Updates in Surgery最新文献

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Short- and midterm results with non-adjustable banded bypass as a revisional procedure. A case series. 短期和中期结果与不可调节带状旁路作为修正程序。一个案例系列。
IF 2.2 3区 医学
Updates in Surgery Pub Date : 2025-07-30 DOI: 10.1007/s13304-025-02333-8
Anna Woestemeier, Andreas Plamper, Christiane Pillny, Philipp Lingohr, Karl Peter Rheinwalt
{"title":"Short- and midterm results with non-adjustable banded bypass as a revisional procedure. A case series.","authors":"Anna Woestemeier, Andreas Plamper, Christiane Pillny, Philipp Lingohr, Karl Peter Rheinwalt","doi":"10.1007/s13304-025-02333-8","DOIUrl":"https://doi.org/10.1007/s13304-025-02333-8","url":null,"abstract":"<p><p>Primary banded Roux-en-Y gastric bypass is performed routinely in many countries worldwide to add more restriction to bariatric procedures and consequently to prevent dilatation of the gastroenterostomy and weight regain. However, in Germany, banded gastric bypass is mainly performed as a revisional procedure for unfavorable post-bariatric results. To investigate the short- and midterm results of revisional banded gastric bypass, 47 patients were included in this retrospective, single-center study. Two years after surgery, a moderate additional total weight loss of 14.7% was observed. In subgroup analysis, patients who underwent revisional surgery due to insufficient weight loss dropped 10.52 BMI points. Patients that required banding for non-weight-related issues, like dumping syndrome, did not experience significant weight loss. Interestingly, revisional banded gastric bypass showed relatively high morbidity and a high band explantation rate of 42.6%, especially with lower ring circumferences. Therefore, adequate patient selection is crucial for revisional banded gastric bypass and small ring circumferences should be strictly avoided.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745137","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
A comparative study of video-assisted thoracoscopic surgery and thoracotomy in elderly patients undergoing segmentectomy and lobectomy for primary non-small cell lung cancer. 老年原发性非小细胞肺癌行节段切除、肺叶切除术的视频胸腔镜手术与开胸手术的比较研究。
IF 2.2 3区 医学
Updates in Surgery Pub Date : 2025-07-30 DOI: 10.1007/s13304-025-02328-5
Yunus Türk, Serkan Yazgan, Bahar Ağaoğlu Şanlı, Esra Yamansavcı Şirzai, Canberk Heskiloğku, Bengisu Arabacı, Ahmet Üçvet
{"title":"A comparative study of video-assisted thoracoscopic surgery and thoracotomy in elderly patients undergoing segmentectomy and lobectomy for primary non-small cell lung cancer.","authors":"Yunus Türk, Serkan Yazgan, Bahar Ağaoğlu Şanlı, Esra Yamansavcı Şirzai, Canberk Heskiloğku, Bengisu Arabacı, Ahmet Üçvet","doi":"10.1007/s13304-025-02328-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02328-5","url":null,"abstract":"<p><p>This study aims to compare postoperative outcomes of video-assisted thoracoscopic surgery (VATS) and thoracotomy in elderly patients undergoing segmentectomy or lobectomy for primary non-small cell lung cancer (NSCLC). A retrospective analysis was conducted on 129 patients aged 70 years or older who underwent anatomical lung resection (segmentectomy or lobectomy) for NSCLC between January 2016 and June 2021. Patients were divided into two groups based on surgical approach: VATS and thoracotomy. Demographics, tumor characteristics, postoperative complications, chest drainage duration, hospital stay, and short- and mid-term mortality rates were analyzed and compared. The mean age of patients was 73.5 ± 3.2 years, with 55% undergoing surgery via VATS. The VATS group had significantly shorter chest drainage duration (median 4 vs. 6 days, p < 0.001) and hospital stay (median 6 vs. 7 days, p < 0.001). Minor complications were more common in the thoracotomy group (p = 0.022), while no significant differences were found in major complications (p = 0.888). Thirty-day, ninety-day, one-year, and in-hospital mortality rates showed no statistically significant differences between groups. Both VATS and thoracotomy are viable surgical options for elderly NSCLC patients, with similar mortality and major morbidity rates. However, VATS provides advantages in terms of reduced chest drainage duration and shorter hospitalization. Surgical approach should be individualized, taking into account patient characteristics and surgical risk.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745135","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
Assessment of PTeye™ versus FLUOBEAM® LX for parathyroid adenomas: a pilot case-control study. 评估PTeye™与FLUOBEAM®LX治疗甲状旁腺瘤:一项试点病例对照研究
IF 2.2 3区 医学
Updates in Surgery Pub Date : 2025-07-29 DOI: 10.1007/s13304-025-02334-7
Theodosios Papavramidis, Angeliki Chorti, Sohail Bakkar
