Clinicopathological importance of colorectal medullary carcinoma
SummaryPurposeMedullary carcinoma (MC) is a  rare tumor with a solid growth pattern without glandular differentiation and constitutes less than 1% of colorectal cancers. Lymph node positivity and distant organ metastasis were reported to be lower than in other poorly differentiated adenocarcinomas. Therefore, the diagnosis of MC is patholog ically important in terms of follow-up and treatment. We aimed to investigate the characteristics of medullary cancer in our case series.Methods427 patients with colorectal cancer (CRC) who underwent surgery between January 2011 and December 2017 were evaluated retrospectively...
Source: European Surgery - October 9, 2019 Category: Surgery Source Type: research

Giant hiatus hernia: closure of the difficult hiatus
ConclusionTechniques adopted and described in this article may facilitate both mesh and non-mesh repair of crural hiatal defects associated with giant hiatus hernia. (Source: European Surgery)
Source: European Surgery - September 27, 2019 Category: Surgery Source Type: research

Autologous aortic arch reconstruction in isolated and combined cardiac lesions
ConclusionAutologous aortic arch reconstruction is a  safe and effective surgical technique for the treatment of aortic arch obstruction in isolated and complex cardiac lesions. It is associated with an extremely low re-intervention rate and a low overall complication rate. (Source: European Surgery)
Source: European Surgery - September 13, 2019 Category: Surgery Source Type: research

Long-term oncological outcome in thymic malignancies: videothoracoscopic versus open thymectomy
ConclusionsCompared to open surgery, VTS leads to superior perioperative outcomes and a  comparable long-term oncological outcome. The authors advocate the VTS approach as a routine option for the surgery of thymic malignancies.Main novel aspectsVideothoracoscopic surgery is less traumatic and has faster recovery times than open surgery, with a  comparable long-term oncological outcome. (Source: European Surgery)
Source: European Surgery - September 10, 2019 Category: Surgery Source Type: research

Amazing autumn surgery behind the light
(Source: European Surgery)
Source: European Surgery - September 4, 2019 Category: Surgery Source Type: research

Relationship of preoperative serum calcium and extent of neck surgery to postoperative hospital stay in patients with primary hyperparathyroidism and severe bone disease. A  case series
ConclusionFor primary hyperparathyroidism with severe bone disease, focused unilateral parathyroidectomy is likely to reduce the duration of postoperative hospital stay. Preoperative total serum calcium is not a  reliable predictor of hospital stay in this subset of patients. (Source: European Surgery)
Source: European Surgery - September 3, 2019 Category: Surgery Source Type: research

Thyroidectomy using superficial cervical block: a  report of 147 cases over 8 years
ConclusionTotal thyroidectomy performed by experienced surgeons in the selected group patients under SCB anesthesia is safe and effective. (Source: European Surgery)
Source: European Surgery - August 26, 2019 Category: Surgery Source Type: research

No surgeon is an island, no echo stands alone
(Source: European Surgery)
Source: European Surgery - July 19, 2019 Category: Surgery Source Type: research

CT and operative images for evaluation of right colectomy with extended D3 mesenterectomy anterior and posterior to the mesenteric vessels
ConclusionThe results demonstrate very short residual vascular stumps and together with operative photographs provide objective evidence for superior lymphadenectomy in right colectomy with extended D3 mesenterectomy. (Source: European Surgery)
Source: European Surgery - July 11, 2019 Category: Surgery Source Type: research

Quantification of the effects of coffee on postoperative ileus after laparoscopic ventral rectopexy: a  randomized controlled trial
ConclusionCoffee consumption accelerates bowel movements, but its clinical effect after LVR is also small. Further studies about the indication of coffee for the type of surgery or the optimal amount of coffee consumption are warranted. (Source: European Surgery)
Source: European Surgery - July 5, 2019 Category: Surgery Source Type: research

Post-esophagectomy diaphragmatic hernia —a case series
ConclusionWhile differences in pressure between the abdominal and thoracic cavities are important, the size of the hiatal defect is something that can be influenced surgically. As with all oncological surgery, safe resection margins are essential without adversely affecting anatomical structure and function. The commonest cause is excessive widening of the esophageal hiatus during surgery and, therefore, narrowing the hiatus to fit the conduit can prevent this complication. (Source: European Surgery)
Source: European Surgery - July 5, 2019 Category: Surgery Source Type: research

