’ functionality and QOL.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139077204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nachruf Prof. Dr. Ingrid Göber","authors":"Bruno K. Podesser, Ernst Wolner","doi":"10.1007/s10353-023-00820-z","DOIUrl":"https://doi.org/10.1007/s10353-023-00820-z","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138820089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery positively translates the fruits of your mind","authors":"Martin Riegler","doi":"10.1007/s10353-023-00824-9","DOIUrl":"https://doi.org/10.1007/s10353-023-00824-9","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"116 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MELD-Na score is associated with postoperative complications in non-cirrhotic gastric cancer patients undergoing gastrectomy","authors":"Omer Akay, Mert Guler, Husnu Sevik, Ishak Yildiz, Mert Mahsuni Sevinc, Aziz Ari, Ufuk Oguz Idiz, Cihad Tatar","doi":"10.1007/s10353-023-00823-w","DOIUrl":"https://doi.org/10.1007/s10353-023-00823-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>We aimed to investigate whether the MELD-Na score has a predictive value for postoperative complications in non-cirrhotic gastric cancer patients undergoing gastrectomy.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>The non-cirrhotic patients who were diagnosed with gastric cancer and underwent gastrectomy in our center from December 2020 to June 2022 were enrolled. MELD-Na scores of all patients were calculated within 48 h before surgery. A cut-off value was calculated for the MELD-Na score and patients were divided into two groups with a score of ≤ 10 and &gt; 10. Postoperative 30-day complications including bleeding, ileus, wound infection, intra-abdominal abscess, evisceration, obstruction, anastomosis leakage, and pulmonary and cardiac complications were recorded. Clavien–Dindo scores were calculated. Univariate and multivariate analyses were performed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 159 patients were included in this study. In the patients with a score of more than 10, wound infection, postoperative bleeding, pulmonary complications, re-operation risk, and any complications were found to increase significantly. A positive correlation was found between the Clavien–Dindo score and the higher value of MELD-Na score (<i>p</i> = 0.046). Moreover, postoperative complications were significantly higher in patients with comorbidity and high pathologic stages (<i>p</i> = 0.002 and 0.044, respectively). Multivariate analysis showed that comorbidity and high MELD-Na score were independent risk factors for postoperative complications.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In this study, it was found that a higher value of MELD-Na score was an independent predictive factor for development of postoperative complications.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138575895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of custom-made endograft simulation techniques: physical prototypes versus numerical simulations","authors":"Fadi Taher, Miriam Kliewer, Jean-Noel Albertini, Joris Vermunt, Raphael Doustaly, Corinna Walter, Markus Plimon, Jürgen Falkensammer, Herbert Langenberger, Afshin Assadian","doi":"10.1007/s10353-023-00819-6","DOIUrl":"https://doi.org/10.1007/s10353-023-00819-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The technical success of fenestrated endovascular aortic repair (FEVAR) relies on the exact fit of the custom-made endograft in the patient. Numerical simulation software has been made available (PLANOP™, PrediSurge) to digitally test the intended endograft design.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The distance between opposite peaks of the proximal endograft sealing ring were measured on computed tomography (CT) scans of the test implantation within a 3D printed model, on numerical simulation software, and on postoperative CT (reference). Two types of modeling were used for the aorta in the numerical simulation software: rigid and deformable. This resulted in four measurements: (1) CT scan of the physical endograft prototype implanted in a rigid printed silicone model of the aorta, (2) rigid numerical or finite element (FE) simulation of the endograft implanted in a rigid aortic model, (3) numerical or FE simulation with a deformable virtual aortic model, and (4) patient postoperative CT.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Ten patients were included in the study. The mean distance between peaks was 26.8 mm in the postoperative CT scan (reference). The distance in the rigid printed model was 23.8 ± 2.0 mm <i>p</i> &lt; 0.003). The FE analysis with rigid aorta measured 23.8 ± 1.5 mm (<i>p</i> &lt; 0.006). Measurements performed on CT of the physical prototype test implanted in the printed silicone model of the aorta, and measurements from FE analysis with rigid modeling, were not significantly different. Measurements in a simulated deformable aorta were 27.4 ± 2.1 mm (<i>p </i> &lt; 0.521). A high correlation (<i>r</i> = 0.81, <i>p</i> &lt; 0.01) was found between measurements on postoperative CT and deformable aorta FE analysis.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Numerical simulation with a rigid aorta may be a suitable substitute for traditional test implantation of a non-sterile prototype within a 3D aortic model. This may help reduce time for graft planning and fabrication. The FE analysis with a deformable aorta was able to predict peak-to-peak distances at the proximal sealing ring more reliably. The effect on clinical outcomes and endoleak occurrence remains to be elucidated in future trials.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138567049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-139-5p mediates TGIF1 to regulate the TGFβ pathway and inhibit growth of esophageal squamous cell carcinoma cells","authors":"Xiaowu Fan","doi":"10.1007/s10353-023-00818-7","DOIUrl":"https://doi.org/10.1007/s10353-023-00818-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Esophageal squamous cell carcinoma (ESCC) is the most prevalent histological subtype of esophageal cancer. miR-139-5p has been shown to have abnormal expression in ESCC. We intend to probe into the roles of miR-139-5p in ESCC, thus providing references for investigating underlying therapeutic targets.