Updates in Surgery最新文献

{"title":"Comment on \"Is there a role for minor resections in perihilar cholangiocarcinoma? Single institutional results from a western center\".","authors":"Adem Ozcan","doi":"10.1007/s13304-026-02869-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02869-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064647","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 \"Clinical factors associated with early high-output stoma and 30-day readmission: aretrospective cohort study\".","authors":"Ipshita Dhiman, P Vanaja, V Ambli","doi":"10.1007/s13304-026-02803-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02803-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064625","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":"One-year weight-loss trajectories and associated baseline factors after laparoscopic sleeve gastrectomy: a retrospective cohort study.","authors":"Yaxuan Wang, Rui Zhao, Anming Xu, Cao Li, Chunyan Lu, Jing Liao, Yanling Ma, Yue Wen","doi":"10.1007/s13304-026-02863-9","DOIUrl":"https://doi.org/10.1007/s13304-026-02863-9","url":null,"abstract":"<p><p>This retrospective cohort study evaluated one-year weight-loss trajectories after laparoscopic sleeve gastrectomy and explored baseline factors associated with postoperative outcomes. Adult patients who underwent surgery between January 2021 and June 2024 were identified from an institutional bariatric surgery database. Body weight was assessed at 1, 3, 6, and 12 months after surgery. Generalized linear mixed-effects models were used to characterize longitudinal changes in body weight, body mass index, percentage total weight loss, and percentage excess weight loss, and multivariable linear regression was performed to identify baseline factors associated with percentage total weight loss at 12 months. A total of 489 patients were included, with a mean age of 32.5 ± 9.5 years and a mean body mass index of 36.7 ± 5.6 kg/m². All weight-related indicators showed significant nonlinear trajectories characterized by rapid early change followed by gradual deceleration. At 12 months, mean percentage total weight loss was 30.2%, and 73.6% of patients achieved at least 20% total weight loss. Age, ethnicity, baseline body mass index, and visceral fat area were independently associated with postoperative weight-loss outcomes. These findings support trajectory-based monitoring after sleeve gastrectomy and may help identify patients at risk of suboptimal early weight loss.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064660","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":"Thyroid surgery in children: a single pediatric center experience.","authors":"Giovanni Conzo, Carmine Noviello, Mercedes Romano, Ilaria Cascone, Gaia De Francesco, Giovanni Docimo, Anna Grandone, Alfonso Papparella","doi":"10.1007/s13304-026-02864-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02864-8","url":null,"abstract":"<p><p>The increasing incidence of thyroid disease in children requires appropriate training for pediatric surgeons. The specific characteristics of this age group require a different treatment approach from that used in adults.The authors report their pediatric experience over a 5-year period. For each patient, we analyzed the indication for surgery, type of procedure, postoperative complications, and follow-up, with a mean follow-up of one year. The mean age of the 25 patients treated was 12 years (range, 5-16 years), and the male-to-female ratio was 1:1.27. The most common clinical presentation was asymptomatic neck swelling or an incidental finding of a thyroid nodule, often detected during evaluation for weight loss or follow-up for another condition. All patients with thyroid nodules underwent preoperative fine-needle aspiration, and surgery was indicated in cases of malignancy. Four patients were diagnosed with Graves' disease. Surgical treatment was performed by a pediatric surgeon and a general surgeon. All patients underwent total thyroidectomy, and three underwent lymph node dissection. The mean operative time was 80.7 min (range, 61.0-100.4 min). Histopathological examination of the surgical specimens showed 22 cases of carcinoma (18 papillary and 4 follicular) and 3 cases of autoimmune thyroid disease. The mean hospital stay was 4 days (range, 3-6 days). Transient asymptomatic hypocalcemia was observed in seven patients (28%). Preoperative laryngoscopy identified unilateral vocal cord paralysis in two patients (8%); these abnormalities were present before surgery and were therefore not considered surgical complications. Postoperative radioiodine treatment was administered to three patients. Pediatric endocrinologists conducted postoperative follow-up, including clinical assessment, ultrasound, and laboratory tests. Thyroidectomy in children should be performed in a specialized multidisciplinary pediatric center, with the involvement of an experienced thyroid surgeon when appropriate.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064584","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 \"Spleen volume-to-platelet count ratio correlates with portal pressure and is associated with blood loss in laparoscopic non-anatomical hepatectomy\".","authors":"Jin Liu, Junhua Zhang","doi":"10.1007/s13304-026-02851-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02851-z","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064595","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":"Comparative effectiveness of nasobiliary versus intravenous indocyanine green fluorescence guidance for early laparoscopic cholecystectomy after ERCP: a retrospective cohort study.","authors":"Jionghui Fu, Dake Liu, Yubin Zhang, Shuai Song, Cheng Yu, Jianbin Gu","doi":"10.1007/s13304-026-02841-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02841-1","url":null,"abstract":"<p><p>This study aimed to evaluate whether direct ICG administration through a pre-existing indwelling nasobiliary drain (NBD-ICG) was associated with improved biliary visualization and surgical efficiency compared with IV-ICG and white-light (WL) laparoscopy. This single-center retrospective cohort study included 181 patients undergoing early LC 2-3 days after ERCP, all with an indwelling NBD placed as part of routine post-ERCP care (November 2023-February 2026). Patients received NBD-ICG (n = 47), IV-ICG (n = 53), or white-light laparoscopy (WL, n = 81). Propensity score matching (caliper 0.03) yielded 21, 30, and 45 patients, respectively. The primary outcome was biliary visualization quality, assessed by fluorescence contrast and identification of the common hepatic, cystic, and common