Langenbeck's Archives of Surgery最新文献

{"title":"Open abdomen versus primary closure in the management of severe abdominal sepsis: What is the right way? Results of the last 5 years of a reference center.","authors":"Tommaso Guagni, P Prosperi, M Marzano, A Falcone, Matteo Bussotti, C Bergamini, M Mastronardi, A Giordano","doi":"10.1007/s00423-025-03693-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03693-w","url":null,"abstract":"<p><strong>Purpose: </strong>WSES guidelines allow open abdomen (OA) for critically ill patients due to secondary peritonitis in the case of inadequate source control, but this option results quite vague and with a low grade of evidence (Grade 2 C). Moreover, the emerging increasing in literature of complications, makes the use of OA in secondary peritonitis more debated. The aim of our study is to analyze the postoperative outcomes of patients undergoing OA versus primary closure (PC) in secondary peritonitis.</p><p><strong>Methods: </strong>We collected data from Tertiary Trauma Center from 2019 to 2024. The study included patients who underwent urgent laparotomy for severe secondary peritonitis, divided into two groups based on the strategy chosen in the index laparotomy: PC or OA. We retrospectively analyzed the data, considering as primary outcome post-operative mortality, while as secondary outcomes short terms complications and LOS.</p><p><strong>Results: </strong>283 patients fit the research for the diagnosis of peritonitis but only 176 were included as with a WSES-SSS > = 7. 128 patients (72,7%) were in the PC group, while 48 (27,3%) were managed with an OA strategy. There were no statistical differences in terms of mortality (p = 0.371), between the two groups. Complications were higher in the OA group (p = 0.001). From the logistic regression only MPI resulted an independent factor of mortality (p = 0.016; OR 1.080).</p><p><strong>Conclusion: </strong>The study shows that OA in severe secondary peritonitis does not improve mortality and is associated with higher short-term complications and incisional hernias. However, RCT are necessary to better investigate the role of OA in the management of abdominal sepsis.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"147"},"PeriodicalIF":2.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971295","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":"Comparison of outcomes of laparoscopic vs. robotic surgical resection of pancreatic neuroendocrine tumors: a systematic review and meta-analysis.","authors":"Deepti Singh, Manya Prasad, Bharat Yalla, Vitish Singla, Puneet Khanna, Asuri Krishna, Om Prakash, Sanjeet Rai, Virinder Kumar Bansal","doi":"10.1007/s00423-025-03662-3","DOIUrl":"https://doi.org/10.1007/s00423-025-03662-3","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms. Minimal access surgery has been the favoured approach for these tumors over the past decade. There is a lack of robust data comparing laparoscopic and robotic pancreatic surgery for PNETs and this has led to the lack of a global conclusion regarding which approach is superior. Thus, we conducted a systematic review and meta-analysis of the available data to compare outcomes following laparoscopic versus robotic pancreatic surgery for pancreatic neuroendocrine tumors.</p><p><strong>Methods: </strong>Studies reporting outcomes of laparoscopic or robotic surgery for pancreatic neuroendocrine tumors were included. Inverse variance and Mantel-Haenszel statistical analysis methods were used for continuous and dichotomous data, respectively. All outcomes were quantitatively analyzed using the random effects model. The risk of bias was assessed using the ROBINS-1 tool.</p><p><strong>Results: </strong>A total of 14 studies with 767 patients were included. The mean difference in the operating time was 21.08 min (95% CI: -4.38, 46.54, I² = 43%), favouring the laparoscopic group. The pooled odds ratio for the rate of formation of the pancreatic fistula was 0.88 (95% CI: 0.54, 1.45, I² = 0%), favouring the robotic group. Blood loss was higher in the laparoscopic group (MD = -89.72 ml, 95% CI:-143.37 to -36.06, I² = 93%). Other parameters, including re-exploration rate, length of hospital stay, R0 resection, rate of conversion, and spleen preservation, were similar in both groups.</p><p><strong>Conclusion: </strong>The robotic approach might be preferable to the laparoscopic approach because of the lower rate of POPF and blood loss. Larger randomised controlled trials are required to ascertain these findings.