Langenbeck's Archives of Surgery最新文献

{"title":"Effects of combined transversus abdominis plane block under direct vision and acupoint injection on promoting rapid recovery after laparoscopic cholecystectomy.","authors":"Xue-Yan Fu, Hai Huang, Lin Zhu, Tian-Han Zhou, Xiao-Gang Qi, Shan-Shan Xu, Rong Zhou, Hai-Min Jin, Zhong-Kai Ni","doi":"10.1007/s00423-025-03608-9","DOIUrl":"10.1007/s00423-025-03608-9","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of transversus abdominis plane (TAP) block under direct vision with acupoint injection on the rapid recovery of patients after laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Ninety-three patients undergoing laparoscopic cholecystectomy at Hangzhou Hospital of Traditional Chinese Medicine from January 2023 to December 2023 were selected and divided into control, TAP block under direct vision (TAP-DV), and TAP-DV with acupoint injection (TAP-DVA) groups using a random number table method. Postoperative VAS, Ramsay score, IL-6, CRP, and postoperative rehabilitation indices were compared among the three groups.</p><p><strong>Results: </strong>The VAS pain score at 6 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05). The VAS pain score at 24 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was significantly lower in the TAP-DVA group than in the TAP-DV group (P < 0.05). The VAS pain score 48 h after surgery was significantly lower in the TAP-DVA group than in the control and TAP-DV groups (P < 0.05). The mean IL-6 level was significantly lower in the TAP-DVA and TAP-DV groups than in the control group (P < 0.05). The postoperative nausea and vomiting rate was significantly lower in the TAP-DVA group than in the control group (P < 0.05). The postoperative exhaust time was earlier in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was earlier in the TAP-DVA group than in the TAP group (P < 0.05). The postoperative hospitalization days and total cost were significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05).</p><p><strong>Conclusion: </strong>TAP-DVA has a stable and good analgesic effect and can promote rapid recovery after laparoscopic cholecystectomy.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"42"},"PeriodicalIF":2.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007793","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 treatment of acute traumatic aortic injuries with TEVAR: a retrospective analysis of 19 cases in a level-1 trauma center.","authors":"F Liese-Landolt, H-C Pape, G N Jukema","doi":"10.1007/s00423-025-03613-y","DOIUrl":"10.1007/s00423-025-03613-y","url":null,"abstract":"<p><strong>Introduction: </strong>Blunt traumatic aortic injury (TAI) is a critical condition and a leading cause of mortality in trauma patients, often resulting from high-speed accidents. Thoracic endovascular aortic repair (TEVAR) has developed into the preferred therapeutic approach due to its minimally invasive nature and promising outcomes. This study evaluates the safety and efficacy of TEVAR for managing TAI over a 10-year period at a Level-1 trauma center.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 19 patients with acute TAI treated with TEVAR between 2012 and 2022 at the University Hospital Zurich. Data were collected from digital records and analyzed according to the Fillinger TEVAR reporting framework. Outcomes included technical success, perioperative complications, and long-term graft durability.</p><p><strong>Results: </strong>The cohort had a mean age of 39 years and included patients with severe polytrauma. Technical success was achieved in 95% of cases, with no intraoperative deaths or need for open surgical conversion. Perioperative complications were minimal, and the reintervention rate was 5.3%. This study evaluates 10 years of clinical experience managing TAI with TEVAR. Long-term follow-up, with a median duration of 29 months, revealed no graft-related complications or secondary interventions. Imaging confirmed sustained graft integrity, and clinical outcomes were favorable.</p><p><strong>Conclusion: </strong>TEVAR is a reliable and effective treatment for traumatic aortic injuries, offering excellent technical success rates and minimal perioperative and long-term complications. This study highlights TEVAR's advantages in managing polytrauma patients and its role as a minimally invasive alternative to open surgery. Additionally, the findings emphasize the need for comprehensive long-term follow-up protocols. Future research should aim to address challenges related to device durability and the integration of advanced imaging techniques to further enhance patient outcomes and broaden the applicability of TEVAR in trauma care.