Frontiers in Surgery最新文献

{"title":"Conservative management of asymptomatic vertebral artery stent fracture with fragment embolisation to V3 segment: a case report.","authors":"Bin Hou, Chuangzhong Li, Yuan Cao, Xiaogang Wang, Dandan Gao, Ligang Chen","doi":"10.3389/fsurg.2025.1659557","DOIUrl":"10.3389/fsurg.2025.1659557","url":null,"abstract":"<p><strong>Introduction: </strong>Stent fracture represents a recognised but rare complication tied to vertebral artery origin stenting.</p><p><strong>Methods: </strong>We present a male who was diagnosed with left vertebral artery origin stenosis due to vertigo and diplopia, and who was deployed with a rapamycin-eluting stent. One-year follow-up computed tomography angiography demonstrated mid-stent fracture with distal fragment migration into the V3 segment, but the patient was asymptomatic and managed medically with close surveillance.</p><p><strong>Results: </strong>This case elucidates that rapamycin-eluting stents are an effective treatment for stenosis at the vertebral artery origin.</p><p><strong>Discussions: </strong>In rare instances involving complete stent fracture and migration of distal debris, conservative management may be a feasible option for asymptomatic patients.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1659557"},"PeriodicalIF":1.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231931","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":"Effect of the thumbtack needle on gastrointestinal function recovery after laparoscopic radical gastrectomy for gastric cancer with the concept of enhanced recovery after surgery: a randomized controlled trial.","authors":"Shuai Guo, Xiang-Ping Lin, Xiang-Ren Jin, Kang-Xiu Tuo, Pei Li, Wei-Wei Yang, Qian Wang","doi":"10.3389/fsurg.2025.1612766","DOIUrl":"10.3389/fsurg.2025.1612766","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Postoperative gastrointestinal (GI) dysfunction is a common complication in patients undergoing gastric cancer surgery. This study aimed to evaluate the effect of thumbtack needle therapy on GI function recovery after laparoscopic radical gastrectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants were randomly assigned to either the treatment or control group. Both groups received perioperative enhanced recovery after surgery management. Participants in the treatment group received thumbtack needle therapy at bilateral Neiguan (PC6), Zusanli (ST36), Shangjuxu (ST37), Hegu (LI4), and Sanyinjiao (SP6). Primary outcomes included the time to bowel sound recovery and time to first flatus (all measured in hours). Secondary outcomes included the time to first defecation, time to removal of the nasogastric tube and intra-abdominal drains (all measured in hours), postoperative pain scores, nausea and vomiting scores, abdominal distension scores (all measured in points), length of hospital stay (days), incidence of complications (%), safety evaluation, and overall response rate (%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 103 participants were screened, and 80 were enrolled (40 per group). Baseline characteristics were similar between groups. Compared with the control group, the treatment group showed significantly shorter times to bowel sound recovery (difference, -4.0 h, 95% CI: -7.0 to -1.0, &lt;i&gt;P&lt;/i&gt; = 0.010), first flatus (-11.0 h, 95% CI: -19.0 to -2.0, &lt;i&gt;P&lt;/i&gt; = 0.017), first defecation (-8.0 h, 95% CI: -16.0 to -1.0, &lt;i&gt;P&lt;/i&gt; = 0.026), nasogastric tube removal (-12.0 h, 95% CI: -27.0 to -2.0 &lt;i&gt;P&lt;/i&gt; = 0.023), and intra-abdominal drain removal (-10.0 h, 95% CI: -21.0 to -1.0, &lt;i&gt;P&lt;/i&gt; = 0.038). Pain scores were significantly lower in the treatment group on postoperative day (POD) 1 (-1, 95% CI: -1 to 0, &lt;i&gt;P&lt;/i&gt; = 0.031), POD 2 (-1, 95% CI: -2 to -1, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), and POD 3 (-1, 95% CI: -2 to 0, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Similar improvements were observed in nausea, vomiting, and abdominal distension scores on POD 1-3 (all showing a median difference of -1, all &lt;i&gt;P&lt;/i&gt; &lt; 0.05). The treatment group also had a significantly shorter hospital stay (difference, -1.7 days, 95% CI: -3.0 to -0.3, &lt;i&gt;P&lt;/i&gt; &lt;i&gt;=&lt;/i&gt; 0.015). There was no significant difference in the incidence of postoperative complications (difference, -5.0%, 95% CI: -18.6 to 8.0, &lt;i&gt;P&lt;/i&gt; &lt;i&gt;=&lt;/i&gt; 0.396), and no adverse reactions occurred in the treatment group. The overall response rate was significantly higher in the treatment group (difference, 17.5%, 95% CI: 0.18-34.0, &lt;i&gt;P&lt;/i&gt; &lt;i&gt;=&lt;/i&gt; 0.046).