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Article ; Online: Comparison between the open and the laparoscopic approach in the primary ventral hernia repair: a systematic review and meta-analysis.

Martins, Márcia Regina / Santos-Sousa, Hugo / do Vale, Miguel Alves / Bouça-Machado, Raquel / Barbosa, Elisabete / Sousa-Pinto, Bernardo

Langenbeck's archives of surgery

2024 Volume 409, Issue 1, Page(s) 52

Abstract: Background: Ventral hernia repair underwent various developments in the previous decade. Laparoscopic primary ventral hernia repair may be an alternative to open repair since it prevents large abdominal incisions. However, whether laparoscopy improves ... ...

Abstract	Background: Ventral hernia repair underwent various developments in the previous decade. Laparoscopic primary ventral hernia repair may be an alternative to open repair since it prevents large abdominal incisions. However, whether laparoscopy improves clinical outcomes has not been systematically assessed. Objectives: The aim is to compare the clinical outcomes of the laparoscopic versus open approach of primary ventral hernias. Methods: A systematic search of MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted in February 2023. All randomized controlled trials comparing laparoscopy with the open approach in patients with a primary ventral hernia were included. A fixed-effects meta-analysis of risk ratios was performed for hernia recurrence, local infection, wound dehiscence, and local seroma. Meta-analysis for weighted mean differences was performed for postoperative pain, duration of surgery, length of hospital stay, and time until return to work. Results: Nine studies were included in the systematic review and meta-analysis. The overall hernia recurrence was twice less likely to occur in laparoscopy (RR = 0.49; 95%CI = 0.32-0.74; p < 0.001; I Conclusion: The results of available studies are controversial and have a high risk of bias, small sample sizes, and no well-defined protocols. However, the laparoscopic approach seems associated with a lower frequency of hernia recurrence, local infection, wound dehiscence, and local seroma.
MeSH term(s)	Humans ; Herniorrhaphy/methods ; Seroma/epidemiology ; Seroma/etiology ; Seroma/surgery ; Hernia, Ventral/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Pain, Postoperative ; Laparoscopy/methods ; Wound Infection/surgery ; Surgical Mesh ; Recurrence
Language	English
Publishing date	2024-02-03
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-024-03241-y
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Article ; Online: Impact of a Multicomponent Exercise Training Program on Muscle Strength After Bariatric Surgery: A Randomized Controlled Trial.

Boppre, Giorjines / Diniz-Sousa, Florêncio / Veras, Lucas / Bezerra, Andrea / Devezas, Vitor / Preto, John / Santos-Sousa, Hugo / Oliveira, José / Fonseca, Hélder

Obesity surgery

2024 Volume 34, Issue 5, Page(s) 1704–1716

Abstract: Purpose: This study examined the benefits of an 11-months multicomponent exercise program (MEP) on muscular strength (MS) after bariatric surgery.: Methods: Of the 84 randomized patients, 41 participants from the exercise group (EG) and 20 ... ...

Abstract	Purpose: This study examined the benefits of an 11-months multicomponent exercise program (MEP) on muscular strength (MS) after bariatric surgery. Methods: Of the 84 randomized patients, 41 participants from the exercise group (EG) and 20 participants from the control group (CG) were included in the analysis. The EG received supervised MEP for 11 months, starting 1-month post-bariatric surgery (BS) in addition to standard medical care, while the CG received medical care recommendations only. Knee and trunk MS was assessed by isokinetic dynamometry pre-surgery, 1-, 6-, and 12-month post-surgery, while body composition was assessed by dual-energy X-ray absorptiometry. Results: The MEP did not significantly impact absolute MS in the dominant knee and trunk regions at 6- and 12-month post-BS. However, relative MS showed significant improvements. At 6-month post-BS, knee flexion at 60°/s relative to body weight (BW) increased significantly (p = 0.047), as did knee extension at 180°/s relative to BW (p = 0.009), and knee extension at 60°/s relative to total lean mass (p=0.040). At 12-month post-BS, knee flexion at 60°/s relative to BW also significantly improved (p=0.038). Conclusion: While absolute MS was not significantly improved with MEP, this study found significant enhancements in relative MS, particularly in dominant knee flexion post-MEP participation. Further research should explore different exercise intensities and frequencies to optimize postoperative MS recovery post-BS. Clinical trial registration: ClinicalTrials.gov (NCT02843048).
MeSH term(s)	Humans ; Obesity, Morbid/surgery ; Exercise ; Muscle Strength/physiology ; Exercise Therapy ; Bariatric Surgery
Language	English
Publishing date	2024-03-27
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-024-07173-w
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Article ; Online: Impact of serum albumin concentration and neutrophil-lymphocyte ratio score on gastric cancer prognosis.

