Minerva Surgery最新文献

{"title":"Common bacterial species and drug resistance of surgical site infection after upper gastrointestinal surgery.","authors":"Bingyou Yin, Xinjun Hu","doi":"10.23736/S2724-5691.25.10925-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10925-8","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226941","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":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","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":"Current evidence and new trends in anal fissure treatment.","authors":"Marta Domínguez-Muñoz, Andrea Balla, Juan Carlos Gómez-Rosado, Salvador Morales-Conde","doi":"10.23736/S2724-5691.25.10778-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10778-8","url":null,"abstract":"<p><p>An anal fissure is a benign and painful ulcer extending from the pectinate line to the anal margin. It leads to an increase in the resting pressure of the internal anal sphincter and the pressure within the anal canal, resulting in local ischemia and impaired wound healing. Anal fissures are mostly located in the posterior midline. They are primarily caused by local trauma to the anoderm, often due to the passage of hard stools, irritation from diarrhea, or anorectal surgery. For both acute and chronic anal fissures, several treatment options are available, and surgery typically reserved as a second-line option. Recent trends in first-line therapy prefer calcium channel blockers (CCBs) over topical glyceryl trinitrate (GTN), as they offer similar healing rates but are associated with fewer side effects and better patient's compliance. Lateral internal sphincterotomy (LIS) remains the gold-standard surgical treatment for this condition. Additionally, emerging therapies, such as platelet-rich plasma (PRP) application, adipose-derived regenerative cells (ADRCs), and percutaneous tibial nerve stimulation (PTNS), have shown promising results and they are gaining attention as potential alternatives for managing chronic anal fissures. The present narrative review aims to provide a comprehensive overview of current therapeutic approaches for anal fissures, evaluating their effectiveness in promoting healing and comparing them with guideline-based recommendations.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121007","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":"Unilateral Graves' disease: a case report with concomitant thyroid cancer and systematic review of literature.","authors":"Lorenzo Scappaticcio, Paola Caruso, Miriam Longo, Alessandra Volatile, Paolo Cirillo, Francesco DI Maio, Claudia Varro, Vanda Amoresano Paglionico, Sium Wolde Sellasie, Maria I Maiorino, Katherine Esposito, Giuseppe Bellastella","doi":"10.23736/S2724-5691.25.10685-0","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10685-0","url":null,"abstract":"<p><strong>Introduction: </strong>Unilateral uptake (i.e., increased radiotracer in one lobe) on a thyroid scan in a patient with Graves' disease (GD) is the distinctive feature of unilateral GD (UGD), representing a rare entity and variant of GD with few documented cases to date. Considering the diagnostic and therapeutical implications of the knowledge of this form of GD, this study was designed to bring more light on the UGD entity within the bilobar thyroid gland.</p><p><strong>Evidence acquisition: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in reporting this systematic review. We developed a search strategy combining terms for Graves or Hyperthyroidism and unilateral systematically and searched PubMed from inception through August 25, 2024. The inclusion criteria were: 1) patients with Graves' hyperthyroidism due to a unilateral involvement in bilobar thyroid gland; 2) articles written in English or any language with an English abstract.</p><p><strong>Evidence synthesis: </strong>A total of 10 articles met inclusion criteria, in addition to our institutional experience (comprising 27 individual patients in total). All the included studies were case reports/series. Of the 27 patient cases, 20 (74.1%) were female and the mean age of patients was 44.5±10.6 years. 24 patients (88.9%) had overt hyperthyroidism, two (7.4%) subclinical hyperthyroidism, one (3.7%) had initially normal thyroid function. Orbitopathy was present in two cases out of ten (20%). thyrotropin receptor antibodies (TRAb) or thyroid stimulating immunoglobulin (TSI) were positive in 9 cases out of 12 (75%). Right thyroid lobe was involved in 17 cases (63.0%), while the left one in 10 cases (37.0%). Antithyroid drugs ATDs were adopted by 13 patients (68.4%). Four patients (21.1%) underwent surgery, while radioactive iodine (RAI) was performed in two cases. Two cases (15.4%) received a 12-month course of ATD therapy, one of whom recurred. In two out of three cases after hemithyroidectomy hyperthyroidism recurred due to the involvement of the contralateral lobe of the thyroid gland.