Langenbeck's Archives of Surgery最新文献

{"title":"Safety and outcomes of gasless transoral endoscopic thyroidectomy and lateral neck dissection for papillary thyroid cancer.","authors":"Jing Fang, Shengying Wang, Yiwei Wang, Weifang Tang, Zhengzhi Zhu, Shikai Hong, Jianjun Liu","doi":"10.1007/s00423-025-03639-2","DOIUrl":"https://doi.org/10.1007/s00423-025-03639-2","url":null,"abstract":"<p><strong>Purpose: </strong>Entirely endoscopic surgery via an oral approach is a novel surgical procedure that results in favorable cosmetic outcomes for papillary thyroid cancer (PTC) patients. However, technical constraints have limited the utilization of a single approach for neck lymph node dissection. The aim of this study was to report the safety and outcomes of a novel gasless transoral endoscopic thyroidectomy and lateral neck dissection (LND) procedure for papillary thyroid cancer patients with lateral lymph node metastases.</p><p><strong>Methods: </strong>This study reported a newly designed suspension system and trocars for a novel surgical procedure of gasless transoral endoscopic thyroidectomy and LND. Patients who underwent gasless transoral endoscopic thyroidectomy and LND at the Department of Thyroid Surgery, the First Affiliated Hospital of the University of Science and Technology of China, between January 2022 and December 2023 were included. This study documented the demographic information, operative details, postoperative outcomes, and rates of postoperative complications among the patients included in the analysis.</p><p><strong>Results: </strong>A total of 43 PTC patients, including 6 male patients and 37 female patients with an average age of 30.53 years, were included in the study. The average number of examined lymph nodes was 33.81, including an average of 5.21 examined lymph nodes at level II. The mean operative time was 293.05 min, with an average postoperative hospital stay of 5.21 days. One patient had a history of chyle leakage, three had transient recurrent laryngeal nerve injury, and four experienced transient hypoparathyroidism after surgery.</p><p><strong>Conclusion: </strong>Our innovative design of gasless transoral endoscopic thyroidectomy and LND surgery prevents incisional scars and shows promising safety and outcomes in papillary thyroid cancer patients with lateral lymph node metastases. This entirely endoscopic approach represents a viable alternative surgical option for selected cases.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"77"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Allograft Dysfunction after liver transplantation- definition, incidence and relevance in a single-centre analysis.","authors":"Bengt A Wiemann, Oliver Beetz, Clara A Weigle, Philipp Tessmer, Simon Störzer, Dennis Kleine-Döpke, Florian W R Vondran, Nicolas Richter, Moritz Schmelzle, Felix Oldhafer","doi":"10.1007/s00423-025-03633-8","DOIUrl":"https://doi.org/10.1007/s00423-025-03633-8","url":null,"abstract":"<p><strong>Purpose: </strong>Early Allograft Dysfunction (EAD) is a serious complication following liver transplantation. With more marginal donors and critical recipients, identifying EAD risk factors and their impact on long-term outcomes is crucial.</p><p><strong>Methods: </strong>We reviewed all liver transplants performed between 2007 and 2017 at our institution, excluding pediatric recipients, combined thoracic transplants, and retransplants in the same hospital stay. EAD was defined as either: (i) AST/ALT > 2000 IU/l in first 7 postoperative days (POD), (ii) Bilirubin ≥ 10 mg/dl on POD 7, (iii) INR ≥ 1.6 on POD 7.</p><p><strong>Results: </strong>Of the 621 cases analyzed, the EAD rate was 53.6%. Multivariate analysis identified only donor-dependent variables as independent risk factors for the onset of EAD: donor age (p = 0.012), donor serum sodium (p = 0.021), cold ischemic time (p = 0.007) and graft weight (p < 0.001). EAD significantly impaired graft survival (69.2% vs. 86.2% after 1 year; p = 0.005) but did not impact long-term patient survival (76.3% vs. 87.6% after 1 year; p = 0.162). Of the EAD components, elevated INR proved to be the only reliable predictor of patient mortality. Additionally, an AST/ALT concentration of > 4000 IU/l significantly improved the predictive value of the EAD definition for patient survival (p = 0.002).</p><p><strong>Conclusions: </strong>EAD risk factors are primarily donor-based and significantly impair graft but not patient survival. The high EAD rates and increased use of marginal grafts suggest the need to adjust conventional EAD definitions to optimize graft allocation in the future.