Journal of Visceral Surgery最新文献_第3页

Effectiveness of a low-cost simulation model using animal tissue for training digestive anastomoses. 利用动物组织训练消化吻合术的低成本模拟模型的有效性。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-21 DOI: 10.1016/j.jviscsurg.2026.07.007

Imen Ben Ismail, Hakim Zenaidi, Marwen Sghaier

{"title":"Effectiveness of a low-cost simulation model using animal tissue for training digestive anastomoses.","authors":"Imen Ben Ismail, Hakim Zenaidi, Marwen Sghaier","doi":"10.1016/j.jviscsurg.2026.07.007","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.007","url":null,"abstract":"Background: Simulation-based surgical training provides a safe environment for developing technical skills before operating on patients. In low-resource settings, however, access to high-fidelity simulators is limited. This study evaluated the educational effectiveness of a low-cost animal-tissue model using sheep intestine for teaching digestive anastomosis to surgical residents.Methods: A prospective before-after study was conducted at the Department of Digestive and General Surgery, Traumatology and Great Burns Center, Ben Arous, Tunisia, from January 2023 to December 2025. Fifty-four residents attended a four-hour workshop combining demonstration, supervised practice, and structured feedback. Each performed two hand-sewn small-bowel anastomoses (end-to-end and side-to-side). Performance was assessed with the 7-item Objective Structured Assessment of Technical Skills (OSATS) scale. Operative time, leak testing, and self-assessment questionnaires (immediate and three-month follow-up) were analyzed using paired t-tests and McNemar's test (P<0.05).Results: Mean OSATS scores improved from 18.9±3.2 to 28.1±3.6 (P<0.001; Cohen's d=2.1). The mean improvement was +9.2 points (95% CI [8.5-9.9]). Mean operative time decreased by ≈15minutes. Leak-free anastomoses rose from 55.6% to 100% (P<0.001). Satisfaction and realism scores were 4.8±0.4 and 4.6±0.5/5. At three months, 77.8% had applied the skills clinically and 66.7% reported increased confidence. Material cost was <6 € per trainee.Conclusions: A procedural simulation using fresh sheep intestine is an effective, realistic, and affordable tool for teaching digestive anastomosis. It significantly enhances technical performance, efficiency, and confidence, supporting its integration into surgical curricula, especially in resource-limited environments.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018562","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}

引用次数: 0

Management strategies for rectal cancer with curative intent: A snapshot of practice in French Association of Surgery centers. 以治疗为目的的直肠癌的管理策略：法国手术中心协会的实践快照。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-21 DOI: 10.1016/j.jviscsurg.2026.07.009

Perrine Lioret, Maxime K Collard, Jacques-Emmanuel Saadoun, Jérémie H Lefevre, Cécile De Chaisemartin, Zaher Lakkis

{"title":"Management strategies for rectal cancer with curative intent: A snapshot of practice in French Association of Surgery centers.","authors":"Perrine Lioret, Maxime K Collard, Jacques-Emmanuel Saadoun, Jérémie H Lefevre, Cécile De Chaisemartin, Zaher Lakkis","doi":"10.1016/j.jviscsurg.2026.07.009","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.009","url":null,"abstract":"Introduction: Treatment strategies for rectal cancer are evolving rapidly, including an increased use of total neoadjuvant (TNT) therapy and organ preservation approaches. The objective of this study was to describe the practices in 2024 within the centers affiliated to the French Association of Surgery (AFC).Materials and methods: The participating centers prospectively collected data for all patients treated for rectal adenocarcinoma with curative intent during the month of October 2024.Results: Analysis of medical records for 140 patients from 52 centers revealed that 84% of tumors were classified as cT3-4 and 68% were cN+. Neoadjuvant therapy was administered to 80% of patients, and 53% received TNT. Radical surgery was performed in 76% of patients, 47% of who were robotic-assisted. Eleven percent of patients underwent a delayed colo-anal anastomosis. Thirty-three percent of patients who underwent surgery for low rectal cancer had an abdominoperineal resection. The overall postoperative complication rate was 43%, 13% of which were severe, and mortality was zero. A pathologic complete response (ypT0N0) was observed in 21% of patients undergoing surgery, and in 25% after TNT. An organ preservation strategy was planned in 16% of patients and effectively implemented in 10%.Conclusion: This survey attests to the widespread use of TNT in France, but organ preservation remains limited, highlighting the need for better dissemination of good practices and the development of specialized pathways to optimize patient selection for rectal preservation.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018538","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}

