Ejso最新文献

英文中文

Ultrasound-guided, indocyanine green-directed robot-assisted surgery for breast cancer with negative margins: A single center study 超声引导、吲哚菁绿定向机器人辅助阴性切缘乳腺癌手术：一项单中心研究

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-02 DOI: 10.1016/j.ejso.2026.111445

Ning Liao , Nanqiu Liu , Guochun Zhang , Chongyang Ren , Weiqi Zhang , Cheukfai Li , Hsiaopei Mok , Fenggui Bie , Zhanhua Wu , Jiyuan Cao , Charles M. Balch

Objective

This pilot study evaluated the feasibility of a novel technique combining ultrasound-guided and indocyanine green (ICG) intra-tumoral injection with robot-assisted surgery to enable accurate local excision (lumpectomy) for breast cancer.

Background

Robot-assisted breast surgery has been used for nipple-sparing mastectomy for breast cancer; however, there are few published data on robot-assisted lumpectomy.

Methods

A novel surgical technique combined intraoperative ultrasound and indocyanine green (ICG) injections was developed to delineate narrow surgical excisions in 63 breast cancer patients by a single surgeon with precisely timed robotic-assisted excision. The surgical margins were assessed pathological with intraoperative frozen section examination. ICG-marked tumor boundaries were identified with clips and later evaluated using permanent sections. All patients underwent postoperative breast irradiation.

Results

The study demonstrated the specific timing with ICG diffusion throughout tumors after 3.3 ± 0.9 min before surgical excision. Total operating time averaged 192.9 ± 28.5 min, including sentinel lymph node biopsy or axillary lymph node dissection when indicated. The robotic lumpectomy component averaged 46.4 ± 10.5 min of console time. Notably, the surgical outcomes were successful with negative margins by frozen section examination in all 63 patients (100%). Analysis of ICG-guided surgical margins by permanent sectioning showed negative pathological margins in 62 of 63 specimens (98.4%).

Conclusion

This surgical study represents one of the first demonstrations of a novel surgical technique with potential to reduce reoperation rates. The technique offers particular advantages for patients with larger, deeper breast tumors, potentially achieving results without visible breast scarring. Although the initial findings from this single institution are promising, multi-institutional studies are needed both the reproducibility of the technique and its long-term oncological outcomes.

目的探讨超声引导下肿瘤内注射吲哚菁绿（ICG）与机器人辅助手术相结合的新技术的可行性，以实现乳腺癌的精确局部切除（乳房肿瘤切除术）。背景：机器人辅助乳房手术已被用于保留乳头的乳腺癌乳房切除术；然而，很少有关于机器人辅助乳房肿瘤切除术的公开数据。方法采用一种新的手术技术，结合术中超声和吲哚菁绿（ICG）注射，在精确定时机器人辅助下对63例乳腺癌患者进行手术切除。术中冰冻切片检查手术边缘的病理情况。用夹子确定icg标记的肿瘤边界，然后用永久切片评估。所有患者术后均行乳房放疗。结果观察到ICG在手术前3.3±0.9 min扩散到肿瘤的具体时间。总手术时间平均为192.9±28.5 min，包括前哨淋巴结活检或腋窝淋巴结清扫。机器人乳房肿瘤切除术组件的平均控制时间为46.4±10.5 min。值得注意的是，所有63例患者的冷冻切片检查结果均为阴性，手术结果均成功（100%）。icg引导下手术边缘永久切片分析显示63例标本中62例（98.4%）病理边缘呈阴性。结论：这项外科研究首次证明了一种新的外科技术具有降低再手术率的潜力。这项技术对较大、较深的乳房肿瘤患者尤其有利，有可能实现没有可见乳房疤痕的效果。虽然这个单一机构的初步发现很有希望，但需要多机构的研究来验证该技术的可重复性及其长期的肿瘤学结果。

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引用次数: 0

Ethnicity and breast cancer incidence in over 329 500 women in England in 2011–2019 2011-2019年，英格兰超过329,500名女性的种族和乳腺癌发病率。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.109585

Gathani T. , Kan S.W. , Sweetland S. , Reeves G.K.

Introduction

Previous studies have reported an overall lower breast cancer incidence in women from Asian and Black backgrounds compared with white women. Age standardised and age specific incidence rates in the largest specific ethnicities within Asian and Black groups are not reported.

Materials and methods

Data on population size and the age distribution of women in five ethnic groups of interest (white British, Black African, Black Caribbean, Indian and Pakistani) were extracted from the Office for National Statistics 2001, 2011 and 2021 census data for England.

Cancer registrations for invasive breast cancer (ICD-10 C50) in women in England aged ≥25 years during 2011–2019 with a recorded ethnicity were extracted from the National Cancer Registration and Analysis Service.

