Frontiers in Surgery最新文献

{"title":"Optimal exercise prescription parameters in Schroth training for adolescent idiopathic scoliosis: a systematic review and meta-analysis.","authors":"Daoquan Guan, Yahui Liu, Tongwu Yu, Wen Cheng","doi":"10.3389/fsurg.2026.1796813","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1796813","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) affects 0.5%-5% of the adolescent population, representing the most common spinal deformity in this age group. This systematic review and meta-analysis aimed to determine optimal exercise prescription parameters for Schroth training in AIS by examining dose-response relationships between exercise frequency, duration, and clinical outcomes.</p><p><strong>Methods: </strong>Systematic searches of PubMed, Scopus, Web of Science, and SPORTDiscus were conducted following PRISMA 2020 guidelines. Randomized controlled trials examining Schroth interventions in adolescents aged 10-18 years with idiopathic scoliosis were included. Network meta-analysis was performed using MetaInsight platform for Cobb angle outcomes, with traditional pairwise meta-analyses conducted for all outcomes using standardized mean differences with 95% confidence intervals.</p><p><strong>Results: </strong>15 randomized controlled trials encompassing 620 participants were included. The overall meta-analysis demonstrated Schroth exercises produced statistically significant Cobb angle improvements (SMD = -0.52, <i>p</i> < 0.0001; I<sup>2</sup> = 0%). Subgroup analysis revealed dose-response relationships favouring moderate exercise frequencies (3-4 sessions/week), which showed the largest pooled effect (SMD = -0.58, I<sup>2</sup> = 3%). Duration analysis demonstrated medium duration interventions (46-75 min) provided the most precise improvements (MD = -2.92°), while optimal frequency was the moderate (MD = -2.79°, 95% CI: -4.05, -1.48). Combined subgroup analysis identified moderate frequency plus medium duration as the most robust combination (SMD = -0.65, I<sup>2</sup> = 10%). Health-related quality of life outcomes showed non-significant improvements with substantial heterogeneity (SMD = 0.52, <i>p</i> = 0.43; I<sup>2</sup> = 93%). Secondary outcomes showed statistically significant improvements in trunk rotation (SMD = -0.86, <i>p</i> = 0.002; I<sup>2</sup> = 22%) and cosmetic appearance perception (SMD = -0.73, <i>p</i> = 0.01; I<sup>2</sup> = 0%), while postural stability measures showed non-significant effects (SMD = 0.08; <i>p</i> = 0.81; I<sup>2</sup> = 68%). Publication bias assessment using Egger's test shows no statistically significant funnel plot asymmetry (<i>p</i> = 0.745).</p><p><strong>Conclusions: </strong>Exploratory subgroup and network meta-analyses suggest that moderate frequency Schroth exercises (3-4 sessions/week) combined with medium duration sessions (46-75 min) may represent optimal parameters for Cobb angle improvement in AIS. Non-linear dose-response patterns show diminishing returns at higher frequencies, challenging conventional exercise prescription assumptions. These findings require validation through prospective studies with pre-specified dose-stratification examining long-term effectiveness, cost-effectiveness, and patient adherence across diverse healthcare contexts before broa","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1796813"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous transforaminal endoscopic discectomy vs. unilateral biportal endoscopy for far lateral lumbar disc herniation: a retrospective comparative study.","authors":"Lu Yongjiang, Li Chunbo, Wang Jianyuan","doi":"10.3389/fsurg.2026.1790170","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1790170","url":null,"abstract":"<p><strong>Objective: </strong>To compare the early clinical efficacy, perioperative parameters, and safety profiles of percutaneous transforaminal endoscopic discectomy (PTED) and unilateral biportal endoscopic (UBE) discectomy in treating single-level far lateral lumbar disc herniation (FLLDH).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 81 patients with FLLDH treated between January 2021 and June 2024. Patients were allocated to the PTED group (<i>n</i> = 38) or the UBE group (<i>n</i> = 43) based on the surgical technique received. Perioperative indicators (operative time, incision length, blood loss, hospital stay) and clinical outcomes-assessed by Visual Analogue Scale (VAS) for back/leg pain and the Oswestry Disability Index (ODI) preoperatively and at 1, 3, 6, and 12 months postoperatively-were compared. Statistical analyses included independent samples t-tests, chi-square tests, and repeated-measures ANOVA.</p><p><strong>Results: </strong>All patients completed 12-month follow-up. The two groups were comparable at baseline (<i>P</i> > 0.05). The PTED group demonstrated significantly shorter operative time (62.4 ± 8.7 vs. 105.3 ± 14.1 min, <i>P</i> < 0.001), smaller incision length (7.8 ± 0.9 vs. 24.6 ± 4.2 mm, <i>P</i> < 0.001), less intraoperative blood loss (18.5 ± 4.3 vs. 68.2 ± 10.5 mL, <i>P</i> < 0.001), and shorter hospital stay (4.8 ± 1.1 vs. 5.9 ± 1.7 days, <i>P</i> = 0.002). Both groups showed significant and sustained improvement in VAS and ODI scores postoperatively (<i>P</i> < 0.05). At 1 month, PTED was associated with lower back pain VAS but slightly higher leg pain VAS and ODI compared to UBE (<i>P</i> < 0.05). From 3 months onward, no significant inter-group differences were observed in any clinical scores (<i>P</i> > 0.05). Repeated-measures ANOVA indicated a different improvement trajectory for back pain between the groups (interaction <i>P</i> = 0.024).