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"43"},"PeriodicalIF":2.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007800","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":"Development and current status of anti-reflux esophagogastrostomy after proximal gastrectomy: a literature review.","authors":"Yuan Tian, Kekang Sun, Qiankun Shao, Souya Nunobe, Yongyou Wu","doi":"10.1007/s00423-025-03606-x","DOIUrl":"10.1007/s00423-025-03606-x","url":null,"abstract":"<p><strong>Background: </strong>The selection of an appropriate gastrointestinal (GI) reconstruction procedure after proximal gastrectomy (PG) has long been a challenge. Surgeons have had a long history of exploring anti-reflux gastroesophageal anastomosis. The aim of this article is to systematically summarize the anti-reflux principles of GI reconstructive procedures through a review of the previous literature and to provide a theoretical basis for clinicians to select or innovate procedures.</p><p><strong>Methods: </strong>The PubMed, Google Scholar, China National Knowledge Infrastructure, Cochrane Databases and Medline were searched using Medical Subject Headings terms and keywords from inception until May 1, 2023. We traced the early research on the anti-reflux mechanisms of the esophagogastric junction and analyzed each piece of literature.</p><p><strong>Results: </strong>Three principles according to the current mainstream anti-reflux esophagogastrostomy: (1) reduction of the acid secreting glands; (2) reconstruction of the His angle or fundus; (3) reconstruction of the anti-reflux valve resembles the cardiac (including barrier method, rotation method, and compression method). This article provides a literature review of anti-reflux esophagogastrostomy after PG.</p><p><strong>Conclusions: </strong>Anti-reflux esophagogastrostomy, represented by seromuscular flap valvuloplasty, which restored the natural physiological structure, had better feasibility and safety theoretically. However, this still needs to be supported by evidence from large multi-center prospective randomized controlled studies.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"41"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007789","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":"Indocyanine green dyed gauze-guided minimum invasive surgery for anatomical landmarks and preventing gauze remnants: a pilot study.","authors":"Yoshihiko Tashiro, Takeshi Aoki, Hidekazu Yasunaga, Shinji Ando","doi":"10.1007/s00423-024-03592-6","DOIUrl":"https://doi.org/10.1007/s00423-024-03592-6","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to develop a novel fluorescent surgical gauze dyed with indocyanine green (ICG) to guide surgeons to the target anatomical destination during surgery for real-time navigation and to prevent gauze remnants after surgery.</p><p><strong>Methods: </strong>Surgical gauze was dyed with an aqueous solution of ICG (5.0 × 10^- 5 mol L^- 1 for Steraze, 1.5 × 10^- 4 mol L^- 1 for BK-Opeze) at 132 °C (inside pressure: 2.82 atm, 286 kPa) for 15 min using an autoclave, followed by washing with distilled water, drying at room temperature, and sterilizing at 132 °C for 8 min before surgery. Fluorescence (FL) intensity was examined preclinically in the resected specimens using the SPY PHI (Stryker) system. Fourteen patients who underwent laparoscopic- and robotic-assisted gastroenterological surgery at Showa University Hospital were included.</p><p><strong>Results: </strong>Fluorescent emission of ICG-dyed gauze was clearly observed through resected specimens with a thickness of approximately 10 mm or more. In a clinical trial, the ICG-dyed gauze was detected earlier with near-infrared (near-IR) FL imaging than under white light during seven cases of laparoscopic and robotic surgery, which could become a precise marker for surgeons to locate the dissection site despite overlaying tissues and nearby disturbances. Additionally, no seepage of ICG from the gauze was observed in all surgical fields.</p><p><strong>Conclusion: </strong>We successfully developed ICG-dyed gauze exhibiting bright near-IR FL which can guide surgeons to the target anatomical destination and prevent gauze remnants during surgery. This invention would be a powerful support for real-time navigation surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"40"},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and economic effects of the transformation from an open to a laparoscopic center for colorectal surgery.","authors":"Markus Zimmermann, Thaer S A Abdalla, Kai-Uwe Schlüter, Michael Thomaschewski, Tobias Keck, Erik Schlöricke","doi":"10.1007/s00423-024-03590-8","DOIUrl":"10.1007/s00423-024-03590-8","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the feasibility of transitioning from open to laparoscopic surgery for colorectal carcinoma in a primary care hospital setting. Despite the recognized benefits of laparoscopic surgery in postoperative recovery and its demonstrated oncological equivalence, only a minority of patients (30-40%) in Germany undergo laparoscopic procedures, primarily due to concerns which, in addition to the perioperative quality data and economic aspects, focus on patient safety.