Langenbeck's Archives of Surgery最新文献

{"title":"Technical aspects in sarcoma surgery - a surgical survey among surgeons at sarcoma centers in Germany and Switzerland.","authors":"Anne-Christine Zygmunt, Elif Yilmaz, Madelaine Hettler, Michael Ghadimi, Florian Bösch, Jens Jakob","doi":"10.1007/s00423-025-03854-x","DOIUrl":"10.1007/s00423-025-03854-x","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery is a substantial pillar of extremity sarcoma treatment. There are no standardized, evidence-based strategies to perform a wide R0 resection which is recommended by international and German guidelines. The aim of this study was to use a standardized questionnaire combined with a semi-structured interview to survey the reality of surgical care in German and Swiss sarcoma centers and establish a rationale for future prospective studies to improve postoperative outcome and oncological quality in extremity sarcoma surgery.</p><p><strong>Methods: </strong>The questionnaire was developed based on a real case of a 32-year-old female patient with a locally advanced soft tissue sarcoma of the proximal thigh. We invited surgeons who were currently treating patients with extremity sarcomas at German and Swiss sarcoma centers.</p><p><strong>Results: </strong>15 of 24 (62.5%) invited surgeons participated. Participants had a broad type of surgical training and specialization (e.g. general surgery n = 5, special visceral surgery n = 4, orthopedics and trauma surgery n = 8, vascular surgery n = 2, plastic surgery n = 3). Significant differences (agreement of less than 50%) were found in the planned resection margin at the skin level, the resection planes in other tissues and strategies towards critical structures such as nerves and vessels. Similarities (agreement above 80%) were found in regard to the placement of suction drains and subcutaneous closure.</p><p><strong>Conclusion: </strong>The current survey shows relevant differences in surgical techniques among sarcoma surgeons at certified sarcoma centers. It is unclear to what extent these differences influence surgical morbidity and oncological outcome. Further studies should be planned to optimize and standardize sarcoma surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"272"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069984","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":"Callosomarginal artery: an in-depth of anatomical characteristics, clinical significance, neurosurgical considerations, and surgical applications.","authors":"Murtaja Satea Shafeea, Sandra Thair Al-Aish, Biam Saydo, Abbas F Abdul Hussein, Abdullah Aldalati, Zahraa Natheer, Santiago Pastrana-Brandes","doi":"10.1007/s00423-025-03847-w","DOIUrl":"10.1007/s00423-025-03847-w","url":null,"abstract":"<p><strong>Introduction: </strong>The Callosomarginal artery (CMA) is a terminal branch of the anterior cerebral artery (ACA). It is the main branch and the largest artery branching off from the pericallosal artery and coursing in parallel to it. Its course is posterior to or within the cingulate sulcus of the brain. The Callosomarginal artery (CMA) has several anatomical variations and established neurosurgical applications. The Callosomarginal artery (CMA) is poorly described in the standard anatomical textbooks. Therefore, we conducted this study as an overview to illustrate a complete picture of the anatomical variations and their implications in the neurosurgical field.</p><p><strong>Method: </strong>We conducted a literature review in Google Scholar and PubMed medical databases to review the literature discussing the CMA, its anatomical variations, and neurosurgical applications.</p><p><strong>Results: </strong>We identified 40 articles that discuss the CMA's anatomical variations and neurosurgical applications. We noticed the CMA's anatomical variations in origin, course, diameter, branches, depth, and distance from the associated structures. While reviewing the available articles and original works regarding CMA, we also discussed certain applications of CMA and its importance in neurosurgical bypass, embolization, and aneurysms.</p><p><strong>Conclusion: </strong>Comprehending the anatomy of the CMA is crucial for neurosurgeons to safely and effectively perform procedures such as bypass and embolization. In addition, knowledge of the anatomical variations of the CMA and its clinical significance can help surgeons anticipate potential challenges and tailor their approach accordingly.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"271"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054309","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":"Predictive value of preoperative MELD-Na score versus APRI for postoperative outcomes after infrainguinal bypass in peripheral artery disease.","authors":"Ömer Arda Çetinkaya, Yasemin Keskin, Mertcan Kayıkçı, Can Yahya Boztuğ","doi":"10.1007/s00423-025-03809-2","DOIUrl":"10.1007/s00423-025-03809-2","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"270"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033718","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 there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis.","authors":"Kellil Tarek, Tormane Mohamed Amine, Rhaiem Rami, Amara Amal, Gianpaoli Francesca, Sanchez Stephane, Piardi Tullio","doi":"10.1007/s00423-025-03778-6","DOIUrl":"10.1007/s00423-025-03778-6","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates' palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.</p><p><strong>Methods: </strong>A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.</p><p><strong>Results: </strong>The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33- 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.