Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Short-term outcomes and the learning curve for laparoscopic right hemicolectomy using the ArtiSential: a multicenter pooled analysis.","authors":"Seijong Kim, Jaeim Lee, Heung-Kwon Oh, Dae Hee Pyo, Yoon Suk Lee, Yong Sik Yoon, Dong Hwan Bae, Byung Soh Min, Chang Hyun Kim, Jung Wook Huh","doi":"10.1007/s00464-025-11670-z","DOIUrl":"https://doi.org/10.1007/s00464-025-11670-z","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery for colorectal cancer has demonstrated significant advantages over traditional methods, but laparoscopic procedures remain technically challenging. ArtiSential is an articulated handheld laparoscopic system designed to offer greater maneuverability similar to robotic surgery, while addressing cost constraints. However, its clinical efficacy in right hemicolectomy (RHC) for right-sided colon cancer remains underexplored.</p><p><strong>Methods: </strong>A multicenter, retrospective study was conducted from January 2021 to October 2022, enrolling 511 patients who underwent laparoscopic RHC for right-sided colon cancer. Of these, 167 patients underwent ArtiSential-assisted RHC, while 344 underwent conventional RHC. Propensity-score matching (PSM) was used to balance baseline variables. Additionally, we employed cumulative sum analysis to evaluate the learning curve associated with ArtiSential use.</p><p><strong>Results: </strong>After PSM, each group consisted of 165 patients, with no significant differences in baseline clinical characteristics. The median operation time was 148 min for both procedures (p = 0.423). No significant differences were observed in complication rates, including intraoperative blood loss, open conversion, postoperative ileus, anastomotic leakage, or wound complications between ArtiSential-assisted RHC and conventional RHC. Moreover, the total expenses were not different between the groups. Cumulative sum analysis indicated that surgeons reached proficiency with ArtiSential after an average of 19 cases.</p><p><strong>Conclusion: </strong>ArtiSential-assisted RHC proves to be a safe and feasible option, yielding comparable outcomes to conventional RHC with no significant differences in intraoperative or postoperative metrics. Surgeons can achieve proficiency with ArtiSential after performing an average of 19 cases. These findings suggest that ArtiSential could be a valuable addition to the minimally invasive surgical toolkit for right-sided colon cancer treatment.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young pediatric surgeons without endoscopic surgical skill qualification safely perform advanced endoscopic surgery under the supervision of expert qualified surgeons.","authors":"Kazuki Ota, Takahisa Tainaka, Akinari Hinoki, Chiyoe Shirota, Satoshi Makita, Akihiro Yasui, Yoichi Nakagawa, Daiki Kato, Takuya Maeda, Hiroki Ishii, Hiroo Uchida","doi":"10.1007/s00464-025-11657-w","DOIUrl":"https://doi.org/10.1007/s00464-025-11657-w","url":null,"abstract":"<p><strong>Background: </strong>Young pediatric surgeons should receive adequate training in various minimally invasive surgeries (MIS). However, it is essential to maintain patient safety and outcomes during the learning process. In Japan, the endoscopic surgical skill qualification (ESSQ) system in pediatric surgery was initiated by the Japan Society for Endoscopic Surgery (JSES) in 2009 to objectively evaluate the skill of endoscopic surgeons. This study compared perioperative outcomes between pediatric surgeons with ESSQ qualifications and those without (non-ESSQ).</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of children with choledochal cyst (CC), lobectomy, and biliary atresia (BA) who underwent MIS at our hospital from 2013 to 2023. We assessed the performance of nonqualified surgeons assisted by supervisors with ESSQ qualifications.</p><p><strong>Results: </strong>This study included the records of 101 surgical cases with CC (operated by ESSQ: 36, non-ESSQ: 65), 78 patients with BA (operated by ESSQ: 35, non-ESSQ: 43), and 67 patients with lobectomy (operated by ESSQ: 31, non-ESSQ: 36). For the CC and lobectomy groups, there were no significant differences in operating time, blood loss, and postoperative complications (PO) between the ESSQ and non-ESSQ groups. In BA, the operative times for the ESSQ and non-ESSQ groups were 310 and 377 min, respectively (p = 0.001). Furthermore, no significant differences were observed in blood loss, PO, jaundice-clearance ratio, and jaundice-free survival rate with the native liver between the two groups.</p><p><strong>Conclusion: </strong>The results indicate that young pediatric surgeons can safely perform MIS while practicing under the supervision of experienced ESSQ-qualified surgeons.