Updates in Surgery最新文献_第2页

Anterior component separation versus posterior component separation with transversus abdominis release for large ventral hernias: a randomized controlled study. 前成分分离与后成分分离联合腹侧释放治疗大腹疝：一项随机对照研究。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-13 DOI: 10.1007/s13304-025-02229-7

Zaza Demetrashvili, Irakli Pipia, Lali Patsia, George Kenchadze, Luka Tkhelidze, George Kamkamidze

{"title":"Anterior component separation versus posterior component separation with transversus abdominis release for large ventral hernias: a randomized controlled study.","authors":"Zaza Demetrashvili, Irakli Pipia, Lali Patsia, George Kenchadze, Luka Tkhelidze, George Kamkamidze","doi":"10.1007/s13304-025-02229-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02229-7","url":null,"abstract":"The aim of this study was to analyze outcomes of open anterior component separation technique (ACST) and posterior component separation technique with transversus abdominis release (TAR) for midline large ventral hernias. From December 2016 to July 2022, patients over 18 years of age, who underwent elective surgery for midline large ventral hernia via open component separation technique (ACST and TAR), were enrolled in this study. Preoperative and intraoperative factors, also hospital stay days, Surgical Site Occurrences (SSO), hernia recurrence and quality of life (QoL) were determined in ACST and TAR groups. To determine QoL we used the Carolinas Comfort Scale (CCS). Data of 43 patients (22 patients from ACST group and 21-from TAR group) were analyzed. Bivariate analysis showed that the proportions of SSO in TAR group (4 out of 21; 19%) was significantly lower than in ACST group (11 out of 22; 50%) (OR 1.87, 95% CI 1.07-3.24, p = 0.033). Seroma was the most frequent SSO, ranging from 9.5% to 40.9% among the groups, respectively (P = 0.018). There was no significant difference between the groups in terms of surgical site infection (SSI), hematoma, wound dehiscence, skin necrosis, hernia recurrence and QoL. Our study revealed that when comparing the ACST and TAR groups for large midline ventral hernia, there was no significant difference in terms of hernia recurrence and QoL. TAR was associated with significantly less SSO than ACST. This can be considered as an advantage of TAR, making it more preferable than ACST.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051853","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}

引用次数: 0

Conundrum of station 13 lymph nodes in Gallbladder Carcinoma: Retrospective tryst with a forgotten entity. 胆囊癌第13站淋巴结的难题：与一个被遗忘的实体的回顾性幽会。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-13 DOI: 10.1007/s13304-025-02237-7

Mayank Tripathi, Kumar Vineet, Nitesh Joshi, Ankita Pal, Tejas Vispute, Akhil Kapoor, Paramita Paul

{"title":"Conundrum of station 13 lymph nodes in Gallbladder Carcinoma: Retrospective tryst with a forgotten entity.","authors":"Mayank Tripathi, Kumar Vineet, Nitesh Joshi, Ankita Pal, Tejas Vispute, Akhil Kapoor, Paramita Paul","doi":"10.1007/s13304-025-02237-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02237-7","url":null,"abstract":"Gallbladder cancers are one of the lethal cancers with dismal prognosis. There is discrepancy between various biliary societies regarding extent of regional lymph nodes of gallbladder. Some consider station 13 as regional nodes, whereas others consider it as distant metastatic node. This is a retrospective analysis of disease-free survival of stage IIIB and IVB-M0 patients in gall bladder cancer with positive station 13 lymph node. Electronic medical records of patients were used to retrieve the data. The mean and median disease-free survival of gallbladder carcinoma patients with station 13 lymph-node positivity is 16.2 months (95% CI 11.57-20.85 months) and 12 months (95% CI 9.57-14.43 months), respectively. Disease-free survival of Stage IIIB and IVB-M0 gallbladder carcinoma patients with station 13 lymph-node positivity is better than overall survival of stage IVB-M1 patients and supports the inclusion of station 13 lymph node as regional lymph-nodal basin of gall bladder carcinoma. This study paves the way for a large prospective study to consider station 13 lymph node as regional lymph node in gallbladder cancer.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034722","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}

