Updates in Surgery最新文献

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Interpretation of inflammatory markers in lung cyst hydatid disease. 解读肺囊肿水瘤病的炎症指标。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-03 DOI: 10.1007/s13304-024-01931-2
Barış Gülmez, S Gökalp Güneş, Beniz I E Şığva, Kübra Saçar, Bahar A Şanlı, Abdullah Adıyaman
{"title":"Interpretation of inflammatory markers in lung cyst hydatid disease.","authors":"Barış Gülmez, S Gökalp Güneş, Beniz I E Şığva, Kübra Saçar, Bahar A Şanlı, Abdullah Adıyaman","doi":"10.1007/s13304-024-01931-2","DOIUrl":"10.1007/s13304-024-01931-2","url":null,"abstract":"<p><p>Studies on alterations in inflammatory markers and risk factors for perforation in hydatid cysts of the lung are rare. In our study, we planned to investigate the effect of inflammatory markers on prognosis of hydatid cyst disease. 37 patients underwent surgery for pulmonary hydatid cyst between February 2022 and October 2023 and analyzed retrospectively. Inflammatory markers were calculated from preoperative and postoperative 3rd-month peripheral blood results. Cyst size was 58.5 ± 28.0 mm, 5 patients had bilateral cysts and 11 patients had multifocal cysts. Preoperative white blood cell, white blood cell difference, preoperative and postoperative eosinophils, preoperative neutrophils, neutrophils difference, preoperative systemic immune inflammatory index, systemic immune inflammatory index difference and preoperative eosinophil lymphocyte ratio were higher in patients with perforated cysts, the cut-off value for preoperative white blood cell for perforation was 10,535, preoperative cut-off value for eosinophils was 230, preoperative cut-off value for neutrophils was 8815, the cut-off value for preoperative systemic immune inflammatory index was 1129.83 and the cut-off value for preoperative eosinophil-lymphocyte ratio was 0.09. In patients with preoperative eosinophil, neutrophil, white blood cell, eosinophil-lymphocyte ratio and systemic immune inflammatory index values above the cut-off value, the probability of perforation increased 7.5, 13.6, 6.3, 9.6, and 9.3 times, respectively.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2917-2922"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493627","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 multidisciplinary team management on postoperative short-term outcomes in colorectral cancer surgery. 多学科团队管理对结直肠癌手术术后短期疗效的临床影响。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-07 DOI: 10.1007/s13304-024-02032-w
Shota Kuwabara, Keita Ishido, Yuma Aoki, Kazuyuki Yamamoto, Yasuhito Shoji, Tatsunosuke Ichimura, Hiroto Manase, Satoshi Hirano
{"title":"Clinical impact of multidisciplinary team management on postoperative short-term outcomes in colorectral cancer surgery.","authors":"Shota Kuwabara, Keita Ishido, Yuma Aoki, Kazuyuki Yamamoto, Yasuhito Shoji, Tatsunosuke Ichimura, Hiroto Manase, Satoshi Hirano","doi":"10.1007/s13304-024-02032-w","DOIUrl":"10.1007/s13304-024-02032-w","url":null,"abstract":"<p><p>The multidisciplinary team (MDT) approach has become the standard for perioperative patient care. At our institution, a multidisciplinary perioperative care team called \"Surgical, Nutrition and Rehabilitation Integrated Services for Excellence Team (SUNRISE)\" was established for all patients with gastrointestinal cancer undergoing surgery. This study aimed to elucidate the significance of SUNRISE as a perioperative MDT by comparing short-term postoperative outcomes before and after the introduction of SUNRISE in patients with colorectal cancer. We included 181 patients diagnosed with colorectal who underwent radical surgical resection with regional lymphadenectomy. The patients were divided into two groups: the pre-SUNRISE group, consisting of 105 patients who underwent radical colorectal surgery before the introduction of the SUNRISE, and the SUNRISE group, consisting of 76 patients who underwent radical colorectal surgery after the introduction of the SUNRISE. We compared the short-term postoperative outcomes between these two groups and analyzed the risk factors affecting postoperative complications using logistic regression