Pub Date : 2026-01-22DOI: 10.1016/j.cireng.2026.800300
Aram Rojas, Sarah B Hays, Syed Mehdi, Melissa E Hogg
{"title":"Intraoperative management of iatrogenic bile duct injury during robotic Whipple procedure.","authors":"Aram Rojas, Sarah B Hays, Syed Mehdi, Melissa E Hogg","doi":"10.1016/j.cireng.2026.800300","DOIUrl":"10.1016/j.cireng.2026.800300","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800300"},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044505","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 : 2026-01-14DOI: 10.1016/j.cireng.2026.800285
Rebeca Abad Moret, Esteban Díaz, Laura Córdoba, Sylwia Bilas, Teresa Gómez-Elvira, Natalia González Alcolea, Beatriz Díaz San Andrés, Francisco J Cueto, Eduardo López-Collazo, Ramón Cantero Cid
Background: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, with treatment resistance posing a persistent clinical challenge. Patient-derived organoids (PDO) offer a promising platform for modelling tumour biology and therapeutic responses; however, conventional Matrigel-based PDO lack the immune contexture necessary to capture the full complexity of the tumour microenvironment (TME). In this study, we performed a second model, known as air-liquid interface patient-derived organoids (ALI-PDO), that preserves infiltrating immune cells, evaluating its relative advantages over the classical Matrigel culture in modelling CRC.
Materials and methods: In this study, we present a comparative analysis of 2 organoid systems-Matrigel-PDO and air-liquid interface PDO (ALI-PDO)-generated from CRC surgical biopsies obtained from 5 patients.
Results: Both models recapitulated key histopathological and proliferative features of the original tumours; however, only ALI-PDO preserved native immune infiltrates, including CD45+, CD3+, and CD68+ cells. Functional assays demonstrated that ALI-PDO allowed for the investigation of drug-induced immune dynamics, revealing selective sensitivity of immune cells to 5-fluorouracil (5-FU) treatment. In contrast, Matrigel-PDO, composed solely of neoplastic epithelial cells, failed to reflect these interactions.
Conclusions: Our findings establish ALI-PDO as an advanced preclinical model that more accurately mirrors the immunological and architectural complexity of CRC. This system offers a valuable tool for evaluating immunomodulatory therapies and guiding personalised treatment strategies. Future studies should expand the application of ALI-PDO to immunotherapy and incorporate additional components of the TME to further enhance translational relevance.
{"title":"Modelling the colorectal cancer immune microenvironment using air-liquid interface organoids for personalised therapeutic evaluation.","authors":"Rebeca Abad Moret, Esteban Díaz, Laura Córdoba, Sylwia Bilas, Teresa Gómez-Elvira, Natalia González Alcolea, Beatriz Díaz San Andrés, Francisco J Cueto, Eduardo López-Collazo, Ramón Cantero Cid","doi":"10.1016/j.cireng.2026.800285","DOIUrl":"10.1016/j.cireng.2026.800285","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, with treatment resistance posing a persistent clinical challenge. Patient-derived organoids (PDO) offer a promising platform for modelling tumour biology and therapeutic responses; however, conventional Matrigel-based PDO lack the immune contexture necessary to capture the full complexity of the tumour microenvironment (TME). In this study, we performed a second model, known as air-liquid interface patient-derived organoids (ALI-PDO), that preserves infiltrating immune cells, evaluating its relative advantages over the classical Matrigel culture in modelling CRC.</p><p><strong>Materials and methods: </strong>In this study, we present a comparative analysis of 2 organoid systems-Matrigel-PDO and air-liquid interface PDO (ALI-PDO)-generated from CRC surgical biopsies obtained from 5 patients.