Updates in Surgery最新文献

{"title":"Rigid-platform transanal excision (TEM/TEO/TAMIS) for rectal neuroendocrine tumours: a single-centre TEM/TEO series and systematic review.","authors":"Alberto Arezzo, Carlo Alberto Ammirati, Giovanni Distefano, Michele Barbiero, Mario Morino","doi":"10.1007/s13304-026-02621-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02621-x","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":"147609922","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":"Critical appraisal and temporal validation of the Niguarda scoring model: a CT-based diagnostic score for detecting hollow viscus and mesenteric injury in blunt abdominal trauma.","authors":"Michele Altomare, Stefano Granieri, Ilaria Milanesi, Giuliano Bottaro, Maria Eugenia Di Sabato, Alessandro Bonomi, Gaia Ghilardi, Carlotta Casale, Stefano Piero Bernardo Cioffi, Andrea Spota, Shailvi Gupta, Federico Ambrogi, Stefania Cimbanassi","doi":"10.1007/s13304-026-02617-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02617-7","url":null,"abstract":"<p><p>Blunt traumatic hollow viscus and mesenteric injuries (THVMI) are uncommon but carry high morbidity if diagnosis is delayed. The Niguarda Score, based on six predefined computed tomography (CT) findings, was originally developed in 2020 to aid early identification of surgically relevant THVMI. This study aimed to perform a critical appraisal and temporal validation of the score. The data of all adult blunt trauma patients consecutively admitted to our trauma center from 2010 to 2021, who underwent contrast-enhanced CT-scan on admission, were collected and retrospectively analyzed. Patients admitted between 2010 and 2018 represented the cohort used to build the original score, and their data were re-analyzed for a critical appraisal of the Niguarda score. The data of patients admitted from 2019 to 2021 were used for temporal validation in an independent cohort from the same institution. Six CT findings-free intraperitoneal air, free fluid without solid organ injury, gastrointestinal wall alteration, mesenteric alteration, intra-mesenteric fluid, and mesenteric blushing-were scored 0-6, with one point for each present finding. The primary outcome was THVMI requiring surgical repair. Model performance was assessed in the derivation and temporal validation cohorts for discrimination (C-index), calibration slope, and overall accuracy (Brier score). Cut-offs were identified using ROC-based methods. In the derivation cohort, the score achieved AUC 0.925 (95% CI 0.874-0.976), Nagelkerke R² 0.662, and Brier score 0.111, with a calibration slope of ≈1. Internal bootstrap validation yielded optimism-corrected C-index 0.930. Temporal validation demonstrated preserved discrimination (AUC 0.914, 95% CI 0.807-1.000). The optimal cut-off in correspondence of one or more findings present gave a sensitivity of 81.8% and a specificity of 90.0%. After critical re-evaluation of the original tool, a remarkable diagnostic and predictive performance was confirmed for the Niguarda scoring model. The model also showed excellent diagnostic accuracy and calibration in the temporal validation cohort, supporting its utility as a simple and reproducible tool to guide early operative decision-making in blunt THVMI.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595028","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":"Is atypical parathyroid tumor a different clinical entity than parathyroid adenoma and carcinoma? A retrospective review of a large single-center case series.","authors":"C Maconi, A M Saibene, L Castellani, P Lozza, C Pescia, M Falleni, L De Pasquale","doi":"10.1007/s13304-025-02445-1","DOIUrl":"10.1007/s13304-025-02445-1","url":null,"abstract":"<p><p>Primary hyperparathyroidism is primarily caused by single-gland pathology (80-85% of cases). According to the 2022 World Health Organization (WHO) guidelines (Erickson et al. in Endocr Pathol, 2022), single-gland pathologies include parathyroid adenoma, atypical parathyroid tumor and parathyroid carcinoma (Gurrado in J Clin Med 12:6297, 2023). The aim of this study is to identify differences or similarities of both pre-, intra- and post-operative characteristics between atypical parathyroid tumor and parathyroid adenoma/carcinoma, thereby establishing an appropriate follow-up protocol for atypical parathyroid tumor. We retrospectively analyzed 437 patients who underwent parathyroidectomy for primary hyperparathyroidism between 2012 and 2022 at the Thyroid Unit of ASST Santi Paolo e Carlo in Milan focusing our analysis on 352 patients with single-gland disease. Several pre-, intra-, and post-operative variables, including follow-up, were analyzed and compared using non-parametric statistical methods. Histological analysis identified 316 cases of PA (90%), 27 cases of atypical parathyroid tumor (7.7%), and 9 cases of parathyroid carcinoma (2.3%). Patients with atypical parathyroid tumor had significantly higher pre-operative PTH levels, intermediate calcium levels, falling between those of parathyroid adenoma and parathyroid carcinoma patients and larger gland diameter. No cases of disease persistence or recurrence were observed in patients with atypical parathyroid tumor after a mean follow-up of 42.8 months. APT exhibits biochemical and pathological features overlap with both PA and PC. However, the lack of recurrence or persistence suggests that APT behaves more similarly to PA than PC. The favorable evolution of APT in our case series could be a factor in favor of reducing the follow-up time for atypical tumors to a shorter period than the one recommended for carcinomas.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"549-560"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401892","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}

