Cirugia espanola最新文献

{"title":"Wandering spleen as a cause of acute abdomen","authors":"María Abellán López , Luis Carrasco González , Benito Manuel Flores Pastor , Victoriano Soria Aledo","doi":"10.1016/j.cireng.2024.05.019","DOIUrl":"10.1016/j.cireng.2024.05.019","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 1","pages":"Page 54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581876","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: How do I make good decisions?","authors":"Rocío Franco Herrera, María Dolores Pérez Díaz","doi":"10.1016/j.cireng.2024.12.006","DOIUrl":"10.1016/j.cireng.2024.12.006","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878936","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":"Radioguided parathyroidectomy: How does it contribute to surgery?","authors":"Pilar Salvador Egea, Isabel Blanco Saiz, Emma Anda Apiñániz, Aitor Redondo Expósito, Cristina Erce García, Irati Pérez Otermin, Naomi Cruz Vásquez","doi":"10.1016/j.cireng.2024.12.005","DOIUrl":"10.1016/j.cireng.2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether a radioguided approach allows a higher intraoperative detection rate of adenoma and a minimally invasive parathyroidectomy (MIP), with the same or better cure rate of hyperparathyroidism secondary to parathyroid adenoma.</p><p><strong>Methods: </strong>This was an observational, prospective, single-center study involving 254 consecutive patients with primary hyperparathyroidism, between 2017 and 2022. A total of 258 procedures were performed: 129 non radioguided (NRS) and 129 radioguided (RS) (112 with intravenous 99mTc- MIBI and 17 with ultrasound-guided intralesional 99mTc-MAA injection) with an intraoperative gamma probe and gamma camera. Follow-up was performed for at least one year.</p><p><strong>Results: </strong>There were no differences between the groups in terms of age, sex, preoperative calcium or parathyroid hormone levels, adenoma localization with 99mTc-MIBI-gammagraphy and ultrasound, and surgical morbidity. Intraoperative surgical localization was 97.7% in both groups. Statistically significant differences supported RS: It allowed to perform MIP (RS: 96.9%, NRS 88.4%; p = 0.015), also in patients with previous neck surgery (RS: 75%, NRS: 28%; p = 0.019) and with ectopic adenomas (RS: 93.3%, NRS: 71.4%; p = 0.012). The operative time was significantly shorter (RS: 51 min, NRS: 59.79 min; p = 0.005). There were no significant differences in the postoperative complications between the groups. Biochemical cure at six months was achieved in RS: 97.7% and NRS: 93.8% (p = 0.12).</p><p><strong>Conclusions: </strong>Radioguided MIP is useful in ectopic adenomas and in patients with previous cervical surgery and allows a minimally invasive approach more frequently. It is a safe surgery, easily reproducible by an endocrine surgeon and requires usual equipment found in operating rooms.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878943","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":"Current obesity treatment: A story about beliefs, devotion and confrontation.","authors":"José María Balibrea, María Recarte-Rico, María Dolores Frutos","doi":"10.1016/j.cireng.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.cireng.2024.11.012","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873651","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":"Futility, failure to cure, failure to rescue and aborted surgery: New ways to measure the real usefulness of surgery.","authors":"Jose M Ramia, Silvia Carbonell-Morote","doi":"10.1016/j.cireng.2024.11.011","DOIUrl":"10.1016/j.cireng.2024.11.011","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873652","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":"Preoperative management of patients with oesophageal cancer: expert recommendations.","authors":"Marcos Bruna Esteban, Rocío Pérez Quintero, M Asunción Acosta Mérida, Aitana García Tejero","doi":"10.1016/j.cireng.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.cireng.2024.12.003","url":null,"abstract":"<p><p>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. Using the Delphi methodolgy 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 to 10). 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 tumors with invasion of the tracheobronchial tract, large vessels, and spinal column, multivisceral metastases, and/or peritoneal carcinomatosis. 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.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","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}

