Annali italiani di chirurgia最新文献

{"title":"Incidence and Risk Factors of Postoperative Acute Kidney Injury in Colorectal Cancer Patients With Metabolic Syndrome: A Retrospective Cohort Study.","authors":"Quanyong Zha, Kun Xiong, Man Wei, Yunjing Chen","doi":"10.62713/aic.4595","DOIUrl":"https://doi.org/10.62713/aic.4595","url":null,"abstract":"<p><strong>Aim: </strong>Postoperative acute kidney injury (AKI) is a serious complication commonly occurring after colorectal cancer surgery, primarily associated with prolonged hospitalization and poor prognosis. Metabolic syndrome (MetS) is accompanied by chronic inflammation, insulin resistance, and subclinical renal dysfunction-factors that could augment susceptibility to AKI in patients under surgical stress. This study aims to investigate the incidence and risk factors of postoperative AKI in colorectal cancer patients with MetS and provide a reference for perioperative risk management.</p><p><strong>Methods: </strong>In this retrospective cohort study, 209 patients with MetS who underwent radical resection for colorectal cancer at Ezhou Central Hospital from January 2023 to December 2025 were consecutively enrolled. According to whether AKI occurred after surgery, the patients were divided into AKI group (<i>n</i> = 63) and non-AKI group (<i>n</i> = 146). Demographic data, metabolic indicators, inflammatory markers, and surgery-related variables were collected. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors of AKI, and a predictive model was constructed. The model's performance was evaluated by analyzing the area under the curve (AUC) and the calibration curve.</p><p><strong>Results: </strong>Univariate analysis showed that fasting plasma glucose, 2-hour postprandial blood glucose, systolic blood pressure, diastolic blood pressure, components of metabolic syndrome, preoperative neutrophil-to-lymphocyte ratio (NLR), intraoperative blood loss, hypoalbuminemia, and intraoperative hypotension were significantly associated with AKI (<i>p</i> < 0.05). Multivariate analysis showed that diastolic blood pressure (odds ratio [OR] = 1.071, 95% confidence interval [CI]: 1.033-1.109), preoperative NLR (OR = 2.832, 95% CI: 1.381-5.804), intraoperative blood loss (OR = 1.040, 95% CI: 1.026-1.054), and intraoperative hypotension (OR = 3.499, 95% CI: 1.276-9.592) were independent risk factors for postoperative AKI. The AUC of the predictive model was 0.86, indicating good calibration.</p><p><strong>Conclusions: </strong>Colorectal cancer patients with MetS are at an increased risk of postoperative AKI. Elevated diastolic blood pressure, a higher preoperative NLR, increased intraoperative blood loss, and episodes of intraoperative hypotension are independent risk factors of AKI. Therefore, optimizing perioperative blood pressure control, assessing the inflammatory status, adopting more delicate surgical techniques, and ensuring vigilant hemodynamic monitoring are essential strategies to reduce the risk of AKI in these patients.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1050-1059"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263012","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":"Impact of Individualized Positioning Care on Cardiac Function Recovery and Comfort in Patients After Heart Valve Surgery.","authors":"Yuping Zhang, Yue Wang, Yongbo Hou, Yuan Ning","doi":"10.62713/aic.4624","DOIUrl":"https://doi.org/10.62713/aic.4624","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Postoperative recovery after heart valve surgery is an important topic in the realm of nursing care. This study aimed to evaluate the effect of individualized positioning care on cardiac function recovery and comfort in patients after heart valve surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-center, retrospective cohort study was conducted, continuously enrolling patients who underwent heart valve surgery at Affiliated Hospital of Xuzhou Medical University from June 2022 to June 2025. A total of 150 patients were included. The patients were divided into a control group (conventional positioning care, &lt;i&gt;n&lt;/i&gt; = 76) and an experimental group (individualized positioning care, &lt;i&gt;n&lt;/i&gt; = 74) according to the nursing method received. The primary outcome measures were changes in cardiac function indicators, such as left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after nursing, as well as postoperative comfort scores measured using the Visual Analog Scale for Comfort (VAS-Comfort). Secondary outcomes included postoperative pain scores (Numeric Rating Scale [NRS]), sleep quality (Richards-Campbell Sleep Questionnaire [RCSQ]), pulmonary complications, pressure ulcer incidence, intensive care unit (ICU) length of stay, and postoperative hospital days. Group comparisons were performed using &lt;i&gt;t&lt;/i&gt;-test, Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, Chi-square test, or Fisher's exact test. Postoperative NT-proBNP was analyzed using analysis of covariance (ANCOVA), adjusting for baseline levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline characteristics were balanced and comparable between the two groups (all &lt;i&gt;p&lt;/i&gt; &gt; 0.05). Compared to the control