Frontiers in Surgery最新文献

{"title":"The predictive role of platelet-to-lymphocyte ratio and systemic immune-inflammation index in young and middle-aged patients with tibial plateau fractures.","authors":"Shaowei Zhou, Xuemei Yang, Fang Hu, Xiaomeng Dong, Qingcheng Song, Shuhong Yang, Yingze Zhang","doi":"10.3389/fsurg.2025.1654222","DOIUrl":"10.3389/fsurg.2025.1654222","url":null,"abstract":"<p><strong>Background: </strong>There is suggestive evidence that the platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are related to the severity of fracture. The purpose of this study was to investigate the role of PLR and SII in predicting fracture severity in young and middle-aged patients with tibial plateau fractures (TPFs).</p><p><strong>Methods: </strong>A retrospective cohort study involving 229 patients with isolated TPFs was conducted between January 2015 and December 2019. Medical records of hospitalized patients were extracted from the electronic case system. Three experienced orthopedic surgeons classified the imaging data according to the Schatzker classification. All the patients were divided into two groups: group1 consisted of fractures of mild to moderate severity (Schatzker types I-IV), and group2 consisted of fractures of severe severity (Schatzker types V-VI). Platelet, neutrophil, and lymphocyte values at admission were obtained. The PLR = platelet/lymphocyte counts and the SII = platelet × neutrophil/lymphocyte counts were noted. Patients in groups 1 and 2 were statistically compared in terms of PLR and SII value on hospital admission.</p><p><strong>Results: </strong>There were significant differences in the blood PLR, SII, Na⁺ and K⁺ levels, and neutrophil count between the two groups. According to the receiver operating characteristic (ROC) curve, the cut-off of PLR and SII were 157.9 and 923.9, respectively. Our results showed that high PLR and SII were remarkably associated with the severity of TPFs. The sensitivity was 60% and the specificity was 86.9% when using the PLR ≥ 157.9 to predict the severity of the TPFs whereas the sensitivity was 63.3% and the specificity was 74.4% to predict the severity of TPFs at SII ≥ 923.9. In the multivariate analyses, the high preoperative PLR and SII were identified as independent predictors of severe TPFs.</p><p><strong>Conclusions: </strong>The PLR and SII are simple and economical biomarkers that require only routine blood tests with low associated costs. They can be calculated directly from platelet, neutrophil, and lymphocyte counts in standard blood routine reports, making them readily accessible and cost-effective tools to predict the severity of tibial plateau fractures.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1654222"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206244","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 outcomes of the closure of mesenteric defects in side-to-side jejunoileal anastomosis plus proximal loop ligation (SSJIBL) using absorbable and non-absorbable surgical sutures.","authors":"Yonglin Li, Jing Wang, Chengyu Wu, Xiaojing Lu, Qi Zheng, Rongwei Wei, Ziliang Zong, Yigang Chen","doi":"10.3389/fsurg.2025.1650828","DOIUrl":"10.3389/fsurg.2025.1650828","url":null,"abstract":"<p><strong>Background: </strong>Mesenteric hiatal hernia represents a significant complication following gastrointestinal surgery, and the closure of mesenteric defects has been shown to mitigate the risk of such hernias. SSJIBL, a surgical technique that has gained prominence in recent years, is widely acknowledged for its efficacy in glucose reduction and its association with fewer complications. Nevertheless, there remains a gap in the literature regarding the optimal suture choice for closing mesenteric defects, as no definitive studies or reports have addressed this specific issue to date. So we wanted to know what sutures we could use to more safely close the mesenteric defect.</p><p><strong>Materials and methods: </strong>36 New Zealand rabbits were divided into three groups, NC, Absorbable suture and Non-absorbable suture. Group NC was not operated, group Absorbable suture close the mesenteric defect with absorbable suture, and group Non-absorbable suture close the mesenteric defect with non-absorbable suture; the rabbits were weighed and measured monthly, and after three months, the rabbits were observed to see if there was any internal hernia and to detect the tethered lacunae tension.</p><p><strong>Results: </strong>According to the results of the experiment, both absorbable suture and non-absorbable suture can induce infiltration of inflammatory cells and enhance adhesion strength relative to the NC group.</p><p><strong>Conclusion: </strong>Both absorbable and non-absorbable sutures are safe and reliable.