Surgery open science最新文献

英文中文

Laparoscopy versus open surgery in truncal vagotomy with gastrojejunostomy for peptic pyloric stenosis: a retrospective study of 151 patients 151例消化性幽门狭窄患者行迷走神经截切胃空肠吻合术的回顾性研究

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-09-03 DOI: 10.1016/j.sopen.2025.08.003

Souhaib Atri , Mahdi Hammami , Amine Sebai , Ahmed ben Mahmoud , Nadia Rabhi , Dhouha Cherif , Houcine Maghrebi , Amine Makni , Anis Haddad , Montassar Kacem

Background

Peptic ulcer disease continues to be a major health concern. Surgical intervention is usually reserved for complications, such as pyloric stenosis, leading to gastric outlet obstruction. We compared the outcomes of laparoscopic and open surgery.

Materials and methods

This is a retrospective study comparing Laparoscopic Truncal vagotomy and Gastrojejunostomy with open procedure. We examined the medical records of 151 patients treated for peptic pyloric stenosis at La Rabta Hospital in Tunis, Tunisia, from January 2000 to December 2018. The study focused on benign gastric outlet obstruction due to peptic ulcer disease, with patient progress monitored for over 24 months.

Results

A hundred and fifty-one patients treated for peptic ulcer stenosis by gastojejunostomy and truncal vagotomy were included in the study, featuring 52 cases of LTVGJ 99 cases ofOTVGJ. The male-to-female ratio was 5.2, with a mean age of 48 years for both groups. Perioperative outcomes revealed that OTVGJ had a shorter mean operative time (95 min) compared to LTVGJ (115 min), while the median hospital stay was longer for OTVGJ (7.9 days) versus LTVGJ (5.5 days). Both groups exhibited similar rates of delayed gastric emptying and postoperative gastrointestinal symptoms, with no cases of leakage or operative mortality. Diabetes was the only significant risk factor for delayed gastric emptying.

Conclusion

Laparoscopic truncal vagotomy and gastrojejunostomy for gastric outlet obstruction secondary to peptic ulcer disease is a safe and effective modality, offers low morbidity and satisfactory clinical status on long term follow up.

背景：消化性溃疡疾病一直是一个主要的健康问题。手术干预通常用于并发症，如幽门狭窄，导致胃出口梗阻。我们比较了腹腔镜和开放手术的结果。材料与方法回顾性比较腹腔镜下迷走神经截切和胃空肠吻合术与开放式手术的疗效。我们检查了2000年1月至2018年12月在突尼斯突尼斯La Rabta医院治疗的151例消化性幽门狭窄患者的医疗记录。该研究的重点是消化性溃疡引起的良性胃出口梗阻，对患者的进展进行了超过24个月的监测。结果纳入经胃空肠吻合术加迷走神经截尾术治疗消化性溃疡狭窄患者151例，其中LTVGJ 52例，otvgj 99例。男女比例为5.2，两组的平均年龄为48岁。围手术期结果显示，与LTVGJ（115分钟）相比，OTVGJ的平均手术时间（95分钟）较短，而OTVGJ的中位住院时间（7.9天）较LTVGJ（5.5天）更长。两组均表现出相似的胃排空延迟率和术后胃肠道症状，无漏或手术死亡病例。糖尿病是胃排空延迟的唯一显著危险因素。结论腹腔镜迷走神经截尾联合胃空肠吻合术治疗消化性溃疡继发性胃出口梗阻是一种安全有效的手术方式，发病率低，长期随访效果满意。

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引用次数: 0

Exploring diversity and inclusion in surgery: Insights from the 2025 Dutch Surgical Society Symposium 探索手术的多样性和包容性：来自2025年荷兰外科学会研讨会的见解

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.1016/j.sopen.2025.08.002

Begüm Pekbay MD , Hajar Rotbi MSc , Michael El Boghdady MBChB, MD, MCh, MRCS, MHPE, MFSTEd, PFCAPHE, FHEA , Joanna W.A.M. Bosmans MD, PhD , Joris J. Blok MD, PhD, FEBVS