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Thumbtack needle therapy at bilateral Neiguan (PC6), Zusanli (ST36), Shangjuxu (ST37), Hegu (LI4), and Sanyinjiao (SP6) is a safe and effective intervention that promotes early recovery of GI function after laparoscopic radical gastrectomy for gastric cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial registration: &lt;/strong&gt;http://www.chictr.o","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1612766"},"PeriodicalIF":1.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232039","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":"A clinical risk prediction model for perioperative lower extremity DVT in patients undergoing spinal fracture surgery.","authors":"ShuYuan Zhuang, Jing Wang, Peng Du, SiHong Dong, Jiao Wu, DeLong Li, YuanTong Zang, Li Li","doi":"10.3389/fsurg.2025.1597101","DOIUrl":"10.3389/fsurg.2025.1597101","url":null,"abstract":"<p><strong>Objective: </strong>To develop a perioperative lower-extremity deep vein thrombosis (DVT) risk prediction model for spinal fracture surgery patients using logistic regression, supporting clinical prevention strategies.</p><p><strong>Methods: </strong>Clinical data from 249 patients undergoing spinal fracture surgery (July 2019-October 2024) were retrospectively analyzed. Participants were divided into a model group (<i>n</i> = 166) and a validation group (<i>n</i> = 83) in a 2:1 ratio. Univariate and multivariate logistic regression identified independent risk factors for perioperative DVT, and a predictive model was established. Model fit was evaluated using the Hosmer-Lemeshow test, and predictive performance was assessed via receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Independent risk factors included perioperative blood transfusion, elevated C-reactive protein, D-dimer >500 μg/L, hypertension, age ≥60 years, and prolonged bed rest. The model [<i>P</i> = 1/(1 + e^-Z)] demonstrated a good fit (Hosmer-Lemeshow <i>χ</i> ² = 12.139, <i>P</i> = 0.807). ROC analysis showed AUC values of 0.75 (95% CI: 0.80-0.92) for the model group and 0.81 (95% CI: 0.64-0.98) for the validation group, indicating robust predictive performance.</p><p><strong>Conclusion: </strong>The identified risk factors are critical predictors of perioperative DVT in spinal fracture patients. The proposed model exhibits strong clinical utility for early risk stratification and intervention guidance.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1597101"},"PeriodicalIF":1.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231961","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":"Machine learning-based assessment of condylar changes after orthognathic surgery of asymmetric dentofacial deformities.","authors":"Jin Tang, Jiayu Shi, Shuguang Liu","doi":"10.3389/fsurg.2025.1594849","DOIUrl":"10.3389/fsurg.2025.1594849","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study aimed to investigate three-dimensional (3D) condyle change including volumetric, positional, rotational alterations in patients with asymmetric dentofacial deformities immediate and long after bimaxillary orthognathic surgery.</p><p><strong>Methods: </strong>The sample included 36 patients who underwent bimaxillary orthognathic surgery, with a maxillomandibular dental midline deviation >3 mm, excluding those with class II/III malocclusions and craniofacial syndrome. A fully automated deep learning-based assessment method was used to analyze the volume, position and rotation of condyle based on Cone-beam Computed Tomography (CBCT) images. Repeated measures ANOVA was used to compared the changes at three intervals-pre-surgery (T0), one-week post-surgery (T1), and six months post-surgery (T2)-of the deviated sides and non-deviated sides condyle.</p><p><strong>Results: </strong>The condyle on the deviated side was smaller than that on the non-deviated side, with significant volume reductions observed six months post-surgery on the deviated side. Several condylar changes were observed immediately after surgery, though of small magnitude, and it mostly tended to return to their original positions 6 months after surgery. However, the condyle rotated laterally on the deviated side and medially on the non-deviated side post operation and in long-term.