Search Results (2)

Objective: To evaluate the extent of intraoperative bacterial and tumour cell spillage during minimally invasive colorectal surgery and to assess the protective value of systematic specimen retrieval using a tear-proof extraction bag. Methods: This multicentre, prospective observational study included patients undergoing conventional or single-port laparoscopic colorectal surgery for adenocarcinoma, premalignant polyps, or chronic diverticulitis. Three intraoperative samples were obtained for microbiological and cytological analysis: after pneumoperitoneum induction (sample 1), after vascular ligation and bowel division (sample 2), and after specimen extraction using a retrieval bag (sample 3). Results: Eighty-eight patients were included. Bacterial contamination increased significantly throughout the procedure occurring in 11.4% of sample 1, 37.5% of sample 2, and 67% of sample 3 (p < 0.001). When sample 1 was positive, sample 2 was positive in 100% of cases; when sample 2 was positive, sample 3 was positive in 79% of cases. In 33 patients (37.5%), bacterial growth was detected exclusively in sample 3. Contamination in sample 2 was significantly associated with surgical approach (p = 0.013), anastomotic technique (p = 0.022), and malignant disease (p = 0.038). A longer hospital stay was significantly associated with contamination in samples 1 and 2 (p = 0.014 and p < 0.001, respectively). No tumour cells were detected in any sample, except for one case showing atypical cells without clinical relevance in sample 3. Conclusions: Intraoperative bacterial contamination progressively increases during minimally invasive colorectal surgery, peaking after specimen extraction. Most clinical and surgical variables did not significantly influence contamination rates. The use of a specimen retrieval bag demonstrated a potential protective effect by containing bacterial spillage. However, no protective effect regarding tumour cell dissemination could be demonstrated based on cytology analysis. Full article

Aim: The aim of this study was to determine the age-specific characteristics of ovarian teratoma and associated malignancies. Methods: This retrospective single-centre cohort study included 2181 women with ovarian teratoma who underwent surgery at our institution between January 2008 and April 2019. Malignancies associated with ovarian teratoma were divided into immature teratoma, combined ovarian malignancy, and malignant transformation of mature cystic teratoma. The median patient age was 30 years (range, 7–82) and the median follow-up duration was 10 months (range, 0–152). Results: Most ovarian teratomas were detected incidentally, except in patients with abdominal pain under 20 years of age; torsion was significantly more common in this age group (p < 0.001). Tumours were larger in the younger age group (p < 0.01). The incidence of immature teratoma was 0.5% (n = 11), that of combined ovarian malignancy was 0.4% (n = 9), and that of malignant transformation was 0.4% (n = 9). The median patient age was 24.0 years for immature teratoma and 27.0 years for combined ovarian malignancy. The most common cell type was mucinous borderline tumour (55.6%, n = 5). The median patient age of malignant transformation was 33.0 years, and the most common cell type was carcinoid tumour (77.8%, n = 7). At our institution, the clinical manifestations of ovarian teratoma varied according to age group, with younger patients being more likely to be symptomatic and to have larger tumours and bilateral tumours. Although there was no statistically significant relationship between age and associated malignancy (p = 0.442), most of the malignancies associated with ovarian teratoma were found in childbearing age, not in older age. Conclusions: Given the possible associated malignancy with ovarian teratoma, surgeons should perform detailed preoperative evaluations, avoid intraoperative spillage, and perform intraoperative frozen biopsy when appropriate. Full article