Langenbeck's Archives of Surgery最新文献

{"title":"Surgeons' prioritization of emergency abdominal surgery and its impact on postoperative outcomes.","authors":"Severin Gloor, Antonio Wyss, Daniel Candinas, Beat Schnüriger","doi":"10.1007/s00423-025-03723-7","DOIUrl":"https://doi.org/10.1007/s00423-025-03723-7","url":null,"abstract":"<p><strong>Background: </strong>Emergency general abdominal surgery (EGS) is associated with high morbidity and mortality. Timely intervention and effective triage systems are crucial to improve outcomes. This study evaluates the impact of surgeons' prioritization and adherence to a triage protocol on postoperative outcomes.</p><p><strong>Methods: </strong>Single-center retrospective analysis of patients undergoing EGS at Bern University Hospital from 03/2015-12/2022. Patients were categorized into four triage levels based on the urgency of surgery (level 1 within 1 h, level 2 within 6 h, level 3 within 12 h, and level 4 within 24 h). \"Protocol violation\" was defined in cases where the delay to surgery exceeded the triage level. Primary endpoint included complications according to Clavien-Dindo classification in patients with versus without \"protocol violation\".</p><p><strong>Results: </strong>A total of 1'947 patients were included. The mean overall delay from admission to surgery was in triage level 1 69.5 ± 127.5 min., in triage level 2 206.5 ± 178.0 min., in triage level 3 350.6 ± 282.6 min. and in triage level 4 693.4 ± 354.8 min.. Triage levels 1 and 2 correlated significantly with increased complication rates compared to triage level 3 and 4 (64% vs. 43% vs. 11% vs. 10%, p < 0.001). Similarly, mortality rates decreased significantly from triage level 1 through 4 (26% vs. 7% vs. 1% vs. 2%, p < 0.001). \"Protocol violation\" occurred in a total of 13% of patients with decreasing proportions from triage level 1 to 4 (37% vs. 13% vs. 12% vs. 0%, p < 0.001). \"Protocol violation\" did not statistically affect overall morbidity and mortality in most of the diagnoses. In patients with intestinal ischemia or abdominal abscesses, mortality was significantly higher in patients with \"protocol violation\". In contrast, in patients suffering from acute inguinal hernias or gastrointestinal bleeding, morbidity was significantly higher in patients without \"protocol violation\". A significantly shorter hospital length of stay (HLOS) was shown in triage level 2 and triage level 3 when patients were treated without \"protocol violation\" (8.6 ± 10.0 days vs. 13.5 ± 17.3 days, p = 0.022 and 5.3 ± 8.7 days vs. 6.4 ± 6.7 days, p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Surgeons' triage levels significantly correlated with mortality and morbidity. Moreover, \"protocol violation\" resulted in higher mortality in patients suffering from mesenteric ischemia and abdominal abscesses and resulted in prolonged HLOS. Further incorporating objective parameters into triage decisions in the EGS population may enhance prioritization accuracy, patient safety and resource utilization.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"153"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989606","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":"Time-varying mortality risk after gastrointestinal surgery complicated by postoperative infections: a Danish Nationwide study of 859,766 patients.","authors":"Doruk Orgun, Ask Tybjaerg Nordestgaard, Rasmus Peuliche Vogelsang, Henrik Enghusen Poulsen, Christina Ellervik, Ismail Gogenur","doi":"10.1007/s00423-025-03718-4","DOIUrl":"https://doi.org/10.1007/s00423-025-03718-4","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative infections are associated with increased mortality risk, but it is unclear if this risk increase persists over time. This study aims to estimate mortality risk associated with postoperative infections at different time-points within the first postoperative year in a nationwide cohort of gastrointestinal surgery patients.</p><p><strong>Methods: </strong>We included all individuals residing in Denmark who underwent gastrointestinal surgery between 1996 and 2018 and were alive at postoperative day 30. For different time-intervals during the one-year follow-up, we calculated mortality rates and cumulative incidences of death for patients with and without 30-day postoperative infections. Time-varying Cox regression analyses estimated the relative mortality risk associated with postoperative infection exposure.</p><p><strong>Results: </strong>Of 859,766 patients (female:49.2%; median age:51 years), 25,126 (2.9%) had at least one 30-day postoperative infection. In patients with or without infections, cumulative incidences of death between postoperative days 30-365 were 13.5% versus 4.7%. Adjusted hazard ratios (HRs) for mortality from postoperative days 30, 91, 181, and 271 until end of follow-up (until postoperative day 365) were 2.25(95% CI:2.13-2.38), 1.88(1.74-2.04), 1.44(1.29-1.62), and 1.11(1.00-1.28) for any postoperative infection compared to no infection (p_{time-interaction}<0.001). The adjusted HRs for mortality for postoperative days 30-365 in patients exposed to different postoperative infection types were: sepsis: 4.38(3.90-4.93), pneumonia: 2.60(2.37-2.85), urinary tract infection: 1.26(1.05-1.52), surgical site infection: 1.16(1.04-1.30).