group receiving conventional care, the experimental group receiving individualized positioning care showed more significant improvement in cardiac function: the change in LVEF (ΔLVEF) was significantly higher in the experimental group (0.85 ± 3.98% vs. -3.15 ± 4.20%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001); NT-proBNP levels on postoperative day 7 were significantly lower in the experimental group (median: 685.00 pg/mL vs. 1003.50 pg/mL, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and the difference remained statistically significant after adjusting for preoperative values (&lt;i&gt;F&lt;/i&gt; = 12.13, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The VAS-Comfort score at 72 h postoperatively was significantly higher in the experimental group (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). For secondary outcomes, the experimental group had significantly lower NRS pain scores at 72 h postoperatively (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), significantly higher RCSQ sleep scores (69.26 ± 9.87 vs. 59.86 ± 12.02, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), a lower incidence of pulmonary complications (9.46% vs. 23.68%, &lt;i&gt;p&lt;/i&gt; = 0.019), and significantly shorter ICU stay and postoperative hospital days (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001). There were no statistically significant differences between the two groups in the incidence of pressure ulcers or adverse events (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1017-1025"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262959","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 Clivus Bone Lesions.","authors":"Vinicius Trindade Gomes da Silva, Thales Bhering Nepomuceno, Rhuann Pontes Dos Santos Silva, Caio Martucci, Eberval Gadelha Figueiredo, Wellingson Silva Paiva","doi":"10.62713/aic.4056","DOIUrl":"https://doi.org/10.62713/aic.4056","url":null,"abstract":"<p><strong>Aim: </strong>To address the diagnostic and therapeutic challenges posed by primary clival bone lesions, specifically chordoma, chondrosarcoma, giant cell tumor, and benign notochordal cell tumor, by providing a comprehensive review of their clinical, radiological, and biological characteristics.</p><p><strong>Methods: </strong>A systematic review was performed using the Cochrane Library, Scielo, and Medline databases. The search incorporated MeSH terms such as \"chordomas\", \"chondrosarcoma\", \"giant cell tumor of bone\", and \"bone neoplasms\". From 2630 initial results, 33 studies were selected and categorized by tumor type, histology, clinical presentation, imaging findings, diagnosis, treatment, and prognostic factors.</p><p><strong>Results: </strong>Despite extensive literature on individual aspects of these tumors, comprehensive reviews encompassing all four primary clival lesions are scarce. These tumors exhibit overlapping radiological features and complex anatomical locations, each with distinct biological behavior. The systematic review highlights the importance of differentiating among these lesions to inform diagnosis and management, as well as the current limitations in evidence-based treatment strategies due to the rarity and complexity of these entities.</p><p><strong>Conclusions: </strong>Understanding the key characteristics of primary clival bone lesions is essential for clinicians and neurosurgeons to select optimal diagnostic and therapeutic approaches, ultimately aiming to improve patient outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"956-972"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262934","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":"Impact of Evidence-Based Nursing and Health Empowerment on Self-Efficacy and Cognitive Function in Lung Cancer Patients Undergoing Thoracoscopic Surgery.","authors":"Changmei Shu, Changhui Jin, Junhua Peng","doi":"10.62713/aic.4456","DOIUrl":"https://doi.org/10.62713/aic.4456","url":null,"abstract":"<p><strong>Aim: </strong>Given the high incidence of postoperative cognitive decline and reduced self-efficacy in lung cancer patients undergoing radical thoracoscopic surgery, this study aimed to investigate the effect of evidence-based nursing combined with health empowerment intervention on self-efficacy and cognitive function in this patient population.</p><p><strong>Methods: </strong>A total of 516 patients who underwent thoracoscopic radical lung cancer surgery between February 2021 and June 2025 in The First People's Hospital of Zunyi were included. The patients were divided into an observation group (232 cases, who received evidence-based nursing combined with health empowerment intervention) and a control group (284 cases, who received conventional nursing). General data of the patients, along with their visual analogue scale (VAS) scores, forced vital capacity (FVC), maximal voluntary ventilation (MVV), forced expiratory volume in 1 second to FVC ratio (FEV1/FVC), General Self-Efficacy Scale (GSES) score, and Mini-Mental State Examination (MMSE) score, were collected.