Minerva Surgery最新文献

{"title":"Noninvasive subharmonic-aided pressure estimation for surgical management of portal hypertension: a clinical study in TIPS patients.","authors":"Ziyin Zhu, Si Liang, Linxue Qian","doi":"10.23736/S2724-5691.25.10917-9","DOIUrl":"10.23736/S2724-5691.25.10917-9","url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension (PH) is a critical condition often managed through surgical interventions such as transjugular intrahepatic portosystemic shunt (TIPS). Conventional portal pressure monitoring relies on invasive measurements, necessitating alternative approaches. Subharmonic-aided pressure estimation (SHAPE) technology offers a noninvasive method utilizing contrast-enhanced ultrasound, potentially reducing procedural risks. This study evaluated the clinical utility of SHAPE in assessing portal hypertension and monitoring hemodynamic changes pre- and post-TIPS placement.</p><p><strong>Methods: </strong>A total of 23 patients with PH underwent direct portal vein pressure (PVP) measurement, and SHAPE was performed for noninvasive estimation. Six patients who underwent TIPS received SHAPE evaluations before and after the procedure. Agreement and correlation between SHAPE and PVP were analyzed.</p><p><strong>Results: </strong>SHAPE demonstrated a strong correlation with PVP (P<0.001), with significant changes observed post-TIPS (P=0.011). These findings suggest SHAPE as a valuable tool for noninvasive monitoring of PH and evaluating TIPS efficacy.</p><p><strong>Conclusions: </strong>SHAPE technology presents a promising noninvasive alternative for assessing portal hypertension in surgical settings. It offers a safer and efficient approach to monitoring hemodynamic changes, particularly in patients undergoing TIPS, potentially reducing reliance on invasive procedures.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"381-384"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477023","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":"Differences between the Surgical Pleth Index and the RE-SE difference as measures of nociception monitoring under propofol-remifentanil anesthesia.","authors":"Cuicui Jiao, Xiaoping Chen, Jialin Wang, Lin Jin, Xinzhong Chen, Lihong Sun","doi":"10.23736/S2724-5691.25.10885-X","DOIUrl":"10.23736/S2724-5691.25.10885-X","url":null,"abstract":"<p><strong>Background: </strong>To achieve an equilibrium a balance between nociception and antinociception, a suitable depth of anesthesia is essential. The Surgical Pleth Index (SPI) and entropy measurements, which consist of response entropy (RE) and state entropy (SE), serve as tools to assess the level of pain perception during surgical procedures. Research has indicated that the SPI is a more dependable instrument than the RE-SE difference for evaluating pain perception under sevoflurane-remifentanil anesthesia. Nevertheless, the effectiveness of the SPI and RE-SE difference in gauging noxious stimuli under propofol-remifentanil anesthesia is still uncertain. The objective of this study is to compare the sensitivity and dependability of the SPI and RE-SE difference in evaluating noxious stimuli during general anesthesia maintained with propofol and remifentanil.</p><p><strong>Methods: </strong>Thirty patients were administered incremental remifentanil effect-site concentrations (CeREMIs) of 0, 2, and 4 ng/mL under propofol-remifentanil anesthesia. A standardized noxious stimulus was applied for 30 seconds at each CeREMI level. Data regarding changes in the SPI, RE-SE difference difference, RE, SE, heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were collected for each patient both before and during the stimulus. Receiver operating characteristic curves were analyzed to assess the predictive ability of these indicators for nociceptive stimuli.</p><p><strong>Results: </strong>Under propofol-remifentanil anesthesia, the change in the SPI value gradually decreased in accordance with the CeREMI increase under the same intensity of nociceptive stimulation. Compared with the other indicators, the SPI demonstrated greater reliability in assessing noxious stimulation, exhibiting the highest combination of sensitivity and specificity.</p><p><strong>Conclusions: </strong>In the context of this study, the SPI proved to be a superior indicator compared to the RE-SE difference for monitoring nociception during propofol-remifentanil anesthesia.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"373-380"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152100","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":"Application of enhanced recovery after surgery in tonsillectomy and adenoidectomy.","authors":"Jingyu Yao, Zhenpeng Liao, Jiaoping Mi, Lukun Yang","doi":"10.23736/S2724-5691.25.10930-1","DOIUrl":"10.23736/S2724-5691.25.10930-1","url":null,"abstract":"<p><strong>Background: </strong>This study was to evaluate the application of ERAS in pediatric patients undergoing tonsillectomy and adenoidectomy.