Minerva Surgery最新文献

{"title":"Clinicopathologic characteristics and surgical outcomes of remnant gastric cancer: a comparative study of minimally invasive approaches.","authors":"Nasser Alrashidi","doi":"10.23736/S2724-5691.26.11078-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11078-8","url":null,"abstract":"<p><strong>Background: </strong>Remnant gastric cancer (RGC), a malignancy arising in the gastric stump after partial gastrectomy, presents unique diagnostic and surgical challenges. The aim of the study is to recognize the clinicopathologic characteristics of the florescent (FL) and non-FL groups in RGC patients.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinicopathologic characteristics and surgical outcomes of 68 patients with RGC from 2014 to 2024 who underwent curative resection, comparing two distinct minimally invasive surgical approaches: the FL group (N.=31) and the non-FL group (N.=37). Baseline demographics, prior gastrectomy history, and tumor characteristics were comparable between the two cohorts.</p><p><strong>Results: </strong>The only statistically significant difference observed was in the operation method, with the FL group showing a significantly higher proportion of robotic-assisted surgery (61.3% vs. 24.3%, P=0.002). Although the FL group had a longer mean operation time (275.0 vs. 251.7 minutes, P=0.163), it demonstrated favorable trends toward lower estimated blood loss (100 vs. 120 mL, P=0.098) and shorter hospital stay (6 vs. 7 days, P=0.089). Postoperative complication rates and mortality were similar and acceptable in both groups.</p><p><strong>Conclusions: </strong>These findings suggest that while the FL approach, characterized by a higher utilization of robotic technology, is associated with a longer operative duration, it may offer marginal benefits in perioperative metrics for the complex surgery of RGC, underscoring the feasibility and safety of advanced minimally invasive techniques in this challenging patient population.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating adjuvant therapy as standard multimodal treatment for patients with esophageal cancer after neoadjuvant therapy.","authors":"Subin Lee, Andrew Conner, Feredun Azari, Monisha Sudarshan, Sudish Murthy, Siva Raja","doi":"10.23736/S2724-5691.26.11079-X","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11079-X","url":null,"abstract":"<p><p>Recent developments in the treatment paradigm for esophageal cancer have brought major changes in our approach to caring for patients with this disease. Now, both neoadjuvant and adjuvant therapies have become integral components of the multimodal standard treatment delivered to these patients. While there has been a substantial body of evidence in the neoadjuvant realm, progress for adjuvant therapy has been slower. This review aims to provide a comprehensive summary of the current recommendations and newest evolutions in adjuvant treatment following neoadjuvant therapy for patients with esophageal and gastroesophageal cancers. A review of phase II-III randomized controlled trials on the use of adjuvant therapy has been performed. The latest clinical guidelines were examined to identify the evidence-based recommendations on the role of adjuvant therapy after neoadjuvant and surgical treatment for locally advanced esophageal and gastroesophageal cancers. The CheckMate 577 and MATTERHORN are landmark trials that established immunotherapy as standard adjuvant treatment for patients with resectable esophageal and gastroesophageal cancers who had previously received neoadjuvant therapy. In keeping with these advances, there have been ongoing developments to discover other immunotherapy and targeted treatment options to decrease recurrence and improve survival for these patients. Determining the optimal regimen and duration of treatment, as well as finding the appropriate patient selection for adjuvant therapy remains an active area of research. Adjuvant therapy offers patients with resectable esophageal and gastroesophageal cancers a chance for longer disease-free survival. The additions of PD-1/PD-L1 inhibitors have been instrumental in improving outcomes for patients with residual disease despite neoadjuvant therapy. Further work is needed to refine the current treatment regimens and incorporate novel systemic and immunotherapeutic options into our treatment armamentarium.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine during carotid endarterectomy: a registry on safety and satisfaction of patients and operators (DexTEA).","authors":"Diego Fiume, Elisa DE Carolis, Michele Arciuolo, Giulia Liciani, Silvia Carlini, Roberto Polidoro, Paola Picerno, Pasquale Avella, Stefano Bartoli, Mario Peverini, Massimo Galletti","doi":"10.23736/S2724-5691.25.11007-1","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.11007-1","url":null,"abstract":"<p><strong>Background: </strong>From an anesthesiologic perspective, carotid endarterectomy (CEA) is an operation that is increasingly being performed with locoregional techniques and sedation. The aim of this observational study was to compare dexmedetomidine with midazolam and fentanyl during CEA in terms of perioperative adverse events, patient, anesthetist, and surgeon satisfaction, as well as the possible reduction in clamping time and the number of times additional local anesthesia is needed.