European Surgery最新文献

{"title":"Bariatrisch-metabolische Operationstechniken","authors":"Aline-Louise Schäfer, Heinz Wykypiel","doi":"10.1007/s10353-023-00811-0","DOIUrl":"https://doi.org/10.1007/s10353-023-00811-0","url":null,"abstract":"Zusammenfassung Bariatrisch-metabolische Operationen gelten als die effektivste Therapiemöglichkeit der morbiden Adipositas. In Langzeitstudien konnten sehr gute Erfolge bei der Reduktion des Übergewichts und bei der Behandlung Adipositas-assoziierter Komorbiditäten (u. a. arterielle Hypertonie, Diabetes mellitus Typ 2) gezeigt werden. Die bariatrischen Operationstechniken beruhen auf dem Wirkungsprinzip der Restriktion und Malabsorption. Die damit verbundenen metabolischen Effekte, die z. T. unabhängig vom Gewichtsverlust und der Kalorienreduktion schon früh postoperativ einsetzen, werden derzeit intensiv beforscht. Die am häufigsten angewandten restriktiven Verfahren sind Schlauchmagen, Magenband, Magenfaltung und Magenballon. Beim Magenbypass, der biliopankreatischen Diversion (mit und ohne duodenalem Switch) und dem „single anastomosis duodenal-ileal-bypass“ mit Sleeve werden die Wirkprinzipien kombiniert. Die Eingriffe werden üblicherweise laparoskopisch durchgeführt und haben akzeptable Komplikationsraten. Postoperativ sind lebenslange Stoffwechselkontrollen und Substitution mit Vitaminen und Spurenelementen (insbesondere bei malabsorptiven Verfahren) erforderlich, um einer Malnutrition vorzubeugen.","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"57 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136102696","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":"Minimally invasive approaches in pancreatic cancer surgery","authors":"Steffen Deichmann, Ulrich Wellner, Louisa Bolm, Kim Honselmann, Rüdiger Braun, Thaer Abdalla, Tobias Keck","doi":"10.1007/s10353-023-00812-z","DOIUrl":"https://doi.org/10.1007/s10353-023-00812-z","url":null,"abstract":"Summary This literature review reflects the present evidence on minimally invasive pancreatic surgery, differentiating between distal pancreatic resection and pancreatoduodenectomy for pancreatic cancer. The review analyzed studies comparing minimally invasive and open pancreatic surgery in PubMed, the Cochrane Library, and the WHO Trial Register according to the following MeSH search strategy: MeSH items: pancreatic surgery, minimally invasive surgery, robotic surgery, laparoscopic surgery, pancreatoduodenectomy, and distal pancreatic resection. In systematic reviews and meta-analysis, minimally invasive distal pancreatectomy (MI-DP) has been shown to result in shorter hospital stays, less blood loss, and better quality of life than open distal resection (ODP) with similar morbidity and mortality. Meta-analyses have suggested similar oncological outcomes between the two approaches. Minimally invasive pancreatoduodenectomy (MI-PD) has been shown to offer advantages over open surgery, including shorter length of stay and less blood loss, by expert surgeons in several studies. However, these studies also reported longer operative times. As the procedure is technically demanding, only highly experienced pancreatic surgeons have performed MI-PD in most studies, so far limiting widespread recommendations. In addition, selection of cases for minimally invasive operations might currently influence the results. Registry studies from dedicated groups such as the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) and randomized controlled trials currently recruiting (DIPLOMA‑1 and 2, DISPACT-2) will bring more reliable data in the coming years. In conclusion, both MI-DP and MI-PD have shown some advantages over open surgery in terms of shorter hospital stays and reduced blood loss, but their effectiveness in terms of oncological outcomes is uncertain due to limited evidence. The study highlights the need for further randomized controlled trials with larger sample sizes and registry studies to further evaluate the safety, efficacy, and oncological outcomes of minimally invasive pancreatic resections.","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"921 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134975806","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":"Personalized treatment in localized pancreatic cancer","authors":"John P. Neoptolemos, Kai Hu, Peter Bailey, Christoph Springfeld, Baobao Cai, Yi Miao, Christoph Michalski, Carlos Carvalho, Thilo Hackert, Markus W. Büchler","doi":"10.1007/s10353-023-00814-x","DOIUrl":"https://doi.org/10.1007/s10353-023-00814-x","url":null,"abstract":"Summary The treatment elements used for pancreatic ductal adenocarcinoma (PDAC) include surgical resection, systemic cytotoxic agents, and targeted drugs. For second- and third-line therapies in PDAC, approximately 15% of patients have actionable mutations although only 2.5% receive matched targeted treatment but with a significant improvement in survival of around 16 months. For the majority of PDAC patients the current most effective strategy is surgical resection of the primary tumor and systemic combination chemotherapy. The chemotherapy regimens and the order of delivery relative to the resection reference point have been based to a large extent on randomized trials using a newly developed empirical staging (Em) system. Although the reductionist TNM based AJCC and UICC systems work well for pathology staging, they are less accurate and less manageable for treatment decision-making. This Em system defines locally resectable (EmR), borderline resectable (EmBR), and unresectable (EmUR) stages, plus the emerging entity of oligometastatic disease (EmOm). For EmR patients, 6 months of adjuvant chemotherapy achieves 5‑year survival rates of 30–50%. In EmBR short-course (2 months) neoadjuvant plus 6‑month adjuvant chemotherapy increases 12-month survival rates to around 77%, compared to 40% for upfront surgery, despite resection rates of 64–85% and 75%, respectively. Longer-course (4 months) neoadjuvant chemotherapy has also been shown to achieve an 18-month overall survival of 67%. In EmUR, induction therapy (3–6 months) may result in resections rates of 20–60% with significantly improved survival rates compared to no resection. For