{"title":"Goal-directed neoadjuvant therapy: What should we offer in each case?","authors":"Bruna Borba Vailati , Guilherme Pagin São Julião , Leonardo Ervolino Corbi , Rodrigo Oliva Perez","doi":"10.1016/j.cireng.2025.800145","DOIUrl":"10.1016/j.cireng.2025.800145","url":null,"abstract":"<div><div>The management of rectal cancer has undergone significant evolution, driven by advancements in staging, treatment strategies, and understanding tumor biology. Initially dominated by total mesorectal excision (TME) with or without neoadjuvant chemoradiation (nCRT), the landscape shifted with the advent of high-resolution magnetic resonance imaging (MRI), which refined locoregional staging and identified prognostic markers such as extramural venous invasion (EMVI) and mesorectal fascia involvement. Tumor response to therapy, particularly complete clinical response (cCR), enabled organ-preserving strategies like the Watch & Wait approach and transanal local excision. Total neoadjuvant therapy (TNT) emerged as a strategy to improve systemic outcomes, though controversies persist regarding its optimal sequencing and survival benefits. Recent breakthroughs, such as immunotherapy for microsatellite instability-high tumors, demonstrate promising non-surgical management options. Current treatment objectives prioritize personalized approaches based on tumor location, risk factors, and the potential for organ preservation, reflecting a nuanced balance between efficacy, functional outcomes, and patient quality of life.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800145"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192610","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}
Cirugia espanolaPub Date : 2025-08-01DOI: 10.1016/j.cireng.2025.800160
Génesis Parra Eslava , Ana María Sarrión Bosque , Fernando Carvajal López , Natalia Uribe Quintana
{"title":"Implementation of a “minor surgery program in primary care”: Impact on the reduction of the surgical waiting list in a healthcare area","authors":"Génesis Parra Eslava , Ana María Sarrión Bosque , Fernando Carvajal López , Natalia Uribe Quintana","doi":"10.1016/j.cireng.2025.800160","DOIUrl":"10.1016/j.cireng.2025.800160","url":null,"abstract":"<div><h3>Introduction</h3><div>This study analyzes the implementation of a Minor Surgery programme in Primary Care within a healthcare area and its impact on hospital activity indicators.</div></div><div><h3>Materials and methods</h3><div>A clinical training programme was designed for Primary Care professionals. The number of minor procedures performed in Primary Care and in the General Surgery Department was assessed, along with the evolution of hospital activity indicators: average waiting time, mean accumulated delay, and the number of patients on the surgical waiting list.</div></div><div><h3>Results</h3><div>The number of minor procedures in Primary Care increased from 95 in 2022 to 945 in 2024, resulting in a 43.8% reduction in hospital-based minor surgery and a decrease in average waiting time, total delay, and number of patients on the surgical waiting list.</div></div><div><h3>Conclusions</h3><div>The implementation of minor surgery in Primary Care has improved healthcare delivery by increasing its problem-solving capacity and reducing the hospital workload.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800160"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628005","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}
Cirugia espanolaPub Date : 2025-08-01DOI: 10.1016/j.cireng.2025.800110
Andres Montaner , Ines Rubio-Perez
{"title":"Digital tools for the surgeon of today","authors":"Andres Montaner , Ines Rubio-Perez","doi":"10.1016/j.cireng.2025.800110","DOIUrl":"10.1016/j.cireng.2025.800110","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800110"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096195","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}
Cirugia espanolaPub Date : 2025-08-01DOI: 10.1016/j.cireng.2025.800150
Gonzalo de Lucio Usechi, Víctor Echenagusia Serrats, Miriam Tellaeche de la Iglesia, Amaia Martínez Roldán
