Frontiers in Surgery最新文献

{"title":"Comprehensive surgery of complex scalp arteriovenous fistula: a successful trial.","authors":"Zhiming Ma, Zhihao Zou, Dajiang Xie, Linlin Qian","doi":"10.3389/fsurg.2024.1492616","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1492616","url":null,"abstract":"<p><strong>Background: </strong>Traumatic scalp arteriovenous fistula is a rare vascular abnormality. Open surgical removal and embolization have been employed to address this condition.</p><p><strong>Methods: </strong>In this report, we present a case involving a 41-year-old man who exhibited a progressively enlarging pulsatile mass in his right occipital scalp. Computerized tomography angiography (CTA) and digital subtraction angiography (DSA) identified a complex scalp arteriovenous fistula (S-AVF). The combination of clinical symptoms and neuroimaging findings facilitated the diagnosis.</p><p><strong>Results: </strong>Following a thorough discussion, we implemented a comprehensive strategy that included both endovascular embolization and surgical resection. The patient demonstrated an excellent prognosis with no reported discomfort.</p><p><strong>Conclusions: </strong>A comprehensive surgical approach should be considered in the management of patients with complex scalp arteriovenous fistula.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1492616"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052288","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":"Relationship between serum ECP and TIgE levels and the risk of postoperative recurrence in patients with chronic rhinosinusitis with nasal polyps.","authors":"Qing Zhang, Hui Li, Di Xie, SiJian Fan","doi":"10.3389/fsurg.2024.1516981","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1516981","url":null,"abstract":"<p><strong>Objective: </strong>This study was undertaken to assess the association between the likelihood of surgical recurrence and serum ECP and TIgE levels in chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methodology: </strong>Clinical information was gathered retrospectively from 166 cases of surgically treated CRSwNP as well as 60 cases of chronic rhinosinusitis without nasal polyps (CRSsNP). A comparative analysis on serum levels of total immunoglobulin E (TIgE) and eosinophil cationic protein (ECP) was carried out between the two groups. The CRSwNP patients were assigned into recurrence and non-recurrence groups based on the absence/presence of disease recurrence after a 2-year follow-up. An analysis was conducted on the correlation between the patients' clinical data and their serum ECP and TIgE levels. Receiver operating characteristic (ROC) curves were utilized to assess the clinical utility of these two biomarkers.</p><p><strong>Results: </strong>The CRSwNP participants had higher serum levels of ECP and TIgE (4.28 ± 0.81 > 3.58 ± 0.77 ng/L, <i>P</i> < 0.001; 52.99 ± 8.62 > 15.65 ± 3.25 KU/L, <i>P</i> < 0.001) compared to CRSsNP participants. Univariate analysis indicated that neutrophil ratio, lymphocyte ratio, Lund-Kennedy score, Lund-Mackay score, SNOT-22 score, olfactory function score, and postoperative recurrence were significantly correlated with serum ECP and TIgE levels. Higher serum levels of TIgE and ECP (4.89 ± 0.79 < 4.11 ± 0.72, <i>P</i> < 0.001; 58.74 ± 8.27 < 51.40 ± 8.04, <i>P</i> < 0.001) were detected in the recurrence groups vs. the non-recurrence group. Multivariate analysis showed that serum ECP and TIgE were independent risk factors for recurrence of CRSwNP. Serum ECP and TIgE levels were found to be predictive of postoperative recurrence risk in CRSwNP patients (AUC: 0.77, 0.74, 0.84; <i>P</i> < 0.05) according to ROC curve analysis. Significant differences were not observed in any general clinical data.</p><p><strong>Conclusion: </strong>The findings suggest that elevated serum ECP and TIgE levels in patients with CRSwNP can be as good predictors for the risk of recurrence after endoscopic sinus surgery.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1516981"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052290","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":"Indocyanine green fluorescence-guided laparoscopic central pancreatectomy for complete pancreatic transection trauma: a rare case and literature review.","authors":"Xitao Wang, Xiong Teng, Yi Liu, Wei Cheng","doi":"10.3389/fsurg.2024.1448064","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1448064","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic trauma is a rare solid organ injury. Conservative treatment is often indicated in patients with no pancreatic duct injury, while patients with high-grade pancreatic damage most often require surgical intervention. Laparoscopic central pancreatectomy (LCP) is a parenchyma-sparing approach and can prevent endocrine and exocrine insufficiency after pancreatic resection. Indocyanine green (ICG) fluoroscopy can help the surgeon assess the blood supply of the target organ.</p><p><strong>Case presentation: </strong>The case we describe here is a 33-year-old male patient who was transferred to our hospital due to blunt abdominal trauma caused by a car accident. The patient was hemodynamically stable on admission and was diagnosed with isolated pancreatic trauma by a multidisciplinary team that included radiologists, emergency physicians, and pancreatic surgeons. The patient then underwent emergency laparoscopic central pancreatectomy, during which we used ICG fluoroscopy to assess the blood perfusion of the damaged pancreas to determine the extent of resection. The patient developed a biochemical fistula (grade A pancreatic fistula) after surgery, and no other intervention was performed except for continuous drainage. The patient was discharged on postoperative day 13. At the 3-month follow-up, the patient did not present any clinical manifestations of pancreatic endocrine and exocrine insufficiency.