Langenbeck's Archives of Surgery最新文献

{"title":"Digital standardization in liver surgery through a surgical workflow management system: A pilot randomized controlled trial.","authors":"Fabian Haak, Philip C Müller, Otto Kollmar, Adrian T Billeter, Joël L Lavanchy, Andrea Wiencierz, Beat Peter Müller-Stich, Marco von Strauss Und Torney","doi":"10.1007/s00423-025-03634-7","DOIUrl":"10.1007/s00423-025-03634-7","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical process models (SPM) are simplified representations of operations and their visualization by surgical workflow management systems (SWMS), and offer a solution to enhance communication and workflow.</p><p><strong>Methods: </strong>A 1:1 randomized controlled trial was conducted. A SPM consisting of six surgical steps was defined to represent the surgical procedure. The primary outcome, termed \"deviation\" measured the difference between actual and planned surgery duration. Secondary outcomes included stress levels of the operating team and complications. Analyses employed Welch t-tests and linear regression models.</p><p><strong>Results: </strong>18 procedures were performed with a SWMS and 18 without. The deviation showed no significant difference between the intervention and control group. Stress levels (TLX score) of the team remained largely unaffected. Duration of operation steps defined by SPM allows a classification of all liver procedures into three phases: The Start Phase (low IQR of operation time), the Main Phase (high IQR of operation time) and the End Phase (low IQR of operation time).</p><p><strong>Conclusion: </strong>This study presents a novel SPM for open liver resections visualized by a SWMS. No significant reduction of deviations from planned operation time was observed with system use. Stress levels of the operation team were not influenced by the SWMS.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"96"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of ursodeoxycholic acid in dissolving gallstones formed after laparoscopic sleeve gastrectomy: retrospective cohort study.","authors":"Fatih Buyuker, Medeni Sermet, Mehmet Sait Ozsoy, Salih Tosun, Özgür Ekinci, Hakan Baysal, Orhan Alimoglu","doi":"10.1007/s00423-025-03656-1","DOIUrl":"10.1007/s00423-025-03656-1","url":null,"abstract":"<p><strong>Purpose: </strong>Rapid weight loss that often occurs after laparoscopic sleeve gastrectomy (LSG) has been linked to an increased risk of gallstone formation. This study aimed to investigate whether ursodeoxycholic acid could be an effective alternative treatment for gallstone dissolution, potentially offering a nonsurgical option for patients requiring gallstone removal.</p><p><strong>Methods: </strong>This retrospective study analyzed 88 patients who underwent LSG and subsequently developed gallstones between 2017 and 2023. Fifty-one patients who received UDCA treatment were compared to 37 patients who did not receive UDCA. Demographic and clinical characteristics and gallstone dissolution rates were analyzed using SPSS v25.0.</p><p><strong>Results: </strong>Gallstones dissolved in 60% of patients who received UDCA treatment, and symptoms such as dyspepsia decreased. A stone diameter of less than 5 mm was associated with a higher treatment success rate. The number of hospitalizations and admissions due to gallstone symptoms has decreased. The side effects were mild and did not require treatment discontinuation.</p><p><strong>Conclusions: </strong>UDCA treatment is an effective option for the resolution of gallstones after LSG. However, surgery may be more appropriate for treating larger stones. The results of this study suggest that UDCA is an effective intervention for reducing gallstone-related complications following LSG.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"91"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573434","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":"Prognostic analysis and limited efficacy of adjuvant TACE in hepatocellular carcinoma following hepatectomy: a propensity score-matched study.","authors":"Yi Peng, Shuang Shen, Yifei Feng, Zhaochan Wen, Jiayin Qin, Wei Lu, Bangde Xiang","doi":"10.1007/s00423-025-03663-2","DOIUrl":"10.1007/s00423-025-03663-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative adjuvant transarterial chemoembolization (PA-TACE) is proposed as a potentially effective treatment for hepatocellular carcinoma (HCC), but its benefits may be limited according to recent evidence.