Cirugia espanola最新文献_第2页

Preoperative management of patients with oesophageal cancer: Expert recommendations 食管癌患者的术前管理：专家建议。

Cirugia espanola Pub Date : 2025-03-01 DOI: 10.1016/j.cireng.2024.12.003

Marcos Bruna Esteban , Rocío Pérez Quintero , M. Asunción Acosta Mérida , Aitana García Tejero , group of experts

{"title":"Preoperative management of patients with oesophageal cancer: Expert recommendations","authors":"Marcos Bruna Esteban , Rocío Pérez Quintero , M. Asunción Acosta Mérida , Aitana García Tejero , group of experts","doi":"10.1016/j.cireng.2024.12.003","DOIUrl":"10.1016/j.cireng.2024.12.003","url":null,"abstract":"<div><div>The aim of this work is to establish recommendations for the preoperative evaluation and selection of patients with malignant oesophageal neoplasms, who are candidates for surgical resection with curative intent, based on the consensus established by a group of experts.</div><div>Using the Delphi methodology and after 2 rounds of evaluation, responses were obtained from 37 experts to 47 questions about the preoperative management of oesophageal cancer, considering consensus if there was a mean score greater than 8 (range between 0–10).</div><div>Of the respondents, 54% were women, with a mean age of 50.2 years, with more than 15 years of average experience in oesophageal surgery. In the preoperative evaluation, agreement was obtained on most of the recommendations, with the indication of a staging laparoscopy being the only one where it was not reached. In the preoperative optimisation, agreement was reached on nutritional, anaemia, physical status, respiratory and comorbidities evaluation, but no agreement was reached on recommending immunonutrition or echocardiography routinely. In the inoperability criteria were included ECOG greater than 1, impaired lung function, and/or Child B or C liver cirrhosis. Agreement was reached on considering unresectable tumours with invasion of the tracheobronchial tract, large vessels, and spinal column, multivisceral metastases, and/or peritoneal carcinomatosis.</div><div>Therefore, the recommendations established in this manuscript may be useful to support decision-making in daily clinical practice, with a high degree of consensus that decisions regarding the management of these patients should be made on an individual basis and within a multidisciplinary committee of experts.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 3","pages":"Pages 156-164"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873653","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

Indocyanine green for axillary sentinel lymph node biopsy in patients with breast cancer (INSEAN study)

Cirugia espanola Pub Date : 2025-03-01 DOI: 10.1016/j.cireng.2024.11.017

Sandra López Gordo , Iva Borisova , Neus Ruiz-Edo , David López-Cano , Marta De la Iglésia , Mario Giner Pichel , Maite Salcedo-Pujantell , Cristina Serra-serra , Breast Cancer Research Group

{"title":"Indocyanine green for axillary sentinel lymph node biopsy in patients with breast cancer (INSEAN study)","authors":"Sandra López Gordo , Iva Borisova , Neus Ruiz-Edo , David López-Cano , Marta De la Iglésia , Mario Giner Pichel , Maite Salcedo-Pujantell , Cristina Serra-serra , Breast Cancer Research Group","doi":"10.1016/j.cireng.2024.11.017","DOIUrl":"10.1016/j.cireng.2024.11.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Sentinel lymph node (SLN) detection is the technique of choice for staging early-stage breast cancer (BC). The preferred technique for SLN detection is labelling with the radioisotope Technetium-99 (Tc-99). Other methods have been evaluated, including methylene blue, magnetic tracers, iodine seeds, or fluorescent substances. Various studies have shown the non-inferiority of indocyanine green (ICG) for SLN detection; however, inclusion criteria are selective and restrictive.</div></div><div><h3>Main and secondary hypotheses</h3><div>Main hypotheses: SLN detection using ICG provides results that are not inferior to those obtained with Tc-99.</div><div>Secondary hypotheses:<ul><li><span>•</span><span><div>The combination of ICG and Tc-99 does not increase the average number of SLNs identified in primary surgery but does in the post-neoadjuvant setting.</div></span></li><li><span>•</span><span><div>Using ICG does not prolong surgical time once the learning curve is achieved.</div></span></li><li><span>•</span><span><div>The cost of ICG is lower than Tc-99.</div></span></li></ul></div></div><div><h3>Methods and design</h3><div>This is a multicenter, prospective, observational study in BC patients undergoing primary or post-neoadjuvant surgery with SLN detection. INSEAN study (NCT: 06378944).</div><div>Inclusion criteria: Patients of both sexes with cN0 BC undergoing primary surgery or cN1 with good axillary response post-neoadjuvant. The detected nodes will be classified according to the detection method used as \"Tc,\" \"Tc + ICG,\" or \"ICG.\" Final anatomopathological (AP) analysis will be conducted for comparison.</div></div><div><h3>Discussion</h3><div>The SLN detection rates will be compared across techniques, along with potential adverse effects, definitive AP results, and costs between the two techniques.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 3","pages":"Pages 173-178"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044037","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

