Scandinavian Journal of Surgery最新文献

{"title":"Visceral artery aneurysms: A shred of light on rare entities.","authors":"Nicola Leone, Mattia Migliari, Giovanni F Baresi, Stefano Gennai","doi":"10.1177/14574969251321936","DOIUrl":"10.1177/14574969251321936","url":null,"abstract":"<p><p>Visceral artery aneurysms (VAAs) and pseudoaneurysms are rare but clinically significant vascular pathologies with potentially fatal complications including rupture. VAAs are often asymptomatic and frequently discovered incidentally during imaging performed for unrelated reasons. Their pathophysiology, clinical presentation, and management vary based on the etiology, anatomical location, and patient-specific factors. The prognosis for conservatively managed VAAs is generally favorable, with slow growth rates and low rupture risks. However, pseudoaneurysms, often associated with trauma or pancreatitis, carry a much higher rupture risk and typically require early intervention, regardless of size. Endovascular techniques have progressively replaced open surgery as the preferred treatment approach due to lower complication rates and comparable long-term outcomes. However, current knowledge is biased by the scarcity of high-quality evidence regarding the natural history, rupture risk, and optimal management of VAAs and pseudoaneurysms, largely due to the rarity of these conditions. Consequently, different international societies have provided recommendations with low strength and, in some cases, conflicting indications.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"390-399"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651520","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":"Comparative analysis of early-onset rectal cancer in patients aged <35 years and 35-49 years: A national population-based retrospective cohort study.","authors":"Qiuhan Yao, Wei-Yu Yang","doi":"10.1177/14574969251337847","DOIUrl":"10.1177/14574969251337847","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"374-377"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036501","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":"Changing paradigms in the management of complicated diverticulitis.","authors":"Johannes Kurt Schultz, Maziar Nikberg, Abbas Chabok, Arnar Thorisson, Johanna Sigurdardottir, Pamela Buchwald, Ville Sallinen, Najia Azhar","doi":"10.1177/14574969251343452","DOIUrl":"10.1177/14574969251343452","url":null,"abstract":"<p><p>Complicated colonic diverticulitis remains a frequent cause of hospital admissions in Western countries, associated with significant morbidity and health care utilization. Complications include abscess formation, perforation, sepsis, fistulas, and colonic stenosis, which may be present at initial presentation or develop during the disease course. Approximately 10%-20% of hospitalized diverticulitis cases are classified as complicated. Over recent decades, the management of this condition has undergone a paradigm shift-from routine surgical intervention to more individualized, evidence-based strategies emphasizing conservative treatment where appropriate. This review provides a comprehensive, clinically oriented summary of current diagnostic approaches, including the role of cross-sectional imaging, as well as non-operative and operative treatment options. It also outlines recommendations for follow-up, including indications for colonoscopy, and discusses ongoing controversies and future directions in the management of complicated diverticulitis.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"381-389"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235730","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":"The gender gap between female medical students and recruitment to surgical training in Norway: A cross-sectional, nationwide cohort study of medical students, surgical trainees, and specialists.","authors":"Kjetil Søreide, Torhild Veen, Elen M Hauge, Martine Aarsland, Cecilie F Torkildsen","doi":"10.1177/14574969251355053","DOIUrl":"10.1177/14574969251355053","url":null,"abstract":"<p><strong>Background and aims: </strong>All Nordic countries have reported a high female admission rate to medical schools over the past decades. A similar female rate is not observed among surgical specialists. The aim of this study was to report the observed female rate in admission to medical school and compare to the female recruitment rate observed in surgical training.</p><p><strong>Material and methods: </strong>An observational, cross-sectional, nationwide, point-prevalence study (index year 2024) derived from registered medical students (from 2010 to 2025), number of trainees, and certified specialists' statistics of active specialists (defined <70 years of age) in 10 surgical specialties. The national averages of female rate were compared.