Langenbeck's Archives of Surgery最新文献

{"title":"Patient-reported questionnaires to preoperatively identify high-risk surgical patients.","authors":"Renske Meijer, David W G Ten Cate, Bart C Bongers, Marta Regis, Hans H C M Savelberg, Gerrit D Slooter, Stef Janssen, Martijn van Hooff, Goof Schep","doi":"10.1007/s00423-024-03560-0","DOIUrl":"10.1007/s00423-024-03560-0","url":null,"abstract":"<p><strong>Purpose: </strong>Low cardiorespiratory fitness (CRF) increases the risk of postoperative morbidity and mortality following major surgery. Assessing CRF preoperatively, by measuring peak oxygen uptake (VO_2peak) during cardiopulmonary exercise testing (CPET), is valuable yet not widely available. This study aimed to assess whether questionnaires could be used preoperatively to identify high-risk surgical patients.</p><p><strong>Methods: </strong>Healthy participants and patients who underwent CPET completed the FitMáx, Duke Activity Status Index (DASI), the modified 4-questions DASI (M-DASI-4Q), Veterans-Specific Activity Questionnaire (VSAQ), and Metabolic Equivalents of Task (MET) questionnaire. Questionnaire-VO_2peak was compared with CPET-VO_2peak. Overall performance of the questionnaires was assessed by the area under the curve (AUC) of receiver operating characteristic (ROC) curves. Furthermore, corresponding to the Youden index or pre-specified levels, sensitivity, specificity, and predictive values were determined.</p><p><strong>Results: </strong>In total, 361 participants were included. All questionnaires showed high AUC values to identify high-risk patients, defined on the basis of CPET-VO_2peak thresholds. FitMáx and VSAQ demonstrated superior results compared to the other questionnaires. Based on the Youden index, the optimal questionnaire-VO_2peak cut-off values were 20.6, 21.3, and 26.1 ml·kg^-1·min^-1 for the FitMáx and 16.3, 18.2, and 20.4 ml·kg^-1·min^-1 for the VSAQ corresponding to the VO_2peak thresholds 16.0, 18.2 and 24.5 ml·kg^-1·min^-1 respectively.</p><p><strong>Conclusion: </strong>The ability to identify high-risk surgical patients preoperatively (defined by the CPET-VO_2peak thresholds) by the FitMáx and the VSAQ indicates that they could be used to identify high-risk surgical patients. Patients with a poor predicted VO_2peak ≤ 21.3 and ≤ 18.2 ml·kg^-1·min^-1, respectively for FitMáx and VSAQ, should be referred to formal preoperative (cardiopulmonary) exercise testing.</p><p><strong>Trial registration: </strong>The study was registered as NL-OMON23304 in the Overview of Medical Research in the Netherlands, retrospectively at 28-04-2020.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"372"},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780382","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":"Surgical treatment of pancreatic metastases: More appropriate surgical methods based on a clinicopathologic study of 43 patients.","authors":"Makoto Seki, Akio Saiura, Yu Takahashi, Yosuke Inoue, Masamichi Katori, Noriko Yamamoto, Manabu Takamatsu, Yo Kato","doi":"10.1007/s00423-024-03549-9","DOIUrl":"https://doi.org/10.1007/s00423-024-03549-9","url":null,"abstract":"<p><strong>Purpose: </strong>There is no established surgical method for metastatic lesion to the pancreas. In the case of relatively small lesion, we often hesitate to select which surgical method, that is, wedge/partial resection or Whipple/distal pancreatectomy. Moreover, it is debatable whether lymph node dissection is necessary or not. We investigated clinicopathological characteristics in order to resolve the above problems.</p><p><strong>Methods: </strong>Forty-three patients underwent pancreatic resection for metastatic tumors in Cancer Institute of the Japanese Foundation for Cancer Research, whose specimens were investigated clinicopathologically.</p><p><strong>Results: </strong>Primary tumors included renal cell carcinoma(RCC), colorectal carcinoma (CRC), and miscellaneous malignancy (MM) in 23, 9, and 11 cases, respectively. Plural metastases in a resected specimen or mpd, i.e., tumor extension into the main pancreatic duct (MPD) was observed in eleven (26%, 11/43) or 9 (21%, 9/43) patients, respectively. Five of 9 mpd cases had more over 2 cm intraductal tumor extention from the main metastatic lesion. Lymph node metastasis surrounding the main metastasis was observed in 11 patients (5 CRCs, 5 MMs, and 1 RCC), with a metastatic rate to lymph node of 56% (5/9), 45% (5/11), and 4% (1/23) for CRCs, MMs, and RCCs, respectively.</p><p><strong>Conclusions: </strong>1) Wedge or partial resection of the pancreas for metastatic tumor should not be easily chosen, because of positive resection margin due to mpd and/or leaving another metastatic lesion. 