Annali italiani di chirurgia最新文献

{"title":"A Retrospective Analysis of Laparoscopic Totally Extraperitoneal (TEP) and Transabdominal Preperitoneal (TAPP) Techniques in the Treatment of Unilateral Inguinal Hernias.","authors":"Yahya Ozel, Muhammer Ergenc, Servet Emir, Yalcin Burak Kara","doi":"10.62713/aic.3852","DOIUrl":"https://doi.org/10.62713/aic.3852","url":null,"abstract":"<p><strong>Aim: </strong>Inguinal hernia is a common surgical issue, with laparoscopic techniques such as totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) being widely used. However, there is no clear consensus on the superiority of either method for unilateral primary or recurrent inguinal hernias. This study compares TEP and TAPP, focusing on efficacy, safety, and clinical outcomes.</p><p><strong>Methods: </strong>This study included patients who underwent elective laparoscopic surgery for unilateral inguinal hernias between April 2009 and May 2024. Patients who underwent inguinal hernia repair were divided into two groups according to whether the TAPP or TEP procedure was used. Primary and recurrent cases were analyzed, with data on demographic features such as age, gender, body mass index (BMI), operative duration, hospital stay, and complications compared between the groups.</p><p><strong>Results: </strong>Of the 985 patients, 72.6% underwent TAPP and 27.4% underwent TEP. The median BMI was significantly higher in the TAPP group (24.23 [23.4-25.6] vs. 24.00 [23.06-25.62], p = 0.038). The proportion of recurrent hernias was higher in the TEP group (15.6% vs. 9.0%, p = 0.004). Operative time was significantly longer for TEP compared to TAPP (60.0 [40-80] vs. 35.0 [25-45] minutes, p < 0.001). Although the median hospital stay was the same in both groups (1 [1] vs. 1 [1] days), the TAPP group had a wider range of hospital stays (p < 0.001). Complication rates were higher in the TEP group (11.1% vs. 4.3%, p < 0.001), primarily driven by increased seroma formation. Linear regression analysis revealed a significant association between case volume and operative duration for TEP primary cases (p < 0.001, R2 = 0.380), recurrent TEP cases (p = 0.024, R2 = 0.121), primary TAPP cases (p = 0.017, R2 = 0.009), and recurrent TAPP cases (p = 0.627, R2 = 0.004).</p><p><strong>Conclusions: </strong>Both TAPP and TEP are effective for unilateral inguinal hernia repair; however, TAPP demonstrated shorter operative times, and fewer complications compared to TEP. Case volume significantly influences operative duration, particularly in TEP repairs. Further studies with larger cohorts are warranted to refine surgical approaches and outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"703-712"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075574","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":"Well-Differentiated Extraosseous Chondrosarcoma Arising of Gall Bladder: A Detailed Case Report.","authors":"ZhangQiang Wu, QingQu Guo, YuLian Wu","doi":"10.62713/aic.3739","DOIUrl":"https://doi.org/10.62713/aic.3739","url":null,"abstract":"<p><p>This article reports a rare case of extraosseous myxoid chondrosarcoma originating from the gallbladder. The patient, a 50-year-old female, presented with recurrent right upper quadrant abdominal pain for over two months, with worsening symptoms in the month prior to admission. Before hospitalization, enhanced computed tomography (CT) of the upper abdomen performed at a local hospital suggested a malignant gallbladder tumor (gallbladder cancer) with lymphadenopathy near the hepatic portal, as well as chronic cholecystitis with gallstones. Upon admission, whole-abdomen enhanced CT and liver-enhanced magnetic resonance imaging (MRI) confirmed uneven thickening of the gallbladder wall and multiple enlarged lymph nodes in the hepatic portal, further supporting the suspicion of gallbladder cancer. Tumor marker tests revealed elevated levels of carbohydrate antigen 19-9 (CA19-9) and cytokeratin 19 fragment. On 12 March 2020, the patient underwent extended radical resection for gallbladder cancer. The procedure included the removal of the gallbladder, hepatic lobe, right half of the colon, and greater omentum, along with extensive lymphadenectomy of the hepatic portal and posterior of the pancreatic head. Postoperative pathological examination confirmed the diagnosis of extraosseous myxoid chondrosarcoma, with the tumor involving the full thickness of the gallbladder, intrahepatic parenchyma, and the serosa to the muscular layer of the intestinal wall. Hematoxylin and eosin staining results supported this diagnosis. The patient recovered well postoperatively and did not receive any additional antitumor therapies, such as chemotherapy or radiotherapy. During a 36-month follow-up period after surgery, no tumor recurrence or metastasis was observed.