</p><p><strong>Results: </strong>There was no significant difference between the two groups in terms of baseline characteristics (<i>p</i> > 0.05). After the intervention, the observation group achieved significantly greater improvement than the control group in terms of VAS pain scores, pulmonary function indices (FVC, MVV, FEV1/FVC), GSES scores and MMSE scores (<i>p</i> < 0.001). In addition, the total incidence of postoperative adverse reactions was significantly lower in the observation group than in the control group (7.76% vs. 13.73%, <i>p</i> = 0.031).</p><p><strong>Conclusions: </strong>Evidence-based nursing combined with health empowerment intervention significantly relieves postoperative pain, promotes recovery of lung function, enhances self-efficacy and cognitive function, and reduces the incidence of postoperative adverse events.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1088-1096"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262962","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":"Diagnostic Efficacy of ¹³¹I-SPECT/CT in Detecting Postoperative Residual and Recurrent Lesions in Patients With Differentiated Thyroid Cancer: A Meta-Analysis.","authors":"Weiping Liu, Renzhi Lin, Yuxingzi Chen, Qiangang Gao, Jijun Zhong","doi":"10.62713/aic.4495","DOIUrl":"10.62713/aic.4495","url":null,"abstract":"<p><strong>Aim: </strong>Single-photon emission computed tomography/computed tomography (SPECT/CT) technology is a promising imaging tool for the detection of postoperative residual and recurrent lesions in differentiated thyroid cancer (DTC). However, existing studies presented mixed results, and the overall diagnostic efficacy of this technology remains unclear. Therefore, this meta-analysis was conducted to systematically evaluate the diagnostic value of ¹³¹I-SPECT/CT for identifying residual or recurrent disease in patients with DTC.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Web of Science, EMBASE, and Cochrane Library from inception to 4 December 2025. The search strategy incorporated relevant keywords and MeSH terms, such as \"differentiated thyroid cancer\", \"thyroidectomy\", \"SPECT\", \"SPECT/CT\", \"SPECT-CT\", \"metastasis\", \"recurrence\", and \"residual\". Study selection, data extraction, and risk-of-bias assessment were performed independently by two investigators. The overall diagnostic performance was assessed by calculating the pooled sensitivity (SENS), specificity (SPEC), and summary receiver operating characteristic (SROC) curve. Sensitivity analyses were performed by excluding individual studies to assess the robustness and stability of the pooled results. Subgroup analysis was used to determine the source of heterogeneity.</p><p><strong>Results: </strong>Six studies involving 800 patients were included. Pooled analysis showed that lesion-level ¹³¹I-SPECT/CT had a pooled SENS of 0.59 (0.33-0.81) and a pooled SPEC of 0.92 (0.85-0.96). The pooled diagnostic odds ratio (DOR) was 18 (3-91), and the area under the curve (AUC) was 0.92. Based on patient-level ¹³¹I-SPECT/CT, the pooled SENS was 0.89 (0.63-0.98), the pooled SPEC was 0.95 (0.70-0.99), and the DOR was 166 (7-4126). The AUC of the SROC curve was 0.97. The overall diagnostic accuracy of ¹³¹I-SPECT/CT was confirmed, regardless of whether it was conducted at the patient or lesion level. To avoid potential patient overlap, we excluded an earlier study for a sensitivity analysis. The results after exclusion remained within reasonable limits, supporting the robustness of the main findings. Subgroup analyses indicated that patient type may be a potential source of heterogeneity in the non-threshold effect. No publication bias was statistically suggested through Deeks' funnel plot.</p><p><strong>Conclusions: </strong>¹³¹I-SPECT/CT demonstrates efficacy for the targeted detection of postoperative residual and recurrent lesions in DTC, showing high diagnostic accuracy. However, existing evidence is subject to high heterogeneity, and clinical application should be carefully interpreted in combination with the specific characteristics of patients. Future higher-quality studies conducted using unified standards are needed to further verify its clinical value.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"973-982"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263004","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":"Predictive Value of Early Postoperative CT Imaging Parameters for Major Complications Following Thoracoscopic Segmentectomy.","authors":"Wei Jiang, Meng Zhang, Dong Zhang","doi":"10.62713/aic.4569","DOIUrl":"https://doi.org/10.62713/aic.4569","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to systematically evaluate the independent predictive value and diagnostic performance of quantitative indices derived from early postoperative computed tomography (CT) imaging for predicting major complications (Clavien-Dindo grade ≥II) within 30 days after pulmonary segmentectomy.</p><p><strong>Methods: </strong>A total of 231 patients who underwent Video-Assisted Thoracoscopic Surgery (VATS) segmentectomy were retrospectively enrolled. On CT images obtained within 2-3 days postoperatively, the depth of pleural effusion, pneumothorax rate, lung re-expansion ratio, and maximum subcutaneous air thickness were measured. The primary outcome was the occurrence of Clavien-Dindo grade ≥II complications within 30 days. Univariate and multivariate logistic regression analyses were performed, and predictive performance was evaluated using the area under the curve (AUC).