引用次数: 0

Risk factors for postoperative anastomotic leakage in obstructive left colonic carcinoma. 梗阻性左结肠癌术后吻合口瘘的危险因素分析。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-13 DOI: 10.1007/s13304-025-02231-z

Zhenzhen Liu, Chaowei Zhang, Binliang Zhao, Zhicheng Zhang, Yunjie Huang, Zhaohui Lin, Jie Qin, Lijun Huang

{"title":"Risk factors for postoperative anastomotic leakage in obstructive left colonic carcinoma.","authors":"Zhenzhen Liu, Chaowei Zhang, Binliang Zhao, Zhicheng Zhang, Yunjie Huang, Zhaohui Lin, Jie Qin, Lijun Huang","doi":"10.1007/s13304-025-02231-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02231-z","url":null,"abstract":"Anastomotic leakage (AL) is one of the most severe complications of colon carcinoma surgery. This study aims to investigate the related factors of AL and evaluate the independent risk factors in predicting AL after one-stage resection and primary anastomosis (RPA) for obstructive left colonic carcinoma (OLCC) patients. The demographic and clinical data, intra-operative indexes, pathologic characteristics, and ileocecal valve status shown on CT of the patients with OLCC who submitted to one-stage RPA were retrospectively analyzed. They were divided into AL group and no AL group. All indexes of the two groups were compared and the independent risk factors for AL were investigated. Receiver operating characteristic (ROC) curve analysis was used to explore the ability of the statistically significant parameters to predict AL. A total of 141 patients (AL group, 15; no AL group, 126) were enrolled. There were no statistical differences in these indexes between the two groups except for BMI (P = 0.001), ALB (P = 0.020), lymphatic metastasis (P = 0.027), and ileocecal valve status (P < 0.001). BMI, ALB, and ileocecal valve status shown on CT were the independent risk factors for AL. A BMI and ALB cutoff value of 22.2 kg/m2 and 27.9 g/L showed the area under the curve (AUC 0.765; 95% CI 0.686-0.832 and 0.684; 95% CI 0.601-0.760) in predicting AL, separately. Higher BMI, lower ALB, and incontinent ileocecal valve shown on preoperative CT may indicate an increased risk of postoperative AL after one-stage RPA for OLCC patients.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997058","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}

引用次数: 0

Does preservation of the ileocecal valve make a difference? A propensity score matched comparison of Deloyers procedure versus extended right hemicolectomy. 保留回盲瓣会有影响吗？倾向评分与Deloyers手术与扩展右半结肠切除术的比较相匹配。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-13 DOI: 10.1007/s13304-025-02159-4

Lukas Schabl, Philipp Schredl, Florentina Dermuth, Ruth Bogusch, Hermann Kessler, Jan Philipp Ramspott, Klaus Emmanuel, Tarkan Jäger, Jaroslav Presl

{"title":"Does preservation of the ileocecal valve make a difference? A propensity score matched comparison of Deloyers procedure versus extended right hemicolectomy.","authors":"Lukas Schabl, Philipp Schredl, Florentina Dermuth, Ruth Bogusch, Hermann Kessler, Jan Philipp Ramspott, Klaus Emmanuel, Tarkan Jäger, Jaroslav Presl","doi":"10.1007/s13304-025-02159-4","DOIUrl":"https://doi.org/10.1007/s13304-025-02159-4","url":null,"abstract":"Background: When performing left hemicolectomies, surgeons might encounter difficulties when restoring bowel continuity. Ileocecal valve resection and performing an ileosigmoid anastomosis is one possible solution. An alternative is preserving the ileocecal valve by counterclockwise rotation of the remaining colon, ensuring a tension-free anastomosis. This study compares functional outcomes after Deloyers procedure and extended right colectomy with an ileosigmoid anastomosis.Methods: Between 2008 and 2021, we included patients who underwent Deloyers procedure. Using propensity score matching, controls who underwent extended right hemicolectomy were identified. Perioperative outcomes were compared and patients were questioned using the St. Marks-score and the EORTC-29CR.Results: We identified 19 patients who underwent the Deloyers procedure and 28 controls. Both groups had comparable mean age (61.4 years, p = 0.3), gender distribution (women: 40%, p = 0.19), ASA classification (p = 0.89) and BMI (26.8 kg/m2, p = 74). Deloyers patients were less often treated for oncologic indications (53% vs. 86%, p = 0.02). Postoperative morbidity (37% vs. 36%, p = 0.99) and mortality (0 vs. 4%, p = 0.99) were similar. Deloyers patients reported worse body perception (83.3 vs. 100, p = 0.02), but frequency of bowel movements (2 vs. 3, p = 0.09) and use of antimotility agents (8% vs. 0%, p = 0.22) were comparable. The overall and individual results of the St. Marks and EORTC QLQ-CR29 questionnaires showed no significant differences (p > 0.05).Conclusion: In our study, patients who underwent Deloyers procedure showed no mortality and comparable morbidity, functional and quality of life outcomes to patients who underwent extended right hemicolectomy.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983382","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}