</p><p><strong>Methods: </strong>We analyzed clinicopathologic data from HCC patients who underwent hepatectomy between 2014 and 2019, categorizing them into two groups: surgery alone (non-PA-TACE) and PA-TACE. Propensity score matching (PSM) was used to adjust for selection bias. Cox proportional hazard models identified independent prognostic factors for overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier estimates were used to compare RFS and OS rates between groups.</p><p><strong>Result: </strong>PA-TACE was not an independent prognostic factor for RFS (entire cohort: hazard ratio [HR] 1.17, 95% confidence interval [CI] 0.92-1.50, p = 0.206; matched cohort: HR 1.10, 95% CI 0.79-1.54, p = 0.560) or OS (entire cohort: HR 1.15, 95% CI 0.87-1.52, p = 0.317; matched cohort: HR 0.96, 95% CI 0.68-1.36, p = 0.823). In the matched cohort, independent Predictors of worse OS included tumor diameter ≥ 5 cm, positive microvascular invasion (MVI), Edmondson-Steiner grade III-IV, pathological cirrhosis, and Barcelona Clinic Liver Cancer (BCLC) B/C stage. Predictors of worse RFS included tumor diameter ≥ 5 cm and Edmondson-Steiner grade III-IV. Only in the BCLC B/C stage subgroup, PA-TACE may improve OS compared to non-PA-TACE (HR 0.47, 95% CI 0.26-0.85, p = 0.011).</p><p><strong>Conclusion: </strong>PA-TACE may not extend OS or RFS in HCC patients with BCLC 0/A stage, tumor diameter ≥ 5 cm, or MVI. PA-TACE should be administered with caution, even in HCC patients with BCLC B/C stage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"92"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573433","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":"Tumor burden score combined with AFP and PIVKA-II (TAP score) to predict the prognosis of hepatocellular carcinoma patients after radical liver resection.","authors":"Zhan-Cheng Qiu, You-Wei Wu, Jun-Long Dai, Wei-Li Qi, Chu-Wen Chen, Yue-Qing Xu, Jun-Yi Shen, Chuan Li, Tian-Fu Wen","doi":"10.1007/s00423-025-03650-7","DOIUrl":"10.1007/s00423-025-03650-7","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to combine the morphological behavior (tumor burden score, TBS) and the biological behavior (AFP and PIVKA-II) to predict the prognosis of HCC patients after radical liver resection.</p><p><strong>Methods: </strong>A total of 1766 HCC patients were divided into the training cohort (n = 1079) and the validation cohort (n = 687) with a ratio of 6:4. The Kaplan-Meier method was used to analyze the recurrence-free (RFS) and overall survival (OS). The multivariable Cox regression model was established based on the variables screened by the least absolute shrinkage and selection operator (LASSO) regression to identify variables independently associated with recurrence-free survival (RFS) and overall survival (OS). Constructing our prognostic score (TBS-LN(AFP + PIVKA-II) score, TAP score) based on regression coefficients and the predictive ability of the TAP score was compared with Barcelona Clinic Liver Cancer (BCLC) stage.</p><p><strong>Results: </strong>The TAP score had good performance in stratifying RFS (p < 0.001) and OS (p < 0.001) in the training cohort and the validation cohort. There still existed significant differences in the intergroup comparisons among three TAP score groups for RFS and OS in the training cohort and the validation cohort. In our LASSO-Cox regression model, the TAP score was independently associated with RFS and OS. The TAP score also outperformed the BCLC stage in predicting RFS (1, 2 and 3 years) and OS (1, 3 and 5 years).</p><p><strong>Conclusions: </strong>The TAP score had good performance in predicting the prognosis of HCC patients after radical liver resection and was superior to the BCLC stage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"89"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567579","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":"Evaluation of hand-assisted laparoscopic surgery of small intestinal neuroendocrine tumours as an alternative surgical treatment to open surgery.","authors":"Branislav Klimácek, Tobias Åkerström, Matilda Annebäck, Per Hellman, Olov Norlén, Peter Stålberg","doi":"10.1007/s00423-025-03658-z","DOIUrl":"10.1007/s00423-025-03658-z","url":null,"abstract":"<p><strong>Purpose: </strong>Small intestinal neuroendocrine tumours (SI-NETs) are the most common malignancy of the small bowel. Curative treatment is surgical, with exploratory laparotomy considered the standard approach. This study aimed to assess the outcomes of minimally invasive surgery compared to open approach for SI-NETs at the Endocrine surgical unit at Uppsala University Hospital.