Swallowing MRI for GERD —diagnosis and treatment monitoring
ConclusionReal-time MRI swallowing, as a  noninvasive and nonionizing method, offers a new perspective for the combined anatomic and functional visualization of GERD, with the possibility of direct visualization of the surrounding structures. (Source: European Surgery)
Source: European Surgery - June 17, 2019 Category: Surgery Source Type: research

Revisiting Barrett ’s Esophagus
(Source: European Surgery)
Source: European Surgery - June 17, 2019 Category: Surgery Source Type: research

Advances in the surgical management of pancreatic disease
(Source: European Surgery)
Source: European Surgery - May 29, 2019 Category: Surgery Source Type: research

60th Annual Meeting of The Austrian Society of Surgery
(Source: European Surgery)
Source: European Surgery - May 21, 2019 Category: Surgery Source Type: research

Imaging response evaluation after novel neoadjuvant treatments of pancreatic cancer
ConclusionCurrently, patients with non-metastatic borderline resectable and locally advanced pancreatic ductal adenocarcinoma are brought to diagnostic laparotomy in the absence of overt radiologic progression after neoadjuvant therapy. Apart from morphologic patterns, ongoing research is focused on defining robust functional imaging parameters for response assessment. (Source: European Surgery)
Source: European Surgery - May 17, 2019 Category: Surgery Source Type: research

Surgery for Hilar cholangiocarcinoma: the Newcastle upon Tyne Liver Unit experience
SummaryBackgroundHilar cholangiocarcinoma (HCCA) arises from the confluence of the common hepatic duct and has a  poor prognosis. If resectable, an extended left (eLH) or right hemihepatectomy (eRH) is usually required to provide oncological clearance. We reviewed outcomes for patients with HCCA managed at our centre.MethodsElectronic records of patients referred to our centre for HCCA were retrospectively reviewed. The Kaplan –Meier method was used to estimate overall survival (OS) with the log rank test used for significance (p 
Source: European Surgery - May 17, 2019 Category: Surgery Source Type: research

Management of ductal pancreatic cancer
ConclusionsIn conclusion, despite recent advances, there remains much room for improvement in all aspects of treatment for pancreatic cancer. (Source: European Surgery)
Source: European Surgery - May 15, 2019 Category: Surgery Source Type: research

Enhanced recovery after colorectal surgery: the clinical and economic benefit in elderly patients
ConclusionWe showed that our enhanced recovery after colorectal surgery protocol in elderly patients is feasible, effective, safe and reduces treatment costs. (Source: European Surgery)
Source: European Surgery - May 14, 2019 Category: Surgery Source Type: research

Exploring the limits of hepatic surgery for alveolar echinococcosis —10-years’ experience in an endemic area of Austria
ConclusionThe relevance and perioperative risks of an extensive AE resection and avoidance of R2 resections are reflected in the present study. Determination of PNM stage and evaluation of in-all resectability build the foundation for successful surgical treatment even in an advanced AE stage. (Source: European Surgery)
Source: European Surgery - May 9, 2019 Category: Surgery Source Type: research

Management of cystic pancreatic lesions
ConclusionIn patients with a confirmed diagnosis of the cyst subtype, pancreatic resection should be performed in surgically fit patients for intraductal papillary mucinous neoplasia (IPMN) with main duct and mixed type appearance, mucinous cystic neoplasia (MCN) and solid pseudopapillary neoplasia (SPN) regardless their size. (Source: European Surgery)
Source: European Surgery - May 8, 2019 Category: Surgery Source Type: research

The role of surgery in chronic pancreatitis
ConclusionA  tailored approach to CP patients is mandatory in this heterogeneous disease. Surgery provides good outcomes especially as prophylaxis for and treatment of chronic pain. A multidisciplinary approach is mandatory, including physicians, pancreatic surgeons, endoscopists, dieticians and radiologists. (Source: European Surgery)
Source: European Surgery - May 7, 2019 Category: Surgery Source Type: research