{"title":"Shaping the future of breast surgery training in Italy: insights from a national survey.","authors":"Massimo Ferrucci, Nicola Rocco, Rosa Di Micco, Giuseppe Catanuto, Francesco Milardi, Daniela Terribile, Annalisa Curcio, Secondo Folli, Manuela Roncella, Matteo Ghilli","doi":"10.1007/s13304-026-02595-w","DOIUrl":"https://doi.org/10.1007/s13304-026-02595-w","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521883","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":"Thoracoscopic phase with mini-thoracotomy during laparoscopic Ivor Lewis esophagectomy is associated with a reduced risk of postoperative acute respiratory distress syndrome.","authors":"Caroline Gronnier, Damien Bouriez, Marion Pujos, Picard Flor, Simon Monziols, Catherine Fleureau, Denis Collet","doi":"10.1007/s13304-026-02599-6","DOIUrl":"https://doi.org/10.1007/s13304-026-02599-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521844","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 \"Prophylactic triple neurectomy during open tension-free inguinal hernia repair: a clinical trial for the prevention of chronic postoperative pain\".","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.1007/s13304-026-02609-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02609-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521865","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":"Transanal drainage tube placement in patients with temporary ileostomy after laparoscopic rectal resection for rectal cancer.","authors":"Valeria Fico, Filomena Misuriello, Giuseppe Brisinda","doi":"10.1007/s13304-026-02604-y","DOIUrl":"https://doi.org/10.1007/s13304-026-02604-y","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515042","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":"Negative pressure wound therapy in primary closure surgeries for pilonidal disease: a meta-analysis.","authors":"Marcelo Albuquerque Barbosa Martins, Wellgner Fernandes Oliveira Amador, Rachid Eduardo Noleto da Nobrega Oliveira, João Ricardo Duda, Fernanda Bellotti Formiga","doi":"10.1007/s13304-026-02536-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02536-7","url":null,"abstract":"<p><p>Primary closure with negative pressure wound therapy (NPWT) has been investigated in patients with sacrococcygeal pilonidal sinus to enhance healing and reduce recurrence. To address existing controversies, we conducted a systematic review and meta-analysis comparing primary closure with NPWT versus non-NPWT (control) for treatment of pilonidal disease. PubMed, Embase, and Cochrane Library databases were searched from inception to December 2024 to identify studies comparing NPWT versus control in primary closure surgeries in pilonidal sinus. Statistical analyses were performed using R Software with a random-effects model. Six studies with a total of 479 patients were included, of whom 164 (34.2%) underwent NPWT. NPWT had an association with lower pain score 24 h postoperative (MD - 0.65 points; 95% CI - 0.81 to - 0.50), shorter return time to activities (MD - 2.57 days; 95% CI - 3.74 to - 1.4). However, there was no difference between groups in the time of wound closure (MD - 18.94; 95% CI - 41.68 to 3.80), rate of wound dehiscence (RR 1.03; 95% CI 0.50 to 2.14), hospital length of stay (MD - 3.05; 95% CI - 15.77 to 9.67), infection rates (RR 0.38; 95% CI 0.05 to 2.84), recurrence rates (RR 0.54; 95% CI 0.07 to 4.48), and pain 6 h post-operative, which showed a borderline trend favoring NPWT but did not reach statistical significance (MD - 1.19; 95% CI - 2.38 to 0.01). NPWT appears to shorten time to resume normal activities and pain 24 h postoperatively. Despite these promising results, more randomized clinical trials are needed for greater analysis.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515045","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":"Correction: Aligning perspectives: towards a standardized concept of \"complexity\" in thyroid surgery-an international web-based survey.","authors":"Giacomo Di Filippo, Gian Luigi Canu, Leonardo Rossi, Fabio Medas, Federico Cappellacci, Piermarco Papini, Mattia Cammarata, Eleonora Morelli, Giovanni Lazzari, Dorin Serbusca, Alessandro Pasculli, Francesco Paolo Prete, Giuliana Rachele Puglisi, Alessandro Monaco, Luigi Ragucci, Giovanni Cozzolino, Eleonora Lori, Francesco Pennestrì, Pierpaolo Gallucci, Carmela De Crea, Salvatore Sorrenti, Giovanni Docimo, Mario Testini, Marco Raffaelli, Gabriele Materazzi, Pietro Giorgio Calò","doi":"10.1007/s13304-026-02635-5","DOIUrl":"https://doi.org/10.1007/s13304-026-02635-5","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515023","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":"Designing a national network of pancreas units: the Italian model for high-quality pancreatic cancer care.","authors":"Sergio Alfieri, Giuseppe Quero, Vincenzo Tondolo, Giampaolo Balzano, Antonella Cardone, Giovanni Conzo, Carlo Fabbri, Viviana Ferrari, Luca Frulloni, Salvatore Gruttadauria, Elisabetta Ianelli, Evaristo Maiello, Roberta Menghi, Michele Milella, Michele Reni, Roberto Salvia, Cristiano Spada, Manuela Tamburo De Bella, Ilaria Tarantino, Giampaolo Tortora, Federica Valsecchi, Leonardo Vincenti, Fabio Vistoli, Ugo Boggi","doi":"10.1007/s13304-026-02598-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02598-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515007","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}