Scandinavian Journal of Surgery最新文献

{"title":"Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal malignancy-outcomes and learning curves in medium volume center.","authors":"N Algethami, V Valdimarsson, H Thorlacius, V Verwaal, I Syk","doi":"10.1177/14574969251397312","DOIUrl":"10.1177/14574969251397312","url":null,"abstract":"<p><strong>Introduction: </strong>Implementing new treatment regimens entails a learning phase with a concomitant risk of suboptimal results. High caseload has generally been shown to improve results in complex surgical procedures. This study aimed to evaluate results of Cytoreductive Surgery (CRS) and Intraperitoneal Chemotherapy (IP), given as Early Postoperative Intraperitoneal Chemotherapy (EPIC) or Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in a mid-size volume center, stratified by time periods.</p><p><strong>Method: </strong>This retrospective single-center cohort study included all CRS-IP procedures in Malmö, Sweden. All data were retrieved from a prospective quality control registry. Primary outcomes were: 5-year overall survival (5-Yr OS) and 30-day severe and total postoperative complication rates. Secondary outcomes were: recurrence rate, 3-year disease-free survival (DFS), and 90-day mortality rate. Outcomes were analyzed by time periods divided into initiating phase (n = 56) and established phase (n = 208).</p><p><strong>Results: </strong>In total 264 CRS-IP in 240 patients were performed from 2004 to 2021 (35 EPIC, 229 HIPEC). The 5-Yr OS after primary CRS-IP was 43% in colorectal cancer (n = 169) and 87% in pseudomyxoma (n = 53). In pmCRC, the 5-year OS was significantly lower in the initiation phase (29%) compared to the established phase (48%), verified in an adjusted multivariable analysis showing a hazard ratio of 0.51 for mortality in the established phase. The risk of recurrence did however not differ. Total 30-day complication rate was 67%, severe complication rate 15% and 90-day mortality was 1%. None of which differed depending on time period in multivariable analysis.</p><p><strong>Conclusion: </strong>Our results for both pseudomyxoma peritonei (PMP) and pmCRC are in line with previously published results, implying that high volume is not a prerequisite for high-quality CRS-IP. Although long-term survival in pmCRC was significantly better in the established phase, recurrence rates remained unchanged. Further, postoperative mortality and risk of complications did not differ between time periods, suggesting that the impact of the learning curve was limited.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"50-61"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764374","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":"Prognostic CT-imaging findings for complicated acute appendicitis: A prospective cohort study.","authors":"Sami Sula, Miska Kujala, Ville Tammilehto, Saija Hurme, Tero Rautio, Pia Nordström, Tuomo Rantanen, Tarja Pinta, Anne Mattila, Juha Grönroos, Suvi Sippola, Jussi Haijanen, Paulina Salminen","doi":"10.1177/14574969251386556","DOIUrl":"10.1177/14574969251386556","url":null,"abstract":"<p><strong>Background and aims: </strong>Antibiotics for computed tomography (CT)-confirmed uncomplicated acute appendicitis is a safe and feasible treatment alternative highlighting the importance of accurate pre-interventional differentiation between uncomplicated and complicated appendicitis. CT is the gold standard in assessing appendicitis severity. The aim of this study was to assess potential prognostic CT factors for complicated acute appendicitis.</p><p><strong>Methods: </strong>A large prospective patient cohort was collected in concurrence with enrollment in two randomized clinical trials between April 2017 and November 2018 with CT-diagnosed acute appendicitis with both available histopathology and surgical diagnosis. The main aim was to evaluate the effect of appendiceal diameter on appendicitis severity. Other assessed CT variables included appendiceal wall enhancement defect and fluid and edema around the appendix. A subgroup analysis on patients without an appendicolith was performed.</p><p><strong>Results: </strong>The main analysis included 3085 patients with CT-diagnosed appendicitis, and there were 1965 patients without an appendicolith in the subgroup analysis. In both analyses, wider appendiceal diameter (p < 0.001) and appendiceal wall enhancement defect (p < 0.001) were associated with increased risk of complicated acute appendicitis. No clear cut-off point for appendiceal diameter association with complicated appendicitis could be determined. Among patients without an appendicolith, appendiceal wall enhancement defect had an odds ratio (OR) of 3.39 (95% confidence interval [CI] = 2.10 to 5.50) for complicated appendicitis.