Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Initial experience with the Carina™ platform in robotic-assisted hysterectomy for gynecological malignant disease.","authors":"Yafen Liu, Zhao Zhao, Penglin Xu, Yue Li, Weizhong Chang, Mei Ji","doi":"10.1007/s00464-025-11588-6","DOIUrl":"10.1007/s00464-025-11588-6","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study was performed to evaluate the efficiency and safety of a new modular robotic system, the Carina™ Platform (Ronovo Surgical, Shanghai, China), in gynecological surgery.</p><p><strong>Methods: </strong>All patients underwent robotic hysterectomies (RH) using the Carina performed by a single gynecologist experienced in laparoscopic and robotic surgery from November to December 2023. Patients were evaluated for estimated blood loss (EBL), intraoperative and postoperative complications, length of hospital stay, conversion rate, as well as console and docking times.</p><p><strong>Results: </strong>Two separate populations were involved: 10 cervical cancer patients (group 1) and six endometrial cancer patients (group 2). There were no conversions to laparotomies or laparoscopies. The mean docking time was 5.75 ± 2.38 min. The mean console time and mean operative time were 154.60 ± 26.01 min and 211.90 ± 53.65 min in group 1, respectively. The mean console time and mean operative time were 98.67 ± 26.71 min and 153.33 ± 22.77 min in group 2, respectively. The median estimated blood loss for group 1 and group 2 were 30 ml (20, 50) and 20 ml (7.5, 20), respectively. No intraoperative or postoperative complications related to the device were recorded.</p><p><strong>Conclusion: </strong>Our experience allows us to state that the modular Carina Platform is safe and efficient in complex gynecologic surgery.</p><p><strong>Clinical trial registration: </strong>researchregistry10353  https://www.researchregistry.com/browse-the-registry#home/registrationdetails/665c1a398a97c302739cce06/.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2346-2353"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450473","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":"Recurrence and complications after laparoscopic inguinal hernia repair using a self-adherent mesh: a patient-reported follow-up study.","authors":"Helle Lund, Lene Spanager, Azalie Caroline Riberholdt Winther, Mathias Gierløff, Katharina Sunekær, Jakob Kleif, Claus Anders Bertelsen","doi":"10.1007/s00464-025-11614-7","DOIUrl":"10.1007/s00464-025-11614-7","url":null,"abstract":"<p><strong>Background: </strong>Recurrence and postoperative pain are major concerns after laparoscopic surgery for inguinal hernia. Follow-up on all patients is difficult and time consuming for both the hospital and the patient. We conducted a patient-reported follow-up study to estimate the rate of recurrence and postoperative pain in our department.</p><p><strong>Method: </strong>Patients undergoing the TAPP (TransAbdominal PrePeritoneal) procedure with a self-adherent mesh at Copenhagen University Hospital - North Zealand from 2016 to 2019 received an online survey about signs of recurrence, postoperative pain, and complications. Patients reporting signs of recurrence or pain were contacted and invited for a clinical examination if relevant. Forty-five randomly selected patients who did not report any symptoms of recurrence or pain were contacted by phone for validation.</p><p><strong>Results: </strong>871 patients received a questionnaire, and 546 responded, leaving a response rate of 62.7%. Median follow-up time was 34 months (IQR 23-47). The self-reported recurrence rate was 8.1% (95% CI: 6.0-11.0%). On examination, recurrence was diagnosed in 2.4% (95% CI: 1.4-4.1%) of the patients. When including the patients with self-reported recurrence who did not accept the offer of clinical examination, the recurrence rate was 3.8% (95% CI: 2.5-5.8%). Four patients (0.7%, 95% CI: 0.2-2.0%) underwent herniotomy for recurrence. The rate of chronic postoperative pain impairing daily activity was 0.5%.</p><p><strong>Conclusion: </strong>We found an acceptable low rate of recurrence and postoperative pain compared to other studies. The patient-reported recurrence rate was significantly higher than the clinical recurrence rate after the examination, indicating that patient-reported recurrence seems to overestimate true recurrence after TAPP.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2464-2470"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493608","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":"Energy dashboard: post-operative insights into electrosurgical device use.","authors":"Simon C Baltus, Vincent J Ribbens, Arjen Wiersma, Renske M Hoeben, Can Ozan Tan, Ivo A M J Broeders","doi":"10.1007/s00464-025-11642-3","DOIUrl":"10.1007/s00464-025-11642-3","url":null,"abstract":"<p><strong>Background: </strong>This study presents a post-operative energy dashboard to teach surgeons about electrosurgical device use. By analyzing the energy generator, we aim to add new information to the current assessment of surgical skills. This study evaluated how such a dashboard can provide insight into differences in electrosurgery application.