2) Lymph node dissection is not strictly necessary for the surgical removal of pancreatic metastasis from RCC, whereas this is highly recommended for patients with metastasis from CRC or MM.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"371"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770310","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":"Prevalence and outcomes of Hartmann's reversal following Hartmann's procedure in a regional center, a retrospective cohort study.","authors":"William Fleischl, Kari Clifford, Deborah Wright","doi":"10.1007/s00423-024-03558-8","DOIUrl":"https://doi.org/10.1007/s00423-024-03558-8","url":null,"abstract":"<p><strong>Background: </strong>Hartmann's procedure (sigmoid resection with end colostomy) is a commonly performed emergency procedure for diseases of the sigmoid colon.</p><p><strong>Aim: </strong>To determine the proportion of patients undergoing Hartmann's reversal (restoration of GI continuity) following Hartmann's procedure, the clinical and demographic factors associated with reversal, and the reasons for non-reversal.</p><p><strong>Method: </strong>This is a single center, retrospective audit of patients undergoing Hartmann's procedure between June 2011 and May 2020. Age, sex, American Society of Anesthesiologists classification (ASA), indication for Hartmann's, surgical approach, specialty of responsible surgeon (General or Colorectal), 30-day reoperation, requirement for radiologically-guided drain, and reason for non-reversal were recorded. The association between these factors and reversal was determined with Fischer's exact test and logistic regression. Cumulative reversal proportions were calculated with the Kaplan-Meier method.</p><p><strong>Results: </strong>Data was obtained for 114/117 patients, of whom 31% (35/114) underwent Hartmann's reversal. The median (IQR) time to reversal was 372 (188-500) days. Patients with restoration of GI continuity were younger (median 67 versus 73 years, P < 0.001) with fewer co-morbidities, (ASA ≤ 2 34% versus 9% P = 0.002). The estimated cumulative 24-month reversal incidence was 37%. Patients who had a Hartmann's procedure performed for diverticulitis had an increased odds of being reversed (OR 4.1 (95% CI 1.6, 10.5) P = 0.001); Hartmann's for malignancy was associated with decreased odds of reversal (OR 0.37 (95% CI 0.12, 1) P = 0.035).</p><p><strong>Conclusion: </strong>Of patients who underwent Hartmann's procedure, the majority retained a permanent stoma. Older patients, those with high ASA, and those who underwent index procedures for malignancy had lower rates of reversal.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"369"},"PeriodicalIF":2.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770307","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 application of mobile CT combined with procedural sedation and analgesia in the preoperative localization of multiple pulmonary nodules.","authors":"Siyang Jiao, Feng Shao, Qiang Zhang, Yun-Gang Sun","doi":"10.1007/s00423-024-03561-z","DOIUrl":"https://doi.org/10.1007/s00423-024-03561-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and efficacy of mobile CT combined with procedural sedation and analgesia for the preoperative localization of multiple nodules.</p><p><strong>Methods: </strong>The clinical data of 200 patients who underwent CT-guided localization before single-port thoracoscopic pulmonary lobe surgery at our hospital from July 2023 to September 2023 were retrospectively analyzed. The patients were divided into two groups according to the localization method: Group A consisted of 100 patients who were localized under local anesthesia, and Group B consisted of 100 patients who were localized under procedural sedation and analgesia combined with local anesthesia. The general clinical data and localization data of the two groups were compared and analyzed.</p><p><strong>Results: </strong>The incidence of localization complications in Group B was significantly lower than that in Group A (4% vs. 13%, P = 0.04). The localization success rate in Group B was significantly greater than that in Group A (98% vs. 92%, P = 0.04). The localization time in Group B was significantly shorter than that in Group A (15.23 ± 5.96 min vs. 19.90 ± 8.66 min, P<0.01), and the pain score in Group B was significantly lower than that in Group A (2.01 ± 2.09 min vs. 3.29 ± 2.54 min, P<0.01).</p><p><strong>Conclusion: </strong>Mobile CT combined with procedural sedation and analgesia for preoperative puncture localization of multiple pulmonary nodules is safe and effective, with significant clinical application value.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"370"},"PeriodicalIF":2.