Frontiers in Surgery最新文献

{"title":"Editorial: Translational research in surgical applications and spinal tumors.","authors":"Madison J Michles, Margot Martinez Moreno, Patricia L Zadnik Sullivan, Ziya L Gokaslan","doi":"10.3389/fsurg.2024.1492713","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1492713","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1492713"},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846306","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":"Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting.","authors":"Mestet Yibeltal Shiferaw, Abat Sahlu Baleh, Abel Gizaw, Tsegazeab Laeke Teklemariam, Abenezer Tirsit Aklilu, Atalel Fentahun Awedew, Denekew Tenaw Anley, Bereket Hailu Mekuria, Ermias Fikiru Yesuf, Mengistu Ayele Yigzaw, Henok Teshome Molla, Mekides Muse Awano, Alemu Adise Mldie, Endeshaw Chekole Abebe, Nebyou Hailu, Sura Daniel, Dejen Teke Gebrewahd","doi":"10.3389/fsurg.2024.1398829","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1398829","url":null,"abstract":"<p><strong>Objective: </strong>Globally, skull base tumors are among the most challenging tumors to treat and are known for their significant morbidity and mortality. Hence, this study aimed to identify robust associated factors that contribute to mortality of patients following surgical resection for a variety of skull base tumors at the 3-month follow-up period. This in turn helps devise an evidence-based meticulous treatment strategy and baseline input for quality improvement work.</p><p><strong>Methodology: </strong>A retrospective cohort study of patients undergoing skull base tumor resection was conducted at two large-volume neurosurgery centers in Ethiopia. The categorical variables were expressed in frequencies and percentages. Normal distribution of continuous data was checked by histogram and the Shapiro-Wilk test. Median with interquartile range (IQR) was calculated for skewed data, while mean with standard deviation (SD) was used for normally distributed data. Odds ratio and adjusted odds ratio (AOR) were used to express the result of univariate and multivariate binary logistic analyses, respectively. A <i>p</i>-value <0.005 was considered statistically significant at 95% confidence interval (CI).</p><p><strong>Result: </strong>The study involved 266 patients. Of this, women accounted for 63.5% of patients. The median age of patients was 37 (±IQR = 17) years while the median size of the tumor in this study was 4.9 (±IQR 1.5) cm. The mean duration of symptoms at time of presentation was 17.3 (±SD = 11.1) months. Meningioma, pituitary adenoma, and craniopharyngioma contributed to 68.4%, 19.2%, and 9% of the skull-based tumors, respectively. Mortality following skull base tumor resection was 21.1%. On multivariable binary logistic regression analysis, intraoperative iatrogenic vascular insult (AOR = 28.76, 95% CI: 6.12-135.08, <i>p</i> = 0.000), intraventricular hemorrhage (AOR = 6.32, 95% CI: 1.19-33.63, <i>p</i> = 0.031), hospital-associated infection (AOR = 6.96, 95% CI: 2.04-23.67, <i>p</i> = 0.002), and extubation time exceeding 24 h (AOR = 12.89, 95% CI: 4.89-40.34, <i>p</i> = 0.000) were statistically significant with 3-month mortality.</p><p><strong>Conclusion: </strong>Mortality from skull base tumor resection remains high in our setting. Holistic pre-operative surgical planning, meticulous intraoperative execution of procedures, and post-operative dedicated follow-up of patients in a neurointensive care unit alongside quality improvement works on identified risks of mortality are strongly recommended to improve patient outcomes. The urgent need for setup improvement and further training of neurosurgeons is also underscored.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1398829"},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853591","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: A young man with frontal traumatic sinus pericranii.","authors":"Zihao Zhang, Qingpei Hao, Ruirui Luan, Guangbiao Qin, Ruen Liu","doi":"10.3389/fsurg.2024.1479233","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1479233","url":null,"abstract":"<p><p>Sinus pericranii is a rare venous anomaly characterized by abnormal communication between intracranial and subperiosteal veins, and reports of trauma-induced sinus pericranii are even rarer. Herein, we report a case of delayed-onset sinus pericranii resulting from a traumatic injury to the left side of the midline of the forehead sustained in early childhood. The anomaly was successfully resected via a coronal incision within the hairline, followed by meticulous bone wax sealing. In this paper, we aim to provide details on the diagnosis and surgical techniques of trauma-induced sinus pericranii, contributing valuable insights for the management of such rare condition.