Cirugia espanola最新文献

英文中文

Gastric diverticulum: incidental finding in preoperative study. 胃憩室：术前研究中偶然发现。

Cirugia espanola

Pub Date : 2025-12-03 DOI: 10.1016/j.cireng.2025.800253

Mónica Pujante Menchón, Asunción Candela Gomis, Laura Rius Acebes, Antonio F Compañ Rosique

引用次数: 0

Can we decrease the risk of complex liver surgery with the new GLP1 and GIP analogues? 我们可以用新的GLP1和GIP类似物降低复杂肝脏手术的风险吗？

Cirugia espanola

Pub Date : 2025-12-02 DOI: 10.1016/j.cireng.2025.800264

Iago Justo, María Calatayud, Javier Salamanca, María Camara, Alvaro García-Sesma, Carmelo Loinaz

引用次数: 0

Predictive values of axillary involvement in breast cancer 腋窝受累对乳腺癌的预测价值。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800231

Laura Comín Novella , Mónica Oset García , Marta González Pérez , El Mostafa el Yaqine er Raoudi , Pedro Pablo Stredel Russian , Francisco Luis Carrillo Trabalón , Sandra Lario Pérez , José Francisco Noguera Aguilar

Introduction

In breast cancer, recommendations for axillary surgery are currently shifting toward omitting SLNB. Studies have shown that not performing axillary staging has no impact on regional control or survival and translates into improved quality of life. We sought to determine whether certain clinical factors such as tumor size or type, immunohistochemical characteristics, tumor grade or Ki 67 value are predictive of metastatic disease in the lymph nodes.

Methods

A retrospective observational study was conducted of patients who underwent breast cancer surgery during the years 2019–2024. Inclusion criteria were: tumor size equal to or less than 2 cm as measured by ultrasound, and axilla that was clinically and ultrasound-negative.

Results

One hundred and fifty-six breasts were operated on, with a mean age of 64.5 years. Regarding immunohistochemistry, tumor grade, and age, no differences were observed. However, patients with tumors >2 cm and lobular tumors did have greater lymph node involvement (P < .05).

Conclusions

There are no variables that predict lymph node involvement before surgery. Today, we are not prepared to lose the information provided by SLNB, and part of the postoperative treatment is determined by its results.

简介：在乳腺癌中，腋窝手术的建议目前正在转向省略SLNB。研究表明，不进行腋窝分期对局部控制或生存没有影响，并转化为生活质量的提高。我们试图确定某些临床因素，如肿瘤大小或类型、免疫组织化学特征、肿瘤分级或Ki 67值是否可预测淋巴结转移性疾病。方法：对2019-2024年间接受乳腺癌手术的患者进行回顾性观察研究。纳入标准：超声测量肿瘤大小等于或小于2cm，临床及超声阴性腋窝。结果：共手术156例，平均年龄64.5岁。在免疫组化、肿瘤分级和年龄方面，没有观察到差异。然而，肿瘤bbb2cm和小叶肿瘤患者确实有更大的淋巴结累及(P)结论：术前没有预测淋巴结累及的变量。今天，我们不准备失去SLNB提供的信息，部分术后治疗取决于其结果。

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引用次数: 0

Inguinoscrotal hernia with bladder herniation and ureterohydronephrosis 腹股沟阴囊疝合并膀胱疝和输尿管肾积水。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800243

Gema Cabanillas Vera , Alejandro Rodriguez Caballero , Alberto Hernández Matías , Sara Gortázar de las Casas

引用次数: 0

Hepatic gas gangrene 肝气性坏疽。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800241

María del Mar Gómez Cisneros , Cristina Méndez García , Jesús Cañete Gómez , Pablo Parra-Membrives

引用次数: 0

Evaluation of textbook outcome in liver transplantation 肝移植临床疗效评价。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800255

Esther Brea Gómez , Pablo Dabán López , Ana Belén Vico Arias , Antonio Palomeque Jiménez , Natalia Zambudio Carroll , María Trinidad Villegas Herrera , Jesús María Villar del Moral , Mario Serradilla Martín

Introduction

The textbook outcome (TO) is a qualitative measurement tool for surgical procedures that has been tested in a multitude of cases. Liver transplantation (LT) is one of the most complex interventions in our specialty. In this study, we evaluate the achievement of TO in patients undergoing LT. We also propose a definition of specific TO for LT surgery.

