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Topic Review
Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs)
Pancreatic neuroendocrine tumours (pNETs) are a group of rare neoplasms with an incidence of 1–2/100,000 inhabitants/year. They represent 2% of all pancreatic neoplasms and are characterized by a great heterogeneity according to their genetic or sporadic origin, their functional or non-functional character, their degree of locoregional or systemic invasion and their single or multiple localization. The reference curative treatment is surgical resection of the pancreatic tumor in specialized high-volume centres, after a multidisciplinary discussion involving surgeons, oncologists, radiologists and pathologists.
  • 423
  • 14 Jan 2022
Topic Review
Surgical Management of Gastroesophageal Junction Adenocarcinoma
Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last two decades to incorporate a multidisciplinary approach, including endoscopic intervention, neoadjuvant chemotherapy/chemoradiation, and open or minimally invasive surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and, more recently, proximal gastrectomy. 
  • 83
  • 21 Feb 2024
Topic Review
Surgical Antibiotic Prophylaxis
In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP).
  • 131
  • 02 Feb 2024
Topic Review
Surgery in Autoimmune Pancreatitis
Autoimmune pancreatitis (AIP) was first described as a clinical entity in 1961 by Sarles et al. who described a type of sclerosing pancreatitis associated with hypergammaglobulinemia.
  • 232
  • 06 Feb 2023
Topic Review
Surgery for Non-Small-Cell Lung Cancer
Circulating tumor cells (CTCs) are dislodged from the primary tumor into the bloodstream, travel within the bloodstream to distant organs, and finally extravasate and proliferate as epithelial metastatic deposits.  In surgery for malignancies, the surgical manipulation of tumors and tissues around the tumor may lead to the release of CTCs into the bloodstream. The non-touch isolation technique (NTIT) has been advocated to prevent the release of CTCs during surgery. The concept of NTIT is the prevention of intraoperative increment of CTCs from the primary tumor by the early blockade of outflow vessels, and ‘pulmonary vein (PV)-first lobectomy’ during surgery for non-small-cell lung cancer (NSCLC) corresponds to this technique. 
  • 272
  • 16 Mar 2022
Topic Review
Status and Clinical Significance of Lymph Node Dissection
Despite its decreasing incidence, gastric cancer remains an important global healthcare problem due to its overall high prevalence and high mortality rate. Since the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) and Fédération Nationale des Centres de Lutte contre le Cancer (FNLCC)/ Fédération Francophone de Cancérologie Digestive (FFCD) trials, the neoadjuvant chemotherapy has been recommended throughout Europe in gastric cancer. Potential benefits of preoperative treatments include a higher rate of R0 resection achieved by downstaging the primary tumor, a likely effect on micrometastases and isolated tumor cells in the lymph nodes, and, as a result, improved cancer-related survival. Nevertheless, distortion of anatomical planes of dissection, interstitial fibrosis, and sclerotic tissue changes may increase surgical difficulty. The collection of at least twenty-five lymph nodes after neoadjuvant therapy would seem to ensure removal of undetectable node metastasis and reduce the likelihood of locoregional recurrence. 
  • 215
  • 15 Jun 2023
Topic Review
Speed_Bump_Sign as a Diagnostic Tool for Acute Appendicitis
The ‘speed bump sign’ is a clinical symptom characterised by aggravated abdominal pain while driving over speed bumps. The speed bump sign is a useful ‘rule-out’ test for diagnosing acute appendicitis. With good accessibility, the speed bump sign may be added as a routine part of taking the history of patients with abdominal pain.
  • 344
  • 25 Feb 2022
Topic Review
Sinistral Portal Hypertension after Pancreaticoduodenectomy
To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has been widely accepted in high-volume centers for pancreatic resection due to its favorable outcomes compared with non-operative treatment. However, in patients with long-term survival, sinistral portal hypertension (SPH) occurs as a late-onset postoperative complication. These patients present gastrointestinal varices due to congested venous flow from the spleen, which may cause critical variceal bleeding.
  • 408
  • 02 Nov 2021
Topic Review
Segmentectomy for Lung Cancer
A lung segmentectomy, a type of sublobar resection, preserves more pulmonary function than is lobectomy. The use of minimally invasive lung segmentectomy for early-stage lung cancer has been increasing. This procedure is associated with technical challenges because (1) it requires a thorough understanding of the complex segmental anatomy that frequently accompanies anomalies, and (2) it is difficult to confirm the location of small tumors during minimally invasive surgery, which makes it difficult to obtain adequate surgical margins. 
  • 825
  • 22 Jul 2021
Topic Review
Screw Fixation in Patients with Osteoporotic Spine
Osteoporosis is a common disease in elderly populations and is a major public health problem worldwide. It is not uncommon for spine surgeons to perform spinal instrumented fusion surgeries for osteoporotic patients. In patients with severe osteoporosis, instrumented fusion may result in screw loosening, implant failure or nonunion because of a poor bone quality and decreased pedicle screw stability as well as increased graft subsidence risk.
  • 445
  • 30 May 2022
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