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1479233"},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846221","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":"Platelet rich fibrin three-layer reconstruction of the sellar floor after endoscopic endonasal transsphenoidal approach: technical note and initial experience.","authors":"Mukesch Johannes Shah, Katerina Argiti, Julia M Nakagawa, Angeliki Stathi, Emilia Schönen, Daniel Strahnen, Kevin Joseph, Jakob Straehle, Nicolas Neidert, Jürgen Beck, Ioannis Vasilikos","doi":"10.3389/fsurg.2024.1500158","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1500158","url":null,"abstract":"<p><strong>Background: </strong>Cerebrospinal fluid (CSF) leakage frequently complicates endoscopic endonasal transsphenoidal pituitary resections, despite the use of lumbar drains, nasoseptal flaps, or commercial dura sealants. Managing this complication often requires revision surgery and increases the risk of infection. Platelet-rich fibrin (PRF), an affordable autologous biomaterial derived from the patient's blood through short, angulated centrifugation, contains growth factors and leukocytes embedded in a fibrin matrix. PRF exhibits regenerative properties in various surgical disciplines. This study assesses a three-layer sellar reconstruction method employing solid membranous (s-PRF) and high-viscosity injectable (i-PRF) forms of PRF.</p><p><strong>Materials and methods: </strong>We present our initial experience on a series of 22 patients with pituitary macroadenomas. For all patients, an endoscopic transnasal transsphenoidal approach was selected. Following the resection of the pathology, sellar reconstruction was accomplished using a three-layer orthobiologic technique. A membranous s-PRF was utilized as an inlay inside the opened sellar floor, followed by a layer of injectable i-PRF finally covered with another s-PRF membrane over the top to the sellar corridor.</p><p><strong>Results: </strong>In all cases the implementation of the proposed three-layer PRF reconstruction strategy was feasible and safe. During the 12-month follow-up period there were no adverse effects reported associated with the PRF application. 77% (17/22) of the patients demonstrated intraoperatively a cerebrospinal fluid (CSF) leak (Esposito Grade 1-3). In total, the proposed PRF reconstruction effectively prevented postoperative CSF leaks in 95% of the patients and in 94% of those with an Esposito Grade 1-3. One of the two patients with intraoperative Esposito Grade 3 developed a CSF leak on the first postoperative day, which was successfully managed with a lumbar drain for 5 days.</p><p><strong>Conclusion: </strong>Sellar reconstruction after endoscopic endonasal transsphenoidal resection of pituitary adenomas with PRF is feasible and safe. The three layer PRF augmentation is a novel technique to prevent CSF-leakage.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1500158"},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846308","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":"Challenges following CRS and HIPEC surgery in cancer patients with peritoneal metastasis: a comprehensive review of clinical outcomes.","authors":"Mehdi Karimi, Niyousha Shirsalimi, Eshagh Sedighi","doi":"10.3389/fsurg.2024.1498529","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1498529","url":null,"abstract":"<p><p>Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are a pair of relatively modern therapeutic surgical methods in advanced cancerous patients with peritoneal metastasis (PM). The goal of CRS + HIPEC is treatment or to improve survival outcomes, which are linked to high morbidity side effects and complications, even with their possible advantages. Surgical-related, chemotherapy-related, anesthetic-related, gastrointestinal, organs and systemic complications are the categories into which complications are separated according to frequency, risk factors, and effect on patient outcomes. In this narrative review of the literature, the side effects and complications of HIPEC + CRS in cancer patients with PM are examined. The present knowledge on the incidence, frequency, kinds, and risk factors of acute complications following CRS + HIPEC is summarized in this study. This review emphasizes the need for careful patient selection criteria, precise surgical technique, and thorough intraoperative care to reduce or manage these risks. Moreover, it highlights the need for interdisciplinary collaboration in treating these patients. This study aims to know these complications, improve clinical practice, and guide future studies to increase the safety and efficacy of CRS + HIPEC in treating metastatic colorectal cancer.