Materials and methods

A single-centre retrospective study was conducted between May 2012 and December 2022. Patients whose data were incomplete in the database, patients with retransplantation, transplants for acute liver failure, intraoperative findings of portal vein thrombosis, and patients who received a donor graft after circulatory death were excluded. TO was defined as the absence of mortality and major complications in the first 90 days after surgery, absence of readmission in the first 30 days, and a hospital stay not prolonged > p75.

Results

A total of 132 patients were included. More than half achieved TO (56.8%). Prolonged hospital stay was the variable that most limited the achievement of TO (25% of patients). Pre-transplant hypertension in the recipient and prolonged cold ischaemia time were associated with a lower rate of TO. Survival was higher in the group that achieved TO, although statistical significance could not be demonstrated.

Conclusions

TO is a valuable measure for assessing LT. A universal definition of TO for LT will be necessary given the lack of consensus on the criteria used among the different series published to date.

简介：教科书结果（TO）是一种定性测量工具，用于外科手术，已在众多病例中进行了测试。肝移植（LT）是我们专业中最复杂的干预之一。在本研究中，我们评估了肝移植患者的TO成就。我们还提出了肝移植手术特异性TO的定义。材料和方法：2012年5月至2022年12月进行单中心回顾性研究。排除了数据库中数据不完整的患者、再移植患者、因急性肝衰竭而进行移植的患者、术中发现门静脉血栓形成的患者以及在循环性死亡后接受供体移植的患者。TO的定义是术后90天内无死亡和主要并发症，30天内无再入院，住院时间不延长[p] 75。结果：共纳入132例患者。超过一半的人达到了TO（56.8%）。延长住院时间是最限制TO实现的变量（25%的患者）。移植前受者的高血压和延长的冷缺血时间与较低的TO率相关。虽然无法证明统计学意义，但达到TO的组生存率更高。结论：TO是评估LT的一项有价值的措施。鉴于迄今为止发表的不同系列中使用的标准缺乏共识，有必要对LT的TO进行普遍定义。

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引用次数: 0

Comparison of weight loss and metabolic syndrome parameters between sleeve gastrectomy and Roux-en-Y gastric bypass: A propensity score analysis 袖式胃切除术和Roux-en-Y胃旁路术的体重减轻和代谢综合征参数比较：倾向评分分析。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800226

María Asunción Acosta-Mérida , Raquel Bañolas-Suárez , Julia Díaz-Dávila , Pedro Saavedra-Santana , Joaquín Marchena-Gómez

Introduction

Although laparoscopic sleeve gastrectomy (LSG) has positioned itself as the leading bariatric technique worldwide, surpassing laparoscopic Roux-en-Y gastric bypass (LRYGB), its possible inferiority in terms of weight and metabolic results remains controversial. The of this study was to compare the response of both techniques in terms of weight loss and obesity-related metabolic complications.

Methods

We conducted a retrospective study of all patients who had undergone LSG and LRYGB in our center from 2013 to 2022. Patient characteristics, postoperative complications, postoperative weight loss and evolution of comorbidities were recorded. Propensity score matching (1:1) was performed to homogenize the 2 intervention groups for body mass index (BMI) and preoperative metabolic syndrome.

Results

Out of the 354 patients who met the selection criteria, 309 patients were ultimately included in the study (172 LSG and 137 LRYGB); mean age was 45.8 ± 9.5 years; 205 were women (66.3%). Median BMI was 47 (interquartile range = 42.8–52.9). After propensity score matching, 118 patients remained in each group. BMI trajectories during the first 3 years of follow-up after the 2 types of surgery showed no significant differences (P = .693). One month after treatment, there were also no differences in postoperative metabolic syndrome parameters or complication rates (P = .866).

Conclusions

Our data suggest that sleeve gastrectomy provides a similar weight and metabolic response to Roux-en-Y gastric bypass in patients with similar BMI and metabolic syndrome characteristics.