Diversity and inclusion are increasingly recognized as critical components of effective surgical practice and team dynamics. Despite growing awareness, structural barriers continue to limit the entry and advancement of individuals from underrepresented groups in surgery. At the annual meeting of the Dutch Surgical Society in 2025, a dedicated symposium on diversity and inclusion was organized to explore the relevance, urgency, and potential impact of these topics in surgery. Drawing from lived experience, research evidence, and a multidisciplinary panel discussion, this event underscored the necessity of shifting from performative diversity toward meaningful inclusion. Key insights from the symposium and actionable strategies to foster sustainable change within surgical education and practice are discussed in this paper. Future directions would include concrete policy development by the Dutch Surgical Society to achieve sustainable change, incorporating these topics in national education programs and development of structured mentorship networks and facilitating a continuous open dialogue.

多样性和包容性越来越被认为是有效的外科实践和团队动力的关键组成部分。尽管越来越多的人意识到，结构性障碍继续限制个人的进入和进步，从代表性不足的群体在外科手术。在2025年荷兰外科学会年会上，组织了一个关于多样性和包容性的专题研讨会，探讨这些主题在外科手术中的相关性、紧迫性和潜在影响。从生活经验、研究证据和多学科小组讨论中，这次活动强调了从表演多样性转向有意义的包容的必要性。本文讨论了研讨会的关键见解和促进外科教育和实践可持续变化的可行策略。未来的方向将包括荷兰外科学会制定具体的政策，以实现可持续的变化，将这些主题纳入国家教育计划和发展结构化的指导网络，并促进持续的公开对话。

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引用次数: 0

Chronic inflammation following hernia repair and cancer risk: A nationwide study 疝气修复后的慢性炎症与癌症风险：一项全国性研究

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1016/j.sopen.2025.06.004

Malene Broholm MD, PhD , Ismail Gögenur MD, DMSc , Lau Caspar Thygesen Cand.Scient.san.publ, PhD , Frederik Helgstrand MD, PhD

Purpose

Implantation of mesh in patients undergoing hernia surgery or prolonged inflammation due to postoperative complication may be associated with increased risk of cancer.

We aim to test whether implementation of mesh or complicated postoperative course with readmittance was associated with increased risk of cancer.

Methods

This register-based nationwide observational cohort study included 48,392 and 127,756 patients undergoing ventral and inguinal hernia surgery, respectively, during 1996–2004, with follow-up until Dec. 2014. In total, 16,909 patients undergoing ventral hernia repair with mesh, and 31,483 undergoing sutured repair, as well as 106,342 patients undergoing inguinal hernia repair with mesh and 21,414 undergoing sutured repair were included. Patients were matched with a reference cohort from the general Danish population and were followed in the Danish Cancer Registry.

Results

For ventral hernia surgery, there was a significant association between mesh repair and risk of cancers, [(vs general population), HR 1.09 (95%CI, 1.00–1.18)]. Thirty-day readmission after mesh and sutured repair was associated with developing cancer [HR 1.15 (0.99–1.34) and 1.14 (1.00–1.31), respectively]. However, the association for suture repair (HR 1.14) did not reach statistical significance (p = 0.055). For inguinal hernia surgery, mesh repair was not associated with increased risk of cancer [(vs. general population), HR 1.00 (95%CI, 0.97–1.02)]. For both mesh and sutured repair, there was an increased risk for developing cancer after 30-day readmission, [HR 1.21 (1.12–1.31) and 1.24 (1.07–1.43), respectively].

Conclusion

Patients undergoing ventral hernia repair with mesh and patients readmitted after inguinal or ventral hernia repair may have higher risk of developing cancer than the general population.

These exploratory findings do not establish causality, but the association warrants further investigations in other populations.