First description of an acquired internal hernia: a  case report
ConclusionWe present the first description of a  young man with an internal hernia due to an intraperitoneal aperture formed by his appendix fused to the spleen. Internal hernia are difficult to diagnose but should be included in the differential diagnosis in cases of intestinal obstruction. CT should be performed in cases of suspicion. Surgical intervention shouldn’t be delayed in order to reduce the high morbidity and mortality rates. (Source: European Surgery)
Source: European Surgery - April 26, 2019 Category: Surgery Source Type: research

Surgery, fields, and phenomena
(Source: European Surgery)
Source: European Surgery - April 23, 2019 Category: Surgery Source Type: research

Interventional management after complicated pancreatic surgery
ConclusionsRadiologic procedures allow for minimal invasive treatment of postoperative complications after pancreatic surgery, reducing the time of hospitalization and the time of recovery. (Source: European Surgery)
Source: European Surgery - April 16, 2019 Category: Surgery Source Type: research

Evaluation and comparison of postoperative outcomes of octogenarians and non-octogenarians undergoing carotid endarterectomy
ConclusionWe thought that CEA remains the most efficient treatment modality among symptomatic and asymptomatic octogenarians with severe carotid artery stenosis and no difference was found compared to non-octogenarians. Advanced age should not be considered as a  high-risk group and selected octogenarians are good candidates for CEA. (Source: European Surgery)
Source: European Surgery - April 16, 2019 Category: Surgery Source Type: research

Surgical and local therapeutic concepts of oligometastatic pancreatic cancer in the era of effective chemotherapy
ConclusionsThere are promising data to support resection of metastatic PC, presuming this approach is embedded in a  multimodal oncological concept with modern and effective multi-agent chemotherapies and proper patient selection. Based on this, future studies should specify distinct groups of patients who benefit from extended surgical approaches including synchronous or staged metastasectomy. (Source: European Surgery)
Source: European Surgery - April 15, 2019 Category: Surgery Source Type: research

Usefulness of the holistic context of frailty as a  prognostic factor for the outcome of geriatric patients undergoing emergency abdominal surgery
ConclusionFrailty is a  predictive factor that should be routinely used in emergency geriatric surgery in a holistic context that includes physical, cognitive, functional, and social variables. Designing scores based on a broader concept of frailty will enable a more consistent predictive evaluation. Social frailty ma y have an important predictive value in the postoperative hospital outcome and in other medical fields, and should be studied in more depth in the future. (Source: European Surgery)
Source: European Surgery - April 11, 2019 Category: Surgery Source Type: research

Prognostic impact of allogenic blood transfusion following surgical treatment of esophageal cancer
SummaryBackgroundEsophageal cancer (EC) surgery is associated with relatively high morbidity and mortality rates and poor overall survival (OS). The impact of allogeneic blood transfusion (aBT) on OS is still a  matter of debate. We aimed to investigate the impact of aBT on OS in a homogeneous population of patients undergoing surgical treatment for EC in a single center during a 15-year period.MethodsIn total, 409 patients who had undergone surgical resection for EC were studied. The clinicopathological parameters and OS were compared between 170 patients (41.6%) who received perioperative aBT and 239 ...
Source: European Surgery - April 10, 2019 Category: Surgery Source Type: research

Evolution of oncosurgical management of pancreatic cancer
SummaryBackgroundPancreatic cancer is the third leading cause of cancer-related death in the Western world and is projected to soon become the second commonest cause of cancer mortality. During the past two decades, there have been important clinical developments in the fight against this aggressive disease.ObjectiveThe aim of this review article is to summarize the evolution of the multidisciplinary oncological and surgical management of pancreatic cancer.ResultsThe centralization of pancreatic surgery into specialized institutions has led to improvements in surgical techniques, with reduced surgical mortality rates of
Source: European Surgery - April 10, 2019 Category: Surgery Source Type: research

Outcomes following pancreatic resections —results and challenges of an Austrian university hospital compared to nationwide data and international centres
ConclusionsPancreatic resections in our centre are performed with low mortality, although morbidity still represents a  relevant clinical problem, especially POPF and PPH. (Source: European Surgery)
Source: European Surgery - April 3, 2019 Category: Surgery Source Type: research