</p><p><strong>Conclusion: </strong>Compared to patients with no infection, patients exposed to 30-day postoperative infections after gastrointestinal surgery had a 2.3-fold risk of mortality at postoperative days 30, and the relative risk of mortality attributed to infection exposure gradually diminished over time.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"152"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000881","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":"Cabergoline-induced cerebrospinal fluid fistulae in macroprolactinomas.","authors":"Elvis J Hermann, Sabine Hertz, Makoto Nakamura, Christoph Terkamp, Thomas M Kinfe, Stefan Stolle, Holger Leitolf, Rudolf Fahlbusch, Joachim K Krauss","doi":"10.1007/s00423-025-03722-8","DOIUrl":"https://doi.org/10.1007/s00423-025-03722-8","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebrospinal fluid (CSF) rhinorrhea is a rare complication after dopamine agonist treatment of macroprolactinomas. Up to 90% need surgical repair, however, there are controversial opinions on the necessity of tumor resection upon this occasion. Here we present our long-term follow-up experience in patients who underwent surgical repair of the CSF leak or observation.</p><p><strong>Methods: </strong>We report a series of three patients who presented with cabergoline-induced CSF rhinorrhea with long-term follow-up up to 170 months. Two patients underwent endoscopic transnasal-transsphenoidal surgical repair of CSF rhinorrhea by fat graft and fibrin glue without tumor removal. In another patient, CSF rhinorrhea resolved spontaneously after two weeks without recurrence.</p><p><strong>Results: </strong>All three patients had no recurrence of CSF rhinorrhea during long-term follow-up up to 170 months. One patient with surgical CSF leak repair was asymptomatic with continued medication at long-term follow-up of 116 months. Tumor progression occurred 21 months after CSF leakage repair in another patient after cessation of dopamine agonist treatment and necessitated tumor debulking. The patient with continued medication without surgery had no recurrence of CSF rhinorrhea on long-term follow-up of 170 months.</p><p><strong>Conclusion: </strong>The optimal management of CSF fistulae due to tumor shrinkage of macroprolactinomas after dopamine agonist therapy remains to be defined. Exceptionally, medication-induced CSF fistulae in response to tumor shrinkage may close spontaneously without recurrence. If persistent, transnasal-transsphenoidal closure of CSF fistulae represents an efficient treatment and dopamine agonist treatment may be continued. Thus, we recommend early surgical repair.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"151"},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027416","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":"Sex and age-related implications for preventive measures of intensive care admitted traumatic brain injury patients in Switzerland: an observational study.","authors":"Juliane Fleischer, Giovanna Brandi, Henrik Teuber, Sarah Flückiger, Stefan Y Bögli, Simone Unseld","doi":"10.1007/s00423-025-03720-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03720-w","url":null,"abstract":"<p><strong>Purpose: </strong>Epidemiological studies of traumatic brain injury (TBI) in Switzerland have, to date, poorly investigated sex-related differences in causality and predisposing factors. This study examines differences in sex and age related TBI epidemiology in a high-volume trauma centre intensive care unit (ICU) cohort, aiming to identify potential targets for prevention.</p><p><strong>Methods: </strong>This retrospective, single centre study includes all consecutive TBI patients admitted to the ICU in a 4-year study period. Patient demographics, comorbidities, co-medication, trauma setting and associated risk behaviour were compared between sexes and age groups (over/under 65 years).</p><p><strong>Results: </strong>592 patients (73.3% male, 26.7% female) were included. The leading cause of TBI was falls (52.4%), followed by road traffic accidents (RTA) (35.8%). Overall, men were more likely to suffer from a road traffic accident, while women were more likely to suffer a low energy fall. No differences in injury severity and comorbidities between sexes were observed. Young patients most likely suffered from a RTA while older patients from a low energy fall irrespective of sex. Both sexes portrayed risk associated behaviors with higher rates of alcohol intoxication in males, while females were less likely to wear a helmet in two-wheeled RTAs.