Turkish Journal of Surgery最新文献

{"title":"Intergluteal fold depth has no influence on pilonidal sinus disease development.","authors":"Matthias Maak, Philipp Mörsdorf, Layla Bari, Myriam Braun-Münker, Maximilian Scharonow, Marcel Orth, Dietrich Doll","doi":"10.47717/turkjsurg.2025.6665","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6665","url":null,"abstract":"<p><strong>Objective: </strong>The etiology of primary pilonidal sinus disease (PSD) remains unclear. Prior investigations suggest that sharp fragments from the occiput contribute to the formation of PSD. In 2009 a correlation between PSD and a deeper natal cleft was reported. We investigated the association between intergluteal fold (IGF) depth and PSD risk using a standardized five-step measuring protocol.</p><p><strong>Material and methods: </strong>Our clinical prospective study included 95 PSD patients and 105 non-PSD individuals, and measurements were taken from the glabella sacralis to the anus in a northern German population.</p><p><strong>Results: </strong>The mean (± standard deviation) intergluteal depth progressively increased from the intergluteal opening from the sacral glabella at 9.1 (±3.4) mm to a maximum of 62.6 (±10.4) mm. Notably, the deepest point was consistently observed at the anus, where PSD occurrence is rare. No significant difference in IGF depth between PSD and non-PSD patients was found. Additionally, PSD predominantly developed in the proximal (cranial) third of the IGF, despite the maximum depth being in the distal region.</p><p><strong>Conclusion: </strong>These findings suggest that IGF depth is not a risk factor for PSD.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the secrets of the profunda femoris artery: A cadaveric journey with morphometric insights.","authors":"Athikayala Gopikrisshna Dhaminirithika, Hannahsugirthabai Rajilarajendran, Gowthaman Kavinnilavan, P Indra","doi":"10.47717/turkjsurg.2025.6571","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6571","url":null,"abstract":"<p><strong>Objective: </strong>Profunda femoris artery (PFA), a branch of femoral artery primarily supplies blood to skin, muscles of the inner thigh and proximal femur and plays a significant role in collateral blood supply. This study aimed to investigate the origin, branching pattern and morphometries of PFA in cadavers.</p><p><strong>Material and methods: </strong>Lower limbs of male and female cadavers (n=41) were analyzed for origin of PFA, lateral circumflex artery (LCFA) and medial circumflex artery (MCFA), distance from mid-inguinal point, course, branching pattern and their external calibers. Data were tabulated and analyzed using SPSS.</p><p><strong>Results: </strong>The PFA showed origins that are posterolateral, posteromedial, and posterior. The distance between PFA and the midpoint of the inguinal ligament was (L=3.7-6.2; mean =5.19±0.7 cm; R=3.2-6.2 cm, mean =4.74±0.9 cm). The origin of MCFA was medial (R=61%, L=52%) and posteromedial (R=39%, L=48%); LCFA was lateral (R=100%, L=78%) and posterolateral (R=0%, L=22%). The average diameter of PFA, MCFA, & LCFA was (L=5.04, 2.9, 2.8 cm and R=5.4, 3.09, 3.71 cm). The paired t-test with a significant p-value (95% confidence) demonstrated that differences in the diameters of the arteries at the specified levels between the left and right limbs could have clinical implications, such as differences in blood flow or susceptibility to vascular conditions.</p><p><strong>Conclusion: </strong>To reduce intra-operative and post-operative complications in the femoral region branches during diagnostic and surgical procedures, it is essential to comprehend the normal and variant positions and distances of the PFA's origin and its circumflex branches.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effects of epidermal growth factor mesenchymal stem cell and silver sulfadiazine on burn stasis zone.","authors":"Ömer Kürklü, Sinan Soylu","doi":"10.47717/turkjsurg.2025.6684","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6684","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effects of adipose tissue-derived mesenchymal stem cell (MSC), human recombinant epidermal growth factor (EGF) and silver sulfadiazine (SSD) on wound healing in the burn stasis zone by applying the comb burn model in rats.</p><p><strong>Material and methods: </strong>A comb burn model was used for the burns and 32 Wistar albino female rats were randomly divided into four groups (control, SSD, SSD+MSC, SSD+EGF). On the 1^st day and the 21^st day, the total burn area on the 1^st day and the healed, healing, and non-healing burn area on the 21^st day were calculated with the Image-J program. At the end of the 21^st day, the pathology samples taken after euthanasia were scored semiquantitatively in terms of epithelization, inflammatory cell density, fibroblast density, collagen amount, and angiogenesis after hematoxylin-eosin staining.