Langenbeck's Archives of Surgery最新文献

{"title":"Self-Expanding metal stent placement for hepatic venous outflow obstruction following ex vivo liver resection and autotransplantation.","authors":"Xinyu You, Bangyou Zuo, Chong Yang, Tao Liu, Donghui Cheng, Jiangji Peng, Peng Li, Jianjie Hao, Yu Zhang","doi":"10.1007/s00423-025-03801-w","DOIUrl":"10.1007/s00423-025-03801-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and efficacy of self-expanding metal stents (SEMS) for managing hepatic venous outflow obstruction (HVOO) following ex vivo liver resection and autotransplantation (ELRA).</p><p><strong>Methods: </strong>We retrospectively analyzed patients who received SEMS placement for HVOO after ELRA between January 2018 and December 2024. The study analyzed details of vascular invasion, liver resection, vascular reconstruction during ELRA, and the condition before and after stent placement. Complications and short-term and long-term prognoses were also observed.</p><p><strong>Results: </strong>The study included 10 patients who underwent SEMS placement for HVOO after ELRA. Three patients had preoperative stent placement for Budd-Chiari syndrome. During ELRA, 3 patients underwent left trisegmentectomy, and 7 underwent right trisegmentectomy. Six patients required artificial vascular grafts for inferior vena cava (IVC) reconstruction, and 4 patients underwent partial IVC resection with bovine pericardial patch reconstruction. All patients underwent HV-IVC end-to-side anastomosis after HV widening. Two cases used allogeneic vein reconstruction for hepatic venous outflow. The median time to HVOO after ELRA was 3.0 [IQR 2.0-7.3] months. Three patients experienced left hepatic vein (LHV) obstruction, and 7 experienced right hepatic vein (RHV) obstruction, with a median hepatic venous pressure gradient (HVPG) of 11.8 [IQR 8.8-14.1] mmHg. After stent placement, the HVPG decreased to a median of 2.8 [IQR 2.1-3.1] mmHg. The median follow-up period was 29.5 [IQR 11.3-55.8] months. During follow-up, one patient developed restenosis; other than this, no complications of grade III or higher occurred.</p><p><strong>Conclusion: </strong>In this single-center cohort, SEMS demonstrated favorable safety and efficacy for HVOO after ELRA, However, larger multicenter studies are required to validate these findings and assess long-term outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"282"},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192046","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":"Integrating safety culture, environment, and sensory perceptions in the operating room: a narrative review.","authors":"Diego Adão, Gabriela C L Martins, Leonardo Y Kasputis Zanini, Fernando Herbella","doi":"10.1007/s00423-025-03813-6","DOIUrl":"10.1007/s00423-025-03813-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to review the literature and reflect on the importance of sensory perceptions-colors, sounds, odors, taste, and kinetics (tactile and postural)-alongside team behavior and safety culture in the operating room.</p><p><strong>Methods: </strong>MEDLINE search via PubMed up to March 2025, using both free terms and MeSH related to surgery, sensory perception, safety culture, and situational awareness in the operating room. Only English-language studies were included, with a focus on recent publications. Article selection was based on relevance to the core themes of the review.</p><p><strong>Results: </strong>The study highlights how visual, auditory, olfactory, and thermal stimuli influence team performance and decision-making in the operation room. Color schemes, alarm sounds, ambient odors, and temperature control all play key roles in enhancing situational awareness and patient safety. Effective posture, communication, and ergonomics further contribute to minimizing errors and promoting a safety-driven culture.</p><p><strong>Conclusion: </strong>The senses, along with communication and discipline, help the team respond effectively to critical situations. Like in aviation, sensory awareness is central to a strong safety culture.