Cirugia Espanola最新文献

{"title":"Laparoscopic vs open approach for acute cholecystitis in octogenarians. A prospective multicenter observational nationwide study","authors":"N. Lluís ,&nbsp;C. Villodre ,&nbsp;P. Zapater ,&nbsp;M. Cantó ,&nbsp;L. Mena ,&nbsp;J.M. Ramia ,&nbsp;F. Lluís ,&nbsp;on behalf of the LUCENTUM Project Collaborative Group","doi":"10.1016/j.ciresp.2024.06.006","DOIUrl":"10.1016/j.ciresp.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><div>The world population is aging, with octogenarians expected to reach over 400 million by 2050. Acute cholecystitis is a serious complication in the elderly. Age is not a contraindication for emergency cholecystectomy, an option that can both save lives and preserve quality of life.</div></div><div><h3>Methods</h3><div>The present study aimed to compare open and laparoscopic surgical approaches. Over six months, 38 emergency surgery units enrolled all consecutive octogenarians with acute cholecystitis undergoing cholecystectomy. Postoperative outcomes were compared after propensity score matching analysis.</div></div><div><h3>Results</h3><div>The study included 212 patients (84 years [81–86], 47.2% women). The open approach was used in 32.1% of patients, and the laparoscopic approach in 67.9%. After propensity score matching, a decrease in hospital stays (open, 8 days [6–13]; laparoscopic, 5 days [4–8]; P &lt; .001), 30-day morbidity (open, 48.5%; laparoscopic, 26.5%; P = .01), and 30-day mortality (open, 13.2%, laparoscopic, 1.5%; P = .02) was found. Among the specific postoperative complications, a decrease in septicemia (open, 14.7%; laparoscopic, 0%; P = .001) was observed.</div></div><div><h3>Conclusions</h3><div>Laparoscopic approach was used in two out of three octogenarians. After propensity score matching, octogenarians undergoing laparoscopic approach had shorter length of hospital stay, fewer 30-day postoperative complications, fewer episodes of septicemia, and less 30-day mortality than octogenarians undergoing open approach. These findings suggest that the laparoscopic approach may be the preferred choice for octogenarians with acute cholecystitis undergoing cholecystectomy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 1","pages":"Pages 34-42"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132708","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":"Pseudoaneurisma postraumático de arco aórtico por perforación esofágica a causa de espina de pescado","authors":"Benjamin Thorpe Plaza ,&nbsp;Lucía Lesquereux ,&nbsp;Ana Berta Bermudez Naveira ,&nbsp;Purificación Parada","doi":"10.1016/j.ciresp.2024.06.002","DOIUrl":"10.1016/j.ciresp.2024.06.002","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 1","pages":"Page 53"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132678","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":"Diathermy versus scalpel in midline abdominal incision: A systematic review and meta-analysis of randomized controlled trials","authors":"Nicole dos Santos Pimenta ,&nbsp;Ana Clara Felix de Farias Santos ,&nbsp;João Pedro Costa Esteves Almuinha Salles ,&nbsp;Juliana Millani de Oliveira ,&nbsp;Pedro Henrique Costa Matos da Silva ,&nbsp;Renan Carlo Colombari","doi":"10.1016/j.ciresp.2024.07.011","DOIUrl":"10.1016/j.ciresp.2024.07.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Our study aimed to compare the midline abdominal incision with scalpel and diathermy.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, and Cochrane were searched through January 2024 following PRISMA guidelines (PROSPERO, ID: CRD42024516771), and only randomized controlled trials were included. Heterogeneity was assessed using Cochran's Q test and the I² heterogeneity index. Statistical analysis was performed using Review Manager 5.4 software.</div></div><div><h3>Results</h3><div>Six randomized controlled trials were included, from which 469 patients (51.5%) received diathermy incision and 442 patients (48.5%) underwent the scalpel technique. Patients treated with the electrocautery approach had less incision blood loss (MD −17.57 mL; <em>P</em> &lt; .01). No statistically significant differences were found between groups regarding wound infection incidence, incision time, incision area or first-day postoperative pain.</div></div><div><h3>Conclusion</h3><div>Diathermy use in midline abdominal incision may be advocated as it demonstrated a significant reduction in incision-related blood loss, with no differences in wound infection or early postoperative pain incidences compared to the scalpel.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 1","pages":"Pages 3-10"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132275","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":"Análisis de ganglios coincidentes con SentiMag® y técnica estándar en la BSGC del cáncer de mama","authors":"Cristina Isabel Davó Pérez,&nbsp;Virginia Pellicer Sánchez,&nbsp;Edelmira Soliveres Soliveres,&nbsp;María José Cases Baldó,&nbsp;Arantxa Cabrera Vilanova,&nbsp;Lorena Rodríguez Cazalla,&nbsp;Piotr Kosny,&nbsp;Miguel Ángel Morcillo Rodenas","doi":"10.1016/j.ciresp.2024.09.008","DOIUrl":"10.1016/j.ciresp.2024.09.008","url":null,"abstract":"<div><h3>Introduction</h3><div>In breast cancer surgery, there are techniques for sentinel lymph node biopsy (SLNB) that do not require nuclear medicine, such as SentiMag®, which uses ferromagnetic particles. The main purpose of this analysis is to study the degree of concordance in SLNB between SentiMag® and the standard method (Tc99 radiotracer). The secondary objective is to identify factors that impact in sentinel node detection rate and matching detection rate between both probes.