Cirugia Espanola最新文献

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Recidiva de un pólipo fibrovascular gigante esofágico: ¿qué hemos aprendido? 食管巨纤维血管性息肉复发：我们学到了什么？

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.1016/j.ciresp.2025.800118

Ángela Alcaraz Solano , Eduardo Ortiz , David Ruiz de Angulo , Ana Conesa Plá , Vicente Munitiz Ruiz , Ana Isabel Gutiérrez

引用次数: 0

Análisis de las variables predictoras de respuesta tumoral completa tras la terapia sistémica primaria en el cáncer de mama 乳腺癌一级全身治疗后肿瘤全反应预测变量分析

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-05-31 DOI: 10.1016/j.ciresp.2025.800112

Sonia Martinez Alcaide , Izaskun Balciscueta Coltell , Ricardo Bou Monterde , Maria Jose Enguix Soriano , Pedro Juan Gonzalez Noguera , Francisco Javier del Pino Porres

Introduction

Primary systemic therapy in breast cancer is an effective tool for increasing pathological complete response prior to surgery and improving patient survival. The main objective of this study was to analyze the predictive variables for complete tumor response after neoadjuvant therapy.

Material and methods

Data from 146 breast cancer patients treated with primary systemic therapy at La Ribera Hospital between 2018 and 2022 were reviewed. Statistical methods were employed using SPSS 23 software to identify factors predicting tumor response to treatment.

Results

Among the patients analyzed, 22.6% presented complete response according to magnetic resonance imaging, and 31.5% showed no residual tumor in the surgical specimen. In the univariate analysis, variables associated with higher presence of residual tumor included lymphovascular invasion (P=0; 95% CI: 2.361-45.390), Luminal B subtype (P=.039; 95%CI: 1.028-5.826), and sentinel node involvement or positive axillary nodes in axillary lymphadenectomy (P=.031; 95%CI: 1.006-72.361). Conversely, tumors smaller than 2 cm (P=.002; 95% CI: 1.567-7.535) and the Her2⁺ subtype (P=.004; 95% CI: 0.086-0.667) were associated with a higher likelihood of no residual tumor. In the multivariate analysis, lymphovascular invasion was the only statistically significant factor associated with the presence of residual tumor (P=.021; 95% CI: 0.037-0.760).

Conclusions

Lymphovascular invasion was identified as a predictor of lack of response to neoadjuvant treatment. Additionally, the Her2⁺ subtype demonstrated the best response to preoperative therapy. These findings suggest that, to improve therapeutic outcomes, it is crucial to consider these variables when personalizing patient treatment.

乳腺癌的原发性全身治疗是提高术前病理完全缓解和提高患者生存率的有效工具。本研究的主要目的是分析新辅助治疗后肿瘤完全缓解的预测变量。材料和方法回顾了2018年至2022年在La Ribera医院接受原发性全身治疗的146例乳腺癌患者的数据。统计学方法采用SPSS 23软件识别预测肿瘤治疗反应的因素。结果22.6%的患者磁共振成像完全缓解，31.5%的患者手术标本未见肿瘤残留。在单因素分析中，与肿瘤残留率较高相关的变量包括淋巴血管侵犯(P=0；95% CI: 2.361-45.390)， Luminal B亚型(P= 0.039；95%CI: 1.028-5.826)，腋窝淋巴结切除术中前哨淋巴结受累或腋窝淋巴结阳性(P= 0.031；95%置信区间:1.006—-72.361)。相反，小于2 cm的肿瘤(P= 0.002；95% CI: 1.567-7.535)和Her2+亚型(P= 0.004；95% CI: 0.086-0.667)与无残留肿瘤的可能性较高相关。在多因素分析中，淋巴血管侵犯是唯一与肿瘤残留相关的有统计学意义的因素(P= 0.021；95% ci: 0.037-0.760)。结论淋巴血管浸润是新辅助治疗缺乏反应的一个预测因素。此外，Her2+亚型表现出对术前治疗的最佳反应。这些发现表明，为了改善治疗结果，在个性化患者治疗时考虑这些变量是至关重要的。

