Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery最新文献

{"title":"The use of mesenchymal stem cells adhered to the suture filament in the closure of rat aponeurosis.","authors":"Jefferson Kalil, Joaquim Murray Bustorff-Silva, Davi Reis Calderoni, Krissia Caroline Leme, Gabriela Cardoso de Arruda Camargo, Wagner José Fávaro, Ângela Cristina Malheiros Luzo","doi":"10.1590/0102-67202026000002e1931","DOIUrl":"https://doi.org/10.1590/0102-67202026000002e1931","url":null,"abstract":"<p><strong>Background: </strong>Abdominal wall hernia is a common disease, with an incidence of around 20%. Recent studies have shown the benefits of using stem cells, especially mesenchymal ones, to improve tissue healing.</p><p><strong>Aims: </strong>Evaluate the use of mesenchymal stem cells derived from adipocytes adhered to a suture filament to enhance tensile strength and collagen formation in aponeurosis.</p><p><strong>Methods: </strong>Human stem cells derived from adipocytes were adhered to a suture filament. Thirty-seven rats of the species Sprague Dawley were divided into three groups: Group 1 was the control group, Group 2 used only a regular suture filament to close abdominal aponeurosis, and Group 3 used a suture filament with stem cells. These animals were evaluated seven, 14, and 56 days after the intervention.</p><p><strong>Results: </strong>Rupture occurred at the semilunar line and the midline. All animals from Groups 2 and 3, submitted to incision and closure, evaluated at D7 and D14, showed a rupture in the midline. However, all animals evaluated at D56 (all groups) ruptured at the semilunar line. Furthermore, tensile strength was significantly lower at D7 in Groups 2 and 3 compared to Group 1 (p<0,001). On D14, Groups 2 and 3 showed a similar increase in tensile strength, but still inferior to the one observed in Group 1 (p<0,05). On D56, all groups reached similar values (p=0,074, p>0.05). Collagen histologic analysis showed that animals from Group 3 had the highest values in all time points, and Group 2 had higher values than Group 1 in all time points (p>0,05). In graphical analysis, Groups 2 and 3, on D7, had an increase in collagen, but on D14 showed a decrease, with a similar level on D56 (p>0,05).</p><p><strong>Conclusions: </strong>This study do not support the use of mesenchymal stem cells to improve the healing of a midline abdominal incision in healthy subjects. However, an option for future studies is to employ this filament, combined with matrices for reconstructive purposes, in areas requiring extensive repair, such as large hernias where the aponeurosis is insufficient for defect correction.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"39 ","pages":"e1931"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pouch cancer in familial adenomatous polyposis. Incidence, risk factors and literature review: a propos of three rare cases.","authors":"Fábio Guilherme Campos, Carlos Augusto Real Martinez, Renata Nobre Moura, Adriana Vaz Safatle-Ribeiro, Carlos Frederico Sparapan Marques, Ulysses Ribeiro Junior, Paulo Herman","doi":"10.1590/0102-67202025000059e1928","DOIUrl":"10.1590/0102-67202025000059e1928","url":null,"abstract":"<p><strong>Background: </strong>Development of pouch cancer is a great challenge to both surgeons and patients with familial adenomatous polyposis (FAP) after restorative proctocolectomy (RPC).</p><p><strong>Aims: </strong>We aimed to present our experience with pouch cancer diagnosis and review literature data regarding incidence and associated risk factors.</p><p><strong>Methods: </strong>This retrospective study enrolled FAP patients undergoing RPC between 1981 and 2023 in our academic institution. It included only J-pouch stapled patients with at least three years of follow-up. Patients' demographics and disease features were retrieved.</p><p><strong>Results: </strong>After excluding seven patients, we selected 87 RPC, and three cases (3.4%) of pouch cancer were identified. They were diagnosed in three men aged 23-40 years at RPC and 41-62 years at cancer diagnosis. Interval from RPC to pouch cancer diagnosis varied from 11.6 to 20 years (average 14.6 years). All patients had colorectal cancers (CRC) detected in the specimen from the index surgery, two of them with multicenter lesions. A brief review of the literature series showed that pouch cancer has been detected in incidences ranging from 0.8 to 3.4%. Male sex, CRC in the RPC specimen, pouch phenotype during follow-up and an association with duodenal adenomas are considered risk factors.</p><p><strong>Conclusions: </strong>Pouch cancer is a rare event associated with specific risk factors. After RPC, all patients should undergo endoscopic surveillance, with special attention to those who develop an aggressive phenotype during the first decade of follow-up.