Updates in Surgery最新文献

{"title":"Dual-center development and validation of an immunoinflammatory-based preoperative model for predicting postoperative cachexia in colorectal cancer.","authors":"Jiakui Liang, Chenkai Zhang, Fanyu Zhao, Daorong Wang","doi":"10.1007/s13304-025-02494-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02494-6","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":"147366746","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":"Enhanced recovery after surgery (ERAS) protocols in esophagectomy: a comprehensive review of current practices.","authors":"Diamantis I Tsilimigras, Mahdi Neshan, Dimitrios Papaconstantinou, Dimitrios Schizas","doi":"10.1007/s13304-026-02571-4","DOIUrl":"https://doi.org/10.1007/s13304-026-02571-4","url":null,"abstract":"<p><p>The ERAS (Enhanced Recovery After Surgery) protocols are multimodal perioperative pathways that accelerate patient recovery. Despite the widespread adoption of ERAS protocols in a variety of surgical subspecialties (i.e. colorectal, bariatric, orthopedic surgery), their use in esophageal surgery is still debated. Although still not universally accepted, an increasing number of institutions are adopting the ERAS protocols for esophagectomy. In this review, we sought to provide a comprehensive summary of the components of ERAS protocols following esophagectomy, encompassing preoperative, intraoperative, and postoperative phases. Furthermore, we sought to examine variations in the most recent ERAS guidelines and identify gaps that future researchers need to address to achieve consensus on universally accepted ERAS guidelines.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356663","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":"Tumor biology versus nodal stage in predicting survival after resection of pulmonary atypical carcinoids.","authors":"Luca Bertolaccini, Lavinia Benini, Francesca Spada, Eleonora Pisa, Renato Lobrano, Giovanni Caffarena, Matteo Chiari, Juliana Guarize, Nicola Fusco, Lorenzo Spaggiari, Nicola Fazio","doi":"10.1007/s13304-026-02578-x","DOIUrl":"https://doi.org/10.1007/s13304-026-02578-x","url":null,"abstract":"<p><p>Pulmonary atypical carcinoid (AC) demonstrates a variable prognosis influenced by both tumor biology and anatomic staging. It remains unclear whether histopathologic markers such as mitotic count, necrosis, and Ki-67 more effectively predict overall survival (OS) than nodal involvement (pN). This study aims to determine whether OS after surgical resection of pulmonary AC is more strongly associated with pathologic markers or with nodal involvement, by directly comparing their prognostic performance within a single institutional cohort. We retrospectively analyzed 111 patients with resected AC and complete OS data, comparing prognostic performance between a biologic model (mitoses > 2 per 2 mm², necrosis present, Ki-67 > 10%), an anatomic model (pN > 0), and a combined model. Survival curves were estimated by Kaplan-Meier analysis. Model discrimination was evaluated using Harrell's C-index; nested models were compared via likelihood-ratio testing. Restricted mean survival time (RMST) at 60 months was used to quantify absolute survival differences by category. Median follow-up was 88 months (IQR 46-136 months). Proportions of high-risk features were: mitoses > 2 mm², 66%; necrosis, 31%; Ki-67 > 10%, 42%; nodal involvement, 36%. The biologic model achieved a higher C-index (0.748) than the anatomic model (0.559), and the combined model showed minimal incremental gain (C-index = 0.755, p = 0.97 vs. biologic model). Only 11 deaths occurred during follow-up, which limits the precision of effect estimates. RMST analysis showed that the presence of necrosis was associated with the largest absolute difference in 60-month survival, followed by high mitotic count, elevated Ki-67, and nodal involvement. Histopathologic indicators of tumor biology, particularly necrosis and mitotic activity, were more strongly associated with OS than nodal stage. These findings support the potential value of pathology-anchored prognostic stratification in AC. Validation in larger multicenter cohorts is required before implications for clinical decision-making can be fully defined. These results may help refine postoperative counselling and surveillance strategies if prospectively confirmed.