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"281"},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186171","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":"Is it safer to perform surgery before or after liver transplantation? A case-match study for colorectal and small-bowel surgery.","authors":"Phil Meister, Roxana Pantea, Samira Vestweber, Marc A Reschke, Ulf Neumann, Andreas D Rink","doi":"10.1007/s00423-025-03858-7","DOIUrl":"10.1007/s00423-025-03858-7","url":null,"abstract":"<p><strong>Aims: </strong>Surgical risks are elevated in both patients with cirrhosis and in liver transplant recipients. We aimed to quantify surgical outcomes in comparable patients and procedures.</p><p><strong>Methods: </strong>This case-control study included liver transplant recipients and cirrhosis patients who underwent small bowel or colorectal surgery. Patients were matched based on Charlson Comorbidity Index (CCI) (± 1), age (± 5 years), and surgical modality. In-hospital mortality, length of hospital stay (LOS), and major morbidity (Dindo-Clavien grade ≥ 3) were used as outcome criteria.</p><p><strong>Results: </strong>45 cirrhosis and 45 matched transplant patients were included. Mean age and CCI were 65 years and 6.3, respectively. 38% of all patients underwent emergency surgery. Mortality was significantly higher in the cirrhosis group (38% vs. 11%, p = 0.003). Stratification of cirrhosis patients by MELD revealed no significant difference between patients with MELD ≤ 14 and transplant recipients. However, patients with MELD > 14 exhibited substantially increased mortality (64% vs. 9%, p = 0.07, ns).</p><p><strong>Conclusions: </strong>Colorectal and small bowel surgery in both cirrhosis and transplant patients carries significant risks. Mortality was significantly higher in cirrhosis patients overall, but data suggests the risk of surgery in cirrhosis patients with MELD scores ≤ 14 might be comparable to transplant patients, while those with MELD scores > 14 are at particular risk. Small sample size and heterogeneity of procedures limit these findings; still, the necessity of surgery in patients with higher MELD should be carefully evaluated, as delaying surgery until after liver transplantation may be safer. WHAT DOES THIS PAPER ADD TO LITERATURE? : This paper contains the largest case-matched comparison of surgery in cirrhosis patients with liver transplant patients. We quantify the risk for small bowel and colorectal surgery in comparable patients for the first time, to assist clinical decision of potentially delaying surgery until after liver transplantation.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"280"},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176436","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 indocyanine green fluorescence angiography on esophagogastric anastomotic leakage after Ivor Lewis esophagectomy.","authors":"Laure Davoust, Yaniss Belaroussi, Flor Picard, Denis Collet, Caroline Gronnier","doi":"10.1007/s00423-025-03793-7","DOIUrl":"10.1007/s00423-025-03793-7","url":null,"abstract":"<p><strong>Purpose: </strong>Esophagectomy for esophageal cancer involves high morbimortality when anastomotic leakage occurs. Optimal perfusion of the gastric tube can be assessed by indocyanine green fluorescence-angiography (ICG-FA). We evaluated whether locating the anastomosis in a zone enhanced within 60 s after ICG-FA injection reduced severe anastomotic leakage (Stage 2 or 3) within 30 days after esophagectomy.</p><p><strong>Methods: </strong>ICG-FA was assessed in 69 patients and compared to 122 control patients undergoing minimally invasive Ivor Lewis esophagectomy. Whenever possible, the anastomosis was placed on gastric tissue enhanced within 60 s after ICG-FA injection, with resection of the gastric tip if needed.</p><p><strong>Results: </strong>Severe anastomotic leakage occurred in 8.4% of cases, with 6 cases of anastomotic leakage (8.7%) in the ICG-FA group and 10 (8.2%) in the non-ICG-FA group (p = 1.000). There was no difference in postoperative outcomes between both groups, the main complications being pulmonary. ICG-FA enhancement level at 60 s was below the gastric tip in 33.8% of cases, with lowering of the anastomotic site in 18% of cases and resection of the gastric tip in 23% of cases. Overall, use of ICG-FA changed the surgical management in 29.9% of patients, with 2 patients presenting with anastomotic leakage.</p><p><strong>Conclusion: </strong>Our results were not statistically significant, possibly due to a lack of power. There was no trend indicating a decrease in anastomotic leakage using our ICG-FA method, therefore other studies must help determine an optimal quantitative ICG-FA method to reduce postoperative morbidity after esophagectomy.