</p><p><strong>Conclusion: </strong>Both PTED and UBE are effective minimally invasive techniques for FLLDH, offering comparable and excellent mid-term clinical outcomes. PTED offers advantages in reduced surgical trauma and faster early recovery, whereas UBE provides superior endoscopic visualization. The choice of technique can be individualized based on patient characteristics and surgical expertise.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1790170"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postlaparoscopic appendectomy acute pain: identifying risk factors and building a clinical prediction model.","authors":"Yubo Zhang, Dake Liu, Dongdong Wang, Ying Chen, Lin Li, Jionghui Fu, Weibo Liu, Jingcheng Zhang","doi":"10.3389/fsurg.2026.1793752","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1793752","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic appendectomy is the standard treatment for acute appendicitis; however, postoperative acute pain remains a significant challenge. This study aimed to identify risk factors and develop an externally validated nomogram to predict moderate-to-severe acute pain following the procedure.</p><p><strong>Methods: </strong>A retrospective study was conducted, including a training cohort (<i>n</i> = 430) and an independent external validation cohort (<i>n</i> = 124). Postoperative pain intensity was quantified using the peak numeric rating scale (NRS) score recorded within the first 24 h (assessed at 1, 3, 7, 9, 12, and 24 h). Patients were categorized into mild (NRS ≤ 3) and moderate-to-severe (NRS > 3) pain groups. Potential risk factors were identified via univariate analysis, and multivariable binary logistic regression was performed to determine independent predictors after assessing multicollinearity using the variance inflation factor. A nomogram-based predictive model was then developed and rigorously evaluated using the area under the curve (AUC), calibration plots, and decision curve analysis (DCA) in both cohorts.</p><p><strong>Results: </strong>Multivariable binary logistic regression identified three independent predictors of moderate-to-severe acute postoperative pain: surgical approach [three-port laparoscopic appendectomy (TPLA) vs. single-port laparoscopic appendectomy (SPLA); <i>P</i> < 0.01, odds ratio (OR) = 5.504; 95% CI 3.423-8.852], preoperative total delay (<i>P</i> = 0.005, OR = 1.496; 95% CI 1.129-1.983), and admission body temperature (<i>P</i> = 0.008, OR = 1.797; 95% CI 1.168-2.763). The developed nomogram exhibited robust discriminative performance, with an AUC of 0.762 (95% CI 0.716-0.808) in the training set and 0.785 in the external validation set. Calibration curves for both cohorts demonstrated optimal agreement between predicted and observed outcomes. In the validation cohort, DCA confirmed significant clinical net benefits across threshold ranges of 10%-14% and 16%-95%.</p><p><strong>Conclusion: </strong>Surgical approach, preoperative total delay, and admission body temperature were identified as independent predictors of acute pain following laparoscopic appendectomy. Compared with TPLA, the SPLA approach was associated with a significantly lower risk of moderate-to-severe acute pain. The externally validated nomogram provides a reliable clinical tool with high discriminative power and practical applicability, facilitating the identification of high-risk patients and supporting the optimization of individualized perioperative pain management strategies.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1793752"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report and reconsideration of pathogenesis: C5 palsy after corrective surgery for severe congenital cervicothoracic scoliosis.","authors":"Bo Zhou, Qihui Duan, Wenjin Li, Li Zhang, Tao Li, Zhi Zhao, Yingsong Wang","doi":"10.3389/fsurg.2026.1767159","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1767159","url":null,"abstract":"<p><strong>Objective: </strong>This case report presents a rare case of C5 nerve root palsy following corrective surgery for severe congenital cervicothoracic scoliosis in a child, and explores its distinctive pathogenesis and treatment strategy.</p><p><strong>Methods: </strong>This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Kunming Medical University (PJ-2021-100), and informed consent was obtained from the patient's guardian. The clinical data of a 9-year-old boy with congenital cervicothoracic scoliosis (Cobb angle of 99°) who underwent posterior corrective instrumentation and fusion were retrospectively analyzed. Typical C5 palsy developed on postoperative day 7. Imaging studies and the clinical course were used to identify the responsible mechanism.</p><p><strong>Results: </strong>Postoperatively, left deltoid strength decreased to grade II/III. CT excluded direct implant impingement, and no laminectomy had been performed, thus excluding the classic \"posterior cord drift\" hypothesis. Comparative imaging revealed a significant reduction in the vertical diameter of the C4-C5 foramen. We concluded that reduction maneuvers had transmitted excessive traction through the C5 pedicle screw, producing dynamic foraminal stenosis and nerve root stretching. Conservative management (with cervical traction and hyperbaric oxygen) was instituted, and complete neurological recovery was documented at 3 months.