Updates in Surgery最新文献_第2页

Clinico-pathological features and prognosis of mixed-IPMNs with a focal involvement of the main pancreatic duct. 局灶性累及主胰管的混合型ipmns的临床病理特征及预后。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-21 DOI: 10.1007/s13304-026-02654-2

Francesca Aleotti, Valentina Andreasi, Giaime Arru, Giulio Belfiori, Stefano Partelli, Nicolò Pecorelli, Diego Palumbo, Cristina Marmorale, Francesco De Cobelli, Gabriele Capurso, Paolo Giorgio Arcidiacono, Marco Schiavo Lena, Massimo Falconi, Stefano Crippa

引用次数: 0

Feasibility and safety of surgical strategy based on tumor characteristics and location in laparoscopic and endoscopic cooperative surgery for non-ampullary duodenal tumors. 基于肿瘤特征和位置的腹腔镜内镜联合手术治疗非壶腹十二指肠肿瘤的可行性和安全性。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-21 DOI: 10.1007/s13304-026-02656-0

Satoru Kikuchi, Yasushi Yamasaki, Hiromitsu Kanzaki, Masahiko Nishizaki, Yoshihiko Kakiuchi, Shinji Kuroda, Yuki Matsumi, Kenjiro Kumano, Hajime Kashima, Shunsuke Tanabe, Kazuhiro Noma, Hiroyuki Okada, Motoyuki Otsuka, Toshiyoshi Fujiwara

{"title":"Feasibility and safety of surgical strategy based on tumor characteristics and location in laparoscopic and endoscopic cooperative surgery for non-ampullary duodenal tumors.","authors":"Satoru Kikuchi, Yasushi Yamasaki, Hiromitsu Kanzaki, Masahiko Nishizaki, Yoshihiko Kakiuchi, Shinji Kuroda, Yuki Matsumi, Kenjiro Kumano, Hajime Kashima, Shunsuke Tanabe, Kazuhiro Noma, Hiroyuki Okada, Motoyuki Otsuka, Toshiyoshi Fujiwara","doi":"10.1007/s13304-026-02656-0","DOIUrl":"https://doi.org/10.1007/s13304-026-02656-0","url":null,"abstract":"Background and aim: Recently, several studies have demonstrated the safety and feasibility of laparoscopic and endoscopic cooperative surgery for duodenal tumors (D-LECS). However, the standard procedure for D-LECS has not been established. Herein, we introduce the feasibility and safety of a surgical strategy based on tumor characteristics and location in D-LECS.Methods: This retrospective single-center study included 17 consecutive patients with duodenal tumors who underwent D-LECS between October 2017 and November 2023.Results: Two, 13 and 2 tumors were located in the first, second and third portions of the duodenum, respectively. Three tumors were protruded type and 14 were superficial type. The median tumor size was 25 (6-45) mm. Supracolic, mesenteric and inferior approaches were employed in 14, 2 and 1 case, respectively, during D-LECS. Laparoscopic reinforcement after endoscopic submucosal dissection (ESD) (D-LECS with ESD), laparoscopic suturing after full-thickness resection (FTR) (D-LECS with FTR) and Closed-LECS were performed in 13, 2 and 2 cases, respectively. The median operation time and blood loss were 237 (159-420) min and 0 (0-75) ml, respectively. En-bloc pathological curative resection was achieved in all cases. Two patients had paralytic ileus and delayed gastric emptying as postoperative complications. The median duration of postoperative hospital stay was 10 (6-22) days. One local recurrence was observed in a case of adenocarcinoma in situ during the median follow-up of 13 (2-71) months.Conclusions: The feasibility and safety of our surgical strategy based on the tumor characteristics and location were demonstrated in D-LECS.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782531","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

Optimizing pain management: a systematic review and meta-analysis of opioid-sparing and opioid-free analgesia in minimally invasive colorectal surgery. 优化疼痛管理：微创结直肠手术中阿片类镇痛和无阿片类镇痛的系统回顾和meta分析。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-20 DOI: 10.1007/s13304-026-02643-5

Kyle Leong, Carlos A Balthazar da Silveira, Harvey Wang, Laura Cogua, Nicole Salevitz, Ana Caroline Rasador, Conrad Ballecer, Vikram Deka, Thomas Gillespie

引用次数: 0

Ability of 3-D liver reconstruction to estimate liver resection volume after anatomical minor resection: a prospective study. 三维肝脏重建评估解剖小切除后肝切除体积的能力：一项前瞻性研究。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-20 DOI: 10.1007/s13304-026-02580-3