Age standardised (ASIRs) and age specific (ASRs) incidence rates in five ethnic groups of interest were calculated.

Results

329 655 women who were aged ≥25 years and in one of the five ethnic groups of interest had a record of an incident C50 cancer registration during 2011–2019. The ASIR was highest for white women (199.6 (95 % CI 198.9–200.3)), and lowest for Black African women (118.2 (95 % CI 111.6–125.1)). The ASRs for invasive breast cancer were generally lower in women from minority ethnic groups compared to white women in all age groups examined except for younger Black Caribbean women.

Conclusions

There are significant differences in breast cancer incidence rates between women from specific ethnicities. This requires further investigation in large scale prospective studies considering potential differences by ethnicity in known risk factors for breast cancer.

先前的研究报道，与白人女性相比，亚洲和黑人女性的乳腺癌发病率总体较低。亚洲和黑人群体中最大的特定种族的年龄标准化和年龄特定发病率未见报告。材料和方法：从英国国家统计局2001年、2011年和2021年的人口普查数据中提取了五个感兴趣的种族群体（英国白人、非洲黑人、加勒比黑人、印度人和巴基斯坦人）的人口规模和妇女年龄分布数据。从国家癌症登记和分析服务中提取了2011-2019年期间英格兰年龄≥25岁的女性浸润性乳腺癌（icd - 10c50）的癌症登记，并记录了种族。计算5个感兴趣民族的年龄标准化（asir）和年龄特异性（ASRs）发病率。结果：329,655名年龄≥25岁且属于五个感兴趣的种族之一的女性在2011-2019年期间有C50癌症事件登记记录。白人妇女的ASIR最高（199.6 (95% CI 198.9-200.3)），非洲黑人妇女最低（118.2 (95% CI 111.6-125.1)）。除年轻的加勒比黑人妇女外，在所有被检查的年龄组中，少数族裔妇女的浸润性乳腺癌的asr一般低于白人妇女。结论：不同种族女性的乳腺癌发病率存在显著差异。这需要在大规模的前瞻性研究中进行进一步的调查，考虑到乳腺癌已知危险因素在种族上的潜在差异。

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引用次数: 0

Women as surgical leaders: from fixing women to fixing systems 女性作为外科领导者：从修复女性到修复系统。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.110433

I.T. Rubio , L. Pitoni

Advancing women in surgical leadership has traditionally focused on individual adaptation, mentorship, resilience, and personal skills rather than addressing systemic barriers. Despite improvements in awareness, representation, and support networks, meaningful change remains limited due to persistent institutional biases, structural constraints, and cultural norms. Female surgeons face additional challenges related to recruitment, mentorship, research access, and work-life integration, particularly around motherhood, which can penalize career progression even in supportive systems. Leadership programs and sponsorship opportunities remain unevenly available, and formal recognition of mentorship and informal leadership roles is often lacking. True transformation requires shifting from “fixing women” to “fixing systems” through formal leadership curricula, institutional accountability, and measurable outcomes. By empowering women to actively shape culture rather than merely navigate it, surgery can achieve female leadership that is inclusive, effective, and equitable. Addressing these challenges demands a collective responsibility of surgical societies, academic centers, and hospital leadership to foster structural reform, recognize diverse career trajectories, and cultivate visible female role models.

传统上，提高女性在外科领导方面的地位侧重于个人适应、指导、恢复力和个人技能，而不是解决系统性障碍。尽管意识、代表性和支持网络有所改善，但由于持续存在的制度偏见、结构约束和文化规范，有意义的变革仍然有限。女外科医生在招聘、指导、研究获取和工作与生活的整合方面面临着额外的挑战，特别是在母性方面，即使在支持系统中，这些挑战也会阻碍职业发展。领导力项目和赞助机会仍然不均衡，对导师和非正式领导角色的正式认可往往缺乏。真正的转型需要通过正式的领导力课程、机构问责制和可衡量的成果，从“修复女性”转向“修复系统”。通过赋予女性积极塑造文化的权力，而不仅仅是驾驭文化，外科手术可以实现包容、有效和公平的女性领导。应对这些挑战需要外科学会、学术中心和医院领导层共同承担责任，促进结构改革，认识到多样化的职业轨迹，并培养可见的女性榜样。

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引用次数: 0

Breaking the scalpel ceiling: Persistent barriers faced by female surgeons in modern surgical practice 打破手术刀天花板：女性外科医生在现代外科实践中面临的持续障碍。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.110423

Adele Ketley , Jenna Morgan

Despite female medical students and newly qualifying doctors now outnumbering males, surgery remains a male-dominated specialty. Whilst numbers of female within surgical specialties continue to rise, they still lag behind other specialties, even though women have equivalent or better surgical outcomes than their male counterparts. Reasons for this under representation are multifactorial, but include historic cultural issues, lack of representation, sexism, misogyny, sexual misconduct and challenges with pregnancy and childcare, that disproportionally affect female surgeons. Cancer surgery has traditionally been male dominated, often involving complex, lengthy surgery and is often a very competitive career. However, the data suggests that female surgeons have greater empathy, sensitivity and communication skills, which are assets in this often emotionally charged area of practice. This article presents an overview of these issues and calls for systemic reform and a cultural shift in surgical specialties to address these barriers.

