Langenbeck's Archives of Surgery最新文献

{"title":"Multi-Indicator analysis of the impact of preoperative inflammatory states on complications following pancreatoduodenectomy.","authors":"Jiajie Feng, Yongjiang Zhou, Hongyin Liang, Yiwen Zhao, Kexin Jiang, Ruiwu Dai","doi":"10.1007/s00423-025-03676-x","DOIUrl":"10.1007/s00423-025-03676-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pancreatoduodenectomy (PD) is a complex surgery with a high rate of postoperative complications, for which effective preoperative indicators are currently lacking. Inflammatory indices such as the pan-immune-inflammation value (PIV), platelet-neutrophil product (PPN), and platelet-albumin ratio (PAR) have shown potential as biomarkers for postoperative prognosis in various cancers. However, their predictive value for complications in open-PD (OPD) patients remains underexplored. This study aims to investigate the relationship between these inflammatory indices and postoperative complications, identify new preoperative biomarkers, and provide a theoretical basis for improving perioperative management in OPD patients.</p><p><strong>Methods: </strong>We analyzed data from 309 patients who underwent open-PD (OPD). Six preoperative inflammatory indices-platelet-to-lymphocyte ratio (PLR), PIV, PPN, PAR, neutrophil-to-HDL ratio (NHR), and neutrophil-albumin ratio (NAR)-were assessed for their association with postoperative complications using logistic regression and restricted cubic spline analysis. Predictive performance was evaluated with ROC curves and decision curve analysis.</p><p><strong>Results: </strong>PLR, PIV, and PPN were significantly linked to most outcomes and had good predictive performance. NHR was associated with severe complications. PAR effectively predicted hemorrhage (AUC = 0.684) and delayed gastric emptying (DGE) (AUC = 0.701). Combining indices enhanced predictive accuracy.</p><p><strong>Conclusions: </strong>PLR, PIV, and PPN are key preoperative indicators for OPD patients, with PAR also useful for predicting complications like hemorrhage and DGE.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"111"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753324","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":"Surgical and postoperative management of congenital heart disease: a systematic review of observational studies.","authors":"Ramin Ghasemi Shayan, Mahsa Fatollahzadeh Dizaji, Fakhrosadat Sajjadian","doi":"10.1007/s00423-025-03673-0","DOIUrl":"10.1007/s00423-025-03673-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Congenital heart disease (CHD) remains a critical concern in pediatric and adult cardiovascular care, requiring continuous advancements in surgical techniques and perioperative strategies. While survival rates have improved, challenges persist in optimizing long-term neurodevelopmental outcomes, addressing disparities in healthcare access, and overcoming systemic barriers to implementing best practices. This systematic review integrates recent evidence on predictive factors, perioperative innovations, and economic challenges affecting CHD management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted, analyzing data from 27 observational studies, including retrospective and prospective cohort studies, as well as case reports, sourced from diverse geographic and clinical settings. Studies were selected based on strict inclusion criteria, emphasizing clear surgical outcomes, perioperative advancements, and neurodevelopmental follow-up. Data were extracted and synthesized to identify key trends in CHD surgery, anesthetic management, and long-term patient care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Key findings include: • Neurodevelopmental Outcomes: Long-term follow-up studies identified associations between prolonged ICU stays, intraoperative cerebral oxygenation deficits, and developmental delays. Hearing loss was reported in 21.6% of post-surgical patients, significantly impacting cognitive and language abilities. • Predictive Factors for Postoperative Outcomes: Hemoglobin saturation, lactate levels, and platelet counts were statistically associated with adverse postoperative outcomes (p &lt; 0.05), reinforcing the need for preoperative risk stratification. • Fast-Track Extubation and Resource Optimization: Early extubation protocols reduced ICU stays by an average of 20%, with a 15% decrease in postoperative complications. However, financial disincentives and inadequate reimbursement models limited their widespread adoption, particularly in low-resource settings. • Tailored Anesthetic Techniques: Individualized anesthesia strategies, including