</p><p><strong>Methods: </strong>Over a three-year period (2012-2014), the transformation process was observed in a colorectal cancer center. Data from 237 patients (115 laparoscopic; 122 open) were collected prospectively and analyzed retrospectively. Short-term outcomes, including demographic data, perioperative complications, and quality metrics, as well as long-term survival data, were included.</p><p><strong>Results: </strong>Laparoscopic surgery demonstrated several advantages. Postoperative intensive care needs decreased significantly (average length of stay: laparoscopic 1.2 days vs. open 2.5 days; p = 0.032). Hospital stays were also shorter following laparoscopic surgery (median laparoscopic 10 days vs. median open 14 days; p = 0.011). Quality of specimens, particularly lymph node retrieval, remained comparable (median laparoscopic = 18 vs. median open = 19). Survival data showed non- inferiority of the laparoscopic approach. Despite higher initial costs, laparoscopic surgery yielded cost savings of approximately 3150 € per case due to reduced intensive care and shorter hospital stays.</p><p><strong>Conclusion: </strong>In conclusion, this study demonstrates the feasibility of transitioning from open to laparoscopic oncologic colorectal surgery in a primary care hospital setting. The findings suggest that such a transition can be accomplished without compromising the quality of specimens, while also realizing cost savings and maintaining patient safety.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"38"},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983872","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":"Objective surgical skill assessment based on automatic recognition of dissection and exposure times in robot-assisted radical prostatectomy.","authors":"Kodai Sato, Shin Takenaka, Daichi Kitaguchi, Xue Zhao, Atsushi Yamada, Yuto Ishikawa, Nobushige Takeshita, Nobuyoshi Takeshita, Shinichi Sakamoto, Tomohiko Ichikawa, Masaaki Ito","doi":"10.1007/s00423-024-03598-0","DOIUrl":"10.1007/s00423-024-03598-0","url":null,"abstract":"<p><strong>Purpose: </strong>Assessing surgical skills is vital for training surgeons, but creating objective, automated evaluation systems is challenging, especially in robotic surgery. Surgical procedures generally involve dissection and exposure (D/E), and their duration and proportion can be used for skill assessment. This study aimed to develop an AI model to acquire D/E parameters in robot-assisted radical prostatectomy (RARP) and verify if these parameters could distinguish between novice and expert surgeons.</p><p><strong>Methods: </strong>This retrospective study used 209 RARP videos from 18 Japanese institutions. Dissection time was defined as the duration of forceps energy activation, and exposure time as the combined duration of manipulating the third arm and camera. To measure these times, an AI-based interface recognition model was developed to automatically extract instrument status from the da Vinci Surgical System^® UI. We compared novices and experts by measuring dissection and exposure times from the model's output.</p><p><strong>Results: </strong>The overall accuracies of the UI recognition model for recognizing the forceps type, energy activation status, and camera usage status were 0.991, 0.998, and 0.991, respectively. Dissection time was 45.2 vs. 35.1 s (novice vs. expert, p = 0.374), exposure time was 195.7 vs. 89.7 s (novice vs. expert, p < 0.001), and the D/E ratio was 0.174 vs. 0.315 (novice vs. expert, p = 0.003).</p><p><strong>Conclusions: </strong>We successfully developed a model to automatically acquire dissection and exposure parameters for RARP. Exposure time may serve as an objective parameter to distinguish between novices and experts in RARP, and automated technical evaluation in RARP is feasible.</p><p><strong>Trial registration number and date: </strong>This study was approved by the Institutional Review Board of the National Cancer Center Hospital East (No.2020 - 329) on January 28, 2021.