</p><p><strong>Methods: </strong>Sixty patients listed for CEA were enrolled and two types of sedation were used, both protocols widely used in our hospital, resulting in the formation of two groups of patients. Both the intermediate and superficial cervical plexus blocks were administered, and the patients in Group 1 were sedated with midazolam and fentanyl, and Group 2 was sedated with dexmedetomidine. We examined comorbidities, surgical time and clamping, and possible intraoperative use of local anesthetics and intraprocedural complications, and follow-up at 180 days to observe any residual deficits. The data were analyzed with SPSS Statistics 25 (IBM).</p><p><strong>Results: </strong>Patients, anesthetists and surgeons levelled off on a high level of satisfaction (scores 3 and 4). Clamping and operation times were similar between the two groups and within the ranges described in the literature.</p><p><strong>Conclusions: </strong>There were no significant differences between the two groups regarding perioperative adverse events or decreased clamping or intervention times. Only surgeons and anesthetists were clearly aligned towards a satisfaction score of 4 with dexmedetomidine, although patients did not seem to experience any differences between the two sedations under study.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Basal cell adenoma and pleomorphic adenoma of the parotid gland: a single center experience\".","authors":"Jiayi Chen","doi":"10.23736/S2724-5691.26.11090-9","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11090-9","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of early cardiac rehabilitation nursing on cardiac function and quality of life in patients after emergency PCI.","authors":"Lin Zhang, Chunrong Ma, Guoyong Zhang","doi":"10.23736/S2724-5691.24.10525-4","DOIUrl":"10.23736/S2724-5691.24.10525-4","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"76-79"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of ultrafine percutaneous nephrolithotripsy on renal and ureteral calculi and its effect on stone clearance rate and postoperative complication rate.","authors":"Huanshuang Qiu, Junbin Zheng, Xiaomin Chen, Jinjie Zhang, Ce Dong, Hao Zheng, Mengling Ying","doi":"10.23736/S2724-5691.24.10268-7","DOIUrl":"10.23736/S2724-5691.24.10268-7","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"70-73"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effect of warm acupuncture at Jiaji point combined with lumbar back muscle training on lumbar disc herniation.","authors":"Xiaoming Wang, Jinzhong Wang, Xijun Hu","doi":"10.23736/S2724-5691.24.10229-8","DOIUrl":"10.23736/S2724-5691.24.10229-8","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"66-68"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ligasure versus voyant hemorrhoidectomy: comparison of 30-day postoperative complications.","authors":"Fabio Marino, Rossella Donghia","doi":"10.23736/S2724-5691.26.11077-6","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11077-6","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency (RF) hemorrhoidectomy features shorter operating times, less intraoperative bleeding, less postoperative pain, and a quicker return to work compared to conventional hemorrhoidectomy. Numerous RF devices are available at varying costs. The purpose of our study was to compare the 30-day postoperative outcomes of LigaSure hemorrhoidectomy versus Voyant hemorrhoidectomy for grade III and IV hemorrhoids in terms of bleeding, urinary retention, and anal stenosis.</p><p><strong>Methods: </strong>A prospective observational study was conducted from May 2017 to March 2023. Patients with concomitant anal disorders and patients who had undergone previous anal surgery were excluded from the study. Patient data collected during hospitalization and subsequent 30-day follow-up were entered into an electronic database. Data was analysed using Stata version 18 (StataCorp LLC, TX, USA).</p><p><strong>Results: </strong>In total, 123 patients were enrolled (61 in group A and 62 in group B). Patient demographics and clinical characteristics (age, gender, ASA score, hemorrhoid grade) and the number of resected piles were similar in the two groups. There were three cases of hemorrhage in group A (one requiring blood transfusion and reoperation) and four cases in group B (one requiring blood transfusion). In each group, two cases of anal (sub)stenosis occurred, all resolved with self mechanical anal dilatation. There were two cases of urinary retention in group A and one case in group B. No statistical differences were observed between the two groups in terms of postoperative bleeding, urinary retention, and anal stenosis.</p><p><strong>Conclusions: </strong>The LigaSure and Voyant devices show comparable results in terms of postoperative complications in the treatment of grade III and IV hemorrhoids. However, the Voyant device is much less expensive.