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引用次数: 0

Carcinoma adrenocortical sarcomatoide: una variante histológica excepcional 腺皮质肉瘤样癌：特殊组织学变异

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.ciresp.2025.800122

Alfonso Sánchez-Mayoral , Arkaitz Perfecto Valero , Katherine Goncalves Villarreal , Mikel Gastaca Mateo

引用次数: 0

COMUNICACIONES ORALES ENFERMERÍA 口头来文

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-09-18 DOI: 10.1016/S0009-739X(25)01564-7

引用次数: 0

PÓSTERES ENFERMERÍA 海报的护士

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-09-18 DOI: 10.1016/S0009-739X(25)01565-9

引用次数: 0

Comunicación con los pacientes y sus familiares: cómo dar malas noticias 与患者及其家属沟通：如何传达坏消息

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-06-02 DOI: 10.1016/j.ciresp.2025.800107

Miriam Abellán Lucas , Marc Vallve-Bernal

引用次数: 0

PÓSTERES 海报

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-09-18 DOI: 10.1016/S0009-739X(25)01562-3

引用次数: 0

Premios Nobel y cirugía 诺贝尔奖与手术

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.ciresp.2025.800123

Julio Cesar Alfaro Varela

The Nobel Prize is an international recognition awarded to individuals who have made significant contributions to humanity. The areas that are recognized are Physics, Chemistry, Physiology or Medicine, Literature, and Peace. With more than 100 years of existence, only 10 surgeons have been recipients of this recognition. Their contributions range from cardiac catheterization, the discovery of insulin to the beginning of the modern era of organ transplantation. These surgeons through their research have greatly contributed to modern medicine, saving, and improving quality of life of millions of human beings. This article will describe a brief history of the surgeons and their contribution to medical advances that allowed them to be recognized with the Nobel Prize in physiology or medicine.

诺贝尔奖是授予对人类做出重大贡献的个人的国际认可。被认可的领域有物理、化学、生理或医学、文学和和平。在100多年的历史中，只有10位外科医生获得了这一荣誉。他们的贡献范围从心导管插入术、胰岛素的发现到现代器官移植时代的开始。这些外科医生通过他们的研究为现代医学做出了巨大贡献，挽救了数百万人的生命，提高了他们的生活质量。本文将简要介绍外科医生的历史，以及他们对医学进步的贡献，使他们能够获得诺贝尔生理学或医学奖。

引用次数: 0

Estudio de los cambios morfológicos observados en TC de abdomen en el tratamiento preoperatorio con toxina botulínica tipo A en pacientes con hernias incisionales localizadas en línea media o con componente lateral A型肉毒杆菌毒素术前治疗中线或侧线切口疝患者腹部形态变化的研究

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-05-30 DOI: 10.1016/j.ciresp.2025.800117

Salvador Argudo Garijo , Félix Javier Jiménez Jiménez , Jessie Ramírez Calderón , Ariel Christian Jullien Petrelli , Javier del Corral Rodríguez , Miguel Hernández García , María García-Conde Delgado , Alfredo Alonso Poza

Introduction

Preoperative treatment with botulinum toxin is very common in complex incisional hernias, although it lacks clear indications.

Methods

Between July 2019 and May 2022, measurements of the thickness and length of the lateral abdominal wall, transverse diameter of the abdomen and diameter of the hernia defect were taken from patient CT scans both pre- and post-treatment with botulinum toxin at our hospital. In order to establish differences between patients with lateral and midline hernias, a logistic regression analysis was performed.

