Acta Chirurgica Belgica最新文献

{"title":"Brain natriuretic peptide is a long-term cardiovascular predictor in carotid endarterectomy.","authors":"Gustavo Martim Clemente Gouveia de Gramilho, Juliana Pereira-Macedo, Lara Romana Pereira Dias, Ana Rita Dias Ferreira, Piotr Myrcha, José Paulo Alves Vieira Andrade, João Manuel Palmeira da Rocha-Neves","doi":"10.1080/00015458.2024.2377889","DOIUrl":"10.1080/00015458.2024.2377889","url":null,"abstract":"<p><strong>Background: </strong>In noncardiac surgery, several biomarkers are known to play a role in predicting long-term complications, such as major adverse cardiovascular events (MACE), myocardial infarction, or death. Carotid endarterectomy (CEA) is considered a low to medium-risk surgery for carotid stenosis aimed at preventing stroke events. Brain natriuretic peptide (BNP) is a biomarker with potential prognostic value regarding MACE. Since its role in patients undergoing CEA is unknown, this study aims to assess the potential role of BNP as a short and long-term predictor of all-cause mortality and MACE in patients undergoing CEA.</p><p><strong>Methods: </strong>From a prospective database, patients who underwent CEA under regional anesthesia (RA) at a tertiary hospital center were enrolled, and a <i>post hoc</i> analysis was conducted. Patients on which BNP levels were measured up to fifteen days before surgery, and two groups based on the BNP threshold (200 pg/mL) were defined and compared. Kaplan Meier survival curves and adjusted hazard ratios (aHR) were assessed by multivariable Cox regression. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included the incidence of AMI and AHF.</p><p><strong>Results: </strong>A total of 89 patients were evaluated. The mean age of the cohort was 71.2 ± 8.7 years, with 71 (79.8%) males, and presented a median follow-up of 30 [13.5-46.4] months. BNP > 200 pg/mL has demonstrated positive predictive value for MACE (aHR: 5.569, confidence interval (CI): 2.441-12.7, <i>p</i> < 0.001) and all-cause mortality (aHR: 3.469, CI: 1.315-9.150, <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>BNP has been demonstrated to independently predict long-term all-cause mortality, MACE and AMI following CEA. It serves as a low-cost, ready-to-use biomarker, although further studies are necessary.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"22-28"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141553940","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":"Thoracic aortic coarctation with asbestos-induced pleural fibrosis presenting as lower limb claudication.","authors":"Kerbi Alejandro Guevara-Noriega, Raquel Chavez-Abiega, Vladimir Cheranovskiy, Teresa Solanich Valldaura","doi":"10.1080/00015458.2024.2418150","DOIUrl":"10.1080/00015458.2024.2418150","url":null,"abstract":"<p><p>Asbestos exposure is a well-documented cause of pulmonary diseases. However, its systemic effects, particularly on the cardiovascular system, are less understood. We expose a case that highlights an unusual cardiovascular manifestation in a patient with a history of pleural asbestosis compressing the aorta and clinically manifested as lower limb claudication. A 65-year-old individual presented with bilateral short-distance lower extremity claudication. The patient's clinical presentation prompted advanced imaging studies, including CT angiography, to assess the extent of vascular involvement. The imaging confirmed the presence of substantial calcification and narrowing of the thoracic aorta. The patient had a documented history of pleural asbestosis. This case underscores the potential for asbestos-related diseases to extend beyond pulmonary manifestations, affecting cardiovascular health. The observed aortic calcification and coarctation represent an atypical progression of asbestosis related pathology.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"76-77"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492673","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 case report of a mesenteric cystic lymphangioma in a young adult woman presenting to the emergency room.","authors":"L C A van der Broeck, S H J Ketelaers, J G Bloemen","doi":"10.1080/00015458.2024.2424046","DOIUrl":"10.1080/00015458.2024.2424046","url":null,"abstract":"<p><strong>Background: </strong>Mesenteric cystic lymphangiomas (MCLs) are rare benign tumours seen in adults. The clinical presentation may vary from asymptomatic to acute abdominal pain with inexplicable abdominal pain, nausea and vomiting.</p><p><strong>Case presentation: </strong>In the current case report, a 22-year old, healthy women presented to the emergency room with acute abdominal pain in need of urgent surgical exploration. Histopathological examination revealed an mesenteric cystic lymphangioma.