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel self-assembling peptide as new submucosal injection solution in endoscopic submucosal dissection.","authors":"Kenichiro Okimoto, Tomoaki Matsumura, Tsubasa Ishikawa, Shohei Mukai, Satsuki Takahashi, Ryosuke Horio, Chihiro Goto, Akane Kurosugi, Michiko Sonoda, Tatsuya Kaneko, Yuki Ohta, Takashi Taida, Keisuke Matsusaka, Jun Kato, Jun-Ichiro Ikeda, Naoya Kato","doi":"10.1007/s00464-025-11655-y","DOIUrl":"https://doi.org/10.1007/s00464-025-11655-y","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the effectiveness of PuraLift, a novel self-assembling peptide-based submucosal injection solution, in endoscopic submucosal dissection (ESD) procedures. We compared its performance to MucoUp in a variety of organ-spanning lesions (esophagus, stomach, and colon/rectum).</p><p><strong>Methods: </strong>We included 40 consecutive ESD lesions from our hospital, with 19 treated using PuraLift and 21 using MucoUp. Special cases (such as those with ulcerative colitis, evident fibrosis due to post-treatment scars, and circumferential esophageal cases) and the cases that used device without waterjet function were excluded. Endoscopists assessed the satisfaction of submucosal lifting through needle injection on a 5-point scale. Firmness during local injection by the assistant for the PuraLift group was compared to MucoUp (MucoUp was set as a baseline score of 3) using a 5-point scale.</p><p><strong>Results: </strong>The firmness during local injection was significantly lower with PuraLift compared to MucoUp across all locations: esophagus (1 (1-2) vs. 3 (3-3), p = 0.018), stomach (1.5 (1-2) vs. 3 (3-3), p < 0.001), and colon/rectum (2 (1-2) vs. 3 (3-3), p < 0.001). However, there were no significant differences between PuraLift and MucoUp in terms of endoscopist satisfaction with lifting, amount of solution injected, glycerol used via jet function, or procedure time for any organ.</p><p><strong>Conclusion: </strong>PuraLift, with its novel mechanism, offers comparable lifting satisfaction to MucoUp but with less firmness during injection. It presents a promising alternative as a local injection solution in ESD procedures.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of prehabilitation for patients undergoing complex abdominal wall surgery.","authors":"Martina Cattaneo, Atif Jastaniah, Tahereh Najafi Ghezeljeh, Bhagya Tahasildar, Nour Kabbes, Raman Agnihotram, Paola Fata, Liane S Feldman, Kosar Khwaja, Melina Vassiliou, Franco Carli","doi":"10.1007/s00464-025-11638-z","DOIUrl":"https://doi.org/10.1007/s00464-025-11638-z","url":null,"abstract":"<p><strong>Introduction: </strong>Prehabilitation in the context of abdominal wall repair has received increasing interest as a strategy to improve postoperative outcomes by focusing on optimizing preoperative risk factors. The main approach includes nutritional counseling, exercise, and psychological intervention. The aim of this project was to assess whether a multimodal prehabilitation program for patients scheduled to undergo large ventral incisional hernia repair could modify the risk factors and optimize them for surgery. In addition, the impact on postoperative outcomes was evaluated.</p><p><strong>Patients and methods: </strong>This retrospective analysis included patients referred to a multimodal prehabilitation program preceding complex abdominal wall repair for incisional hernia between 2016 and 2020. The program comprised medical optimization, supervised and home-based exercise training, personalized nutrition plans, smoking cessation counseling, and psychological support. Patients were deemed optimized if they met one of the recommended criteria: weight loss ≥ 7% of total body weight, smoking cessation, or Hemoglobin A1c < 7%. Perioperative care adhered to an Enhanced Recovery After Surgery (ERAS) pathway. Primary outcome was the number of patients reaching optimization criteria preoperatively. Secondary outcomes included functional capacity changes from baseline (six-minute walk test), length of stay, and postoperative complications.</p><p><strong>Results: </strong>Seventy consecutive patients were analyzed, with 57.1% completing the program (prehabilitation group) and 42.9% not (dropout group). Groups were similar in baseline characteristics. In the prehabilitation group, 27.5% were fully optimized, 45% partially optimized, and 82.5% underwent surgery, while 30% partially met criteria and 33.3% underwent surgery in the control group. Patients showed functional improvement (mean + 61 m in 6MWT), with no significant differences in postoperative outcomes.