models. The incidence of postoperative complications in the SUNRISE group was significantly lower than that in the pre-SUNRISE group (22.4% vs. 41.0%, p = 0.011). Multivariate analysis identified the presence of SUNRISE (odds ratio, 0.33, 95% confidence interval, 0.15-0.73, p < 0.006) as an independent risk factor for postoperative complications. The median postoperative hospital stay in the SUNRISE group was significantly shorter than that in the pre-SUNRISE group (9 vs. 11 days, p < 0.01). The MDT approach is useful for optimizing preoperative patient care and improving short-term postoperative outcomes in patients with colorectal cancer.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2777-2785"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606566","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
Is the transection of the hernia sac during laparoscopic inguinal hernioplasty safe and feasible? An updated systematic review and meta-analysis. 腹腔镜腹股沟疝成形术中横断疝囊是否安全可行?最新系统综述和荟萃分析。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-10-24 DOI: 10.1007/s13304-024-02025-9
Feng Wang, Li-Yan Huang, Yue-Juan Li, Deng-Chao Wang
{"title":"Is the transection of the hernia sac during laparoscopic inguinal hernioplasty safe and feasible? An updated systematic review and meta-analysis.","authors":"Feng Wang, Li-Yan Huang, Yue-Juan Li, Deng-Chao Wang","doi":"10.1007/s13304-024-02025-9","DOIUrl":"10.1007/s13304-024-02025-9","url":null,"abstract":"<p><p>There is a debate over whether to transect or completely reduce the hernia sac during laparoscopic tension-free repair of inguinal hernia. This study endeavors to systematically assess the efficacy and safety of two approaches, namely transected sac (TS) and completely reduced sac (RS), in laparoscopic tension-free repair of inguinal hernia. Utilizing a meta-analysis methodology, we aim to provide a comprehensive analysis of these techniques. A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases to identify comparative studies focusing on laparoscopic tension-free repair of inguinal hernia, specifically comparing TS and RS techniques. The selected studies were subjected to meta-analysis using RevMan 5.3 software. A total of 8 studies, involving 2995 patients with inguinal hernia, were included in the analysis. The meta-analysis results revealed that the TS group had a higher incidence of seroma compared to the RS group [OR = 1.74, 95% CI (1.35, 2.25), P < 0.0001], and a prolonged time to return to normal activity postoperatively [MD = 0.99, 95% CI (0.85, 1.14), P < 0.00001]. However, no statistically significant differences were observed between the two groups in terms of operation time [MD = -1.75, 95% CI (- 8.72, 5.22), P = 0.62], incidence of postoperative pain [OR = 1.00, 95% CI (0.41, 2.44), P = 1.00], overall postoperative complication rate [OR = 0.98, 95% CI (0.43, 2.20), P = 0.95], and recurrence rate fOR = 2.53, 95% CI (0.61, 10.39), P = 0.20]. Transected sac in laparoscopic inguinal hernia repair is associated with an increased incidence of seroma and a longer recovery time for patients to return to normal activity. Clinical trial registration Registration number is INPLASY20223110070.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2733-2743"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508881","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
Impact of indocyanine green on decision making for performing laparoscopic cortical sparing adrenalectomy. 吲哚菁绿对腹腔镜肾上腺皮质切除术决策的影响。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1007/s13304-024-01966-5
Martos Martínez Juan Manuel, Rubio-Manzanares Dorado Mercedes, Pino Díaz Verónica, Padillo Ruíz Javier