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"437-442"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954054","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":"Investigating the Impact of Post-extubation Water Intake Timing in Cardiac Surgery With Cardiopulmonary Bypass on Patient Recovery Outcomes.","authors":"Dandan Geng, Yuzhen Guan, Zhen Lu, Yanyan Lu, Qingqing Chen, Wei Jiang, Wei Zhang","doi":"10.62713/aic.4042","DOIUrl":"https://doi.org/10.62713/aic.4042","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the efficacy and safety of various early post-extubation water intake regimens in cardiovascular disease (CVD) patients undergoing cardiac surgery with cardiopulmonary bypass.</p><p><strong>Methods: </strong>This retrospective analysis included 286 CVD patients admitted to The First Affiliated Hospital of Nanjing Medical University between October 2023 and September 2024. Among these patients, 84 drank water immediately after extubation (Group A), 92 started drinking water 1 hour after extubation (Group B), and 110 began drinking water 4 hours after extubation (Group C). The interval between extubation and water consumption across the three groups was carefully monitored. The degree of moisture of the lip and oral mucosa, as well as the Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), and Self-Rating Anxiety Scale (SAS) were used to assess the postoperative experiences of patients. Additionally, gastrointestinal function recovery and incidence of adverse reactions in patients were recorded, and their satisfaction levels were assessed upon discharge from the hospital.</p><p><strong>Results: </strong>The interval between extubation and water intake was the shortest in Group A and the longest in Group C (p < 0.05). The scores of lip and oral mucosa moisture degree, NRS, VAS, and SAS before and after intervention in Group A were the lowest among the three groups, while the time for bowel sounds to return to normal, first exhaust, and first defecation was the shortest (p < 0.05). Furthermore, there was no significant difference in adverse reactions between Group A and Group B (p > 0.05). Group A had the highest overall satisfaction with treatment than the other two groups (p < 0.05).</p><p><strong>Conclusions: </strong>Giving water immediately after extubation to cardiac surgery patients with cardiopulmonary bypass can improve their postoperative experience and promote gastrointestinal function recovery, thereby improving patients' comfort.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"824-832"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301090","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":"Pancreatic Pseudocyst Following Spinal Surgery: Always Think About It-A Case Report.","authors":"Maria Vittoria Stern, Filomena Valentina Paradiso, Riccardo Rizzo, Sara Silvaroli, Simone Frediani, Lorenzo Nanni","doi":"10.62713/aic.3798","DOIUrl":"https://doi.org/10.62713/aic.3798","url":null,"abstract":"<p><strong>Aim: </strong>To report the conservative management of a pancreatic pseudocyst (PP) following spinal surgery for neurogenic scoliosis in a pediatric patient.</p><p><strong>Case presentation: </strong>A 12-years-old girl presented with spinal arthrodesis and lumbar fixation for neurogenic scoliosis secondary to cerebral palsy (CP). On postoperative day 11, abdominal computed tomography (CT) showed accumulated fluid (74 × 52 mm) extending along the greater gastric curvature, from the left liver lobe to the anterior abdominal wall.</p><p><strong>Results: </strong>The fluid was percutaneously drained. The fluid contained a high concentration of amylase; therefore, a diagnosis of PP was made. After 23 days, the symptoms progressively resolved, and the accumulated fluid disappeared. Gastrointestinal complications following spinal surgery in patients with CP are reported in 5%-55% of cases; among these, PP is extremely rare. Pancreatic postoperative ischemia or pancreatic iatrogenic trauma are possible causes of PP formation. In our case, conservative management was safe and effective.</p><p><strong>Conclusions: </strong>In patients with persistent postoperative abdominal symptoms following spinal surgery, pancreatic complications should be ruled out. If PP is diagnosed, conservative management is recommended, particularly in young patients with a poor general condition.