Nadia Russolillo, Serena Langella, Gaia Russo, Andrea Pierluigi Fontana, Roberto Lo Tesoriere, Alessandro Ferrero

{"title":"Ability of 3-D liver reconstruction to estimate liver resection volume after anatomical minor resection: a prospective study.","authors":"Nadia Russolillo, Serena Langella, Gaia Russo, Andrea Pierluigi Fontana, Roberto Lo Tesoriere, Alessandro Ferrero","doi":"10.1007/s13304-026-02580-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02580-3","url":null,"abstract":"Estimation of liver resection volume (LRV) is a key step to plane safe liver surgery. Modern 3D liver reconstruction software (3-D) allows to calculate LRV based on the portal blood supply, overcoming some limits of the conventional hand-trace method. The aim of this prospective study was to evaluate the ability of 3-D to estimate the LRV after minor anatomical resections (mAR). The consistency of virtual LRV (vLRV) and real weighted specimen (rLRV) was evaluated. Factors affecting the median discrepancy between vLRV and rLRV were analyzed. Exclusion criteria included inadequate contrast-enhanced computed tomography, left lateral sectionectomy, and changes in the surgical plan based on intraoperative ultrasound findings. Thirty-five consecutive mARs were analyzed: 4 subsegmentectomies, 9 segmentectomies, and 22 bisegmentectomies. A strong positive correlation was found between vLRV and rLRV (r = 0.945, p < 0.001). The median vLRV and rLRV were 236 mL and 180 mL, respectively. The median discrepancy between vLRV and rLRV was - 38 mL, indicating a slight tendency of the 3D software to overestimate LRV. The median discrepancy was greater in cases of large subglissonian lesions (> 3 cm) (65 mL vs. 22.5 mL for other lesion types, p = 0.028) and bisegmentectomies (60.5 mL vs. 16 mL for segmentectomies/subsegmentectomies, p = 0.001). Multivariate analysis confirmed that bisegmentectomy was the only factor independently associated with increased discrepancy [RR 2.724 (12.8-88.9), p = 0.010]. 3D software provided accurate predictions of liver specimen volume in patients who underwent minor anatomical resections.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730153","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

Area-based centralization of pancreatic surgery: a Hub-and-Spoke system balances patient proximity and quality of care. 基于区域的胰腺手术集中化：中心辐射式系统平衡患者接近性和护理质量。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-20 DOI: 10.1007/s13304-026-02646-2

Tommaso Giuliani, Chiara Casadei, Giulia Elena Cantelli, Giulia Marchetti, Carlo Alberto Pacilio, Mario Luciano Brancaccio, Stefano Tamberi, Ilario Rapposelli, Carlo Fabbri, Alessandro Cucchetti, Giorgio Ercolani

{"title":"Area-based centralization of pancreatic surgery: a Hub-and-Spoke system balances patient proximity and quality of care.","authors":"Tommaso Giuliani, Chiara Casadei, Giulia Elena Cantelli, Giulia Marchetti, Carlo Alberto Pacilio, Mario Luciano Brancaccio, Stefano Tamberi, Ilario Rapposelli, Carlo Fabbri, Alessandro Cucchetti, Giorgio Ercolani","doi":"10.1007/s13304-026-02646-2","DOIUrl":"https://doi.org/10.1007/s13304-026-02646-2","url":null,"abstract":"Area-based centralization optimizes both patient access by minimizing long-distance transfers and enables hospitals to reach adequate surgical volumes to ensure optimal outcomes. This study aimed to analyze a Hub-and-Spoke system applied to pancreatic surgery by evaluating both patient logistics and clinical outcomes. Data from a Hub-and-Spoke system for pancreatic surgery were collected over a 3-year period. The Hub center managed patient referrals from its own region and three additional Spoke hospitals. Clinical decision-making was standardized through dedicated inter-institutional multidisciplinary team meetings. Surgical outcomes and quality metrics were collected and analyzed. Patient transfer patterns related to key steps in the care pathway were retrieved and quantified. Overall, 187 patients underwent surgical exploration at the Hub center, with pancreatic ductal adenocarcinoma as the most common indication (56.1%). A minimally invasive approach was used in 57 (33.1%) patients. Postoperative pancreatic fistula (POPF) rate following pancreaticoduodenectomy was 39.7%, with grade C POPF being 9.0%. The 90-day mortality for the entire cohort was 0.6%, with a failure-to-rescue rate of 2.8%. Textbook outcomes were obtained in 58.1% of cases. The median patient transfer distance from home to the Hub center was 43 kilometers (IQR 25-50), with an estimated travel time of 48 minutes. The cumulative distance required to complete the entire care process was 197 km (IQR 90-225) with an estimated travel time of less than 5 hours. The centralization of pancreatic care through a Hub-and-Spoke system ensured adequate surgical outcomes. Simultaneously, the model maintained patient proximity to care facilities, optimizing access to care pathways and enhancing patient-centered management.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730148","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: "Dual-center development and validation of an immunoinflammatory-based preoperative model for predicting postoperative cachexia in colorectal cancer". 评论：“基于免疫炎症的预测结直肠癌术后恶病质的术前模型的双中心开发和验证”。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-20 DOI: 10.1007/s13304-026-02642-6

