Langenbeck's Archives of Surgery最新文献

{"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":"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":"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":"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}

{"title":"Correction to: Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.","authors":"Simone Guadagni, Annalisa Comandatore, Niccolò Furbetta, Gregorio Di Franco, Bianca Bechini, Filippo Vagelli, Niccolò Ramacciotti, Raffaele Gaeta, Luca Emanuele Pollina, Matteo Palmeri, Giulio Di Candio, Luca Morelli","doi":"10.1007/s00423-025-03711-x","DOIUrl":"10.1007/s00423-025-03711-x","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"133"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000827","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":"Interim analysis of single - centre randomised controlled trial on incisional hernia repair with vs without synthetic mesh fixation.","authors":"Gintaras Varanauskas, Gintautas Brimas, Audrius Dulskas","doi":"10.1007/s00423-025-03707-7","DOIUrl":"https://doi.org/10.1007/s00423-025-03707-7","url":null,"abstract":"<p><strong>Introduction: </strong>In a prospective randomised trial, we aimed to compare incisional hernia repair with mesh fixation versus incisional hernia repair without mesh fixation.</p><p><strong>Methods: </strong>The study was performed from June 2018 to August 2024 at a single centre in Vilnius, Lithuania. Fifty-seven patients with incisional abdominal wall hernia were randomly included into two groups: group one-\"sublay\" hernia repair with mesh fixation and the second - without mesh fixation. The duration of surgery, hospital stay, pain levels, quality of life and rate of complications were compared.</p><p><strong>Results: </strong>Of the 38 women and 19 men who were included in the study, 30 were with mesh fixation and 27 without mesh fixation. The median patient's body mass index was 31.57 ± 5.96 (19.5-49.6). The most common hernia width was W2 according to the European Hernia Society (EHS) classification. A significant difference between the groups was found in duration of surgery - 108.00 ± 47.35 (40-235) minutes in the mesh fixation group vs. 75.74 ± 30.25 (35-150)-without the mesh fixation group (p < 0.05). A higher pain level was observed on the 10th postoperative day-3.03 ± 2.54 in the mesh fixation group versus 1.67 ± 2.22 in the group without the mesh fixation group (p < 0.05). A statistically significant difference was also observed in seroma rate after 6 months (16.6% versus 0%, p < 0.05). There have been no hernia recurrences in either group so far.</p><p><strong>Conclusions: </strong>No mesh fixation on \"sublay\" hernia repair does not worsen the patient's postoperative condition. It does not increase postoperative pain, worsen the quality of life, or increase the risk of postoperative complications. On the 10th postoperative day, the non-fixed mesh group had less postoperative pain, however, later the pain was equal. A lower number of seromas was also observed in this group after 6 months. However, the operative time in the group without mesh fixation was significantly shorter.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"134"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006677","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 safety profile of subthalamic nucleus and globus pallidus internus deep brain stimulation for Parkinson's diseases: A systematic review of perioperative complications and psychological impacts.","authors":"Elihuruma Eliufoo, Chimwemwe Kamuyalo, Tian Yusheng, Azan Nyundo, Li Yamin","doi":"10.1007/s00423-025-03674-z","DOIUrl":"https://doi.org/10.1007/s00423-025-03674-z","url":null,"abstract":"<p><strong>Background: </strong>Despite its widespread use and acceptance, there is still a significant need for a comprehensive understanding of the safety profile of deep brain stimulation (DBS) for Parkinson's Disease. This study investigates the surgical and psychological complications associated with DBS surgery for movement disorders, aiming to quantify patient risk and promote broader acceptance of the procedure.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It focused on a substantial population of 3,599 patients from various studies who underwent DBS between 2000 and 2024. A thorough literature search was carried out to identify studies on the safety profile of DBS in Parkinson's Disease (PD) across multiple electronic databases. Two reviewers extracted data and independently assessed the risk of bias, and all authors resolved any discrepancies collectively.</p><p><strong>Results: </strong>This review identified 17,453 studies, but only 26 were thoroughly reviewed after fulfilling all inclusion criteria. DBS showed both therapeutic benefits and significant risks, with complications including neurological deficits, infections, cognitive and psychiatric symptoms, surgical or device-related issues, motor dysfunction, and mortality.</p><p><strong>Conclusion: </strong>Overall, the findings support the cognitive safety of DBS, revealing limited adverse effects on cognitive functions. This review confirms therapeutic advantages and significant risks during and after surgery, including intraoperative and long-term adverse events. Additional reviews are required to evaluate the long-term impact of these complications, thereby enhancing patient safety and quality of life.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"131"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042047","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 aortic calcification at the origin of celiac artery on post-operative outcomes of major hepatectomy: A significant risk factor for posthepatectomy liver failure.","authors":"Takahiro Ito, Naohisa Kuriyama, Benson Kaluba, Shogo Teraoka, Haruna Komatsubara, Tatsuya Sakamoto, Daisuke Noguchi, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Akihiro Tanemura, Yasuhiro Murata, Masashi Kishiwada, Shugo Mizuno","doi":"10.1007/s00423-025-03701-z","DOIUrl":"https://doi.org/10.1007/s00423-025-03701-z","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic calcification is associated with arteriosclerosis and is often seen in patients undergoing hepatectomy. However, its impact on post-operative outcomes after major hepatectomy is still unclear.</p><p><strong>Methods: </strong>From July, 2015 to December, 2022, 127 patients who underwent resection of three or more adjacent liver segments (major hepatectomy) were retrospectively reviewed. Aortic calcification at the origin of celiac artery was assessed on pre-operative abdominal CT scan images. pPerioperative factors and postoperative outcomes were compared between patients with and without aortic calcification. Uni-variable and multi-variable analyses were performed to identify risk factors of posthepatectomy liver failure (PHLF).</p><p><strong>Results: </strong>Aortic calcification at the origin of celiac artery was observed in 62 (48.8%) of 127 patients. Those with aortic calcification were significantly older and had a higher incidence of hypertension, as a comorbidity, compared to those without. Furthermore, incidences of both post-operative liver failure and other complications were significantly higher among patients with aortic calcification, who also had a longer hospital stay. Multivariable logistic analysis identified aortic calcification and longer operation time as independent risk factors of PHLF. Additionally, stenosis of the celiac artery also impacted the development of PHLF.</p><p><strong>Conclusion: </strong>These findings indicate that aortic calcification at the origin of celiac artery is associated with advanced age and may be a risk factor of PHLF following major hepatectomy.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"129"},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021360","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}