Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Treatment strategies for solitary hepatocellular carcinoma: comparative outcomes of radiofrequency ablation vs. laparoscopic liver resection based on tumor location.","authors":"Boram Lee, Ho-Seong Han, Yoo-Seok Yoon, Jai Young Cho, Hae Won Lee, Jae-Hwan Lee, Yeshong Park, MeeYoung Kang, Jinju Kim","doi":"10.1007/s00464-025-11566-y","DOIUrl":"10.1007/s00464-025-11566-y","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of early stage hepatocellular carcinoma (HCC) has become increasingly complex. This study evaluates the effectiveness of radiofrequency ablation (RFA) versus laparoscopic liver resection (LLR) for treating solitary hepatocellular carcinoma (HCC) ≤ 3 cm, with a focus on tumor location and depth.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients treated for solitary HCC ≤ 3 cm in the right liver lobe from 2004 to 2022. Tumor depth was categorized into three zones based on proximity to portal vein branches: Zone I (near first-order branches), Zone II (adjacent to second-order branches), and Zone III (near third-order branches). Outcomes were measured using overall survival (OS) and recurrence-free survival (RFS) rates.</p><p><strong>Results: </strong>Of the 662 patients, for Zone I, II, and III, 240 (65 LLR, 175 RFA); 174 (100 LLR, 74 RFA); and, 248 patients were treated (244 LLR, 4 RFA), respectively. Statistically significant differences in the treatment outcomes based on the tumor depth were observed. For Zone I, LLR demonstrated superior OS (p = 0.043) and RFS rates (p = 0.030) than did RFA. For Zone II, both treatments had comparable survival outcomes, with no statistically significant differences in the OS (p = 0.460) and RFS (p = 0.358). For Zone III, LLR was principally favored, due to easier surgical access and cleaner margins.</p><p><strong>Conclusions: </strong>This study highlighted the importance of including tumor location and depth, in addition to the tumor size and liver function, in the management of early stage HCC. A multidisciplinary approach is essential for treatment planning and optimizing survival outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2175-2184"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190598","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":"Laparoscopic common bile duct exploration for common bile duct stones after gastric surgery.","authors":"Xavier De Raeymaeker, Joris Blondeel, Bert Houben, A Karimi, Bart Appeltans, Gregory Sergeant","doi":"10.1007/s00464-025-11554-2","DOIUrl":"10.1007/s00464-025-11554-2","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease is common after gastric surgery and especially after weight loss from bariatric surgery. In patients with normal gastroduodenal anatomy, treatment of common bile duct stones (CBS) generally consists of, endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic sphincterotomy (ES), followed by cholecystectomy in a second stage. However, after gastric surgery the papilla may not be easily accessible endoscopically. The aim of our study was to evaluate the therapeutic success of single-stage laparoscopic cholecystectomy and common bile duct exploration (LCBDE) after previous gastric surgery.</p><p><strong>Methods: </strong>In this observational cohort study, all LCBDE in patients with previous gastric surgery between January 2014 and July 2022 were retrospectively reviewed. Gastric surgery consisted of Roux-en-Y gastric bypass, BII subtotal gastrectomy, total gastrectomy and subtotal gastrectomy with Roux-en-Y reconstruction. Outcomes of interest consisted of successful duct clearance, postoperative adverse events and CBS recurrence.</p><p><strong>Results: </strong>Forty-four patients (M/F: 22/22) underwent LCBDE after previous gastric surgery, in which simultaneous cholecystectomy was performed in 38 cases. Median (range) age 68 (25-90) years. Presence of CBS was confirmed in 38 patients (85%), a choledochal polyp in one patient (2%) and recurrence of gastric cancer in another (2%). Duct clearance was successful in 37 out of 38 patients (97%). Median (range) length of stay after LCBDE was 1 (0-12) day(s). Eight patients developed a postoperative adverse event, of which three Clavien-Dindo > 3a complications. Three patients were readmitted. At a median (range) follow-up of 60 (24-120) months, no CBS recurrences were observed.</p><p><strong>Conclusions: </strong>LCBDE is a safe technique, with a high rate of successful duct clearance after previous gastric surgery, even after previous cholecystectomy. In experienced centers, LCBDE provides a valid alternative for complex interventional endoscopy, omitting the need for the creation of a gastro-gastric fistula.