Documents published in Scipedia

• Post-mastectomy breast reconstruction: a systematic review of surgical techniques and patient-reported quality of life outcomes

  V. Claudia, P. Erika, X. Lozano

  Collection of Articles on Medicine (2025). 7

  
  

  Abstract

  '''Objective''': To synthesize contemporary evidence (2015–2025) comparing post-mastectomy breast reconstruction techniques—including prepectoral and subpectoral implants, as well as autologous flaps (DIEP, TRAM, latissimus dorsi)—focusing on patient-reported quality of life (QoL) and safety outcomes. '''Methods''': A systematic review was conducted following PRISMA 2020 guidelines. Searches were performed in PubMed/MEDLINE, Embase, CENTRAL, and Scopus for studies published between January 2015 and August 2025. Eligible designs included randomized controlled trials and comparative cohort studies. The primary outcome was QoL assessed with the BREAST-Q instrument. Secondary outcomes included complications (implant loss, capsular contracture), reoperations, and the impact of post-mastectomy radiotherapy (PMRT). Risk of bias was assessed using RoB-2 for RCTs and ROBINS-I for observational studies. '''Results''': Autologous reconstruction consistently achieved higher long-term BREAST-Q scores compared with implant-based techniques, despite longer recovery times. Prepectoral implant placement reduced animation deformity and capsular contracture relative to subpectoral reconstruction, with similar overall complication rates but increased rippling and seroma in selected cohorts. PMRT significantly increased the risks of implant loss and severe capsular contracture, favoring autologous approaches in patients requiring radiotherapy. BREAST-Q remains the gold standard PROM, with updated multilingual validations enhancing cross-cultural applicability. '''Conclusions''': Autologous flaps offer sustained QoL benefits in selected candidates. Prepectoral implant reconstruction, with or without acellular dermal matrix, is safe and effective, particularly in non-PMRT settings. Shared decision-making guided by BREAST-Q and aligned with NCCN/ESMO guidelines is essential.

  Abstract
  '''Objective''': To synthesize contemporary evidence (2015–2025) comparing post-mastectomy breast reconstruction techniques—including prepectoral [...]

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• ''Appendicitis during Pregnancy: A Narrative Review Comparing Laparoscopic and Open Approaches''

  C. Vanegas-Mondragon, E. Perera-Escalante, X. Lozano-Cancino

  Collection of Articles on Medicine (2025). 5

  
  

  Abstract

  '''Background:''' Acute appendicitis is the most common non-obstetric surgical emergency during pregnancy. The choice between laparoscopic appendectomy (LA) and open appendectomy (OA) remains controversial due to maternal and fetal safety concerns. '''Objective:''' To analyze current evidence comparing laparoscopic and open appendectomy in pregnant women. '''Methods:''' A narrative review was conducted using PubMed, Elsevier, and ClinicalKey. Systematic reviews, meta-analyses, and observational studies published between 2000 and 2023 were included. '''Results:''' LA was associated with shorter hospital stay, fewer wound infections, and faster recovery compared to OA. Earlier meta-analyses suggested a slightly higher risk of fetal loss with LA (OR ~1.7), but more recent studies and sensitivity analyses demonstrated no significant differences. LA is increasingly considered safe throughout all trimesters when performed with appropriate surgical technique and intraoperative monitoring. '''Conclusions:''' Laparoscopic appendectomy provides maternal benefits and comparable fetal safety to open surgery. The choice of surgical approach should be guided by surgeon expertise and institutional resources.

  Abstract
  '''Background:''' Acute appendicitis is the most common non-obstetric surgical emergency during pregnancy. The choice between laparoscopic appendectomy [...]

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• Use of Indocyanine Green in Colorectal Surgery: Perfusion Assessment and Prevention of Anastomotic Leaks. A Systematic Review.

  V. Claudia, P. Erika, L. Ximena

  medRXiv (2025). Systematic review article

  
  

  Abstract

  Objective: To evaluate the role of indocyanine green near-infrared fluorescence angiography (ICG-FA) in colorectal surgery for perfusion assessment and prevention of anastomotic leaks. Methods: A systematic review of medical databases (2020–2025) identified randomized controlled trials, observational studies, and meta-analyses reporting outcomes of ICG-FA in colorectal resections. Results: Major RCTs demonstrated that ICG-FA modified intraoperative strategy in 10–20% of cases. While some large multicenter trials found no significant reduction in overall leak rates, consistent benefits were observed in low rectal anastomoses and high-risk subgroups. Meta-analyses confirmed a modest absolute reduction in leaks (2–3%), with observational studies highlighting improved reproducibility when using quantitative fluorescence metrics. Emerging approaches, such as intraluminal ICG-FA, showed promise in detecting hypoperfusion. Cost-effectiveness analyses suggested potential savings from reduced complications and reoperations.

  Abstract
  Objective: To evaluate the role of indocyanine green near-infrared fluorescence angiography (ICG-FA) in colorectal surgery for perfusion assessment and prevention of anastomotic [...]

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