Updates in Surgery最新文献_第4页

Totally robotic proximal gastrectomy with esophagogastrostomy using a double-flap technique. 全机械胃近端切除及双瓣食管胃造口术。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-22 DOI: 10.1007/s13304-025-02214-0

P M Lombardi, T Kinoshita, M Mazzola, G Ferrari

{"title":"Totally robotic proximal gastrectomy with esophagogastrostomy using a double-flap technique.","authors":"P M Lombardi, T Kinoshita, M Mazzola, G Ferrari","doi":"10.1007/s13304-025-02214-0","DOIUrl":"10.1007/s13304-025-02214-0","url":null,"abstract":"Proximal gastrectomy (PG) with D1 + lymphadenectomy and anti-reflux reconstruction is a standard surgical procedure for early-stage (EGC) proximal gastric cancer (PGC) in the East. The double-flap technique (DFT) for esophagogastrostomy has been established as an optimal anti-reflux reconstructive method after PG. However, its technical difficulty makes it a procedure not yet performed in the West. We present the technique of robotic PG with D1 + lymphadenectomy and DFT. The technique was learned during a period of attendance at the National Cancer Center Hospital East, Japan. A 70-year-old patient was submitted to endoscopic submucosal dissection for EGC-PGC. The pathologic report showed pT1b R1 disease. Additional surgery was recommended. Surgery was accomplished via a totally robotic approach (da Vinci Xi Surgical System). The patient was placed in a supine position with legs apart. Four robotic trocars and two laparoscopic trocars were placed above the transversal umbilical line. The surgical steps are summarized as follows: opening of the lesser omentum; dissection of the abdominal esophagus and lymphadenectomy of no. 1, 2 stations; partial omentectomy with lymphadenectomy of no. 4sa and 4sb stations and ligation of the left gastro-epiploic vessels; lymphadenectomy of no. 3a, 7, 8a, 9, 11p stations; transection of the esophagus; proximal gastrectomy; dissection of the posterior aspect of the remnant stomach; creation of the seromuscular flap; posterior esophageal suspension; anastomosis; flap closure. Pathology report showed the absence of residual disease with 27 lymph nodes collected from the specimen. After 1 year, the patient is disease free; no reflux esophagitis, weight loss, or anastomotic stricture was reported on follow-up. To the best of our knowledge, no other previous cases have been reported in the West describing the present surgical technique. The authors propose that PG with DFT seems feasible in a Western setting, representing an important and desirable skill for any referral center for gastric cancer surgical oncology.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1147-1151"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997059","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 : 2025-08-01 Epub 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":"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":"1019-1027"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","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

Robotic stapled cardioplasty, an alternative before esophagectomy. 机器人心脏吻合器成形术，是食管切除术前的另一种选择。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-03-19 DOI: 10.1007/s13304-025-02161-w

Elisenda Garsot, Arantxa Clavell, Pau Moreno, Marta Viciano

引用次数: 0

Poor prognosis in stage III colorectal cancer with apical lymph node metastasis: a single-center retrospective study. 伴有根尖淋巴结转移的III期结直肠癌预后不良：一项单中心回顾性研究。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-05 DOI: 10.1007/s13304-025-02219-9

