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Healthcare
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Contemporary Surgical Trends and Management
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Contemporary Surgical Trends and Management

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Perioperative Care".

Deadline for manuscript submissions: 10 June 2025 | Viewed by 3371

Special Issue Editors

Dr. Zenon Pogorelić

E-Mail Website
Guest Editor
Department of Pediatric Surgery, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Interests: surgery; laparoscopy; pediatric surgery; minimally invasive surgery; pediatric urology; testis; appendicitis; thoracoscopic surgery; testicular torsion; neonatal surgery; esophageal atresia; varicocele; acute scrotum; surgical infection
Special Issues, Collections and Topics in MDPI journals
Dr. Marko Bašković

E-Mail Website
Guest Editor Assistant
Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia
Interests: surgery; pediatric surgery; pediatric urology; reproductive medicine; testis; testicular torsion; acute scrotum; congenital anomaly; neonatal surgery; transplant surgery; surgical infection

Special Issue Information

Dear Colleagues,

Although the beginnings of surgery date back to antiquity, the daily rapid development of new technologies and research, which even leads to personalized medicine, improves care in this area. However, more knowledge is needed among experts worldwide about new advances. This Special Issue provides space for surgeons and related professionals who wish to remain updated on new contemporary surgical trends.

This Special Issue aims to present articles that bring new knowledge related to the field of surgery, especially in the part related to the use of new biomarkers, prognostic factors, sophisticated imaging methods, the newest surgical techniques, minimally invasive surgery, robotic surgery, and transplant surgery.

Staying updated with the latest knowledge is essential to every clinician and researcher in providing the best management for the well-being of patients.

Surgeons and related professionals are invited to contribute manuscripts to this Special Issue. Contributions can be original articles (prospective/retrospective studies), experimental studies, narrative reviews, systemic reviews and meta-analyses, or new diagnostics or surgical techniques.

We look forward to receiving your contributions.

Dr. Marko Bašković
Dr. Zenon Pogorelić
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • surgery
  • pediatric surgery
  • urology
  • biomarkers and prognostic factors
  • surgical infections
  • surgical techniques
  • minimally invasive surgery
  • robotic surgery
  • transplant surgery

