Langenbeck's Archives of Surgery最新文献

{"title":"Biomarker-guided strategy for Denver peritoneovenous shunts in refractory ascites: a retrospective single-center study.","authors":"Yuhi Shimura, Shohei Komatsu, Yoshimasa Hashimoto, Miho Nishio, Yu Hashimoto, Michihiko Yoshida, Toshihiko Yoshida, Kenji Fukushima, Itsuo Fujita, Takumi Fukumoto","doi":"10.1007/s00423-025-03710-y","DOIUrl":"https://doi.org/10.1007/s00423-025-03710-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the utility of peritoneovenous shunt (PVS) placement for refractory ascites (RA) based on preoperative biomarkers.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with malignant and cirrhotic RA undergoing PVS placement treated at Sumoto Itsuki Hospital between January 2001 and March 2024. The efficacy of PVSs was defined according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). The usefulness of the prognostic nutritional index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and C-reactive protein-to-albumin ratio as prognostic indicators for the efficiency of PVS was evaluated.</p><p><strong>Results: </strong>In total, 149 consecutive patients (malignant RA, n = 100; cirrhotic RA, n = 49) were included in this study. PVS placement satisfied the efficacy criteria for ascites in 102 (68%) patients in the entire cohort. The estimated glomerular filtration rate (eGFR) ≤ 30 mL/min/1.73 m² was an independent predictor for the inefficacy of PVSs (odds ratio: 2.82, 95% CI: 1.04-7.73, P = 0.042). Based on receiver operating characteristic curve and multivariate analysis of the entire cohort, NLR ≥ 5.8 was an independent risk factor for death within 1 week after PVS placement (odds ratio: 18.2, 95% CI: 2.07-29.7, P = 0.016).</p><p><strong>Conclusion: </strong>PVS placement for RA may be a treatment option when preoperative eGFR is > 30 mL/min/1.73 m² and NLR is < 5.8.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"140"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of metabolic bariatric surgery: a 10-Year multicenter retrospective study in Poland (BARI-10-POL).","authors":"Natalia Dowgiałło-Gornowicz, Paweł Jaworski, Michał Orłowski, Paula Franczak, Monika Proczko-Stepaniak, Anna Kloczkowska, Izabela Karpińska, Paweł Lech, Piotr Major","doi":"10.1007/s00423-025-03713-9","DOIUrl":"https://doi.org/10.1007/s00423-025-03713-9","url":null,"abstract":"<p><strong>Purpose: </strong>Metabolic bariatric surgery (MBS) is an effective treatment for obesity and obesity-related diseases, but long-term data on its outcomes remain limited, particularly in Poland. These data are crucial for understanding the durability of weight loss, trends in weight regain, and comorbidity remission, as well as for refining surgical techniques and improving long-term care. This study aims to evaluate the 10-year outcomes of MBS in Poland, focusing on weight loss and remission of obesity-related diseases in patients who completed follow-up.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study, named BARI-10-POL, analyzed 485 patients (mean age: 41.0 years, 71.5% female, median BMI: 43.4 kg/m²) who underwent laparoscopic MBS between 2008 and 2014 across five bariatric centers. Data collected included demographics, type of surgery, weight loss (%TWL, %EWL), and remission of type 2 diabetes (T2D) and hypertension (HT).</p><p><strong>Results: </strong>The follow-up rate was 28.5% (485/1703). Among the procedures, 317 (65.4%) were sleeve gastrectomies (SG). The median %EWL and %TWL were 59.2% and 22.8%, respectively. Revisional procedures were required in 23.9% of patients, most commonly after SG (24.3%) and adjustable gastric banding (100%). The remission rates for T2D and HT were 70.8% and 56.7%, respectively. One anastomosis gastric bypass (OAGB) demonstrated superior median %EWL (80.1%) compared to SG (55.0%, p < 0.001) and Roux-en-Y gastric bypass (RYGB) (51.4%, p < 0.001).</p><p><strong>Conclusions: </strong>Conducting long-term follow-up after bariatric surgery is challenging. MBS leads to significant long-term outcomes in both weight loss and remission of obesity-related diseases.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"142"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of indocyanine green on tumor visualization and procedural adjustment in minimally invasive liver surgery.","authors":"Mareike Franz, Jörg Arend, Antonia Bollensdorf, Eric Lorenz, Mirhasan Rahimli, Frederike Stelter, Manuela Petersen, Andrew A Gumbs, Roland Croner","doi":"10.1007/s00423-025-03712-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03712-w","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive hepatobiliary surgery is performed increasingly either with robotic assistance or conventional laparoscopy. The lack of haptic feedback is one of the main challenges which has to be addressed during these procedures. Especially in oncological minimally invasive liver surgery Indocyanine green (ICG) can help to gain additional information for improved oncological quality.