Costa, Teresa / Nogueiro, Jorge / Ribeiro, Daniel / Viegas, Pedro / Santos-Sousa, Hugo

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 57

Abstract: Introduction/aim: Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC).: Material and methods! ...

Abstract	Introduction/aim: Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC). Material and methods: We perform a retrospective analysis on a database of 637 GC cases, between January 2010 and December 2017. In 396 patients, the inclusion criteria for this study were met (non-resectional or palliative surgery were excluded). Analytic data was only available in 203 patients. COA-NLR score was defined as follows: COA under 35 g/L and NLR value of 2.585 or higher, score 2; one of these conditions, score 1; and neither, score 0. Results: In our population (n = 203), 87 patients were classified as score 0, 82 as score 1 and 34 as score 2. COA-NLR score was significantly associated with DFS (HR 1.674; CI 95% 1.115-2.513; p = 0.013) and with OS (HR 2.072; CI 95% 1.531-2.805; p < 0.001). Kaplan-Meier curve analysis (log rank test) revealed that a higher score of COA-NLR predicted a worse OS (p < 0.001) and DFS (p = 0.03). COA-NLR was an independent prognostic factor for OS when adjusted to pStage and age (adjusted HR 1.566; CI 95% 1.145-2.143; p = 0.005). Conclusions: Preoperative COA-NLR score was significantly associated with worse OS and DFS and, in this way, with worse prognosis on GC patients submitted to curative-intent resectional surgery.
MeSH term(s)	Humans ; Neutrophils ; Serum Albumin ; Stomach Neoplasms/surgery ; Retrospective Studies ; Lymphocytes ; Prognosis
Chemical Substances	Serum Albumin
Language	English
Publishing date	2023-01-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02799-3
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Article ; Online: Impact of perioperative chemotherapy in the treatment of patients with gastric cancer.

Fonseca, Telma / Coimbra, Mariana / Santos-Sousa, Hugo / Barbosa, Elisabete / Barbosa, José

Porto biomedical journal

2022 Volume 7, Issue 6, Page(s) e180

Abstract: Background: Perioperative chemotherapy (PeriCh) is the current standard of care for stage II/III gastric cancer tumors in Europe. However, when it concerns patients who endure complications during PeriCh it is unclear if it increases the risk of ... ...

Abstract	Background: Perioperative chemotherapy (PeriCh) is the current standard of care for stage II/III gastric cancer tumors in Europe. However, when it concerns patients who endure complications during PeriCh it is unclear if it increases the risk of postoperative complications and other poorer surgical outcomes. We aim to demonstrate if there is an association between having complications during PeriCh and postoperative complications and histopathological response. Methods: We conducted a retrospective, transversal, and observational study, including all patients with diagnosed gastric cancer who underwent PeriCh followed by surgical resection during the period of eight years. Results: We included 80 patients with a median age of 64.0years (min 24, max 78). Eighty-eight-point eight percent ended the chemotherapy regime proposed, with a median duration of 42 days, and were also submitted to gastric resection: 58.8% total gastrectomy and 41.2% distal gastrectomy. Twelve-point five percent of the patients had no complications during the PeriCh period and 16.3% had >2 complications. Twenty-five percent of patients had a histological response of <10% of tumor burden, but in 41.3% only regression of <50% could be obtained. No significant association was found between complications during PeriCh and adverse surgical outcomes ( Conclusions: In our sample, the existence of association between complications during PeriCh and postoperative complications or histological response was not demonstrated.
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Journal Article
ISSN	2444-8672
ISSN (online)	2444-8672
DOI	10.1097/j.pbj.0000000000000180
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Article ; Online: Impact of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-analysis.

Martins, Mariana / Santos-Sousa, Hugo / Araújo, Francisco / Nogueiro, Jorge / Sousa-Pinto, Bernardo

Annals of surgical oncology

2022 Volume 29, Issue 12, Page(s) 7528–7537

Abstract: Background: Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. ... ...