</p><p><strong>Central message: </strong>Familial adenomatous polyposis (FAP) is an autosomal dominant disease associated with mutations in the APC gene. As a dominantly inherited cancer-predisposing syndrome, the main challenge of FAP management is the significant risk of CRC that requires prophylactic colectomy in a timely manner aiming to reduce colorectal cancer (CRC) risk while maintaining quality of life. Cancer prevention is most usually accomplished through restorative procedures such as total colectomy with ileorectal anastomosis (IRA) or a restorative proctocolectomy with ileoanal anastomosis (RPC). The development of ileoanal pouch cancer is not so common in patients with FAP, even in specialized centers.</p><p><strong>Perspectives: </strong>Pouch cancer is a rare disease diagnosed in incidences varying from 0.8 to 3.4% in worldwide FAP series. Male patients, presence of CRC in the RPC specimen, colorectal phenotype, and association with duodenal adenomas are considered the main risk factors. Pouch adenomas develop after both hand-sewn or stapled anastomosis. Pouch polypectomy might prevent the development of adenocarcinomas, as patients under surveillance are diagnosed with more localized diseases.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1928"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric neuroendocrine tumors: a comprehensive analysis of clinicopathological characteristics and survival outcomes from a reference center.","authors":"Mateus Barradas Ribeiro, Marina Alessandra Pereira, Donato Roberto Mucerino, Osmar Kenji Yagi, André Roncon Dias, Bruna de Camargo Nigro, Ulysses Ribeiro Junior, Marcus Fernando Kodama Pertille Ramos","doi":"10.1590/0102-67202025000056e1925","DOIUrl":"10.1590/0102-67202025000056e1925","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastric neuroendocrine tumors (gNETs) are uncommon neoplasms arising from enterochromaffin-like cells, representing a distinct subset of gastric malignancies, with challenging clinical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;To analyse the classification, treatment indication, and survival of patients diagnosed with gNETs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively analyzed patients diagnosed with gNETs between 2009 and 2025 at a high-volume tertiary center in Brazil. Clinical, pathological, and treatment data were reviewed, and tumors were classified according to World Health Organization and clinicopathological criteria into Types I, II, and III.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 75 patients included, 53 (70.7%) were classified as Type I, 5 (6.7%) as Type II, and 17 (22.6%) as Type III. Treatment included surgery in 25 patients (33.3%) and endoscopic resection in 50 (66.7%). Type I tumors predominated in females (p&lt;0.001), were frequently multifocal (p&lt;0.001), associated with higher body mass index (p=0.002), and were mainly managed endoscopically (p=0.008). Type II tumors were rare and associated with multiple endocrine neoplasia Type 1, while Type III tumors were predominantly male, larger, high-grade (G3), and frequently metastatic, requiring surgical resection and palliative therapy. Among the 25 surgically treated patients, most were men (52%) and included 12 patients (48.0%) with Type I, 3 (12.0%) with Type II, and 10 (40.0%) with Type III tumors. Survival analysis showed significantly worse outcomes for Type III and G3 tumors. Multivariable analysis identified advanced age (hazards ratio 4.11; 95% confidence interval (95%CI): 1.14-14.80; p=0.030) and tumor, lymph node, metastasis (TNM) stage III/IV (HR 5.42; 95%CI: 1.26-23.26; p=0.023) as independent predictors of poorer survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;gNETs exhibit heterogeneous clinical behavior, with Type I tumors predominating in the Brazilian population. Tumor type, grade, and TNM stage are critical determinants of prognosis and should guide individualized treatment strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Central message: &lt;/strong&gt;The stomach is the most frequent site of gastrointestinal neuroendocrine neoplasms (NENs), with an annual incidence of approximately 0.4 per 1,00,000 individuals. According to the most recent World Health Organization Classification of Tumors of the Digestive System, NENs are divided into three major categories: gastric neuroendocrine tumors, which are the most common, well-differentiated, and have any grade; neuroendocrine carcinomas, which are poorly differentiated and high-grade; and mixed neuroendocrine-non-neuroendocrine neoplasms, which are aggressive and harbor multiple molecular alterations. These neoplasms originate from enterochromaffin-like cells of the gastric mucosa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Perspectives: &lt;/strong&gt;Gastric neuroendocrine tumors (gNETs) are uncommon and heterogeneous, and require individualized","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1925"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finsterer- Bancroft-Plenk operation and Bouveret's syndrome: a rare association.","authors":"Philipe Franco do Amaral Tafner, Giulia Trucolo de Brito, Joao Guilherme Oliveira Vaz, Bruna Mattos Vanetti de Albuquerque, Ana Carolina Arantes, Ary Augusto de Castro Macedo, Valdir Tercioti Junior, João de Souza Coelho Neto, Nelson Adami Andreollo, Luiz Roberto Lopes","doi":"10.1590/0102-67202025000060e1929","DOIUrl":"10.1590/0102-67202025000060e1929","url":null,"abstract":"<p><p>Peptic ulcer disease (PUD) presents different spectrums of evolution and severity. Epigastric pain is the patient's most important complaint and may be associated with other complications, such as bleeding, perforations and stenosis, associated with comorbidities. Bouveret syndrome is a rare syndrome with nonspecific symptoms and prolonged evolution, characterizing duodenal obstruction by a large gallstone migrated through a cholecystoduodenal fistula. It is currently known as the Finsterer-Bancroft-Plenk technique, the preservation of the antrum and removal of the antral mucosa associated by partial gastrectomy. The Finsterer-Bancroft-Plenk technique is still a surgical option in the face of complex duodenal stenoses secondary to PUD.