Cirugia espanola最新文献

英文中文

Competency development, continuous training, and performance evaluation in surgical practice. 外科实践中的能力发展、持续培训和绩效评估。

Cirugia espanola

Pub Date : 2025-08-06 DOI: 10.1016/j.cireng.2025.800200

Víctor Soria-Aledo, José Luis Aguayo-Albasini

引用次数: 0

Decision-making in surgical practice: Informed consent and shared decision-making strategies. 外科实践中的决策：知情同意和共同决策策略。

Cirugia espanola

Pub Date : 2025-08-06 DOI: 10.1016/j.cireng.2025.800196

Roger Cabezali-Sanchez

引用次数: 0

Benchmarking in surgery: The comparison to achieve excellence in results. 外科标杆：通过比较达到卓越的结果。

Cirugia espanola

Pub Date : 2025-08-06 DOI: 10.1016/j.cireng.2025.800201

Clara Gené-Škrabec, David Parés

引用次数: 0

Delayed gastric emptying after distal pancreatectomy: A systematic review of the literature 远端胰腺切除术后胃排空延迟：文献系统回顾。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800151

Ana Belén Hernández-Ferriz , Belén Hernández-Roca , Jordi Seguí-Orejuela , Assumpta Hernández-Santiago , María José Gil-Torregrosa , Carlos Felipe Campo-Betancourth , Celia Villodre-Tudela , Silvia Carbonell-Morote , José Manuel Ramia-Ángel

Most studies on delayed gastric emptying (DGE) after pancreatic surgery have been carried out after pancreatoduodenectomy. Information on DGE after left or distal pancreatectomy (DP) and the factors that cause it is very scarce.

We have conducted a systematic review in accordance with PRISMA guidelines using the descriptors “delayed gastric emptying” AND “distal pancreatectomy”, with no language limitations and date until December 31, 2024. To evaluate the quality of the non-randomized studies, we used the Newcastle-Ottawa Scale.

A total of 121 articles were obtained. Upon review, only 4 articles were relevant. They included 2549 patients, 52.9% of whom were women. A total of 228 presented DGE after DP, representing an incidence of 8.9%. The only factor related to DGE present in all series was the existence of a postoperative pancreatic fistula. The presence of abdominal collections, laparotomy approach used, multivisceral resection, older patients, tumor vascular involvement, and drains have been related to DGE after DP in some of the 4 articles studied.

The incidence of DGE after DP is close to 10%. Therefore, it should be systematically evaluated in any DP series. Among the factors associated with DGE, postoperative pancreatic fistula is the only confirmed factor contributing to its development. More studies are needed to evaluate these factors and thus reduce their incidence.

大多数关于胰腺手术后胃排空延迟的研究都是在胰十二指肠切除术后进行的。关于左侧或远端胰腺切除术（DP）后DGE及其引起因素的信息非常少。我们按照PRISMA指南使用“胃排空延迟”和“远端胰腺切除术”进行了系统评价，没有语言限制，日期截止到2024年12月31日。为了评价非随机研究的质量，我们使用了纽卡斯尔-渥太华量表。共获得121件物品。经审查，只有4篇文章是相关的。包括2549例患者，其中52.9%为女性。DP后DGE共228例，发生率为8.9%。所有系列中与DGE相关的唯一因素是术后胰瘘的存在。在研究的4篇文章中，腹部积液、开腹入路、多脏器切除、老年患者、肿瘤血管受累和引流与DP后DGE有关。DP后DGE的发生率接近10%。因此，在任何DP序列中都应该系统地评估它。在与DGE相关的因素中，术后胰瘘是唯一确定的导致其发展的因素。需要更多的研究来评估这些因素，从而减少它们的发生率。

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引用次数: 0

Impact of anesthetic technique on time to discharge of patients undergoing proctological surgery in major outpatient surgery 门诊大手术中麻醉技术对直肠手术患者出院时间的影响。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800157

