Cirugia espanola最新文献

{"title":"Prospective evaluation of clinical and analytical values in the early diagnosis of anastomotic leak after oncological gastric surgery (PROFUGO study)","authors":"Marcos Bruna,&nbsp;Antonio J. Serrano,&nbsp;Rocío Pérez-Quintero,&nbsp;Carla Bettonica,&nbsp;Cristina Alegre,&nbsp;María Tudela,&nbsp;Miriam Menéndez,&nbsp;Adrián Herrero,&nbsp;Alessandro Bianchi,&nbsp;Irene Álvarez,&nbsp;Felipe Parreño,&nbsp;Jennifer Triguero,&nbsp;Sergio Rodríguez,&nbsp;Rocío González,&nbsp;Marta de Vega,&nbsp;Ander Bengoechea,&nbsp;Elena Fernández,&nbsp;Mª Asunción Acosta,&nbsp;Silvia Carbonell,&nbsp;Fernando López,&nbsp;María del Campo","doi":"10.1016/j.cireng.2026.800372","DOIUrl":"10.1016/j.cireng.2026.800372","url":null,"abstract":"<div><h3>Introduction</h3><div>Resective surgery is the cornerstone of gastric cancer treatment, but it carries considerable morbidity and mortality, with anastomotic leak (AL) being the most feared complication. This study aims to describe the prevalence and diagnostic management of AL after oncological gastrectomy, analyzing clinical and laboratory parameters that may facilitate its early diagnosis.</div></div><div><h3>Methods</h3><div>A prospective, multicentre, national study was conducted between 2023 and 2024. 435 patients who underwent surgery for gastric cancer at 43 centres were included. Sociodemographic variables and diagnostic and therapeutic management data were described, comparing the postoperative evolution of clinical and laboratory variables in patients with and without anastomotic leak.</div></div><div><h3>Results</h3><div>The overall prevalence of AL was 10.5%, with patients exhibiting a significantly higher heart rate from the second postoperative day. In the group of patients with AL, C-reactive protein, procalcitonin, and interleukin-6 showed higher levels from the first postoperative day. Other markers, such as leukocytes and the neutrophil-to-lymphocyte ratio, were also significantly higher in the AL group. The diagnosis of AL was established at a median of 6 days post-surgery, with a resolution rate of 80% using endoscopic therapies, interventional radiology and surgery.</div></div><div><h3>Discussion</h3><div>Although the diagnosis of AL is often delayed until the sixth postoperative day, the differences in the values of variables such as C-reactive protein, procalcitonin, and interleukin-6 between patients with and without AL become noticeable earlier. These findings support the creation of predictive models based on the variables studied to diagnose this complication early.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 10","pages":"Article 800372"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876849","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":"Reply – Coloproctology practice during General and Digestive Surgery training. Survey of the Galician Coloproctology Group","authors":"Antonio Ríos","doi":"10.1016/j.cireng.2026.800370","DOIUrl":"10.1016/j.cireng.2026.800370","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 10","pages":"Article 800370"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868332","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":"Mode of presentation and severity of cervical anastomotic leak after McKeown esophagectomy in the era of endoscopic therapies","authors":"Julieta Puente Montserrat,&nbsp;M-Carmen Fernández-Moreno,&nbsp;Georgy Kadzhaya,&nbsp;Ricardo Gadea Mateo,&nbsp;María Eugenia Barrios Carvajal,&nbsp;Fernando López Mozos","doi":"10.1016/j.cireng.2026.800387","DOIUrl":"10.1016/j.cireng.2026.800387","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervical drainage has been used to facilitate the diagnosis of anastomotic dehiscence (AD) and its local control. The aim of this study has been to analyse the association between the initial mode of presentation of cervical AD after McKeown esophagectomy (ME) and its overall clinical severity.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included patients with oesophageal neoplasia who underwent ME between 2010 and 2024, developed cervical AD, and had a cervical drain in place. The mode of diagnosis (clinical presentation vs drainage output), treatment, and severity of AD were analysed using the Comprehensive Complication Index (CCI). A temporal analysis comparing the periods before and after 2020 was performed following the introduction of new endoscopic therapies. Multivariable linear regression was used to identify factors associated with CCI.</div></div><div><h3>Results</h3><div>A total of 31 patients with cervical AL were included. Diagnosis was established through the cervical drain in 14 patients (45.2%) and through clinical manifestations in 17 (54.8%). No significant differences were observed in time to diagnosis between the groups (<em>p</em> = 0.49). Temporal analysis showed a reduction in surgical treatment of AD after 2020 (<em>p</em> = 0.039). In the multivariable analysis, the independent factors associated with CCI were the mode of diagnosis (<em>p</em> = 0.043) and diagnostic delay (<em>p</em> = 0.041).</div></div><div><h3>Conclusion</h3><div>Diagnosis through cervical drainage was not associated with earlier detection of AD. Severity was mainly related to diagnostic delay and the mode of clinical presentation. The introduction of endoscopic therapies has reduced the need for surgery.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 10","pages":"Article 800387"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889709","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":"Morbidity and mortality of inguinal hernia surgery in patients aged 80 years or older","authors":"Alba María Serrano Molina,&nbsp;Omar Carreño Sáenz,&nbsp;Carmen Gutiérrez Sánchez,&nbsp;José Bueno Lledó,&nbsp;Santiago Bonafé Diana,&nbsp;Providencia García Pastor,&nbsp;Victoria Pareja Ibars,&nbsp;Salvador Pous Serrano","doi":"10.1016/j.cireng.2026.800388","DOIUrl":"10.1016/j.cireng.2026.800388","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse morbidity, mortality, and outcomes of inguinal hernia surgery in patients aged 80 years or older.