Acta Chirurgica Belgica最新文献_第5页

Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis. 烧伤手术患者的氨甲环酸：一项最新的荟萃分析。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-09-08 DOI: 10.1080/00015458.2025.2557015

Jianzhen Shi, Jianru Xu, Yanmei Chen, Siyu Sun

{"title":"Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis.","authors":"Jianzhen Shi, Jianru Xu, Yanmei Chen, Siyu Sun","doi":"10.1080/00015458.2025.2557015","DOIUrl":"10.1080/00015458.2025.2557015","url":null,"abstract":"Background: Surgical procedures often entail significant blood loss, potentially leading to various complications. Thus, reducing perioperative bleeding is crucial to enhancing patient outcomes. This study systematically evaluates and conducts a meta-analysis on the efficacy of tranexamic acid (TXA) in patients undergoing burn surgery.Methods: A comprehensive literature search was performed across PubMed, the Cochrane Central Register of Controlled Trials, Embase, and Web of Science databases to identify pertinent clinical studies on the application of TXA in burn-related surgical procedures. The evaluated outcomes included total blood loss, postoperative hemoglobin levels, postoperative hematocrit, intraoperative packed red blood cell (PRBC) transfusion units, incidence of intraoperative transfusion, and duration of hospitalization.Results: The analysis incorporated seven studies with a total of 427 patients. Compared to the control group, TXA was associated with a significant reduction in total blood loss [MD = -152.17 mL (95% CI: -159.48 to -144.87)], total PRBC units transfused [MD = -0.61 units (95% CI: -0.92 to -0.30)], and intraoperative transfusion incidence [logRR = -0.70 (95% CI: -1.04 to -0.35)]. However, there were no significant differences observed in postoperative hemoglobin levels [MD = 0.47 g/dL (95% CI: -0.12 to 1.06)], postoperative hematocrit [MD = 2.13% (95% CI: -0.66 to 4.92)], or length of hospital stay [MD = -2.80 days (95% CI: -6.44 to 0.83)].Conclusions: TXA appears to effectively reduce blood loss and the requirement for PRBC transfusions in burn surgery. Further high-quality research is necessary to substantiate these findings.Abbreviations: TXA: tranexamic acid; PRBC: packed red blood cell; MD: mean difference; REML: restricted maximum likelihood; logOR: log odds ratio.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"227-235"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999484","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}

引用次数: 0

Late, solitary small bowel metastasis of anaplastic thyroid cancer: a case report. 甲状腺间变性癌晚期孤立性小肠转移1例。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-07-26 DOI: 10.1080/00015458.2025.2536364

Margo Hendrickx, Ellen Peters, Paul Willemsen

引用次数: 0

8-Years' experience of the interventional and non-interventional treatment of pancreatic and peripancreatic necrosis in patients with severe acute pancreatitis secondary to gallstones and alcohol abuse. A single centre analysis. 8年胆结石合并酒精滥用的严重急性胰腺炎继发性胰腺及胰周坏死的介入及非介入治疗经验单中心分析。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-09-03 DOI: 10.1080/00015458.2025.2554882

Davide Di Mauro, Alex Reece-Smith, Ikechukwu Njere, Shahjehan Wajed, Antonio Manzelli

{"title":"8-Years' experience of the interventional and non-interventional treatment of pancreatic and peripancreatic necrosis in patients with severe acute pancreatitis secondary to gallstones and alcohol abuse. A single centre analysis.","authors":"Davide Di Mauro, Alex Reece-Smith, Ikechukwu Njere, Shahjehan Wajed, Antonio Manzelli","doi":"10.1080/00015458.2025.2554882","DOIUrl":"10.1080/00015458.2025.2554882","url":null,"abstract":"Background: The treatment of acute pancreatitis (AP) with pancreatic and peripancreatic necrosis (PN and PPN) can be challenging. It is unclear why some patients respond to conservative management while others require an invasive treatment. This study aimed to assess the clinical and radiological characteristics of patients with gallstone or alcohol-induced AP with PN and PPN who underwent interventional or non-interventional treatment.Methods: Subjects with gallstone or alcohol-induced AP and radiological evidence of PN and PPN, from 2010 to 2018, were divided in two treatment-based groups: interventional-percutaneous drainage (PD) and/or surgical necrosectomy-and non-interventional. A comparison of clinical and radiological characteristics between groups was conducted.Results: Of 99 patients, 18 underwent interventional treatment, 81 conservative management. The interventional group had larger PN (p = 0.010) and a greater proportion of infected necrosis (p = 0.002). Acute necrotic collection (ANC) >10 cm (95% CI 1.26-3.6, OR 1.839, p = 0.012), infected necrosis (95% CI 4.28-61305.6, OR 153.9, p = 0.026), admission to the intensive care unit (ICU) (95% CI 16.79-326,532.21, OR 489.915, p = 0.007), were predictors of interventions. Patients who underwent PD only had up to four drains inserted and 16.7% hospital mortality; subjects who underwent surgery had up to two drains and 33.3% death rate.Conclusions: Most subjects with severe gallstone and alcohol-related AP were treated medically. Large ANC, infected necrosis, and ICU admission predicted the need for intervention. When an invasive treatment was required, PD alone was effective with a tendency towards repeated drain insertions.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"244-253"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938338","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}