neuroprotective approaches and blood conservation techniques, improved outcomes in high-risk CHD populations, reducing complication rates by up to 10%. • Global Disparities in CHD Care: Studies from low-income countries revealed significantly higher rates of malnutrition, delayed surgical interventions, and postoperative complications. These disparities highlight the urgent need for global policy reforms to improve healthcare equity in CHD management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This review highlights the necessity of integrating predictive analytics, multidisciplinary approaches, and healthcare system reforms to enhance CHD management. While advancements in surgical techniques and perioperative care yield promising outcomes, persistent challenges-including healthcare disparities, financial constraints, and long-term neurodevelopmental risks-require targeted int","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"113"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753332","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":"Initial clinical experiences of robotic distal gastrectomy for gastric cancer using the Da Vinci™ SP system: a single-center retrospective study.","authors":"Ayaka Ito, Masaya Nakauchi, Masahiro Fujita, Yusuke Umeki, Kazumitsu Suzuki, Akiko Serizawa, Shingo Akimoto, Yusuke Watanabe, Tsuyoshi Tanaka, Susumu Shibasaki, Kazuki Inaba, Ichiro Uyama, Koichi Suda","doi":"10.1007/s00423-025-03685-w","DOIUrl":"10.1007/s00423-025-03685-w","url":null,"abstract":"<p><strong>Purpose: </strong>Reduced-port surgery has been utilized in gastric cancer surgery but is not predominantly used due to its high technical difficulty. A new single-port surgical robot named da Vinci™ SP System (DVSP) was launched and eventually approved for clinical use in Japan in November 2022. We initiated robotic gastrectomy for gastric cancer using DVSP in March 2023. Here, we report our initial experiences and assessments of the feasibility and safety of robotic gastrectomy for gastric cancer using DVSP.</p><p><strong>Methods: </strong>This single-center retrospective study included 20 patients with gastric cancer who underwent robotic gastrectomy with DVSP from March 2023 to April 2024. The primary endpoint was the postoperative complication rate within 30 days postoperatively. Secondary endpoints were surgical outcomes, including intraoperative adverse events, operative time, blood loss, and the number of dissected nodes.</p><p><strong>Results: </strong>Of the 20 patients, 6 (30.0%) were male. The median age was 74 years. Tumors in the middle to lower stomach were observed in 20 patients (100.0%), including 18 (90.0%) and 2 (10.0%) with clinical stages I and II diseases, respectively. All patients underwent distal gastrectomy. The postoperative complications of Clavien-Dindo grade ≥ II occurred in 3 (15%) patients. Intraoperative adverse events, including conversion to other approaches, were not observed. All patients underwent R0 resection. The median operative and console times were 289 and 240 min, respectively. The median blood loss was 11 mL with 50 dissected nodes.</p><p><strong>Conclusion: </strong>This study revealed the safe performance of robotic distal gastrectomy with standard lymphadenectomy for clinical stage I/II gastric cancer using DVSP.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"110"},"PeriodicalIF":2.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743597","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 necessity of prophylactic central lymph node dissection in clinically n0 papillary thyroid carcinoma: perspective from the endemic region.","authors":"Tugba Matlim Ozel, Yigit Soytas, Sezer Akbulut, Aykut Celik, Gorkem Yildiz, Huseyin Karatay, Serkan Sari","doi":"10.1007/s00423-025-03667-y","DOIUrl":"10.1007/s00423-025-03667-y","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic central lymph node dissection (pCND) in papillary thyroid carcinoma (PTC) is still a matter of debate. Therefore, we aimed to identify the factors affecting central lymph node metastasis (CLNM) in patients with clinically node-negative (cN0) PTC.</p><p><strong>Methods: </strong>This retrospective study included 248 patients with cN0 PTC who underwent total thyroidectomy (TT) or TT + pCND. Clinicopathological associations among CLNM, complication rates and the effect of pCND on staging were assessed. Risk factors (RFs) and the pattern of lymph node metastasis (LNM) in PTC patients were studied via multivariate analysis.