Cirugia Espanola最新文献

{"title":"Manejo del cáncer de recto: el futuro ya es presente","authors":"Carlos Cerdán-Santacruz , 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}

{"title":"Hernias de hiato complejas. Recomendaciones de manejo diagnóstico y terapéutico","authors":"Marcos Bruna ,&nbsp;María Asunción Acosta ,&nbsp;Silvia Carbonell ,&nbsp;Luis Gómez ,&nbsp;Marian Mayo ,&nbsp;Salvador Morales-Conde ,&nbsp;Aitana Garcia-Tejero ,&nbsp;Silvia Aguas ,&nbsp;David Ruíz de Angulo ,&nbsp;Vicente Munitiz ,&nbsp;Luisa Martínez de Haro ,&nbsp;Vanessa Concepción ,&nbsp;Fernando Mingol ,&nbsp;Miriam Menéndez ,&nbsp;Gabriel Salcedo ,&nbsp;Esteban Martín ,&nbsp;Ana Senent ,&nbsp;Alexis Luna ,&nbsp;Dulce Momblán ,&nbsp;Pablo Priego ,&nbsp;Mónica Miró","doi":"10.1016/j.ciresp.2025.800279","DOIUrl":"10.1016/j.ciresp.2025.800279","url":null,"abstract":"<div><div>Hiatal hernia (HH) is a relatively prevalent condition in our setting, yet there is little clinical evidence or guidelines establishing precise recommendations for its diagnostic and therapeutic management.</div><div>In order to establish clinical recommendations for the diagnostic and therapeutic management of patients with complex hiatal hernia, defined as a primary type III or IV mixed hernia, a large one with<!--> <!-->&gt;30% of the gastric contents in the thoracic cavity, or a recurrence. This document was prepared based on current scientific evidence and the experience of a group of 28 expert surgeons, using GRADE methodology in order to establish recommendations on 13 controversial aspects related to this pathology.</div><div>Although the quality of evidence and the degree of recommendation are high in some areas, high-quality prospective clinical studies are needed to clarify certain unresolved points of controversy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800279"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080001","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":"Evidencia clínica del uso de Hemopatch® en la reducción del sangrado y fístula biliar tras resección hepática. Estudio prospectivo aleatorizado en cirugía programada","authors":"Andrea Boscà Robledo ,&nbsp;Eva M. Montalvá Orón ,&nbsp;Ana Navío Seller ,&nbsp;Javier Maupoey Ibáñez ,&nbsp;Ana Hernando Sanz ,&nbsp;David Calatayud Mizrahi ,&nbsp;Francisco J. Orbis Castellanos ,&nbsp;Rafael López Andújar","doi":"10.1016/j.ciresp.2025.800270","DOIUrl":"10.1016/j.ciresp.2025.800270","url":null,"abstract":"<div><h3>Background</h3><div>There is abundant scientific literature on the use of haemostatics and sealants in liver surgery, but there is a lack of evidence due to the difficulty to apply adequate methodologies without conflicts of interest.</div><div>This prospective randomized study with the main objective is to determine the efficacy of the local haemostatic Hemopatch® in the incidence of bleeding and biliary fistula in patients undergoing elective liver resection.</div></div><div><h3>Methods</h3><div>This was a single-center study where 222 patients were analyzed: 115 patients had been randomized to the control group and 107 to the experimental group. The patients after liver resection are randomized to place Hemopatch® or not on the transection liver surface. Patients with all types of liver resections and with laparotomic and laparoscopic approaches were included. During postoperative follow-up, an abdominal drain is placed, and hemoglobin and bilirubin are analyzed during the first three days.</div></div><div><h3>Results</h3><div>Clinically postoperative bleeding occurred in 3.5% of the patients in the control group and in 2.8% of the experimental group (<em>P</em> <!-->=<!--> <!-->.409). The incidence of postoperative biliary fistula was 17.4% in the control group and 23.4% in the experimental group (<em>P</em> <!-->=<!--> <!-->.269). There were also no differences in the rest of the parameters analyzed.</div></div><div><h3>Conclusions</h3><div>The results on the use of Hemopatch® in liver resection to prevent hemorrhage and biliary fistula are inconclusive. It cannot be routinely recommended and surgeons should be more demanding with the scientific evidence to justify the systematic use of haemostatics agents.