Cirugia Espanola最新文献

{"title":"IA en el diagnóstico y manejo del adenocarcinoma gástrico: revisión sistemática","authors":"Ismael Gómez Giménez ,&nbsp;Juan Jesús Rubio Garcia ,&nbsp;Silvia Carbonell Morote ,&nbsp;José Manuel Ramia Ángel","doi":"10.1016/j.ciresp.2025.800276","DOIUrl":"10.1016/j.ciresp.2025.800276","url":null,"abstract":"<div><div>Gastric cancer (GC) has high mortality due to late diagnosis from nonspecific symptoms. Advances in diagnostics and artificial intelligence (AI) promise earlier detection through greater sensitivity and specificity. This study reviews literature, including meta-analyses and systematic reviews, on AI in gastric adenocarcinoma (GA). In December 2024, following PRISMA, we searched PubMed, Web of Science, and Cochrane. Seventeen of 228 articles met inclusion criteria, comparing AI with other diagnostic or therapeutic approaches. Findings indicate AI may enhance imaging, histological assessment, endoscopy techniques, and surgical procedures. Progressive hospital implementation could significantly transform GA diagnosis, treatment, and prognosis.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800276"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081417","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 psicosociales y conductuales asociados a la experiencia alimentaria tras cirugía bariátrica: un estudio transversal en pacientes españoles","authors":"David Peña-Otero ,&nbsp;Ma Alexandra Gualdrón-Romero ,&nbsp;María Eguillor-Mutiloa ,&nbsp;Francisco José Gracia-Cordero ,&nbsp;Jaione Beristain-Larrucea","doi":"10.1016/j.ciresp.2026.800286","DOIUrl":"10.1016/j.ciresp.2026.800286","url":null,"abstract":"<div><h3>Introduction</h3><div>Food satisfaction and relationship with food are key determinants of quality of life after bariatric surgery; however, the factors that modulate them remain poorly defined. The objective of this study was to analyze the eating experience of bariatric surgery patients and identify the clinical, behavioral, and psychosocial factors that influence it.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 63 patients (71.4% women; age 42.6<!--> <!-->±<!--> <!-->9.7 years) who underwent gastric <em>bypass</em> or gastric sleeve surgery (25.3<!--> <!-->±<!--> <!-->17.2 months). Sociodemographic data, postoperative time, and self-reported variables were collected: eating satisfaction (Likert 1–5), relationship with food (VAS 1–10), self-esteem, physical activity, and eating patterns. ANOVA and multiple linear regression (α<!--> <!-->=<!--> <!-->0.05) were applied.</div></div><div><h3>Results</h3><div>47.6% reported being able to eat any food. These patients showed greater food satisfaction than those reporting restrictions (4.20<!--> <!-->±<!--> <!-->0.68 vs. 3.48<!--> <!-->±<!--> <!-->0.87; F<!--> <!-->=<!--> <!-->12.96; p &lt;<!--> <!-->0.001; η² &lt;<!--> <!-->p &lt;<!--> <!-->/ sub<!--> <!-->&gt;<!--> <!-->=<!--> <!-->0.18). The timing of the main meal was associated with the relationship with food (F<!--> <!-->=<!--> <!-->3.49; p<!--> <!-->=<!--> <!-->0.037): lunch (7.62<!--> <!-->±<!--> <!-->1.89)<!--> <!-->&gt; dinner (5.38<!--> <!-->±<!--> <!-->2.77). The multivariate model explained 45% of the variance in the relationship with food (R² <!-->=<!--> <!-->0.454): self-esteem (β<!--> <!-->=<!--> <!-->0.53; p &lt;<!--> <!-->0.001) and physical activity (β<!--> <!-->=<!--> <!-->0.23; p<!--> <!-->=<!--> <!-->0.043) were independent predictors, while postoperative time was not significant (p<!--> <!-->=<!--> <!-->0.232).</div></div><div><h3>Conclusions</h3><div>Perceived dietary flexibility, self-esteem, and regular physical activity are the main determinants of a satisfactory eating experience after bariatric surgery, above and beyond the mere passage of time. These results support the inclusion of psychological interventions and structured physical exercise in multidisciplinary postoperative follow-up.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800286"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191179","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":"Impacto clínico y económico sostenido de la gastrectomía vertical. Más allá de la pérdida de peso","authors":"Ibabe Villalabeitia Ateca ,&nbsp;Oihane Gutiérrez Grijalba ,&nbsp;Iker Ustarroz Aguirre ,&nbsp;Maria Teresa Acaiturri Ayesta ,&nbsp;Alvaro Andrés Bilbao ,&nbsp;Gaizka Errazti Olartekoetxea ,&nbsp;Aingeru Sarriugarte Lasarte","doi":"10.1016/j.ciresp.2026.800287","DOIUrl":"10.1016/j.ciresp.2026.800287","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity represents a growing public health problem with significant clinical and economic implications. Sleeve gastrectomy is currently the most widely performed bariatric procedure worldwide. This study evaluates its clinical effectiveness and its impact on healthcare resource utilization in a referral hospital.</div></div><div><h3>Methods</h3><div>Retrospective study of a prospective series of 321 patients who underwent sleeve gastrectomy between 2011 and 2020, with a minimum follow-up of 5 years. Anthropometric variables, comorbidities, and healthcare resource utilization were analyzed. For the economic evaluation, 42 patients with complete data were included, applying a bottom-up real-costing approach. Comparisons were stratified by age, sex, and baseline BMI.