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"145"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989633","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":"How-I-do-it: a novel technique of portal vein-right gastroepiploic vein side-to-side anastomosis to improve gastric venous congestion following total pancreatectomy: a retrospective cohort study and literature review (with video).","authors":"Kenta Aso, Ryuji Yoshioka, Atsushi Takahashi, Shoichi Irie, Yoshinori Takeda, Yoshihiro Hirata, Takaaki Kato, Hirofumi Ichida, Yoshihito Kotera, Yoshihiro Mise, Akio Saiura","doi":"10.1007/s00423-025-03702-y","DOIUrl":"https://doi.org/10.1007/s00423-025-03702-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study was to evaluate the outcomes and preventive techniques for gastric venous congestion (GVC) following total pancreatectomy (TP), with a focus on gastric venous drainage reconstruction.</p><p><strong>Methods: </strong>This retrospective single-center study included patients who underwent TP between January 2019 and June 2024, encompassing both primary one-step TP and planned elective completion pancreatectomy following either pancreatoduodenectomy (PD) or distal pancreatectomy (DP). Intraoperative evaluation and reconstruction of gastric venous drainage were performed when GVC was observed. Demographic, clinical, technical, perioperative, and postoperative data were analyzed.</p><p><strong>Results: </strong>Sixteen patients underwent either one-step TP (n = 4) or elective completion pancreatectomy (n = 12), including four following DP and eight following PD. Intraoperative GVC was detected in two patients, necessitating portal vein (PV)-right gastroepiploic vein (RGEV) side-to-side anastomosis. No major complications occurred in these patients, and no GVC was observed during the postoperative follow-up period (mean: 39.8 months, range: 2.1-60.7 months).</p><p><strong>Conclusion: </strong>In cases where preservation of gastric drainage veins is not feasible, PV-RGEV side-to-side anastomosis can be a convenient and useful option to resolve intraoperative GVC.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"146"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023305","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":"Quality of life after endoscopic vs. conventional open thyroidectomy: a systematic review and meta-analysis.","authors":"Vishesh Agrawal, Sanjay Kumar Yadav, Pawan Agarwal, Dhananjaya Sharma, Saroj Kanta Mishra","doi":"10.1007/s00423-025-03616-9","DOIUrl":"10.1007/s00423-025-03616-9","url":null,"abstract":"<p><strong>Background: </strong>We have performed a meta-analysis of studies reporting on Health-related quality of life (QoL) after endoscopic thyroidectomy (ETx) vs. open thyroidectomy (OTx).</p><p><strong>Objectives: </strong>The objective was to evaluate the QoL outcomes of ETx compared to OTx.</p><p><strong>Methods: </strong>Eligibility criteria: Studies comparing ETx vs OTx INFORMATION SOURCES: PubMed, EMBASE, the Cochrane library, and online registers were searched for articles comparing QoL in ETx vs OTx.</p><p><strong>Risk of bias: </strong>Articles were assessed for risk of bias using Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.</p><p><strong>Synthesis of results: </strong>The main summary measures using the random effects model were mean difference (MD).</p><p><strong>Results: </strong>Three studies were included in the meta-analysis.  Two studies compared QoL between Transoral Endoscopic Thyroidectomy vs OTx and one compared Transaxillary Endoscopic Thyroidectomy vs OTx. There were no significant differences in the QoL outcomes using SF-36 scale. Pain scores assessed using the visual analogue scale (VAS) and overall satisfaction were also comparable between ETx and OTx.</p><p><strong>Conclusion: </strong>Our systematic review and meta-analysis indicate that QoL outcomes for ETx and OTx may be comparable based on the currently available evidence. The substantial heterogeneity across studies and the lack of adequately powered trials limit the generalizability of these findings. Future large-scale randomized controlled trials with robust QoL measures, such as ThyPRO-39, are needed to provide higher-quality evidence on the comparative effectiveness of ETx versus OTx.