{"title":"Impact of indocyanine green on decision making for performing laparoscopic cortical sparing adrenalectomy.","authors":"Martos Martínez Juan Manuel, Rubio-Manzanares Dorado Mercedes, Pino Díaz Verónica, Padillo Ruíz Javier","doi":"10.1007/s13304-024-01966-5","DOIUrl":"10.1007/s13304-024-01966-5","url":null,"abstract":"<p><strong>Background: </strong>Indocyanine green imaging (ICG) is an expansion technology that can contribute to the development of demanding techniques such as cortical-sparing adrenalectomy (CSA). The aim of this study was to determine in which cases CSA should be performed and when total adrenalectomy should be performed instead based on ICG fluorescence. Here, we present our experience through a series of cases and videos.</p><p><strong>Methods: </strong>Prospective and descriptive study on patients with surgical adrenal lesions who were proposed for CSA using ICG with near-infrared fluorescence imaging in our center. A first bolus of 6,25 mg ICG was administered intravenously upon exposure of the retroperitoneal plane. Fluorescence was visualized using a Storz<sup>®</sup> NIR/ICG endoscopic system.</p><p><strong>Results: </strong>Seven patients were proposed for CSA. After the application of ICG, a change in attitude was carried out in 71.4% of the cases (five of seven). In the two patients in whom CSA could be performed, the adrenal remnants were functional, and the resection margins of the surgical specimens were free of disease. The reasons why partial adrenalectomy could not be completed, and a total adrenalectomy was decided instead were the presence of a tumor located very close to the adrenal vein that prevented a correct remnant volume (n = 4) and one case of isofluorescent tumor with the adrenal parenchyma.</p><p><strong>Conclusion: </strong>ICG fluorescence guidance could help in the decision making to select patients intraoperatively for successful cortical preservation.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2851-2862"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073892","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
How does sutures pattern influence stomach motility after endoscopic sleeve gastroplasty? A computational study. 内镜袖状胃成形术后缝合模式对胃运动有何影响?一项计算研究。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-01 DOI: 10.1007/s13304-024-01917-0
Alice Berardo, Lino Polese, Emanuele Luigi Carniel, Ilaria Toniolo
{"title":"How does sutures pattern influence stomach motility after endoscopic sleeve gastroplasty? A computational study.","authors":"Alice Berardo, Lino Polese, Emanuele Luigi Carniel, Ilaria Toniolo","doi":"10.1007/s13304-024-01917-0","DOIUrl":"10.1007/s13304-024-01917-0","url":null,"abstract":"<p><p>The relatively recent adoption of Endoscopic Sleeve Gastroplasty (ESG) amongst obese patients has gained approval within the surgical community due to its notable benefits, including significant weight loss, safety, feasibility, repeatability, and potential reversibility. However, despite its promising clinical outcomes and reduced invasiveness, there is still a lack of standardised procedures for performing ESG. Multiple suture patterns and stitching methods have been proposed over time, yet rational tools to quantify and compare their effects on gastric tissues are absent. To address this gap, this study proposed a computational approach. The research involved a case study analyzing three distinct suture patterns (C-shaped, U-shaped and Z-shaped) using a patient-specific computational stomach model generated from magnetic resonance imaging. Simulations mimicked food intake by placing wire features in the intragastric cavity to replicate sutures, followed by applying a linearly increasing internal pressure up to 15 mmHg. The outcomes facilitated comparisons between suture configurations based on pressure-volume behaviours and the distribution of maximum stress on biological tissues, revealing the U-shaped as the more effective in terms of volume reduction, even if with reduced elongation strains and increased tissues stresses, whereas the Z-shaped is responsible of the greatest stomach shortness after ESG. In summary, computational biomechanics methods serve as potent tools in clinical and surgical settings, offering insights into aspects that are challenging to explore in vivo, such as tissue elongation and stress. These methods allow for mechanical comparisons between different configurations, although they might not encompass crucial clinical outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2833-2839"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493626","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
