Acta Chirurgica Belgica最新文献

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Outcomes of robotic versus laparoscopic ventral mesh rectopexy for rectal prolapse. 机器人与腹腔镜腹侧网片直肠切除术治疗直肠脱垂的效果。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI: 10.1080/00015458.2023.2191073
Ahmed M Chaoui, Ismaël Chaoui, Frederick Olivier, Joachim Geers, Mohamed Abasbassi
{"title":"Outcomes of robotic versus laparoscopic ventral mesh rectopexy for rectal prolapse.","authors":"Ahmed M Chaoui, Ismaël Chaoui, Frederick Olivier, Joachim Geers, Mohamed Abasbassi","doi":"10.1080/00015458.2023.2191073","DOIUrl":"10.1080/00015458.2023.2191073","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive ventral mesh rectopexy is considered the standard of care in the surgical management of rectal prolapse syndromes in fit patients. We aimed to investigate the outcomes after robotic ventral mesh rectopexy (RVR) and compare them with our laparoscopic series (LVR). Additionally, we report the learning curve of RVR. As the financial aspect for the use of a robotic platform remains an important obstacle to allow generalized adoption, cost-effectiveness was also evaluated.</p><p><strong>Patients and methods: </strong>A prospectively maintained data set including 149 consecutive patients who underwent a minimally invasive ventral rectopexy between December 2015 and April 2021 was reviewed. The results after a median follow-up of 32 months were analyzed. Additionally, a thorough assessment of the economic aspect was performed.</p><p><strong>Results: </strong>On a total of 149 consecutive patients 72 underwent a LVR and 77 underwent a RVR. Median operative time was comparable for both groups (98 min (RVR) vs. 89 min (LVR); <i>p</i> = 0.16). Learning curve showed that an experienced colorectal surgeon required approximately 22 cases in stabilizing the operative time for RVR. Overall functional results were similar in both groups. There were no conversions or mortality. There was, however, a significant difference (<i>p</i> < 0.01) in hospital stay in favor of the robotic group (1 day vs. 2 days). The overall cost of RVR was higher than LVR.</p><p><strong>Conclusions: </strong>This retrospective study shows that RVR is a safe and feasible alternative for LVR. With specific adjustments in surgical technique and robotic materials, we developed a cost-effective way of performing RVR.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"91-98"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9140891","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
Dynamics of PTH levels in the development of post-operative hypoparathyroidism. 术后甲状旁腺功能减退症发病过程中PTH水平的动态变化。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-03-28 DOI: 10.1080/00015458.2023.2194598
José Alberto Vilar Tabanera, Joaquín Gómez Ramirez, Philip Brabyn, Alberto G Barranquero, Ana Puerta Vicente, Belén Porrero, Patricia Luengo, José María Fernández Cebrián
{"title":"Dynamics of PTH levels in the development of post-operative hypoparathyroidism.","authors":"José Alberto Vilar Tabanera, Joaquín Gómez Ramirez, Philip Brabyn, Alberto G Barranquero, Ana Puerta Vicente, Belén Porrero, Patricia Luengo, José María Fernández Cebrián","doi":"10.1080/00015458.2023.2194598","DOIUrl":"10.1080/00015458.2023.2194598","url":null,"abstract":"<p><strong>Background: </strong>Post-operative hypoparathyroidism is the most frequent complication after total thyroidectomy. The identification of preoperative predictors could be helpful to identify patients at risk. This study aimed to evaluate the potential influence of preoperative PTH levels and their perioperative dynamics as a predictor of transient, protracted, and permanent post-operative hypoparathyroidism.</p><p><strong>Methods: </strong>A prospective, observational study that includes 100 patients who underwent total thyroidectomy between September 2018 and September 2020.</p><p><strong>Results: </strong>Transient hypoparathyroidism was present in 42% (42/100) of patients, 11% (11/100) developed protracted hypoparathyroidism, and 5% (5/100) permanent hypoparathyroidism. Patients who presented protracted hypoparathyroidism had higher preoperative PTH levels. The protracted and permanent hypoparathyroidism rate was higher in groups with greater preoperative PTH [0% group 1 (<40 pg/mL) <i>vs.</i> 5.7% group 2 (40-70 pg/mL) <i>vs.</i> 21.6% group 3 (>70 pg/mL); <i>p</i> = 0.03] and (0 <i>vs.</i> 8.3 <i>vs.