Daniel Aliseda Jover

All Publications

• "How I Do It:" Robotic Transduodenal Ampullectomy for an Ampullary Adenoma. Journal of hepato-biliary-pancreatic sciences Salazar Gonzalez, J. F., Aliseda, D., Harrison, J. M., Visser, B. C. 2025

  View details for DOI 10.1002/jhbp.70002

  View details for PubMedID 40879215

• Changes in Antidepressant Absorption After Metabolic Bariatric Surgery. Obesity surgery Sabatella, L., Aldaz Pastor, A., Landecho Acha, M. F., Moncada Durruti, R., Aliseda Jover, D., Blanco Asensio, N., Valentí Azcárate, V. 2025; 35 (8): 3173-3181

  Abstract

  Metabolic bariatric surgery (MBS), particularly Roux-en-Y gastric bypass (RYGB), is one of the most effective long-term intervention for weight loss, but its hypoabsortive nature may affect drug metabolism.A retrospective longitudinal study with intra-individual comparisons was conducted on patients who underwent RYGB at Clínica Universidad de Navarra between 2014 and 2019 at our institution and were on antidepressant treatment before and after surgery. Apparent oral clearance (CL/F), concentration/dose ratio (CDR), and weight loss parameters were compared pre- and post-surgery. Measurements were taken at the time of surgery (M1), 1 month after surgery (M2), and between 6 and 15 months after surgery (M3).Fourteen patients (10 females) with a mean age of 48.92 years and a mean baseline BMI of 37.32 kg/m2 were included in the study. They were being treated with fluoxetine (n = 6), duloxetine (n = 2), bupropion (n = 2), sertraline (n = 1), clobazam (n = 1), topiramate (n = 1), and aripiprazole (n = 1). Patients who were within the therapeutic range for their medications prior to surgery remained within that range postoperatively. The fluoxetine + D-fluoxetine concentrations and CDR significantly varied between M1 and M2, with a p-value of 0.022, and an inverse association between BMI and D-fluoxetine CDR was observed (p = 0.004).These findings suggest, in a small cohort, that chronic use of antidepressants does not require major changes in the management of patients undergoing MBS. Two distinct absorption patterns were identified for different antidepressants after surgery, highlighting the potential influence of metabolic pathways and enzymatic activity. The inverse association between D-fluoxetine CDR and BMI may be linked to changes in CYP enzyme function following MBS.

  View details for DOI 10.1007/s11695-025-08025-x

  View details for PubMedID 40610843

  View details for PubMedCentralID PMC12380868

• Comparison Between Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) and Roux-En-Y Gastric Bypass (RYGB) in Terms of Weight Loss, Associated Medical Problems Remission, and Complications: A Systematic Review with Meta-Analysis. Obesity surgery Sabatella, L., Aliseda Jover, D., M Ortega, P., Landecho Acha, M. F., Rotellar Sastre, F., Tuero Ojanguren, C., Blanco Asensio, N., Uriz Pagola, A., Valentí Azcárate, V. 2025

  Abstract

  Evaluate and compare the results of weight loss outcomes, associated medical problems resolution, and complications in the short and long term between SADI-S and RYGB.A systematic review was conducted following PRISMA guidelines. Studies comparing SADI-S and RYGB as primary surgery were included if they reported weight loss (total weight loss (TWL), excess weight loss (EWL), or body mass index (BMI) changes), associated medical problems remission (diabetes and hypertension), and postoperative outcomes (complications, hospital stay, and operative time). A meta-analysis of mean differences (MD) was conducted to assess continuous outcomes, and a meta-analysis of odds ratios (OR) was performed to evaluate the categorical variables; a random effects model was used.Eight studies, including 4259 patients (1625 SADI-S; 2634 RYGB), were analysed. Six studies with over 2 years of follow-up (mean 3.93 years (1.79)) were included for long-term outcomes, while all eight were considered for short-term outcomes. SADI-S resulted in a statistically significant higher total weight loss (MD 10.03; 95% CI 4.7-15.35; p < 0.001), excess weight loss (MD 10.15; 95% CI 5.2-15.1; p < 0.01), diabetes remission (OR 3.48; 95% CI 2.02-6.02; p < 0.001) with a similar number of long-term complications (OR = 0.19, 95% CI 0.03-1.36; p = 0.10). Short-term complications were inferior in the subgroup of patients undergoing SADI-S with < 50 kg/m2 of BMI (OR 0.45, 95% CI 0.33 to 0.61; p < 0.01) as well as hospital stay (MD = -0.69; 95% CI -1.03 to -0.36, p < 0.01) and severe complications (OR = 0.44, 95% CI 0.25-0.80; p = 0.01).This meta-analysis suggests that SADI-S may offer advantages over RYGB in terms of weight loss, diabetes remission, and safety profile.