</p><p><strong>Methods: </strong>Sixty patients were randomly divided into ERAS and control group. Patient outcomes, including hospital stay, operation time, bleeding volume, total cost, complications, m-YPAS, FLACC, and RSAS were observed.</p><p><strong>Results: </strong>The length of hospital stay, total cost, and the incidence of postoperative nausea and vomiting in the ERAS group were significantly lower than those in the control group. The RSAS score, m-YPAS and FLACC score of the ERAS group were lower than those of the control group.</p><p><strong>Conclusions: </strong>Our study shows that the application of ERAS can reduce hospital charges and postoperative pain from tonsillectomy and adenoidectomy in children.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"385-392"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121004","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 role of emergency resuscitative thoracotomy in blunt trauma: a systematic review.","authors":"Gaetano Poillucci, Pietro Fransvea, Angelo Serao, Annamaria Pronio, Edoardo Piras, Mauro Podda, Ennio A Adami","doi":"10.23736/S2724-5691.25.10839-3","DOIUrl":"10.23736/S2724-5691.25.10839-3","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency resuscitative thoracotomy (ERT) is a potentially life-saving procedure for selected trauma patients presenting in extremis with pending or already witnessed cardiopulmonary collapse. Outcome mostly in blunt trauma is believed to be poor. Our aim was to identify all studies reported over the past fourteen years and compare reported outcomes for blunt trauma.</p><p><strong>Evidence acquisition: </strong>We performed a systematic literature search according to PRISMA guidelines (from January 1^st, 2010 to May 31^st, 2024). Qualitative comparison of studies and outcomes was done.</p><p><strong>Evidence synthesis: </strong>A total of 22 articles were included for an overall number of 6315 ERT for blunt trauma. Male-to-female distribution was 3:1. The collectively reported overall survival was 4.5%. Mean age varied from lowest at 32.4 years to highest at 53 years. Neurological outcome was reported in 6 of 21 studies; among this six publications, just one reported neurological outcome using the Glasgow Outcome Scale (GOS). Heterogeneity in the studies prevented outcome analyses by formal quantitative meta-analysis.</p><p><strong>Conclusions: </strong>The reported outcome after ERT for blunt trauma is not favorable, with an extremely low survival rate highlighted in most studies. Multicenter, prospective, observational data are needed to validate the modern role of ERT in blunt trauma.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"399-408"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508686","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 systematic review assessing the significance of Body Mass Index as a contributing factor of outcomes in patients undergoing complex robotic pancreatic resections.","authors":"Garnet Vanterpool Jr, Kristina Milivojev Covilo, Sharona B Ross","doi":"10.23736/S2724-5691.25.10806-X","DOIUrl":"10.23736/S2724-5691.25.10806-X","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic operations can be regarded as the most complex and high-risk procedures, with robotic approaches offering improved outcomes. This systematic review aimed to evaluate the impact of Body Mass Index (BMI) on perioperative outcomes in robotic pancreaticoduodenectomy (RPD) and robotic distal pancreatectomy (RDP).</p><p><strong>Evidence acquisition: </strong>Articles published from 2000 to 2024 were sourced from PubMed and Google Scholar using relevant keywords, with inclusion criteria focusing on robotic procedures involving at least 30 patients and BMI classification. Studies using non-robotic approaches were excluded unless used for comparison. Of 17,187 articles identified, 11 met the inclusion criteria. The risk of bias was minimized through dual independent reviewers, adhering to the PRISMA checklist.</p><p><strong>Evidence synthesis: </strong>Overall, 4645 patients (1501 RPD and 3144 RDP cases) were analyzed and highlighted some BMI-associated challenges, including longer operative times and increased postoperative complications in obese patients. However, robotic techniques were found to mitigate some of these issues, demonstrating reduced blood loss, lower conversion rates, and faster recovery compared to open or laparoscopic methods.</p><p><strong>Conclusions: </strong>Results showed that robotic approaches improved surgical safety and efficacy, even in patients with BMI >25 kg/m², supporting their use in high-risk populations. Despite limited available studies, findings highlight the need for further research on BMI's influence in robotic pancreatic operations to optimize patient outcomes and refine clinical practices.