Management of blunt hepatic and splenic trauma in Austria: a  national questionnaire study
ConclusionNon-operative management is the standard of care for blunt hepatic and splenic injuries in Austria. In many clinically relevant questions there is still a  lack of consensus. Based on this experience, national standard protocols may be generated for systematisation of care in blunt liver and spleen trauma. (Source: European Surgery)
Source: European Surgery - April 3, 2019 Category: Surgery Source Type: research

Histologic changes in early colonic anastomotic healing using autologous platelet-rich fibrin matrix
ConclusionObsidian-ASG ® matrix may have beneficial effects on anastomotic healing by shifting the inflammatory response towards a mature and more stable collagen phenotype in the early phase. (Source: European Surgery)
Source: European Surgery - April 3, 2019 Category: Surgery Source Type: research

Technical aspects of pancreatic anastomosis
ConclusionThe best strategy for reducing pancreatic fistula rate includes a  standardized institutional concept of pancreatic anastomosis, documentation of surgical quality, and continuous enhancement by benchmarking. (Source: European Surgery)
Source: European Surgery - April 2, 2019 Category: Surgery Source Type: research

Simultaneous versus staged resection of rectal cancer and synchronous liver metastases (RESECT)
DiscussionSimultaneous resection of synchronous rectal cancer with liver metastases carries a  similar risk of overall and major complications compared to the staged approach. However, QOE is very low and a simultaneous approach ought to be pursued only in selected patients until better evidence is available. (Source: European Surgery)
Source: European Surgery - April 2, 2019 Category: Surgery Source Type: research

Diagnosis and treatment of microvascular invasion in hepatocellular carcinoma
ConclusionThe presence of MVI is thought to reflect increased capacity for local infiltration and distant metastases and affects the prognosis of HCC patients. To accurately assess MVI early based on some biomarkers prior to surgery, we need to work hard to explore and integrate various treatments to create a  personalized treatment plan for MVI. (Source: European Surgery)
Source: European Surgery - March 18, 2019 Category: Surgery Source Type: research

Minimally invasive pancreatic surgery —where are we going?
ConclusionWell-designed prospective studies based on national registries are needed to expand knowledge on MIPS and determine its role in pancreatic surgery. To facilitate further development of MIPS, it has to integrate effectively with the outcome-improving effect of a  dedicated pancreatic team. (Source: European Surgery)
Source: European Surgery - March 13, 2019 Category: Surgery Source Type: research

Integrating radiation oncology into the management of pancreatic cancer
SummaryAlthough some improvements have been made in recent years, the prognosis of pancreatic ductal adenocarcinoma remains poor. Surgical resection followed by adjuvant systemic therapy is the only curative treatment option in early stage disease. The role of radiotherapy in the treatment of pancreatic cancer is not well defined and still controversially discussed. Following the results of the ESPAC-1 trial, adjuvant radiochemotherapy (RCT) was no longer employed in most European countries. Nevertheless, in high-risk situations for local recurrence, the addition of adjuvant radiochemotherapy to adjuvant systemic therapy s...
Source: European Surgery - March 12, 2019 Category: Surgery Source Type: research

Molecular biology in pancreatic ductal adenocarcinoma: implications for future diagnostics and therapy
ConclusionNovel molecular techniques have the potential to accelerate the road to improved outcomes in patients with pancreatic cancer. (Source: European Surgery)
Source: European Surgery - March 5, 2019 Category: Surgery Source Type: research

Systematic review and meta-analysis on the treatment of diffuse esophageal spasm
SummaryBackgroundDiffuse esophageal spasm is a  rare motility disorder and although diagnosis has improved over the years, optimal treatment remains controversial. The aim of this study was to determine the success rates of alternative treatments for diffuse esophageal spasm.MethodsMEDLINE, EMBASE, and the Cochrane Library were searched for studies which reported treatment outcomes in patients with diffuse esophageal spasm. The primary outcome measure was success rate. Secondary outcome measures were morbidity and mortality.ResultsTen observational studies involving 101 patients (35  male, 66 female, median ...
Source: European Surgery - March 1, 2019 Category: Surgery Source Type: research