目的疝手术或术后并发症引起的长期炎症患者植入补片可能会增加患癌风险。我们的目的是测试是否实施补片或复杂的术后再接纳过程与癌症风险增加有关。方法：这项基于登记的全国观察队列研究纳入了1996-2004年间分别接受腹疝和腹股沟疝手术的48,392和127,756例患者，随访至2014年12月。共纳入腹侧疝补片修补术16909例，缝合修补术31483例，腹股沟疝补片修补术106342例，缝合修补术21414例。患者与来自丹麦普通人群的参考队列相匹配，并在丹麦癌症登记处进行随访。结果对于腹疝手术，补片修复与癌症风险之间存在显著关联[（与一般人群相比），HR 1.09 (95%CI, 1.00-1.18)]。补片和缝合修复后30天再入院与发生癌症相关[HR分别为1.15（0.99-1.34）和1.14(1.00-1.31)]。但缝线修复相关性（HR 1.14）无统计学意义（p = 0.055）。对于腹股沟疝手术，补片修复与癌症风险增加无关[（与一般人群相比），相对危险度1.00 (95%CI, 0.97-1.02)]。对于补片和缝合修复，30天再入院后发生癌症的风险增加，[HR分别为1.21（1.12-1.31）和1.24(1.07-1.43)]。结论腹股沟疝修补术及腹股沟疝修补术或腹股沟疝修补术后再入院的患者发生肿瘤的风险高于一般人群。这些探索性的发现并没有建立因果关系，但这种联系值得在其他人群中进一步调查。

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引用次数: 0

Dall-E in hand surgery: Exploring the utility of ChatGPT image generation: Correspondence 手外科中的Dall-E：探索ChatGPT图像生成的效用：对应

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-09-19 DOI: 10.1016/j.sopen.2025.06.010

Hinpetch Daungsupawong , Viroj Wiwanitkit

引用次数: 0

Outcomes of simultaneous resection for colorectal liver metastases: A nationwide cohort study (2005–2022) 同时切除结直肠肝转移的结果：一项全国队列研究（2005-2022）

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI: 10.1016/j.sopen.2025.07.008

J.H. Angelsen , S. Yaqub , T.A. Hegvik , L.S. Nymo , T. Veen , V.J. Dagenborg , E.A. Bringeland

Introduction

The optimal treatment strategy for synchronous colorectal liver metastases (CRLM) has been a topic for ongoing debate. We present a national cohort containing simultaneous resections of the primary tumour and CRLM, with emphasis on postoperative complications, and survival.

Method

This population-based national cohort study included consecutive patients who underwent simultaneous resections in Norway between 2005 and 2022. Postoperative complications (Accordion Severity Grading System – ASGS) and overall survival (OS) were analysed in relation to the extent of liver resection and location of the primary tumour.

Results

A total of 193 patients underwent simultaneous resection of the primary tumour and liver metastases. Postoperative complications graded as ASGS ≥3 occurred in 48 (24.9 %) while 23 (11.9 %) patients developed ASGS ≥4 complications. Anastomotic leakage was observed in 9 (4.7 %) patients. Among 18 (9.3 %) patients undergoing major liver resections, 10 (55.6 %) and seven (38.9 %) patients experienced ASGS ≥3 and ASGS ≥4 complications, respectively. Major liver resection was an independent predictor for ASGS ≥3, (RR: 2.40; p = 0.002). The 30- and 90-day mortality rates were 0.5 % (n = 1) and 2.1 % (n = 4), respectively. Median, 5- and 10-year OS were 4.8 years, 46.7 % and 35.6 %, respectively. In a multivariable analysis both an increasing number of liver metastases and ASGS ≥4 complications were independently associated with inferior OS.

Conclusions

Simultaneous resection for synchronous CRLM was a safe option, particularly in minor liver resections. Major liver resections were associated with increased risk of severe complications and inferior OS.

