Cirugia espanola最新文献_第4页

Ethical challenges of technological progress in surgery. 外科技术进步的伦理挑战。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800382

Julio Mayol

引用次数: 0

What is an ethical problem? How can I identify if I have an ethical problem? 什么是道德问题？我如何识别自己是否有道德问题？

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800383

Benjamín Herreros

引用次数: 0

Deficiencies in preoperative CT staging reports for colon cancer: A national survey of colorectal surgeons 结肠癌术前CT分期报告的不足：一项全国结直肠外科医生调查。

Cirugia espanola Pub Date : 2026-09-01 Epub Date: 2026-07-22 DOI: 10.1016/j.cireng.2026.800366

Sergio García-Hernández, Álvaro García-Granero, Sebastián Jerí-McFarlane, Noemí Torres-Marí, Margalida Campaner-Payeras, Juan Díaz-Ferrando, Margarita Gamundí-Cuesta, Francisco Javier González-Argente

{"title":"Deficiencies in preoperative CT staging reports for colon cancer: A national survey of colorectal surgeons","authors":"Sergio García-Hernández, Álvaro García-Granero, Sebastián Jerí-McFarlane, Noemí Torres-Marí, Margalida Campaner-Payeras, Juan Díaz-Ferrando, Margarita Gamundí-Cuesta, Francisco Javier González-Argente","doi":"10.1016/j.cireng.2026.800366","DOIUrl":"10.1016/j.cireng.2026.800366","url":null,"abstract":"<div><h3>Aim</h3><div>To identify the main deficiencies in preoperative staging reports using computed tomography (CT) in colon cancer and to assess their impact on surgical planning as well as the need for a national standardized radiological protocol.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted using a national survey of colorectal surgeons, members of the Young Group of the Spanish Association of Coloproctology (GJ-AECP). The anonymous and voluntary survey included 30 items organized into 8 domains related to tumor staging by CT: location and T stage, lymph node involvement, tumor deposits, anatomical lymph node territories, vascular landmarks, surgical planning, standards of radiological practice, and the use of 3D reconstruction and standardized protocols. The results were analyzed descriptively.</div></div><div><h3>Results</h3><div>Forty-six surgeons from 37 Spanish hospitals responded. Although tumor location was reported in 84.8% of cases, the T stage was not mentioned in 45.7%, and the differentiation between T4a and T4b was omitted in 56.5%. Retroperitoneal fascial infiltration was not reported in 30.4%. While lymphadenopathy was routinely described, the number of lymph nodes and affected stations were detailed in only 58.7% and 19.6% of cases, respectively. Tumor deposits were omitted in 56.5%. The description of specific lymph node territories and key vascular landmarks was exceptionally low. Only 10.9% of centers had a structured CT staging protocol.</div></div><div><h3>Conclusions</h3><div>Preoperative CT reports in colon cancer have significant shortcomings that limit their usefulness for surgical planning. There is an urgent need to implement a standardized national radiology reporting protocol tailored to the surgical requirements of oncology.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 9","pages":"Article 800366"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563917","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 of implementing an Integrated Care Area for frail patients requiring surgery. 413 patients: Short and long-term postoperative morbidity and quality of life 对需要手术的虚弱病人实施综合护理区的结果。413例患者：术后短期和长期发病率及生活质量。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800381

Jordi Castellví Valls, Amparo Rodríguez, Lucía Gil, Julia Pareja, Sira García, Elisenda Pujol, Esther Sotelo, Lluís Pascual, Jesús Badía, Isidre Martí

