Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"The dissemination of surgical clinical practice guidelines-evaluating SAGES' strategies for distribution.","authors":"Elisa C Calabrese, Bethany J Slater, Wendy Babidge, Patricia Sylla, Guy Maddern","doi":"10.1007/s00464-025-11778-2","DOIUrl":"10.1007/s00464-025-11778-2","url":null,"abstract":"<p><strong>Background: </strong>The Society of Gastrointestinal and Endoscopic Surgeons (SAGES) has been a leader in the development of surgical clinical practice guidelines; however, the dissemination and implementation of these remains a challenge. We aim to analyze the user interaction with the SAGES website (sages.org) guidelines' page and guideline downloads from their associated journal Surgical Endoscopy to help inform the organization about its distribution and dissemination methods.</p><p><strong>Methods: </strong>Google analytics from the sages.org website and Surgical Endoscopy downloads for each guideline were obtained from July 2023 to April 2024, as well as number of downloads for the lifetime of the guideline. Data were organized by overall guideline popularity, defined as number of sages.org views or number of journal downloads, and its associated citations. Popularity by country was only informed by google analytics data from sages.org. The country's associated economic status-high, upper middle, lower middle, and low-income was obtained and a chi-squared test, applied to proportions, was performed on each guideline to determine if the economic status of the country significantly influences guideline popularity (p-value less than 0.05, confidence interval 95%).</p><p><strong>Results: </strong>The hiatal hernia guideline had the most sages.org views and citations over the 9-month period; however, the management of diverticulitis guideline had the most journal downloads from time of publication. Colorectal surgery (CRS) guidelines were the most popular category in journal downloads which was not observed in sages.org views. Additionally, the popularity significantly differed in four guidelines based on the country's economic status.</p><p><strong>Conclusions: </strong>Society websites and journals were found to be reasonable platforms for dissemination of guidelines, with viewership and download numbers in the tens of thousands for some articles. The variability in engagement across platforms may suggest different audiences with different needs. The data emphasizes the importance of SAGES diversifying their platforms for broader dissemination.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3930-3940"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032370","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":"The feasibility of endoscopic resection for esophageal gastrointestinal stromal tumor.","authors":"Yanwu Zhou, Ruyi Peng, Xingcen Chen, Xinxin Xie, Jiefei Chen, Rong Li","doi":"10.1007/s00464-025-11763-9","DOIUrl":"10.1007/s00464-025-11763-9","url":null,"abstract":"<p><strong>Objectives: </strong>Esophageal gastrointestinal stromal tumor (e-GIST) is a rare type that is distinct from gastric GIST (g-GIST), and comprehensive studies are limited. The present study aims to compare the clinicopathological characteristics between e-GIST and g-GIST, evaluate the feasibility of using endoscopic resection (ER) to treat e-GIST, and explore its clinical implications.</p><p><strong>Methods: </strong>Patients with GISTs from January 2010 to May 2019 were enrolled in this study. Comprehensive clinicopathological, endoscopic, and follow-up data were collected and systematically analyzed.</p><p><strong>Results: </strong>There were 46 e-GIST patients and 366 g-GIST patients were enrolled. The distinct characteristics of e-GIST were as follows: (1) greater prevalence in male patients than in female patients, in contrast with the predominance of females among patients with g-GIST; (2) the median onset age was 61 years (range 20 to 80 years), with 58.7% of patients aged > 65 years in e-GIST; (3) the proportion of larger tumors was much more frequent in the esophagus; (4) greater incidence of ulceration/bleeding than in g-GIST; (5) increased mitotic count (≥ 5/50HPF). These factors collectively contribute to significantly shorter overall survival in e-GIST patients. Importantly, our analysis revealed that the outcomes of endoscopic resection (ER) were comparable to those of surgical resection for selected e-GISTs (tumor diameter ≤ 5 cm, without ulceration/bleeding, and mitotic count < 5/50HPF), with no significant differences in recurrence rate or survival time between these procedures.</p><p><strong>Conclusions: </strong>This study highlights the distinct clinicopathological features of e-GIST from those of g-GIST with increased tumor size, ulceration/bleeding, and higher mitotic counts identified as significant prognostic factors. Our findings suggest that ER is a feasible and effective treatment approach for carefully selected e-GIST cases (tumor diameter ≤ 5 cm, without ulceration/bleeding), as assessed by endoscopic ultrasound (EUS). These results provide valuable insights for the management of this rare tumor subtype.