{"title":"Giant seroma","authors":"Gonzalo de Lucio Usechi, Víctor Echenagusia Serrats, Miriam Tellaeche de la Iglesia, Amaia Martínez Roldán","doi":"10.1016/j.cireng.2025.800150","DOIUrl":"10.1016/j.cireng.2025.800150","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800150"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337353","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}
Cirugia espanolaPub Date : 2025-08-01DOI: 10.1016/j.cireng.2025.800114
Rocío Pérez Quintero , Marcos Bruna Esteban
{"title":"Social media as a professional tool for general surgeons","authors":"Rocío Pérez Quintero , Marcos Bruna Esteban","doi":"10.1016/j.cireng.2025.800114","DOIUrl":"10.1016/j.cireng.2025.800114","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800114"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096180","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}
Cirugia espanolaPub Date : 2025-07-22DOI: 10.1016/j.cireng.2025.800194
Héctor Aguado López, Francisco Javier Ruescas García, Andrés García Marín, Beatriz Aguado Rodríguez
{"title":"Bowel obstruction due to adhesions of the appendix.","authors":"Héctor Aguado López, Francisco Javier Ruescas García, Andrés García Marín, Beatriz Aguado Rodríguez","doi":"10.1016/j.cireng.2025.800194","DOIUrl":"10.1016/j.cireng.2025.800194","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800194"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710304","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}
Cirugia espanolaPub Date : 2025-07-22DOI: 10.1016/j.cireng.2025.800190
Luisa Paola Garzón Hernández, Rosa Martí Fernández, Maria Lapeña Rodríguez, Norberto Cassinello Fernández
{"title":"Patient with hereditary syndrome, pheochromocytoma and paraganglioma type I.","authors":"Luisa Paola Garzón Hernández, Rosa Martí Fernández, Maria Lapeña Rodríguez, Norberto Cassinello Fernández","doi":"10.1016/j.cireng.2025.800190","DOIUrl":"10.1016/j.cireng.2025.800190","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800190"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710307","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}
Cirugia espanolaPub Date : 2025-07-21DOI: 10.1016/j.cireng.2025.800189
Luis Sabater
{"title":"Results audit: Accreditation and certification systems. How do they contribute to continuous improvement?","authors":"Luis Sabater","doi":"10.1016/j.cireng.2025.800189","DOIUrl":"10.1016/j.cireng.2025.800189","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800189"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700652","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}
Cirugia espanolaPub Date : 2025-07-21DOI: 10.1016/j.cireng.2025.800186
Miguel Gili-Miner, Lucas Giner, Enrique Gili-Ortiz, Dolores Franco-Fernández, Juan Luís Cabanillas-Moruno, Gonzalo Germán-Castellani, Luís Béjar-Prado
{"title":"Prevalence of burnout dimensions among general surgeons. A systematic review and meta-analysis.","authors":"Miguel Gili-Miner, Lucas Giner, Enrique Gili-Ortiz, Dolores Franco-Fernández, Juan Luís Cabanillas-Moruno, Gonzalo Germán-Castellani, Luís Béjar-Prado","doi":"10.1016/j.cireng.2025.800186","DOIUrl":"10.1016/j.cireng.2025.800186","url":null,"abstract":"<p><p>Our aim was to summarize global prevalence rates of the burnout subscales emotional exhaustion (EE) and depersonalization (DP) among general surgeons, as well as potential contributing factors. A systematic literature search was performed to identify studies reporting EE and DP prevalence and associated potential stressors. Heterogeneity was assessed by I<sup>2</sup> statistic and tau<sup>2</sup> statistic. We also performed subgroup analysis, meta-regression analysis and funnel plot asymmetry tests. A total of 21 cross-sectional studies were included in this meta-analysis, totaling 3325 subjects. Analysis of EE and DP indicated burnout in 43% and 41% of general surgeons, respectively. The moderators used in the meta-regression analysis did not account for significant heterogeneity. The Egger and Peters tests did not detect publication bias due to small studies. The prevalences of EE and DP in general surgeons are very high, and further studies are needed to clarify the discrepancies observed in certain results.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800186"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700651","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}