Abstract	Background: Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. The aim of this systematic review is to compare the survival, complications and risk of recurrence between CRS + HIPEC versus CRS alone in GCPC. Patients and methods: A systematic review was performed in MEDLINE and Web of Science according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Primary studies with patients with GCPC older than 18 years were included. Methodological Index for Non-randomized Studies (MINORS) criteria were used to assess the quality of the studies. We performed random-effects meta-analysis of risk ratios (RR). We assessed heterogeneity using the I Results: Five studies were included in the qualitative and four in the quantitative analysis. The overall survival (OS) rate after 1 year was 3.65 times higher for CRS + HIPEC than CRS alone [RR = 3.65, 95% confidence interval (95% CI) = 1.01-13.26, I Conclusions: Results should be analysed cautiously given the detected heterogeneity and limitations of included studies. However, treatment with CRS + HIPEC seems to increase the survival of patients with GCPC, more than treatment with CRS alone, decrease the risk of peritoneal recurrence and not be associated with more complications.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/methods ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms/surgery ; Retrospective Studies ; Stomach Neoplasms/surgery ; Survival Rate
Language	English
Publishing date	2022-08-05
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12312-7
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Article ; Online: ASO Author Reflections: Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis.

Martins, Mariana / Santos-Sousa, Hugo / Araújo, Francisco / Nogueiro, Jorge / Sousa-Pinto, Bernardo

Annals of surgical oncology

2022 Volume 29, Issue 12, Page(s) 7538–7539

MeSH term(s)	Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms/surgery ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/surgery
Language	English
Publishing date	2022-07-30
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Comment
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12317-2
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Article: A Rare Case of a Migrating Inguinal Hernia Mesh Presenting as Acute Appendicitis.

Nogueiro, Jorge / Santos-Sousa, Hugo / de Almeida, Marinho / Malheiro, Luis / Barbosa, Elisabete

Case reports in surgery

2021 Volume 2021, Page(s) 2007935

Abstract: Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP ... ...

Abstract	Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the "recoil ring" from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis.
Language	English
Publishing date	2021-09-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2657697-1
ISSN	2090-6919 ; 2090-6900
ISSN (online)	2090-6919
ISSN	2090-6900
DOI	10.1155/2021/2007935
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Article ; Online: The impact of the prognostic nutritional index (PNI) in gastric cancer.

Nogueiro, Jorge / Santos-Sousa, Hugo / Pereira, André / Devezas, Vítor / Fernandes, Cristina / Sousa, Fabiana / Fonseca, Telma / Barbosa, Elisabete / Barbosa, José Adelino

Langenbeck's archives of surgery

2022 Volume 407, Issue 7, Page(s) 2703–2714

Abstract: Background: Regarding the assessment of patients' immune and nutritional status, prognostic nutritional index (PNI) has been reported as a predictive marker for surgical outcomes in various types of cancer. The aim of our study was to evaluate the ... ...

Abstract	Background: Regarding the assessment of patients' immune and nutritional status, prognostic nutritional index (PNI) has been reported as a predictive marker for surgical outcomes in various types of cancer. The aim of our study was to evaluate the effect of PNI in prognosis of gastric cancer patients submitted to curative-intent resectional surgery. Material and methods: A retrospective analysis with 637 gastric cancer cases submitted to curative-intent surgery, between 2010 and 2017, in an upper GI surgery unit. We analyzed 396 patients that met the inclusion criteria for this study. The median follow-up was 37 (0-113) months. Results: According to Youden's method, the optimal PNI cutoff for OS was 41.625 (sensitivity 89.3% and specificity 41.3%). OS was significantly shorter in the lower-PNI group of patients when compared to the higher-PNI group (40.26 vs 77.49 months; p < 0.001). Higher PNI had a positive impact on OS in univariable analysis. When adjusted to pStage, higher PNI was still significantly associated with better OS (HR 0.405; CI 95% 0.253-0.649; p < 0.001). Regarding DFS, higher PNI was associated with better DFS (HR 0.421; CI 95% 0.218-0.815; p = 0.010). Higher-PNI group had a protective effect regarding postoperative morbidity and mortality. Conclusions: In this cohort, PNI was disclosed to significantly impact GC patients' OS and DFS, including in multivariable analysis when adjusting for classical prognostic features. PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. This index may be of use in identifying candidate patients who would benefit from perioperative nutritional support to improve surgical outcomes.
MeSH term(s)	Humans ; Nutrition Assessment ; Stomach Neoplasms/surgery ; Gastrectomy/adverse effects ; Prognosis ; Retrospective Studies ; Nutritional Status
Language	English
Publishing date	2022-08-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02627-0
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Article: Late Recurrence of Pancreatic Solid Pseudopapillary Neoplasm With Peritoneal Carcinomatosis Treated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Case Report.