</p><p><strong>Results: </strong>Histopathological analysis demonstrated that epithelialization scores were highest in the MSC (3.88±0.35, p<0.001) and EGF (3.63±0.52) groups, while the control group had the lowest values (1.50±0.53). Inflammatory cell density was significantly lower in the MSC (1.50±0.53, p<0.001) and EGF (1.88±0.64) groups than in the control group (3.75±0.46). Similarly, fibroblast density was lowest in the MSC (1.38±0.52, p<0.001) and EGF (1.75±0.71) groups, while the control group had the highest values (3.63±0.52). Collagen fibril density was significantly increased in the MSC (3.88±0.35, p<0.001) and EGF (3.50±0.53) groups compared to the control (1.63±0.74). Angiogenesis was highest in the EGF group (3.75±0.46, p<0.001), followed by the MSC group (3.00±0.53), while the control group had the lowest values (1.25±0.46). These results suggest that MSC and EGF play a significant role in wound healing, with MSC demonstrating superior epithelialization and EGF exhibiting the greatest angiogenic effect. Photo-analytical measurements showed that on day 1, burn area sizes were similar among all groups (p>0.05). By day 21, the healing burn area was significantly smaller in the MSC (3.19±0.98 cm², p<0.001) and EGF (4.33±0.48 cm²) groups compared to the control (8.43±2.35 cm²). The non-healing area was smallest in the EGF group (0.67±0.49 cm²), followed by the MSC (1.06±0.49 cm², p<0.001) and SSD (1.91±0.75 cm²) groups, whereas the control group had the largest non-healing area (7.29±2.20 cm²). These findings suggest that MSC was the most effective treatment for promoting wound healing, followed by EGF and SSD.</p><p><strong>Conclusion: </strong>We determined that both histologically and photo analytically, MSC and EGF provided faster wound healing in the burn stasis zone EGF gave better results than all groups in preventing necrosis.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of enhanced view-totally extraperitoneal technique and totally extraperitoneal technique in S1 scrotal hernia repair.","authors":"Abdullah Hilmi Yılmaz, Mehmet Eşref Ulutaş","doi":"10.47717/turkjsurg.2025.6669","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6669","url":null,"abstract":"<p><strong>Objective: </strong>The treatment of scrotal hernias may vary according to the surgeon's experience. Although open anterior approaches are mostly preferred, specialized hernia surgeons prefer laparoscopic approaches. The study evaluated the safety and efficacy of the laparoscopic enhanced view-totally extraperitoneal (eTEP) technique and the laparoscopic totally extraperitoneal (TEP) technique in treating scrotal hernias.</p><p><strong>Material and methods: </strong>The retrospective cohort study compared patients with unilateral scrotal hernia who underwent eTEP or TEP from November 2022 to October 2023. The two groups were compared in demographic characteristics and operative and postoperative data. The main result of this study was the recurrence rate.</p><p><strong>Results: </strong>A study analyzed 54 patients: 30 underwent the eTEP technique, and 24 underwent the TEP technique. No significant difference was observed between the groups regarding recurrence rates, incidence of chronic pain, time of the surgical procedure, length of stay, time taken to resume daily activities, pneumoperitoneum occurrence, and complications, particularly hematoma and seroma formation. Patients were followed up for an average of 19 months (±5.2).</p><p><strong>Conclusion: </strong>The comparison of the eTEP technique to traditional TEP for scrotal hernia repair has not demonstrated any conclusive evidence of the superiority of eTEP. The outcomes associated with the eTEP technique were found to be comparable to those of TEP, with an average follow-up period of 19 months. Similar to TEP, the eTEP technique demonstrates both safety and feasibility in the management of scrotal hernias. Furthermore, it is necessary for prospective randomized studies to compare these two techniques directly, specifically in the realm of scrotal hernia repair.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive score for conversion in laparoscopic cholecystectomy - a prospective study.","authors":"Shravan Teja V, Ramya Ramakrishnan, Jai Prakash Srinivasan","doi":"10.47717/turkjsurg.2025.6690","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6690","url":null,"abstract":"<p><strong>Objective: </strong>2-15% of laparoscopic cholecystectomy gets converted to an open procedure due to various factors. The aim of this study was to identify pre-operative risk factors that could predict the conversion of laparoscopic cholecystectomy to open surgery. Pre-operative prediction would help in reducing the morbidity.</p><p><strong>Material and methods: </strong>Adult patients undergoing elective laparoscopic cholecystectomy at a tertiary institute were included in the study. The parameters analysed were age, gender, body mass index, total count, liver function test, gall bladder size and wall thickness, impacted stone in Hartmann's pouch and common bile duct (CBD) diameter on ultrasonography. Intra-operative findings and the total number of conversions to open surgery were documented. Statistical analysis was done using SPSS 16.0 Inc., IBM system. A univariate regression analysis was used to find the significant risk factors followed by multivariate linear regression.