Acta Chirurgica Belgica最新文献

{"title":"Adrenal cortical carcinoma - a case series and literature review of aggressive adrenal incidentalomas.","authors":"Liesbeth Verlinde, Sam Kinet, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke","doi":"10.1080/00015458.2025.2506935","DOIUrl":"10.1080/00015458.2025.2506935","url":null,"abstract":"<p><strong>Objective: </strong>Adrenal cortical carcinoma (ACC) is a rare and aggressive endocrine malignancy. Clinical symptoms are mainly related to excess hormone secretion. Hypercortisolism and virilisation are among the most common presentations.</p><p><strong>Methods: </strong>We report a case series of five patients with ACC, three of which presented as adrenal incidentalomas. Additionally, a literature review on current diagnosis and management of ACC was performed.</p><p><strong>Results: </strong>ACCs are often incidentally detected because of the liberal use of medical imaging. Management of ACC remains challenging, and the poor prognosis makes early diagnosis of crucial importance to increase chances of a better outcome. Biochemical evaluation should be performed to diagnose hormonally active tumours.</p><p><strong>Conclusion: </strong>Surgery is the main and only potentially curative treatment option. Adjuvant treatment with mitotane may improve survival and is indicated for patients with a perceived high risk of recurrence. Aggressive cytotoxic therapy should be given to patients with an unfavourable prognosis.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-9"},"PeriodicalIF":0.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075318","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":"Plain versus drug-eluting balloon angioplasty in the treatment of non-thrombotic hemodialysis arteriovenous fistula stenosis: results from a single center comparative retrospective analysis.","authors":"Merve Horoz, Murat Yoğurtçu, Anıl Hüvez, Ömür Ballı, Serkan Gür","doi":"10.1080/00015458.2025.2503647","DOIUrl":"https://doi.org/10.1080/00015458.2025.2503647","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the mid-term primary and assisted-primary patency results of plain balloon angioplasty (PBA) versus drug-eluting balloon angioplasty (DEB) with non-thrombotic arteriovenous fistula (AVF) stenosis in hemodialysis (HD) patients.</p><p><strong>Subject and methods: </strong>A total of 128 consecutive HD patients, who underwent endovascular treatment with DEB or PBA between October 2015 and December 2021, were investigated in this retrospective study. Color Doppler examination was performed for follow-up after 1, 3, 6, 12, 18, 24, and 36 months. Survival curves for primary and assisted primary vein patencies of the PTA and DEB group were generated with Kaplan-Meier survival analysis and were compared with the log-rank test.</p><p><strong>Results: </strong>78 patients (60.9%) underwent PBA (45 men, 33 women; mean age: 64.2 ± 13.9, range: 29-82 years) and 50 (39%) patients underwent DEB (36 men, 14 women; mean age: 65.6 ± 12.8, range: 28-87 years). The estimated primary patency rates at 6, 12,18, 24, and 36 months for the DEB group (95.5%, 92.8%, 88.6%, 77.1% and 54.0%, respectively) were significantly higher than those in the PBA group (84.5%, 76.9%, 73.9%, 66.4% and 59.0%, respectively) (<i>p</i> = .048). Assisted primary patency rates at 6, 12, 18, 24, and 36 months were higher in the DEB group (97.9%, 95.4%, 90.2%, 87.3% and 75.5%, respectively) than PBA group (94.7%, 86.9%, 85.0%, 78.0%, and 66.9%, respectively) but they were not statistically significant (<i>p</i> = .187).</p><p><strong>Conclusion: </strong>Our study confirms DEB is a safe and effective treatment of dysfunctional AVF. We demonstrate higher primary patency rates in DEB than PBA at 6, 12, 18, 24 and 36 months. However, no statistically significant were detected between the two groups in mid-term follow-up.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957166","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":"Common trunk between V^1 + 2 and V³ of the left superior pulmonary vein.","authors":"Dario Amore, Dino Casazza, Pasquale Imitazione, Umberto Caterino, Lucio Cagini","doi":"10.1080/00015458.2025.2502777","DOIUrl":"https://doi.org/10.1080/00015458.2025.2502777","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957926","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":"Historical perspectives on the surgical treatment of hernias in Greece: from 18th century's attempts to late 19th century's innovations in hernia surgery.","authors":"Laios Konstantinos, Pavlos Lytsikas-Sarlis, Lazaros Vladimiros, Dimitrios Filippou, Stylianos Kykalos, Irina Noskova, Dimitrios Zisiadis, Tsoucalas Gregory, Dimitrios Schizas","doi":"10.1080/00015458.2025.2499843","DOIUrl":"https://doi.org/10.1080/00015458.2025.2499843","url":null,"abstract":"<p><strong>Purpose: </strong>To understand the possibilities and the limitations of the modern Greek surgeons during nineteenth century on hernia surgery.