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Examinando Artículos de Revistas por Materia "3.1.1 - Anatomía y Morfología||3.2.11 - Cirugía"
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Ítem Anatomical variants in pancreatic irrigation and their clinical considerations for the pancreatic approach and surrounding structures: a systematic review with meta-analysis(MDPI, 2025-02-19) Valenzuela Fuenzalida, Juan JoséBackground and Objectives: The pancreas receives blood through a complex network of multiple branches, primarily originating from the celiac trunk (CeT) and the superior mesenteric artery (SMA). This blood supply is structured into three main arterial groups, each serving different regions of the pancreas to effectively support its endocrine and exocrine functions. Materials and Methods: The databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and the Caribbean Literature in Health Sciences (LILACS) were searched until January 2025. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of sixteen studies met the established selection criteria in this study for meta-analysis. Pancreatic irrigation variants presented a prevalence of 11.2% (CI: 7–14%) and a heterogeneity of 88.2%. The other studies were analyzed by subgroups, showing statistically significant differences in the following subgroups: (1) sample type—a larger sample of images analyzed in the included studies (p = 0.312), which did not show statistically significant differences; (2) geographical region (p = 0.041), which showed a greater presence in the Asian population studied, and this was statistically significant; and (3) sex (male or female) (p = 0.12), where there were no statistically significant differences. Conclusions: The discovery of variations in pancreatic irrigation is common due to the numerous blood vessels involved in supplying this vital organ. Understanding different vascular patterns (such as those from the splenic and mesenteric arteries) is crucial for surgical interventions on the pancreas. For transplant patients, a thorough vascular analysis of both the donor and recipient is essential. Variations can impact blood flow and compatibility, potentially leading to transplant rejection if not addressed. To enhance outcomes, it is recommended to develop more accurate imaging tools for pre-surgical analysis, necessitating ongoing research in this area.Ítem Systematic review and meta-analysis: recurrent laryngeal nerve variants and their implication in surgery and neck pathologies, using the Anatomical Quality Assurance (AQUA) checklist(MDPI, 2023-04-24) Valenzuela Fuenzalida, Juan JoséThe recurrent laryngeal nerve (RLN) is the structure responsible for sensory and motor innervation of the larynx, and it has been shown that its lesion due to a lack of surgical rigor led to alterations such as respiratory obstruction due to vocal cords paralysis and permanent phonation impairment. The objectives of this review were to know the variants of the RLN and its clinical relevance in the neck region. Methods: This review considered specific scientific articles that were written in Spanish or English and published between 1960 and 2022. A systematic search was carried out in the electronic databases MEDLINE, WOS, CINAHL, SCOPUS, SCIELO, and Latin American and Caribbean Center for Information on Health Sciences to compile the available literature on the subject to be treated and was enrolled in PROSPERO. The included articles were studies that had a sample of RLN dissections or imaging, intervention group to look for RLN variants, or the comparison of the non-recurrent laryngeal nerve (NRLN) variants, and finally, its clinical correlations. Review articles and letters to the editor were excluded. All included articles were evaluated through quality assessment and risk of bias analysis using the methodological quality assurance tool for anatomical studies (AQUA). The extracted data in the meta-analysis were interpreted to calculate the prevalence of the RLN variants and their comparison and the relationship between the RLN and NRLN. The heterogeneity degree between included studies was assessed. Results: The included studies that showed variants of the RLN included in this review were 41, a total of 29,218. For the statistical analysis of the prevalence of the RLN variant, a forest plot was performed with 15 studies that met the condition of having a prevalence of less than 100%. As a result, the prevalence was shown to be 12% (95% CI, SD 0.11 to 0.14). Limitations that were present in this review were the publication bias of the included studies, the probability of not having carried out the most sensitive and specific search, and finally, the authors’ personal inclinations in selecting the articles. Discussion: This meta-analysis can be considered based on an update of the prevalence of RLN variants, in addition to considering that the results show some clinical correlations such as intra-surgical complications and with some pathologies and aspects function of the vocal cords, which could be a guideline in management prior to surgery or of interest for the diagnostic.Ítem The Gastric Vein Variants: An Evidence-Based Systematic Review of Prevalence and Clinical Considerations(MDPI, 2025-05-22) Bruna-Mejías, AlejandroThe objective of the present systematic study was to analyze and characterize the gastric vein (GV) variations to understand their significance within clinical contexts, particularly in gastric and liver surgeries and managing conditions associated with the portal vein system. Methods: We conducted a systematic review, examining various databases, including Medline, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE, up to April 2025. Two independent authors conducted the literature search, selected pertinent studies, and extracted relevant data. The methodological quality of the studies was evaluated utilizing the Assessment Tool for Anatomical Studies (AQUA). The pooled prevalence was estimated through the application of a random effects model. Results: Among the 279 articles reviewed, 11 studies were ultimately incorporated into the systematic analysis, encompassing 47,993 subjects. The pooled prevalence of GV variants was determined to be 8.32%, revealing considerable heterogeneity (I2 = 98.92%). A subgroup analysis showed a greater prevalence of GV variants in diagnostic imaging studies than in cadaveric studies, with a higher frequency observed in males than in females. Conclusions: The morphological variability of the GVs holds clinical significance, as it may significantly impact the management of abdominal disorders, particularly during surgical and endovascular interventions. This study emphasizes the necessity of thorough preoperative evaluations to identify these variations, thereby minimizing surgical complications and enhancing therapeutic outcomes for patients suffering from gastric and portal vein system disorders. Integrating advanced imaging techniques into clinical practice may facilitate improved surgical and therapeutic planning.