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"144"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971038","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":"Biomarker-guided strategy for Denver peritoneovenous shunts in refractory ascites: a retrospective single-center study.","authors":"Yuhi Shimura, Shohei Komatsu, Yoshimasa Hashimoto, Miho Nishio, Yu Hashimoto, Michihiko Yoshida, Toshihiko Yoshida, Kenji Fukushima, Itsuo Fujita, Takumi Fukumoto","doi":"10.1007/s00423-025-03710-y","DOIUrl":"https://doi.org/10.1007/s00423-025-03710-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the utility of peritoneovenous shunt (PVS) placement for refractory ascites (RA) based on preoperative biomarkers.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with malignant and cirrhotic RA undergoing PVS placement treated at Sumoto Itsuki Hospital between January 2001 and March 2024. The efficacy of PVSs was defined according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). The usefulness of the prognostic nutritional index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and C-reactive protein-to-albumin ratio as prognostic indicators for the efficiency of PVS was evaluated.</p><p><strong>Results: </strong>In total, 149 consecutive patients (malignant RA, n = 100; cirrhotic RA, n = 49) were included in this study. PVS placement satisfied the efficacy criteria for ascites in 102 (68%) patients in the entire cohort. The estimated glomerular filtration rate (eGFR) ≤ 30 mL/min/1.73 m² was an independent predictor for the inefficacy of PVSs (odds ratio: 2.82, 95% CI: 1.04-7.73, P = 0.042). Based on receiver operating characteristic curve and multivariate analysis of the entire cohort, NLR ≥ 5.8 was an independent risk factor for death within 1 week after PVS placement (odds ratio: 18.2, 95% CI: 2.07-29.7, P = 0.016).</p><p><strong>Conclusion: </strong>PVS placement for RA may be a treatment option when preoperative eGFR is > 30 mL/min/1.73 m² and NLR is < 5.8.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"140"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032494","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":"Long-term outcomes of metabolic bariatric surgery: a 10-Year multicenter retrospective study in Poland (BARI-10-POL).","authors":"Natalia Dowgiałło-Gornowicz, Paweł Jaworski, Michał Orłowski, Paula Franczak, Monika Proczko-Stepaniak, Anna Kloczkowska, Izabela Karpińska, Paweł Lech, Piotr Major","doi":"10.1007/s00423-025-03713-9","DOIUrl":"https://doi.org/10.1007/s00423-025-03713-9","url":null,"abstract":"<p><strong>Purpose: </strong>Metabolic bariatric surgery (MBS) is an effective treatment for obesity and obesity-related diseases, but long-term data on its outcomes remain limited, particularly in Poland. These data are crucial for understanding the durability of weight loss, trends in weight regain, and comorbidity remission, as well as for refining surgical techniques and improving long-term care. This study aims to evaluate the 10-year outcomes of MBS in Poland, focusing on weight loss and remission of obesity-related diseases in patients who completed follow-up.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study, named BARI-10-POL, analyzed 485 patients (mean age: 41.0 years, 71.5% female, median BMI: 43.4 kg/m²) who underwent laparoscopic MBS between 2008 and 2014 across five bariatric centers. Data collected included demographics, type of surgery, weight loss (%TWL, %EWL), and remission of type 2 diabetes (T2D) and hypertension (HT).</p><p><strong>Results: </strong>The follow-up rate was 28.5% (485/1703). Among the procedures, 317 (65.4%) were sleeve gastrectomies (SG). The median %EWL and %TWL were 59.2% and 22.8%, respectively. Revisional procedures were required in 23.9% of patients, most commonly after SG (24.3%) and adjustable gastric banding (100%). The remission rates for T2D and HT were 70.8% and 56.7%, respectively. One anastomosis gastric bypass (OAGB) demonstrated superior median %EWL (80.1%) compared to SG (55.0%, p < 0.001) and Roux-en-Y gastric bypass (RYGB) (51.4%, p < 0.001).</p><p><strong>Conclusions: </strong>Conducting long-term follow-up after bariatric surgery is challenging. MBS leads to significant long-term outcomes in both weight loss and remission of obesity-related diseases.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"142"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000828","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 impact of indocyanine green on tumor visualization and procedural adjustment in minimally invasive liver surgery.","authors":"Mareike Franz, Jörg Arend, Antonia Bollensdorf, Eric Lorenz, Mirhasan Rahimli, Frederike Stelter, Manuela Petersen, Andrew A Gumbs, Roland Croner","doi":"10.1007/s00423-025-03712-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03712-w","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive hepatobiliary surgery is performed increasingly either with robotic assistance or conventional laparoscopy. The lack of haptic feedback is one of the main challenges which has to be addressed during these procedures. Especially in oncological minimally invasive liver surgery Indocyanine green (ICG) can help to gain additional information for improved oncological quality.