</p><p><strong>Conclusion: </strong>Prehabilitation positively impacted modifiable risk factors in hernia patients, aiding in their eligibility for complex abdominal wall surgery. Patients participating in the program experienced enhanced functional capacity, indicating the potential benefits of prehabilitation in optimizing surgical outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green fluorescence navigation with 4K overlay vs. conventional laparoscopic liver resection: a propensity score-matched analysis (liver-light study).","authors":"Omid Ghamarnejad, Ghassan Batikha, Elias Khajeh, Hamraz Javaheri, Mahmoud Jabal, Rizky Widyaningsih, Gregor Alexander Stavrou","doi":"10.1007/s00464-025-11671-y","DOIUrl":"https://doi.org/10.1007/s00464-025-11671-y","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic liver resection (LLR) has revolutionized liver surgery by offering several advantages over traditional open procedures. However, conventional LLR (C-LLR) has certain limitations, such as the inability to palpate tumors and the need for continuous ultrasound guidance during surgery, which can result in complications. Real-time tumor-tracking technologies, such as indocyanine green (ICG) fluorescence imaging, have shown potential in enhancing tumor detection and improving perioperative outcomes. The Liver-Light study aims to evaluate the feasibility of integrating ICG fluorescence with 4 K imaging technology during LLR (ICG4K-LLR) to improve postoperative surgical and oncological outcomes.</p><p><strong>Methods: </strong>This study is a prospective, single-center investigation that included 42 patients who underwent ICG4K-LLR. These patients were matched in a 1:1 ratio using propensity scores with patients from retrospective data who underwent C-LLR. Potential confounding factors, including sex, age, body mass index, tumor type, and the complexity of LLR, were selected for matching. Postoperative surgical and oncological outcomes were then compared between the two groups.</p><p><strong>Results: </strong>After propensity score-matched analysis, the ICG4K-LLR group demonstrated several significant advantages over the C-LLR group. Operation times were shorter in the ICG4K-LLR group (155.2 min vs. 196.6 min, p = 0.002), with reduced blood loss (300.0 ml vs. 501.2 ml, p = 0.006) and fewer blood transfusions (0% vs. 14.3%, p = 0.011). Additionally, no patients in the ICG4K-LLR group had positive resection margins, whereas 14.3% of patients in the C-LLR group did (p = 0.011). The incidence of clinically relevant posthepatectomy liver failure (p = 0.040) and major morbidity (p = 0.035) was significantly lower in the ICG4K-LLR group. Furthermore, the 1-year disease free survival rate was significantly higher in the ICG4K-LLR group (92.3% vs. 64.3%, p = 0.004).</p><p><strong>Conclusion: </strong>ICG4K-LLR has a promising potential as a safe and effective navigation system, offering improved perioperative surgical and oncological outcomes compared to C-LLR.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological characteristics and long-term prognosis of peritoneal and retroperitoneal gastrointestinal stromal tumors.","authors":"Yunfu Feng, Luojie Liu","doi":"10.1007/s00464-025-11600-z","DOIUrl":"https://doi.org/10.1007/s00464-025-11600-z","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal and retroperitoneal gastrointestinal stromal tumors (PRGISTs) are exceedingly uncommon, and their clinicopathological characteristics and long-term prognosis remain unreported. Therefore, our objective is to analyze these aspects of patients with PRGISTs using the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Methods: </strong>Patients diagnosed with PRGISTs and small intestine stromal tumors (SISTs) between 2000 and 2019 were included in the study. Differences between groups were compared using Chi-square tests. Kaplan-Meier analysis and Cox proportional hazards models were used to evaluate overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Results: </strong>A total of 3817 patients were enrolled, with 3513 diagnosed with SISTs and 304 with PRGISTs. Compared to SISTs, PRGISTs patients were older, with larger tumors, higher mitotic rates, and greater risk of lymph node (5.3%) and distant (30.6%) metastasis (P < 0.001). Multivariate analysis identified N stage and mitotic rate as risk factors for distant metastasis in PRGISTs. In comparison to SISTs, PRGISTs patients exhibited a significantly worse OS (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.57-2.15, P < 0.001) and CSS (HR 2.11, 95% CI 1.73-2.58, P < 0.001). Subgroup analyses by age, sex, surgical status, chemotherapy, and marital status consistently demonstrated poorer OS and CSS for PRGISTs patients compared to SISTs patients (P < 0.05). The 1-, 3-, 5-, and 10-year OS rates for PRGISTs patients were 77.9%, 61.6%, 51.6%, and 32.8%, respectively, with corresponding CSS rates of 84.5%, 71.7%, 63.3%, and 49.0%. Multivariate Cox regression analysis identified age, race, surgical status, and mitotic rate as risk factors influencing OS, while race, surgical status, and mitotic rate were identified as risk factors affecting CSS.</p><p><strong>Conclusions: </strong>In comparison to SISTs, PRGISTs patients exhibit distinct clinicopathological features and have a worse prognosis. However, surgical intervention can improve the prognosis of PRGISTs patients.