</div></div><div><h3>Results</h3><div>The percentage of excess BMI loss at 5 years was 62.4%. Significant remission was observed in metabolic syndrome (64%), type 2 diabetes (63.5%), and hypertension (52.7%), with a lower impact on dyslipidemia. The economic analysis showed a mean reduction of 1.6 primary care visits, 2.7 hospital visits, and an average saving of €<!--> <!-->673 per patient per year. In multimorbid patients, savings reached €<!--> <!-->1,262 per year.</div></div><div><h3>Conclusions</h3><div>Sleeve gastrectomy is an effective and safe intervention, providing sustained clinical benefits and a significant reduction in healthcare expenditure, particularly among patients with multiple comorbidities. These findings support its inclusion in public health strategies aimed at ensuring the sustainability of the healthcare system.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800287"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147400073","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":"Abordaje robótico real para la hemihepatectomía izquierda extendida al caudado con resección de vena porta por colangiocarcinoma hiliar extrahepático de Klatskin tipo Bismuth IIIb","authors":"Jordi Navinés-López,&nbsp;Alba Zárate Pinedo,&nbsp;Francisco Espin Alvarez,&nbsp;Esteban Cugat Andorrà","doi":"10.1016/j.ciresp.2025.800267","DOIUrl":"10.1016/j.ciresp.2025.800267","url":null,"abstract":"<div><div>This article provides a detailed description of the robotic approach used to perform an extended left hepatectomy with venous resection in a 65-year-old female patient with a Bismuth-Corlette tumour type 3b infiltrating the portal confluence. A Glissonean pedicle approach was used to achieve total prehepatic vascular control and resection of the left portal confluence, followed by transverse reconstruction according to the Heineke-Mikulicz technique. The parenchymal transection, including the entire caudate lobe, was performed robotically, with left hanging manoeuvre after complete piggybacking of the vena cava. The final pathological result was G3 pT2bN1M0 (2/11) signet ring cell adenocarcinoma. The robotic approach enabled adjuvant treatment to be initiated immediately. No major complications were recorded within 90 days, and the patient was discharged on the 5th day.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800267"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191227","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":"Definiendo límites de seguridad en la donación de órganos: el donante de riesgo no estándar","authors":"Antonio Ríos ,&nbsp;Beatriz Mahíllo ,&nbsp;Beatriz Domínguez-Gil","doi":"10.1016/j.ciresp.2025.800277","DOIUrl":"10.1016/j.ciresp.2025.800277","url":null,"abstract":"<div><div>The transmission of diseases through organ transplantation is an inherent risk to the transfer of biological material between individuals. This risk must be minimized, while also avoiding the unnecessary loss of organs suitable for transplantation obtained from donors with a history of a condition that may affect organ function or may be transmitted to the recipient—such donors are referred to as non-standard risk donors. The final decision to transplant organs from these donors must be made following a thorough risk/benefit assessment.</div><div>To this end, the approach in Spain has been based on the provision of targeted support to transplant teams through the development and adoption of reference documents, a second-opinion system, and the generation of evidence through the prospective follow-up of recipients of organs trasplanted from this type of donors.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800277"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057541","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":"Apendicitis aguda contenida en hernia umbilical","authors":"María Orellana León,&nbsp;Alejandro Moreno Bargueiras,&nbsp;Daniel Pastor Altaba,&nbsp;Pedro Yuste García","doi":"10.1016/j.ciresp.2025.800252","DOIUrl":"10.1016/j.ciresp.2025.800252","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800252"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025183","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":"Cuidados perioperatorios en la cirugía del sarcoma retroperitoneal primario: una encuesta hispano-lusa sobre prácticas actuales","authors":"Pablo Lozano Lominchar ,&nbsp;Paula Muñoz ,&nbsp;Cristina Ballester ,&nbsp;Cristobal Muñoz Casares ,&nbsp;Daniel Díaz ,&nbsp;Vicente Olivares-Ripoll ,&nbsp;Patricia Marrero ,&nbsp;Lorena Cambeiro ,&nbsp;Irene López ,&nbsp;Hugo Vasques ,&nbsp;Jose Manuel Asencio ,&nbsp;on behalf of the Spanish Society of Surgeons, the Portuguese Sarcoma Group (Society of Surgeons)","doi":"10.1016/j.ciresp.2025.800283","DOIUrl":"10.1016/j.ciresp.2025.800283","url":null,"abstract":"<div><h3>Background</h3><div>Retroperitoneal sarcoma (RPS) is a rare malignancy requiring complex surgical management. While Enhanced Recovery After Surgery (ERAS®) protocols have improved outcomes in various surgical specialties, their implementation in RPS remains inconsistent.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate current perioperative care practices for RPS surgery across Spain and Portugal, identifying gaps in protocol standardization and assessing the feasibility of consensus-based approaches.