</p><p><strong>Methods: </strong>Research on the authentic medical writings of the Greek physicians during nineteenth century. The majority of them is brought to light for the first time.</p><p><strong>Results: </strong>The Greek surgeons of the nineteenth century tried a lot to be updated according to the achievements of the European surgeons regarding the surgery of hernias. Many prominent Greek surgeons contributed to the formation of a scientific method in order this to be taught to the medical students and to the other Greek physicians of the time.</p><p><strong>Conclusion: </strong>In Greece, it was Spyridon Kontoleon who adopted Lister's method to prevent infections, while his team of physicians contributed further in hernia surgery. The earliest documented with a figure hernia case was that of Pavlos Ioannou in 1882. Theodoros Aretaios recorded his cases, demonstrating an interest in hydroceles. Many of his cases may be found in his archive in the National Library of Greece. Procedures' description and vivid depictions paved the way of hernia surgery's evolution in the newly formed Greek state.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-9"},"PeriodicalIF":0.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959248","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":"Surgical training; destination unknown? A survey on surgical employment in Flanders.","authors":"Niels Komen, Marian Vanhoeij, Paul De Leyn, Frederik Berrevoet, Piet Pattyn, Guy Hubens","doi":"10.1080/00015458.2024.2391176","DOIUrl":"10.1080/00015458.2024.2391176","url":null,"abstract":"<p><strong>Background: </strong>A surgical fellowship allows both additional training as well as maintenance of surgical skills while searching for a steady job. As the presence of fellows usually does not result in a measurably higher productivity, fellowships may be considered a form of disguised unemployment. The aim of this study is to evaluate the career flow of a surgical trainee to a staff position and to determine the number of surgeons working on temporary basis within the general surgery workforce in Flanders.</p><p><strong>Methods: </strong>All surgeons graduated in Flanders between 2000 and 2022 were invited to fill out a web-based survey concerning their current and past employment. Reminders were sent out after 2 and 4 weeks. Statistical analysis was performed with SPSS version 27.0 (IBM Inc., Chicago, IL).</p><p><strong>Results: </strong>Response rate was 64% (292/457) with 76% of respondents currently working as surgeons, 14% (38) as fellows and 10% working outside the surgical domain. Eighty-two percent of current fellows graduated in 2019 or later. Thirty-one percent of surgeons graduated in 2019 are still working as fellows. For surgeons graduated in 2020, 2021 and 2022, this is 45%, 80% and 90%, respectively. Compared to staff surgeons, the number of additional training years (2.8 ± 1.0 vs. 2.2 ± 1.3; <i>p</i> = .009) and the number of applications (6.6 ± 5 vs. 3.3 ± 3; <i>p</i> < .001) are significantly higher for current fellows.</p><p><strong>Conclusion: </strong>This study shows that disguised unemployment is present in the general surgical community in Flanders. The status of 'fellow' should be incorporated in calculations concerning future needs of the surgical workforce in order to prevent open unemployment.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905506","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":"Safety analysis of a multispecialty surgical volunteerism mission over 13 years - age alone is not a contraindication.","authors":"Shekhar Gogna, Mahir Gachabayov, Rifat Latifi","doi":"10.1080/00015458.2021.1920669","DOIUrl":"10.1080/00015458.2021.1920669","url":null,"abstract":"<p><strong>Introduction: </strong>About five billion people worldwide lack access to safe surgery and multispecialty surgical volunteerism missions (SVMs) offer a plausible solution to this problem. This study aimed to evaluate the outcomes of elderly patients operated on over 13 surgical missions between 2006 and 2019 from 'Operation Giving Back Bohol' (OGBB) Tagbilaran, Philippines.</p><p><strong>Patients and methods: </strong>This was a retrospective analysis of prospectively collected data on all patients treated during SVM over 13 years (2006-2019). Non-elderly (age 16-64 years) were compared with the elderly (age ≥ 65 years) for pre-, intra-, and postoperative variables. Multivariable logistic regression was utilized to identify independent predictors of postoperative complications.