</p><p><strong>Methods: </strong>A semi-automated methodology for the energy dashboard was developed by acquiring intra-operative energy generator and video data, and computing metrics to compare device use. The energy dashboard quantified the use of the electrosurgical device based on the number of activations (N), the duration of individual activations (s), the total use time (s), and the total applied energy (kJ). The methodology and differences in device use were assessed based on forty-eight fundoplication surgeries performed by three surgeons.</p><p><strong>Results: </strong>The methodology identified the device activations with an F1-score of 0.95. The comparison between the surgeons showed significant differences in total usage, turn-on count, and amount of applied energy. In addition, the dashboard showed a significant difference in total applied energy (kJ) over the dissections of the gastrohepatic and gastrosplenic ligament.</p><p><strong>Conclusion: </strong>The study showed that energy monitoring can provide insights into application differences. In addition, the pilot study showed that the use of electrosurgical devices can differ significantly between surgeons. A broader application of the energy dashboard can enable a new source of information for surgical skill assessment.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2641-2647"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586808","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":"Robotic-assisted hiatal hernia repairs with and without magnetic sphincter augmentation (MSA): short- and long-term patient-centered outcomes in a single academic center.","authors":"Maher El Chaar, Allincia Michaud, Scott Allen Farabaugh, Dustin Manchester, Meredith Harrison, Luis Alvarado","doi":"10.1007/s00464-025-11583-x","DOIUrl":"10.1007/s00464-025-11583-x","url":null,"abstract":"<p><strong>Introduction: </strong>Hiatal Hernia (HH) repairs are commonly performed using a laparoscopic (L) approach. Recently, the robotic-assisted (RA) approach was introduced. The objective of the study is to describe our experience and analyze patient-centered clinical outcomes of RA-HH repairs with and without MSA (Magnetic Sphincter Augmentation).</p><p><strong>Methods: </strong>Patients who underwent RA-HH repair with or without MSA between April 2018 and February 2023 were included. The data were summarized using mean and standard deviation for all continuous variables. Frequency and percent were used for categorical data. Postoperative endoscopy and/or barium swallow were done on all patients. Postoperative clinical follow-up occurred at 2 weeks, 3,6,12, and 24 months. At 6 months, the Gastroesophageal Reflux Disease Health-Related Quality-of-Life (GERD-HRQL) scale was used to assess quality of life and symptom severity. The data were analyzed for both MSA and non-MSA patients and reported at 2 years. All data management and analysis were conducted using Stata V.18.</p><p><strong>Results: </strong>Overall, the study included 295 patients. 30-day readmission and ED visit rates were 7.51% and 14.92%, respectively. In-hospital postoperative complication rate was 10.85%. We had no 30-day mortality. Conversion to open was 0.34%. Hospital length of stay was 0-1 day in 82.03% of cases. GERD-HRQL score decreased from 8.78 preoperatively to 1.34 at 6 months with 86.1% of patients reporting a score of 0. Our follow-up rate at year 2 from the index procedure was 74% ( 217 patients out of 295). Hernia recurrence rate at 24 months was 3.93%. PPI use at 2 years was 38.71%. MSA group had more post-op globus at 24 months (5.13% vs 1.12%) but similar rates of post-op heartburn and PPI use.</p><p><strong>Conclusion: </strong>RA-HH at our center appears to be safe and feasible with low recurrence rates at 24 months. MSA had similar rates of PPI use but more post-op globus compared to the non-MSA group at 2 years.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2211-2220"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390421","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":"Feasibility and outcome of transcystic laparoscopic common bile duct exploration as first-line treatment for common bile duct stones: a retrospective cross-sectional study.","authors":"Lea Sander Berg, Hans Friis-Andersen, Nellie Bering Zinther, Mehmet Öztoprak, Kåre Andersson Gotschalck","doi":"10.1007/s00464-025-11587-7","DOIUrl":"10.1007/s00464-025-11587-7","url":null,"abstract":"<p><strong>Background: </strong>For treatment of common bile duct stones (CBDS), guidelines recommend a one-stage approach, including laparoscopic common bile duct exploration (LCBDE) or intraoperative endoscopic retrograde cholangiopancreatography (intraERCP). Studies show favourable outcomes with transcystic LCBDE (tLCBDE), but this technique is not widely adopted. The use of tLCBDE may be limited by several factors, but to what degree is unknown. The aim of this study is to examine the feasibility and, secondarily, outcomes of tLCBDE for patients undergoing removal of CBDS and laparoscopic cholecystectomy (LC) when tLCBDE is the first-line treatment.