Cirugia Espanola最新文献

{"title":"Prevalence of burnout dimensions among general surgeons. A systematic review and meta-analysis","authors":"Miguel Gili-Miner ,&nbsp;Lucas Giner ,&nbsp;Enrique Gili-Ortiz ,&nbsp;Dolores Franco-Fernández ,&nbsp;Juan Luís Cabanillas-Moruno ,&nbsp;Gonzalo Germán-Castellani ,&nbsp;Luís Béjar-Prado","doi":"10.1016/j.ciresp.2025.800186","DOIUrl":"10.1016/j.ciresp.2025.800186","url":null,"abstract":"<div><div>Our aim was to summarize global prevalence rates of the burnout subscales <em>emotional exhaustion</em> (EE) and <em>depersonalization</em> (DP) among general surgeons, as well as potential contributing factors. A systematic literature search was performed to identify studies reporting EE and DP prevalence and associated potential stressors. Heterogeneity was assessed by I² statistic and tau² statistic. We also performed subgroup analysis, meta-regression analysis and funnel plot asymmetry tests. A total of 21 cross-sectional studies were included in this meta-analysis, totaling 3325 subjects. Analysis of EE and DP indicated burnout in 43% and 41% of general surgeons, respectively. The moderators used in the meta-regression analysis did not account for significant heterogeneity. The Egger and Peters tests did not detect publication bias due to small studies. The prevalences of EE and DP in general surgeons are very high, and further studies are needed to clarify the discrepancies observed in certain results.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800186"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340482","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":"Obstrucción intestinal secundaria a brida apendicular","authors":"Héctor Aguado López,&nbsp;Francisco Javier Ruescas García,&nbsp;Andrés García Marín,&nbsp;Beatriz Aguado Rodríguez","doi":"10.1016/j.ciresp.2025.800194","DOIUrl":"10.1016/j.ciresp.2025.800194","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800194"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340484","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":"Impact of an abdominal wall surgery specialist on incisional hernia outcomes: A registry-based analysis","authors":"Manuel López-Cano ,&nbsp;Carles Olona Casas ,&nbsp;Pilar Hernández-Granados ,&nbsp;José A. Pereira Rodriguez ,&nbsp;on behalf of the EVEREG group","doi":"10.1016/j.ciresp.2025.800211","DOIUrl":"10.1016/j.ciresp.2025.800211","url":null,"abstract":"<div><h3>Introduction</h3><div>General surgery is undergoing progressive super-specialization with conditions previously managed by general surgeons now being treated by super-specialists (SS). No universal criteria currently exist to define abdominal wall surgery super-specialization (AWS-SS), and the designation remains a self-reported classification. The aim of our paper is to evaluate the outcomes of incisional hernia (IH) procedures in the context of super-specialization or not, focusing on complications and recurrence rates.</div></div><div><h3>Methods</h3><div>All patients who underwent elective and emergency IH repair with mesh between 2017 and 2022 were included in the Spanish IH registry (EVEREG database). At the time of data inclusion, surgeons self-identified as either super-specialists or not (SS vs NSS), using no predefined criteria. Patients were divided into 2 groups: those performed by SS or NSS. Using a 1:1 matched analysis, differences in the incidence of complications and recurrence rates within 30 days, 6 months, one year, or 2 years of follow up were compared.</div></div><div><h3>Results</h3><div>A total of 6231 IH procedures were analyzed, 3441 (55.2%) of which were recorded as having been performed in the presence of a super-specialist. After matching, 4680 IH procedures were included in the final analysis. IH repairs performed in the presence of a super-specialist were associated with a lower incidence of surgical site occurrences (SSO), reduced recurrence rates within the first 2 years of follow-up, and lower rates of bulging and overall complications.</div></div><div><h3>Conclusions</h3><div>Involvement of a super-specialist in the repair of an IH can be associated with lower complication rates and reduced recurrence.