</p><p><strong>Methods: </strong>Patients who underwent minimally invasive liver surgery for liver tumors between 01/2019 and 09/2022 and matched the study criteria were selected from the Magdeburg Registry of Minimally invasive liver surgery (MD-MILS). Patient demographics, tumor characteristics and perioperative data were analyzed retrospectively. The benefit of ICG for tumor identification and the resection procedure was assessed as 'very helpful', 'helpful' and 'not helpful' depending on the surgeon´s estimation.</p><p><strong>Results: </strong>Seventy-two patients who met the selection criteria were included in the analysis. Of these, 49 patients received ICG for intraoperative tumor visualization (ICG). Twenty-three patients with comparable demographics did not receive ICG and served as comparison group (nICG). A total of 69.4% robotic and 30.6% laparoscopic procedures were performed. In the ICG group procedural adjustments were significantly more frequent intraoperatively (p = 0.023). Intraoperative frozen section analysis on additional biopsies of ICG positive lesions were performed in 37% in the ICG group. In the nICG group suspect lesions, identified by ultrasound, went to frozen section in 17% (p = 0.006). Histopathological tumor positivity was identified in 12.2% in the ICG cohort vs no tumor positivity in the nICG cohort. This was one factor which led to the termination of surgery in 8% in the ICG vs the nICG 4.3% group (p = 0.485). In 88% intraoperative ICG visualization was scored as \"helpful\" when injected on preoperative day 4-7 with respect to the liver parenchyma structure and hepatocellular function.</p><p><strong>Conclusion: </strong>ICG can improve oncological quality in minimally invasive liver resections. It provides additional visual information which can help to compensate the loss of haptics and tumor identification during liver tissue palpation. The intraoperative use of ICG was associated with no adverse events and did not prolong operative time. We recommend its routine use during minimally invasive liver surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"143"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of mesh fixation in incisional hernia repair using the open sublay technique: results from the herniamed-registry.","authors":"P Schelbert, R N Vuille-Dit-Bille, F Köckerling, D Adolf, R F Staerkle","doi":"10.1007/s00423-025-03714-8","DOIUrl":"https://doi.org/10.1007/s00423-025-03714-8","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernias reflect a common complication after abdominal surgery. Main treatment consists of defect closure and mesh insertion using the sublay method. The aim of the present study was to assess the association of mesh fixation to patients' outcome.</p><p><strong>Methods: </strong>Using the Herniamed registry, data from 13'452 incisional hernia repairs were analyzed retrospectively. Three groups of patients were compared: those with mesh fixation (n = 9'986), those with self-fixing meshes (n = 2'725), and those without mesh fixation (n = 741). Postoperative complications, recurrence and postoperative pain scores were assessed over a follow-up period of one year postoperatively.</p><p><strong>Results: </strong>Taking into account that patients without mesh fixation had smaller defects and were treated with smaller meshes indicating non-equivalent groups, postoperative complications (general, intra- and postoperative complications, as well as complication-related reoperations), were similar among groups except that self-fixing meshes showed a lower general complication rate compared to fixed meshes (OR = 0.733 [0.579; 0.929]; p = 0.010). Mesh fixation had no relation to recurrence rate. Self-fixating meshes were associated with increased pain at rest rate (OR = 1.325 [1.156; 1.518]; p < 0.001), pain on exertion rate (OR = 1.255 [1.125; 1.400], p < 0.001) and chronic pain requiring treatment (OR = 1.271 [1.086; 1.488], p = 0.003) compared to fixed meshes. Self-fixating (OR = 1.675 [1.322; 2.120], p < 0.001) and fixed meshes (OR = 1.334 [1.069; 1.666], p = 0.011) were associated to increased pain on exertion rate compared to non-fixed meshes.</p><p><strong>Conclusion: </strong>It appears that mesh fixation can be omitted during sublay incisional hernia repair.