Cirugia espanola最新文献

Predictive factors for prolonged postoperative length of stay in patients undergoing colon cancer surgery. 结肠癌手术患者术后住院时间延长的预测因素。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800399

Beatriz Remezal Serrano, José Luis Duro Torrijos, Jesús Sánchez Más, Pilar Serrano Paz

{"title":"Predictive factors for prolonged postoperative length of stay in patients undergoing colon cancer surgery.","authors":"Beatriz Remezal Serrano, José Luis Duro Torrijos, Jesús Sánchez Más, Pilar Serrano Paz","doi":"10.1016/j.cireng.2026.800399","DOIUrl":"10.1016/j.cireng.2026.800399","url":null,"abstract":"Introduction: Prolonged postoperative length of stay (PLOS) is a relevant indicator of clinical outcomes and healthcare efficiency after colon cancer surgery. Identifying predictive factors may improve perioperative planning and resource allocation.Methods: A retrospective observational study was conducted in patients undergoing curative-intent surgery for colon cancer between 2019 and 2024. PLOS was defined as a postoperative stay above the 75th percentile of the cohort (>8 days). Demographic, clinical, surgical and outcome-related variables were analysed and organized according to their temporality as preoperative, perioperative and postoperative variables. Univariable analysis and a multivariable logistic regression model, based on preoperative and perioperative variables, were performed to identify independent predictors of PLOS. The discriminatory ability of the model was assessed using a receiver operating characteristic (ROC) curve.Results: A total of 263 patients were included, of whom 64 (24.3%) presented PLOS. PLOS was significantly associated with urgent surgery, open approach, lower inclusion in the ERAS protocol and a higher rate of postoperative complications. In the multivariable analysis, open approach (OR 4.13; 95% CI: 1.97-8.68) and conversion to open surgery (OR 2.85; 95% CI: 1.19-6.82) were identified as independent predictors of PLOS. The model showed moderate-to-good discriminatory ability (AUC 0.73).Conclusions: PLOS after colon cancer surgery is mainly associated with perioperative factors, especially open approach and conversion to open surgery. Postoperative complications are related to a longer hospital stay, although they should be interpreted as associated factors rather than baseline predictors. The predictive model developed may be useful for early risk stratification and perioperative planning.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800399"},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139937","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

Shared decision-making and its tools to aid surgeons and their patients: a narrative review. 共同决策及其辅助外科医生和患者的工具：叙述性回顾。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800397

María Luisa Sánchez de Molina Rampérez, Olatz López-Fernández, Bárbara Horrillo, Héctor Guadalajara Labajo, Damián Garcia-Olmo

引用次数: 0

Ethical responsibility of the doctor in a possible case of organ trafficking. 医生在可能的器官贩卖案件中的道德责任。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800402

Alicia Pérez-Blanco

引用次数: 0

Intraoperative endoscopy in colorectal surgery in Spain: Results of a national survey. 西班牙结直肠手术术中内镜检查：一项全国性调查的结果。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800394

Manuela Elía-Guedea, Estíbaliz Echazarreta-Gallego, Blas Flor-Lorente, Vincenzo Vigorita

{"title":"Intraoperative endoscopy in colorectal surgery in Spain: Results of a national survey.","authors":"Manuela Elía-Guedea, Estíbaliz Echazarreta-Gallego, Blas Flor-Lorente, Vincenzo Vigorita","doi":"10.1016/j.cireng.2026.800394","DOIUrl":"10.1016/j.cireng.2026.800394","url":null,"abstract":"Introduction: Anastomotic leakage remains one of the most feared complications in colorectal surgery. Intraoperative colonoscopy (IOC) enables direct assessment of anastomotic integrity and allows immediate therapeutic intervention. The aim of this study is to describe the implementation of intraoperative endoscopy in colorectal surgery in Spain, analysing available resources, training, utilization patterns, and impact on intraoperative decision-making.Methods: Observational, descriptive, cross-sectional study based on an online survey distributed through the Asociación Española de Cirugía. The questionnaire, validated by a panel of experts, comprised 26 questions grouped into five domains: professional profile, infrastructure, technique and protocols, perceived outcomes, and training. The survey was active for 46 days. Descriptive statistical analysis was performed using absolute frequencies and percentages.Results: A total of 122 complete responses were obtained from 92 hospitals across 16 autonomous communities (completion rate: 31.7%). Flexible endoscopy was used by 55.7% of respondents, and 36.1% performed IOC routinely. Surgeons performed the procedures in 61.5% of cases. IOC was also used for localisation of lesions by 54.9% of respondents. In 61.8% of surgeons, the surgical approach was modified in up to 20% of patients. Indocyanine green fluorescence angiography was available in 85.2% of centres. Overall, 86.1% considered IOC a fundamental tool, and complications were virtually absent.Conclusions: IOC is highly regarded in Spain, yet its systematic integration remains heterogeneous. Deficits in structured training, therapeutic methods, and equipment persist. A joint effort from scientific societies, hospital management, and surgical teams is required to ensure uniform implementation and improve anastomotic safety.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800394"},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139871","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