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3718-3726"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038870","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":"Artificial intelligence classifies surgical technical skills in simulated laparoscopy: a pilot study.","authors":"Orr Erlich-Feingold, Roi Anteby, Eyal Klang, Shelly Soffer, Mordechai Cordoba, Ido Nachmany, Imri Amiel, Yiftach Barash","doi":"10.1007/s00464-025-11715-3","DOIUrl":"10.1007/s00464-025-11715-3","url":null,"abstract":"<p><strong>Objective: </strong>To develop a computer algorithm for the automatic classification of basic surgical skills in laparoscopy. The ability to objectively assess the operative skills of trainees would be invaluable for the success of competency-based medical education. Although technical advancements in computer vision have resulted in promising clinical applications, they have not yet been utilized in surgical education.</p><p><strong>Methods: </strong>A single-institution, prospective study involving faculty and trainee surgeons recruited to use a bench-top simulator in order to complete the \"precision cutting\" task from the Fundamentals of Laparoscopic Surgery. An artificial intelligence (AI) computer algorithm was developed based on a transformer neural network model to classify videos of laparoscopic tasks as either executed by an expert or a novice surgeon. Performance metrics were reported in line with the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis guidelines. The model was trained using fivefold cross-validation. The model's performance was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, accuracy, F1 score, and area under the curve (AUC). The results were averaged across the folds, and 95% confidence intervals were computed for each metric. ROC curves were plotted to visualize the model's performance.</p><p><strong>Results: </strong>The internal dataset comprised 135 videos from 46 participants recruited between 2022 and 2023. Among these, 30 participants (65.2%) were junior surgical residents or medical students, and 16 (34.8%) were board-certified surgeons with prior laparoscopic experience. Following cross-validation, the AI model achieved an accuracy of 0.867 in classifying between novice and expert groups based on video analysis, independent of task completion time. For single-image classification, the model achieved an accuracy of 0.57.</p><p><strong>Conclusion: </strong>This proof-of-concept study serves as a pilot investigation into the application of AI for classifying surgical skills, demonstrating the utility of computer vision in automatically and objectively classifying surgical expertise. While the results show promise, further validation is necessary to establish its utility in routine surgical training and certification. By providing objective evaluations, this technology could support and enhance the role of human evaluators in surgical education.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3592-3599"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047506","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":"Outcomes evaluation of robotic versus laparoscopic pancreaticoduodenectomy: a propensity score matching and learning curve analysis.","authors":"Lixin Chen, Shuai Yuan, Qiang Xu, Ming Cui, Pengyu Li, Wenjing Liu, Chen Lin, Weijie Chen, Haomin Chen, Ya Hu, Menghua Dai","doi":"10.1007/s00464-025-11684-7","DOIUrl":"10.1007/s00464-025-11684-7","url":null,"abstract":"<p><strong>Background: </strong>Limited research has been conducted on the short-term outcomes comparing laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), particularly in the post-learning curve stage. This study aims to investigate surgical efficacy and provide clinical practices for selecting suitable techniques between LPD and RPD.</p><p><strong>Methods: </strong>A retrospective study was conducted on consecutive patients who underwent RPD and LPD between April 2016 and December 2023. Baseline characteristics, pathological information, and perioperative data were analyzed. Propensity score matching (PSM) analysis was performed to ensure the comparability of important factors between the groups.</p><p><strong>Results: </strong>A total of 277 patients were enrolled in the study, of which 145 underwent RPD. Following PSM, 116 patients were included in each group and baseline characteristics were well matched. The RPD group demonstrated a lower conversion rate to laparotomy (5.2% vs. 18.1%, p = 0.002), reduced blood loss (350 vs. 500 ml, p = 0.031), and a higher rate of R0 resection (91.4% vs. 80.7%, p < 0.05) compared to the laparoscopic group. The incidence of B2-Grade postoperative pancreatic fistula (B2-POPF) was also lower in the RPD group compared to the LPD group (4.3% vs. 11.2%, p = 0.037). Among patients in the post-learning curve stage, perioperative outcomes were similar between the two groups.</p><p><strong>Conclusion: </strong>RPD offered several advantages over LPD, including lower rates of conversion to open and blood loss, higher rates of R0 resection, and improved POPF outcomes. Other perioperative outcomes were comparable between the two groups. Both techniques appeared feasible and safe in experienced surgeons, though RPD was preferred in complex cases.