  View details for DOI 10.1007/s11695-025-08092-0

  View details for PubMedID 40691384

  View details for PubMedCentralID 11026210

• Defining Precision Surgery: Totally Laparoscopic Transduodenal Ampullectomy : A Combined Approach Aims for Margin Resection Success. Annals of surgical oncology Blanco, N., Aliseda, D., Zozaya, G., Martí-Cruchaga, P., Uriz, A., Sabatella, L., Benito, A., Rotellar, F. 2025

  Abstract

  Adenomas are premalignant lesions of the ampulla of Vater and should therefore be resected.1 Three approaches are accepted: pancreatoduodenectomy and surgical and endoscopic ampullectomy.2,3 When endoscopic management is not amenable, a transduodenal minimally invasive ampullectomy is the less aggressive option. Complete resection is paramount to avoid local recurrence. We present a combined approach to maximize the precision of this demanding procedure.A 64-year-old female patient, following an episode of acute pancreatitis, was diagnosed with a lesion of the ampulla of Vater. An endoultrasound-guided biopsy revealed an ampullary adenoma with low-grade dysplasia. Its growth along the duct made it not amenable for endoscopic resection. Consequently, a laparoscopic ampullectomy was then proposed. To obtain optimal free margins, a combined strategy was designed: the use of a choledochoscope (allowing for a direct view of the lesion limits), intraoperative ultrasound (to rule out possible intramural tumor growth), and indocyanine green (used to identify the bile duct and also in the filling of a Fogarty Catheter2 inserted in the common bile duct to do a traction of the tumor/ampulla to expose the free margins).Operative time was 416 min. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. Pathology reported a well-demarcated ampullary adenoma with low-grade dysplasia and free margins. Twenty-four months after surgery, the patient is asymptomatic with no evidence of recurrence.Transduodenal minimally invasive ampullectomy is a demanding procedure. The combined use of technologies herein presented warrants a precision surgery allowing for a free-margin anatomical resection.

  View details for DOI 10.1245/s10434-025-17780-1

  View details for PubMedID 40670838

• Proceedings of the 29th Annual Congress of the International Liver Transplantation Society. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Patel, M. S., Shankar, S., Tejedor, M., Barbas, A. S., Kim, J., Mao, S., Ivanics, T., Shaji Mathew, J., Shingina, A., Khan, M. Q., Wilson, E. A., Syn, N., Alconchel, F., Patel, D., Liu, J., Nasralla, D., Mazzola, A., Tanaka, T., Victor, D. W., Yoon, Y. I., Vinaixa, C., Mi Kyaw, A. M., Galante, A., Magistri, P., Kathirvel, M., Aliseda, D., Moral, K., Di Maira, T., De Martin, E., Chadha, R., Hakeem, A. R., Bonaccorsi-Riani, E., Rammohan, A. 2025; 31 (7): 945-955

  Abstract

  The 2024 Annual Congress of the International Liver Transplantation Society (ILTS) was from May 1-4 in Houston, Texas, USA, under the theme "Liver Disease and Transplantation: Breaking Barriers and Exploring New Frontiers." In addition to a robust scientific program, the congress also hosted a hands-on cadaveric robotic liver surgery course, a machine perfusion workshop, and a transesophageal echocardiography course. In this report, the ILTS Vanguard and Basic Sciences Committees present a summary of the congress proceedings.

  View details for DOI 10.1097/LVT.0000000000000593

  View details for PubMedID 40062745

• Reply: Liver transplantation for primary and secondary liver tumours-Patient-level meta-analyses compared to UNOS conventional indications. Hepatology (Baltimore, Md.) Ciria, R., Aliseda, D., Berardi, G., Rotellar, F., Sapisochin, G. 2025; 81 (6): E173-E174

  View details for DOI 10.1097/HEP.0000000000001272

  View details for PubMedID 39964289

• Liver transplantation for primary and secondary liver tumors: Patient-level meta-analyses compared to UNOS conventional indications. Hepatology (Baltimore, Md.) Ciria, R., Ivanics, T., Aliseda, D., Claasen, M., Alconchel, F., Gaviria, F., Briceño, J., Berardi, G., Rotellar, F., Sapisochin, G. 2025; 81 (6): 1700-1713

  Abstract

  Liver transplant (LT) for transplant oncology (TO) indications is being slowly adopted worldwide and has been recommended to be incorporated cautiously due to concerns about mid-long-term survival and its impact on the waiting list.We conducted 4 systematic reviews of all series on TO indications (intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma [phCC]) and liver metastases from neuroendocrine tumors (NETs) and colorectal cancer (CRLM) and compared them using patient-level meta-analyses to data obtained from the United Network for Organ Sharing (UNOS) database considering conventional daily-practice indications. Secondary analyses were done for specific selection criteria (Mayo-like protocols for phCC, SECA-2 for CRLM, and Milan criteria for NET). A total of 112,014 LT were analyzed from 2005 to 2020 from the UNOS databases and compared with 345, 721, 494, and 103 patients obtained from meta-analyses on intrahepatic cholangiocarcinoma and phCC, and liver metastases from NET and CRLM, respectively. Five-year overall survival was 53.3%, 56.4%, 68.6%, and 53.8%, respectively. In Mantel-Cox one-to-one comparisons, survival of TO indications was superior to combined LT, second, and third LT and not statistically significantly different from LT in recipients >70 years and high BMI.Liver transplantation for TO indications has adequate 5-year survival rates, mostly when performed under the selection criteria available in the literature (Mayo-like protocols for phCC, SECA-2 for CRLM, and Milan for NET). Despite concerns about its impact on the waiting list, some other LT indications are being performed with lower survival rates. These oncological patients should be given the opportunity to have a definitive curative therapy within validated criteria.