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1929"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviews, expert opinions, consensus statements, position papers, protocols, and evidence-based guidelines: what are their roles in clinical practice?","authors":"Francisco Tustumi, Lucia Calthorpe, Felipe José Fernández Coimbra, Adnan Alseidi","doi":"10.1590/0102-67202025000057e1926","DOIUrl":"10.1590/0102-67202025000057e1926","url":null,"abstract":"<p><strong>Central message: </strong>Clinical practice guidance documents are not all the same. In digestive surgery, evidence-based guidelines, consensus statements, position papers, and protocols each serve different purposes, and the distinctions between them should be clear. Recognizing the strengths and limitations of each format is essential to improving decision-making, guiding research, and ultimately benefiting our patients.</p><p><strong>Perspectives: </strong>Digestive surgery evolves rapidly, and traditional publication models may not keep pace with emerging technologies and clinical demands. Future guidance documents are expected to incorporate artificial intelligence for evidence screening, living systematic reviews for continuous updates, and transparent digital repositories for open access to consensus voting and dissent. National registries and real-world data will complement trials where randomized evidence is scarce.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1926"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of pringle maneuver on hepatectomies: analysis of survival and clinical effects.","authors":"Allan Rubens Zucolotto Cansi, Jhonatan de Souza Vitor, João Felipe da Silva Lopes, Rogério Dardengo Glória","doi":"10.1590/0102-67202025000053e1922","DOIUrl":"10.1590/0102-67202025000053e1922","url":null,"abstract":"<p><strong>Background: </strong>The Pringle maneuver remains a widely used technique in hepatic surgery with varying opinions on its effects on postoperative outcomes and survival, requiring evidence-based evaluation of its impact on liver function and long-term results.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the impact of the intermittent Pringle maneuver on postoperative liver function and survival in hepatectomy patients, focusing on early dysfunction markers as prognostic factors.</p><p><strong>Results: </strong>In this retrospective cohort of 198 patients (106 women and 92 men; mean age, 59 years), the Pringle group showed longer surgical times (226.87±82.18 vs. 184.00±80.90 min, p<0.001) and extended intensive care unit stays (4.02±2.1 vs 3.11±1.9 days, p=0.026), but lower bilirubin levels (2.18±0.33 vs. 3.13±0.39 mg/dL, p=0.049). Multivariate analysis revealed that the Pringle maneuver reduced mortality risk (hazard ratio [HR]=0.540, 95% confidence interval [95%CI]: 0.333-0.876, p=0.013). Early liver dysfunction markers strongly predicted worse outcomes: elevated bilirubin nearly doubled mortality risk (HR 1.975, 95%CI 1.100-3.545, p=0.023), and decreased prothrombin activity tripled it (HR 3.055, 95%CI 1.839-5.075, p<0.001).</p><p><strong>Conclusions: </strong>While the Pringle maneuver extends operative time and intensive care unit stay, it demonstrates a protective effect on survival. Early postoperative liver dysfunction strongly predicts poor outcomes, emphasizing the importance of careful postoperative monitoring regardless of vascular control strategy. These findings suggest that a controlled intermittent Pringle maneuver offers survival benefits when properly timed.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1922"},"PeriodicalIF":1.8,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147292054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ALDH1 and ALCAM as emerging biomarkers in personalized rectal cancer therapy.","authors":"Jurandir Marcondes Ribas-Filho, Efstathia N Doelken, Sudipta Tripathi, Bülent Polat, Reinhard Lissner, Thomas Böeldicke, Carmen Austrália Paredes Marcondes Ribas, Osvaldo Malafaia, Martin Gasser, Ana Maria Waaga-Gasser","doi":"10.1590/0102-67202025000051e1920","DOIUrl":"10.1590/0102-67202025000051e1920","url":null,"abstract":"<p><strong>Background: </strong>The preoperative evaluation of serum tumor markers provides valuable prognostic and therapeutic insights in solid malignancies. Although not diagnostic by themselves, increased preoperative concentrations often reflect greater tumor burden, advanced disease stage, and unfavorable clinical outcomes.