引用次数: 0

Impact of parathyroidectomy on neuropsychological disorders and quality of life in primary hyperparathyroidism. 甲状旁腺切除术对原发性甲状旁腺功能亢进患者神经心理障碍及生活质量的影响。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-18 DOI: 10.1016/j.jviscsurg.2026.07.014

Samuel Frey, Maxime Constant, Nicolas Santucci, Laure Maillard, Muriel Mathonnet, François Pattou, Fabrice Menegaux, Eric Mirallie

{"title":"Impact of parathyroidectomy on neuropsychological disorders and quality of life in primary hyperparathyroidism.","authors":"Samuel Frey, Maxime Constant, Nicolas Santucci, Laure Maillard, Muriel Mathonnet, François Pattou, Fabrice Menegaux, Eric Mirallie","doi":"10.1016/j.jviscsurg.2026.07.014","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.014","url":null,"abstract":"Neuropsychiatric disorders are among the classic manifestations of primary hyperparathyroidism (PHPT), along with bone and renal involvement. They correspond to a broad spectrum of nonspecific neuropsychological symptoms, including depression, anxiety, sleep disturbances, concentration difficulties, memory loss, and even more severe psychiatric syndromes such as psychosis or dementia. These symptoms contribute to a significant deterioration in patients' quality of life compared to the general population. Despite their frequency and functional impact, neuropsychiatric disorders and impaired quality of life are not recognized as formal indications for parathyroidectomy in current French and international guidelines. This position is explained by the heterogeneity of results and the low level of evidence in the available literature. In particular, while some observational studies suggest an improvement in quality of life after surgery, randomized trials published to date have not allowed for a definitive conclusion. The aim of this review is to summarize existing data concerning the effect of parathyroidectomy on neuropsychiatric disorders and on impaired quality of life, and to discuss the remaining questions with the goal of guiding future research.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002799","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}

引用次数: 0

Recurrent or persistent primary hyperparathyroidism, parathyromatosis. 复发性或持续性原发性甲状旁腺功能亢进，甲状旁腺瘤病。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-17 DOI: 10.1016/j.jviscsurg.2026.07.022

Miriam Ladsous, Sophie Deguelte, Elif Hindié, Robert Caiazzo, Brigitte Delemer

{"title":"Recurrent or persistent primary hyperparathyroidism, parathyromatosis.","authors":"Miriam Ladsous, Sophie Deguelte, Elif Hindié, Robert Caiazzo, Brigitte Delemer","doi":"10.1016/j.jviscsurg.2026.07.022","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.022","url":null,"abstract":"Persistent primary hyperparathyroidism is defined as the persistence or recurrence of hypercalcemia within 6 months of parathyroid surgery. Recurrent primary hyperparathyroidism is defined as the recurrence of primary hyperparathyroidism more than 6 months after an initially curative parathyroidectomy. In these situations, it is essential to rule out differential diagnoses, and in particular secondary hyperparathyroidism and familial hypocalciuric hypercalcemia. Failure to remove the pathological parathyroid gland or glands during initial surgery for primary hyperparathyroidism is the most common situation in non-expert centers. In other situations, genetically determined multi-glandular primary hyperparathyroidism must be screened for. More rarely, a second sporadic adenoma is identified, or, exceptionally, a parathyroid carcinoma or parathyromatosis. Effective morphological evaluation, combining a morphological and functional imaging, is essential prior to any new parathyroid surgery. The indications for surgery must be discussed in a multidisciplinary team, assessing the risk/benefit ratio, since the risk of surgical complications is higher. Revision surgery should be performed using a suitable approach, after laryngoscopy, in an expert center, ideally with intraoperative PTH measurement and recurrent nerve neuromonitoring.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992145","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}

引用次数: 0

Syndromic primary hyperparathyroidism. 综合征性原发性甲状旁腺功能亢进。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-14 DOI: 10.1016/j.jviscsurg.2026.07.015

Abdallah Al-Salameh, Magalie Haissaguerre, Christophe Tresallet, Paulina Kuczma, Camille Marciniak, Catherine Cardot-Bauters

