Updates in Surgery最新文献

{"title":"Risk factors of cervical lymph node metastasis and distant metastasis in patients with primary squamous cell carcinoma of the thyroid: a population-based study.","authors":"Xunyi Lin, Jun Li, Jianwu Yin, Ming Li","doi":"10.1007/s13304-025-02143-y","DOIUrl":"10.1007/s13304-025-02143-y","url":null,"abstract":"<p><p>To analyze the risk factors associated with the occurrence of cervical lymph node metastasis (LNM) and distant metastasis (DM) in patients with primary squamous cell carcinoma of the thyroid (PSCCT). Clinical data of 96 patients with PSCCT from SEER database were obtained and analyzed by logistic regression for clinicopathological characteristics, including age, marital status, race, gender, tumor size (mm), extrathyroidal extension (ETE), multifocality, T stage, M stage and other indicators. Differences were considered statistically significant when P < 0.05. (1) Analysis of risk factors for the occurrence of cervical lymph node metastasis in patients with PSCCT: The results of univariate analysis showed that compared with patients without lymph node metastasis, patients with metastasis had a higher percentage of patients with the age ≥ 70 years old, tumor sizes greater than 40 mm, extrathyroidal extension, multifocal tumors, T4 stage and distant metastasis, the difference was statistically significant (P < 0.05). The results of multivariate analysis showed that multifocality and M stage were independent risk factors for the occurrence of LNM in PSCCT patients (P < 0.05). (2) Analysis of risk factors for the occurrence of distant metastasis in PSCCT patients: The results of univariate analysis showed that the percentage of patients who developed distant metastasis with age ≥ 70 years old, tumor size > 40 mm, T4 stage, and lymph node metastasis was higher than that of those who did not develop distant metastasis, and the difference was statistically significant (P < 0.05). The results of multivariate logistic regression analysis showed that cervical lymph node metastasis was an independent risk factor for the occurrence of distant metastasis in PSCCT patients (P < 0.05). (3) Relevant clinicopathologic features have not been found to be statistically significant with lung and bone metastasis, with P values greater than 0.05. Multifocality and M stage are independent risk factors for LNM in PSCCT patients, and cervical lymph node metastasis is an independent risk factor for distant metastasis in PSCCT patients. The findings of this study may provide guidance for individualized treatment plans for PSCCT patients.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"401-410"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543618","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":"Long-term durability and temporal pattern of revisional surgery of laparoscopic large hiatal hernia repair.","authors":"Elettra Ugliono, Fabrizio Rebecchi, Caterina Franco, Mario Morino","doi":"10.1007/s13304-025-02070-y","DOIUrl":"10.1007/s13304-025-02070-y","url":null,"abstract":"<p><p>Laparoscopic repair is the preferred surgical treatment for symptomatic Large Hiatal Hernia (LHH). However, data on long-term outcomes are limited. This study aims to evaluate the 20-year follow-up results of laparoscopic LHH repair in a high-volume experienced tertiary center. Retrospective analysis of patients who underwent elective laparoscopic LHH repair between 1992 and 2008. Preoperative and perioperative data were collected. The primary endpoint was the long-term reoperation rate. Survival analyses were calculated according to the Kaplan-Meier method and compared with the log-rank test. A Cox proportional hazard model was used to investigate predictive factors of the need for revisional surgery. A total of 176 patients were included. All the procedures were performed laparoscopically, and in 5 cases (3.0%) with a robot-assisted approach. Mesh-augmented cruroplasty was performed in 26 patients (15.8%). A fundoplication was added in all patients: Nissen in 158 (89.8%), Toupet in 5 (2.8%), and Collis-Nissen in 13 (7.4%). Postoperative mean follow-up was 224.6 ± 83.3 months. Clinically significant hiatal hernia recurrence occurred in 27 (16.2%), and 18 patients (10.2%) underwent surgical revision. The median time-to-redo was 12 months (IQR 6-42 months). Overall durability without revisional surgery at 20-year follow-up was 90%. The rate of revisional surgery after LHH repair is low and is generally required within 12 months from primary surgery. Our results highlight the long-lasting effects of LHH repair at 20-year follow-up.