引用次数: 0

Detection of anatomic landmarks during laparoscopic cholecystectomy with the use of artificial intelligence-a systematic review of the literature. 在腹腔镜胆囊切除术中使用人工智能检测解剖标志-对文献的系统回顾。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-12 DOI: 10.1007/s13304-025-02227-9

Dimitrios Kehagias, Charalampos Lampropoulos, Aggeliki Bellou, Ioannis Kehagias

{"title":"Detection of anatomic landmarks during laparoscopic cholecystectomy with the use of artificial intelligence-a systematic review of the literature.","authors":"Dimitrios Kehagias, Charalampos Lampropoulos, Aggeliki Bellou, Ioannis Kehagias","doi":"10.1007/s13304-025-02227-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02227-9","url":null,"abstract":"Identifying the critical view of safety (CVS) and other safe anatomic landmarks during laparoscopic cholecystectomy (LC) is the cornerstone for avoiding bile duct injuries (BDI). Artificial intelligence (AI), which has infiltrated in the operating room, appears as a promising tool, enabling surgeons to safely dissect during LC. The aim of this study is to investigate the AI models and their performance for identifying these critical structures. A systematic literature review of the PubMed and Google Scholar databases was conducted using medical subject headings (MeSH). Studies presenting the application of AI models for identifying CVS and anatomic landmarks were included and analyzed in terms of performance and reliability. Clinical feasibility trials with preliminary data were separately analyzed. Seventeen studies were found eligible and analyzed for various parameters. Generating AI models for identifying CVS and anatomic landmarks during LC is feasible, while their performance in terms of accuracy, precision and recall has remarkably improved. Regarding their reliability, intersection over union (IoU) and F1/Dice scores have been improved, as well. AI models can be successfully deployed in the operating room, and could assist surgeons in decision-making. Implementation of AI during LC for identifying CVS and important anatomic landmarks appears as a feasible and promising option. Preliminary data are encouraging in terms of performance but still major obstacles and barriers need to be overcome. Whether this will lead to reduced BDIs and enhanced patient safety, requires more well-designed studies. PROSPERO database registration: (UIN: CRD42024557432).","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050179","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}

引用次数: 0

Presidential address: current state and future prospects of the European Society of Endocrine Surgeons. 主席讲话：欧洲内分泌外科医师协会的现状和未来展望。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-08 DOI: 10.1007/s13304-025-02249-3

Marcin Barczyński, Thomas J Musholt, Marco Raffaelli

{"title":"Presidential address: current state and future prospects of the European Society of Endocrine Surgeons.","authors":"Marcin Barczyński, Thomas J Musholt, Marco Raffaelli","doi":"10.1007/s13304-025-02249-3","DOIUrl":"https://doi.org/10.1007/s13304-025-02249-3","url":null,"abstract":"The European Society of Endocrine Surgeons (ESES) was officially founded in Vienna in 2003, following discussions that began in the late 1990s. Its primary mission is to promote collaboration, research, and education in endocrine surgery across Europe. The society organizes biennial congresses and topic-specific conferences focused on guidelines and consensus statements. ESES has established partnerships with key organizations, including the Eurocrine Society, the Division of Endocrine Surgery (DES) of the European Union of Medical Specialists (UEMS), and the British Journal of Surgery Foundation, to enhance surgical standards, education, and research dissemination. In addition, ESES collaborates with various international endocrine surgery societies to further innovation and improve clinical outcomes. Recent initiatives include the accreditation of European surgical units as competence centers in endocrine surgery, ensuring high standards in training and practice. The field has seen transformative advancements, such as minimally invasive techniques, precision medicine, improved diagnostics, and multidisciplinary collaboration. These innovations were showcased at the 10th Biennial Congress of ESES in Rome in 2024, which marked the society's 20th anniversary and featured research presentations from international experts. This special issue of Updates in Surgery highlights key contributions from the congress, providing insight into the latest advancements shaping endocrine surgery.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029639","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}

