Cirugia espanola最新文献

Impact of sarcopenic obesity on surgical complications and oncologic outcomes of upper gastrointestinal tumors: A systematic review and meta-analysis. 肌肉松弛性肥胖对上消化道肿瘤手术并发症和肿瘤治疗效果的影响：系统回顾和荟萃分析。

Cirugia espanola Pub Date : 2024-09-27 DOI: 10.1016/j.cireng.2024.09.005

Luz Divina Juez, Ana Del Carmen Ortega, Pablo Priego, Juan Carlos García Pérez, José María Fernández-Cebrián, Jose I Botella-Carretero

引用次数: 0

Robotic Approach for Remnant Cholelithiasis and CBD Exploration for Gallstones Removal. 机器人方法治疗残余胆石症，CBD探查术取出胆结石。

Cirugia espanola Pub Date : 2024-09-27 DOI: 10.1016/j.cireng.2024.08.004

Aram Rojas, Pierce Paterakos, Sarah B Hays, Melissa E Hogg

引用次数: 0

Indocyanine green in laparoscopic cholecystectomy: utility and correlation with a preoperative risk score. 腹腔镜胆囊切除术中的吲哚菁绿：实用性以及与术前风险评分的相关性。

Cirugia espanola Pub Date : 2024-09-19 DOI: 10.1016/j.cireng.2024.09.004

Maria Luisa Galaviz-Sosa, Eric Herrero Fonollosa, María Isabel García-Domingo, Judith Camps Lasa, María Galofré Recasens, Melissa Arias Aviles, Esteban Cugat Andorrà

{"title":"Indocyanine green in laparoscopic cholecystectomy: utility and correlation with a preoperative risk score.","authors":"Maria Luisa Galaviz-Sosa, Eric Herrero Fonollosa, María Isabel García-Domingo, Judith Camps Lasa, María Galofré Recasens, Melissa Arias Aviles, Esteban Cugat Andorrà","doi":"10.1016/j.cireng.2024.09.004","DOIUrl":"10.1016/j.cireng.2024.09.004","url":null,"abstract":"Background: This study aims to compare the visualization of the cystic duct-common bile duct junction with indocyanine green (ICG) among 3 groups of patients divided according to the difficulty of elective laparoscopic cholecystectomy.Methods: Conducted at a single center, this non-randomized, prospective, observational study encompassed 168 patients who underwent elective laparoscopic cholecystectomy and were assessed with a preoperative risk score to predict difficult cholecystectomies, including clinical factors and radiological findings. Three groups were identified: low, moderate, and high risk. A dose of 0.25 mg of IV ICG was administered during anesthesia induction and the different objectives were evaluated.Results: The visualization of the cystic duct-common bile duct junction was achieved in 28 (100%), 113 (91.1%), and 10 (63%) patients in the low, moderate, and high-risk groups, respectively. The high-risk group had longer total operative time, higher conversion, more complications and longer hospital stay. In the surgeon's subjective assessment, ICG was considered useful in 36% of the low-risk group, 58% in the moderate-risk group, and 69% in the high-risk group. Additionally, there were no cases where ICG modified the surgeon's surgical approach in the low-risk group, compared to 11% in the moderate-risk group and 25% in the high-risk group (p < 0.01).Conclusions: The results of this study confirm that in the case of difficult cholecystectomies, the visualization of the cystic duct-common bile duct junction is achieved in 63% of cases and prompts a modification of the surgical procedure in one out of four patients.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303400","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}

引用次数: 0

Need for a targeted perioperative antibiotic treatment protocol for patients with preoperative biliary drainage undergoing pancreaticoduodenectomy. 需要为接受胰十二指肠切除术的术前胆道引流患者制定有针对性的围手术期抗生素治疗方案。

Cirugia espanola Pub Date : 2024-09-19 DOI: 10.1016/j.cireng.2024.09.003

Judith Camps-Lasa, María Isabel García-Domingo, Eric Herrero Fonollosa, María Luisa Galaviz Sosa, María Galofré Recasens, Aurora Rodríguez Campos, Xavier Serra-Aracil, Esteban Cugat Andorrá