尽管女医科学生和新获得资格的医生的数量现在超过了男性，但外科仍然是男性主导的专业。虽然女性在外科专业的人数持续上升，但她们仍然落后于其他专业，即使女性的手术效果与男性相当或更好。造成这种情况的原因是多方面的，但包括历史文化问题、缺乏代表性、性别歧视、厌女症、性行为不端以及怀孕和育儿方面的挑战，这些都对女外科医生造成了不成比例的影响。传统上，癌症手术以男性为主，通常涉及复杂、漫长的手术，而且往往是一个竞争非常激烈的职业。然而，数据表明，女性外科医生有更强的同理心、敏感度和沟通技巧，这些在这个经常充满情感的领域都是宝贵的资产。本文概述了这些问题，并呼吁系统改革和外科专业的文化转变，以解决这些障碍。

引用次数: 0

Women in surgical academic Careers: What is needed to get there? 从事外科学术事业的女性：需要什么才能达到这个目标？

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.111366

A. Bosman , W.H. Schreurs , M.L. Smidt

Despite comprising the majority of medical students, women remain significantly underrepresented in senior academic surgical positions. In the Netherlands, only 15.6 % of surgical professors are female. This article examines cultural and structural barriers, including unequal access to networks, underrepresentation on editorial boards, academic “housework,” implicit bias, and unequal caregiving responsibilities, that hinder women's advancement in academic surgery.

Targeted interventions such as mentorships, flexible work policies, salary transparency, and gender-conscious recruitment (e.g., Eindhoven University of Technology's preferential hiring strategy) have shown promise in promoting equity without compromising academic output. The “critical mass” threshold of 28 % female representation emerges as a tipping point for cultural change.

Achieving gender equity in academic surgery requires both systemic reform and cultural transformation to ensure equal opportunity, career sustainability, and inclusive institutional environments.

尽管妇女占医学生的大多数，但在外科高级学术职位上的人数仍然明显不足。在荷兰，只有15.6%的外科教授是女性。本文探讨了阻碍女性在学术外科领域进步的文化和结构性障碍，包括进入网络的不平等、编辑委员会的代表性不足、学术“家务”、隐性偏见和不平等的护理责任。有针对性的干预措施，如导师制、灵活的工作政策、工资透明度和有性别意识的招聘（例如埃因霍温理工大学的优先招聘策略），在不影响学术产出的情况下促进了公平。28%女性代表的“临界质量”门槛成为文化变革的转折点。实现学术外科领域的性别平等需要系统改革和文化转型，以确保机会平等、职业可持续性和包容性的机构环境。

引用次数: 0

Advert ESSO Congress 2026 广告ESSO大会2026

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/S0748-7983(26)00048-X

引用次数: 0

Women surgeons: Are they Better?: Narrative review 女外科医生：她们更好吗？：叙事回顾。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.110421

Natsumi Saka , Jun Watanabe

Surgery has historically been a male-dominated field; however, the representation of female surgeons has steadily increased, necessitating a comprehensive review of comparative performance. This narrative review synthesises recent literature to evaluate male and female surgeons across several key domains: technical skills, non-technical abilities, patient outcomes, and academic contributions.

In terms of technical skills, research presents nuanced findings. While some studies suggest a potential male advantage in visuospatial skills, other evidence indicates that these initial differences can be mitigated or eliminated through dedicated training and prior experience with activities such as video games. Conversely, female surgeons consistently demonstrate superior manual dexterity. In non-technical areas, female surgeons consistently receive higher patient scores for communication, including providing clear explanations, listening attentively, and dedicating sufficient time during consultations.

The literature on patient outcomes is complex and sometimes contradictory. Several large-scale observational studies and meta-analyses have reported a small but statistically significant reduction in mortality for patients treated by female surgeons, whereas other research has found no such association.

Despite these findings, female surgeons remain underrepresented in senior academic and organisational leadership roles, with persistent disparities in departmental chair positions and grant funding. This gap is not necessarily attributable to a lack of productivity but rather to insufficient mentorship and institutional support. The evidence highlights that individual qualities and training are more significant than gender, although persistent systemic biases continue to pose challenges to female surgeons’ career advancement and patient trust. Addressing these prejudices is essential to fostering a safe and equitable environment for all.