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800211"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340480","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":"Paciente con síndrome hereditario, feocromocitoma y paraganglioma tipo I","authors":"Luisa Paola Garzón Hernández,&nbsp;Rosa Martí Fernández,&nbsp;Maria Lapeña Rodríguez,&nbsp;Norberto Cassinello Fernández","doi":"10.1016/j.ciresp.2025.800190","DOIUrl":"10.1016/j.ciresp.2025.800190","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800190"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340485","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":"Dilatación cervical masiva: riesgos y desafíos en el manejo de complicaciones de la coloplastia retroesternal","authors":"Lucía Lavín Montoro,&nbsp;Elías Rodríguez Cuéllar,&nbsp;Inés Marcos Cortés,&nbsp;Eduardo Ferrero Herrero","doi":"10.1016/j.ciresp.2025.800192","DOIUrl":"10.1016/j.ciresp.2025.800192","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800192"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340483","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":"Immunomarkers could predict overall survival and disease-free survival after neoadjuvant therapy and surgery due to locally advanced rectal cancer","authors":"Miguel A. Bonilla-Cozar ,&nbsp;Anabel Garcia-Leon ,&nbsp;Carlos J. Garcia-Sanchez ,&nbsp;M. Luisa Reyes-Diaz ,&nbsp;Irene Ramallo-Solis ,&nbsp;Fernando De la Portilla ,&nbsp;Javier Padillo ,&nbsp;Rosa M. Jimenez-Rodriguez","doi":"10.1016/j.ciresp.2025.800199","DOIUrl":"10.1016/j.ciresp.2025.800199","url":null,"abstract":"<div><h3>Background</h3><div>In daily clinical practice, patients with similar risk profiles often show varied oncologic outcomes, including differing responses to neoadjuvant therapy and surgery. In this study, we seek to analyze the relationship of neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios with survival and recurrence in patients treated for locally advanced rectal cancer.</div></div><div><h3>Material and methods</h3><div>We have conducted a retrospective analysis of patients operated on due to rectal cancer with neoadjuvant long-course radiotherapy and sensitizing chemotherapy. After neoadjuvant therapy and before surgery, these immunomarker indices were analyzed. Each index was assigned a cut-off point to assess their association with overall survival (OS) and disease-free survival (DFS).</div></div><div><h3>Results</h3><div>A total of 156 patients were analyzed with a median follow-up of 71.5 months (51–89). The NLR index was identified as an independent predictor of 5-year OS and DFS. Values above the 6.3 cut-off point showed an OS of 58.9% (<em>P</em> = .019); in patients with values above 4.72, DFS was 57.4% (<em>P</em> = .034). Patients whose 3 indices (NLR, PLR, MLR) were elevated had a 5-year OS of 25% (HR 3.16, 95% CI [1.45−6.87], <em>P</em> = .004); and a 5-year DFS of 39.4% (HR 2.88, 95% CI [1.35–6.17], <em>P</em> = .006).</div></div><div><h3>Conclusions</h3><div>Elevated preoperative immunomarker values are related to worse outcomes in terms of OS and DFS in those patients with locally advanced rectal cancer after neoadjuvant therapy. The combination of the three indices is more accurate in predicting OS and DFS. These immunomarkers may be useful in choosing an individualized therapeutic strategy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800199"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340478","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 de la hernia inguinoescrotal en España. Resultados de una encuesta nacional","authors":"Luisana Riba-Combatti ,&nbsp;Alejandro Bravo-Salvá ,&nbsp;Montserrat Juvany-Gómez ,&nbsp;José Antonio Pereira Rodríguez","doi":"10.1016/j.ciresp.2025.800210","DOIUrl":"10.1016/j.ciresp.2025.800210","url":null,"abstract":"<div><h3>Introduction</h3><div>Inguinoscrotal hernia (ISH) represents an advanced form of inguinal hernia, with greater technical complexity and higher risk of complications. Despite its significant prevalence, its management remains heterogeneous in Spain. This study evaluates clinical practice and adherence to the recommendations of the European Hernia Society (EHS).</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted through an online survey distributed among members of the Spanish Association of Surgery (AEC). Demographic variables and specific data on the diagnostic and therapeutic management of ISH were collected. Subgroup analyses were performed based on age and specialization in abdominal wall surgery.</div></div><div><h3>Results</h3><div>Out of 3014 surveys distributed, 392 complete responses were obtained (13%). While 60.2% had an Abdominal Wall Unit, only 11.7% centralized all inguinal hernia cases. Open surgery remains the most frequent approach (96.4%). In ISH cases, the use of minimally invasive surgery (MIS) is lower (38.6%), with TAPP being the predominant technique. Surgeons specialized in abdominal wall procedures used more posterior and endoscopic techniques. Adherence to EHS guidelines was partial (58.8%).</div></div><div><h3>Conclusions</h3><div>The treatment of ISH in Spain lacks proper centralization in specialized units, which limits the adoption of advanced techniques and adherence to international guidelines. Promoting specific training, European certification, and the creation of specialized units could improve clinical outcomes and the quality of life for these patients.