Acta Chirurgica Austriaca

Background: (Heart-)Lung transplantation has become an accepted surgical therapy for selected patients suffering from a variety of (cardio-)pulmonary diseases. Methods: The objective of this paper is to give an overview on the international knowledge, trends and results of lung transplantation, including the experience with 72 lung and heart-lung transplantations at the University Hospital of Leuven, Belgium is described. Results: According to the International Registry for Heart and Lung Transplantation, the number of lung and heart-lung transplantations has plateaued over the last few years. Donor age in both types of transplants is still increasing with less suitable donor organs available. Therefore, alternative treatment modalities such as lung volume reduction surgery for patients suffering from emphysema and pulmonary tromboendarterectomy for patients with pulmonary hypertension secondary to chronic pulmonary emboli, are now receiving renewed interest. Overall 5-year survival following pulmonary transplantation is close to 40%. Morbidity of chronic immunosuppression and late graft failure from chronic rejection presenting as bronchiolitis obliterans syndrome remain the major drawbacks of this surgical treatment. Conclusions: A greater donor supply is necessary until xenotransplantation becomes a practical reality. Future efforts to improve the results of lung transplantation should be directed towards both a better control of immune response of the allograft and an effective treatment for bronchiolitis obliterans.

D. Raemdonck

G. Verleden

J. Vanhaecke

Kristiane Boeck

W. Daenen

M. Demedts

W. Coosemans

P. Leyn

T. Lerut

The current status of lung transplantation

肺移植的现状

Anastomotic leakage after esophagectomy for underlying malignancy is a major cause of postoperative morbidity and mortality. Diagnosis and management of anastomotic leakage has changed drastically over the past two decades. The aim of this study was to highlight the necessity of treatment algorithms to decrease postoperative mortality. All patients who underwent Ivor Lewis esophagectomy between 2010 and 2022 were included in this study. All patients who developed an anastomotic leakage were extracted and divided into two groups to analyze the differences in management between 2010–2015 and 2016–2022. Of 174 patients enrolled in this study, 33 patients developed an anastomotic leakage. Changes in management led to a significant decrease in re-do surgeries and a subsequent decrease in hospital mortality. Our data clearly show that optimizing patient management is a necessity, as it drastically improves patient survival.

Nader El-Sourani

Sorin Miftode

Achim Troja

Fadl Alfarawan

Maximilian Bockhorn

European surgery. Supplement/European surgery

RETRACTED ARTICLE: Changes in diagnosis and management of anastomotic leakage after esophagectomy for underlying malignancy reduce postoperative mortality and improve patient outcome

撤稿文章：食管切除术后吻合口漏的诊断和管理变化降低了术后死亡率并改善了患者预后

Nebojsa Mitrovic

Dejan Stevanovic

Damir Jasarovic

Aleksandar Lazic

Adenocarcinoma of the duodenojejunal flexure: our recent experience

十二指肠空肠曲腺癌：我们的近期经验

Mark Portelli

Samuel Attard

Tonio Bezzina

Single-incision laparoscopic cholecystectomy vs. conventional laparoscopic cholecystectomy: a meta-analysis of the literature

单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术的文献荟萃分析

Pietro Santocchi

Flavio Tirelli

Roberto Persiani

Antonio Laurino

Francesco Belia

Annamaria Agnes

Laura Lorenzon

Domenico D’Ugo

Alberto Biondi

Pseudoaneurysms after curative-aim gastrectomy for gastric carcinoma: clinical presentation and management

胃癌治愈性胃切除术后假性动脉瘤：临床表现与处理

Matthew McGuirk

Abbas Smiley

Rifat Latifi

Predictors of in-hospital mortality in non-elderly adult patients requiring emergency admission for acute pancreatitis: a retrospective analysis based on a generalized additive model

非老年急性胰腺炎急诊入院患者院内死亡率的预测因素：基于广义加性模型的回顾性分析

Summary Background Gastric per-oral endoscopic pyloromyotomy (G-POEM) has been performed for 10 years in the treatment of refractory gastroparesis (Gp). Many studies from the early years of G‑POEM reported short-term outcomes with 60–80% clinical success. Notably, no recent studies have assessed short-term outcomes after a decade of experience with this procedure. In this study, we compare the short-term outcomes of our initial 16 patients undergoing G‑POEM 8 years ago with 16 of our recent patients undergoing G‑POEM. Patients and methods The initial 16 patients who underwent G‑POEM from 06/2015 to 07/2016 (group A; the first 16 G-POEM procedures QC performed) and 16 recent patients who underwent G‑POEM from 07/2021 to 01/2022 (group B; the first 16 procedures performed when QC moved to a different institution) were enrolled in the study. Patients’ demographics, clinical success, procedure time, and length of hospital stay were analyzed and compared between the two groups. All procedures were performed by a single advanced endoscopist (QC). Results Patients’ age, gender, and etiology of gastroparesis were similar between the two groups. There were no differences between the two groups in terms of short-term clinical outcomes. However, there was a significant difference in procedure time and the length of hospital stay between the two groups. There were no adverse events reported for either group A or group B. Conclusion For a single experienced advanced submucosal endoscopist, there were no differences in the short-term clinical outcomes of G‑POEM when comparing the initial timeframe of performing G‑POEM with that after 8 years of experience at the time of the study in a different institution. Notably, the procedure time and the length of hospital stay were significantly shorter after 8 years of practice.