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1650828"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206284","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: \"Stent-within-a-Stent\" technique after telescopic flow diverter reconstruction for basilar artery aneurysm with proximal stenosis.","authors":"Iroda Mammadinova, Chingiz Nurimanov, Nurtay Nurakay, Karashash Menlibayeva, Serik Akshulakov, Yerbol Makhambetov","doi":"10.3389/fsurg.2025.1603876","DOIUrl":"10.3389/fsurg.2025.1603876","url":null,"abstract":"<p><strong>Background: </strong>Complex basilar artery aneurysms are challenging to treat due to their deep anatomical location and proximity to critical perforating arteries, as well as their frequent fusiform morphology and association with long-segment stenosis or atherosclerotic changes. Endovascular flow diversion has become an important option; however, its use in large and fusiform basilar artery aneurysms is complicated by the risks of device malapposition, migration, and incomplete occlusion.</p><p><strong>Case presentation: </strong>We report a case of a large basilar artery aneurysm with severe pre-aneurysmal stenosis treated using a telescopic flow-diverter strategy. Balloon angioplasty prior to stent deployment was performed to optimize vessel diameter, followed by the sequential distal-to- proximal placement of overlapping flow diverters. Post-procedural angiography revealed device instability, necessitating the deployment of an additional flow diverter in a \"stent-within-a-stent\" configuration to improve wall apposition and prevent migration. This approach resulted in sustained aneurysm thrombosis and long-term vessel patency.</p><p><strong>Conclusion: </strong>This case illustrates the technical challenges of managing complex basilar artery aneurysms and emphasizes the role of adjunctive stenting in stabilizing flow diverters. Carefully individualized endovascular strategies that account for fusiform morphology, long-segment arterial involvement, atherosclerotic changes, and the perforator-rich environment, together with technical challenges such as the need for telescopic reconstruction or adjunctive balloon angioplasty, are essential for enhancing procedural safety and achieving durable aneurysm occlusion in high-risk patients.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1603876"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206192","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: Isolated surgical decompression for compressive internal jugular vein stenosis: case series and literature review.","authors":"Haiyang Ma, Rui Zhao, Shuaibin Lu, Weicheng Peng, Xupeng Peng, Sheng Xu, Beibei Mao, Guangtong Zhu, Zhiqiang Hu","doi":"10.3389/fsurg.2025.1639108","DOIUrl":"10.3389/fsurg.2025.1639108","url":null,"abstract":"<p><strong>Background: </strong>Internal jugular vein stenosis (IJVS) is an underrecognized cause of cerebral venous outflow obstruction, commonly presenting with nonspecific symptoms such as head-noise, tinnitus, dizziness, headaches, and visual or auditory disturbances. Extrinsic compression by bony structures, particularly transverse process of the atlas (C1), has emerged as a significant but frequently ignored etiology. This study presents the first case series demonstrating that isolated resection of the C1 transverse process can restore venous outflow and provide durable relief of head-noise-dominant symptoms.</p><p><strong>Objective: </strong>This study presents three cases of symptomatic IJVS caused by bony compression, marked by head noise-dominant presentation and failure of conservative or endovascular treatments, emphasizing the diagnostic challenges, individualized surgical strategies, and clinical outcomes, along with a review of current literature.</p><p><strong>Methods: </strong>Three patients with imaging-confirmed compressive IJVS underwent Doppler ultrasound, 3D computed tomography venography, and magnetic resonance imaging. All patients receivedtargeted surgical decompression via resection of the compressive bony structures, with one patient receiving adjunctive venous stenting due to persistent flow limitation.</p><p><strong>Results: </strong>All patients achieved significant postoperative improvement, including resolution of head noise and amelioration of associated symptoms. Imaging confirmed improved venous caliber and outflow. Notably, one patient with previous stenting failure benefited from staged decompression and re-intervention, highlighting the value of individualized management.</p><p><strong>Conclusion: </strong>Extrinsic compression is a treatable cause of IJVS. Isolated surgical decompression offers a viable treatment option, particularly in patients unresponsive to endovascular approaches. These cases support the need for greater awareness of compressive IJVS and further studies to refine treatment indications and evaluate long-term outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1639108"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206134","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 novel approach of manual manipulation of the transnasal ileus tube for severe or recurrent benign adhesive small bowel obstruction.","authors":"Er-Sheng Li, Yin-Jun Zhai, Yin Han, Qian Chang, Qi Wang, Hong-Yu Zhang","doi":"10.3389/fsurg.2025.1601111","DOIUrl":"10.3389/fsurg.2025.1601111","url":null,"abstract":"<p><strong>Purpose: </strong>This study seeks to evaluate the safety and efficacy of an innovative manual manipulation technique for the transnasal ileus tube in patients experiencing severe or recurrent adhesive small bowel obstruction (ASBO).