  View details for DOI 10.1097/HEP.0000000000001129

  View details for PubMedID 39465987

• Recent advances in systemic therapy for advanced biliary tract cancer: A systematic review and meta-analysis using reconstructed RCT survival data. JHEP reports : innovation in hepatology Li, Z., Aliseda, D., Jones, O., Rajendran, L., Magyar, C., Grant, R., O'Kane, G. M., Saborowski, A., Sapisochin, G., Vogel, A. 2025; 7 (3): 101290

  Abstract

  Gemcitabine/cisplatin (GemCis) was the long-standing first-line treatment for advanced biliary tract cancers (BTCs). Following positive results from the TOPAZ-01 and KEYNOTE-966 trials, immune checkpoint inhibitors (ICIs) combined with chemotherapy are now the standard of care. We aim to compare the efficacy of first-line therapies for advanced BTCs.Our systematic review included studies from five databases focusing on English-language articles published between January 2010 and June 2024. We included randomized clinical trials (RCTs) that featured GemCis in a treatment arm for treatment-naive adults with advanced BTCs. The primary endpoints were overall survival (OS) and progression-free survival. We conducted a one-stage meta-analysis using reconstructed survival data, Cox-based models, and restricted mean survival time (RMST).After screening 8,797 studies, 17 RCTs were selected, involving a total of 4,584 patients. Of these, 2,140 (46.7%) received GemCis. The majority (68.9%) were diagnosed with intrahepatic or extrahepatic cholangiocarcinoma, and 80% had metastatic disease at the time of treatment. The pooled median OS in the GemCis group was 11.6 months (95% CI 11.3-12.2 months). GemCis plus pembrolizumab (hazard ratio [HR] 0.99, 95% CI 0.98-0.99; p <0.001), GemCis plus durvalumab (HR 0.98, 95% CI 0.97-0.99; p = 0.015), GemCis plus S-1 (HR 0.97 95% CI 0.95-0.99; p <0.001), and GemCis plus nab-paclitaxel (HR 0.98, 95% CI 0.98-0.99; p <0.001) demonstrated superior OS compared with GemCis alone. These combinations also showed increases in RMST by +1.1, +2.5, +2.8, and +2.1 months, respectively. In terms of progression-free survival, GemCis with ICIs (HR 0.91, 95% CI 0.78-0.94; p <0.001), GemCis plus S-1 (HR 0.98, 95% CI 0.96-0.99; p = 0.003), and GemCis plus nab-paclitaxel (HR 0.98, 95% CI 0.97-0.99; p <0.001) also demonstrated superiority, with corresponding RMST increases of +0.7, +1.9, and +2.5 months, respectively.Despite incremental advancements, a breakthrough in advanced BTC treatment remains elusive. Further improvements in treatment efficacy may require biomarker identification to optimize combinational therapies for better patient selection.This study analyzed recent RCTs, including KEYNOTE-966, TOPAZ-1, NIFE, and SWOG 1815, involving 4,584 patients with advanced biliary tract cancer. A meta-analysis of 17 treatment arms, using reconstructed survival data, confirmed the modest survival benefit of GemCis plus ICIs, supporting its guideline adoption. The findings, however, highlight the need for biomarker identification and better patient selection.

  View details for DOI 10.1016/j.jhepr.2024.101290

  View details for PubMedID 39980751

  View details for PubMedCentralID PMC11840543

• Prognostic value of circulating tumor DNA in different cancer types detected by ultra-low-pass whole-genome sequencing: a systematic review and patient-level survival data meta-analysis. Carcinogenesis Sogbe, M., Aliseda, D., Sangro, P., de la Torre-Aláez, M., Sangro, B., Argemi, J. 2025; 46 (1)

  Abstract

  Ultra-low-pass whole-genome sequencing (ULP-WGS) (≤0.5 × coverage) of plasma cell-free DNA (cfDNA) has emerged as a low-cost, promising tool to assess the circulating tumor DNA (ctDNA) fraction. This meta-analysis aims to summarize the current findings and comprehensively investigate the prognostic value of baseline ctDNA detected by ULP-WGS in solid tumors. A systematic review was carried out by searching PubMed/MEDLINE and Scopus databases to identify eligible studies conducted between January 2014 and January 2024. Inclusion criteria comprised studies with reported overall survival and progression-free survival outcomes across therapy-naïve patients with different solid tumors. All patients underwent baseline ULP-WGS of plasma cfDNA and were categorized as ctDNA positive (tumor fraction ≥10%) or negative (tumor fraction <10%). A one-stage meta-analysis was performed using patient-level survival data reconstructed from published articles. A Cox proportional hazards model with shared frailty was used to assess the difference in survival between arms. A total of six studies, comprising 620 patients (367 negative ctDNA and 253 positive ctDNA), were included in the overall survival analysis, while five studies, involving 349 patients (212 negative ctDNA and 137 positive ctDNA), were included in the progression-free survival analysis. The meta-analysis showed that patients with baseline positive ctDNA had a significantly higher risk of death (HR = 2.60, 95% CI: 2.01-3.36) and disease progression (HR = 2.28, 95% CI: 1.71-3.05) compared to those with negative ctDNA. The presence of a positive ctDNA at baseline is associated with increased risk of death and progression in patients with same-stage cancer.

