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IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.05.004
Marta Roqué i Figuls , Marta Sabater-Martos , Ivan Solà
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引用次数: 0
Etapas para la realización de una revisión sistemática con metaanálisis 进行荟萃分析系统综述的步骤
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.05.010
Josep M Garcia-Alamino , Manuel López-Cano
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引用次数: 0
Esplenectomía robótica: ¿el nuevo patrón oro? 机器人脾脏切除术：新的黄金标准？
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.07.002
Jose M Ramia , Cándido Alcazar , Beniamino Pascotto , Paola Melgar , Juan Santiago Azagra
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引用次数: 0
Necesidad de un protocolo de tratamiento antibiótico perioperatorio dirigido para pacientes con drenaje biliar preoperatorio intervenidos de duodenopancreatectomía cefálica 对接受头十二指肠切除术的术前胆汁引流患者实施有针对性的围手术期抗生素治疗方案的必要性
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.09.001
Judith Camps-Lasa , María Isabel García-Domingo , Eric Herrero Fonollosa , María Luisa Galaviz Sosa , María Galofré Recasens , Aurora Rodríguez Campos , Xavier Serra-Aracil , Esteban Cugat Andorrá

Purpose

To evaluate the bacterobilia in patients undergoing pancreaticoduodenectomy (PD) based on whether they carry a preoperative biliary drainage or not and to analyse if a targeted perioperative antibiotic treatment based on the expected microbiology leads in no differences in Surgical Site Infections (SSI) between the groups.

Methods

Retrospective observational single-center study of patients undergoing pancreaticoduodenectomy with preoperative biliary stent (group P, Prosthesis) and without stent (group NP, No Prosthesis). Postoperative complications including SSI and its subtypes were analyzed after applying a targeted perioperative antibiotic treatment protocol with cefotaxime and metronidazole (group NP) and piperacillin-tazobactam (group P).

Results

Between January 2014 and December 2021, 127 patients were treated (84 in group NP and 43 in group P). Intraoperative cultures were positive in 16.7% (group NP) vs 76.7% (group P, P< .01). Microorganisms isolated in group NP included Enterobacterales (10.7%) and Enterococcus spp. (7.1%) with no Candida detected. In group P: Enterobacterales (51.2%), Enterococcus spp. (48.8%), and Candida (16.3%) were higher (P< .01%). No differences in morbidity and mortality were observed between the groups. SSI rate was 17.8% in group NP and 23.2% in group P (ns).

Conclusion

Bacterobilia differs in patients with biliary drainage, showing a higher presence of Enterobacterales, Enterococcus spp. and Candida. There were no differences in SSI incidence after applying perioperative antibiotic treatment tailored to the expected microorganisms in each group. This raises the need to reconsider conventional surgical prophylaxis in patients with biliary stent.
目的根据接受胰十二指肠切除术（PD）的患者术前是否携带胆道引流管评估其细菌嗜好，并分析根据预期的微生物学情况进行有针对性的围手术期抗生素治疗是否会导致两组患者的手术部位感染（SSI）无差异。方法对接受胰十二指肠切除术的患者进行单中心回顾性观察研究，研究对象为术前使用胆道支架的患者（P 组，支架）和不使用支架的患者（NP 组，无支架）。结果2014年1月至2021年12月，127名患者接受了治疗（NP组84人，P组43人），其中包括SSI及其亚型。16.7%（NP 组）与 76.7%（P 组，P< .01）的术中培养呈阳性。NP 组分离出的微生物包括肠杆菌属（10.7%）和肠球菌属（7.1%），未检出念珠菌。在 P 组中：肠杆菌属（51.2%）、肠球菌属（48.8%）和念珠菌属（16.3%）较高（P< .01%）。两组患者的发病率和死亡率无差异。NP 组的 SSI 感染率为 17.8%，P 组为 23.2%（ns）。各组患者在围手术期根据预期微生物使用抗生素治疗后，SSI 发生率并无差异。因此，有必要重新考虑胆道支架患者的常规手术预防措施。
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引用次数: 0
Nueva utilidad de las mallas biológicas. Refuerzo en anastomosis pancreatoyeyunal ducto-mucosa 生物网格的新用途。胰空肠导管-粘膜吻合术中的加固。
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.01.006
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引用次数: 0
Nuevas técnicas y estrategias quirúrgicas para la enfermedad de Crohn: resultados frente a expectativas 治疗克罗恩病的外科新技术和新策略：结果与预期
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.04.014
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引用次数: 0
Paciente con hiperplasia difusa idiopática de células neuroendocrinas de pulmón (DIPNECH) y nódulos bilaterales: dilema terapéutico 肺弥漫性特发性弥漫性神经内分泌细胞增生症（DIPNECH）和双侧结节患者：治疗难题
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.05.013
Eric Gutiérrez Pérez, Carlos Alberto Rombolá
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引用次数: 0
Fístula biliobronquial como complicación infrecuente tras el manejo intervencionista de las complicaciones biliares 胆道并发症介入治疗后的罕见并发症--胆支气管瘘
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.01.009
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引用次数: 0
Seguridad y factibilidad de un nuevo rectoscopio en la cirugía por cáncer de recto. Primer ensayo clínico 新型直肠镜在直肠癌手术中的安全性和可行性。首次临床试验
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.07.003
Mario Álvarez Gallego , Sara Gortázar de las Casas , Esteban Díaz Serrano , Isabel Pascual Migueláñez
We present a first in human clinical trial of a new rectoscope that shows, by means of transillumination, the optimal point of transection of the rectum in oncologic surgery. The device was developed together with a team of engineers and was manufactured by 3 D printing. Eighteen patients with a mean age of 71 years and a mean distance from the tumor to the anal margin measured by colonoscopy of 10.4 ± 3.9 cm and by MRI of 10 ± 2.4 cm were included in the trial. Transillumination was feasible in all cases, and the use of the rectoscope was safe, as no adverse events due to its use were recorded.
我们首次在人体临床试验中展示了一种新型直肠镜，它能通过透射光显示肿瘤手术中直肠横切的最佳点。该设备是与一个工程师团队共同开发的，并通过 3 D 打印制造而成。参与试验的 18 名患者平均年龄为 71 岁，结肠镜测量的肿瘤到肛门边缘的平均距离为 10.4 ± 3.9 厘米，核磁共振成像测量的肿瘤到肛门边缘的平均距离为 10 ± 2.4 厘米。所有病例均可进行透视，直肠镜的使用也很安全，没有因使用直肠镜而导致不良反应的记录。
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引用次数: 0
Fusión hepatolienal, un hallazgo extremadamente infrecuente 肝肾融合，极为罕见的发现
IF 1.3 4区 医学 Q3 SURGERY
Cirugia Espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.ciresp.2024.01.010
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引用次数: 0
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