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"419-425"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024924","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":"A modified totally stapled KONO-S anastomosis for ileal and ileo-colic Crohn's disease: technical aspects and case series.","authors":"Xiujun Liao, Michele Cricrì, Yang Tang, Pan Sun, Massimo Mongardini, Ludovico Docimo, Salvatore Tolone, Federico Maria Mongardini","doi":"10.1007/s13304-025-02122-3","DOIUrl":"10.1007/s13304-025-02122-3","url":null,"abstract":"<p><p>Crohn's disease (CD) is a chronic immune-mediated disorder affecting the gastrointestinal tract. While medical therapies have advanced, approximately 80% of CD patients will require surgery due to disease recurrence. A significant debate exists regarding the primary site of post-operative recurrence. This discrepancy in recurrence patterns underscores the complexity of CD management and the ongoing need for tailored surgical approaches. It has been recently demonstrated that the Kono-S anastomosis is safe and efficient in reducing endoscopic and surgical recurrence. Newer versions of the Kono-S anastomosis using staplers have been reported to further simplify the procedure and decrease operative time. The aim of this paper was to describe a distinct version of a totally stapled Kono-S anastomosis and provide preliminary results from our center. The technical procedure of a totally stapled Kono-S anastomosis is illustrated. A consecutive series of patients undergoing ileal or ileo-colic resection followed by totally stapled Kono-S anastomosis was identified from a prospectively collated database. Data included patient demographics and baseline characteristics, intraoperative details, short- and long-term post-operative outcomes. Between January and November 2023, 41 patients (mean age 36.4 years, 61% males) underwent ileal or ileo-colic resection followed by totally stapled Kono-S anastomosis for Crohn's disease. Mean operative time was 150.76 ± 43.22 min, and mean time of anastomotic construction was 19.71 ± 4.24. Time to flatus and stool were 2.73 ± 0.70 and 3.51 ± 1.16 days, respectively, and the length of post-operative stay was 6.80 ± 2.13 days. Only two patients (4.8%) presented complications following surgery, namely anastomotic bleeding. At a mean follow-up of 17.0 ± 2.1 months, no patient needed re-do surgery for disease recurrence at anastomotic site. The endoscopic recurrence rate was 14.4% (4/28). Our fully stapled version of the Kono-S anastomosis is safe and feasible, and short construction time and low technical complexity may help its diffusion among colorectal surgeons. Long-term outcomes on disease recurrence are still to be defined.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"355-361"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075663","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":"Transmanubrial osteomuscular sparing approach: different indications for non-pulmonary malignancies.","authors":"Leonardo Duranti, Luca Tavecchio","doi":"10.1007/s13304-024-02027-7","DOIUrl":"10.1007/s13304-024-02027-7","url":null,"abstract":"<p><p>The transmanubrial osteomuscular sparing approach (TMA) is recommended for surgeries involving or originating from the thoracic outlet structures. We present a series of consecutive patients treated from 2014 to 2024 who underwent oncological thoracic outlet surgery for primary or metastatic (non-pulmonary) malignancies. Overall, 33 patients were included. Our procedures resulted in no mortality, seven complications (21.2%) and all surgeries achieved radical (R0) status. In the hands of experienced professionals, the TMA approach proves to be safe and conservative, enabling radical surgery for tumors of the thoracic outlet. For low-grade tumors, it avoids the need for additional combined surgical access, while for high-grade tumors, it allows for more extensive en bloc resection.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"541-547"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508883","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":"Propensity-score matched outcomes of minimally invasive and open pelvic exenteration in locally advanced rectal cancer.","authors":"Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Ebram Salama, Steven D Wexner","doi":"10.1007/s13304-025-02102-7","DOIUrl":"10.1007/s13304-025-02102-7","url":null,"abstract":"<p><p>Pelvic exenteration (PE) entails an en bloc resection of locally advanced primary or recurrent rectal cancer. This study aimed to assess the short-term and survival outcomes of minimally invasive (MI)- and open PE. A retrospective cohort analysis of patients with stage III rectal adenocarcinoma treated with PE from the National Cancer Database (2010-2019) was conducted. Open and MI-PE were matched for baseline and treatment characteristics using 2:1 propensity score matching. Primary outcomes were 30- and 90-day mortality; secondary outcomes included 30-day readmission, hospital stay, surgical margins, lymph node yield, and overall survival (OS). PE was performed in 1010 (1.9%) of 52,242 patients; 705 (69.8%) were open and 304 were (30.2%) MI procedures. After matching, 169 patients in the MI-PE group were matched to 338 patients in the open PE group. The matched cohort included 507 patients (54.2% female). Hospital stay was shorter after MI compared to open PE (median: 6 vs. 8 days, p < 0.001). MI and open PE had similar odds of 30- (OR: 0.33, p = 0.306) and 90-day mortality (OR: 0.29, p = 0.113), and comparable rates of positive surgical margins (12.7% vs. 15%, p = 0.586) and suboptimal lymph node yield (19% vs. 26%, p = 0.096). MI-PE had a similar OS to open surgery (82.5 vs. 77.5 months, p = 0.281). Robotic-assisted PE was associated with significantly lower odds of conversion to open surgery (OR: 0.15, p = 0.003) and shorter hospital stay (median: 5 vs. 7 days, p = 0.026) than laparoscopic PE. MI-PE provided similar pathologic and survival outcomes to open PE with comparable short-term mortality rates and significantly shorter hospital stays.