Langenbeck's Archives of Surgery最新文献

{"title":"Intraoperative hemodynamic management during pancreatoduodenectomy - an analysis of 525 patients.","authors":"Maximilian Dietrich, Tobias Hölle, Mattia Piredda, Manuel Feißt, Patrick Rehn, Maik von der Forst, Dania Fischer, Thilo Hackert, Jan Larmann, Christoph W Michalski, Markus A Weigand, Martin Loos, Felix C F Schmitt","doi":"10.1007/s00423-025-03669-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03669-w","url":null,"abstract":"<p><strong>Importance: </strong>Optimization of perioperative hemodynamic management during major pancreatic surgery can reduce postoperative complications.</p><p><strong>Objective: </strong>In this study, we aimed to investigate the effect of intraoperative hemodynamic management, in consideration of both anesthesiologic and surgery-related aspects on major short-term complications following partial pancreatoduodenectomy (PD).</p><p><strong>Design, setting and participants: </strong>Data of 525 patients undergoing PD between January 2017 and December 2018 at the Heidelberg University Hospital were retrospectively analyzed.</p><p><strong>Main outcomes and measures: </strong>Primary outcome was a composite of 90-day mortality, pancreatic fistula and completion pancreatectomy. Logistic regression was performed to estimate the impact of anesthesiologic and surgical factors. Furthermore, patients were stratified by the amount of fluid administered intraoperatively and the maximum catecholamine dose to examine the impact on the primary endpoint.</p><p><strong>Results: </strong>Using logistic regression analysis we demonstrated that epidural anesthesia was associated with a reduction in the occurrence of the combined endpoint (OR 0.568; CI 0.331-0.973), this effect was primarily driven by a lower rate of completion pancreatectomy. The intraoperative administration of fresh frozen plasma (FFP) doubled the odds of the occurrence of the primary endpoint (OR 2.238; CI 1.290-3.882). The comparison of patients with and without FFP transfusion showed that all components of the primary endpoint were more frequent in the FFP group. Complication rates in the stratified fluid groups showed a U-shaped curve with the least amount of complications in patients who received 6.5 to 8 ml/kg/h of intraoperative fluid. The comparison of maximum norepinephrine doses revealed the same pattern with the least complication rate in the low-intermediate dose range (0.05-0.08 µg/kg/min and 0.08-0.11 µg/kg/min).</p><p><strong>Conclusions and relevance: </strong>Epidural anesthesia had a beneficial effect on the rate of major surgical complications following PD, whereas intraoperative FFP transfusion showed a negative association. Intraoperative hemodynamic management appears to have a major impact on perioperative mortality and morbidity with a U-shaped relation for both fluid and vasopressor dose.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"123"},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811707","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":"Efficacy of arthroscopic cartilage transplantation combined with platelet-rich plasma in the treatment of early knee osteoarthritis: a retrospective cohort study.","authors":"Xin Li, Yuefu Dong, Jian Liu, Weidong He, Chen Yan, Jian Zhang","doi":"10.1007/s00423-025-03690-z","DOIUrl":"10.1007/s00423-025-03690-z","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a common degenerative disease that leads to functional decline in the knee joint and a significant reduction in quality of life. Arthroscopic cartilage transplantation combined with platelet-rich plasma (ACT-PRP) has emerged as a novel treatment method and is gradually being applied to patients with early KOA. This study aimed to evaluate the therapeutic efficacy of ACT-PRP compared to conventional conservative treatment.</p><p><strong>Methods: </strong>Patients diagnosed with KOA who were treated in the Department of Orthopedics at the First People's Hospital of Lianyungang from January 2020 to January 2022 were included in the study. Patients were divided into two groups: the ACT-PRP group, receiving arthroscopic cartilage transplantation combined with PRP, and the conservative treatment group, receiving standard conservative treatment. All patients were followed for six months, and knee function and pain relief were assessed using the Lysholm score, IKDC score, KOOS, and VAS.