Surgical Oncology-Oxford最新文献

{"title":"Evaluating the Impact of Minimally Invasive Surgery on Long-Term Quality of Life in Foregut Cancer Patients","authors":"Edward A. Joseph ,&nbsp;Muhammed Anees ,&nbsp;Muhammad Muntazir Mehdi Khan ,&nbsp;Sricharan Chalikonda ,&nbsp;Casey J. Allen","doi":"10.1016/j.suronc.2025.102207","DOIUrl":"10.1016/j.suronc.2025.102207","url":null,"abstract":"<div><h3>Introduction</h3><div>Compared to open surgery (OS), minimally invasive surgery (MIS) for foregut cancer improves perioperative outcomes. However, the impact of MIS on long-term quality of life (QOL) is unknown. We compare the long-term QOL of patients who underwent MIS and OS for foregut cancer.</div></div><div><h3>Methods</h3><div>Surgically managed esophageal and gastric cancer patients were surveyed globally via online support groups. Physical (P-QOL) and mental (M-QOL) well-being were determined using the Short Form-12 questionnaire and compared based on the surgical approach (MIS vs OS). We defined “long-term” as greater than 3 months from surgery.</div></div><div><h3>Results</h3><div>Out of 100 respondents with esophageal and gastric cancer, 64 survivors underwent surgical management greater than 3 months before the survey. They were 56.6 ± 9.9 years, 46.0% female, and 95.2% White, with a median survival of 33.0 (14.0–63.0) months. The most common diagnosis was esophageal adenocarcinoma (69.8%). Surgical procedures included esophagectomy (56.5%), esophagogastrectomy (29.0%), and gastrectomy (14.5%), of which 45.2% were OS and 48.4% were MIS. The cohort overall exhibited lower P-QOL (40.7 ± 10.4) and M-QOL (44.6 ± 15.2) compared to the general population (50.0 ± 10.0; p &lt; 0.050). There was no difference in age, sex, race, education, income, diagnosis, and adjuvant therapy between OS and MIS cohorts (all p &gt; 0.050). Long-term P-QOL (38.5 ± 11.6 OS vs. 42.8 ± 9.5 MIS, p = 0.123) and M-QOL (44.7 ± 15.3 OS vs. 44.9 ± 14.9 MIS, p = 0.901) was similar between patients who underwent OS and MIS for foregut cancer.</div></div><div><h3>Conclusion</h3><div>MIS is not associated with higher long-term QOL in patients who have undergone surgery for foregut malignancy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102207"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579062","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":"Do unplanned resections in soft tissue sarcomas of the extremities have an adverse impact on the prognosis? Experience of a Latin-American sarcoma reference center","authors":"Melendez-Fernandez Ana P ,&nbsp;García-Ortega Dorian Y ,&nbsp;Caro-Sanchez Claudia H. ,&nbsp;Villavicencio-Valencia Veronica ,&nbsp;Martinez-Said Hector ,&nbsp;Cuellar-Hubbe Mario","doi":"10.1016/j.suronc.2025.102210","DOIUrl":"10.1016/j.suronc.2025.102210","url":null,"abstract":"<div><h3>Background</h3><div>Soft tissue sarcomas (STS) are rare, heterogeneous neoplasms often not optimally managed by teams without sarcoma expertise. Between 40 % and 50 % of primary resections for extremity sarcomas occur without prior biopsy, resulting in inadequate excisions, termed “unplanned resections” or “whoops surgery.”</div></div><div><h3>Objective</h3><div>To determine the rate of unplanned resections in extremity STS referred to a high-volume sarcoma center and evaluate their impact on oncological outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study of 680 extremity STS patients referred between 2005 and 2020. Of these, 239 (35 %) had unplanned resections. We analyzed the impact of unplanned resections on recurrence, disease-free survival (DFS), and overall survival (OS) after re-excision.</div></div><div><h3>Results</h3><div>Among the 239 patients with unplanned resections, 52 % were male, the median age was 46, and the most common histologies were liposarcoma (24 %) and synovial sarcoma (20 %). The median tumor size was 9 cm. Re-excisions achieved R0 margins of 88.6 %. Recurrence occurred in 26.3 % of cases and progression in 12.9 %, with an overall recurrence or progression rate of 39.2 %. The median DFS was 151 months for R0 resections, compared to 57.1–61.8 months for R1/R2 resections. The median OS was 140 months for R0 resections versus 50.8–52.3 months for R1/R2 resections.</div></div><div><h3>Conclusions</h3><div>Unplanned resections by non-specialized surgeons significantly reduce DFS and OS. Nonetheless, re-excision with negative margins (R0) provides oncological outcomes comparable to those reported in planned surgeries, emphasizing the importance of timely referral to specialized sarcoma centers.