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study was conducted including patients aged ≥80 years who underwent inguinal hernia repair at a tertiary referral centre between April 2021 and April 2024. Demographic, clinical, and surgical variables were analysed, as well as intraoperative and postoperative complications, mortality, follow-up, and hernia recurrence.</div></div><div><h3>Results</h3><div>A total of 104 patients were included, accounting for 113 inguinal hernias. Mean age was 84 ± 3.2 years, and 76% of patients were male. Most procedures were performed electively (80.8%). Open mesh hernioplasty was the most frequently used technique (95.6%). Intraoperative complications occurred in 3.8% of cases, and mild postoperative complications were observed in 13.5%, with haematoma being the most common. No reoperations or postoperative mortality were recorded. Mean hospital stay was 1.55 days. During follow-up, two hernia recurrences and four de novo contralateral inguinal hernias were identified.</div></div><div><h3>Conclusion</h3><div>Inguinal hernia surgery in patients aged 80 years or older is associated with low morbidity and mortality when performed electively. Advanced age alone should not be considered a contraindication for surgical treatment.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 10","pages":"Article 800388"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889722","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":"Self-locking knot for thoracic wall closure in trauma anterolateral thoracotomy: a retrospective cohort study.","authors":"Luis Felipe Cabrera Vargas, Isabella Garavis Montagut, María Isabella Zúñiga Velasquez, Ana Gabriela Ayala, Carlos José Perez Rivera, Mauricio Pedraza Ciro, Diego Salcedo","doi":"10.1016/j.cireng.2026.800392","DOIUrl":"10.1016/j.cireng.2026.800392","url":null,"abstract":"<p><strong>Background: </strong>Thoracic trauma is one of the most frequent reasons for consultation in emergency departments worldwide. Surgical management of unstable injuries remains a challenge for trauma surgeons, as current evidence regarding chest wall closure techniques does not yet support a clear consensus. Although multiple techniques have been described, no single approach has been universally adopted.</p><p><strong>Methods: </strong>We performed a retrospective cohort study comparing the results for operative time, surgical site infection and postoperative pain between closures using the self-locking knot versus the rib approximator.</p><p><strong>Results: </strong>Our results demonstrate a difference between the 2 techniques analyzed that could be significant in terms of postoperative pain (18% for the self-locking knot group vs 65% for the rib approximator), surgical site infections (0% vs 9%, respectively) and operative time (100 versus 110 min, respectively).</p><p><strong>Conclusion: </strong>The self-locking knot technique could be considered a promising option for the intercostal space after anterolateral thoracotomy closure. Further studies are needed to confirm these results.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800392"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972226","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":"Use of artificial intelligence for the detection of anatomical structures and surgical planes in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.","authors":"Salvador Morales-Conde, Elena Guarnieri, Eugenio Licardie Bolaños, Andrea Balla","doi":"10.1016/j.cireng.2026.800390","DOIUrl":"10.1016/j.cireng.2026.800390","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800390"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946345","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":"Synthetic data in research: A methodological revolution, or a more sophisticated form of bias?","authors":"Carlos Cerdán-Santacruz, Julio Mayol Martínez","doi":"10.1016/j.cireng.2026.800391","DOIUrl":"10.1016/j.cireng.2026.800391","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800391"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946366","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":"Hemoperitoneum secondary to mesenteric tear due to traction from a giant inguinoscrotal hernia.","authors":"Claudia Santamaría García, Pablo Vázquez Beltrán, Pedro Yuste García, Eduardo Ferrero Herrero","doi":"10.1016/j.cireng.2026.800385","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800385","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800385"},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889716","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":"Informed Consent: more than signing a document.","authors":"Iñigo García Sanz","doi":"10.1016/j.cireng.2026.800386","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800386","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800386"},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889741","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":"Remarks on the current legal framework governing medical practice.","authors":"R Pérez-Villar Aparicio","doi":"10.1016/j.cireng.2026.800380","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800380","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800380"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883002","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}