</p><p><strong>Conclusions: </strong>Clinicians should be aware of the possibility that GD can present in the bilobar thyroid gland with unilateral gland involvement at scintigraphy. Ultrasound examination is indicated to detect the presence of contralateral thyroid tissue, and to exclude the possibility of a hyperfunctioning nodule or hemiagenesis. When choosing surgery, total thyroidectomy seems to be the appropriate treatment. Further investigation is needed to determine the natural course of UGD and its best management. Future guidelines should consider this form of GD.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121068","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":"Day surgery for rhegmatogenous retinal detachment: analyzing complications, long-term outcomes, and recurrence rates.","authors":"Juanying Li, Wenfang Zhang","doi":"10.23736/S2724-5691.25.10829-0","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10829-0","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121009","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 correlation between serum albumin, exercise endurance, and pulmonary complications after lobectomy.","authors":"Xiaowei Liu, Su Wang, Xiujun Chen, Yan Zhang, Kun Zhang, Ci Tian, Bing Dong","doi":"10.23736/S2724-5691.25.10874-5","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10874-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of the article is to explore the relationship between serum albumin, exercise endurance, and pulmonary complications after lobectomy.</p><p><strong>Methods: </strong>Overall, 166 lung cancer patients who were treated in our hospital from January 2020 to June 2023 were selected to analyze the incidence of postoperative pulmonary complications and the differences in clinical data between patients with and without pulmonary complications. Logistic regression equations were used to analyze the influencing factors of postoperative pulmonary complications.</p><p><strong>Results: </strong>There were 46 patients with postoperative pulmonary complications, incidence rate was 27.71%; Among the 46 patients, eight had two or more complications. The age of patients with pulmonary complications was 69.29±6.65 years old, which was higher than that of patients without pulmonary complications (P<0.05). The proportions of surgical time ≥4 hours, intraoperative blood loss ≥50 mL, and preoperative albumin <35 g/L in patients with pulmonary complications were 58.70%, 65.22% and 76.09%, respectively, which were significantly higher than those in patients without pulmonary complications (P<0.05). Patients with pulmonary complications had peak expiratory flow rate (PEF), peak oxygen uptake as a percentage of expected value (VO<inf>2</inf>%P), kilogram oxygen uptake (VO<inf>2</inf>/kg), anaerobic threshold (AT), oxygen pulse as percentage of expected value (O<inf>2</inf>pulse%P), respiratory rate (BF), and 6-Minute Walking Test (6-MWT), which were 291.10±43.34 L/min, 55.54±12.21%, 16.21±4.32 mL, 44.45±10.02%, 71.18±15.56 L, 26.68±6.67 times and 410.04±45.54 m, which were significantly lower than patients without pulmonary complications (P>0.05). Logistic regression analysis showed that age, surgical time, preoperative albumin, VO<inf>2</inf>% P, and 6-MWT were the influencing factors for postoperative pulmonary complications (P<0.05).</p><p><strong>Conclusions: </strong>Serum albumin, cardiopulmonary motility indicators, and 6MWT are associated with the occurrence of pulmonary complications after lobectomy, and the occurrence of pulmonary complications is influenced by patient age and surgical time.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121020","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":"Local flaps for partial breast reconstruction.","authors":"Fernando Rosatti, Dario Melita, Paolo Marchica, Isidoro Musmarra, Francesco Ciancio, Francesca DE Lorenzi, Francesca Toia, Simone LA Padula, Giuseppe A Lombardo","doi":"10.23736/S2724-5691.25.10805-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10805-8","url":null,"abstract":"<p><strong>Introduction: </strong>Breast-conserving surgery (BCS) is often the first-line treatment for early-stage invasive breast cancer. Many studies claim that survival is non-inferior to radical treatments in selected cases. Although BCS preserves some breast tissue and often the nipple-areola complex, asymmetry and distortion of the breast contour may occur and reconstruction is sometimes required. The authors' aim is to conduct a review of main breast reconstruction options with local flaps after partial mastectomy.</p><p><strong>Evidence acquisition: </strong>A literature review was conducted on PubMed using the keywords: \"partial breast reconstruction,\" \"local flaps,\" \"LICAP,\" \"ICAP,\" \"AICAP,\" \"TDAP,\" \"MS-LD\" and \"SAAP.\" Reviews, meta-analyses, clinical trials, experimental studies and case reports focused on breast reconstruction with local flaps after partial mastectomy (quadrantectomy or lumpectomy) were included in the study. Only English-written studies published in the past 20 years were considered eligible. Older articles, non-English written articles or papers regarding random flaps/video assisted harvested flaps/combined flaps were excluded.</p><p><strong>Evidence synthesis: </strong>A cumulative number of 292 scientific articles was produced by the research. After screening by the two principal investigators, 73 articles were deemed eligible for full-text examination. In total, twenty-seven articles met the inclusions criteria.