</p><p><strong>Conclusion: </strong>In patients with inexplicable abdominal pain, the suspicion of MCLs and proper diagnostic strategies are important. The primary treatment of MCLs consists of radical surgical resection to prevent invasion in surrounding tissue. Tertiary referral centres should be consulted to support in the diagnosis, treatment and follow-up of MCLs.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"62-66"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543029","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 risk factors on the incidence of tunneled dialysis catheter infections: a systematic review and meta-analysis.","authors":"Stijn van Meurs, Jonne Hopman, Guy Hubens, Niels Komen, Jeroen M H Hendriks, Dirk Ysebaert, David Nellensteijn, Philip Plaeke","doi":"10.1080/00015458.2024.2397177","DOIUrl":"10.1080/00015458.2024.2397177","url":null,"abstract":"<p><strong>Introduction: </strong>Tunneled dialysis catheters (TDCs) are important for hemodialysis in patients awaiting a permanent surgical solution, kidney transplantation or without feasible surgical access. Infection of a TDC is a common and severe complication, which often requires removal of the TDC and causes high morbidity and mortality. To date, several risk factors for TDC infections have been reported. This systematic review and meta-analysis aim to provide an overview of currently known risk factors.</p><p><strong>Methods: </strong>A systematic literature search was conducted, including all studies describing patient-, catheter-, and dialysis-related risk factors for TDC infections. In case sufficient data was available for a risk factor, a meta-analysis with random effects model was performed.</p><p><strong>Results: </strong>Out of 1273 studies, 30 were included describing a total of 71 risk factors. A meta-analysis was conducted for 26 risk factors. The average incidence of TDC infections was 1.16 ± 0.70/1000 catheter days. Diabetes (odds ratio, OR 1.96), coronary artery disease (OR 2.16), peripheral artery disease (OR 2.28), history of sepsis (OR 2.79), and the number of prior TDCs (OR 1.24) were the most significant risk factors for infection.</p><p><strong>Conclusion: </strong>Several risk factors are associated with increased TDC infection rates. Most of these risk factors are also linked with infection in other populations and most likely reflect the general frailty of hemodialysis patients. The association between many risk factors and TDC infections was often unclear due to the low number of studies available. Additional large cohort studies are necessary to demonstrate the relevance of these risk factors.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-13"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131569","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":"Robotic subtotal D2-gastrectomy for gastric cancer after right hemiliver transplantation: case report and literature review.","authors":"Francesco Maria Crafa, Serafino Vanella, Emanuele Caruso, Enrico Coppola Bottazzi, Adele Noviello, Alfonso Amendola","doi":"10.1080/00015458.2024.2406603","DOIUrl":"10.1080/00015458.2024.2406603","url":null,"abstract":"<p><strong>Background: </strong>With the progress achieved in transplant surgeries an improved long-term survival of patients is obtained due to more effective immunosuppressant therapy. <i>De novo</i> malignancy (DNM) has gained interest in this group of patients. DNM is a major cause of late mortality after liver transplantation.</p><p><strong>Methods: </strong>We report the case of a patient who underwent orthotopic liver transplantation with right hemiliver (right split) 18 years ago who came to our attention for gastric cancer. We performed a robotic subtotal gastrectomy D2 lymphadenectomy with manual latero lateral trans mesocolic BII gastro jejunal anastomosis using da Vinci robotic surgery system at our hospital.</p><p><strong>Results: </strong>The operation was successful, the operative time was 230 min, the intraoperative blood loss was 100 ml. The patient was discharged on day 8 after surgery, and no complications occurred. Postoperative pathological stages were pT2 N0 (0/25). During the follow-up period, the patient was in good health without long-term complications.</p><p><strong>Conclusion: </strong>Robotic approach is feasible in patients after liver transplantation.