Cirugia Espanola最新文献

{"title":"Valores predictivos de afectación axilar en cáncer de mama","authors":"Laura Comín Novella,&nbsp;Mónica Oset García,&nbsp;Marta González Pérez,&nbsp;El Mostafa el Yaqine er Raoudi,&nbsp;Pedro Pablo Stredel Russian,&nbsp;Francisco Luis Carrillo Trabalón,&nbsp;Sandra Lario Pérez,&nbsp;José Francisco Noguera Aguilar","doi":"10.1016/j.ciresp.2025.800231","DOIUrl":"10.1016/j.ciresp.2025.800231","url":null,"abstract":"<div><h3>Introduction</h3><div>In breast cancer, recommendations for axillary surgery are currently shifting toward omitting SLNB. Studies have shown that not performing axillary staging has no impact on regional control or survival and translates into improved quality of life. We sought to determine whether certain clinical factors such as tumor size or type, immunohistochemical characteristics, tumor grade or Ki-67 value are predictive of metastatic disease in the lymph nodes.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted of patients who underwent breast cancer surgery during the years 2019-2024. Inclusion criteria were: tumor size equal to or less than 2<!--> <!-->cm as measured by ultrasound, and axilla that was clinically and ultrasound-negative.</div></div><div><h3>Results</h3><div>One hundred and fifty-six breasts were operated on, with a mean age of 64.5 years. Regarding immunohistochemistry, tumor grade, and age, no differences were observed. However, patients with tumors<!--> <!-->&gt;<!--> <!-->2<!--> <!-->cm and lobular tumors did have greater lymph node involvement (p<!--> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>There are no variables that predict lymph node involvement before surgery. Today, we are not prepared to lose the information provided by SLNB, and part of the postoperative treatment is determined by its results.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 12","pages":"Article 800231"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468034","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":"Evaluación del textbook outcome en trasplante hepático","authors":"Esther Brea Gómez ,&nbsp;Pablo Dabán López ,&nbsp;Ana Belén Vico Arias ,&nbsp;Antonio Palomeque Jiménez ,&nbsp;Natalia Zambudio Carroll ,&nbsp;María Trinidad Villegas Herrera ,&nbsp;Jesús María Villar del Moral ,&nbsp;Mario Serradilla Martín","doi":"10.1016/j.ciresp.2025.800255","DOIUrl":"10.1016/j.ciresp.2025.800255","url":null,"abstract":"<div><h3>Introduction</h3><div>The textbook outcome (TO) is a qualitative measurement tool for surgical procedures that has been tested in a multitude of cases. Liver transplantation (LT) is one of the most complex interventions in our specialty. In this study, we evaluate the achievement of TO in patients undergoing LT. We also propose a definition of specific TO for LT surgery.</div></div><div><h3>Materials and methods</h3><div>A single-center retrospective study was conducted between May 2012 and December 2022. Patients whose data were incomplete in the database, patients with retransplantation, transplants for acute liver failure, intraoperative findings of portal vein thrombosis, and patients who received a donor graft after circulatory death were excluded. TO was defined as the absence of mortality and major complications in the first 90 days after surgery, absence of readmission in the first 30 days, and a hospital stay not prolonged &gt;<!--> <!-->p75.</div></div><div><h3>Results</h3><div>A total of 132 patients were included. More than half achieved TO (56.8%). Prolonged hospital stay was the variable that most limited the achievement of TO (25% of patients). Pre-transplant hypertension in the recipient and prolonged cold ischemia time were associated with a lower rate of TO. Survival was higher in the group that achieved TO, although statistical significance could not be demonstrated.</div></div><div><h3>Conclusions</h3><div>TO is a valuable measure for assessing LT. A universal definition of TO for LT will be necessary given the lack of consensus on the criteria used among the different series published to date.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 12","pages":"Article 800255"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617783","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 true case of gastrointestinal duplicity","authors":"Paola Peralta Fernández-Revuelta ,&nbsp;Luis Carlos Jiménez Romero ,&nbsp;Esperanza Ulloa Márquez ,&nbsp;Iago Justo Alonso","doi":"10.1016/j.ciresp.2025.800224","DOIUrl":"10.1016/j.ciresp.2025.800224","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800224"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617779","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 current status of immunotherapy in colorectal cancer: A systematic review","authors":"Hanna Cholewa ,&nbsp;Pablo Guerrero-Antolino ,&nbsp;David Quevedo ,&nbsp;Jorge Sancho-Muriel ,&nbsp;Matteo Frasson ,&nbsp;Blas Flor-Lorente","doi":"10.1016/j.ciresp.2025.800225","DOIUrl":"10.1016/j.ciresp.2025.800225","url":null,"abstract":"<div><div>The following systematic review aimed to present the current status of immunotherapy in colorectal cancer, in the neoadjuvant, adjuvant and metastatic setting. Pubmed, Cochrane and Embase databases were searched up to April 2024 and the PICO framework, as well as the following inclusion criteria (clinical studies in English published ≥2000 per year, both retrospective and prospective, including abstracts from relevant congresses, yet excluding case reports, letters, phase I clinical trials and radioimmunotherapy) were applied. MINORS and RoB2 were used to assess quality and risk of bias. Due to heterogeneity of the studies, a descriptive analysis was performed. In total, 99 studies (including 11 226 patients) were analysed, concluding that immunotherapy application, although encouraging, still needs refinement, most importantly in terms of patient and treatment regimen selection. The review was registered on the PROSPERO platform (ID: CRD42023417537) and funded by a grant by the Spanish Association of Surgery (AEC).