</p><p><strong>Results: </strong>A total of 113 patients were enrolled, with 43 in the ACT-PRP group and 70 in the conservative treatment group. Baseline characteristics showed no significant differences (P > 0.05). At the final follow-up, the ACT-PRP group showed greater improvements in knee function and pain relief compared to the conservative treatment group, with significantly higher Lysholm score (P < 0.001), IKDC score (P < 0.001), and KOOS (P < 0.001), and lower VAS (P < 0.001). These findings suggest the ACT-PRP approach is more effective for early knee osteoarthritis.</p><p><strong>Conclusions: </strong>Arthroscopic cartilage transplantation combined with platelet-rich plasma is significantly superior to conventional conservative treatment in improving knee function, alleviating pain, and enhancing patient satisfaction, making it a recommended option for early KOA.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"122"},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795777","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":"The optimal number of lymph node dissections in three-field lymphadenectomy for esophageal squamous cell carcinoma: a large retrospective study.","authors":"Huaiyuan Zhang, Jun-Peng Lin, Xiao-Feng Chen, Feng Wang","doi":"10.1007/s00423-025-03686-9","DOIUrl":"10.1007/s00423-025-03686-9","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is no consensus on the optimal number of lymph node dissections (LNDs) in three-field lymphadenectomy for esophageal squamous cell carcinoma (ESCC). This study aimed to explore the relationship between the LND count and overall survival (OS) in ESCC patients to determine the optimal number of LNDs that confer a survival benefit.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on ESCC patients who underwent three-field lymphadenectomy at Fujian Cancer Hospital from February 2004 to January 2018. The optimal LND number was determined using X-Tile software. Kaplan‒Meier survival curves and Cox regression analyses were used to evaluate the relationship between LND count and OS.</p><p><strong>Results: </strong>A total of 1053 ESCC patients who underwent three-field lymphadenectomy were included in this study (median age 58 years [IQR: 52-65], 781 males [74.2%]). Using X-Tile software, 27 was identified as the optimal cutoff value for the number of LNDs. The 5-year OS for the > 27 LNDs group was significantly better than that for the ≤ 27 LNDs group (67.8% vs. 59.8%, P = 0.042). Multivariate Cox regression analysis confirmed that LND count (≤ 27 and > 27) was an independent protective factor for OS (HR = 0.724; P = 0.004). Stratified analysis on the basis of TNM stage revealed that in patients with T3-4N0M0 disease (HR = 0.412; P = 0.001) and T1-2 N + M0 disease (HR = 0.503; P = 0.025), a greater number of dissected lymph nodes was closely associated with a survival benefit.</p><p><strong>Conclusion: </strong>For ESCC patients undergoing three-field lymphadenectomy, dissecting more than 27 lymph nodes is associated with better prognosis, especially for patients with T3-4N0M0 and T1-2 N + M0 stages.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"121"},"PeriodicalIF":2.1,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788376","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":"The effect of pre-operative MRI on the in-breast tumor recurrence rate of patients with breast cancer: a meta-analysis.","authors":"Mahdieh Khoshzaban Banisi, Hani Ghadri, Behnaz Soltani, Amirali Farshid, Bahar Behnam, Amir Abbas Rhouholamini, Amirhossein Mohammadi, Seyedeh Fatemeh Hamzavi, Ashkan Azizi, Niloofar Deravi, Masoud Noroozi, Amin Magsudy, Sina Seyedipour, Shima Behzad, Yaser Khakpour","doi":"10.1007/s00423-025-03691-y","DOIUrl":"10.1007/s00423-025-03691-y","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of preoperative MRI on breast cancer recurrence and long-term outcomes remains undefined. Therefore, this study aims at determining the influence of preoperative MRI on in-breast tumor recurrence rates in cases of surgical treatment for breast cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed. Literature searches of PubMed, Scopus, and Google Scholar were conducted for studies up to February 2024. Two authors assessed the quality of the eligible studies and extracted their data.