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"76"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis.","authors":"Alberto Aiolfi, Riccardo Damiani, Michele Manara, Francesco Cammarata, Gianluca Bonitta, Antonio Biondi, Davide Bona, Luigi Bonavina","doi":"10.1007/s00423-025-03648-1","DOIUrl":"10.1007/s00423-025-03648-1","url":null,"abstract":"<p><strong>Background: </strong>The surgical treatment for esophageal achalasia has evolved over the years, with laparoscopic Heller myotomy (LHM) and partial fundoplication becoming widely used worldwide. More recently, an increased interest in the robotic Heller myotomy (RHM) has arisen.</p><p><strong>Purpose: </strong>Compare short-term and functional outcomes of RHM vs. LHM.</p><p><strong>Methods: </strong>Systematic review and meta-analysis. PubMed, MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried. Primary outcome was esophageal perforation (EP). Risk ratio (RR), standardized mean difference (SMD), and 95% confidence intervals (95% CI) were effect size and relative inference measures. PROSPERO Registration Number: CRD42024512644.</p><p><strong>Results: </strong>Fourteen observational studies (12962 patients) were included. Of those, 2503 (19.3%) underwent RHM. The patient age ranged from 34 to 66 years and 51.7% were males. EP occurred in 259 patients (1.99%). The cumulative incidence of EP was 1.67% for RHM and 2.07% for LHM. Compared to LHM, RHM was associated with a reduced risk of EP (RR: 0.31; 95% CI 0.16-0.59). No differences were found in term of dysphagia requiring reoperation or additional endoscopic procedures (RR: 0.47; 95% CI 0.20-1.09) and postoperative Eckardt score (SMD: -0.42; 95% CI -0.94, 0.11). Blood loss, conversion to open, operative time, and hospital length of stay were comparable.</p><p><strong>Conclusions: </strong>RHM may be associated with a reduced risk of EP compared to LHM. However, because of selection bias, diverse surgeon expertise, variations in surgical technique, and prior endoscopic procedures these findings should not be viewed as conclusive while the superiority of one approach over the other remains to be established.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"75"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for blood transfusion in patients undergoing hysterectomy for stage I endometrial cancer.","authors":"Abdelrahman Yousif, Hatem S Mohamed, Anna Woodham, Mohanad Elchouemi, IIana Chefetz","doi":"10.1007/s00423-025-03629-4","DOIUrl":"10.1007/s00423-025-03629-4","url":null,"abstract":"<p><strong>Purpose: </strong>To highlight the risk factors contributing to blood transfusion among patients undergoing surgical intervention for Stage I Endometrial Cancer (EC).</p><p><strong>Method: </strong>Using the American College of Surgeons National Surgical Quality Improvement Program database, a nationally validated database dedicated to improving surgical care, females over the age of 18 who underwent surgery for EC stage I between the years 2016-2022 were queried. The cohort was then characterized based on those who received blood transfusion 72 h postoperatively.</p><p><strong>Results: </strong>27,183 patients with endometrial cancer who received surgical management were identified. 668 (2.5%) of those patients received blood transfusions. A multivariate logistic model found that a medical factor low preoperative Hct % (aOR 22.4, 95% CI[17.7, 28.3]; p < 0.001) and surgical factors such as 180 min or more of operative time (aOR 3.38, 95% CI[2.77, 4.14]; p < 0.001), larger uteri of 250-500 g (aOR 1.93, 95% CI[1.48, 2.49]; p < 0.001) and ≥ 500 g (aOR 2.35, 95% CI[1.77, 3.12]; p < 0.001), and abdominal approach compared to laparoscopic (aOR 6.36,95% CI[4.95, 8.18]; p < 0.001) were significantly associated with receiving blood transfusion.</p><p><strong>Conclusion: </strong>Many significant risk factors were found to be associated with blood transfusions in patients with Stage I endometrial cancer. These findings allow surgeons to proactively prepare adequate measures for patients who may require blood transfusions when they undergo surgery for endometrial cancer.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"72"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal surgeons' perspectives on the efficacy of intraoperative bowel perfusion technology with a focus on indocyanine green fluorescence angiography.","authors":"Ashokkumar Singaravelu, Philip D Mc Entee, Patrick A Boland, Alice Moynihan, Cathleen McCarrick, Alexander L Vahrmeijer, Alberto Arezzo, Luigi Boni, Roel Hompes, Ronan A Cahill","doi":"10.1007/s00423-025-03640-9","DOIUrl":"10.1007/s00423-025-03640-9","url":null,"abstract":"<p><strong>Background: </strong>Level one evidence supports indocyanine green fluorescence angiography (ICGFA) use reducing anastomotic leak rates in colorectal surgery. We surveyed surgeons exploring perceptions and factors affecting its use in daily practice and adoption as routine standard of care.