Langenbeck's Archives of Surgery

Langenbeck's Archives of Surgery publishes the best results in the field of clinical surgery and basic surgical research. The focus is on the highest level of ...

List of Papers (Total 1,268)

The safety profile of subthalamic nucleus and globus pallidus internus deep brain stimulation for Parkinson’s diseases: A systematic review of perioperative complications and psychological impacts

Despite its widespread use and acceptance, there is still a significant need for a comprehensive understanding of the safety profile of deep brain stimulation (DBS) for Parkinson’s Disease. This study investigates the surgical and psychological complications associated with DBS surgery for movement disorders, aiming to quantify patient risk and promote broader acceptance of the...

Transversalis fascia collagen content and the risk of surgical complications: results of a prospective study

Collagen is the major protein of the extracellular matrix that provides mechanical strength to the tissues. The relationship between the development of complications and the quality and quantity of collagen fibres has not been investigated in the literature, yet. This was a prospective study of 392 patients who underwent subcostal laparotomy for confirmed or suspected...

Impact of aortic calcification at the origin of celiac artery on post-operative outcomes of major hepatectomy: A significant risk factor for posthepatectomy liver failure

Aortic calcification is associated with arteriosclerosis and is often seen in patients undergoing hepatectomy. However, its impact on post-operative outcomes after major hepatectomy is still unclear. From July, 2015 to December, 2022, 127 patients who underwent resection of three or more adjacent liver segments (major hepatectomy) were retrospectively reviewed. Aortic...

Spleen volume after stage-I associated liver partition and portal vein ligation for staged hepatectomy predicts future liver remnant

The spleen has been reported to inhibit liver regeneration following hepatectomy; however, the underlying mechanisms remain poorly understood. In particular, its role in future liver remnant (FLR) regeneration after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) warrants investigation. To evaluate the relationship between splenic volume...

Long-term patient-centered outcomes following carpal tunnel release surgery: a 10-year follow-up

Carpal Tunnel Syndrome (CTS) is a painful orthopedic hand condition caused by compression of the median nerve at the wrist. Diagnosis is typically clinical, relying on patient’s symptoms and physical examination findings, but confirmation often requires electrodiagnostic studies. Previous research on CTS has explored the relationship between median nerve compression severity and...

The concept of dynamic frailty: an exploratory study of the trajectory to postoperative mortality

Frailty is a heightened vulnerability to stress due to decreased physical and mental abilities. Preoperative frailty has been associated with poorer outcomes. However, frailty is not static, and those patients who eventually die appear to become more frail. Our hypothesis is in-patient, postoperative changes in frailty after major operations predicts the trajectory to...

Does very high alpha-fetoprotein affect very early hepatocellular carcinoma receiving hepatectomy?

Following liver resection (LR), recurrence is critical to the prognosis of hepatocellular carcinoma (HCC). A higher level of alpha-fetoprotein (AFP) is typically associated with poor prognosis and recurrence concerns. Specifically, we attempted to determine whether high AFP (> 1,000ng/ml) and other potentially relevant factors affect survivals of patients with BCLC stage 0 HCC...

Intraoperative hemodynamic management during pancreatoduodenectomy – an analysis of 525 patients

Optimization of perioperative hemodynamic management during major pancreatic surgery can reduce postoperative complications. In this study, we aimed to investigate the effect of intraoperative hemodynamic management, in consideration of both anesthesiologic and surgery-related aspects on major short-term complications following partial pancreatoduodenectomy (PD). Data of 525...

Efficacy of arthroscopic cartilage transplantation combined with platelet-rich plasma in the treatment of early knee osteoarthritis: a retrospective cohort study

Knee osteoarthritis (KOA) is a common degenerative disease that leads to functional decline in the knee joint and a significant reduction in quality of life. Arthroscopic cartilage transplantation combined with platelet-rich plasma (ACT-PRP) has emerged as a novel treatment method and is gradually being applied to patients with early KOA. This study aimed to evaluate the...

The optimal number of lymph node dissections in three-field lymphadenectomy for esophageal squamous cell carcinoma: a large retrospective study

Currently, there is no consensus on the optimal number of lymph node dissections (LNDs) in three-field lymphadenectomy for esophageal squamous cell carcinoma (ESCC). This study aimed to explore the relationship between the LND count and overall survival (OS) in ESCC patients to determine the optimal number of LNDs that confer a survival benefit. A retrospective analysis was...

The effect of pre-operative MRI on the in-breast tumor recurrence rate of patients with breast cancer: a meta-analysis

The impact of preoperative MRI on breast cancer recurrence and long-term outcomes remains undefined. Therefore, this study aims at determining the influence of preoperative MRI on in-breast tumor recurrence rates in cases of surgical treatment for breast cancer. A systematic review and meta-analysis were performed. Literature searches of PubMed, Scopus, and Google Scholar were...

Evaluation of the validity of pancreatoduodenectomy in older patients with distal cholangiocarcinoma in terms of recurrence

This retrospective study investigated the validity of pancreatoduodenectomy (PD) with regard to recurrence in older patients with distal cholangiocarcinoma (DC). We compared 28 patients aged ≥ 75 years and 65 patients aged < 75 years who underwent PD for DC, and evaluated the relationship between age, clinicopathological factors, and outcomes. Postoperative mortality and...