</p><p><strong>Conclusion: </strong>For patients with asymmetry, condyle on the deviated side undergo greater remodeling than the non-deviated side after orthognathic surgery. There are measurable rotations in the coronal plane of condyle on both sides.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1594849"},"PeriodicalIF":1.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232151","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":"The uncertain fate of a wandering appendicolith: personal experience and literature review.","authors":"Andrea Cavallaro, Antonio Zanghì, Paolo Di Mattia, Filippo Sanfilippo, Luigi La Via, Giordana Riccioli, Alessandro Cappellani, Kenya Tiralongo","doi":"10.3389/fsurg.2025.1646625","DOIUrl":"10.3389/fsurg.2025.1646625","url":null,"abstract":"<p><strong>Introduction: </strong>Retained appendicoliths are an uncommon but clinically relevant complication of appendectomy, particularly in cases of perforated appendicitis. Migration of the appendicolith into the peritoneal cavity or liver may lead to persistent or recurrent abscess formation.</p><p><strong>Case description: </strong>We present the case of a 29-year-old male with recurrent hepatic abscesses following laparoscopic appendectomy. Initial CT and MRI imaging revealed calcified components within the liver consistent with a migrated appendicolith. Despite percutaneous drainage and antibiotic therapy, the patient experienced relapse. Definitive resolution was achieved through laparoscopic hepatic resection and removal of the retained appendicolith.</p><p><strong>Discussion: </strong>This case highlights the diagnostic challenges and potential complications associated with retained appendicoliths. Imaging plays a crucial role in identification and management. While conservative approaches may be attempted, surgical retrieval is often required to prevent recurrent infections.</p><p><strong>Conclusion: </strong>Retained appendicoliths should be considered in the differential diagnosis of hepatic abscesses following appendectomy. Timely diagnosis and complete removal are essential to avoid long-term morbidity.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1646625"},"PeriodicalIF":1.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212418","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":"Nursing strategies after pancreaticoduodenectomy: continuity of care combined with immunomodulatory nutrition.","authors":"Xiaodong Feng, Wei Li, Yufu Tang, Lei Han, Ting Bi, Wei Zhang, Yuqing Miao","doi":"10.3389/fsurg.2025.1650974","DOIUrl":"10.3389/fsurg.2025.1650974","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is a highly invasive procedure with a long operation time, resulting in a high incidence of postoperative complications. The quality of patient care remains a key factor in improving prognosis. This study aimed to evaluate the impact of continuity of care combined with immunomodulatory nutrition on the postoperative recovery and quality of life of patients undergoing PD surgery.</p><p><strong>Methods: </strong>This was a randomized controlled study involving 120 patients who underwent PD surgery at our hospital between February 2022 and February 2024. The patients were randomly divided into the conventional care group (CG) and the intervention group (IG), with the latter receiving continuity of care combined with arginine-rich immunonutritional support. The main observation indicators included survival analysis, recovery of gastrointestinal function, length of hospital stay, nutritional status, immune function, postoperative complications, negative emotions and quality of life.</p><p><strong>Results: </strong>There was no significant difference in the overall survival rate between the two groups. Compared with the CG, the IG had shorter length of hospital stay, better recovery of gastrointestinal function, better improvements of nutritional indicators such as ALB and PAB, lower levels of pro-inflammatory factors TNF-α, IL-6 and CRP, better improvement of CD4⁺/CD8⁺ ratio, lower incidence of postoperative complications, lower SAS and SDS scores and better quality of life.</p><p><strong>Conclusion: </strong>Continuity of care combined with immunomodulatory nutrition provides a strong rationale for postoperative care of PD, and is worthy of clinical promotion and practice. More clinical cases and long-term follow-ups are needed to further verify its effectiveness.