Frontiers in Surgery最新文献

{"title":"Transforming spinal surgery: five years of navigation, workflow optimization and clinical impact.","authors":"Johannes Groh, Simon Schramm, Lilli Holzmann, Simon Wagner, Mario Perl, Johannes Krause","doi":"10.3389/fsurg.2026.1761489","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1761489","url":null,"abstract":"<p><strong>Background: </strong>Navigation-assisted spinal instrumentation is increasingly used in modern spine surgery, offering improvements in accuracy, workflow efficiency, and radiation safety. However, real-world implementation and the transition from fluoroscopy to navigation in high-volume trauma centers remain insufficiently described.</p><p><strong>Methods: </strong>This retrospective single-center study reviewed all dorsal spinal instrumentation procedures performed between 2015 and 2025 at a Level I trauma center. A total of 557 patients were analyzed: 119 navigated and 438 fluoroscopic procedures. Demographics, ASA classification, operative time, screw count, radiation parameters, anatomical distribution, and revision rates were compared, with specific focus on changes after the introduction of navigation in 2020.</p><p><strong>Results: </strong>Navigation use increased steadily and expanded from lumbar to more anatomically demanding regions. Navigated cases involved older patients with higher ASA scores. Although operative times were longer in navigated procedures, this was explained by higher screw counts, and time per screw did not differ significantly. A clear learning curve was observed, with time per screw improving from 27 (±22) to 19 (±7) minutes (<i>p</i> = 0.03). Radiation time was significantly lower in the navigated group, while total dose was comparable. Screw misplacement-related revisions were less frequent with navigation (1% vs. 5%), whereas wound-related revisions were more common, reflecting higher comorbidity and a greater proportion of open procedures.</p><p><strong>Conclusion: </strong>Navigation substantially altered clinical practice, leading to its predominant use in complex anatomies and higher-risk patients. It improved screw accuracy and reduced radiation exposure while maintaining procedural efficiency after the learning curve. With ongoing advances such as robotics, augmented reality, and markerless registration, the role of navigation in spinal trauma surgery is expected to expand further.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1761489"},"PeriodicalIF":1.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836706","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 short-term outcomes of open, laparoscopic, and robotic surgery for Kasai portoenterostomy in biliary atresia: a 10-year single center study.","authors":"Yuliang Jiang, Menglei Zhu, Jianlei Chen, Zhenwei Zhu, Haowei Zhao, Qi Wang, Ziang Wang, Jie Zhu, Peng Cai","doi":"10.3389/fsurg.2026.1789037","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1789037","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to clarify the comparative clinical efficacy and safety of open (OKPE), laparoscopic (LKPE), and robotic-assisted (RAKPE) approaches for Kasai portoenterostomy in patients with biliary atresia (BA).</p><p><strong>Methods: </strong>We retrospectively analyzed 50 patients diagnosed with type III BA who underwent Kasai portoenterostomy between January 2015 and December 2024. Based on the surgical approach, patients were categorized into three groups: OKPE (<i>n</i> = 21), LKPE (<i>n</i> = 18), and RAKPE (<i>n</i> = 11). Clinical characteristics, perioperative indicators, and short-term outcomes, including jaundice clearance (JC) at 6 months and one-year survival with native liver (SNL), were compared among the groups.</p><p><strong>Results: </strong>RAKPE was associated with a significantly longer operative time compared to LKPE and OKPE (310 ± 39 vs. 230 ± 34 vs. 200 ± 74 min; <i>P</i> < 0.001). OKPE showed shorter fibrous cone dissection time (47 ± 11 vs. 66 ± 7 vs. 66 ± 9 min; <i>P</i> < 0.001) and less dissection blood loss [2(2-3) vs. 4(3-5) vs. 3(2-4) mL; <i>P</i> < 0.001]. Conversely, minimally invasive approaches achieved faster oral feeding [10 (8-10) vs. 4.5 (4-5) vs. 4 (4-5) days; <i>p</i> < 0.001] and shorter hospital stay [29 (23-36) vs. 19 (15-27) vs. 18 (17-28) days; <i>P</i> = 0.003]. No significant differences were observed across the three groups regarding 6-month JC rates (67% vs. 61% vs. 55%; <i>P</i> = 0.81), postoperative cholangitis incidence (55% vs. 44% vs. 38%; <i>P</i> = 0.66), or one-year SNL rates (71% vs. 72% vs. 64%; <i>P</i> = 0.85).</p><p><strong>Conclusions: </strong>OKPE, LKPE, and RAKPE demonstrate comparable short-term efficacy and safety for type III BA. While OKPE offers technical advantages in hilar dissection, minimally invasive approaches significantly optimize postoperative recovery. Surgical technique selection should be individualized based on patient characteristics, surgeon experience, and institutional resources.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1789037"},"PeriodicalIF":1.