Pub Date : 2025-11-22DOI: 10.1016/j.cireng.2025.800261
V D Yagnik, P R Choudhary
{"title":"The TROPIS technique for complex anal fistula: A promising but still evolving approach.","authors":"V D Yagnik, P R Choudhary","doi":"10.1016/j.cireng.2025.800261","DOIUrl":"10.1016/j.cireng.2025.800261","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800261"},"PeriodicalIF":0.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598234","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 : 2025-11-13DOI: 10.1016/j.cireng.2025.800259
Alejandra García-Botella, Juan Pablo Arjona Trujillo, Sofía de la Serna, Pedro José Gil Vázquez, Santos Jiménez-Galanes Marchán, Erik Llàcer-Millán, Ana Belén Martín Arnau, David Martínez-Cecilia, Alba Zárate Pinedo, Alberto Martínez-Isla
The transcystic laparoscopic approach to manage choledocholithiasis using ultrathin flexible choledochoscopes is aimed at reducing complications linked to ERCP and transductal techniques when treating common bile duct stones with gallbladder in situ. Despite their advantages, transcystic techniques are not being widely adopted, highlighting the need for structured protocols, a multidisciplinary approach, and adequate resource allocation to optimize outcomes. This consensus document addresses key issues to standardize the approach, based on the responses to the 25 questions posed to the panel of experts. The recommendations issued, based on the evidence and expert opinion, cover the key factors for the success of the technique, including appropriate patient selection, technical characteristics of the approach, advanced equipment required, etc. This comprehensive guide aims to standardize the technique in order to improve patient outcomes and ensure safe, effective treatment of choledocholithiasis.
{"title":"Consensus document for the transcystic approach to choledocholithiasis with ultrathin flexible choledochoscope.","authors":"Alejandra García-Botella, Juan Pablo Arjona Trujillo, Sofía de la Serna, Pedro José Gil Vázquez, Santos Jiménez-Galanes Marchán, Erik Llàcer-Millán, Ana Belén Martín Arnau, David Martínez-Cecilia, Alba Zárate Pinedo, Alberto Martínez-Isla","doi":"10.1016/j.cireng.2025.800259","DOIUrl":"10.1016/j.cireng.2025.800259","url":null,"abstract":"<p><p>The transcystic laparoscopic approach to manage choledocholithiasis using ultrathin flexible choledochoscopes is aimed at reducing complications linked to ERCP and transductal techniques when treating common bile duct stones with gallbladder in situ. Despite their advantages, transcystic techniques are not being widely adopted, highlighting the need for structured protocols, a multidisciplinary approach, and adequate resource allocation to optimize outcomes. This consensus document addresses key issues to standardize the approach, based on the responses to the 25 questions posed to the panel of experts. The recommendations issued, based on the evidence and expert opinion, cover the key factors for the success of the technique, including appropriate patient selection, technical characteristics of the approach, advanced equipment required, etc. This comprehensive guide aims to standardize the technique in order to improve patient outcomes and ensure safe, effective treatment of choledocholithiasis.</p>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800259"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531052","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 : 2025-11-05DOI: 10.1016/j.cireng.2025.800245
Alberto Cabañero Sánchez, Luis Gorospe Sarasúa, Nicolás Moreno Mata
{"title":"Applications of radiomics in thoracic surgery: Enhancing precision and personalization of treatment.","authors":"Alberto Cabañero Sánchez, Luis Gorospe Sarasúa, Nicolás Moreno Mata","doi":"10.1016/j.cireng.2025.800245","DOIUrl":"10.1016/j.cireng.2025.800245","url":null,"abstract":"","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":" ","pages":"800245"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472609","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 : 2025-11-01Epub Date: 2025-10-10DOI: 10.1016/j.cireng.2025.800225
Hanna Cholewa , Pablo Guerrero-Antolino , David Quevedo , Jorge Sancho-Muriel , Matteo Frasson , Blas Flor-Lorente
The following systematic review aimed to present the current status of immunotherapy in colorectal cancer, in the neoadjuvant, adjuvant and metastatic setting. Pubmed, Cochrane and Embase databases were searched up to April 2024 and the PICO framework, as well as the following inclusion criteria (clinical studies in English published ≥2000 per year, both retrospective and prospective, including abstracts from relevant congresses, yet excluding case reports, letters, phase I clinical trials and radioimmunotherapy) were applied. MINORS and RoB2 were used to assess quality and risk of bias. Due to heterogeneity of the studies, a descriptive analysis was performed. In total, 99 studies (including 11 226 patients) were analysed, concluding that immunotherapy application, although encouraging, still needs refinement, most importantly in terms of patient and treatment regimen selection. The review was registered on the PROSPERO platform (ID: CRD42023417537) and funded by a grant by the Spanish Association of Surgery (AEC).