Armando Cuesta Amigo , Nazrin Bakhshaliyeva , Javier García Septiem , Enrique Alday Muñoz

Introduction

The present study aims to compare the length of postoperative stay in outpatient surgery (OS) setting of patients undergoing anorectal surgery in four different anaesthetic techniques: local anaesthesia with deep sedation (LA + DS), low-dose spinal anaesthesia (LDSA) (less than 5 mg of hyperbaric bupivacaine or less than 20 mg of hyperbaric prilocaine), high-dose spinal anaesthesia (HDSA), and general anaesthesia (GA). Secondary outcomes include analysing postoperative complications and their relationship with the chosen anaesthetic technique.

Methods

Retrospective observational study of patients who underwent scheduled proctological surgery between January 2018 and September 2021. Patients were classified into four groups according to the anaesthetic technique used. The primary outcomes were the length of stay in AS, the need for postoperative opioids, postoperative nausea and vomiting, acute urinary retention, and failure to complete the AS regimen (unscheduled admission to the ward or visit to the emergency room in the first 24 h with or without hospital admission).

Results

Out of 337 patients, 137 (40.4%) received HDSA, 68 (20.5%) LDSA, 106 (31.3%) GA, and 26 (7.7%) LA + DS. The longest median stay (226 min) was associated with HDSA (p < 0.001). The shortest time was recorded with LA + DS (121 min). Around 2% required opioids. 71% of them were operated under GA (p = 0.06). AUR occurred in 4% of patients, with no significant differences between groups. The rate of PONV was 74% in the GA group compared to 7–19% in the rest of the groups. A higher OS failure rate (15%) was observed in afternoon shifts compared to 5% in morning shifts.

Conclusions

In ambulatory proctological surgery, spinal anaesthesia with doses less than 5 mg of bupivacaine or 20 mg of hyperbaric prilocaine is effective and reduces postoperative stay times. General anaesthesia is associated with a higher incidence of nausea, vomiting, and increased need for postoperative opioids.

本研究旨在比较四种不同麻醉技术下肛肠手术患者的门诊手术（OS）时间：深度镇静局部麻醉（LA + DS）、低剂量脊髓麻醉（LDSA）（少于5 mg高压布比卡因或少于20 mg高压丙罗卡因）、高剂量脊髓麻醉（HDSA）和全身麻醉（GA）。次要结果包括分析术后并发症及其与所选麻醉技术的关系。方法：回顾性观察研究2018年1月至2021年9月期间接受直肠外科手术的患者。根据麻醉方式将患者分为四组。主要结局是AS住院时间、术后阿片类药物的需求、术后恶心和呕吐、急性尿潴留以及未能完成AS治疗方案（在住院或不住院的前24小时内未安排入住病房或访问急诊室）。结果：337例患者中，137例（40.4%）接受HDSA， 68例（20.5%）接受LDSA， 106例（31.3%）接受GA， 26例（7.7%）接受LA + DS。中位住院时间最长（226分钟）与HDSA相关(p结论：在门诊直肠外科手术中，布比卡因剂量小于5mg或高压丙胺卡因剂量小于20mg的脊髓麻醉是有效的，可减少术后住院时间。全身麻醉与恶心、呕吐发生率增高和术后阿片类药物需求增加有关。

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引用次数: 0

Elective versus non-elective surgery in the treatment of giant paraoesophageal hiatal hernia 选择性与非选择性手术治疗巨大食管旁裂孔疝。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800126

Ana María Fuentes Zaplana, José Ruiz Pardo, Pedro Antonio Sánchez Fuentes, Elisabet Vidaña Márquez, Luis Candil Valero, Daniel González Sánchez, Ricardo Belda Lozano, Ángel Reina Duarte

Introduction

There are few studies comparing elective surgery (ES) and non-elective surgery (NES) in the treatment of giant paraoesophageal hiatal hernia (GPHH). The aim of this study is to analyze and compare the results in terms of morbidity, mortality and recurrences of ES and NES in the treatment of GPHH.

