Cirugia espanola最新文献

{"title":"Need for a targeted perioperative antibiotic treatment protocol for patients with preoperative biliary drainage undergoing pancreaticoduodenectomy","authors":"Judith Camps-Lasa ,&nbsp;María Isabel García-Domingo ,&nbsp;Eric Herrero Fonollosa ,&nbsp;María Luisa Galaviz Sosa ,&nbsp;María Galofré Recasens ,&nbsp;Aurora Rodríguez Campos ,&nbsp;Xavier Serra-Aracil ,&nbsp;Esteban Cugat Andorrá","doi":"10.1016/j.cireng.2024.09.003","DOIUrl":"10.1016/j.cireng.2024.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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, <em>p</em> &lt; 0.01). Microorganisms isolated in group NP included <em>Enterobacterales</em> (10.7%) and <em>Enterococcus</em> spp. (7.1%) with no <em>Candida</em> detected. In group P: <em>Enterobacterales</em> (51.2%), <em>Enterococcus</em> spp. (48.8%), and <em>Candida</em> (16.3%) were higher (<em>p</em> &lt; 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).</div></div><div><h3>Conclusion</h3><div>Bacterobilia differs in patients with biliary drainage, showing a higher presence of <em>Enterobacterales</em>, <em>Enterococcus</em> spp., and <em>Candida.</em> 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.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 540-547"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","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}

{"title":"Bronchobiliary fistula as a rare complication after interventional management of biliary complications","authors":"","doi":"10.1016/j.cireng.2024.02.002","DOIUrl":"10.1016/j.cireng.2024.02.002","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Page 562"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907066","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}

{"title":"New surgical techniques and strategies for Crohn’s disease: Results vs expectations","authors":"","doi":"10.1016/j.cireng.2024.04.017","DOIUrl":"10.1016/j.cireng.2024.04.017","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 552-554"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141058366","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}

{"title":"Safety and feasibility of a new rectoscope in rectal cancer surgery. First clinical trial","authors":"Mario Álvarez Gallego ,&nbsp;Sara Gortázar de las Casas ,&nbsp;Esteban Díaz Serrano ,&nbsp;Isabel Pascual Migueláñez","doi":"10.1016/j.cireng.2024.07.005","DOIUrl":"10.1016/j.cireng.2024.07.005","url":null,"abstract":"<div><div>We present a first in human clinical trial of a new rectoscope that shows, by means of transillumination, the optimal point of transection of the rectum in oncologic surgery. The device was developed together with a team of engineers and was manufactured by 3D printing. Eighteen patients with a mean age of 71 years and a mean distance from the tumor to the anal margin measured by colonoscopy of 10.4 ± 3.9 cm and by MRI of 10 ± 2.4 cm were included in the trial. Transillumination was feasible in all cases, and the use of the rectoscope was safe, as no adverse events due to its use were recorded.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 548-551"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121324","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}

{"title":"Robotic Splnectomy: the new gold standard?","authors":"Jose Manuel Ramia ,&nbsp;Cándido Alcazar ,&nbsp;Beniamino Pascotto ,&nbsp;Paola Melgar ,&nbsp;Juan Santiago Azagra","doi":"10.1016/j.cireng.2024.07.003","DOIUrl":"10.1016/j.cireng.2024.07.003","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 565-567"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891314","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}

{"title":"Steps in conducting a systematic review with meta-analysis","authors":"","doi":"10.1016/j.cireng.2024.06.003","DOIUrl":"10.1016/j.cireng.2024.06.003","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 558-560"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473517","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}

{"title":"Abdominal hernias secondary to non-penetrating trauma. A systematic review","authors":"José Ceballos Esparragón ,&nbsp;Javier Dagnesses Fonseca ,&nbsp;Jordi Marín García ,&nbsp;Patrizio Petrone","doi":"10.1016/j.cireng.2024.07.002","DOIUrl":"10.1016/j.cireng.2024.07.002","url":null,"abstract":"<div><div>Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024. Computed tomography is the gold-standard imaging test for diagnosis. Open surgery is generally the preferred approach, particularly in emergencies. Acute TAWH can be treated by primary suture or mesh repair, depending on local conditions, while late cases usually require mesh.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 515-523"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621954","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}

