Surgery Today最新文献_第10页

Treatment strategy and clinical outcomes of thoracoscopic endoscopic cooperative surgery for submucosal tumors in the esophagus. 胸腔镜内镜合作手术治疗食道粘膜下肿瘤的治疗策略和临床效果。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-28 DOI: 10.1007/s00595-025-03003-3

Yasunori Otowa, Fumiaki Kawara, Gosuke Takiguchi, Kodai Yamanaka, Tadahiro Goto, Chiharu Nishioka, Daisuke Kuroda, Yonson Ku

{"title":"Treatment strategy and clinical outcomes of thoracoscopic endoscopic cooperative surgery for submucosal tumors in the esophagus.","authors":"Yasunori Otowa, Fumiaki Kawara, Gosuke Takiguchi, Kodai Yamanaka, Tadahiro Goto, Chiharu Nishioka, Daisuke Kuroda, Yonson Ku","doi":"10.1007/s00595-025-03003-3","DOIUrl":"10.1007/s00595-025-03003-3","url":null,"abstract":"Purpose: Recently, submucosal tumors (SMTs) of the esophagus have been treated with peroral endoscopic tumor resection (POET) and a new procedure called thoracoscopic endoscopic cooperative surgery (TECS). This study aimed to validate the treatment strategy for SMTs and determine whether or not TECS is a viable option when POET is not feasible.Methods: POET and TECS were performed in 12 patients between February 2020 and January 2024. The clinical characteristics and perioperative outcomes were retrospectively evaluated.Results: Six patients were included in each group, with most of the tumors located in the middle thoracic esophagus (75%). The general anesthesia duration was significantly longer in the TECS group than in the POET group (P < 0.001), but no significant differences in endoscopic procedure time, tumor mass index, oral intake date, or length of hospital stay were observed between the two groups. En bloc and R0 resections were performed in all patients. One patient in the TECS group experienced a Clavien-Dindo grade 3a adverse event, and no tumor recurrence occurred during the median follow-up period of 33 (range, 6-53) months.Conclusion: TECS is a safe and feasible option for SMTs when POET is difficult to perform.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1205-1212"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isoperistaltic hand-sewn side-to-side bowel primary anastomosis: a safe approach after bowel resection in children with neutropenic enterocolitis. 等径手缝侧对侧肠一期吻合：中性粒细胞减少性小肠结肠炎患儿肠切除术后的安全方法。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-01 DOI: 10.1007/s00595-025-02998-z

Mohammad Taher, Maged Elshafiey, Ahmed Refaat, Eman Nasr, Gehad Ahmed

{"title":"Isoperistaltic hand-sewn side-to-side bowel primary anastomosis: a safe approach after bowel resection in children with neutropenic enterocolitis.","authors":"Mohammad Taher, Maged Elshafiey, Ahmed Refaat, Eman Nasr, Gehad Ahmed","doi":"10.1007/s00595-025-02998-z","DOIUrl":"10.1007/s00595-025-02998-z","url":null,"abstract":"Background and aim: Whether to perform primary anastomosis (PA) or create a stoma after bowel resection has always been a dilemma in pediatric cancer patients with neutropenic enterocolitis (NEC). The risk of leakage after PA must be weighed against the risk of stoma complications. We evaluated the outcomes of managing NEC patients with either PA or stoma and the utility of the isoperistaltic hand-sewn side-to-side anastomosis (ISSA) technique in PA.Patients and methods: A retrospective study on all Children's Cancer Hospital Egypt patients with NEC who underwent surgical exploration at our hospital from 2008 to 2022.Results: Of 153 children, 80 (52.3%) underwent PA and 73 (47.7%) underwent stoma formation. Among the 80 PA patients, 68 (85%) underwent ISSA, 9 (11.2%) end-to-end anastomosis (EEA), and 3 (3.8%) end-to-side anastomosis (ESA). The perioperative complication rate was 38/73 (52.1%) in the stoma patients and 35/80 (43.8%) in the PA patients. Leakage occurred in 6/68 (8.8%) ISSA patients, 5/9 (55.6%) EEA patients, and 1/3 (33.3%) of ESA patients.Conclusions: In pediatric cancer patients with NEC, PA using ISSA after bowel resection is considered a better approach than any other anastomotic configuration.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1088-1094"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An original flap fixation technique with suturing to the fascia of serratus anterior for reducing seroma after mastectomy: a single-center retrospective study. 前锯肌筋膜缝合的原始皮瓣固定技术用于减少乳房切除术后血清肿：一项单中心回顾性研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-07-30 DOI: 10.1007/s00595-025-03078-y