Nogueiro, Jorge / Gomes, Fábio / Pacheco, João / Santos-Sousa, Hugo / Meireles, Sara / Bessa Melo, Renato / Aral, Marisa / Barbosa, Elisabete

Cureus

2022 Volume 14, Issue 11, Page(s) e31189

Abstract: Pancreatic solid pseudopapillary neoplasm (SPN) is a rare malignant tumour predominantly affecting young women. The occurrence of peritoneal carcinomatosis (PC) in this setting is an even rarer condition, usually related to perioperative tumour rupture. ... ...

Abstract	Pancreatic solid pseudopapillary neoplasm (SPN) is a rare malignant tumour predominantly affecting young women. The occurrence of peritoneal carcinomatosis (PC) in this setting is an even rarer condition, usually related to perioperative tumour rupture. We present a case of a 43-year-old woman who previously underwent distal splenopancreatectomy after the diagnosis of a pancreatic SPN. Thirteen years later, the patient underwent a radical hysterectomy due to a uterine myoma. Intraoperatively, a peritoneal mass was additionally found and resected. Histological examination revealed an implant with morphology compatible with pancreatic SPN. The patient was then referred to our institution. Staging MRI and CT revealed multiple nodular lesions adjacent to the left colon, suggestive of peritoneal implants. The patient was then submitted to cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin and irinotecan. Histological examination confirmed peritoneal involvement by a pancreatic SPN. The postoperative course was unremarkable. Two years after surgery, the patient remains asymptomatic with no evidence of relapse. Despite SPN being cancer with a relatively indolent evolution, one needs to be aware of a possible recurrence several years after the primary resection, mainly in patients with evidence of intraoperative tumour rupture.
Language	English
Publishing date	2022-11-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.31189
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Article ; Online: Effects of a supervised exercise training on body composition after bariatric surgery: a randomized controlled trial.

Boppre, Giorjines / Borges, Lara Pereira Saraiva Leão / Diniz-Sousa, Florêncio / Veras, Lucas / Devezas, Vitor / Preto, John / Santos-Sousa, Hugo / da Costa, Teresa Helena Macedo / Oliveira, José / Fonseca, Hélder

Obesity (Silver Spring, Md.)

2023 Volume 31, Issue 11, Page(s) 2750–2761

Abstract: Objective: This study aimed to determine the effects of a multicomponent exercise intervention during the first year post-bariatric surgery (BS) on body composition, weight loss (WL), energy expenditure, and nutrient intake.: Methods: A total of 84 ... ...

Abstract	Objective: This study aimed to determine the effects of a multicomponent exercise intervention during the first year post-bariatric surgery (BS) on body composition, weight loss (WL), energy expenditure, and nutrient intake. Methods: A total of 84 patients were included in this study and were randomly assigned to either an exercise group (n = 41) or a control group (n = 20). The exercise group participated in a multicomponent exercise program that began 1-month post-BS, whereas the control group received only standard medical care post-BS. Body composition was assessed by dual-energy x-ray absorptiometry, and physical activity energy expenditure was assessed by accelerometers. Nutritional intake was assessed through a 4-day food diary. Results: A total of 6-months post-BS, exercise was found to be effective in mitigating the loss of lower-limb and appendicular lean mass (LM), as well as favoring trunk fat mass (FM) loss. Moreover, it further decreased percent FM and promoted additional excess WL. After 12 months, exercise not only reduced waist circumference but also helped to lessen the loss of total, trunk, and appendicular LM. Conclusions: Exercise further induced trunk fat mass, percent FM, excess WL, and waist circumference reductions. Moreover, exercise attenuated the loss of total and regional LM.
MeSH term(s)	Humans ; Body Composition ; Exercise ; Bariatric Surgery ; Weight Loss ; Energy Intake
Language	English
Publishing date	2023-04-04
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2230457-5
ISSN	1930-739X ; 1071-7323 ; 1930-7381
ISSN (online)	1930-739X
ISSN	1071-7323 ; 1930-7381
DOI	10.1002/oby.23894
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