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"279"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149827","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":"Optimal duration of postoperative drainage following burr hole surgery for chronic subdural hematoma: A systematic review and network meta-analysis.","authors":"Khaled Moghib, Malek T Ahmed, Thoria I Essa Ghanm, Mostafa Talaat Shafiey, Joshua Limantoro, Antonio Medina Luna, Izere Salomon, Mahmoud T Hefnawy, Muhannad Wael Abu Arafeh, Ismail Bozkurt","doi":"10.1007/s00423-025-03853-y","DOIUrl":"10.1007/s00423-025-03853-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition with a high recurrence rate after burr-hole surgery. The optimal duration of postoperative drainage remains controversial, with varying clinical practices worldwide.</p><p><strong>Objective: </strong>This systematic review and network meta-analysis aimed to determine the optimal postoperative drainage duration to minimize recurrence while maintaining favorable clinical outcomes.</p><p><strong>Methods: </strong>A comprehensive search was conducted across five databases up to January 2025, including randomized controlled trials (RCTs) and cohort studies evaluating the postoperative drainage duration in CSDH patients undergoing burr-hole surgery. The primary outcome was recurrence rate, while the secondary outcomes included mortality and functional outcomes. A random-effects network meta-analysis was performed, and the risk of bias was assessed using standardized tools.</p><p><strong>Results: </strong>Seven studies with 1,842 patients were included, comprising three RCTs and four cohort studies. Drainage durations of 3 and 6 days significantly reduced recurrence rates compared with shorter durations (0-8 h and 17-24 h). Notably, the 6-day drainage had the highest probability (86.2%) of minimizing recurrence, followed by the 3-day drainage (13.8%). A shorter drainage duration (< 24 h) was associated with higher recurrence risks. However, no significant differences in mortality rates were observed across the drainage durations.</p><p><strong>Conclusion: </strong>This study highlights that longer postoperative drainage durations (3-6 days) may reduce recurrence rates after burr-hole surgery for chronic subdural hematomas. However, its effect on mortality remains unclear. These findings support the importance of optimizing the drainage duration and call for further high-quality studies to guide clinical practice.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"278"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149744","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":"Validation of MELD 3.0 and ReMELD-Na scoring systems: a German clinical cohort study.","authors":"Aghnia J Putri, Decan Jiang, Zoltan Czigany, Arianeb Mehrabi, Markus Wolfgang Buechler, Uta Merle, Christoph Michalski, Peri Husen","doi":"10.1007/s00423-025-03846-x","DOIUrl":"10.1007/s00423-025-03846-x","url":null,"abstract":"<p><strong>Background: </strong>The Model for End-Stage Liver Disease (MELD) score, introduced in 2002, has since been refined. MELD 3.0, launched in 2023 in the United States, improves mortality prediction by incorporating sex and albumin. Since March 2025, Germany started to use reMELD-Na to improve prioritization of patients on the waiting list for liver transplantation (LT). This study compares the performance of original MELD, MELD-Na, MELD 3.0 with and without albumin, and reMELD-Na for patients waitlisted for LT in a large German transplant center.</p><p><strong>Methods: </strong>This retrospective single-center study included 206 listed patients from 2017 to 2021 for LT. Reclassification patterns along with predictive accuracy for three-month survival and overall survival (OS) of five different MELD scores were assessed using Harrell's c-index and integrated area under the curve (iAUC).</p><p><strong>Results: </strong>Over a median follow-up of 33.9 months, 100 patients (51.5%) underwent LT, with a post-transplant survival rate of 70%. Thirty-eight patients (18.4%) received LT and sixteen patients died within the first three months after listing. ReMELD-Na and MELD 3.0 without albumin demonstrated the highest discrimination for three-month survival (c-index 0.848 and 0.827, respectively). Original MELD showed the poorest discrimination. MELD 3.0 without albumin showed the best overall performance in predicting OS (c-index 0.827) in males, while reMELD-Na performed best in females (c-index 0.705). Females with higher original MELD scores tended to receive even higher scores with MELD 3.0.