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102210"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579063","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":"Prediction of early recurrence as a marker of surgical futility in pancreatic adenocarcinoma","authors":"Davide Citterio ,&nbsp;Michele Droz dit Busset ,&nbsp;Carlo Sposito ,&nbsp;Michele Mazzola ,&nbsp;Samuele Grandi ,&nbsp;Andrea Zironda ,&nbsp;Giuseppe Leoncini ,&nbsp;Nicolò Simonotti ,&nbsp;Carlo Battiston ,&nbsp;Maria Flores ,&nbsp;Giovanni Ferrari ,&nbsp;Vincenzo Mazzaferro","doi":"10.1016/j.suronc.2025.102208","DOIUrl":"10.1016/j.suronc.2025.102208","url":null,"abstract":"<div><h3>Background</h3><div>Long-term survival after resection for pancreatic ductal adenocarcinoma (PDAC) is impaired by very high recurrence rates. When recurrence occurs within 6 months (early recurrence: ER) the benefit of surgery is equivalent to palliative chemotherapy in unresectable patients. Therefore, ER is a surrogate of surgical futility in PDAC.</div></div><div><h3>Materials and methods</h3><div>To investigate predictive factors of ER and its impact on survival, a training and a validation cohort of prospectively collected patients who underwent surgery for resectable or borderline-resectable PDAC were analyzed in two independent Pancreas Units during the same period. Logistic regression model on the training cohort identified independent predictors of ER, used to build a prognostic risk-score then tested on the validation cohort.</div></div><div><h3>Results</h3><div>Out of 176 patients in the training cohort, 21.6 % experienced ER, with significant impact on survival (OS: 9.7 months vs. 32.7 months for ER vs. late/no recurrence, respectively). At multivariable analysis, three independent risk factors for ER were identified: Ca19.9 &gt; 100 U/mL, G3 tumors and lack of adjuvant chemotherapy. Based on such features the derived ER-score stratified three prognostic classes at incremental risk of ER (12 %, 35 % and 53 %) with different OS (31.1, 19.7 and 9.3 months, respectively, p &lt; 0.001). The ER predictive score was then tested on a validation cohort of 242 patients, 22.3 % of whom underwent ER. Despite significant differences in tumor-related features, the score was able to discriminate among the predicted ER-risk classes (15 %, 27 % and 53 %, respectively) and forecast significantly different OS (5.8, 19 and 31.1 months, p &gt; 0.001). The discriminative capability of the score in the two cohorts was similar (training AUC = 0.72 vs. validation AUC = 0.68, p = 0.28).</div></div><div><h3>Conclusion</h3><div>An externally validated clinical score, able to identify three prognostic classes at incremental risk of developing ER after resection of PDAC is provided. In patients at high risk of ER, prediction of surgical futility may help in decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102208"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastasis directed therapy in recurrent renal cell carcinoma – Retrospective analysis of a ten-year experience","authors":"R. Himmelsbach,&nbsp;J. Stigler,&nbsp;M. Weishaar,&nbsp;S. Astheimer,&nbsp;A. Sigle,&nbsp;C. Jilg,&nbsp;C. Gratzke,&nbsp;M. Grabbert,&nbsp;M. Glienke","doi":"10.1016/j.suronc.2025.102202","DOIUrl":"10.1016/j.suronc.2025.102202","url":null,"abstract":"<div><h3>Introduction</h3><div>Current guidelines provide a weak recommendation for metastasis directed therapy (MDT) in patients with recurrent renal cell carcinoma (RCC) and is focused on the goal of symptom control and potentially delaying systemic therapy. Especially in light of systemic treatment entailing targeted therapies for metastatic RCC, MDT's role remains undefined. Goal of our study was to evaluate which patients might benefit most from MDT. Our assessed endpoints were time to initiation of systemic therapy and progression-free survival (PFS).</div></div><div><h3>Material &amp; methods</h3><div>We collected data retrospectively and exclusively at our centre; our study included patients with recurrent RCC after initial partial or radical nephrectomy, who subsequently underwent MDT at the University Hospital Freiburg and whose cases were discussed at our interdisciplinary urogenital tumour board between 2011 and 2021.