</div></div><div><h3>Methods</h3><div>Observational and retrospective study performed from January to December 2021 focused on patients undergoing breast surgery and SLNB who were injected with both tracers, the ferromagnetic SentiMag® and Tc99 radiotracer. Once the diagnostic accuracy tests were performed, a further evaluation of the detection rate for each probe and the concordance between probes were accomplished. After those results, a deeper analysis of differences in detection rates for each probe and concordance between probes were assessed for various factors: neoadjuvant therapy, BMI, mitotic index, and triple-negative immunohistochemical profile.</div></div><div><h3>Results</h3><div>The clinical study had a sample size of 70 patients. The overall false-negative rate (FNR) was 4.3%. The detection rate was the same for each technique (85.7%). A total of 106 nodes were biopsied, with a concordance rate of 70.75%. Significant differences were found in concordant nodes according to neoadjuvant therapy (<em>p</em>-value 0.012). For the Ki-67 factor (&lt;20 or ≥20), significant differences were found in detected nodes (<em>p</em>-value 0.031 gamma probe; <em>p</em>-value 0.124 SentiMag®).</div></div><div><h3>Conclusions</h3><div>The detection rates of SentiMag® and the gamma probe are equivalent. The application of the dual technique minimizes the FNR. A high mitotic index affects the detection rate of the gamma probe, and neoadjuvant therapy negatively impacts the concordance rate.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 1","pages":"Pages 11-17"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132277","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 para manejo de litiasis del remanente vesicular y exploración de la vía biliar","authors":"Aram Rojas ,&nbsp;Pierce Paterakos ,&nbsp;Sarah B. Hays ,&nbsp;Melissa E. Hogg","doi":"10.1016/j.ciresp.2024.08.005","DOIUrl":"10.1016/j.ciresp.2024.08.005","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Pages 667-668"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135305","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":"Hemoglobinuria posterior a reabsorción de un hemoperitoneo","authors":"Owen Korn,&nbsp;Álvaro Morales,&nbsp;Sebastián Sapiain,&nbsp;María Jesús Vial","doi":"10.1016/j.ciresp.2024.08.002","DOIUrl":"10.1016/j.ciresp.2024.08.002","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Pages 679-681"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135301","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":"Fístula asociada a prótesis gástrica","authors":"Elena Fernández-Elvira,&nbsp;Esther García Santos,&nbsp;Ángel Fernández-Camuñas,&nbsp;Aurora Gil Rendo","doi":"10.1016/j.ciresp.2024.05.005","DOIUrl":"10.1016/j.ciresp.2024.05.005","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Page 677"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135387","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":"Esplenopancreatectomía caudal emergente tras traumatismo pancreático cerrado","authors":"Lucía Santos Vieitez,&nbsp;Aloia Guerreiro Caamaño,&nbsp;Jorge Pérez Grobas","doi":"10.1016/j.ciresp.2024.05.018","DOIUrl":"10.1016/j.ciresp.2024.05.018","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Page 678"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135302","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 pronóstico del Log Odds de ganglios linfáticos positivos (LODDS) en la estratificación de pacientes con cáncer de recto","authors":"Vincenzo Vigorita ,&nbsp;Oscar Cano-Valderrama ,&nbsp;Raquel Sánchez-Santos ,&nbsp;Marta Paniagua-Garcia-Señorans ,&nbsp;Enrique Moncada ,&nbsp;Gianluca Pellino ,&nbsp;Jesús Paredes-Cotoré ,&nbsp;Enrique Casal","doi":"10.1016/j.ciresp.2024.09.006","DOIUrl":"10.1016/j.ciresp.2024.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of the N category of the TNM staging system, lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in predicting overall survival (OS) and disease-free survival (DFS) in patients with rectal cancer is still controversial.</div></div><div><h3>Material and methods</h3><div>A retrospective study of 445 patients with rectal cancer who underwent surgery between 2008 and 2017 in the University Complex Hospital of Vigo was performed. Patients were stratified according to number of lymph nodes examined (NLNE), N staging, LNR and LODDS. The analysis was performed using the log-rank test, Kaplan-Meier functions, Cox regression and ROC curves.</div></div><div><h3>Results</h3><div>Five-year OS and DFS were 73.7% and 62.5%, respectively. No statistically significant differences were observed depending on NLNE. Increased LNR and LODDS were associated with shorter OS and DFS, independently of NLNE.</div><div>Multivariate analysis showed that N stage, LNR and LODDS were independently associated with OS and DFS; however, the LODDS system obtained the best area under the curve, with greater predictive capacity for OS (AUC: 0.679) and DFS (AUC: 0.711).</div></div><div><h3>Conclusion</h3><div>LODDS and LNR give prognostic information that is not related to NLNE. LODDS provides better prognostic accuracy in patients with negative nodes than LNR and N stage.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Pages 649-657"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135306","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":"El tamaño del efecto en el metaanálisis","authors":"Marina Iniesta-Sepúlveda ,&nbsp;José Antonio Pereira-Rodríguez","doi":"10.1016/j.ciresp.2024.06.004","DOIUrl":"10.1016/j.ciresp.2024.06.004","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 12","pages":"Pages 675-676"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839908","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}