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"33-39"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339032","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":"Two-staged repair of a giant iliac aneurysm and open repair of a true deep femoral artery aneurysm in Loeys-Dietz syndrome type V: a case report and review of literature.","authors":"Annefleur Mauritz, Karen Van Langenhove, Stijn Van Wiemeersch, Lieven Dedrye, Anneleen Verbrugghe, Stephan Ceuppens","doi":"10.1080/00015458.2024.2420422","DOIUrl":"10.1080/00015458.2024.2420422","url":null,"abstract":"<p><strong>Background: </strong>The syndrome of Loeys-Dietz (LDS) is a rare connective tissue disorder. A classic triad of symptoms is seen: hypertelorism, atypical uvula or clef palate, and multiple tortuous arteries and aneurysms of the aorta and main arterial branches. Mutations in genes involving the transforming growth factor-beta (TGFB) signaling pathway are the cause of this syndrome. There are six subtypes of LDS, categorized based on the gene mutation that is involved. LDS type V and VI, concerning the TGFB3 and SMAD2 gene respectively, are the two subtypes that are least frequently seen. Mostly, in the patients with LDS type V non-cardiovascular symptoms are most prominent and there is a lower prevalence of vascular abnormalities.</p><p><strong>Methods and results: </strong>This case report illustrates extensive vascular disease in Loeys-Dietz syndrome type V. We present open repair of a true deep femoral artery aneurysm and two-staged repair of a giant common iliac aneurysm with coiling of an ipsilateral internal iliac artery aneurysm and subsequent endovascular aortic repair (EVAR).</p><p><strong>Conclusion: </strong>Loeys-Dietz syndrome type V is a rare connective tissue disorder, that was thought to have non-cardiovascular symptoms at the forefront. However, this case represents multiple vascular abnormalities, including arterial tortuosity and iliac and femoral artery aneurysms, as the main symptom in LDS type V, presents our multi-stage treatment and discusses the different therapeutic strategies.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"53-61"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492674","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 Hellenic surgical School for treatment of neuralgias and dystonias as presented in 19th-20th centuries in Greece.","authors":"Konstantinos Laios, Pavlos Lytsikas-Sarlis, Evangelia Mourellou, Constantinos G Zografos, Gregory Tsoucalas, Marianna Karamanou, Georgios Androutsos","doi":"10.1080/00015458.2024.2424038","DOIUrl":"10.1080/00015458.2024.2424038","url":null,"abstract":"<p><strong>Background: </strong>This article examines the surgical techniques used for the treatment of neuralgia and dystonia in Greece during the late 19th to the middle of the twentieth century. It emphasizes on the Greek contribution to neurosurgery.</p><p><strong>Methods: </strong>The aim of this study is achieved by examining unpublished archives as well as historical documents collected from both the National Library of Greece and the Library of the Hellenic Parliament.</p><p><strong>Results: </strong>Greek medicine of the nineteenth century emerged through the practice of Greek physicians who have studied abroad. Many important figures on surgery, like Theodoros Aretaios, Nikolaos Taptas and Konstantinos Mermigas attempted myotomies, neurectomies, trasoraphies, and injections according the European protocols, though introducing some variants on well established procedures. This article also refers to the early stereotactic neurosurgery in Greece, especially in the treatment of Parkinson's Disease and extrapyramidal syndromes by Aggelos Karakalos, ultimately contributing toward a better understanding of the evolution of Greek surgery, highlighting its pivotal role in the international development of neurosurgical techniques. Greek school of surgery avoided brutal operations like trephination and proved worthy among most advanced school of the 19^th and 20^th centuries.</p><p><strong>Conclusion: </strong>Neuralgias and dystonias constituted for the physicians of the past a riddle connected with the mystery of the central and peripheral neural system. Surgical procedures were proposed, finding ways of implication mainly in the cases of neuralgias. Gradually drug administration of simple substances like alcohol demonstrated some results. The study of Greek medical archives dated back to 19^th and early twentieth century allow us to have a comprehensive idea about the therapeutical approaches and especially the operative ones used by the Greek physicians of the time to fight dystonias and neuralgias unveiling their capabilities and theoretical medical knowledge.