</p><p><strong>Results: </strong>Major complications occurred in 42 patients (18.2%). Multivariate analysis identified depth of pleural effusion (odds ratio [OR] = 1.213, 95% confidence interval [CI]: 1.107-1.329, <i>p</i> < 0.001), pneumothorax rate (OR = 1.201, 95% CI: 1.081-1.333, <i>p</i> < 0.001), lung re-expansion ratio (OR = 0.872, 95% CI: 0.809-0.940, <i>p</i> < 0.001), and maximum subcutaneous air thickness (OR = 1.438, 95% CI: 1.248-1.656, <i>p</i> < 0.001) as independent predictors. Receiver operating characteristic (ROC) analysis demonstrated that maximum subcutaneous air thickness had the highest predictive performance (AUC = 0.850), followed by pneumothorax rate (AUC = 0.831), lung re-expansion ratio (AUC = 0.785), and depth of pleural effusion (AUC = 0.783).</p><p><strong>Conclusions: </strong>Quantitative indices derived from early postoperative CT scans may serve as reliable imaging biomarkers for predicting major complications after pulmonary segmentectomy, thereby facilitating early identification of high-risk patients and guiding individualized postoperative management.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1104-1111"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262917","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":"Risk Factors for Surgical Site Infection After Open Reduction and Internal Fixation in Overweight and Obese Patients With Tibial Plateau Fractures.","authors":"Qunfang Lei, Xianjie Sun, Min Ye, Qingyan Yao, Lanhong Zhu, Qunyan Lei","doi":"10.62713/aic.4517","DOIUrl":"https://doi.org/10.62713/aic.4517","url":null,"abstract":"<p><strong>Aim: </strong>Overweight and obese patients present unique pathophysiological characteristics that may increase the risk of surgical site infection (SSI) following orthopedic surgery. However, the specific risk factors for SSI in overweight and obese patients with tibial plateau fractures remain unclear. This study aimed to identify the independent risk factors for SSI after open reduction and internal fixation (ORIF) in this high-risk population.</p><p><strong>Methods: </strong>A total of 300 patients with tibial plateau fractures who underwent ORIF were retrospectively analyzed. Patients were divided into three groups according to body mass index (BMI): control group (BMI <25 kg/m², n = 50), overweight group (25 ≤ BMI < 30 kg/m², n = 194), and obese group (BMI ≥30 kg/m², n = 56). To evaluate the influencing factors of SSI in overweight and obese patients, those with BMI ≥25 kg/m² were further classified into an infection group (n = 30) and a non-infection group (n = 220) based on postoperative infection status. All patients were followed for one year to document the occurrence of SSI. Logistic regression analysis was performed to identify the independent factors associated with SSI after ORIF in overweight and obese patients.</p><p><strong>Results: </strong>A total of 31 patients developed postoperative SSI (10.33%), including 8 cases of deep SSI and 23 cases of superficial SSI. There was a significant difference in the incidence of SSI among the three groups (<i>p</i> = 0.042), with the overweight group exhibiting the highest incidence. Among overweight and obese patients, the proportions of open fracture, compartment syndrome, and operation time were significantly higher in the infection group than in the non-infection group (<i>p</i> = 0.022, 0.017, and <0.001, respectively). Multivariate logistic regression analysis showed that open fracture (odds ratio [OR] = 6.012, 95% confidence interval [CI]: 1.393-25.945, <i>p</i> = 0.016), compartment syndrome (OR = 3.276, 95% CI: 1.151-9.322, <i>p</i> = 0.026), and operation time >178 min (OR = 5.012, 95% CI: 1.907-13.172, <i>p</i> = 0.001) were independent risk factors for postoperative SSI after ORIF in overweight and obese patients.</p><p><strong>Conclusions: </strong>Overweight and obese patients with tibial plateau fractures have a relatively high incidence of SSI. Open fracture, compartment syndrome, and operation time >178 min significantly increase the risks of postoperative SSI after ORIF in overweight and obese patients.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1097-1103"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262925","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":"Multimodal Imaging-Guided and Intraoperatively Verified Resection of Mediastinal Ectopic Parathyroid Adenomas: A Five-Case Series.","authors":"Mustafa Yılmaz, Mahsum Barçin, Cansu Zerey, Mahmut Süleymanoğlu, Sami Benli, Mustafa Berkeşoğlu","doi":"10.62713/aic.4597","DOIUrl":"10.62713/aic.4597","url":null,"abstract":"<p><strong>Aim: </strong>To present the diagnostic approach, surgical management, and early outcomes of patients with mediastinal ectopic parathyroid adenoma (MEPA) causing primary hyperparathyroidism.