  View details for DOI 10.1093/carcin/bgae073

  View details for PubMedID 39549302

  View details for PubMedCentralID PMC11886806

• Anatomic Versus Non-anatomic Liver Resection for Intrahepatic Cholangiocarcinoma: A Systematic Review and Patient-Level Meta-Analysis. Annals of surgical oncology Berardi, G., Risi, L., Muttillo, E. M., Aliseda, D., Colasanti, M., Ettorre, G. M., Viganò, L. 2024; 31 (13): 9170-9182

  Abstract

  The current standard treatment for intrahepatic cholangiocarcinoma (ICC) involves complete liver resection with negative surgical margins and lymphadenectomy, followed by adjuvant chemotherapy. Debate is ongoing regarding the necessity of systematic anatomic resection (AR). This study aimed to summarize existing literature to determine whether AR leads to better oncologic outcomes than non-AR for patients with resectable ICC.A systematic literature review (PubMed, Embase, and Google Scholar) was performed until December 2023. Only studies comparing the oncologic outcomes of AR and non-AR for ICC using propensity score matching or inverse probability of treatment weighting were considered. A meta-analysis of aggregated data for perioperative variables and a reconstructed patient-level meta-analysis for survival data were performed.Five articles were gathered (n = 930 patients after matching: 465 AR/465 non-AR patients). The overall survival (OS) rates were higher in the AR group than in the non-AR group at 1, 3, and 5 years (71.5%, 46.1% and 34.3% vs. 63.6%, 32.9%, and 24.8%, respectively; hazard ratio [HR] 0.74; 95% CI 0.63-0.87; P < 0.001). The same results were observed for the disease-free survival (DFS) rates (58.3%, 33.4%, and 24.5% for AR vs. 45.6%, 23.1%, and 17.4% for non-AR; HR 0.74; 95% CI 0.63-0.86; P < 0.001). The results were confirmed in the two-stage meta-analysis for OS (HR 0.73; P < 0.001) and DFS (HR 0.73; P < 0.001). No differences were observed between the two approaches in terms of operative time, intraoperative blood loss, overall and major morbidity, and hospital length of stay.By pooling the available evidence, the current study demonstrated that AR for ICC patients is associated with better OS and DFS without any negative impact on postoperative outcomes.

  View details for DOI 10.1245/s10434-024-16121-y

  View details for PubMedID 39251512

  View details for PubMedCentralID 7447603

• Safety and feasibility of pure laparoscopic living donor right hepatectomy. Updates in surgery Kim, S. H., Kim, K. H., Rotellar, F., Aliseda, D. 2024

  Abstract

  Pure laparoscopic living-donor right hepatectomy (PLDRH) has emerged as a significant advancement in liver transplantation, offering reduced donor morbidity and improved recovery times. However, PLDRH is still performed in only a limited number of centers. This retrospective study reports on the outcomes of 215 living donors who underwent PLDRH at Asan Medical Center in Seoul, Korea between November 2014 and December 2021. We reviewed donor and recipient demographics and anatomical characteristics of the donor grafts. Donor complications were classified and evaluated based on the Clavien-Dindo classification. The incidence of early donor complications within 30 days of surgery was 0.9% (n = 3), with minor complications in 0.3% (n = 1) patients and major complications in 0.6% (n = 2). No biliary complications were observed and no late complications had been reported by 30 days after surgery. The mean length of postoperative hospital stay was 7.2 days. PLDRH was a safe and feasible surgical technique characterized by a low complication rate and short hospital stays. PLDRH has the potential to become the standard procedure for the retrieval of right liver grafts from living donors.

  View details for DOI 10.1007/s13304-024-01920-5

  View details for PubMedID 39407055

  View details for PubMedCentralID 7061046

• Neoadjuvant therapy versus upfront surgery in resectable pancreatic cancer: reconstructed patient-level meta-analysis of randomized clinical trials. BJS open Aliseda, D., Martí-Cruchaga, P., Zozaya, G., Blanco, N., Ponz, M., Chopitea, A., Rodríguez, J., Castañón, E., Pardo, F., Rotellar, F. 2024; 8 (5)