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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12 pages, 2702 KiB  
Article
The Feasibility and Safety of Robot-Assisted Vaginal Natural Orifice Transluminal Endoscopic Surgery (RA-vNOTES) for Gynecologic Disease: 298-Case Series
by Qiannan Yang, Daniel Y. Lovell, Yingchun Ma, Chunhua Zhang and Xiaoming Guan
Healthcare 2025, 13(7), 720; https://doi.org/10.3390/healthcare13070720 - 25 Mar 2025
Viewed by 431
Abstract
Objectives: To explore the feasibility and surgical outcomes of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES) for women suffering from gynecologic disease. Methods: We performed an observational study reporting and analyzing the perioperative outcomes of 298 patients with gynecologic disease who underwent [...] Read more.
Objectives: To explore the feasibility and surgical outcomes of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES) for women suffering from gynecologic disease. Methods: We performed an observational study reporting and analyzing the perioperative outcomes of 298 patients with gynecologic disease who underwent RA-vNOTES in a single institution from June 2019 to August 2024. Results: A total of 298 patients with a median age of 41 years and median body mass index of 29 kg/m2 underwent RA-vNOTES. The primary indications for surgery were endometriosis (43.62%), chronic pelvic pain (11.07%), abnormal uterine bleeding (20.81%), and uterine leiomyomata (14.77%). A total of 286 of 298 (95.97%) patients had a hysterectomy. The median total operating time was 138 min, with a port placement time of 5 min, dock time of 3 min, and robot console time of 63 min. The median estimated blood loss was 50 milliliters. Endometriosis resection of all stages was performed in 192 of 298 (64.43%) patients. Three cases (1.01%) were converted to laparoscopic surgery. One case was converted to robot-assisted single incision plus one port laparoscopic surgery (SILS plus one) and two cases were converted to robot-assisted multi-port surgery. The total complication rate was 17.45% (52 cases), of which 2.1% (6 cases) were intraoperative complications and 15.44% (46 cases) were postoperative complications. Conclusions: Our findings indicate that RA-vNOTES is a feasible and less invasive option for various gynecologic procedures, including complex endometriosis excision and sacrocolpopexy. Full article
(This article belongs to the Special Issue Contemporary Surgical Trends and Management)
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14 pages, 652 KiB  
Article
Epidemiology and Treatment Outcomes in Neonates with Esophageal Atresia: A 30-Year Population-Based Study
by Tanja Kovačević, Branka Polić, Joško Markić, Tatjana Ardalić Čatipović, Marija Bucat, Svjetlana Mikulić, Leona Žuvan, Zenon Pogorelić, Ranka Despot, Vanda Žitko, Julije Meštrović, Bernarda Lozić and Ana Jerončić
Healthcare 2025, 13(4), 418; https://doi.org/10.3390/healthcare13040418 - 14 Feb 2025
Viewed by 725
Abstract
Background and objectives: Outcomes of neonates diagnosed with esophageal atresia (EA), a rare congenital malformation, vary widely. Due to limited and fragmented data globally, major regional centers offer a crucial opportunity to better understand EA’s epidemiology and the management. This study aimed [...] Read more.
Background and objectives: Outcomes of neonates diagnosed with esophageal atresia (EA), a rare congenital malformation, vary widely. Due to limited and fragmented data globally, major regional centers offer a crucial opportunity to better understand EA’s epidemiology and the management. This study aimed to address these gaps by determining total birth prevalence and early treatment outcomes of EA in southern Croatia. Methods: All EA cases (1991–2020) were retrospectively ascertained from medical documentation at the only tertiary referral center for EA in southern Croatia, with birth data collected from the entire background population. We collected data on neonates’ status and diagnosis, operative findings, early postoperative complications, and treatment outcome from this single center. Results: A total of 53 cases were identified, with an average total birth prevalence of 2.44 per 10,000 total births/year. No significant sex differences were found (p = 0.339), and most cases were complex Vogt 3B. The mortality rate dropped from 87 to 8% over a 30-year period (p < 0.001). The 1-year survival rate was 54% (95% CI 40–68%) for liveborns and 64% (50–79%) for liveborns who underwent surgery and intensive care. However, 16% of patients died before surgery due to hemodynamic instability, and among those operated on, high sepsis, pneumonia, and atelectasis rates were observed. Conclusions: EA prevalence in southern Croatia aligns with European data. Survival improved significantly after 2002, coinciding with a dedicated pediatric ICU and enhanced pediatric care training. Further advancements in early diagnosis and a multidisciplinary approach are needed to further reduce mortality. Strengthened postoperative infection control and optimized postoperative respiratory support are also crucial to minimizing complications. Full article
(This article belongs to the Special Issue Contemporary Surgical Trends and Management)
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14 pages, 1796 KiB  
Article
Hyperbaric Oxygen Therapy in the Treatment of Crohn’s Disease
by Jure Krstulović, Goran Augustin, Ivan Romić, Ante Tavra, Franko Batinović and Zrinka Hrgović
Healthcare 2025, 13(2), 128; https://doi.org/10.3390/healthcare13020128 - 11 Jan 2025
Cited by 1 | Viewed by 1089
Abstract
Background/Objectives: Our study describes hyperbaric oxygen therapy (HBOT) as an additional therapy in the conservative treatment of Crohn’s disease (CD) and its benefit in the early postoperative period to prevent surgical complications and improve gastrointestinal motility. Methods: This retrospective study evaluated [...] Read more.
Background/Objectives: Our study describes hyperbaric oxygen therapy (HBOT) as an additional therapy in the conservative treatment of Crohn’s disease (CD) and its benefit in the early postoperative period to prevent surgical complications and improve gastrointestinal motility. Methods: This retrospective study evaluated HBOT in patients hospitalized at the Clinical Hospital Center Split for complications of CD between 2015 and 2020. Patients (N = 61) aged 19 to 67 with perianal fistulas, abscesses, fistulas, obstruction, stenosis, or bleeding were included, excluding those with ulcerative colitis or requiring intensive care. Patients were retrospectively divided into conservatively and surgically treated groups, and HBOT was administered over 15–25 days, with treatment lasting 60 min at 2.2 absolute atmospheres (ATA). We analyzed treatment outcomes between the HBOT-treated surgical and conservative groups and compared patients treated with HBOT to a cohort from the preceding five years who did not receive HBOT. Results: We treated 61 CD patients with HBOT, including 34 conservatively and 27 surgically treated patients. HBOT significantly reduced disease activity indices (311.7 ± 59.1 vs. 114 ± 29.8; 203.6 ± 24.1 vs. 83.8 ± 15, for conservatively treated patients, and 352.8 ± 45.7 vs. 109 ± 22.8; 270.4 ± 19.7 vs. 140.3 ± 10.6 for surgically treated patients) and accelerated bowel peristalsis recovery, with 94.1% of conservatively treated patients achieving remission. Comparison with a historical cohort showed faster recovery and improved outcomes in the HBOT group. Conclusions: HBOT is useful in postponing or avoiding surgical treatment, and in operated patients, it improves postoperative recovery and reduces the rate of postoperative complications. Full article
(This article belongs to the Special Issue Contemporary Surgical Trends and Management)
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Other