</p><p><strong>Results: </strong>Both models recapitulated key histopathological and proliferative features of the original tumours; however, only ALI-PDO preserved native immune infiltrates, including CD45<sup>+</sup>, CD3<sup>+</sup>, and CD68<sup>+</sup> cells. Functional assays demonstrated that ALI-PDO allowed for the investigation of drug-induced immune dynamics, revealing selective sensitivity of immune cells to 5-fluorouracil (5-FU) treatment. In contrast, Matrigel-PDO, composed solely of neoplastic epithelial cells, failed to reflect these interactions.</p><p><strong>Conclusions: </strong>Our findings establish ALI-PDO as an advanced preclinical model that more accurately mirrors the immunological and architectural complexity of CRC. This system offers a valuable tool for evaluating immunomodulatory therapies and guiding personalised treatment strategies. Future studies should expand the application of ALI-PDO to immunotherapy and incorporate additional components of the TME to further enhance translational relevance.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800285"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992381","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 : 2026-01-08DOI: 10.1016/j.cireng.2026.800275
Jordi Seguí Orejuela, Juan Jesús Rubio, Celia Villodre, María Marco, José M Ramia
{"title":"Pseudoaneurysm of the cystic artery: a rare complication.","authors":"Jordi Seguí Orejuela, Juan Jesús Rubio, Celia Villodre, María Marco, José M Ramia","doi":"10.1016/j.cireng.2026.800275","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800275","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800275"},"PeriodicalIF":0.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949527","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 : 2026-01-08DOI: 10.1016/j.cireng.2026.800278
Jaime López Sánchez, José E Quiñones Sampedro, Pedro A Montalbán Valverde, Luis M González Fernández, Manuel J Iglesias Iglesias, María C Esteban Velasco, Francisco Blanco Antona
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.
{"title":"Green light for safer biliary surgery: the expanding role of fluorescent cholangiography.","authors":"Jaime López Sánchez, José E Quiñones Sampedro, Pedro A Montalbán Valverde, Luis M González Fernández, Manuel J Iglesias Iglesias, María C Esteban Velasco, Francisco Blanco Antona","doi":"10.1016/j.cireng.2026.800278","DOIUrl":"https://doi.org/10.1016/j.cireng.2026.800278","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800278"},"PeriodicalIF":0.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949522","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 : 2026-01-01Epub Date: 2025-11-21DOI: 10.1016/j.cireng.2025.800248
Rosa M. Jimenez-Rodriguez , Fátima Aguilar-del-Castillo , Felipe Quezada-Diaz , Julio García-Aguilar
Locally advanced rectal cancer has traditionally been treated with neoadjuvant chemoradiotherapy, followed by total mesorectal excision (TME)—a technique that is effective but associated with high morbidity and functional impairment. The identification of patients with a clinical complete response (cCR) after treatment has driven the adoption of the “Watch-and-Wait” (W&W) strategy, aimed at avoiding surgery without compromising oncologic safety. Current evidence, drawn from international series, multicentre records, and clinical trials, supports the view that W&W offers overall survival and disease-free survival rates comparable to those of radical surgery, with clear advantages in organ preservation and quality of life. However, this strategy requires careful patient selection, standardised re-evaluation protocols, and intensive follow-up in specialised centres. In summary, W&W has become a valid and safe alternative to surgical treatment in selected patients with rectal cancer following neoadjuvant therapy.
