Pub Date : 2025-02-04DOI: 10.23736/S2724-5691.24.10650-8
Minglu Sun, Yuxin Hou, Yinyan Li
{"title":"True or false malignant features on breast mass lesions.","authors":"Minglu Sun, Yuxin Hou, Yinyan Li","doi":"10.23736/S2724-5691.24.10650-8","DOIUrl":"https://doi.org/10.23736/S2724-5691.24.10650-8","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.23736/S2724-5691.24.10660-0
Yuyan Cao, Yingchun LE, Xiaofang Tan, Baoqin Lu, Yongqiang Xia, Wenjing Sun
{"title":"Comparison of effects of breast-conserving surgery and modified radical surgery on complications and survival prognosis of patients with breast cancer.","authors":"Yuyan Cao, Yingchun LE, Xiaofang Tan, Baoqin Lu, Yongqiang Xia, Wenjing Sun","doi":"10.23736/S2724-5691.24.10660-0","DOIUrl":"https://doi.org/10.23736/S2724-5691.24.10660-0","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.23736/S2724-5691.24.10743-5
Manli DU, Junrong Tang, Wen Sun
{"title":"Enhancing postoperative care and nursing education through internet-based continuity of care for surgical patients.","authors":"Manli DU, Junrong Tang, Wen Sun","doi":"10.23736/S2724-5691.24.10743-5","DOIUrl":"https://doi.org/10.23736/S2724-5691.24.10743-5","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.23736/S2724-5691.25.10731-4
Pier Paolo Brollo, Tommaso Stecca, Adriana DI Giacomo, Marco Massani, Vittorio Bresadola
Introduction: At present, harvesting more lymph nodes is considered more conducive to the prognosis of colorectal cancer surgery. The recent development of enhanced surgical visualization has led to the wide employment of indocyanine green (ICG) to assist minimally invasive surgery. This systematic review aims to provide a wide and critical overview of the current state of the art of ICG lymphography during rectal surgery, by focusing on the most relevant literature on this topic.
Evidence acquisition: After validation and registration in the PROSPERO international prospective register of systematic reviews on the 5th May 2024 (ID: CRD42024539426), 8 publications have been considered relevant for the research query and have been divided into two groups: lateral pelvic lymph node dissection (LPLND) and lateral pelvic sentinel lymph node biopsy (LPSLNB). A meta-analysis has not been performed due to the low statistical significance.
Evidence synthesis: ICG lymphography seems to improve the number of harvested lateral pelvic lymph nodes, to reduce intraoperative blood loss and hospital length of stay during LPLND. In LPSLNB the detection rate of lateral pelvic sentinel lymph nodes ranged from 91.3% to 92%.
Conclusions: ICG lymphography for fluorescence guidance for LLND is a feasible and safe technique, with promising application in terms of the number of harvested lymph nodes and post-operative outcomes improvement during rectal oncological surgery. As some of these benefits have been already suggested by the current literature, they need to be confirmed in larger and randomized clinical.
{"title":"Near-infrared imaging with indocyanine green fluorescence for intraoperative lymphatic assessment in rectal cancer surgery: a systematic review.","authors":"Pier Paolo Brollo, Tommaso Stecca, Adriana DI Giacomo, Marco Massani, Vittorio Bresadola","doi":"10.23736/S2724-5691.25.10731-4","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10731-4","url":null,"abstract":"<p><strong>Introduction: </strong>At present, harvesting more lymph nodes is considered more conducive to the prognosis of colorectal cancer surgery. The recent development of enhanced surgical visualization has led to the wide employment of indocyanine green (ICG) to assist minimally invasive surgery. This systematic review aims to provide a wide and critical overview of the current state of the art of ICG lymphography during rectal surgery, by focusing on the most relevant literature on this topic.</p><p><strong>Evidence acquisition: </strong>After validation and registration in the PROSPERO international prospective register of systematic reviews on the 5<sup>th</sup> May 2024 (ID: CRD42024539426), 8 publications have been considered relevant for the research query and have been divided into two groups: lateral pelvic lymph node dissection (LPLND) and lateral pelvic sentinel lymph node biopsy (LPSLNB). A meta-analysis has not been performed due to the low statistical significance.</p><p><strong>Evidence synthesis: </strong>ICG lymphography seems to improve the number of harvested lateral pelvic lymph nodes, to reduce intraoperative blood loss and hospital length of stay during LPLND. In LPSLNB the detection rate of lateral pelvic sentinel lymph nodes ranged from 91.3% to 92%.</p><p><strong>Conclusions: </strong>ICG lymphography for fluorescence guidance for LLND is a feasible and safe technique, with promising application in terms of the number of harvested lymph nodes and post-operative outcomes improvement during rectal oncological surgery. As some of these benefits have been already suggested by the current literature, they need to be confirmed in larger and randomized clinical.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"80 1","pages":"86-94"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.23736/S2724-5691.25.10712-0
Mohamed A Boukhlik, Mohamed A Daghmouri, Mohamed A Chaouch, François Depret, Benjamin Deniau
Introduction: Studies suggested that restrictive fluid therapy during major surgery could be associated with better post-operative outcomes. The albumin uses in the perioperative period has been the subject of numerous studies with a still controversial efficacy and safety profile. This study aimed to assess the efficacy and safety of perioperative albumin use during major non-cardiac surgery.