Burak Dinçer, Ahmet Karayiğit, Fatma Markoç, Serdar Sarıdemir, Cihangir Özaslan

{"title":"Poor prognosis in stage III colorectal cancer with apical lymph node metastasis: a single-center retrospective study.","authors":"Burak Dinçer, Ahmet Karayiğit, Fatma Markoç, Serdar Sarıdemir, Cihangir Özaslan","doi":"10.1007/s13304-025-02219-9","DOIUrl":"10.1007/s13304-025-02219-9","url":null,"abstract":"The impact of apical lymph node (ALN) status on the prognosis of colorectal cancer (CRC) remains controversial, and ALN status is not included in the current Tumor Node Metastasis (TNM) staging system. This study aimed to evaluate the effect of ALN status on recurrence and survival rates. In this retrospective study, 117 stage 3 CRC patients aged over 18 who underwent surgery between 2015 and 2024 and had their ALN status determined were evaluated. Patients with metastatic disease at diagnosis, those with undetermined ALN status, and those with concurrent malignancies were excluded. Patients were analyzed based on demographic, clinical, pathological, and survival data. The median age was 61 years (range: 33-83), and 60.7% of the patients were male. The pN stage was significantly more advanced (p < 0.001) and the number of metastatic lymph nodes was significantly higher (p = 0.003) in the ALN ( +) group. During a median follow-up of 46 months, 14 local recurrences, 31 systemic recurrences, and 27 cancer-related deaths were observed. Local recurrence, systemic recurrence, and cancer-related deaths were significantly more frequent in the ALN ( +) group (p = 0.027, p < 0.001, and p < 0.001, respectively). Locoregional disease-free survival, systemic disease-free survival and overall survival were significantly shorter in the ALN ( +) group (p = 0.011, p < 0.001, and p < 0.001, respectively). In multivariate analysis, SDFS and OS were found to be significantly shorter in the ALN ( +) and pN2 groups. ALN metastasis can be considered as an additional adverse prognostic factor in CRC beyond the pN stage.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1009-1017"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case report: laparoscopic keyhole splenopexy with composite mesh for wandering spleen. 腹腔镜锁孔补脾术治疗游离脾1例报告。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-04 DOI: 10.1007/s13304-025-02181-6

Giovanni Cesana, Carolina Rubicondo, Matteo Uccelli, Stefano Olmi

引用次数: 0

The times they are a-changin'. 时代在变。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-25 DOI: 10.1007/s13304-025-02209-x

Dejan Ignjatovic, Bojan Vladimir Stimec

引用次数: 0

The relationship between preoperative serum cystatin C levels and postoperative oncologic outcomes in patients with renal cell carcinoma: a systematic review and meta-analysis of 1641 patients. 肾细胞癌患者术前血清胱抑素C水平与术后肿瘤预后的关系：1641例患者的系统回顾和荟萃分析

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-06 DOI: 10.1007/s13304-025-02208-y

Shuai Lu, Yulin Wang, Zhongbao Zhou, Yong Zhang, Liqing Yang, Xudong Yang

{"title":"The relationship between preoperative serum cystatin C levels and postoperative oncologic outcomes in patients with renal cell carcinoma: a systematic review and meta-analysis of 1641 patients.","authors":"Shuai Lu, Yulin Wang, Zhongbao Zhou, Yong Zhang, Liqing Yang, Xudong Yang","doi":"10.1007/s13304-025-02208-y","DOIUrl":"10.1007/s13304-025-02208-y","url":null,"abstract":"An increasing number of studies have indicated that cystatin C (CysC) may serve as an effective indicator for predicting the prognosis of renal cell carcinoma (RCC). However, there was currently a lack of meta-analysis examining the influence of serum CysC on the prognosis of RCC. From April 2016 to June 2024, we ultimately selected five retrospective studies including 1641 participants to evaluate the effect of serum CysC on patients with RCC. All data were analyzed using Review Manager version 5.3. The research findings primarily focused on overall survival (OS) and disease-free survival (DFS). Both univariate and multivariate analyses were conducted to evaluate the results. Five studies involving a total of 1641 patients were selected based on predefined eligibility criteria. Univariate analysis revealed that serum CysC levels were significantly correlated with OS (P < 0.00001) and DFS (P = 0.02) in postoperative patients with RCC. Elevated serum CysC levels were considered a reliable predictor of poor prognosis in patients with RCC. Multivariate analysis indicated that high serum CysC levels were an independent risk factor for OS (P < 0.00001) and DFS (P = 0.006) in postoperative patients with RCC, remaining unaffected by other factors. Our research results indicated that elevated serum CysC levels were associated with reduced OS and DFS in patients with RCC. However, caution must be exercised before making recommendations as this interpretation was based on very few clinical studies and small samples.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1253-1260"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036095","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

Clinical impact of closed-incision negative-pressure therapy in DIEP flap breast reconstruction's donor site. 闭合切口负压治疗在DIEP皮瓣乳房供区再造术中的临床应用。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-23 DOI: 10.1007/s13304-025-02207-z

Giuseppe Angelo Giovanni Lombardo, Francesco Ciancio, Francesco Ruben Giardino, Alessio Stivala, Dario Melita, Paolo Marchica, Rosario Ranno, Domenico Marrella