</i> 20%; <i>p</i> = 0.442), respectively. The rate of protracted and permanent hypoparathyroidism was higher in patients with PTH at 24 h lower than 6.6 pg/mL and whose percentage of PTH decline was higher than 90%. The rate of transient hypoparathyroidism was higher in patients who showed a PTH decline rate of more than 60%. The percentage of PTH increase one week after surgery in patients with permanent hypoparathyroidism was significantly lower.</p><p><strong>Conclusion: </strong>The prevalence of protracted hypoparathyroidism was higher in groups with higher preoperative PTH levels. PTH levels 24 h after surgery lower than 6.6 pg/mL and a decline of more than 90% predict protracted and permanent hypoparathyroidism. The percentage of PTH increase a week after surgery could predict permanent hypoparathyroidism.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"99-106"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9186451","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
Adenocarcinoma arising from a chronic perianal fistula in a Crohn's disease patient: case report and review of the literature. 克罗恩病患者肛周慢性瘘管引发的腺癌:病例报告和文献综述。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-09-05 DOI: 10.1080/00015458.2023.2205722
Juliette Gosse, Vincenzo Simonelli, Michael Dessily
{"title":"Adenocarcinoma arising from a chronic perianal fistula in a Crohn's disease patient: case report and review of the literature.","authors":"Juliette Gosse, Vincenzo Simonelli, Michael Dessily","doi":"10.1080/00015458.2023.2205722","DOIUrl":"10.1080/00015458.2023.2205722","url":null,"abstract":"<p><p>Crohn's disease patients frequently develop perianal fistulas during their life. They are also at higher risk to develop cancers. Rarely, those cancers appear within a prior chronic fistula. The main types are adenocarcinoma mostly mucinous and squamous cell carcinoma. They are generally discovered at an advanced stage with a poor prognosis because symptoms are generally the same as those of the fistula itself. Regular follow-up of chronic fistulas is then important for an early diagnosis as well as histological analysis of the fistula during surgery. There is no consensus on the ideal treatment but abdominoperineal resection is the corner stone with or without neo or adjuvant chemo-radiotherapy. This paper presents a rare case of mucinous adenocarcinoma in a chronic perianal fistula in a Crohn's disease female and provides a review of the literature.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"143-146"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10527224","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
Primary EGIST of the greater omentum - a rare presentation. 原发性大网膜EGIST--一种罕见的表现。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-04-20 DOI: 10.1080/00015458.2023.2201084
Miguel Almeida, Fabiana Sousa, Fernando Resende, Vítor Devesa, António Ferrão, Silvestre Carneiro, Pedro Canão, Elisabete Barbosa, José Barbosa
{"title":"Primary EGIST of the greater omentum - a rare presentation.","authors":"Miguel Almeida, Fabiana Sousa, Fernando Resende, Vítor Devesa, António Ferrão, Silvestre Carneiro, Pedro Canão, Elisabete Barbosa, José Barbosa","doi":"10.1080/00015458.2023.2201084","DOIUrl":"10.1080/00015458.2023.2201084","url":null,"abstract":"<p><p>Extragastrointestinal stromal tumors (EGISTs) are rare mesenchymal neoplasms, which develop in the retroperitoneum, mesentery, and omentum, lacking continuity to the stomach or intestines. Authors hereby present a female patient with a large heterogeneous abdominal mass as a case of an omental EGIST. A 46-year-old woman was referred to our hospital due to an insidious enlargement and colicky pain in the right iliac fossa. Abdominal palpation revealed a voluminous, freely mobile, and non-pulsatile mesoabdominal bulge expanding to the hypogastrium. On exploratory midline laparotomy, the tumor was densely fused to the greater omentum, not connected to the stomach, without gross involvement of adjacent structures. The large mass was completely excised after adequate mobilization. Immunohistochemical techniques showed strong and diffuse expression of WT1, actin and DOG-1, as well as multifocal c-KIT marking. Mutational study concluded a double mutation of KIT exon 9 and a mutation of PDGFRA exon 18. The patient was submitted to adjuvant treatment with imatinib mesylate 800 mg/day. Despite an extremely diverse presentation, omental EGISTs often remain clinically silent for a long time having enough space to grow before becoming symptomatic. These tumors have a consistent pattern of metastasis that typically spares lymph nodes unlike epithelial gut neoplasms. Surgery remains the preferred treatment for non-metastatic EGISTs of the greater omentum. It is possible that DOG-1 will supplant KIT as the leading marker in the future. The scarcity of knowledge on omental EGISTs implies a close monitoring of these patients to detect local relapse or distant metastasis.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"137-142"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9319772","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