Comparison of postoperative pulmonary complications and intraoperative safety in thoracoscopic surgery under non-intubated versus intubated anesthesia: a randomized, controlled, double-blind non-inferiority trial. 非插管麻醉与插管麻醉下胸腔镜手术术后肺部并发症和术中安全性的比较:随机对照双盲非劣效性试验。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-08-10 DOI: 10.1007/s13304-024-01935-y
Lingfei Wang, Dan Wang, Yanmei Zhang
{"title":"Comparison of postoperative pulmonary complications and intraoperative safety in thoracoscopic surgery under non-intubated versus intubated anesthesia: a randomized, controlled, double-blind non-inferiority trial.","authors":"Lingfei Wang, Dan Wang, Yanmei Zhang","doi":"10.1007/s13304-024-01935-y","DOIUrl":"10.1007/s13304-024-01935-y","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional anesthesia for video-assisted thoracoscopy (VATS) such as double-lumen tracheal intubation (DLT) and one-lung ventilation (OLV), may lead to post-operative pulmonary complications (PPCs). Non-intubation VATS (NIVATS) is an anesthetic technique that avoided DLT and OLV, maybe avoiding the PPCs. So we hypothesized that NIVATS would non-inferiority to intubation VATS (IVATS) in the risk of developing PPCs and some safety indicators.</p><p><strong>Methods: </strong>This study is a randomised, controlled, double-blind, non-inferiority trial, 120 patients were randomly assigned to the NIVATS group and IVATS group according to 1:1. The primary outcome was the incidence of PPCs with a pre-defined non-inferiority margin of 10%. The second outcome was the safety indicators, including the incidence of cough/body movement, hypoxemia, malignant arrhythmia, regurgitation and aspiration, and transferring to endobronchial intubation intraoperatively (The malignant arrhythmia was defined as an arrhythmia that caused hemodynamic disturbances in a short period of time, resulting in persistent hypotension or even cardiac arrest in the patient).</p><p><strong>Results: </strong>There was no significant difference in demographic indicators such as gender and age between the two groups. The incidence of PPCs in the NIVATS group was non-inferior to that in the IVATS group (1.67% vs. 3.33%, absolute difference: - 1.67%; 95%CI - 7.25 to 3.91). In additionan, no significant differences were found between the two groups for the incidence of cough/body movement (10.00% vs. 11.67%, p = 0.77), the incidence of hypoxemia (25% vs. 18.33%, p = 0.38), the incidence of malignant arrhythmia (1.67% vs. 6.67%, p = 0.36), the incidence of regurgitation and aspiration (0% vs. 0%, p > 0.999) and the incidence of transferring to endobronchial intubation intraoperatively (0% vs. 0%, p > 0.999).</p><p><strong>Conclusion: </strong>We conclude that when using the non-intubation anesthesia for VATS, the incidence of PPCs was not inferior to intubation anesthesia. Furthermore, NIVATS had little effect on perioperative safety.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2863-2873"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914121","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
The advantages of preoperative 3D reconstruction over 2D-CT in thoracoscopic segmentectomy. 在胸腔镜肺段切除术中,术前三维重建比二维 CT 更具优势。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-29 DOI: 10.1007/s13304-024-01965-6
Hao He, Peiyuan Wang, Hang Zhou, Wenwei Wei, Junpeng Lin, Yujie Chen, Feng Wang, Shuoyan Liu
{"title":"The advantages of preoperative 3D reconstruction over 2D-CT in thoracoscopic segmentectomy.","authors":"Hao He, Peiyuan Wang, Hang Zhou, Wenwei Wei, Junpeng Lin, Yujie Chen, Feng Wang, Shuoyan Liu","doi":"10.1007/s13304-024-01965-6","DOIUrl":"10.1007/s13304-024-01965-6","url":null,"abstract":"<p><p>Performing a pulmonary segmentectomy is a complex process, with precise localization of pulmonary nodules and recognition of intraoperative anatomical variations posing significant challenges. This study aims to assess the advantages of preoperative three-dimensional reconstruction (3D-RE) in thoracoscopic segmentectomy. The study, at Fujian Medical University Cancer Hospital, analyzed data from segmentectomy patients from January 2016 to February 2022. It compared 3D-RE and two-dimensional