{"title":"Assessment of PTeye™ versus FLUOBEAM® LX for parathyroid adenomas: a pilot case-control study.","authors":"Theodosios Papavramidis, Angeliki Chorti, Sohail Bakkar","doi":"10.1007/s13304-025-02334-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02334-7","url":null,"abstract":"<p><p>Identifying the parathyroids is compulsory for success of parathyroidectomy for parathyroid adenoma. The aim of the present study is to evaluate and compare the efficacy of PTeye™ and FLUOBEAM® LX in identifying parathyroid adenomas. Patients undergoing parathyroidectomy due to a parathyroid adenoma were enrolled prospectively in this study and were randomly included to Group A (PTeye™) or Group B (FLUOBEAM® LX). After intraoperative identification of parathyroid adenomas and before tissue dissection (minute 0), we evaluated the efficacy of both devices in confirming the adenomas. We re-evaluated devices' efficacy in minutes 1, 3 and 5 during tissue dissection and before adenoma excision. All PAs were confirmed and identified with PTeye™, while FLUOBEAM® LX could not identify 3/20 adenomas (15%). PTeye™ confirmed parathyroid tissue in less than 1 min in 13 cases (65%), in < 3 min in 7 (35%), whereas FLUOBEAM® LX identified 4 adenomas in < 3 min (20%), in < 5 min 9 adenomas (60%) and > 5 min in 4 (20%). PTeye™ and FLUOBEAM® LX are both useful tools in confirming parathyroid tissue intraoperatively. PTeye™ confirmed the suspected adenoma earlier before tissue dissection, while FLUOBEAM® LX demands tissue dissection as it identifies the normal parathyroid tissue.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745136","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
Postoperative antibiotic strategies in acute complicated appendicitis: a systematic review. 急性复杂阑尾炎术后抗生素策略:系统回顾。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-25 DOI: 10.1007/s13304-025-02327-6
Hussayn Shinwari, Béatrice Marianne Ewalds-Kvist, Michael El Boghdady
{"title":"Postoperative antibiotic strategies in acute complicated appendicitis: a systematic review.","authors":"Hussayn Shinwari, Béatrice Marianne Ewalds-Kvist, Michael El Boghdady","doi":"10.1007/s13304-025-02327-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02327-6","url":null,"abstract":"<p><p>Acute appendicitis is a common surgical emergency, with complicated cases carrying an increased risk of infections and morbidity. Whilst preoperative antibiotics help reduce infections, the optimal postoperative regimen remains undefined. Variability exists in antibiotic choice, route and duration. This review aimed to examine recent evidence on postoperative antibiotic stewardship for complicated appendicitis to guide optimal treatment strategies. A systematic review was conducted in accordance with PRISMA guidelines and registered in the PROSPERO registry. A search on PubMed and Cochrane library databases identified studies on postoperative antibiotic use in appendicectomy. Two independent reviewers screened studies, including RCTs, cohort studies and observational studies. Data extraction covered study characteristics, interventions and outcomes. Risk of bias was assessed using RoB 2 and ROBINS-I, with GRADE used to evaluate evidence certainty. This review included 11 studies with 8361 participants. Shorter intravenous antibiotic courses (2-6 days) were found to be non-inferior to longer regimens in preventing infections and reducing hospital stays. Risk factors for prolonged antibiotic use included disease severity and surgical complexity. In selected patients, oral antibiotics were shown to be equally effective. Shorter intravenous antibiotic courses and early transition to oral antibiotics effectively managed complicated appendicitis, reducing hospital stays and healthcare costs without increasing complications. Individualised treatment decisions based on patient risk factors and intraoperative findings are essential. Tailoring antibiotic regimens to individual patient characteristics remains crucial. These findings support antibiotic stewardship efforts and highlight the need for further research, particularly in high-risk populations.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708996","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: "Analysis of intra‑ and postoperative interventional endoscopic measures in 3000 bariatric surgical procedures over 15 years: a single center study". 评论:“15年来3000例减肥手术的手术内和术后介入内镜措施分析:单中心研究”。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-23 DOI: 10.1007/s13304-025-02335-6
Qi Xu
{"title":"Comment on: \"Analysis of intra‑ and postoperative interventional endoscopic measures in 3000 bariatric surgical procedures over 15 years: a single center study\".","authors":"Qi Xu","doi":"10.1007/s13304-025-02335-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02335-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699607","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
Bariatric surgery: is an alternative for patients with obesity class III on dialysis, future kidney transplantation candidates? 减肥手术:是III级肥胖患者透析的替代方案,未来的肾移植候选人?
