Frontiers in Surgery最新文献

{"title":"How well do large language models answer postoperative lumbar fusion questions? A blinded comparative analysis of accuracy, quality, readability, and safety-related content.","authors":"Ahmet Kürşat Kara, Ozan Işık","doi":"10.3389/fsurg.2026.1932133","DOIUrl":"10.3389/fsurg.2026.1932133","url":null,"abstract":"<p><strong>Background: </strong>Patients recovering from lumbar fusion increasingly seek guidance from large language model (LLM) chatbots when their surgeon is unavailable, but the accuracy, completeness, and safety-related content of such responses have not been compared across models for the postoperative period.</p><p><strong>Objective: </strong>To compare the accuracy, quality, safety-related content, and readability of responses from ChatGPT, Gemini, and Claude to frequently asked postoperative lumbar fusion questions, and to identify the question types for which responses are weakest.</p><p><strong>Methods: </strong>Thirty questions, compiled by three neurosurgeons and grouped into six clinical categories, were submitted to each model, each with a standardized, patient-oriented prompt requesting warning signs. Ninety anonymized, randomized responses were rated independently by three blinded neurosurgeons for accuracy and four quality subdomains (clarity, completeness, relevance, and patient safety) on 4-point scales. Readability (Flesch-Kincaid, Flesch Reading Ease, and Gunning Fog), word count, and responses meeting an operational screening criterion for potential harm were also assessed. Models were compared with Friedman and Holm-corrected pairwise tests.</p><p><strong>Results: </strong>Accuracy was high for all models without significant differences. Quality, clarity, completeness, relevance, and patient safety differed globally, but effect sizes were small (Kendall's <i>W</i>: 0.10-0.21) and, after correction across the six outcome families, only quality and completeness remained significant, with Gemini scoring lower than ChatGPT and Claude. Gemini had the most favorable readability. ChatGPT responses were the shortest (mean 294 vs. 462 and 445 words); length was unrelated to completeness or readability. Two Gemini responses (6.7%) and none from ChatGPT or Claude met a <i>post hoc</i> operational screening criterion for potential harm (a score of ≤2 on accuracy or patient safety from at least one of three raters, without concurrence from the other two); no response was adjudicated as actually harmful. In exploratory question- and category-level analyses, responses tended to be rated highest for standardized questions and lowest for those requiring individualized judgment or interpretation of wound-related symptoms.</p><p><strong>Conclusion: </strong>Responses from contemporary LLMs to common postoperative lumbar fusion questions were generally rated as accurate, with small between-model differences and a model-level divergence between readability and completeness. Because safety-related content was explicitly prompted and no patient outcomes were assessed, these findings describe the quality of safety-related information rather than clinical safety. LLMs may support postoperative patient education but should not replace physician guidance, particularly for warning signs and patient-specific recovery decisions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1932133"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215654","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 staging of gastric cancer: a prospective comparison of gastric filling ultrasonography and enhanced CT with implications for surgical decision-making.","authors":"Xinxin Qin, Junmei Zhao, Litao Ge, Song Wu, Xiaofeng Sun, Wei Li","doi":"10.3389/fsurg.2026.1925096","DOIUrl":"10.3389/fsurg.2026.1925096","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative staging is essential for optimizing treatment strategies in gastric cancer. While gastric-enhanced CT is widely used, its accuracy remains suboptimal, particularly for early-stage tumors. Gastric filling ultrasonography, a non-invasive technique using oral contrast to displace intraluminal gas, offers potential advantages in mural visualization. This prospective study compared the diagnostic performance of gastric filling ultrasonography and gastric-enhanced CT against postoperative pathological staging.</p><p><strong>Methods: </strong>We enrolled 406 patients with histologically confirmed gastric cancer who underwent both imaging modalities prior to surgery. Preoperative T and N stages assigned by each modality were compared with pathological results. Diagnostic accuracy, sensitivity, specificity, and area under the ROC curve (AUC) were calculated. McNemar's test was used for paired comparisons, DeLong test for AUC comparisons, and Kappa statistics for agreement assessment. Univariate logistic regression identified factors affecting ultrasound accuracy.