Results

The study included 23 patients: 17 had midline hernias, and 6 had lateral hernias (4 right and 2 bilateral). We observed increased length of the right wall (1.15 ± 1.64 cm; P = .0029), left wall (1.96 ± 1.74 cm; P < .0001) and transverse abdominal diameter (2.85 ± 4.83 cm; P < .0001), and a reduction in the thickness of the right (−0.54 ± 0.53 cm; P < .0001) and left walls (−0.58 ± 0.42 cm; P < .0001). There were no differences in the transverse diameter of the defect (−0.01 ± 1.37 cm; P = .4593). After logistic regression, increased right wall length (OR 14.99; 95%CI 1.58-142.12) and transverse abdominal diameter (OR 9.33; 95%CI 1.13-76.68) was more likely to be observed in patients with midline hernias than in those with lateral locations.

Conclusions

Preoperative treatment with botulinum toxin appears to be more effective in patients with midline hernias than in those with lateral locations.

术前应用肉毒杆菌毒素治疗复杂切口疝是很常见的，但缺乏明确的适应症。方法对2019年7月至2022年5月在我院接受肉毒杆菌毒素治疗前后的患者进行CT扫描，测量其腹侧壁厚度和长度、腹部横径和疝缺损直径。为了确定外侧疝和中线疝患者之间的差异，进行了逻辑回归分析。结果共纳入23例患者，其中中线疝17例，外侧疝6例（右侧4例，双侧2例）。我们观察到右壁长度增加(1.15±1.64 cm；P = 0.0029)，左壁(1.96±1.74 cm；P & lt;0.0001)，腹横径（2.85±4.83 cm）；P & lt;.0001)，右侧厚度减少(- 0.54±0.53 cm；P & lt;0.0001)和左壁(−0.58±0.42 cm；P & lt;。)。两组缺损的横径无明显差异(−0.01±1.37 cm；p = .4593)。经logistic回归，右壁长度增加(OR 14.99；95%CI 1.58-142.12)和腹横径(OR 9.33；95%CI 1.13-76.68)中线疝患者比外侧疝患者更容易观察到。结论应用肉毒杆菌毒素治疗中线疝比外侧疝更有效。

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引用次数: 0

Drenaje de vía biliar mediante colecistoduodenostomía endoscópica como puente a duodenopancreatectomía por ictericia obstructiva de origen maligno 通过内镜十二指肠造口术将胆道引流作为十二指肠胰腺切除术的桥梁，以治疗恶性阻塞性黄疸

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola

Pub Date : 2025-07-01 Epub Date: 2025-07-11 DOI: 10.1016/j.ciresp.2025.800152

Jasone Larrea Oleaga , Aingeru Sarriugarte Lasarte , Hector Marín Ortega , Miguel Durá Gil , Ignacio Casado Morentin , Rul Saa Álvarez

A series of 6 cases was analyzed in which endoscopic ultrasound-guided cholecystoduodenostomy was performed because biliary stent placement by ERCP was not possible for the treatment of malignant obstructive jaundice prior to pancreaticoduodenectomy. The Hot-Axios® device was used in combination with a coaxial pigtail. No complications were reported related to the procedure or associated with pancreaticoduodenectomy. Endoscopic ultrasound-guided cholecystoduodenostomy has been shown to be a safe and effective procedure for preoperative improvement of jaundice in these patients. The fact that it can be performed simultaneously with the failed ERCP, without delaying surgery, and the absence of complications or worsening prognosis makes it an effective and safe alternative to percutaneous transhepatic biliary drainage.

由于恶性梗阻性黄疸在胰十二指肠切除术前不能行ERCP胆道支架置入术，我们对6例行内镜下胆囊十二指肠吻合术的病例进行了分析。Hot-Axios®设备与同轴尾纤结合使用。无与手术或胰十二指肠切除术相关的并发症报告。超声内镜引导下的胆囊十二指肠吻合术已被证明是一种安全有效的术前改善黄疸的方法。它可以与失败的ERCP同时进行，不延迟手术，无并发症或预后恶化，使其成为经皮经肝胆道引流的有效和安全的替代方案。

引用次数: 0

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