Updates in Surgery最新文献

{"title":"Comment on \"Postoperative antibiotic strategies in acute complicated appendicitis: a systematic review\".","authors":"Prajnasini Satapathy, Rachana Mehta, Ranjana Sah","doi":"10.1007/s13304-025-02431-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02431-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic hepatopancreatobiliary surgery using the Toumai® system: initial experience and technical considerations from a single center.","authors":"Yinzhe Xu, Zhiming Zhao, Xuan Zhang, Shaoke Sun, Zhaohai Wang, Xianglong Tan, Zhuzeng Yin, Minggen Hu, Shichun Lu, Rong Liu","doi":"10.1007/s13304-025-02404-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02404-w","url":null,"abstract":"<p><p>Robotic-assisted hepatopancreatobiliary (HPB) surgery is increasingly adopted in high-volume centers. This study evaluated the feasibility, safety, and technical characteristics of the Toumai® robotic system in HPB surgery. We retrospectively analyzed 160 consecutive patients who underwent HBP surgery using the Toumai® system at the Chinese People's Liberation Army General Hospital between November 2024 and June 2025. Procedures included liver resection (92 cases: 32 lobectomies/segmentectomies and 60 local resections), pancreatic surgery (23 cases: 2 pancreaticoduodenectomies, 9 distal pancreatectomies, 11 tumor resections, 1 pancreatic duct incision and pancreaticojejunostomy), and biliary surgery (37 cases: 3 radical resections for hilar cholangiocarcinoma, 23 biliary explorations and stone removals, 6 gallbladder cancer resections, 3 choledochojejunostomies, and 2 cholecystectomies). Of the cohort, 46 patients (28.8%) had prior abdominal surgery. Conversion to open surgery occurred in 3 cases (1.9%). Postoperatively, one patient developed pancreatic fistula managed with percutaneous drainage; no other Clavien-Dindo III-IV complications or in-hospital deaths were observed. Median postoperative length of stay was 5 days (range, 1-27 days). Toumai® robotic-assisted surgery demonstrates preliminary feasibility and safety across a spectrum of HPB procedures. With technical refinements and device iterations, broader adoption may enhance the accessibility and affordability of robotic surgery in resource-variable settings.​.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing the feasible: advancing thyroid cartilage needle electrodes in nerve monitoring.","authors":"Muhammad Hamza, Ashfaq Ahmad, Javed Iqbal","doi":"10.1007/s13304-025-02432-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02432-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional image guidance for diagnosis and treatment of adrenal disease: a systematic review.","authors":"Sofia Di Lorenzo, Farahdiba Zarin, Matteo Pavone, Didier Mutter, Marco Raffaelli, Michel Vix, Barbara Seeliger","doi":"10.1007/s13304-025-02386-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02386-9","url":null,"abstract":"<p><p>Adrenal abnormalities are common imaging findings requiring comprehensive workup. Invasive diagnostic and therapeutic procedures, including adrenal surgery, demand expertise to mitigate risks of severe complications. Recent applications of 3D image analyses range from enhanced diagnosis to therapeutic guidance with anatomical visualisation. This study assesses the efficacy and clinical utility of 3D image analyses in managing adrenal disease. This systematic review, registered with PROSPERO (CRD42024500783), adheres to PRISMA guidelines. Searches of PubMed, Google Scholar and ClinicalTrials.gov up to August 2024 identified eligible studies. Extracted data included imaging modalities, 3D applications for diagnosis or treatment, volumetric segmentation techniques, and differentiation between pathologic and normal adrenal glands. Technological maturity was assessed with the IDEAL framework. Of 1813 studies screened, 30 met inclusion criteria, encompassing 5304 imaging exams (2060F/2106M, and 10 studies with 1115 cases), predominantly CT (27 CT, 90%; 2 MRI, 6.7%; 1 CT/MRI 3.3%). Volumetric reconstructions employed manual, semiautomatic and automatic methods for digital visualisation, and subsequent 3D printing. 