Frontiers in Surgery最新文献

{"title":"Sex differences in inflammatory parameters after shoulder arthroplasty and blood loss.","authors":"Stefan Hertling, Ekkehard Schleußner, Franziska Maria Loos, Niklas Eckhardt, Mario Kaiser, Isabel Graul","doi":"10.3389/fsurg.2024.1264443","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1264443","url":null,"abstract":"<p><strong>Background: </strong>In many diseases, sex differences in diagnostics and therapy play role that is increasingly becoming recognized as important. C-reactive protein (CRP) and white blood cell (WBC) levels are determined as inflammatory markers to detect inflammation and even infection after total shoulder arthroplasty (TSA). The general course of white blood cell, CRP, and hemoglobin (Hb) levels after TSA is well known, but there is insufficient evidence of a possible association with sex. Therefore, we aimed to investigate whether there is an influence of sex on CRP, WBCs, and Hb after TSA in the first 10 days after surgery in a complication-free course in male and female patients and to re-evaluate the specific postoperative CRP, WBC, and Hb course with their maximums (minimum for Hb) and further course until the end of the inpatient period.</p><p><strong>Methods: </strong>We retrospectively studied patients treated with TSA, reverse shoulder arthroplasty (RSA), and prosthesis replacement between 2015 and 2021. Patients with active inflammation, rheumatoid arthritis, secondary osteoarthritis, active cancer, and documented postoperative complications were not included. CRP, WBC, and Hb levels before shoulder arthroplasty (SA) and up to 10 days after SA were recorded and analyzed for sex differences.</p><p><strong>Results: </strong>Data from a total of 316 patients (209 women and 107 men) were finally analyzed. There were no sex differences in the CRP and WBC values, but women had significantly lower preoperative Hb values, postoperative Hb values, and minimum Hb values. There were no significant differences in Hb, CRP, or WBC levels in the prosthesis exchange group.</p><p><strong>Conclusion: </strong>The progression of CRP and WBC levels showed no sex-specific significant differences after TSA within the first 7 postoperative days. The study confirmed a decreased Hb value for women at all stages of SA. Blood loss was significantly higher for RSA than for TSA for both men and women.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1264443"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607955","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":"C-arm CT scanning combined with simple laser device-assisted puncture therapy for cerebellar hemorrhage.","authors":"Yang Chen, Chenglong Li, Qingbo Wang, Zefu Li","doi":"10.3389/fsurg.2024.1421517","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1421517","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar hemorrhage is a severe cerebrovascular disease. The small posterior fossa space can cause compression of surrounding brain tissue with even a small amount of bleeding, leading to increased intracranial pressure, disruption of blood supply to surrounding brain tissue, and exacerbation of brain function damage. The most common surgical approach currently is craniotomy for hematoma evacuation, inevitably causing damage to surrounding nerves and blood vessels. In this study, we introduced C-arm CT scanning combined with simple laser device technology to assist in puncture drainage for cerebellar hemorrhage, aiming to improve the accuracy of surgery and maximize the protection of patients' brain function, providing a physiological basis for better clinical prognosis.</p><p><strong>Materials and methods: </strong>From January 2023 to February 2024, a total of 8 patients (6 males, 2 females) with cerebellar hemorrhage underwent C-arm CT-assisted puncture therapy combined with a simple laser device at the affiliated hospital of Binzhou Medical University. Statistical analysis was performed on operation time, number of punctures, impact on important structures and vessels, postoperative hematoma clearance, complications, and neurological function recovery.</p><p><strong>Results: </strong>All 8 patients underwent the surgery smoothly without causing damage to important structures or blood vessels. There was no rebleeding intraoperatively. Among the 8 patients, 5 were discharged smoothly, while 3 patients opted to discontinue treatment and requested discharge. At the 3-month follow-up, 3 patients showed no ataxia, while 2 patients had impaired cerebellar motor function.</p><p><strong>Conclusion: </strong>C-arm CT scanning combined with a simple laser device technology can accurately locate the position of the hematoma, effectively avoid important structures and vessels, reduce damage to surrounding normal brain tissue, and maximize the protection of normal brain tissue function. Real-time navigation and dynamic adjustments during surgery allow immediate access to imaging data postoperatively. It also has the advantages of being minimally invasive, highly precise, easy to operate, and short operation time, demonstrating high practicality and feasibility.