{"title":"Organ preservation in rectal cancer: Clinical basis of the watch-and-wait strategy","authors":"Rosa M. Jimenez-Rodriguez , Fátima Aguilar-del-Castillo , Felipe Quezada-Diaz , Julio García-Aguilar","doi":"10.1016/j.cireng.2025.800248","DOIUrl":"10.1016/j.cireng.2025.800248","url":null,"abstract":"<div><div>Locally advanced rectal cancer has traditionally been treated with neoadjuvant chemoradiotherapy, followed by total mesorectal excision (TME)—a technique that is effective but associated with high morbidity and functional impairment. The identification of patients with a clinical complete response (cCR) after treatment has driven the adoption of the “Watch-and-Wait” (W&W) strategy, aimed at avoiding surgery without compromising oncologic safety. Current evidence, drawn from international series, multicentre records, and clinical trials, supports the view that W&W offers overall survival and disease-free survival rates comparable to those of radical surgery, with clear advantages in organ preservation and quality of life. However, this strategy requires careful patient selection, standardised re-evaluation protocols, and intensive follow-up in specialised centres. In summary, W&W has become a valid and safe alternative to surgical treatment in selected patients with rectal cancer following neoadjuvant therapy.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 1","pages":"Article 800248"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589622","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 : 2026-01-01Epub Date: 2025-11-05DOI: 10.1016/j.cireng.2025.800244
Paula Muñoz-Muñoz , Irene López-Rojo , Amaia Ilundain-Idoate , Pedro Bretcha-Boix , Rosa M. Cañon , Felipe A. Calvo , Jose Manuel Asencio-Pascual
Soft tissue sarcomas (STS) require a multidisciplinary approach that balances oncologic control with functional preservation. Adjuvant external beam radiotherapy (EBRT) improves local control but is often limited by its toxicity. Intraoperative radiotherapy (IORT) allows for precise delivery of a single high dose during surgery, minimizing radiation exposure to adjacent tissues. This study reviews the role of IORT to treat sarcoma in the extremities and retroperitoneum, while also evaluating current clinical applications, prognosis and usage trends in Spain, based on a national survey that collected responses from all centers currently using IORT. IORT is employed in STS treatment in 11 Spanish hospitals (mostly electron-based systems), but the volume of patients treated is very low (63.6% use IORT in ≤10 cases per year). Despite favorable local control rates and reduced morbidity, access to IORT remains inconsistent at sarcoma referral centers. Broader integration and standardized protocols are needed, alongside future prospective studies on neoadjuvant EBRT and IORT.
{"title":"“Current Use and Clinical Applications of Intraoperative Radiotherapy in Soft Tissue Sarcomas: Insights from a National Survey in Spain”","authors":"Paula Muñoz-Muñoz , Irene López-Rojo , Amaia Ilundain-Idoate , Pedro Bretcha-Boix , Rosa M. Cañon , Felipe A. Calvo , Jose Manuel Asencio-Pascual","doi":"10.1016/j.cireng.2025.800244","DOIUrl":"10.1016/j.cireng.2025.800244","url":null,"abstract":"<div><div>Soft tissue sarcomas (STS) require a multidisciplinary approach that balances oncologic control with functional preservation. Adjuvant external beam radiotherapy (EBRT) improves local control but is often limited by its toxicity. Intraoperative radiotherapy (IORT) allows for precise delivery of a single high dose during surgery, minimizing radiation exposure to adjacent tissues. This study reviews the role of IORT to treat sarcoma in the extremities and retroperitoneum, while also evaluating current clinical applications, prognosis and usage trends in Spain, based on a national survey that collected responses from all centers currently using IORT. IORT is employed in STS treatment in 11 Spanish hospitals (mostly electron-based systems), but the volume of patients treated is very low (63.6% use IORT in ≤10 cases per year). Despite favorable local control rates and reduced morbidity, access to IORT remains inconsistent at sarcoma referral centers. Broader integration and standardized protocols are needed, alongside future prospective studies on neoadjuvant EBRT and IORT.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 1","pages":"Article 800244"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472575","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 : 2026-01-01Epub Date: 2025-11-22DOI: 10.1016/j.cireng.2025.800262
Corrado P. Marini , Patrizio Petrone , Francesca Izzo , David A. Lieb II , Srinivas H. Reddy , John McNelis
Background
This study assessed whether there is a correlation between the grade of splenic injury and the semiquantitative assessment of the amount of the hemoperitoneum (HP) by a modified Federle score (mFS), and which of the 2 factors is more predictive of the need for intervention in adult patients with isolated blunt splenic injury (iBSI).
