Cirugia EspanolaPub Date : 2025-05-01DOI: 10.1016/j.ciresp.2024.11.019
Del Río-Solá M.ª Lourdes , Romero-Estrella M.ª Rosario , Roedan-Oliver Joan , Asensio-Rodriguez Sergio , Pérez-Fernández Sandra , Rial-Horcajo Rodrigo
{"title":"Strategic management and outcomes of surgical repair for ruptured abdominal aortic aneurysms in women: a systematic review and meta-analysis","authors":"Del Río-Solá M.ª Lourdes , Romero-Estrella M.ª Rosario , Roedan-Oliver Joan , Asensio-Rodriguez Sergio , Pérez-Fernández Sandra , Rial-Horcajo Rodrigo","doi":"10.1016/j.ciresp.2024.11.019","DOIUrl":"10.1016/j.ciresp.2024.11.019","url":null,"abstract":"<div><h3>Introduction</h3><div>The repair of ruptured abdominal aortic aneurysms (R-AAA) entails high mortality. This study aims to analyze differences in postoperative outcomes.</div></div><div><h3>Methods</h3><div>A meta-analysis was conducted of 8 studies involving 26 473 patients, evaluating 30-day mortality rates by comparing open surgical repair with endovascular repair and stratifying results by sex.</div></div><div><h3>Results</h3><div>The 30-day mortality rate was 23.0% in women versus 13.0% in men, with an odds ratio (OR) of 2.05. Women had higher rates of postoperative complications, such as stroke (6.0% vs. 4.0%) and renal failure (8.0% vs. 5.0%), as well as prolonged ICU stay (12.3 ± 6.4 days vs. 10.2 ± 5.7 days).</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of adjusting surgical approaches to improve outcomes in women with R-AAA. Continued prospective studies are recommended to optimize treatment protocols.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 257-267"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901944","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}
Cirugia EspanolaPub Date : 2025-05-01DOI: 10.1016/j.ciresp.2025.02.001
Franco Marinello , José M. Balibrea
{"title":"Comunicación asertiva: decir lo que hay que decir y no dañar en el intento","authors":"Franco Marinello , José M. Balibrea","doi":"10.1016/j.ciresp.2025.02.001","DOIUrl":"10.1016/j.ciresp.2025.02.001","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 324-325"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901932","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":"Factores predictores de curación de la apnea obstructiva del sueño en pacientes bariátricos","authors":"Sergio Navarro-Martínez , Jose Ángel Diez-Ares , Marina Carrasco-Llatas , Núria Peris-Tomás , Silvia Matarredona-Quiles , Ramón Trullenque-Juan , Carlos Domingo-del-Pozo","doi":"10.1016/j.ciresp.2024.12.010","DOIUrl":"10.1016/j.ciresp.2024.12.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Obstructive sleep apnea (OSA) is common among candidates for bariatric surgery and is often underdiagnosed. Given that obesity and OSA share comorbidities and mutually reinforce each other, it is important to identify factors that predict OSA resolution after bariatric surgery. However, studies on this topic are limited and offer contradictory results. The objective of the study was to identify predictors of OSA resolution one year after bariatric surgery.</div></div><div><h3>Methods</h3><div>A prospective study was conducted with bariatric surgery candidates aged 18 to 65. Patients underwent preoperative cardiorespiratory polygraphy (PR) and an otorhinolaryngological examination. A follow-up PR was performed one year after surgery. A multivariate analysis was conducted, examining anthropometric, metabolic, and upper airway anatomical variables to determine predictors of resolution.</div></div><div><h3>Results</h3><div>The prevalence of OSA was 75%. Predictors of resolution included preoperative body mass index (BMI), neck circumference and age. Each additional kg/m<sup>2</sup> in BMI reduced the probability of resolution by 14% (OR<!--> <!-->=<!--> <!-->0.86; <em>P</em>=.037), each additional centimeter of neck circumference reduced the probability by 16% (OR<!--> <!-->=<!--> <!-->0.84; <em>P</em>=.018), and each year of age reduced the probability by 11% (OR<!--> <!-->=<!--> <!-->0.89; <em>P</em>=.009).</div></div><div><h3>Conclusions</h3><div>The prevalence of OSA in bariatric patients is high, and BMI, neck circumference, and age are predictive factors of OSA resolution after bariatric surgery.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 295-301"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902001","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}
Cirugia EspanolaPub Date : 2025-05-01DOI: 10.1016/j.ciresp.2024.12.006
Néstor J. Martínez-Hernández , Míriam Estors-Guerrero , José M. Galbis-Caravajal , Manuel Mata-Roig , Amparo Roig-Bataller