{"title":"The current status of immunotherapy in colorectal cancer: A systematic review","authors":"Hanna Cholewa , Pablo Guerrero-Antolino , David Quevedo , Jorge Sancho-Muriel , Matteo Frasson , Blas Flor-Lorente","doi":"10.1016/j.cireng.2025.800225","DOIUrl":"10.1016/j.cireng.2025.800225","url":null,"abstract":"<div><div>The following systematic review aimed to present the current status of immunotherapy in colorectal cancer, in the neoadjuvant, adjuvant and metastatic setting. Pubmed, Cochrane and Embase databases were searched up to April 2024 and the PICO framework, as well as the following inclusion criteria (clinical studies in English published ≥2000 per year, both retrospective and prospective, including abstracts from relevant congresses, yet excluding case reports, letters, phase I clinical trials and radioimmunotherapy) were applied. MINORS and RoB2 were used to assess quality and risk of bias. Due to heterogeneity of the studies, a descriptive analysis was performed. In total, 99 studies (including 11 226 patients) were analysed, concluding that immunotherapy application, although encouraging, still needs refinement, most importantly in terms of patient and treatment regimen selection. The review was registered on the PROSPERO platform (ID: CRD42023417537) and funded by a grant by the Spanish Association of Surgery (AEC).</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 11","pages":"Article 800225"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276930","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 : 2025-11-01Epub Date: 2025-10-17DOI: 10.1016/j.cireng.2025.800233
Enrique Biel , Luis Grande , Manuel Pera
Background
Main treatment options for pharyngoesophageal diverticulum are the surgical excision or diverticulopexy, always associated with a myotomy, and the endoscopic peroral myotomy. The aim of this study was to describe the outcomes of a consecutive surgical series.
Methods
Observational study of patients who underwent open surgery (2004–2024) and who had a 2-years structured follow-up. Main outcome were symptom resolution and postoperative complications. Baseline characteristics, surgical technique, reinterventions, readmission and recurrence were also analyzed. Descriptive statistics was used, including percentages, mean and standard deviations, and medians with complete ranges.
Results
During the study period, 40 patients (73% male) were operated on, with a mean age of 72 ± 11 years. Ninety-five percent presented dysphagia and/or regurgitation, while 2 patients were referred due to a history of pneumonia to bronchoaspiration. The most frequent surgical technique was cricopharyngeal myotomy combined with diverticulectomy. Postoperative morbidity was 15%, with no cases of esophageal fistula. There was no mortality, and the median hospital stay was 3 days. Initial symptom resolution was achieved in 95% of patients. During follow-up (median 7 years [1–20]), 2 recurrences were observed at 18 and 24 months, respectively, both successfully managed endoscopically.
Conclusions
Surgical treatment achieves symptoms resolution in the vast majority of cases, with limited morbidity and recurrence.
{"title":"Surgical treatment for pharyngo-esophageal diverticulum: Consecutive series over 20 years","authors":"Enrique Biel , Luis Grande , Manuel Pera","doi":"10.1016/j.cireng.2025.800233","DOIUrl":"10.1016/j.cireng.2025.800233","url":null,"abstract":"<div><h3>Background</h3><div>Main treatment options for pharyngoesophageal diverticulum are the surgical excision or diverticulopexy, always associated with a myotomy, and the endoscopic peroral myotomy. The aim of this study was to describe the outcomes of a consecutive surgical series.</div></div><div><h3>Methods</h3><div>Observational study of patients who underwent open surgery (2004–2024) and who had a 2-years structured follow-up. Main outcome were symptom resolution and postoperative complications. Baseline characteristics, surgical technique, reinterventions, readmission and recurrence were also analyzed. Descriptive statistics was used, including percentages, mean and standard deviations, and medians with complete ranges.</div></div><div><h3>Results</h3><div>During the study period, 40 patients (73% male) were operated on, with a mean age of 72 ± 11 years. Ninety-five percent presented dysphagia and/or regurgitation, while 2 patients were referred due to a history of pneumonia to bronchoaspiration. The most frequent surgical technique was cricopharyngeal myotomy combined with diverticulectomy. Postoperative morbidity was 15%, with no cases of esophageal fistula. There was no mortality, and the median hospital stay was 3 days. Initial symptom resolution was achieved in 95% of patients. During follow-up (median 7 years [1–20]), 2 recurrences were observed at 18 and 24 months, respectively, both successfully managed endoscopically.</div></div><div><h3>Conclusions</h3><div>Surgical treatment achieves symptoms resolution in the vast majority of cases, with limited morbidity and recurrence.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 11","pages":"Article 800233"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331046","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}
Pectus carinatum is a chest wall deformity characterized by a protrusion. For its correction, the flexibility of the chest wall is essential, as it will determine the possibility of correction through orthopedic or surgical treatment.