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3681-3690"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019775","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":"EAES rapid guideline: complete mesocolic excision for right-sided colon cancer-with SAGES and ESCP participation.","authors":"Stavros A Antoniou, Francesco Maria Carrano, Alexander A Tzanis, Konstantinos Perivoliotis, Sunjay S Kumar, Christos Christogiannis, Dimitris Mavridis, Bright Huo, Nicole Bouvy, Niki Christou, Suzanne Dore, Audrius Dulskas, Christos Kontovounisios, Tim Lubbers, Francesco Palazzo, Philip Quirke, Dimitra Repana, Monica Terlizzo, Bethany J Slater, Ivan D Florez, Monica Ortenzi, Tan Arulampalam","doi":"10.1007/s00464-025-11782-6","DOIUrl":"10.1007/s00464-025-11782-6","url":null,"abstract":"<p><strong>Background: </strong>Complete mesocolic excision (CME) is a surgical technique that aims to improve oncological outcomes of right-sided colon cancer resections. However, CME's technical complexity, surgical risks, and need for specialized training, present challenges. Also, variations in technical aspects and implementation lead to inconsistent outcomes.</p><p><strong>Objective: </strong>To develop evidence-informed clinical practice recommendations on complete mesocolic excision for right-sided colon cancer, aiming to address whether laparoscopic CME should be preferred over standard laparoscopic right hemicolectomy for right-sided colon cancer.</p><p><strong>Methods: </strong>The present guideline adheres to GRADE, AGREE-S, and Cochrane standards, using MAGICapp for development. The steering group included colorectal and general surgeons, supported by a Guidelines International Network-certified lead guideline developer, trainee methodologists, systematic reviewers and statisticians. The guideline panel included surgeons, oncologists, a pathologist, and a patient partner. It provides recommendations based on a linked systematic review, appraisal of benefits and harms, the certainty of the evidence, patient values and preferences, acceptability, feasibility, use of resources, and equity.</p><p><strong>Results: </strong>A conditional recommendation is issued in favor of CME for patients undergoing right hemicolectomy for right-sided colon cancer where expertise is available, based on low-to-moderate certainty evidence. The panel suggests CME is acceptable to stakeholders and feasible, despite potential equity issues due to variable expertise availability. There is insufficient evidence to recommend CME based on tumor location or cancer stage. A conditional recommendation means that the majority of well-informed patients, surgeons and other stakeholders, would opt for the recommended course of action, but discussion of relevant benefits and harms is advised prior to decisions. The full guideline with user-friendly decision aids is available in https://app.magicapp.org/#/guideline/EaG1dL .</p><p><strong>Conclusions: </strong>This guideline provides evidence-informed recommendations on the management of right-sided colon cancer, developed in line with the highest quality methodological and reporting standards, and informed by an interdisciplinary panel of stakeholders.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3474-3483"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019740","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":"Risk factors associated with inguinal hernia recurrence after single-incision laparoscopic totally extraperitoneal repair.","authors":"Sungwoo Jung, Jin Ho Lee, Jae Uk Chong, Hyung Soon Lee","doi":"10.1007/s00464-025-11726-0","DOIUrl":"10.1007/s00464-025-11726-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify risk factors contributing to recurrence after single-incision laparoscopic totally extraperitoneal (SILTEP) inguinal hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the medical records of patients who underwent SILTEP repair performed by a single surgeon between 2016 and 2021. The learning curve for the procedure was assessed using the moving average method and a cumulative sum (CUSUM) control chart based on operative times. Intraoperative complications were defined as events requiring additional port placement, peritoneal tears, conversion to open surgery, or visceral or vascular injuries.</p><p><strong>Results: </strong>A total of 180 patients underwent SILTEP repair during the study period, of whom 172 met the inclusion criteria for analysis. Recurrence occurred in 12 patients (7.0%). The CUSUM analysis revealed an inflection point at 30 cases, indicating stabilization of operative times to under 57 min. The first 30 cases were categorized as the learning phase. Univariate analysis identified several factors associated with recurrence, including the learning period, recurrent hernia, operative time exceeding 57 min, intraoperative blood loss > 20 cc, and the presence of intraoperative complications. However, multivariate analysis revealed that intraoperative complications were the sole independent predictor of recurrence after SILTEP repair (hazard ratio, 13.38; p = 0.03).