Pub Date : 2024-09-02DOI: 10.1016/j.cireng.2024.06.012
Rocío Pérez Quintero, Marcos Bruna Esteban, Antonio José Serrano López
In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications. Because of this, research and the creation of predictive models that identify patients at high risk of developing complications are mandatory in order to obtain an early diagnosis. The PROFUGO study (PRedictivO Model for Early Diagnosis of anastomotic LEAK after esophagectomy and gastrectomy) is proposed as a prospective and multicenter national study that aims to develop, with the help of artificial intelligence methods, a predictive model that allows for the identification of high-risk cases. of anastomotic leakage and/or major complications by analyzing different clinical and analytical variables collected during the postoperative period of patients undergoing esophagectomy or gastrectomy.
{"title":"PROFUGO study protocol: Predictive model for the early diagnosis of anastomotic leak after esophagectomy and gastrectomy.","authors":"Rocío Pérez Quintero, Marcos Bruna Esteban, Antonio José Serrano López","doi":"10.1016/j.cireng.2024.06.012","DOIUrl":"https://doi.org/10.1016/j.cireng.2024.06.012","url":null,"abstract":"<p><p>In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications. Because of this, research and the creation of predictive models that identify patients at high risk of developing complications are mandatory in order to obtain an early diagnosis. The PROFUGO study (PRedictivO Model for Early Diagnosis of anastomotic LEAK after esophagectomy and gastrectomy) is proposed as a prospective and multicenter national study that aims to develop, with the help of artificial intelligence methods, a predictive model that allows for the identification of high-risk cases. of anastomotic leakage and/or major complications by analyzing different clinical and analytical variables collected during the postoperative period of patients undergoing esophagectomy or gastrectomy.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1016/j.cireng.2024.07.008
Xavier Serra-Aracil, Marc Fradera
{"title":"Non-inferiority clinical trial. Features and practical considerations.","authors":"Xavier Serra-Aracil, Marc Fradera","doi":"10.1016/j.cireng.2024.07.008","DOIUrl":"10.1016/j.cireng.2024.07.008","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.04.012
Introduction
Virtual reality (VR) provides a firsthand active learning experience through varying degrees of immersion. The aim of this study is to evaluate the use of VR as a potential tool for training operating room nurses to perform thoracic surgery procedures.
Methods
This is an open parallel-group randomized clinical trial. One group received basic formation followed by an assessment module. The experimental group received the same basic formation, followed by thoracic surgery training and an assessment module.
Results
Fifty-six nurses participated in the study (51 females), with a mean age of 41.6 years. Participants achieved a median evaluation mode score of 480 points (IQR = 32 points). The experimental group (520 points) achieved an overall higher score than the control group (440 points; P = .04). Regarding age, women in the second quartile of age among the participants (35–41 years) achieved significantly better results than the rest (P = .04). When we evaluated the results based on the moment of practice, exercises performed in the last 10 min obtained better results than those performed in the first 10 min (1064 points versus 554 points; P < .001). Regarding adverse effects blurred vision was the most frequent. The overall satisfaction rating with the experience was 8.5 out of 10.
Conclusion
Virtual reality is a useful tool for training operating room nurses. Clinical trial with ISRCTN16864726 registered number.
{"title":"Clinical trial on nurse training through virtual reality simulation of an operating room: assessing satisfaction and outcomes","authors":"","doi":"10.1016/j.cireng.2024.04.012","DOIUrl":"10.1016/j.cireng.2024.04.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Virtual reality (VR) provides a firsthand active learning experience<span> through varying degrees of immersion. The aim of this study is to evaluate the use of VR as a potential tool for training operating room nurses to perform thoracic surgery procedures.</span></p></div><div><h3>Methods</h3><p>This is an open parallel-group randomized clinical trial<span>. One group received basic formation followed by an assessment module. The experimental group received the same basic formation, followed by thoracic surgery training and an assessment module.</span></p></div><div><h3>Results</h3><p>Fifty-six nurses participated in the study (51 females), with a mean age of 41.6 years. Participants achieved a median evaluation mode score of 480 points (IQR = 32 points). The experimental group (520 points) achieved an overall higher score than the control group (440 points; <em>P</em> = .04). Regarding age, women in the second quartile of age among the participants (35–41 years) achieved significantly better results than the rest (<em>P</em> = .04). When we evaluated the results based on the moment of practice, exercises performed in the last 10 min obtained better results than those performed in the first 10 min (1064 points versus 554 points; <em>P</em><span> < .001). Regarding adverse effects blurred vision was the most frequent. The overall satisfaction rating with the experience was 8.5 out of 10.</span></p></div><div><h3>Conclusion</h3><p>Virtual reality is a useful tool for training operating room nurses. Clinical trial with ISRCTN16864726 registered number.</p></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.04.019
Introduction
The main objective of our study is to analyze the results in our hospital after launching a treatment protocol without antibiotic therapy for patients diagnosed with acute uncomplicated diverticulitis.