</p><p><strong>Methods: </strong>Validated electronic survey distributed via the Irish Association of Coloproctology, Royal College of Surgeons in Ireland, European Society of Surgical Oncology, European Association for Endoscopic Surgery, Milan Colorectal Congress and social media.</p><p><strong>Results: </strong>200 colorectal surgeons (143 consultants) responded. 147 (73.5%) surgeons already use ICGFA, with 90 (61.2%) using it routinely and 69 (46.9%) having a concomitant research interest. Strong clinical evidence base (83.5%) and protocol standardisation (78%) were overall rated most important for bowel perfusion technology with a majority of surgeons rating lack of standardisation and inter-user variability as challenges (similar between consultants and non-consultants). Lack of training and staff, reliability concerns and data security were perceived as significant barriers by selective users compared to non-users, and cost and operating time were perceived as significant barriers by selective users compared to routine users. Most surgeons (41.5%) ideated a number needed to treat (NNT) between 20 and 40 acceptable to advocate routine ICGFA use with 28% requiring a NNT < 20. Most surgeons (38.5%) indicate a per case cost savings of €250-500 supports routine use with 17% advocating it > €750.</p><p><strong>Conclusions: </strong>With now a strong evidence base regarding clinical benefit, the survey respondents articulate remaining challenges for ICGFA as standard of care. Levels of expected benefit are largely in keeping with its reported performance.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"73"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open versus laparoscopic oncologic resection for gallbladder cancer after index cholecystectomy: international multicenter comparative study.","authors":"Łukasz Masior, Maciej Krasnodębski, Emilia Kruk, Martín de Santibañes, Pedro Uad, Juan Ramos, Michał Pędziwiatr, Wojciech Serednicki, Gilton Marques Fonseca, Paulo Herman, Robert P Sutcliffe, Ravi Marudanayagam, Alessandro Parente, Arianeb Mehrabi, Ali Ramouz, Peter Lodge, Keyur Shah, Hauke Lang, Constantin Scholz, Ganesh Gunasekaran, Nazanin Khajoueinejad, Samantha Troob, Marek Krawczyk, Michał Grąt","doi":"10.1007/s00423-025-03643-6","DOIUrl":"10.1007/s00423-025-03643-6","url":null,"abstract":"<p><strong>Background: </strong>Liver resection and lymphadenectomy is a standard procedure in patients with incidental gallbladder cancer. Data regarding laparoscopic approach in this setting are scarce. The aim of this study was to compare laparoscopic and open approach in this population.</p><p><strong>Methods: </strong>This was a multicenter retrospective study including 177 patients. The primary outcome measure was overall survival (OS). The secondary outcomes measures were recurrence-free survival (RFS), lymph node yield, operative time, postoperative complications and length of hospital stay.</p><p><strong>Results: </strong>Surgery was laparoscopic in 60 (33.9%), including 18 conversions (30.0%). By intention to treat analysis, 3 and 5 year OS were 72.1% and 51.8% after laparoscopic surgery compared to 62.8% and 36.2% after open surgery (p = 0.201). 3- and 5-year RFS were 29.1% and 19.4% after laparoscopic surgery and 28.7% and 19.1% after open surgery (p = 0.697). Severe (grade ≥ 3 ) complications (p = 0.032) and Comprehensive Complication Index (CCI; p = 0.027) were both significantly higher after laparoscopic surgery (p = 0.032), although length of hospital stay was significantly shorter after laparoscopic procedures both on intention-to-treat (median 6 vs. 8 days; p = 0.004) and per protocol analysis (median 6 vs. 8 days; p = 0.004).</p><p><strong>Conclusions: </strong>Laparoscopic approach is feasible in patients with gallbladder cancer and may shorten the duration of hospital stay.</p><p><strong>Synopsis: </strong>This retrospective cohort study suggests that laparoscopic liver resection is feasible in patients with gallbladder cancer and may shorten the duration of hospital stay. Minimally invasive procedures should be performed by surgeons experienced in laparoscopic liver surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"74"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of cerebrospinal fluid diversion in patients with intracranial germinoma at Ramathibodi Hospital.","authors":"Wasawat Muninthorn, Wattana Mahattanakul, Siriwut Pokanan, Atthaporn Boongird, Tanaporn Jaroenngarmsamer, Ake Hansasuta","doi":"10.1007/s00423-025-03631-w","DOIUrl":"10.1007/s00423-025-03631-w","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial germinoma has a favorable prognosis with modern therapies, but the long-term outcome of cerebrospinal fluid (CSF) diversion for its associated hydrocephalus has been rarely focused on.