</p><p><strong>Conclusion: </strong>To the best of our knowledge, there have been no reports of ICG-guided emergency LCP for blunt abdominal trauma. In selected patients, emergency LCP is feasible and should be supported by a multidisciplinary team and performed by an experienced pancreatic surgeon with advanced laparoscopic skills.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1448064"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052289","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":"Analysis of artery injury types and clinical characteristics of patients with transcatheter angioembolization after percutaneous nephrolithotomy.","authors":"Xianghu Meng, Rong Cong, Yibo Hua, Zengjun Wang, Ninghong Song, Wei Yang, Rijin Song","doi":"10.3389/fsurg.2024.1429821","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1429821","url":null,"abstract":"<p><strong>Background: </strong>There is no systematic classification of renal vascular injuries conducted for severe post-percutaneous nephrolithotomy (PCNL) bleeding.</p><p><strong>Aim: </strong>The aim of the present study was to explore the various types of artery injury and clinical characteristics of patients who underwent transcatheter angioembolization (TAE) after PCNL.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 52 patients who underwent renal arteriography (RA) because of severe bleeding after PCNL between April 2009 and December 2023. Among the patients, 38 underwent TAE due to positive RA results. Clinical data on the TAE patients, such as gender, age, body mass index, TAE interval, hemoglobin (Hb) decrease, operation time, stone size, the number and size of tracts, and clinical bleeding type, were summarized. The types of artery injury in TAE patients and their relationships with clinical characteristics were analyzed.</p><p><strong>Results: </strong>Retrospective analysis revealed that, among the 38 TAE patients (32 males and 6 females), the mean TAE interval, average Hb decrease, mean tract number, and mean tract size reached 5.00 (6.25) days, 44.50 (24.50) g/L, 1 (0.25), and F20(6), respectively. Among the TAE patients, four kinds of vascular injury were observed, namely, 18 cases of pseudoaneurysm (PA), 12 cases of arteriocaliceal fistula (ACF), 7 cases of arteriovenous fistula (AVF), and 1 case of arterioperirenal fistula (APF). Analysis of the clinical characteristics of the three types of vascular injury (PA, ACF, and AVF) revealed that the number of tracts was the only factor that differed.</p><p><strong>Conclusion: </strong>The RA results indicate that the types of postoperative renal artery injury mainly include PA, ACF, AVF, and APF, and the number of tracts may be related to the type of vascular injury.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1429821"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052287","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":"Corrigendum: Case Report: A rare presentation of rapidly progressive moyamoya disease refractory to unilateral surgical revascularization.","authors":"Daniel F Leach, Srivikram Margam S, Aaron J Gustin, Paul J Gustin, Mohamad N Jajeh, Yhana C Chavis, Kristin V Walker, Joshua S Bentley","doi":"10.3389/fsurg.2024.1550675","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1550675","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fsurg.2024.1409692.].</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1550675"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046039","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":"Editorial: Visceral surgery and education.","authors":"Gabriel Sandblom, Magnus Kjellman, Lars Enochsson","doi":"10.3389/fsurg.2024.1548598","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1548598","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1548598"},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028292","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":"Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis.","authors":"Bin Zheng, Yixin Lu, Erqi Li, Ziyu Bai, Kaiqian Zhang, Jian Li","doi":"10.3389/fsurg.2024.1412334","DOIUrl":"10.3389/fsurg.2024.1412334","url":null,"abstract":"<p><strong>Background: </strong>The choice of surgical methods for common bile duct stones (CBDS) is controversial. The aim of this study was to compare the safety and efficacy of laparoscopic transcystic common bile duct exploration (LTCBDE) and laparoscopic common bile duct exploration (LCBDE).</p><p><strong>Methods: </strong>Relevant literature published before March 30, 2023 in PubMed, Web of Science, Embase, and Cochrane was searched to screen studies comparing LTCBDE and LCBDE. RevMan 5.4 was used for meta-analysis of fixed-effects and random-effects models.