</p><p><strong>Results: </strong>Of 1184 patients, the majority (1030) was in the non-elderly group and 154 in the elderly. The mean age was 36 ± 13.6 and 68.3 ± 3.8 years in the non-elderly and elderly groups, respectively. Comorbidities, type of surgery, type of anesthesia, operating time, estimated blood loss, estimated blood loss, need for blood transfusion, postoperative complication rates, comprehensive complication index, length of hospital, ICU requirement, and mortality rates stay did not significantly differ between the groups. Multivariable logistic regression found pelvic surgery (OR (95%CI)=3.7 (1.3-10.8); <i>p</i>=.01), hypertension (OR (95%CI)=8.4 (2.2-32.9); <i>p</i><.01), and intraoperative blood loss (OR (95%CI) = 1.007 (1.005-1.009); <i>p</i><.01) to be independent predictors of postoperative complications.</p><p><strong>Conclusions: </strong>Elderly patients may safely undergo general surgery procedures in surgical volunteer missions, and age alone should not preclude them.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38925919","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":"Teaching humanitarian surgery: filling the gap between NGO needs and subspecialized surgery through a novel inter-university certificate.","authors":"Maximilien Thoma, Lynette Dominguez, Martial Ledecq, Jean-Paul Goolaerts, Réginald Moreels, Innocent Nyaruhirira, Jean-François Brichant, Thierry Roumeguere, Raymond Reding","doi":"10.1080/00015458.2020.1846943","DOIUrl":"10.1080/00015458.2020.1846943","url":null,"abstract":"<p><strong>Background: </strong>Access to surgical care is a global health burden. A broad spectrum of surgical competences is required in the humanitarian context whereas current occidental surgical training is oriented towards subspecialties. We proposed to design a course addressing the specificities of surgery in the humanitarian setting and austere environment.</p><p><strong>Method: </strong>The novelty of the course lies in the implication of academic medical doctors alongside surgeons working for humanitarian non-governmental organizations (NGO). The medical component of the National Defense participated regarding particular topics of war surgery. The course is aimed at trained surgeons and senior residents interested in participating in humanitarian missions.</p><p><strong>Results: </strong>The program includes theoretical teaching on surgical knowledge and skills applied to the austere context. The course also covers non-medical aspects of humanitarian action such as international humanitarian law, logistics, disaster management and psychological support. It comprises a large-scale mass casualty exercise and a practical skills lab on surgical techniques, ultrasonography and resuscitation. Attendance to the four teaching modules, ATLS certification and succeeding final examinations provide an interuniversity certificate. Thirty participants originating from 11 different countries joined the course. Various surgical backgrounds, training levels as well as humanitarian experience were represented. Feedback from the participants was solicited after each teaching module and remarks were applied to the following session. Overall participant evaluations of the first-course session are presented.</p><p><strong>Conclusion: </strong>Teaching humanitarian surgery joining academic and field actors seem to allow filling the gap between high-income country surgical practice and the needs of the humanitarian context.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38726741","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":"An early report of using protecting gloves by Ḥakim Mohammad, a Persian surgeon (16th century CE).","authors":"Narges Tajik, Zahra Ghahremani, Sobhan Ghezloo, Shahrzad Irannejad, Arman Zargaran","doi":"10.1080/00015458.2025.2489802","DOIUrl":"10.1080/00015458.2025.2489802","url":null,"abstract":"<p><strong>Background: </strong>Although using gloves in surgery dates back to the nineteenth century in modern medicine, it seems that the earliest evidence can be found in the Middle Ages.</p><p><strong>Methods: </strong>It is a library research-based study on the book of <i>Ḏaḫīre-ye Kāmele</i>, written by Ḥakim Mohammad (Ḥakīm Muhammad), a Persian surgeon in the sixteenth century.</p><p><strong>Results: </strong>Ḥakim Mohammad advises the surgeons to use a sheath made of sheep testicle skin for their fingers when examining a wound and putting ointment and bandage on it to protect oneself from diseases that are transmitted through the skin and blood, such as people with wounds whose wounds are caused by smallpox, anthrax, leprosy and infectious wounds.