</p><p><strong>Results: </strong>Twenty-one of the 222 (9.5%) patients who underwent laparoscopic cholecystectomy, were converted to open cholecystectomy. Six variables were found significant on univariate analysis: Age, sex, total count, gallbladder wall thickness and size and diameter of the CBD. On logistic regression analysis, gall bladder wall thickness and size were found to be significant, and were used in the scoring system, wherein 1 point was given to each variable. The predicted risk of conversion was 0.5%, 1.8% and 7.2% for a score of zero, one and two respectively.</p><p><strong>Conclusion: </strong>The most significant factors predicting conversion of laparoscopic cholecystectomy to open surgery were gall bladder size and wall thickness. This prediction can be used to minimize the time to conversion and reduce the morbidity.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical procedure and retrospective comparative series of Microport's AnteriorPath^® vs. AMIS^® in total hip arthroplasty. Preliminary findings from a single institution.","authors":"Periklis Godolias, Mateusz Moskal, Anastasija Grimm, Julius Gerstmeyer, Ravi Nunna, Marcel Dudda, Hansjörg Heep, Stephan Feulner","doi":"10.47717/turkjsurg.2025.6613","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6613","url":null,"abstract":"<p><strong>Objective: </strong>In recent years, the paradigm of surgical approaches for total hip arthroplasty (THA) has evolved, with portal-assisted techniques emerging as a promising avenue for increasing precision and minimizing invasiveness. The purpose of this study was to compare early experience with the Microport anterior percutaneously assisted total hip arthroplasty (MAP) system, with the established AMIS direct anterior approach (DAA).</p><p><strong>Material and methods: </strong>A retrospective chart analysis was performed on 200 consecutive patients who underwent DAA or MAP at our institution in 2022. The research was conducted in accordance with the Declaration of Helsinki (as revised in 2013), and was approved by the institutional review board of the University Duisburg-Essen (23-11274-BO).</p><p><strong>Results: </strong>Two hundred patients were enrolled (100 DAA and 100 MAP; time to follow-up 1.7 years ±88 days). The mean operative time was 81 minutes (MAP) and 67 minutes (DAA, p>0.05). The mean cup tilt angle was 39° (MAP) and 40° (DAA; p>0.05). The mean cup anteversion angle was 13° (MAP) and 16° (DAA; p>0.05). The mean postoperative hemoglobin (Hb) decrease was 2.6 mg/dL ±0.9 mg/dL (MAP) and 2.5 mg/dL ±0.9 mg/dL (DAA; p>0.05). No major complications were documented in any of the 200 cases during the observation period. Additional screw fixation was performed in 7 cases and hybrid stem cementation was performed in 3 cases due to lack of rotational stability. All 10 cases were in patients with DAA. In only one of the 200 cases, two units of RBC were transfused postoperatively in a DAA case after a postoperative decrease of 5.7 mg/dL Hb.</p><p><strong>Conclusion: </strong>Anterior Path^® has been demonstrated to provide reliable results, despite the presence of a steep learning curve. The employment of a working cannula has been shown to enhance the surgeon's perspective during the preparation of the acetabulum. In relation to skin incision, the bikini line incision, which is regarded as advantageous due to its alignment with the cleavage lines, has been identified as a notable benefit that is acknowledged by the patient.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of efficacy of ultrasound guided erector spinae plane block (ESPB) for post-operative analgesia in patients undergoing laparoscopic cholecystectomy.","authors":"Smita Chauhan, Ashwini Gupta, Mamta Harjai, Manoj Kumar Giri","doi":"10.47717/turkjsurg.2025.6605","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6605","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to assess the clinical efficacy of erector spinae plane block (ESPB) for post-operative analgesia in patients undergoing laparoscopic cholecystectomies.</p><p><strong>Material and methods: </strong>This prospective, interventional, quasi-randomized single-blind study was approved by institutional ethical committee. Total 82 patients undergoing laparoscopic cholecystectomy were allocated into two groups, ESPB and control group. Postoperatively, the total tramadol consumption in 24 hours, the visual analogue scale (VAS) at various time intervals and time to rescue analgesia in both groups were monitored.</p><p><strong>Results: </strong>The requirement of tramadol in first 24 hours was significantly more in controls as compared to cases (p=0.005). The mean VAS at rest, coughing and at movement was significantly lower in the immediate period, at 2nd hour and 4th hour after being shifted to post-operative area, in case group as compared to control. The time to rescue analgesia was statistically significantly more in ESPB group (p=0.002).</p><p><strong>Conclusion: </strong>ESPB for laparoscopic cholecystectomy is a safe and effective technique of multimodal analgesia which provides better pain relief, reduced opioid requirement, lower post-operative pain scores, reduced total post-operative analgesic consumption along with prolonged time to rescue analgesia.