National survey on data governance and digital surgery: Challenges and opportunities for surgeons in the era of artificial intelligence

Cirugia espanola Pub Date : 2025-03-01 DOI: 10.1016/j.cireng.2024.12.008

María Asunción Acosta-Mérida , Luis Sánchez-Guillén , Mario Álvarez Gallego , Xavier Barber , Juan Antonio Bellido Luque , Ana Sánchez Ramos , en nombre de la Sección de Cirugía Mínimamente Invasiva e Innovación Tecnológica de la AEC

{"title":"National survey on data governance and digital surgery: Challenges and opportunities for surgeons in the era of artificial intelligence","authors":"María Asunción Acosta-Mérida , Luis Sánchez-Guillén , Mario Álvarez Gallego , Xavier Barber , Juan Antonio Bellido Luque , Ana Sánchez Ramos , en nombre de la Sección de Cirugía Mínimamente Invasiva e Innovación Tecnológica de la AEC","doi":"10.1016/j.cireng.2024.12.008","DOIUrl":"10.1016/j.cireng.2024.12.008","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates the knowledge of Spanish surgeons regarding data governance and Digital Surgery, their usage, errors, and training deficiencies, as well as differences in knowledge between those who perform robotic surgery and those who do not.</div></div><div><h3>Methods</h3><div>A descriptive study was conducted using a closed survey promoted by the Minimally Invasive Surgery and Technological Innovation Section of the Spanish Association of Surgeons, directed at its members between February and March 2024.</div></div><div><h3>Results</h3><div>Out of 1086 surgeons contacted, 396 responded (36.46%). While 98.3% use electronic medical records, 45.4% lack organized data recording systems. Although 55.9% have access to robotic technology, 70.6% do not use it directly. Surgeons who perform robotic surgery show a higher general knowledge of Digital Surgery terms (7.2 vs 6.619; <em>P</em> = .215) and specifically of “Artificial Intelligence” (57.14% compared to less than 25% for other terms), although these differences are not significant. However, there are significant differences in interest in digital technology between those who perform robotic surgery and those who do not (<em>P</em> = .023). Additionally, surgeons who support training in digital technology during residency are nearly twice as likely to research Digital Surgery.</div></div><div><h3>Conclusion</h3><div>Surgeons are crucial for the digital transformation in surgery, but many are poorly prepared and insufficiently involved. Those who practice robotic surgery have more knowledge and interest in digital technology, highlighting the need for improved training and governance frameworks to better integrate surgeons into the digital era.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 3","pages":"Pages 143-152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030484","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

Results at one year of the TROPIS technique in the treatment of complex anal fistula 结果：TROPIS技术治疗复杂性肛瘘1年。

Cirugia espanola Pub Date : 2025-03-01 DOI: 10.1016/j.cireng.2024.12.001

María Luisa Reyes Díaz , Fatima Hinojosa-Ramirez , Irene María Ramallo Solís , Rosa María Jiménez Rodríguez , Jose Pintor Tortolero , Ana María García Cabrera , Jorge M. Vázquez Monchul , Fernando de la Portilla de Juan