Alp Omer Canturk

引用次数: 0

Surgical management of pediatric primary splenic lesions: safety and feasibility of transumbilical single-port laparoscopic partial splenectomy. 小儿原发性脾病变的外科治疗：经脐单孔腹腔镜脾部分切除术的安全性和可行性。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-13 DOI: 10.1007/s13304-026-02552-7

Zhen-Sheng Liu, Yong Yang, Jian Bian, Shi-Qin Qi

引用次数: 0

Comment on: comparison analysis of short-term outcomes between degradable stent placement and diverting ileostomy in mid-to-low rectal cancer-a retrospective cohort study. 评论：可降解支架置入术与回肠转移造口术治疗中低位直肠癌的近期疗效对比分析——一项回顾性队列研究。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-13 DOI: 10.1007/s13304-026-02641-7

Zilong Zhao

引用次数: 0

Towards a neuro-symbolic approach for precision anti-reflux surgery. 精确抗反流手术的神经符号方法

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-10 DOI: 10.1007/s13304-026-02645-3

Quan Wang, Yaowei Dai, Alberto Aiolfi, Marco Manna, Aldo Ricioppo, Xiaonan Liu, Vincenzo Pezzi, Nicola Leone, Luigi Bonavina

引用次数: 0

The association between patient-reported postoperative recovery and health-related quality of life in patients undergoing pancreatic cancer surgery: an explorative single-centre study. 胰腺癌手术患者报告的术后恢复与健康相关生活质量之间的关系：一项探索性单中心研究

IF 2.2 3区医学

Updates in Surgery Pub Date : 2026-04-10 DOI: 10.1007/s13304-026-02616-8

Thomas Andersson, My Engström, Johanna Wennerblom, Ulrica Nilsson, Hanna Gyllensten, Kristofer Bjerså

{"title":"The association between patient-reported postoperative recovery and health-related quality of life in patients undergoing pancreatic cancer surgery: an explorative single-centre study.","authors":"Thomas Andersson, My Engström, Johanna Wennerblom, Ulrica Nilsson, Hanna Gyllensten, Kristofer Bjerså","doi":"10.1007/s13304-026-02616-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02616-8","url":null,"abstract":"Pancreaticoduodenectomy (PD) is associated with a long and complex recovery. Enhanced recovery programmes have improved short-term clinical outcomes, but there is a growing interest in patient-reported outcomes as an indicator for postoperative recovery. Health-related quality of life (HRQoL) and patient-reported postoperative recovery provide a wider perspective on the effects of surgery. However, the relationship between the two measures remains unexplored. Therefore, the aim of this study was to explore the relationship between HRQoL and patient-reported recovery in patients undergoing PD. This prospective, single-centre study included 77 participants who all underwent PD in the context of an enhanced recovery programme. Instruments used were the EQ-5D-3L and the SwQoL-24. Data was collected preoperatively and at 1,3,6,9, and 12 months postoperatively. Longitudinal trends were analysed using a mixed-effect repeated measures model. Predictive associations were explored via linear regression. The EQ-5D-3L improved, and the SwQoL-24 total score declined throughout the first year. The EQ-5D-3L Index and the VAS explained the SwQoR-24 value at six months and 12 months; R2 0.52/0.47 and 0.52/0.56, respectively. Preoperative EQ-5D-3L values predicted between (R2) 0.09-0.17 for 6 and 12-month SwQoR-24 values. Other tested factors were statistically non-significant. This study demonstrates a significant improvement in postoperative recovery as well as HRQoL during the first year after PD, with a strong association between the two measures. The findings also suggest that the EQ-5D-3L index and the EQ VAS have a significant but limited predictive value for postoperative recovery. Other demographical and care-related factors did not predict levels of recovery quality.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646387","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