Methods
Retrospective cohort study of patients admitted (1/1/2019−12/31/2022) with iBSI. Continuous data are presented as means ± standard deviation and non-parametric data as frequencies with percentages. A test-retest analysis for intra- and inter-class reliability of HP assessment was done in a 10-patient subgroup.
Results
Among the 62 patients, 47 (75.8%) were managed nonoperatively (23 observation, 24 splenic artery embolization [SAE]), and 15 underwent splenectomy. The grade of splenic injury and mFS scores were 3.6 ± 1.3 and 4.1 ± 1.9, respectively. The 22 patients who underwent SAE were more severely injured in terms of grade of splenic injury (4.0 ± 1.2 vs 2.6 ± 1.1), amount of HP by mFS (4.1 ± 1.8 vs 3.1 ± 1.7) and ISS (21 ± 11 vs 15 ± 12) compared to the observed patients (P < .05). Mortality was 8%. SAE and splenectomy groups differed only by the quantity of HP (4.1 ± 1.8 vs 5.5 ± 1.3). While there was a correlation between AAST grade and mFS, only mFS was predictive of splenectomy.
Conclusion
The quantity of HP as assessed by mFS may be more predictive than the grade of splenic injury regarding the need for splenectomy in patients with iBSI.
背景：本研究评估脾脏损伤等级与改良Federle评分（mFS）半定量评估腹腔积血（HP）量之间是否存在相关性，以及这两个因素中哪一个更能预测成人孤立性钝性脾损伤（iBSI）患者是否需要干预。方法：对2019年1月1日至2022年12月31日住院的iBSI患者进行回顾性队列研究。连续数据以平均值±标准差表示，非参数数据以频率和百分比表示。在10例患者亚组中，对HP评估的类内和类间可靠性进行了重测分析。结果：62例患者中，非手术治疗47例（75.8%）（23例观察，24例脾动脉栓塞[SAE]）， 15例脾切除术。脾损伤分级和mFS评分分别为3.6±1.3分和4.1±1.9分。与观察的患者相比，22例SAE患者在脾损伤等级（4.0±1.2 vs 2.6±1.1）、mFS HP（4.1±1.8 vs 3.1±1.7）和ISS（21±11 vs 15±12）方面的损伤更严重(P结论：mFS评估的HP数量可能比脾损伤等级更能预测iBSI患者是否需要脾切除术。
{"title":"A modified Federle score is superior to injury grade in predicting the need for splenectomy in patients with isolated blunt splenic trauma","authors":"Corrado P. Marini , Patrizio Petrone , Francesca Izzo , David A. Lieb II , Srinivas H. Reddy , John McNelis","doi":"10.1016/j.cireng.2025.800262","DOIUrl":"10.1016/j.cireng.2025.800262","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed whether there is a correlation between the grade of splenic injury and the semiquantitative assessment of the amount of the hemoperitoneum (HP) by a modified Federle score (mFS), and which of the 2 factors is more predictive of the need for intervention in adult patients with isolated blunt splenic injury (iBSI).</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients admitted (1/1/2019−12/31/2022) with iBSI. Continuous data are presented as means ± standard deviation and non-parametric data as frequencies with percentages. A test-retest analysis for intra- and inter-class reliability of HP assessment was done in a 10-patient subgroup.</div></div><div><h3>Results</h3><div>Among the 62 patients, 47 (75.8%) were managed nonoperatively (23 observation, 24 splenic artery embolization [SAE]), and 15 underwent splenectomy. The grade of splenic injury and mFS scores were 3.6 ± 1.3 and 4.1 ± 1.9, respectively. The 22 patients who underwent SAE were more severely injured in terms of grade of splenic injury (4.0 ± 1.2 vs 2.6 ± 1.1), amount of HP by mFS (4.1 ± 1.8 vs 3.1 ± 1.7) and ISS (21 ± 11 vs 15 ± 12) compared to the observed patients (<em>P</em> < .05). Mortality was 8%. SAE and splenectomy groups differed only by the quantity of HP (4.1 ± 1.8 vs 5.5 ± 1.3). While there was a correlation between AAST grade and mFS, only mFS was predictive of splenectomy.</div></div><div><h3>Conclusion</h3><div>The quantity of HP as assessed by mFS may be more predictive than the grade of splenic injury regarding the need for splenectomy in patients with iBSI.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 1","pages":"Article 800262"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598233","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 : 2026-01-01Epub Date: 2025-12-02DOI: 10.1016/j.cireng.2025.800263
Ramazan Serdar Arslan , Resad Beyoglu , Yavuz Savas Koca , Ahmet Emre Yenipazar
Background
Appendiceal diverticulosis is a rare and often underdiagnosed entity with significant clinical implications. Limited data are available regarding its incidence, clinicopathological features, and optimal management strategies.
