Acta Chirurgica Belgica最新文献

{"title":"Comparison of short‑term outcomes and 3-year overall survival between robotic and laparoscopic gastrectomy for gastric cancer: a propensity score matching analysis.","authors":"Li Zhang, Jingli Cui, Mingzhi Cai, Bin Li, Gang Ma, Xuejun Wang, Yong Liu, Jingyu Deng, Rupeng Zhang, Han Liang, Jilong Yang","doi":"10.1080/00015458.2024.2348256","DOIUrl":"10.1080/00015458.2024.2348256","url":null,"abstract":"<p><strong>Background: </strong>Despite the increasing use of robotic gastrectomy (RG) as an alternative to laparoscopic gastrectomy (LG) in treating gastric cancer, controversy remains over the advantages of RG compared to LG and there is a paucity of studies comparing the two techniques regarding patient survival.</p><p><strong>Methods: </strong>In this retrospective cohort study, 675 patients undergoing minimally invasive gastrectomy were recruited from January 2016 to January 2018 (LG: <i>n</i> = 567; RG: <i>n</i> = 108). A one-to-one propensity score matching (PSM) analysis was applied to minimize the selection bias due to confounding factors, yielding 104 patients in each of the RG and LG groups. After matching, the short-term outcomes and 3-year overall survival were compared in the two groups.</p><p><strong>Results: </strong>The PSM cohort analysis showed a similar 3-year overall survival between RG and LG groups (<i>p</i> = .249). Concerning the short-term outcomes, the RG compared to LG resulted in lower blood loss (<i>p</i> = .01), lower postoperative complications (<i>p</i> = .001), lower postoperative pain (<i>p</i> = .016), earlier initiation of soft diet (<i>p</i> = .011), shorter hospital stay ‌(<i>p</i> = .012), but higher hospitalization expenses (<i>p</i> = .001).</p><p><strong>Conclusion: </strong>Our findings suggest that RG may offer advantages in terms of blood loss, surgical complications, recovery time, and pain management compared to LG while maintaining similar overall survival rates. However, RG is associated with higher hospital costs, potentially limiting its wider adoption. Further research, including large, multi-center randomized controlled trials with longer patient follow-up, particularly for advanced gastric cancer, is needed to confirm these findings.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"478-486"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847089","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":"Primary percutaneous metal stenting above the ampulla in resectable perihilar cholangiocarcinoma.","authors":"J A Luyten, S W M Olde Damink, C van der Leij, B Groot Koerkamp, O Detry, U P Neumann, M J L Dewulf","doi":"10.1080/00015458.2024.2432739","DOIUrl":"https://doi.org/10.1080/00015458.2024.2432739","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case of a patient with resectable perihilar cholangiocarcinoma (pCCA) who underwent primary metal stenting above the ampulla, followed by a successful surgical resection. Biliary drainage is a crucial step in the preoperative management of pCCA, yet there is no consensus on the optimal approach. Traditional drainage methods involve passing through the ampulla and/or the skin barrier, thereby increasing the risk of bacterial contamination of the biliary tree and secondary cholangitis.</p><p><strong>Method: </strong>A novel drainage technique was utilised in this case. A metal stent was percutaneously placed across the malignant hilar stenosis without external biliary drainage. During the procedure, both guidewires and stents were meticulously prevented from passing through the ampulla. Additionally, percutaneous access to the biliary tree was removed during the index procedure to minimise the risk of biliary colonisation and cholangitis.</p><p><strong>Results: </strong>Following the drainage, bilirubin levels rapidly normalised, and no clinical or biochemical signs of cholangitis were observed. This allowed for rapid and uncomplicated surgical resection.</p><p><strong>Conclusion: </strong>This case illustrates the potential of a novel biliary drainage technique in patients with pCCA. By minimising the risk of biliary colonisation and cholangitis, this approach could potentially improve surgical outcomes.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680182","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":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2024-11-19","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":"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":"1-5"},"PeriodicalIF":0.6,"publicationDate":"2024-11-11","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":"Spontaneous splenic rupture two days after laparoscopic sleeve gastrectomy.","authors":"M Mertens, L Verheyen, J Ceulemans","doi":"10.1080/00015458.2024.2424047","DOIUrl":"10.1080/00015458.2024.2424047","url":null,"abstract":"<p><strong>Introduction: </strong>Sleeve gastrectomy is a common bariatric procedure to manage morbid obesity. Splenic injury such as splenic rupture after sleeve gastrectomy is a rare complication which can be treated both with a splenectomy or conservative approach, called spleen-preserving surgery.</p><p><strong>Patients and methods: </strong>A 42-year old male, in whom we performed a sleeve gastrectomy, presented with splenic rupture, within 48 h postoperative, for which spleen-preserving surgery was performed. As splenic rupture is a very rare complication, we performed an extensive literature search in the PubMed database. After obtaining patient informed consent, we aim to describe a sixth presentation of this rare surgical complication.</p><p><strong>Result: </strong>To the best of our knowledge, only five cases of splenic rupture after laparoscopic sleeve gastrectomy have been described before, all treated with a splenectomy. Furthermore, we are the first to describe spleen-preserving surgery.</p><p><strong>Conclusion: </strong>We present the sixth case of spontaneous splenic rupture after laparoscopic sleeve gastrectomy, and the first to treat it with spleen-preserving surgery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-3"},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543030","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":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2024-11-03","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":"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":"1-9"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","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":"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":"https://doi.org/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":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2024-10-26","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":"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":"1-9"},"PeriodicalIF":0.6,"publicationDate":"2024-10-24","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":"In Memoriam.","authors":"Charlotte Vercauteren","doi":"10.1080/00015458.2024.2419206","DOIUrl":"10.1080/00015458.2024.2419206","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455426","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}