</p><p><strong>Conclusion: </strong>This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"269"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030180","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 role of remote ischaemic preconditioning (RIPC) in colorectal surgery: a meta-analysis of randomized-controlled studies.","authors":"Maria Chara Stylianidi, Sascha Vaghiri, Peter C Ambe, Wolfram Trudo Knoefel, Dimitrios Prassas","doi":"10.1007/s00423-025-03864-9","DOIUrl":"10.1007/s00423-025-03864-9","url":null,"abstract":"<p><strong>Introduction: </strong>Remote ischaemic preconditioning (RIPC) which consists of repeated brief episodes of non-lethal limb ischaemia is associated with organ protection and improved clinical outcomes through complex pathophysiological pathways. The aim of this meta-analysis was to evaluate the postoperative effects of RIPC in bowel recovery and surgical morbidity after colorectal surgery.</p><p><strong>Methods: </strong>In strict adherence to the PRISMA guidelines, a systematic literature search was performed for studies comparing the postoperative effect RIPC in colorectal surgery. Data from eligible studies were extracted, qualitatively assessed, and included. Odds ratios (OR) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Four studies with a total of 311 patients were included. RIPC resulted in reduced rates of postoperative ileus (POI) (OR 0.42, 95% CI 0.21-0.85, p = 0.02) and lower postoperative TNF-α levels (SMD - 1.01, 95% CI -1.59,-0.43, p = 0.0007). There were no significant differences between the two groups in other clinical outcomes such as anastomotic leak, surgical morbidity and length of hospital stay.</p><p><strong>Conclusions: </strong>RIPC demonstrated significantly reduced POI rates and TNF-α levels in colorectal surgery and could be a potential supportive strategy to promote less tissue trauma and thus enhance bowel recovery. Larger randomized controlled trials with standardized study protocols are needed to validate the results presented here.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"268"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023528","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":"Ergonomic stress and surgical performance of general surgeons: a cross-sectional comparison of laparoscopic and open procedures.","authors":"Ibrahim Serag, Mohammed Yahia Sarhan, Jehad Feras AlSamhori, Angelica Habash, Batool Qura'an, Sana'a Quran, Marah Alabbasi, Basil Albustanji, Mohammad Al-Jafari, Mariam Akram Nofal, Mohamed Abouzid, Mohammad Abu-Jeyyab","doi":"10.1007/s00423-025-03780-y","DOIUrl":"10.1007/s00423-025-03780-y","url":null,"abstract":"<p><strong>Background: </strong>Surgeons are actively seeking ways to enhance operating room ergonomics. A comprehensive report on surgeon job-related disease and injuries could raise awareness, encourage workplace improvements, and emphasize the importance of ergonomic practices such as body posture awareness, appropriate operating room setup, and exercise to lessen discomfort and improve general health.</p><p><strong>Purpose: </strong>To address the ergonomic challenges that surgeons in Jordan face during their work and to investigate how demographic variables may impact a surgeon's ability to perform open and laparoscopic procedures proficiently.</p><p><strong>Methods: </strong>This cross-sectional observational study investigated the ergonomics of surgical practice and evaluated the impact of demographic factors on the proficiency of surgeons performing both open and laparoscopic procedures. Using a self-administered questionnaire, data were gathered from 150 Jordanian doctors who had completed more than six months of surgical training and were employed by the government, the military, or the private sector.</p><p><strong>Results: </strong>In this study involving 150 surgeons in Jordan, demographic characteristics were assessed, revealing that male respondents, particularly from the military sector, had higher mean scores in both laparoscopic and open surgical approaches. Multiple linear regression analysis identified private institutions and military affiliation as significant positive predictors for achieving high scores in laparoscopic procedures, while exclusive military affiliation emerged as the sole significant predictor for open procedures.</p><p><strong>Conclusion: </strong>The study highlights surgical ergonomics' role in reducing pain and improving outcomes. Prioritizing appropriate ergonomic training, encouraging discomfort reporting, and raising awareness of official recommendations are critical for the longevity of surgeons' careers, well-being, and, ultimately, better patient outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"265"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000942","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":"Factors influencing satisfaction with preoperative education among elective surgical patients at Dessie hospital, ethiopia, 2024: a cross-sectional study.","authors":"Sitina Yimam Getahun, Afework Edmealem, Ali Seid Eshetu, Endalew Minwuye Andargie, Yonas Fissha Adem","doi":"10.1007/s00423-025-03802-9","DOIUrl":"10.1007/s00423-025-03802-9","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"264"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000972","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":"Interdisciplinary evidence-based tumor board simulation training in surgical medical education.","authors":"Nora Corinna Altmayer, Elias Khajeh, Johanna Fellhofer-Hofer, Anna Lintner, Matthias Alexander Fink, Constantin Schwab, Niels Halama, Felix Nickel, Arianeb Mehrabi, Fee Klupp","doi":"10.1007/s00423-025-03856-9","DOIUrl":"10.1007/s00423-025-03856-9","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence-based medicine (EBM), precision medicine and interdisciplinarity are becoming increasingly important in medical education. The purposeful connection between EBM and interdisciplinary work is given in the context of a tumor board, since therapy decisions are discussed here in an interdisciplinary team based on current evidence-based guidelines. To date, there has been little focus on either topic. Therefore, we aimed to assess the existing knowledge and offered a practical exercise in terms of a tumor board simulation training for medical students during their surgical study semester.