Yukako Mouri, Masayuki Saito, Kanna Ozaki, Hirona Banno, Manami Goto, Mirai Ido, Takahito Ando, Junko Kousaka, Kimihito Fujii, Tsuneo Imai, Shogo Nakano, Wataru Ohashi

{"title":"An original flap fixation technique with suturing to the fascia of serratus anterior for reducing seroma after mastectomy: a single-center retrospective study.","authors":"Yukako Mouri, Masayuki Saito, Kanna Ozaki, Hirona Banno, Manami Goto, Mirai Ido, Takahito Ando, Junko Kousaka, Kimihito Fujii, Tsuneo Imai, Shogo Nakano, Wataru Ohashi","doi":"10.1007/s00595-025-03078-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03078-y","url":null,"abstract":"Purpose: Seroma formation is a common complication of mastectomy. Recently, flap fixation using sutures was shown to significantly reduce the number of seroma aspirations. We attempted a new flap fixation technique to reduce seromas in patients undergoing mastectomy with a sentinel node biopsy (SLNB).Methods: At Aichi Medical University, 469 patients with clinical stage 0-II breast cancer underwent mastectomy with an SLNB in 2018-2022. There were 47 patients who underwent flap fixation using sutures (study group) and 422 who underwent conventional wound closure (control group).Results: In patients undergoing mastectomy with an SLNB, the drainage tube was removed within five days in the control group and three days in the study group. The median total in-hospital drainage volumes were 200 mL in the control group and 114 mL in the study group. After discharge, the study group had fewer seroma aspirations than did the control group. The total seroma volumes were 242 mL in the control group and 134 mL in the study group (p < 0.001). These results were the similar regardless of body mass index.Conclusions: Our flap fixation technique resulted in approximately half of the usual total drainage volume. Many patients do not require outpatient visits for seroma aspiration, thus simplifying postoperative management.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes of chimney endovascular aneurysm repair versus open surgical repair for short-neck abdominal aortic aneurysms. 短颈腹主动脉瘤烟囱腔内修复与开腹手术修复的临床效果。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-25 DOI: 10.1007/s00595-025-03104-z

Shinichiro Yoshino, Koichi Morisaki, Daisuke Matsuda, Jun Okadome, Ryoichi Kyuragi, Shinichi Tanaka, Kohei Ueno, Yusuke Fujioka, Go Kinoshita, Kentaro Inoue, Kenichi Honma, Takahiro Omine, Terutoshi Yamaoka, Hiroyuki Ito, Tomoharu Yoshizumi

{"title":"Clinical outcomes of chimney endovascular aneurysm repair versus open surgical repair for short-neck abdominal aortic aneurysms.","authors":"Shinichiro Yoshino, Koichi Morisaki, Daisuke Matsuda, Jun Okadome, Ryoichi Kyuragi, Shinichi Tanaka, Kohei Ueno, Yusuke Fujioka, Go Kinoshita, Kentaro Inoue, Kenichi Honma, Takahiro Omine, Terutoshi Yamaoka, Hiroyuki Ito, Tomoharu Yoshizumi","doi":"10.1007/s00595-025-03104-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03104-z","url":null,"abstract":"Purpose: To compare the outcomes of chimney endovascular aneurysm repair (Ch-EVAR) and open surgical repair (OSR) for abdominal aortic aneurysm (AAA) in consideration of the lack of comparative evidence.Methods: The subjects of this retrospective study were patients who underwent elective Ch-EVAR or OSR for short-neck AAAs between 2013 and 2020 at five vascular centers. The primary endpoint was 30-day mortality and the secondary endpoints were postoperative complications and midterm clinical outcomes, including renal function changes, reintervention, overall survival, and aneurysm-related mortality.Results: We analyzed 38 Ch-EVARs and 42 OSRs. The 30-day mortality rates were 2.6 and 2.4% in the Ch-EVAR and OSR groups, respectively (P = 1.00). The acute kidney injury incidence was higher in the OSR group than in the Ch-EVAR group (P < 0.01). The freedom from reintervention rate at 5 years was lower in the Ch-EVAR group than in the OSR group (81.0% vs. 100%, P = 0.04). Other midterm clinical outcomes did not differ between the groups.Conclusions: Ch-EVAR may be a feasible treatment option for short-neck AAA; however, it should be limited to patients at high operative risk for OSR, considering the concern about its long-term durability.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Jejunal and colonic reconstruction after esophagectomy in difficult gastric conduit: a multicenter study and meta-analysis. 困难胃导管食管切除术后空肠和结肠重建：一项多中心研究和荟萃分析。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-24 DOI: 10.1007/s00595-025-03105-y