{"title":"Need for a targeted perioperative antibiotic treatment protocol for patients with preoperative biliary drainage undergoing pancreaticoduodenectomy.","authors":"Judith Camps-Lasa, María Isabel García-Domingo, Eric Herrero Fonollosa, María Luisa Galaviz Sosa, María Galofré Recasens, Aurora Rodríguez Campos, Xavier Serra-Aracil, Esteban Cugat Andorrá","doi":"10.1016/j.cireng.2024.09.003","DOIUrl":"10.1016/j.cireng.2024.09.003","url":null,"abstract":"Purpose: To evaluate the bacterobilia in patients undergoing pancreaticoduodenectomy (PD) based on whether they carry a preoperative biliary drainage or not and to analyse if a targeted perioperative antibiotic treatment based on the expected microbiology leads in no differences in Surgical Site Infections (SSI) between the groups.Methods: Retrospective observational single-center study of patients undergoing pancreaticoduodenectomy with preoperative biliary stent (group P, Prosthesis) and without stent (group NP, No Prosthesis). Postoperative complications including SSI and its subtypes were analyzed after applying a targeted perioperative antibiotic treatment protocol with cefotaxime and metronidazole (group NP) and piperacillin-tazobactam (group P).Results: Between January 2014 and December 2021, 127 patients were treated (84 in group NP and 43 in group P). Intraoperative cultures were positive in 16.7% (group NP) vs 76.7% (group P, p < 0.01). Microorganisms isolated in group NP included Enterobacterales (10.7%) and Enterococcus spp. (7.1%) with no Candida detected. In group P: Enterobacterales (51.2%), Enterococcus spp. (48.8%), and Candida (16.3%) were higher (p < 0.01%). No differences in morbidity and mortality were observed between the groups. SSI rate was 17.8% in group NP and 23.2% in group P (ns).Conclusion: Bacterobilia differs in patients with biliary drainage, showing a higher presence of Enterobacterales, Enterococcus spp., and Candida. There were no differences in SSI incidence after applying perioperative antibiotic treatment tailored to the expected microorganisms in each group. This raises the need to reconsider conventional surgical prophylaxis in patients with biliary stent.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303401","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}

引用次数: 0

Embolize, supercharge, resect: Embolization to enhance hepatic vascularization prior to en-bloc pancreas and arterial resection. 栓塞、增压、切除：在胰腺全层和动脉切除术之前，通过栓塞增强肝脏血管。

Cirugia espanola Pub Date : 2024-09-18 DOI: 10.1016/j.cireng.2024.08.001

Juli Busquets, Luis Secanella, Thiago Carnaval, Maria Sorribas, Mónica Serrano-Navidad, Esther Alba, Elena Escalante, Sandra Ruiz-Osuna, Núria Peláez, Juan Fabregat

{"title":"Embolize, supercharge, resect: Embolization to enhance hepatic vascularization prior to en-bloc pancreas and arterial resection.","authors":"Juli Busquets, Luis Secanella, Thiago Carnaval, Maria Sorribas, Mónica Serrano-Navidad, Esther Alba, Elena Escalante, Sandra Ruiz-Osuna, Núria Peláez, Juan Fabregat","doi":"10.1016/j.cireng.2024.08.001","DOIUrl":"10.1016/j.cireng.2024.08.001","url":null,"abstract":"Introduction: Embolization could increase the resectability of pancreatic tumors by supercharging visceral arterial perfusion prior to pancreatic surgery with arterial en-bloc resection. Its indications, however, are controversial.Methods: We retrospectively analyzed the results of a single-center database of patients undergoing pancreatic surgery with arterial resection (AR) after preoperative arterial embolization (PAE) to increase hepatic vascular flow and spare arterial reconstruction.Results: PAE was planned in 15 patients with arterial involvement due to pancreatic tumors. Three patients were excluded due to the finding of irresectable disease during surgery. Twelve cases were resected because of pancreatic cancer (10), distal cholangiocarcinoma (1), and pancreatic neuroendocrine tumor (1). Arterial involvement in these cases required embolization of the substitute right hepatic artery (RHA) (5), left hepatic artery (1), and common hepatic artery (CHA) (6) to enhance liver vascularization. Two patients presented migration of the vascular plug after PAE. Six pancreatoduodenectomies and 6 distal pancreatectomies were performed, the latter associated with en-bloc celiac trunk and CHA resection. R0 was achieved in 7 out of 12 patients, and pathological vascular involvement was confirmed in 8. Postoperative complications included one patient who developed gastric ischemia and underwent gastrectomy, and one patient who underwent reoperation for acute cholecystitis with liver abscesses.Conclusion: Preoperative arterial embolization before pancreatic surgery with hepatic arterial resection enables surgeons to precondition hepatic vascularization and prevent hepatic ischemia. In addition, this avoids having to perform arterial anastomosis in the presence of pancreatic suture.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303397","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}