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metal versus plastic stents for EUS-guided walled-off necrosis drainage: a systematic review and meta-analysis of randomized controlled trials.","authors":"Omar Saab, Hasan Al-Obaidi, Marwah Algodi, Asma Algodi, Yasir Rashid, Alhareth Al-Sagban, Nooraldin Merza, Mohamed Abuelazm, Layth Alzubaidy, Muhammad Usman Baig, Reem Sharaiha","doi":"10.1007/s00464-025-11665-w","DOIUrl":"https://doi.org/10.1007/s00464-025-11665-w","url":null,"abstract":"<p><strong>Background & objective: </strong>The endoscopic step-up approach is the mainstay of walled-off necrosis management (WON). However, using metal stents versus plastic stents during WON drainage is debatable, with limited high-quality evidence. Therefore, we aim to investigate the comparative safety and efficacy of metal versus plastic stents for endoscopic ultrasound (EUS) guided WON drainage.</p><p><strong>Methods: </strong>A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), retrieved by systematically searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through July 2024. Continuous and dichotomous outcome variables were pooled using mean difference (MD) and risk ratio (RR), with confidence interval (CI) using Stata MP v. 17. We assessed heterogeneity using the chi-square test and I² statistic.</p><p><strong>Prospero id: </strong>CRD42024573859.</p><p><strong>Results: </strong>Six RCTs with 352 patients were included. There was no difference between both groups regarding clinical success (RR: 1.04 with 95% CI [0.88-1.23], p = 0.61), WON recurrence (RR: 1.46 with 95% CI [0.59-3.61], p = 0.41), the need of necrosectomy (RR: 0.96 with 95% CI [0.65-1.41], p = 0.84), the total number of necrosectomy sessions (MD: 1.03 with 95% CI [- 0.33, 2.40], p = 0.14), total number of interventions (MD: - 0.09 with 95% CI [- 0.72, 0.54], p = 0.79), mortality (RR: 0.87 with 95% CI [0.32-2.37], p = 0.79), bleeding (RR: 1.35 with 95% CI [0.58-3.12], p = 0.48), and stent migration (RR: 0.69 with 95% CI [0.28-1.71], p = 0.42). However, metal stents significantly decreased the procedure duration (MD: - 11.27 with 95% CI [- 17.69, - 4.86], p < 0.001).</p><p><strong>Conclusion: </strong>There was no significant difference between metal and plastic stents in efficacy and safety outcomes during WON EUS-guided drainage, except for a shorter procedural duration with metal stents.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the annual hospital volume associated with recurrence and chronic postoperative inguinal pain (CPIP) syndrome after inguinal hernia repair in laparo-endoscopic or open mesh technique (Lichtenstein)?","authors":"Reinhard Bittner, Solveig Unger, Ferdinand Köckerling, Daniela Adolf","doi":"10.1007/s00464-025-11619-2","DOIUrl":"https://doi.org/10.1007/s00464-025-11619-2","url":null,"abstract":"<p><strong>Background: </strong>In major surgery, several studies have shown a correlation between high annual hospital volume (hospital caseload) and better outcome. Therefore, centralization is recommended. However, in inguinal hernia surgery the data are limited.</p><p><strong>Methods: </strong>The study is based on a retrospective analysis of prospective data from the German Herniamed Registry collected between 2009 and 2018. Out of the total of 731,982 patients operated on in 737 institutions, patients who had undergone inguinal hernia repair in Lichtenstein or in laparo-endoscopic (TAPP/TEP) technique were included. Hospitals were divided into three annual caseload categories: Low volume: ≤ 75 cases; middle volume: 76-199 cases; high volume: ≥ 200 cases. The relationship between hospital volume and the outcome parameters was analyzed using multivariable binary logistic models.</p><p><strong>Results: </strong>222,487 patients were enrolled in analysis, with 70.4% hernias operated on in laparo-endoscopic technique and 29.6% cases in open mesh technique. Overall, the outcome after laparo-endoscopic repair was significantly favorable except for the intraoperative complications (worse) and recurrence rate (no significant difference). Descriptive and multivariable analysis identified a long operating time as the main factor associated with an unfavorable outcome. In low-volume hospitals the risk was higher for intraoperative complications as well as for postoperative complications in both techniques. There was a significantly favorable association between the recurrence rate and hospital volume but only after laparo-endoscopic repair. Patients who were operated on in a low-volume center experienced significantly less pain across all three pain categories, independently of the technique used.