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1421517"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604254","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":"Robotic colorectal surgery in Latin America: a systematic review on surgical outcomes.","authors":"Bruno Augusto Alves Martins, Nicolas Avellaneda, Guglielmo Niccolò Piozzi","doi":"10.3389/fsurg.2024.1480444","DOIUrl":"10.3389/fsurg.2024.1480444","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robotic approach in colorectal surgery is rapidly gaining interest, particularly in the context of rectal cancer resection. Despite economic barriers, substantial proliferation of robotic colorectal procedures has been observed throughout Latin America. However, there is a lack of data regarding intraoperative and early postoperative outcomes, as well as oncological and long-term results. This systematic review aims to provide an overview of the surgical outcomes of robotic-assisted colorectal approaches across Latin America.</p><p><strong>Material and methods: </strong>A systematic literature search of electronic databases, including PubMed, LILACS, Scopus, Cochrane Library and Scielo, was performed and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The main target of the literature search was studies that reported outcomes of colorectal robotic surgery in Latin America.</p><p><strong>Results: </strong>A total of 9,694 published articles were identified from the initial search. Nine thousand six hundred thirty-six publications were excluded after title and abstract review and removal of duplicates. Fifty-eight articles were thoroughly reviewed, and 11 studies met the inclusion criteria. The critical appraisal of study quality (biases risk assessment) was performed according to the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. In general, the overall study quality was poor. Of the 11 studies included in the analysis, ten addressed intraoperative and early postoperative outcomes, seven addressed oncological/pathological outcomes, and just one addressed long-term outcomes. Ten studies evaluated intraoperative and early postoperative outcomes, encompassing a total of 425 patients, the majority of whom were diagnosed with colorectal cancer. Morbidity rates exhibited a range between 0% and 45.9%, while mortality ranged from 0% to 2.5%.</p><p><strong>Conclusion: </strong>Few studies have been published addressing intraoperative, postoperative, pathological, and oncological outcomes of robotic colorectal surgery in this region. Undoubtedly, there are unique challenges not encountered by developed countries, including economic obstacles in establishing structured training programmes and high-quality centres for the development of robotic surgery. Further studies are needed to assess the real extent of robotic surgery in the region and its results.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/, PROSPERO (CRD42023494112).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1480444"},"PeriodicalIF":1.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590146","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":"Integrating 3D technology with the Sampaio classification for enhanced percutaneous nephrolithotomy in complex renal calculi treatment.","authors":"Jiamo Zhang, Jing Qing, Ke Hu, Honglin Cheng","doi":"10.3389/fsurg.2024.1471958","DOIUrl":"10.3389/fsurg.2024.1471958","url":null,"abstract":"<p><strong>Background: </strong>To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the treatment of complicated renal calculi by integrating three-dimensional (3D) computed tomography (CT) reconstruction with the Sampaio classification of the renal collecting system.</p><p><strong>Methods: </strong>Sixty-four consecutive patients with complex kidney calculi who underwent PCNL between January 2019 and October 2023 were retrospectively analyzed and divided into experimental group (3D printing) and control group (CT imaging) according to their willingness to pay for 3D imaging. Both groups underwent preoperative CT urography. The Digital Imaging and Communications (DICOM) in Medicine data of the experimental group from CT imaging were used for 3D reconstruction and model printing. Then, the Sampaio classification system was used to design the puncture channel and develop a surgical strategy.