Cirugia espanola最新文献

Hiatus hernia (HH) is a relatively prevalent condition in our setting, yet there is little clinical evidence or guidelines establishing precise recommendations for its diagnostic and therapeutic management. In order to establish clinical recommendations for the diagnostic and therapeutic management of patients with complex hiatal hernia, defined as a primary type III or IV mixed hernia, a large one with >30% of the gastric contents in the thoracic cavity, or a recurrence. This document was prepared based on current scientific evidence and the experience of a group of 28 expert surgeons, using GRADE methodology in order to establish recommendations on 13 controversial aspects related to this pathology. Although the quality of evidence and the degree of recommendation are high in some areas, high-quality prospective clinical studies are needed to clarify certain unresolved points of controversy.

The transmission of diseases through organ transplantation is an inherent risk to the transfer of biological material between individuals. This risk must be minimised, while also avoiding the unnecessary loss of organs suitable for transplantation obtained from donors with a history of a condition that may affect organ function or may be transmitted to the recipient-such donors are referred to as non-standard risk donors. The final decision to transplant organs from these donors must be made following a thorough risk/benefit assessment. To this end, the approach in Spain has been based on the provision of targeted support to transplant teams through the development and adoption of reference documents, a second-opinion system, and the generation of evidence through the prospective follow-up of recipients of organs transplanted from this type of donors.

Gastric cancer (GC) has high mortality due to late diagnosis from nonspecific symptoms. Advances in diagnostics and artificial intelligence (AI) promise earlier detection through greater sensitivity and specificity. This study reviews literature, including meta-analyses and systematic reviews, on AI in gastric adenocarcinoma (GA). In December 2024, following PRISMA, we searched PubMed, Web of Science, and Cochrane. Seventeen of 228 articles met inclusion criteria, comparing AI with other diagnostic or therapeutic approaches. Findings indicate AI may enhance imaging, histological assessment, endoscopy techniques, and surgical procedures. Progressive hospital implementation could significantly transform GA diagnosis, treatment, and prognosis.

Near-infrared fluorescent cholangiography (NIFC) has emerged as a promising technique in laparoscopic cholecystectomy (LC), enabling accurate anatomical identification of the biliary tract. Its use has been associated with improved visualization of critical structures, reduced incidence of complications, lower conversion rates to open surgery, and shorter operative times and hospital stays. Key advantages include its easy integration into routine practice, a short learning curve, and straightforward interpretation of images, provided that appropriate protocols are followed. Nevertheless, several limitations currently hinder its widespread standardization. The absence of high-quality evidence prevents consensus on the optimal indocyanine green dose and timing of administration, while the need for specialized imaging systems restricts universal adoption. Future research should focus on defining uniform protocols, validating their impact on LC outcomes, and consolidating the role of NIFC as an intraoperative reference technique for enhancing safety and efficiency in biliary surgery.