</p><p><strong>Methods: </strong>First, a knowledge test was performed in 4th year medical students (n = 149) addressing the topic of EBM following an evaluation questionnaire. Subsequently, a structured one hour- lecture was held. The students were divided into groups of up to ten and assigned with specific professional roles of tumor board members. Thereafter, students participated in a live simulated tumor board. At the end the same knowledge test and evaluation questionnaire were delivered (n = 163). Study was conducted at Heidelberg Medical University between 2023 and 2024.</p><p><strong>Results: </strong>A significant increase in knowledge was seen before versus after the course only in the primarily better students (p < 0.0001). Almost no difference in knowledge test was seen before and after the course pertaining all students (p = 0.205). Evaluation questionnaire displayed that 45% (n = 66) of the students had not dealt with the topic of EBM before the course. 98% (n = 146) of the students considered that interdisciplinary work in medical profession is very important.</p><p><strong>Conclusion: </strong>Including EBM and precision medicine in a practical way into the medical curriculum is necessarily needed. As only the best students seemed to benefit significantly, a more sustainable approach might be the implementation of a longitudinal precision medicine curriculum.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"267"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000985","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":"Approaches for the treatment of perforated peptic ulcers: a network meta-analysis of randomized controlled trials.","authors":"Elisabeth Wadewitz, Juliane Friedrichs, Maurizio Grilli, Johannes A Vey, Samuel Zimmermann, Yoshiaki Sunami, Jörg Kleeff, Ulrich Ronellenfitsch, Johannes Klose, Artur Rebelo","doi":"10.1007/s00423-025-03848-9","DOIUrl":"10.1007/s00423-025-03848-9","url":null,"abstract":"<p><strong>Purpose: </strong>This network meta-analysis (NMA) aims to evaluate surgical and alternative treatment strategies for perforated peptic ulcers (PPU) with respect to mortality and other clinically relevant outcomes.</p><p><strong>Methods: </strong>An NMA was conducted in accordance with PRISMA guidelines to assess treatment approaches for PPU. Randomized controlled trials (RCT) were identified through systematic searches of PubMed/MEDLINE, Cochrane Library, Embase, CINAHL, ClinicalTrials.gov, and ICTRP databases. Outcomes were analyzed using standardized mean differences (SMDs) for continuous data and odds ratios (ORs) for binary data, both presented with 95% confidence intervals (CI) in a network meta-analysis framework.</p><p><strong>Results: </strong>Sixteen studies comprising 1,259 patients were included in this NMA. The laparoscopic approach demonstrated significantly reduced mortality (OR 0.36, 95% CI 0.17-0.75, p = 0.0065) and postoperative complications, including wound infections (OR 0.15, 95% CI 0.08-0.27, p < 0.0001) and ileus (OR 0.33, 95% CI 0.18-0.59), compared to the open surgical approach.</p><p><strong>Conclusions: </strong>This NMA, particularly the pairwise analysis, confirms the significant advantages of laparoscopic over open surgery, reinforcing its status as the gold standard for PPU. The potential benefits of alternative approaches, are inconclusive due to insufficient evidence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"266"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000902","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":"Feasibility and safety of an algorithm for the management of adhesive small bowel obstruction.","authors":"Dimitri Chappalley, Nicolas Dupasquier, Gabriel Heierli, Maria Teresa Torres, Dieter Hahnloser, Fabian Grass, Martin Hübner","doi":"10.1007/s00423-025-03820-7","DOIUrl":"10.1007/s00423-025-03820-7","url":null,"abstract":"<p><strong>Introduction: </strong>This single-center, prospective cohort study assessed the feasibility and safety of a structured management protocol (Ileus Management Algorithm Protocol: I-MAP) for patients with adhesive small bowel obstruction (ASBO).</p><p><strong>Method: </strong>Among 63 patients initially admitted for ASBO, 40 met the inclusion criteria and were managed in line with I-MAP, incorporating nasogastric tube (NGT) output and water-soluble contrast (WSC) administration within a standardized decision-making framework.</p><p><strong>Results: </strong>The study's primary outcome, protocol adherence, was achieved in 87.5% (35/40) of patients, demonstrating the protocol's feasibility. 27/35 patients (77%) had ASBO resolution with conservative management. Eight patients required surgery, mostly due to lack of improvement after 72 hours of conservative management. Complications were minimal, with only two cases of bronchial aspiration. No patient died within 30 days of conservative management.</p><p><strong>Conclusion: </strong>This standardized algorithm using pre-defined NGT output values proved feasible and safe, standardizing care and providing structured guidance in clinical decision-making. Larger trials are necessary to confirm efficacy and explore patient-reported outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"262"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959361","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}