</p><p><strong>Results: </strong>For T-staging, overall accuracy was 72.7% (295/406) for ultrasound vs. 63.5% (258/406) for CT (<i>P</i> < 0.001). Ultrasound significantly outperformed CT in T1 (81.5% vs. 56.3%, <i>P</i> = 0.009) and T2 (81.1% vs. 67.9%, <i>P</i> < 0.001) stages. For N-staging, accuracy was 82.0% (333/406) for ultrasound vs. 60.1% (244/406) for CT (<i>P</i> < 0.001). Kappa agreement with pathology was substantial for ultrasound T-staging (<i>κ</i> = 0.625) and N-staging (<i>κ</i> = 0.748), compared with moderate agreement for CT (<i>κ</i> = 0.508 and 0.395, respectively). In multivariate analysis, vascular infiltration was the only independent factor associated with ultrasound T-staging accuracy.</p><p><strong>Conclusions: </strong>Gastric filling ultrasonography demonstrates superior accuracy over gastric-enhanced CT for preoperative T1/T2 and N-staging, with substantial agreement with pathological findings. This non-invasive and radiation-free examination method can serve as an effective complement to CT, and is particularly suitable for gastric cancer at the T1 and T2 stages. We have proposed a complementary imaging protocol to assist in surgical decision-making, which is expected to enable clinicians to make more accurate preoperative staging assessments for patients with gastric cancer.</p><p><strong>Registration: </strong>It was registered in the ClinicalTrials.gov (NCT05596864).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1925096"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215703","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":"Current progress and controversies in thoracic ossification of the ligamentum flavum: pathogenesis, diagnosis and surgical management.","authors":"Guoxing Ding, Huijing Shang, Fuhai Yan, Weijie Cui, Zhi Li, Yiheng Zhang, Zhan Wang, Jie Wen, Yifan Feng, Junxiao Su, Hui Zhang","doi":"10.3389/fsurg.2026.1896885","DOIUrl":"10.3389/fsurg.2026.1896885","url":null,"abstract":"<p><p>Thoracic ossification of ligamentum flavum (TOLF) is the primary pathological driver of thoracic spinal stenosis (TSS), characterized by insidious clinical onset, high surgical complexity, and a elevated risk of permanent neurological deficits. This systematic review synthesizes the epidemiological landscape and genetic, mechanical, and inflammatory pathogeneses ofTOLF. We provide a comprehensive evaluation of current radiological classification systems and critically appraise different decompressive procedures-ranging from classic open laminectomies to emerging minimally invasive biportal and uniportal endoscopic techniques. By assessing surgical outcomes, complications (e.g., cerebrospinal fluid leakage), and clinical indicators, this review aims to provide clinicians with an evidence-based framework for individualized surgical decision-making in managing TOLF.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1896885"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215889","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":"Age is the wrong axis: rethinking surgical selection for octogenarians with early-stage non-small cell lung cancer.","authors":"Vasiliki Androutsopoulou, Prokopis-Andreas Zotos, Dimitrios E Magouliotis","doi":"10.3389/fsurg.2026.1961761","DOIUrl":"10.3389/fsurg.2026.1961761","url":null,"abstract":"<p><p>Lung cancer is increasingly a disease of older age, and as low-dose computed tomography screening extends into the ninth decade, a growing number of octogenarians present with early-stage, potentially curable non-small cell lung cancer. Faced with these patients, clinicians repeatedly ask a single question: is this patient too old for surgery? Recent prospective data show that selected octogenarians achieve long-term survival comparable to younger patients despite substantially higher complication rates, with quality of life that recovers over the first postoperative year. Yet the favorable result is attributed to careful selection that is rarely defined, and is seldom accompanied by any account of the patients who were assessed and not offered an operation. This article argues that chronological age is the wrong axis for the decision. Physiologic reserve, measurable through validated frailty instruments and established physiologic testing, predicts postoperative outcome far better than birth year, and aging is sufficiently heterogeneous that any age threshold misclassifies patients in both directions. A substantial competing risk of non-cancer death, compounded by overdiagnosis among screen-detected tumors, tempers the survival gain expected from aggressive treatment and makes overtreatment as real a hazard as age-based exclusion. A graded menu of options now exists, extending from minimally invasive lobectomy through sublobar resection and stereotactic ablative radiotherapy to active surveillance, and intensity should descend with reserve rather than with age. The task is to operationalize careful selection through structured geriatric assessment, multidisciplinary collaboration, prehabilitation, and shared decision-making, and to judge success by outcomes that older patients actually value.