</p><p><strong>Results: </strong>The 3D-printed models of the experimental group successfully displayed the Sampaio classification system. There was no significant difference in the baseline parameters between the groups. Compared with the control group, the experimental group exhibited significant improvements in the puncture time, number of puncture needles, number of puncture channels, target calyx consistency, number of first puncture channels, and stone clearance. There were no significant differences in the total operative time, decrease in the hemoglobin level, length of hospital stay, and postoperative complications between the groups.</p><p><strong>Conclusions: </strong>Integration of 3D technology with the Sampaio classification of the renal collecting system can enhance the preoperative evaluation and planning of percutaneous renal access. This approach allows a more precise method of PCNL for treating complex renal calculi.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1471958"},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582822","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":"Integrative prognostic modeling for stage III lung adenosquamous carcinoma post-tumor resection: machine learning insights and web-based implementation.","authors":"Min Liang, Peimiao Li, Shangyu Xie, Xiaoying Huang, Xiaocai Li, Shifan Tan","doi":"10.3389/fsurg.2024.1489040","DOIUrl":"10.3389/fsurg.2024.1489040","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic landscape of stage III Lung Adenosquamous Carcinoma (ASC) following primary tumor resection remains underexplored. A thoughtfully developed prognostic model has the potential to guide clinicians in patient counseling and the formulation of effective therapeutic strategies.</p><p><strong>Methods: </strong>Utilizing data from the Surveillance, Epidemiology, and End Results database spanning 2000 to 2018, this study identified independent prognostic factors influencing Overall Survival (OS) in ASC using Boruta analysis. Employing Gradient Boosting, Random Forest, and Neural Network algorithms, predictive models were constructed. Model performance was assessed through key metrics, including Area Under the Receiver Operating Characteristic Curve (AUC), calibration plot, Brier score, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>Among 241 eligible patients, seven clinical parameters-age, sex, primary tumor size, N stage, primary tumor site, chemotherapy, and systemic therapy-were identified as significant predictors of OS. Advanced age, male gender, larger tumor size, absence of chemotherapy, and lack of systemic therapy were associated with poorer survival. The Random Forest model outperformed others, achieving 3- and 5-year AUCs of 0.80/0.79 (training) and 0.74/0.65 (validation). It also demonstrated better calibration, lower Brier scores (training: 0.189/0.171; validation: 0.207/0.199), and more favorable DCA. SHAP values enhanced model interpretability by highlighting the impact of each parameter on survival predictions. To facilitate clinical application, the Random Forest model was deployed on a web-based server for accessible prognostic assessments.</p><p><strong>Conclusions: </strong>This study presents a robust machine learning model and a web-based tool that assist healthcare practitioners in personalized clinical decision-making and treatment optimization for ASC patients following primary tumor resection.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1489040"},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590144","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":"Impact of pleural reconstruction on postoperative outcomes in rib tumor resection: a decade-long retrospective study.","authors":"Hao Xie, Bowen Li, Yixin Sun, Lin Ma, Qiang Zhang","doi":"10.3389/fsurg.2024.1473791","DOIUrl":"10.3389/fsurg.2024.1473791","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the effects of pleural reconstruction during rib compartment tumor resection surgery on postoperative outcomes, including drainage volume, drainage duration, hospital stay, complications, and pain control.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 142 patients who underwent rib compartment tumor resection surgery at Beijing Jishuitan Hospital from January 2013 to October 2023. The patients were divided into two groups: those who received pleural reconstruction and those who did not. Data were collected from hospital medical records and outpatient care records, focusing on postoperative drainage volume, total drainage time, length of hospital stay, complications, and pain scores. Continuous variables were compared using <i>t</i>-tests or nonparametric tests, while categorical variables were analyzed using chi-square tests or Fisher's exact tests.