Tomohiko Yasuda, Akihisa Matsuda, Nobutoshi Hagiwara, Keisuke Mishima, Takeshi Matsutani, Satoshi Nomura, Hiroshi Makino, Keisuke Minamimura, Masanori Watanabe, Yoshiharu Nakamura, Hiroshi Yoshida

{"title":"Jejunal and colonic reconstruction after esophagectomy in difficult gastric conduit: a multicenter study and meta-analysis.","authors":"Tomohiko Yasuda, Akihisa Matsuda, Nobutoshi Hagiwara, Keisuke Mishima, Takeshi Matsutani, Satoshi Nomura, Hiroshi Makino, Keisuke Minamimura, Masanori Watanabe, Yoshiharu Nakamura, Hiroshi Yoshida","doi":"10.1007/s00595-025-03105-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03105-y","url":null,"abstract":"Purpose: When using the stomach for esophageal reconstruction is not viable, the jejunum or colon is used, but the optimal choice of organ remains unclear.Methods: We conducted this multicenter retrospective cohort study to compare the short-term outcomes of patients who underwent jejunal or colonic reconstruction across four centers between January 2011 and March 2023. We also conducted a meta-analysis of studies published before November 2024 using the Mantel-Haenszel random-effects model to compare cervical anastomosis outcomes between jejunal and colonic reconstruction after esophageal cancer surgery.Results: Vascular anastomosis was more frequent in the jejunal group (n = 16; p = 0.001), whereas simultaneous gastrectomy was more common in the colonic group (n = 13; p = 0.029). No significant differences were observed in anastomotic leakage (31.3 vs. 46.2%, p = 0.466), graft necrosis (6.3 vs. 0.0%, p = 1), or hospital mortality (6.3 vs. 7.7%, p = 1) between the groups. The meta-analysis showed a trend toward reduced leakage for jejunal reconstruction with vascular anastomosis (OR = 0.42, 95% CI = 0.16-1.01, p = 0.05). Other outcomes were similar.Conclusions: The short-term outcomes of jejunal and colonic reconstructions were comparable. Jejunal reconstruction with vascular anastomosis may reduce leakage, but its prognostic benefits remain unclear.Trial registration: no. M-2023-102.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Methods used for smoke evacuation in laparoendoscopic surgery: a technical review. 腹腔镜手术中排烟方法技术综述。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-24 DOI: 10.1007/s00595-025-03107-w

Jianlu Zhang, Ziqi Zhou, Wai San Ho, Qiaofei Liu, Feng Tian, Junchao Guo

{"title":"Methods used for smoke evacuation in laparoendoscopic surgery: a technical review.","authors":"Jianlu Zhang, Ziqi Zhou, Wai San Ho, Qiaofei Liu, Feng Tian, Junchao Guo","doi":"10.1007/s00595-025-03107-w","DOIUrl":"https://doi.org/10.1007/s00595-025-03107-w","url":null,"abstract":"Purpose: The surgical smoke generated in laparoendoscopic surgery compromises visual clarity and poses health hazards to the operating team. While numerous strategies to maintain a clear surgical field and mitigate these risks have been developed, existing research remains fragmented. This lack of systematic evidence of effective solutions creates challenges in clinical practice.Methods: We conducted this study to evaluate the effectiveness of current smoke evacuation methods aimed at maintaining surgical field visibility and mitigating occupational hazards during laparoendoscopic procedures. The analysis synthesizes literature retrieved from PubMed/MEDLINE, Scopus, and the Cochrane Library databases, with all included studies published up until January, 2025.Results: A total of 19 techniques were categorized systematically into four distinct approaches: active instrument-tip suction, port-side evacuation, valveless trocar systems, and continuous suction for gasless laparoendoscopy. Each category exhibits unique operational mechanisms, advantages, and limitations.Conclusions: Multiple solutions exist for surgical smoke management in laparoendoscopic procedures, but their future development should prioritize creating more efficient, user-friendly, and safer evacuation technologies that will account for global healthcare resource disparities to ensure broad clinical applicability.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term survival outcome after surgical resection of pulmonary neuroendocrine tumors. 肺神经内分泌肿瘤手术切除后的长期生存预后。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-23 DOI: 10.1007/s00595-025-03077-z