Methods

Retrospective study whose study population consisted of patients with GPHH (types II, III and IV with >30% of the herniated stomach in the thorax) who underwent surgery. Patients with a complete clinical history and a minimum follow-up of 6 months were included. Patients under 15 years old, those with hiatal hernia (HH) type I and those with recurrent HH were excluded. Two groups were compared: patients with GPHH in whom ES was performed and patients with GPHH in whom NES was performed.

Results

The ES group was composed of 31 patients and the NES group of 13 patients. There were no differences in terms of age and sex. Patients in the NES group had a lower percentage of laparoscopic approach (100% vs. 38.5%; P < .001), a higher percentage of complications (9.7% vs. 53.8%; P = .003) and a longer hospital stay (4.8 ± 7.8 vs. 14.3 ± 10.4 days; P < .001). There were no differences between the two groups in terms of recurrence and mortality.

Conclusions

Repair of GPHH by NES presents greater morbidity and hospital stay compared to repair by ES, however, there are no differences in terms of recurrences and mortality.

导读：比较选择性手术（ES）和非选择性手术（NES）治疗巨大食管旁裂孔疝（GPHH）的研究很少。本研究的目的是分析和比较ES和NES治疗GPHH的发病率、死亡率和复发率。方法：回顾性研究，研究人群为行手术治疗的GPHH （II、III、IV型，胸胃疝占30%）患者。患者有完整的临床病史和至少6个月的随访。排除15岁以下患者、ⅰ型裂孔疝患者和复发性裂孔疝患者。比较两组：行ES的GPHH患者和行NES的GPHH患者。结果：ES组31例，NES组13例。在年龄和性别方面没有差异。NES组患者采用腹腔镜入路的比例较低(100% vs. 38.5%；p结论：与ES相比，NES修复GPHH的发病率和住院时间更高，但在复发率和死亡率方面没有差异。

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引用次数: 0

Large portal aneurysm as an incidental finding in an asymptomatic patient: Diagnosis and management 无症状患者偶然发现的大门静脉动脉瘤：诊断和处理。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800155

Alejandro Hueso Mor, Adriá Rosat Rodrigo, Ayaya Alonso Alvarado, Javier Padilla Quintana

引用次数: 0

Predictive pre-surgical factors for failure of sleeve gastrectomy as an obesity surgery 套筒胃切除术作为肥胖手术失败的术前预测因素。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800125

Ibabe Villalabeitia Ateca , Aingueru Sarriugarte Lasarte , Borja Santos Zorrozua , Oihane Gutiérrez Grijalba , Patricia Mifsut Porcel , Gaizka Errazti Olartekoetxea

Introduction

Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. However, long-term outcomes are heterogeneous due to the influence of multiple factors. The aim of this study was to analyse the effect of various psychosocial and demographic factors on medium-term weight loss outcomes.

Materials and methods

A retrospective study of a prospective, single-centre series of patients who underwent GV surgery between 2011 and 2020, with a minimum follow-up of 5 years; Failure was defined as EBMIL% <65%. Univariate and multivariate logistic regression models were developed to identify potential predictors of poor outcomes. A predictive nomogram was designed.

Results

A total of 324 patients were analysed, 74% were women. Most patients were married (64.1%), had medium or higher education levels (73%), and belonged to a low-to-middle socioeconomic class (64.26%). High vulnerability (64.13%) and low physical activity levels (97.44%) were common. Anxiety/depressive syndrome was more prevalent in women (55.88% vs. 36.49%; p < 0.05), whereas metabolic syndrome was more frequent in men (43.9% vs. 28.51%; p = 0.015). Factors associated with weight loss failure included marital status, socioeconomic level, vulnerability, and metabolic syndrome (p < 0.05).