Methods
We retrospectively reviewed 6836 appendectomy specimens at our institution between January 2013 and December 2024. Cases diagnosed with appendiceal diverticulosis were identified, and their demographic, clinical, radiological, and pathological data were analyzed. The incidence, presentation, complications, and association with neoplasms were assessed.
Results
Nineteen cases (0.27%) of appendiceal diverticulosis were identified, with a male predominance (68.4%) and a mean age of 49.7 ± 16.8 years. Preoperative diagnosis of AD was challenging; ultrasonography and computed tomography often failed to differentiate AD from conventional appendicitis. The perforation rate in AD cases was 26.3%, significantly higher than typical appendicitis. Neoplastic lesions were observed in 10.5% of AD specimens, although no malignancies were detected during the follow-up period. All patients underwent appendectomy, including those with incidentally discovered AD.
Conclusions
Appendiceal diverticulosis is a rare but clinically significant condition associated with increased risk of perforation and potential neoplastic transformation. Early surgical intervention is recommended for all cases, including incidental findings, to prevent complications. Our findings contribute to the limited body of literature on AD and highlight the importance of routine histopathological examination of appendectomy specimens.
{"title":"Prevalence and clinical significance of appendiceal diverticulosis: An 11-year retrospective study","authors":"Ramazan Serdar Arslan , Resad Beyoglu , Yavuz Savas Koca , Ahmet Emre Yenipazar","doi":"10.1016/j.cireng.2025.800263","DOIUrl":"10.1016/j.cireng.2025.800263","url":null,"abstract":"<div><h3>Background</h3><div>Appendiceal diverticulosis is a rare and often underdiagnosed entity with significant clinical implications. Limited data are available regarding its incidence, clinicopathological features, and optimal management strategies.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 6836 appendectomy specimens at our institution between January 2013 and December 2024. Cases diagnosed with appendiceal diverticulosis were identified, and their demographic, clinical, radiological, and pathological data were analyzed. The incidence, presentation, complications, and association with neoplasms were assessed.</div></div><div><h3>Results</h3><div>Nineteen cases (0.27%) of appendiceal diverticulosis were identified, with a male predominance (68.4%) and a mean age of 49.7 ± 16.8 years. Preoperative diagnosis of AD was challenging; ultrasonography and computed tomography often failed to differentiate AD from conventional appendicitis. The perforation rate in AD cases was 26.3%, significantly higher than typical appendicitis. Neoplastic lesions were observed in 10.5% of AD specimens, although no malignancies were detected during the follow-up period. All patients underwent appendectomy, including those with incidentally discovered AD.</div></div><div><h3>Conclusions</h3><div>Appendiceal diverticulosis is a rare but clinically significant condition associated with increased risk of perforation and potential neoplastic transformation. Early surgical intervention is recommended for all cases, including incidental findings, to prevent complications. Our findings contribute to the limited body of literature on AD and highlight the importance of routine histopathological examination of appendectomy specimens.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"104 1","pages":"Article 800263"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679682","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}
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