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770185","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":"A right colectomy case study: transitioning to the Hugo RAS system with a novel 3-ports technique in experienced robotic colorectal practice.","authors":"Tommaso Violante, Matteo Rottoli, Jan Colpaert, Martin Poortmans, Kim Boterbergh, Peter Potvlieghe, Ilia Van Campenhout, Bert Van Den Bossche","doi":"10.1007/s00423-024-03559-7","DOIUrl":"https://doi.org/10.1007/s00423-024-03559-7","url":null,"abstract":"<p><strong>Introduction: </strong>Advancements in robotic technology have revolutionized general surgery, with new platforms and continuous improvements enhancing surgical procedures. Our unit adopted the Da Vinci Si model in 2012 and later the X model for various abdominal surgeries. In early 2023, we integrated the Hugo RAS system by Medtronic into our practice following comprehensive training. This study examines the transition of experienced robotic surgeons from the Da Vinci platform to the Hugo RAS system, focusing on robotic right hemicolectomy.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of consecutive adult patients who underwent robotic right hemicolectomy using the Da Vinci X and Hugo RAS systems. Outcomes from the latest seven cases with the Da Vinci X system were compared to the initial seven cases with the Hugo RAS system.</p><p><strong>Results: </strong>The baseline characteristics of the two groups were comparable, with no significant differences in age, sex, comorbidities, ASA score, or BMI. Operative times showed a trend towards being shorter with the Da Vinci X (127 ± 30 min) compared to the Hugo RAS (163 ± 43 min), but this was not statistically significant (p = 0.2). Other measures, including blood loss, anastomotic configuration, and length of hospital stay, were similar. Two non-surgical postoperative complications occurred in the Hugo RAS group, with no complications in the Da Vinci X group. There were no 30-day readmissions or reoperations in either group.</p><p><strong>Conclusion: </strong>Experienced robotic surgeons can seamlessly transition to the Hugo RAS system for right hemicolectomy, achieving comparable outcomes to the Da Vinci system.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"368"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770180","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":"Evaluation of the accuracy of 3D-printed patient-specific osteotomy templates in pelvic tumor resection and reconstruction.","authors":"Lulu Zhao, Zhengjia Zhang, Xin Zhou, Xiaomin Li, Wen Wu, Songtao Ai","doi":"10.1007/s00423-024-03552-0","DOIUrl":"https://doi.org/10.1007/s00423-024-03552-0","url":null,"abstract":"<p><strong>Purpose: </strong>The treatment of pelvic tumors has been widely recognized as challenging. Patient-specific osteotomy templates were designed and generated for precise surgery, based on tumor fusion images and 3D printing technology. This study aimed to investigate the accuracy of patient-specific osteotomy templates for the resection of pelvic tumors.</p><p><strong>Methods: </strong>From April 2014 to August 2023, 27 patients with pelvic tumors at our hospital were enrolled in this study. All patients underwent CT and enhanced MRI before surgery to develop a 3D preoperative imaging plan model for pelvic tumors based on tumor fusion images. For patients in the intraoperative use of osteotomy templates group, we designed and generated patient-specific osteotomy templates for intraoperative assisted tumor resection. For patients in the no use of osteotomy templates group, surgeons performed tumor resection according to conventional techniques. All patients were followed up to obtain postoperative CT images of the pelvis. Preoperative planning osteotomy surface and intraoperative actual osteotomy surface were obtained by means of the image registration technique. Then, the distance deviation and angle deviation between the two surfaces were compared to assess the accuracy of surgery.</p><p><strong>Results: </strong>Surgery was successfully completed in 27 patients, and all specimens were obtained for tumor-free resection margins. The median of intraoperative bleeding was 2350(1425 ∼ 3000) ml in the intraoperative use of osteotomy templates group and 4500(3150 ∼ 5200)ml in the no use of osteotomy templates group. p-value was 0.016. The median angular deviation of the actual osteotomy surfaces from the planned osteotomy surfaces was 5.02 (2.84 ∼ 7.37)° in the intraoperative use of osteotomy templates group, and 7.17 (4.49 ∼ 11.96)° in the no use of osteotomy templates group. p-value was 0.044. The absolute mean distance deviation between the two surfaces was 4.90 ± 3.01 mm in the intraoperative use of osteotomy templates group, and 7.21 ± 3.89 mm in the no use of osteotomy templates group. p-value was 0.038.