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800270"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982101","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":"Shunt íleo-cava intraoperatorio transitorio en la resección de adenocarcinoma de cabeza de páncreas localmente avanzado: ¿rompiendo un techo?","authors":"Juli Busquets ,&nbsp;Núria Peláez ,&nbsp;Luis Secanella ,&nbsp;Maria Sorribas ,&nbsp;Elena Iborra","doi":"10.1016/j.ciresp.2025.800249","DOIUrl":"10.1016/j.ciresp.2025.800249","url":null,"abstract":"<div><div>The resection of locally advanced adenocarcinoma of the pancreatic head with occlusion of the superior mesenteric vein and involvement of the splenomesentericportal confluent (EMP) sometimes requires prolonged venous clamping with risk of intestinal ischemia. The use of intraoperative venous <em>shunt</em>s has been published by reference groups to allow successful resection. In our center we performed a total pancreatoduodenectomy for locally advanced pancreatic head adenocarcinoma with superior mesenteric vein occlusion (SMV) and splenomesentericportal confluent. The use of a transient ileo-caval <em>shunt</em> via a venous graft allowed resection of the tumor without repercussion on the bowel. The surgery ended with closure of the <em>shunt</em>, anastomosis of the graft to the portal vein and digestive reconstruction. The patient presented good tolerance to surgery and was discharged on the 7<!--> <!-->th postoperative day. The pathology report described pancreatic adenocarcinoma ypT1N0(R0) regression grade GRT2/IIa, with 0/30 affected adenopathies.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800249"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982102","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":"Características de los ensayos clínicos españoles en cirugía digestiva completados en 2009-2024","authors":"Rafael Dal-Ré ,&nbsp;Elena García-Méndez ,&nbsp;Ignacio Mahillo-Fernández","doi":"10.1016/j.ciresp.2025.800268","DOIUrl":"10.1016/j.ciresp.2025.800268","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800268"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982100","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 quirúrgico del adenocarcinoma gástrico estadio IV: revisión sistemática y recomendaciones del Grupo de Tratamiento de los Tumores Digestivos y la Asociación Española de Cirujanos","authors":"Paula Jimenez-Fonseca ,&nbsp;Marcos Bruna ,&nbsp;Javier Gallego ,&nbsp;Mónica Miró ,&nbsp;Mireia Gil ,&nbsp;Fernando Pereira ,&nbsp;Gema Marín ,&nbsp;Delia Cortés ,&nbsp;Roberto Pazo ,&nbsp;Mariagiulia Dal Cero ,&nbsp;Elena Martín ,&nbsp;Fernando Rivera","doi":"10.1016/j.ciresp.2025.800254","DOIUrl":"10.1016/j.ciresp.2025.800254","url":null,"abstract":"<div><div>This manuscript presents a systematic review and expert consensus from oncology and surgery on the management of metastatic gastric cancer. A literature search was conducted in PubMed and Google Scholar, selecting 28 relevant studies (21 clinical trials and 7 systematic reviews), along with international guidelines. The objective was to assess the role of surgery and locoregional therapies in patients with peritoneal, hepatic, pulmonary, or nodal metastases, and to establish multidisciplinary recommendations. Cytoreductive surgery associated to HIPEC may offer benefits in selected patients with limited peritoneal carcinomatosis (Peritoneal Carcinomatosis Index ≤6), an absence of distant metastasis, an adequate response to systemic chemotherapy and an ECOG performance status of 0-1. Resection of non-peritoneal metastases may also be considered in specific contexts. Prospective clinical trials are required to confirm these findings and define optimal selection criteria.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800254"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080000","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":"Invaginación intestinal secundaria a metástasis de melanoma","authors":"Sara Peidro Parres ,&nbsp;Javier Cortés Climent ,&nbsp;Antonio Boluda Sánchez ,&nbsp;Ma de los Lirios Ferri Candela","doi":"10.1016/j.ciresp.2025.800269","DOIUrl":"10.1016/j.ciresp.2025.800269","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800269"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972951","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":"A modified Federle score is superior to injury grade in predicting the need for splenectomy in patients with isolated blunt splenic trauma","authors":"Corrado P. Marini ,&nbsp;Patrizio Petrone ,&nbsp;Francesca Izzo ,&nbsp;David A. Lieb II ,&nbsp;Srinivas H. Reddy ,&nbsp;John McNelis","doi":"10.1016/j.ciresp.2025.800262","DOIUrl":"10.1016/j.ciresp.2025.800262","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed whether there is a correlation between the grade of splenic injury and the semiquantitative assessment of the amount of the hemoperitoneum (HP) by a modified Federle score (mFS), and which of the 2 factors is more predictive of the need for intervention in adult patients with isolated blunt splenic injury (iBSI).