</p><p><strong>Conclusions: </strong>Wider appendiceal diameter and appendiceal wall enhancement defect on CT are objective imaging findings associated with an increased risk of complicated acute appendicitis. These findings and risks should be acknowledged by clinicians when selecting the optimal treatment alternative for each patient and assessing whether a patient is suitable for non-operative treatment.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"42-49"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356632","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":"Gender-affirming genital surgery in the Nordic countries: Narrative review of current practices and challenges.","authors":"Antti Mikkola, Isak Gran, Martin Sollie, Rikke Holmgaard, Kaisu Ojala, Hannes Sigurjonsson, Lucy Bai, Helena Sackey, Pehr Sommar, Jenny Löfgren","doi":"10.1177/14574969251371888","DOIUrl":"10.1177/14574969251371888","url":null,"abstract":"<p><p>Genital gender-affirming surgery is a crucial yet often overlooked component of gender-affirming care for transgender individuals. Genital gender-affirming surgery is a rapidly evolving field, and it is not uncommon for surgeons - sometimes without prior experience in gender-affirming care - to encounter transgender individuals in clinical practice; hence, it is essential that all healthcare providers possess a foundational understanding of gender-affirming procedures and individual's needs.Research has shown that genital gender-affirming surgery significantly improves the quality of life for transgender individuals by aligning their physical characteristics with their gender identity. It can offer substantial satisfaction, both aesthetically and functionally. For transwomen, genital gender-affirming surgery enables them to wear underwear aligned with their gender identity, facilitates sexual function and the potential for vaginal intercourse. For transmen, it provides a more masculine appearance in the groin area, allows for penetrative intercourse with a reconstructed penis (neophallus), and in some cases enables urination while standing when combined with urethral lengthening.Today, a wide range of surgical options exists for both transwomen and transmen. Thorough preoperative counseling is essential when selecting the most appropriate reconstructive method. Advances in plastic, reconstructive, and microsurgery continue to expand these options, offering greater personalization and improved outcomes. While genital gender-affirming surgery is complex and often irreversible, individuals are generally highly satisfied with the results, particularly when they have realistic expectations prior to surgery.The aim of this narrative review is to provide an overview of genital gender-affirming surgery from a Nordic perspective. In the Nordic countries, gender-affirming care is highly centralized and integrated into publicly funded healthcare systems. The care programs across these countries share many similarities and are largely comparable in structure and approach.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"27-41"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318908","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":"A randomized open-label multicentre clinical trial comparing single-anastomosis duodenal switch (SADI-S) versus Roux-en-Y gastric bypass for the treatment of severe obesity: BYPSADIS study protocol.","authors":"Javier Osorio, Claudio Lazzara, Marta Guimaraes, Antonio Torres, Victor Turrado-Rodríguez, Ainitze Ibarzabal, Lucia Sobrino, Mario Nora, Nuria Vilarrassa, Ana de Hollanda, Miguel A Rubio-Herrera, Josep Vidal, Violeta Moizé, Concepción Yarnoz, Isabel Fernandez-Falop, Manuel Portillo, Andrés Sánchez-Pernaute","doi":"10.1177/14574969251385873","DOIUrl":"10.1177/14574969251385873","url":null,"abstract":"<p><strong>Background: </strong>Roux-en-Y gastric bypass (RYGB) is a standard bariatric surgical technique, associated with suboptimal response and recurrent weight gain in 25%-50% of cases. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of duodenal switch with promising results. However, a comparison of the two techniques in a randomized clinical trial (RCT) has not yet been reported. This RCT aims to compare SADI-S and RYGB.