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"141"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving textbook outcome in liver resection for hepatocellular carcinoma: malnutrition's pivotal role.","authors":"Kentaro Oji, Takeshi Urade, Satoshi Omiya, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto","doi":"10.1007/s00423-025-03703-x","DOIUrl":"https://doi.org/10.1007/s00423-025-03703-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of textbook outcome (TO) achievement on survival post-liver resection for hepatocellular carcinoma (HCC) and explore the associated factors.</p><p><strong>Methods: </strong>We retrospectively reviewed 330 patients diagnosed with HCC who underwent initial liver resection at our hospital between January 2011 and December 2019. We also investigated the achievement rates of five TOs and sub-analyzed the relationship between them and malnutrition. The patient's nutritional status was classified following the Global Leadership Initiative on Malnutrition (GLIM) criteria.</p><p><strong>Results: </strong>The TO achievement rate was 72.7%. In the prognostic analysis, the TO-achieving group showed significantly longer overall survival (OS) and recurrence-free survival (RFS). Significant differences in age, body mass index, weight loss, muscle mass, serum aspartate aminotransferase level, serum protein induced by vitamin K absence or antagonist-II, tumor characteristics, intraoperative blood loss, perioperative transfusion, and nutritional status were found between the groups.</p><p><strong>Conclusions: </strong>TO achievement is associated with OS and RFS post-liver resection for HCC. The TO is valuable for evaluating treatment quality in liver resection. Additionally, malnutrition graded following the GLIM criteria, age, tumor stage, and intraoperative blood loss are independent factors for achieving a TO post-liver resection for HCC.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"139"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of infectious complications and their implication on health system costs after esophagectomy for esophageal cancer: Real-world data from three European centers.","authors":"Anna Lucia Ledda, Ignazio Tarantino, Sabine Schiefer, Ulrich Ronellenfitsch, Artur Rebelo, Carsten Sekulla, Henrik Nienhüser, Christoph Michalski, Bruno Schmied, Jörg Kleeff, Johannes Klose","doi":"10.1007/s00423-025-03709-5","DOIUrl":"https://doi.org/10.1007/s00423-025-03709-5","url":null,"abstract":"<p><strong>Purpose: </strong>Infectious complications occur frequently after esophagectomy leading to prolonged hospital stay and increased costs. This study aimed to analyze the pattern of infectious complications, the spectrum of associated microbiota, and its impact on health system costs in patients who underwent esophagectomy for esophageal cancer.</p><p><strong>Methods: </strong>All patients undergoing curative resection for histologically confirmed esophageal cancer between January 2017 and August 2022 were included. Patients' survival was analyzed by Kaplan-Meier estimate. Contingency tables were applied to assess the association between microbiota and the occurrence of infectious complications and their impact on patients' survival.</p><p><strong>Results: </strong>Four hundred forty-one patients who received a R0 resection for esophageal cancer were identified. Infectious complications occurred in 153 patients (34.7%). Pneumonia was the most frequent complication (28.8%) followed by anastomotic leakage (25.4%). Enterococcus and Candida species were the dominant microbiota associated with infectious complications (Candida species: OR 7.34, 95% CI 2.38-22.67) and anastomotic leakage (Enterococcus species: OR 6,15, 95% CI 1,51-24,99; Candida species: OR 7.14, 95% CI 2.48-20.56). Intensive care unit stay (mean 14.3 vs. 4.9 days, p < 0.001) and total hospital stay (mean 34.1 vs. 18.8 days, p < 0.001) were significantly longer in patients with infectious complications. Total health system costs (44.084 € vs. 25.907 €) increased after the occurrence of infectious complications.</p><p><strong>Conclusion: </strong>Infectious complications after esophagectomy are predominantly associated with the presence of Enterococcus and Candida species, leading to increased health system costs. Preventive antibiotic and antimycotic treatment might result in reduction of infectious complications and lower health system costs.