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent surgery for SI-NET between 2013 and 2023 at Uppsala University Hospital. Variables such as operative time, length of hospital stay, use of analgesia and radicality were compared between groups of patients operated on before and after 2019, when hand-port assisted laparoscopic surgery (HALS) for SI-NETs was introduced at our unit. Outcomes were further compared between open and hand-port assisted laparoscopic approaches. The primary outcome was the rate of radicality achieved for stage II-III patients. Secondary outcomes included operative time, the length of hospital stay and the use of epidural and patient-controlled analgesia.</p><p><strong>Results: </strong>Of 97 patients, 58 (59.8%) underwent open surgery and 39 (40.2%) underwent hand-port assisted laparoscopic surgery. There was no significant difference in operative time (121 min [91.3-150.3] vs 108 min [83-141]), length of hospital stay, 6 days [4-7] vs 5 days [4-8]), and surgical radicality in patients with stage II-III, 85.2% vs 100%, (p = 0.079). 86.2% of patients with explorative laparotomy required epidural analgesia compared to only 23.1% with HALS (p < 0.001).</p><p><strong>Conclusion: </strong>Hand-port assisted laparoscopic surgery of SI-NETs is a feasible approach that preserves radical resection while enhancing postoperative recovery, with a lower requirement of epidural analgesia.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"90"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567577","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":"Postoperative pancreatic fistula is higher in patients with necrotizing pancreatitis who develop a colon-transverse fistula.","authors":"Weiliang Tian, Tao Hu, Shikun Luo, Guoping Zhao, Risheng Zhao, Yunzhao Zhao, Qiurong Li, Zheng Yao, Qian Huang","doi":"10.1007/s00423-024-03578-4","DOIUrl":"10.1007/s00423-024-03578-4","url":null,"abstract":"<p><strong>Background: </strong>This study explores the association between the need for open necrosectomy (ON) during infected necrotizing pancreatitis (INP) treatment and the development of postoperative pancreatic fistula (POPF) following definitive surgery (DS) for transverse colonic fistulas.</p><p><strong>Materials and methods: </strong>This study was conducted at two tertiary hospitals and included patients who underwent DS for colonic fistula secondary to INP from January 2009 to December 2023. Patients were followed until hospital discharge. The primary outcome was the incidence of POPF.</p><p><strong>Results: </strong>A total of 135 patients were included. The median age was 38 years (interquartile range [IQR]: 32-44 years), with 85 (62.9%) being male. ON was required in 52 patients (38.5%), with 24 patients developing POPF post-DS. The need for ON (odds ratio [OR] = 2.78, 95% confidence interval [CI]: 1.03-7.58, p = 0.040) and the interval from INP resolution to DS (OR = 0.82, 95% CI: 0.68-0.92, p = 0.011) were associated with POPF.</p><p><strong>Conclusion: </strong>The need for ON during INP treatment is significantly associated with an increased risk of POPF following DS for transverse colonic fistulas.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"88"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567578","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":"Poor bony density can independently trigger higher incidence of adjacent vertebral fracture after percutaneous vertebralplasty: a mono-center retrospective study.","authors":"Shengyu Wan, Zichuan Wu, Hong Li, Jian Zhang, Xu Lin, Tao Gao, Jingchi Li","doi":"10.1007/s00423-025-03649-0","DOIUrl":"10.1007/s00423-025-03649-0","url":null,"abstract":"<p><strong>Objective: </strong>Symptomatic adjacent vertebral fractures (AVF) poses a challenge to patient prognosis in osteoporotic vertebral compressive fractures (OVCF) treated by percutaneous vertebralplasty (PVP). This study aimed to identify potential risk factors for AVF, thereby offering theoretical insights for refining patient management strategies and surgical protocols.