</p><p><strong>Results: </strong>A total of 21 studies met the inclusion criteria, including 3065 patients in the LTCBDE group and 2,453 patients in the LCBDE group. CBDS clearance was 95.4% (2,682/2,812) in LTCBDE group and 94.7% (1,810/1,911) in LCBDE group (OR: 1.84, 95% CI: 1.36, 2.48, <i>P</i> < 0.0001; <i>I</i> ² = 0%, <i>P</i> = 0.56). In LTCBDE group, operative time(MD = -34.60, 95% CI: -46.05, -23, 15, <i>P</i> < 0.00001 <i>I</i> ² = 96%, <i>P</i> < 0.00001), postoperative hospital stay (MD = -2.92, 95% CI: -3.62, -2.21, <i>P</i> < 0.00001; <i>I</i> ² = 92%, <i>P</i> < 0.00001), postoperative complications (OR: 0.47, 95% CI: 0.38, 0.58, <i>P</i> < 0.0001; <i>I</i> ² = 26%, <i>P</i> = 0.15), residual stone(OR: 0.48, 95% CI: 0.34, 0.66, <i>P</i> < 0.0001; <i>I</i> ² = 0%, <i>P</i> = 0.56), bile leak (OR: 0.37, 95% CI: 0.25, 0.55, <i>P</i> < 0.00001; <i>I</i> ² = 0%,<i>P</i> = 0.52), mortality (OR: 0.10, 95% CI: 0.01, 0.88, <i>P</i> = 0.04; <i>I</i> ² = 0%, <i>P</i> = 0.71) and recurrent stones(OR: 0.34, 95% CI: 0.15, 0.74, <i>P</i> = 0.007; <i>I</i> ² = 5%, <i>P</i> = 0.38) were better than LCBDE group. There was no difference in pancreatitis (OR: 1.06, 95% CI: 0.52, 2.16. <i>P</i> = 0.86; <i>I</i> ² = 0%, <i>P</i> = 0.98) and biliary stricture(OR: 0.30, 95% CI: 0.08, 1.09, <i>P</i> = 0.07; <i>I</i> ² = 0%, <i>P</i> = 0.57).</p><p><strong>Conclusions: </strong>LTCBDE is safe, efficient, and of great clinical significance, and is worth promoting to some patients.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1412334"},"PeriodicalIF":1.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022812","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: Metastatic involvement of the acromioclavicular joint in a patient with papillary carcinoma of the ureter.","authors":"Cihangir Türemiş, Mustafa Çeltik, Mehmet Erduran","doi":"10.3389/fsurg.2024.1298556","DOIUrl":"10.3389/fsurg.2024.1298556","url":null,"abstract":"<p><p>Ureteral papillary carcinoma is a rare subtype of urothelial carcinoma, ranking fourth among cancers following prostate (or breast) cancer, lung cancer, and colorectal cancer. Although previous studies have documented bone metastases mainly in the pelvis, spine, ribs, and femur, this case report presents the first recorded instance of metastasis occurring in the acromioclavicular joint. A 62-year-old woman with a history of left flank pain and macroscopic hematuria underwent a left nephroureterectomy, which revealed ureteral papillary carcinoma. Three years later, she reported left shoulder pain, leading to the discovery of a metastatic lesion in the distal clavicle. Approximately 9 cm of metastatic bone was resected while preserving nearby nerve and vascular structures. The resulting bone defect was grafted with a 9-cm bone graft removed from the middle third of the fibula. This case report underscores the importance of considering distant metastases, even in atypical locations, in patients with ureteral papillary carcinoma and aims to share the entire treatment journey and insights gained.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1298556"},"PeriodicalIF":1.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022667","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":"Preoperative anemia is associated with prolonged hospital stay and increased facility discharges after glioblastoma resection.","authors":"Ahmad K Almekkawi, Ammar Adenwalla, James P Caruso, William H Hicks, Benjamin Rail, Carlos A Bagley, Jonathan D Breshears, Tarek Y El Ahmadieh, Tomas Garzon-Muvdi, Samuel A Goldlust","doi":"10.3389/fsurg.2024.1466924","DOIUrl":"10.3389/fsurg.2024.1466924","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous operative and non-operative treatment modalities, patients with glioblastoma (GBM) have a dismal prognosis. Identifying predictors of survival and recurrence is an essential strategy for guiding treatment decisions, and existing literature demonstrates associations between hematologic data and clinical outcomes in cancer patients. As such, we provide a novel analysis that examines associations between preoperative hematologic data and postoperative outcomes following GBM resection.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients who underwent GBM resection from January 2016 to December 2020. Standard demographic and clinical variables were collected, including pre-operative complete blood count (CBC), and inferential analyses were performed to analyze associations between CBC parameters and postoperative outcomes.</p><p><strong>Results: </strong>One hundred and eighty nine (189) patients met inclusion criteria, with a mean age of 60.7 years. On multivariate regression analysis, controlling for age, gender, and performance status, we observed trends suggesting anemic patients may have longer lengths of stay (t statistic = 3.23, <i>p</i> = 0.0015) and higher rates of discharge to inpatient facilities [OR 3.01 (1.09-8.13), <i>p</i> = 0.029], though these associations did not reach statistical significance after correction for multiple comparisons (Bonferroni-corrected significance threshold <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Preoperative anemia may be a useful pre-operative predictor of postsurgical GBM outcomes. Further study is required to determine whether pre-operative hemoglobin optimization can improve postoperative clinical outcomes, and whether other hematologic and inflammatory markers are predictive of postoperative recovery and functional status.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1466924"},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003857","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":"Editorial: Tailoring treatment in invasive and non-invasive cervical pathology volume II.","authors":"Violante Di Donato, Tullio Golia D'Augè, Alejandro Soderini, Andrea Giannini, Francesco Plotti","doi":"10.3389/fsurg.2024.1540134","DOIUrl":"10.3389/fsurg.2024.1540134","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1540134"},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003939","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}