{"title":"Male breast cancer: A multicenter study in Aragon over 27 years","authors":"Olga Dobato Portoles ,&nbsp;Daniel Aparicio Lopez ,&nbsp;Reyes Ibañez Carreras ,&nbsp;Elena Aguirre Ortega ,&nbsp;Beatriz Eizaguirre Zarza ,&nbsp;Carmen García Mur ,&nbsp;Aurora Carrasquer Puyal ,&nbsp;María Pilar Cebollero Benito ,&nbsp;Laura Isabel Comín Novella ,&nbsp;Marta Allue Cabañuz ,&nbsp;Fernando Martinez Ubieto ,&nbsp;Ramón Sousa Domínguez ,&nbsp;Javier Torcal Aznar ,&nbsp;Carmen Casamayor Franco","doi":"10.1016/j.cireng.2024.09.001","DOIUrl":"10.1016/j.cireng.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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%.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 524-532"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","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}

{"title":"Impact of sarcopenic obesity on surgical complications and oncologic outcomes of upper gastrointestinal tumors: a systematic review and meta-analysis.","authors":"Luz Divina Juez, Ana Del Carmen Ortega, Pablo Priego, Juan Carlos García Pérez, José María Fernández-Cebrián, Jose I Botella-Carretero","doi":"10.1016/j.cireng.2024.09.005","DOIUrl":"10.1016/j.cireng.2024.09.005","url":null,"abstract":"<p><p>Sarcopenic obesity (SO) is a new entity whose definition encompasses the diagnosis of overweight in malnourished patients. The aim of the review was to assess the impact of body composition in patients with esophago-gastric tumors (EGT) on perioperative and oncological outcomes. This systematic review was conducted under the PRISMA guidelines. MEDLINE (PubMed), Embase, Web of Science and SCOPUS databases were searched until January 2024. Sixteen articles were identified for analysis analyzing 5,378 patients. The prevalence of SO was 10% (95%CI: 6-16; I² = 94%). Preoperative diagnosis of SO was associated with a twofold increased risk of severe postoperative complications (OR 2.32 [95%CI 1.41-3.82] I² = 70%). Meta-analysis of overall survival outcomes identified that SO was associated with worse overall survival (HR 2.30; 95%CI 1.46-3.61).</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334370","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}

{"title":"Clinical trial on nurse training through virtual reality simulation of an operating room: assessing satisfaction and outcomes","authors":"","doi":"10.1016/j.cireng.2024.04.012","DOIUrl":"10.1016/j.cireng.2024.04.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Virtual reality (VR) provides a firsthand active learning experience<span> through varying degrees of immersion. The aim of this study is to evaluate the use of VR as a potential tool for training operating room nurses to perform thoracic surgery procedures.</span></p></div><div><h3>Methods</h3><p>This is an open parallel-group randomized clinical trial<span>. One group received basic formation followed by an assessment module. The experimental group received the same basic formation, followed by thoracic surgery training and an assessment module.</span></p></div><div><h3>Results</h3><p>Fifty-six nurses participated in the study (51 females), with a mean age of 41.6 years. Participants achieved a median evaluation mode score of 480 points (IQR = 32 points). The experimental group (520 points) achieved an overall higher score than the control group (440 points; <em>P</em> = .04). Regarding age, women in the second quartile of age among the participants (35–41 years) achieved significantly better results than the rest (<em>P</em> = .04). When we evaluated the results based on the moment of practice, exercises performed in the last 10 min obtained better results than those performed in the first 10 min (1064 points versus 554 points; <em>P</em><span> &lt; .001). Regarding adverse effects blurred vision was the most frequent. The overall satisfaction rating with the experience was 8.5 out of 10.</span></p></div><div><h3>Conclusion</h3><p>Virtual reality is a useful tool for training operating room nurses. Clinical trial with ISRCTN16864726 registered number.</p></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 9","pages":"Pages 469-476"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056158","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}