</p><p><strong>Results: </strong>A total of 216 patients underwent pCND, and 58.8% (127/216) had positive CLNM. Male patients, aged < 41 years, and those with lymphatic invasion were identified as RFs for CLNM, with odds ratios of 2.59, 2.26, and 4.09, respectively. Among the 216 patients, 65 (30%) had transient hypoparathyroidism (HPT), and 20 (9.3%) had permanent HPT. Transient recurrent laryngeal nerve (RLN) palsy occurred in 15 (6.9%) patients, and permanent RLN palsy occurred in 3 (1.4%) patients. Over 55 years of age, 46.7% of patients were upstaged according to the American Joint Committee on Cancer (AJCC) TNM staging system, and 14.2% (n = 18) of the 127 patients with CLNM were upgraded according to the American Thyroid Association (ATA) risk stratification system (RSS).</p><p><strong>Conclusion: </strong>Taken together, in terms of the high incidence rate of CLNM in cN0 PTC patients; We believe that routine pCND, which can be performed with low morbidity rates, is optimal for cN0 PTC patients during their first treatment, especially for those with RFs for CLNM.</p><p><strong>Clinical trials number: </strong>NCT05873283.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"109"},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735708","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 effects of endoscopic vacuum therapy for non-operative treatment of anastomotic leakage on oncological outcomes in rectal cancer patients.","authors":"Catherine Kollmann, Beata Kusnezov, Lars Kollmann, Jasmin Schmitt, Christoph-Thomas Germer, Johan F Lock, Sven Flemming","doi":"10.1007/s00423-025-03672-1","DOIUrl":"10.1007/s00423-025-03672-1","url":null,"abstract":"<p><strong>Purpose: </strong>Rectal resection has remained the cornerstone in curative treatment of rectal cancer. This however, implies the risk of anastomotic leakage leading to morbidity, mortality and potentially disease progression. Endoscopic vacuum therapy (EVT) has emerged as a promising tool in leakage therapy in order to avoid reoperation and Hartman resection. However, its clinical efficacy and its potential effect on oncological outcomes still requires further research.</p><p><strong>Methods: </strong>In this retrospective single-centre cohort study, we analysed all consecutive patients undergoing rectal resection for rectal cancer during 2012-2021. The incidence and management of anastomotic leakage and its effects on long-term oncological outcomes were analysed.</p><p><strong>Results: </strong>A total of 334 patients underwent rectal resection of whom 47 patients (14.1%) developed postoperative anastomotic leakage. Non-operative leakage treatment (NOLT) was successful in in 76.9% of which EVT was the most efficient (90.0% success) while reoperation was successful in 52.4% (p = 0.073). The more frequent application of EVT increased the NOLT rate from 48.3 to 66.7% during the observation period (p = 0.176). Concerning long-term outcomes, no differences in disease-free survival (p = 0.657) nor patient survival (p = 0.295) could be determined.</p><p><strong>Conclusion: </strong>EVT is an effective treatment option for anastomotic leakage after rectal resection. EVT enables NOLT in the majority of cases. However, there might be no impact on oncological outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"107"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720059","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":"Laparoscopic vs. Robotic transabdominal adrenalectomy- propensity matched analysis and learning curve.","authors":"M Meir, A Wiegering, F Sperschneider, A Hendricks, J F Lock, S Flemming, M Kelm, S Hahner, N Schlegel, C T Germer, J Reibetanz","doi":"10.1007/s00423-025-03688-7","DOIUrl":"10.1007/s00423-025-03688-7","url":null,"abstract":"<p><strong>Background: </strong>While laparoscopic transabdominal or retroperitoneal adrenalectomy is standard care for adrenal tumors, benefits of robotic adrenalectomy (RA) are yet unclear. We evaluated the costs (including disposables), outcomes as well as the learning curve of robotic and laparoscopic adrenalectomy (LA) in a specialized center.</p><p><strong>Methods: </strong>In retrospective analysis of our prospective database (ethical approval number 88/11) 263 LA were compared to 27 RA in the study period between 2018 and 2023. A propensity score match analysis was used to exclude possible confounders. Furthermore, the learning curve of RA was investigated.</p><p><strong>Results: </strong>Intraoperative Riva Rocci (RR) fluctuations (> 160mmHg, < 90 mmHg), early complications (within 30 days) and intraoperative blood loss were comparable in both groups. However, length of stay was decreased following robotic adrenalectomy (3.50d ± 1.81d compared to 4.61d ± 2.75d; p = 0.04). Due to this, overall costs of RA were lower compared to LA even if cost for disposables were slightly higher in the robotic group. An analysis of the learning curve of robotic adrenalectomy revealed that learning curve is completed after 5- 6th procedure.