{"title":"Syndromic primary hyperparathyroidism.","authors":"Abdallah Al-Salameh, Magalie Haissaguerre, Christophe Tresallet, Paulina Kuczma, Camille Marciniak, Catherine Cardot-Bauters","doi":"10.1016/j.jviscsurg.2026.07.015","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.015","url":null,"abstract":"Syndromic primary hyperparathyroidism has several features in common: younger age at diagnosis when compared with sporadic primary hyperparathyroidism, often synchronous or metachronous multi-glandular involvement, higher possibility of recurrence, association with other endocrine or extra-endocrine disorders, and suggestive family background with autosomal dominant inheritance. Hyperparathyroidism in multiple endocrine neoplasia type 1 is the most common syndromic hyperparathyroidism. It is often asymptomatic in adolescents and young adults, but may be responsible for recurrent lithiasis and/or bone loss. Hyperparathyroidism jaw tumor syndrome is less frequent, but often immediately symptomatic, with higher blood calcium levels, and is sometimes associated with an atypic parathyroid tumor or parathyroid carcinoma. Hyperparathyroidism in multiple endocrine neoplasia type 2A is not at the forefront of the clinical picture, rarely revealing the disease, and often manifests with few symptoms. Multiple endocrine neoplasia type 4 is a more recently described entity, in which hyperparathyroidism seems to occur later and be less severe than in previous syndromes. In all cases, the indications and modalities of surgical treatment should be discussed in an expert center. The risk of recurrence after surgery, particularly high in multiple endocrine neoplasia type 1, requires long-term monitoring.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971927","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}

引用次数: 0

Indications for the treatment of primary hyperparathyroidism. 治疗原发性甲状旁腺功能亢进的适应症。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-09-04 DOI: 10.1016/j.jviscsurg.2026.07.017

Samuel Frey, Helena Mosbah, Gianluca Donatini, Laurent Brunaud, Olivier Chabre, Delphine Vezzosi

引用次数: 0

Duodenal perforations: Etiologies, diagnosis and management. 十二指肠穿孔：病因、诊断和处理。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-08-25 DOI: 10.1016/j.jviscsurg.2026.07.006

Juliette Yvart-Degardin, Franck Brazier, Stéphane Bar, Fabien Werey, Gaétan Pasinato, Jean-Marc Regimbeau

{"title":"Duodenal perforations: Etiologies, diagnosis and management.","authors":"Juliette Yvart-Degardin, Franck Brazier, Stéphane Bar, Fabien Werey, Gaétan Pasinato, Jean-Marc Regimbeau","doi":"10.1016/j.jviscsurg.2026.07.006","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.006","url":null,"abstract":"Duodenal perforation is a rare occurrence and is associated with high mortality, which rises to 30-50% in cases that involve associated peritonitis. The most frequent etiologies include peptic ulcer, post-operative fistula, endoscopic perforation, and trauma. The challenge in managing this pathology lies in the fact that resection with anastomosis is often unfeasible, and the creation of a stoma is not possible. Management must be tailored on a case-by-case basis that always involves medical measures, often endoscopic interventions, and sometimes surgery. Indeed, the surgical option is feasible in selected patients who are diagnosed early and present without complications. Surgical procedures are classified into two categories: preferably, reconstructive procedures-where resection of the perforation and restoration of digestive continuity is possible, provided that local and hemodynamic conditions are favorable; conversely, a duodenojejunal diversion procedure-in which the perforation is left in situ while enteric secretions are diverted-is the preferred approach when conditions are unfavorable. When local conditions are unfavorable, or there is hemodynamic instability, duodenostomy drainage is the preferred option. This technique involves directing duodenal secretions toward the skin, thereby inducing the formation of a fibrotic fistulous tract with eventual wound healing. The management of duodenal perforation is a lengthy and challenging process.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819954","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}

引用次数: 0

Fistulotomy and primary sphincter reconstruction is a useful tool in the management of anoperineal fistula: Results of a two-center retrospective study. 瘘管切开术和初级括约肌重建是治疗肛门瘘的有效工具：一项双中心回顾性研究的结果。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-08-19 DOI: 10.1016/j.jviscsurg.2026.07.008

Aniss Nasraoui, Vincent de Parades, Mounzer Dia, Maëlig Poitevin, Aurélien Venara