Shazia Rashid

Michelle Neice

Maryam Mubashir

Syed Musa Raza

Natalie Roppolo

Victoria Andrus

David Okuampa

Brittany Pass

Elizabeth Armstrong

Ross Dies

Lena Kawji

Ashely Deville

Sidra Ahsan

Parit Mekaroonkamol

Qiang Cai

Short-term outcomes of gastric per-oral endoscopic pyloromyotomy (G-POEM) then and now: a comparison analysis

胃经口内镜幽门肌切开术（G-POEM）短期结果的今昔对比分析

Summary Background The rapidly expanding field of robot-assisted surgery necessitates a parallel evolution in surgical education. A surgeon introduced to the telemanipulator control system can count on technological support that increases precision and supports decisions made during surgery. Generally, the surgeon (operator) is an integral part of the robot, so the synergy of this cooperation may bring the expected progress in access to high-quality services for many patients. Methods This review explores the current state of robotic surgery education, analyzing its limitations and established applications. Additionally, it delves into promising future directions, including the potential of artificial intelligence and advancements in training methods. Results This review identifies key challenges and highlights innovative strategies such as virtual reality simulation and cadaveric training. Furthermore, it emphasizes the importance of developing standardized national curricula to ensure consistent training quality. Conclusion This review emphasizes the need for a robust educational framework to equip surgeons with the necessary skills for safe and effective robotic surgery integration. The use of high-tech tools also requires the use of innovative educational methods. By embracing innovative technologies and prioritizing a standardized curriculum, we can ensure that the future of surgical training empowers surgeons and ultimately improves patient outcomes.

Paweł Łajczak

Julita Janiec

Krzysztof Żerdziński

Kamil Jóźwik

Przemysław Nowakowski

Zbigniew Nawrat

M.D. meets machine: the symbiotic future of surgical learning

医生与机器相遇：外科学习共生的未来

Summary Background Robotic-assisted surgery is gaining popularity and is about to become the leading principle for less invasive procedures in colorectal diseases. Despite the great achievements made in terms of robotic technology and the high ergonomics that current systems offer, the application of these devices still places special demands on the user and requires comprehensive training and knowledge. Methods This review article combines recommendations from the current literature with personal experience in performing robotic interventions and supplements these with expert knowledge derived from scientific conferences and peer-to-peer meetings. Results The two essential aspects of robotic surgery are case-related planning and standardization of the technique, which both consider the special technical possibilities and limitations of the systems used. The article provides comprehensive recommendations in this regard and discusses the essential steps of left- and right-sided interventions. Conclusion This article is aimed at surgeons performing their first robot-assisted procedures in colorectal surgery and aims to help them to optimize their own approach, but it might also feature interesting insights for persons already trained in robotic colorectal surgery.

C. Bittermann

M. Berlet

D. Wilhelm

Principles of robot-assisted colorectal surgery

机器人辅助结直肠手术的原则

Summary Background Laparoscopic Nissen fundoplication is considered the gold standard in surgical management of gastroesophageal reflux disease. Therefore, exhaustive scrutiny of the procedure is necessary. The aim of this study was to perform a complete and systematic literature review of laparoscopic Nissen fundoplication to summarize the evidence for safety and efficacy over time. Methods MEDLINE, Embase, CINAHL, the Cochrane Library, and Web of Science were searched for randomized controlled trials investigating intra- and postoperative outcomes at follow-ups between 4–6 weeks and 17 years. Results Among 1675 screened articles, 63 articles were identified comprising 40 trials with a total of 2619 participants. Intraoperative events included bleeding (2.9%), gastroesophageal injury/perforation (0.9%), and spleen injury/splenectomy (0.9%). One-year clinical follow-up presented the following: dysphagia (22.4%), heartburn or epigastric/sternal pain (15.1%), gas bloating (30.1%), and inability to vomit/belch (16.4%). These outcomes displayed a U-shaped curve with a minimum of symptoms at 1 year. At 10 years postoperatively, clinical outcomes deteriorated, demonstrating dysphagia (45.3%), heartburn or epigastric/sternal pain (30.9%), inability to vomit/belch (48.8%), and gas bloating (44.4%). Furthermore, the surgical benefit seems to dissipate at 17 years. At 1 and 10 years after surgery, reoperation rates were 6.7% and 16.3%, whereas proton pump inhibitor (PPI) use was at 12.3% and 23.3%, respectively. Conclusion The performance of Nissen fundoplication declines over time, as demonstrated by increased PPI medication usage for recurrent symptoms and an increased reoperation rate reaching a combined 39.6%, representing failures after 10 years. The complication rates are dominated by dysphagia, gas bloating, inability to belch/vomit, and/or recurrent reflux symptoms with heartburn.

Joerg Zehetner

Johanna Hoffsten

Shuchesmita Das

Sebastian F. Schoppmann

John C. Lipham

Looking back on a gold standard: a systematic literature review of laparoscopic Nissen fundoplication as an anti-reflux treatment option

回顾金标准：腹腔镜尼森胃底折叠术作为抗反流治疗选择的系统文献综述

短名	Eur Surg
Journal Impact	0.60
国际分区	SURGERY(Q4)
期刊索引	SCI Q4中科院 4 区

ISSN	0001-544X, 1563-2563, 1682-1769, 1682-4016, 1682-8631
h-index	24
国内分区	医学(4区)医学外科(4区)

出版信息	出版商: Springer-Verlag Wien，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 1969，原创研究文献占比: ，自引率:， Gold OA占比:

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