</p><p><strong>Results: </strong>The meta-analysis included 14 studies (2 RCTs, 12 cohort studies) with 12,889 patients with 5,451 undergoing preoperative MRI. Pooled hazard ratio for in-breast tumor recurrence was 0.95, using fixed effects and 0.94 using random effects models with 95% confidence intervals of 0.80-1.14 and 0.77-1.14, respectively. A trend towards lower recurrence rates in the MRI group was seen, but the reduction was not statistically significant.</p><p><strong>Conclusion: </strong>This meta-analysis found no significant reduction in in-breast tumor recurrence rates associated with preoperative MRI use in breast cancer patients, consistent with previous findings.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"120"},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780407","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":"Portal vein reconstruction with bovine pericardium: a comparative analysis of postoperative outcomes in pancreatic surgery.","authors":"Silvan Patalong, Annatina Weber, Elena Krombholz, Michael Frey, Dominique Sülberg, Andrea Wirsching, Antonio Nocito","doi":"10.1007/s00423-025-03689-6","DOIUrl":"10.1007/s00423-025-03689-6","url":null,"abstract":"<p><strong>Purpose: </strong>Extended pancreatic resections with venous reconstruction are increasingly performed for borderline resectable pancreatic cancer. Various venous reconstruction techniques have been described. At our center, reconstruction is performed using bovine pericardium patches. So far, few studies reported outcomes using this technique in the field of pancreatic surgery.</p><p><strong>Methods: </strong>Data of consecutive pancreatoduodenectomies between January 1st 2015 and December 31st 2023 were analyzed retrospectively. Postoperative complications were graded by the Clavien-Dindo Classification, Comprehensive Complication Index (CCI) and complications specific to pancreatic resections as recommended and published by the International Study Group of Pancreatic Surgery (ISGPS).</p><p><strong>Results: </strong>Pancreatoduodenectomy included portal vein resection (PVR) in 23 patients compared to 95 patients without PVR. Patient age and comorbidities were similarly distributed between groups. Pancreatic adenocarcinoma was more prevalent in the PVR-group compared to no-PVR (87% vs. 58%, p = 0.009). Operation time and blood loss were both increased with PVR (median: 416 min vs. 315 min and 300 ml vs. 150 ml, p < 0.001 for both comparisons). Within ISGPS defined complications, grade B delayed gastric emptying and grade A postoperative hemorrhage were increased with PVR (N = 22 vs. N = 1, p = 0.001 and N = 13 vs. N = 0, p = 0.007). All other ISGPS complications, overall complications, CCI, 30-day and 90-day mortality were similar between groups. Out of 23 patients with PVR, early and late thrombosis occurred in one patient each.</p><p><strong>Conclusion: </strong>Portal vein reconstruction with bovine pericardium is feasible with comparable overall morbidity and mortality compared to pancreatoduodenectomy without PVR.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"118"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772583","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":"Evaluation of the validity of pancreatoduodenectomy in older patients with distal cholangiocarcinoma in terms of recurrence.","authors":"Wataru Izumo, Hiromichi Kawaida, Ryo Saito, Yuki Nakata, Hidetake Amemiya, Yudai Higuchi, Takashi Nakayama, Kazunori Takahashi, Suguru Maruyama, Koichi Takiguchi, Katsutoshi Shoda, Kensuke Shiraishi, Shinji Furuya, Yoshihiko Kawaguchi, Daisuke Ichikawa","doi":"10.1007/s00423-025-03694-9","DOIUrl":"10.1007/s00423-025-03694-9","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study investigated the validity of pancreatoduodenectomy (PD) with regard to recurrence in older patients with distal cholangiocarcinoma (DC).</p><p><strong>Methods: </strong>We compared 28 patients aged ≥ 75 years and 65 patients aged < 75 years who underwent PD for DC, and evaluated the relationship between age, clinicopathological factors, and outcomes.