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2185-2190"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256463","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":"Multidimensional analysis of clinicopathological characteristics and long-term prognosis of colonic signet-ring cell carcinoma.","authors":"Luojie Liu, Yibin Sun","doi":"10.1007/s00464-025-11548-0","DOIUrl":"10.1007/s00464-025-11548-0","url":null,"abstract":"<p><strong>Background: </strong>Colonic signet-ring cell carcinoma (SRCC) is a rare pathological subtype of colonic tumors. This study aims to comprehensively analyze the clinicopathological characteristics and long-term prognosis of colonic SRCC from multiple perspectives.</p><p><strong>Methods: </strong>Patients diagnosed with colonic SRCC and mucinous adenocarcinoma (MA) between 2000 and 2021 were retrieved from the surveillance, epidemiology, and end results database. Clinicopathological characteristics were compared using Chi-square tests. Overall survival (OS) and cancer-specific survival (CSS) were assessed using Kaplan-Meier curves and Cox regression analysis.</p><p><strong>Results: </strong>A total of 29,495 patients were enrolled, including 4000 with SRCC and 25,495 with MA. Compared to MA patients, the SRCC cohort was younger, had more males, less differentiation, and higher risks of lymph node (51.2%) and distant (36.6%) metastases. Age, T stage, and M stage were identified as risk factors for lymph node metastasis in SRCC, while age, T stage, and N stage were associated with distant metastasis. SRCC patients demonstrated significantly poorer OS and CSS compared to MA patients (P < 0.001). The 1-, 3-, 5-, and 10-year OS rates for SRCC patients were 57.8, 33.3, 26.0, and 17.1%, respectively, with corresponding CSS rates of 62.8, 39.7, 34.3, and 29.3%. Multivariate Cox regression analysis revealed that age, gender, grade, TNM stage, surgical intervention, chemotherapy, and marital status were predictive of OS, while age, gender, TNM stage, surgery, and marital status were significantly associated with CSS. Notably, female SRCC patients were younger and had a lower incidence of distant metastasis compared to males. Additionally, elderly patients had a higher proportion of females and Caucasians, and a lower incidence of lymph node and distant metastases compared to non-elderly patients.</p><p><strong>Conclusion: </strong>Compared to colonic MA, SRCC demonstrates unique clinicopathological features and inferior prognosis, with variations observed across age and gender. Hence, individualized treatment strategies are essential.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2380-2395"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449569","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":"Usefulness of a new foot switch for comport digestive endoscopic examination: a pilot study.","authors":"Dong Seok Lee, Sang Gyun Kim, Byung-Wook Kim, Jeong-Seon Ji, Ji Yong Ahn","doi":"10.1007/s00464-025-11580-0","DOIUrl":"10.1007/s00464-025-11580-0","url":null,"abstract":"<p><strong>Background: </strong>Foot switches are commonly used to record gastrointestinal lesions. However, prolonged use of foot switches can cause unstable posture, leading to musculoskeletal disorders. Therefore, this study aimed to develop and evaluate the usability of a compact foot switch for reducing musculoskeletal disorders among endoscopists.</p><p><strong>Methods: </strong>A new endoscopic foot switch was developed to reduce musculoskeletal disorders and was compared with a previous foot switch. Between January 1 and October 1, 2024, 50 expert endoscopists from five different centers analyzed its usability, postural stability, ability to reduce pain and work fatigue, and efficiency.</p><p><strong>Results: </strong>Compared with the conventional foot switch, the new foot switch showed favorable outcomes in terms of musculoskeletal disease-related factors, with better results in the following areas: comport endoscopic examination (6.5 [6-7] vs. 2 [1-2], p < 0.001), stable posture (6 [6-6] vs. 2 [2-3], p < 0.001), relief of musculoskeletal disorders (6 [5-6] vs. 3 [2-3], p < 0.001), efficiency of examination (6 [6-7] vs. 3 [2-3], p < 0.001), and applicability to other equipment (6 [6-7] vs. 2 [2-3], p < 0.001).</p><p><strong>Conclusions: </strong>We developed a new foot switch that can prevent musculoskeletal disorders among endoscopists. Further validation of its usefulness in various hospitals and users is required.