</p><p><strong>Conclusion: </strong>The words of Ḥakim Mohammad suggest a preliminary concept of using surgical gloves to prevent transmitted diseases, dating back to sixteenth century, 3 centuries before its use in modern era.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771001","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":"Incidental finding of giant dedifferentiated liposarcoma of the spermatic cord: case report and review of the literature.","authors":"Andreas Bouckaert, Bruno Bamelis, Lieven Dedrye, Stefan Sohier, Anneleen Verbrugghe, Johan Fierens","doi":"10.1080/00015458.2025.2481696","DOIUrl":"https://doi.org/10.1080/00015458.2025.2481696","url":null,"abstract":"<p><strong>Introduction: </strong>Giant dedifferentiated liposarcomas of the spermatic cord are a rare and aggressive entity. Both large size and dedifferentiated liposarcoma histology implicate a poorer prognosis with a high risk of recurrence and metastasis.</p><p><strong>Methods: </strong>This is a retrospective case report. We describe a 58-year-old patient who presented with a hemodynamic collapse, caused by a high gastro-intestinal bleeding. A giant inguinoscrotal mass challenged the diagnostic path.</p><p><strong>Results: </strong>A combined abdominal and scrotal approach was used to remove the giant mass (26x15x11cm, 1.617kg) en bloc with the right testicle and spermatic cord. Pathological examination showed a giant dedifferentiated liposarcoma (FNCLCC grade 2), with a microscopically complete resection. Follow-up at 24 months showed no locoregional recurrence or distant metastasis.</p><p><strong>Conclusion: </strong>Radical surgery remains the cornerstone of treatment for retroperitoneal liposarcoma. Microscopically complete resection is an important positive prognostic indicator for risk of recurrence. Rigorous follow up is necessary, considering the high risk for recurrence. This patient illustrates the challenge of not allowing the giant inguinoscrotal mass to draw away all attention from a life-threatening high gastro-intestinal bleeding.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794337","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":"Let us ask the patient: psychological well-being from a patients'-perspective due to postponed care of cardiac surgery during the COVID-19 lockdown.","authors":"Ashley Welch, Jan Nijs, Ines Van Loo, Marina Mallefroy, Mark La Meir","doi":"10.1080/00015458.2021.1917749","DOIUrl":"10.1080/00015458.2021.1917749","url":null,"abstract":"<p><strong>Introduction: </strong>The onset of the COVID-19 pandemic has forced a rapid and extensive change in the need of intensive care beds. Therefore, we decided early in the pandemic to suspend all elective cases of cardiac surgery and closed the ambulatory clinic. The effect of this strategy on the mental well-being of the non-COVID-19 patients is unknown. The aim of this study is to assess whether planned or operated patients suffered from either anxiety or depression by their altered medical care trajectory and if their score influenced decision-making. The findings intend to anticipate individual needs during subsequent waves of the COVID-19 pandemic.</p><p><strong>Methods: </strong>The patient population consisted of two groups. The first group included planned patients whose operation date was delayed; in the second group, the postoperative control visit was postponed. Both groups received a twofold questionnaire. Part one was the Hospital Anxiety and Depression scale, part two a series of questions on the influence of the COVID-19 pandemic on cardiac surgical care from a patient's perspective.</p><p><strong>Results: </strong>The study population was composed of 46 patients (63% men). Most of them (82.6%) would like the surgery to be performed as fast as possible, even before the end of the first wave of COVID-19-related hospitalizations. Of all patients 30.4% have avoided to consult a physician because of fear and 34.8% consulted a physician by phone call. When they physically consulted a physician, there was a prominent role for the general practitioner (41.3% went to the GP vs 19.6% to the specialist). Most (58.7%) of the patients would have liked a (tele)consultation with the cardiac surgeon.</p><p><strong>Conclusions: </strong>Regardless of the HADS, one can state that a closer follow-up using telemedicine during the pandemic is expected by all patients. All patients prefer their surgery to take place even during a pandemic.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"90-94"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39052945","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}