</p><p><strong>Results: </strong>The female rate of medical students was 70% (n = 3460 females; n = 1491 males) in Norway in 2024 (with stable rate since 2020 and >60% female rate since 2010). In 2024, there were a total of 9601 doctors in training across 46 medical specialties, with a female rate of 62.7% (n = 6022) of trainees. Among all trainees, some 13.6% (n = 1304) were registered in one of 10 surgical specialties, with 62.7% (n = 817) female rate. Gynecology (n = 324) stands out with >90% of the trainees being female. Excluding gynecology, the female rate of surgeon trainees drops to 53.5% (524 of 980). Even though breast-endocrine and plastic surgery have a high female rate of trainees (>80% and >70%, respectively), they make up for a relatively small actual number of surgical trainees altogether (n = 23 and n = 40, respectively). For 2024, the total number of certified surgeons (n = 3636), with 1409 (38.8%) being female, was lower than the national average for all specialties (48.9%). A considerable number of male surgeons (>30%) are approaching retirement age within the next decade.</p><p><strong>Conclusion: </strong>Female rate of admission to medical school has been >60% for two decades. Female rate of trainees and specialist surgeons remains lower than the reported national average while improving in general surgery, orthopedics, and gastrointestinal surgery in terms of numbers and rate of females. Research into recruitment, retention and retirement projections is needed.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"303-311"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838389","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":"Time-trend analysis of female rates among certified surgeon specialists across 10 surgical specialties in Norway.","authors":"Kjetil Søreide, Elen M Hauge, Cecilie F Torkildsen, Torhild Veen, Martine Aarsland, Jan T Kvaløy","doi":"10.1177/14574969251363332","DOIUrl":"10.1177/14574969251363332","url":null,"abstract":"<p><strong>Background and aims: </strong>Gender balance in surgical specialization has received increased focus, as women have traditionally made up a minority in surgical specialties. Little is known about how surgical disciplines are approaching gender equity and balance in general and subspecialty surgery in Norway. The aim of this study was to explore gender distributions across surgical disciplines to investigate gender balance and changes over time.</p><p><strong>Material and methods: </strong>An observational, cross-national study derived from specialists statistics on board certification in Norway. We investigated gender balance for surgical disciplines for the time period 2008 to 2024. Temporal time trends were investigated for fiscal years 2010, 2015, 2020, and 2024. Statistical analyses were done by the Poisson regression for temporal trends and gender distribution.</p><p><strong>Results: </strong>For the 10 surgical disciplines investigated, the total number (n) of surgical specialists increased by 33.3% during the period. Numerically, general surgery, gynecology, and orthopedics made up 72% of all surgeon specialists in 2024. The female rate increased from 20.2% to 36.2% across all surgical disciplines. The observed female rate in 2024 was the highest in gynecology (75% women) and the lowest in thoracic surgery (<10% women). Despite a significant increase (with P < 0.001) in the female rate in all specialties, only gynecology and breast-endocrine surgery achieved >50% female rate among specialist surgeons.</p><p><strong>Conclusion: </strong>Considerable variation in the rate and speed of obtaining gender equity exists across surgical specialties, concerningly in some of the larger surgical specialties. Further investigations should focus on identifying and addressing factors influencing the recruitment and retention of women in surgical specializations.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"312-318"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976537","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":"Improving research reproducibility in surgery: A narrative review on caveats in research methodology.","authors":"Rasmus Liukkonen, Matias Vaajala, Ilari Kuitunen, Ville M Mattila, Ville Ponkilainen, Mikko Uimonen, Aleksi Reito","doi":"10.1177/14574969251371880","DOIUrl":"https://doi.org/10.1177/14574969251371880","url":null,"abstract":"<p><p>Scientific integrity relies on reproducibility. Reproducible scientific results are essential for advancing clinical practice and improving patient outcomes. However, despite the importance, reproducibility issues are widespread, often arising from inadequate methodologies and a lack of expertise in research design. Methodological shortcomings can lead to unreliable and biased findings, wasted resources, and thus compromised clinical decisions. Recent studies indicate that researchers frequently struggle to replicate findings, emphasizing the need for improvements in quality and transparency.This review aimed to enhance the understanding of common pitfalls in research methodologies by identifying and describing the common limitations. Ultimately, this review aims to strengthen the quality of surgical research and improve patient care through more reliable and clinically applicable research findings.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251371880"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030858","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":"Recurrence after treatment for differentiated thyroid cancer: Observations on risk factors, long-term follow-up and treatments.","authors":"Gunilla M Hedbäck","doi":"10.1177/14574969251356064","DOIUrl":"10.1177/14574969251356064","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of differentiated thyroid cancer (DTC) is good, and radical surgery has been questioned, especially for small tumors. Size alone cannot, however, predict prognosis. Recurrences occur after several decades, and other risk factors should be included when deciding on an optimal treatment strategy.