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 1","pages":"32-37"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nursing-driven enhanced recovery after surgery protocol improves postoperative outcomes in hip surgery: a prospective cohort study.","authors":"Wei Guo, Yuan Chen","doi":"10.23736/S2724-5691.25.11055-1","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.11055-1","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) programs improve outcomes after major orthopedic procedures, but the specific contribution of nursing-led implementation has not been well defined. This study evaluated the impact of a nursing-driven ERAS protocol on recovery outcomes in patients undergoing hip surgery.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in a tertiary academic center. Patients managed under a structured nursing-coordinated ERAS pathway (N.=36) were compared with historical controls receiving conventional perioperative care (N.=34). The cohort included total hip arthroplasty, hemiarthroplasty, and internal fixation procedures. The ERAS protocol emphasized nurse-led preoperative education, multimodal analgesia, early mobilization, nutritional optimization, and standardized postoperative monitoring. Primary outcomes were hospital length of stay (LOS) and postoperative complications. Secondary outcomes included pain scores, opioid consumption, early functional recovery, discharge disposition, and patient satisfaction.</p><p><strong>Results: </strong>Baseline characteristics and distribution of surgical procedures were comparable between groups. The ERAS cohort experienced a significantly shorter LOS (median 7 vs. 9 days; P<0.01) and fewer postoperative complications, with the control group exhibiting approximately triple the complication rate. ERAS patients reported lower pain scores and nearly 50% less opioid use postoperatively. Early mobilization within 24 hours was achieved in 89% of ERAS patients versus 50% of controls (P<0.01). More ERAS patients were discharged directly home, and satisfaction scores were higher (94% vs. 76%; P=0.04).</p><p><strong>Conclusions: </strong>A nursing-driven ERAS protocol significantly enhanced postoperative recovery across a heterogeneous hip surgery population. Nurse-led coordination and adherence monitoring were central to improved outcomes. These findings support broader adoption of nursing-centered ERAS pathways to optimize surgical recovery.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 1","pages":"22-31"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the environmental impact of breast cancer surgery: a pilot study on sustainable practices in the operating room.","authors":"Rebecca Allievi, Silvia Vicini, Chiara Bassetti, Marco Gipponi, Raquel Diaz, Letizia Cuniolo, Chiara Cornacchia, Federica Murelli, Francesca Depaoli, Cecilia Margarino, Chiara Boccardo, Marianna Pesce, Simonetta Franchelli, Maila Castellano, Marina Alloisio, Piero Fregatti","doi":"10.23736/S2724-5691.25.11034-4","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.11034-4","url":null,"abstract":"<p><strong>Background: </strong>The environmental impact of climate change is unequivocal, and surgical practice, given its substantial carbon footprint, must also move toward sustainability. The primary aim of the study is to assess the environmental impact of surgical practice in breast cancer treatment and to identify interventions that can effectively reduce it. The secondary aim was to explore the feasibility and preliminary clinical performance of indocyanine green (ICG) compared with technetium-99m (99mTc) for sentinel lymph node mapping, within the context of a pilot project on sustainable surgical practices.</p><p><strong>Methods: </strong>At the Breast Surgery Clinic of Polyclinic San Martino IRCCS Hospital in Genoa, a prospective study was conducted from September 2024 to May 2025 to assess the effectiveness of a series of environmentally sustainable measures within the operating room. Thirty-four women diagnosed with HR-positive/HER2-negative, T1-T2, cN0 invasive breast cancer underwent quadrantectomy and sentinel lymph node biopsy (SLNB). Seventeen patients were treated using a conventional high-impact surgical protocol, while the remaining 17 were treated with a green protocol based on the \"5R rule\" (Reduce, Reuse, Recycle, Rethink, Research). Key strategies included the use of ICG for SLNB, local anesthesia with intravenous sedation, waste minimization, and the adoption of reusable surgical gowns, drapes, and instruments, along with the segregation of non-infectious plastic waste.</p><p><strong>Results: </strong>Sentinel lymph node identification was achieved in 100% of patients in the 99mTc group and in 94.1% of patients in the ICG group. The green approach was operationally feasible and associated with preliminary indicators of reduced environmental burden, although a full quantitative analysis was beyond the scope of this pilot study. Patients avoided preoperative hospitalization, radiotracer administration, and, importantly, 58.8% were discharged the same day.</p><p><strong>Conclusions: </strong>Considering the pressing climate crisis, these findings highlight the feasibility and necessity of adopting sustainable practices in surgical oncology to mitigate greenhouse gas emissions while maintaining high-quality patient care.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 1","pages":"13-21"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}