Cirugia Espanola最新文献_第6页

Revisión crítica 2024 de las recomendaciones de gestión de sangre de los pacientes sometidos a cirugía mayor en la vía rica 《2024年大手术患者血液管理建议的关键审查》

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.10.011

Vicky Moral , Carlos Jericó , Ane Abad Motos , José Antonio Páramo , Manuel Quintana Díaz , José Antonio García Erce , en representación del grupo asesor y revisor externo de las recomendaciones PBM de la vía RICA 2021

{"title":"Revisión crítica 2024 de las recomendaciones de gestión de sangre de los pacientes sometidos a cirugía mayor en la vía rica","authors":"Vicky Moral , Carlos Jericó , Ane Abad Motos , José Antonio Páramo , Manuel Quintana Díaz , José Antonio García Erce , en representación del grupo asesor y revisor externo de las recomendaciones PBM de la vía RICA 2021","doi":"10.1016/j.ciresp.2024.10.011","DOIUrl":"10.1016/j.ciresp.2024.10.011","url":null,"abstract":"<div><div>The Spanish enhanced recovery in adult surgery strategy, the “RICA pathway”, was published in 2021 and includes 19 specific recommendations and more than 20 indirect recommendations for patient blood management (PBM).</div><div>After reviewing these recommendations, and in the context of the new clinical evidence available, we propose the following updates:</div><div><em>- First</em>: Detection and treatment of any preoperative anemia status in ALL patients who are candidates for major surgery with hematinic deficiencies.</div><div><em>- Second</em>: Universal use of tranexamic acid in major surgery, bedside monitoring of intraoperative hemoglobin levels, restrictive transfusion criteria, and monitoring of patient well-being in terms of hydration, coagulability, normothermia and analgesia.</div><div><em>- Third</em>: Restrictive transfusion criteria, single-unit blood transfusion and diagnosis/treatment of postoperative anemia.</div><div>Real, universal implementation and integration of PBM in the RICA program is urgently needed.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 2","pages":"Pages 104-114"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178174","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}

引用次数: 0

Instilación de azul de metileno intravascular ex vivo en piezas de esofaguectomía y gastrectomía y su implicación en la evaluación histopatológica tumoral 在胃和食道切除术中注入活体内蓝甲烯及其对肿瘤组织病理学评估的影响

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.12.002

Carmen Gutiérrez Sánchez, Marta Nieto Sánchez, Miriam Menéndez Jiménez de Zadava Lisson, Marcos Bruna Esteban

{"title":"Instilación de azul de metileno intravascular ex vivo en piezas de esofaguectomía y gastrectomía y su implicación en la evaluación histopatológica tumoral","authors":"Carmen Gutiérrez Sánchez, Marta Nieto Sánchez, Miriam Menéndez Jiménez de Zadava Lisson, Marcos Bruna Esteban","doi":"10.1016/j.ciresp.2024.12.002","DOIUrl":"10.1016/j.ciresp.2024.12.002","url":null,"abstract":"<div><div>Surgical resection and lymphadenectomy are the central mainstay of curative treatment of esophagogastric cancer. In this study we evaluate the results of intravascular methylene blue injection into esophagectomy and gastrectomy specimens as a tool to increase lymph node detection.</div><div>A prospective and descriptive study was performed in 24 patients (11 esophagus, 13 stomachs). The most frequent histological type was adenocarcinoma (esophagus 29.2%, stomach 90.9%). All patients with esophageal cancer received neoadjuvant treatment, compared to 8 with gastric cancer. The anatomopathological analysis of esophagectomies showed a median of 42 isolated nodes, compared to 46 in gastrectomies. In esophageal cancer, a total of 8 (72.7%) patients did not show lymphatic involvement, whereas, in gastric cancer patients, 76.9% of patients had lymph nodes, with a median number of positive nodes of 3 (RIC: 0.5-7).</div><div>The instillation of methylene blue allows a large number of nodes to be analysed and could atherefore improve staging, treatment and prognosis of patients with esophagogastric cancer.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 2","pages":"Pages 91-94"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178184","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}

引用次数: 0

Impact of team experience on robot-assisted surgery for rectal cancer: A comparative study 团队经验对机器人辅助直肠癌手术的影响：比较研究

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.10.012

Ernesto Barzola , Pere Planellas , Lidia Cornejo , Nuria Gómez , David Julià , Kelly-Ann Bobb , Ramón Farrés , Marcos Gómez