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-22 DOI: 10.1007/s13304-025-02331-w
Silvana Lapi Cruz, Gustavo Bruno Mato, Gustavo Rodriguez Temesio
{"title":"Bariatric surgery: is an alternative for patients with obesity class III on dialysis, future kidney transplantation candidates?","authors":"Silvana Lapi Cruz, Gustavo Bruno Mato, Gustavo Rodriguez Temesio","doi":"10.1007/s13304-025-02331-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02331-w","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691662","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
Comments on "Folic acid deficiency as a modifiable risk factor for anastomotic leak in patients undergoing colorectal cancer surgery". 对“叶酸缺乏是结直肠癌手术患者吻合口瘘的可改变危险因素”的评论。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-21 DOI: 10.1007/s13304-025-02336-5
Eda Karapelit Agitoglu, Beliz Bahar Karaoglan, Kadriye Bir Yucel
{"title":"Comments on \"Folic acid deficiency as a modifiable risk factor for anastomotic leak in patients undergoing colorectal cancer surgery\".","authors":"Eda Karapelit Agitoglu, Beliz Bahar Karaoglan, Kadriye Bir Yucel","doi":"10.1007/s13304-025-02336-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02336-5","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683240","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 complete gastric staple line bioabsorbable reinforcement during laparoscopic sleeve gastrectomy: a propensity score matched analysis. 腹腔镜袖式胃切除术中完全胃钉线生物吸收强化的评估:倾向评分匹配分析。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-21 DOI: 10.1007/s13304-025-02326-7
Panagiotis Lainas, Radwan Kassir, Evangelia Triantafyllou, Carmelisa Dammaro, Maissa Safieddine, Niaz Devaquet, Ibrahim Dagher
{"title":"Evaluation of complete gastric staple line bioabsorbable reinforcement during laparoscopic sleeve gastrectomy: a propensity score matched analysis.","authors":"Panagiotis Lainas, Radwan Kassir, Evangelia Triantafyllou, Carmelisa Dammaro, Maissa Safieddine, Niaz Devaquet, Ibrahim Dagher","doi":"10.1007/s13304-025-02326-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02326-7","url":null,"abstract":"<p><p>Two feared complications of laparoscopic sleeve gastrectomy (LSG) are bleeding and gastric staple line leak. The aim of this study was to evaluate the safety and efficacy of complete gastric staple line bioabsorbable reinforcement to minimize surgical complications in patients undergoing LSG. Data from consecutive patients undergoing LSG were prospectively collected and retrospectively analyzed. Patients were divided into two groups: (i) complete staple line bioabsorbable reinforcement with standardized perioperative arterial hypertension control; ii) absence of reinforcement with standardized perioperative arterial hypertension control. A propensity score adjustment was performed on factors known to influence LSG postoperative complications. Four hundred thirty-nine patients were matched in each group, with similar preoperative data between groups. Mean operative time significantly decreased when reinforcement was used (84 vs. 104 min; p < 0.001). Intraoperative blood loss was similar. Postoperative bleeding was noted in 17 patients (3.9%) in the no-reinforcement group vs. none in the reinforcement group (p < 0.001). Gastric staple line leak decreased in the reinforcement group (1.4% vs 3.4%), without reaching statistical significance (p = 0.07). Reoperation was required for two patients (0.4%) in the reinforcement group vs. 24 patients (5.4%) in the no-reinforcement group (p < 0.001). Mean length of hospital stay significantly decreased in the reinforcement group (p = 0.044). Complete gastric staple line bioabsorbable reinforcement coupled to perioperative arterial hypertension control leads to significant decrease of bleeding, reoperation rate, and length of hospital stay, as well as non-significant reduction of gastric staple line leak rates in patients with severe obesity undergoing LSG.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683241","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 vs laparoscopic resection for hepatocellular carcinoma: multicentric propensity-score matched analysis of surgical and oncologic outcomes in 647 patients. 机器人与腹腔镜肝细胞癌切除术:647例患者手术和肿瘤结果的多中心倾向评分匹配分析
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-20 DOI: 10.1007/s13304-025-02293-z
Stefano Di Sandro, Leonardo Centonze, Francesca Ratti, Nadia Russolillo, Simone Conci, Enrico Gringeri, Francesco Ardito, Marco Colasanti, Carlo Sposito, Riccardo De Carlis, Mario Giuffrida, Pasquale Bonsignore, Matteo Zanello, Samuele Frassoni, Roberta Odorizzi, Vincenzo Bagnardi, Elio Jovine, Salvatore Gruttadauria, Maurizio Iaria, Andrea Lauterio, Vincenzo Mazzaferro, Giuseppe Maria Ettorre, Felice Giuliante, Umberto Cillo, Andrea Ruzzenente, Alessandro Ferrero, Luca Aldrighetti, Fabrizio Di Benedetto
