Is fundoplication advisable in repair of para-oesophageal hernia? “Little operation” or “big operation”?
ConclusionThese data support the case for routine fundoplication when repairing hiatus hernia, unless otherwise contraindicated. Probably due to the configuration of para-oesophageal hiatus hernias, there is a  diminution of reflux symptoms as the hernia progresses. Despite this presentation there is a high level of reflux symptomology and a high level of regurgitation shown objectively by scintigraphy, often culminating in pulmonary aspiration. (Source: European Surgery)
Source: European Surgery - July 24, 2020 Category: Surgery Source Type: research

General surgeons ’ attitudes towards COVID-19
ConclusionA  high proportion of surgeons admitted being afraid of working during the COVID-19 pandemic, which had various implications for their attitude towards surgical practice. Protecting health care workers is an important component of public health measures for addressing the epidemic (Source: European Surgery)
Source: European Surgery - July 16, 2020 Category: Surgery Source Type: research

COVID-19: an opportunity to restructure surgical education
(Source: European Surgery)
Source: European Surgery - July 9, 2020 Category: Surgery Source Type: research

Robotic liver surgery —advantages and limitations
ConclusionThe robotic platform is not appropriate for all liver operations at this time. Benefits of robotic surgery are most clearly realized when approaching lesions in the posterior and superior segments, and when a  large incision would be required to remove a small amount of liver parenchyma were the operation to be performed in an open fashion. (Source: European Surgery)
Source: European Surgery - July 8, 2020 Category: Surgery Source Type: research

Coronavirus and surgery
(Source: European Surgery)
Source: European Surgery - July 7, 2020 Category: Surgery Source Type: research

Safety and feasibility of single-incision laparoscopic totally extraperitoneal inguinal hernia repair: a  retrospective comparative analysis of 163 patients
ConclusionSIL  TEP is as feasible and safe a procedure as laparoscopic herniorrhaphy. Surgeons familiar with single-incision laparoscopic surgeries like appendectomy or cholecystectomy can begin to perform SIL TEP for hernia repair. (Source: European Surgery)
Source: European Surgery - July 7, 2020 Category: Surgery Source Type: research

Rootically invasive surgery: allow yourself and smile
(Source: European Surgery)
Source: European Surgery - June 23, 2020 Category: Surgery Source Type: research

Letter to the editor
(Source: European Surgery)
Source: European Surgery - June 12, 2020 Category: Surgery Source Type: research

Laparoscopic versus open surgery: aerosols and their implications for surgery during the COVID-19 pandemic
(Source: European Surgery)
Source: European Surgery - June 10, 2020 Category: Surgery Source Type: research

Protective effect of astaxanthin against cisplatin-induced gastrointestinal toxicity in rats
SummaryBackgroundThe aim of the present study was to demonstrate astaxanthin ’s attenuating effects against cisplatin (CIS)-induced gastrointestinal toxicity in a rat model.MethodsThirty-two Wistar rats (weight 200 –250 g) were divided into four groups (8 rats/group): control group, CIS group, astaxanthin 25 (ASTA25) group, and astaxanthin 75 (ASTA75) group. Tissue samples of small intestine extracted from rats were histopathologically and immunohistochemically analyzed. Histopathological findings were graded with the Duodenal Histopathological Damage Score. Evaluation of enterocytes showi...
Source: European Surgery - June 5, 2020 Category: Surgery Source Type: research

Resumption of elective surgery during the COVID-19 pandemic: what lessons can we apply?
(Source: European Surgery)
Source: European Surgery - June 5, 2020 Category: Surgery Source Type: research

A  comparative analysis of radical and non-radical surgical treatment of hydatid liver echinococcosis: a single-center analysis
SummaryBackgroundThe aim of this study was to compare the postoperative outcome and long-term results after management of liver hydatid cyst by radical and non-radical surgeries.MethodsFrom January 2015 to December 2017, 86  patients were treated with various surgical interventions for liver hydatid cyst. These patients were retrospectively divided into two groups according to the surgical method for treatment: radical methods (e.g., liver resection and pericystectomy) and non-radical methods (e.g., echinococcectomy). Of the 86 patients, 50 (58%) underwent radical treatment and 36 (42%) underwent non-radical trea...
Source: European Surgery - June 4, 2020 Category: Surgery Source Type: research