</p><p><strong>Conclusions: </strong>While hospital volume has a favorable association with most outcome parameters, this varied in accordance with the operative technique used. In contrast to open surgery, laparo-endoscopic surgery in a low-volume hospital (≤ 75) has the disadvantage of a higher recurrence rate. Long operating time is the most detrimental factor, proving that surgeon proficiency is of paramount importance. However, chronic postoperative inguinal pain (CPIP) syndrome is significantly less frequent in patients operated on in low-volume hospitals; this result is difficult to explain but may be due to a closer patient-surgeon relationship in these institutions.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of small intestinal endoscopic ultrasonography for protruding lesions of the small intestine.","authors":"Liu Zhongcheng, Chen Dongting, Wang Biyao, Liu Xinyu, Guo Qin","doi":"10.1007/s00464-025-11653-0","DOIUrl":"https://doi.org/10.1007/s00464-025-11653-0","url":null,"abstract":"<p><strong>Background: </strong>Small intestinal endoscopic ultrasonography (SIEUS) enables the comprehensive analysis of the origin and sonographic characteristics of protruding submucosal lesions. Current evidence is limited to case reports. We aimed to investigate the application value of SIEUS for protruding lesions of the small intestine.</p><p><strong>Methods: </strong>Clinical data of patients who underwent double-balloon enteroscopy combined with SIEUS at the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2023 and December 2024 were retrospectively collected. A total of 28 patients had concurrently received a diagnosis of protruding lesions of the small intestine and pathological results during their first visit. SIEUS findings were compared with the pathological results.</p><p><strong>Results: </strong>Patient cases included stromal tumor (n = 10), ectopic pancreas (n = 7), hemangioma (n = 5), lipoma (n = 3), neuroendocrine tumor (n = 2), and invaginated Meckel's diverticulum (n = 1). All cases were initially detected via white light endoscopy (WLE) and subsequently characterized by endoscopic ultrasonography during the first visit. Pathological specimens were obtained for all lesions through biopsy, endoscopic minimally invasive surgery, or surgery. Our results indicated 100% diagnostic agreement (28/28) between endoscopic ultrasonography and pathology findings.</p><p><strong>Conclusion: </strong>The combination of WLE and SIEUS provides a comprehensive assessment of protruding lesions, with WLE enabling detection and SIEUS facilitating detailed submucosal characterization.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde puncture for trocar placement for the establishment of the preperitoneal space in laparoscopic totally extraperitoneal repair for groin hernias: 10 years of experience.","authors":"Rui Ma, Huiyong Jiang, Yijun Guo, Xuefeng Zhang, Xize Wang, Cheng Zhang","doi":"10.1007/s00464-025-11623-6","DOIUrl":"https://doi.org/10.1007/s00464-025-11623-6","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the feasibility and safety of retrograde puncture for trocar placement for the establishment of the preperitoneal space in laparoscopic total extraperitoneal repair (TEP) for groin hernias.</p><p><strong>Methods: </strong>A retrospective analysis of the clinical data of 1388 patients who underwent TEP surgery for a groin hernia at the General Hospital of Northern Theater Command of the Chinese People's Liberation Army (hereinafter referred to as the General Hospital of Northern Theater Command) from August 2013 to August 2023 was conducted. The feasibility and safety of retrograde puncture for trocar placement for the establishment of the preperitoneal space were examined.</p><p><strong>Results: </strong>All 1388 operations were successful, with no conversion to open surgery. The mean time for unilateral placement of the Trocars was 6.36 ± 2.32 min. The mean time for unilateral hernia surgery was 42.73 ± 10.33 min, and the mean time for bilateral hernia surgery was 73.11 ± 20.31 min. Peritoneal injuries were observed in 8 patients (0.58%), but there were no abdominal organ injuries. Two patients (0.14%) had inferior epigastric vascular injuries, and 16 patients (1.15%) experienced muscle hemorrhage during retrograde puncture. Twenty-five patients (1.80%) had postoperative local hematomas of the abdominal wall, and 37 patients (2.67%) had subcutaneous emphysema. Sixty-four patients (4.61%) experienced seroma retention, and 13 patients (0.94%) experienced urinary retention. The postoperative follow-up period ranged from 3 to 124 months, with a median follow-up time of 66 months. None of the patients experienced recurrence, persistent pain, localized foreign body sensation, mesh infection, or incision infection.</p><p><strong>Conclusions: </strong>The retrograde puncture method for placing trocars to establish the preperitoneal space in laparoscopic TEP surgery for groin hernias is feasible and safe.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}