Updates in Surgery最新文献

{"title":"Comparative study of the Karydakis flap versus conventional surgical techniques for pilonidal sinus disease: a systematic review and meta-analysis.","authors":"Alaa Hussain Alwan Alsalaumy","doi":"10.1007/s13304-026-02585-y","DOIUrl":"10.1007/s13304-026-02585-y","url":null,"abstract":"<p><p>The ideal surgical treatment for pilonidal sinus disease (PSD) is controversial. The Karydakis flap (KF) was compared with midline closure (MC) and excision with healing by secondary intention (EHSI). A systematic review and meta-analysis of randomised and comparative cohort studies (through February 2025) was performed. The primary outcomes included recurrence and infection, whereas secondary outcomes were seroma, operative time, hospital stay, overall complications, and return to work. The effect sizes were identified using odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI), using random-effects models. Fifteen studies (n = 3,108) were identified for inclusion (KF = 1,257, MC = 1,593, EHSI = 258). KF was associated with a significant reduction in recurrence compared to MC (OR 0.30, 95% CI 0.16-0.59; p < 0.001; I² = 34%) and EHSI (OR 0.29, 95% CI 0.12-0.71; p = 0.006; I² = 11%). KF had fewer infections than EHSI (OR 0.06, 95% CI 0.007-0.486; p = 0.008) and returned to work earlier compared with MC (MD - 6.5 days) and EHSI (MD - 18.9 days). Hospital stay did not differ between KF and MC (MD - 0.08 days). KF provides lower recurrence and faster recovery compared with MC and EHSI, supporting its use as the preferred surgical technique for PSD.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487373","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":"Improved outcomes of fluorescence-guided laparoscopic lymph node biopsy vs. conventional laparoscopic technique in lymphoma diagnosis.","authors":"Marco Casaccia, Franco De Cian, Adalberto Ibatici, Chiara Ghiggi, Marco Mora, Gregorio Santori","doi":"10.1007/s13304-026-02582-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02582-1","url":null,"abstract":"<p><p>This study compared the clinical outcomes and diagnostic accuracy of Fluorescence-guided laparoscopic lymph node biopsy (FGLLB) with conventional laparoscopic lymph node biopsy (LLB) at a single institution. We compared 42 patients who underwent FGLLB between April 2022 and September 2025 with a historical group of 55 LLB patients. The main outcomes measured were surgical time, blood loss, surgical conversion rates, hospital stay, and morbidity. Diagnostic accuracy was the secondary outcome. Surgical conversion occurred in one FGLLB patient (2.3%) and two LLB patients (3.6%) due to surgical difficulties. Surgical time was shorter in the FGLLB group (67.5 ± 33.7 min) compared to the LLB group (83 ± 22.2 min), though this difference was not statistically significant (p = 0.093). The average hospital stay was also shorter for FGLLB patients (1.6 days) compared to LLB patients (2.2 days), a difference that nearly reached statistical significance (p = 0.073). Minor postoperative complications were observed in two FGLLB patients and one LLB patient (4.7% vs 1.8%, p = 0.411). The biopsy provided the necessary diagnostic information in 97.6% of FGLLB cases and 96.3% of LLB cases. FGLLB showed good procedural and postoperative outcomes and a high diagnostic yield, comparable to traditional LLB. FGLLB was associated with shorter surgical times and hospital stays. The fluorescence guidance makes dissection more precise and safer by targeting a visible structure, which helps avoid unnecessary dissection and may contribute to the reduced surgical duration. More research is needed to confirm the reliability of this technique before it is widely adopted.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481703","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":"Parathyroid autotransplantation during thyroidectomy among the European Society of Endocrine Surgeons: we still do not agree.","authors":"Muharrem Oner, Maite de Miguel-Palacio, Eduardo Luque-Villalobos, Juan J Sancho-Insenser, Leyre Lorente-Poch","doi":"10.1007/s13304-025-02510-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02510-9","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475389","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":"Effect of enhanced recovery after surgery protocols on mortality and morbidity after trauma and non-trauma emergency laparotomies: a systematic review and meta-analysis.","authors":"Ahmad Al-Sarireh, Hashim Al-Sarireh, Shahin Hajibandeh, Shahab Hajibandeh","doi":"10.1007/s13304-026-02590-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02590-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475393","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":"Safety of non-absorbable tack fixation in laparoscopic ventral rectopexy for external and high-grade internal rectal prolapse: early outcomes from a single-centre cohort.","authors":"Annalisa Coppola, Francesco Palmieri, Claudio Missaglia, Luca Manfrino, Gianpiero Gravante, Sofia Teresa Cozzolino, Gaetano Gallo, Pierpaolo Sileri","doi":"10.1007/s13304-026-02594-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02594-x","url":null,"abstract":"<p><p>The optimal method for mesh fixation during laparoscopic ventral rectopexy (LVR) remains debated, particularly regarding its impact on postoperative chronic pelvic pain and infectious complications. This study aimed to evaluate the safety and early outcomes of non-absorbable helical tack fixation in patients undergoing LVR for external rectal prolapse or high-grade internal prolapse Particular attention was paid to the identification and preservation of key neurovascular structures, including the right hypogastric nerve, L5-S1 intervertebral disc, and first sacral nerve. Mesh fixation over the sacral promontory was performed using three 5-mm non-absorbable helical tacks. Perioperative outcomes and postoperative pain recorded at 30 days, and 3 months were reported. Eighty-seven women underwent LVR between June 2023 and February 2025 (mean age 59.2 ± 12.8 years; BMI 23.5 ± 3.4 kg/m²), 38 with additional sacrocolpopexy (SC). Operative time was 116 min (range: 60-190). No intraoperative conversion occurred and one port-site bleeding was the only intraoperative complication observed. Hospital stay was 2 days (range 2-6); the early postoperative course was uneventful in all patients. At 30 days, 8 (9.2%) patients reported mild pain, and 5 (5.2%) moderate pain. At 3 months, 4 patients (4.6%) reported mild pain. No cases of chronic neuropathic pelvic pain, spondylodiscitis, or tack-related complications were