</p><p><strong>Aims: </strong>The aim of this study was to investigate the expression and diagnostic-prognostic potential of the tumor markers aldehyde dehydrogenase 1 (ALDH1) and activated leukocyte cell adhesion molecule (ALCAM) in the blood of rectal cancer patients under the influence of short- or long-term radio-/chemoradiotherapy (RTx/RCTx).</p><p><strong>Methods: </strong>Serum samples taken from patients with rectal carcinoma (n=164) at different time points during and after RTx/RCTx were retrospectively examined to determine whether these markers could predict disease progression and long-term survival.</p><p><strong>Results: </strong>Kaplan-Meier analysis confirmed the prognostic relevance of the Union for International Cancer Control (UICC) staging, while no significant associations were observed between serum levels of the investigated biomarkers and individual patient or tumor characteristics such as age, sex, or tumor stage. Overall, ALCAM and ALDH1 in this limited patient cohort exhibited elevated serum levels compared with healthy controls, and tumor tissues demonstrated stage-dependent increases in marker expression (UICC III/IV versus I/II).</p><p><strong>Conclusions: </strong>Serum concentrations of ALCAM and ALDH1 were significantly elevated in our patient cohort with rectal cancer but showed no significant correlation with tumor stage or survival, whenever serum samples were obtained either during or after neoadjuvant and adjuvant therapy, which may be particularly due to the limited number of studied subjects. Although their prognostic utility remains limited, their consistent elevation in cancer patients underscores their potential value in early detection or as components of a broader biomarker panel.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1920"},"PeriodicalIF":1.8,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterus transplantation - indications, technique, and results.","authors":"Wellington Andraus, Dani Ejsenberg, Daniel Reis Waisberg, Alexandre Chagas Santana, Liliana Ducatti, Rubens Macedo Arantes, Rodrigo Bronze de Martino, Vinicius Rocha Santos, Rafael Soares Pinheiro, Luciana Leis, Maciana Santos Silva, Luciana Bertocco Haddad, José Maria Soares Junior, Pedro Augusto Araujo Monteleone, Edmund Chada Baracat","doi":"10.1590/0102-67202025000054e1923","DOIUrl":"10.1590/0102-67202025000054e1923","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Central message: &lt;/strong&gt;Uterus transplantation was a transformative innovation in reproductive medicine and organ transplantation in general, and an alternative for the treatment of infertility. The problem of infertility affects 8-12% of the population of reproductive age, causing an enormous social impact. Uterus transplantation, a relatively new treatment, has emerged as an excellent option for couples with absolute uterine infertility. The first uterus transplant performed was in 2000, in Saudi Arabia. At this same time, a Swedish researcher began several experimental works with uterine transplantation in different animal models. Only more than a decade after the first attempt in humans was a second case performed, in Turkey, in 2011. The first transplant in the Americas was performed in the United States of America, in 2016, with a deceased donor. In the same year, in Brazil, the group from Hospital das Clínicas, Faculty of Medicine, University of São Paulo, performed the first uterus transplant in Latin America, also with a deceased donor. This Brazilian case resulted in the world's first birth from a deceased donor uterus transplant in December 2017, making Brazil and Hospital das Clínicas in a vanguard position in the world transplant scenario. Even so, we have today more than 100 transplants performed on the planet, with the birth of more than 70 children. Uterus transplantation was a transformative innovation in reproductive medicine and organ transplantation. It is an alternative for the treatment of absolute uterine factor infertility. Mayer-Rokitansky-Küster-Hauser syndrome is the main cause of uterine agenesis. This Brazilian case resulted in the world's first birth from a deceased donor uterus transplant in December 2017. Today, more than 100 transplants are performed on the planet, with the birth of more than 70 children. Uterus transplantation has undoubtedly been a transformative innovation in reproductive medicine and organ transplantation. It comes as an alternative for treating infertility of an absolute uterine cause. Among these causes, we have women who were born without this organ, or there was a need to perform a hysterectomy, or they have a non-functioning uterus, such as severe malformations (severe bicornuate uterus, Asherman syndrome). Modern society has increasingly respected each individual's decision, provided they are informed of all alternatives and risks involved. In this way, uterine transplantation has become an important alternative for patients with infertility due to uterine causes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Perspectives: &lt;/strong&gt;Uterus transplantation