Eisuke Goto, Keiju Aokage, Kotaro Nomura, Makoto Tada, Yutaro Koike, Tetsuro Taki, Tomohiro Miyoshi, Kenta Tane, Joji Samejima, Kenji Suzuki, Genichiro Ishii, Masahiro Tsuboi

{"title":"Long-term survival outcome after surgical resection of pulmonary neuroendocrine tumors.","authors":"Eisuke Goto, Keiju Aokage, Kotaro Nomura, Makoto Tada, Yutaro Koike, Tetsuro Taki, Tomohiro Miyoshi, Kenta Tane, Joji Samejima, Kenji Suzuki, Genichiro Ishii, Masahiro Tsuboi","doi":"10.1007/s00595-025-03077-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03077-z","url":null,"abstract":"Purpose: Surgery is the standard treatment for early-stage pulmonary neuroendocrine tumors (NETs); however, long-term prognostic data are limited. This study aimed to establish the long-term outcomes of surgically resected pulmonary NETs.Methods: This study included 263 patients who underwent pulmonary resection between January, 1997 and December, 2019: 89 with small cell lung carcinoma (SCLC), 120 with large cell neuroendocrine carcinoma (LCNEC), 14 with atypical carcinoid (AC), and 40 with typical carcinoid (TC). We analyzed clinicopathological characteristics and long-term prognosis.Results: The 5-year relapse-free survival (RFS) rates were 38.7%, 54.2%, 62.3%, and 85.0%, and the 10-year RFS rates were 24.5%, 39.8%, 20.8%, and 76.4% for SCLC, LCNEC, AC, and TC, respectively. All deaths from TC occurred more than 5 years after surgery, whereas three of the four deaths from AC occurred after this period. Most patients with high-grade NETs had relapses within 3 years after surgery, whereas patients with AC had relapses not only in the early phase but also in the late phase.Conclusions: The long-term prognosis of AC is comparable to that of high-grade NETs, suggesting that its biological characteristics might be more closely related to high-grade NETs than to TC.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endotoxin in drainage fluid as an early and predictive marker of anastomotic leakage after colorectal surgery. 引流液内毒素作为结直肠术后吻合口漏的早期预测指标。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-23 DOI: 10.1007/s00595-025-03106-x

Takashi Matsunaga, Toru Miyake, Takeru Maekawa, Fumie Tsukaguchi, Toru Obata, Tomoharu Shimizu, Masaji Tani

{"title":"Endotoxin in drainage fluid as an early and predictive marker of anastomotic leakage after colorectal surgery.","authors":"Takashi Matsunaga, Toru Miyake, Takeru Maekawa, Fumie Tsukaguchi, Toru Obata, Tomoharu Shimizu, Masaji Tani","doi":"10.1007/s00595-025-03106-x","DOIUrl":"https://doi.org/10.1007/s00595-025-03106-x","url":null,"abstract":"Purpose: To assess the predictive value of the endotoxin (ET) assay for the detection of anastomotic leakage (AL) after colorectal surgery (CRS).Methods: ET levels in the drainage fluid were measured using endotoxin scattering photometry (ET-ESP) and turbidimetric (ET-TUB) assays on postoperative day (POD) zero, POD1 and POD3, comparing tumor necrosis factor (TNF)-α.Results: AL was observed in 8 (4.9%) of the 162 patients. ET-ESP, ET-TUB, and TNF-α levels on POD0 and serum C-reactive protein (CRP) on POD1 were significantly elevated in the AL group. The area under the receiver operating characteristic curve (AUROC) for ET-ESP level (0.903) on POD0 showed early and better predictive performance for AL compared to that for ET-TUB (0.869, p = 0.230) and TNF-α (0.758, p = 0.034) levels on POD0; the AUROC for CRP level (0.711) on POD1 was inferior to other parameters. In subgroup analysis, five (3.7%) of 136 patients with colorectal cancer (CRC) developed AL. Additionally, the ET-ESP level on POD0 showed relatively good predictive performance for AL after CRC (AUROC: ET-ESP [0.871], ET-TUB [0.840], and TNF-α [0.737] on POD0).Conclusion: ET levels in drainage fluid, especially those measured using ESP, on POD0 may have an early predictive ability to detect AL post-CRS.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of extended prophylactic antibiotic administration on surgical site infections: A multicenter real-world data study. 延长预防性抗生素给药对手术部位感染的影响：一项多中心真实世界数据研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-19 DOI: 10.1007/s00595-025-03101-2