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"69-75"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543031","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":"Is Uniportal-VATS a feasible approach for pericardial cyst treatment? Comment on: \"A case series: Uniportal VATS excision of pericardial cyst in symptomatic patients\".","authors":"Antonio Giulio Napolitano, Dania Nachira, Adriana Nocera, Claudia Bellettati, Maria Letizia Vita, Stefano Margaritora","doi":"10.1080/00015458.2024.2430070","DOIUrl":"10.1080/00015458.2024.2430070","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"67-68"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638313","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":"Congenital diaphragmatic hernia with intrathoracic kidney: case report, review of the literature, and strategy for treatment in neonates and infants.","authors":"Yannick Vancampenhout, Stijn Heyman, Daphne Arnold, Stefanie Devriendt, Dirk Vervloessem","doi":"10.1080/00015458.2024.2419705","DOIUrl":"10.1080/00015458.2024.2419705","url":null,"abstract":"<p><strong>Background: </strong>Congenital diaphragmatic hernia (CDH) is a rare developmental defect in the diaphragm, occurring in 2 in 10,000 births. Herniation of intraperitoneal organs through the diaphragmatic opening is always present, however few cases mention the herniation of retroperitoneal organs, such as a kidney. Due to the rarity of this condition, the optimal treatment strategy remains unclear.</p><p><strong>Methods: </strong>A PubMed search was conducted, gathering all published reports of CDH with intrathoracic herniation of the kidney. Cases of isolated intrathoracic kidney without CDH and cases of traumatic hernia were excluded. Patients who underwent surgical repair before the age of 5 years were included for further analysis.</p><p><strong>Results: </strong>Thirty-seven cases were found from 1970 to 2022. The approach used for surgical repair was not mentioned in 55.6% of cases. 52.9% of the remaining patients were treated through laparotomy, whereas in 23.5% a thoracoscopy was performed. A primary repair of the hernia was performed in 88.6%. A hernia sac was noted in 70%. Most patients had a normal origin of the renal vessels and reduction of the intrathoracic kidney was achieved in 78.8%. Moreover, we report a case of CDH with intrathoracic kidney treated through thoracoscopic repair.</p><p><strong>Conclusion: </strong>A thoracoscopic approach is effective for the treatment of CDH with an intrathoracic kidney case with an associated intrathoracic kidney. A therapeutic strategy for CDH with intrathoracic kidney is suggested based on data from published cases.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"44-52"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455425","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":"Blood group is a long-term cardiovascular risk factor after carotid endarterectomy.","authors":"Filipa Jácome, Mariana Basílio Martins, Alexandre Sarmento, Andreia Coelho, Marina Dias-Neto, Ahmed Khairy, Eduardo Ocke-Reis, José Andrade, João Rocha-Neves","doi":"10.1080/00015458.2024.2371697","DOIUrl":"10.1080/00015458.2024.2371697","url":null,"abstract":"<p><strong>Background: </strong>ABO blood group system has been clinically related to an increased incidence of cardiovascular diseases. Preliminary data relating Rhesus (Rh) factor and these outcomes also have been published. Our aim was to analyse the impact of blood group on the short and long-term outcomes after carotid endarterectomy (CEA).</p><p><strong>Materials and methods: </strong>From 2012 to 2019, patients from a referral centre who underwent CEA for atherosclerotic carotid stenosis were prospectively followed. Our primary outcomes were long-term major adverse cardiovascular events (MACEs) and all-cause mortality. Secondary outcomes were perioperative complications and myocardial injury after non-cardiac surgery (MINS). Median follow-up was 50 months (interquartile range 21-69). Time-to-event analysis was used to determine the effect of ABO and Rh groups in long-term outcomes.</p><p><strong>Results: </strong>One hundred and eighty-four patients were included, with a mean age of 70.1 ± 9.1 years. Eighteen (25.7%) patients with O type and 48 (42.1%) patients with non-O type presented coronary artery disease (odds ratio [OR]: 2.313, 5-95% confidence interval (CI) 1.245-4.297, <i>p</i> = .008). Patients Rh⁺ presented significantly more congestive heart failure, 23 (14.7%), <i>p</i> = .03. The incidence of MACE in the long-term was higher in non-O patients (adjusted hazard ratio: 2.034; CI: 1.032-4.010, <i>p</i> = .040). Rh^- patients, presented a higher incidence of perioperative MINS. However, there was no statistically significant association with long-term risk of MACE.</p><p><strong>Conclusion: </strong>The incidence of MACE in long-term analysis was higher in non-O blood type and 30-day MINS was significantly more common amongst Rh^- patients. The benefit from a more complete preoperative cardiac study in these patients should be performed.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"14-21"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431077","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}