Pierre Puygrenier, Bader Al Taweel, Astrid Herrero, Martin Gaillard
{"title":"Unplanned hospital readmission of older adults having undergone digestive surgery.","authors":"Pierre Puygrenier, Bader Al Taweel, Astrid Herrero, Martin Gaillard","doi":"10.1016/j.jviscsurg.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2025.04.002","url":null,"abstract":"<p><p>Decreasing the risk of unplanned hospital readmission in older adults is of major concern in public health. If this risk is heightened in comparison with the general population in those having undergone digestive surgery, it is due not only to more frequent occurrence of postoperative complications, but also to overall frailty, which combines comorbidities, functional disorders and dependency. Moreover, given that any unplanned readmission is a major event in the life of an elderly patient, counteraction to its consequences (immobilization syndrome, malnutrition, cognitive disorders, loss of autonomy…) must be considered by the entire surgical team, in coordination with geriatric specialists, as the priority. Readmission prevention is based on a dedicated, comprehensive geriatric assessment accompanied by an individualized, multidisciplinary prehabilitation program. The intervention of geriatricians before and after surgery is likely to improve perioperative management of the elderly patient, thereby reducing the frequency and impact of hospital readmission.</p>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056341","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":"Non-programmed rehospitalizations after cholecystectomy.","authors":"Claire Goumard, Hadrien Tranchart","doi":"10.1016/j.jviscsurg.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2025.02.009","url":null,"abstract":"<p><p>Cholecystectomy is one the most frequent procedures in digestive surgery. While the operation is generally associated with low rates of morbidity and mortality, frequency of occurrence can vary considerably according to surgical indication, time elapsed between symptom appearance and surgical intervention, anatomical area under treatment, and the experience of the different centers. Rehospitalization after cholecystectomy remains potentially problematic in numerous units, due in part to the ongoing development of day hospital treatment and short-term hospitalization. The objective of this update is to assess not only the rate, causes and risk factors of non-programmed hospitalizations subsequent to cholecystectomy, but also the available ways and means of prevention and management in the patient's best interests.</p>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051827","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":"Mobilization of the splenic flexure in laparoscopic colorectal surgery: Why and how?","authors":"Zaki Boudiaf, Kamel Bentabak","doi":"10.1016/j.jviscsurg.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2025.03.006","url":null,"abstract":"<p><p>Whether or not to mobilize the splenic flexure during laparoscopic colorectal surgery remains a subject of debate. Its usefulness in decreasing the rate of anastomotic leak has not been demonstrated. The difficulty of performing splenic flexure mobilization via laparoscopy and the increase in operative duration are its principal drawbacks. The splenic flexure is an anatomic threshhold zone with complex anatomy, particularly with numerous vascular variations. The laparoscopic approach to splenic flexure mobilization must take into account the embryologic planes while respecting its vascular supply. From the technical standpoint, laparoscopic splenic flexure mobilization can proceed from outside-in by a lateral or anterior approach or from inside-out by a medial approach immediately following the vascular transection. Splenic flexure mobilization can result in an average gain in length of 28cm (extremes: 10-65cm) as demonstrated by cadaver dissections, and allows a tension-free anastomosis in every case. The impact of splenic flexure mobilization on the rate of anastomotic leak has shown discordant results. Meta-analyses based on retrospective studies have not shown beneficial effects of SF mobilization. The only available randomized study demonstrated a statistically significant decrease of anastomotic leak in favor of SF mobilization (9.6% versus 17.9%, P=0.04). Operative duration is prolonged by at least 30minutes, a statistically significant difference, in most studies, but without a significant impact on the rate of conversion to laparotomy or on the global rates of morbidity and mortality. Pre-operative imaging can allow the surgeon to better plan the procedure while predicting potential operative difficulties. In the future, robotic surgery should permit safe SF mobilization thanks to improved vision and more stable exposure.</p>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781866","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}
Benjamin Darnis, Louise Tedeschi, Marie-Cécile Blanchet, Vincent Frering, Jessica Crozet, Benoit Gignoux, Christophe Duchamp
{"title":"Management of pilonidal sinus and recurrences in 2025","authors":"Benjamin Darnis, Louise Tedeschi, Marie-Cécile Blanchet, Vincent Frering, Jessica Crozet, Benoit Gignoux, Christophe Duchamp","doi":"10.1016/j.jviscsurg.2024.12.005","DOIUrl":"10.1016/j.jviscsurg.2024.12.005","url":null,"abstract":"<div><div>Pilonidal sinus is a common pathology of the intergluteal cleft that can develop into abscess or suppuration. This lesion corresponds histologically to a granuloma that organizes around foreign bodies, most often hairs, and fistulizes to the skin through partially epithelialized orifices. If suppuration and abscess develop, treatment is based either on medical treatment combining analgesics, local antiseptics and sometimes antibiotics, or on emergency incision and drainage in the operating room. This is performed in more than 10,000 patients per year in France. Outside of emergencies, elective surgery for pilonidal sinus is indicated to treat bothersome symptoms or to avoid the risk of recurrent abscess. The surgical indication must take into account the patient's risk factors, particularly active smoking, that increase the risk of postoperative complications and recurrence. Elective intervention is performed on more than 30,000 patients per year in France. Radical excision followed by secondary healing is the most commonly performed option. This strategy carries a risk of failure or recurrence for at least 10% of patients. Primary closure after excision can reduce the time for healing and convalescence, but at the cost of more frequent infectious complications. Midline closure should be avoided, in favor of paramedian or flap closure. Minimally invasive techniques are being developed that combine the extraction of foreign bodies and mechanical debridement or thermal or chemical cautery of the granulomatous walls. They avoid complex and unpleasant nursing care of secondarily healing wounds, at the cost of a recurrence rate equivalent to that from excision techniques. They have the merit of avoiding difficult situations of failure to heal or recurrence after radical excision that are associated with a clear deterioration in the quality of life. The treatment of surgical failures is complex, and combines comprehensive patient care (smoking cessation, anti-infectious treatments, treatment of excess weight, avoidance of a sedentary lifestyle) and often a repeat operation. Minimally invasive treatments, particularly laser treatments, have their place in these difficult situations.</div></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 117-127"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059677","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}
Julien Epailly , Olivier Georges , Florence de Dominicis
{"title":"RE: RE : Traumatic diaphragmatic wound repair","authors":"Julien Epailly , Olivier Georges , Florence de Dominicis","doi":"10.1016/j.jviscsurg.2024.12.002","DOIUrl":"10.1016/j.jviscsurg.2024.12.002","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Page 163"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833844","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}