Cirugia espanola最新文献

{"title":"Short-term results of unroofing and marsupialization compared to the Karydakis technique in the treatment of pilonidal sinus. A randomized prospective study","authors":"Pedro Antonio Parra Baños ,&nbsp;Nuria Martínez Sanz ,&nbsp;Francisco Miguel González Valverde ,&nbsp;Jorge Alejandro Benavides Buleje ,&nbsp;Miguel Ruiz Marín ,&nbsp;Emilio Peña Ros ,&nbsp;Carmen Martínez Sanz ,&nbsp;Mari Fe Candel Arenas","doi":"10.1016/j.cireng.2024.10.002","DOIUrl":"10.1016/j.cireng.2024.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment of pilonidal sinus (PS) is usually surgical, but no procedure is considered the <em>gold standard</em>. The Karydakis (K) technique is widely used, and unroofing and marsupialization (UM) is a simple surgery with good results.</div></div><div><h3>Primary objective</h3><div>To evaluate early postoperative complications (EPC) 30 days after UM surgery compared to the K technique.</div></div><div><h3>Secondary objectives</h3><div>To evaluate surgical time, postoperative pain, patient satisfaction, return to daily activity and early recurrence within 3 months.</div></div><div><h3>Method</h3><div>Prospective, single-center, randomized study in patients who underwent surgery for primary PS with no abscess between June 2016 and November 2017. They were randomized using a computer-generated block method. To analyze the main objective, a non-inferiority analysis was performed.</div></div><div><h3>Results</h3><div>122 patients with symptomatic primary PS were randomized: 60 in the K group and 62 in the UM group. Both groups were homogeneous.</div><div>There were statistically significant differences between surgery and postoperative complications at 15 and 30 days in favor of UM. There were also differences in favor of UM in surgical time and return to daily activity. During the 90-day follow-up, there were 3 recurrences in the UM group and 0 in the K group.</div></div><div><h3>Conclusions</h3><div>UM is a simple, minimally invasive, easily reproducible technique that has a lower rate of early complications, with a shorter operative time and an earlier return to daily activity.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 25-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483163","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":"Diathermy versus scalpel in midline abdominal incision: A systematic review and meta-analysis of randomized controlled trials","authors":"Nicole dos Santos Pimenta ,&nbsp;Ana Clara Felix de Farias Santos ,&nbsp;João Pedro Costa Esteves Almuinha Salles ,&nbsp;Juliana Millani de Oliveira ,&nbsp;Pedro Henrique Costa Matos da Silva ,&nbsp;Renan Carlo Colombari","doi":"10.1016/j.cireng.2024.09.002","DOIUrl":"10.1016/j.cireng.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Our study aimed to compare the midline abdominal incision with scalpel and diathermy.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, and Cochrane were searched through January 2024 following PRISMA guidelines (PROSPERO, ID: CRD42024516771), and only randomized controlled trials were included. Heterogeneity was assessed using Cochran's Q test and the I² heterogeneity index. Statistical analysis was performed using Review Manager 5.4 software.</div></div><div><h3>Results</h3><div>Six randomized controlled trials were included, from which 469 patients (51.5%) received diathermy incision and 442 patients (48.5%) underwent the scalpel technique. Patients treated with the electrocautery approach had less incision blood loss (MD −17.57 mL; <em>P</em> &lt; .01). No statistically significant differences were found between groups regarding wound infection incidence, incision time, incision area or first-day postoperative pain.</div></div><div><h3>Conclusion</h3><div>Diathermy use in midline abdominal incision may be advocated as it demonstrated a significant reduction in incision-related blood loss, with no differences in wound infection or early postoperative pain incidences compared to the scalpel.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 3-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303452","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":"Decision-making concordance in thoracic drain management: is necessary previous experience?","authors":"Álvaro Fuentes-Martín ,&nbsp;Miriam Suena Doncel ,&nbsp;José Soro García ,&nbsp;Mauricio Alfredo Loucel Bellino ,&nbsp;Itziar Gómez-Salvador ,&nbsp;Manuel Carrasco-Moraleja ,&nbsp;Ángel Cilleruelo Ramos","doi":"10.1016/j.cireng.2024.09.013","DOIUrl":"10.1016/j.cireng.2024.09.