Minilaparoscopic left paraduodenal hernia repair —a case report
ConclusionMinilaparoscopic repair of a paraduodenal hernia is safe and feasible regardless of age and size of the patient. (Source: European Surgery)
Source: European Surgery - May 20, 2020 Category: Surgery Source Type: research

Burnout in Swiss and Australian surgeons in training —a cross-sectional study
ConclusionReduced free time activities and augmented working hours increase the risk of burnout, whereas having children, salary satisfaction, and regulated weekly working hours decrease the risk of burnout. (Source: European Surgery)
Source: European Surgery - April 29, 2020 Category: Surgery Source Type: research

Impact of the elderly donor on an abdominal organ transplantation program
SummaryBackgroundOlder donors have become widespread in recent years. Given that they have comorbidities, the treatment of theses donors is crucial. Our aim was to analyze the influence of the elderly donor ( ≥65 years) on the subsequent evolution of liver and kidney recipients.MethodsRetrospective study including all liver and kidney transplants performed at the Marqu és de Valdecilla University Hospital with grafts generated from local donors in brain death. Period: 2014–2017. Two groups were considered, depending on the age of the donor (≥ or
Source: European Surgery - April 24, 2020 Category: Surgery Source Type: research

Phthalates and infertility: an issue in hernia meshes?
ConclusionThe implantation of mesh materials affecting male fertility, whether temporarily or not, cannot be explained by the presence of the targeted plasticizers, since none of them were found in the wide range of commonly used meshes that were tested in our study. (Source: European Surgery)
Source: European Surgery - April 16, 2020 Category: Surgery Source Type: research

Surgery watch out the needle eye
(Source: European Surgery)
Source: European Surgery - April 16, 2020 Category: Surgery Source Type: research

Robotic repair of lateral incisional hernias using intraperitoneal onlay, preperitoneal, and retromuscular mesh placement: a  comparison of mid-term results and surgical technique
SummaryBackgroundGiven the paucity of evidence surrounding lateral incisional hernias (LIH), optimal techniques remain elusive. We aim to compare perioperative and mid-term outcomes of patients who underwent robotic LIH repair using three techniques.MethodsPatients were grouped as intraperitoneal onlay (IPOM), transabdominal preperitoneal (TAPP), or retromuscular (RM). Clavien –Dindo classification and Comprehensive Complication Index (CCI®; University of Zurich, Zurich, Switzerland) were used to report postoperative complications and morbidity scores. Surgical site events (SSEs), including surgical site occurren...
Source: European Surgery - April 15, 2020 Category: Surgery Source Type: research

Combined pharmacologic antireflux therapy after esophagectomy: effect on symptoms and endoscopic findings at 1-year follow-up
ConclusionAt 1 ‑year after esophagectomy, combination therapy with 30 mg lansoprazole and Esoxx® appears to be an effective antireflux strategy. (Source: European Surgery)
Source: European Surgery - April 8, 2020 Category: Surgery Source Type: research

Comparison of Hartmann ’s procedure vs. resection with primary anastomosis in perforated sigmoid diverticulitis: a retrospective single-center study
SummaryBackgroundThe surgical management of perforated sigmoid diverticulitis (PSD) is controversial and challenging. Hartmann ’s procedure (HP) still remains the most frequently performed procedure for diffuse peritonitis. However, because less than 50% of patients never achieve restored bowel continuity, alternative surgical procedures have been proposed, including laparoscopic lavage and resection with primary anastomo sis (PRA), with or without a covering ileostomy. We performed a retrospective study to compare HP vs. PRA with loop-ileostomy for the treatment of PSD with generalized peritonitis.MethodsD...
Source: European Surgery - March 24, 2020 Category: Surgery Source Type: research