</div></div><div><h3>Results</h3><div>A total of 92 patients were included. Median follow up was 57.6 months (IQR 30.9–89.6). Median age was 65.1 (IQR 59.05–72.36) at the time of first MDT. Lung and lymph nodes were the most frequent locations of recurrence (40.2 % and 20.7 %, respectively). Median PFS after the first MDT was 392 days (IQR 100–855). Median time to the initiation of systemic therapy was 534 days (IQR 142–1707). In multivariate regression analysis, a higher T-stage in the initial pathology was associated with shorter PFS (HR 1.64, 95%-CI 0.98–2.66; p = 0.05). Furthermore, older age lowered the risk of progression after MDT (HR 0.97, 95%CI 0.94–1.00; p = 0.04). According to the non-parametrical log-rank test, patients with early recurrence (within 1 year after initial diagnosis) had significant shorter time to initiation of systemic therapy (p = 0.05). However, this effect was not apparent in multivariable regression analysis.</div></div><div><h3>Conclusion</h3><div>We report on a large cohort of patients who underwent MDT for recurrent RCC within the last ten years at our institution. Within the limitations of a retrospective single-centre analysis, our findings support the concept of MDT for recurrent disease in patients presenting a favourable initial tumour stage and rather late recurrence after initial therapy. However, as mRCC is a very heterogeneous disease, more investigation is needed to refine the definition of predictive parameters that facilitate patient-centred decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102202"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic distal pancreatectomy using the hinotori™ surgical system: Differences in surgical techniques from the daVinci™ surgical system","authors":"Yuichiro Uchida ,&nbsp;Takeshi Takahara ,&nbsp;Takahisa Kawase ,&nbsp;Takuya Mizumoto ,&nbsp;Masaya Nakauchi ,&nbsp;Akihiro Nishimura ,&nbsp;Satoshi Mii ,&nbsp;Hirotaka Fukuoka ,&nbsp;Shinichi Taniwaki ,&nbsp;Hideaki Iwama ,&nbsp;Masayuki Kojima ,&nbsp;Ichiro Uyama ,&nbsp;Koichi Suda","doi":"10.1016/j.suronc.2025.102195","DOIUrl":"10.1016/j.suronc.2025.102195","url":null,"abstract":"<div><h3>Background</h3><div>The use of the hinotori™ Surgical System (hinotori) in distal pancreatectomy (DP) is new compared to the da Vinci™ Surgical System (DVSS). The hinotori is equipped with mechanisms distinct from those of DVSS, and comprehensive reports detailing the surgical techniques and outcomes associated with hinotori in DP (hinotori-DP) are lacking. This study aimed to compare the outcomes of DP using the hinotori and DVSS (Xi system), focusing on differences in settings and techniques between the two methods.</div></div><div><h3>Methods</h3><div>This study retrospectively investigated consecutive patients who underwent robotic DP from April 2010 (the introduction of robotic DP at our institute) to July 2024. The analysis excluded patients who underwent spleen-preserving procedures or procedures performed using robotic platform other than hinotori or daVinci Xi. The hinotori-DP cases were compared with those performed using DVSS (DVSS-DP). The techniques used in hinotori-DP were examined in more detail.</div></div><div><h3>Results</h3><div>A total of 75 robotic DP cases (11 with hinotori and 64 with DVSS) were analyzed in this study. Different port configurations and techniques, including a lesser curvature approach, were used in the hinotori-DP compared to DVSS-DP. The operation time was relatively shorter in the hinotori-DP group (299 vs. 366 min, p = 0.095), and the postoperative complication rates were comparable (pancreatic fistula: 27 % vs. 30 %, p = 0.871; Clavien–Dindo Grade ≥3a complications: 18 % vs. 19 %, p = 0.964) between the two groups.</div></div><div><h3>Conclusion</h3><div>The hinotori-DP can be safely performed by focusing on the unique characteristics of the hinotori surgical system.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102195"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430094","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":"Optimizing oncological and functional outcomes with wide resection techniques in robot-assisted radical prostatectomy for very high-risk prostate cancer: A single-institution retrospective study","authors":"Yu Ozawa,&nbsp;Shin Koike,&nbsp;Keisuke Aoki,&nbsp;Keita Okamoto,&nbsp;Kei Ushijima,&nbsp;Toshiaki Kayaba,&nbsp;Sunao Nohara,&nbsp;Masumi Yamada,&nbsp;Yu Odagaki,&nbsp;Hideo Sakamoto,&nbsp;Kunihiko Yoshioka","doi":"10.1016/j.suronc.2025.102192","DOIUrl":"10.1016/j.suronc.2025.102192","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess our wide resection robot-assisted radical prostatectomy techniques in very high-risk prostate cancer.</div></div><div><h3>Methods</h3><div>Among 600 patients, we identified 63 patients with localized or locally advanced very high-risk prostate cancer (cT3b-T4, primary Gleason pattern 5, multiple high-risk features, or ≥5 positive biopsy cores with Grade Group 4–5 pathology) undergoing wide resection robot-assisted radical prostatectomy following six months of vintage hormonal therapy between 2019 and 2023. Clinical staging included digital rectal exams, magnetic resonance imaging, computed tomography, and bone scintigraphy.