Updates in Surgery最新文献

{"title":"Surgically confirmed mesenteric avulsion following blunt abdominal trauma: a contemporary case series.","authors":"M Zafer Sabuncuoglu, Isa Sozen, Bilal Turan, Serdar Acar, İsa Karaca, Mert E Irkin, A Burak Erdogan","doi":"10.1007/s13304-026-02638-2","DOIUrl":"https://doi.org/10.1007/s13304-026-02638-2","url":null,"abstract":"<p><strong>Background: </strong>To summarize the clinical, radiologic, and surgical characteristics of the rare but potentially fatal cases of mesenteric avulsion (MA) following blunt abdominal trauma, based on our single-center experience, and to highlight key implications for early diagnosis and management.</p><p><strong>Methods: </strong>Consecutive patients who underwent surgery between January 2017 and September 2025 and were intraoperatively confirmed to have MA were retrospectively reviewed. Demographic data, mechanism of injury, CT findings, involved intestinal segments, surgical procedures, intensive care and hospital stay, complications, and mortality were recorded. Results were analyzed descriptively.</p><p><strong>Results: </strong>A total of 13 patients (mean age, 44.5 years (20-83) were included. The most common mechanism of trauma was motor vehicle collision (69.2%). No patient showed direct CT evidence of MA (0%); all exhibited only nonspecific findings such as free fluid, solid-organ injury, or mesenteric hematoma (100%). Intraoperative involvement included jejunal (30.8%), ileal (38.5%), colonic (15.4%), and multisegmental (15.4%) regions. Segmental resection with primary anastomosis was performed in 69.2% of patients, stoma formation in 15.4%, and damage-control surgery (diagnostic laparotomy + packing) in 15.4%. The mean ICU stay was 3.1 days, and total hospital stay was 11.2 days. Postoperative complications occurred in 30.7% and resolved with conservative treatment. Four patients (30.7%) died, primarily due to concomitant multisystem or severe cranial/thoracic trauma.</p><p><strong>Conclusions: </strong>In MA cases, preoperative CT typically demonstrates nonspecific findings, making prospective diagnosis difficult. Maintaining a low threshold for early surgical exploration in the presence of hemodynamic instability, peritonitis, or a high index of clinical suspicion is essential to preserve bowel viability and reduce morbidity and mortality. Our study demonstrates that jejunal-ileal predominance, frequent use of resection with primary anastomosis, and the impact of associated multiple injuries are the major determinants of outcomes. Sustaining clinical vigilance and prompt surgical decision-making remain key to improving patient survival. Our findings emphasize that mesenteric avulsion remains largely a clinical and intraoperative diagnosis, and early surgical exploration should not be delayed based on negative or nonspecific CT findings.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618986","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 surgical management of gallbladder cancer: comparing outcomes and feasibility of hepatectomy with or without bile duct resection and reconstruction.","authors":"Garnet Vanterpool, Roberta Odorizzi, Sharona B Ross, Hasan Al Harakeh, Kristina Milivojev Covilo, Henry Zhang, Iswanto Sucandy","doi":"10.1007/s13304-026-02611-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02611-z","url":null,"abstract":"<p><strong>Introduction: </strong>Gallbladder cancer (GBC) is an aggressive malignancy, with surgery being the only curative option for resectable cases. Surgical approaches vary based on disease stage, ranging from cholecystectomy to extended liver resection and lymphadenectomy, with or without biliary resection. This study presents our experience of robotic surgery for GBC with and without biliary resection/reconstruction.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 38 patients who underwent robotic resection for GBC between February 2016 and November 2024. Beyond the standard partial segment 4B/5 resection and portal lymphadenectomy, the cohort was divided into two groups: common bile duct (CBD) resection and non-CBD resection group. Data are presented as median (mean ± SD).</p><p><strong>Results: </strong>The median age was 68 years (68 ± 11.49), with 71% women. Nineteen patients (50%) were diagnosed incidentally and required subsequent liver resection. Bile duct resection and Roux-en-Y hepaticojejunostomy were performed in 9 patients (23.7%), due to positive cystic duct margins. No conversions to open surgery occurred. Operative time was longer in the CBD resection group (470 vs. 219 min), which also had higher rates of vascular resection (33% vs. 3%), lymphovascular invasion (67% vs. 28%), and node-positive disease (67% vs. 24%), though the latter was not statistically significant. No differences were found in lymph node retrieval [6 (6.21 ± 4.58)], R0 resection rates (95%) or postoperative morbidity.