Characteristics and risk factors of cervical lymph node metastasis in cN0 papillary thyroid microcarcinoma of the isthmus
AbstractThe surgical resection range of papillary thyroid microcarcinoma of the isthmus (PTMCI) is controversial, and the guidelines do not fully guide the central lymph node dissection (CLND).We retrospectively studied the comparison of PTMCI (Group A,n = 65 cases) and non-PTMCI (Group B,n = 80 cases). Based on whether central lymph node metastasis (CLNM) was further detected, they were further divided into the PTMCI with CLNM (group C,n = 42 cases), the PTMCI without CLNM (group D,n = 23 cases), the non-PTMCI with CLNM (group E,n = 45 cases), the non-PTMCI without CLNM (group F,n = 35 cases). All ...
Source: Updates in Surgery - March 26, 2024 Category: Surgery Source Type: research

Omentopexy versus no omentopexy in sleeve gastrectomy: an updated systematic review and meta-analysis
AbstractLaparoscopic sleeve gastrectomy with omentopexy (O-LSG) has been compared to laparoscopic sleeve gastrectomy with no-omentopexy (NO-LSG) in terms of postoperative outcomes and one-year anthropometric results. This systematic review with meta-analysis aimed to compare the utility of omentopexy in sleeve gastrectomy. We performed a systematic review with meta-analysis according to PRISMA 2020 and AMSTAR 2 guidelines. We included studies that systematically searched electronic databases and compared the O-LSG with the NO-LSG conducted through 1st March 2023. The bibliographic research yielded 13 eligible studies. Thes...
Source: Updates in Surgery - March 26, 2024 Category: Surgery Source Type: research

Evaluation of the prognostic performance of different cutoff values of lymph node ratio staging system for stage III colorectal cancer
This study attempted to compare the prognostic performance of lymph node ratio (LNR) staging system with different cutoff values relative to American Joint Committee on Cancer (AJCC) pN staging system in stage III colorectal cancer (CRC). Overall, 45,069 patients from the SEER dataset and 69 patients from the Second Affiliated Hospital of Nanjing Medical University (the External set) who underwent surgical resection of the primary tumor and were diagnosed with stage III CRC by postoperative pathology were included. Patients were divided into three subgroups based on the LNR cutoff used in previous studies, Kaplan –Meier ...
Source: Updates in Surgery - March 26, 2024 Category: Surgery Source Type: research

Changes in cardiac functions in patients treated with parathyroidectomy for secondary hyperparathyroidism
AbstractOur study aims to investigate the changes in cardiac functions, especially myocardial performance index (MPI), in patients who underwent parathyroidectomy for secondary hyperparathyroidism. Patients who underwent parathyroidectomy for secondary hyperparathyroidism between June 2010 and September 2021 were analyzed retrospectively. The patients were divided into two groups: those who underwent total parathyroidectomy (group 1) and those who underwent subtotal parathyroidectomy (group 2). The groups were compared according to the echocardiogram findings performed in the preoperative period and the postoperative sixth...
Source: Updates in Surgery - March 26, 2024 Category: Surgery Source Type: research

“O.R. GOES GREEN”: a first step toward reducing our carbon footprint in the operating room and hospital
AbstractHospitals in Europe produce approximately 6 million tons of medical waste annually, about one-third of this originating in operating rooms. Most of it is solid waste, which can be recycled if bodily fluids do not contaminate it. Only 2 –3% of hospital waste must be disposed of as infectious waste, and this is much lower than the 50–70% of garbage in the biohazard waste stream. In June 2021, at the main operating room of the Department of General Surgery of the University of Turin, we began a separate collection program for mat erials consisting of plastic, paper, TNT (material not contaminated by bodily fluids)...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Compensatory expansion of the right middle lobe: volumetric and functional analysis of the changes after right upper or lower lobectomy
This study examined the difference in the postoperative right middle lobe expansion and pulmonary function between right upper and right lower lobectomy. Patients who underwent right upper or right lower lobectomy through video-assisted thoracic surgery (n = 82) were enrolled in this retrospective study. Pulmonary function tests and computed tomography were performed preoperatively and at 1 year postoperatively. Using three-dimensional computed tomography volumetry, the preoperative and postoperative lung volumes were measured, and the predicted postoperative forced expiratory volume in 1 s was calculated. Middle lob...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Long-term impact of replaced right hepatic artery resection in pancreaticoduodenectomy
AbstractThe clinical impact of replaced right hepatic artery (rRHA) resection during pancreaticoduodenectomy (PD) has not been thoroughly investigated. We therefore assessed the short- and long-term effects of rRHA resection during PD, with special reference to alterations in the volumetric profile of the liver. Patients with rRHA were divided into two groups based on the presence (R group) or absence (nR group) of resection. The nR group included cases of rRHA resection and reconstruction. We compared the postoperative short-term complications and detailed liver volume profile by CT volumetry in the long term between the ...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Pre-operative assessment of living liver donors ’ liver anatomy and volumes
AbstractDecades of experience supports LDLT as a favorable strategy to reduce waitlist mortality. The multiple regenerative pathways of hepatocytes and other hepatic cells justify the rationale behind it. Nonetheless, living liver donation is still underused and its broader implementation is challenging, mostly due to variability in practices leading to concerns related to donor safety. A non-systematic literature search was conducted for peer-reviewed original articles related to pre-operative evaluation of living liver donor candidates. Eligible studies were synthesized upon consensus for discussion in this up-to-date re...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