computed tomography (2D-CT) preoperative scans, focusing on perioperative complications within30 days to identify any differences. This investigation encompassed a total of 265 instances, with 148 belonging to the 3D-RE group and 117 aligned with the 2D-CT group. The 3D-RE group showed reduced intraoperative blood loss and shorter postoperative hospital stays (P < 0.001). They also had higher rates of lymph node sampling and combined subsegmentectomy and segmentectomy procedures (P < 0.01). Postoperative complications, particularly pneumonia and lung fistula, were lower in the 3D-RE group (P = 0.041). The rates of minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) were significantly higher in the 3D-RE group, while adenocarcinoma in situ (AIS) and benign cases were less common (P = 0.006). Surgical duration, chest tube duration, chest drainage volume, surgery complexity, and pathological diagnoses showed no significant differences between the groups. Utilization of preoperative 3D-RE holds potential to minimize both intraoperative and postoperative complications, thereby enhancing the safety and feasibility of undertaking segmentectomy procedures.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2875-2883"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354711","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
Simultaneous treatment of large hiatal hernias during Roux-en-Y gastric bypass: technical considerations and outcome. 在 Roux-en-Y 胃旁路手术中同时治疗巨大食管裂孔疝:技术考虑因素和结果。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-10-02 DOI: 10.1007/s13304-024-02017-9
Lars Kollmann, Annette Thurner, Alexander Dimitri Miras, Florian Seyfried
{"title":"Simultaneous treatment of large hiatal hernias during Roux-en-Y gastric bypass: technical considerations and outcome.","authors":"Lars Kollmann, Annette Thurner, Alexander Dimitri Miras, Florian Seyfried","doi":"10.1007/s13304-024-02017-9","DOIUrl":"10.1007/s13304-024-02017-9","url":null,"abstract":"<p><p>Roux-en-Y gastric bypass (RYGB) is the preferred surgical option for patients with proven gastroesophageal reflux disease and obesity grade ≥ II (BMI ≥ 35 kg/m<sup>2</sup>). Data on simultaneous treatment of larger hiatal hernias during RYGB are scarce. From 2012 until 2022, data from all consecutive patients undergoing gastric bypass procedures were collected and retrospectively analyzed. The characteristics and surgical outcomes of patients undergoing RYGB alone (RYGBa) versus RYGB with simultaneous treatment of a large hiatal hernia (RYGB-HH) were compared. Out of 573 patients who received RYGB, we identified 12 simultaneously treated for large hiatal hernia. The characteristics of RYGB-HH versus RYGBa patients were higher age (55 vs. 44 years; p = 0.004) and lower BMI (39.2 vs. 46.9 kg/m<sup>2</sup>; p = 0.001). Duration of surgery in the RYGB-HH group was longer (144 min vs. 98 min; p < 0.001), while complications > Clavien-Dindo II were similar compared to the RYGBa group (8.3 vs. 9.4%, p = 0.56). Length of stay did not differ among the groups (4 vs. 5.5 days, p = 0.051). At a median follow-up of 12 months, there was no clinical recurrence of hiatal hernia in the RYGB-HH group. Simultaneous treatment of large hiatal hernias during Roux-en-Y gastric bypass surgery prolongs operation time but seems feasible and safe in the hands of experienced surgeons.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2973-2976"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366686","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
Recurrence-free survival curve for pulmonary metastasectomy in colorectal cancer plateaus at 3 years. 结直肠癌肺转移切除术的无复发生存期曲线在 3 年后趋于平稳。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-05-27 DOI: 10.1007/s13304-024-01874-8
Chihiro Yoshida, Sung Soo Chang, Taku Okamoto, Ryo Inada