3D analyses of normal vs. neoplastic adrenal tissue supported diagnosis in 18 studies (60%), and treatment in 12 (40%), improving understanding of respective anatomical features and planning for operative and interventional procedures. These applications represented early IDEAL stages of surgical innovation (0-preclinical, 1-idea and 2-development/exploration). 3D image analyses show promise in optimising adrenal disease management by aiding adrenal lesion characterisation and treatment optimisation through pre- and intraprocedural guidance. Further clinical assessment and long-term studies are warranted to establish the broader clinical impact.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic prediction of hepatoblastoma in children: development and validation of machine learning models-an SEER-based study.","authors":"Jianfeng Luo, Kaikun Huang, Le Zheng, Long Li","doi":"10.1007/s13304-025-02395-8","DOIUrl":"https://doi.org/10.1007/s13304-025-02395-8","url":null,"abstract":"<p><p>Hepatoblastoma (HB) is the most common primary malignant liver tumor in children. Although the incidence is low, it is a serious threat to children's health. Traditional methods have limitations in prognosis prediction. In the era of precision medicine, machine learning (ML) shows great potential in medical fields, especially in prognosis prediction. This study aims to develop ML-based predictive models for the overall survival (OS) of children with HB, to improve prognosis assessment and quality of life. Data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2021 were used. A total of 525 pediatric HB patients meeting the inclusion criteria were included. The data were randomly divided into a training cohort (n = 420) and a validation cohort (n = 105) in an 8:2 ratio. Four ML algorithms, including Decision Tree, Random Survival Forest (RSF), Gradient Boosting Survival Analysis (GBSA), and Support Vector Machine (SVM), were used to evaluate the OS of HB patients. The performance of the models was assessed using the area under the receiver-operating characteristic curve (AUC) and the consistency index (C-Index). Shapley Additive Explanations (SHAP) plots were used to interpret the contribution of each variable to the model prediction. The basic characteristics of the patients were analyzed. Through feature variable selection, six variables (age, tumor size, lymph-node invasion, metastatic status, surgical therapy, and chemotherapy) were identified as significant prognostic factors. Among the four ML models, the RSF model showed the best predictive performance. In the training cohort, the AUC for predicting 1-year, 3-year, and 5-year OS was 0.822, 0.810, and 0.809, respectively, and the C-index was 0.791 (95% CI 0.667-0.813). In the validation cohort, the AUC was 0.740, 0.765, and 0.765, and the C-index was 0.764 (95% CI 0.571-0.909). The SHAP summary plot showed that surgical therapy, metastatic status, and tumor size were the most important variables. This study successfully developed and validated four ML-based predictive models for the prognosis of HB patients. The RSF model had superior predictive performance and has broad application prospects in assisting clinicians in making individualized treatment decisions, improving survival prediction accuracy, and optimizing the prognosis of HB patients.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction in anastomotic leakage by fluorescent laparoscopic resection for ultra-low rectal cancer: a propensity-matched analysis with BMI stratification.","authors":"Wenlong Qiu, Gang Hu, Zhaodong Xing, Kunshan He, Shiwen Mei, Qi Wang, Jianqiang Tang","doi":"10.1007/s13304-025-02352-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02352-5","url":null,"abstract":"<p><p>Anastomotic leakage (AL) is a serious complication in colorectal surgery, particularly after laparoscopic intersphincteric resection (LsISR) for ultra-low rectal cancer. This study evaluates the effectiveness of ICG fluorescence laparoscopic (FL) resection in reducing AL and improving recovery, especially in high-BMI patients. A retrospective cohort study was conducted on patients undergoing LsISR for ultra-low rectal adenocarcinoma from January 2012 to July 2023, comparing FL (n = 133) and non-FL groups (n = 266). The primary endpoint was the incidence of anastomotic leakage, including symptomatic AL. Secondary endpoints included intraoperative blood loss, lymph node yield, and short-term recovery parameters