all stages including the polymetastatic (EmPm) setting, patients with good performance status receive combination chemotherapies based on either oxaliplatin (FOLFIRINOX or NALIRIFOX) or gemcitabine (GEM-CAP, or Gem-NabP). Molecular subtypes (Moffitt, Collisson, Bailey, and Cheng-Sen-Yue) are shown to be associated with treatment responses. Transcriptomic signatures have also been developed as classifiers for determining either oxaliplatin- or gemcitabine-based therapies (PurIST, Tiriac, GemPred+, and ESPAC) and are being evaluated in various studies. Most notably the ESPAC transcriptomic signature is being used as the treatment classifier in the experimental arms of the randomized ESPAC6 adjuvant trial in EmR patients and the ESPAC7 induction therapy trial in EmUR patients. Genomic and transcriptomic profiling at baseline and over time is an integral part of ESPAC6/7 to deepen our understanding of tumor plasticity during the course of therapy, identifying the intrinsic (persister cell) and acquired (genetic) tumor plasticity evolving over time and in reaction to different therapies in order to enable a scientific approach to overcoming clonal-resistance clades.","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135828493","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 assists cleaning the roots","authors":"M. Riegler","doi":"10.1007/s10353-023-00813-y","DOIUrl":"https://doi.org/10.1007/s10353-023-00813-y","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135193177","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":"Do regular morbidity and mortality conferences reduce preventable death rates? Our experience at Princess Marina Hospital","authors":"Mpapho J. Motsumi, Nkhabe Chinyepi, Samuel Rackara, Rashid Lwango, Getrude Kapinga, Karabo Ngwako, Maranatha Sentsho, Tefo Leshomo, Unami Chilisa, Pako Motlaleselelo, Elijah K. Lekgowe","doi":"10.1007/s10353-023-00810-1","DOIUrl":"https://doi.org/10.1007/s10353-023-00810-1","url":null,"abstract":"Summary Background The role of morbidity and mortality conferences (M&MC) in surgical departments is to provide education and improve patient care. However, there is sparse evidence in the literature that M&MCs reduce preventable deaths. Therefore, this study aimed to assess the impact of routine M&MC on reducing the preventable death rate over 4 years at a tertiary hospital in Botswana. Methods This study used a quantitative research methodology. In this retrospective audit of the M&MC data, we collected all mortality data for the surgery department from the time the database started, July 2016, to December 2019. The department adopted and adapted the criteria and definitions of preventability based on the World Health Organization (WHO) guidelines for trauma quality improvement programs. We used the Pearson correlation statistic to evaluate the correlation between the time (years) since the start of routine M&MC and the preventable death rate. Ethical approval for the study was obtained. Results There were 4660 registered admissions from July 2016 to December 2019. Of these, 267 deaths were recorded, resulting in a crude mortality rate of 6%. Overall, the department considered 23% (61/267) of the deaths as preventable. A strong linear correlation ( R 2 = 0.982, p = 0.009) was found between the preventable death rate and time (years) since the commencement of routine M&MC. Trauma was the leading cause of preventable deaths (24.6%, 15/61). Conclusion Our findings suggest that routine M&MCs have the desired effect of reducing preventable death rates. Further studies are required to investigate this observed effect.","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135938867","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":"Unraveling the impact of interval length between neoadjuvant chemoradiotherapy and surgery on perioperative and postoperative complications in rectal cancer patients","authors":"B. Behboudi, M. Fazeli, A. Abkhoo, A. Kazemeini, S. H. Tafti, M. Keramati, A. Naseri, A. Keshvari","doi":"10.1007/s10353-023-00809-8","DOIUrl":"https://doi.org/10.1007/s10353-023-00809-8","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"158 1","pages":"142 - 148"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79821598","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":"Lymphatic node dissection in liver resection for colorectal metastasis","authors":"F. Čečka, J. Zajak, K. Vinklerová, A. Šafus","doi":"10.1007/s10353-023-00808-9","DOIUrl":"https://doi.org/10.1007/s10353-023-00808-9","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"37 1","pages":"116 - 123"},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89114645","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":"An unlikely path: hernia mesh migration","authors":"A. Ferreira, B. Castro, Catarina Ortigosa, Sílvia Costa, B. Pereira, Manuel Oliveira","doi":"10.1007/s10353-023-00807-w","DOIUrl":"https://doi.org/10.1007/s10353-023-00807-w","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78701208","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":"Comparison of conventional right colectomy and complete mesocolic excision technique—case–control analysis of short-term results","authors":"T. Sztipits, P. Mészáros, Z. Dubóczki, D. Wettstein, G. Oláh, Kornel Mezo, B. Budai, T. Mersich","doi":"10.1007/s10353-023-00804-z","DOIUrl":"https://doi.org/10.1007/s10353-023-00804-z","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"60 1","pages":"134 - 141"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73086529","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":"A novel trans hiatal esophago-gastrostomy with anti-reflux triangle-valve for laparoscope assisted lower esophagectomy and proximal gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction: a three-year retrospective cohort study","authors":"Yongshun Gao, Jiangang Sun, Peng Chen","doi":"10.1007/s10353-023-00806-x","DOIUrl":"https://doi.org/10.1007/s10353-023-00806-x","url":null,"abstract":"","PeriodicalId":12253,"journal":{"name":"European Surgery","volume":"4 1","pages":"124 - 133"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74934701","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}