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"725-730"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301092","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":"Splenectomy and Emergency Cesarean Delivery for Traumatic Splenic Rupture in a Patient in the Third Trimester of Pregnancy: A Case Report.","authors":"Miriam Biancu, Federico Cappellacci, Stefano Piras, Raffaela Bura, Alessandro Manca, Gian Luigi Canu, Pietro Giorgio Calò","doi":"10.62713/aic.3736","DOIUrl":"https://doi.org/10.62713/aic.3736","url":null,"abstract":"<p><p>Splenic rupture is one of the most frequent trauma-related injuries in the general population. While splenic injury is uncommon in pregnant patients, trauma is the leading non-obstetric cause of maternal death and is associated with significant maternal and fetal morbidity and mortality. The most frequent and life-threatening cause of trauma in this population is road traffic accidents. This article describes the case of a 32-week-pregnant patient who was involved in a car accident. She sustained a grade V splenic injury and a grade III left kidney injury, according to the classifications of the American Association for the Surgery of Trauma (AAST). The patient underwent laparotomy, an emergency cesarean section resulting in the delivery of a live-born female, and splenectomy. The renal injury was treated conservatively. The fetus required intensive care immediately after birth. The diagnostic approach, even during pregnancy, must address not only the uterus but also other potential injuries, which may lead to severe hemorrhage, shock, and possible maternal and fetal death. A multidisciplinary approach is essential to ensure the best outcomes for both mother and fetus.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"713-717"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Importance of the Count and Percentage of Immature Granulocytes in the Determination of the Severity of Acute Pancreatitis.","authors":"Mehmet Akif Üstüner, Güniz Yanık Üstüner","doi":"10.62713/aic.3794","DOIUrl":"https://doi.org/10.62713/aic.3794","url":null,"abstract":"<p><strong>Aim: </strong>Acute pancreatitis (AP) is a disease with high rates of morbidity and mortality. As the severity of pancreatitis increases, the risk of mortality also rises; however, there is still no definitive marker for the early determination of pancreatitis severity. The aim of this study was to investigate the value of immature granulocytes (IG) count and percentage (IG%) in diagnosing the disease, determining the severity, and predicting mortality in AP patients.</p><p><strong>Methods: </strong>The records were retrospectively scanned of patients admitted to our hospital because of AP between January 2022 and March 2023. The patients were analyzed by classification into 3 groups of mild, moderate, and severe pancreatitis according to the modified Atlanta criteria.</p><p><strong>Results: </strong>Evaluation was made of a total of 163 patients, comprising 93 females and 70 males with a mean age of 55.78 ± 20.11 years. In the Receiver Operating Characteristic (ROC) analysis performed to determine disease severity, a cut-off value of 0.65% for IG% was found to have Area Under the Curve (AUC): 0.975, 100% sensitivity, 87.5% specificity, 36.7% Positive Predictive Value (PPV), and 100% Negative Predictive Value (NPV) (p < 0.001). IG% was more effective in determining the disease than Lactate Dehydrogenase (LDH) and C-reactive protein (CRP) (p = 0.012, p = 0.001, respectively). In the ROC analysis performed to determine mortality, a cut-off value of 0.55% for IG% was found to have AUC: 0.945, 100% sensitivity, 78.3% specificity, 14.6% PPV, and 100% NPV (p < 0.001).</p><p><strong>Conclusions: </strong>The amount and percentage of immature granulocytes is an effective predictive marker in the diagnosis of acute pancreatitis, determination of disease severity, and prediction of mortality.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"841-846"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301097","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":"Surgical Procedures as Predictors of Postoperative Outcomes in Elderly Patients Undergoing Non-Emergency Colorectal Cancer Surgery.","authors":"Guanchi Chen, Zhonglin Liang, Long Cui","doi":"10.62713/aic.3919","DOIUrl":"10.62713/aic.3919","url":null,"abstract":"<p><strong>Aim: </strong>Elderly patients are at increased risk of morbidity and prolonged hospital stays following non-emergency colorectal cancer (CRC) surgery. This study aimed to determine which surgical procedures are associated with postoperative morbidity and shorter postoperative hospital stay in elderly patients undergoing colorectal surgery.