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Proper management of thoracic drainages is essential in the recovery of patients after lung resection. This study evaluates the concordance in decision-making for drain removal depending on the type of drainage system used and the previous experience of the personnel.</div></div><div><h3>Material and methods</h3><div>Prospective, comparative, and stratified randomization study on interobserver variability between senior specialist doctors and inexperienced healthcare personnel in the removal of thoracic drains in patients undergoing lung resection connected to conventional systems (CS) or digital systems (DS) with continuous recording. The withdrawal criteria were established before the study, and decisions were recorded during three postoperative days.</div></div><div><h3>Results</h3><div>75 patients were included, 38 CS and 37 DS, with no statistically significant differences in sex distribution, age, intervention performed, presence of pleuropulmonary adhesions, drain time, or post-extraction complications between the groups. The overall concordance in drain removal decisions was moderate (kappa = 0.452), with notable variations in concordance depending on the drainage system used: CS (kappa = 0.188) with an overall agreement rate of 61.7% compared to DS (kappa = 0.716) with an overall agreement rate of 86.4%. Digital systems showed substantial concordance regardless of the operator's experience, with kappa values indicating high concordance on all postoperative days.</div></div><div><h3>Conclusions</h3><div>The use of digital systems for managing thoracic drains significantly improves concordance in clinical decision-making regardless of the experience level. These findings suggest that adopting digital systems not only optimizes patient safety but also reduces the dependence on highly specialized healthcare professionals.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483157","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":"Evaluation of ChatGPT in surgical research","authors":"Sergi Sanchez-Cordero ,&nbsp;Julio Mayol","doi":"10.1016/j.cireng.2024.01.010","DOIUrl":"10.1016/j.cireng.2024.01.010","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907067","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":"Minimally invasive approach for colonic gallstone ileus","authors":"Eugenio Licardie ,&nbsp;Andrea Balla ,&nbsp;José Antonio López-Ruiz ,&nbsp;Salvador Morales-Conde","doi":"10.1016/j.cireng.2024.09.006","DOIUrl":"10.1016/j.cireng.2024.09.006","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 43-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407383","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":"Laparoscopic vs open approach for acute cholecystitis in octogenarians. A prospective multicenter observational nationwide study","authors":"N. Lluís ,&nbsp;C. Villodre ,&nbsp;P. Zapater ,&nbsp;M. Cantó ,&nbsp;L. Mena ,&nbsp;J.M. Ramia ,&nbsp;F. Lluís ,&nbsp;on behalf of the LUCENTUM Project Collaborative Group","doi":"10.1016/j.cireng.2024.06.008","DOIUrl":"10.1016/j.cireng.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>The world population is aging, with octogenarians expected to reach over 400 million by 2050. Acute cholecystitis is a serious complication in the elderly. Age is not a contraindication for emergency cholecystectomy, an option that can both save lives and preserve quality of life.</div></div><div><h3>Methods</h3><div>The present study aimed to compare open and laparoscopic surgical approaches. Over six months, 38 emergency surgery units enrolled all consecutive octogenarians with acute cholecystitis undergoing cholecystectomy. Postoperative outcomes were compared after propensity score matching analysis.</div></div><div><h3>Results</h3><div>The study included 212 patients (84 years [81–86], 47.2% women). The open approach was used in 32.1% of patients, and the laparoscopic approach in 67.9%. After propensity score matching, a decrease in hospital stays (open, 8 days [6–13]; laparoscopic, 5 days [4–8]; P &lt; .001), 30-day morbidity (open, 48.5%; laparoscopic, 26.5%; P = .01), and 30-day mortality (open, 13.2%, laparoscopic, 1.5%; P = .02) was found. Among the specific postoperative complications, a decrease in septicemia (open, 14.7%; laparoscopic, 0%; P = .001) was observed.