{"title":"Results of implementing an Integrated Care Area for frail patients requiring surgery. 413 patients: Short and long-term postoperative morbidity and quality of life","authors":"Jordi Castellví Valls, Amparo Rodríguez, Lucía Gil, Julia Pareja, Sira García, Elisenda Pujol, Esther Sotelo, Lluís Pascual, Jesús Badía, Isidre Martí","doi":"10.1016/j.cireng.2026.800381","DOIUrl":"10.1016/j.cireng.2026.800381","url":null,"abstract":"<div><h3>Introduction</h3><div>The objective was to analyse the functioning and short and long-term outcomes of an Integrated Care Area for frail patients requiring surgery.</div></div><div><h3>Methods</h3><div>Observational, descriptive study with prospective data collection. From December 2016 to January 2025, 413 frail patients were included in an Integrated Care Area for the Complex Surgical Patient (AAPQC for its initials in Spanish). Age, sex, referring service, ASA, frailty index (VGI-Frail and Clinical Frailty scale), Barthel, Pfeiffer, Complex Chronic Patient (PCC), and Advanced Chronic care Model (MACA) were analysed. Operated and non-operated patients were compared. Complications (Clavien-Dindo), mean length of stay, 30-day mortality, readmissions, and quality of life at 3 months and one year were evaluated.</div></div><div><h3>Results</h3><div>413 patients, mean age 80 years, 251 men (60.8%). 91.8% were ASA III-IV, 219 (53%) PCC and 61 (14.8%) MACA. 321 (77.6%) came from general surgery. 7.3% lived in care facilities. 125 (30.3%) were recommended not to undergo surgery. Age, ASA, PCC, MACA, VGI-frail, Clinical Frailty Score, Barthel and Pfeiffer were significantly (<em>P</em> < 0.0001) better in those operated. Postoperative complications (Clavien-Dindo III-IV-V), readmissions and mortality were 9.7%, 13.2% and 3.1% respectively. 10% required convalescence resources at discharge. 82.5% of operated patients were better or the same as before surgery at three months and one year. Of those not operated (<em>n</em> = 125), 48.3% died during the first year.</div></div><div><h3>Conclusions</h3><div>The establishment of an Integrated Care Area for frail patients requiring surgery facilitates decision-making and reduces postoperative morbidity with acceptable quality of life.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 9","pages":"Article 800381"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876790","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

Liver transplantation training and career interest among residents in related specialties: A national survey 肝移植培训与相关专业住院医师职业兴趣：一项全国性调查。

Cirugia espanola Pub Date : 2026-09-01 Epub Date: 2026-07-22 DOI: 10.1016/j.cireng.2026.800365

Gerardo Blanco-Fernández, Isabel Campos-Varela, Sara Lorente, Sonia Pascual, Patricia Ruiz, Gloria Sánchez-Antolín, Maria Trapero-Marugán, Laura Lladó

{"title":"Liver transplantation training and career interest among residents in related specialties: A national survey","authors":"Gerardo Blanco-Fernández, Isabel Campos-Varela, Sara Lorente, Sonia Pascual, Patricia Ruiz, Gloria Sánchez-Antolín, Maria Trapero-Marugán, Laura Lladó","doi":"10.1016/j.cireng.2026.800365","DOIUrl":"10.1016/j.cireng.2026.800365","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver transplantation (LT) is a demanding and highly specialized procedure requiring coordination among different specialists. Ensuring that future professionals acquire the necessary expertise is essential, yet a career in LT is often perceived by residents as inaccessible or unattractive. In Spain, LT training is not systematically integrated into residency programs. This study aimed to explore the training experiences, motivations and perceptions of medical residents from LT-related specialties.</div></div><div><h3>Methods</h3><div>A working group from the Spanish Society of Liver Transplantation (SETH) designed an online survey assessing demographics, LT exposure and attitudes toward LT, including perceptions of workload, burnout and motivation to pursue a future career in LT. The survey was sent through national scientific societies to residents in general and digestive surgery, gastroenterology, internal medicine and anesthesiology.</div></div><div><h3>Results</h3><div>A total of 280 residents completed the survey (60.3% women). Most respondents (62.1%) trained at hospitals with an LT program, as LT training is significantly more common at these hospitals than at hospitals without LT programs (86.8% vs 41.5%; <em>P</em> < .001). Only 14.6% considered it an accessible career path. Although 38.2% expressed interest in pursuing a career in LT, 86.9% viewed it as difficult to achieve. The main disincentives were poor work–life balance and frequent night shifts.</div></div><div><h3>Conclusions</h3><div>LT training among Spanish residents remains inconsistent and largely unstructured. Despite recognizing its prestige and educational value, residents perceive LT as demanding and inaccessible. Establishing standardized LT training and offering targeted incentives may help attract future specialists to this critical field.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 9","pages":"Article 800365"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Failure to rescue after oesophagectomy. The importance of recording complications. A 20-year retrospective study 食管切除术后抢救失败。记录并发症的重要性。一项20年的回顾性研究。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800376