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1650974"},"PeriodicalIF":1.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212454","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":"Arthroscopic reduction with non-fixation for Broberg & Morrey type II radial head fracture with mechanical rotation block: a propensity score-matched case-control study.","authors":"Yanmao Wang, Shiyang Yu, Jian Ding, Shengdi Lu","doi":"10.3389/fsurg.2025.1680368","DOIUrl":"10.3389/fsurg.2025.1680368","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate arthroscopic reduction without fixation (ARnF) for Broberg & Morrey Type II radial head fractures presenting with a mechanical block to forearm rotation.</p><p><strong>Methods: </strong>We reviewed 11 patients with Broberg & Morrey Type II radial head fractures and a mechanical rotation block treated with ARnF. Clinical outcomes included elbow range of motion (ROM), the American Shoulder and Elbow Surgeons (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Outcomes were compared with those of patients who underwent arthroscopic reduction and internal fixation (ARIF) using cannulated screws at 6 weeks, 12 weeks, and 1 year postoperatively.</p><p><strong>Results: </strong>Eleven patients were included (7 male; mean age 33.6 years). All showed significant postoperative improvement. At each follow-up, mean ROM and both functional scores (ASES and DASH) in the ARnF group were comparable to those in the ARIF cohort.</p><p><strong>Conclusion: </strong>or Broberg & Morrey Type II radial head fractures with a mechanical rotation block, ARnF achieved outcomes comparable to ARIF while avoiding implant costs and implant-related risks.<b>Clinical Trial Registration</b>: https://www.chictr.org.cn/, identifier (ChiCTR2000035958).<b>Level of Evidence:</b> LEVEL III; Treatment study; Case control study.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1680368"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212466","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":"Learning curve analysis of transurethral thulium fiber laser enucleation of the prostate with preserving urethral Mucosa at the prostatic apex.","authors":"Dawei Xie, Yirui Wei, Weifeng He, Hao Wang, Pushen Yang, Liyang Wu, Jianwen Wang","doi":"10.3389/fsurg.2025.1646928","DOIUrl":"10.3389/fsurg.2025.1646928","url":null,"abstract":"<p><strong>Objective: </strong>To introduce a unique surgical technique, analyze perioperative data to demonstrate the safety of Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP) with preservation of the urethral mucosa at the prostatic apex, and construct a learning curve to assess its feasibility and potential for broader clinical application is the aim of this study.</p><p><strong>Methods: </strong>From June 2020 to June 2024, a urologist at Beijing Chaoyang Hospital, with no prior ThuFLEP experience, was trained under the supervision of an experienced chief physician. A retrospective analysis of 100 Benign Prostatic Hyperplasia (BPH) patients treated with ThuFLEP was conducted. Perioperative data were analyzed, including prostate volume, operative time, and enucleation weight. Statistical methods included <i>T</i>-tests, chi-square tests, and linear regression. Learning curves were constructed using Loess regression, with box plots visualizing differences in operative time, efficiency, and enucleation ratio efficacy. Postoperative follow-up assessed changes in IPSS, Qmax, and urinary incontinence.</p><p><strong>Results: </strong>The learning curve analysis showed a significant reduction in operative time after 56 cases. Linear regression indicated a decrease in operative time (<i>R</i> = -0.5, <i>p</i> < 0.01) and improvements in efficiency (<i>R</i> = 0.14, <i>p</i> < 0.01) and enucleation ratio efficacy (<i>R</i> = 0.41, <i>p</i> < 0.01) with increased experience. Comparing the first and last 50 cases, operative time and enucleation efficiency significantly improved (<i>p</i> < 0.01). Postoperatively, 31% of patients experienced incontinence one week after catheter removal, but all recovered within 12 weeks. IPSS scores improved by 13.67 ± 3.99 points.</p><p><strong>Conclusions: </strong>ThuFLEP with urethral mucosa preservation improves efficiency, reduces operative time, and has a manageable learning curve. Attention to complications and structured mentorship are crucial for successful implementation.