</div></div><div><h3>Conclusions</h3><div>Laparoscopic approach was used in two out of three octogenarians. After propensity score matching, octogenarians undergoing laparoscopic approach had shorter length of hospital stay, fewer 30-day postoperative complications, fewer episodes of septicemia, and less 30-day mortality than octogenarians undergoing open approach. These findings suggest that the laparoscopic approach may be the preferred choice for octogenarians with acute cholecystitis undergoing cholecystectomy.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 34-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790356","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":"Epidemiological profile of women with moderate-risk breast cancer mutations","authors":"Rita Galama ,&nbsp;Cátia Ribeiro ,&nbsp;João Silva ,&nbsp;Joaquim Abreu de Sousa","doi":"10.1016/j.cireng.2024.09.008","DOIUrl":"10.1016/j.cireng.2024.09.008","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 55-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407382","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":"Match detection analysis on SentiMag® system and standard technique in SLNB of breast cancer","authors":"Cristina Isabel Davó Pérez,&nbsp;Virginia Pellicer Sánchez,&nbsp;Edelmira Soliveres Soliveres,&nbsp;María José Cases Baldó,&nbsp;Arantxa Cabrera Vilanova,&nbsp;Lorena Rodríguez Cazalla,&nbsp;Piotr Kosny,&nbsp;Miguel Ángel Morcillo Rodenas","doi":"10.1016/j.cireng.2024.09.012","DOIUrl":"10.1016/j.cireng.2024.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>In breast cancer surgery, there are techniques for sentinel lymph node biopsy (SLNB) that do not require Nuclear Medicine, such SentiMag®, which uses ferromagnetic particles. The main purpose of this analysis is to study the degree of concordance in SLNB between SentiMag® and the standard method (Tc99 radiotracer). The secondary objective is to identify factors that impact in sentinel node detection rate and matching detection rate between both probes.</div></div><div><h3>Methods</h3><div>Observational and retrospective study performed from January to December 2021 focused on patients undergoing breast surgery and SLNB who were injected with both tracers, the ferromagnetic SentiMag® and Tc99 radiotracer. Once the diagnostic accuracy tests were performed, a further evaluation of the detection rate for each probe and the concordance between probes were accomplished. After those results, a deeper analysis of differences in detection rates for each probe and concordance between probes were assessed for various factors: neoadjuvant therapy, BMI, mitotic index, and triple-negative immunohistochemical profile.</div></div><div><h3>Results</h3><div>The clinical study had a sample size of 70 patients. The overall false-negative rate (FNR) was 4.3%. The detection rate was the same for each technique (85.7%). A total of 106 nodes were biopsied, with a concordance rate of 70.75%. Significant differences were found in concordant nodes according to neoadjuvant therapy (p-value 0.012). For the Ki-67 factor (&lt;20 or ≥20), significant differences were found in detected nodes (p-value 0.031 gamma probe; p-value 0.124 SentiMag®).</div></div><div><h3>Conclusions</h3><div>The detection rates of SentiMag® and the gamma probe are equivalent. The application of the dual technique minimizes the FNR. A high mitotic index affects the detection rate of the gamma probe, and neoadjuvant therapy negatively impacts the concordance rate.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 11-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483158","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":"Post-traumatic pseudoaneurysm of the aortic arch due to esophageal perforation by a fishbone","authors":"Benjamin Thorpe Plaza ,&nbsp;Lucía Lesquereux ,&nbsp;Ana Berta Bermudez Naveira ,&nbsp;Purificación Parada","doi":"10.1016/j.cireng.2024.06.005","DOIUrl":"10.1016/j.cireng.2024.06.005","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Page 53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581875","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":"Non-inferiority clinical trial. Features and practical considerations","authors":"Xavier Serra-Aracil ,&nbsp;Marc Fradera","doi":"10.1016/j.cireng.2024.07.008","DOIUrl":"10.1016/j.cireng.2024.07.008","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Pages 49-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134742","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}