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2458-2463"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining racial disparities in counseling about sacral neuromodulation for men and women with idiopathic fecal incontinence.","authors":"Vienne Seitz, Jessica Ziccarello, Jed Calata, Ling Mei, Emily R W Davidson","doi":"10.1007/s00464-025-11597-5","DOIUrl":"10.1007/s00464-025-11597-5","url":null,"abstract":"<p><strong>Background: </strong>Black patients undergo sacral neuromodulation for urinary incontinence less than White patients. There is less known about racial disparities in fecal incontinence.</p><p><strong>Objective: </strong>To determine if racial disparities in fecal incontinence care exist, specifically sacral neuromodulation education.</p><p><strong>Design: </strong>This was a retrospective cohort study of adults treated for fecal incontinence from 2011 to 2021 at an academic health center.</p><p><strong>Settings: </strong>Medical records were queried to collect clinical variables, including diagnostic tests ordered, treatments offered or discussed, and specialties treating the patients' fecal incontinence.</p><p><strong>Patients: </strong>The two cohorts were patients who identified as non-Hispanic Black or non-Hispanic White.</p><p><strong>Main outcome measures: </strong>The primary outcome was the percent of patients with documentation of discussion of sacral neuromodulation.</p><p><strong>Results: </strong>180 Black patients and 360 age-matched White patients were included. 21.7% of patients with fecal incontinence had documented counseling about sacral neuromodulation which was significantly less frequent in Black patients (12.8% vs 26.1%, p < 0.001). However, among only patients with this counseling documented, there was no difference based on race (17.4% vs 21.3%, p = 0.679). Black patients were also less likely to receive referrals for pelvic floor physical therapy (52.2% vs 72.2%, p < 0.001), anorectal manometry (41.1% vs 51.9%, p = 0.018), sphincter imaging (1.1% vs 5.3%, p = 0.018), and defecography (7.2% vs 16.1%, p = 0.004). Patients seen by Urogynecology, Colorectal Surgery, and/or Urology were more likely to be counseled about sacral neuromodulation (48.4% vs 2.8%, p < 0.001). On multivariate logistic regression, Black race (OR 0.45 95% CI 0.25-0.81), male sex (OR 3.15 95% CI 1.33-7.41), and not seeing a surgical specialist (OR 0.03 95% CI: 0.01-0.06) were associated with no sacral neuromodulation counseling.</p><p><strong>Limitations: </strong>Limitations include reliance on chart documentation for the primary outcome.</p><p><strong>Conclusion: </strong>Racial differences in treatment of fecal incontinence exist between Black and White patients, including differences in counseling about sacral neuromodulation.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2443-2449"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493600","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":"Enhanced prediction of 5-year postoperative recurrence in hepatocellular carcinoma by incorporating LASSO regression and random forest models.","authors":"Bing-Bing Su, Chao-Jie Zhu, Jun Cao, Rui Peng, Dao-Yuan Tu, Guo-Qing Jiang, Sheng-Jie Jin, Qian Wang, Chi Zhang, Dou-Sheng Bai","doi":"10.1007/s00464-025-11631-6","DOIUrl":"10.1007/s00464-025-11631-6","url":null,"abstract":"<p><strong>Background: </strong>Tumor recurrence post-operation of hepatocellular carcinoma (HCC) impacts patient prognosis. Identifying and predicting 5-year HCC recurrence following surgery remains a substantial challenge.</p><p><strong>Methods: </strong>We included 338 patients diagnosed with HCC who underwent surgery from January 2013 to December 2018. Traditional logistic regression, random forest (RF), and LASSO regression methods were used to develop a predictive model for 5-year recurrence. The findings were presented visually using nomogram. The accuracy and sensitivity of the predictive model were evaluated by receiver operating curves (ROC) and decision curve analysis (DCA).</p><p><strong>Results: </strong>Of the 338 patients, 172 (50.9%) experienced 5 years recurrence, with a gender distribution of 79.7% males. Univariate and multivariate logistic regression analysis identified that three independent predictors of 5-year HCC recurrence (all P < 0.001). The area under the curve (AUC) value of the model (Model-1) constructed was 0.678. Then we combined LASSO regression and RF construct a predictive model including six factors: age, transarterial chemoembolization (TACE), microvascular invasion (MVI), alcohol, size, and number. The AUC of the model (Model-2) constructed was 0.733. DeLong's test results showed that Model-2 had significantly better prediction ability compared with Model-1 (P = 0.004). DCA also demonstrated that Model-2 had better predictive accuracy (P < 0.05). Then we constructed a nomogram, and Kaplan-Meier analysis showed that patients in the low-risk group had significantly better prognosis than the high (P < 0.001).