</p><p><strong>Method: </strong>A retrospective cross-sectional study including patients with removal of CBDS and LC at Horsens Regional Hospital during June 2017-March 2022. We classified patients into three groups: tLCBDE, preoperative ERCP (preERCP), and other procedures. The reasons for not performing tLCBDE were registered from medical charts. In the tLCBDE and the preERCP group, we registered clearance rate, postoperative complications, and subsequent ERCP.</p><p><strong>Results: </strong>In total, 229 patients received a procedure due to CBDS, of which 73% were emergency procedures. The groups were as follows: 179 (78%) tLCBDE, 25 (11%) preERCP, and 25 (11%) other procedures. preERCP was chosen due to the patient being unfit for emergency surgery, tLCBDE not being technically possible, and other reasons. Other procedures were chosen, because tLCBDE was not technically possible, lack of equipment or qualified surgeon, and other reasons. In the tLCBDE group, 94% of patients with CBDS were cleared, 5.6% had a complication of Clavien-Dindo grade ≥ 3, and 3.9% patients needed a subsequent ERCP.</p><p><strong>Conclusion: </strong>tLCBDE is feasible, safe, and effective treatment which can be performed in the majority of patients with CBDS and should be considered an equivalent to ERCP or choledochotomy as first-line treatment of patients with CBDS. As some patients require ERCP or choledochotomy, tLCBDE should not be the sole treatment available.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2256-2266"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399919","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":"First-intention EUS-guided transluminal drainage with LAMS: an effective and safe method for management of fluid collections after any kind of surgery.","authors":"Maria Terrin, Francesca D'Errico, Hugo Rotkopf, Thierry Tuszynski, Jean-Loup Dumont, Serge Dehry, Roberta Maselli, Alessandro Fugazza, Hadrien Tranchart, Sébastien Gaujoux, Ibrahim Dagher, Olivier Scatton, Alessandro Repici, Gianfranco Donatelli","doi":"10.1007/s00464-025-11615-6","DOIUrl":"10.1007/s00464-025-11615-6","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic postoperative collections (PCs) frequently complicate surgery with significant morbidity and mortality. In contrast with pancreatic inflammatory collections, little is known about endoscopic ultrasound-guided drainage of PCs (EUS-PCD). The aim of this study is to evaluate the safety and efficacy of EUS-PCD using lumen-apposing metal stent (LAMS) as the first-line drainage approach for PCs of any kind.</p><p><strong>Methods: </strong>This is a monocentric retrospective study. We retrieved all consecutive symptomatic PCs treated at our center between February 2019 and September 2024. All cases were considered suitable for EUS-PCD after multidisciplinary discussion. Rates of technical success, clinical success, and AEs were calculated.</p><p><strong>Results: </strong>We retrieved 66 PCs, mainly resulting from pancreatic and lower gastrointestinal tract surgery. The median size of collections was 7.6 cm and infection occurred in 54 of the cases. The median time from surgery to drainage was 19 days (IQR 13-29); in 10 cases, this occurred ≤ 7 days after surgery. 51 drainages were performed from the gastric/duodenal window, 15 transrectally. LAMS were removed after a median time of 18.5 days (IQR 12-27). After removal, double-pigtail stents were placed in 25 PCs and at least one necrosectomy session was performed in 13. Technical success was achieved in 97.0% of cases. Clinical success was achieved in 95.2%; in 3 cases, collection recurrence occurred and retreatment with LAMS was successful. Overall AEs rate was 9.1%, but only one was severe, requiring surgery. Rates of technical and clinical failure and AEs were not affected by surgery type (pancreatic, non-pancreatic), timing of drainage (≤ 7, 7-10, > 10 days), size of collections (≤ 4, 4-10, > 10 cm), and access window (transgastric/duodenal/rectal). Necrosectomy performance was the only predictor of AEs occurrence (OR 6.9, C.I.: 1.1-46.9, p = 0.048) at univariable analysis.</p><p><strong>Conclusion: </strong>First-intention EUS-PCD seems to be a safe and effective treatment, regardless of the origin and size of the collection and drainage timing.