</p><p><strong>Conclusion: </strong>In cervical deformity surgeries performed without decompression, iatrogenic alteration of the foramina's geometry, produced by corrective forces, is an important and frequently overlooked mechanism of postoperative C5 palsy. Surgeons should avoid overtightening a single screw during rod reduction; once the complication occurs, systematic conservative treatment usually yields a favorable outcome.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1767159"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of visualized reamer foraminoplasty in transforaminal endoscopic lumbar discectomy: a retrospective controlled study.","authors":"Honglin Liu, Yuxiang Hu, Yang Zhan, Zhixin Kang, Zhuoxuan Zhang, Chengyu Huang, Ningjing Zeng, Yang Xiao, Juntao Ma, Zibo Gao, Hao Liu, Guoyi Su, Yongpeng Lin, Zhirong Fan, Dingkun Lin, Yihao Liang, Yongjin Li","doi":"10.3389/fsurg.2026.1806067","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1806067","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to retrospectively compare the efficacy and safety of visualized reamer foraminoplasty vs. the traditional TESSYS technique in transforaminal endoscopic lumbar discectomy (TELD) for lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>In this retrospective study, 140 LDH patients were assigned to the visualized reamer group (<i>n</i> = 70) or the TESSYS group (<i>n</i> = 70). Perioperative parameters (operative time, fluoroscopy frequency), clinical outcomes [Visual Analog Score (VAS) for back/leg pain, Oswestry Disability Index (ODI)] were assessed preoperatively and at 1 day, 1, 3, 6, and 12 months postoperatively. Peri-operative complications were recorded. Subgroup analyses were performed.</p><p><strong>Results: </strong>The visualized reamer group demonstrated significant advantages in operative time (66.34 ± 7.65 vs. 76.06 ± 15.89 min, <i>P</i> < 0.05) and intraoperative fluoroscopy frequency (6.10 ± 0.90 vs. 12.06 ± 0.92, <i>P</i> < 0.05). Both groups showed significant clinical improvement at all timepoints (<i>P</i> < 0.05). The visualized reamer group demonstrated superior early postoperative leg pain relief, evidenced by significantly lower VAS leg scores at 1 day (mean difference: -0.64 points) and 1 month (mean difference: -0.43 points) compared to the TESSYS group (both <i>P</i> < 0.05). Mid-term clinical outcomes were comparable between the two groups. Complication analysis revealed a significantly lower incidence of postoperative lower limb dysesthesia in the visualized reamer group (0% vs. 5.71%, <i>P</i> < 0.05), while recurrence rates showed no significant difference (1.43% vs. 2.86%, <i>P</i> > 0.05). Subgroup analyses confirmed consistent treatment benefits across age, BMI, and sex (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The visualized reamer technique significantly enhances perioperative efficiency and early pain control in TELD, with comparable mid-term efficacy to the TESSYS technique. Its benefits are consistent across diverse patient populations, supporting its broad applicability.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1806067"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Asymmetric adult-onset asthma with periocular xanthogranuloma associated with IgG4-related disease: a case report.","authors":"Yue Cheng, Qianqian Mi, Dan Wang","doi":"10.3389/fsurg.2026.1787830","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1787830","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1787830"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted surgery for Hirschsprung disease in children: initial single-center experience.","authors":"Girolamo Mattioli, Maria Stella Cipriani, Stefano Avanzini, Michela Cing Yu Wong, Valentina Rossi, Maria Grazia Faticato","doi":"10.3389/fsurg.2026.1797606","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1797606","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery (RS) application to Hirschsprung disease (HSCR) is spreading. The aim of this study was to describe our series of children operated with RS for HSCR, focusing on surgical outcomes.</p><p><strong>Methods: </strong>Case series of 20 children operated for HSCR disease with robotic approach over a 10-year period (October 2015 to July 2025). Preoperative characteristics, intraoperative data, and postoperative outcomes were collected. A comparison with patients who underwent a laparoscopic surgery for HSCR disease was done.</p><p><strong>Results: </strong>The median age at surgery was 1.3 years (IQR 0.6-4.8), with a mean weight of 16 kg. Seven-teen patients had rectosigmoid HSCR (85%), and three had long-segment HSCR (15%). The median total operative time was 253 minutes (IQR 188-402), while the median console operative time was 50 minutes (IQR 40-95). Postoperatively, five patients developed mild anastomotic stenosis, and one required redo ileoanal anastomosis (5%). Median follow-up was 11 months (IQ range 5-12). At last follow-up, two patients complained mild constipation with soiling episodes (12%); and two had experienced episodes of HAEC (12%). Comparative analysis with laparoscopy showed no significant differences in operative outcomes.