</p><p><strong>Methods: </strong>Patients aged ≥75 years who underwent CRC resection between June 2015 and May 2019 at one hospital were included in this observational study. Logistic regression models were used to analyze the relationship between different surgical procedures and both overall postoperative complications and surgery-related complications, expressed as odds ratios (ORs) with 95% confidence intervals (CIs). The relationship between surgical procedures and postoperative hospital stay was evaluated using negative binomial regression, reported as incidence rate ratios (IRRs) with 95% CI. Additionally, Cox regression models were applied to assess the association between surgical procedures and postoperative mortality, expressed as hazard ratios (HRs) with 95% CIs.</p><p><strong>Results: </strong>A total of 442 patients who underwent CRC resection were included, of whom 196 (44.34%) experienced postoperative complications and 121 (27.38%) had surgery-related complications. Patients undergoing anastomosis (adjusted OR = 0.43, 95% CI: 0.22-0.84, p = 0.014) had a lower risk of postoperative complications. Laparoscopy (adjusted OR = 0.51, 95% CI: 0.28-0.89, p = 0.019) was associated with a reduced risk of surgery-related complications. For postoperative hospital stay, laparoscopy (IRR = 0.883, 95% CI: 0.790-0.987, p = 0.027) was associated with shorter stays, whereas stoma formation (IRR = 1.154, 95% CI: 1.006-1.326, p = 0.044) was associated with prolonged hospital stay. Moreover, stoma formation (HR = 5.18, 95% CI: 1.03-25.91, p = 0.045) was associated with an increased risk of postoperative mortality.</p><p><strong>Conclusions: </strong>Anastomosis and laparoscopy were associated with a lower risk of complications, while stoma formation was related to poorer prognosis in elderly patients undergoing CRC resection. The influence of surgical procedure choice on postoperative outcomes should be carefully considered.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"800-810"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Timing of Percutaneous Coronary Intervention on the Prognosis of Non-ST Segment Elevation Myocardial Infarction Patients.","authors":"Tianzhu Li, Nimin Lu, Yingxue Dong","doi":"10.62713/aic.3339","DOIUrl":"10.62713/aic.3339","url":null,"abstract":"<p><strong>Aim: </strong>To study the effect of timing of percutaneous coronary intervention (PCI) to prognosis of Non-ST segment elevation myocardial infarction (NSTEMI) patients.</p><p><strong>Methods: </strong>295 Patients were derived from our hospital who were diagnosed as NSTEMI and accepted PCI therapy in 24 hours from admission during March 2017 to May 2020. According to results of coronary angiography, patients with NSTEMI were divided into culprit artery occlusion (CO, n = 117) and non-culprit artery occlusion (N-CO, n = 178) two groups and then according to timing of PCI into three categories: <6 h, 6-12 h and 12-24 h from admission. We defined major adverse cardiovascular events (MACE) in 1 year follow.</p><p><strong>Results: </strong>In this study, with earlier time to PCI, the incidence of MACE was lower in NSTEMI patients with CO. The incidence of MACE was higher in the CO group than in the N-CO group (25.8% vs. 36.8%, p = 0.046). The incidence of MACE was 11.8% in T1 (<6 h) group (n = 50), less than 29.4% in T2 (6-12 h) group (n = 30) and 43.4% in T3 (12-24 h) group (n = 215), with a statistically significant difference (p = 0.044). However, this phenomenon does not occur in N-CO group. As the duration of PCI increased, patient survival decreased progressively over the course of follow-up in NSTEMI with CO (p = 0.048).</p><p><strong>Conclusions: </strong>Our study found that early PCI improves the prognosis of NSTEMI patients with culprit artery occlusion.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"339-344"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639437","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":"Patient-Specific Rods vs Traditional Rods in Surgical Correction of Adult Spinal Deformities: A Case-Matched Study.","authors":"Luigi Aurelio Nasto, Chiara Paolicelli, Angelo Sieczak, Paolo Ulisse, Alessandro Cattolico, Enrico Pola","doi":"10.62713/aic.3367","DOIUrl":"10.62713/aic.3367","url":null,"abstract":"<p><strong>Aim: </strong>Patient specific pre-contoured rods (PSRs) represent a relatively new technological development aimed at improving surgical outcomes and reducing complications in adult spinal deformity surgery. To date, only a limited number of studies have been published comparing PSRs with traditional spinal rods. In this paper, we compare the surgical, imaging, and clinical outcomes of PSRs and traditional spinal rods in a single-center case-matched study.