Evidence acquisition: This study was registered in PROSPERO (ID: CRD42022353278). We performed an electronic search of the relevant literature from 2000 until 2023. The primary endpoint was the incidence of moderate postoperative complications (defined by a Clavien-Dindo classification grade ≥2). Secondary endpoints were intraoperative fluid balance, intraoperative blood loss, postoperative wound infection and acute kidney injury (AKI).
Evidence synthesis: We identified four relevant studies involving 426 patients (213 patients in the albumin group versus 213 patients in the control group). The meta-analysis did not reveal any significant difference between both group regarding the incidence of postoperative moderate complications even after subgroup analyses based on intraoperative or postoperative albumin administration (OR=1.23, 95% CI 0.73, 2.08, P=0.44). No difference was found for intraoperative fluid balance (MD=-190.83, 95% CI -408.67, 27.02, P=0.09), intraoperative blood loss (MD=-27.54, 95% CI -225.55, 170.48, P=0.79) and postoperative wound infection (OR=1.91, 95% CI 0.98, 3.73, P=0.06). Moreover, albumin administration was not associated with a significant increase of AKI incidence (OR=2.02, 95% CI 0.90, 4.53, P=0.09).
Conclusions: Perioperative use of albumin during major non-cardiac surgery did not result in an increased incidence of moderate postoperative complications.
{"title":"Evaluation of efficacy and safety of perioperative albumin administration in major non-cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed A Boukhlik, Mohamed A Daghmouri, Mohamed A Chaouch, François Depret, Benjamin Deniau","doi":"10.23736/S2724-5691.25.10712-0","DOIUrl":"https://doi.org/10.23736/S2724-5691.25.10712-0","url":null,"abstract":"<p><strong>Introduction: </strong>Studies suggested that restrictive fluid therapy during major surgery could be associated with better post-operative outcomes. The albumin uses in the perioperative period has been the subject of numerous studies with a still controversial efficacy and safety profile. This study aimed to assess the efficacy and safety of perioperative albumin use during major non-cardiac surgery.</p><p><strong>Evidence acquisition: </strong>This study was registered in PROSPERO (ID: CRD42022353278). We performed an electronic search of the relevant literature from 2000 until 2023. The primary endpoint was the incidence of moderate postoperative complications (defined by a Clavien-Dindo classification grade ≥2). Secondary endpoints were intraoperative fluid balance, intraoperative blood loss, postoperative wound infection and acute kidney injury (AKI).</p><p><strong>Evidence synthesis: </strong>We identified four relevant studies involving 426 patients (213 patients in the albumin group versus 213 patients in the control group). The meta-analysis did not reveal any significant difference between both group regarding the incidence of postoperative moderate complications even after subgroup analyses based on intraoperative or postoperative albumin administration (OR=1.23, 95% CI 0.73, 2.08, P=0.44). No difference was found for intraoperative fluid balance (MD=-190.83, 95% CI -408.67, 27.02, P=0.09), intraoperative blood loss (MD=-27.54, 95% CI -225.55, 170.48, P=0.79) and postoperative wound infection (OR=1.91, 95% CI 0.98, 3.73, P=0.06). Moreover, albumin administration was not associated with a significant increase of AKI incidence (OR=2.02, 95% CI 0.90, 4.53, P=0.09).</p><p><strong>Conclusions: </strong>Perioperative use of albumin during major non-cardiac surgery did not result in an increased incidence of moderate postoperative complications.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":"80 1","pages":"76-85"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-09-11DOI: 10.23736/S2724-5691.24.10444-3
Gianni Belcaro, Maria R Cesarone, Claudia Scipione, Valeria Scipione, Umberto Cornelli, Roberto Cotellese, Edmondo Ippolito, Mark Dugall, Morio Hosoi, Marcello Corsi, Beatrice Feragalli, Pietro Bavera
Background: The aim of this supplement registry study was to evaluate the efficacy of Pycnogenol® in controlling signs and symptoms of chronic venous insufficiency (CVI), diabetic microangiopathy and microcirculatory parameters - in diabetic patients with CVI and microangiopathy. These CVI patients are eligible for medical procedures as their incompetent superficial veins can be treated with repeated sclerotherapy and or local surgery according to needs.
