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Multifocal small bowel adenocarcinoma with liver metastasis based on a 16-year history of Crohn’s disease 基于 16 年克罗恩病史的多灶性小肠腺癌伴肝脏转移。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.01.007
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引用次数: 0
Hepatosplenic fusion: an extremely rare finding 肝脾融合：极为罕见的发现：[[en]]肝脾融合：极为罕见的发现。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.01.009
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引用次数: 0
Umbrella reviews 雨伞评论。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.05.006
{"title":"Umbrella reviews","authors":"","doi":"10.1016/j.cireng.2024.05.006","DOIUrl":"10.1016/j.cireng.2024.05.006","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 555-557"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199928","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}
引用次数: 0
Need for a targeted perioperative antibiotic treatment protocol for patients with preoperative biliary drainage undergoing pancreaticoduodenectomy 需要为接受胰十二指肠切除术的术前胆道引流患者制定有针对性的围手术期抗生素治疗方案。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.09.003
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 < 0.01). 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 < 0.01%). 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）的患者是否在术前进行胆道引流，评估患者的细菌嗜好，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：单中心回顾性观察研究：对接受胰十二指肠切除术的患者进行术前胆道支架（P组，支架）和无支架（NP组，无支架）手术。在采用头孢他啶和甲硝唑（NP组）和哌拉西林-他唑巴坦（P组）的围手术期针对性抗生素治疗方案后，对包括SSI及其亚型在内的术后并发症进行了分析：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）。16.7%（NP 组）与 76.7%（P 组）的术中培养结果呈阳性，P 组为阴性：胆道引流患者的细菌嗜好不同，肠杆菌、肠球菌属和念珠菌的嗜好更高。针对各组预期微生物采用围手术期抗生素治疗后，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
Bronchobiliary fistula as a rare complication after interventional management of biliary complications 支气管胆瘘是胆道并发症介入治疗后的罕见并发症。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.02.002
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引用次数: 0
New surgical techniques and strategies for Crohn’s disease: Results vs expectations 治疗克罗恩病的外科新技术和新策略：结果与预期
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.04.017
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引用次数: 0
Safety and feasibility of a new rectoscope in rectal cancer surgery. First clinical trial 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。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.07.005
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 3D 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，该直肠镜可通过透射光显示肿瘤手术中横切直肠的最佳点。该设备是与工程师团队共同开发的，并通过 3D 打印技术制造而成。参与试验的 18 名患者平均年龄为 71 岁，通过结肠镜检查测量的肿瘤到肛门边缘的平均距离为 10.4 ± 3.9 厘米，通过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
Robotic Splnectomy: the new gold standard? 机器人脾脏切除术：新的黄金标准？
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.07.003
Jose Manuel Ramia , Cándido Alcazar , Beniamino Pascotto , Paola Melgar , Juan Santiago Azagra
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引用次数: 0
Steps in conducting a systematic review with meta-analysis 进行荟萃分析系统综述的步骤。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.06.003
{"title":"Steps in conducting a systematic review with meta-analysis","authors":"","doi":"10.1016/j.cireng.2024.06.003","DOIUrl":"10.1016/j.cireng.2024.06.003","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"102 10","pages":"Pages 558-560"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473517","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}
引用次数: 0
Abdominal hernias secondary to non-penetrating trauma. A systematic review 非穿透性创伤继发的腹股沟疝。系统综述。
Cirugia espanola
Pub Date : 2024-10-01 DOI: 10.1016/j.cireng.2024.07.002
José Ceballos Esparragón , Javier Dagnesses Fonseca , Jordi Marín García , Patrizio Petrone
Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024. Computed tomography is the gold-standard imaging test for diagnosis. Open surgery is generally the preferred approach, particularly in emergencies. Acute TAWH can be treated by primary suture or mesh repair, depending on local conditions, while late cases usually require mesh.
创伤性腹壁疝（TAWH）是指由于钝器损伤导致腹壁缺损，腹腔内容物突出。本综述旨在描述这种罕见病症的人口统计学和临床方面，确定手术干预的最佳时机，评估使用网片的必要性，并分析手术治疗的有效性。因此，我们在 2004 年 1 月至 2024 年 3 月期间使用 PubMed、Embase 和 Scopus 数据库进行了系统性综述。计算机断层扫描是诊断的金标准成像检查。开腹手术通常是首选方法，尤其是在紧急情况下。急性 TAWH 可根据当地情况进行初次缝合或网片修复，晚期病例通常需要进行网片修复。
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引用次数: 0
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