</p><p><strong>Conclusion: </strong>This is the first German study to validate reMELD-Na and MELD 3.0, showing superior predictive performance over original MELD. MELD 3.0 may better reflect disease severity in women at advanced stages due to more upward reclassification.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"276"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138040","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 vacuum assisted wound therapy on wound complications in STS surgery- A 3-year retrospective single-centre analysis.","authors":"Simone Schewe, Adrian Sagebiel, Jonas Wakker, Nina Voss, Ruba Al Shonikat, Matthias Priemel, Alonja Reiter, Jana Striefler, Marco Blessmann, Thilo Hackert, Anna Duprée","doi":"10.1007/s00423-025-03865-8","DOIUrl":"10.1007/s00423-025-03865-8","url":null,"abstract":"<p><strong>Purpose: </strong>In sarcomas, surgery is an essential component of therapy. Depending on their location, sarcomas can reach a considerable size, which increases the risk of wound complications (WC) after resections. This often results in longer hospital stays and thus delays further oncological treatment. Therefore, reducing WCs is indispensable for improving treatment. The VAC (Vacuum-Assisted Closure) therapy has been shown to have a positive effect on wound healing, but there are limited studies for its use after sarcoma resections. The aim of this study was to analyze the outcomes of various wound closure techniques. This was intended to identify optimal wound care to prevent WCs and to determine risk factors for complications.</p><p><strong>Methods: </strong>This study is a single-center study that included all patients who underwent surgery for sarcomas of the body surface and extremities. A retrospective data analysis was conducted for the years 2021-2023. The primary endpoint was the development of wound complications. Here, primary wound closure was compared with secondary closure after negative wound pressure therapy (NWPT). Secondary endpoints included the impact of drains, subtype, location, and comorbidities.</p><p><strong>Results: </strong>A total of 211 patients were examined. The most common histological subtype was liposarcoma (32,88%), followed by undifferentiated sarcoma (19,18%). Wound complications occurred in 30,19% of all cases. The analysis showed that 40,4% of patients with primary wound closure developed a complication, while only 20% of patients with NWPT did. A significant risk factor for the development of a WC was a tumor diameter > 10 cm, which led to a 20,13% higher risk of infection compared to smaller tumors. 68.3% of wound complications occurred in the lower extremity. Additionally, neoadjuvant therapy, longer operation time and immunosuppression were detected as risk factors for a higher complication rate.</p><p><strong>Conclusions: </strong>This study highlights the significantly increased risk of WCs in large sarcomas of the lower extremities. VAC therapy showed a significant improvement in wound closure especially in high-risk cases. Based on the results, the use of NWPT can be essential for wound management in sarcomas and improve convalescence and oncological treatment.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"277"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138074","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":"Post-Total-Pancreatectomy-Hemorrhage (PTPH) - approaching a new definition.","authors":"Lea Timmermann, Richard Schensar, Federico Storni, Johann Pratschke, Thomas Malinka","doi":"10.1007/s00423-025-03869-4","DOIUrl":"10.1007/s00423-025-03869-4","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative hemorrhagic complications in pancreatic surgery are classified according to the International Study Group for Pancreatic Surgery (ISGPS). However, following total pancreatectomy, the predominant bleeding causes associated with pancreatic fistula or insufficiency of the pancreatico-enteric anastomosis are eliminated. The objective of this study is to examine bleeding sources following total pancreatectomy, and propose a novel classification, termed Post-Total Pancreatectomy Hemorrhage (PTPH).