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800210"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340479","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":"Conditioning of the abdominal wall with progressive pneumoperitoneum in hernias with loss of domain. A consensus proposal","authors":"Salvador Pous-Serrano ,&nbsp;Jose Bueno-Lledó ,&nbsp;Jesús Martínez-Hoed ,&nbsp;Omar Carreño-Sáenz ,&nbsp;Providencia García-Pastor ,&nbsp;Santiago Bonafé-Diana ,&nbsp;Belén Porrero Guerrero ,&nbsp;Guillermo Lillo-Albert ,&nbsp;Member of the AEC Abdominal Wall Division","doi":"10.1016/j.ciresp.2025.800212","DOIUrl":"10.1016/j.ciresp.2025.800212","url":null,"abstract":"<div><div>The performance of progressive pneumoperitoneum in hernias with loss of domain is a common practice in surgical units with a special focus on abdominal wall surgery. The main objective of this article is to describe a consensus proposal on the utility of the procedure, its indications, contraindications, the description of the different catheter placement techniques for insufflation, the recommendation of insufflation protocols, and the potential complications arising from the procedure. Additionally, an informed consent proposal endorsed by the Abdominal Wall Group of the Spanish Association of Surgeons (AEC) is included.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 10","pages":"Article 800212"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340481","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":"Tipo de abordaje y complicaciones postoperatorias tras pancreatectomia izquierda (estudio prospectivo SPANDISPAN)","authors":"Belén Hernández-Roca ,&nbsp;José M. Ramia ,&nbsp;Juli Busquets ,&nbsp;Luis Secanella ,&nbsp;Nuria Peláez ,&nbsp;Maialen Alkorta ,&nbsp;Itziar de Ariño Hervas ,&nbsp;M. Mar Achalandabaso ,&nbsp;Enrique Toledo ,&nbsp;Fernando Rotellar ,&nbsp;Pablo Marti-Cruchaga ,&nbsp;Miguel Ángel Gómez-Bravo ,&nbsp;Gonzalo Suárez ,&nbsp;Marina Garcés ,&nbsp;Luis Sabater ,&nbsp;Gabriel García Plaza ,&nbsp;Francisco Javier Alcalá ,&nbsp;Enrique Asensio ,&nbsp;David Pacheco ,&nbsp;Esteban Cugat ,&nbsp;Cándido Alcazar","doi":"10.1016/j.ciresp.2025.800197","DOIUrl":"10.1016/j.ciresp.2025.800197","url":null,"abstract":"<div><h3>Introduction</h3><div>Left pancreatectomy (LP) is a surgical technique with low mortality but high morbidity (30%), particularly pancreatic fistula (PF). Its minimally invasive (MI) approach has become popular, but its implementation in Spain remains unknown. We present a national multicenter study on LP to determine morbidity-mortality, PF incidence, and the percentage of MI approach.</div></div><div><h3>Methods</h3><div>A descriptive, observational, prospective, and multicenter study on LP. Study period: 02/01/2022–02/28/2023. Inclusion criteria: Elective LP. Exclusion criteria: LP following pancreaticoduodenectomy, with celiac trunk resection, or performed as an emergency. Major complications (MC): Clavien-Dindo ≥ IIIA.</div></div><div><h3>Results</h3><div>A total of 41 centers participated, including 313 patients. Women accounted for 53.4%. Mean age: 63.4 years. The most common indications for LP were neuroendocrine tumors (32.6%), pancreatic adenocarcinoma (28%), and IPMN (15.7%). The surgical approach was laparoscopic (53%), open (30.7%), and robotic (16.3%). The most frequently performed techniques were distal splenopancreatectomy (72.2%) and radical antegrade modular pancreatosplenectomy (RAMPS) (14.4%). Complications occurred in 57.5% of patients, with 21.1% classified as MC. The most frequent was PF (38.3%), with 52.5% of PFs classified as B-C (20.1% of the total). The 90-day mortality rate was 1.6%. The use of a protective sleeve and the absence of drains were associated with the absence of PF in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>In our series, the MI approach was significantly higher than expected (70%). The MC rate was 21.1%, and mortality was 1.6%, confirming that LP is a procedure with low mortality but high morbidity.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 9","pages":"Article 800197"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049947","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":"Severe bacterial soft tissue infection in the chest due to S. pyogenes: A case series","authors":"Leonidas Alejandro Landero Ascencio,&nbsp;Raúl Guerrero Lopez,&nbsp;Marc Perez Xaus,&nbsp;Sara Fernandez Planas,&nbsp;Hellena Vallverdú Cartié","doi":"10.1016/j.ciresp.2025.800187","DOIUrl":"10.1016/j.ciresp.2025.800187","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"103 9","pages":"Article 800187"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050668","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}