Updates in Surgery最新文献

{"title":"Comparative analysis of early outcomes in laparoscopic and open surgery for chronic pancreatitis: a retrospective study.","authors":"Saket Kumar, Ashish Kumar Sharma, Lakshit Tomar, Salman Ahmad, Sanjay Kumar, Manish Mandal","doi":"10.1007/s13304-026-02589-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02589-8","url":null,"abstract":"","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":"147435987","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 and cost-effectiveness of day surgery in Da Vinci-assisted pulmonary segmentectomy.","authors":"Weifang Cui, Zhuiqiu Zhou, Yuanda Cheng, Yanwu Zhou, Liqing Lu, Xin Li, Jun Zeng, Chunfang Zhang","doi":"10.1007/s13304-026-02587-w","DOIUrl":"https://doi.org/10.1007/s13304-026-02587-w","url":null,"abstract":"","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":"147435998","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":"Pure single-port robotic Roux-en-Y gastric bypass in a patient with metabolic syndrome: first worldwide report.","authors":"Siqi Wang, Biao Zhou, Zenghui Li, Hua Meng","doi":"10.1007/s13304-026-02584-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02584-z","url":null,"abstract":"","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":"147436007","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":"A journey from marginality to routine and beyond: single center experience with DCD utilization for liver transplantation in Italy.","authors":"Guido Fallani, Alberto Stocco, Giorgia Radi, Enrico Prosperi, Antonio Siniscalchi, Maria Cristina Morelli, Matteo Cescon, Matteo Ravaioli","doi":"10.1007/s13304-026-02581-2","DOIUrl":"https://doi.org/10.1007/s13304-026-02581-2","url":null,"abstract":"<p><p>Donation after cardiovascular determination of death (DCD) has expanded the liver donor pool but remains limited by concerns over prolonged donor warm ischemia and inferior outcomes, particularly in countries such as Italy where legally mandated asystolic periods increase donor risk. This study evaluates trends in DCD liver transplantation at a high-volume Italian center, to assess whether accumulated experience and advanced reconditioning strategies influenced outcomes over time. We retrospectively analyzed adult DCD liver transplants performed between 2016 and 2023. Donor characteristics, recipient risk profiles, perfusion strategies, ischemia times, and post-transplant outcomes were compared between an early (2016-2021) and a late (2022-2023) period. Temporal trends were evaluated using linear regression. Seventy-five DCD liver transplants were included. Later-period recipients had more advanced liver disease (39.1% vs. 17.2% Child-Pugh C, p = 0.045) and higher P-SOFT and LTRS risk scores. Moreover, later-period donors were older (median 72 vs. 62 years, p = 0.022), and exhibited higher DRI and ET-DRI scores. Concurrently, HOPE duration increased, and total ischemia time decreased linearly with program maturation. Despite the progressive rise in donor and recipient risk, rates of early allograft dysfunction, biliary complications, retransplantations, and graft and patient survival remained unchanged between periods. In a high-risk regulatory setting, DCD liver transplantation outcomes remained stable despite increasing donor and recipient complexity. Program maturation, ischemia minimization, and prolonged hypothermic oxygenated perfusion appear to effectively mitigate DCD-associated risk, supporting broader and safer utilization of DCD liver grafts even in challenging clinical environments.</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":"147435884","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":"Duct to duct biliary reconstruction during major hepatectomy with limited resection of the biliary confluence.","authors":"Nasser Abdul Halim, Marta Merayo Alvarez, Nicolas Golse, Gabriella Pittau, Oriana Ciacio, Daniel Azoulay, Antonio Sa Cunha, Daniel Cherqui","doi":"10.1007/s13304-026-02588-9","DOIUrl":"https://doi.org/10.1007/s13304-026-02588-9","url":null,"abstract":"<p><p>In major hepatectomies, biliary reconstruction may be necessary due to oncological reasons or intraoperative events. Duct-to-duct biliary reconstruction (DDBR) may be an alternative to the classical Roux-en-Y bilioenteric (RYBE) anastomosis in well selected cases. This study aims to evaluate the outcomes of DDBR in our institution. Between 2014 and 2023, 14 patients underwent major hepato-biliary resection with subsequent DDBR. Ten were planned preoperatively and classified as intentional and 4 were dictated by intraoperative events and classified as non-intentional. Bile leak occurred in a single patient (7%), requiring reoperation for biliary peritonitis. Five patients (36%) developed intra-abdominal collections, including three abscesses and two bilomas that required percutaneous drainage. During these procedures, routine cholangiography was performed through the trans-anastomotic drain