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9 pages, 4644 KiB  
Case Report
Associating Liver Partition with Portal Vein Ligation and Staged Hepatectomy (ALPPS): Feasibility of Performing in Infants with Large Hepatic Tumor—Case Report
by Aleksandar Sretenovic, Srdjan Nikolic, Nada Krstovski, Nenad Zdujic, Milan Slavkovic, Ivana Dasic and Dejan Nikolic
Healthcare 2025, 13(5), 460; https://doi.org/10.3390/healthcare13050460 - 21 Feb 2025
Viewed by 505
Abstract
Background: Surgical resection remains an important treatment of choice for a large number of liver tumors in children. Sometimes, if a tumor infiltrates a large part of the liver, after resection, the future liver remnant (FLR) is not enough for normal liver [...] Read more.
Background: Surgical resection remains an important treatment of choice for a large number of liver tumors in children. Sometimes, if a tumor infiltrates a large part of the liver, after resection, the future liver remnant (FLR) is not enough for normal liver function. The size of the FLR is one of the determining factors for resectability as postoperative liver failure (PLF) is the most severe complication after partial hepatectomy. A new strategy for treating marginally resectable liver tumors in adult patients which were initially considered as unresectable was formally reported in 2011. This operative technique is a hepatectomy consisting of two stages with initial portal vein ligation and in situ splitting of the liver parenchyma. In 2012, the acronym “ALPPS” (associating liver partition and portal vein ligation for staged hepatectomy) was proposed for this novel technique. However, there is a small number of ALPPS procedures performed in pediatric patients published in the literature. Objectives: The aim of this paper is to present the first case of a pediatric patient with a marginally resectable rhabdoid tumor of the liver which was initially considered unresectable and who was treated with two-stage hepatectomy. We report a case of a 4-month-old girl with a large rhabdoid tumor of the liver who underwent this procedure. Conclusions: ALPPS can be a valuable technique to achieve complete resection of pediatric liver tumors although indications for ALPPS in children still need further research mainly focused on validation of the minimally needed FLR in children undergoing extended liver resections. To our knowledge, this is the youngest patient on whom ALPPS was performed, and the only one with a rhabdoid tumor. Full article
(This article belongs to the Special Issue Contemporary Surgical Trends and Management)
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