{"title":"Advances and stagnation in airway surgery: A historical perspective","authors":"Néstor J. Martínez-Hernández , Míriam Estors-Guerrero , José M. Galbis-Caravajal , Manuel Mata-Roig , Amparo Roig-Bataller","doi":"10.1016/j.ciresp.2024.12.006","DOIUrl":"10.1016/j.ciresp.2024.12.006","url":null,"abstract":"<div><div>Airway pathology is a complex and incompletely mastered field. Historically, its management was rudimentary, with tracheostomies performed in ancient Egypt, and progress remained stagnant for millennia. Significant advances began in the late 19<sup>th</sup> century, followed by notable surgical and anesthetic progress in the mid-20<sup>th</sup> century. The 1952 polio epidemic spurred further development, with tracheal resection and anastomosis as the first major milestone, later extending to the larynx and carina. All significant advances in airway surgery ended in the latter half of the 20<sup>th</sup> century, with minimal progress since. This article analyzes its atypical evolution of an initial step that awaited millennia for subsequent advances, only to halt again in recent times.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 302-307"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901948","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}
Cirugia EspanolaPub Date : 2025-05-01DOI: 10.1016/j.ciresp.2025.01.002
Carlos Domingo-Del Pozo , Sergio Navarro-Martínez , Juan Carlos Sebastián-Tomás , Inés Domingo-Roig , Marta Córcoles-Córcoles , Amparo Martínez-Blasco , Inmaculada Ortiz-Tarín , Carmen Paya-Llorente
{"title":"Resultados a corto plazo de la exploración laparoscópica de la vía biliar principal por coledocolitiasis en los pacientes de edad avanzada","authors":"Carlos Domingo-Del Pozo , Sergio Navarro-Martínez , Juan Carlos Sebastián-Tomás , Inés Domingo-Roig , Marta Córcoles-Córcoles , Amparo Martínez-Blasco , Inmaculada Ortiz-Tarín , Carmen Paya-Llorente","doi":"10.1016/j.ciresp.2025.01.002","DOIUrl":"10.1016/j.ciresp.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Laparoscopic common bile duct exploration (LCBDE) is an alternative to endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of choledocholithiasis. However, its use in elderly patients has been limited, often avoided due to concerns about associated morbidity. This study aims to evaluate the success rate and outcomes of LCBDE in elderly patients.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted on patients with a confirmed diagnosis of choledocholithiasis via intraoperative cholangiography who underwent LCBDE from January 2009 to December 2022. Demographic, clinical, intraoperative, and postoperative data were collected. Patients were divided into two groups: those aged ≥70 years and those aged <70 years. Additionally, a subgroup analysis was performed on patients aged ≥80 years.</div></div><div><h3>Results</h3><div>A total of 330 patients were included (<70 years<!--> <!-->=<!--> <!-->168; ≥70 years<!--> <!-->=<!--> <!-->162). The success rate of LCBDE in patients aged ≥70 years was similar to that in patients aged <70 years (95.7 vs. 97%; <em>P</em>=.514). No statistically significant differences were found in intraoperative outcomes, short-term complications, or mortality between the two groups. These results were consistent in the subgroup analysis of patients aged ≥80 years (n<!--> <!-->=<!--> <!-->67) compared with those aged <70 years.</div></div><div><h3>Conclusion</h3><div>LCBDE is a safe and effective procedure for patients aged ≥70 years and could be considered a first-line therapeutic option for this group.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 279-286"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901952","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}
Cirugia EspanolaPub Date : 2025-05-01DOI: 10.1016/j.ciresp.2024.11.020
Alessio Lucarini , Andrea Martina Guida , Yves Panis
{"title":"Laparoscopic approach for rectal cancer surgery: triumph of reason or necessity of evolution?","authors":"Alessio Lucarini , Andrea Martina Guida , Yves Panis","doi":"10.1016/j.ciresp.2024.11.020","DOIUrl":"10.1016/j.ciresp.2024.11.020","url":null,"abstract":"<div><div>The role of laparoscopy in rectal cancer surgery has evolved considerably since the early 2000s. Initial randomized trials, such as COLOR II and COREAN, indicated that laparoscopic approaches offered similar pathological outcomes with better postoperative recovery than open surgery. In contrast, trials like ACOSOG Z6051 and ALaCaRT suggested noninferiority could not be established. Variability in trial outcomes, focusing on either disease-free survival or pathological measures, initially hindered consensus. Long-term analyses have shown no significant difference in disease-free survival between laparoscopic and open approaches. Meta-analyses have reinforced the benefits of laparoscopic surgery, with reduced mortality and similar oncologic effectiveness to open surgery. However, new techniques like transanal TME (TaTME) and robotic approaches have introduced alternatives, though each presents unique challenges, from recurrence rates in TaTME to costs in robotics. While laparoscopy remains the preferred method due to accessibility and outcomes, robotic surgery is expected to gain traction in high-volume centers.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 5","pages":"Pages 328-334"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901982","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}