</p><p><strong>Conclusion: </strong>The predictive accuracy of our model, incorporating factors, such as age, alcohol, size, number, MVI, and TACE, significantly enhances clinical practice management by accurately forecasting 5 years HCC recurrence.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2540-2550"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543454","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":"Development of a prognostic oxidative stress-immune-inflammation score and online calculators for predicting survival and recurrence in gastric cancer: a multicenter study.","authors":"Hualong Zheng, Honghong Zheng, Xiaoqiang Du, Binbin Xu, Minggao Hu, Junhua Yu, Rongzhen Xie, Linghua Wei, Zhen Xue, Lili Shen, Jia Lin, Jianwei Xie, Chaohui Zheng, Changming Huang, Ping Li","doi":"10.1007/s00464-025-11596-6","DOIUrl":"10.1007/s00464-025-11596-6","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress, immune response, and inflammation play an important role in the occurrence and progression of gastric cancer (GC). This study is to develop a novel prognostic oxidative stress-immune-inflammation score (POSII score) and to explore the clinical value of the novel nomograms incorporating this factor in survival and recurrence risk.</p><p><strong>Methods: </strong>This study included 3612 GC patients who underwent radical gastrectomy at three tertiary hospitals from 2009 to 2020. One hospital formed the training and internal validation cohorts, while the other two constituted the external validation cohort. Twelve hematological markers were collected and analyzed to develop the POSII score via LASSO regression. Two online calculators were developed and validated.</p><p><strong>Results: </strong>The POSII score categorized patients into low and high POSII groups, with the low POSII group showing significantly improved 5-year overall survival (OS) and disease-free survival (DFS) rates, as well as a markedly reduced risk of recurrence (all P < 0.05). Multivariate COX regression showed that the POSII score was an independent prognostic factor. Based on the POSII score, two nomograms (OS: AUC = 0.837; DFS: AUC = 0.834, respectively) for individualized prognostic prediction were constructed. To enhance clinical usability, we further developed two user-friendly online calculators. The high-risk group had an earlier, more persistent peak of recurrence and a high incidence of multiple recurrence patterns.</p><p><strong>Conclusion: </strong>Two novel online calculators based on the POSII score can be used as reliable tools for predicting survival and recurrence after radical gastrectomy. Our findings provide new insights into the role of cancer-related immune dysregulation, inflammation, and oxidative stress imbalances.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2609-2624"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574062","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":"Computational fluid dynamics for vascular assessment in hepatobiliopancreatic surgery: a pilot study and future perspectives.","authors":"Carolina González-Abós, Roberto Molina, Sofía Almirante, Mariano Vázquez, Fabio Ausania","doi":"10.1007/s00464-025-11536-4","DOIUrl":"https://doi.org/10.1007/s00464-025-11536-4","url":null,"abstract":"<p><strong>Introduction: </strong>In major hepatobiliopancreatic surgery, an accurate preoperative planning is essential. Postoperative impaired blood supply due to arterial disease or variants can cause postoperative complications. Computational fluid dynamics has previously been successful in revealing distinct features of haemodynamic disturbances. The purpose of our study is to describe the feasibility of a computational fluid dynamics model to predict hepatic artery flow and its variations following gastroduodenal (GDA) or common hepatic (CHA) artery ligation.</p><p><strong>Material and methods: </strong>This is a pilot study including 20 patients undergoing robotic pancreaticoduodenectomy at a single centre. Preoperative images and intraoperative vascular flows were used to the computational model. Three scenarios of the hepatic artery were analysed: (1) without any clamps, (2) clamped GDA and (3) clamped CHA. Patients 1 to 15 were used to develop the model, and patients 15 to 20 were used for model validation. Finally, the model was tested in 3 abnormal cases: celiac trunk stenosis (2) and replaced right hepatic artery (1).</p><p><strong>Results: </strong>The selected methodology proved to be reproducible, with the CFD model demonstrating 100% accuracy in predicting blood flow redistribution after gastroduodenal artery (GDA) clamping and 80% accuracy following common hepatic artery (CHA) clamping. The model accurately simulated reversed GDA flow in cases of celiac trunk stenosis and displayed independent flow distribution in patients with anatomical variations, even without prior specific model training.