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2415-2424"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450471","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":"Impact of immunosuppression medication management on short-term complications following sleeve gastrectomy.","authors":"Kamal Abi Mosleh, Sara Bocchinfuso, Katarzyna Bartosiak, Richard S Betancourt, Simon Laplante, Todd A Kellogg, Tayyab S Diwan, Omar M Ghanem","doi":"10.1007/s00464-025-11628-1","DOIUrl":"10.1007/s00464-025-11628-1","url":null,"abstract":"<p><strong>Background: </strong>Sleeve gastrectomy (SG) is the most performed bariatric procedure in the United States due to its favorable safety profile. However, managing patients on chronic immunosuppressive therapy (CIT) during bariatric surgery poses challenges, particularly in balancing surgical outcomes with the risks associated with CIT interruption. This study aims to compare the short-term outcomes of SG in patients who temporarily discontinued CIT versus those who continued it perioperatively.</p><p><strong>Methods: </strong>A retrospective review was conducted of 75 patients on CIT who underwent SG at a single academic center between 2008 and 2022. Patients were categorized based on perioperative CIT management: 20 (26.7%) interrupted CIT and 55 (73.3%) continued therapy. Data on patient demographics, CIT indications, operative details, and short-term outcomes, including complications and readmissions, were analyzed.</p><p><strong>Results: </strong>The most common CIT indication was organ transplantation (61.4%), predominantly in the non-interruption group, while rheumatoid arthritis was the leading indication (50%) among patients who interrupted CIT. Early complications (≤ 30 days) were significantly higher in the non-interruption group (20% vs. 5%, p = 0.031), with bleeding being the most frequent (7 cases), followed by wound infections (4 cases). In contrast, the interruption group experienced only one complication, a wound infection. Weight outcomes were similar between groups, with no significant differences in percentage of total weight loss (%TWL) at 3 or 6 months. Notably, the interruption group had no 30-day readmissions or reoperations, compared to 16.4% and 5.5%, respectively, in the non-interruption group.</p><p><strong>Conclusions: </strong>Temporary interruption of CIT in SG patients is associated with lower early complication rates and improved short-term outcomes. These findings highlight the importance of individualized perioperative CIT management and suggest potential benefits of CIT interruption when clinically feasible.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2571-2578"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568208","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":"National trends in operative approach to esophagectomy: utilization rates, outcomes, and overall survival.","authors":"Lucas Weiser, Claire Perez, Justin J J Watson, Qiudong Chen, Shruthi Nammalwar, Allen Razavi, Charles Fuller, Sevannah G Soukiasian, Andrew R Brownlee, Harmik J Soukiasian","doi":"10.1007/s00464-025-11563-1","DOIUrl":"10.1007/s00464-025-11563-1","url":null,"abstract":"<p><strong>Background: </strong>Although open esophagectomies (OE) have traditionally been favored, minimally invasive approaches are increasingly utilized and associated with improved outcomes. We investigated the adoption rates of robotic-assisted minimally invasive esophagectomy (RAMIE) and minimally invasive esophagectomy (MIE) compared with OE. Utilization rates by surgical approach, post-operative outcomes, and overall survival were analyzed.</p><p><strong>Methods: </strong>The National Cancer Database was queried for patients who underwent OE, MIE, and RAMIE for esophageal cancer from 2010 to 2019. Adoption rates of RAMIE, MIE and OE were determined for all patients. Patients with primary cervical esophageal cancer, stage 4 disease, unknown staging, or missing follow-up data were excluded. Multivariable Cox regression models compared overall survival based on surgical approach.</p><p><strong>Results: </strong>A total of 17,765 patients underwent an esophagectomy for stage I, II, and III disease (OE: n = 10,039; MIE: n = 5388; RAMIE: n = 2338). Between 2010 and 2019, OE decreased by 52%, while MIE and RAMIE increased by 49% and 704%, respectively. The overall conversion rate of MIE and RAMIE to OE decreased significantly over the study time period. On multivariable analysis, the odds of 30-day and 90-day mortality was lower for MIE (p < 0.001; p < 0.001) and trended towards lower for RAMIE when compared to OE, though was not a statistically significant difference. Further, the overall 5-year survival was higher in the MIE and RAMIE cohort compared to the OE cohort. Like short-term survival, patients who underwent MIE had a significantly lower mortality (p < 0.001) while those who underwent RAMIE trended towards lower mortality.