  Abstract

  Neoadjuvant treatment has shown promising results in patients with borderline resectable pancreatic ductal adenocarcinoma. The potential benefits of neoadjuvant treatment on long-term overall survival in patients with resectable pancreatic ductal adenocarcinoma have not yet been established. The aim of this study was to compare long-term overall survival of patients with resectable pancreatic ductal adenocarcinoma based on whether they received neoadjuvant treatment or underwent upfront surgery.A systematic review including randomized clinical trials on the overall survival outcomes between neoadjuvant treatment and upfront surgery in patients with resectable pancreatic ductal adenocarcinoma was conducted up to 1 August 2023 from PubMed, MEDLINE and Web of Science databases. Patient-level survival data was extracted and reconstructed from available Kaplan-Meier curves. A frequentist one-stage meta-analysis was employed, using Cox-based models and a non-parametric method (restricted mean survival time), to assess the difference in overall survival between groups. A Bayesian meta-analysis was also conducted.Five randomized clinical trials comprising 625 patients were included. Among patients with resectable pancreatic ductal adenocarcinoma, neoadjuvant treatment was not significantly associated with a reduction in the hazard of death compared with upfront surgery (shared frailty HR 0.88, 95% c.i. 0.72 to 1.08, P = 0.223); this result was consistent in the non-parametric restricted mean survival time model (+2.41 months, 95% c.i. -1.22 to 6.04, P < 0.194), in the sensitivity analysis that excluded randomized clinical trials with a high risk of bias (shared frailty HR 0.91 (95% c.i. 0.72 to 1.15; P = 0.424)) and in the Bayesian analysis with a posterior shared frailty HR of 0.86 (95% c.i. 0.70 to 1.05).Neoadjuvant treatment does not demonstrate a survival advantage over upfront surgery for patients with resectable pancreatic ductal adenocarcinoma.

  View details for DOI 10.1093/bjsopen/zrae087

  View details for PubMedID 39329454

  View details for PubMedCentralID PMC11428068

• Never discard enucleation as a possibility: successful enucleation of a neuroendocrine tumor in the pancreatic neck in long and close proximity to the main pancreatic duct. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Blanco, N., Aliseda, D., Rotellar, F. 2024; 28 (8): 1379

  View details for DOI 10.1016/j.gassur.2024.05.006

  View details for PubMedID 38729419

• Anatomical Left Hepatectomy Extended to Caudate Lobe due to Colorectal Metastasis with Intrabiliary Growth: Securing Optimal Margins with a Laennec's Capsule Approach and Vein-Guided Resection. Annals of surgical oncology Blanco Asensio, N., Aliseda Jover, D., Martí-Cruchaga, P., Lapuente, F., Sabatella, L., Zozaya Larequi, G., Rotellar Sastre, F. 2024; 31 (7): 4447-4448

  View details for DOI 10.1245/s10434-024-15174-3

  View details for PubMedID 38517615

• The Impact of Portal Hypertension Assessment Method on the Outcomes of Hepatocellular Carcinoma Resection: A Meta-Analysis of Matched Cohort and Prospective Studies. Annals of surgery Aliseda, D., Zozaya, G., Martí-Cruchaga, P., Herrero, I., Iñarrairaegui, M., Argemí, J., Martínez De La Cuesta, A., Blanco, N., Sabatella, L., Sangro, B., Rotellar, F. 2024; 280 (1): 46-55

  Abstract

  Examine portal hypertension (PHT) impact on postoperative and survival outcomes in hepatocellular carcinoma (HCC) patients after liver resection (LR), specifically exploring distinctions between indirect signs and invasive measurements of PHT.PHT has historically discouraged LR in individuals with HCC due to the elevated risk of morbidity, including liver decompensation (LD).A systematic review was conducted using 3 databases to identify prospective-controlled and matched cohort studies until December 28, 2022. Focus on comparing postoperative outcomes (mortality, morbidity, and liver-related complications) and overall survival in HCC patients with and without PHT undergoing LR. Three meta-analysis models were utilized: for aggregated data (fixed-effects inverse variance model), for patient-level survival data (one-stage frequentist meta-analysis with gamma-shared frailty Cox proportional hazards model), and for pooled data (Freeman-Tukey exact and double arcsine method).Nine studies involving 1124 patients were analyzed. Indirect signs of PHT were not significantly associated with higher mortality, overall complications, PHLF or LD. However, LR in patients with hepatic venous pressure gradient (HVPG) ≥10 mm Hg significantly increased the risk of overall complications, PHLF, and LD. Despite elevated risks, the procedure resulted in a 5-year overall survival rate of 55.2%. Open LR significantly increased the risk of overall complications, PHLF, and LD. Conversely, PHT did not show a significant association with worse postoperative outcomes in minimally invasive LR.LR in the presence of indirect signs of PHT poses no increased risk of complications. Yet, in HVPG ≥10 mm Hg patients, LR increases overall morbidity and liver-related complications risk. Transjugular HVPG assessment is crucial for LR decisions. Minimally invasive approach seems to be vital for favorable outcomes, especially in HVPG ≥10 mm Hg patients.