Methods
Our observational, prospective, single-center study was developed after launching a treatment protocol without antibiotic therapy for patients diagnosed with acute uncomplicated diverticulitis (AUD) in January 2021. The follow-up period was from January 1, 2021 to September 30, 2023. Variables evaluated by the study have included demographic and analytical variables, as well as those related to diagnosis and whether the patients needed to start antibiotic treatment, inpatient treatment, or surgical procedures.
Results
In total, 199 patients were diagnosed with AUD, 75 of whom were treated without antibiotic therapy as outpatients. Seven of these patients needed to start antibiotic treatment because of adverse evolution; none of these patients required surgical procedures. The need for inpatient treatment, urgent care, or surgical procedures is similar to the group of patients treated with antibiotics.
The main risk factor of failure of outpatient treatment without antibiotic therapy identified by the study was the presence of bacteriuria at diagnosis.
Conclusions
Our results confirm previous reports, observing that treatment without antibiotic therapy in selected patients with AUD is safe.
{"title":"Prospective study about the security and efficacy of treatment without antibiotic therapy of patients diagnosed with acute uncomplicated diverticulitis after launching a protocol at a tertiary hospital","authors":"","doi":"10.1016/j.cireng.2024.04.019","DOIUrl":"10.1016/j.cireng.2024.04.019","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The main objective of our study is to analyze the results in our hospital after launching a treatment protocol without antibiotic therapy for patients diagnosed with acute uncomplicated </span>diverticulitis.</p></div><div><h3>Methods</h3><p>Our observational, prospective, single-center study was developed after launching a treatment protocol without antibiotic therapy for patients diagnosed with acute uncomplicated diverticulitis (AUD) in January 2021. The follow-up period was from January 1, 2021 to September 30, 2023. Variables evaluated by the study have included demographic and analytical variables, as well as those related to diagnosis and whether the patients needed to start antibiotic treatment, inpatient treatment, or surgical procedures.</p></div><div><h3>Results</h3><p>In total, 199 patients were diagnosed with AUD, 75 of whom were treated without antibiotic therapy as outpatients. Seven of these patients needed to start antibiotic treatment because of adverse evolution; none of these patients required surgical procedures. The need for inpatient treatment, urgent care, or surgical procedures is similar to the group of patients treated with antibiotics.</p><p>The main risk factor of failure of outpatient treatment without antibiotic therapy identified by the study was the presence of bacteriuria at diagnosis.</p></div><div><h3>Conclusions</h3><p>Our results confirm previous reports, observing that treatment without antibiotic therapy in selected patients with AUD is safe.</p></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.05.012
There is no international consensus on the definition of the type of oncological resection that corresponds to each of the colectomies existing in the current literature.
The objective is to define for each colectomy described in the literature: embryological dissection plane, vascular pedicles in which to perform central ligation, the extent of the colectomy, and the need for resection of the greater momentum.
A consensus of experts is carried out through the Delphi methodology through two rounds from the Coloproctology Section of the Spanish Association of Surgeons. Study period: November 2021-January 2023. 120 experts were surveyed.
Degrees of consensus: Very strong: >90%, Strong: 80%–90%, Moderate: 50%–80%, No consensus: <50%.
The definition for each oncological colectomy was established by very strong, and strong recommendations.
Each oncological colectomy was established as Right hemicolectomy (RHC), RHC with D3 lymphadenectomy, Extended-RHC, transverse colon segmental colectomy, splenic flexure segmental colectomy, subtotal colectomy, total colectomy, left hemicolectomy (LHC), extended-LHC, sigmoidectomy.
{"title":"Standardization of the definition of the types of oncological colectomy. Delphi method for consensus of experts of the Spanish Association of Surgeons","authors":"","doi":"10.1016/j.cireng.2024.05.012","DOIUrl":"10.1016/j.cireng.2024.05.012","url":null,"abstract":"<div><p>There is no international consensus on the definition of the type of oncological resection that corresponds to each of the colectomies existing in the current literature.</p><p>The objective is to define for each colectomy described in the literature: embryological dissection plane, vascular pedicles in which to perform central ligation, the extent of the colectomy, and the need for resection of the greater momentum.</p><p>A consensus of experts is carried out through the Delphi methodology through two rounds from the Coloproctology Section of the Spanish Association of Surgeons. Study period: November 2021-January 2023. 120 experts were surveyed.</p><p>Degrees of consensus: Very strong: >90%, Strong: 80%–90%, Moderate: 50%–80%, No consensus: <50%.</p><p>The definition for each oncological colectomy was established by very strong, and strong recommendations.</p><p>Each oncological colectomy was established as Right hemicolectomy (RHC), RHC with D3 lymphadenectomy, Extended-RHC, transverse colon segmental colectomy, splenic flexure segmental colectomy, subtotal colectomy, total colectomy, left hemicolectomy (LHC), extended-LHC, sigmoidectomy.</p></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.05.017
{"title":"Surgical management of recurrent intraparietal hernia following disruption of the semilunar line by pararectus incision","authors":"","doi":"10.1016/j.cireng.2024.05.017","DOIUrl":"10.1016/j.cireng.2024.05.017","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173507724001534/pdfft?md5=d84985be4bb9897b51add5b1aafa2daf&pid=1-s2.0-S2173507724001534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.04.007
{"title":"Interpretation and critical appraisal of a systematic review and/or meta-analysis","authors":"","doi":"10.1016/j.cireng.2024.04.007","DOIUrl":"10.1016/j.cireng.2024.04.007","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.04.013
Introduction
Local resection (LR) is an alternative to total mesorectal excision (TME) that avoids its associated morbidity to the detriment of oncological radicality in early stages of rectal cancer. There are several conditioning factors for the success of this strategy, such as poor prognosis histological factors (PPHF), involvement of resection margins, clinical under staging, or complications that may lead to the indication for radical surgery with TME.