</p><p><strong>Results: </strong>The analysis showed no significant differences between the two groups in terms of postoperative complications and pain thresholds. However, patients who underwent pleural reconstruction had significantly lower postoperative drainage volume (937.74 ± 855.97 vs. 1,595.26 ± 1,054.50 ml, <i>p</i> < 0.05), shorter drainage duration (5.5 ± 2.39 vs. 8.43 ± 2.87 days, <i>p</i> < 0.05), and reduced length of hospital stay (7.32 ± 3.30 vs. 10.99 ± 6.83 days, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Pleural reconstruction during rib compartment tumor resection surgery reduces postoperative drainage volume, drainage duration, and hospital stay without increasing complications or short-term pain. Further large-scale studies are recommended to validate these findings.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1473791"},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567984","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":"Extrarenal renal cell carcinoma in the adrenal region: a case report.","authors":"Kai Yao, Long Huang, Jing Li Zhang, Yan Xu, Dong Liang Liu","doi":"10.3389/fsurg.2024.1449879","DOIUrl":"10.3389/fsurg.2024.1449879","url":null,"abstract":"<p><p>This case report describes a rare instance of extrarenal clear cell renal cell carcinoma (ccRCC) in a 48-year-old woman who presented with a loss of consciousness. Abdominal CT revealed a 24 × 31 mm mass in the left adrenal region, with no kidney involvement. The mass was surgically excised, and histopathological examination confirmed the diagnosis of ccRCC. Immunohistochemical analysis revealed positive markers, including CA9, CD10, PAX-8, and vimentin. The patient did not undergo adjuvant therapy, and a 6-month follow-up showed no signs of recurrence or metastasis. This case emphasizes the importance of considering extrarenal ccRCC in differential diagnoses of adrenal masses.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1449879"},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567981","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":"Surgical Hyperspectral imaging and Indocyanine green Near-infrared Examination (SHINE) for brain arteriovenous malformation resection: a case report on how to visualize perfusion.","authors":"Johannes Wach, Ferdinand Weber, Martin Vychopen, Felix Arlt, Annekatrin Pfahl, Hannes Köhler, Andreas Melzer, Erdem Güresir","doi":"10.3389/fsurg.2024.1477920","DOIUrl":"10.3389/fsurg.2024.1477920","url":null,"abstract":"<p><strong>Background and importance: </strong>Arteriovenous malformations (AVMs) are complex vascular anomalies that pose significant risks, including intracranial hemorrhage and neurological deficits. Surgical resection is the preferred treatment, requiring precise intraoperative imaging to ensure complete removal while preserving critical structures. This case report presents the first combined use of hyperspectral imaging (HSI) and indocyanine green video angiography (ICG VA) to visualize perfusion during brain AVM surgery, highlighting the potential benefits of these advanced imaging techniques.</p><p><strong>Case description: </strong>A 66-year-old male presented with chronic headaches but no neurological deficits. MRI revealed a superficial AVM in the left frontal lobe within the superior frontal sulcus, measuring approximately 2.4 cm. The AVM was fed by feeders from the pericallosal artery, callosomarginal artery, and middle cerebral artery (MCA) branches, with drainage through a dilated cortical vein into the superior sagittal sinus. Preoperative embolization of two MCA feeding branches was performed, followed by microsurgical resection with ICG VA and HSI.</p><p><strong>Conclusions: </strong>This case report demonstrates the successful application of HSI and ICG VA in brain AVM surgery. The combined use of these technologies provided comprehensive intraoperative assessment, enhancing surgical precision and safety. The integration of HSI offers non-invasive, contrast-agent-free imaging, potentially improving outcomes by enabling detailed perfusion mapping. Future studies should explore the broader applications of these imaging modalities in neurovascular practice.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1477920"},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567986","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: Does the misplaced titanium mesh cage after total spondylectomy causing cervicothoracic cord compression need to be removed during revision surgery?","authors":"Xin Wang, XiaoFei Cheng, Jie Zhao, ChangQing Zhao","doi":"10.3389/fsurg.2024.1394135","DOIUrl":"10.3389/fsurg.2024.1394135","url":null,"abstract":"<p><strong>Background: </strong>Mechanical failure following total spondylectomy is a surgical challenge. The cervicothoracic junction region is a special anatomical site with complex biomechanics, and few studies have reported a detailed surgical management strategy for cases where the mesh cage subsides and compresses the spinal cord in the cervicothoracic junction region after total spondylectomy.