</p><p><strong>Methods: </strong>BYPSADIS is a randomized, open-label, multicentre clinical trial comparing SADI-S with RYGB. Patients aged 18-60 years with body mass index (BMI) = 40-50 kg/m² will be recruited in six hospitals. Primary endpoints are as follows: (1) efficacy, measured as percentage of patients with total weight loss (TWL) > 30% at 5 years; and (2) safety, defined as percentage of patients experiencing at least one severe complication either at 90 days postoperatively (Clavien-Dindo >2) or up to 5 years, including severe malnutrition, diarrhea, dumping, hypoglycemia, or need for surgical reintervention. Sample size was calculated for both primary outcomes, needing 432 patients to prove superiority of SADI-S in efficacy and 423 to prove non-inferiority in safety, with statistical power of 0.8, alpha risk of 0.025, assuming 10% loss throughout follow-up. To ensure power for both primary endpoints, 450 subjects will be included, 225 SADI-S and 225 RYGB. Secondary outcomes include metabolic comorbidities, quality of life, digestive symptoms (dumping, bowel habits, and GERD), need of extra supplementations, and alimentary habits. Outcomes will be compared using one-sided 95% confidence interval of proportion difference between groups.</p><p><strong>Discussion: </strong>To our knowledge, there is only one ongoing RCT comparing SADI-S with RYGB (SADISLEEVE trial, ClinicalTrials.gov identifier NCT03610256), which includes primary and revisional surgeries, without BMI restrictions and with varying limb lengths. The BYPSADIS trial will complement its findings and help to bridge the knowledge gap on whether SADI-S is more effective than RYGB, while offering a similar safety profile.</p><p><strong>Trial registration: </strong>The study protocol has been approved by the Ethics Committee of the six participating hospitals and has been registered in ClinicalTrials.gov, NCT06789965.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"119-128"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309822","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":"Cytoreductive surgery and HIPEC: A 10-year single-center retrospective cohort study.","authors":"Jukka M Rintala, Marjo Koskela, Pekka Peroja, Heikki Huhta, Juha Saarnio, Vesa-Matti Pohjanen, Heikki Takala","doi":"10.1177/14574969251397325","DOIUrl":"10.1177/14574969251397325","url":null,"abstract":"<p><strong>Background and aims: </strong>The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is widely used to treat pseudomyxoma peritonei (PMP), peritoneally metastasized colorectal or appendiceal cancer (pmCRC or pmAppCa) and peritoneal mesothelioma, although the specific efficacy of HIPEC remains inadequately proven. The aim of this retrospective study was to evaluate the outcomes of our CRS-HIPEC procedures and compare them with prior reports.</p><p><strong>Materials and methods: </strong>All patients operated with the intent of CRS-HIPEC at Oulu University Hospital (OUH) between September 2013 and August 2023 were prospectively registered in a CRS-specific quality control registry that included preoperative, intraoperative, and pathological data, as well as 30-day postoperative complications. The follow-up included thoracoabdominal computed tomography (CT) every 6 months for 3 years and after this yearly until 6 years postoperatively. Survival data were retrieved both from hospital records and from a national registry to analyze both short- and long-term outcomes of CRS-HIPEC.</p><p><strong>Results: </strong>Since its introduction at OUH in 2013, CRS-HIPEC was performed with curative intent in 272 patients. Peritoneal disease was confirmed in 223 (82%) cases. Among 171 resectable patients operated with CRS, 162 (95%) received HIPEC. Indications included pmCRC in 67 patients (41%), PMP in 61 (37%), pmAppCa in 23 (14%), and peritoneal mesothelioma in 7 (4%, other histology 4). Severe complications within 30 days (Clavien-Dindo class III-V) occurred in 68 patients (40%) of the CRS patients with a postoperative mortality of 0.6% (n = 1). The mean follow-up was 39 months (range 1-138). The estimated 5-year overall survival after CRS-HIPEC was 87% for PMP, 41% for pmCRC and 58% for pmAppCa. Estimated 5-year disease-free survival was 70%, 24%, and 36%, respectively.</p><p><strong>Conclusion: </strong>CRS-HIPEC is associated with good OS and DFS in PMP, whereas survival after both pmCRC and pmAppCa is considerably lower. The procedure is associated with a considerable risk of severe complications and should therefore be performed in specialized centers only.