导论：尽管腹腔镜袖胃切除术（LSG）已经超越腹腔镜Roux-en-Y胃旁路手术（LRYGB），成为全球领先的减肥技术，但其在体重和代谢结果方面可能存在的劣势仍然存在争议。本研究的目的是比较两种技术在减肥和肥胖相关代谢并发症方面的反应。方法：对2013年至2022年在我中心接受LSG和LRYGB治疗的所有患者进行回顾性研究。记录患者特征、术后并发症、术后体重减轻和合并症的演变情况。采用倾向评分匹配（1:1）对体重指数（BMI）和术前代谢综合征进行均一化。结果：在符合选择标准的354例患者中，309例患者最终被纳入研究（172例LSG和137例LRYGB）；平均年龄45.8±9.5岁；205例为女性（66.3%）。BMI中位数为47（四分位数范围为42.8 - 52.9）。倾向评分匹配后，每组保留118例患者。两种手术后3年随访的BMI轨迹差异无统计学意义（P = .693）。治疗1个月后，两组患者的术后代谢综合征参数及并发症发生率也无差异（P = .866）。结论：我们的数据表明，在BMI和代谢综合征特征相似的患者中，套筒胃切除术提供了与Roux-en-Y胃旁路术相似的体重和代谢反应。

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引用次数: 0

Assessing improvements in quality using textbook outcomes in colorectal surgery: A systematic review 使用教科书结果评估结直肠手术质量的改善：一项系统综述。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800223

Luis Hurtado-Pardo, Zutoia Balciscueta Coltell, Janine Tabet Almeida, Mº Carmen Martin Diéguez, Manuel López Bañeres, Natalia Uribe Quintana

Textbook outcome is a composite measure of several clinically important perioperative outcomes that are included in the definition of ideal surgical care. The aim of this study is to summarize the different definitions concerning textbook outcome in colorectal surgery. A systematic review of the literature according to PRISMA guidelines was carried out until April 2025. Primary studies on adult patients undergoing colon or rectal resection and assessing the textbook outcomes of the procedure were included. Twenty-one studies were included for review. Textbook outcomes achieved varied from 41.8% to 80.8%. The most prevalent variables were “no mortality” and “length of stay” (85.7%). The variable that contributed mostly to not meeting the definition of textbook outcome was “no complications” (42.9%), with 6 possible definitions. As a result of the variability described, a consensus is to be reached in order to validate the extension of this tool. The proposed definition for textbook outcomes in colorectal surgery would be the following: no complications (>III Clavien-Dindo), length of stay (<75th percentile), no readmissions (<30 days), no mortality (<30 days), and oncological surgery (R0 resection and >12 lymph nodes).

教科书结果是几种临床重要围手术期结果的综合测量，包括在理想手术护理的定义中。本研究的目的是总结关于结直肠手术的不同定义。根据PRISMA指南对文献进行了系统的审查，直到2025年4月。包括对接受结肠或直肠切除术的成年患者的初步研究，并评估该手术的教科书结果。21项研究被纳入审查。教科书完成率从41.8%到80.8%不等。最常见的变量是“无死亡率”和“住院时间”（85.7%）。导致不符合教科书结果定义的变量主要是“无并发症”（42.9%），有6种可能的定义。由于所描述的可变性，为了验证该工具的扩展，需要达成共识。建议的结直肠手术预后的教科书定义如下：无并发症（>III Clavien-Dindo），住院时间（百分位数），无再入院（12个淋巴结）。

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引用次数: 0

Does obtaining textbook outcome influence the survival rates of patients undergoing surgery for hepatocellular carcinoma? 获得教科书结局是否会影响肝细胞癌手术患者的生存率？

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800239

Jose M. Ramia , A Paredes , Cándido Alcazar , Silvia Carbonell-Morote , Paola Melgar , Celia Villodre

引用次数: 0

Generational change in liver transplantation: Challenges and opportunities following a national survey 肝移植的代际变化：一项全国调查的挑战和机遇。

Cirugia espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.cireng.2025.800238

Víctor López-López , Cándido Alcázar , Ricardo Robles Campos , Jose Manuel Ramia , Pablo Ramírez

引用次数: 0

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