{"title":"Robotic vs laparoscopic resection for hepatocellular carcinoma: multicentric propensity-score matched analysis of surgical and oncologic outcomes in 647 patients.","authors":"Stefano Di Sandro, Leonardo Centonze, Francesca Ratti, Nadia Russolillo, Simone Conci, Enrico Gringeri, Francesco Ardito, Marco Colasanti, Carlo Sposito, Riccardo De Carlis, Mario Giuffrida, Pasquale Bonsignore, Matteo Zanello, Samuele Frassoni, Roberta Odorizzi, Vincenzo Bagnardi, Elio Jovine, Salvatore Gruttadauria, Maurizio Iaria, Andrea Lauterio, Vincenzo Mazzaferro, Giuseppe Maria Ettorre, Felice Giuliante, Umberto Cillo, Andrea Ruzzenente, Alessandro Ferrero, Luca Aldrighetti, Fabrizio Di Benedetto","doi":"10.1007/s13304-025-02293-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02293-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) has been linked to several advantages compared to open approach, but the actual benefit of robotic liver resection (RLR) over LLR in HCC needs further investigation.</p><p><strong>Methods: </strong>We performed a multicentric propensity-score matched (PSM) analysis comparing perioperative and oncologic outcomes of LLR vs. RLR for HCC. The PSM model was estimated using a multivariable logistic regression, with type of surgery as dependent variable and age, BMI, clinically-significant portal hypertension, αFP, size of principal lesion, number of nodules and Kawaguchi difficulty score as covariates. Overall (OS) and recurrence-free (RFS) survivals were estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Six-hundred-forty-seven HCC patients from 12 IGoMILS registry centers treated by LLR (553 patients) or RLR (94 patients) were included. After PSM, RLR resulted in wider surgical margins (median: 10 vs 5 mm; p = 0.002) with higher prevalence of R0 resection (98.9 vs 93.1%; p = 0.037), lower conversion rate (2.1 vs. 8.5%; p = 0.039) and shorter hospital stay (median: 4 vs 5 days; p = 0.025), with no significant difference in postoperative complication rate. We observed similar OS among RLR and LLR cohorts [5-y OS: 68.7 vs 65.0%; univariable HR = 0.95 (95% CI: 0.60-1.49); p = 0.82], with significantly better RFS in RLR cohort [5-y RFS: 46.8 vs 24.0%; univariable HR = 0.71 (95% CI: 0.52-0.98); p = 0.04].</p><p><strong>Conclusions: </strong>Perioperative outcomes were significantly better in the RLR cohort, with a lower conversion rate and shorter hospital stay, although the latter may be influenced by the multi-institutional study design. Notably, we observed wider resection margins in the RLR group, which were associated with significantly improved RFS.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675903","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 perioperative hydrocortisone reduce morbidity after pancreatoduodenectomy? A propensity score matched analysis. 围手术期氢化可的松能降低胰十二指肠切除术后的发病率吗?倾向评分匹配分析。
IF 2.4 3区 医学
Updates in Surgery Pub Date : 2025-07-20 DOI: 10.1007/s13304-025-02280-4
O Radulova-Mauersberger, F Oehme, N Mibelli, C Teske, G Krause-Jüttler, J Weitz, M Distler, S Hempel
{"title":"Does perioperative hydrocortisone reduce morbidity after pancreatoduodenectomy? A propensity score matched analysis.","authors":"O Radulova-Mauersberger, F Oehme, N Mibelli, C Teske, G Krause-Jüttler, J Weitz, M Distler, S Hempel","doi":"10.1007/s13304-025-02280-4","DOIUrl":"https://doi.org/10.1007/s13304-025-02280-4","url":null,"abstract":"<p><p>The use of steroids in pancreatic surgery may reduce complications through the anti-inflammatory potential. We aimed to evaluate the impact of hydrocortisone (HC) on postoperative morbidity after pancreatoduodenectomy (PD). The data were retrospectively extracted from a prospective clinical database. Complicatons after PD with 100 mg HC intravenously (i.v.) for 48 h and a corresponding propensity score-matched cohort without HC were evaluated by using logistic regression analyses. We analyzed 691 patients who underwent PD over a period of ten years. After propensity score matching, 220 patients (110 patients in each group) remained. Postoperative complications were comparable in both groups (p = 0.56). Major complications (CDC ≥ 3) did not differ significantly, n = 44 (40%) for non-HC n = 45 (40.9%) and HC group (p = 0.89). There was no difference (p = 0.88) in the POPF incidence, non-HC, n = 31 (28.2%) and HC group, n = 30 (27.3%). After stratifying for fistula risk score (FRS), results remained equal and no difference was observed in CDC ≥ 3 in the low (p = 1), intermediate (p = 0.82) and high-risk (p = 0.74) group. HC has been suggested to be effective in reducing postoperative morbidity, but the evidence is controversial. The benefit of HC in reducing postoperative complications after pancreatoduodenectomy cannot be supported in the present study.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668609","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
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