Scandinavian Journal of Surgery最新文献

{"title":"Swedish female and male general surgeons differ in personality traits.","authors":"My Blohm, Aleksandra McGrath, Sebastian Mukka, Per Jolbäck","doi":"10.1177/14574969241299472","DOIUrl":"10.1177/14574969241299472","url":null,"abstract":"<p><strong>Background and aims: </strong>Evidence suggests that female surgeons achieve comparable or even more favorable outcomes than male surgeons. It is currently unclear what factors contribute to these potential differences. Possible explanations might be differences in personality traits, communication style, attitude, and risk-taking behavior. This cross-sectional study aimed to examine disparities in personality traits between male and female general surgeons in Sweden.</p><p><strong>Methods: </strong>The research was conducted as a cross-sectional study of personality traits. Between August 29, 2022, and December 15, 2023, Swedish specialists in general surgery were invited to participate in an online survey. The survey, assessed with the Big Five Inventory, collected information on self-reported surgeon gender, years in practice, employment data, and differences in personality traits.</p><p><strong>Results: </strong>The analysis encompassed responses from 223 Swedish general surgeons: 121 (54%) males and 102 (46%) females. In contrast to female surgeons, male surgeons were older and had longer surgical experience. A higher proportion of male surgeons were employed in rural hospitals. Higher mean scores were observed in all personality traits among female surgeons. The adjusted analysis showed significantly higher scores for conscientiousness (p < 0.001), extraversion (p < 0.001), agreeableness (p = 0.006), and neuroticism (p < 0.001); however, no such change was observed for openness.</p><p><strong>Conclusion: </strong>This cross-sectional study demonstrates that Swedish female and male surgeons differ in personality traits. The implications of these results could lead to a deeper understanding of the variations in surgical outcomes based on the gender of the surgeon.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"164-171"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of reconstruction techniques after pancreatoduodenectomy: A single-center retrospective cohort study.","authors":"Iago Justo Alonso, Paola Peralta Fernández-Revuelta, Alberto Marcacuzco Quinto, Oscar Caso Maestro, Laura Alonso Murillo, Carlos Jiménez-Romero","doi":"10.1177/14574969241312287","DOIUrl":"10.1177/14574969241312287","url":null,"abstract":"<p><strong>Background: </strong>There is controversy regarding which is the best reconstruction technique after the pancreatoduodenectomy. Currently, there are no studies comparing the three most frequent reconstruction techniques: Whipple + Roux-en-Y gastrojejunostomy (WRYGJ), pyloric-preserving + Billroth II (PPBII), and Whipple + BII (WBII).</p><p><strong>Methods: </strong>Between 2012 and March 2023, 246 patients underwent pancreaticoduodenectomy with the following type of reconstruction techniques: (1) WRYGJ: 40 patients; (2) PPBII: 118 patients; and (3) WBII: 88 patients. A retrospective comparative study among these groups was performed.</p><p><strong>Results: </strong>No significant differences were found among the groups regarding duration of the surgery, the blood volume transfused, or caliber of the Wirsung duct. The size and types of tumors, the degree of differentiation and tumor invasion of the peripancreatic tissue, vascular and neural structures, and lymph nodes were similar among the groups. The rate of R0 resection was lower in WBII (62.5% [55/88]) than in WRYGJ (75% [30/40]) and PPBII (72% [85/118]), but statistically insignificant among the groups (p = 0.232). The incidences of relevant B/C postoperative pancreatic fistula (POPF) were similar among the groups: 7.5% (7/40) in WRYGJ, 17% (20/118) in PPBI, and 26.2% (23/88) in WBII (p = 0.292). In addition, the incidence of B/C delayed gastric emptying (DGE) was higher in WBII (27.3% [24/88]) than in WRYGJ (20% [8/40]) and PPBII (19.5% [23/118]) but statistically insignificance among the groups (p = 0.381). The incidence of medical and surgical complications, intensive care unit and hospital stays, morbimortality at 90 days, and 5-year survival were similar among the groups. Multivariate analysis revealed that POPF grade B/C was a risk factor for DGE grade B/C (odds ratio (OR) = 9.903, 95% confidence interval (CI) = 4.829-20.310; p < 0.001), and a <3-mm Wirsung duct was a risk factor for POPF (OR = 3.604, 95% CI = 1.791-7.254; p < 0.001).</p><p><strong>Conclusion: </strong>No technique was superior to the others. Only relevant POPF B/C was a risk factor for DGE B/C, and <3 mm Wirsung for a POPF.