  View details for DOI 10.1097/SLA.0000000000006185

  View details for PubMedID 38126757

• ASO Author Reflections: The Integration of Precision Anatomy Concepts into Minimally Invasive Liver Surgery-A New Way to Approach Routine Clinical Practice Complex Situations. Annals of surgical oncology Rotellar, F., Blanco, N., Aliseda, D., Martí-Cruchaga, P., Zozaya, G. 2024; 31 (6): 4050-4051

  View details for DOI 10.1245/s10434-024-15287-9

  View details for PubMedID 38615150

• Survival and safety after neoadjuvant chemotherapy or upfront surgery for locally advanced colon cancer: meta-analysis. The British journal of surgery Aliseda, D., Arredondo, J., Sánchez-Justicia, C., Alvarellos, A., Rodríguez, J., Matos, I., Rotellar, F., Baixauli, J., Pastor, C. 2024; 111 (2)

  Abstract

  Neoadjuvant chemotherapy is increasingly used to treat locally advanced (T3-4 Nx-2 M0) colon cancer due to its potential advantages over the standard approach of upfront surgery. The primary objective of this systematic review and meta-analysis was to analyse data from comparative studies to assess the impact of neoadjuvant chemotherapy on oncological outcomes.A systematic review was conducted by searching the MEDLINE and Scopus databases. The search encompassed RCTs, propensity score-matched studies, and controlled prospective studies published up to 1 April 2023. As a primary objective, overall survival and disease-free survival were compared. As a secondary objective, perioperative morbidity, mortality, and complete resection were compared using the DerSimonian and Laird models.A total of seven studies comprising a total of 2120 patients were included. Neoadjuvant chemotherapy was associated with a reduction in the hazard of recurrence (HR 0.73, 95% c.i. 0.59 to 0.90; P = 0.003) and death (HR 0.67, 95% c.i. 0.54 to 0.83; P < 0.001) compared with upfront surgery. Additionally, neoadjuvant chemotherapy was significantly associated with higher 5-year overall survival (79.9% versus 72.6%; P < 0.001) and disease-free survival (73.1% versus 64.5%; P = 0.028) rates. No significant differences were observed in perioperative mortality (OR 0.97, 95% c.i. 0.28 to 3.33), overall complications (OR 0.95, 95% c.i. 0.77 to 1.16), or anastomotic leakage/intra-abdominal abscess (OR 0.88, 95% c.i. 0.60 to 1.29). However, neoadjuvant chemotherapy was associated with a lower risk of incomplete resection (OR 0.70, 95% c.i. 0.49 to 0.99).Neoadjuvant chemotherapy is associated with a reduced hazard of recurrence and death, as well as improved overall survival and disease-free survival rates, compared with upfront surgery in patients with locally advanced colon cancer.

  View details for DOI 10.1093/bjs/znae021

  View details for PubMedID 38381934

  View details for PubMedCentralID PMC10881053

• Association of Laparoscopic Surgery with Improved Perioperative and Survival Outcomes in Patients with Resectable Intrahepatic Cholangiocarcinoma: A Systematic Review and Meta-Analysis from Propensity-Score Matched Studies. Annals of surgical oncology Aliseda, D., Sapisochin, G., Martí-Cruchaga, P., Zozaya, G., Blanco, N., Goh, B. K., Rotellar, F. 2023; 30 (8): 4888-4901

  Abstract

  Recent studies have associated laparoscopic surgery with better overall survival (OS) in patients with hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM). The potential benefits of laparoscopic liver resection (LLR) over open liver resection (OLR) have not been demonstrated in patients with intrahepatic cholangiocarcinoma (iCC).A systematic review of the PubMed, EMBASE, and Web of Science databases was performed to search studies comparing OS and perioperative outcome for patients with resectable iCC. Propensity-score matched (PSM) studies published from database inception to May 1, 2022 were eligible. A frequentist, patient-level, one-stage meta-analysis was performed to analyze the differences in OS between LLR and OLR. Second, intraoperative, postoperative, and oncological outcomes were compared between the two approaches by using a random-effects DerSimonian-Laird model.Six PSM studies involving data from 1.042 patients (530 OLR vs. 512 LLR) were included. LLR in patients with resectable iCC was found to significantly decrease the hazard of death (stratified hazard ratio [HR]: 0.795 [95% confidence interval [CI]: 0.638-0.992]) compared with OLR. Moreover, LLR appears to be significantly associated with a decrease in intraoperative bleeding (- 161.47 ml [95% CI - 237.26 to - 85.69 ml]) and transfusion (OR = 0.41 [95% CI 0.26-0.69]), as well as with a shorter hospital stay (- 3.16 days [95% CI - 4.98 to - 1.34]) and a lower rate of major (Clavien-Dindo ≥III) complications (OR = 0.60 [95% CI 0.39-0.93]).This large meta-analysis of PSM studies shows that LLR in patients with resectable iCC is associated with improved perioperative outcomes and, being conservative, yields similar OS outcomes compared with OLR.

  View details for DOI 10.1245/s10434-023-13498-0

  View details for PubMedID 37115372

  View details for PubMedCentralID PMC10319676

• Response to comment: Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (ETEP) approach: systematic review and meta-analysis. Hernia : the journal of hernias and abdominal wall surgery Aliseda, D., Sanchez-Justicia, C., Zozaya, G., Martí-Cruchaga, P., Rotellar, F. 2023; 27 (2): 479-480

  View details for DOI 10.1007/s10029-022-02735-2

  View details for PubMedID 36592253

  View details for PubMedCentralID 9684241

• Minimally invasive liver surgery for hepatocellular carcinoma in patients with portal hypertension. BJS open Aliseda, D., Zozaya, G., Martí-Cruchaga, P., Lujan, J., Almeida, A., Blanco, N., Sabatella, L., Sangro, B., Rotellar, F. 2023; 7 (2)