{"title":"Results at one year of the TROPIS technique in the treatment of complex anal fistula","authors":"María Luisa Reyes Díaz , Fatima Hinojosa-Ramirez , Irene María Ramallo Solís , Rosa María Jiménez Rodríguez , Jose Pintor Tortolero , Ana María García Cabrera , Jorge M. Vázquez Monchul , Fernando de la Portilla de Juan","doi":"10.1016/j.cireng.2024.12.001","DOIUrl":"10.1016/j.cireng.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.</div></div><div><h3>Method</h3><div>Prospective, observational study from January 2021 to January 2023. Patients with complex anal fistulas who met the inclusion criteria were treated using the TROPIS technique. A one-year follow up review was conducted, assessing healing rates, recurrence, continence, and complications.</div></div><div><h3>Results</h3><div>A total of 23 patients with cryptoglandular complex perianal fistula were included (87% male, mean age 54.7 ± 9.6 years). 78.3% were treated for recurrent fistulas with an average of 3.3 ± 3.2 previous interventions. At one month, 82.6% of the patients had complete healing. At three, six, and twelve months, complete healing occurred in 63.6%, 61.9%, and 55.6%, respectively. One patient developed an abscess at one month. Continence was altered in 8.7%.</div></div><div><h3>Conclusions</h3><div>The treatment of cryptoglandular complex anal fistula with this procedure was safe and showed acceptable healing rates.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 3","pages":"Pages 135-142"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866613","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

“Cirugía Española”: New time at the beginning of a new era

Cirugia espanola Pub Date : 2025-03-01 DOI: 10.1016/j.cireng.2025.02.001

Eduardo M. Targarona, Ruth Blanco-Colino, Marcos Bruna, Carlos Cerdán, Xabier García Albéniz, Manuel López Cano, Néstor Martínez, Antonio Ríos

引用次数: 0

Preliminary results of the implementation of a Complex Surgical Patient Area as a tool to improve the quality of care.

Cirugia espanola Pub Date : 2025-02-25 DOI: 10.1016/j.cireng.2025.02.005

Mihai-Calin Pavel, Ana Ferre, Lucia Garcia-Huete, Iban Oliva, Lluisa Guillem, Ignacio Tomas, Marcela Renzulli, Rosa Jorba-Martin

{"title":"Preliminary results of the implementation of a Complex Surgical Patient Area as a tool to improve the quality of care.","authors":"Mihai-Calin Pavel, Ana Ferre, Lucia Garcia-Huete, Iban Oliva, Lluisa Guillem, Ignacio Tomas, Marcela Renzulli, Rosa Jorba-Martin","doi":"10.1016/j.cireng.2025.02.005","DOIUrl":"10.1016/j.cireng.2025.02.005","url":null,"abstract":"<p><strong>Introduction: </strong>Given the increasing complexity of surgical patients, their evaluation within a Complex Surgical Patient Area (APQC) is essential. This study aims to present the functioning of the APQC and analyse its outcomes.</p><p><strong>Methods: </strong>Between 2022 and 2024, 73 patients were evaluated, with a mean age of 72.8 ± 10 years. Of these, 97.3% were ASA ≥ III, and 41.1% had a Clinical Frailty Score ≥4. The evaluation centered on a multidisciplinary committee responsible for determining the patient's operability and guiding the intrahospital circuit. During postoperative evolution, patient follow-up was carried out by two complementary teams in continuous communication. Failure to Rescue (FTR) was defined as the death of a patient following one or more serious complications.</p><p><strong>Results: </strong>The main reason for including patients in the CSPA was multimorbidity in 53.4% of cases and a specific pathology in 28.8%. In 31.5% of cases, the intervention was ruled out, with one-year survival below 40%. Among the 35 operated patients, the Comprehensive Complication Index (CCI) was 18.034 ± 21.94, the average hospital stay was 14.34 ± 20.15 days, and the readmission rate was 25.7%. The FTR rate was 12.5%.</p><p><strong>Conclusions: </strong>Current data suggest a positive impact of the APQC on the evolution of complex patients. A larger patient sample is needed for a detailed analysis of the factors where APQC activities may have the greatest influence.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517691","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

Short-term outcomes of laparoscopic common bile duct exploration for choledocholithiasis in elderly patients: A comparative single-centre study.

Cirugia espanola Pub Date : 2025-02-21 DOI: 10.1016/j.cireng.2025.01.004

Carlos Domingo-Del Pozo, Sergio Navarro-Martínez, Juan Carlos Sebastián-Tomás, Inés Domingo-Roig, Marta Córcoles-Córcoles, Amparo Martínez-Blasco, Inmaculada Ortiz-Tarín, Carmen Paya-Llorente