</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800225"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617819","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":"Implementación y resultados de un protocolo multidisciplinar para el manejo de la fístula perianal en la enfermedad de Crohn: impacto clínico y en la calidad de vida","authors":"Natalia González Alcolea ,&nbsp;M Dolores Martín Arranz ,&nbsp;Blanca Monje Vera ,&nbsp;Mario Álvarez Gallego ,&nbsp;Jesús Díez Sebastián ,&nbsp;Isabel Pascual Miguelañez","doi":"10.1016/j.ciresp.2025.800230","DOIUrl":"10.1016/j.ciresp.2025.800230","url":null,"abstract":"<div><h3>Introduction</h3><div>Perianal fistula is a common and disabling complication of Crohn's disease, with a significant impact on patients’ quality of life. Although structured protocols exist in some centers, no universally accepted management guideline is currently available. In this context, we developed and implemented a protocol in our center aimed at reducing suppuration, preserving continence, and improving quality of life.</div></div><div><h3>Methods</h3><div>A single-center prospective study was conducted, including 38 patients treated at Hospital Universitario La Paz between January 2020 and January 2022. The protocol combined surgical drainage, seton placement, and biological therapy for at least one year. Indications for curative surgery were based on clinical and radiological criteria. Clinical outcomes, continence (Wexner score), perianal disease activity (Perianal Disease Activity Index [PDAI]), and quality of life (Inflammatory Bowel Disease Questionnaire-9 [IBDQ-9], and a specific 20-item questionnaire) were assessed.</div></div><div><h3>Results</h3><div>Curative surgery was performed in 55.2% of patients, with a clinical recurrence rate of 31.6%, and no worsening of continence. The IBDQ-9 score was significantly improved (from 59 to 65.4; <em>P</em> <!-->&lt;<!--> <!-->.001). The disease-specific questionnaire revealed a significant impact on social, occupational, emotional, and sexual aspects, particularly among women. Fear of chronic seton use and incontinence was common, and symptomatic control more closely associated with better quality of life than complete fistula healing.</div></div><div><h3>Conclusions</h3><div>Implementation of the protocol led to improved quality of life. We emphasise the importance of incorporating disease-specific patient-reported outcome measures (PROMs) and adopting a comprehensive perspective, including the patient's experience as a core component of the therapeutic process.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800230"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374639","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":"Más alla del donante en muerte encefálica. La donación en asistolia y de donante vivo. Experiencia y perspectiva española","authors":"Antonio Ríos ,&nbsp;Beatriz Domínguez-Gil","doi":"10.1016/j.ciresp.2025.800227","DOIUrl":"10.1016/j.ciresp.2025.800227","url":null,"abstract":"<div><div>Traditionally, organ transplantation has relied on donation after brain death (DBD). However, the growing demand for organs has driven the search for alternatives to expand the donor pool. In this context, donation after the circulatory determination of death (DCD) has experienced significant growth throughout the current century, particularly in cases of death following the withdrawal of life-sustaining treatments (Maastricht type III donation). Although still limited to a small number of countries, the volume of DCD in Spain is similar to that of DBD, and it is the only country that has successfully transplanted all types of organs from this type of donor. Living organ donation also makes a meaningful contribution to overall transplant activity, and it must be firmly grounded in comprehensive donor protection. In Spain, 10% of kidney transplants are performed using organs from living donors.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800227"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468516","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":"Colecistectomía transcilíndrica ambulatoria por minilaparotomía bajo diferentes técnicas anestésicas","authors":"Enrique Javier Grau Talens ,&nbsp;Ángel Alois Osorio Manyari ,&nbsp;Desirée Diestro Gallego ,&nbsp;Carlos A Celis Pinilla ,&nbsp;Octavio López Sánchez ,&nbsp;Osama Aburedwan ,&nbsp;Enrique del Cojo Peces ,&nbsp;Francisco Gabriel Onieva González ,&nbsp;Javier Arias Díaz","doi":"10.1016/j.ciresp.2025.800235","DOIUrl":"10.1016/j.ciresp.2025.800235","url":null,"abstract":"<div><h3>Introduction</h3><div>Laparoscopic cholecystectomy is widely performed in ambulatory surgery, whereas minilaparotomy approaches remain underreported. This study evaluates the outcomes of transcylindrical cholecystectomy (TCC), performed with a cylindrical retractor, in an outpatient setting under different anesthetic techniques.