placed at the initial surgery. In all five patients, no anastomotic leakage was demonstrated, indicating that the collections originated from the transection margin of the liver rather than the anastomosis. Clinically relevant anastomotic stricture occurred in four patients (28.5%): three (75%) were successfully managed endoscopically, while one (25%) required conversion to RYBE. An additional patient was diagnosed with a stricture on follow-up imaging without biochemical or clinical consequences and was managed conservatively. DDBR, when performed under optimal conditions, yields satisfactory functional outcomes and long-term results. The ability to manage complications effectively further supports DDBR as a viable reconstructive technique in major hepatectomy in well selected cases.</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":"147436010","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":"Pre-stoma closure anastomotic leakage severity: Could it explain why late closure increases LARS risk?","authors":"Yongliang Li, Shenjia Kong","doi":"10.1007/s13304-026-02560-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02560-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390904","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":"Prognostic drivers beyond anatomy: towards tailored surgical management in descending necrotizing mediastinitis.","authors":"Lubiao Liang, Lin Yuan, Yang Tang, Anping Chen, Cheng Chen, Yongxiang Song, Gang Xu","doi":"10.1007/s13304-026-02592-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02592-z","url":null,"abstract":"<p><p>The management of descending necrotizing mediastinitis (DNM) is challenging due to diagnostic delays and a lack of consensus on optimal therapeutic. While the Endo classification describes anatomical extent, its link to patient outcomes remains unclear. This study aimed to evaluate the prognostic utility of the Endo classification and identify key factors predictive 90-day mortality and prolonged hospitalization. We performed a retrospective, single-center cohort study spanning 2015-2025 that included 52 consecutive patients with descending necrotizing mediastinitis who were managed surgically. Demographic characteristics, clinical features, Endo classification, operative approaches, and postoperative outcomes were systematically evaluated. Univariable regression and correlation analyses were applied to determine factors associated with 90-day mortality and length of postoperative hospital stay. The cohort (median age 54 years, 65.4% male) had an 11.5% 90-day mortality rate. The Endo classification guided surgical approach but was not significantly associated with mortality or hospital stay. Instead, preoperative hypoalbuminemia (odds ratio (OR) 1.29 per 1 g/L decrease, p = 0.032), postoperative white blood cell count (OR 1.40 per × 10⁹ decrease, p = 0.046) and odontogenic of infection (OR 0.122, p = 0.026) were significant risk factors for mortality. A shorter symptom-to-diagnosis interval (r = - 0.386, p = 0.008) and the presence of empyema (median stay 34.5 vs. 25.5 days, p = 0.020) were independently associated with a longer postoperative hospital stay. In lower mediastinitis (Types IIA-C), a thoracic approach was associated with a lower incidence of the composite outcome (reoperation/death) compared to a transcervical approach (9.1% vs. 33.3%), though this difference was not statistically significant (p = 0.227). In DNM, physiological reserve and disease tempo are more powerful prognostic indicators than anatomical extent alone. A fulminant presentation and nutritional status are key prognostic indicators. These findings support a management paradigm that integrates early physiological optimization with tailored surgical intervention and postoperative care based on disease extent.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366696","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":"Global research trends on endoscopic bariatric surgery: bibliometric analysis over past 2 decades.","authors":"Linjing Li, Kun Zhou, Hang Yin, Rongrong Bi, Lei Wang","doi":"10.1007/s13304-026-02591-0","DOIUrl":"https://doi.org/10.1007/s13304-026-02591-0","url":null,"abstract":"<p><p>Endoscopic bariatric surgery (EBS) has rapidly evolved as a minimally invasive and effective intervention for obesity. This study conducts a comprehensive bibliometric analysis to map the global landscape, influential contributors, and emerging research directions in the field of EBS. Publications on EBS from 2007 to 2025 were retrieved from the Web of Science Core Collection and analyzed using VOSviewer, CiteSpace, and R (bibliometrix package). Analyses included keyword clustering, temporal stratification by procedure type and study design, and mapping of international collaborations. A total of 999 publications from 45 countries were identified. The USA led in both publication volume and citations. Key institutions included Harvard Medical