</p><p><strong>Results: </strong>Postoperative mortality and morbidity rates did not differ between the groups. Although there were no significant differences in 5-year recurrence, disease-specific survival, and overall survival rates between the groups (45.4, 58.1, and 51.7% in patients ≥ 75 years and 50.3%, 62.7%, and 58.1% in patients < 75 years; P = 0.73, 0.44, and 0.24, respectively), the median time from recurrence to death (RTD) in older patients was significantly shorter than that in younger patients (0.5 years vs. 1.3 years, P = 0.013). In multivariate analysis, age ≥ 75 years (hazard ratio [HR]: 3.0), controlling nutritional status (CONUT) score ≥ 4 (HR: 2.5), poorly-differentiated adenocarcinoma or adenosquamous carcinoma (HR: 3.2), and failure to implement treatment after recurrence (HR: 5.3) were independent risk factors for a short time from RTD. Furthermore, at the time of recurrence, older patients had significantly poorer serum albumin levels, prognostic nutrition index, Glasgow prognostic score, and CONUT score. Age ≥ 75 years (odds ratio: 0.19) was an independent risk factor for implementation of treatment after recurrence.</p><p><strong>Conclusions: </strong>PD in older patients may be acceptable; however, the median time from RTD was shorter owing to lower nutritional status and rates of treatment implementation after recurrence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"119"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772649","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":"Recurrence patterns and management of locally recurrent rectal cancer: a retrospective cohort study.","authors":"P Hakenberg, G Kalev, S Seyfried, C Reißfelder, J Hardt","doi":"10.1007/s00423-025-03692-x","DOIUrl":"10.1007/s00423-025-03692-x","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of locally recurrent rectal cancer (LRRC) is still challenging because of inhomogeneous patient cohorts regarding previous treatments as well as different recurrence patterns and locations. The aim of this study was to investigate the treatments and surgical approaches tailored to them.</p><p><strong>Methods: </strong>We included all patients who were treated for LRRC without distant metastasis at the University Medical Center Mannheim, Germany, between 2010 and 2021. We collected data from our electronic clinical data management system regarding the initial diagnosis and treatment, as well as the locations and treatment of the recurrent tumor.</p><p><strong>Results: </strong>We identified a total of 666 patients who were curatively treated for rectal cancer of whom 36 patients (5.4%) developed LRRC without distant recurrence. Most patients (26/36) had a tailored therapy regimen that included surgery with or without perioperative radiation and/or chemotherapy. The most common site of local relapse was around the former colorectal anastomosis (15/36, 41.7%). The operative procedures ranged from anterior resection to multi-organ resection and exenteration. A complete resection (R0) could be achieved in twelve patients (12/22. 54.5%). The 3- and 5-year overall survival rates were 79% and 72%, respectively.</p><p><strong>Conclusion: </strong>Most local recurrences occur at the anastomotic site and are mostly eligible for curative surgical therapy with good long-term survival.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"116"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764296","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":"Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.","authors":"Guadagni Simone, Comandatore Annalisa, Furbetta Niccolò, Di Franco Gregorio, Bechini Bianca, Vagelli Filippo, Ramacciotti Niccolò, Gaeta Raffaele, Pollina Luca Emanuele, Palmeri Matteo, Di Candio Giulio, Morelli Luca","doi":"10.1007/s00423-025-03684-x","DOIUrl":"10.1007/s00423-025-03684-x","url":null,"abstract":"<p><strong>Background: </strong>High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.</p><p><strong>Methods: </strong>Data from all patients undergoing EGs-ITA from January 2013 to June 2023 were collected from an institutional database and retrospectively analyzed. Additionally, data on the volume of all MOSs performed in the same 10-year period were retrieved.</p><p><strong>Results: </strong>This study included 32 patients, averaging three EGs-ITA performed annually. The anastomotic leak rate was 6.2%. The median hospital stay was 12 days, and 30- and 90-day mortality rates were 3.1% and 6.2%, respectively. The mean harvested lymph nodes were 26.3 ± 10.2. Re-admission and locoregional recurrence occurred in 6.2% and 9.3% of patients, respectively. During the study period, the surgical team managed over 400 MOSs annually.