Journal of Visceral Surgery最新文献

英文中文

Risk factors for local recurrence of rectal cancer after curative surgery: A single-center retrospective study. 直肠癌根治术后局部复发的风险因素：单中心回顾性研究

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-21 DOI: 10.1016/j.jviscsurg.2024.10.001

Floryn Cherbanyk, Marie Burgard, Lucien Widmer, François Pugin, Bernhard Egger

Purpose: Approximately 7% of patients with rectal cancer experience local recurrence within 5 years of curative surgery. A positive circumferential resection margin (CRM) is among the most significant risk factors. Other reported risk factors include histopathologic type, anastomotic leakage, positive distal margins, and more recently, the anterior localization of the tumor. In this retrospective cohort study, we aimed to assess risk factors for local recurrence in our institution, with a focus on tumor localization as an independent negative predictive factor.

Patients and methods: From 2007 to 2018, all patients with stage II or III rectal cancer were included in this study. Patients underwent neoadjuvant chemoradiotherapy followed by surgical resection with total mesorectal excision. The tumor's anterior or posterior localization was assessed by preoperative endosonography or magnetic resonance imaging. Risk factors for local recurrence were assessed using univariate and multivariate regression analyses.

Results: A total of 128 patients were included. The 3-year and 5-year local recurrence rates were 4.7% and 7%, respectively. In univariate and multivariate analyses, the histologic type of a poorly differentiated tumor (P=0.001) and a positive CRM (P=0.001) were correlated with local recurrence. Tumor localization (anterior or posterior) was not identified as a statistically significant factor associated with local recurrence.

Conclusion: Positive CRM and a poorly differentiated tumor histological subtype were found to be independent risk factors for local recurrence. In contrast to previous findings, anterior localization was not identified as an independent risk factor for local recurrence in our patient cohort.

目的：约有 7% 的直肠癌患者在治愈性手术后 5 年内出现局部复发。周缘切除边缘（CRM）阳性是最重要的风险因素之一。其他已报道的风险因素包括组织病理学类型、吻合口漏、远端边缘阳性以及最近出现的肿瘤前部定位。在这项回顾性队列研究中，我们旨在评估本院的局部复发风险因素，重点关注肿瘤定位这一独立的阴性预测因素：从2007年到2018年，所有II期或III期直肠癌患者都纳入了这项研究。患者在接受新辅助化放疗后进行手术切除，并行全直肠系膜切除术。肿瘤的前方或后方定位通过术前内窥镜或磁共振成像进行评估。采用单变量和多变量回归分析评估局部复发的风险因素：结果：共纳入 128 例患者。3年和5年局部复发率分别为4.7%和7%。在单变量和多变量分析中，组织学类型为分化不良肿瘤（P=0.001）和CRM阳性（P=0.001）与局部复发相关。肿瘤定位（前部或后部）未被确定为与局部复发有统计学意义的相关因素：结论：CRM阳性和分化不良的肿瘤组织学亚型是局部复发的独立危险因素。与之前的研究结果不同的是，在我们的患者队列中，前部定位并未被确定为局部复发的独立风险因素。

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引用次数: 0

Re : "Traumatic diaphragmatic wound repair". Re : "创伤性膈肌伤口修复"。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-19 DOI: 10.1016/j.jviscsurg.2024.10.002

Vincent Dubuisson

引用次数: 0

Hemocholecyst: A rare indication for cholecystectomy. 血性胆囊炎：胆囊切除术的罕见适应症。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-17 DOI: 10.1016/j.jviscsurg.2024.09.010

Fabien Werey, Hugo Defives, Jean-Marc Regimbeau

引用次数: 0

Management of Boerhaave syndrome by right thoracoscopy in prone position (with video). 俯卧位通过右胸腔镜治疗博尔哈弗综合征（附视频）。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-09 DOI: 10.1016/j.jviscsurg.2024.09.002

Quentin Chenevas-Paule, Pierre-Yves Sage, Mircea Chirica

引用次数: 0

Accessibility and satisfaction's analysis of simulation-based training in surgery for residents and surgical fellows in France 法国住院医师和外科研究员外科模拟培训的可及性和满意度分析。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.07.001

Gabriel Saiydoun , Maxime Vallée , Saadé Saade , Clément Colombier , Krystel Nyango Timoh , Philine de Vries , Cyril Perrenot , Nicolas Berte , Arnaud Delafontaine

Background

In surgery, simulated-based training improves the knowledge and interpersonal skills needed for surgeons to improve their performance and meet the “never the first time on a patient” imperative. The objective is to evaluate the effects of a 2017 reform on surgeon's accessibility to simulation-based training, five years after the implementation of the program, and to gauge surgeon satisfaction.