School, Mayo Clinic, and Brigham and Women's Hospital. Obesity Surgery was the most prolific and influential journal, followed by Surgery for Obesity and Related Diseases and Surgical Endoscopy. Eight major research clusters were identified, covering comprehensive clinical approaches, pathogenesis and risk assessment, complications management, biliary/procedural complications, procedural outcomes, and technical innovations. Recent years have seen a marked increase in randomized controlled trials and international collaborations. Citation burst analysis revealed a shift from foundational and procedural topics to current hotspots including advanced endoscopic techniques, metabolic effects, complication prevention, and evidence-based guidelines. This bibliometric analysis provides a comprehensive, up-to-date overview of global EBS research. It highlights evolving research priorities and collaboration patterns, offering actionable insights to guide future studies and optimize clinical strategies in the management of obesity.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366743","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":"MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer-a retrospective multi-center study analysis.","authors":"Theodossis Papavramidis, Angeliki Chorti, Sohail Bakkar, Marco Raffaelli, Andro Košec, Van Trung Hoang, James Y Lim, Volkan Genc, Michele N Minuto, Pietro Giorgio Calò, Andrzej Hellmann, Giacomo Di Filippo, Lampros Karakozis, Alexandra Chrisoulidou, Viyey Kishore Doulatram Gamgaram, Chutintorn Sriphrapradang, Jean-Christophe Leclère, Aida Orois, Demarchi Marco, Muthuswamy Dhiwakar, Loredana de Pasquale, Antoine Buemi, Cédric Nesti, Rumen Pandev, Andres Chala, Selen Soylu Yalıman, Jiannis Hajiioannou, Shirley Yuk-Wah Liu, Sergii Cherenko, Nikolaos Voloudakis, Ioannis Koutelidakis, Konstantinos Nastos, Ramacciotti Constanza, Chiara Dobrinja, Maximilian Brunner, Lovenish Bains, Ramakanth Bhargav Panchangam, Fábio Muradás Girardi, Akif Enes Arikan, Hadj Omar El Malki, Michael de Cillia, Luigi Oragano, Ioannis Pliakos, Moysis Moysidis, Francesco Pennestrì, Carmela De Crea, Mateo Čukman, Andro Tarle, Olga S Senashova, Maisie L Shindo, İlgiz Tüzken, Mustafa Anil Turhan, Emanuela Varaldo, Manuela Albertelli, Fabio Medas, Gian Luigi Canu, Federico Cappellacci, Maciej Śledziński, Giovanni Lazzari, Eleonora Morelli, Stavros Karakozis, Maria Boudina, Michael Katsamakas, Marta Iturregui Guevara, Rangsima Aroonroch, Martí Manyalich, Oscar Vidal, Frederic Triponez, Nathalie Masse, Lokesh Kathirvel, Rajeshwari Muthusamy, Paula La Rubia, Luca Castellani, Burlacu Maria-Cristina, Furnica Raluca-Maria, Reto Kaderli, Serkan Teksoz, Tom Chi-Man Chow, Man Sze Lai, Liuchiia Shchekaturova, Evangelia Bellou, Maria Banus, Roxana Da Milano, Manuela Mastronardi, Robert Grützmann, Luiz Alberto Hauth, Aliende Lengler Abentroth, Onur Dulgeroglu, Cihan Uras, Giuseppe Placentino, Monica Leutner","doi":"10.1007/s13304-025-02513-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02513-6","url":null,"abstract":"<p><p>Medullary thyroid carcinoma (MTC) is a rare, but biologically aggressive cancer that accounts for 1-2% of all thyroid malignancies. Its aggressiveness has been linked to distinct clinicopathological features. Novel pathological predictors of aggressiveness have also been described in the literature. However, these remain contentious, to date. To assess the prognosticators of aggressiveness for MTC and establish potentially novel ones. The primary endpoint was to establish predictors for central and/or lateral cervical nodal metastatic disease. Whereas secondary endpoints include defining biochemical and histopathologic markers of aggressiveness. A multi-center retrospective analysis of prognosticators of aggressiveness in MTC. 785 patients with MTC were enrolled. The mean age was 56 years with a female to male ratio of 1: 1.7. Regression analysis demonstrated that aggressive prognosticator predictive of nodal metastasis included: age, pre- and post-operative Calcitonin and CEA levels, tumor size, multifocality, capsular and lymphovascular invasion, the presence of extrathyroidal extension, Ki-67, and RET positivity, desmoplasia, and inflammatory scores. This study provides an expanded spectrum of prognosticators of tumor aggressiveness. Furthermore, it also highlights the potential meaningful therapeutic implications of preoperative inflammatory scores, tumor desmoplastic reaction, and metastatic nodal ratio.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366704","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 \"Outcomes of carinal sleeve resection versus primary suturing in post‑pneumonectomy bronchopleural fistula\".","authors":"Yuan Yao, Yang Yang","doi":"10.1007/s13304-026-02540-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02540-x","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366751","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}