</p><p><strong>Conclusions: </strong>Intraoperative complications were identified as the only independent risk factor for recurrence after SILTEP repair. These findings highlight the need to minimizing intraoperative complications to improve outcomes and reduce recurrence rates in patients undergoing SILTEP repair.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3552-3558"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013345","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":"Minimally invasive versus open liver resection for hepatocellular carcinoma with microvascular invasion: a propensity score-matching study.","authors":"Zaibo Yang, Yewei Zhang, Junhao Zheng, Liye Tao, Chao Song, Linghan Gong, Renan Jin, Xiao Liang","doi":"10.1007/s00464-025-11717-1","DOIUrl":"10.1007/s00464-025-11717-1","url":null,"abstract":"<p><strong>Background: </strong>Microvascular invasion (MVI) is one of the major risk factors for postoperative recurrence of HCC. For HCC patients with MVI, few studies have examined the differences in prognosis between minimally invasive and open liver resection.</p><p><strong>Materials and methods: </strong>A total of 171 HCC patients with MVI who underwent curative-intent hepatectomy from September 2017 to October 2022 at Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, were enrolled in this study. Patients were categorized into minimally invasive liver resection (MILR) group (Robotic or laparoscopic) and open liver resection (OLR) group. In order to balance the baseline characteristics between the two groups, 1:4 propensity score matching (PSM) was performed on the two groups. The survival parameters and perioperative parameters were compared between the two groups before and after PSM, respectively.</p><p><strong>Results: </strong>There was no significant difference in Recurrence Free Survival (RFS) and Overall Survival (OS) between the two groups before and after PSM. Subgroup analysis showed that there were no significant differences in OS and RFS between the two groups regarding anatomical resection, IWATE difficulty score, surgical margins, and postoperative adjuvant therapy. Perioperative parameters and the rate of major postoperative complications were comparable between the two groups.</p><p><strong>Conclusion: </strong>Minimally invasive approach can provide a comparable long-term survival result compared with conventional open approach for patients with HCC associated with MVI.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3492-3503"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054736","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":"Comparison of short-term outcomes for robotic rectal surgery between the hinotori™ surgical robot system and da Vinci surgical system: a single-center retrospective study using propensity score matching analysis.","authors":"Kazuki Tsujimura, Masaya Nakauchi, Junichiro Hiro, Ayaka Ito, Yuko Chikaishi, Yosuke Kobayashi, Megumu Kamishima, Gaku Inaguma, Yusuke Omura, Yeongcheol Cheong, Tsutomu Kumamoto, Koji Masumori, Tsunekazu Hanai, Ichiro Uyama, Koichi Suda, Koki Otsuka","doi":"10.1007/s00464-025-11766-6","DOIUrl":"10.1007/s00464-025-11766-6","url":null,"abstract":"<p><strong>Background: </strong>Robotic surgery for rectal cancer has grown popular in recent years and has primarily used the da Vinci Surgical System (Intuitive Surgical, CA, USA; da Vinci). In 2020, Japan introduced the hinotori™ Surgical Robot System (Medicaroid, Kobe, Japan; hinotori). We report our initial surgical experiences with robotic surgery using hinotori for rectal cancer and its feasibility and safety comparing with da Vinci.</p><p><strong>Methods: </strong>A single-institution retrospective study was conducted. Between November 2022 and November 2023, 38 and 96 patients with rectal cancer underwent robotic surgery using hinotori and da Vinci, respectively. The primary endpoint was the incidence of postoperative complications of the Clavien-Dindo classification (CD) grade ≥ II within postoperative 30 days. Secondary endpoints included surgical and console time, blood loss, conversion to other approaches, number of dissected lymph nodes, and postoperative hospital stay. A propensity score matching (PSM) analysis was used to adjust for imbalance in baseline characteristics.</p><p><strong>Results: </strong>After PSM, a total of 76 patients (hinotori: 38, da Vinci: 38) were included. Compared to the da Vinci group, the hinotori group showed a similar postoperative complication rate of CD ≥ II (15.8% vs. 18.4%), comparable operative time (280.5 vs. 258 min), comparable console time (166 vs. 156 min), and less blood loss (9 vs. 17.5 mL, p = 0.025). There was no conversion in either group. The number of dissected nodes and postoperative stay were similar between the two groups.</p><p><strong>Conclusion: </strong>Our findings support that robotic surgery for rectal cancer using hinotori is as safe as surgery performed using the da Vinci system.