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"62-72"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688537","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 effect of diabetes on complications after distal pancreatectomy: A population-based cross-matched registry study.","authors":"Henrik Bergenfeldt, Eva Ekström, Katarina Fagher, Karin Filipsson, Bodil Andersson","doi":"10.1177/14574969251390998","DOIUrl":"10.1177/14574969251390998","url":null,"abstract":"<p><strong>Background: </strong>Distal pancreatic resection is associated with a high frequency of postoperative complications. The aim of this study was to characterize the effect of diabetes mellitus (DM) on short-term complications after distal pancreatectomy.</p><p><strong>Methods: </strong>Patients who underwent distal pancreatectomy between 1 January 2010 and 31 December 2020 were identified from the Swedish National Pancreatic and Periampullary Cancer Registry, and the data were cross-linked with the National Diabetes Registry. The complication rates were compared between patients with and without diabetes.</p><p><strong>Results: </strong>In total, 1297 patients underwent distal pancreatectomy, and 247 (19%) of these patients had DM. Postoperative complications occurred in 697/1297 (54%) patients. There was no difference observed in the risk of overall complications (odds ratio (OR) = 0.76, 95% confidence interval [CI]: 0.58-1.00; p = 0.052), general surgical complications (p = 0.053), medical complications (p = 0.872), or postoperative pancreatic fistula rates (p = 0.603) according to the univariable analysis. In the multivariable analysis, patients with DM demonstrated a lower risk of overall complications (OR = 0.72, 95% CI = 0.54-0.96; p = 0.025). In the subgroup analysis, patients with high mean HbA_1c levels (p = 0.041), high last measurement (p = 0.032), or DM duration >10 years (p = 0.022) exhibited lower risks of complications in the multivariable analysis.</p><p><strong>Conclusion: </strong>This study revealed a lower overall complication risk in patients with DM compared to patients without DM after distal pancreatectomy; however, no difference in the pancreatic fistula rate or medical complications was observed.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"106-115"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483452","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":"Validation and reliability testing of the Swedish version of the BREAST-Q reconstruction.","authors":"Christian Jepsen, Anna Paganini, Emma Hansson","doi":"10.1177/14574969251387498","DOIUrl":"10.1177/14574969251387498","url":null,"abstract":"<p><strong>Purpose: </strong>This study validates and assesses the reliability of the Swedish version of the BREAST-Q Reconstruction Module, a patient-reported outcome measure (PROM) designed to evaluate satisfaction and health-related quality of life (HRQoL) before and after breast reconstruction.</p><p><strong>Methods: </strong>This observational study included 300 patients undergoing breast reconstruction at Sahlgrenska University Hospital. The psychometric evaluation involved content validity through cognitive interviews, internal consistency (Cronbach's α), test-retest reliability, convergent validity (comparison with the EORTC QLQ-BRECON 23), responsiveness (Wilcoxon rank test), and analysis of floor and ceiling effects. BREAST-Q version 1.0 was used to maintain item richness and comparability with historical data.</p><p><strong>Results: </strong>Content validity was confirmed through interviews. Internal consistency was acceptable across all domains (Cronbach's α = 0.70-0.95). Test-retest reliability showed good agreement on the group level. Moderate correlations with BRECON-23 supported convergent validity. Responsiveness was demonstrated with significant improvements across all domains postoperatively (mean difference = 20.3, p < 0.001). Ceiling effects were observed preoperatively in Physical Well-being abdomen (40.1%) and postoperatively in four domains, notably Physical Well-being chest (45.5%). These effects may reflect true clinical success but also suggest limited sensitivity in high-functioning populations.</p><p><strong>Conclusion: </strong>The Swedish BREAST-Q Reconstruction Module demonstrates good validity, reliability, and responsiveness. However, ceiling effects in several domains highlight limitations in detecting subtle differences among patients with high levels of satisfaction, suggesting a need for stratified analysis and potential refinement of the scale.</p><p><strong>Preregistration: </strong>ClinicalTrials.gov Identifier: NCT05233891 and NCT04714463.