Methods: During this registry study, only non-interventional managements were used. The effects of the use of elastic compression with standard management (SM) was compared to Pycnogenol® intake (150 mg/day) and SM, without using elastic compression for 8 weeks.
Results: Fifty-eight diabetic patients with CVI completed the study with 28 subjects supplemented with Pycnogenol® and 30 in the control group. The two groups completing 8 weeks were comparable at baseline. After 8 weeks, no side effects were observed; the compliance was optimal with >98.5% of the supplement capsules correctly used. The tolerability to stockings was lower (73% of stockings were not fully used for the whole day). There were no dropouts. Venous pressures were comparable in the two groups at baseline. Microcirculatory and clinical measurements of the patients were comparable at inclusion. After 8 weeks, the differences between Pycnogenol® and elastic compression were statistically significant for skin resting flux (RF), rate of ankle swelling (RAS), transcutaneous PO2 and PCO2 indicating a significant improvement in microcirculatory perfusion with Pycnogenol® in comparison with elastic compression. In parallel, clinical symptoms assessed by the Composite Symptom Score (CSS), the venous Clinical severity Score (VCSS) and the Venous Disability Score (VDS), were significantly lower in the Pycnogenol® group than in the compression group, indicating a significant clinical effect of Pycnogenol® compared to elastic compression (P<0.05). Pycnogenol® showed important antioxidant properties and lowered oxidative stress as seen also in previous studies.
Conclusions: This registry study confirms the clinical and microcirculatory efficacy of Pycnogenol® in CVI in diabetics. The study indicates the significant supplementary, clinical role of Pycnogenol® in the management of this common clinical condition over a short period of time, possibly preventing ulcerations.
{"title":"Pycnogenol® relieves chronic venous insufficiency (CVI) in diabetics: a supplement registry study.","authors":"Gianni Belcaro, Maria R Cesarone, Claudia Scipione, Valeria Scipione, Umberto Cornelli, Roberto Cotellese, Edmondo Ippolito, Mark Dugall, Morio Hosoi, Marcello Corsi, Beatrice Feragalli, Pietro Bavera","doi":"10.23736/S2724-5691.24.10444-3","DOIUrl":"10.23736/S2724-5691.24.10444-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this supplement registry study was to evaluate the efficacy of Pycnogenol<sup>®</sup> in controlling signs and symptoms of chronic venous insufficiency (CVI), diabetic microangiopathy and microcirculatory parameters - in diabetic patients with CVI and microangiopathy. These CVI patients are eligible for medical procedures as their incompetent superficial veins can be treated with repeated sclerotherapy and or local surgery according to needs.</p><p><strong>Methods: </strong>During this registry study, only non-interventional managements were used. The effects of the use of elastic compression with standard management (SM) was compared to Pycnogenol<sup>®</sup> intake (150 mg/day) and SM, without using elastic compression for 8 weeks.</p><p><strong>Results: </strong>Fifty-eight diabetic patients with CVI completed the study with 28 subjects supplemented with Pycnogenol<sup>®</sup> and 30 in the control group. The two groups completing 8 weeks were comparable at baseline. After 8 weeks, no side effects were observed; the compliance was optimal with >98.5% of the supplement capsules correctly used. The tolerability to stockings was lower (73% of stockings were not fully used for the whole day). There were no dropouts. Venous pressures were comparable in the two groups at baseline. Microcirculatory and clinical measurements of the patients were comparable at inclusion. After 8 weeks, the differences between Pycnogenol<sup>®</sup> and elastic compression were statistically significant for skin resting flux (RF), rate of ankle swelling (RAS), transcutaneous PO<inf>2</inf> and PCO<inf>2</inf> indicating a significant improvement in microcirculatory perfusion with Pycnogenol<sup>®</sup> in comparison with elastic compression. In parallel, clinical symptoms assessed by the Composite Symptom Score (CSS), the venous Clinical severity Score (VCSS) and the Venous Disability Score (VDS), were significantly lower in the Pycnogenol<sup>®</sup> group than in the compression group, indicating a significant clinical effect of Pycnogenol<sup>®</sup> compared to elastic compression (P<0.05). Pycnogenol<sup>®</sup> showed important antioxidant properties and lowered oxidative stress as seen also in previous studies.</p><p><strong>Conclusions: </strong>This registry study confirms the clinical and microcirculatory efficacy of Pycnogenol<sup>®</sup> in CVI in diabetics. The study indicates the significant supplementary, clinical role of Pycnogenol<sup>®</sup> in the management of this common clinical condition over a short period of time, possibly preventing ulcerations.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"36-43"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-11-13DOI: 10.23736/S2724-5691.24.10339-5
Bradley Sherman, Syed A Farhan, Rami Aoun, Amber Traugott, Alan Harzman, Syed A Husain
Background: There is a scarcity of literature describing outcomes of reoperative Crohn's disease. An in-depth knowledge of these outcomes is critical for managing patient expectations and optimal perioperative planning. We sought to examine outcomes in patients undergoing reoperative surgeries for Crohn's disease compared to index operations.