</p><p><strong>Conclusion: </strong>Exposure to high volume and broad range of MOSs appears beneficial for achieving favorable outcomes in esophagogastric junction and distal esophageal cancer surgeries, even in centers with lower volumes of these specific procedures. This finding underscores the potential for excellent surgical results in settings with substantial overall volumes in major oncologic procedures, as an alternative to high-volume specialization in a single surgery type.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"115"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764289","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":"Insufficient weight loss after bariatric surgery and its predictors: Tehran Obesity Treatment Study (TOTS).","authors":"Minoo Heidari Almasi, Maryam Barzin, Maryam Mahdavi, Alireza Khalaj, Danial Ebrahimi, Majid Valizadeh, Farhad Hosseinpanah","doi":"10.1007/s00423-025-03682-z","DOIUrl":"10.1007/s00423-025-03682-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the factors related to insufficient weight loss (IWL) following bariatric surgery.</p><p><strong>Methods: </strong>The data for 3456 individuals who had bariatric surgery were obtained prospectively. A bioelectrical impedance analyzer was used to measure body composition changes and compare them between the sufficient (SWL) and IWL groups. The generalized estimated equation approach was used to assess changes in fat mass (FM), fat-free mass (FFM), FFM loss/weight loss percentage (FFML/WL%), and excess weight loss percentage (EWL%). Multivariate logistic regression models were used for IWL to establish independent baseline factors.</p><p><strong>Results: </strong>IWL was recorded in 8% of the cases. The data analysis revealed substantial differences in the changes in FM%, FFM%, FFML/WL%, and EWL% between the SWL and IWL groups after six months of follow-up. The IWL group demonstrated a greater FFML/WL% (Ptime before & after 6 months < 0.05). An older age, a higher baseline BMI, diabetes mellitus (DM), non-smoking, and sleeve gastrectomy (SG) were the predictors of IWL.</p><p><strong>Conclusion: </strong>the significant predictors of IWL included older age, a higher baseline BMI, DM, SG, and non-smoking.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"114"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764293","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":"Transarterial embolization of gastroduodenal peptic ulcer bleeding: a single-center study of safety and efficacy.","authors":"Cihan Ozen, Muhanad Al-Hashimi, Mogens Tornby Stender, Ole Thorlacius-Ussing, Anders Christian Larsen","doi":"10.1007/s00423-025-03695-8","DOIUrl":"10.1007/s00423-025-03695-8","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and efficacy of transarterial embolization (TAE) in patients with bleeding gastroduodenal peptic ulcers with an emphasis on prophylactic TAE (pTAE).</p><p><strong>Methods: </strong>This retrospective cohort study was conducted from 1 January 2010 to 30 June 2022. The primary outcome was rebleeding rate after TAE. Secondary outcomes were frequency and severity of complications, 30-day mortality rate, and overall survival.</p><p><strong>Results: </strong>87 patients were included. The overall rebleeding rate after TAE was 13/87 (15%). The rebleeding rate was non-significantly higher in the therapeutic TAE (tTAE) group (31%) when compared to the pTAE group (12%). Minor complications were observed in 14/87 patients (16%) and severe complications were observed in 6/87 patients (7%). The complication rate did not differ between the tTAE and pTAE groups. The 30-day overall mortality rate was 19/87 (22%). The 30-day mortality rate was non-significantly higher in the tTAE-group (31%) when compared to the pTAE group (20%). Of the 19 mortalities within 30-days, three were considered procedure-related. The overall median survival rate was 21 months (95% CI: 9.8 - 31). A non-significant higher median survival of 46.7 months (95% CI 1.2 - 74.9) was observed in the tTAE group when compared to 20.5 months (95% CI 7.1-29.1) in the pTAE group.</p><p><strong>Conclusion: </strong>TAE is safe and efficient but is associated with a high 30-day mortality rate and poor overall survival owing to a high burden of comorbidity and disease-related rather than TAE-related complications. Further studies are needed to clarify the gain and selection criteria for pTAE.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"117"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772587","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}