Orthopedic treatment has experienced a boom in recent years thanks to the development of a dynamic compression system (vest) that applies pressure to the area.
This effect can be limited by the rigidity of the chest wall (which increases with age) or by the presence of pronounced depressions of abnormally positioned cartilage (limiting cartilage). In these cases, we propose combining the use of the vest with limited partial chondrectomies to facilitate the vest's effect after this surgery. We have called this combination of vest-chondrectomy-vest the “3-Cs” technique.
We present a description of the technique and its application in the first patients we have treated in thus manner.
{"title":"Innovation in the correction of pectus carinatum: A combination of orthopedic and surgical treatment (the “3-Cs” technique)","authors":"José Marcelo Galbis Caravajal , Miriam Estors Guerrero , Nestor Martinez Hernández , Inmaculada Sabariego Arenas","doi":"10.1016/j.cireng.2025.800240","DOIUrl":"10.1016/j.cireng.2025.800240","url":null,"abstract":"<div><div>Pectus carinatum is a chest wall deformity characterized by a protrusion. For its correction, the flexibility of the chest wall is essential, as it will determine the possibility of correction through orthopedic or surgical treatment.</div><div>Orthopedic treatment has experienced a boom in recent years thanks to the development of a dynamic compression system (vest) that applies pressure to the area.</div><div>This effect can be limited by the rigidity of the chest wall (which increases with age) or by the presence of pronounced depressions of abnormally positioned cartilage (limiting cartilage). In these cases, we propose combining the use of the vest with limited partial chondrectomies to facilitate the vest's effect after this surgery. We have called this combination of vest-chondrectomy-vest the “3-Cs” technique.</div><div>We present a description of the technique and its application in the first patients we have treated in thus manner.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 11","pages":"Article 800240"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427250","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 : 2025-11-01Epub Date: 2025-10-16DOI: 10.1016/j.cireng.2025.800227
Antonio Ríos , Beatriz Domínguez-Gil
Traditionally, organ transplantation has relied on donation after brain death (DBD). However, the growing demand for organs has driven the search for alternatives to expand the donor pool. In this context, donation after the circulatory determination of death (DCD) has experienced significant growth throughout the current century, particularly in cases of death following the withdrawal of life-sustaining treatments (Maastricht type III donation). Although still limited to a small number of countries, the volume of DCD in Spain is similar to that of DBD, and it is the only country that has successfully transplanted all types of organs from this type of donor. Living organ donation also makes a meaningful contribution to overall transplant activity, and it must be firmly grounded in comprehensive donor protection. In Spain, 10% of kidney transplants are performed using organs from living donors.
{"title":"Beyond the donor after brain death: Donation in asystole and living donor. Spanish experience and perspective","authors":"Antonio Ríos , Beatriz Domínguez-Gil","doi":"10.1016/j.cireng.2025.800227","DOIUrl":"10.1016/j.cireng.2025.800227","url":null,"abstract":"<div><div>Traditionally, organ transplantation has relied on donation after brain death (DBD). However, the growing demand for organs has driven the search for alternatives to expand the donor pool. In this context, donation after the circulatory determination of death (DCD) has experienced significant growth throughout the current century, particularly in cases of death following the withdrawal of life-sustaining treatments (Maastricht type III donation). Although still limited to a small number of countries, the volume of DCD in Spain is similar to that of DBD, and it is the only country that has successfully transplanted all types of organs from this type of donor. Living organ donation also makes a meaningful contribution to overall transplant activity, and it must be firmly grounded in comprehensive donor protection. In Spain, 10% of kidney transplants are performed using organs from living donors.</div></div>","PeriodicalId":93935,"journal":{"name":"Cirugia espanola","volume":"103 11","pages":"Article 800227"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319050","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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