such as bowel function recovery, soft diet initiation, and hospital stay.Propensity score matching (PSM) was used to reduce baseline differences. In the PSM cohort, the FL group had a significantly lower AL rate (3.0%) compared to the non-FL group (9.4%) (P = 0.035). Severe symptomatic anastomotic leaks (SSAL) were also reduced in the FL group (0.8% vs. 5.6%, P = 0.045). Subgroup analysis showed that FL significantly reduced AL in normal BMI patients (2.4% vs. 8.5%, P = 0.041). In high-BMI patients, FL reduced AL (3.9% vs. 10.8%, P = 0.063), but the difference was not statistically significant. FL also reduced blood loss, improved lymph node yield, and accelerated recovery, including earlier return of bowel function, quicker soft diet initiation, and shorter hospital stays. ICG FL reduces AL and enhances recovery, particularly in normal BMI patients, with a potential benefit for high-BMI patients. Further studies are needed to confirm its effect in this group.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Preservation of EUS-guided gastrojejunostomy LAMS during pancreaticoduodenectomy: a paradigm shift in the surgical management of borderline resectable pancreatic cancer.","authors":"Raffaele Vincenzo De Rosa, Timothée Wallenhorst, Fabien Robin, Laurent Sulpice","doi":"10.1007/s13304-025-02424-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02424-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Ligation of the intersphincteric fistula tract (LIFT) in complex anorectal fistulas: retrospective analysis of the outcomes in a tertiary hospital.","authors":"Dirk Van De Putte, Martijn Depuydt, Jan Colpaert, Gabrielle H Van Ramshorst","doi":"10.1007/s13304-025-02423-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02423-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphincter-preserving total fistulectomy: promising outcomes but questions remain.","authors":"Semra Demirli Atici, Nurhilal Kiziltoprak, Yasemin Yildirim","doi":"10.1007/s13304-025-02422-8","DOIUrl":"https://doi.org/10.1007/s13304-025-02422-8","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OAGB 2025. A systematic review with meta-analysis of indications and results for primary procedures at 5+ years.","authors":"Mario Musella, Sonja Chiappetta, Antonio Franzese, Pasquale Avella, Vincenzo Schiavone, Alessandra D'Ambrosio, Lucrezia Borrelli, Gerardo D'Amato","doi":"10.1007/s13304-025-02420-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02420-w","url":null,"abstract":"<p><p>One-anastomosis gastric bypass (OAGB) has gained increasing popularity as a metabolic and bariatric procedure due to its technical simplicity, promising weight loss and metabolic outcomes. However, its indications, long-term efficacy and long-term safety, remain the subject of an ongoing investigation. A systematic review of retrospective and prospective studies evaluating OAGB with a follow-up of minimum five years was conducted. 22 studies encompassing a total of 14,692 patients were included. The analysis included data on patient demographics, surgical indications, comorbidities, weight loss outcomes, and post-operative complications. Studies varied in design, with case numbers ranging from 101 to 2678 patients. Mean follow-up was 89.04 months (min 60 months, max 180 months). Patient age range was 33.8 to 47 years. Body mass index at surgery was between 33.4 and 54 kg/m². Total weight loss rate ranged from 24.62% to 48.80% and excess weight loss percentage reached up to 94%, showing diabetes remission between 36.4% and 100%, hypertension resolution from 17% to 90.9%, and dyslipidemia improvement in up to 90% of cases. Long-term complications included anemia (1%), hypoalbuminemia (0.09%), marginal ulcers (0.19-7.7%), and bile reflux (0.8-9.8%). The necessity for revisional surgery was from 0.19 to 5.21%. OAGB appears to be an effective metabolic and bariatric procedure with high rates of weight loss and metabolic improvement in the long term. However, careful patient selection, nutritional monitoring, and long-term follow-up are essential to mitigate risks, such as anemia, hypoalbuminemia, marginal ulcers, and bile reflux. Further prospective, multicentric studies are warranted to establish standardized indications and optimize patient outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}