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1961761"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215954","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":"Pseudo-cerebrospinal fluid rhinorrhea following endoscopic endonasal transsphenoidal surgery for PitNET: a case report and literature review.","authors":"Guotao Peng, Jiankuai Zhou, Jun Mo","doi":"10.3389/fsurg.2026.1945557","DOIUrl":"10.3389/fsurg.2026.1945557","url":null,"abstract":"<p><p>Pseudo-cerebrospinal fluid (CSF) rhinorrhea, defined as non-CSF nasal discharge mimicking true CSF leakage, is a rare but clinically significant complication that may prompt unnecessary aggressive treatment. We report a case of a 64-year-old man who developed positional clear nasal discharge after endoscopic endonasal resection of recurrent pituitary neuroendocrine tumor (PitNET). Glucose oxidase testing was negative, and imaging demonstrated intact skull base reconstruction. Nasal endoscopy revealed bilateral crusting and purulent secretions without evidence of CSF leak. The condition was diagnosed as vasomotor rhinitis. Conservative management-including nasal debridement, antibiotic therapy, topical corticosteroids, and saline irrigation-led to complete symptom resolution. This case underscores the importance of differentiating pseudo-CSF rhinorrhea from true CSF rhinorrhea to avoid invasive interventions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1945557"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215816","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":"Risk factors and prediction model for post-endoscopic lithotripsy infections.","authors":"Xiaotao Liang, Ziyong Lei, Yuxi Chen, Wei Fang, Ruming Liu, Xiaoyu Liu, Yizhe Yang, Lianhong Gao, Yongming Jiang","doi":"10.3389/fsurg.2026.1861286","DOIUrl":"10.3389/fsurg.2026.1861286","url":null,"abstract":"<p><strong>Objective: </strong>To identify independent risk factors for infectious complications (fever, SIRS, sepsis) after endoscopic lithotripsy and construct a multi-outcome hierarchical prediction model.</p><p><strong>Methods: </strong>Retrospective study of 914 patients (<i>n</i> = 914). Primary analysis used multinomial logistic regression for sepsis; sensitivity analysis used binary logistic regression for fever and SIRS with backward elimination. Bootstrap validation, AUC, calibration (MAE), and DCA were performed.</p><p><strong>Results: </strong>Primary analysis: positive urine culture (OR = 3.36), previous surgery (OR = 3.62), radiological signs of infection (OR = 4.02), and combined surgery (OR = 4.95) were independent risk factors for sepsis (AUC=0.794, MAE=0.008). Fever model: radiological signs and surgical modality (AUC=0.715). SIRS model: radiological signs and ULE+++ (OR = 5.1, AUC=0.73). DCA showed net clinical benefit for all three models.</p><p><strong>Conclusion: </strong>The multi-outcome hierarchical model effectively predicts postoperative infection risk. Nomograms guide individualized perioperative interventions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1861286"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215760","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":"Modern hysteroscopic management of congenital uterine anomalies: current techniques, emerging technologies, and future directions.","authors":"Mariana da Cunha Vieira, Giovanna C C Martin, Katherine A R Miller, Juliana A Oliveira, Ana Clara P Servidoni, Mauricio S Abrao","doi":"10.3389/fsurg.2026.1931279","DOIUrl":"10.3389/fsurg.2026.1931279","url":null,"abstract":"<p><strong>Background: </strong>Congenital uterine anomalies are clinically relevant in reproductive medicine, particularly among women with infertility, recurrent pregnancy loss, adverse obstetric outcomes, or obstructive symptoms. Hysteroscopy has transformed the management of correctable intracavitary anomalies by enabling conservative, image-guided reconstruction of the uterine cavity while avoiding the morbidity of historical abdominal metroplasty.</p><p><strong>Scope: </strong>This narrative review critically examines contemporary hysteroscopic management of septate uterus, dysmorphic uterus, bicorporeal septate uterus and rare obstructive malformations, such as Robert's uterus. We discuss the implications of the ESHRE/ESGE, CUME, and ASRM classification systems; the role of three-dimensional transvaginal ultrasound and magnetic resonance imaging in preoperative mapping; and the technical principles that guide metroplasty, cavity remodeling, ultrasound-guided hysteroscopy, office-based metroplasty, and staged approaches in complex anatomy.