Cirugia espanola最新文献

{"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,&nbsp;Alejandra García-Novoa,&nbsp;Sergio Rodríguez-Rojo,&nbsp;Carlota Díaz-Carballada,&nbsp;Alberto Bouzón-Alejandro","doi":"10.1016/j.cireng.2024.08.002","DOIUrl":"10.1016/j.cireng.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>During oncoplastic procedures, the vascularization and perfusion of the skin flaps is modified, thus increasing the possibility of skin necrosis.</div><div>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).</div></div><div><h3>Patients and method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 573-581"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","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}

{"title":"Criteria for quality assessment of a systematic review and/or meta-analysis","authors":"Víctor Soria-Aledo ,&nbsp;Andrés Carrillo-Alcaraz","doi":"10.1016/j.cireng.2024.04.008","DOIUrl":"10.1016/j.cireng.2024.04.008","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 609-611"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873844","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":"The textbook outcome for cholecystectomy: Is it a good quality tool for a low-morbidity procedure?","authors":"David Hernández-Bermejo ,&nbsp;Celia García-Vega ,&nbsp;Juan Jesús Rubio-García ,&nbsp;Celia Villodre-Tudela ,&nbsp;Silvia Carbonell-Morote ,&nbsp;José Manuel Ramia","doi":"10.1016/j.cireng.2024.06.004","DOIUrl":"10.1016/j.cireng.2024.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Cholelithiasis is the most common hospital diagnosis of the digestive system, and its treatment, if symptomatic, is </span>laparoscopic cholecystectomy. There is a growing need for comprehensive determination of postoperative outcomes and the efficiency of healthcare facilities. The “textbook outcome”(TO) indicates the quality of care commonly used in </span>oncological procedures<span>, obtained by adding several postoperative parameters, which informs whether a perfect result has been obtained. The main objective of this study is to determine the TO for cholecystectomy and to see the factors that influence its achievement.</span></div></div><div><h3>Methods</h3><div>Retrospective observational unicentric cohort study<span> on patients who underwent cholecystectomy between 2018–2020. We defined TO as those patients who met the following premises: Clavien-Dindo complications &lt; III, postsurgical stay less than the 75th percentile (&lt;3 days), and no readmissions or mortality in the first ninety days. Perioperative characteristics were analyzed, and the patients were divided into two groups according to whether or not they achieved TO. We defined criteria for difficult cholecystectomy according to the operative report.</span></div></div><div><h3>Results</h3><div><span>The percentage of TO was 72% (342/475) (82.6% in elective surgery and 60.5% in urgent surgery). The </span>univariate analysis<span> showed that the following factors are associated with achieving TO: female sex, age &lt;63 years, ASA risk &lt; III, elective surgery, laparoscopic approach, and not difficult cholecystectomy. After multivariate analysis ASA &lt; III (OR 2.39 CI95% 1.37–4.16), elective surgery (OR 2.77 CI95% 1.64–4.67), laparoscopic approach (OR 5.71 CI95% 2.89–11.30) and not to be difficult cholecystectomy (OR 0.42 CI95% 0.259–0.71) remained statistically significant.</span></div></div><div><h3>Conclusions</h3><div>The TO is a healthcare quality tool that is simple to perform, easily interpretable, and helpful for evaluating quality in healthcare and comparing centers. It applies not only to oncological procedures but also to cholecystectomy.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 582-589"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441252","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":"Network meta-analysis: concept and value in practical application","authors":"Salvador Morales-Conde ,&nbsp;Juan Carlos Gómez Rosado ,&nbsp;Stavros A. Antoniou","doi":"10.1016/j.cireng.2024.04.018","DOIUrl":"10.1016/j.cireng.2024.04.018","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 607-608"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023290","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":"Postoperative complications after liver-first Approach RENACI project","authors":"Jose M. Ramia ,&nbsp;Celia Villodre ,&nbsp;Belinda Sánchez Pérez ,&nbsp;Laia Falgueras Verdaguer ,&nbsp;Mario Serradilla Martín ,&nbsp;miembros del Proyecto RENACI","doi":"10.1016/j.cireng.2024.06.010","DOIUrl":"10.1016/j.cireng.2024.06.010","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 619-623"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768355","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":"Results of the implementation of a specialized cervical tracheal surgery program","authors":"Usue Caballero-Silva,&nbsp;Sara Fra-Fernández,&nbsp;C.ristina Cavestany García-Matres,&nbsp;Albarto Cabañero-Sánchez,&nbsp;Nicolás Moreno-Mata","doi":"10.1016/j.cireng.2024.05.014","DOIUrl":"10.1016/j.cireng.2024.05.014","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 617-619"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441250","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 the laparoscopic approach, early closure and preoperative stimulation on outcomes of ileostomy closure after rectal resection","authors":"Andrea Norte,&nbsp;Carmen Martínez,&nbsp;Ana Pasalodos,&nbsp;Ivette Tort,&nbsp;Anna Sánchez,&nbsp;Pilar Hernández,&nbsp;Jesús Bollo,&nbsp;Eduard Maria Targarona","doi":"10.1016/j.cireng.2024.05.013","DOIUrl":"10.1016/j.cireng.2024.05.013","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach.</div></div><div><h3>Methods</h3><div>We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission.</div></div><div><h3>Results</h3><div>Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57–113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5–7). Readmission was needed in 6.8% (n = 7) of patients.</div></div><div><h3>Conclusion</h3><div>A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 590-598"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441247","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":"Percutaneous transhepatic cholangioscopy in the management of hepatolithiasis","authors":"Ana Belén Martín Arnau ,&nbsp;Antonio Molera Espelt ,&nbsp;Jordi Villaba Auñon ,&nbsp;Santiago Sánchez-Cabús","doi":"10.1016/j.cireng.2024.06.011","DOIUrl":"10.1016/j.cireng.2024.06.011","url":null,"abstract":"<div><div>The treatment of lithiasis in patients with biliodigestive bypass can be controversial. The combination of percutaneous access together with cholangioscopy is an alternative to surgical treatment for the management of this pathology.</div><div>In recent years, the appearance of smaller and more flexible fiber-optic cholangioscopes as well as the possibility to perform lithotripsy have changed the treatment of this pathology, providing good results. After our experience, we believe that cholangioscopy assisted by a percutaneous approach is a safe technique, with few complications and early recovery for patients in whom it is not possible to perform endoscopic management.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 599-604"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876960","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":"Are surgeons the worst part of surgery?","authors":"Manuel López Cano","doi":"10.1016/j.cireng.2024.05.018","DOIUrl":"10.1016/j.cireng.2024.05.018","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 605-606"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592363","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":"PROFUGO study protocol: Predictive model for the early diagnosis of anastomotic leak after esophagectomy and gastrectomy","authors":"Rocío Pérez Quintero ,&nbsp;Marcos Bruna Esteban ,&nbsp;Antonio José Serrano López","doi":"10.1016/j.cireng.2024.06.012","DOIUrl":"10.1016/j.cireng.2024.06.012","url":null,"abstract":"<div><div>In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications. Because of this, research and the creation of predictive models that identify patients at high risk of developing complications are mandatory in order to obtain an early diagnosis.</div><div>The PROFUGO study (PRedictivO Model for Early Diagnosis of anastomotic LEAK after esophagectomy and gastrectomy) is proposed as a prospective and multicenter national study that aims to develop, with the help of artificial intelligence methods, a predictive model that allows for the identification of high-risk cases. of anastomotic leakage and/or major complications by analyzing different clinical and analytical variables collected during the postoperative period of patients undergoing esophagectomy or gastrectomy.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 11","pages":"Pages 624-629"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134743","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}