</p><p><strong>Purpose: </strong>To evaluate the long-term success of CSF diversion methods-endoscopic third ventriculostomy (ETV) versus ventriculoperitoneal (VP) shunt-in intracranial germinoma patients.</p><p><strong>Methods: </strong>Only pure intracranial germinomas with obstructive hydrocephalus and a minimum follow-up duration of 24 months were retrospectively reviewed. Their demographics, as well as pre-and postoperative data, were recorded. Patients were stratified into the ETV and the non-ETV groups and subsequently compared to determine the longevity and morbidity related to the procedures. Factors associated with the failure of CSF diversion were examined.</p><p><strong>Results: </strong>From 1993 to 2022, eighty-three pathologically confirmed intracranial germinomas were identified. Excluding four cases of mixed pathology, eight with incomplete data, and two with insufficient follow-up, we enrolled 69 eligible patients for analysis. Among them, forty-three cases with obstructive hydrocephalus were classified into the ETV (n = 22) and non-ETV (n = 21) groups. No intraoperative or immediate postoperative complications occurred. With a median follow-up of 101 months (IQR 77.75-139.75), the ETV group had no failures. In the non-ETV cohort (median follow-up 144 months (IQR 97-210)), two VP shunt cases (9.5%) required revision due to blockage, and two patients (9.5%) experienced transient over-drainage. These 4 patients were without long-term difficulty despite short-term cumbersome events. No significant factors predicting CSF diversion failure were identified. To date, all 43 patients are alive without metastases, maintaining a good quality of life.</p><p><strong>Conclusion: </strong>This study highlights ETV as a preferred CSF diversion method in pure intracranial germinoma, achieving 100% success without morbidity. Apart from simultaneous biopsy, avoiding a separate operation, this approach eliminates shunt-related complications, ensuring long-term quality of life in patients with extraordinary prognoses from modern chemo- and radiotherapy.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"70"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of three subtypes of thyroid cancer based on IFN-γ-related genes to reveal their prognostic characteristics.","authors":"Fang Huang, Qian Sui, Ke Li","doi":"10.1007/s00423-025-03623-w","DOIUrl":"10.1007/s00423-025-03623-w","url":null,"abstract":"<p><strong>Background: </strong>Thyroid cancer is one of the deadliest malignancies. Increasing evidence suggests that interferon-γ (IFN-γ) plays an important role in anti-tumor immunity and its treatment. However, the effectiveness of classifying, predicting prognosis, and immunotherapy for thyroid cancer based on IFN-γ-related genes has not been discovered.</p><p><strong>Methods: </strong>We used the Gene Set Enrichment Analysis (GSEA) database to obtain IFN-γ-related genes and classified thyroid cancer patients from The Cancer Genome Atlas (TCGA). We systematically explored the differences among various thyroid cancer subtypes from multiple perspectives, such as Kaplan-Meier survival analysis, tumor mutation analysis, immune analysis, enrichment analysis, and drug sensitivity analysis. Finally, we screened some potential drugs suitable for each population.</p><p><strong>Results: </strong>Through clustering analysis, we obtained three thyroid cancer subtypes with different IFN-γ-related gene expression levels. The survival analysis results showed significant survival differences among these three subtypes. In addition, gene mutation analysis in different subtypes found that BRAF, TTN, and TG were the top three genes with the highest mutation frequency in the three subtypes, which may be related to their prognosis. Cluster 1 and cluster 2 were the two subtypes with the greatest difference in immune cell infiltration levels, and the differentially expressed genes were mainly enriched in immune-related biological processes or signaling pathways such as leukocyte-mediated immunity, regulation of T cell activation, and chemokine signaling pathway. Eighteen compounds such as Cyclopamine, Erlotinib, FH535, Imatinib, and A-770,041 were selected as potential therapeutic drugs in this study, and their sensitivity to different subtypes varied.</p><p><strong>Conclusion: </strong>Based on bioinformatics analysis, we discovered a new classification method based on IFN-γ genes, which could divide thyroid cancer patients into three populations with significant characteristics. Different populations had different mutation patterns, immune infiltration levels, and candidate therapeutic drugs.