</p><p><strong>Methods: </strong>Clinical data of PVP patients treated between March 2018 and May 2020 were retrospectively analyzed, with an average follow-up period of 30 months. Patients were stratified into two groups based on the presence or absence of recurrent symptomatic AVF. Demographic characteristics and imaging based parameters were assessed to identify potential risk factors for AVF.</p><p><strong>Results: </strong>Demographic parameters, including age, sex, body mass index, and fracture location (junctional or non-junctional), did not significantly differ between the two groups and were not found to be independent risk factors for AVF. However, patients with AVF exhibited significantly lower bone mineral density, as assessed by T-score and Hounsfield unit (HU) values. Notably, lower HU values emerged as an independent risk factor for AVF. Contrary to expectations, larger vertebral distraction and intervertebral disc cement leakage did not trigger higher incidence of AVF.</p><p><strong>Conclusion: </strong>Progression of bony density reduction emerged as the primary driver for the heightened incidence of AVF. Accordingly, anti-osteoporosis therapy should be regarded as an effective strategy for mitigating the risk of AVF in patients undergoing PVP.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"87"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542425","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":"Multicenter Belgian prospective registry on minimally invasive and open liver surgery (BReLLS): experience from 1342 consecutive cases.","authors":"Roberto Ivan Troisi, Gianluca Rompianesi, Mathieu D'Hondt, Aude Vanlander, Claude Bertrand, Catherine Hubert, Olivier Detry, Bert Van den Bossche, Philippe Malvaux, Joseph Weerts, Thibault Sablon, Koen Vermeiren, Mehrdad Biglari, Filip Gryspeerdt, Celine De Meyere, Alexandra Dili, Kim Boterbergh, Valerio Lucidi","doi":"10.1007/s00423-025-03661-4","DOIUrl":"10.1007/s00423-025-03661-4","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive liver surgery (MILS) still appears to be adopted with significant variability. We aimed to investigate the diffusion, indications, and short-term outcomes of MILS compared to the open approach.</p><p><strong>Methods: </strong>A prospective registry of all liver resections performed for any indication and using any technique between January 1, 2017, and December 31, 2019, was established (BReLLS) and analyzed.</p><p><strong>Results: </strong>A total of 1342 consecutive liver resections were included, 684 (51%) MILS and 658 (49%) open procedures. MILS was not attempted due to technical complexity in the 46.2% of cases, followed by previous abdominal surgery (22.5%). Patients undergoing MILS had a higher proportion of benign indications and of hepatocellular carcinomas, patients affected by liver cirrhosis with portal hypertension and a lower proportion of major hepatectomies (all p < 0.001). After propensity-score matching, MILS showed better results in terms of surgery duration (p < 0.001), blood loss (p = 0.015), complication rate (p < 0.001), rate of Clavien-Dindo grade ≥ 3 complications (p = 0.012), comprehensive complication index (p < 0.001), length of stay (p < 0.001), readmissions (p = 0.016). Centers performing over 50 liver resections per year had a higher proportion of overall MILS cases (p < 0.001), a similar proportion of major resections (p = 0.362), but a higher prevalence of MILS major resections (p = 0.004), lower 90-day mortality rates (p < 0.001), lower overall complication rates (p < 0.001), and shorter hospital length of stay (p < 0.001).</p><p><strong>Conclusion: </strong>MILS was the preferred technique in half of the cases, particularly in patients with cirrhosis and portal hypertension, and benign lesions. It provided superior short-term outcomes compared to the open approach for both minor and major liver resections in selected patients.