</p><p><strong>Conclusion: </strong>The developed computational model accurately predicts flow variations in the proper hepatic artery in case of gastroduodenal artery and common hepatic artery clamping. Further studies are needed to validate this methodology.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764364","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":"Single-port sleeve gastrectomy: a comparison between transumbilical and left hypochondrium approaches.","authors":"Hussein Abdallah, Joseph Derienne, Rodi Courie, Cosmin Sebastian Voican, Gabriel Perlemuter, Gianfranco Donatelli, Ibrahim Dagher, Hadrien Tranchart","doi":"10.1007/s00464-025-11529-3","DOIUrl":"10.1007/s00464-025-11529-3","url":null,"abstract":"<p><strong>Background: </strong>Left hypochondrium (LHC) approach has been routinely used in our department for performing single-port sleeve gastrectomy (SPSG). Starting from 2019, a transumbilical approach (TU) has been adopted in selected patients. The aim of this study was to report and compare our results of both approaches (LHC and TU) with special focus on incisional hernia (IH).</p><p><strong>Methods: </strong>The data of patients who underwent sleeve gastrectomy via both approaches between 2019 and 2022 were retrospectively analyzed. An assessment of IH rate was carried out by reviewing abdominal computed tomography scans performed one year after surgery.</p><p><strong>Results: </strong>During the study period, 449 patients who underwent SPSG were included in the final analyze. Patients in the TU group (n = 136, 30%) were more frequently female with a lower BMI and fewer comorbidities. An umbilical hernia was observed in 60% of patients in the TU group. Operative duration was longer in the LHC group (80 min vs. 64 min, P < 0.0001). Early complications rates did not differ between the groups (1.9% LHC vs. 0.7% TU, P = 0.353). During follow-up, 65 patients (14%) developed an IH: 9.9% and 25% in the LHC and TU groups, respectively (P < 0.0001). Weight loss and comorbidities resolution at 1 year were globally similar between the two groups.</p><p><strong>Conclusion: </strong>We have demonstrated the feasibility, safety, and efficacy of SPSG via both LHC and TU approaches. The advantage of the LHC approach is its routine applicability. The TU approach offers an esthetic advantage and a shorter operative time but is associated with a much higher IH rate.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2221-2227"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year outcomes of a randomized controlled trial evaluating a non-adjustable ring in Roux-en-Y gastric bypass.","authors":"Sietske Okkema, Abel Boerboom, Willem den Hengst, Edo Aarts, Frits Berends, Eric Hazebroek","doi":"10.1007/s00464-025-11545-3","DOIUrl":"10.1007/s00464-025-11545-3","url":null,"abstract":"<p><strong>Background: </strong>Several retrospective studies suggest that adding a non-adjustable silicone ring to a Roux-en-Y gastric bypass (RYGB) results in more weight loss and prevents weight regain in the long term. The aim of this study was to evaluate the effect of a banded Roux-en-Y gastric bypass (B-RYGB) on weight loss outcomes in a randomized controlled trial (RCT).</p><p><strong>Methods: </strong>In this single center RCT, 130 patients were divided into two groups: a standard Roux-en-Y gastric bypass (S-RYGB) or a B-RYGB using a Minimizer® ring. Subsequently, weight loss, morbidity, reduction of obesity-associated medical conditions, quality of life (QoL), and complication rates were measured during a follow-up period of five years. A two-sided p < 0.05 (with 95% confidence interval) indicated statistical significance.</p><p><strong>Results: </strong>After five years, mean percentage total body weight loss (%TBWL) was 30.5% in the S-RYGB versus 31.8% in the B-RYGB group (p > 0.05). The follow-up percentage was 81%. Overall, no significant differences in complication rates, resolution of obesity-associated medical conditions, and QoL were found between the two groups. In the B-RYGB group, 8 (12%) silicone rings were removed due to symptoms of dysphagia.</p><p><strong>Conclusion: </strong>B-RYGB is a safe procedure showing similar comorbidity when compared to a S-RYGB. However, B-RYGB led to a higher rate of postoperative dysphagia which poses a risk of ring removal over time. The results from this RCT do not support the hypothesis that implantation of a non-adjustable silicone ring improves long-term weight loss outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2324-2334"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}