{"title":"Short-term outcomes of laparoscopic common bile duct exploration for choledocholithiasis in elderly patients: A comparative single-centre study.","authors":"Carlos Domingo-Del Pozo, Sergio Navarro-Martínez, Juan Carlos Sebastián-Tomás, Inés Domingo-Roig, Marta Córcoles-Córcoles, Amparo Martínez-Blasco, Inmaculada Ortiz-Tarín, Carmen Paya-Llorente","doi":"10.1016/j.cireng.2025.01.004","DOIUrl":"10.1016/j.cireng.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic common bile duct exploration (LCBDE) is an alternative to endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of choledocholithiasis. However, its use in elderly patients has been limited, often avoided due to concerns about associated morbidity. This study aims to evaluate the success rate and outcomes of LCBDE in elderly patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with a confirmed diagnosis of choledocholithiasis via intraoperative cholangiography who underwent LCBDE from January 2009 to December 2022. Demographic, clinical, intraoperative, and postoperative data were collected. Patients were divided into two groups: those aged ≥70 years and those aged <70 years. Additionally, a subgroup analysis was performed on patients aged ≥80 years.</p><p><strong>Results: </strong>A total of 330 patients were included (<70 years = 168; ≥70 years = 162). The success rate of LCBDE in patients aged ≥70 years was similar to that in patients aged <70 years (95.7% vs. 97%; p = 0.514). No statistically significant differences were found in intraoperative outcomes, short-term complications, or mortality between the two groups. These results were consistent in the subgroup analysis of patients aged ≥80 years (n = 67) compared with those aged <70 years.</p><p><strong>Conclusion: </strong>LCBDE is a safe and effective procedure for patients aged ≥70 years and could be considered a first-line therapeutic option for this group.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485063","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

Bibliometric study of publications on pancreatic surgery carried out by spanish surgeons.

Cirugia espanola Pub Date : 2025-02-21 DOI: 10.1016/j.cireng.2024.12.015

Juan Jesús Rubio-García, Celia Villodre Tudela, Cándido Alcázar López, Silvia Carbonell Morote, Mariano Franco Campello, Paola Melgar Requena, Adrián Paredes Segura, José Manuel Ramia Ángel

{"title":"Bibliometric study of publications on pancreatic surgery carried out by spanish surgeons.","authors":"Juan Jesús Rubio-García, Celia Villodre Tudela, Cándido Alcázar López, Silvia Carbonell Morote, Mariano Franco Campello, Paola Melgar Requena, Adrián Paredes Segura, José Manuel Ramia Ángel","doi":"10.1016/j.cireng.2024.12.015","DOIUrl":"10.1016/j.cireng.2024.12.015","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic pathology is a constant multidisciplinary challenge. It is a growing pathology and one of the main research topics. The aim of the study is to analyse the current situation in Spain in this field from a bibliometric perspective.</p><p><strong>Methods: </strong>We conducted a systematic review following the PRISMA guidelines, utilizing the PubMed/Medline and sCIELO databases. The search strategy included the terms: '(pancreas OR pancreatectomy) AND surgery AND Spain.' The publication period spanned from January 2019 to March 2024. Our inclusion criteria specified any article, in any language, where at least one participant was a surgeon in a hospital in Spain, and that had an impact factor (IF).</p><p><strong>Results: </strong>The search yielded 522 citations, of which 133 articles were selected after applying our inclusion and exclusion criteria. The trend over time indicates a progressive increase in publications. Notably, 36.1% of the articles were published in Q1 journals, while 35.3% appeared in Q3 journals, with a mean impact factor of 4.07. Spanish authors accounted for 63.2% of publications. The most common types of articles were retrospective studies, case reports, and systematic reviews, with 35.3% being international multicenter studies. Key topics addressed included minimally invasive approaches, surgical techniques, and postoperative management. The journal Cirugía Española (Q3) published the highest number of papers (20.3%).</p><p><strong>Conclusion: </strong>In recent years, Spain has experienced a significant increase in publications related to pancreatic surgery. However, when compared to leading countries in this field, the number of randomised clinical trials remains low.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485062","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

How are non-technical skills learned? Importance of simulation and high-performance teams.

Cirugia espanola Pub Date : 2025-02-17 DOI: 10.1016/j.cireng.2025.02.004

Ismail Hameed Mallick

引用次数: 0

Acute biliary peritonitis secondary to rupture of complicated hepatic cystic echinococcosis. Case series with follow-up.

Cirugia espanola Pub Date : 2025-02-17 DOI: 10.1016/j.cireng.2025.02.003

Carlos Manterola, Josue Rivadeneira

引用次数: 0