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"69"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of metabolic and bariatric surgery outcomes and complications in patients under and over 50 years of age.","authors":"Alireza Rezapanah, Parisa Ebrahimi, Hamzeh Sherafati, Amin Dalili, Ali Jangjoo, Maryam Emadzadeh, Pooyan Parhizgar","doi":"10.1007/s00423-025-03644-5","DOIUrl":"10.1007/s00423-025-03644-5","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of obesity is increasing globally, necessitating effective treatment strategies. The effectiveness of Metabolic and Bariatric surgery (MBS) as a therapeutic option across different age groups remains debated. This study aimed to compare the outcomes and complications of MBS in patients less than 50 years old and 50 years or older.</p><p><strong>Methods and materials: </strong>This retrospective study analyzed data from patients who underwent MBS in a referral hospital in Mashhad, Iran, between April 2012 and March 2017. The recorded follow-up information was included for patients with at least six months post-surgery.</p><p><strong>Results: </strong>The study included 709 patients, 519 patients aged ≤ 50 years, and 190 patients > 50. The average age, weight, and BMI of the participants were 42.7 ± 13.24 years, 126.6 ± 31.23 kg, and 47.2 ± 10.37 kg/m2, respectively. Both age groups demonstrated significant improvements in BMI, cholesterol, and TG levels post-surgery, while significant improvements in FBS levels were observed only in the younger group (p < 0.05). Overall, substantial reductions in the prevalence of obesity-related comorbidity were observed in both age groups post-surgery (p < 0.05). None of the post-surgical complications had a statistically significant difference between the two age groups (p > 0.05).</p><p><strong>Conclusion: </strong>MBS is effective in reducing obesity-related comorbidities, regardless of age. Age should not be a limiting factor for MBS, as the benefits and complications do not differ significantly between patients under and over 50 years old.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"71"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparity in endoscopic localisation of early distal colorectal cancers: a retrospective cohort analysis from a single institution.","authors":"Aiswarya Sukumar, Shafquat Zaman, Omar E S Mostafa, Jamie Patel, Akinfemi Akingboye, Peter Waterland","doi":"10.1007/s00423-025-03642-7","DOIUrl":"10.1007/s00423-025-03642-7","url":null,"abstract":"<p><strong>Background: </strong>Accurate staging of distal colorectal cancers is paramount in guiding neoadjuvant therapy, peri-operative, and ostomy planning. Early colonic lesions can be difficult to visualise on computed tomography (CT) scans, with tumour location solely deduced via endoscopy with the potential for introducing error. We aimed to address the paucity in literature in this area and assessed the accuracy of radiological and endoscopic localisation of distal colorectal cancers.</p><p><strong>Methods: </strong>Retrospective analysis of an electronic database of patients at a large District General Hospital (DGH) diagnosed with distal colorectal cancer between January 2014 to January 2023 was performed. Patient demographics, investigations, endoscopic, and operative findings were analysed. Outcomes were assessed to determine disparities between pre-operative endoscopy and final tumour location.</p><p><strong>Results: </strong>A total of 212 patients were endoscopically diagnosed with distal sigmoid tumour. Of these, 207 (97.6%) had a CT scan performed with 25.1% (52/207) lesions not being identified on this imaging modality with the remainder (74.9%; 155/207) being reported as visible. 38.2% (79/207) of tumours were in the sigmoid colon, 17.4% (36/207) rectosigmoid, and 19.3% (40/207) in the rectum. Pre-operative magnetic resonance imaging (MRI) was performed in 42.5% (90/212) of cases showing 84 tumours: 6.0% (5/84) sigmoid colon, 9.5% (8/84) rectosigmoid and 83.3% (70/84) rectal cancers (upper: 34, mid-rectum: 26, low: 10), with one anal cancer. 42.3% (22/52) of patients with non-visible lesions on CT had MRI scans: 68.2% (15/22) had rectal cancer (upper: 10, mid-rectum: 4, low: 1). Of the 30 where MRI was not performed, 46.7% (14) had sigmoid cancer, 16.7% (5) rectosigmoid, and 33.3% (10) rectal intraoperatively. Overall, 30.7% (65/212) of patients reported as having a distal sigmoid lesion endoscopically in fact had rectal cancer intra-operatively (rectosigmoid lesions excluded).</p><p><strong>Conclusion: </strong>Endoscopic localisation of distal colorectal tumours can be unreliable for accurate staging and operative planning. A pre-operative MRI scan should be considered in such instances, and particularly for non-visible lesions on CT scan. This may improve peri-operative planning, staging accuracy and patient outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"68"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}