</p><p><strong>Discussion: </strong>Bipolar saline-based platforms, miniaturized resectoscopes, bipolar needle electrodes, cold scissors, and selected tissue removal systems have expanded the therapeutic spectrum and improved safety. The evidence supporting surgery remains heterogeneous: the TRUST randomized trial challenged routine septum resection in unselected women, whereas data for T-shaped and other dysmorphic uteri remain largely observational. Emerging technologies, including laser platforms, artificial intelligence-assisted hysteroscopy, and robotic concepts, are promising, but currently lack prospective validation.</p><p><strong>Conclusion: </strong>Optimal management should therefore be individualized, anatomy-driven, and grounded in shared decision-making, with careful preservation of endometrium and myometrium. Standardized reporting, multicenter registries, and prospective comparative studies are needed to define which patients benefit most from hysteroscopic correction.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1931279"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215567","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":"Cross-cultural adaptation, validation, and arabic translation of the rhinoplasty outcome evaluation.","authors":"Feras Alkholaiwi, Yazeed Alghonaim","doi":"10.3389/fsurg.2026.1744891","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1744891","url":null,"abstract":"<p><strong>Background & aim: </strong>Rhinoplasty is among the most commonly performed cosmetic surgeries, yet patient satisfaction with this procedure tends to be lower compared to other facial aesthetic surgeries. To measure patient satisfaction following rhinoplasty, the Rhinoplasty Outcome Evaluation (ROE) questionnaire is employed. Therefore, this research was designed to determine the dependability and accuracy of the Arabic version of the ROE questionnaire.</p><p><strong>Methods: </strong>In this prospective study, the ROE questionnaire was administered to 76 patients who underwent rhinoplasty and seventy-four (74) volunteers who did not require functional or cosmetic nasal surgery. Started from June 2019 up to February 2021, The patients were followed up at 3 and 9 months after the procedure. To compare the initial distribution of questionnaire items between patients and control groups, an unpaired <i>t</i>-test was conducted. Internal consistency was assessed using Cronbach's <i>α</i> (Alpha). Hypothesis testing was performed with a significance threshold of 5%.</p><p><strong>Results: </strong>The control group exhibited a notably higher average total ROE score compared to the patient group, with scores of seventy-eight point six percent (78.6%) and forty-five point six per cent (45.6%), respectively (<i>P</i> < 0.001). Additionally, significant variations were identified in the mean scores of all questionnaire items when comparing baseline responses to both the first and second follow-up responses. The study tool's reliability, determined by Cronbach's <i>α</i> (Alpha), was reported to be 0.83.</p><p><strong>Conclusion: </strong>The Rhinoplasty Outcome Evaluation (ROE) questionnaire has been proven to be a reliable and valid tool for assessing outcomes in Arabic-speaking patients who have undergone rhinoplasty.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1744891"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192524","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":"Changes in parent-rated attention-deficit/hyperactivity disorder symptom scores and sleep parameters during individualized multidisciplinary clinical management in children with comorbid obstructive sleep apnea: a prospective cohort study in Vietnam.","authors":"Mai Nguyen-Thi-Phuong, Mai Nguyen-Thi-Thanh, Robert Joel Goldberg, Hoa L Nguyen, Thang Dac Hoang","doi":"10.3389/fsurg.2026.1941040","DOIUrl":"10.3389/fsurg.2026.1941040","url":null,"abstract":"<p><strong>Objective: </strong>To describe changes in parent-rated attention-deficit/hyperactivity disorder (ADHD) symptom scores, respiratory-polygraphy-derived parameters, and sleep characteristics over 6 months in children with ADHD and comorbid obstructive sleep apnea (OSA) who received individualized multidisciplinary clinical management.</p><p><strong>Methods: </strong>This single-arm prospective cohort study was conducted at Vietnam National Children's Hospital from November 2022 to October 2024. Among 629 children with ADHD screened using the Pediatric Sleep Questionnaire (PSQ), 293 had at least 8 positive responses and underwent home respiratory polygraphy; 147 had clinical features consistent with pediatric OSA and met the prespecified respiratory-polygraphy criterion of a respiratory event index (REI) ≥ 1 event/hour, and 141 completed follow-up. Parent-rated Vanderbilt ADHD Diagnostic Rating Scale (VADRS) scores were assessed at baseline, 3 months, and 6 months. Respiratory-polygraphy and sleep-diary measures were assessed at baseline and 6 months.