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1646928"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206164","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":"Endoscopic vs. microscopic tympanoplasty in children: a retrospective case-control study.","authors":"Raffael Fink, Sven Beckmann, Sean C Sheppard, Marco Caversaccio, Lukas Anschuetz","doi":"10.3389/fsurg.2025.1649552","DOIUrl":"10.3389/fsurg.2025.1649552","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of endoscopic and microscopic tympanoplasty (TPL) types I-III in pediatric patients.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted on 70 TPL cases in 58 pediatric patients at Inselspital, Bern University Hospital, Switzerland, from June 2017 to December 2023. Data on hearing function, graft intake, residual disease, operating time and complications were collected.</p><p><strong>Results: </strong>We observed mean postoperative air-bone gap (ABG) of 16.83 dB using the endoscopic and 19.37 dB for the microscopic techniques, as well as a higher graft intake rate (91%) for the endoscopic compared to the microscopic group (80%), although these differences did not reach statistical significance. No residual cholesteatoma was found in the endoscopic group, while the microscopic group had a significantly higher incidence of residual disease (42%; <i>p</i> = .03). The mean operative time was shorter in the endoscopic group (87 min vs. 113 min; <i>p</i> < .01). Postoperative complications were lower in the endoscopic group compared to a 14% incidence in the microscopic group.</p><p><strong>Conclusion: </strong>Endoscopic tympanoplasty in pediatric patients achieves similar audiological outcomes and graft intake rates compared to the microscopic approach while offering significant advantages, including reduced operation times and lower complication rates. This minimally invasive approach is highly effective especially regarding cholesteatoma resection and provides excellent functional and structural outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1649552"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206181","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":"Combined predictive values of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for surgical site infection after emergency cesarean section: a retrospective case-control study.","authors":"Xuemei Yang, Weina Yang, Qianqian He, Xiuqing Zhou, Qianwen Liu, Haiying Li","doi":"10.3389/fsurg.2025.1670583","DOIUrl":"10.3389/fsurg.2025.1670583","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) independently and in combination for surgical site infection (SSI) after emergency cesarean section (CS).</p><p><strong>Method: </strong>This retrospective case-control study was conducted at the Maternity Medical Centre in China, a large tertiary teaching medical centre, between January 2019 and February 2022. A total of 627 patients with emergency CS were enrolled, and cases (post-SSI) and controls (without post-SSI) were matched 1:2. Various demographic, clinical and obstetric characteristics were collected. Laboratory values were measured on preoperative and postoperative days 1, 3. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors. The predictive values of NLR and PLR independently and in combination for SSI were evaluated using receiver operating characteristics (ROC) analysis.</p><p><strong>Result: </strong>In the univariate analysis, the BMI before delivery, preoperative NLR and PLR, and postoperative day 1 NLR and PLR et al. were significantly different between the two groups (<i>P</i> < 0.05). In multivariate analysis, BMI before delivery > 28.89 kg/m², preoperative NLR > 9.89 and PLR > 177.99 appeared to be independent predictors of SSI after emergency CS. Combined indices of BMI before delivery, NLR and PLR were significantly more predictive of SSI after emergency CS than independent indices (AUC 0.85, <i>P</i> < 0.001, 95% CI 0.757-0.912, sensitivity 79.1%, and specificity 88.5%).</p><p><strong>Conlusion: </strong>The combined index of BMI before delivery, preoperative NLR and PLR may be a simple, sensitive, inexpensive, versatile, and rapid test for predicting SSI after emergency CS. Of course, further prospective research and external verification will be more scientific and also our future work focus.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1670583"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206209","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}