{"title":"Response Letter to the Article: \"Expanding horizons of indocyanine green in breast surgery\".","authors":"Eugenio Licardie, Salvador Morales-Conde","doi":"10.1016/j.cireng.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.cireng.2024.12.002","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866606","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 wall closure: How do we do it in Spain? Survey of specialist general surgeons members of the AEC (Spanish Society of Surgeons).","authors":"Montserrat Juvany, Alejandro Bravo-Salva, Jose Antonio Pereira-Rodríguez","doi":"10.1016/j.cireng.2024.12.004","DOIUrl":"10.1016/j.cireng.2024.12.004","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the knowledge of abdominal wall closure in a cohort of specialist general surgeons who are members of the AEC and to see its adequacy with current recommendations. Sub-analysis in terms of years of specialization.</p><p><strong>Material and methods: </strong>Individual questionnaire of 21 questions on abdominal wall closure in elective and urgent context.</p><p><strong>Results: </strong>A total of 371 responses were received from specialist surgeons who are members of the AEC. Closure of the median laparotomy is performed with continuous suture in 99.7% and with slowly absorbable materials in 95.4%. 88.4% of surgeons report using the ratio equal to or greater than 4:1 between suture length and incision length (SL:IL) and short stitches. These results are equivalent in transverse and urgent elective laparotomy. 85.2% of the respondents systematically close trocars of 10 mm or more and 30.7% use prophylactic mesh in high-risk patients. Surgeons with less than 10 years of experience use the ratio ≥ 4:1 SL:SI and short stitches more than surgeons with more experience (93.4% vs 84.9%; P = .013).</p><p><strong>Conclusions: </strong>Abdominal wall closure among general surgeons who are members of the ACS is adequate and adjusted to the recommendations with a tendency to improve among surgeons with less experience. There is an opportunity for improvement in the use of prophylactic mesh in high-risk patients.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866463","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":"Patient safety, why is it important?","authors":"Javier García Septiem, Alba Correa Bonito","doi":"10.1016/j.cireng.2024.11.010","DOIUrl":"10.1016/j.cireng.2024.11.010","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866589","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 at one year of the TROPIS technique in the treatment of complex anal fistula.","authors":"María Luisa Reyes Díaz, Fátima 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":"https://doi.org/10.1016/j.cireng.2024.12.001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The treatment of cryptoglandular complex anal fistula with this procedure was safe and showed acceptable healing rates. [[es]]Resumen INTRODUCCIóN: Es prioritario encontrar técnicas quirúrgicas que garanticen tasas de curación aceptables sin secuelas en el tratamiento de la fístula anal compleja. El concepto de espacio interesfintérico profundo como origen de la sepsis perianal ha dado una nueva perspectiva, permitiendo la aparición de técnicas como, TROPIS (Transanal Opening of Intersphincteric Space), con escasas series publicada hasta el momento. El objetivo de este estudio es valorar la tasa de curación y las complicaciones al año de la técnica TROPIS, como tratamiento de la fistula anal compleja sin ingreso. MéTODO: Estudio ambispectivo, observacional, desde enero del 2021 a enero del 2023. Se trató mediante técnica TROPIS a pacientes con fístula anal compleja que cumplían criterios de inclusión. Se realizó una evaluación al año, valorando tasas de curación, recurrencia, de continencia y complicaciones.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Resultados: &lt;/strong&gt;Se han incluido un total de 23 pacientes con fistula anal compleja criptoglandular (87% varones, edad media 54,7 +/- 9,6 años). El 78,3% fueron fistulas recidivadas con una media de 3,3+/- 3,2 intervenciones previas. Al mes, un 82,6% de las pacientes tuvieron una curación completa. A los tres, seis y doce meses la curación completa se dio en un 63,6%, 61,9% y 55,6% respectivamente. Un paciente tuvo un absceso al mes. La continencia se modificó en un 8.7%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusiones: &lt;/strong&gt;El tr","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","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}