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836765","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":"Graft rejection across solid organ transplants: mechanisms, monitoring, and immunosuppressive therapeutics.","authors":"Edward Akosah Danso, Malik Olatunde Oduoye, Williams Chukwuebuka Enuh, Umer Wamiq, Hafsa Shuja, Fnu Sawaira, Hareem Fatima, Sadia Tameez-Ud-Din","doi":"10.3389/fsurg.2026.1762417","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1762417","url":null,"abstract":"<p><strong>Background: </strong>Organ and tissue transplantation has transformed the management of end-stage organ failure, yet graft rejection remains a major barrier. Rejection arises from complex immune mechanisms involving MHC mismatch, T-cell allorecognition, and antibody-mediated injury. Advances in immunosuppressive therapy have improved graft survival, but significant challenges persist.</p><p><strong>Aim: </strong>This scoping review synthesizes current insights into the immunological basis of graft rejection and evaluates conventional, biologic, and emerging immunosuppressive strategies. Particular attention is given to organ-specific differences and newer fields such as vascularized composite allografts (VCA) and xenotransplantation.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Google Scholar, Cochrane, and ClinicalTrials.gov (updated June 2025) following PRISMA guidelines. Studies addressing mechanisms of rejection, therapeutic innovations, and clinical outcomes in solid organ transplantation were included.</p><p><strong>Results: </strong>Rejection manifests in distinct forms: hyperacute rejection, though rare due to modern screening, remains catastrophic when pre-existing antibodies are present; acute rejection affects 10%-20% of patients within the first year, driven by both T-cell and antibody-mediated pathways; and chronic rejection, emerging months to years later, leads to progressive fibrosis, vasculopathy, and graft loss across organs. The degree of HLA mismatch consistently emerged as the strongest predictor of long-term survival. Conventional regimens of corticosteroids, calcineurin inhibitors, and antimetabolites remain foundational but are limited by nephrotoxicity, metabolic complications, and infection risk. Biologics such as basiliximab, belatacept, and rituximab have introduced more targeted suppression, while innovative approaches, including regulatory T-cell therapy, tolerogenic dendritic cells, gene-editing strategies, and nanotechnology-based drug delivery, show promise. Despite these advances, long-term therapy is challenged by 20%-70% patient non-adherence, heightened infection risk, and malignancy.</p><p><strong>Conclusion: </strong>Future strategies must emphasize personalized, biomarker-guided regimens, immune tolerance induction, and AI-driven diagnostics to achieve durable graft acceptance with minimal complications. Integration of consensus frameworks and precision medicine approaches will be essential to improving long-term graft survival and patient health.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1762417"},"PeriodicalIF":1.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836633","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 management of stage 3 and 4 pressure injuries in trauma patients using ovine forestomach matrix grafts: a prospective case series.","authors":"Sophia M Trinh, Kaitlyn Andre, Ada I Özcan, Dhanushka S Vitharana, Paige E Deville, Joseph W Mason, John P Hunt, Alan B Marr, Patrick P Greiffenstein, Lance E Stuke, Alison A Smith","doi":"10.3389/fsurg.2026.1704665","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1704665","url":null,"abstract":"<p><strong>Introduction: </strong>Stage 3 and 4 pressure injuries (PIs) pose significant challenges in trauma patients. Surgical management aims to support improvements in tissue vitality and often relies on debridement and negative pressure wound therapy. The use of ovine forestomach matrix (OFM)-based grafts to augment existing surgical approaches may improve tissue quality prior to reconstruction or closure by secondary intention.</p><p><strong>Methods: </strong>This prospective observational study is part of a larger Institutional Review Board-approved study (Registry: ClinicalTrials.gov. Clinical trial number: NCT05243966). The study enrolled patients with Stage 3 and 4 PIs between July 2022 and July 2024 at a single level 1 trauma center. The study's primary endpoint was the incidence of postoperative complications and secondary endpoints included time to granulation tissue coverage and/or fill, percent area reduction, and number of OFM applications.</p><p><strong>Results: </strong>Nine participants (eight men, one woman) with a total of 12 PIs (25% Stage 3 and 75% Stage 4) were enrolled in the study. The mean surface area was 46 ± 24 cm², and 10 of the 12 enrolled PIs included areas of tunneling and/or undermining. The median time to 50% granulation tissue was 2.0 (IQR: 1.5, 8.5) weeks and the median time to complete granulation tissue coverage was 6.5 (IQR: 2.0, 15.0) weeks. Tunneling or undermining was eradicated in 50% of PIs. The mean percent area reduction at the last recorded visit was 61% ± 30%. There were no postoperative complications.</p><p><strong>Conclusion: </strong>These results suggest that OFM-based grafts may serve as a valuable adjunct for the surgical management of late-stage PIs that are clinically challenging to heal.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1704665"},"PeriodicalIF":1.