引用次数: 0

Comment on: "An outcome analysis of utilizing contrast-free near-infrared autofluorescence imaging in thyroid cancer surgery: a retrospective study". 点评：“无对比近红外自体荧光成像在甲状腺癌手术中的疗效分析：一项回顾性研究”。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-07 DOI: 10.1007/s13304-025-02248-4

Qi Xu, Xiaohui Chen

引用次数: 0

Ligation of the intersphincteric fistula fract (LIFT) in complex anorectal fistulas: retrospective analysis of the outcomes in a tertiary hospital. 结扎复杂肛肠瘘的括约肌间瘘（LIFT）：回顾性分析在三级医院的结果。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-07 DOI: 10.1007/s13304-025-02174-5

Dirk Van De Putte, Martijn Depuydt, Jan Colpaert, Gabrielle H Van Ramshorst

{"title":"Ligation of the intersphincteric fistula fract (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/s13304-025-02174-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02174-5","url":null,"abstract":"Anal fistula treatment remains a surgical challenge. This study focuses on the efficiency and safety of the Ligation of Intersphincteric Fistula Tract (LIFT) procedure for high intersphincteric anorectal fistulas, aiming to identify prognostic factors for success and complications. A retrospective chart review was conducted on all patients who underwent LIFT procedure at a tertiary referral hospital between January 2013 and January 2021. The primary endpoint was the success rate of fistula closure, confirmed with clinical investigation. Secondary endpoints included postoperative complications, reintervention and self-reported incontinence. Logistic regression analyses were performed for assessing prognostic factors for fistula closure and postoperative complications. Ninety-two patients were included in the study; after a median follow-up of 19.3 months, fistula closure was achieved in 71% (n = 65) and in 89% (n = 82) after reinterventions. 46% (n = 42) reported persistent symptoms, although 83% of which (n = 32/42) had succesful fistula tract closure by clinical evaluation. One patient developed incontinency for gas. Smoking emerged as a significant risk factor for fistula closure failure, OR = 6.75, 95% CI = [1.65, 27.69], p = 0.030. Wound dehiscence was the most common complication, occuring in 25% (n = 23). Prolonged oral antibiotics demonstrated a significant protective effect against wound dehiscence, OR = 0.31, 95% CI = [0.10, 0.96], p = 0.036. The LIFT procedure is an efficient and safe treatment for complex perianal fistula. Patient satisfaction emerged as a crucial treatment goal, as patients can remain symptomatic after fistula closure. Emphasizing smoking cessation is integral to the treatment approach. The findings suggest prolonged antibiotic treatment as a potential preventive measure for wound dehiscence.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040107","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}

引用次数: 0

Evaluation of predictive factors for lymph node metastasis in thyroid microcarcinoma: a two-year experience from two high-volume centers. 甲状腺微癌淋巴结转移的预测因素评估：来自两个高容量中心的两年经验。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-07 DOI: 10.1007/s13304-025-02211-3