Magnets and children: a dangerous combination. 磁铁与儿童:危险的组合
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-06-05 DOI: 10.1080/00015458.2023.2219086
X De Raeymaeker, S Van Cauwenbergh, B Houben, A Karimi, G Sergeant, B Appeltans
{"title":"Magnets and children: a dangerous combination.","authors":"X De Raeymaeker, S Van Cauwenbergh, B Houben, A Karimi, G Sergeant, B Appeltans","doi":"10.1080/00015458.2023.2219086","DOIUrl":"10.1080/00015458.2023.2219086","url":null,"abstract":"<p><strong>Background: </strong>Accidental ingestion of foreign bodies is a common problem in children. Fortunately, the gastrointestinal tract is quite resilient to foreign bodies. On the other hand, the ingestion of magnets can result in enormous morbidity. Because of their natural tendency to firmly adhere they can cause intestinal obstruction, pressure necrosis, fistula formation or perforation. With this case report, we aim to raise awareness of the risks that these magnets pose to children.</p><p><strong>Methods: </strong>We describe a case of intestinal perforation caused by the separate ingestion of multiple magnets from a children's toy (buckyballs, Neodymium spheres) by a two-year-old boy. A search in the Pubmed database showed some publications and varied management guidelines.</p><p><strong>Results: </strong>The boy was treated with an exploratory laparoscopy converted to a mini-laparotomy. We removed the four magnets through separate enterotomies. Postoperative recovery was uneventful. The boy was discharged on a postoperative day five and had no complications at three months follow-ups.</p><p><strong>Conclusion: </strong>Accidental ingestion of multiple magnets is rare but can create a life-threatening situation in children. If the magnets are still in the stomach, endoscopic retrieval is needed. If they are beyond the stomach, in asymptomatic cases close clinical and radiographic vigilance is mandatory. When symptomatic we advise urgent removal. If treated on time, the surgical outcome is good and fast recovery is expected.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"156-159"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945186","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
Botulinum toxin injection in outpatients for chronic anal fissure. 为门诊慢性肛裂患者注射肉毒杆菌毒素。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-07-14 DOI: 10.1080/00015458.2023.2234179
Şeref Dokcu, Salim İlksen Başçeken
{"title":"Botulinum toxin injection in outpatients for chronic anal fissure.","authors":"Şeref Dokcu, Salim İlksen Başçeken","doi":"10.1080/00015458.2023.2234179","DOIUrl":"10.1080/00015458.2023.2234179","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the effect of botulinum toxin (BT) injection on fissure healing in the treatment of chronic anal fissure (CAF) in outpatient conditions without any analgesia and sedation to the internal anal sphincter (IAS). The primary outcome measure was post-procedural pain. The secondary outcome measures were fissure healing and complications.</p><p><strong>Methods: </strong>Prospectively preserved data of 67 patients who received BT injections for CAF were analyzed prospectively. Demographic data, duration of symptomatic improvement, fissure location and number, parity, post-procedural pain, complications, continence status, response to treatment, and duration of follow-up were examined. Participants received bilateral (50 + 50 units) BT injections into the internal anal sphincter (IAS) in an outpatient setting.</p><p><strong>Results: </strong>Symptomatic improvement was observed in 58% of patients within 1 week. The complete response rate to treatment was 82% at a mean follow-up of 6 months. Patients with partial response to treatment (10%) were successfully treated with topical therapy, and patients with persisting fissures (8%) were successfully treated with partial lateral internal sphincterotomy (LIS). 