{"title":"Clinical impact of closed-incision negative-pressure therapy in DIEP flap breast reconstruction's donor site.","authors":"Giuseppe Angelo Giovanni Lombardo, Francesco Ciancio, Francesco Ruben Giardino, Alessio Stivala, Dario Melita, Paolo Marchica, Rosario Ranno, Domenico Marrella","doi":"10.1007/s13304-025-02207-z","DOIUrl":"10.1007/s13304-025-02207-z","url":null,"abstract":"The donor-site wound from deep inferior epigastric perforator flap breast reconstruction differs from abdominoplasty due to higher positioning and tension, potentially affecting healing. Closed-incision negative-pressure therapy has been proposed to improve wound healing and reduce complications. This study aimed to evaluate the impact of this tool on donor-site wound's complications and scar-related patient outcomes. This retrospective cohort study included 140 patients who underwent delayed deep inferior epigastric perforator flap breast reconstruction between September 2020 and March 2023. Patients were assigned to Group A (closed-incision negative-pressure therapy) or group B (micropore tape dressings). Both groups received standardized perioperative care. Complications were analyzed, and scar were assessed 1 year postoperatively using SCAR-Q. Statistical significance was set at p ≤ 0.05. There were no significant differences between the two groups in baseline characteristics. Wound dehiscence was significantly lower in Group A compared to Group B (p = 0.0003). The mean time to wound healing after dehiscence was similar between groups (p = 0.270). No significant differences were found in other complications, such as infection or hematoma. Concerning SCAR-Q, patients in Group A reported significantly better outcomes on the symptom scale (p = 0.03), whereas no significant differences were observed for appearance or psychosocial impact. Closed-incision negative-pressure therapy reduced the rate of wound dehiscence but did not significantly improve scar quality or other complications. Given the limited benefits and lack of cost-effectiveness data, this tool should be considered for further study rather than routine clinical use in low-risk deep inferior epigastric perforator flap patients.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"993-998"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048611","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: "Clinical impact of closed-incision negative-pressure therapy in DIEP flap breast reconstruction's donor site". 点评：“闭合切口负压治疗在DIEP皮瓣乳房再造术供区应用的临床影响”。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-28 DOI: 10.1007/s13304-025-02274-2

Qi Xu

引用次数: 0

The use of thyroid cartilage needle electrodes during intra-operative nerve monitoring in thyroid surgery: A multi-center retrospective study. 甲状腺软骨针电极在甲状腺手术术中神经监测中的应用：一项多中心回顾性研究。

IF 2.4 3区医学

Updates in Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-23 DOI: 10.1007/s13304-025-02178-1

Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay

{"title":"The use of thyroid cartilage needle electrodes during intra-operative nerve monitoring in thyroid surgery: A multi-center retrospective study.","authors":"Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay","doi":"10.1007/s13304-025-02178-1","DOIUrl":"10.1007/s13304-025-02178-1","url":null,"abstract":"In previous studies, the use of thyroid cartilage needle electrodes (TCN) was defined as an inexpensive method for intra-operative nerve monitoring (IONM) in thyroid surgery. This multi-center retrospective study aims to determine the effectiveness and reliability of TCN in thyroid surgery. Patients operated on between January 2018 and August 2023 from five centers were included in this study. Demographic data, indications, type of surgery, IONM recording system, pre-post-resection vagus nerve (V1-V2), pre-post-resection recurrent laryngeal nerve (R1-R2) amplitudes and latency values, type of loss of signal (LOS), adverse event (AE), intra-operative injury mechanism, and post-operative vocal cord examination (VCE) were evaluated. Patients with abnormal preoperative vocal cord examination were excluded. A total of 2105 patients (3772 nerves at risk) were included [1626 (77%) female, 479 (23%) male]; within this study, 1112 patients (53%) received a diagnosis of malignancy, while 993 (47%) were diagnosed with benign conditions. The mean initial vagus amplitude was 1093.74 µV (± 861.39). LOS occurred in 63 patients [Type 1 (84%), Type 2 (16%)] and AE in 36. No false-positive LOS occurred. Forty-six (87%) of LOS type 1 patients and nine (90%) of LOS type 2 patients had vocal cord palsy (VCP) during VCE (p < 0.05). In AE patients, there were only two (5.5%) patients who had vocal cord palsy during VCE (p < 0.05). VCP occurred in 57(2.7%) patients, with 9 (0.42%) remaining permanent. TCN is an inexpensive and feasible alternative to endotracheal tube electrodes and a system with satisfying amplitudes. It can also precisely predict post-operative vocal cord functions.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1171-1180"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0