引用次数: 0

Diathermy Versus Scalpel in Midline Abdominal Incision: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 腹部中线切开术中的热疗与手术刀：随机对照试验的系统回顾和元分析》。

Cirugia espanola Pub Date : 2024-09-18 DOI: 10.1016/j.cireng.2024.09.002

Nicole Dos Santos Pimenta, Ana Clara Felix de Farias Santos, João Pedro Costa Esteves Almuinha Salles, Juliana Millani de Oliveira, Pedro Henrique Costa Matos da Silva, Renan Carlo Colombari

{"title":"Diathermy Versus Scalpel in Midline Abdominal Incision: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Nicole Dos Santos Pimenta, Ana Clara Felix de Farias Santos, João Pedro Costa Esteves Almuinha Salles, Juliana Millani de Oliveira, Pedro Henrique Costa Matos da Silva, Renan Carlo Colombari","doi":"10.1016/j.cireng.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.cireng.2024.09.002","url":null,"abstract":"Introduction: Our study aimed to compare the midline abdominal incision with scalpel and diathermy.Methods: PubMed, EMBASE, and Cochrane were searched through January 2024 following PRISMA guidelines (PROSPERO, ID: CRD42024516771), and only randomized controlled trials were included. Heterogeneity was assessed using Cochran's Q test and the I2 heterogeneity index. Statistical analysis was performed using Review Manager 5.4 software.Results: Six randomized controlled trials were included, from which 469 patients (51.5%) received diathermy incision and 442 patients (48.5%) underwent the scalpel technique. Patients treated with the electrocautery approach had less incision blood loss (MD -17.57 mL; P < .01). No statistically significant differences were found between groups regarding wound infection incidence, incision time, incision area or first-day postoperative pain.Conclusion: Diathermy use in midline abdominal incision may be advocated as it demonstrated a significant reduction in incision-related blood loss, with no differences in wound infection or early postoperative pain incidences compared to the scalpel.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303452","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}

引用次数: 0

Evaluation of the efficacy and concordance of indocianine color green angiography in oncoplastic and reconstructive breast surgery. Preliminary results of the gBREAST-22 prospective study. 评估吲哚倩宁色绿血管造影在乳房肿瘤整形和再造手术中的疗效和一致性。gBREAST-22前瞻性研究的初步结果。

Cirugia espanola Pub Date : 2024-09-18 DOI: 10.1016/j.cireng.2024.08.002

Benigno Acea-Nebril, Alejandra García-Novoa, Sergio Rodríguez-Rojo, Carlota Díaz-Carballada, Alberto Bouzón-Alejandro

{"title":"Evaluation of the efficacy and concordance of indocianine color green angiography in oncoplastic and reconstructive breast surgery. Preliminary results of the gBREAST-22 prospective study.","authors":"Benigno Acea-Nebril, Alejandra García-Novoa, Sergio Rodríguez-Rojo, Carlota Díaz-Carballada, Alberto Bouzón-Alejandro","doi":"10.1016/j.cireng.2024.08.002","DOIUrl":"10.1016/j.cireng.2024.08.002","url":null,"abstract":"Introduction: During oncoplastic procedures, the vascularization and perfusion of the skin flaps is modified, thus increasing the possibility of skin necrosis. The objective of this study is to evaluate the effectiveness of indocyanine color green angiography (ICG-A) to determine intraoperative skin necrosis after oncoplastic surgery or skin-sparing or nipple-skin sparing mastectomy (NSSM).Patients and method: Prospective observational study to evaluate the sensitivity, specificity and positive and negative predictive values of the ICG-A in women with high-risk breast cancer.Results: 98 women and 156 breasts were included in the study. A total of 20 women (20.4%) presented an image of ischemia in the ICG-A. 21 women (21.4%) presented ischemic events in the postoperative period, 71.4% of these events had been detected in the third ICG-A. Three of these patients (3.1%) presented a serious complication that required reintervention. The sensitivity and specificity of the ICG-A was 71.4% and 93.5%, respectively.Conclusions: ICG-A has high specificity and negative predictive value for detecting areas of low perfusion. In breast units with highly complex surgery, it can be useful to plan extreme surgeries and identify skin areas of low perfusion.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303398","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}