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"267-276"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012415","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":"Single-incision versus conventional laparoscopic appendectomy in adults: a systematic review and meta-analysis of randomized controlled trials.","authors":"Konstantinos Kossenas, Riad Kouzeiha, Olga Moutzouri, Filippos Georgopoulos","doi":"10.1007/s13304-025-02112-5","DOIUrl":"10.1007/s13304-025-02112-5","url":null,"abstract":"<p><p>Three-port (trocar) laparoscopic appendectomy is the standard treatment for acute appendicitis and previous studies have compared to single-incision approach, however, they often include both pediatric and adult patients and fail to account for surgeons' experience, leading to variability in outcomes. This systematic review and meta-analysis aims to address these literature gaps by focusing on adult patients and controlling for surgeon expertise. We conducted a comprehensive search of randomized controlled trials comparing single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) up to November 2024. We assessed the length of hospitalization, operative duration, postoperative complications, and surgical wound infections. Data were synthesized using random-effects models to account for variability among studies. The meta-analysis included four studies with a total of 408 patients, comprising 202 in the single-incision laparoscopic appendectomy (SILA) group and 206 in the conventional laparoscopic appendectomy (CLA) group. For the length of hospitalization, no statistically significant difference was observed, with a weighted mean difference (WMD) of 0.07 days (95% CI  - 0.32 to 0.47, I² = 0%, p = 0.72). Similarly, the operative duration showed no significant difference, with a WMD of 4.49 min (95% CI  - 7.02 to 16.00, I² = 89%, p = 0.44). The analysis of postoperative complications also revealed no significant difference between the groups, with an odds ratio (OR) of 1.32 (95% CI 0.69 to 2.51, I² = 0%, p = 0.40). Surgical wound infections were found to be comparable, with an OR of 1.14 (95% CI 0.46 to 2.83, I² = 0%, p = 0.78). Sensitivity analysis indicated that the results were statistically significant regarding operative duration when Kim et al. was excluded from the analysis. SILA and CLA yield comparable outcomes in terms of hospitalization length, operative duration, and complications, suggesting that both techniques are viable options for the management of acute appendicitis in adults. Further studies investigating overall cosmesis, patient satisfaction, and postoperative pain are warranted to optimize surgical approaches.PROSPERO registration: CRD42024612596.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"287-296"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190756","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":"Comparison of different surgical techniques and anastomosis methods in short-term outcomes of right colon cancer: a network meta-analysis of open surgery, laparoscopic, and robot-assisted techniques with extracorporeal and intracorporeal anastomosis.","authors":"Baobong Liao, Xueyi Xue, Hao Zeng, Wen Ye, Tingjiang Xie, Xiaojie Wang, Shuangming Lin","doi":"10.1007/s13304-025-02096-2","DOIUrl":"10.1007/s13304-025-02096-2","url":null,"abstract":"<p><p>With the rapid development of minimally invasive surgical techniques, there remains considerable controversy regarding the choice of surgical approach and anastomosis method for patients with right-sded colon cancer (RSCC). This meta-analysis compared the short-term outcomes of open right colectomies (ORC), laparoscopic right colectomies with intracorporeal and extracorporeal anastomosis (LRC-IA and LRC-EA), as well as robot right colectomies with intracorporeal and extracorporeal anastomosis (RRC-IA and RRC-EA). A systematic search was conducted across PubMed (n = 549), Web of Science (n = 821), Embase (n = 591), and the Cochrane Central Register (n = 86) from January 2000 to August 2024. Studies comparing at least two of the surgical techniques for RSCC were included. The primary outcomes evaluated were overall complications, wound infection, ileus, and reoperation rates. Secondary outcomes included operative time, blood loss, hospital stay, time to resume diet, and conversion rates. A Bayesian network meta-analysis was performed. A total of 39 studies comprising 6098 patients were included. The results indicated that LRC-IA had the lowest overall complication rate (OR 0.65; 95% CI [0.41, 1.07]), while ORC had the highest. RRC-IA was most effective in reducing wound infection (OR 0.77; 95% CI [0.39, 1.35]), blood loss (MD 18.01; 95% CI [4.62, 40.87]), and hospital stay (MD 0.93; 95% CI [0.67, 1.31]), while also demonstrating advantages in preventing postoperative ileus (OR 0.47; 95% CI [0.05, 1.31]) and ensuring faster bowel function recovery (OR 0.80; 95% CI [0.44, 1.53]). The analysis demonstrates that for patients with RSCC, RRC shows better short-term outcomes compared to LRC and ORC, while IA also surpasses EA.