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>miR-139-5p expression in esophageal carcinoma was predicted by the Starbase online website. miR-139-5p expression in human ESCC cell lines (KYSE-150, KYSE-410, KSE-30) and human esophageal epithelial cell line Het1A was determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR). KYSE-150 cells were manipulated with miR-139-5p mimic to upregulate miR-139-5p. Cell colony formation, viability, apoptosis, migration, and invasion were assessed by colony formation assay, CCK‑8, flow cytometry, wound healing test, and Transwell. The targeted binding between miR-139-5p and TGIF1 was predicted on Starbase, Targetscan, and miRDB online websites and verified by Dual-Luciferase assay. Cells were transfected with miR-139-5p mimic and pcDNA3.1 TGIF1. The phosphorylation levels of TGFβ pathway-related proteins Smad2 and Smad3 were assessed by RT-qPCR and western blot.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>miR-139-5p was underexpressed in ESCC cells. miR-139-5p overexpression reduced ESCC cell viability, migration, and invasion, and promoted apoptosis. TGIF1 overexpression averted miR-139-5p mimic-inhibited ESCC cell growth. miR-139-5p overexpression decreased the phosphorylation levels of TGFβ pathway-related proteins Smad2 and Smad3, while the phosphorylation levels were increased by additional TGIF1 vector transfection.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>miR-139-5p mediates TGIF1 to regulate TGFβ pathway and inhibit ESCC cell growth.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute mechanical intestinal obstruction due to lung cancer metastasis","authors":"Sefa Ergün, Ergin Erginöz, Şebnem Batur","doi":"10.1007/s10353-023-00817-8","DOIUrl":"https://doi.org/10.1007/s10353-023-00817-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Acute mechanical small bowel obstruction is commonly caused by intraabdominal adhesions and various pathological processes such as malignancy or inflammatory bowel disease. It can also be the result of a metastatic disease such as lung cancer.</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>In this report, we present the case of a 57-year-old male patient who presented to the emergency room with epigastric pain, vomiting, and absent passage of stool or flatus. The work-up of the patient revealed a 3-cm obstructive tumor within the wall of the distal jejunum. The pathological result was consistent with squamous cell carcinoma of the jejunum, and this was believed to be a metastasis of the primary cancer of the lung since patient’s thoracic CT revealed a mass surrounding the right main bronchus.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Metastasis to the small bowel is rare and often indicates an advanced stage of disease since the condition often goes undiagnosed. Patients may present with symptoms due to ileus such as nausea, vomiting, and abdominal pain, or due to bleeding such as hematochezia or melena. The work-up of the patient should include CT and thorough history taking should be accomplished to rule out metastasis.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Patients presenting with small bowel metastasis from primary lung cancer often present with severe complications such as perforation, hemorrhage, or obstruction, since the diagnosis is delayed. Metastasis should be included in the differential diagnosis in patients presenting with acute mechanical bowel obstruction and the work-up should include CT of the thorax, abdomen, and pelvis to rule out primary tumor.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"38 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of digital infrared thermal imaging in surgical management of fistula-in-ano","authors":"Sedat Carkit, Talha Sarigoz, Mustafa Bilgili, Tamer Ertan","doi":"10.1007/s10353-023-00816-9","DOIUrl":"https://doi.org/10.1007/s10353-023-00816-9","url":null,"abstract":"<p>Anal fistulas represent an inflammatory condition with a connection formed between the anal canal and the perianal skin. Surgery aims to eradicate the fistula while preserving sphincter function. However, inadequate removal of fistula tracts often results in recurrence, and excessive division of the anal sphincter complex can result in fecal incontinence. Therefore, comprehensive preoperative evaluation of the fistula tract is crucial and contributes considerably to outcomes. MRI has emerged as a key method in patients with perianal fistula, but is expensive, uses intravenous contrast agent, and experience is needed to interpret images. Endoanal ultrasound (EUS) is cheaper and more practical than MRI, but is highly operator dependent and its role in suprasphincteric and complex fistulas is controversial. This study aimed to assess the usefulness of digital infrared thermal imaging (DITI) for evaluating of fistula-in-ano. DITI monitors infrared radiation emanated by a surface, in this case the perianal skin. The scientific rationale is based on the inflammatory state caused by perianal fistulization. Because one of the pathological findings of inflammation is increased local temperature due to altered blood flow, we hypothesized that by using a contrast agent colder than the human body, the perianal fistula tract could be visualized by DITI cameras. A protocol and simple diagnostic algorithm for evaluation of perianal fistulas are presented.</p>","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"41 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"17th European Colorectal Congress – ECC, St.Gallen","authors":"","doi":"10.1007/s10353-023-00815-w","DOIUrl":"https://doi.org/10.1007/s10353-023-00815-w","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":" 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135241810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}