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836685","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 decision-making in paediatric penetrating trauma: case report from two paediatric tertiary centres.","authors":"Simone Frediani, Lorenzo Nanni, Martina Granello, Ilaria Buconi, Angelo Zarfati, Filomena Valentina Paradiso, Antonella Accinni, Sara Silvaroli, Arianna Bertocchini, Federico Beati, Silvia Madafferi, Cristina Martucci, Valerio Pardi, Ivan Pietro Aloi","doi":"10.3389/fsurg.2026.1810768","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1810768","url":null,"abstract":"<p><strong>Introduction: </strong>Penetrating trauma in children is relatively uncommon but is associated with significant morbidity and mortality, particularly when major vascular or visceral structures are involved. Owing to anatomical and physiological differences, as well as limited paediatric-specific evidence, surgical decision-making remains challenging and often relies on extrapolation from adult data. This study aimed to describe the surgical decision-making strategies for haemodynamically stable paediatric patients with penetrating injuries, highlighting the roles of clinical assessment, imaging, and multidisciplinary management.</p><p><strong>Methods: </strong>We report a retrospective case series of three paediatric patients with penetrating trauma who were managed at two tertiary paediatric referral centres. The clinical presentation, diagnostic workup, surgical approach, and outcomes were analysed.</p><p><strong>Case description: </strong>All patients were haemodynamically stable on admission but presented with penetrating injuries involving high-risk anatomical regions. Contrast-enhanced computed tomography played a key role in the preoperative assessment of extremity injuries, whereas surgical exploration was deemed mandatory in the presence of abdominal evisceration, despite stable vital signs. A tailored surgical approach based on clinical and radiological findings allowed safe foreign body removal or exploratory surgery without major complications. No vascular or visceral injuries requiring repair were observed. The postoperative course was uneventful, and no early or late complications occurred during follow-up.</p><p><strong>Conclusion: </strong>Penetrating trauma in haemodynamically stable paediatric patients requires individualised decision-making, supported by careful clinical evaluation, appropriate imaging, and multidisciplinary collaboration. Selective surgical exploration guided by injury pattern and anatomical risk can result in favourable outcomes while avoiding unnecessary procedures.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1810768"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813792","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: Cholesteatoma surgery: treatment outcome and follow up.","authors":"Hans Thomeer, Paul Merkus, Nicolas Verhaert, Marc Lammers","doi":"10.3389/fsurg.2026.1834766","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1834766","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1834766"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813808","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: Managing COVID-19 in heart and lung transplantation: clinical challenges and emerging solutions.","authors":"Chengliang Yang, Wenjun Mao, Ömer Senbaklavaci","doi":"10.3389/fsurg.2026.1843253","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1843253","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1843253"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813772","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":"3D printing technology-assisted total hip arthroplasty for acute proximal femoral fracture and Hartofilakidis type II developmental dysplasia of the hip: a case report and literature review.","authors":"Hang Wen, Ming Liu, Bin Zhang, Yong Chen","doi":"10.3389/fsurg.2026.1752462","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1752462","url":null,"abstract":"<p><p>Developmental dysplasia of the hip (DDH) associated with an acute proximal femoral fracture on the same side is uncommon, and performing a one-stage total hip arthroplasty (THA) with concurrent fracture stabilization in such cases poses significant technical challenges. We present a case involving a 57-year-old female with a long history of right-sided DDH who was involved in a vehicular accident, leading to acute pain in her right hip, shortening of the limb, and restricted movement. Imaging studies indicated Hartofilakidis type II DDH along with a comminuted intertrochanteric fracture of the proximal femur and a pseudoacetabulum. Utilizing thin-slice computed tomography, we created a customized three-dimensional (3D) printed model of the pelvis and proximal femur, which allowed for detailed preoperative planning. This included evaluating the acetabular bone quality, identifying the true center of the acetabulum, selecting the appropriate cup size and orientation, and strategizing the femoral osteotomy and fixation with plates and cables. A one-stage cementless THA was executed through a posterolateral approach, featuring a small hemispherical cup securely placed in the true acetabulum and a size-16 biological femoral stem anchored distally across the fracture site, followed by the application of a lateral plate and titanium cable to stabilize the proximal femoral fracture. The patient began ambulation with the assistance of a walker on postoperative day 1. At 2 months after surgery, the pain score had decreased to 1/10 on the visual analog scale (VAS), and radiographic evaluation demonstrated ongoing fracture healing. By 3 months postoperatively, the patient was pain-free (VAS 0/10), had achieved a Harris Hip Score of 92, and showed restoration of lower-limb length. Imaging confirmed fracture union and stable prosthesis positioning, and the patient had returned to work independently. This case suggests that individualized 3D printing-assisted preoperative planning may improve the feasibility and early safety of one-stage cementless total hip arthroplasty combined with internal fixation for adult DDH with an ipsilateral proximal femoral fracture, and may provide a useful reference for preoperative decision-making in similarly complex cases.