</p><p><strong>Conclusions: </strong>Taken together our study supports the fact that RA is as secure and feasible as LA. Furthermore, it might provide advantages due to shorter length of stay, a short learning curve and similar costs compared to LA.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"108"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720006","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":"Incidence and risk factors of biliary leaks after partial hepatectomy within an enhanced recovery perioperative pathway: a single-center retrospective cohort study.","authors":"Jamy Vienet, Ismail Labgaa, Rafael Duran, Sébastien Godat, Catherine Blanc, Emilie Uldry, Emmanuel Melloul, David Fuks, Gaëtan-Romain Joliat","doi":"10.1007/s00423-025-03677-w","DOIUrl":"10.1007/s00423-025-03677-w","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary leak is a specific and frequent complication after hepatectomy. This study aimed to assess the incidence and risk factors of biliary leak after hepatectomy.</p><p><strong>Methods: </strong>A retrospective cohort study was performed. All consecutive patients who underwent hepatectomy between January 2013 and June 2022 were included. Abdominal drainage was performed in case of biliary anastomosis or major hepatectomy. Biliary leak was defined and classified according to the International Study Group for Liver Surgery definition with grades A, B, C based on the required management. Logistic binary regression was used to find risk factors.</p><p><strong>Results: </strong>Data were collected from 565 patients who underwent hepatectomy during the study period. Biliary leaks occurred in 10% (55/565) of patients. The rates of biliary leak grades A, B, and C were 18% (10/55), 37% (20/55), and 45% (25/55), respectively. A high nutrition risk screening (OR 2.1, 95% CI 1.3-3.4), preoperative biliary drainage (OR 4.6, 95% CI 1.5-13.5), and intraoperative biliary anastomosis (OR 3.4, 95% CI 1.3-8.9) were found as independent risk factors for biliary leak on multivariable analysis. In terms of morbidity, biliary leak patients had more infectious complications (46% vs. 8%, p < 0.001) and a longer median hospital stay (26 vs. 7 days, p < 0.001). Regarding treatment, 41 (75%) patients with biliary leak underwent drainage either endoscopically or percutaneously.</p><p><strong>Conclusion: </strong>Preoperative biliary drainage, high nutrition risk screening, and intraoperative biliary anastomosis were independent predictive factors for postoperative biliary leaks. Most frequent treatments of biliary leaks after hepatectomy were antibiotics and drainage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"104"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710512","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":"Osteosarcopenia as a Predictor of Histopathologic Response to Neoadjuvant Chemoradiotherapy in Esophageal Cancer: a Retrospective Cohort Study.","authors":"Yuki Hirase, Ken Sasaki, Yusuke Tsuruda, Masataka Shimonosono, Yasuto Uchikado, Daisuke Matsushita, Takaaki Arigami, Nobuhiro Tada, Kenji Baba, Yota Kawasaki, Takao Ohtsuka","doi":"10.1007/s00423-025-03687-8","DOIUrl":"10.1007/s00423-025-03687-8","url":null,"abstract":"<p><strong>Purpose: </strong>Predicting chemoradiotherapy (CRT) response in esophageal cancer is essential as outcomes vary among patients. This study aimed to evaluate the impact of osteosarcopenia on the effectiveness of neoadjuvant CRT (NACRT).</p><p><strong>Methods: </strong>Ninety-five patients with advanced esophageal cancer who underwent surgical resection post-NACRT were included. Sarcopenia and osteopenia were determined using pre-NACRT skeletal muscle index and bone density at L3 and Th11 levels. Patients were categorized based on osteosarcopenia status.</p><p><strong>Results: </strong>Thirty-seven patients (39%) had osteosarcopenia. Among tumors, 49 (51.6%) were grade 1 (non-responders), 12 (12.6%) were grade 2, and 34 (35.8%) were grade 3 (responders). NACRT was significantly more effective in patients with above-median body mass index, shallow tumor depth, low squamous cell carcinoma antigen levels, and without osteosarcopenia. Osteosarcopenia was independently correlated with the histopathologic response to NACRT. No significant differences in overall or relapse-free survival were observed based on osteosarcopenia status.