Methods: A retrospective chart review of surgeries performed from 2018-2023 at a single tertiary care academic institution was performed. A subgroup analysis of index vs. reoperative ileocolic resections was performed to minimize confounding due to the heterogeneity of operations between the index and reoperative groups.
Results: Out of 119 patients, 70 (59%) underwent index operations, and 49 (41%) were reoperations. Overall complication rates (24.28% vs. 34.69%, P=0.224), EBL (189.5 vs. 193.4 mL, P=0.94), operative time (209 vs. 236 min, P=0.091), length of stay (mean: 7.24 vs. 10.08 days, P=0.0142), utilization of laparoscopy (92.85% vs. 65.3%, P=0.0002) and conversion to open technique (4.61% vs. 9.37%, P=0.392) favored index cases. The laparoscopic approach narrowed the gap in length of stay between the index and reoperative groups from 2.83 to 0.6 days. Subgroup analysis of ileocolic resections (Index: 50, reoperations: 26) also favored the index operations.
Conclusions: The current study provides valuable insight into managing patient expectations and optimal perioperative planning for reoperative Crohn's disease. Reoperations were associated with longer stays, lower utilization of laparoscopic platforms, and a trend toward higher overall complication rates. Laparoscopy reduces the gap in length of stay between index and reoperations; however, it is associated with a higher reoperation conversion rate.
{"title":"Comparison of index and reoperative bowel resections in Crohn's disease.","authors":"Bradley Sherman, Syed A Farhan, Rami Aoun, Amber Traugott, Alan Harzman, Syed A Husain","doi":"10.23736/S2724-5691.24.10339-5","DOIUrl":"10.23736/S2724-5691.24.10339-5","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of literature describing outcomes of reoperative Crohn's disease. An in-depth knowledge of these outcomes is critical for managing patient expectations and optimal perioperative planning. We sought to examine outcomes in patients undergoing reoperative surgeries for Crohn's disease compared to index operations.</p><p><strong>Methods: </strong>A retrospective chart review of surgeries performed from 2018-2023 at a single tertiary care academic institution was performed. A subgroup analysis of index vs. reoperative ileocolic resections was performed to minimize confounding due to the heterogeneity of operations between the index and reoperative groups.</p><p><strong>Results: </strong>Out of 119 patients, 70 (59%) underwent index operations, and 49 (41%) were reoperations. Overall complication rates (24.28% vs. 34.69%, P=0.224), EBL (189.5 vs. 193.4 mL, P=0.94), operative time (209 vs. 236 min, P=0.091), length of stay (mean: 7.24 vs. 10.08 days, P=0.0142), utilization of laparoscopy (92.85% vs. 65.3%, P=0.0002) and conversion to open technique (4.61% vs. 9.37%, P=0.392) favored index cases. The laparoscopic approach narrowed the gap in length of stay between the index and reoperative groups from 2.83 to 0.6 days. Subgroup analysis of ileocolic resections (Index: 50, reoperations: 26) also favored the index operations.</p><p><strong>Conclusions: </strong>The current study provides valuable insight into managing patient expectations and optimal perioperative planning for reoperative Crohn's disease. Reoperations were associated with longer stays, lower utilization of laparoscopic platforms, and a trend toward higher overall complication rates. Laparoscopy reduces the gap in length of stay between index and reoperations; however, it is associated with a higher reoperation conversion rate.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-02DOI: 10.23736/S2724-5691.24.10479-0
Yafang Wang, Guixia Dong, Liping Zhao, Ying Ni
{"title":"Analysis of the influence of different surgical methods on the gynecological endocrine status of uterine fibroids.","authors":"Yafang Wang, Guixia Dong, Liping Zhao, Ying Ni","doi":"10.23736/S2724-5691.24.10479-0","DOIUrl":"10.23736/S2724-5691.24.10479-0","url":null,"abstract":"","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":"103-105"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}