observed. No differences were present among LVR and LVR plus SC for all parameters investigated. In this single-centre cohort, non-absorbable helical tack fixation during LVR was associated with favourable early postoperative outcomes and a low incidence of pain and complications when meticulous surgical technique was applied. However, in the absence of a comparator group, these findings should be interpreted as descriptive and limited to early postoperative safety. Prospective studies with long-term follow-up and a control group are warranted to confirm these findings and further optimize patient-centered outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469200","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":"Manifesto of the collaborative alliance for research and educationin surgery: the CARES network. \"Surgical research must become amilestone of progress in patient care in Italy\".","authors":"Chiara Gerardi","doi":"10.1007/s13304-026-02569-y","DOIUrl":"https://doi.org/10.1007/s13304-026-02569-y","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469250","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 \"Anticipating surgical complexity in laparoscopic cholecystectomy: a clinical score based on inflammatory markers\".","authors":"Jiayi Yu, Yingzhe Zhang","doi":"10.1007/s13304-026-02608-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02608-8","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469232","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":"The emerging landscape of artificial intelligence in robot-assisted surgery: a bibliometric and visualization analysis.","authors":"Jing Wang, Xianfa Zhang","doi":"10.1007/s13304-026-02575-0","DOIUrl":"https://doi.org/10.1007/s13304-026-02575-0","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460389","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":"CT imaging is a feasible method for the preoperative prediction of the main pathologic response after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma.","authors":"Hang Zhou, Wen-Wei Wei, Jun-Peng Lin, Peng-Qiang Gao, Hao He, Shuo-Yan Liu, Feng Wang","doi":"10.1007/s13304-026-02559-0","DOIUrl":"https://doi.org/10.1007/s13304-026-02559-0","url":null,"abstract":"<p><p>The purpose of this study was to explore the feasibility of predicting the main pathologic response (MPR) after neoadjuvant therapy (NAT) for locally advanced esophageal squamous cell carcinoma (LAESCC) using computed tomography (CT) imaging. From January 2022 to December 2023, a retrospective study was conducted on 150 patients who underwent neoadjuvant therapy and radical resection of R0 esophageal cancer in our hospital. Before and after neoadjuvant therapy, the tumour volume (TV) was manually delineated using an enhanced CT image background processor combined with MIMINICS reconstruction software, and the tumour volume regression rate (TVRR) was calculated. Binary logistic regression was used to analyse the factors influencing the postoperative pathological MPR using univariate and multivariate analyses. Determine the predictive value of TVRR through the receiver operating characteristic curve. The mean baseline tumor volume regression ratio was 42.8% (± 22.0). Multivariate analysis revealed that the neoadjuvant therapy mode, tumour volume after neoadjuvant therapy (TV after NAT) and TVRR were independent factors affecting the postoperative pathological MPR. According to the receiver operating characteristic (ROC) analysis, the TVRR showed good predictive value for the postoperative pathological MPR (AUC = 0.828, sensitivity = 85.7%, specificity = 71.2%, p < 0.001), and the cut-off value determined by the Youden index was 42.61%. Subgroup analysis indicated that TVRR had good predictive efficacy for postoperative pathological MPR in different neoadjuvant treatment modes and various tumour locations in the thoracic segment. The TVRR before and after neoadjuvant therapy for esophageal squamous cell carcinoma is an independent factor influencing the postoperative pathological MPR and has good predictive efficacy.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460434","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":"Single-port robotic total colectomy: technical standardisation and ergonomic considerations of suprapubic versus periumbilical access.","authors":"Teresa Pagano, Massimiliano Di Marzo, Fabio Carbone, Paolo Delrio","doi":"10.1007/s13304-026-02586-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02586-x","url":null,"abstract":"<p><strong>Background: </strong>Single-port (SP) robotic platforms represent an evolution of minimally invasive colorectal surgery, enabling complex multi-quadrant procedures through a single incision. Evidence on SP robotic total colectomy (TC) remains limited, and technical standardisation is lacking. We describe a standardised SP robotic TC technique and report the technical/ergonomic considerations for two access configurations: suprapubic and periumbilical.</p><p><strong>Methods: </strong>Three consecutive patients with Familial Adenomatous Polyposis underwent SP robotic TC with ileorectal anastomosis at a high-volume colorectal centre. Suprapubic access was used in one case, and periumbilical access in two. Operative steps, quadrant sequence, vascular approach, ergonomics and anastomotic strategy were systematically documented. Operative and short-term postoperative outcomes were analysed. A detailed surgical video accompanies the manuscript.</p><p><strong>Results: </strong>All procedures were completed robotically without conversion. Median operative time was 240 min, and median estimated blood loss was 50 ml. No intraoperative or 30-day postoperative complications occurred. The suprapubic access facilitated a bottom-up right colectomy but limited direct visualisation of left-sided central vessels, requiring a lateral-to-medial approach. Conversely, the periumbilical access provided a more central operative view, facilitating medial-to-lateral dissection of the left mesocolon and enabling a fully intracorporeal anastomosis.</p><p><strong>Conclusions: </strong>SP robotic TC is feasible and safe in selected patients when performed by experienced colorectal robotic surgeons. Access configuration may influence exposure and dissection strategy, particularly for central vascular control and anastomotic planning. Standardised operative steps and awareness of platform-specific technical considerations may enhance reproducibility and support broader adoption of SP robotic TC.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435936","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}