同步性结直肠肝转移（CRLM）的最佳治疗策略一直是一个争论不休的话题。我们提出了一个包含原发肿瘤和CRLM同时切除的国家队列，重点是术后并发症和生存率。方法：这项以人群为基础的国家队列研究纳入了2005年至2022年间在挪威接受同期切除术的连续患者。分析术后并发症（Accordion严重性分级系统- ASGS）和总生存期（OS）与肝脏切除程度和原发肿瘤位置的关系。结果193例患者同时行原发肿瘤和肝转移灶切除术。术后出现ASGS≥3级并发症48例（24.9%），ASGS≥4级并发症23例（11.9%）。吻合口瘘9例（4.7%）。18例（9.3%）大肝切除术患者中，ASGS≥3例（55.6%）和ASGS≥4例（38.9%）并发症发生率分别为10例（55.6%）和7例（38.9%）。肝大切除是ASGS≥3的独立预测因子（RR: 2.40; p = 0.002）。30天和90天的死亡率分别为0.5% （n = 1）和2.1% （n = 4）。中位、5年和10年OS分别为4.8年、46.7%和35.6%。在一项多变量分析中，肝转移数量的增加和ASGS≥4的并发症与较差的OS独立相关。结论同步CRLM的同时切除是一种安全的选择，特别是在小范围的肝切除中。大肝切除术与严重并发症和不良OS的风险增加有关。

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引用次数: 0

Feasibility of intraluminal oxygen delivery after minimally invasive esophagus resection 微创食管切除术后腔内供氧的可行性

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI: 10.1016/j.sopen.2025.07.004

Douwe van der Steen MSc , Anne M. Leferink PhD , Frederieke A. Dijkstra MD , Boudewijn van Etten MD, PhD , Eric Keus MD, PhD , Rutger J. Spruit MD , Roy J.J. Verhage MD, PhD , Jeroen J. Kolkman MD , Jan Willem Haveman MD, PhD

Introduction

Anastomotic leakage (AL) is a severe complication after esophagectomy. Intraluminal oxygen delivery at the anastomosis site might improve the viability of the tissue and thereby reduce the incidence of AL. We present a feasibility study of intraluminal oxygen delivery after esophagectomy.

Methods

Eighteen patients scheduled for robot-assisted minimally invasive esophagectomy with an intrathoracic anastomosis were selected to receive an additional manometry catheter for intraluminal oxygen delivery at the anastomosis site. The primary endpoint was the feasibility of placing the catheter in the correct position and staying in situ for five days postoperatively. Intraluminal pressure was monitored during oxygen delivery at flow rates of 0 (control group), 1, 2, or 4 ml/min. Patients were questioned on the comfort of the catheter.

Results

In two patients, intraoperative placement of the catheter was unsuccessful. Two others replaced these patients according to the study protocol. 16 patients were analyzed. In five patients, the catheter was accidentally removed before the end of the study. The primary endpoint was successful in 11/16 patients (69 %). Intraluminal pressure in the 1 ml/min group did not differ from the control group. Intraluminal pressure in the 2 ml/min group increased substantially compared to the control group. Patients reported comfort rates that decreased over time.

Conclusion

This study shows that it is feasible to administer intraluminal oxygen in the first five days after esophagectomy and that a flow rate of 1 ml/min is not associated with increased intraluminal pressure. Future studies are required to study the effectiveness of intraluminal oxygen delivery in preventing AL.

吻合口漏是食管切除术后的严重并发症。吻合口腔内供氧可提高组织活力，从而减少AL的发生率。我们提出了食管切除术后腔内供氧的可行性研究。方法选择18例行机器人辅助微创食管切除术胸内吻合的患者，在吻合处附加测压导管供氧。主要终点是将导管放置在正确位置的可行性，并在术后5天内保持原位。以0（对照组）、1、2或4 ml/min的流速给氧时监测腔内压力。病人被询问导管的舒适度。结果2例患者术中置管不成功。根据研究方案，另外两名患者代替了这些患者。对16例患者进行分析。在五名患者中，导管在研究结束前被意外取出。主要终点有11/16（69%）患者成功。1 ml/min组的腔内压与对照组无差异。与对照组相比，2 ml/min组的腔内压显著升高。患者报告的舒适率随着时间的推移而下降。结论食管切除术后5天内给予腔内氧是可行的，1 ml/min的流速与腔内压力升高无关。需要进一步研究腔内供氧在预防AL中的有效性。