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"138"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors: a retrospective 10-year single-center experience.","authors":"Marek Szczepkowski, Piotr Witkowski, Alicja Przywózka-Suwała, Karolina Skonieczna-Żydecka, Teresa Starzyńska, Krzysztof Dąbkowski","doi":"10.1007/s00423-025-03704-w","DOIUrl":"https://doi.org/10.1007/s00423-025-03704-w","url":null,"abstract":"<p><strong>Purpose: </strong>Transanal endoscopic surgery is a recommended full-thickness resection technique for the treatment of rectal neuroendocrine tumors. We aimed to compare the efficacy, safety and follow-up of patients with rectal neuroendocrine tumors treated with transanal endoscopic microsurgery in the primary setting and as salvage therapy after non-radical endoscopic polypectomy.</p><p><strong>Methods: </strong>A retrospective analysis of a 10-year database of patients treated with transanal endoscopic microsurgery was performed. The procedure-related measures, including duration of the procedure, adverse events, and patient-related measures, including age, gender, tumor size, grading, and length of follow-up, were obtained. We compared the primary TEM group with the salvage group.</p><p><strong>Results: </strong>In total, 30 patients with rectal neuroendocrine tumors were included in the study; 13 of them received primary treatment and 17 salvage therapy of the scar. Patients receiving primary treatment were significantly older (60.5 vs. 51.7 years). There were no significant differences in patient gender, tumor size and grading, length of follow-up, hospital stay or procedure time. The R0 resection rate was 92.3% in the primary treatment group. Adverse events were mild or managed with endoscopic treatment. Follow-up was slightly but not significantly longer in the primary treatment group and showed no recurrences in both groups of patients.</p><p><strong>Conclusions: </strong>Transanal endoscopic microsurgery is safe and effective for both primary and salvage treatment of rectal neuroendocrine tumors.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"137"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative risk factors for suboptimal initial clinical response or weight regain in patients undergoing bariatric surgery, a retrospective cohort study from a high-volume center.","authors":"Enrique Salazar-Rios, Cesar A Martínez Ortíz, Maria E Salazar-Rios, Carlos A Gutiérrez Rojas","doi":"10.1007/s00423-025-03700-0","DOIUrl":"https://doi.org/10.1007/s00423-025-03700-0","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery is widely recognized as a mainstay in the treatment of obesity; however, there is limited information regarding its success and the factors that influence outcomes within the Mexican population. This study provides an analysis of bariatric surgery outcomes at the \"Hospital de Especialidades\" of the \"Centro Médico Nacional Siglo XXI,\" with a particular focus on the prevalence of suboptimal initial clinical response, weight regain, and the identification of predictive factors.</p><p><strong>Methods: </strong>A retrospective cohort study involving 132 patients who underwent bariatric surgery between January 2018 and March 2023 was conducted. The prevalence of suboptimal initial clinical response was determined, and a binary logistic regression was applied to identify potential risk factors.</p><p><strong>Results: </strong>The study found that 21.97% of patients experienced suboptimal initial clinical response, a rate lower than reported in global literature. The population exhibited a significant prevalence of comorbidities, including type 2 diabetes mellitus (63.64%), hypertension (55.3%), and obstructive sleep apnea (60.61%), reflecting Mexico's high obesity rates. Additionally, male sex was identified as a significant predictor of suboptimal initial clinical response, while glycated hemoglobin and serum albumin emerged as relevant biochemical predictors, underscoring the importance of preoperative glycemic control.</p><p><strong>Conclusion: </strong>These findings offer valuable insights into bariatric surgery outcomes and identifies adequate preoperative glycemic control as an important modifiable factor that can inform future policies aimed at enhancing patient care and surgical success in bariatric procedures.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"136"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978775","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":"Chronic pain and foreign body sensation based on mesh placement in primary ventral hernia repair: a systematic review highlighting the evidence gap and a call to action.","authors":"Usamah Ahmed, Jacob Rosenberg, Jason Joe Baker","doi":"10.1007/s00423-025-03671-2","DOIUrl":"https://doi.org/10.1007/s00423-025-03671-2","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aimed to investigate differences in chronic pain and foreign body sensation based on mesh placement, with recurrence as a secondary outcome.