Patients and method
An international multicenter prospective observational open-label study has been designed. Consecutive patients diagnosed with early rectal cancer (cT1N0 on MRI +/− endorectal ultrasound) whose lower limit is a maximum of 2 cm proximal to the ano-rectal junction will be included. The primary objective of the study is to determine the overall prevalence of PPHF after LR and requiring TME or postoperative radio-chemotherapy.
Discussion
The prevalence of PPHF conditioning the success of LR in early distal rectal cancer has been scarcely studied in the literature, and there are very few prospective data. Considering the increasing interest in the watch and wait strategy in rectal cancer and its possible application in early-stage tumors, it seems necessary to know this information.
The results of this study will help guide clinical practice in patients with early distal rectal cancer. It will also provide quality information for the design of future comparative studies to improve organ preservation success in these patients.
Trial registration number: NCT05927584.
导言:局部切除术(LR)是全直肠系膜切除术(TME)的一种替代方案,在直肠癌的早期阶段,它可以避免与之相关的发病率,但不利于肿瘤根治。这一策略的成功有几个条件因素,如预后不良的组织学因素(PPHF)、切除边缘受累、临床分期不足或可能导致TME根治术指征的并发症:设计了一项国际多中心前瞻性开放标签观察研究。该研究将连续纳入被诊断为早期直肠癌(核磁共振成像+/-肛门直肠超声检查结果为cT1N0)且下限在肛门直肠交界处近端不超过2厘米的患者。研究的主要目的是确定 LR 后需要 TME 或术后放射化疗的 PPHF 的总体发病率:讨论:文献中几乎没有研究早期远端直肠癌 LR 成功与否的 PPHF 发生率,前瞻性数据也非常少。考虑到人们对直肠癌观察和等待策略的兴趣与日俱增,以及该策略在早期肿瘤中的可能应用,了解这些信息似乎很有必要。这项研究的结果将有助于指导早期远端直肠癌患者的临床实践。它还将为设计未来的比较研究提供高质量的信息,以提高这些患者的器官保留成功率:NCT05927584.
{"title":"Local Excision for organ preservation in early REctal cancer with No Adjuvant treatment (LORENA Trial): prospective observational study protocol","authors":"","doi":"10.1016/j.cireng.2024.04.013","DOIUrl":"10.1016/j.cireng.2024.04.013","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Local resection (LR) is an alternative to </span>total mesorectal excision (TME) that avoids its associated morbidity to the detriment of oncological radicality in early stages of </span>rectal cancer. There are several conditioning factors for the success of this strategy, such as poor prognosis histological factors (PPHF), involvement of resection margins, clinical under staging, or complications that may lead to the indication for radical surgery with TME.</p></div><div><h3>Patients and method</h3><p>An international multicenter prospective observational open-label study has been designed. Consecutive patients diagnosed with early rectal cancer (cT1N0 on MRI +/− endorectal ultrasound) whose lower limit is a maximum of 2 cm proximal to the ano-rectal junction will be included. The primary objective of the study is to determine the overall prevalence of PPHF after LR and requiring TME or postoperative radio-chemotherapy.</p></div><div><h3>Discussion</h3><p>The prevalence of PPHF conditioning the success of LR in early distal rectal cancer has been scarcely studied in the literature, and there are very few prospective data. Considering the increasing interest in the watch and wait strategy in rectal cancer and its possible application in early-stage tumors, it seems necessary to know this information.</p><p>The results of this study will help guide clinical practice in patients with early distal rectal cancer. It will also provide quality information for the design of future comparative studies to improve organ preservation success in these patients.</p><p>Trial registration number: NCT05927584.</p></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2023.12.004
{"title":"Neurofibroma of the vagus nerve as an incidental finding during left modified radical neck dissection for papillary thyroid cancer","authors":"","doi":"10.1016/j.cireng.2023.12.004","DOIUrl":"10.1016/j.cireng.2023.12.004","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.cireng.2024.04.005
{"title":"Use of systematic review and meta-analysis in surgery: Quality assessment, identification of deficient areas, and points for improvement","authors":"","doi":"10.1016/j.cireng.2024.04.005","DOIUrl":"10.1016/j.cireng.2024.04.005","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}