{"title":"Fistulotomy and primary sphincter reconstruction is a useful tool in the management of anoperineal fistula: Results of a two-center retrospective study.","authors":"Aniss Nasraoui, Vincent de Parades, Mounzer Dia, Maëlig Poitevin, Aurélien Venara","doi":"10.1016/j.jviscsurg.2026.07.008","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.008","url":null,"abstract":"Introduction: Anoperineal fistula (APF) treated by fistulectomy provides the best anatomical results but carries a high risk of anal incontinence. Sphincter reconstruction might improve these outcomes, but limited comparative data are available in the literature. The purpose of this study was to compare the outcomes of fistulotomy plus sphincter reconstruction (FSR) and sphincter-sparing techniques for APF repair.Method: This two-center retrospective study included patients undergoing FSR or ligation of the intersphincteric fistula tract (LIFT) or rectal advancement flap (control group) techniques.Results: Of the 119 patients included, 95 (79.8%) underwent FSR. There were no statistically significant differences in demographic characteristics between groups. More inter- or trans-sphincteric fistulas were included in the control group, while there were more complex fistulas in the FSR group (P<0.001). The healing rate was 76.2% in the control group compared to 91.6% in the FSR group (P=0.056). No statistically significant difference was found in the overall complication (8.4%) or overall anal incontinence rates (14.7%) (P>0.9). In contrast, the recurrence rate was higher in the control group than in the FSR group (P<0.001). In multivariable analysis, FSR was associated with a lower risk of recurrence compared to the control group (OR=0.16; 95% CI: 0.03-0.77).Conclusion: This study suggests that FSR may be superior to the other techniques in terms of cure without increasing morbidity or the risk of anal incontinence.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800389","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}

引用次数: 0

Preparation for parathyroid surgery. 甲状旁腺手术准备。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-08-18 DOI: 10.1016/j.jviscsurg.2026.07.020

Cédric Cirenei, Nathalie Chereau, Arnaud Jannin, Anne-Lise Lecoq, Peter Kamenický, David Osman

{"title":"Preparation for parathyroid surgery.","authors":"Cédric Cirenei, Nathalie Chereau, Arnaud Jannin, Anne-Lise Lecoq, Peter Kamenický, David Osman","doi":"10.1016/j.jviscsurg.2026.07.020","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2026.07.020","url":null,"abstract":"Preoperative treatment of PHPT aims to (1) manage severe and/or symptomatic hypercalcemia and (2) prevent postoperative hypocalcemia. Severe hypercalcemia, defined as a blood calcium level≥3.5mmol/L, requires admission to hospital in a conventional or critical care unit, depending on clinical symptoms and comorbidities. Decision to admit a patient in a critical care unit relies on the existence of one or more clinical manifestations (impaired alertness, dehydration with acute renal failure, severe acute pancreatitis) or threatening electrocardiographic signs, or one or more significant comorbidities, notably cardiovascular. Oral rehydration and/or intravenous volume expansion, adapted to cardiac and renal function, form the basis of treatment to lower blood calcium level. If insufficient, intravenous bisphosphonates (zoledronate or pamidronate) are recommended to achieve a reduction in blood calcium levels sufficiently long to allow surgery to be organized. All bisphosphonate injections must be preceded by a minimum etiological work-up of hypercalcemia, including PTH, phosphate and 25-hydroxy vitamin D levels, as well as calciuria and creatininuria. Since bisphosphonates take 24-36hours to take effect, calcitonin can initially be combined with them, as it has a rapid onset of action of a few hours. Denosumab is recommended in second line therapy where bisphosphonates cannot be used, notably because of impaired renal function. Hemodialysis is proposed for patients with an identified vital risk, especially if volume expansion is not possible due to cardiac or renal insufficiency. Correction of vitamin D deficiency is recommended before parathyroid surgery if blood calcium levels are<3.5mmol/L, to prevent or attenuate severe postoperative hypocalcemia due to massive calcium transfer to the bone.","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800349","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}

引用次数: 0

Treatment modalities for primary hyperparathyroidism. 原发性甲状旁腺功能亢进的治疗方式。

IF 2.3 4区医学

Journal of Visceral Surgery Pub Date : 2026-08-17 DOI: 10.1016/j.jviscsurg.2026.07.019

Grégory Baud, Stéphanie Espiard, Camille Buffet, Adrien Ben Hamou, Héloise Henry, Nunza Cinzia Paladino, Frédéric Sebag, Bernard Goichot

引用次数: 0