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引用次数: 0

Call for participation in a multicenter study: Intraoperative blood loss – Towards a standardized and objective recording method 呼吁参与一项多中心研究：术中失血——迈向标准化和客观的记录方法

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI: 10.1016/j.sopen.2025.07.007

Emelie Nébel, Lätitia Dennin, Johannes Klose, Ulrich Ronellenfitsch, Jörg Kleeff, Artur Rebelo

引用次数: 0

Counterclockwise colonic transposition after left extended colectomy: an efficient and reproducible alternative to the Deloyers procedure 左结肠扩大切除术后的逆时针结肠转位：一种有效且可重复的替代Deloyers手术

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 Epub Date: 2025-09-05 DOI: 10.1016/j.sopen.2025.09.002

Margot Potor , Marie-Céline Schraepen , Julien Lemaire

Reconstruction of the digestive tract after extended left colectomy is a common challenge for colorectal surgeons. The main difficulty lies in lowering the colon into the pelvis to achieve a tension-free and well-vascularized anastomosis. We report our 10-year retrospective experience, in which a counterclockwise colonic transposition according to Lillehei and Wangensteen was performed in more than half of the cases. This technique differs from the more widely known Deloyers procedure solely by its axis of rotation. It offers the advantage of being more anatomical, easily reproducible, and functionally equivalent.

长时间左结肠切除术后消化道重建是结肠外科医生面临的一个共同挑战。主要的困难在于降低结肠进入骨盆，以实现无张力和血管通畅的吻合。我们报告了我们10年的回顾性经验，其中一半以上的病例根据Lillehei和Wangensteen进行了逆时针结肠转位。这种技术不同于更广为人知的Deloyers手术，唯一的区别是旋转轴。它具有解剖性更强、易于复制和功能等效的优点。

引用次数: 0

Consideration of tumor genomics in the management of synchronous colorectal liver metastases. 肿瘤基因组学在同步结直肠肝转移治疗中的应用。

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-08-05 eCollection Date: 2025-09-01 DOI: 10.1016/j.sopen.2025.07.009

Deshka S Foster, Michael I D'Angelica

Colorectal cancer with synchronous metastatic disease to the liver represents a particular challenge in multidisciplinary cancer care. Optimal management involves a combination of surgical resection, systemic, regional and/or targeted therapies; however, the order of and timing of specific therapies requires a nuanced understanding of the disease biology including tumor genomics. In the following article, we conducted a narrative review of the literature to critically examine existing data on the impact of tumor genomics in synchronous colorectal liver metastasis management. We provide a qualitative synthesis of the available literature and identify areas of particular interest for investigation moving forward.

结直肠癌伴肝脏同步转移是多学科癌症治疗的一个特殊挑战。最佳治疗包括手术切除、全身、局部和/或靶向治疗的结合；然而，特定治疗的顺序和时机需要对包括肿瘤基因组学在内的疾病生物学有细致入微的了解。在下一篇文章中，我们对文献进行了叙述性回顾，以批判性地检查肿瘤基因组学在同步结直肠癌肝转移治疗中的影响的现有数据。我们提供了一个定性的综合现有文献，并确定了特别感兴趣的领域进行调查。

引用次数: 0

Robotic Ivor-Lewis esophagectomy - How-we-do-it. 机器人Ivor-Lewis食管切除术-我们是怎么做的。

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-08-05 eCollection Date: 2025-09-01 DOI: 10.1016/j.sopen.2025.07.006

Henrik Nienhüser, Nicolas Jorek, Ali Majlesara, Frank Pianka, Arianeb Mehrabi, Christoph W Michalski

引用次数: 0

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