</div></div><div><h3>Methods</h3><div>Prospective observational study of 1,626 patients with cholelithiasis or related complications who underwent right transrectal epigastric minilaparotomy (4.5<!--> <!-->cm), using a cylindrical retractor with a methacrylate plunger for direct visualization and stable exposure of the hepatocystic triangle. Anesthetic modality (general, supraglottic device, local with sedation, or spinal) was tailored to each patient. Intraoperative cholangiography was selectively performed.</div></div><div><h3>Results</h3><div>A total of 1,626 patients underwent TCC: 916 with orotracheal intubation, 152 with supraglottic device, 503 under local anesthesia with sedation, and 55 with spinal anesthesia. Mean age: 59 years; BMI: 30; operative time: 40<!--> <!-->minutes. The substitution index was 69%. Conversion occurred in 15 cases (0.9%), with 90 unplanned admissions (5.5%), 8 postoperative bile leaks (0.5%), 37 wound infections (2.2%), 2 deaths (0.1%), and 1 major bile duct injury (0.06%). There were 15 readmissions (0.9%) and 8 reoperations (0.5%). At 24<!--> <!-->hours, 78% of patients reported good or excellent physical condition.</div></div><div><h3>Conclusions</h3><div>Transcylindrical cholecystectomy is a fast, safe, and cost-effective technique for treating cholelithiasis in the ambulatory setting. It is feasible under minimally invasive anesthesia, with low complication rates, and may be particularly valuable in resource-limited environments.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800235"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419567","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":"Innovación en la corrección del pectus carinatum: combinación de tratamiento ortopédico y quirúrgico (técnica de las 3 «C»)","authors":"José Marcelo Galbis Caravajal ,&nbsp;Miriam Estors Guerrero ,&nbsp;Nestor Martinez Hernández ,&nbsp;Inmaculada Sabariego Arenas","doi":"10.1016/j.ciresp.2025.800240","DOIUrl":"10.1016/j.ciresp.2025.800240","url":null,"abstract":"<div><div><em>Pectus carinatum</em> is a chest wall deformity characterized by a protrusion. For its correction, the flexibility of the chest wall is essential, as it will determine the possibility of correction through orthopedic or surgical treatment.</div><div>Orthopedic treatment has experienced a boom in recent years thanks to the development of a dynamic compression system (vest) that applies pressure to the area.</div><div>This effect can be limited by the rigidity of the chest wall (which increases with age) or by the presence of pronounced depressions of abnormally positioned cartilage (limiting cartilage). In these cases, we propose combining the use of the vest with limited partial chondrectomies to facilitate the vest's effect after this surgery. We have called th</div><div>is combination of vest-chondrectomy-vest the “3 Cs” technique.</div><div>We present a description of the technique and its application in the first patients we have treated this way.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800240"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520788","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":"Tratamiento quirúrgico del divertículo faringoesofágico: serie consecutiva de 20 años","authors":"Enrique Biel ,&nbsp;Luis Grande ,&nbsp;Manuel Pera","doi":"10.1016/j.ciresp.2025.800233","DOIUrl":"10.1016/j.ciresp.2025.800233","url":null,"abstract":"<div><h3>Background</h3><div>Main treatment options for pharyngoesophageal diverticulum are the surgical excision or fixation, always associated with a myotomy, and the endoscopic peroral myotomy. The aim of this study was to describe the outcomes of a consecutive surgical series.</div></div><div><h3>Methods</h3><div>Observational study of patients who underwent open surgery (2004-2024) and who had a 2-years structured follow-up. Main outcome were symptom resolution and postoperative complications. Baseline characteristics, surgical technique, reinterventions, readmission and recurrence were also analyzed. Descriptive statistics was used, including percentages, mean and standard deviations, and medians with complete ranges.</div></div><div><h3>Results</h3><div>During the study period, 40 patients (73% male) were operated on, with a mean age of 72<!--> <!-->±<!--> <!-->11 years. Ninety-five percent presented dysphagia and/or regurgitation, while 2 patients were referred due to a history of pneumonia to bronchoaspiration. The most frequent surgical technique was cricopharyngeal myotomy combined with diverticulectomy. Postoperative morbidity was 15%, with no cases of esophageal fistula. There was no mortality, and the median hospital stay was 3 days. Initial symptom resolution was achieved in 95% of patients. During follow-up (median 7 years [1-20]), 2 recurrences were observed at 18 and 24 months, respectively, both successfully managed endoscopically.</div></div><div><h3>Conclusions</h3><div>Surgical treatment achieves symptoms resolution in the vast majority of cases, with limited morbidity and recurrence.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800233"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468517","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 Espacio Europeo de Datos Sanitarios y su impacto en la cirugía del siglo XXI","authors":"Josep M. Garcia-Alamino ,&nbsp;Manuel Lopez-Cano","doi":"10.1016/j.ciresp.2025.800234","DOIUrl":"10.1016/j.ciresp.2025.800234","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 11","pages":"Article 800234"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374640","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}