</p><p><strong>Methods: </strong>Patients who underwent minimally invasive liver surgery for liver tumors between 01/2019 and 09/2022 and matched the study criteria were selected from the Magdeburg Registry of Minimally invasive liver surgery (MD-MILS). Patient demographics, tumor characteristics and perioperative data were analyzed retrospectively. The benefit of ICG for tumor identification and the resection procedure was assessed as 'very helpful', 'helpful' and 'not helpful' depending on the surgeon´s estimation.</p><p><strong>Results: </strong>Seventy-two patients who met the selection criteria were included in the analysis. Of these, 49 patients received ICG for intraoperative tumor visualization (ICG). Twenty-three patients with comparable demographics did not receive ICG and served as comparison group (nICG). A total of 69.4% robotic and 30.6% laparoscopic procedures were performed. In the ICG group procedural adjustments were significantly more frequent intraoperatively (p = 0.023). Intraoperative frozen section analysis on additional biopsies of ICG positive lesions were performed in 37% in the ICG group. In the nICG group suspect lesions, identified by ultrasound, went to frozen section in 17% (p = 0.006). Histopathological tumor positivity was identified in 12.2% in the ICG cohort vs no tumor positivity in the nICG cohort. This was one factor which led to the termination of surgery in 8% in the ICG vs the nICG 4.3% group (p = 0.485). In 88% intraoperative ICG visualization was scored as \"helpful\" when injected on preoperative day 4-7 with respect to the liver parenchyma structure and hepatocellular function.</p><p><strong>Conclusion: </strong>ICG can improve oncological quality in minimally invasive liver resections. It provides additional visual information which can help to compensate the loss of haptics and tumor identification during liver tissue palpation. The intraoperative use of ICG was associated with no adverse events and did not prolong operative time. We recommend its routine use during minimally invasive liver surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"143"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020796","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":"Effect of mesh fixation in incisional hernia repair using the open sublay technique: results from the herniamed-registry.","authors":"P Schelbert, R N Vuille-Dit-Bille, F Köckerling, D Adolf, R F Staerkle","doi":"10.1007/s00423-025-03714-8","DOIUrl":"https://doi.org/10.1007/s00423-025-03714-8","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernias reflect a common complication after abdominal surgery. Main treatment consists of defect closure and mesh insertion using the sublay method. The aim of the present study was to assess the association of mesh fixation to patients' outcome.</p><p><strong>Methods: </strong>Using the Herniamed registry, data from 13'452 incisional hernia repairs were analyzed retrospectively. Three groups of patients were compared: those with mesh fixation (n = 9'986), those with self-fixing meshes (n = 2'725), and those without mesh fixation (n = 741). Postoperative complications, recurrence and postoperative pain scores were assessed over a follow-up period of one year postoperatively.</p><p><strong>Results: </strong>Taking into account that patients without mesh fixation had smaller defects and were treated with smaller meshes indicating non-equivalent groups, postoperative complications (general, intra- and postoperative complications, as well as complication-related reoperations), were similar among groups except that self-fixing meshes showed a lower general complication rate compared to fixed meshes (OR = 0.733 [0.579; 0.929]; p = 0.010). Mesh fixation had no relation to recurrence rate. Self-fixating meshes were associated with increased pain at rest rate (OR = 1.325 [1.156; 1.518]; p < 0.001), pain on exertion rate (OR = 1.255 [1.125; 1.400], p < 0.001) and chronic pain requiring treatment (OR = 1.271 [1.086; 1.488], p = 0.003) compared to fixed meshes. Self-fixating (OR = 1.675 [1.322; 2.120], p < 0.001) and fixed meshes (OR = 1.334 [1.069; 1.666], p = 0.011) were associated to increased pain on exertion rate compared to non-fixed meshes.