Methods

A 27-item national online survey was sent to all surgical residents and fellows in the 13 surgical specialties.

Results

Among 523 responses, 405 (77.4%) were residents and 118 (22.6%) were surgical fellows. Two hundred forty-seven (47.2%) of surgical residents and fellows stated they did not have a simulation structure or simulation program in the town of their university hospital center. Two hundred thirty-five (44.9%) reported having simulation training programs and 41 (7.8%) reported having easy and free access to their simulation structure. Regarding simulation-based training, 44.6% of surgical residents and fellows had never received training in technical skills on simulators, 82.2% had never received training in teamwork or interprofessional skills and 76.1% had never received training in behavioral or relational skills. There was a significant difference between the degree of satisfaction of residents at the beginning and at the end of the study (P = 0.02).

Conclusion

Simulation is a well-established educational tool, but there are still strong inequalities between universities. Despite the national deployment of simulation-based teaching programs and institutional efforts, surgical simulation is insufficiently developed in France, and learner satisfaction is poor.

背景：在外科手术中，基于模拟的培训可提高外科医生所需的知识和人际交往技能，从而改善他们的工作表现，并满足 "绝不第一次对病人进行手术 "的要求。我们的目的是评估 2017 年的一项改革对外科医生接受模拟培训的影响，该计划实施五年后，外科医生的满意度如何：向 13 个外科专业的所有外科住院医师和研究员发送了一份包含 27 个项目的全国性在线调查：在 523 位回复者中，405 位（77.4%）是住院医生，118 位（22.6%）是外科研究员。247名（47.2%）外科住院医师和研究员表示，他们所在的大学医院中心没有模拟结构或模拟项目。235人（44.9%）表示有模拟训练项目，41人（7.8%）表示可以方便、自由地使用模拟设施。在模拟培训方面，44.6%的外科住院医师和研究员从未接受过模拟器技术技能培训，82.2%从未接受过团队合作或跨专业技能培训，76.1%从未接受过行为或关系技能培训。住院医师在研究开始和结束时的满意度存在明显差异（P=0.02）：模拟教学是一种行之有效的教育工具，但大学之间仍存在严重的不平等。尽管法国在全国范围内部署了模拟教学计划并做出了制度性努力，但外科模拟教学在法国的发展并不充分，学习者的满意度也不高。

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引用次数: 0

Surgical management of penetrating neck injuries: An update. Part 1 – pre-hospital management 颈部穿透性损伤的手术治疗：最新进展。第 1 部分 - 院前处理。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.07.012

Willem Paillusson , Rajvansh Sesmun , Catherine Arvieux , Paul Balandraud , Emmanuel Martinod , Paulina Kuczma , Christophe Tresallet

引用次数: 0

Sigmoid adenocarcinoma hosted in a giant inguinoscrotal hernia 巨大腹股沟疝中寄生的乙状结肠腺癌。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.05.002

Colorectal cancer is the most frequently diagnosed neoplasm in the population worldwide, regardless of sex. Its presentation is variable, from asymptomatic cases that are diagnosed in the population screening programme, to perforation or intestinal obstruction that appear urgently. The location of the neoplasia inside an inguinal hernia, although it is described in the literature, is uncommon and may increase the risk of incarceration or strangulation with the need for urgent surgery. We report a patient who presents adenocarcinoma of the sigmoid colon lodged in a giant inguino-scrotal hernia.

结肠直肠癌是全世界人群中最常见的肿瘤，不分性别。其表现形式多种多样，既有在人口筛查计划中确诊的无症状病例，也有紧急出现的穿孔或肠梗阻病例。肿瘤位于腹股沟疝内的情况虽然在文献中有所描述，但并不常见，可能会增加嵌顿或绞窄的风险，需要紧急手术。我们报告了一名乙状结肠腺癌嵌顿在巨大腹股沟阴囊疝中的患者。

引用次数: 0

Obturator hernia as a cause of intestinal obstruction in an elderly female patient – A clinical image 作为老年女性患者肠梗阻病因的闭孔疝--临床图片。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.04.005

引用次数: 0

Press review 新闻评论

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.09.001

引用次数: 0

Robotic-assisted parastomal hernia repair using a modified Pauli technique (with video) 使用改良保利技术的机器人辅助腹股沟旁疝修补术（附视频）。

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery

Pub Date : 2024-10-01 DOI: 10.1016/j.jviscsurg.2024.07.005

Yohann Renard , Benoît Romain

引用次数: 0

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