</p><p><strong>Methods: </strong>Thirty cases of adult spinal deformities (ASD) were retrospectively analysed. These included 10 patients who were operated on using UNiD™ (Adaptive Spine Intelligence, MedTronic, Minneapolis, MN, USA) PSRs and 20 operated on using traditional rods from January 2023 to August 2023. Minimum post-surgical follow-up was 6 months. General demographics and standard radiographic parameters, as well as Scoliosis Research Society (SRS)-22, Oswestry Disability Index (ODI) and Short Form Health Survey (SF-12) Scores, were measured at pre-operative examination and at 6-month follow-up. Follow-up imaging data were compared with software-planned correction goals. Intra-operative data and complications were also recorded.</p><p><strong>Results: </strong>Patients in the two groups were matched in terms of age, body mass index (BMI), sex, type and severity of spinal deformity. The magnitude of the coronal deformity (p = 0.812) and preoperative sagittal imbalance (p = 0.845) were similar between the two groups. The number of fused levels (p = 0.439), osteotomies (p = 0.188), implant density (p = 0.880), and surgery duration (p = 0.299) were similar between the two groups. Sagittal correction goals set during preoperative planning were achieved in the PSRs group, with the exception of pelvic tilt (PT) (p = 0.042). In contrast, PT (p = 0.040), L1-S1 lordosis (p = 0.032) and global tilt (GT) (p = 0.001) remained significantly undercorrected in the control group at 6-month follow-up. Clinical outcomes (ODI and SF-12 Scores) and complication rates were similar between the two groups.</p><p><strong>Conclusions: </strong>The use of PSRs improves the achievement of better post-operative spinopelvic alignment in adult spinal deformity surgery. Moreover, no significant differences were noted in terms of complications, operative times, and clinical outcomes compared to traditional spinal rods at 6-month follow-up.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"116-123"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999048","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":"Understanding the Current Practice in Chest Tube Management Following Lung Resection-A Canadian National Survey.","authors":"Fabrizio Minervini, Esther Lau, Housne Begum, Yaron Shargall","doi":"10.62713/aic.3535","DOIUrl":"10.62713/aic.3535","url":null,"abstract":"<p><strong>Aim: </strong>Timing of chest tube removal post lung resection is variable in practice and often based on personal experience rather than evidence. The current practice in chest tube management among thoracic surgeons across Canada is so far unknown. Our primary aim was to assess the current status of chest tube removal in Canada in order to uncover potential shortcomings.</p><p><strong>Methods: </strong>An online anonymous survey was emailed to members of Canadian Association of Thoracic Surgeons in order to better understand the status quo of the chest tubes' removal policy in the different departments preparing the grounds for suggesting a future uniformity. Data were collected and analysed with descriptive statistics. A linear regression analysis was performed in order to understand the factors related to chest tube removal.</p><p><strong>Results: </strong>Sixty responses were received (44.4% response rate). Most surgeons place a single chest tube in both open (75%, 45/60) and minimally invasive lobectomies (93.3%, 56/60). Digital drainage systems are used by half of the surgeons surveyed. A quarter of the respondents report removing chest tubes regardless of drainage output. This practice was independent of the surgeons' number of years in practice (p = 0.127), number of lobectomies performed annually (p = 0.877), proportion of lobectomies performed minimally invasively (p = 0.259), whether digital drainage system is used (p = 0.141) and whether the surgeon is aware of the Enhanced Recovery after Surgery (ERAS) guideline (p = 0.374). Of those who remove chest tubes based on fluid output, thresholds vary widely; a significant proportion (86%, 37/43) uses a volume lower than the 450 mL/24 h threshold set out ERAS. Most respondents (77%) were interested in a clinical trial studying chest tube removal independent of drainage volume.</p><p><strong>Conclusions: </strong>This study demonstrated ongoing diverse practice amongst thoracic surgeons in Canada with regards to post-operative chest tube management, indicating a much-needed area of research.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"69-77"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999053","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}