Conclusion

SG achieves significant weight loss at 5 years post-surgery. Psychosocial factors such as socioeconomic status, marital status, and vulnerability significantly influence surgical outcomes. Pre-surgical evaluation is essential to identify patients at higher risk of failure, enabling targeted therapies to improve success rates.

简介：袖式胃切除术（SG）是最常用的减肥手术。然而，由于多种因素的影响，长期结果是异质性的。本研究的目的是分析各种社会心理和人口因素对中期减肥结果的影响。材料和方法：对2011年至2020年间接受GV手术的前瞻性单中心系列患者进行回顾性研究，随访时间至少为5年；结果：共分析324例患者，其中74%为女性。大多数患者已婚（64.1%），中等或高等文化程度（73%），属于中低社会经济阶层（64.26%）。高脆弱性（64.13%）和低体力活动水平（97.44%）是常见的。焦虑/抑郁综合征在女性中更为普遍(55.88% vs. 36.49%；结论：SG术后5年体重明显减轻。社会经济地位、婚姻状况和脆弱性等社会心理因素显著影响手术结果。术前评估对于确定失败风险较高的患者至关重要，从而使靶向治疗能够提高成功率。

{"title":"Predictive pre-surgical factors for failure of sleeve gastrectomy as an obesity surgery","authors":"Ibabe Villalabeitia Ateca , Aingueru Sarriugarte Lasarte , Borja Santos Zorrozua , Oihane Gutiérrez Grijalba , Patricia Mifsut Porcel , Gaizka Errazti Olartekoetxea","doi":"10.1016/j.cireng.2025.800125","DOIUrl":"10.1016/j.cireng.2025.800125","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. However, long-term outcomes are heterogeneous due to the influence of multiple factors. The aim of this study was to analyse the effect of various psychosocial and demographic factors on medium-term weight loss outcomes.</div></div><div><h3>Materials and methods</h3><div>A retrospective study of a prospective, single-centre series of patients who underwent GV surgery between 2011 and 2020, with a minimum follow-up of 5 years; Failure was defined as EBMIL% <65%. Univariate and multivariate logistic regression models were developed to identify potential predictors of poor outcomes. A predictive nomogram was designed.</div></div><div><h3>Results</h3><div>A total of 324 patients were analysed, 74% were women. Most patients were married (64.1%), had medium or higher education levels (73%), and belonged to a low-to-middle socioeconomic class (64.26%). High vulnerability (64.13%) and low physical activity levels (97.44%) were common. Anxiety/depressive syndrome was more prevalent in women (55.88% vs. 36.49%; p < 0.05), whereas metabolic syndrome was more frequent in men (43.9% vs. 28.51%; p = 0.015). Factors associated with weight loss failure included marital status, socioeconomic level, vulnerability, and metabolic syndrome (p < 0.05).</div></div><div><h3>Conclusion</h3><div>SG achieves significant weight loss at 5 years post-surgery. Psychosocial factors such as socioeconomic status, marital status, and vulnerability significantly influence surgical outcomes. Pre-surgical evaluation is essential to identify patients at higher risk of failure, enabling targeted therapies to improve success rates.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 8","pages":"Article 800125"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251281","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

Minimally invasive repair of intrathoracic gastric volvulus: A delayed surgical complication after peritonectomy and HIPEC 微创修复胸内胃扭转：腹膜切除术和HIPEC后的延迟手术并发症。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800156

Leire Otalora Mazuela , Marta Vicente López , Eugenio Licardie Bolaños , Salvador Morales-Conde

引用次数: 0

Communication as the origin of safety problems, and how to avoid them 沟通是安全问题的根源，如何避免。

Cirugia espanola

Pub Date : 2025-08-01 DOI: 10.1016/j.cireng.2025.800121

José Francisco Noguera Aguilar , Juan José Sánchez Rodriguez

引用次数: 0

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Cirugia espanola

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