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1498529"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835334","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: Surgical management of medial collateral ligament calcification.","authors":"Yihang You, Zhenhua Li, Jie Guo, Tao Zhang","doi":"10.3389/fsurg.2024.1506867","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1506867","url":null,"abstract":"<p><p>Calcification is a self-limiting disease, characterized by the deposition of calcium, causing severe pain, swelling, and movement disorder. It is mainly found in the shoulder joint but has also been reported in other joints such as the wrist, hip, knee, foot, and ankle. However, calcification of the medial collateral ligament (MCL) has been rarely reported. The patient was a 47-year-old female without any trauma, whose chief complaint was pain and impaired flexion-extension of the affected knee joint. The diagnosis was calcification of the MCL, subsequently demonstrated by imaging examination. Conservative treatment was initially attempted, followed by arthroscopic surgery, and the postoperative pathological results confirmed the calcified tendon. The patient had a favorable prognosis 1 month after the procedure. This study demonstrates that arthroscopic surgery can result in effective and swift recovery of clinical outcomes for patients with calcification of the MCL.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1506867"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835329","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":"Untangling sporadic brain arteriovenous malformations: towards targeting the KRAS/MAPK pathway.","authors":"Rashad Jabarkheel, Lun Li, Maxwell Frankfurter, Daniel Y Zhang, Avi Gajjar, Najib Muhammad, Visish M Srinivasan, Jan-Karl Burkhardt, Mark Kahn","doi":"10.3389/fsurg.2024.1504612","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1504612","url":null,"abstract":"<p><p>Brain arteriovenous malformations (AVMs) are vascular lesions characterized by abnormal connections between parenchymal arteries and veins, bypassing a capillary bed, and forming a nidus. Brain AVMs are consequential as they are prone to rupture and associated with significant morbidity. They can broadly be subdivided into hereditary vs. sporadic lesions with sporadic brain AVMs representing the majority of all brain AVMs. However, little had been known about the pathogenesis of sporadic brain AVMs until the landmark discovery in 2018 that the majority of sporadic brain AVMs carry somatic activating mutations of the oncogene, <i>Kirsten rat sarcoma viral oncogene homologue</i> (<i>KRAS</i>), in their endothelial cells. Here, we review the history of brain AVMs, their treatments, and recent advances in uncovering the pathogenesis of sporadic brain AVMs. We specifically focus on the latest studies suggesting that pharmacologically targeting the KRAS/MEK pathway may be a potentially efficacious treatment for sporadic brain AVMs.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1504612"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835350","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":"Incidence and risk factors for unplanned readmission after total hip arthroplasty for osteonecrosis of the femoral head.","authors":"Meng Wang, Xuemei Yang, Junyong Li, Chengsi Li, Yulong Zhang, Xuewei Hao","doi":"10.3389/fsurg.2024.1408343","DOIUrl":"10.3389/fsurg.2024.1408343","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence, primary causes, and risk factors for unplanned readmissions within one year after the first primary total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH).</p><p><strong>Methods: </strong>Data were retrospectively collected from patients who had undergone the first primary THA for ONFH at two tertiary hospitals between January 2021 and December 2022, with complete 1-year follow-up assessments. Patients who experienced an unplanned readmission within 1 year were classified as the readmission group, while the others as the non-readmission group. The incidence rate and primary causes of unplanned readmission were determined, and the risk factors were identified through univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 594 eligible patients were included, with 363 being men (61.1%) and an average age of 59.2 years at the time of surgery. Forty-seven patients were readmitted within one year, representing an accumulated rate of 7.9%. Among these, 18 (38.3%) readmissions occurred within 30 days and 27 (57.4%) within 90 days. The primary reasons for readmissions included hip dislocation (35.3%), followed by periprosthetic fracture, deep vein thrombosis, delayed incision healing, surgical site infection and others. The multivariate regression model revealed that age (every 10-year increment, OR, 1.39; 95% CI, 1.12-1.88), ARCO stage IV vs. Ⅲ (OR, 3.72; 95% CI, 1.96-7.22), CCI ≥4 vs. <4 (OR = 5.49; 95% CI, 2.16-13.77), admission anemia (OR, 2.72; 95% CI, 1.37-6.83) and surgeon inexperience (OR, 2.74; 95% CI, 1.29-6.73) were significantly associated with unplanned readmission.</p><p><strong>Conclusions: </strong>These findings provide valuable clinical insights into unplanned readmission after THA for ONFH and may aid in preoperative counselling for patients and enhance perioperative care.