</p><p><strong>Conclusion: </strong>The higher rates of lymphovascular invasion, vascular resections, and node-positive disease in the CBD resection group likely reflect more advanced disease. Robotic approach for GBC resection is feasible and safe, even when biliary and vascular resections are needed, offering an alternative minimally invasive technique to conventional open surgery.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618883","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":"Oncological outcomes and prognostic factors of pulmonary metastasectomy in pancreatic cancer.","authors":"Dania Nachira, Giuseppe Calabrese, Luca Bertolaccini, Elisa Meacci, Maria Teresa Congedo, Pierluigi Novellis, Angela De Palma, Rosalia Romano, Pietro Bertoglio, Gianmaria Ferretti, Jessica Evangelista, Annalisa Campanella, Matteo Chiari, Francesca Misceo, Francesco De Blasi, Mariangela Valentini, Leonardo Valentini, Jury Brandolini, Marco Taurchini, Giuseppe Bogina, Giulia Veronesi, Giuseppe Marulli, Lorenzo Spaggiari, Stefano Margaritora","doi":"10.1007/s13304-026-02605-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02605-x","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618792","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":"Long-term outcomes and quality of life after sleeve gastrectomy with major complications.","authors":"Matan Shimron, Adam Abu-Abeid, Rotem Kariv, Anat Bendayan, Andrei Keidar, Sigal Fishman, Mati Shnell, Shai Meron Eldar","doi":"10.1007/s13304-026-02633-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02633-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618856","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":"Safety of the use of an absorbable implant in breast-conserving surgery followed by radiotherapy: preplanned interim results from a prospective study.","authors":"Matteo Ghilli, Maria Donatella Mariniello, Andrea Vittorio Emanuele Lisa, Sabrina Montrone, Maria Cristina Leonardi, Dionisia Mazzotta, Manuela Bottoni, Livio Colizzi, Mattia Intra, Margherita Tamplenizza, Irini Gerges, Inma Diaz, Benigno Acea, Mario Rietjens, Manuela Roncella","doi":"10.1007/s13304-026-02629-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02629-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618928","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":"Segmentectomy or Lobectomy in T1N0M0 Non-Small Cell Lung Carcinomas: The Prognostic Role of Histology and Vascular Invasion.","authors":"Gizem Özçıbık Işık, Akif Turna, Serhan Tanju, Celal Buğra Sezen, Hasan Volkan Kara, Hüseyin Melek, Ali Çelik, Muhammet Sayan, Mustafa Vedat Doğru, Suat Erus, Cengiz Gebitekin, Yekta Altemur Karamustafaoğlu, Kadir Burak Özer, Şükrü Dilege","doi":"10.1007/s13304-026-02628-4","DOIUrl":"https://doi.org/10.1007/s13304-026-02628-4","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619028","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":"Fluorescence-guided lymphadenectomy using intralesional indocyanine green during laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumor.","authors":"Luca Ottaviani, Gian Luca Baiocchi","doi":"10.1007/s13304-026-02631-9","DOIUrl":"https://doi.org/10.1007/s13304-026-02631-9","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618874","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":"Comment on: \"3D holographic reconstruction and intraoperative navigation combined with CBL teaching in laparoscopic partial nephrectomy training for urology residents\"-the hidden hurdle to scalability.","authors":"Yanlin Wu","doi":"10.1007/s13304-026-02603-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02603-z","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609956","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":"Advancing pediatric malrotation surgery: robot-assisted versus laparoscopic Ladd's procedures.","authors":"Marko Bašković, Ivan Milas, Dubravko Habek","doi":"10.1007/s13304-026-02626-6","DOIUrl":"https://doi.org/10.1007/s13304-026-02626-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609987","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":"The tunnel-like flap technique for esophagogastrostomy in laparoscopic proximal gastrectomy: a comparative study on operative efficiency and early outcomes.","authors":"Shun Zhang, Ren-Hao Hu, Xi-Mao Cui, Xiao-Hua Jiang","doi":"10.1007/s13304-026-02624-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02624-8","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610053","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}