How effective is the control of laryngopharyngeal reflux symptoms by fundoplication? Symptom score analysis
SummaryBackgroundThe diagnosis and management of laryngopharyngeal reflux (LPR) symptoms are made difficult by the lack of good standard tests for diagnosis and for assessment of responsiveness to medical therapy. Proximal esophageal 24 ‑h pH reading may help identify a group of patients likely to benefit from surgery.MethodsA  consecutive cohort of patients from a prospective populated database were identified. Further review was undertaken by an independent investigator for symptomatic evaluation following fundoplication 24 months after surgery.ResultsThere were 90  patients (70% female) treate...
Source: European Surgery - March 9, 2020 Category: Surgery Source Type: research

Risk-reducing total gastrectomy in asymptomatic CDH1 carriers
ConclusionRisk-reducing total gastrectomy remains the best clinical management for patients with hereditary diffuse gastric cancer harboring a  germline, pathogenicCDH1 variant. In our series, intramucosal carcinoma foci were found in the great majority (89.5%) ofCDH1 carriers. (Source: European Surgery)
Source: European Surgery - March 4, 2020 Category: Surgery Source Type: research

Strategies for management of acute cholecystitis in octogenarians
SummaryLaparoscopic cholecystectomy is a  gold standard procedure for management of acute cholecystitis. In the octogenarian population, it is well documented that cholecystectomy is less likely to be offered to them than their younger counterparts. This review discusses the treatment option available for this unique subset of patients ag ed 80 years and older who present with acute cholecystitis. (Source: European Surgery)
Source: European Surgery - February 27, 2020 Category: Surgery Source Type: research

How disease looks at us
(Source: European Surgery)
Source: European Surgery - February 19, 2020 Category: Surgery Source Type: research

The real risk of nodal disease in T1 oesophageal adenocarcinoma
SummaryBackgroundLymph node status is regarded as an important factor in the prognosis of oesophageal cancer. T1 oesophageal adenocarcinoma management has to include endoscopic management as part of the algorithm. We reviewed the literature to assess the true risk of lymph node metastasis in patients with T1 oesophageal adenocarcinoma.MethodsMedline, Embase, PubMed and Cochrane where searched for manuscripts in English reviewing lymph node metastasis in superficial (T1) oesophageal adenocarcinoma. The main outcome was probability of lymph node metastasis in T1a and T1b oesophageal adenocarcinoma. Secondary outcome was the ...
Source: European Surgery - February 17, 2020 Category: Surgery Source Type: research

Misdiagnosis of cystic pancreatic tumors during a 30-year study period
ConclusionDuring the 30-year study period, more than one third of the patients in our study had a  misdiagnosis preoperatively. The likelihood of misdiagnosis was higher among older patients, patients with symptoms of nausea or vomiting, patients with a clinically palpable tumor, and patients treated during the period between 1992 and 2003. The decline in the prevalence of misdiagnoses should be expected, due to advances in imaging methods and their availability, which are increasing significantly. (Source: European Surgery)
Source: European Surgery - February 17, 2020 Category: Surgery Source Type: research

Modified TAPP is the standard procedure for complex inguinal and femoral hernias: late results and patient satisfaction
ConclusionExperienced endoscopic laparoscopic hernia surgeons have the same or lower complication rates in TAPP therapy in complex inguinal and femoral hernias as in primary hernias with a high patient satifaction with the outcome of TAPP hernioplasty. (Source: European Surgery)
Source: European Surgery - February 5, 2020 Category: Surgery Source Type: research

Transanal total mesorectal excision and adverse conditions for laparoscopic total mesorectal excision
ConclusionTaTME seems to be more difficult in males but not in obesity, benign prostatic hypertrophy, low rectal cancer, pT3-T4, tumor size>5  cm, or neoadjuvant therapy. TaTME could be considered an alternative surgery for low rectal cancer in the presence of these factors affecting laparoscopic TME. (Source: European Surgery)
Source: European Surgery - February 5, 2020 Category: Surgery Source Type: research