  View details for DOI 10.1093/bjsopen/zrad037

  View details for PubMedID 37115654

  View details for PubMedCentralID PMC10146929

• Liver Resection and Transplantation Following Yttrium-90 Radioembolization for Primary Malignant Liver Tumors: A 15-Year Single-Center Experience. Cancers Aliseda, D., Martí-Cruchaga, P., Zozaya, G., Rodríguez-Fraile, M., Bilbao, J. I., Benito-Boillos, A., Martínez De La Cuesta, A., Lopez-Olaondo, L., Hidalgo, F., Ponz-Sarvisé, M., Chopitea, A., Rodríguez, J., Iñarrairaegui, M., Herrero, J. I., Pardo, F., Sangro, B., Rotellar, F. 2023; 15 (3)

  Abstract

  Radioembolization (RE) may help local control and achieve tumor reduction while hypertrophies healthy liver and provides a test of time. For liver transplant (LT) candidates, it may attain downstaging for initially non-candidates and bridging during the waitlist.Patients diagnosed with HCC and ICC treated by RE with further liver resection (LR) or LT between 2005-2020 were included. All patients selected were discarded for the upfront surgical approach for not accomplishing oncological or surgical safety criteria after a multidisciplinary team assessment. Data for clinicopathological details, postoperative, and survival outcomes were retrospectively reviewed from a prospectively maintained database.A total of 34 patients underwent surgery following RE (21 LR and 13 LT). Clavien-Dindo grade III-IV complications and mortality rates were 19.0% and 9.5% for LR and 7.7% and 0% for LT, respectively. After RE, for HCC and ICC patients in the LR group, 10-year OS rates were 57% and 60%, and 10-year DFS rates were 43.1% and 60%, respectively. For HCC patients in the LT group, 10-year OS and DFS rates from RE were 51.3% and 43.3%, respectively.Liver resection after RE is safe and feasible with optimal short-term outcomes. Patients diagnosed with unresectable or high biological risk HCC or ICC, treated with RE, and rescued by LR may achieve optimal global and DFS rates. On the other hand, bridging or downstaging strategies to LT with RE in HCC patients show adequate recurrence rates as well as long-term survival.

  View details for DOI 10.3390/cancers15030733

  View details for PubMedID 36765691

  View details for PubMedCentralID PMC9913597

• A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation. Langenbeck's archives of surgery Manuel-Vázquez, A., Balakrishnan, A., Agami, P., Andersson, B., Berrevoet, F., Besselink, M. G., Boggi, U., Caputo, D., Carabias, A., Carrion-Alvarez, L., Franco, C. C., Coppola, A., Dasari, B. V., Diaz-Mercedes, S., Feretis, M., Fondevila, C., Fusai, G. K., Garcea, G., Gonzabay, V., Bravo, M. Á., Gorris, M., Hendrikx, B., Hidalgo-Salinas, C., Kadam, P., Karavias, D., Kauffmann, E., Kourdouli, A., La Vaccara, V., van Laarhoven, S., Leighton, J., Liem, M. S., Machairas, N., Magouliotis, D., Mahmoud, A., Marino, M. V., Massani, M., Requena, P. M., Mentor, K., Napoli, N., Nijhuis, J. H., Nikov, A., Nistri, C., Nunes, V., Ruiz, E. O., Pandanaboyana, S., Saborido, B. P., Pohnán, R., Popa, M., Pérez, B. S., Bueno, F. S., Serrablo, A., Serradilla-Martín, M., Skipworth, J. R., Soreide, K., Symeonidis, D., Zacharoulis, D., Zelga, P., Aliseda, D., Santiago, M. J., Mancilla, C. F., Fragua, R. L., Hughes, D. L., Llorente, C. P., Lesurtel, M., Gallagher, T., Ramia, J. M. 2022; 407 (8): 3447-3455

  Abstract

  A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included.A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%.Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.

  View details for DOI 10.1007/s00423-022-02687-2

  View details for PubMedID 36198881

• Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis. Hernia : the journal of hernias and abdominal wall surgery Aliseda, D., Sanchez-Justicia, C., Zozaya, G., Lujan, J., Almeida, A., Blanco, N., Martí-Cruchaga, P., Rotellar, F. 2022; 26 (6): 1511-1520

  Abstract

  The enhanced view totally extraperitoneal (eTEP) approach is becoming increasingly more widely accepted as a promising technique in the treatment of ventral hernia. However, evidence is still lacking regarding the perioperative, postoperative and long-term outcomes of this technique. The aim of this meta-analysis is to summarize the current available evidence regarding the perioperative and short-term outcomes of ventral hernia repair using eTEP.A systematic search was performed of PubMed, EMBASE, Cochrane Library and Web of Science electronic databases to identify studies on the laparoscopic or robotic-enhanced view totally extraperitoneal (eTEP) approach for the treatment of ventral hernia. A pooled meta-analysis was performed. The primary end point was focused on short-term outcomes regarding perioperative characteristics and postoperative parameters.A total of 13 studies were identified involving 918 patients. Minimally invasive eTEP resulted in a rate of surgical site infection of 0% [95% CI 0.0-1.0%], a rate of seroma of 5% [95% CI 2.0-8.0%] and a rate of major complications (Clavien-Dindo III-IV) of 1% [95% CI 0.0-3.0%]. The rate of intraoperative complications was 2% [95% CI 0.0-4.0%] with a conversion rate of 1.0% [95% CI 0.0-3.0%]. Mean hospital length of stay was 1.77 days [95% CI 1.21-2.24]. After a median follow-up of 6.6 months (1-24), the rate of recurrence was 1% [95% CI 0.0-1.0%].Minimally invasive eTEP is a safe and effective approach for ventral hernia repair, with low reported intraoperative complications and good outcomes.