{"title":"Impact of team experience on robot-assisted surgery for rectal cancer: A comparative study","authors":"Ernesto Barzola , Pere Planellas , Lidia Cornejo , Nuria Gómez , David Julià , Kelly-Ann Bobb , Ramón Farrés , Marcos Gómez","doi":"10.1016/j.ciresp.2024.10.012","DOIUrl":"10.1016/j.ciresp.2024.10.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The robotic surgical team in the operating room plays an important role in determining the outcome of a robotic approach. This study aimed to compare the outcomes of 2 hospitals with different levels of expertise in robot-assisted rectal cancer surgery.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 195 patients who underwent robot-assisted rectal resection at 2 referral centers for the treatment of rectal cancer between March 2018 and December 2021.</div></div><div><h3>Results</h3><div>In total, 195 patients had undergone robotic rectal cancer surgery: 95 performed by an expert team, and 100 by a novel team. The expert team performed more low anterior resections (55.8%) than the novel team (33%) (<em>P</em> = 0.001), and the total operative time varied significantly between the groups (<em>P</em> < 0.001). The novel team’s operative time was 135 min longer than the expert team’s. The expert team had no conversions to open surgery, while the novel team had an 8% conversion rate (<em>P</em> = 0.007). In this study, overall morbidity was 45.3% among patients treated by the expert team versus 38% among those treated by the novice team (<em>P</em> = 0.304). Severe complications (Clavien–Dindo grade >IIIB) occurred at a rate of 10% in both groups. Incomplete mesorectal excision was observed in 3.2% of the expert team’s patients versus 4.2% of the novice team’s (<em>P</em> = 0.65).</div></div><div><h3>Conclusion</h3><div>The expert team achieved a shorter operative time and less conversion to open surgery. However, the morbidity and pathological outcomes were comparable between the teams. The introduction of robotic surgery in a team with early-stage surgical experience was safe.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 2","pages":"Pages 75-83"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178176","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}

引用次数: 0

Candy cane syndrome with or without concomitant hiatal hernia after Roux-en-Y gastric bypass: A hidden enemy leading to postoperative symptoms Roux-en-Y胃旁路术后伴或不伴裂孔疝的甘蔗糖综合征：导致术后症状的隐藏敌人

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.10.007

Italo Braghetto , Owen Korn , Ramon Sanz-Ongil , Ana Burgos , Deycies Gaete

{"title":"Candy cane syndrome with or without concomitant hiatal hernia after Roux-en-Y gastric bypass: A hidden enemy leading to postoperative symptoms","authors":"Italo Braghetto , Owen Korn , Ramon Sanz-Ongil , Ana Burgos , Deycies Gaete","doi":"10.1016/j.ciresp.2024.10.007","DOIUrl":"10.1016/j.ciresp.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Candy cane syndrome (CCS) is a rare complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). It occurs due to redundancy in the blind loop at the gastro-jejunal anastomosis.</div></div><div><h3>Objective</h3><div>To evaluate the type of symptoms, anatomic and functional findings, and outcome after treatment.</div></div><div><h3>Material and methods</h3><div>A prospective case series study was conducted between 2010 and 2022, including symptomatic patients with CCS after LRYGB. Symptoms were correlated with anatomic and functional findings. Big gastric pouch was defined if its size was <u>></u>5 cm, and a long candy cane loop was diagnosed if its length was <u>></u>5 cm. Due to failure of medical treatment, revision surgery (RS) was indicated for resection of the elongated blind jejunal loop, resizing the redundant gastric pouch and repairing the hiatal hernia repair (HH) when necessary.</div></div><div><h3>Results</h3><div>The study included 23 patients, with a mean age of 49 ± 11 years. Twenty-one patients underwent primary LRYGB, and 2 were converted to this technique after sleeve gastrectomy (SG). The mean time from LRYGB to symptom onset was 7.6 ± 4.3 years. Pain and reflux symptoms were the most frequent, with no differences between patients with or without HH (<em>P</em> < .05). CCS coexisted with a large gastric pouch in 56.5% and HH in 52.2% of cases. A defective lower esophageal sphincter, abnormal esophageal motility, and pathological acid reflux test were observed. After surgery, improvement was observed in 86.9%.</div></div><div><h3>Conclusion</h3><div>CCS can lead to gastrointestinal symptoms following LRYGB, regardless of the presence of HH. Complete examinations are crucial for diagnosis and to determine the surgical intervention, which is the best option for treatment.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 2","pages":"Pages 60-66"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176979","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}

引用次数: 0

Futilidad, fallo de cura, fallo de rescate y cirugía abortada: nuevas formas de medir la utilidad real de la cirugía 无用性、无法治愈性、挽救性失败和流产手术：衡量手术实际效用的新方法

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.11.008

José M. Ramia , Silvia Carbonell-Morote

引用次数: 0

Shock hipovolémico secundario a colecistitis necro-hemorrágica: una entidad muy poco frecuente 坏死出血性胆囊炎继发性低血细胞性休克：一种非常罕见的情况

IF 1.3 4区医学

Cirugia Espanola Pub Date : 2025-02-01 DOI: 10.1016/j.ciresp.2024.10.009

Ángel García Romera, Ana Belén Martín Arnau, Víctor Molina Santos, Santiago Sánchez Cabús

引用次数: 0

Peritonitis en estómago estrangulado en hernia inguinoescrotal gigante 腹膜炎在胃被勒死在巨大腹膜腹膜疝