</p><p><strong>Conclusion: </strong>It appears that mesh fixation can be omitted during sublay incisional hernia repair.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"141"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970970","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":"Achieving textbook outcome in liver resection for hepatocellular carcinoma: malnutrition's pivotal role.","authors":"Kentaro Oji, Takeshi Urade, Satoshi Omiya, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto","doi":"10.1007/s00423-025-03703-x","DOIUrl":"https://doi.org/10.1007/s00423-025-03703-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of textbook outcome (TO) achievement on survival post-liver resection for hepatocellular carcinoma (HCC) and explore the associated factors.</p><p><strong>Methods: </strong>We retrospectively reviewed 330 patients diagnosed with HCC who underwent initial liver resection at our hospital between January 2011 and December 2019. We also investigated the achievement rates of five TOs and sub-analyzed the relationship between them and malnutrition. The patient's nutritional status was classified following the Global Leadership Initiative on Malnutrition (GLIM) criteria.</p><p><strong>Results: </strong>The TO achievement rate was 72.7%. In the prognostic analysis, the TO-achieving group showed significantly longer overall survival (OS) and recurrence-free survival (RFS). Significant differences in age, body mass index, weight loss, muscle mass, serum aspartate aminotransferase level, serum protein induced by vitamin K absence or antagonist-II, tumor characteristics, intraoperative blood loss, perioperative transfusion, and nutritional status were found between the groups.</p><p><strong>Conclusions: </strong>TO achievement is associated with OS and RFS post-liver resection for HCC. The TO is valuable for evaluating treatment quality in liver resection. Additionally, malnutrition graded following the GLIM criteria, age, tumor stage, and intraoperative blood loss are independent factors for achieving a TO post-liver resection for HCC.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"139"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027012","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":"Transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors: a retrospective 10-year single-center experience.","authors":"Marek Szczepkowski, Piotr Witkowski, Alicja Przywózka-Suwała, Karolina Skonieczna-Żydecka, Teresa Starzyńska, Krzysztof Dąbkowski","doi":"10.1007/s00423-025-03704-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03704-w","url":null,"abstract":"<p><strong>Purpose: </strong>Transanal endoscopic surgery is a recommended full-thickness resection technique for the treatment of rectal neuroendocrine tumors. We aimed to compare the efficacy, safety and follow-up of patients with rectal neuroendocrine tumors treated with transanal endoscopic microsurgery in the primary setting and as salvage therapy after non-radical endoscopic polypectomy.</p><p><strong>Methods: </strong>A retrospective analysis of a 10-year database of patients treated with transanal endoscopic microsurgery was performed. The procedure-related measures, including duration of the procedure, adverse events, and patient-related measures, including age, gender, tumor size, grading, and length of follow-up, were obtained. We compared the primary TEM group with the salvage group.</p><p><strong>Results: </strong>In total, 30 patients with rectal neuroendocrine tumors were included in the study; 13 of them received primary treatment and 17 salvage therapy of the scar. Patients receiving primary treatment were significantly older (60.5 vs. 51.7 years). There were no significant differences in patient gender, tumor size and grading, length of follow-up, hospital stay or procedure time. The R0 resection rate was 92.3% in the primary treatment group. Adverse events were mild or managed with endoscopic treatment. Follow-up was slightly but not significantly longer in the primary treatment group and showed no recurrences in both groups of patients.</p><p><strong>Conclusions: </strong>Transanal endoscopic microsurgery is safe and effective for both primary and salvage treatment of rectal neuroendocrine tumors.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"137"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042048","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}