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"39"},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983991","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 depth of body cavity at the upper-right portion of the abdomen on open and laparoscopic liver resection of segment 7.","authors":"Hidetoshi Gon, Shohei Komatsu, Hirotoshi Soyama, Motofumi Tanaka, Masahiro Kido, Kenji Fukushima, Takeshi Urade, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto","doi":"10.1007/s00423-025-03605-y","DOIUrl":"10.1007/s00423-025-03605-y","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of body-cavity depth on open (OLR) and laparoscopic liver resection (LLR) of segment 7 remains unclear. Therefore, we investigated the influence of body-cavity depth at the upper-right portion of the abdomen on LLR and OLR of segment 7.</p><p><strong>Methods: </strong>In total, 101 patients who underwent segment-7 liver resection over 2010-2023 were included. Body-cavity depth was measured from the abdominal-wall surface to the deepest site on the right side of the liver. Patients were categorized into shallow (< 18.4 cm) and deep (≥ 18.4 cm) populations based on median body-cavity depth. We compared surgical outcomes between OLR and LLR in shallow and deep populations after propensity-score adjustments.</p><p><strong>Results: </strong>In OLR and LLR groups, 27 and 22 patients in the shallow population, respectively, and 26 and 26 patients were included in the deep population, respectively, were included. The OLR group in the deep population had significantly greater blood loss than the corresponding LLR group (difference: 144 mL, 95% confidence interval (CI): [50, 238], P = 0.004). Other surgical outcomes, including operative time, were similar between groups. In the shallow population, the OLR group had significantly shorter operative time (difference: - 54 mL, 95% CI: [-101, - 6], P = 0.028) and similar blood loss than the LLR group.</p><p><strong>Conclusions: </strong>For segment-7 liver resection, LLR is likely favorable for patients with a deep body cavity, with similar operative time and lower blood loss compared to OLR. Body-cavity depth could be a useful indicator for determining the suitable surgical approach for segment-7 liver resection.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"37"},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971134","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":"A hypocaloric protein-rich diet before metabolic surgery improves liver function in patients with obesity and diabetes : A secondary analysis of a randomized clinical trial.","authors":"Natalie Krönert, Yusef Moulla, Undine Gabriele Lange, Matthias Blüher, Nicolas Linder, Alexander Fuhrmann, Harald Busse, Anna Linder, Thomas Karlas, Johannes Wiegand, Roland Morgenroth, Lena Seidemann, Arne Dietrich","doi":"10.1007/s00423-024-03600-9","DOIUrl":"10.1007/s00423-024-03600-9","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity and type 2 diabetes (T2DM) are major risk factors for hepatic steatosis. Diet or bariatric surgery can reduce liver volume, fat content, and inflammation. However, little is known about their effects on liver function, as evaluated here using the LiMAx test.</p><p><strong>Methods: </strong>In the MetaSurg study (RCT on the effects of different Roux-en-Y gastric bypass (RYGB) limb lengths on diabetes remission in patients with BMI ≥ 27 to ≤ 60 kg/m² and T2DM; trial registration: DRKS00007810, German Clinical Trials Register Freiburg), 24 consecutive patients underwent liver function (LiMAx) and imaging assessments (MRI, transient elastography; TE) before and after diet and surgery. Two weeks before surgery, the patients received a hypocaloric protein-rich diet.</p><p><strong>Results: </strong>Nine of 18 patients had a pathologic LiMAx value (≤ 315 µg/kg/h) at baseline. After two weeks of diet, LiMAx values improved (p = 0.01, paired t test, n = 15). LiMAx values further recovered six months after RYGB (p = 0.01, paired t test, n = 15), which was accompanied by decreased liver volumes (p = 0.005, paired t test, n = 10), proton density fat fraction (p = 0.003, paired t test, n = 12), and TE measurements (p = 0.032, paired t test, n = 14). The need for medical diabetes treatment decreased from 100 to 35%.</p><p><strong>Conclusion: </strong>Liver function improved after a two-week hypocaloric protein-rich diet and metabolic surgery in patients with obesity and T2DM. These data suggest that a two-week diet for this group of patients prior to abdominal surgery could improve a presumably impaired liver function.