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"309-325"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068149","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 prospective observational study of laparoscopic approaches for suspected gallbladder cancer in Yamaguchi (YPB-002 LAGBY).","authors":"Yukio Tokumitsu, Toru Kawaoka, Satoshi Matsukuma, Eijiro Harada, Shigeyuki Suenaga, Masahiro Tanabe, Hidenori Takahashi, Yoshitaro Shindo, Hiroto Matsui, Masao Nakajima, Tatsuya Ioka, Taro Takami, Katsuyoshi Ito, Hidekazu Tanaka, Kimikazu Hamano, Hiroaki Nagano","doi":"10.1007/s13304-025-02119-y","DOIUrl":"10.1007/s13304-025-02119-y","url":null,"abstract":"<p><p>We have previously reported laparoscopic total biopsy methods for suspected gallbladder cancer (GBC). The present prospective observational study evaluated the safety and feasibility of a novel two-stage algorithm using laparoscopic total biopsy methods. The two-stage algorithm was applied for 40 patients with suspected GBC between July 2018 and September 2022. Laparoscopic whole-layer cholecystectomy (LWLC) was performed for early-stage or suspected malignant lesions without liver invasion and laparoscopic gallbladder bed resection (LGBR) was performed for lesions with an unclear border between the gallbladder and liver. The appropriate strategy could be selected postoperatively depending on the final pathological diagnosis according to examination of permanent sections of gallbladder. If preoperative imaging reveals enlarged lymph nodes (LNs) with possible metastases, LN sampling with intraoperative pathological diagnosis is performed prior to gallbladder removal to determine whether to introduce neoadjuvant chemotherapy. As the first diagnostic procedure, we performed LWLC in 30 cases, LGBR in 8 cases, and LN sampling alone in 2 cases. Median operation time was 165 min and median blood loss was 5.5 ml. No bile leakage caused by intraoperative perforation of the gallbladder was observed. Histologically, GBC was diagnosed in 16 cases (pTis, n = 2; pT1a, n = 2; pT1b, n = 2; pT2, n = 6; pT3, n = 4). Seven of the 10 pT2/3 cases underwent additional open lymphadenectomy. The two-stage algorithm using laparoscopic total biopsy methods for suspected GBC appears to represent a safe, feasible procedure that could play an important role in the optimal treatment strategy.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"435-445"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484118","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":"Pancreas-guided C-shaped surgical procedure: a safer and more efficient procedure for laparoscopic left hemicolectomy in obese patients.","authors":"Huaqi Zhang, Sen Wang, Zhensheng Chen, Tedong Luo, Jinpeng Cao, Zhicheng Li, Yong Ji","doi":"10.1007/s13304-025-02071-x","DOIUrl":"10.1007/s13304-025-02071-x","url":null,"abstract":"<p><p>The surgical risk is higher for obese patients undergoing laparoscopic left hemicolectomy. To enhance the surgical safety and efficacy for obese patients, we have innovatively integrated the advantages of various surgical approaches to modify a pancreas-guided C-shaped surgical procedure. The safety and quality were assessed through a retrospective analysis. Colon cancer patients who underwent laparoscopic left hemicolectomy were categorized into two groups, C-shaped group and Medial-to-lateral group. Baseline data, operative safety indices, operative quality indices and learning curve were subjected to statistical analysis. The complete mesocolic excision rate and R0 resection rate were 100% in both groups. In terms of surgical safety, C-shaped group experienced significantly less blood loss (50(20) mL vs. 50(50) mL, p = 0.002), shorter total operative time (252.65 ± 50.43 min vs. 280.12 ± 70.45 min, p = 0.004) and no organ damage occurred. All patients were classified into four BMI grades (I: BMI < 18.5 kg/m²; II: 18.5 ≤ BMI < 24 kg/m²; III: 24 ≤ BMI < 28 kg/m²; IV: BMI ≥ 28 kg/m²). The total operative time and estimated blood loss were significantly lower in obese patients (BMI grade III and IV) of C-shaped group. In addition, intra-group analysis further confirmed that this modified surgical technique could effectively enhance safety and efficiency for obese patients. Learning curve analysis revealed a significant reduction in total operative time after the completion of 20 surgeries. Utilization of the pancreas-guided C-shaped surgical procedure in obese patients ensures reliable surgical outcomes and significantly increases safety and efficiency. In addition, it is easier to learn and master.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"343-353"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012409","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":"Comment to: Immediate repair of the recurrent laryngeal nerve during thyroid surgery via a tension-free end-to-side anastomosis with the Vagus.","authors":"Mehmet Eşref Ulutaş","doi":"10.1007/s13304-025-02132-1","DOIUrl":"10.1007/s13304-025-02132-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"367-368"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410465","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}