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"183-193"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of frailty in geriatric surgical oncology.","authors":"Joanna Abi Chebl, Ponnandai Somasundar, Lidia Vognar, Steve Kwon","doi":"10.1177/14574969241298872","DOIUrl":"10.1177/14574969241298872","url":null,"abstract":"<p><p>Frailty is a common phenomenon in older adult population and associated with an elevated risk of adverse health outcomes. Recent studies have demonstrated that patients with frailty undergoing surgery had a significantly higher morbidity and mortality compared to those without frailty. This is particularly important in patients with cancer because the prevalence of frailty is persistently high across a spectrum of primary cancers. Identifying frailty in oncological patients undergoing surgery may provide an important preoperative intervention opportunity to mitigate operative risks. In this review, we provide an overview of frailty and its association with other geriatric syndromes. We will also review the impact of frailty on postoperative outcomes focusing on the field of surgical oncology. We then describe currently available tools to objectively measure frailty to provide clinicians with various practical tools that may be adopted in their clinical practice. Finally, we will describe potential interventional programs, including the recently introduced Geriatric Surgery Verification program by the American College of Surgeons, that may be institutionally adopted to mitigate postoperative complications and improve meeting patient-centered goals in the frail patient population.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"276-285"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern surgical treatments for lymphedema.","authors":"Marie Kearns, Susanna Kauhanen, Maria Mani","doi":"10.1177/14574969241300101","DOIUrl":"10.1177/14574969241300101","url":null,"abstract":"<p><p>Lymphedema occurs when the lymphatic system is malformed, leaking or is damaged by infection or cancer treatment. Enlarged extremities due to extensive fluid retention and adipose tissue deposition, recurrent cellulitis, and the requirement for hard-to-wear compression garments lead to impaired limb function and decreased quality of life. This narrative review aims to elucidate classification, diagnostic tools, and conservative management strategies leading the path to patient selection for microsurgical reconstructive procedures or volume reduction procedures. The surgical approaches include reconstructive procedures such as lymphaticovenous anastomosis (LVA) and lymph node transfer and reductive procedures, mainly liposuction and occasionally excisional surgery. Comparing the efficacy of lymphedema surgeries is fully dependent on standardized and reproducible outcome measures. A growing body of knowledge has evolved pointing to the benefits of reconstructive microsurgery of the lymphatic system with or without surgical volume reduction. Tissue engineering and stem cell research leads the way for new approaches. However, several questions remain emphasizing the research needs. Ongoing multicentre trials aiming to elucidate the efficacy and accessibility of surgical treatments for this condition are on their way.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"286-296"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences as a catalyst for the next step in surgeon personality research.","authors":"Juliette A Sier, Joost R van der Vorst, Vincent Q Sier","doi":"10.1177/14574969251336863","DOIUrl":"10.1177/14574969251336863","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"172"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical resection of adrenal metastases: Single-center experience and narrative literature review with emphasis on colorectal metastases.","authors":"Bård I Røsok, Somaya H Ahmad, Åsmund A Fretland, Daniel Østergaard, Bjørn Edwin, Kristoffer W Brudvik, Sheraz Yaqub","doi":"10.1177/14574969251331341","DOIUrl":"10.1177/14574969251331341","url":null,"abstract":"<p><p>Adrenal glands can host metastases from various malignancies. While surgical resection offers potential benefits in solitary- or oligometastatic cases, many patients have systemic disease unsuitable for surgery when adrenal metastases are diagnosed. Most adrenal metastases originate from malignancies in the lungs, kidneys, or liver. This review explores diagnostic and treatment strategies for adrenal metastases including data from a single center. In particular, it is shown that surgical resection of metastases from colorectal cancer to the adrenals may offer a potential survival benefit. Personalized treatment plans and further research are critical for improving outcomes for patients with adrenal metastases.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"142-146"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the attitudes of next of kin toward living donor liver transplantation for patients with colorectal liver metastases.","authors":"Tor M Smedman, Pål-Dag Line, Svein Dueland","doi":"10.1177/14574969251335467","DOIUrl":"10.1177/14574969251335467","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"123-125"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal treatment for colorectal liver metastases: A toolbox for clinicians.","authors":"Sheraz Yaqub, Anne Longva, Jon-Helge Angelsen, Kristoffer W Brudvik, Ulrik Carling, Bjørn Edwin, Åsmund A Fretland, Dirk J Grünhagen, Pål-Dag Line, Bård I Røsok, Tor M Smedman, Ernesto Sparrelid, Trygve Syversveen, Olaug Villanger, Kristoffer Lassen","doi":"10.1177/14574969251333524","DOIUrl":"10.1177/14574969251333524","url":null,"abstract":"<p><p>Colorectal cancer is the second most common cause of cancer-related death worldwide, and liver metastases are the leading cause of mortality in these patients. Surgical innovations combined with modern systemic chemotherapy have improved 5-year overall survival rates. This review aims to equip non-hepatobiliary surgeons with a comprehensive toolbox for the diagnosis and management of colorectal liver metastases. It covers the current landscape of diagnostic workup, including imaging modalities and biomarkers, and reviews the surgical and nonsurgical treatment options. This guide attempts to enhance multidisciplinary care for patients with colorectal liver metastases by integrating evidence-based practices with innovative strategies, which can improve outcomes and survival.