A SICE (Societ à Italiana di Chirurgia Endoscopica e Nuove Tecnologie) observational prospective multicenter study on anatomical variants of the superior mesenteric artery: intraoperative analysis during laparoscopic right hemicolectomy—CoDIG 2 database (ColonDx Italian Group)
AbstractColorectal cancer, the third most common cancer worldwide, affects 40 –45% of patients on the right side. Surgery, especially minimally invasive methods such as laparoscopic and robotic procedures, is the preferred treatment. However, these techniques present technical complications. The anatomical complexity and variations in vessel branching patterns pose challeng es, particularly for less experienced surgeons. The CoDIG 2 is a nationwide observational study involving 76 specialized Italian general surgery departments focused on colorectal surgery. The centres were directed to maintain their standard surgical a...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Pilonidal sinus: an overview of historical and current management modalities
This article details the different methods of managing acute and chronic pilonidal disease ranging from treatments in the primary care setting to those in hospital theatres, with special attention to newer modalities of minimally invasive interventions. As a chronic illness that often affects those of working age, pilonidal disease can confer significant morbidity especially, but not limited to, a substantial amount of time off work. Treatment of chronic disease in particular, has evolved from midline techniques to off-midline techniques, with more recent developments offering promising solutions to reduce acute flare ups ...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Is ALPPS still appropriate for large or locally advanced hepatocellular carcinoma in an era of targeted agents and immunotherapy?
This study investigated the efficacy and safety of drug-eluting beads trans-arterial chemo-embolization (dTACE), portal vein embolization (PVE), tyrosine kinase inhibitor (TKI), and immune checkpoint inhibitors (ICI) compared to Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) for large or locally advanced HCC.Data regarding clinicopathological details, safety, and oncological outcomes were reviewed for the quadruple therapy (dTACE-PVE-TKI-ICI) and compared with ALPPS.From 2019 to 2020, 10 patients with large or locally advanced HCC underwent future remnant liver (FRL) modulation (dTACE-P...
Source: Updates in Surgery - March 25, 2024 Category: Surgery Source Type: research

Intraoperative radio-guided localization of parathyroid adenomas using 3D freehand SPECT technology
AbstractParathyroidectomy for primary hyperparathyroidism (PHPT) could have poor outcomes, even with accurate preoperative localization of the adenomas, because their intraoperative localization can be challenging. Freehand single photon emission computed tomography (fhSPECT) is a new technique for radio-guided intraoperative navigation. Its use during parathyroidectomy could be useful and such data are limited. We herein present our experience on the feasibility of fhSPECT for intraoperative detection of abnormal parathyroid glands. We retrospectively reviewed the clinical data of 55 patients (30 –77 years old) with PH...
Source: Updates in Surgery - March 22, 2024 Category: Surgery Source Type: research

Suture repair versus mesh repair in elderly populations with incarcerated or strangulated groin hernia
AbstractTension-free hernia repair is the gold standard for groin hernia repair. However, the optimal surgical treatment for incarcerated or strangulated groin hernia in elderly populations is controversial. The aim of this study is to compare the clinical efficacy of mesh repair and suture repair in the treatment of incarcerated or strangulated groin hernia in elderly patients. Patients  ≥ 65 years who underwent urgent surgical repair for incarcerated or strangulated groin hernia from January 2012 to June 2022 were included. Patients’ demographic data and postoperative outcomes were retrospectively analyzed. Pati...
Source: Updates in Surgery - March 21, 2024 Category: Surgery Source Type: research

Achieving fascial closure with preoperative botulinum toxin injections in abdominal wall reconstruction: outcomes from a high-volume center
AbstractPreoperative injection of Botulinum Toxin A (Botox) has been described as an adjunctive therapy to facilitate fascial closure of large hernia defects in abdominal wall reconstruction (AWR). The purpose of this study was to evaluate the impact of Botox injections on fascial closure and overall outcomes to further validate its role in AWR. A prospectively maintained database was retrospectively reviewed to identify all patients undergoing AWR at our institution between January 2014 and March 2022. Patients who did and did not receive preoperative Botox injections were analyzed and compared. A total of 426 patients we...
Source: Updates in Surgery - March 20, 2024 Category: Surgery Source Type: research

Evaluating the effectiveness of dual dye combination of indocyanine green and carbon nanoparticles with parathyroid hormone test in preserving parathyroid gland during papillary thyroid cancer surgery: a single-center retrospective cohort study
AbstractPreserving the integrity of parathyroid glands is crucial in papillary thyroid cancer (PTC) surgery to avoid hypoparathyroidism. In recent years, two novel dyes, activated carbon nanoparticles (CNP) and indocyanine green (ICG), have been utilized to assist in parathyroid gland identification. However, the use of CNP or ICG alone can result in extravasation of dye or excessive fluorescence of non-parathyroid tissue, which can affect the accuracy of surgical outcomes by yielding false negative or false positive results. Therefore, it is important to further optimize the application of these two dyes in surgery. We an...
Source: Updates in Surgery - March 20, 2024 Category: Surgery Source Type: research