</div><div>We assessed the effectiveness of our wide resection techniques in reducing PSM rate by evaluating the perioperative, pathological, and oncological outcomes.</div></div><div><h3>Results</h3><div>The overall PSM rate was 19% (6.7% for pT2, 9.1% for pT3a, and 47% for pT3b). The most frequent site for extracapsular extension was the lateral side (30%), followed by the bladder neck (26%). The bladder neck was the most common location of PSM (59%).</div><div>Over a median follow-up of 18.7 months, patients without PSMs had a 46% higher 2-year prostate-specific antigen-free survival rate than those with PSMs. One patient experienced Clavien–Dindo grade Ⅲa deep vein thrombosis, and 51% achieved immediate continence. A limitation of this study was the use of vintage hormonal therapy and conventional imaging modalities.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated that wider bladder neck dissection, rather than wider apical dissection, can achieve acceptable short-term functional and oncological outcomes. Future studies with longer follow-up are warranted to assess effectiveness of wide resection for local cancer control in very high-risk prostate cancer as a part of a multimodality strategy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102192"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403456","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":"Predicting incontinence and erectile function after prostate cancer surgery: International validation of models","authors":"Michael O'Callaghan ,&nbsp;Shahid Ullah ,&nbsp;David Smith ,&nbsp;Stephen Mark ,&nbsp;Jude Clarke ,&nbsp;Darran Rouse ,&nbsp;Rowan David ,&nbsp;Kim Moretti","doi":"10.1016/j.suronc.2025.102194","DOIUrl":"10.1016/j.suronc.2025.102194","url":null,"abstract":"<div><h3>Background</h3><div>Our objective is to externally validate the most accurate, published tools predicting urinary incontinence and erectile dysfunction following prostatectomy. Several models have been developed to predict the risks of adverse events, though most have not been externally validated.</div></div><div><h3>Methods</h3><div>Data were obtained from the Prostate Cancer Outcomes Registry of Australia and New Zealand (PCOR-ANZ). Self-reported urinary incontinence and erectile dysfunction were measured using EPIC-26 at 12 months after radical prostatectomy. Four predictive models were selected for external validation, being the top performing models from a systematic literature review. Two models related to urinary incontinence (Matsushita and Jeong) and two related to sexual function (Alemozaffar and Novara), were examined. Model discrimination was assessed by the Area Under the Received Operator Curve (AUC) and calibration was assessed.</div></div><div><h3>Results</h3><div>We constructed a cohort of 590 patients resident in either New Zealand or South Australia who had received a radical prostatectomy 2007–2019. The average age at diagnosis was 65 years, with most men having few comorbidities (97.1 % Charlson comorbidity index 0) and treated with robotic surgery (93.6 %). In our external validation cohort, the Almozaffar model demonstrated the highest discrimination when predicting erectile dysfunction (AUC 0.73, 95%CI 0.67–0.78). The highest discrimination achieved by a model predicting urinary incontinence was developed by Jeong (AUC 0.69, 95%CI 0.61–0.76).</div></div><div><h3>Conclusions</h3><div>Models predicting erectile dysfunction performed well in external validation and may be suitable for clinical use. Models predicting post-prostatectomy urinary incontinence did not perform as well on validation.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102194"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430059","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 genomic analysis of patients with musculoskeletal metastases from an unknown origin","authors":"Nicholas Eastley ,&nbsp;Paul Cool ,&nbsp;Mariam Jafri ,&nbsp;Manoj Raghavan ,&nbsp;Jonathan Stevenson","doi":"10.1016/j.suronc.2025.102187","DOIUrl":"10.1016/j.suronc.2025.102187","url":null,"abstract":"<div><h3>Background</h3><div>A subgroup of patients present with musculoskeletal (MSK) metastases but no detectable primary tumour. An inability to employ disease-specific treatment means this cohort's median survival is just 6–10 months. We present a novel, prospective, pilot study investigating the role of targeted Next Generation Sequencing (NGS) of metastases in these ‘Cancer of Unknown Primary’ (CUP) patients, reporting on diagnostic, therapeutic and prognostic benefits.