14 patients (21%) reported some degree of transient incontinence at follow-up. Multiparous women experienced more symptoms of Incontinence (<i>p</i> = 0.00). Pre- and post-procedural Vas Score median values were 4. The 7th-week VAS score median value was 3.</p><p><strong>Conclusion: </strong>Dysport injection under sedation-free outpatient conditions is an effective and safe alternative to LIS for the treatment of CAF, with tolerable procedural pain. All patients should be warned of transient incontinence.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"131-136"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779045","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 treatment of constrictive pericarditis at a single center: 10 years of experience. 单一中心的缩窄性心包炎手术治疗:十年经验
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-05-26 DOI: 10.1080/00015458.2023.2216377
Mehmet Ali Yeşiltaş, Ali Aycan Kavala, Saygin Turkyilmaz, Yusuf Kuserli, Gülsüm Türkyilmaz, Hasan Toz, Can Özen
{"title":"Surgical treatment of constrictive pericarditis at a single center: 10 years of experience.","authors":"Mehmet Ali Yeşiltaş, Ali Aycan Kavala, Saygin Turkyilmaz, Yusuf Kuserli, Gülsüm Türkyilmaz, Hasan Toz, Can Özen","doi":"10.1080/00015458.2023.2216377","DOIUrl":"10.1080/00015458.2023.2216377","url":null,"abstract":"<p><strong>Background: </strong>Constrictive pericarditis (CP) is a pericardial disease characterized by the pericardium becoming calcified or fibrotic as a result of chronic inflammation, which impairs diastolic filling by compressing the cardiac chambers. Pericardiectomy is a promising surgical option for treating CP. In this study, we reviewed over 10 years of preoperative, perioperative, and short-term postoperative follow-ups of patients who underwent pericardiectomy for constrictive pericarditis at our clinic.</p><p><strong>Methods: </strong>Between January 2012 and May 2022, 44 patients were diagnosed with constrictive pericarditis. Twenty-six patients underwent pericardiectomy for CP. Median sternotomy is the surgical approach of choice because it provides easy access for complete pericardiectomy.</p><p><strong>Results: </strong>The patient median age was 56 (min: 32, max: 71), and 22 out of 26 patients (84.6%) were male. Twenty-one patients (80.8%) complained of dyspnea, which was the most common reason for admission. Twenty-four patients (92.3%) were scheduled for elective surgery. Cardiopulmonary bypass (CPB) was used during the procedure in six patients (23%). The duration of intensive care stay was two days (min: 1, max: 11), and the total hospitalization was six days (min: 4, max: 21). No in-hospital mortality was observed.</p><p><strong>Conclusion: </strong>The median sternotomy approach provides a critical advantage in terms of performing a complete pericardiectomy. Although CP is a chronic condition, early diagnosis and planning of pericardiectomy before irreversible deterioration of cardiac function leads to a notable reduction in mortality and morbidity.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"107-113"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876694","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
Hyperfunctioning papillary thyroid carcinoma - a case report and literature review. 功能亢进性甲状腺乳头状癌--病例报告和文献综述。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-05-09 DOI: 10.1080/00015458.2023.2210699
Juliana Pereira-Macedo, Bárbara Freire, Carlos Macedo-Oliveira, João Mendes, Márcia Carvalho, João Rocha-Neves, Sofia Fonseca, Margarida Vinagreiro, Ricardo Lemos, Nair Silva, Francisco Sampaio
{"title":"Hyperfunctioning papillary thyroid carcinoma - a case report and literature review.","authors":"Juliana Pereira-Macedo, Bárbara Freire, Carlos Macedo-Oliveira, João Mendes, Márcia Carvalho, João Rocha-Neves, Sofia Fonseca, Margarida Vinagreiro, Ricardo Lemos, Nair Silva, Francisco Sampaio","doi":"10.1080/00015458.2023.2210699","DOIUrl":"10.1080/00015458.2023.2210699","url":null,"abstract":"<p><strong>Background: </strong>Malignant hyperfunctioning thyroid nodules are rare and more likely to occur in follicular cancer types rather than papillary variants. The authors present a case of a papillary thyroid carcinoma associated with a hyperfunctioning nodule.</p><p><strong>Methods: </strong>A single adult patient submitted to total thyroidectomy with the presence of thyroid carcinoma within hyperfunctioning nodules was selected. Additionally, brief literature was conducted.