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"36"},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971563","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":"Efficacy and safety of indocyanine green-fluorescence imaging guided liver resection: a single-arm prospective cohort study.","authors":"Hidetoshi Gon, Satoshi Omiya, Shohei Komatsu, Nobuaki Yamasaki, Sae Murakami, Kenji Fukushima, Takeshi Urade, Daisuke Tsugawa, Hiroaki Yanagimoto, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto","doi":"10.1007/s00423-024-03602-7","DOIUrl":"10.1007/s00423-024-03602-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy of indocyanine green (ICG)-fluorescence imaging for the identification of hepatic boundaries during liver resection and its advantages in surgical outcomes over conventional methods.</p><p><strong>Methods: </strong>This prospective, exploratory, single-arm clinical trial included 47 patients with liver tumors who underwent liver resection using ICG-fluorescence imaging (ICG-LR) between 2019 and 2020. The primary outcome measure was the successful identification of hepatic boundaries during liver resection, from the perspective of both the hepatic surface and intrahepatic boundary, using ICG-fluorescence imaging. The secondary outcomes comprised surgical outcomes. Using propensity score matching (PSM), the surgical outcomes were subsequently compared between the ICG-LR group and patients who underwent conventional liver resection (C-LR, n = 100) between 2017 and 2018.</p><p><strong>Results: </strong>Hepatic boundaries were successfully identified in 28 patients (60%; 95% confidence interval, 45-72%), including 21 and 7 who underwent anatomical and non-anatomical liver resection, respectively. After PSM, 40 patients were included in each of the ICG-LR and C-LR groups. The surgical outcomes were similar between the groups. Subsequently, surgical outcomes were compared between the groups focusing on anatomical liver resection. After PSM, 21 patients were included in each group. The ICG-LR group had a lower rate of Clavien-Dindo grade ≥ IIIa complications (0% vs. 24%; P = 0.017), including ascites and bile leak, and a shorter hospital stay (12 vs. 14 days, P = 0.041) than the C-LR group did.</p><p><strong>Conclusion: </strong>ICG-fluorescence imaging could be used to recognize hepatic boundaries during liver transection. Additionally, ICG-LR may be useful in preventing severe liver-associated complications.</p><p><strong>Trial registration number: </strong>This study is registered at the UMIN Clinical Trials Registry: UMIN0000180139 and Japan Registry of Clinical Trials: jRCT1051180070. The Registration Data Set is available at https://jrct.niph.go.jp/ .</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"34"},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965488","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":"Sleeve gastrectomy with antral resection provides more effective weight loss in patients with super obesity.","authors":"Ahmet Tarik Hamantepe, Emre Gönüllü, Gizem Fırtına, Onur İlhan, Adem Yüksel, Kerem Karaman","doi":"10.1007/s00423-025-03607-w","DOIUrl":"10.1007/s00423-025-03607-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a growing health issue that contributes to numerous diseases and lowers quality of life. In patients with super obesity (BMI > 50 kg/m²), bariatric surgery, particularly laparoscopic sleeve gastrectomy (LSG), is a common treatment option. However, the role of antral resection (AR) in LSG remains unclear, especially in this high-risk population. This study aims to compare the effectiveness of LSG with antral resection (LSG-AR) and LSG with antrum preservation (LSG-AP) on weight loss and postoperative complaints in patients with super obesity.</p><p><strong>Methods: </strong>The medical records of patients with a BMI > 50 kg/m² who underwent LSG between 2016 and 2022 were retrospectively reviewed. Weight data were collected at admission, and at the first, second, and fifth-year follow-up. Patients were divided into two groups based on LSG-AR or LSG-AP procedures.</p><p><strong>Results: </strong>Seventy-two patients were included. No significant difference was found in postoperative vomiting complaints between the groups (p = 0.67). First-year outcomes showed no significant differences in weight, BMI, or % Total Weight Loss (%TWL). However, second and fifth-year %TWL values were significantly higher in the LSG-AR group (p = 0.003 for both).</p><p><strong>Conclusion: </strong>LSG-AR provides more effective long-term weight loss in patients with super obesity. Early postoperative vomiting complaints diminish over time, suggesting LSG-AR as a viable one-stage procedure for this patient population.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"35"},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965493","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}