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1752462"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813649","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":"Minimally invasive vs. open hepatectomy in patients with obesity and liver tumors: a systematic review and meta-analysis.","authors":"Song Jiang, Wanjuan Li, Hongwei He, Yongchuan Huang, Wensong Liu, Qi Zheng","doi":"10.3389/fsurg.2026.1718991","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1718991","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive hepatectomy (MIH) has been considered a safe and feasible treatment approach for liver resection in recent years. However, the application of MIH in patients with obesity still remains controversial, and the outcomes of MIH vs. open hepatectomy (OH) have not been fully evaluated. Our objective is to compare the surgical outcomes of MIH with OH in patients with obesity and liver tumors.</p><p><strong>Methods: </strong>All studies comparing MIH with OH in patients with obesity and liver tumors were identified through a systematic search of the PubMed, Embase, Web of Science, Cochrane Library, WanFang, and CNKI databases. Statistical analysis was conducted using Review Manager version 5.4 software. The final search was conducted on 20 May 2025. The surgical outcomes included operative time, blood loss, blood transfusion rate, tumor size, overall and major postoperative complications, biliary leakage, liver failure, mortality, and length of hospital stay.</p><p><strong>Results: </strong>Eleven studies with a total of 1,713 patients were included in this meta-analysis. Compared with OH, MIH was associated with a shorter operative time [weighted mean difference (WMD) = -54.50, 95% confidence interval (CI) = -96.28 to -12.72, <i>P</i> = 0.01], reduced blood loss (WMD = -416.80, 95% CI = -579.84 to -253.76, <i>P</i> < 0.00001), and a lower blood transfusion rate (OR =  0.31, 95% CI = 0.19-0.48, <i>P</i> < 0.00001). In addition, MIH was associated with lower rates of overall complications (OR =  0.60, 95% CI = 0.48-0.75, <i>P</i> < 0.0001), major complications (OR =  0.61, 95% CI = 0.42-0.89, <i>P</i> = 0.01), biliary leakage (OR =  0.48, 95% CI = 0.26-0.88, <i>P</i> = 0.02), and liver failure (OR =  0.26, 95% CI = 0.08-0.93, <i>P</i> = 0.04) and shorter postoperative hospital stay (WMD = -7.21, 95% CI = -10.22 to -4.21, <i>P</i> < 0.00001). Tumor size was smaller in the MIH group (WMD = -1.06, 95% CI = -1.70 to -0.41, <i>P</i> = 0.001). However, there was no significant difference in mortality between the MIH and OH groups (OR =  0.68, 95% CI = 0.45-1.03, <i>P</i> = 0.07).</p><p><strong>Conclusions: </strong>The results suggested that MIH is associated with shorter operative time, reduced blood loss, lower blood transfusion rate, decreased rates of overall complications, major complications, biliary leakage, and liver failure, and a shorter hospital stay. However, no significant difference in mortality was observed between the MIH and OH groups. MIH appears to be a safe and effective treatment option for patients with obesity and liver tumors.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024502015, PROSPERO CRD 42024502015.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1718991"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813747","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 extraction of a metal ring embedded in the penis for five years: a case report.","authors":"Chaodong Shen, Mengqi Shi, Zhirong Zhu","doi":"10.3389/fsurg.2026.1807432","DOIUrl":"https://doi.org/10.3389/fsurg.2026.1807432","url":null,"abstract":"<p><strong>Introduction: </strong>Penile strangulation represents an uncommon urological emergency that has been increasingly reported in recent literature. However, chronic penile strangulation resulting from subcutaneous embedding of foreign objects is even more rare.</p><p><strong>Case presentation: </strong>A male patient presented to the urology outpatient clinic with progressive swelling at the penile base and purulent discharge from the urethral meatus. Clinical evaluation revealed a metal ring that had been placed at the penile base for five years and had gradually become embedded beneath the skin, rendering it invisible to the naked eye. During surgery, an annular metal object was exposed following an incision of the penile skin and successfully removed without urethral injury. At one-month postoperative follow-up, proper wound healing and normal urinary function were observed.</p><p><strong>Conclusion: </strong>This report describes an exceptionally rare case of chronic penile strangulation. Successful surgical removal of the embedded metal ring was achieved with minimal complications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"13 ","pages":"1807432"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813726","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}