Intrathoracic rib fixation in flail chest: first South American experience. 连枷胸的胸内肋骨固定：首次南美经验。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800398

José Ortega Sepúlveda, Alejandra Trillos Cárdenas, Javiera Isidora Urra Carvajal

引用次数: 0

Is there a Distinct Surgical Ethic of Care? 严格来说，有手术道德规范吗？

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800400

Andrew G Shuman

引用次数: 0

Outcomes of laparoendoscopic rendezvous for cholecysto-choledocolithiasis: A single series of 389 cases from a teaching hospital in Santiago, Chile. 腹腔镜治疗胆囊-胆总管结石的疗效：来自智利圣地亚哥一家教学医院的389例病例。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800404

Ana Hudson, Felipe Farfan, Marco Salazar, Felipe Catan, Jorge Muñoz, Mario Uribe, Francisco Riquelme

{"title":"Outcomes of laparoendoscopic rendezvous for cholecysto-choledocolithiasis: A single series of 389 cases from a teaching hospital in Santiago, Chile.","authors":"Ana Hudson, Felipe Farfan, Marco Salazar, Felipe Catan, Jorge Muñoz, Mario Uribe, Francisco Riquelme","doi":"10.1016/j.cireng.2026.800404","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800404","url":null,"abstract":"Background: The ideal management for cholecysto-choledocholithiasis remains controversial. A one-stage approach technique offers advantages over the two-stage approach, mainly by reducing postoperative complications, length of stay, and costs. This study aimed to describe the clinical and perioperative outcomes of laparoendoscopic rendezvous (LERV) for treating cholecysto-choledocholithiasis in elective and emergency settings.Methods: All patients with cholecysto-choledocholithiasis who underwent simultaneous cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) at a teaching hospital in Santiago, Chile, between January 2012 and December 2022 were included in this retrospective study.Results: Of 389 patients included, LERV was achieved by placing a guidewire through the cystic duct into the duodenum in 79% (309/389) of the patients. When the anterograde guidewire placement failed, intraoperative ERCP was performed. Common bile duct cannulation rate was 99.5% (387/389) and clearance rate was 90% (350/389). The overall morbidity rate was 11.6% (45/389) and surgical complication rate was 6.9%. Surgical morbidity was lower in the LERV group than in the group in which anterograde guidewire placement was not achieved (p = 0.02).Conclusions: The LERV procedure is a safe, feasible, and efficient tool for treating cholecysto-choledocholithiasis. When guided ERCP cannulation was not achieved, inferior intraoperative and postoperative outcomes were observed.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800404"},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139948","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

Technical options in the occlusion of the superior mesenteric vein for locally advanced pancreatic cancer. 局部晚期胰腺癌肠系膜上静脉闭塞术的技术选择。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800395

Juli Busquets, Núria Peláez, Luis Secanella, Maria Sorribas, Elena Iborra

{"title":"Technical options in the occlusion of the superior mesenteric vein for locally advanced pancreatic cancer.","authors":"Juli Busquets, Núria Peláez, Luis Secanella, Maria Sorribas, Elena Iborra","doi":"10.1016/j.cireng.2026.800395","DOIUrl":"10.1016/j.cireng.2026.800395","url":null,"abstract":"Resection of locally advanced adenocarcinoma of the head of the pancreas with occlusion of the superior mesenteric vein and involvement of the splenomesenteric-portal confluence (EMP) requires venous clamping, which is sometimes prolonged, with a risk of intestinal ischemia. The use of temporary venous shunts from the mesenteric territory to the caval vein or from the mesenteric territory to the portal vein has proven to be a useful tool for safely removing the tumour. In this article, we present our experience in five cases performed in 2025 at our centre, with special emphasis on the technical details presented. Furthermore, 3 of them have required arterial resection with preoperative embolization; these being the first published cases combining both technical strategies. In conclusion, the use of temporary mesocaval or mesoportal venous shunts enables the safe resection of pancreatic tumours with extensive involvement of the splenomesenteric-portal confluence. The association of arterial resection with preoperative embolization in this setting is technically feasible and can be performed safely.","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800395"},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139862","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

Peritoneal migration of a lumen-apposing metal stent (LAMS) after EUS-guided cholecystostomy. eus引导下胆囊造瘘术后腔旁金属支架（LAMS）的腹膜迁移。

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800403

Ismael Gómez, Belén Martínez, José Manuel Ramia, Cándido Alcázar

引用次数: 0

How should disagreements between surgeons and anesthesiologists be resolved? 外科医生和麻醉师之间的分歧应该如何解决？

Cirugia espanola Pub Date : 2026-10-08 DOI: 10.1016/j.cireng.2026.800401

Francisco Reinoso-Barbero, José Luis Encinas

引用次数: 0