</p><p><strong>Conclusion: </strong>RS is a safe option for the management of HSCR. More multicentre studies are necessary to define clear indications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1797606"},"PeriodicalIF":1.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double pyramidal lobe detected at ultrasound: a case report with review of the literature.","authors":"Spyridon Chytiris, Marsida Teliti, Laura Croce, Lidia Pizzuto, Linda Loretta Businaro, Tshering Dorji, Mario Rotondi, Benedetto Calì","doi":"10.3389/fsurg.2026.1829850","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1829850","url":null,"abstract":"<p><p>The pyramidal lobe (PL) is a common anatomical variant of the thyroid gland, arising from the caudal end of the thyroglossal duct during embryological development. Although its prevalence is approximately 40% in the general population, the presence of a double pyramidal lobe (DPL) is extremely rare. We report a unique case of preoperative ultrasound diagnosis of DPL, subsequently confirmed intraoperatively and histologically. A 61-year-old male with a long-standing toxic multinodular goiter under methimazole treatment underwent thyroid ultrasound, which revealed a markedly enlarged gland (98 mL) with bilateral nodular disease and two distinct pyramidal lobes originating from the isthmus. Fine-needle aspiration cytology showed benign findings. Due to substernal extension and tracheal deviation, total thyroidectomy was performed. Both pyramidal lobes, preoperatively identified by ultrasound, were successfully excised. Histopathological examination confirmed benign multinodular goiter without malignancy and validated the presence of two separate PLs. To our knowledge, this is the first reported case of DPL diagnosed preoperatively by ultrasound and confirmed histologically. Preoperative recognition of PL, and particularly DPL, is clinically relevant. Residual pyramidal lobe tissue after total thyroidectomy may contribute to persistent or recurrent disease. In malignancy, it can impair thyroglobulin-based surveillance and reduce radioactive iodine efficacy by competing for uptake. Given the potential surgical implications, careful preoperative ultrasound assessment by experienced operators is essential. This case highlights the importance of thorough anatomical evaluation and close collaboration between endocrinologists and surgeons to ensure complete thyroidectomy and reduce the risk of persistent or recurrent disease.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1829850"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal small-bowel evisceration 15 years post wertheim-hysterectomy: a case report and review of literature.","authors":"Florian Högler, Filipp Sokolovski, Sandra Raab, Lena Rossetti, Peter Oppelt, Andreas Shamiyeh","doi":"10.3389/fsurg.2026.1782864","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1782864","url":null,"abstract":"<p><p>Vaginal cuff dehiscence with evisceration (VCDE) is a rare but severe complication of hysterectomy with potentially lethal consequences requiring rapid surgical intervention. Due to the high frequency of hysterectomies, healthcare professionals should be aware of the condition and its aetiology, clinical presentation and precipitating factors to identify patients at risk. We report the case of a 74-year-old woman undergoing bowel resection due to VCDE 15 years post Wertheim-procedure.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1782864"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Marfan syndrome complicated with obturator hernia.","authors":"Danning Zhang, Zining Chen, Xiaolong He, Qingbo Feng","doi":"10.3389/fsurg.2026.1797226","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1797226","url":null,"abstract":"<p><strong>Background: </strong>Obturator hernia is an extremely rare subtype of abdominal wall hernia, typically occurring in elderly female with a history of chronic increased intra-abdominal pressure or multiple pregnancies. However, it is rarely encountered in young individuals, which may lead to diagnostic oversight. Here, we report a case of a young female with Marfan syndrome who developed a left obturator hernia.</p><p><strong>Patient presentation: </strong>A young female with Marfan syndrome and pectus excavatum presented with 6 h of persistent severe left inguinal pain.</p><p><strong>Diagnostic process: </strong>Physical examination revealed a 2 cm × 2 cm localized swelling in the upper medial aspect of the left thigh, medial to the inguinal ligament. Left Howship-Romberg sign (+). Computed tomography (CT) examination indicated pectus excavatum, cardiomegaly, and a left obturator hernia.</p><p><strong>Intervention: </strong>Based on these findings, laparoscopic preperitoneal inguinal hernia mesh repair was performed.</p><p><strong>Outcome: </strong>The patient was discharged on postoperative day 3 and followed up for 14 months. Recovery was uneventful with no complications.</p><p><strong>Conclusion: </strong>This case highlights the importance of differential diagnostic thinking for hernias in patients with connective tissue diseases.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1797226"},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}