</p><p><strong>Conclusions: </strong>3D-printed patient-specific osteotomy templates can be accurately customized based on preoperative tumor fusion image, which can help improve the precision of pelvic tumor surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"367"},"PeriodicalIF":2.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770186","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":"Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer.","authors":"Tadashi Higuchi, Masahiro Niihara, Hiroyuki Minoura, Hiroki Harada, Motohiro Chuman, Marie Washio, Mikiko Sakuraya, Koshi Kumagai, Yusuke Kumamoto, Takeshi Naitoh, Keishi Yamashita, Naoki Hiki","doi":"10.1007/s00423-024-03535-1","DOIUrl":"https://doi.org/10.1007/s00423-024-03535-1","url":null,"abstract":"<p><strong>Background: </strong>The appropriate extent of resection for esophagogastric junction cancer and the method of surgical approach remain controversial. This study aimed to assess the safety and outcomes of the parachute technique, which is an open transhiatal reconstruction method that facilitates stable reconstruction.</p><p><strong>Materials and methods: </strong>The surgical outcomes of 20 consecutive patients who underwent open lower- esophagogastrectomy for EGJ cancer at Kitasato University Hospital from June 2019 to July 2023 were retrospectively reviewed.</p><p><strong>Surgical procedure (parachute technique): </strong>The esophagus was transected, and a purse-string suture was placed at the stump. Then, a fixing string was placed. Hence, the mucosa, muscular layer, and adventitia, including the string of the purse-string suture, were not displaced. By placing approximately 10 stay sutures around the whole esophageal stump, the esophageal stump can be opened to the maximum diameter. Then, insert the anvil head into the esophagus lumen while laying it sideways, and it can be put on smoothly without stress.</p><p><strong>Results: </strong>In total, there were 17 and 3, male and female patients, respectively. The median esophageal invasion length was 12.5 (0-30) mm. One patient presented with cStage I EGJ cancer, four with cStage II, 14 with cStage III, and one with cStage IV. In terms of postoperative complications, three (15%) patients developed grade II intra-abdominal fluid correction according to the Clavien-Dindo classification. However, none of the patients presented with anastomotic leakage.</p><p><strong>Conclusions: </strong>The parachute technique can be a safe and effective reconstruction technique as it does not cause anastomotic leakage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"364"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739606","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":"Possible muscle-sparing advantage and bodyweight maintenance of laparoscopic gastrectomy for older patients with locally advanced gastric cancer.","authors":"Masayoshi Terayama, Manabu Ohashi, Motonari Ri, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Koshi Kumagai, Takeshi Sano, Souya Nunobe","doi":"10.1007/s00423-024-03554-y","DOIUrl":"https://doi.org/10.1007/s00423-024-03554-y","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic gastrectomy (LG) is a promising approach for older patients who require less invasive surgery because of their reduced functional reserve and increased comorbidities, with the expansion of its indication to locally advanced gastric cancer. However, the specific benefits of LG in older patients remain unclear. We evaluated whether LG positively influences the postoperative maintenance of skeletal muscle (SM) and bodyweight (BW).</p><p><strong>Methods: </strong>We retrospectively analyzed the data of consecutive patients aged ≥ 75 years who underwent open gastrectomy (OG) and LG for cStage II or III gastric cancer between 2016 and 2021. After adjustment using propensity score matching, surgical and postoperative outcomes were compared between the groups including the postoperative changes of SM index (%SMI) and BW (%BW).</p><p><strong>Results: </strong>A total of 167 patients who underwent OG (n = 93) and LG (n = 74) were included in the study. After matching, 48 patients in each group were eligible. No significant difference in postoperative complications was observed. Both %SMI and %BW after LG were significantly maintained compared with those after OG during the postoperative first year. LG had consistently positive effects on the maintenance of %SMI and %BW across the prespecified subgroups. Notably, patients with body mass index < 25, performance status 0-1, non-total gastrectomy, and absence of adjuvant chemotherapy benefited from LG in the maintenance of %SMI and %BW.