</p><p><strong>Methods: </strong>The review was registered in PROSPERO (ID: CRD42024592114), and searches were conducted in MEDLINE (PubMed), Embase Ovid, and Cochrane CENTRAL on October 3rd, 2024. Studies were included if they compared mesh placements, categorized as onlay, retromuscular, preperitoneal, or intraperitoneal onlay mesh (IPOM), in primary ventral hernia repairs in adults. Chronic pain (≥ 6 months post-surgery) and foreign body sensation were the primary outcomes. Randomized controlled trials (RCTs) and cohort studies were included, while incisional hernias alone and animal studies were excluded. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies and Cochrane Risk of Bias 2 (RoB2) tool for RCTs. Due to significant heterogeneity, a meta-analysis was not feasible, and a narrative synthesis was provided.</p><p><strong>Results: </strong>A total of 6,562 records were screened, of which nine cohort studies and one RCT were included. Studies were heterogeneous and many did not aim to assess chronic pain as the primary outcome. Two studies reported significantly lower chronic pain rates with retromuscular mesh placement, but data pooling was not possible. Foreign body sensation could not be assessed because the only study reporting on this did not have extractable data.</p><p><strong>Conclusion: </strong>Currently, there is insufficient evidence to favor one mesh placement over another for chronic pain or foreign body sensation. While crude rates suggest that retromuscular and preperitoneal placements may result in less chronic pain than onlay and IPOM, the evidence remains very uncertain due to significant clinical and methodological heterogeneity. Further research is warranted.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"132"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of ERAS-based nursing interventions on postoperative complication management and prognosis in early gastrointestinal tumor endoscopic resection: a prospective randomized controlled study.","authors":"Yun Shen, Yu Xi, Li Gu Xian Ru, Huayu Liu","doi":"10.1007/s00423-025-03652-5","DOIUrl":"https://doi.org/10.1007/s00423-025-03652-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of Enhanced Recovery After Surgery (ERAS)-based nursing interventions in improving postoperative recovery, reducing complications, and enhancing patient satisfaction and quality of life in patients undergoing endoscopic resection for early gastrointestinal tumors.</p><p><strong>Methods: </strong>A single-center, randomized, single-blind controlled trial was conducted from October 2023 to October 2024 at a tertiary hospital. A total of 120 patients with early-stage gastrointestinal tumors scheduled for endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) were randomly assigned to the ERAS group (n = 60) or the control group (NC, n = 60). Data collection included Comprehensive Complication Index (CCI), Visual Analog Scale (VAS), Six-Minute Walk Test (6MWT), EORTC QLQ-C30, SF-36, patient satisfaction, and length of hospital stay. Statistical analyses included repeated measures ANOVA and chi-square tests, with a significance threshold of P < 0.05.</p><p><strong>Results: </strong>Compared to the NC group, the ERAS group demonstrated significantly lower CCI scores and fewer Clavien-Dindo ≥ III complications at 3 days, 2 weeks, and 3 months postoperatively (P < 0.05). The ERAS group also reported shorter hospital stays (4.8 ± 1.5 vs. 6.3 ± 1.8 days, P < 0.001). VAS scores in the ERAS group were significantly lower at 24 h and 3 days postoperatively (P < 0.001), with differences diminishing over time. Functional recovery, measured by 6MWT, was significantly better in the ERAS group at all time points except 12 months. HRQoL scores in the ERAS group were significantly higher at 3 months, particularly in functional and symptom dimensions (P < 0.05), and have higher patient satisfaction rates across all follow-up time points (P < 0.05).</p><p><strong>Conclusion: </strong>ERAS-based nursing interventions significantly improved postoperative recovery, reduced complications, shortened hospital stays, and enhanced patient satisfaction and quality of life in patients undergoing minimally invasive endoscopic resection for early gastrointestinal tumors. These findings support the integration of ERAS principles into nursing care protocols to optimize surgical outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"135"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001161","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}