is a new modality among organ transplants. It has undoubtedly brought great innovation and excellent results to the therapeutic armamentarium for infertility of uterine cause. Uterus transplantation is a great example where multidisciplinarity, in which each one contributes with their expertise, enables the realization of a greater feat. The gain of experi","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1923"},"PeriodicalIF":1.8,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal upfront surgery for gastric adenocarcinoma. Real life situation in Brazil. Results comparable to neoadjuvant treatment.","authors":"Augusto Canton Gonçalves, Rodrigo Silveira Racy, Anna Clara Hebling Mitidieri, Beny Goulart Dias de Castro, Caio de Carvalho Zanon, Wilson Rodrigues Freitas Junior, Osvaldo Antonio Prado Castro, Paulo Kassab","doi":"10.1590/0102-67202025000055e1924","DOIUrl":"10.1590/0102-67202025000055e1924","url":null,"abstract":"<p><strong>Background: </strong>Complete neoadjuvant treatment for gastric cancer is not always tolerated due to nutritional and clinical reasons, such as gastric outlet obstruction. In this context, upfront surgery becomes an alternative.</p><p><strong>Aims: </strong>The aim of the study was to compare upfront resection with neoadjuvant systemic therapy followed by surgery and identify factors influencing their outcomes.</p><p><strong>Methods: </strong>Retrospective study of 410 patients with locally advanced gastric adenocarcinoma followed between 2012 and 2020, comparing upfront surgery and perioperative treatment. Patients with early tumor (cT1N0), metastasis, and stump cancer were excluded. The comparison was stratified by stage without the influence of systemic treatment (primary stage). Resections with D2 dissection, no residual tumor (no R2), and no complications were considered optimal surgery.</p><p><strong>Results: </strong>Upfront resection was performed in 216 patients (85% of upfront surgeries). Gastrectomy after neoadjuvant treatment was performed in 47 cases (76% of indications), and another four were resected among 39 previous unsuccessful surgeries (10%). In total, there were 51 resections after chemotherapy. Independent factors associated with overall survival at 60 months were: preoperative chemotherapy (57.3% vs. 40.7%, p=0.029); complication rate; D2 lymphadenectomy; and primary stage. Initial cases showed a better outcome in the neoadjuvant group without statistical significance (p=0.447), but it was present in more advanced tumors (p=0.027). Optimal surgery was achieved in 68.6% of the neoadjuvant group and 51.9% of the upfront group (p=0.030) and resulted in similar overall survival (56.6% vs. 52.4%, p=0.904).</p><p><strong>Conclusions: </strong>Optimal upfront surgery followed by adjuvant therapy, particularly with D2 dissection, is effective and was not statistically inferior to neoadjuvant treatment.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1924"},"PeriodicalIF":1.8,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repercussions of bariatric surgery on bone mineral density: a comparative analysis between Roux-en-Y gastric bypass and sleeve gastrectomy.","authors":"Bruna Nolasco Siqueira Silva Fradique, André Santos Costa, Margarida Castro Antunes, Anatália Teixeira da Silva Rodrigues, Fernando Santa-Cruz, Álvaro Antonio Bandeira Ferraz","doi":"10.1590/0102-67202025000044e1913","DOIUrl":"https://doi.org/10.1590/0102-67202025000044e1913","url":null,"abstract":"<p><strong>Background: </strong>Malabsorption of micronutrients including calcium and vitamin D may lead to pathological bone fractures in the late postoperative period of bariatric surgery.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on bone mineral density (BMD) and calcium and vitamin D intake after 3 years of surgery.</p><p><strong>Methods: </strong>Cross-sectional study that included 66 patients in the late postoperative period of bariatric surgery to analyze their BMD. Anthropometric and demographic data were collected, and a 24-hour recall questionnaire was carried out to assess food consumption patterns. BMD was assessed by bone densitometry of the femur and spine, and the values were expressed as z-scores.</p><p><strong>Results: </strong>The mean age was 40.1 years, 86.4% were female. RYGB was performed in 60.3% and SG in 39.7%. There was no significant difference between the techniques when comparing anthropometry, body composition, and food consumption patterns. There was a positive correlation, after RYGB, between femoral z-score, calcium and vitamin D intake, and multivitamin supplementation. A total of 12.7% of the sample had compromised bones, and among these, 87.5% underwent RYGB, 100% had inadequate consumption of calcium and vitamin D, and 12.5% were in menopause.</p><p><strong>Conclusions: </strong>A small percentage of the sample showed bone loss after RYGB and SG. The type of surgery was not a significant factor in changing BMD. However, all those affected had a low intake of calcium and vitamin D.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1913"},"PeriodicalIF":1.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}