Minerva Surgery最新文献

{"title":"\"Tips and tricks\" for optimizing the role of gravity force during colonic endoscopic submucosal dissection: a single center experience.","authors":"Damiano Bisogni, Michele Rossi, Luca Talamucci, Fabio Staderini, Fabio Cianchi","doi":"10.23736/S2724-5691.26.11173-3","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11173-3","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399523","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":"Exploring the optimization of outpatient processes in the context of digitalization.","authors":"Jiajun Gu, Lina Ji, Xiuling Lu, Jiefei Song","doi":"10.23736/S2724-5691.23.10102-X","DOIUrl":"10.23736/S2724-5691.23.10102-X","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"146-149"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177475","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":"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":"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":"98-102"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","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":"Fully robotic liver transection using harmonic ACE curved shears: technical refinements, early insights, and challenges during the initial phase of robotic program implementation.","authors":"Marco Palucci, Gabriela Del Angel-Millán, Fabio Giannone, Serena Penpa, Annalisa Roveta, Gianluca Cassese, Fabrizio Panaro","doi":"10.23736/S2724-5691.26.11116-2","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11116-2","url":null,"abstract":"<p><strong>Background: </strong>Robotic liver surgery is rapidly evolving, but its standardization is limited by the lack of dedicated instruments for parenchymal transection. The Harmonic ACE Curved Shears are widely used; however, guidance on optimizing their use and a clear assessment of their advantages and limitations are lacking. This study evaluates the strengths and limitations of this transection method in a newly established robotic hepatopancreatobiliary (HPB) centre, based on surgical outcomes.</p><p><strong>Methods: </strong>Patients undergoing robotic liver resection between February and December 2024 were included. Parenchymal transection was performed using a \"one-surgeon, fully robotic technique\" with the Harmonic ACE Curved Shears. Intraoperative and postoperative data - including operative time, blood loss, clamping time, complications, and hospital stay - were prospectively collected and retrospectively analyzed.</p><p><strong>Results: </strong>Sixteen robotic hepatectomies were performed (15 minor, 1 major) for benign and malignant conditions. Median blood loss was 25 mL (IQR 0-325), mean operative time 341±120 minutes, and median clamping time was 8 minutes (IQR 0-56). Fifteen patients had an uneventful postoperative course, with a mean hospital stay of 5.2±2.8 days. One patient developed a grade B biliary fistula. No 30-day mortality or readmissions occurred.</p><p><strong>Conclusions: </strong>The fully robotic technique using Harmonic ACE Curved Shears is safe, effective, and reproducible. It replicates the crush-clamp technique and mimics other transection tools, facilitating precise dissection of biliary and vascular structures while minimizing blood loss and bile leaks. This approach may be particularly valuable in newly established robotic HPB centers, helping to achieve satisfactory surgical outcomes even during the early phase of program implementation. Nevertheless, these promising results require confirmation in larger cohorts and further studies, particularly to validate the safety and effectiveness of this technique in major hepatectomies and in procedures of greater complexity.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 2","pages":"103-114"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266401","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":"Effect of comprehensive nursing intervention on defecation time and incidence of urinary fistula in patients with neurogenic bladder at acute stage of stroke.","authors":"Xiaoxia Zhang, Wenfang Wang, Hongmei Ma, Yuying Ma, Juan Xue, Xiaoming Ju","doi":"10.23736/S2724-5691.23.10065-7","DOIUrl":"10.23736/S2724-5691.23.10065-7","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"144-146"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239225","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":"Feasibility and early patient-reported outcomes after elective laparoscopic sigmoid resection for diverticular disease: a pilot study.","authors":"Iacopo Verbo, Mattia A Bez, Danilo DI Giorgio, Alessandro Verbo","doi":"10.23736/S2724-5691.26.11118-6","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11118-6","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported quality-of-life (QoL) outcomes are increasingly recognized as relevant endpoints in elective colorectal surgery. However, the feasibility and interpretability of systematic QoL assessment after elective laparoscopic sigmoid resection for diverticular disease remain incompletely defined, particularly in single-center settings.