</p><p><strong>Conclusion: </strong>Osteosarcopenia may predict NACRT response in esophageal cancer.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"105"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710440","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":"MRI is more accurate than FDG-PET in assessing complete response in rectal cancer patients after neoadjuvant therapy.","authors":"Yehuda Kariv, Ronen Berkovitz, Reut El-On, Alexander Barenboim, Hagit Tulchinsky, Meir Zemel, Oded Brautbar, Dan Mirelman, Sharon Pelles-Avraham, Ravit Geva, Inna Ospovat, Guy Lahat, Jonathan B Yuval","doi":"10.1007/s00423-025-03679-8","DOIUrl":"10.1007/s00423-025-03679-8","url":null,"abstract":"<p><strong>Purpose: </strong>The role of FDG-PET in the restaging rectal cancer following neoadjuvant therapy (NAT) is not clear. We compared the accuracy of FDG-PET and MRI in the assessment of rectal cancer response to NAT.</p><p><strong>Methods: </strong>Data of patients treated between January 2015 and September 2022 were captured from a rectal tumor registry. Restaging FDG-PET and MRI were evaluated for the presence of viable tumor. Imaging was compared to the reference standard of pathological results for patients that underwent surgery, and sustained clinical complete response for patients that entered watch and wait. Sensitivity was defined as correctly identifying patients with a complete response.</p><p><strong>Results: </strong>Eighty-two patients met the inclusion criteria. Of these, 60 patients underwent restaging MRI and 54 underwent restaging FDG-PET. Thirty-two were evaluated by both modalities. Mean age and distance from anal verge were 59.9 ± 12.7 years and 5.9 ± 3.2 cm. Baseline staging was cT1-2, cT3 and cT4 for 7 (8.5%), 62 (75.6%) and 13 (15.9%) of the patients, respectively. Baseline nodal staging was cN0 and cN + for 32 (39%) and 50 (61%) of the patients, respectively. All patients were treated with radiation with the majority 73 (89%) receiving chemoradiotherapy. There were 17 patients (21%) that had a pathological or sustained clinical complete response. All baseline characteristics were not meaningfully different between groups. MRI was more accurate than FDG-PET in all parameters including sensitivity, specificity, positive and negative predictive value and overall accuracy.</p><p><strong>Conclusion: </strong>MRI outperforms FDG-PET in the identification of complete response in rectal cancer patients after NAT.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"106"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710521","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 usefulness of fluorescence in decision-making strategy during bariatric and metabolic surgery.","authors":"Mateusz Wityk, Michał R Janik, Maciej Bobowicz, Natalia Dowgiałło-Gornowicz","doi":"10.1007/s00423-025-03683-y","DOIUrl":"10.1007/s00423-025-03683-y","url":null,"abstract":"<p><strong>Purpose: </strong>Fluorescence is used in various surgical fields to detect tissue ischemia. However, its use in obesity surgery is still limited. This study aims to investigate whether fluorescence can change surgical decisions during metabolic and bariatric surgery. The primary objective was to determine the proportion of patients with abnormal blood flow assessed by fluorescence and changes in intraoperative strategy. The second outcome measured was the morbidity and mortality within 30 days.</p><p><strong>Methods: </strong>This single-centre, prospective observational study analysed patients who underwent primary metabolic and bariatric surgery. Data was collected from 66 consecutive patients who qualified for primary one anastomosis gastric bypass and Roux-en-Y gastric bypass procedures.</p><p><strong>Results: </strong>In total, improper blood supply was observed in two cases, and surgical strategy was changed in 5.8% of OAGB and 2% of RYGB. No leakage incidents were reported. One patient (1.5%) experienced non-ischemic-related complications. No mortality was observed 30 days after the surgical procedures. No complications related to ICG administration were observed.</p><p><strong>Conclusion: </strong>Despite the low incidence of tissue ischemia during metabolic and bariatric surgery, adding ICG fluorescence may potentially impact intraoperative surgical decisions due to ischemia detection during metabolic and bariatric surgery. However, this field lacks systematic data, and further research with a larger patient group is necessary to establish conclusive evidence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"103"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700789","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}