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3993-4005"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026142","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":"Intersphincteric abdominoperineal resection with radical en bloc prostatectomy for synchronous or locally advanced rectal or prostate cancer.","authors":"Joline de Groof, Nzubechukwu Ijezie, Matthew Perry, Christopher Eden, Timothy Rockall, Andrea Scala","doi":"10.1007/s00464-025-11739-9","DOIUrl":"10.1007/s00464-025-11739-9","url":null,"abstract":"<p><strong>Introduction: </strong>For patients with locally advanced rectal cancer invading the prostate or prostate cancer invading the rectum a negative resection margin (R0) is the most important criterion to predict local recurrence and disease-free survival. Following neoadjuvant treatment (when indicated), pelvic exenteration is often the surgical treatment of choice in these patients, involving en bloc excision of the rectum, prostate, and bladder to ensure clear resection margins and resulting in a colostomy and ileal conduit. The surgery is most commonly performed by laparotomy. We describe an alternative less invasive option for synchronous or locally advanced rectal or prostate cancer in the form of a laparoscopic (or robotic assisted) intersphincteric abdominoperineal resection (APR) with en bloc prostatectomy and urinary reconstruction in selected patients.</p><p><strong>Methods: </strong>Patients with synchronous rectal and prostate disease or locally advanced rectal and/or prostate cancer undergoing minimally invasive intersphincteric APR with en bloc prostatectomy with urinary reconstruction were retrospectively analyzed. The primary endpoint was the proportion of negative resection margins. Secondary endpoints included complications and disease recurrence.</p><p><strong>Results: </strong>Eleven consecutive patients were identified. All patients had negative resection margins and there were no patients with disease recurrence of either rectal or prostate cancer after a median follow-up of 26 months (IQR 63). There were no same admission reoperations, two patients with a postoperative ileus and two patients with an urinary leak, of which one had a delayed leak at 7 months which was repaired. Urinary incontinence rates varied, but only one patient was referred for insertion of an artificial urinary sphincter.</p><p><strong>Conclusion: </strong>Intersphincteric minimal invasive APR with en bloc prostatectomy is a feasible alternative to complete pelvic exenteration in selected patients with synchronous or locally advanced rectal and/or prostate cancer.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3559-3567"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031792","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":"Esophageal mucosal auto-transplantation versus acellular dermal matrix transplantation for preventing esophageal stenosis after endoscopic resection in patients with superficial esophageal mucosal lesions.","authors":"Ting-Ting Mou, Yue Xu, Ling-Zhu Qian, Xin-Li Mao, Hai-Hong Zheng, Yu Zhang","doi":"10.1007/s00464-025-11718-0","DOIUrl":"10.1007/s00464-025-11718-0","url":null,"abstract":"<p><strong>Background: </strong>Esophageal stricture is the principal complication associated with endoscopic resection (ER) in patients with superficial esophageal cancer (SEC), and medical intervention may be required to prevent esophageal stricture after ER. The aim of this study was to compare acellular dermal matrix (ADM) transplantation and esophageal mucosal autograft (EMA) transplantation in terms of efficacy in preventing esophageal stricture after ER for SEC.</p><p><strong>Methods: </strong>Between May 2017 and November 2022, 48 patients with SEC who underwent EMA or ADM after ER were enrolled in this study. The primary outcomes measured included esophageal stricture, refractory esophageal stricture, and the number of endoscopic dilations after esophageal stricture.</p><p><strong>Results: </strong>A total of 48 patients with SEC were enrolled in this study, 17 of whom underwent EMA after ER (EMA group) and 31 of whom underwent ADM after ER (ADM group). The median of total procedure duration and the median of transplantation duration in the ADM group was significantly shorter than that in the EMA group (Z = - 2.408, P = 0.016; Z = - 2.710, P = 0.006). During the follow-up, 4 patients developed refractory esophageal stricture in the EMA group and 1 developed refractory esophageal stricture in the ADM group. The rate of refractory esophageal stricture was lower in ADM group than in EMA group (3.2% vs. 23.5%, P = 0.047). In patients with > 3/4 circumferential range ER, the rate of refractory esophageal stricture was also lower in ADM group than in EMA group (4.0% vs. 25.0%, P = 0.067). Among the patients who developed esophageal stricture, the median number of endoscopic dilations in the ADM group was less than that in the EMA group (Z = 27.500; P = 0.040).</p><p><strong>Conclusions: </strong>Compared with EMA, ADM provided several advantages, as it reduced the number of endoscopic dilations for patients with esophageal strictures and shortened the procedure duration for patients who underwent esophageal ESD.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3760-3768"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039975","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}