Differences in the recommendation of laparoscopic clinical practice guidelines according to the recommendation system —Re-evaluation using GRADE
ConclusionThere were a  wide variety of recommendation systems for laparoscopic guidelines and there were differences between the recommendations from the guidelines using GRADE, Oxford Methodology, SIGN and the ‘Bespoke’ system when re-evaluated by GRADE. A systematic review of recent laparoscopic guidelines might provide the extent and the main reasons of the problem. (Source: European Surgery)
Source: European Surgery - January 10, 2020 Category: Surgery Source Type: research

Robotic multiport versus robotic single-site cholecystectomy: a  retrospective single-centre experience of 142 cases
ConclusionsDVSSC could be performed safely even in patients with acute cholecystitis and previous abdominal surgery. However, the da Vinci Single-Site ® approach for cholecystectomy should not be considered as (Source: European Surgery)
Source: European Surgery - January 8, 2020 Category: Surgery Source Type: research

Surgery 2020 approximates the essence of disease, being and atmosphere
(Source: European Surgery)
Source: European Surgery - January 8, 2020 Category: Surgery Source Type: research

Regional pain management for oesophagectomy: Cohort study suggests a  viable alternative to a thoracic epidural to enhance recovery after surgery
ConclusionThe Concord regional technique for ILO analgesia appears to provide a  simple alternative to other forms of analgesia, with similar analgesic efficacy and with no differences in postoperative complications. This may provide a pathway to enhanced recovery and is suitable to be evaluated in a Randomised control trial (RCT) of techniques. (Source: European Surgery)
Source: European Surgery - January 8, 2020 Category: Surgery Source Type: research

Cardiovascular Research Days 2020: Translation in cardiovascular medicine – expectations, failures and success
(Source: European Surgery)
Source: European Surgery - January 2, 2020 Category: Surgery Source Type: research

Breast reconstruction with the omentum flap: a  case report with unsatisfactory outcome and review of the literature
ConclusionThe literature review shows that the omentum flap can be reasonably used only in one-sided reconstructions of very small breasts. Due to the limited indications, unpredictable flap volume, and our negative experience, we recommend that this type of reconstruction be used with restraint. (Source: European Surgery)
Source: European Surgery - December 11, 2019 Category: Surgery Source Type: research

Heterotopic pancreas presentation as a  fundal submucosal mass, a case report
ConclusionOur case report demonstrates a  very rare cause of fundal submucosal mass with abdominal pain and fullness. The physicians at major gastrointestinal referral centers are much more likely to be familiar with heterotopic pancreas and its clinical manifestation. (Source: European Surgery)
Source: European Surgery - November 22, 2019 Category: Surgery Source Type: research

The gastric cardia: what it reveals about our society
(Source: European Surgery)
Source: European Surgery - November 6, 2019 Category: Surgery Source Type: research

New evidence defining the pathology and pathogenesis of lower esophageal sphincter damage
ConclusionThe new understanding of the significance of cardiac mucosa provides a new and highly accurate histologic method of assessment of LES damage, the primary cause of GERD. This opens a new door to complete histologic assessment of GERD from its etiologic standpoint and to new research that permit early diagnosis of GERD at its outset. Ultimately, such early diagnosis has the potential to reverse the increasing trend of esophageal adenocarcinoma. (Source: European Surgery)
Source: European Surgery - November 6, 2019 Category: Surgery Source Type: research

Endoscopic atlas of fundoplication
(Source: European Surgery)
Source: European Surgery - November 4, 2019 Category: Surgery Source Type: research

Psycho-oncological distress in patients with peritoneal surface malignancies treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
ConclusionThe mean distress score in patients with peritoneal surface malignancies is high (5.4  ± 2.7), is not related to the medical prognosis of the patients due to their underlying disease, and showed no correlation to the complication rate. Sadness and problems with sleep and getting around have a major influence on this score. (Source: European Surgery)
Source: European Surgery - October 24, 2019 Category: Surgery Source Type: research

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