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholecystectomy associated vasculobiliary injuries: Incidence and impact on surgical repair outcomes.","authors":"Saurabh Singla, Rakesh Kumar Singh, Saket Kumar, Umakant Prasad, Manish Mandal, Sanjay Kumar","doi":"10.47717/turkjsurg.2025.6577","DOIUrl":"10.47717/turkjsurg.2025.6577","url":null,"abstract":"<p><strong>Objective: </strong>Bile duct injury with concomitant vascular injury is a common complication of cholecystectomy. The influence of concomitant vascular injury on the presentation and management of bile duct injury remains debatable. This study aimed to determine the incidence of concomitant vascular injury in patients with post-cholecystectomy bile duct injury and its impact on presentation and short-term outcomes following biliary repair.</p><p><strong>Material and methods: </strong>This prospective study was done between November 2019 and December 2022. Patients presenting with post-cholecystectomy bile duct injury were investigated to detect vascular injury using computed tomography angiography. A comparative analysis of clinical presentation, and results of biliary reconstruction was performed on patients with and without concomitant vascular injury. McDonald criteria were used to grade the outcome of biliary reconstruction in these patients.</p><p><strong>Results: </strong>We studied 48 patients with bile duct injury of which 19 (39%) patients had concomitant vascular injury on imaging. Concomitant vascular injury was found in 87% and 42% of patients with Strasberg type 4 and type 3 injury, respectively. At presentation, the incidence of liver abscesses was significantly higher in patients with concomitant vascular injury. After two years of biliary repair, 75% of patients had McDonald Grade A status, irrespective of whether vascular injury was present.</p><p><strong>Conclusion: </strong>Approximately 39% of patients with biliary injury had concomitant vascular injury. A higher grade of biliary injury was associated with increased chances of concomitant vascular injury. The presence of vascular injury did not correlate with increased operative morbidity, prolonged hospital stay, or inferior outcomes of delayed biliary repair.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"24-30"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of early and delayed cholecystectomy for acute gallstone-related disease.","authors":"Mathew Vithayathil, Cissy Yong, Khaled Dawas","doi":"10.47717/turkjsurg.2025.6568","DOIUrl":"10.47717/turkjsurg.2025.6568","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic cholecystectomy is the definitive treatment for gallstone-related disease. Early laparoscopic cholecystectomy (ELC) is recommended for management of acute gallstone-related disease, as delayed laparoscopic cholecystectomy (DLC) is associated with recurrent presentations and complications. This series evaluated the outcomes of ELC and DLC in patients presenting acutely to secondary care.</p><p><strong>Material and methods: </strong>All cholecystectomies performed for patients presenting with acute gallstone-related disease including biliary colic, acute cholecystitis, gallstone pancreatitis and obstructive jaundice over a 24-month period were included. Clinical outcomes including hospital stay, peri-operative complications, re-presentation of gallstone-related disease, and repeat hospital admissions and imaging were recorded for ELC and DLC cases.</p><p><strong>Results: </strong>Of 105 cholecystectomies performed, only 6.7% were ELC. The mean time from index presentation to cholecystectomy was 3.4 days and 119.6 days for ELC and DLC, respectively. Over one-third of patients (38.8%) undergoing DLC experienced recurrent gallstone-related disease between index presentation and surgery. Re-admission to hospital for gallstone-related symptoms was seen in 25.5% of patients. The mean additional inpatient stay for readmission for gallstone-related disease in the DLC group was 3.3 days, with 30.6% requiring repeat imaging.</p><p><strong>Conclusion: </strong>DLC is associated with significant recurrence of gallstone-related complications. Re-admission to hospital incurs additional inpatient stay, and investigation, leading to a negative impact on patients' health and additional financial burden.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"19-23"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of para-aortic lymph node metastasis for prognosis in patients with pancreaticobiliary cancer who underwent radical surgical resections.","authors":"Atsushi Nanashima, Junichi Arai, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Yuki Tsuchimochi, Ikko Shimizu, Takahiro Ochiai, Hiroshi Kawakami, Yuichiro Sato, Wada Takashi","doi":"10.47717/turkjsurg.2025.6587","DOIUrl":"10.47717/turkjsurg.2025.6587","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC).</p><p><strong>Material and methods: </strong>This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021.</p><p><strong>Results: </strong>Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases.</p><p><strong>Conclusion: </strong>Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"5-18"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}