</p><p><strong>Methods: </strong>This retrospective single-center pilot study analyzed consecutive patients undergoing elective laparoscopic sigmoid resection for diverticular disease. The primary objective was to assess the feasibility and completeness of postoperative QoL assessment using EQ-5D, GIQLI, and LARS questionnaires. Secondary objectives included perioperative outcomes and early postoperative morbidity. Clinical and operative data were analyzed descriptively.</p><p><strong>Results: </strong>Thirty-six patients were included. Completion of postoperative QoL questionnaires was achieved in all cases. No floor or ceiling effects were observed across QoL instruments. Median postoperative length of stay was 7 (6-7) days. Minor postoperative complications (Clavien-Dindo <II) occurred in 8.4% of patients, with no major complications, anastomotic leaks, or reoperations. Mean EQ-5D and GIQLI scores indicated satisfactory early postoperative quality of life, while LARS scores suggested minimal bowel dysfunction.</p><p><strong>Conclusions: </strong>Systematic assessment of patient-reported outcomes after elective laparoscopic sigmoid resection for diverticular disease is feasible and yields interpretable early QoL signals. These pilot data support the integration of standardized QoL metrics in future prospective and comparative studies.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 2","pages":"129-132"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266324","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":"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":"133-141"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","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":"Nursing analysis of minimally invasive intracranial hematoma drainage for hypertensive cerebral hemorrhage.","authors":"Li Li, Xin Gong, Fan Wang, Kangning Li, Yuanyuan Li, Wenshuai Yan","doi":"10.23736/S2724-5691.23.10107-9","DOIUrl":"10.23736/S2724-5691.23.10107-9","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"149-151"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239229","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":"Standardized laparoscopic approach for retroperitoneal tumors: a single-center preliminary experience.","authors":"Marco Visconti, Roberto Peltrini, Andrea G DI Santo Albini, Giuseppe Magno, Francesco Corcione","doi":"10.23736/S2724-5691.26.11067-3","DOIUrl":"https://doi.org/10.23736/S2724-5691.26.11067-3","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal tumors are rare and heterogeneous lesions, and their surgical management remains challenging. Although laparoscopic techniques are increasingly adopted in abdominal surgery, a standardized minimally invasive approach for retroperitoneal pathology has not yet been clearly defined. The present study reports our preliminary single-center experience with a standardized laparoscopic management of retroperitoneal tumors.</p><p><strong>Methods: </strong>We retrospectively reviewed 36 patients treated for retroperitoneal tumors between 2017 and 2022. Patients were selected for a laparoscopic approach when lesion size was ≤10 cm and no vascular invasion was identified on preoperative imaging. Demographic, perioperative, histopathological, and follow-up data were analyzed. Postoperative complications were classified according to the Clavien-Dindo system.</p><p><strong>Results: </strong>Among the 36 patients, 22 underwent laparoscopic surgery, 14 open surgery, and 4 required conversion to an open approach. The mean operative time was 104 minutes for laparoscopic procedures and 168 minutes for open surgery. One patient in the laparoscopic group required postoperative blood transfusion (Clavien-Dindo grade II), with no other postoperative complications observed. Length of hospital stay was shorter after laparoscopy (3.2 vs. 8.8 days). Benign lesions were more frequently treated laparoscopically, whereas sarcomas and metastatic tumors were more commonly managed with an open approach. The laparoscopic technique was standardized by subdividing the retroperitoneum into defined anatomical regions, each associated with specific patient positioning, trocar placement, and surgical steps. R0 resection was achieved in all malignant cases, as confirmed by postoperative pathology. At a mean follow-up of 5 years, no recurrences were observed in either benign or malignant cases.</p><p><strong>Conclusions: </strong>Our preliminary experience suggests that a standardized laparoscopic approach for retroperitoneal tumors is feasible, safe, and reproducible in carefully selected patients. Nevertheless, the retrospective design, limited sample size, and exclusion of more complex cases represent important limitations. Larger multicenter studies are required to further validate these findings.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"81 2","pages":"115-128"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266373","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":"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":"90-97"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","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}