</p><p><strong>Methods: </strong>An overall of 195 patients was included and reviewed for baseline characteristics, comorbidities, intraoperative findings, perioperative coagulation profiles, and postoperative courses. Applicability of the ISGPS classification to PTPH was critically assessed with respect to the existing criteria: timely onset, location and cause, and severity. Subgroups were defined with regard to bleeding sources including erosion, surgical, gastrointestinal, and diffuse bleeding. Furthermore, we developed a severity index to enhance objectivity.</p><p><strong>Results: </strong>Thirty-five of the patients experienced hemorrhagic complications. Timely onset and our severity index corresponded significantly with the bleeding source.</p><p><strong>Conclusion: </strong>The ISGPS classification, although widely utilized in pancreatic surgery, does not fully account for the bleeding complications associated with total pancreatectomy. Our proposed classification for PTPH introduces a more granular and clinically relevant framework, with clearly delineated subgroups based on source, and an innovative severity index.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"274"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124980","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":"Oncologic outcomes and prognostic factors of colloid carcinoma of the pancreas - a retrospective real-world data analysis from the German cancer registry group of the society of German tumor centers.","authors":"Jannis Duhn, Lennart von Fritsch, Kim C Honselmann, Louisa Bolm, Christoph Gerling, Kees Kleihues-van Tol, Maria Elena Lacruz, Constanze Schneider, Fabian Reinwald, Andrea Sackmann, Bianca Franke, Bernd Holleczek, Anna Krauß, Steffen Deichmann, Thaer S A Abdalla, Monika Klinkhammer-Schalke, Sylke Ruth Zeissig, Tobias Keck, Ulrich F Wellner, Rüdiger Braun","doi":"10.1007/s00423-025-03870-x","DOIUrl":"10.1007/s00423-025-03870-x","url":null,"abstract":"<p><strong>Background: </strong>Colloid carcinoma (CC) is a rare subtype of pancreatic ductal adenocarcinoma (PDAC) characterized by mucin pools in over 80% of the tumor. This study compares the histopathology and outcomes of CC and not-otherwise specified PDAC (PDAC-NOS, referring to \"classical\" PDAC) using pooled data retrieved from regional cancer registries participating in the Clinical Cancer Registry Group of the Association of German Tumor Centers (GCRG/ADT).</p><p><strong>Materials and methods: </strong>Data from patients within the pooled dataset of the GCRG/ADT with pancreatic cancer (diagnosed between 2000 and 2023) were analyzed. Histological subtypes were identified by ICD-O3 histology code. Epidemiology, histopathology and survival rates were compared between surgically resected CC and PDAC-NOS. Prognostic impacts were assessed using uni- and multivariable regression analyses in R.</p><p><strong>Results: </strong>The study included 474 CC and 21,360 PDAC-NOS patients. CC patients presented more often without lymph node metastases (pN0: 44.0 vs. 31.5%, p < 0.001), lower grading and less lymphatic and blood vessel invasion (each p < 0.001). The R0 resection rate was similar in both groups. CC patients had superior OS compared to PDAC-NOS (median OS: 24.8 vs. 17.3 months, p < 0.001). Importantly, CC histology was an independent positive prognostic factor for OS. Grading, lymph- and blood-vessel invasion were independent prognostic factors for CC patients. Adjuvant therapy was associated with improved survival in UICC IIB CC patients.</p><p><strong>Conclusion: </strong>CC patients showed better oncological outcomes after surgical resection compared to PDAC-NOS. Thereby, CC-subtype is an independent positive prognostic factor for OS, associated with lower tumor stages, fewer lymph node metastases, and less vascular invasion.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"275"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125001","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":"Correction to: Mesenteric approach for borderline resectable pancreatic head cancer: a 13-year retrospective cohort study.","authors":"Fang-Fei Wang, Qiang He, Shao-Cheng Lyu","doi":"10.1007/s00423-025-03875-6","DOIUrl":"10.1007/s00423-025-03875-6","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"273"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080473","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}