</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients admitted (1/1/2019−12/31/2022) with iBSI. Continuous data are presented as means ± standard deviation and non-parametric data as frequencies with percentages. A test-retest analysis for intra- and inter-class reliability of HP assessment was done in a 10-patient subgroup.</div></div><div><h3>Results</h3><div>Among the 62 patients, 47 (75.8%) were managed nonoperatively (23 observation, 24 splenic artery embolization [SAE]), and 15 underwent splenectomy. The grade of splenic injury and mFS scores were 3.6 ± 1.3 and 4.1 ± 1.9, respectively. The 22 patients who underwent SAE were more severely injured in terms of grade of splenic injury (4.0 ± 1.2 vs 2.6 ± 1.1), amount of HP by mFS (4.1 ± 1.8 vs 3.1 ± 1.7) and ISS (21 ± 11 vs 15 ± 12) compared to the observed patients (<em>P</em> &lt; .05). Mortality was 8%. SAE and splenectomy groups differed only by the quantity of HP (4.1 ± 1.8 vs 5.5 ± 1.3). While there was a correlation between AAST grade and mFS, only mFS was predictive of splenectomy.</div></div><div><h3>Conclusion</h3><div>The quantity of HP as assessed by mFS may be more predictive than the grade of splenic injury regarding the need for splenectomy in patients with iBSI.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 1","pages":"Article 800262"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090622","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":"The impact of microsatellite instability and tumor characteristics on survival of patients with right-sided colon cancer","authors":"Ozgur Ekinci ,&nbsp;Ataturk Nurullayev ,&nbsp;Muhammet Ali Aydemir ,&nbsp;Aysegul Ergun ,&nbsp;Tunc Eren ,&nbsp;Orhan Alimoglu","doi":"10.1016/j.ciresp.2025.800272","DOIUrl":"10.1016/j.ciresp.2025.800272","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to explore the clinical and pathological differences between microsatellite instability-high (MSI-H) and microsatellite stable (MSS) tumors in right-sided colon cancer patients, as well as to evaluate the prognostic significance of MSI status on survival outcomes.</div></div><div><h3>Methods</h3><div>Historical records of patients who underwent surgery for right-sided colon cancer between 2016 and 2024 were evaluated retrospectively. Immunohistochemistry was used for the determination of MSI status, and data on tumor characteristics, lymph node metastasis, carcinoembryonic antigen (CEA) levels, and survival outcomes were analyzed. Comparisons were performed to assess differences between the MSI-H and MSS groups, where <em>P</em> &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study included 100 patients, consisting of 52 men and 48 women with a median age of 72 (range: 63–79). Tumors with MSI-H status were significantly larger (median: 6.50 cm vs 4.50 cm; <em>P</em> &lt; .001) and demonstrated higher rates of mucinous carcinoma (52.9% vs 24.2%; <em>P</em> = .008) compared to MSS tumors. Poor differentiation was more common in MSI-H tumors (20.6% vs 3.03%: <em>P</em> = .003). Overall survival (OS) and disease-free survival (DFS) did not differ significantly between MSI-H and MSS groups (<em>P</em> = .466 and <em>P</em> = .337, respectively). Elevated postoperative CEA levels at 6, 12, 18 and 24 months were significantly associated with poorer survival outcomes (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>Right-sided colon cancers with MSI-H status were associated with larger tumor size, mucinous histology, and poor differentiation but did not significantly affect survival outcomes. Postoperative CEA monitoring provides critical prognostic information. Further large-scale studies are required to confirm these findings and refine therapeutic approaches.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 1","pages":"Article 800272"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090689","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}