引用次数: 0

Historical perspectives on the surgical treatment of hernias in Greece: from 18th century's attempts to late 19th century's innovations in hernia surgery. 希腊疝气手术治疗的历史观点：从18世纪的尝试到19世纪晚期疝气手术的创新。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-05-03 DOI: 10.1080/00015458.2025.2499843

Laios Konstantinos, Pavlos Lytsikas-Sarlis, Lazaros Vladimiros, Dimitrios Filippou, Stylianos Kykalos, Irina Noskova, Dimitrios Zisiadis, Tsoucalas Gregory, Dimitrios Schizas

{"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":"10.1080/00015458.2025.2499843","url":null,"abstract":"Purpose: To understand the possibilities and the limitations of the modern Greek surgeons during nineteenth century on hernia surgery.Methods: 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.Results: 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.Conclusion: 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.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"264-272"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","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}

引用次数: 0

Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children. 儿童经皮内镜与腹腔镜胃造口术后家长满意度及长期标准化结果评价。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-06-18 DOI: 10.1080/00015458.2025.2520698

Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez

{"title":"Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children.","authors":"Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez","doi":"10.1080/00015458.2025.2520698","DOIUrl":"10.1080/00015458.2025.2520698","url":null,"abstract":"Introduction: Percutaneous endoscopic (PEG) and laparoscopic gastrostomy (LG) are two widely used techniques for gastrostomy placement in infants. We aimed to compare the risk of complications using a validated grading system and parent satisfaction.Methods: Infants undergoing gastrostomy placement in a tertiary referral center were retrospectively included. Local and general complications were graded using the Clavien-Dindo (CD)system and categorized as early (≤ 30 days) vs late (>30 days) postoperatively. Parent satisfaction was evaluated prospectively using a questionnaire (Numeric Rating Scale 0- 10).Results: Out of 102 patients, 52 underwent LG and 50 PEG. General complications (CD IIIa, IIIb and IV) were rare and occurred all late (n = 3), local complications were common: twice as much minor local early complications occurred in the LG cohort, however this was not statistically significant (28.8% vs 14.0%; p = 0.092). There was a trend toward more major local late CD IIIb complications in the PEG group, but this was not statistically significant (20.4% vs 8.0%; p = 0.088). After button removal, there was a higher risk of gastrocutaneous fistula requiring surgical closure after LG (53.1% vs 26.7% after PEG; p = 0.003). Parental satisfaction was high in both groups (mean score 8.3 for PEG vs 7.9 for LG; p = 0.341).Conclusion: While the risk of general complications after gastrostomy placement is low, local complications are common. However not significant, PEG was associated with a higher risk of major long-term local complications, while LG required more surgical closures after button removal. Parental satisfaction was high in both groups. Further prospective comparisons are needed.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"236-243"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309399","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}

引用次数: 0

Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma. 婴儿血管瘤坏死后小柱的外科重建。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-10-01 Epub Date: 2025-06-17 DOI: 10.1080/00015458.2025.2520785

Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer

{"title":"Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma.","authors":"Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer","doi":"10.1080/00015458.2025.2520785","DOIUrl":"10.1080/00015458.2025.2520785","url":null,"abstract":"Background: Infantile hemangiomas are common vascular tumors in childhood that usually undergo spontaneous involution. However, complications may arise, particularly in visible areas such as the centrofacial region, leading to significant aesthetic and functional sequelae. Columellar necrosis is a rare but challenging complication requiring specialized reconstruction techniques.Methods: This report presents two cases of columellar necrosis caused by infantile hemangiomas. Reconstruction was achieved using a 3-component technique: cartilage grafts for tip support, oral vestibule mucosal flaps for lateral lining, and cutaneous turn out flaps from the columellar stumps for anterior skin coverage.Results: Both patients achieved excellent functional and aesthetic outcomes. The described technique allowed for reliable reconstruction of the columella, addressing both structural integrity and cosmetic appearance.Conclusion: Reconstruction of columellar defects, particularly in pediatric cases, is challenging due to the columella's small size and challenging anatomy. The described 3-component technique offers a reproducible and effective approach for isolated columellar defects, ensuring satisfactory functional and aesthetic results.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"254-259"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300934","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}