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"393-398"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477022","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":"Optimal timing of blood purification for surgical patients with renal disease.","authors":"Hongyan Wu, Mei Zhang, Yu Zhou","doi":"10.23736/S2724-5691.25.10995-7","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10995-7","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081779","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":"Inframesocolic pancreatic anastomosis after pancreatoduodenectomy: description and initial experience with a novel technique.","authors":"Tiziana Marchese, Valentina Valle, Stefano D'Ugo, Erika Delos, Norma Depalma, Annarita Libia, Farshad Manoochehri, William Sergi, Marcello G Spampinato","doi":"10.23736/S2724-5691.25.10942-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10942-8","url":null,"abstract":"<p><strong>Background: </strong>Pancreatoduodenectomy (PD) is one of the most challenging surgical procedures among abdominal surgeries. The most common complication after PD is postoperative pancreatic fistula (POPF), which can be severe and entail other complications, such as post-pancreatectomy hemorrhage (PPH), which can be fatal. Several surgical techniques have been proposed to reduce the incidence of POPF and PPH.</p><p><strong>Methods: </strong>In this study, we describe inframesocolic pancreatic anastomosis, which involves segregating the pancreatic anastomosis into the inframesocolic area by mobilizing the pancreatic remnant and creating a small window into the transverse mesocolon.</p><p><strong>Results: </strong>This surgical technique was performed in 17 patients, with promising results in terms of delayed PPH prevention. In particular, we had only one case of PPH that was successfully treated by placing a stent into the SMA. No other bleeding events were reported, even in cases of anastomotic leakage.</p><p><strong>Conclusions: </strong>In the context of mitigation strategies, this technique might be efficient in reducing the incidence of delayed PPH due to leakage of pancreatic juice into the supramesocolic area and consequent vascular erosion.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041581","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":"Risk factors for perioperative allogenic blood transfusion and its impact on early recurrence after cytoreductive surgery with or without intraperitoneal hyperthermic chemotherapy.","authors":"Ana Tejedor, Eva Bassas, Marina Vendrell, Lana Bijelic, Graciela Martinez-Palli","doi":"10.23736/S2724-5691.25.10946-5","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10946-5","url":null,"abstract":"<p><strong>Background: </strong>Allogenic blood transfusion (ABT) is associated with postoperative complications and possibly early recurrence (ER). after oncologic surgery. We sought to investigate predictors and impact of ABT in cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC).</p><p><strong>Methods: </strong>All patients who underwent CRS±HIPEC from June 2020 to January 2022 at a high-volume center were included. Patients were classified according to whether they had received a perioperative ABT during the entire hospitalization period. ER was defined as the time from complete resection to the first recurrence (local or distant) or death, whichever occurred first, within 2 years after surgery. Multivariate logistic regression and Cox analysis identified risk factors for ABT and ER, respectively.</p><p><strong>Results: </strong>Of 168 patients, 56 (33.3%) required ABT (mean 2.4 [2.2] red blood cell units). Multivariate logistic analysis showed that hemoglobin levels 24-h before surgery (odds ratio [OR] 0.5; 95% confidence interval [CI]: 0.4 to 0.7), intraoperative fluid balance (OR 1.01; 95% CI: 1.01 to 1.02) and time of surgery (OR 1.1; 95% CI: 1.1 to 1.1) were independently associated with ABT. Multivariate Cox regression identified time of surgery (hazard ratio [HR] 1.01, 95% CI: 1.01 to 1.02) and previous systemic chemotherapy (HR 2.5, 95% CI: 1.3 to 4.8) as risk factors for ER, while ABT was not (P=0.078).</p><p><strong>Conclusions: </strong>Lower preoperative hemoglobin levels, higher intraoperative fluid balance, and longer surgery time are risk factors for ABT. Longer operative time and previous systemic chemotherapy are associated with early recurrence.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041523","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":"Carmezumab combined with albumin-bound paclitaxel in the treatment of advanced non-small cell lung cancer with first-line driver PS≤2 negative.","authors":"Juan Fu, Shasha Zhu, Jinling Bi, Lu Ding, Ruihua Hu","doi":"10.23736/S2724-5691.24.10382-6","DOIUrl":"https://doi.org/10.23736/S2724-5691.24.10382-6","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024287","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":"Caring competence and professional identity of surgical nurses.","authors":"Manli DU, Wen Sun, Junrong Tang, Junjun Long","doi":"10.23736/S2724-5691.25.10982-9","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10982-9","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024304","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}