Cirugia Espanola最新文献

{"title":"Consensus-based validation of key quality indicators in pancreatic cancer surgery in Catalonia: a modified Delphi study","authors":"Laura Guarga ,&nbsp;Patricia Sánchez-Velázquez ,&nbsp;Josep Maria Badia ,&nbsp;Mónica Ballesteros ,&nbsp;Laura Esteban ,&nbsp;Juli Busquets ,&nbsp;Fernando Espín-Álvarez ,&nbsp;Santiago Sánchez-Cabús ,&nbsp;Fabio Ausania ,&nbsp;Elizabeth Pando ,&nbsp;Rosa Jorba-Martin ,&nbsp;María Isabel García-Domingo ,&nbsp;Santi Lopez-Ben ,&nbsp;Alfredo Escartín ,&nbsp;Fernando Burdio ,&nbsp;Francisco García-Borobia ,&nbsp;Josep Maria Borràs ,&nbsp;Paula Manchon-Walsh","doi":"10.1016/j.ciresp.2026.800304","DOIUrl":"10.1016/j.ciresp.2026.800304","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreatic cancer surgery is highly complex and associated with significant perioperative risk, high mortality and morbidity, low quality of life, and increased healthcare costs. Establishing quality indicators to monitor these procedures may improve care quality and outcomes. This study aims to define a set of quality indicators to evaluate pancreatic cancer surgery in Catalonia.</div></div><div><h3>Methods</h3><div>A preliminary list of quality indicators was developed based on a literature review. Subsequently, a modified Delphi study was undertaken, involving 11 expert pancreatic surgeons, one from each center where these complex surgeries are authorized in Catalonia, to achieve consensus on quality indicators for pancreatic cancer surgery.</div></div><div><h3>Results</h3><div>The literature review yielded 21 potential quality indicators. After 4 rounds of voting, the expert panel accepted 17 indicators and rejected 4. The final set of quality indicators encompasses critical aspects including positive tumor resection margin, lymph nodes retrieved, postoperative complications, hospital readmission, reoperation, 90-day mortality and one-year survival.</div></div><div><h3>Conclusion</h3><div>The outcome of this study is a set of agreed quality indicators to measure, describe and monitor the quality and outcomes of pancreatic cancer surgery. These quality indicators can be used as a foundation for benchmarking studies and systematic evaluations of quality of care and enhanced surgical performance in pancreatic cancer.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 5","pages":"Article 800304"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147858933","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":"Modelling the colorectal cancer immune microenvironment using air–liquid interface organoids for personalised therapeutic evaluation","authors":"Rebeca Abad Moret ,&nbsp;Esteban Díaz ,&nbsp;Laura Córdoba ,&nbsp;Sylwia Bilas ,&nbsp;Teresa Gómez-Elvira ,&nbsp;Natalia González Alcolea ,&nbsp;Beatriz Díaz San Andrés ,&nbsp;Francisco J Cueto ,&nbsp;Eduardo López-Collazo ,&nbsp;Ramón Cantero Cid","doi":"10.1016/j.ciresp.2026.800285","DOIUrl":"10.1016/j.ciresp.2026.800285","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, with treatment resistance posing a persistent clinical challenge. Patient-derived organoids (PDO) offer a promising platform for modelling tumour biology and therapeutic responses; however, conventional Matrigel-based PDO lack the immune contexture necessary to capture the full complexity of the tumour microenvironment (TME). In this study, we performed a second model, known as air–liquid interface patient-derived organoids (ALI-PDO), that preserves infiltrating immune cells, evaluating its relative advantages over the classical Matrigel culture in modelling CRC.</div></div><div><h3>Materials and methods</h3><div>In this study, we present a comparative analysis of 2 organoid systems—Matrigel-PDO and air-liquid interface PDO (ALI-PDO)—generated from CRC surgical biopsies obtained from 5 patients.</div></div><div><h3>Results</h3><div>Both models recapitulated key histopathological and proliferative features of the original tumours; however, only ALI-PDO preserved native immune infiltrates, including CD45⁺, CD3⁺, and CD68⁺ cells. Functional assays demonstrated that ALI-PDO allowed for the investigation of drug-induced immune dynamics, revealing selective sensitivity of immune cells to 5-fluorouracil (5-FU) treatment. In contrast, Matrigel-PDO, composed solely of neoplastic epithelial cells, failed to reflect these interactions.</div></div><div><h3>Conclusions</h3><div>Our findings establish ALI-PDO as an advanced preclinical model that more accurately mirrors the immunological and architectural complexity of CRC. This system offers a valuable tool for evaluating immunomodulatory therapies and guiding personalised treatment strategies. Future studies should expand the application of ALI-PDO to immunotherapy and incorporate additional components of the TME to further enhance translational relevance.