</p><p><strong>Conclusions: </strong>Local flaps are a safe and reliable option in breast reconstruction after partial mastectomy. They are associated with a low complication rate reported in the literature, with satisfactory aesthetic outcomes. Prospective multicenter clinical studies are desirable to confirm the results of this study.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120966","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":"Short- and mid-term functional outcomes of STARR procedure in obstructed defecation syndrome.","authors":"Jamal Driouch, Dirk Bausch, Omar Thaher","doi":"10.23736/S2724-5691.25.10863-0","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10863-0","url":null,"abstract":"<p><strong>Background: </strong>To assess the efficacy of the stapled transanal rectal resection (STARR) procedure in treating obstructed defecation syndrome (ODS) in patients with rectocele and rectoanal intussusception grade II-III, focusing on symptom resolution, functional improvement, and pain reduction.</p><p><strong>Methods: </strong>This prospective study included patients undergoing STARR for ODS. Preoperative parameters such as anal pain, smearing, itching, bleeding, and obstructed defecation symptoms were assessed using standardized questionnaires (Wexner and Altomare). Functional outcomes, including constipation, incontinence, and obstruction, were evaluated at baseline and at 1, 3, and 6 months postoperatively. Pain levels were categorized into mild (0-3), moderate (4-7), and severe (8-10). Primary endpoints included functional improvement, pain reduction, and resolution of anal symptoms. Secondary endpoints included complication rates, hospital stay duration, and patient satisfaction. Statistical analysis included paired t-tests and one-way repeated measures ANOVA.</p><p><strong>Results: </strong>Significant improvements were observed postoperatively. Anal smearing (35%) resolved by 3 months, while anal itching (42.5%) and bleeding (75%) significantly declined, stabilizing by 6 months. Severe pain (17.5%) was noted during hospitalization but fully resolved within 1 month, with 97.5% reporting only mild pain at 6 months. Patient satisfaction was 85%. Complication rates were low (7.5% Clavien-Dindo grade I/IIIa), and no reoperations were required.</p><p><strong>Conclusions: </strong>STARR effectively improves functional outcomes and alleviates ODS symptoms, including pain, smearing, itching, and bleeding. Low complication rates and high patient satisfaction support its use as a viable surgical option, though long-term follow-up is warranted.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120969","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":"Treatment of acute pancreatitis.","authors":"Guido Basile, Marco Vacante, Antonino Corsaro, Francesco R Evola, Grazia Maugeri, Martina Barchitta, Antonio Biondi, Giuseppe Musumeci, Velia D'Agata, Giuseppe Evola","doi":"10.23736/S2724-5691.25.10773-9","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10773-9","url":null,"abstract":"<p><p>Acute pancreatitis (AP) is a potentially life-threatening inflammatory condition characterized by localized pancreatic damage and the activation of the inflammatory cascade, leading to systemic inflammatory response syndrome (SIRS). This complex disease often presents with a variable and unpredictable course. The primary causes of AP include the migration of gallstones and alcohol consumption. The Revised Atlanta Classification 2012 (RAC) is the most widely utilized classification system for AP, distinguishing between interstitial edematous pancreatitis and necrotizing pancreatitis, three severity levels and an early and a late phase. Severe AP carries a high risk of mortality. Currently, there is no definitive prognostic score for accurately predicting severe cases of AP. Initial management focuses on supportive care, applicable to both mild and severe forms of the disease, while later management addresses complications associated with severe AP. Although there is no consensus on the optimal type or regimen of fluids for resuscitation, goal-directed fluid therapy, particularly with Ringer's lactate, has been linked to improved outcomes. Prophylactic antibiotics have not proven effective in preventing infectious complications associated with AP. Patients experiencing mild acute gallstone pancreatitis should be advised to undergo laparoscopic cholecystectomy during their initial admission, whereas those with severe gallstone pancreatitis and signs of cholangitis or choledocholithiasis may benefit from early endoscopic retrograde cholangiopancreatography (ERCP). The management of severe AP complications has evolved from an early surgical approach to a minimally invasive step-up strategy, which is now considered the standard intervention.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121062","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":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","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}