引用次数: 0

An early report of using protecting gloves by Ḥakim Mohammad, a Persian surgeon (16th century CE). 波斯外科医生Ḥakim Mohammad（公元16世纪）关于使用防护手套的早期报告。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-04-08 DOI: 10.1080/00015458.2025.2489802

Narges Tajik, Zahra Ghahremani, Sobhan Ghezloo, Shahrzad Irannejad, Arman Zargaran

引用次数: 0

Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report. 颈胸副神经节瘤合并霍纳综合征1例。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-06-09 DOI: 10.1080/00015458.2025.2512488

Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre

{"title":"Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report.","authors":"Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre","doi":"10.1080/00015458.2025.2512488","DOIUrl":"10.1080/00015458.2025.2512488","url":null,"abstract":"Background: Cervico-thoracic paragangliomas are rare hypervascular neuroendocrine tumors, with high morbidity and mortality due to locally invasive growth. They are often misdiagnosed in patients with cervical masses. Horner's syndrome, in this case, results from a lesion of the stellate ganglion. Only a few cases in the literature describe paragangliomas affecting the stellate ganglion.Case report: We report the case of a 61-year-old female with a cervico-thoracic paraganglioma associated with Horner's syndrome. She had no significant medical history. Cervical computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large, highly vascularized antero-superior mediastinal mass measuring 6.8 cm x 5 cm x 9 cm, surrounding the left subclavian and carotid arteries, and slightly compressing the trachea, esophagus, and innominate vein. Surgery provided the definitive diagnosis through histopathological analysis. We highlight the different types of paragangliomas and the challenges in diagnosis. A 2-year follow-up with CT and PET-CT scans confirmed no recurrence of the lesion.Conclusions: Paragangliomas are rare, slow-growing neuroendocrine tumors that may appear wherever autonomic ganglia are present. Clinical presentations vary, including lesions of the stellate ganglion causing ipsilateral Horner's syndrome. Paragangliomas should be considered in the differential diagnosis of cervico-thoracic masses. Treatment involves complete surgical resection while preserving neurovascular structures.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"211-214"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141102","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}

引用次数: 0

A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion? 克罗地亚一家医院对阿尔瓦拉多评分的前瞻性诊断准确性研究——是得出最终结论的时候了吗？

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-06-03 DOI: 10.1080/00015458.2025.2512279

Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak

{"title":"A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion?","authors":"Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak","doi":"10.1080/00015458.2025.2512279","DOIUrl":"10.1080/00015458.2025.2512279","url":null,"abstract":"Background: The diagnosis of acute appendicitis (AA) still represents a considerable problem for surgeons, with a relatively high rate of false positive findings still present. Thus, the aim of our study was to evaluate the diagnostic accuracy of the Alvarado scoring system based on the prospectively included subjects who presented to the emergency department with suspected AA.Methods: From June 2018 to May 2020, 176 adult patients examined in the Emergency surgical department of University Hospital Sveti Duh with suspicion of AA were prospectively included in the study. The decision on the need for surgery in all patients was made by the same surgeon based only on clinical judgment and remained independent of any diagnostic scoring system.Results: Fifty-eight (33.0%) of them were operated with negative appendectomy rate of 17.2%. Results showed that the surgeon's decision-making process is superior to the Alvarado scoring system (sensitivity and specificity were 96 and 92.06% vs. 84 and 87.30%, respectively).Conclusion: The Alvarado scoring system proved to be a worse predictor of the diagnosis of AA compared to the assessment of an experienced surgeon and is not an adequate diagnostic tool for confirming the diagnosis. Only in a narrow group of patients in whom, based on the clinical examination, an indication for surgery has already been established, the Alvarado scoring system can potentially be useful in excluding the diagnosis with considerable caution in terms of close follow-up of the patient.Abbreviations: MSCT: multislice computed tomography; AA: acute appendicitis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"197-201"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141100","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}

引用次数: 0

Surgical training; destination unknown? A survey on surgical employment in Flanders. 外科培训；去向不明？

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-04-29 DOI: 10.1080/00015458.2024.2391176

Niels Komen, Marian Vanhoeij, Paul De Leyn, Frederik Berrevoet, Piet Pattyn, Guy Hubens

{"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":"Background: 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.Methods: 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).Results: 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; p = .009) and the number of applications (6.6 ± 5 vs. 3.3 ± 3; p < .001) are significantly higher for current fellows.Conclusion: 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.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"177-182"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","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}

引用次数: 0