</div></div><div><h3>Materials and methods</h3><div>Patients with an MSK lesion radiologically consistent with a metastases, no previous cancer diagnosis, and no discernible primary tumour were analysed. After biopsy ruled out sarcoma, patients’ tumoural DNA and RNA was analysed using targeted NGS. Data was processed using a custom bioinformatics pipeline and variants classified by biological and clinical significance.</div></div><div><h3>Results</h3><div>19 patients (8F:11M, median age 70 years, range 40–76) were analysed. 18 (95 %) had ≥1 variant with ‘potential’ or ‘strong’ clinical significance. 8 (42 %) patients' variants highlighted them as eligible for an open clinical trial(s). 3 (16 %) had variant(s) with potential therapeutic or prognostic ramifications. Median cohort survival was 15 months (0–41). 5 of the 11 (45 %) patients referred to an appropriate MDT based on their genomic analysis died during follow up (median survival 11 months, 4–32), compared to 7/8 (88 %) managed by a CUP MDT (median survival 9 months, 0–18).</div></div><div><h3>Conclusion</h3><div>Our data suggests the real-time genomic analysis of CUP patients has multiple diagnostic and therapeutic benefits. Larger, prospective trials are needed to characterise the genomics of this vulnerable patient cohort, looking for survival benefits of this analysis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102187"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143262376","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":"Comparison between bipolar scissors, monopolar electrocautery, and hydrodissection in nipple-sparing mastectomy","authors":"Khaled E. Barakat ,&nbsp;Mohamed F. Asal ,&nbsp;Ahmed Adham R. Elsayed ,&nbsp;Lindsey Nichols ,&nbsp;Ahmed Abdelkader ,&nbsp;George Maged ,&nbsp;Marc D. Basson","doi":"10.1016/j.suronc.2024.102182","DOIUrl":"10.1016/j.suronc.2024.102182","url":null,"abstract":"<div><h3>Background</h3><div>The common techniques used in nipple-sparing mastectomy (NSM) are hydrodissection (tumescent dissection) and electrocautery. We hypothesized that bipolar scissors (diathermy scissors) would improve surgical outcomes in mastectomy.</div></div><div><h3>Methods</h3><div>We prospectively compared 50 patients undergoing NSM using the bipolar scissor technique to retrospective data from patients who had previously undergone NSM with hydrodissection (n = 50) or electrocautery (n = 50). Operation time, intraoperative bleeding, drainage per day, duration till drain removal, and serious complications were compared.</div></div><div><h3>Results</h3><div>Operation time was significantly better with the bipolar scissors (34.1 ± 4.9 min) and hydrodissection (36.2 ± 6.6 min) compared to monopolar electrocautery (53.7 ± 4.8 min) (p &lt; 0.001). Intraoperative bleeding was significantly less with the bipolar scissors (123.4 ± 27.7 ml) and hydrodissection (126.6 ± 25.1 ml) compared to electrocautery (161.8 ± 25.0 ml) (p &lt; 0.001). Additionally, the drainage per day and the duration till drain removal was 79.7 ± 18.3 ml for 3.22 ± 0.79 days and 92.4 ± 41.3 ml for 3.58 ± 1.23 days for the bipolar scissors and hydrodissection techniques respectively were significantly better compared to 124.8 ± 40.3 ml for 4.58 ± 1.23 days (p &lt; 0.001) for the electrocautery method. Finally, the bipolar scissor technique had the least complications (2 %) compared to hydrodissection (20 %) (p &lt; 0.004).</div></div><div><h3>Conclusion</h3><div>Although hydrodissection was as effective as bipolar scissors in reducing operation time, intraoperative bleeding, postoperative drainage, and the duration of drainage compared with electrocautery, hydrodissection was associated with more serious complications than the bipolar scissors technique.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102182"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883583","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":"Radioembolization prior to liver resection may increase the risk of severe biliary complications: A multicenter, retrospective cohort study performed in France","authors":"Céline Dananai ,&nbsp;Marie Alaux ,&nbsp;Eric Vibert ,&nbsp;Olivier Facy ,&nbsp;Lilian Schwarz ,&nbsp;Emmanuel Boleslawski ,&nbsp;Olivier Scatton ,&nbsp;Antonio Iannelli ,&nbsp;Bertrand Le Roy ,&nbsp;Kayvan Mohkam ,&nbsp;Stéphanie Truant ,&nbsp;Astrid Herrero ,&nbsp;Nour Bou Saleh ,&nbsp;Guillaume Millet","doi":"10.1016/j.suronc.2025.102186","DOIUrl":"10.1016/j.suronc.2025.102186","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102186"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}