引用次数: 0

Hemoglobinuria following reabsorbed hemoperitoneum. 重吸收性腹腔积血后出现血红蛋白尿。

Cirugia espanola Pub Date : 2024-09-18 DOI: 10.1016/j.cireng.2024.08.003

Owen Korn, Álvaro Morales, Sebastián Sapiain, María Jesús Vial

引用次数: 0

Uncommon anatomical variation of the origin of the right upper pulmonary vein detected by 3D reconstruction prior to robotic segmentectomy. 机器人分段切除术前通过三维重建发现的右上肺静脉起源的罕见解剖变异。

Cirugia espanola Pub Date : 2024-09-04 DOI: 10.1016/j.cireng.2024.07.009

Francisco J Gómez Valle, Cristina Rivas Duarte, Oscar Colmenares Mendoza, María Teresa Gómez Hernández

引用次数: 0

Male breast cancer: A multicenter study in Aragon over 27 years. 男性乳腺癌：阿拉贡 27 年来的一项多中心研究。

Cirugia espanola Pub Date : 2024-09-04 DOI: 10.1016/j.cireng.2024.09.001

Olga Dobato Portoles, Daniel Aparicio Lopez, Reyes Ibañez Carreras, Elena Aguirre Ortega, Beatriz Eizaguirre Zarza, Carmen García Mur, Aurora Carrasquer Puyal, María Pilar Cebollero Benito, Laura Isabel Comín Novella, Marta Allue Cabañuz, Fernando Martinez Ubieto, Ramón Sousa Domínguez, Javier Torcal Aznar, Carmen Casamayor Franco

{"title":"Male breast cancer: A multicenter study in Aragon over 27 years.","authors":"Olga Dobato Portoles, Daniel Aparicio Lopez, Reyes Ibañez Carreras, Elena Aguirre Ortega, Beatriz Eizaguirre Zarza, Carmen García Mur, Aurora Carrasquer Puyal, María Pilar Cebollero Benito, Laura Isabel Comín Novella, Marta Allue Cabañuz, Fernando Martinez Ubieto, Ramón Sousa Domínguez, Javier Torcal Aznar, Carmen Casamayor Franco","doi":"10.1016/j.cireng.2024.09.001","DOIUrl":"10.1016/j.cireng.2024.09.001","url":null,"abstract":"Introduction: Male breast cancer accounts for 1% of all breast cancers. Its low frequency leads to a lack of awareness, resulting in significant diagnostic delays. Additionally, this limits the available evidence, which primarily uses diagnostic-therapeutic algorithms based on women.Objectives: To analyze the prevalence, clinical presentation, anatomical and pathological characteristics, and prognosis of male breast cancer using one of the largest series available. Secondarily, to compare our data with studies conducted in women.Materials and methods: A multicenter, observational, descriptive, retrospective study was conducted in the autonomous community of Aragon, Spain, from 1995 to 2022 including men with a pathological diagnosis of breast cancer.Results: A total of 148 patients were included, with a prevalence of 1%. The most common clinical presentation was a palpable retroareolar mass. Invasive ductal carcinoma was the most frequent type (88.89%), and luminal B was the predominant subtype (47.76%). Surgery was the most utilized treatment; mastectomy was performed in 90.34% and AL in 46.89%. At diagnosis, 52.46% had extramammary involvement. The recurrence rate was 24.1%, and the mortality attributed to the disease was 14.6%.Conclusions: There is a high rate of metastatic involvement at diagnosis, a high percentage of mutilating surgeries, and a high number of recurrences compared to available studies on males. Additionally, a worse prognosis is observed compared to breast cancer in women, despite these tumors having a less aggressive molecular subtype. These findings highlight the importance of conducting studies focused on men to develop specific protocols.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147148","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}

引用次数: 0