  View details for DOI 10.1007/s10029-021-02557-8

  View details for PubMedID 35044545

  View details for PubMedCentralID PMC9684241

• Pure laparoscopic major liver resection after yttrium90 radioembolization: a case-matched series analysis of feasibility and outcomes. Langenbeck's archives of surgery Aliseda, D., Martí-Cruchaga, P., Zozaya, G., Benito, A., Lopez-Olaondo, L., Rodríguez-Fraile, M., Bilbao, J. I., Hidalgo, F., Iñarrairaegui, M., Ciria, R., Pardo, F., Sangro, B., Rotellar, F. 2022; 407 (3): 1099-1111

  Abstract

  Liver surgery after radioembolization (RE) entails highly demanding and challenging procedures due to the frequent combination of large tumors, severe RE-related adhesions, and the necessity of conducting major hepatectomies. Laparoscopic liver resection (LLR) and its associated advantages could provide benefits, as yet unreported, to these patients. The current study evaluated feasibility, morbidity, mortality, and survival outcomes for major laparoscopic liver resection after radioembolization.In this retrospective, single-center study patients diagnosed with hepatocellular carcinoma, intrahepatic cholangiocarcinoma or metastases from colorectal cancer undergoing major laparoscopic hepatectomy after RE were identified from institutional databases. They were matched (1:2) on several pre-operative characteristics to a group of patients that underwent major LLR for the same malignancies during the same period but without previous RE.From March 2011 to November 2020, 9 patients underwent a major LLR after RE. No differences were observed in intraoperative blood loss (50 vs. 150 ml; p = 0.621), operative time (478 vs. 407 min; p = 0.135) or pedicle clamping time (90.5 vs 74 min; p = 0.133) between the post-RE LLR and the matched group. Similarly, no differences were observed on hospital stay (median 3 vs. 4 days; p = 0.300), Clavien-Dindo ≥ III complications (2 vs. 1 cases; p = 0.250), specific liver morbidity (1 vs. 1 case p = 1.000), or 90 day mortality (0 vs. 0; p = 1.000).The laparoscopic approach for post radioembolization patients may be a feasible and safe procedure with excellent surgical and oncological outcomes and meets the current standards for laparoscopic liver resections. Further studies with larger series are needed to confirm the results herein presented.

  View details for DOI 10.1007/s00423-022-02474-z

  View details for PubMedID 35229168

  View details for PubMedCentralID PMC9151566

• Liver transplantation for subacute hepatic necrosis and rapid liver failure following bariatric surgery. ANZ journal of surgery Aliseda, D., Cienfuegos, J. A., Valenti, V., Echeveste, J. I., Lujan, J., Almeida, A., Rotellar, F. 2022; 92 (3): 620

  View details for DOI 10.1111/ans.17373

  View details for PubMedID 35305072

• Critical stenosis of the celiac trunk by the arcuate ligament, successfully treated by a laparoscopic approach. Revista espanola de enfermedades digestivas Aliseda, D., Cienfuegos, J. A., Vivas, I., Rotellar, F. 2022; 114 (3): 168-169

  Abstract

  A 56-year-old female was referred to our department with a five-month history of progressive abdominal pain related to physical exertion and copious meals. The pain was located in the mesogastric region and the right flank and remitted when the patient lay in the recumbent position with the knees bent. The patient reported nausea and a weight loss of 12 kg over the previous ten years. She had been diagnosed 18 years previously with hereditary leiomyomatosis and renal cancer and had undergone a hysterectomy and partial nephrectomy.

  View details for DOI 10.17235/reed.2021.8159/2021

  View details for PubMedID 34182765

• Severe colon ischemia in patients with severe coronavirus-19 (COVID-19). Revista espanola de enfermedades digestivas Almeida Vargas, A., Valentí, V., Sánchez Justicia, C., Martínez Regueira, F., Martí Cruchaga, P., Luján Colás, J., Aliseda Jover, D., Esteban Gordillo, S., Cienfuegos, J. A., Rotellar Sastre, F. 2020; 112 (10): 784-787

  Abstract

  COVID-19 is associated with severe coagulopathy. We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patients died shortly after diagnosis.

  View details for DOI 10.17235/reed.2020.7329/2020

  View details for PubMedID 32954769

• Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2018; 20 (8): O215-O225

  Abstract

  Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients.In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.

  View details for DOI 10.1111/codi.14292

  View details for PubMedID 29897171