</p><p><strong>Conclusions: </strong>We conclude that sex- and age-related epidemiologic differences in TBI exist. Our results suggest that sex and age-specific prevention measures might be advisable for optimal mitigation of TBI and its sequelae.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"150"},"PeriodicalIF":2.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000850","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":"Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study.","authors":"Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner","doi":"10.1007/s00423-025-03724-6","DOIUrl":"https://doi.org/10.1007/s00423-025-03724-6","url":null,"abstract":"<p><strong>Purpose: </strong>The improved prognosis of rectal cancer through modern therapeutic approaches raises questions regarding quality of life (QoL) and functional outcomes. In this study, we compared post-transanal total mesorectal excision (taTME) short- and long-term QoL and functional outcomes with those after abdominal TME (abTME).</p><p><strong>Methods: </strong>Prospective data from patients who underwent elective taTME or abTME for stage I-III rectal cancer followed by anastomosis were retrospectively propensity score-adjusted. The primary endpoint, QoL, was assessed with the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30). Functional outcomes were the secondary endpoints.</p><p><strong>Results: </strong>Among 494 patients during 2013-2022, 187 patients who underwent taTME and 62 patients who underwent abTME were included. QoL was worse after taTME at isolated time points: overall QoL (after 3 years: 72 vs. 82 points, p = 0.017) and QLQ-total (after 3 years: 81 vs. 87 points, p = 0.028; after 4 years: 82 vs. 89 points, p = 0.012). After propensity score matching, the between-group differences were still significant but smaller: overall QoL - 6 points, p = 0.021; QLQ-total - 5 points, p = 0.026.</p><p><strong>Conclusion: </strong>The differences reported at isolated time points have questionable clinical relevance. Therefore, taTME and traditional abTME seem to have comparable long-term QoL and functional outcomes.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, NCT06505863, https://clinicaltrials.gov/search?id=NCT06505863 .</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"149"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971474","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 cluster nursing combined with early enteral nutrition intervention in postoperative severe craniocerebral injury.","authors":"Rehua Chen, Jin Wan, Juanjuan Li, Yaoran Tu","doi":"10.1007/s00423-025-03699-4","DOIUrl":"https://doi.org/10.1007/s00423-025-03699-4","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this paper was to probe the application effect of cluster nursing combined with early enteral nutrition (EEN) intervention in the postoperative period of severe craniocerebral injury (SCI).</p><p><strong>Methods: </strong>This study was a prospective study. The 74 patients with postoperative SCI were randomly divided into the control group and the study group (37 cases each). The patients in the control group were given routine nursing and parenteral nutritional support, and the patients in the study group received cluster nursing and EEN support treatment. Patients' nutritional status, neurological function recovery, psychological status, activity of daily living (ADL), and quality of life were assessed, and the occurrence of complications during the intervention period was recorded in both groups.</p><p><strong>Results: </strong>After the intervention, compared to the control group, the serum total protein, albumin, and transferrin levels of the study group were higher; the National Institutes of Health Stroke Scale scores of the study group were lower; the self-rating anxiety scale and the self-rating depression scale scores of the study group were lower; the ADL scores of the study group were higher; and the 36-item short-form health survey scores of the study group were higher (P < 0.05). The total complication rate of the study group was lower than that of the control group (P < 0.05).</p><p><strong>Conclusion: </strong>The combination of cluster nursing and ENN intervention can improve the nutritional status of postoperative patients with SCI, facilitate the recovery of neurological function, alleviate adverse psychology, enhance ADL, ameliorate the quality of life, and reduce the occurrence of complications.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"148"},"PeriodicalIF":2.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024591","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":"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":"https://doi.org/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":2.1,"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}