Takeshi Yamada, Akihisa Matsuda, Takuya Nishino, Kay Uehara, Nobutoshi Hagiwara, Nobuyuki Sakurazawa, Yoichi Kawano, Akira Matsushita, Takao Shimizu, Keisuke Minamimura, Jun Akatsuka, Hiroshi Yoshida

{"title":"Impact of extended prophylactic antibiotic administration on surgical site infections: A multicenter real-world data study.","authors":"Takeshi Yamada, Akihisa Matsuda, Takuya Nishino, Kay Uehara, Nobutoshi Hagiwara, Nobuyuki Sakurazawa, Yoichi Kawano, Akira Matsushita, Takao Shimizu, Keisuke Minamimura, Jun Akatsuka, Hiroshi Yoshida","doi":"10.1007/s00595-025-03101-2","DOIUrl":"https://doi.org/10.1007/s00595-025-03101-2","url":null,"abstract":"Purposes: Despite guideline recommendations to discontinue prophylactic antibiotics within 24 h postoperatively, extended prophylaxis is sometimes administered in clinical practice, particularly in digestive surgeries with a high risk of surgical site infections (SSI). This multicenter retrospective study evaluated the characteristics of patients receiving extended prophylaxis and its effectiveness in preventing SSI.Methods: Clinical and administrative claims data from three hospitals were analyzed for patients undergoing elective esophageal, gastric, hepatic (with or without biliary reconstruction), pancreatic, colon, or rectal surgery between January 2021 and December 2023. The primary endpoint was SSI, defined as Clavien-Dindo grade ≥ 2 occurring within 30 days postoperatively. The incidence of SSI was compared between extended prophylaxis (continued on or after postoperative day 3) and standard prophylaxis.Results: This study included 2,938 patients, of whom 936 received extended prophylaxis. Prolonged surgical time was significantly associated with extended prophylaxis across various types of surgery. Extended prophylaxis was not associated with a reduction in SSI in most procedures and was linked to a higher incidence of SSI in colon cancer patients.Conclusion: Extended prophylaxis may not only be ineffective but also potentially harmful. These findings underscore the importance of adhering to evidence-based guidelines in the prevention of SSI.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prophylactic negative pressure wound therapy with Prevena™ to prevent perineal surgical site infection. 预防性负压伤口治疗，预防会阴手术部位感染。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-18 DOI: 10.1007/s00595-025-03102-1

Ryo Ohno, Gumpei Yoshimatsu, Yoshiro Itatani, Ryosuke Okamura, Yu Yoshida, Hisatsugu Maekawa, Nobuaki Hoshino, Koya Hida, Kazutaka Obama, Suguru Hasegawa

{"title":"Prophylactic negative pressure wound therapy with Prevena™ to prevent perineal surgical site infection.","authors":"Ryo Ohno, Gumpei Yoshimatsu, Yoshiro Itatani, Ryosuke Okamura, Yu Yoshida, Hisatsugu Maekawa, Nobuaki Hoshino, Koya Hida, Kazutaka Obama, Suguru Hasegawa","doi":"10.1007/s00595-025-03102-1","DOIUrl":"https://doi.org/10.1007/s00595-025-03102-1","url":null,"abstract":"Purpose: Surgical site infection (SSI) of perineal wounds after abdominoperineal resection (APR) or total pelvic exenteration (TPE) for pelvic malignancies is a common postoperative complication. Although several attempts have been made to prevent this complication, SSI of perineal wounds remain common. The efficacy of prophylactic negative-pressure wound therapy (NPWT) in abdominal surgery has been reported; however, few studies have focused on perineal wounds, where the incidence of SSI is particularly high. This study investigated the prophylactic effect of NPWT on closed perineal wounds after APR/TPE to prevent SSI.Methods: This study enrolled 127 consecutive patients with malignant tumors who underwent elective APR/TPE between January 2013 and December 2022. We used the Prevena™ incision management system (IMS) on the perineal wound in 10 patients for prophylactic NPWT (pNPWT group), whereas 117 patients underwent conventional primary closure (cPC group). We compared the incidence of perineal wound SSI between the groups and explored the risk factors associated with SSI.Results: Patients' backgrounds were essentially the same between the groups. There were no SSI cases in the pNPWT group, whereas 29 patients (25%) in the cPC group had SSI (P = 0.067). Exploratory analyses revealed that a body mass index ≥ 25, disinfection method, and neoadjuvant chemotherapy were significantly correlated with SSI in perineal wounds.Conclusion: Prophylactic NPWT for closed perineal wounds after APR/TPE in patients with malignancies can be effective in preventing SSI.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0