</p><p><strong>Conclusion: </strong>This contemporary review of a national cohort demonstrates the rapid adoption of minimally invasive esophagectomy techniques, without compromise in short-term or long-term outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2267-2274"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410664","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":"Long-term efficacy and quality of life after antireflux surgery.","authors":"Philip K Bang, Naja H Andersen, Frederik Hvid-Jensen, Niels Christian Bjerregaard, Daniel W Kjaer","doi":"10.1007/s00464-025-11608-5","DOIUrl":"10.1007/s00464-025-11608-5","url":null,"abstract":"<p><strong>Background: </strong>Antireflux surgery (ARS) has been found to be an effective treatment of gastro-esophageal reflux disease (GERD); however, the long-term effects are uncertain. This study aimed to evaluate the long-term efficacy of ARS on quality of life, symptom severity, and use of proton pump inhibitors (PPIs).</p><p><strong>Methods: </strong>A validated GERD Health-Related Quality of Life (GERD-HRQL) Questionnaire was sent to 419 patients who underwent ARS at Aarhus University Hospital from January 2012 to April 2020. Patient records were reviewed retrospectively. The Danish National Prescription Registry was used to collect data on the use of PPIs before and after ARS.</p><p><strong>Results: </strong>A response rate of 71% resulted in a total of 164 patients included in the study with a median follow-up time of 4.8 years (interquartile range: 2.5-6.7). The total GERD-HRQL median score at follow-up was 11.5 (IQR: 4-22). The proportion of patients experiencing daily symptoms of heartburn and regurgitation was significantly reduced pre- to postoperatively from 90 to 70% to 32% and 29%, respectively. Five years after surgery, 47% of patients had completely ceased PPI usage, while 44% were long-term users.</p><p><strong>Conclusion: </strong>A lasting long-term effect of ARS on GERD symptoms was found, although almost a third of patients still experience heartburn and/or regurgitation daily. Almost half of patients were not taking PPIs 5 years after ARS, but 44% became long-term users. Patients should be made aware that long-term PPI therapy often is necessary following ARS.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2354-2363"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449161","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":"Quantification of indocyanine green fluorescence angiography in colorectal surgery: a systematic review of the literature.","authors":"Philip D McEntee, Ashokkumar Singaravelu, Cathleen A McCarrick, Edward Murphy, Patrick A Boland, Ronan A Cahill","doi":"10.1007/s00464-025-11621-8","DOIUrl":"10.1007/s00464-025-11621-8","url":null,"abstract":"<p><strong>Background: </strong>Indocyanine green fluorescence angiography (ICGFA) during colorectal surgery associates with reduced post-operative anastomotic complication rates. Because its interpretation is subjective, quantification has been proposed to address inter-user variability. This study reviews the published literature regarding ICGFA quantification during colorectal surgery with a focus on impactful clinical deployment.</p><p><strong>Methods: </strong>A systematic review was performed of English language publications regarding clinical studies of ICGFA quantification in colorectal surgery in PubMed, Scopus, Web of Science and Cochrane Library on 29th August 2024, updated to 18th November 2024, following PRISMA guidelines. Newcastle Ottawa scale (NOS) was used to assess quality.</p><p><strong>Results: </strong>A total of 1428 studies were screened with 22 studies (1469 patients) selected. There was significant heterogeneity of ICGFA methodology, quantification methods and parameter selection and only three studies were NOS \"high\" quality. Extracorporeal application was most common. Four studies (154 patients) conducted real-time ICGFA analyses (others were post hoc) and four utilised artificial intelligence methods. Eleven studies only included patients undergoing left-sided resection (six focusing specifically on rectal resections). Only one study employed the quantification method to guide intra-operative decision-making regarding colonic transection. Twenty-six different perfusion parameters were assessed, with time from injection to visible fluorescence and maximum intensity the most commonly (but not only) correlated parameters regarding anastomotic complication (n = 18). Other grounding correlates were tissue oxygenation (n = 3, two with hyperspectral imagery), metabolites (n = 2) and surgeon interpretation (n = 5).</p><p><strong>Conclusion: </strong>Quantification of the ICGFA signal for colorectal surgery is feasible but has so far seen limited academic advancement beyond feasibility.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2677-2691"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524510","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}