</p><p><strong>Results: </strong>The mean age was 7.8 years, and 85.8% were boys. After 6 months, mean REI decreased from 11.8 to 4.4 events/hour, and the lowest nocturnal peripheral oxygen saturation (SpO₂) increased from 78.9% to 83.4% (both <i>p</i> < 0.001). Prespecified respiratory-polygraphy severity categories shifted toward less severe categories (McNemar-Bowker <i>χ</i> ²[6] = 70.80, <i>p</i> < 0.001); 73 children (51.8%) improved by at least one category, and 47 children (33.3%; 95% CI, 26.1-41.5%) no longer met the prespecified respiratory-polygraphy criterion for OSA at 6 months. Sleep-onset latency and daytime sleep duration decreased. Nighttime sleep duration increased from 8.4 ± 1.1 to 8.7 ± 0.6 h (mean change, +0.3 h; 95% CI, +0.14 to +0.46; <i>p</i> < 0.001), whereas total 24-h sleep duration decreased by 0.5 h (<i>p</i> < 0.001). Parent-rated ADHD symptom scores decreased across all VADRS domains.</p><p><strong>Conclusion: </strong>Respiratory-polygraphy-derived indices, selected sleep characteristics, and parent-rated ADHD symptom scores improved during 6 months of individualized multidisciplinary clinical management. The uncontrolled design and concurrent interventions preclude causal attribution of these changes to OSA-directed treatment.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1941040"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181589","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":"Research trends in minimally invasive partial splenectomy: a bibliometric mapping review with cross-database comparison.","authors":"Wei Tian, Xu Deng, Chunyuan Yang, Jianxing Tian, Zonglong Zhu, Rui Huang, Wei Pan","doi":"10.3389/fsurg.2026.1941549","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1941549","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive partial splenectomy (MIPS) is used for hereditary hematologic disorders, splenic cysts, hydatid disease, benign tumors, and selected traumatic lesions. However, its literature remains dispersed across patient groups, indications, and surgical specialties. This study mapped the development, contributors, knowledge base, and thematic structure of MIPS research and examined the concordance of its principal patterns across databases.</p><p><strong>Methods: </strong>Articles and reviews published from 1 January 1995 to 29 August 2026 were retrieved from the Web of Science Core Collection (WoSCC), Scopus, and PubMed. WoSCC supported the primary bibliometric and knowledge-mapping analyses; Scopus and PubMed supported cross-database comparisons. Bibliometrix, VOSviewer, and CiteSpace were used to analyze publication output, contributors, keywords, co-cited references, and citation bursts. Database overlap, annual-output correlations, and journal and theme descriptive agreement were also assessed.</p><p><strong>Results: </strong>The final datasets comprised 150 WoSCC, 154 Scopus, and 161 PubMed publications. WoSCC output increased after 2015 and reached 15 publications in 2024, the highest total among complete years. China contributed the most publications (<i>n</i> = 53), while the United States had the highest country-level total link strength. <i>Surgical Endoscopy</i>, <i>Journal of Pediatric Surgery</i>, and <i>Journal of Laparoendoscopic & Advanced Surgical Techniques</i> were the leading sources. Keyword analysis identified eight moderately coherent clusters (Q = 0.4383; mean silhouette = 0.6477), covering partial splenectomy, laparoscopic surgery, hydatid disease, hereditary spherocytosis, pediatric surgery, and operative techniques. Cross-database linkage identified 183 unique publications; 122 (66.7%) occurred in all three databases. Annual publication counts were strongly correlated for 1995-2025 (Spearman's <i>ρ</i> = 0.960-0.979) and after inclusion of partial-year 2026 data (<i>ρ</i> = 0.963-0.978; all <i>P</i> < 0.001). Eight journals appeared in all three database-specific Top-10 lists, and the leading thematic distributions were broadly similar across databases.</p><p><strong>Conclusion: </strong>MIPS research has expanded but remains relatively small, institutionally dispersed, and focused on operative feasibility, technical refinement, and perioperative outcomes. These broad patterns were consistent across the three databases, although the comparisons do not constitute independent external validation. Disease-stratified multicenter studies with standardized long-term assessment of splenic function are needed.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1941549"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192537","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}