</p><p><strong>Conclusion: </strong>LG offers greater advantages over OG in maintaining postoperative SM mass as well as BW in patients aged ≥ 75 with locally advanced gastric cancer.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"365"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739615","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":"Evaluating the 7-day barrier: early laparoscopic cholecystectomy for cholecystitis with prolonged symptom duration; a systematic review and meta-analysis.","authors":"Max H G van Maasakkers, Teus J Weijs, Oscar P Cnossen, Willemieke G van Braak, Johannes C Kelder, Didier Roulin, Djamila Boerma","doi":"10.1007/s00423-024-03555-x","DOIUrl":"10.1007/s00423-024-03555-x","url":null,"abstract":"<p><strong>Background: </strong>The gold standard for treating acute cholecystitis is an early laparoscopic cholecystectomy. However, whether this still applies for a > 7-day existing cholecystitis remains heavily debated. Therefore, this systematic review investigates the safety of early laparoscopic cholecystectomy for a > 7-day existing cholecystitis.</p><p><strong>Methods: </strong>PubMed and Embase were systematically searched for all studies comparing early laparoscopic cholecystectomy in patients with 0-7 versus > 7-day existing cholecystitis at time of surgery. Meta-analyses were performed on dichotomous and continuous outcomes with risk difference (RD) and mean difference (MD) as measures of effect.</p><p><strong>Results: </strong>A total of 3007 studies were screened, resulting in the inclusion of 13 non-randomised studies comprising 5481 patients. Of these, 4690 received cholecystectomy within 7 days, and 791 after 7 days. Operating times (MD -11.8 min; 95% CI [-18.4; -5.2]) and total hospital stay (MD -2.7 days; 95% CI [-4.0; -1.4]) were longer in the > 7-day group. However, no significant risk difference was found for combined major complications: bile duct injury/leakage and bowel injury (RD -1.0%; 95% CI [-2.3; 0.3]), for complications graded Clavien-Dindo ≥ 3 (RD -0.3%; 95% CI [-2.5; 1.9]), or for conversions (RD -1.5%; 95% CI [-3.9; 0.9]).</p><p><strong>Conclusion: </strong>Early laparoscopic cholecystectomy for cholecystitis after the 7-day barrier might be harder, as reflected by longer operating times. However, a significant increase in complications or conversions was not found. Due to the risk of bias and lack of well-powered studies directly comparing early cholecystectomy after 7 days with alternative strategies, strong recommendations cannot be made. Meanwhile, it is advised to carefully weigh the treatment options in case of a > 7-day existing cholecystitis, based on patient's characteristics and surgeon's experience.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"366"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739610","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 evaluation of the PowerGlide Pro midline catheter- dwell time, complications and outcomes for various medications including prostaglandins.","authors":"Yaser Souri, Edgar Franklin Hernandez Cancino, Hagen Kerndl, Alexander Hyhlik-Duerr, Yvonne Gosslau","doi":"10.1007/s00423-024-03546-y","DOIUrl":"10.1007/s00423-024-03546-y","url":null,"abstract":"<p><strong>Purpose: </strong>The PowerGlide Pro™ Midline Catheter is a peripheral venous access device with a length of 8-10 cm, allowing the tip to reach far into the venous system. The aim of this study was to evaluate the dwell time of the catheter. Secondary endpoints included suitability for specific medications (e.g. prostaglandins) and assessment of complications.</p><p><strong>Methods: </strong>Between January 2019 and November 2021, 50 patients were included in the study. Data on patient demographics, placement characteristics, complications and reasons for removal, were collected.</p><p><strong>Results: </strong>Placement was technically successful in 92% (n = 46) of cases. In all cases, veins of the upper extremity were punctured (34 basilic veins, 7 brachial veins, 6 cephalic veins, and 3 median cubital veins). The average dwell time was 6.1 days (1-17 days). A significant difference between duration and medication administered could not be demonstrated.</p><p><strong>Conclusions: </strong>The longer maximum dwell time compared to a standard peripheral venous catheter makes it particularly suitable for intravenous therapy for more than 7 days or patients who have poor peripheral vein status.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"363"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729443","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}