Giovanni Tacchi, Francesco Pedicini, Pierfilippo Crucitti, Massimo Carlini

{"title":"Evaluation of predictive factors for lymph node metastasis in thyroid microcarcinoma: a two-year experience from two high-volume centers.","authors":"Giovanni Tacchi, Francesco Pedicini, Pierfilippo Crucitti, Massimo Carlini","doi":"10.1007/s13304-025-02211-3","DOIUrl":"https://doi.org/10.1007/s13304-025-02211-3","url":null,"abstract":"Papillary thyroid carcinoma incidence has increased rapidly in recent decades with microcarcinoma (maximum diameter ≤ 10 mm) representing the majority of new diagnoses. Being its prognosis excellent and mortality steady after surgery, some authors suggested active surveillance for microcarcinoma. However, microcarcinomas with lymph node metastasis at diagnosis are not uncommon. We aimed to assess independent risk factors for lymph node metastasis in patients with microcarcinoma. From January 2022 to December 2023, 234 papillary thyroid carcinomas from Fondazione Policlinico Universitario Campus Bio-Medico of Rome and Sant'Eugenio Hospital in Rome were retrospectively analyzed. Age, sex, maximum diameter, lymph node metastasis, Hashimoto's Thyroiditis, multifocality, capsule invasion and histological subtype were considered. Papillary carcinomas were stratified according to size and lymph node metastasis. Microcarcinoma were 145 (62.5%) and lymph node metastasis occurred in 16.6% of them. Multivariate regression revealed that young age (OR 0.90; 95% CI 0.86-0.95; p < 0.001) and capsular invasion (OR \"presence\" = 3.36; 95% CI 1.16-9.76; p = 0.026) resulted as independent risk factors for lymph node metastasis in patients with microcarcinoma. Being younger than 40 years old emerged as a significant cutoff for risk stratification of lymph node metastasis. Lymph node metastasis rate in microcarcinoma is considerable. A more careful evaluation is required for young patients with peripheral microcarcinoma where a more aggressive surgical approach (e.g. prophylactic central lymph node dissection) may be theorized. New tools are essential for the pre-surgical detection of high risk papillary thyroid microcarcinoma.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012099","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}

引用次数: 0

Intersegmental veins between segments 5 and 8 as a landmark along the intersegmental planes during laparoscopic anatomical segmentectomy for hepatocellular carcinoma. 在肝细胞癌腹腔镜解剖节段切除术中，5节段和8节段之间的节段间静脉作为沿节段间平面的标志。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-05-06 DOI: 10.1007/s13304-025-02080-w

Ke-Xi Liao, Li Cao, Rui Guo, Bao-Lin Wang, Jin-Ao Wang, Guang-Shen Zhang, Shu-Guo Zheng, Xiao-Jun Wang

{"title":"Intersegmental veins between segments 5 and 8 as a landmark along the intersegmental planes during laparoscopic anatomical segmentectomy for hepatocellular carcinoma.","authors":"Ke-Xi Liao, Li Cao, Rui Guo, Bao-Lin Wang, Jin-Ao Wang, Guang-Shen Zhang, Shu-Guo Zheng, Xiao-Jun Wang","doi":"10.1007/s13304-025-02080-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02080-w","url":null,"abstract":"Laparoscopic anatomical hepatectomy (LAH) of segments 5 and 8 (LAHSg5/Sg8) for hepatocellular carcinoma (HCC) remains one of the most challenging procedures due to the difficulty in exposing the main vascular structure. The aim of our study was to investigate the anatomical characteristics of inter-SVs based on the three-dimensional (3D) visualization technology exploring its safety and feasibility during LAHSg5/Sg8. A total of 110 patients who underwent LAHSg5/Sg8 in our center between January 2019 and August 2022 were enrolled and analyzed retrospectively. During the operation, the inter-SVs of the first 10 patients were observed. Subsequently, 100 patients were included based on the previous intraoperative understanding. The anatomical parameters of inter-SVs and the perioperative outcomes were recorded and evaluated. The safety and short-term efficacy of LAHSg5/Sg8 were assessed. All the patients underwent preoperative 3D processing software analysis. Of the included patients, 74.6% had inter-SVs in Sg5/Sg8, which could be classified into three types: trunk type, double branch type and multi branch type, accounting for 35.4%, 22.2% and 17.0%, respectively. The concordance between pre-operation and intra-operation in terms of portal vein territory of Sg5/Sg8 was 82 ± 31%. The inlet point diameter was 3.3 ± 1.0 mm. The distance between the inter-SVs in Sg5/Sg8 and P8, point \"B\" were 17.7 ± 6.2 mm, 6.1 ± 17 mm, respectively. The confluence of inter-SVs in Sg5/Sg8 at \"point B\" and below accounted for 10.2%. Preoperative 3D reconstruction and personalized surgical planning based on individual anatomical variations are crucial for successful LAHSg5/Sg8. Inter-SVs between Sg5/Sg8 as a landmark along the ISP during LAHS for HCC may be safe and feasible.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036310","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}

引用次数: 0