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"88-96"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373199","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":"Claims filed after perceived malpractice in management of acute appendicitis: An observational nationwide cohort study.","authors":"Benedicte Skjold-Ødegaard, Geir S Braut, Hege L Ersdal, Kjetil Søreide","doi":"10.1177/14574969251363823","DOIUrl":"10.1177/14574969251363823","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute appendicitis is the most common surgical emergency worldwide. Obtaining a correct diagnosis and timely management can be challenging even in modern medicine. Hence, appendicitis is still considered a \"high-risk\" diagnosis for litigation and claims of malpractice. Few studies have investigated the pattern and outcome of claims for appendicitis in a contemporary universal health care system. The aim of this study is to analyze compensation claims related to the investigation and treatment of appendicitis in Norway.</p><p><strong>Methods: </strong>An observational study based on claims from the Norwegian System of Patient Injury Compensation (NPE) from 2005 to 2023. Population rates of appendicitis treatment were obtained from the Norwegian Patient Registry (NPR; data from 2016 to 2023) and Statistics Norway (SSB).</p><p><strong>Results: </strong>Altogether 207 compensation claims were filed for appendicitis and 56 (27%) received compensation. The probability of receiving compensation was not influenced by age, gender, or geographical location. The most common reasons for compensation granted were delayed diagnosis (n = 25, 45%) and delayed treatment (n = 5, 9%). The most common reasons for the 151 (73%) denied claims were predictable complication (n = 48, 32%) and condition caused by an unrelated disease (n = 40, 26%). Out of the 59,450 appendectomies performed, 96 claims were filed to NPE, giving a claim rate of 0.16% or 1 claim for every 620 appendectomies. For the entire study period, there was a total payout of 27.2 mill NOK (approximately 2.4 mill EUR) with a mean of 460,000 NOK (approximately 40,000 EUR) and a median of 75,000 NOK (approximately 6,600 EUR) per claim.</p><p><strong>Conclusion: </strong>In acute appendicitis, about a quarter of claims are compensated due to malpractice. More than half of the approved claims involved delays in diagnosis or treatment, which can be related to the clinical challenges of diagnosing appendicitis.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"414-420"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024679","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":"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":"494-504"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","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":"The Dome technique: A single-stage liposuction and dermopexy treatment for high-grade gynecomastia.","authors":"Umut Zereyak, Onur Aksoy","doi":"10.1177/14574969251363334","DOIUrl":"10.1177/14574969251363334","url":null,"abstract":"<p><strong>Background: </strong>Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32% to 36%. The goals of surgical treatment are to restore the breast contour with minimal scarring and protect the areolar anatomy and sensation. Here, a new single stage technique is described where peripheral fat tissue is effectively removed using ultrasound-assisted liposuction (UAL) followed by a Dome breast lifting from the superior parabolic periareolar incision without touching the complex inferior pedicle.</p><p><strong>Methods: </strong>A retrospective review of outcomes for 29 patients aged between 18 and 49 years with grade IIB or grade III gynecomastia who were treated with UAL and the Dome technique. Health-related quality-of-life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ).</p><p><strong>Results: </strong>The mean Likert-type score (LS) increased from 1.82 (18%) preoperatively to 4.10 (81%) months postoperatively (<i>p</i> < 0.05). No infection, nipple-areola complex necrosis, nipple retraction, or saucer deformity was encountered.</p><p><strong>Conclusion: </strong>The use of UAL and Dome technique for the treatment of severe gynecomastia allows for the effective removal of both the fat and glandular tissue of the breast through a minimal periareolar parabolic incision. This technique can achieve excellent aesthetic results with inconspicuous scarring in a single session.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"480-487"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976480","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}