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"126-134"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, treatment, and survival of patients with isolated colorectal lung metastases: A registry-based retrospective cohort study.","authors":"Sofia Dahlberg, Fredrik Jörgren, Pamela Buchwald, Halla Vidarsdottir","doi":"10.1177/14574969251319849","DOIUrl":"10.1177/14574969251319849","url":null,"abstract":"<p><strong>Background: </strong>The benefit of surgical resection for colorectal cancer (CRC) lung metastases is unclear. The aim was to investigate the incidence, treatment strategy, and 5-year overall survival (OS) in CRC patients with isolated lung metastases.</p><p><strong>Methods: </strong>This registry-based retrospective cohort study included patients treated with curative resection of CRC within the county of Skåne during the period 2010-2016, who had synchrone or metachrone isolated lung metastases. Exclusion criteria were previous or concurrent metastases at other organ sites. Patients were identified in the Swedish Colorectal Cancer Registry (SCRCR) and data were retrieved from SCRCR and medical charts. Patients were divided into groups based on whether they had synchronous or metachronous lung metastases and curative or palliative treatment intent. The primary endpoint was 5-year OS. Multivariable Cox-regression and Kaplan-Meier survival analysis were performed.</p><p><strong>Results: </strong>Of 8457 curatively resected CRC patients, 93 (1.1%) had isolated lung metastases (53 synchronous/40 metachronous). Of these, 53 were treated with curative intent, 51 (96%) of whom were managed surgically. The remaining 40 patients were treated palliatively and either with chemotherapy or with best supportive care. Five-year OS was 42% (39/93), median 50 months (IQR: 24-60) for the entire cohort, and 68% (36/53), median 60 months (IQR 55-60) and 7.5% (3/40), median 22 months (IQR: 12-33) for curative and palliative patients, respectively. In multivariable analysis, age (hazard ratio (HR): 1.04, confidence interval (CI): 1.01-1.07), multiple lung metastases (HR: 1.64, CI: 1.08-2.47), and unilateral distribution (HR: 0.41, CI: 0.20-0.84) were predictors of OS.</p><p><strong>Conclusions: </strong>Isolated CRC lung metastases are rare. Curative treatment was associated with considerably better 5-year OS than palliative treatment (68% vs 8%). Age, solitary metastases, and unilateral distribution were predictors of survival.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"115-122"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced length of stay and less systemic complications, implementation of the optimized DIEP recovery pathway.","authors":"Ina Korpiola, Päivi Merkkola-von Schantz, Elena Surcel, Susanna Kauhanen, Maiju Härmä","doi":"10.1177/14574969241312286","DOIUrl":"10.1177/14574969241312286","url":null,"abstract":"<p><strong>Background and aims: </strong>The present study aimed to compare patients who underwent deep inferior epigastric perforator (DIEP) flap reconstruction with and without the implementation of the new optimized surgical recovery pathway. The new protocol aims to standardize and optimize perioperative management, shorten hospital stays, and lower complication rates for patients undergoing major surgical procedures.</p><p><strong>Methods: </strong>Consecutive patients who underwent immediate or delayed DIEP flap breast reconstruction were included in this study. Data regarding patient demographics, timing, laterality of reconstruction, hospital length of stay (LOS), and drain management were collected and compared for the pre-protocol group and the post-protocol group.</p><p><strong>Results: </strong>The pre-protocol group consisted of 65 patients, while the post-protocol group consisted of 68 patients. The two groups had similar total complication rates (pre-protocol 43.1% versus post-protocol 32.4%, <i>p</i> = 0.20). Between the two groups, there was a significantly lower rate of major surgical complications in the post-protocol group (pre-protocol 32.3% versus post-protocol 14.7%, <i>p</i> = 0.016). There were no significant differences between the groups regarding minor surgical complications (pre-protocol 7.7% versus post-protocol 17.6%, <i>p</i> = 0.086). In the pre-protocol group, the mean LOS was 6.1 days (range = 4-10, median = 6); in the post-protocol group, the mean LOS was 3.6 days (range = 3-10, median = 3; <i>p</i> < 0.00001). Majority of the post-protocol patients were discharged on postoperative day 3 (<i>n</i> = 47, 69.1%).</p><p><strong>Conclusion: </strong>Patients undergoing DIEP flap reconstruction can be discharged earlier without risking their safety by following the new protocol.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"230-239"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}