Portal vein reconstruction with bovine pericardium: a comparative analysis of postoperative outcomes in pancreatic surgery

Extended pancreatic resections with venous reconstruction are increasingly performed for borderline resectable pancreatic cancer. Various venous reconstruction techniques have been described. At our center, reconstruction is performed using bovine pericardium patches. So far, few studies reported outcomes using this technique in the field of pancreatic surgery. Data of...

Transarterial embolization of gastroduodenal peptic ulcer bleeding: a single-center study of safety and efficacy

To investigate the safety and efficacy of transarterial embolization (TAE) in patients with bleeding gastroduodenal peptic ulcers with an emphasis on prophylactic TAE (pTAE). This retrospective cohort study was conducted from 1 January 2010 to 30 June 2022. The primary outcome was rebleeding rate after TAE. Secondary outcomes were frequency and severity of complications, 30-day...

Recurrence patterns and management of locally recurrent rectal cancer: a retrospective cohort study

Treatment of locally recurrent rectal cancer (LRRC) is still challenging because of inhomogeneous patient cohorts regarding previous treatments as well as different recurrence patterns and locations. The aim of this study was to investigate the treatments and surgical approaches tailored to them. We included all patients who were treated for LRRC without distant metastasis at the...

Insufficient weight loss after bariatric surgery and its predictors: Tehran Obesity Treatment Study (TOTS)

This study aimed to determine the factors related to insufficient weight loss (IWL) following bariatric surgery. The data for 3456 individuals who had bariatric surgery were obtained prospectively. A bioelectrical impedance analyzer was used to measure body composition changes and compare them between the sufficient (SWL) and IWL groups. The generalized estimated equation...

Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis

High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds...

Multi-Indicator analysis of the impact of preoperative inflammatory states on complications following pancreatoduodenectomy

Pancreatoduodenectomy (PD) is a complex surgery with a high rate of postoperative complications, for which effective preoperative indicators are currently lacking. Inflammatory indices such as the pan-immune-inflammation value (PIV), platelet-neutrophil product (PPN), and platelet-albumin ratio (PAR) have shown potential as biomarkers for postoperative prognosis in various...

Beyond the decade: unveiling long-term weight and co-morbidity outcomes up to 10 years post laparoscopic sleeve gastrectomy

Despite its effectiveness, long-term data on the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for morbid obesity are sparce. We collected data through phone interviews and hospital records for patients who had LSG, including those that then underwent revisional bariatric surgery, assessing their weight outcomes, associated health conditions, and complications...

Surgical and postoperative management of congenital heart disease: a systematic review of observational studies

Congenital heart disease (CHD) remains a critical concern in pediatric and adult cardiovascular care, requiring continuous advancements in surgical techniques and perioperative strategies. While survival rates have improved, challenges persist in optimizing long-term neurodevelopmental outcomes, addressing disparities in healthcare access, and overcoming systemic barriers to...

Initial clinical experiences of robotic distal gastrectomy for gastric cancer using the Da Vinci™ SP system: a single-center retrospective study

Reduced-port surgery has been utilized in gastric cancer surgery but is not predominantly used due to its high technical difficulty. A new single-port surgical robot named da Vinci™ SP System (DVSP) was launched and eventually approved for clinical use in Japan in November 2022. We initiated robotic gastrectomy for gastric cancer using DVSP in March 2023. Here, we report our...

The necessity of prophylactic central lymph node dissection in clinically n0 papillary thyroid carcinoma: perspective from the endemic region

Prophylactic central lymph node dissection (pCND) in papillary thyroid carcinoma (PTC) is still a matter of debate. Therefore, we aimed to identify the factors affecting central lymph node metastasis (CLNM) in patients with clinically node-negative (cN0) PTC. This retrospective study included 248 patients with cN0 PTC who underwent total thyroidectomy (TT) or TT + pCND...

The effects of endoscopic vacuum therapy for non-operative treatment of anastomotic leakage on oncological outcomes in rectal cancer patients

Rectal resection has remained the cornerstone in curative treatment of rectal cancer. This however, implies the risk of anastomotic leakage leading to morbidity, mortality and potentially disease progression. Endoscopic vacuum therapy (EVT) has emerged as a promising tool in leakage therapy in order to avoid reoperation and Hartman resection. However, its clinical efficacy and...

Laparoscopic vs. Robotic transabdominal adrenalectomy- propensity matched analysis and learning curve

While laparoscopic transabdominal or retroperitoneal adrenalectomy is standard care for adrenal tumors, benefits of robotic adrenalectomy (RA) are yet unclear. We evaluated the costs (including disposables), outcomes as well as the learning curve of robotic and laparoscopic adrenalectomy (LA) in a specialized center. In retrospective analysis of our prospective database (ethical...

MRI is more accurate than FDG-PET in assessing complete response in rectal cancer patients after neoadjuvant therapy

The role of FDG-PET in the restaging rectal cancer following neoadjuvant therapy (NAT) is not clear. We compared the accuracy of FDG-PET and MRI in the assessment of rectal cancer response to NAT. Data of patients treated between January 2015 and September 2022 were captured from a rectal tumor registry. Restaging FDG-PET and MRI were evaluated for the presence of viable tumor...