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 5","pages":"Article 800285"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147858934","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":"Vídeos","authors":"","doi":"10.1016/S0009-739X(26)01313-8","DOIUrl":"10.1016/S0009-739X(26)01313-8","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 ","pages":"Pages 77-91"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247468","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":"Vídeos enfermería","authors":"","doi":"10.1016/S0009-739X(26)01316-3","DOIUrl":"10.1016/S0009-739X(26)01316-3","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 ","pages":"Page 99"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247465","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":"Comunicaciones orales enfermería","authors":"","doi":"10.1016/S0009-739X(26)01314-X","DOIUrl":"10.1016/S0009-739X(26)01314-X","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 ","pages":"Pages 92-93"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247464","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":"Consensus document for the transcystic approach to choledocholithiasis with ultrathin flexible choledochoscope","authors":"Alejandra García-Botella ,&nbsp;Juan Pablo Arjona Trujillo ,&nbsp;Sofía de la Serna ,&nbsp;Pedro José Gil Vázquez ,&nbsp;Santos Jiménez-Galanes Marchán ,&nbsp;Erik Llàcer-Millán ,&nbsp;Ana Belén Martín Arnau ,&nbsp;David Martínez-Cecilia ,&nbsp;Alba Zárate Pinedo ,&nbsp;Alberto Martínez-Isla","doi":"10.1016/j.ciresp.2025.800259","DOIUrl":"10.1016/j.ciresp.2025.800259","url":null,"abstract":"<div><div>The transcystic laparoscopic approach to manage choledocholithiasis using ultrathin flexible choledochoscopes is aimed at reducing complications linked to ERCP and transductal techniques when treating common bile duct stones with gallbladder in situ. Despite their advantages, transcystic techniques are not being widely adopted, highlighting the need for structured protocols, a multidisciplinary approach, and adequate resource allocation to optimize outcomes.</div><div>This consensus document addresses key issues to standardize the approach, based on the responses to the 25 questions posed to the panel of experts.</div><div>The recommendations issued, based on the evidence and expert opinion, cover the key factors for the success of the technique, including appropriate patient selection, technical characteristics of the approach, advanced equipment required, etc.</div><div>This comprehensive guide aims to standardize the technique in order to improve patient outcomes and ensure safe, effective treatment of choledocholithiasis.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 4","pages":"Article 800259"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650028","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":"Can we decrease the risk of complex liver surgery with the new GLP1 and GIP analogues?","authors":"Iago Justo ,&nbsp;María Calatayud ,&nbsp;Javier Salamanca ,&nbsp;María Camara ,&nbsp;Alvaro García-Sesma ,&nbsp;Carmelo Loinaz","doi":"10.1016/j.ciresp.2025.800264","DOIUrl":"10.1016/j.ciresp.2025.800264","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 4","pages":"Article 800264"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650030","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 huge exophytic leiomyoma of the rectum","authors":"Wei Yang ,&nbsp;Chendong He","doi":"10.1016/j.ciresp.2025.800247","DOIUrl":"10.1016/j.ciresp.2025.800247","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 4","pages":"Article 800247"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650029","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":"Structured outpatient cholecystectomy protocol leads to improving results and expanding indications","authors":"Pablo Ezequiel Finno ,&nbsp;Santiago González-Ayora ,&nbsp;María Fraile Vilarrasa ,&nbsp;Tihomir Georgiev-Hristov","doi":"10.1016/j.ciresp.2026.800301","DOIUrl":"10.1016/j.ciresp.2026.800301","url":null,"abstract":"<div><h3>Background</h3><div>Outpatient laparoscopic cholecystectomy has become increasingly common, yet criteria for patient selection remain conservative. We aimed to assess the long-term outcomes of implementing a structured outpatient cholecystectomy protocol in a secondary hospital and explore its applicability in traditionally high-risk populations.</div></div><div><h3>Materials and methods</h3><div>1024 consecutive elective cholecystectomy patients were retrospectively analyzed for initial indication for outpatient procedure, unplanned admission rate and complications since 2018, when our outpatient cholecystectomy protocol was established. Patient factors and operative parameters were assessed.</div></div><div><h3>Results</h3><div>In 822 patients, the cholecystectomy was initially planned as an outpatient procedure, which was achieved in 673 (81.9%). Both the indication and success rates improved over time (<em>P</em> &lt; .001). Unplanned admissions occurred mainly due to surgical complexity, social factors and timing of the procedure. Age &gt; 70 years of age, BMI &gt; 30, ASA III and complicated cholelithiasis were (except for prior acute cholecystitis) not found to increase the unplanned admission rate, and the indication for outpatient cholecystectomy in these groups rose over time without significant complications. 90-day readmission and complication rates (mostly Clavien-Dindo grade I–II and no mortality) remained low (1.3% and 3.6%, respectively; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>A structured protocol enables safe and effective expansion of outpatient cholecystectomy to higher-risk groups, optimizing resource utilization without compromising patient outcomes.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 4","pages":"Article 800301"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650047","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":"Applications of radiomics in thoracic surgery: Enhancing precision and personalization of treatment","authors":"Alberto Cabañero Sánchez ,&nbsp;Luis Gorospe Sarasúa ,&nbsp;Nicolás Moreno Mata","doi":"10.1016/j.ciresp.2025.800245","DOIUrl":"10.1016/j.ciresp.2025.800245","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 4","pages":"Article 800245"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650048","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}