Cirugia espanolaPub Date : 2024-12-17DOI: 10.1016/j.cireng.2024.11.010
Javier García Septiem, Alba Correa Bonito
{"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}
Cirugia espanolaPub Date : 2024-12-01DOI: 10.1016/j.cireng.2024.08.001
Juli Busquets , Luis Secanella , Thiago Carnaval , Maria Sorribas , Mónica Serrano-Navidad , Esther Alba , Elena Escalante , Sandra Ruiz-Osuna , Núria Peláez , Juan Fabregat
{"title":"Embolize, supercharge, resect: Embolization to enhance hepatic vascularization prior to en-bloc pancreas and arterial resection","authors":"Juli Busquets , Luis Secanella , Thiago Carnaval , Maria Sorribas , Mónica Serrano-Navidad , Esther Alba , Elena Escalante , Sandra Ruiz-Osuna , Núria Peláez , Juan Fabregat","doi":"10.1016/j.cireng.2024.08.001","DOIUrl":"10.1016/j.cireng.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Embolization could increase the resectability of pancreatic tumors by supercharging visceral arterial perfusion prior to pancreatic surgery with arterial <em>en-bloc</em> resection. Its indications, however, are controversial.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the results of a single-center database of patients undergoing pancreatic surgery with arterial resection (AR) after preoperative arterial embolization (PAE) to increase hepatic vascular flow and spare arterial reconstruction.</div></div><div><h3>Results</h3><div>PAE was planned in 15 patients with arterial involvement due to pancreatic tumors. Three patients were excluded due to the finding of irresectable disease during surgery. Twelve cases were resected because of pancreatic cancer (10), distal cholangiocarcinoma (1), and pancreatic neuroendocrine tumor (1). Arterial involvement in these cases required embolization of the substitute right hepatic artery (RHA) (5), left hepatic artery (1), and common hepatic artery (CHA) (6) to enhance liver vascularization. Two patients presented migration of the vascular plug after PAE. Six pancreatoduodenectomies and 6 distal pancreatectomies were performed, the latter associated with <em>en-bloc</em> celiac trunk and CHA resection. R0 was achieved in 7 out of 12 patients, and pathological vascular involvement was confirmed in 8. Postoperative complications included one patient who developed gastric ischemia and underwent gastrectomy, and one patient who underwent reoperation for acute cholecystitis with liver abscesses.</div></div><div><h3>Conclusion</h3><div>Preoperative arterial embolization before pancreatic surgery with hepatic arterial resection enables surgeons to precondition hepatic vascularization and prevent hepatic ischemia. In addition, this avoids having to perform arterial anastomosis in the presence of pancreatic suture.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 12","pages":"Pages 633-641"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303397","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 : 2024-12-01DOI: 10.1016/j.cireng.2024.09.011
Tamara Fernández-Miguel , Óscar Cano-Valderrama , Marta Paniagua García-Señorans , Alba Correa Bonito , Emilio Peña Ros , María Luisa Reyes-Díaz , Carlos Cerdán-Santacruz
{"title":"Specific training in coloproctology: cross-sectional cohort study through the Young Group of the Spanish Association of Coloproctology","authors":"Tamara Fernández-Miguel , Óscar Cano-Valderrama , Marta Paniagua García-Señorans , Alba Correa Bonito , Emilio Peña Ros , María Luisa Reyes-Díaz , Carlos Cerdán-Santacruz","doi":"10.1016/j.cireng.2024.09.011","DOIUrl":"10.1016/j.cireng.2024.09.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Specific training at surgical super-specialities and its objective evaluation is a challenge nowadays in order to measure the potential benefits that it might add.</div></div><div><h3>Material and methods</h3><div>An online survey addressed by the “Grupo Joven de la Asociación Española de Coloproctología” has been performed in order to evaluate the level of formation achieved specifically at colorectal surgery.</div></div><div><h3>Results</h3><div>128 surgeons participated, representing 81 colorectal surgery units. Mean satisfaction after the period of formation was moderate to high in 84% of the ones polled. The main points of improvement were the realization of advanced surgical techniques (52%) and academic questions (45%). The big part of the respondents has performed simple proctologic procedures (98%) and oncological open colic resections (100%) during their training period, observing the scarcity of related pelvic floor procedures (20%) and diagnosis techniques (10–45%). Scientific production (31,5%) and presentation of studies at congresses (82,8%) have been moderated. No differences between accredited units and non-accredited units have been observed.</div></div><div><h3>Conclusions</h3><div>Specific formation in colorectal surgery is appropriate, with a high level of simple procedures and open surgery performed by personal at formation. In view of these results, it seems logical to think that even though is necessary a progress in the formation of minimal invasive and diagnosis techniques.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 12","pages":"Pages 658-666"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483164","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 : 2024-12-01DOI: 10.1016/j.cireng.2024.04.016
Marina Iniesta-Sepúlveda , Antonio Ríos
{"title":"Assessing the risk of bias in studies included in systematic reviews and meta-analyses","authors":"Marina Iniesta-Sepúlveda , Antonio Ríos","doi":"10.1016/j.cireng.2024.04.016","DOIUrl":"10.1016/j.cireng.2024.04.016","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 12","pages":"Pages 672-674"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056569","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 : 2024-12-01DOI: 10.1016/j.cireng.2024.09.007
Xi He , Xiaofeng Zhang , Zhijie Li , Xiaofeng Niu, Lixin Li, Zhenwen Liu, Hui Ren, Dali Zhang
{"title":"Total bile acid as a preoperative risk factor for post-hepatectomy liver failure in patients with hepatocellular carcinoma and normal bilirubin","authors":"Xi He , Xiaofeng Zhang , Zhijie Li , Xiaofeng Niu, Lixin Li, Zhenwen Liu, Hui Ren, Dali Zhang","doi":"10.1016/j.cireng.2024.09.007","DOIUrl":"10.1016/j.cireng.2024.09.007","url":null,"abstract":"<div><h3>Background and aims</h3><div>Total bile acid (TBA) is associated with portal hypertension, a risk factor for post-hepatectomy liver failure (PHLF). We conducted this study to clarify whether TBA is also associated with PHLF in patients with hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>We recruited patients with HCC and Child-Pugh class A, who underwent liver resection, and applied multivariate analyses to identify risk factors for PHLF.</div></div><div><h3>Results</h3><div>We analyzed data from 154 patients. The prevalence of PHLF was 14.3%. The median maximum tumor diameter was 5.1 cm (2.9–6.9 cm). The proportions of patients with elevated TBA levels (<em>P</em> = 0.001), severe albumin-bilirubin (AIBL) grades (<em>P</em> = 0.033), and low platelet counts (<em>P</em> = 0.031) were significantly higher within the subgroup of patients with PHLF than in the subgroup without PHLF. The multivariate analysis results suggest that TBA level (OR, 1.08; 951.03–1.14; <em>P</em> = 0.003) and MRI tumor diameter (OR, 1.17; 95% CI, 1.01–1.35; <em>P</em> = 0.038) are independent preoperative risk factors for PHLF. The TBA levels correlated with the indocyanine green retention rate at 15 minutes (<em>P</em> = 0.001) and the effective hepatic blood flow (<em>P</em> < 0.001), two markers of portal hypertension. However, TBA levels did not correlate with tumor diameter (<em>P</em> = 0.536).</div></div><div><h3>Conclusions</h3><div>Compared to ICG R15 and AIBL score, preoperative TBA was risk factor for PHLF in Chinese patients with HCC, and it may impact PHLF through its potential role as a marker of portal hypertension.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 12","pages":"Pages 642-648"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407384","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}