</p><p><strong>Case presentation: </strong>A 56-year-old male patient experienced screw and rod fracture and mesh cage retropulsion into the spinal canal 5 years after total spondylectomy for osteochondroma in the first to third thoracic vertebrae. The patient complained of numbness and discomfort in both lower extremities, accompanied by unstable walking for 8 months prior to admission at our hospital. We concluded that uncorrected local kyphosis in the cervicothoracic junction after the first surgery resulted in current mesh cage subsidence and rod/screw fracture. Considering the difficulty and risks of removing the mesh cage from the anterior approach, we initially freed the superior end of the mesh cage without removing the mesh from the anterior approach by resecting the C6/7 intervertebral disc and the destroyed C7 vertebral body. We then removed the original screws and rods and performed long segment fixation from C4 to T6 via a posterior approach after recovering sagittal alignment by skull traction. Finally, the iliac bone was harvested and transplanted between the superior end of the mesh cage and the inferior end plate of C6 to fill the defect caused by kyphosis correction and C7 vertebral resection. After surgery, the patient experienced sagittal alignment reconstruction and symptom relief, and he was asked to wear a cast for at least 6 months until bone fusion was achieved. At the 3-year follow-up, there was fusion between the mesh cage and the C6 vertebra with successful instrument reconstruction and no mesh cage subsidence were observed.</p><p><strong>Conclusions: </strong>When a subsided and migrated titanium mesh cage is difficult to remove after mechanical failure following total spondylectomy, recovering sagittal alignment to achieve indirect decompression based on unique anterior and middle column reconstruction, solid instrument construction, and bone fusion is an alternative solution.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1394135"},"PeriodicalIF":1.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557583","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":"FGF-2 enriched nanofiber scaffold for advancing achilles tendon healing: a comparative experimental investigation.","authors":"Necmettin Turgut, Funda Cengiz Çallıoğlu, Aytül Bayraktar, Mehtap Savran, Halil Aşcı, Kanat Gülle, Meriç Ünal","doi":"10.3389/fsurg.2024.1424734","DOIUrl":"10.3389/fsurg.2024.1424734","url":null,"abstract":"<p><strong>Introduction: </strong>Achilles tendon rupture is a common and debilitating injury that significantly impacts mobility and quality of life. Effective treatment options that promote faster and more complete healing are needed. Fibroblast growth factor-2 (FGF-2) has shown potential in enhancing tendon repair. This study aims to investigate the efficacy of FGF-2 in promoting tendon healing in a rat model of Achilles tendon rupture, providing insights into its potential as a therapeutic option.</p><p><strong>Materials and methods: </strong>Forty-eight rat hind legs with complete Achilles tendon ruptures were divided into four equal groups: the Sham (S) group (tendon repair only), the Polymer (P) group (tendon repair with scaffold wrapping), the Produced FGF-2 (PF) group (scaffold coated with lab-produced FGF-2), and the Commercial FGF-2 (CF) group (scaffold coated with commercially sourced FGF-2). Histological analyses at two and four weeks post-surgery evaluated healing based on nuclear morphology, vascularity, fibril organization, inflammation, and adipogenesis.</p><p><strong>Results: </strong>At the end of the second week, no macroscopic healing was observed in one rat each from the S and P groups. By the end of the fourth week, macroscopic healing was observed in all groups. The S and P groups exhibited similarly severe fibril disorganization, pathological adipogenesis, and sustained inflammation, particularly at the fourth week. In contrast, the CF group demonstrated improved tendon healing with increased vascularity and extracellular matrix, lower inflammatory cell infiltration, and better fibril organization. Pathological adipogenesis was absent in the CF group, especially at the fourth week. The PF group showed comparable improvements at the second week but experienced a relapse by the 4th week, with increased inflammation and adipogenesis.</p><p><strong>Conclusion: </strong>FGF-2 coated scaffolds significantly enhanced tendon healing in a rat Achilles tendon rupture model by improving fibril organization, increasing vascularity, and reducing inflammation and pathological adipogenesis. These findings suggest that FGF-2 could be a promising therapeutic option for accelerating tendon repair. Future perspectives on tendon repair will focus on enhancing FGF-2 delivery using innovative scaffolds, paving the way for more effective therapies and improved patient outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1424734"},"PeriodicalIF":1.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557584","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}