外科手术历来是男性主导的领域；然而，女外科医生的代表性稳步增加，有必要对比较表现进行全面审查。这篇叙述性综述综合了最近的文献来评估男性和女性外科医生在几个关键领域：技术技能、非技术能力、患者预后和学术贡献。在技术技能方面，研究提出了细微的发现。虽然一些研究表明男性在视觉空间技能上有潜在的优势，但其他证据表明，通过专门的训练和之前的视频游戏等活动经验，这些最初的差异可以减轻或消除。相反，女性外科医生一贯表现出更强的手灵巧性。在非技术领域，女外科医生在沟通方面的得分一直较高，包括提供清晰的解释、认真倾听、在会诊期间投入足够的时间。关于患者预后的文献是复杂的，有时甚至是矛盾的。几项大规模观察性研究和荟萃分析报告称，女性外科医生治疗的患者死亡率虽小但在统计学上有显著降低，而其他研究则没有发现这种关联。尽管有这些发现，女性外科医生在高级学术和组织领导角色中的比例仍然不足，在部门主席职位和拨款方面存在持续的差异。这种差距不一定是由于缺乏生产力，而是由于缺乏指导和体制支持。尽管持续存在的系统性偏见继续对女外科医生的职业发展和患者信任构成挑战，但证据表明，个人素质和培训比性别更重要。消除这些偏见对于为所有人创造安全和公平的环境至关重要。

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引用次数: 0

Ethnicity and breast cancer incidence in over 329,500 women in England in 2011-2019. 2011-2019年，英格兰超过329500名女性的种族和乳腺癌发病率。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2025.109585

T Gathani, S W Kan, S Sweetland, G K Reeves

Introduction: Previous studies have reported an overall lower breast cancer incidence in women from Asian and Black backgrounds compared with white women. Age standardised and age specific incidence rates in the largest specific ethnicities within Asian and Black groups are not reported.

Materials and methods: Data on population size and the age distribution of women in five ethnic groups of interest (white British, Black African, Black Caribbean, Indian and Pakistani) were extracted from the Office for National Statistics 2001, 2011 and 2021 census data for England.Cancer registrations for invasive breast cancer (ICD-10 C50) in women in England aged ≥25 years during 2011-2019 with a recorded ethnicity were extracted from the National Cancer Registration and Analysis Service.Age standardised (ASIRs) and age specific (ASRs) incidence rates in five ethnic groups of interest were calculated.

Results: 329,655 women who were aged ≥25 years and in one of the five ethnic groups of interest had a record of an incident C50 cancer registration during 2011-2019. The ASIR was highest for white women (199.6 (95% CI 198.9-200.3)), and lowest for Black African women (118.2 (95% CI 111.6-125.1)). The ASRs for invasive breast cancer were generally lower in women from minority ethnic groups compared to white women in all age groups examined except for younger Black Caribbean women.

Conclusions: There are significant differences in breast cancer incidence rates between women from specific ethnicities. This requires further investigation in large scale prospective studies considering potential differences by ethnicity in known risk factors for breast cancer.

先前的研究报道，与白人女性相比，亚洲和黑人女性的乳腺癌发病率总体较低。亚洲和黑人群体中最大的特定种族的年龄标准化和年龄特定发病率未见报告。材料和方法：从英国国家统计局2001年、2011年和2021年的人口普查数据中提取了五个感兴趣的种族群体（英国白人、非洲黑人、加勒比黑人、印度人和巴基斯坦人）的人口规模和妇女年龄分布数据。从国家癌症登记和分析服务中提取了2011-2019年期间英格兰年龄≥25岁的女性浸润性乳腺癌（icd - 10c50）的癌症登记，并记录了种族。计算5个感兴趣民族的年龄标准化（asir）和年龄特异性（ASRs）发病率。结果：在2011-2019年期间，329655名年龄≥25岁且属于五个感兴趣的种族之一的女性有C50癌症事件登记记录。白人妇女的ASIR最高（199.6 (95% CI 198.9-200.3)），非洲黑人妇女最低（118.2 (95% CI 111.6-125.1)）。除年轻的加勒比黑人妇女外，在所有被检查的年龄组中，少数族裔妇女的浸润性乳腺癌的asr一般低于白人妇女。结论：不同种族女性的乳腺癌发病率存在显著差异。这需要在大规模的前瞻性研究中进行进一步的调查，考虑到乳腺癌已知危险因素在种族上的潜在差异。

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引用次数: 0

52.02 ESSO Announcement 52.02它说明了这一点

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2026.111414

引用次数: 0

Advert ESSO Hands-on Course on Liver Surgery 埃索肝脏外科实践课程

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-02-01 DOI: 10.1016/j.ejso.2026.111440

引用次数: 0

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