Silvia Carbonell-Morote, Miriam Menéndez-Jiménez, Marcos Bruna.Esteban, Roberto Adriano Castro, Fabián Velázquez-Rebosa, Inmaculada Mesa Ruiz, Javier Vaqué, Fernando Mingol-Navarro

{"title":"Failure to rescue after oesophagectomy. The importance of recording complications. A 20-year retrospective study","authors":"Silvia Carbonell-Morote, Miriam Menéndez-Jiménez, Marcos Bruna.Esteban, Roberto Adriano Castro, Fabián Velázquez-Rebosa, Inmaculada Mesa Ruiz, Javier Vaqué, Fernando Mingol-Navarro","doi":"10.1016/j.cireng.2026.800376","DOIUrl":"10.1016/j.cireng.2026.800376","url":null,"abstract":"<div><h3>Background</h3><div>Oesophageal cancer is a rare type of neoplasm in Western countries, yet it ranks as the seventh leading cause of death. Due to its anatomical location, oesophageal surgery is a highly complex procedure. The morbidity and mortality associated with oesophagectomy are significant, highlighting the need for a multidisciplinary approach to minimise complications. The measure of failure to rescue (FTR) reflects surgical outcomes and indicates the capacity to prevent death after a major complication (MC). It serves as a valuable metric for comparing results among different medical centers.</div></div><div><h3>Objective</h3><div>To evaluate the failure to rescue rate following esophagectomy at a high-volume tertiary oesophageal surgery center.</div></div><div><h3>Methods</h3><div>This retrospective study analysed FTR, mortality, and morbidity rates following oesophageal surgery from 2003 to 2024. Preoperative, intraoperative, and postoperative variables were assessed across patient groups. Comorbidities were evaluated using the ASA score, and complications were classified according to the Clavien-Dindo classification.</div></div><div><h3>Results</h3><div>268 patients underwent oesophagectomy during the period of study. 129 (48%) experienced MC. Among these, 25 patients died within the first 90 days after surgery: FTR rate of 19.3%. Univariate and multivariate logistic regression analyses identified respiratory complications, including pneumonia and adult respiratory distress syndrome, as independent factors associated with FTR.</div></div><div><h3>Conclusion</h3><div>Respiratory complications are identified as the most significant risk factor for FTR following oesophagectomy.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 9","pages":"Article 800376"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876560","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

Migration of a self-expandable esophageal stent to the small bowel 自膨胀食管支架向小肠的迁移。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800371

Lucía Hernández Ramos, Begoña Pastor Costa, María Teresa Soriano Palao, David Ruiz de Angulo Martín

引用次数: 0

Gastric cancer presenting as an infiltrative retroperitoneal mass. 胃癌表现为浸润性腹膜后肿块。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800384

Lucía Picón Salcedo, María Luisa García García, José Antonio Martínez Torralba, Victoriano Soria Aledo

引用次数: 0

Models of clinical ethics advice: Ethics committees and consultants. 临床伦理咨询模式：伦理委员会和顾问。

Cirugia espanola Pub Date : 2026-09-01 DOI: 10.1016/j.cireng.2026.800379

Diego Real de Asúa

引用次数: 0

Rectal adenocarcinoma coexisting with endometrioid carcinoma arising from pelvic endometriotic foci: en bloc laparoscopic resection 盆腔子宫内膜异位灶引起的直肠腺癌合并子宫内膜样癌：整体腹腔镜切除。

Cirugia espanola Pub Date : 2026-09-01 Epub Date: 2026-05-20 DOI: 10.1016/j.cireng.2026.800352

Candela Echezarreta, María Florencia Sánchez, Pedro Vicente Uad, Esteban González Salazar

引用次数: 0