Effect of fast-track surgery on inflammatory response and immune function in patients with laparoscopic distal gastrectomy
SummaryIntroductionEnhanced recovery after surgery can reduce immunosuppression and inflammation in patients with laparoscopic distal gastrectomyObjectiveThe aim of this study was to investigate the effect of fast-track surgery on inflammatory response and immune function in patients with laparoscopic radical gastrectomy.MethodsA  total of 244 patients undergoing laparoscopic radical gastrectomy for gastric cancer from January 2014 to December 2017 were collected. The patients were divided into fast-track surgery (FTS) and traditional groups. The inflammatory index, immune index, and postoperative complications were m...
Source: European Surgery - February 25, 2019 Category: Surgery Source Type: research

Laparoscopic Heller myotomy after Roux-en-Y gastric bypass
ConclusionDevelopment of achalasia in obese patients after RYGB is rare. The presence of pathognomonic symptoms should always raise clinical suspicion, while HRM is essential to confirm the diagnosis. To date, there is no robust evidence for the more appropriate treatment of esophageal achalasia after RYGB. In these patients, LHM seems feasible, safe, and effective in symptom relief. (Source: European Surgery)
Source: European Surgery - February 13, 2019 Category: Surgery Source Type: research

Outcomes after thoracic endovascular aortic repair in patients with traumatic thoracic aortic injuries —a single-centre retrospective review
ConclusionThoracic endovascular repair after traumatic aortic injury is associated with significantly lower procedural and post-operative mortality. The 30-day and overall mortality after thoracic endovascular repair in our unit is comparable to international standards. Even though there is a  paucity of literature on penetrating traumatic aortic injury, thoracic endovascular repair has low peri-procedural adverse events and is safe in selected patients. (Source: European Surgery)
Source: European Surgery - January 30, 2019 Category: Surgery Source Type: research

A  review of online platforms in training and surgical education
ConclusionOnline platforms were introduced by international technology companies to encourage paperless blended learning in schools. We envisaged the use of online classrooms in surgical education because of its simple format, easy access, low costs, and interaction-inspiring nature between teachers and students in professional surgical education. (Source: European Surgery)
Source: European Surgery - January 29, 2019 Category: Surgery Source Type: research

Changes in liver function tests after laparoscopic cholecystectomy with low- and high-pressure pneumoperitoneum
ConclusionThere were no statistically significant differences in the values of parameters of structural damage to the liver between the two groups, but within the groups themselves. From this we conclude that both values of elevated IAP cause microstructural and functional damage to the liver. (Source: European Surgery)
Source: European Surgery - January 24, 2019 Category: Surgery Source Type: research

Rumination syndrome after esophagectomy
ConclusionIn the absence of anatomical or other functional abnormalities of the gastric conduit, revisional surgery is contraindicated; rather, the diagnosis of rumination syndrome should be considered. The role of behavioral therapy integrated with diaphragmatic breathing training and biofeedback should be investigated in these patients. (Source: European Surgery)
Source: European Surgery - January 15, 2019 Category: Surgery Source Type: research

Far-out surgery of the future
(Source: European Surgery)
Source: European Surgery - January 4, 2019 Category: Surgery Source Type: research

An aggressive surgical approach to rare central biliary invasion of colon cancer
ConclusionA  liberal radical and aggressive resection in a multimodal treatment strategy could offer a favorable outcome in patients with a rare central biliary manifestation of CRC. (Source: European Surgery)
Source: European Surgery - December 14, 2018 Category: Surgery Source Type: research

Incidental resection of a  scrotal aggressive angiomyxoma mimicking a spermatocele: a case report
ConclusionDespite the plurality of benign scrotal masses such as spermatoceles or hydroceles, rare neoplasms should always be kept in mind. Hence, complete excision should be performed whenever possible. We selected an active surveillance strategy despite positive margins, since there is no described case of metastasis in men to date. Therefore, regular scrotal ultrasound examinations every 3  months were arranged as follow-up. (Source: European Surgery)
Source: European Surgery - December 14, 2018 Category: Surgery Source Type: research

Does giving pasireotide to patients undergoing pancreaticoduodenectomy always pay for itself?
ConclusionAt its current price, and with the fistula rate at our institution, pasireotide is more likely to pay for itself than not, but there is a  significant probability that it will not be cost-saving. Negotiating a better price (i.e., to the lowest found in the literature) will reduce the likelihood of pasireotide not being cost-saving by 5%. (Source: European Surgery)
Source: European Surgery - December 10, 2018 Category: Surgery Source Type: research