</p><p><strong>Case presentation: </strong>Between January 2015 and January 2025, patients with mediastinal ectopic parathyroid adenoma identified among 458 patients who underwent surgery for a solitary parathyroid adenoma were retrospectively reviewed, and five cases were identified (1%; n = 5). Diagnostic evaluation included cervical ultrasonography, technetium-99m sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT), and CT. The surgical strategy was individualized according to lesion location and proximity to major vascular structures. Intraoperative confirmation was achieved using radioguided surgery, frozen section analysis, and intraoperative parathyroid hormone (ioPTH) monitoring. Patients were followed for one year with serial serum calcium and parathyroid hormone (PTH) measurements.</p><p><strong>Results: </strong>The median age was 62 years (range, 40-70 years), and three patients were female. Bone pain and fatigue were the most common presenting symptoms, whereas one patient was asymptomatic. Preoperative albumin-corrected serum calcium levels ranged from 11.24 to 13.43 mg/dL, and PTH levels ranged from 161 to 1493 pg/mL. Lesion size ranged from 8 × 8 mm to 35 × 22 mm, and four lesions were located in the anterior mediastinum. Four patients underwent J-shaped partial median sternotomy, and one underwent a transcervical approach. The 10-minute ioPTH decline ranged from 48.3% to 85.5%. No major surgical complications occurred. All patients remained normocalcemic and clinically stable at the 1-year follow-up.</p><p><strong>Conclusions: </strong>In patients with MEPA, the combined use of functional and anatomical imaging, supported by multiple intraoperative confirmation modalities, may facilitate curative resection with low morbidity through an individualized surgical strategy.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"983-991"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262950","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":"Alleviating Effects of Perioperative Psychological Intervention and Distraction Therapy on Discomfort in Patients Undergoing Combined Minimally Invasive Treatment for Lower Limb Varicose Veins.","authors":"Yong Wang, Zhong Zhuang","doi":"10.62713/aic.4579","DOIUrl":"https://doi.org/10.62713/aic.4579","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the alleviating effects of perioperative psychological intervention combined with distraction therapy on discomfort in patients undergoing combined minimally invasive treatment for lower limb varicose veins.</p><p><strong>Methods: </strong>In this retrospective study, 150 patients with lower limb varicose veins who underwent combined minimally invasive treatment at The Affiliated Hospital of Xuzhou Medical University from January 2023 to June 2024 were included. The patients were divided into an observation group (73 cases) and a control group (77 cases) according to the type of perioperative nursing treatments received. Both groups of patients received routine intravenous analgesics during the procedure. The control group received routine intraoperative care, while the observation group underwent perioperative psychological intervention and distraction therapy on the basis of routine care. The Visual Analog Scale (VAS) pain scores were compared between the two groups at key procedural time points, including great saphenous vein trunk closure, local vein excision, and sclerosant injection. The Self-Rating Anxiety Scale (SAS) scores at multiple time points, heart rate, blood pressure fluctuations, and postoperative patient satisfaction were evaluated and compared.</p><p><strong>Results: </strong>The VAS scores at each time point in the observation group were significantly lower than those in the control group (<i>p</i> < 0.001). The SAS scores at the pre- and post-operatively were significantly lower in the observation group than in the control group (<i>p</i> < 0.05). The heart rate, systolic blood pressure, and diastolic blood pressure fluctuation during the surgery were smaller in the observation group than in the control group (<i>p</i> < 0.001). The patient satisfaction rate in the observation group significantly exceeded that in the control group (97.26% vs 83.12%, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Perioperative psychological intervention combined with distraction therapy provides a potential strategy to alleviate preoperative anticipatory anxiety in patients with lower limb varicose veins undergoing combined minimally invasive treatment. By employing various intraoperative methods to divert patients' attention from pain, this approach may further alleviate overall discomfort. These findings suggest that this strategy is associated with favorable outcomes and may warrant further investigation for clinical application.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"1026-1033"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262624","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":"Aortic Repair in Landing Zone 2: From Chimney Technique to Branched Graft.","authors":"Andrea Ascoli Marchetti, Fabio Massimo Oddi, Valerio Turriziani, Cataldo Caruso, Martina Battistini, Mauro Fresilli, Stefano Fazzini, Eugenio Martelli","doi":"10.62713/aic.4523","DOIUrl":"https://doi.org/10.62713/aic.4523","url":null,"abstract":"","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 6","pages":"950-953"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262678","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}