</p><p><strong>Results: </strong>An asymptomatic 58-year-old male was subjected to routine blood analysis and a TSH level of <0.003 mIU/L was found. Ultrasonography revealed a 21 mm solid, hypoechoic, and heterogenous nodule with microcalcifications in the right lobe. A fine needle aspiration guided by ultrasound resulted in a follicular lesion of undetermined significance. A <sup>99m</sup>Tc thyroid scintigram was followed and identified a right-sided hyperfunctioning nodule. Another cytology was performed and a papillary thyroid carcinoma was derived as a result. The patient underwent a total thyroidectomy. Postoperative histology confirmed the diagnosis and a tumor-free margin with no vascular or capsular invasions.</p><p><strong>Conclusion: </strong>Hyperfunctioning malignant nodules are a rare association, although a careful approach should be led since major clinical implications arise. Selective fine needle aspiration in all suspicious ≥1 cm nodules should be considered.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"147-152"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421962","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
Effect of opioid-free anesthesia on post-operative period in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a propensity score matched study. 无阿片类药物麻醉对腹腔内热化疗细胞减灭术术后时间的影响:倾向评分匹配研究。
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-04-01 Epub Date: 2023-03-27 DOI: 10.1080/00015458.2023.2190289
Sylvain Liet, Mathilde Logeay, Emmanuel Besnier, Jean Selim, Gregory Wood, Jean-Jacques Tuech, Julien Coget, Vincent Compère, Emilie Occhiali, Benjamin Popoff, Thomas Clavier
{"title":"Effect of opioid-free anesthesia on post-operative period in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a propensity score matched study.","authors":"Sylvain Liet, Mathilde Logeay, Emmanuel Besnier, Jean Selim, Gregory Wood, Jean-Jacques Tuech, Julien Coget, Vincent Compère, Emilie Occhiali, Benjamin Popoff, Thomas Clavier","doi":"10.1080/00015458.2023.2190289","DOIUrl":"10.1080/00015458.2023.2190289","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is important. It appears essential to reduce postoperative pain and morphine consumption.</p><p><strong>Methods: </strong>Retrospective study in a university hospital comparing patient benefiting from CRS-HIPEC under opioid-free anesthesia (OFA; dexmedetomidine) to those anesthetized with opioid anesthesia (OA; remifentanil) using a propensity score matching method. The main objective was the impact of OFA on postoperative morphine consumption in the first 24 h after surgery.</p><p><strong>Results: </strong>102 patients were included, matching on the propensity score allowed selecting 34 unique pairs analyzed. Morphine consumption was lower in the OFA group than in the OA group (3.0 [0.00-11.0] mg/24 h <i>vs</i>. 13.0 [2.5-25.0] mg/24 h; <i>p</i> = 0.02). In multivariable analysis, OFA was associated with a reduction of 7.2 [0.5-13.9] mg of postoperative morphine (<i>p</i> = 0.04). The rate of renal failure with a KDIGO-score > 1 was lower in the OFA group than in the OA group (12% <i>vs</i>. 38%; <i>p</i> = 0.01). There was no difference between groups concerning length of surgery/anesthesia, norepinephrine infusion, volume of fluid therapy, post-operative complications, rehospitalization or ICU readmission within 90 days, mortality, and postoperative rehabilitation.</p><p><strong>Conclusion: </strong>Our results suggest that OFA for CRS-HIPEC patients appears safe and is associated with less postoperative morphine use and acute kidney injury.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"81-90"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9229116","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
'Carried away by a moonlight shadow' -In memoriam Prof. em. Dr. med. Paul L.O. Broos 1945-2023. "被月光的影子带走"--纪念 Em.Dr. med.Paul L.O. Broos 1945-2023.
IF 0.8 4区 医学
Acta Chirurgica Belgica Pub Date : 2024-02-23 DOI: 10.1080/00015458.2024.2320983
Carl De Crée
{"title":"'Carried away by a moonlight shadow' -<i>In memoriam</i> Prof. em. Dr. med. Paul L.O. Broos 1945-2023.","authors":"Carl De Crée","doi":"10.1080/00015458.2024.2320983","DOIUrl":"10.1080/00015458.2024.2320983","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139745805","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
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