{"title":"Recurrence-free survival curve for pulmonary metastasectomy in colorectal cancer plateaus at 3 years.","authors":"Chihiro Yoshida, Sung Soo Chang, Taku Okamoto, Ryo Inada","doi":"10.1007/s13304-024-01874-8","DOIUrl":"10.1007/s13304-024-01874-8","url":null,"abstract":"<p><p>Pulmonary metastasectomy in colorectal cancer (CRC) has encouraging results; however, specific criteria for lung resection and the timing of resection remain undetermined. Therefore, in this study, we aimed to examine the long-term prognosis and 10-year survival rates and analyze poor prognostic factors in patients who underwent resection of pulmonary metastases from CRC. This retrospective, single-institution study included 156 patients with controlled primary CRC and metastases confined to the lungs or liver who underwent pulmonary metastasectomy between 2005 and 2022. Statistical analyses were conducted using the X<sup>2</sup> and two-tailed Student's t test to compare variables. The receiver operating characteristic (ROC) curve was used to determine the appropriate cut-off point for tumor size as a predictive factor of survival. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and non-parametric group comparisons were performed using log-rank tests. The 5- and 10-year OS rates were 67% and 59%, respectively. Further, there was no recurrence 38 months post-surgery, and the RFS curve plateaued. Moreover, by 88 months post-surgery, no deaths occurred, and the OS curve plateaued. Multivariate analysis revealed that a pulmonary metastatic tumor >14 mm and disease-free interval <2 years indicated poor prognosis. The RFS curve for pulmonary metastasectomy may plateau approximately 3 years after surgery. Pulmonary metastasectomy can achieve long-term survival in selected patients with CRC. Furthermore, surgical resection of recurrence after pulmonary metastasectomy may lead to better results. Thus, tumor size and disease-free interval may be independent prognostic factors.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2795-2803"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155669","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
Urgency an important factor when assessing fecal incontinence. 尿急是评估大便失禁的一个重要因素。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s13304-024-01975-4
Louise Almkvist, Ulf Gunnarsson, Karin Strigård
{"title":"Urgency an important factor when assessing fecal incontinence.","authors":"Louise Almkvist, Ulf Gunnarsson, Karin Strigård","doi":"10.1007/s13304-024-01975-4","DOIUrl":"10.1007/s13304-024-01975-4","url":null,"abstract":"<p><p>The aim of this study was to investigate if Low Anterior Resection Syndrome (LARS) score contributed with complementary information to Wexner score when assessing fecal incontinence (FI). The hypothesis was that LARS score would be likely to provide complementary information to Wexner score in the assessment of FI regardless of etiology. LARS score has been used as a complement to traditional scoring systems to assess bowel dysfunction, targeting FI among patients after radical cystectomy, in women with endometriosis, and in colorectal cancer patients. Wexner score as a single tool does not address the complexity of FI and urgency, a disabling symptom. A retrospective cohort study at a surgical outpatient clinic included patients diagnosed with FI who answered LARS and Wexner scores questionnaires at their first visit to the clinic between 1st January 2015 and 31st December 2018. Kendall's tau, Spearman rank correlation, Cohen's kappa, and scatterplots were analyzed for participants and specific subgroups to assess any correlation and agreement between answers to the two scoring systems. One hundred nineteen patients met the inclusion criteria, one hundred eight women and eleven men. Kendall's tau ranged from 0.32 to 0.39, indicating lack of correlation. Correlation coefficients using Spearman rank ranged from 0.36 to 0.55, i.e., only fair to moderate correlation. Kappa was 0.21-0.28, i.e., only slight to fair agreement. Distribution of LARS and Wexner scores in the scatterplot showed wide variability and lack of agreement. Combined use of both the Wexner and LARS scores provided complimentary information, and thus a more complete mapping of FI as well as taking all entities in consideration.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"2805-2811"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141220","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}
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