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1408343"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828069","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":"Surgeons' opinions and concerns regarding prophylactic mesh placement when conducting a permanent ileo- and colostomy A survey among 172 surgeons in Germany, Switzerland, and Austria.","authors":"Christoph Paasch, Egan Leonidovich Kalmykov, Ralph Lorenz, Nele Neveling, Rene Mantke","doi":"10.3389/fsurg.2024.1479870","DOIUrl":"10.3389/fsurg.2024.1479870","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic mesh placement when creating a permanent colostomy was recommended by the 2017 European Hernia Society guidelines on the prevention and treatment of parastomal hernias (GPTPH2017). The extent of this recommendation is under debate based on the long-term data from clinical trials. Our aim was to conduct a survey of surgeons revealing perspectives and concerns regarding GPTPH2017 and to discuss their concerns.</p><p><strong>Methods: </strong>From January 2023 to September 2023 a survey among surgeons of Germany, Switzerland and Austria was conducted. The questionnaire addressed demographic data of the participants, information on work experience/location, number of elective permanent colo- and ileostomies, and opinions on the recommendation of GPTPH2017 for prophylactic mesh placement.</p><p><strong>Results: </strong>A total of 172 surgeons from Germany, Austria and Switzerland answered the questionnaire and 59 of them stated professional experience of 20-30 years. Most of the surgeons (<i>n</i> = 51, 31.3%) worked in a primary care hospital. A total of 112 participants were familiar with the GPTPH2017. Sixty-five surgeons (40%) stated that they never conduct a prophylactic mesh placement when creating an elective permanent colostomy (rarely, <i>n</i> = 44 (26.7%). Seven participants always place a mesh (4.2%, missing data: 7). Main concerns regarding prophylactic mesh placement was the concern of surgeons about wound infection (<i>n</i> = 107, 67.7%) and lack of evidence (<i>n</i> = 65, 41.1%). For some participants the GPTPH2017 is seen to be industry-driven with low evidence, too old and leading to overtreatment.</p><p><strong>Conclusions: </strong>The main reason for not placing a prophylactic mesh when conducting a permanent colostomy was the risk of wound infection.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1479870"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827633","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":"Urethra-preserving and dorsal capsule fenestration with robot-assisted simple prostatectomy for severe LUTS in small prostate: a case report.","authors":"Lijie Wen, Yue Zhang, Yi He, Yang Yu, Bo Yang","doi":"10.3389/fsurg.2024.1497556","DOIUrl":"10.3389/fsurg.2024.1497556","url":null,"abstract":"<p><strong>Background: </strong>Small prostates (volume <30 ml) induce bladder outlet obstruction with pathophysiological changes distinct from those associated with large prostates. Treatment options often include transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Existing treatments have issues with high recurrence and complication rates. Therefore, we aim to explore a new minimally invasive surgical approach for patients with severe lower urinary tract symptoms (LUTS) and a small prostate.</p><p><strong>Methods: </strong>A patient with severe LUTS and a small prostate was admitted to the Department of Urology at the Second Hospital of Dalian Medical University. The patient had no median lobe but presented with multiple bladder stones. Relevant data (IPSS score, urine flow rate, operation time, hemoglobin drop, catheterization time, hospitalization time, residual urine) were collected before and after surgery to assess the safety and efficiency.</p><p><strong>Results: </strong>The patient was 72 years old with a prostate volume of 22.14 ml, a preoperative IPSS score of 28, PSA of 0.314 ng/ml, maximum urine flow rate of 3.5 ml/s, and a prostate MRI PI-RADS score of 2. The patient underwent robot-assisted cystolithotomy, urethra-preserving prostatectomy and dorsal capsule fenestration. The surgery lasted 105 min, with a postoperative hemoglobin drop of 3 g/L. There was no continuous bladder irrigation postoperatively, and the catheter was removed after 10 days. The patient was hospitalized for 4 days and followed up for 24 months. At 6 months postoperative, the patient had an IPSS score of 6, a QoL score of 1, a urine flow rate of 18 ml/s, and residual urine of 8 ml, with nocturia occurring 1-2 times. At 24 months postoperative, the patient had an IPSS score of 7, a QoL score of 1, a urine flow rate of 21 ml/s, and residual urine of 15 ml, with nocturia occurring 1 time.</p><p><strong>Conclusion: </strong>Robot-assisted urethra-preserving prostatectomy and dorsal capsule fenestration is a promising alternative treatment for patient with severe LUTS due to a small prostate in both long-term safety and efficacy. Further large-sample controlled studies are needed for additional evaluation and validation.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1497556"},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817772","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}