</p><p><strong>Materials and methods: </strong>A consecutive series of 231 patients with DTC were treated in 2004-2016 at Borås Hospital in Sweden. Follow-up was performed in 2023, after a mean of 10.7 years (range = 6.5-19.1). Data on type of surgery, adjuvant radioiodine treatment, thyroglobulin levels, deaths, and recurrences were collected. Patients with negative thyroglobulin levels after treatment were compared with those who had measurable thyroglobulin or high levels of anti-thyroglobulin.</p><p><strong>Results: </strong>In 63/231 patients (27.3%), there was no preoperative suspicion of malignancy, 214 (92.6%) patients underwent total thyroidectomy, and the complication rate was low. There were 181 patients (84.6%) with negative thyroglobulin after treatment, and 33 patients (14.3%) with measurable thyroglobulin and/or anti-thyroglobulin levels. Fifteen patients died from thyroid cancer, and all were in the latter group. Risk factors for recurrence were tumor size, vascular invasion, extra-thyroidal growth, lymph node metastases, and male sex. Multifocality was frequent (32.5%) and patients with bi/multifocal cancers had significantly more lymph node metastases. Ten patients with recurrences had at least two of the identified risk factors.</p><p><strong>Conclusion: </strong>Total thyroidectomy or hemithyroidectomy in DTC is recommended, preferably including the central lymph node clearance. Total thyroidectomy has the advantage of allowing follow-up with thyroglobulin measurements to detect recurrences in time for treatment.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"351-357"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734936","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":"Corrigendum to \"Incidence, treatment, and survival of isolated patients with colorectal cancer lung metastases: A registry-based retrospective cohort study\".","authors":"","doi":"10.1177/14574969251346669","DOIUrl":"10.1177/14574969251346669","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"400"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112398","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":"Application of HoloLens for intra-operative assessment of a retrosternal thyroid goiter.","authors":"Eugene Kwong Fei Leong, Aldred Cheng, James Wai Kit Lee, Yujia Gao, Kee Yuan Ngiam","doi":"10.1177/14574969251360147","DOIUrl":"10.1177/14574969251360147","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"378-380"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976509","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":"Challenges to preserve vascular access functioning after surgical correction for arteriovenous access ischemic steal in hemodialysis patients: A single-center study.","authors":"Eeva-Maija Weselius, Maria Söderström, Maarit Venermo","doi":"10.1177/14574969251319854","DOIUrl":"10.1177/14574969251319854","url":null,"abstract":"<p><strong>Background and aims: </strong>Arteriovenous access ischemic steal (AVAIS) is a rare complication that causes morbidity and threatens hemodialysis access usability in patients with end-stage kidney disease (ESKD). This study aimed to determine the incidence of AVAIS over a 15-year period and assess the access usability after surgical correction.</p><p><strong>Methods: </strong>Access operations between January 2007 and August 2022 at Helsinki University Hospital were reviewed. Demographics, clinical, duplex, and contrast examinations with brachial artery volume flows, finger pressures, and delays to surgery were evaluated. Symptom relief, complications, access closures/re-interventions, primary, secondary, and functional patencies were assessed. Endpoints were permanent cessation of access use due to complication(s), transplantation, closure, definitive occlusion, or death.</p><p><strong>Results: </strong>Among 2914 access-related operations, the overall incidence of AVAIS was 2.2%. At the first vascular consultation 52% had ulcer(s) or gangrene(s) resulting in 28 direct closures, and 30 corrections as follows: 20 proximalization of arterial inflow (PAI), 6 flow reduction procedures, 2 distal revascularization with interval ligation (DRIL), 1 distal radial artery ligation (DRAL), and 1 venous bypass. The median time from consultation to surgery was 18 days (range: 0-348 days) for direct closures and 43 days (0-170 days) for corrective surgery. The functional patencies after correction were 60% at 1 year and 55% at 2 years; the primary patencies were 45% and 28% and secondary patencies 61% and 57%, respectively. The functional patencies after PAI were 41% and 31%, respectively.</p><p><strong>Conclusion: </strong>In AVAIS, access preservation is challenging in ESKD patients with multiple diseases. Attention should be paid to the original choice of vascular access by considering each patient's risks. Delay to vascular consultation and intervention should be minimized. PAI should be reserved for selected patients when no other option is preferable.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"365-373"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517058","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}