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327119","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":"Outcomes of damage control surgery in perforated sigmoid diverticulitis: a comparison before and after implementing a new treatment algorithm.","authors":"Marie Burgard, François Pugin, Michel Adamina, Floryn Cherbanyk","doi":"10.1007/s13304-026-02572-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02572-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310632","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":"Role of virtual reality exposure before elective day care surgery to reduce patient's distress.","authors":"Ludovico Docimo, Claudio Gambardella, Maddalena Paolicelli, Giusiana Nesta, Francesca Fisone, Salvatore Tolone, Roberto Ruggiero, Francesco Saverio Lucido, Giovanni Conzo, Giovanni Cozzolino, Salvatore Gerbino, Francesco Caputo, Antimo Cardillicchio, Simona Parisi","doi":"10.1007/s13304-025-02463-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02463-z","url":null,"abstract":"<p><p>Preoperative anxiety is a common condition that can negatively impact patient compliance, pain tolerance, and anesthesia management. Traditional pharmacological treatments include sedatives and anxiolytics, but these can cause adverse effects, such as respiratory issues. Non-pharmacological approaches like cognitive-behavioral therapy (CBT), aromatherapy, and music therapy have also been explored but they require pathways of variable duration that may delay surgery. Virtual reality (VR) is emerging as a promising alternative, allowing patients to engage in immersive experiences that distract them from anxiety-inducing stimuli. A prospective randomized controlled trial was conducted to assess the impact of VR on preoperative anxiety and postoperative pain in patients undergoing elective surgery. A total of 355 patients were randomized into two groups: Group A received entertainment videos via VR headset during the preoperative phase, while Group B received standard care. The primary outcome was the change in STAI (State-Trait Anxiety Inventory) scores at baseline, preoperatively, and postoperatively. Secondary outcomes included pain assessment using the Visual Analog Scale (VAS). Results showed no significant difference in baseline anxiety scores between the two groups. However, both preoperative and postoperative STAI scores were significantly lower in the VR group (p = 0.001 and 0.005, respectively). Additionally, 12 h post-surgery, patients in the VR group reported significantly lower pain scores (3.6 ± 1.3 vs. 5.6 ± 1.6, p = 0.001). No significant differences in pain scores were observed at 24 and 48 h post-surgery. VR could represent a useful aid in the management of preoperative anxiety.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310660","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":"Need for outcome-linked data to strengthen real-world evidence in parathyroid surgery: commentary on SIUEC survey.","authors":"Ajwa Rabail, Muhammad Zahir Shah, Aisha Rasheed Tahir","doi":"10.1007/s13304-026-02543-8","DOIUrl":"https://doi.org/10.1007/s13304-026-02543-8","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310663","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":"Minimally invasive total pharyngo-laryngo-esophagectomy as a salvage procedure, technical notes and outcomes from a multidisciplinary team approach.","authors":"Andrea Pansa, Mattia Di Benedetto, Lorenzo Giorgi, Elena Russo, Francesca Gaino, Rita Alfieri, Silvia Basato, Giovanni Maria Garbarino, Giuseppe Mauro Spriano, Giuseppe Mercante, Carlo Castoro","doi":"10.1007/s13304-026-02558-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02558-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310602","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":"Composition and influencing factors of hospitalization costs in adult patients undergoing incisional hernia repair surgery.","authors":"Xiaoli Liu, Qiuyue Ma, Chen Liang, Yingmo Shen","doi":"10.1007/s13304-026-02570-5","DOIUrl":"https://doi.org/10.1007/s13304-026-02570-5","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310641","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":"Consensus statement on obesity management in liver transplantation candidates.","authors":"David Pacheco Sánchez, Carmen Vinaixa Aunés, Amador Garcia Ruiz de Gordejuela, Cándido Alcázar López, Rosa Álvarez Seoane, Javier Briceño Delgado, David Calatayud Mizrahi, Benjamín Díaz-Zorita Aguilar, Roberto Fernández Santiago, Yiliam Fundora Suárez, Álvaro García Sesma, Carmen García Bernardo, Miguel Angel Gómez Bravo, Concepción Gómez Gavara, Xavier González Argentés, Diego López Guerra, Adolfo López Buenadicha, José Luis Lucena de la Poza, Mónica Mogollón González, Esther Molina Pérez, Custodia Montiel Casado, Javier Padilla Quintana, Pilar Palacios Gasós, Pilar Pinto Fuentes, Pablo Ramírez Romero, Fernando Rotellar Sastre, Lluis Secanella Medayo, Alberto Ventoso Castiñeira, Laura Lladó","doi":"10.1007/s13304-025-02473-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02473-x","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310607","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 \"Identification of clinical and pathological risk factors for lymphnode metastasis in T1 stage colon cancer: a population-based study\".","authors":"Ahmet Necati Sanli, Deniz Esin Tekcan Sanli","doi":"10.1007/s13304-026-02541-w","DOIUrl":"https://doi.org/10.1007/s13304-026-02541-w","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285292","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}