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"86"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542423","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 optimal cut-off value of postoperative day three C-reactive protein to predict for major complications in colorectal cancer patients.","authors":"Coco Smit, Maryska L Janssen-Heijnen, Frits van Osch, Jonas Rops, Anke H C Gielen, Maarten van Heinsbergen, Jarno Melenhorst, Joop L M Konsten","doi":"10.1007/s00423-025-03655-2","DOIUrl":"10.1007/s00423-025-03655-2","url":null,"abstract":"<p><strong>Purpose: </strong>To identify an optimal postoperative day 3 (POD3) C-reactive protein (CRP) cut-off for predicting major complications in colorectal cancer (CRC) patients. Secondary objectives included identifying patient and surgical factors associated with POD3 CRP levels and assessing the accuracy of the cut-off across subgroups.</p><p><strong>Methods: </strong>A retrospective cohort study of 1536 CRC patients who underwent an oncological resection was conducted. The predictive accuracy of POD3 CRP for major complications was tested using Receiver Operating Characteristics curves. The CRP cut-off was tested across subgroups. Multivariable logistic regression analyses was performed to evaluate the predictive value of the POD3 CRP cut-off, while also determining whether patient and surgical characteristics independently predicted major complications.</p><p><strong>Results: </strong>An optimal cut-off of 114 mg/L was identified, with a sensitivity of 0.80 and specificity of 0.59 and an Area Under the Curve for POD3 CRP of 0.78. Sensitivity remained consistently high across all subgroups, whereas specificity exhibited variability, with a notable decrease observed in the subgroups; aged 66-69, obese, ASA III and open surgery. After adjusting for patient and surgery characteristics, a POD3 CRP level above 114 mg/L was associated with a significant 5.29-fold increase in the odds for developing major complications.</p><p><strong>Conclusions: </strong>A POD3 CRP cut-off of 114 mg/L is an effective predictor of major complications following CRC surgery, supporting safe early discharge. The cut-off remains a reliable predictor, even after adjusting for patient and surgery factors.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"85"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515910","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":"Prospective, monocentric observational study on the clinical use and patient satisfaction of an implantable venous access Port.","authors":"Alexander Werba, Roland Hennes, Fabian Schuh, Magdalena Holze, Barbara Maichle, Ali Ramouz, Mark Bauer, Kai Braunsteffer, Phillip Knebel, Rosa Klotz, Frank Pianka","doi":"10.1007/s00423-025-03654-3","DOIUrl":"10.1007/s00423-025-03654-3","url":null,"abstract":"<p><strong>Purpose: </strong>Long-term totally implantable venous access ports (TIVAP) are essential for administering chemotherapy and parenteral nutrition in cancer patients. This study aimed to evaluate patient satisfaction and postoperative complications, compared to existing literature, emphasizing patient-reported outcomes (PRO) as a critical factor in treatment decisions.</p><p><strong>Methods: </strong>A prospective, monocentric observational study included 149 patients requiring TIVAP between April 13 and August 17, 2022. Patient satisfaction was assessed using a questionnaire covering four domains: overall satisfaction, willingness to choose the port again, cosmetic result, and pain experience. A meta-analysis of seven studies (1,035 patients) was performed to establish baseline data. The study assumed a non-inferiority margin of 12 points on a 0-100 scale (lower scores indicating better outcomes). Follow-ups were carried out at four weeks and six months.</p><p><strong>Results: </strong>Of the 149 patients (mean age 58.8 years, 96% with oncological diseases), 117 (78.5%) TIVAPs were implanted via the cut-down technique, primarily using the cephalic vein (84.6%). Out of 1,240 documented catheter accesses, 91.4% were complication-free. Satisfaction scores demonstrated non-inferiority across all domains compared to literature: overall satisfaction (18.5 vs. 35.6; p < 0.001), willingness to choose the port again (15.8 vs. 29.4; p < 0.001), cosmetic result (38.0 vs. 39.9; p = 0.003), and pain experience (17.1 vs. 31.5; p < 0.001).</p><p><strong>Conclusion: </strong>The study demonstrated adequate patient satisfaction and non-inferiority of the investigated TIVAP system compared to other systems, though no superiority was found in cosmetic outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"84"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501589","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}