</div></div><div><h3>Methods</h3><div>A structured online survey was distributed to members of the Spanish and Portuguese Societies of Surgeons. The questionnaire encompassed five domains: demographics, preoperative, intraoperative, and postoperative practices, and attitudes toward perioperative consensus.</div></div><div><h3>Results</h3><div>Among 266 survey accesses, 37 complete responses were analyzed. Only 27% of respondents reported having a dedicated ERAS® protocol for RPS, though 89.2% employed ERAS® pathways for other surgeries. Prehabilitation elements —such as smoking cessation (21.6%), nutritional support (73%), and supervised physical therapy (37.8%)— were inconsistently applied. Intraoperatively, goal-directed fluid therapy was used by 51.4%, while 97.3% adhered to restrictive transfusion thresholds. Postoperative variability was notable in diet resumption, mobilization, and nasogastric tube use. All respondents supported the creation of an RPS-specific perioperative care consensus.</div></div><div><h3>Conclusions</h3><div>There is marked heterogeneity in perioperative care for RPS across Iberian centers. Standardized, evidence-based guidelines are urgently needed to improve consistency and optimize patient outcomes.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800283"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982103","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":"Protocolo del estudio 3D-PANC: ¿es la tecnología de imagen en tres dimensiones superior a la tomografía computarizada para evaluar la respuesta al tratamiento neoadyuvante en los pacientes con adenocarcinoma de páncreas borderline o localmente avanzado?","authors":"Marina Garcés Albir ,&nbsp;Francisco García García ,&nbsp;Isabel Mora Oliver ,&nbsp;Elena Muñoz Forner ,&nbsp;Luis Sabater Orti ,&nbsp;Dimitri Dorcaratto ,&nbsp;GRUPO 3D-PANC Integrantes Grupo 3D-PANC","doi":"10.1016/j.ciresp.2025.800256","DOIUrl":"10.1016/j.ciresp.2025.800256","url":null,"abstract":"<div><div>Neoadjuvant chemotherapy followed by surgery represents the treatment of choice for patients with borderline and locally advanced pancreatic adenocarcinoma (PAC). Despite being the diagnostic technique of choice for PAC staging, computed tomography (CT) has very low accuracy in identifying patients who may benefit from surgical resection after neoadjuvant therapy. Consequently, the study of new image processing technologies is gaining significant importance. However, no prospective validation studies of these new technologies currently exist. The 3D-PANC study is a multicenter prospective study that will include patients with borderline or locally advanced PAC undergoing neoadjuvant chemotherapy and surgical exploration with curative intent. The objective is to compare the accuracy of the 3D-MSP (Model for Surgery Planning) model versus conventional CT for preoperative diagnosis of vascular involvement after neoadjuvant treatment (NAT) in patients with borderline or locally advanced PAC. This will be achieved by analyzing the accuracy variables of both techniques against the gold standard (surgical outcomes and histopathological analysis).</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800256"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982099","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":"Manejo del cáncer de recto: el futuro ya es presente","authors":"Carlos Cerdán-Santacruz ,&nbsp;Matteo Frasson","doi":"10.1016/j.ciresp.2025.800280","DOIUrl":"10.1016/j.ciresp.2025.800280","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800280"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080002","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":"Impacto asistencial y seguridad quirúrgica de la mastectomía endoscópica en mujeres con cáncer de mama y de alto riesgo. Resultados preliminares del estudio VideoBreast-24","authors":"Benigno Acea-Nebril,&nbsp;Alejandra García-Novoa,&nbsp;Sergio Sierra,&nbsp;Lucía Santos,&nbsp;Carmen Cereijo Garea","doi":"10.1016/j.ciresp.2026.800290","DOIUrl":"10.1016/j.ciresp.2026.800290","url":null,"abstract":"<div><h3>Introduction</h3><div>Skin and nipple-sparing mastectomy with immediate reconstruction has become the standard treatment for women requiring a mastectomy. The objective of this article is to describe endoscopic mastectomy and analyze the initial results after its implementation in terms of care impact and post-surgical complications.</div></div><div><h3>Methods</h3><div>Preliminary results of the VideoBreast-24 in terms of safety and feasibility of the technique. VideoBreast-24 is a non-inferiority study that compares MPPP-E with immediate reconstruction with a polyurethane implant versus skin-sparing or skin-and-nipple mastectomy using the open technique performed within the framework of the PreQ-20 study.</div></div><div><h3>Results</h3><div>60 MPPP-E were performed on 42 women, 92.9% of whom were oncological patients. The average surgery time was 213.7<!--> <!-->minutes. The average implant volume is 322cc, with the largest volume being 545cc. There were no implant losses.</div></div><div><h3>Conclusions</h3><div>Endoscopic mastectomy is a technique with a low incidence of postoperative complications, surgical reintervention and readmission. Surgical time is longer than that of open mastectomy, although it can be optimized 11<!--> <!-->the learning curve has passed.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800290"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174059","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}