bile ducts. Three blinded surgeons independently evaluated subjective image quality, with inter-rater agreement assessed using Fleiss' kappa. Secondary outcomes included operative time, Calot's triangle dissection time, blood loss, and postoperative recovery. All patients underwent laparoscopic cholecystectomy without conversion. After propensity score matching, baseline characteristics were well balanced among the three groups. Compared with IV-ICG, NBD-ICG was associated with higher fluorescence contrast (P = 0.009) and a higher rate of successful biliary visualization (85.71% vs. 60.00%, P = 0.047). Identification rates of the common hepatic, cystic, and common bile ducts were also higher with NBD-ICG (all P < 0.05). Operative time and Calot's triangle dissection time were shorter with NBD-ICG than with both IV-ICG and WL (all pairwise P < 0.05). Postoperative recovery and complications were comparable among the groups (all P > 0.05). For early LC after ERCP, NBD-ICG was associated with improved biliary fluorescence visualization compared with IV-ICG and shorter operative and Calot's triangle dissection times compared with both IV-ICG and white-light laparoscopy. In patients with an NBD already in place as part of routine post-ERCP care, this approach may provide a practical strategy for fluorescence-guided biliary navigation without requiring additional invasive access.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064611","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":"Polidocanol foam sclerotherapy for hemorrhoidal disease in a private outpatient setting: a real-world single-center study combining chart review and WhatsApp-delivered patient-reported outcomes.","authors":"Benedetto Neola, Giovanna Frezza","doi":"10.1007/s13304-026-02866-6","DOIUrl":"https://doi.org/10.1007/s13304-026-02866-6","url":null,"abstract":"<p><strong>Background: </strong>Polidocanol foam sclerotherapy (PFS) is an effective office-based treatment for symptomatic hemorrhoidal disease (HD), but real-world data from private practice and patient-reported outcomes (PROMs) at variable follow-up are scarce.</p><p><strong>Methods: </strong>We retrospectively reviewed all consecutive patients treated with PFS (3% polidocanol, Tessari method) in a single private proctology office (December 2021-May 2026). Indication was primarily symptom-driven rather than based on Goligher grade. Two data sources were combined: session-level chart review and a structured digital questionnaire (Google Forms) delivered through a personalized WhatsApp invitation, exploring symptoms before and after treatment, post-procedural discomfort and satisfaction. Outcomes were also explored by time since the last session.</p><p><strong>Results: </strong>Eighty-four patients underwent 118 sessions (65.5% single). The survey response rate was 65.5% (55/84; median time from last treatment 64 days, range 1-1,438). Among patients symptomatic at baseline, improvement or resolution was reported by 95.8% (46/48) for bleeding, 97.4% (37/38) for heaviness/pain and 86.4% (38/44) for prolapse (composite 121/130, 93.1%). No or mild post-procedural discomfort was reported by 89.0%, overall satisfaction was 94.5%, and no severe discomfort was reported; no major adverse event was reported or documented. Chart review captured in-office follow-up after 38.1% of sessions, with persistence/recurrence in 63.4% of classifiable encounters. Chart and PROM estimates used different units and are not directly comparable; their discrepancy suggests return-to-clinic ascertainment bias.</p><p><strong>Conclusions: </strong>Among respondents, PFS achieved high patient-reported symptom control and satisfaction. A WhatsApp-delivered PROM survey was feasible and may reduce the bias of clinic-return-based follow-up.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064636","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":"ICG fluorescence lymphography in gastric cancer surgery: methodological concerns limiting the strength of current evidence.","authors":"Abdul Raheem Malik, Faham Raza Jaffary","doi":"10.1007/s13304-026-02858-6","DOIUrl":"https://doi.org/10.1007/s13304-026-02858-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031439","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":"Radiofrequency-based stump management and ductal ablation in robotic central pancreatectomy: a technical note and initial experience.","authors":"Andrea Vicinanza, Patricia Sánchez-Velázquez, Fernando Burdio, Benedetto Ielpo","doi":"10.1007/s13304-026-02854-w","DOIUrl":"https://doi.org/10.1007/s13304-026-02854-w","url":null,"abstract":"<p><p>Central pancreatectomy is a parenchyma-sparing procedure for benign or borderline lesions of the pancreatic neck and proximal body but remains associated with high rates of postoperative pancreatic fistula (POPF), largely related to distal remnant management and pancreatico-enteric reconstruction. We describe a novel robotic-assisted technique incorporating radiofrequency (RF)-based stump management combined with endoductal ablation of the main pancreatic duct as a reconstruction-free strategy. This approach is based on our previous preclinical and clinical experience demonstrating that RF-assisted pancreatic transection may improve stump sealing, while ductal ablation induces controlled exocrine atrophy, reducing enzymatic output and potentially mitigating POPF. The technique includes intraoperative ultrasound-guided resection, selective RF application at the transection surface, and intraductal RF ablation using a catheter-based system, without distal pancreatico-enteric anastomosis. Four consecutive patients underwent the procedure. No patient developed POPF or other pancreas-specific complications. This RF-based hybrid strategy represents a biologically driven alternative to conventional reconstruction in central pancreatectomy, with the potential to reduce morbidity while preserving pancreatic parenchyma. These preliminary findings should be regarded as a proof of technical feasibility rather than as evidence of clinical efficacy in reducing POPF, and require validation in larger prospective studies.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026095","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":"Catecholamine-induced hypertensive crisis during laparoscopic adrenalectomy for pheochromocytoma.","authors":"Syeda Rukhsar Fatima, Sassi Ashraf Ali Abbasi, Gauhar Sultan","doi":"10.1007/s13304-026-02848-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02848-8","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026048","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}