</p><p><strong>Materials and methods: </strong>Prior to the initiation of this research, approval was obtained from the institutional review board. The study was conducted within our institution, involving a cohort of fifty-four patients diagnosed with severe, multiple, or recurrent ASBO. These patients underwent treatment through active manipulation of the transnasal ileus tube, which entailed navigating obstructions by adjusting two balloons and resolving adhesions through the alternate advancement and retraction of the ileus tube. Angiographic outcomes were categorized as either complete or incomplete resolution of obstructions. Data were collected on technical success, initial and final angiographic outcomes, mortality, morbidity, and overall clinical outcomes. Follow-up assessments were conducted at 1, 3, 6, and 12 months, with annual evaluations thereafter.</p><p><strong>Results: </strong>The transnasal ileus tube was successfully placed in all patients without any procedure-related complications. The tube was successfully navigated and passed through obstructions to the cecum in 94.4% of cases, specifically in 51 out of 54 attempts. Follow-up angiograms, conducted over a period of 3-38 months, confirmed the unobstructed passage of contrast medium through the small bowel in 52 patients. Clinical follow-up data, with an average duration of 20 ± 11 months (95% CI: 17, 23 months; range, 6-45 months), were available for 52 patients. One patient died due to multiple organ failure, while the remaining 51 patients exhibited no clinical symptoms of small bowel obstruction.</p><p><strong>Conclusion: </strong>These preliminary findings indicate that manual manipulation of the transnasal ileus tube is non-surgical and therefore non-traumatic but nonetheless an effective method of internally lysing the adhesions with their double balloon technique and pulling the tube back and forth.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1601111"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199058","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":"Cervical Malignant Melanotic Nerve Sheath Tumor with retained PRKAR1A expression and a clinically benign course: a case report and review of the literature.","authors":"Alexandru Guranda, Johannes Wach, Erdem Güresir, Max Braune, Peter Kuzman, Ulf Nestler","doi":"10.3389/fsurg.2025.1618362","DOIUrl":"10.3389/fsurg.2025.1618362","url":null,"abstract":"<p><strong>Background: </strong>Malignant melanotic nerve sheath tumors (MMNSTs) are rare Schwann cell-derived tumors. Previously classified as benign melanotic schwannomas, they were redefined as a potentially aggressive entity in the 2020 WHO classification of soft tissue tumors and later included in the 2021 WHO CNS classification. However, optimal therapeutic strategies remain under discussion.</p><p><strong>Case presentation: </strong>We present the case of a 46-year-old Caucasian male who underwent surgery for an intra- and extraspinal cervical mass lesion at the C4/5 level on the left side. Immunohistochemical analysis confirmed the diagnosis of MMNSTs. The patient initially presented with ataxia, left-sided weakness, and hemihypesthesia. Magnetic resonance imaging of the cervical spine revealed a left intra- and extraspinal homogeneous contrast-enhancing mass at the C4/C5 level. After the first intraspinal partial resection, the diagnosis of MMNST was established. Gross-total resection is highly recommended in nearly all cases in the literature, followed by adjuvant radiotherapy or chemotherapy in selected cases to prevent metastases, which occur in 15%-42% of cases. The patient postponed the second neurosurgical intervention and declined adjuvant radiotherapy. At 18 months after gross total resection, no recurrent tumor was detected by MRI.</p><p><strong>Conclusion: </strong>Given the limited epidemiological knowledge on MMNSTs, our study contributes to the literature by documenting a case of intra- and extraspinal, cervical MMNST without any of the previously known driver mutations or copy number changes. While the WHO 2021 classification designates these tumors as potentially malignant, our findings support existing reports that more benign courses can occur.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1618362"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199028","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":"Sex as an independent risk factor for cerebellar mutism syndrome: a validation study.","authors":"Xiaojiao Peng, Zhuo Zhi, Xinyi Chai, Hong Zhang, Yingjie Cai, Kaiyi Zhu, Nijia Zhang, Jia Wang, Hailang Sun, Guangheng Yin, Wenping Ma, Wei Yang, Ming Ge","doi":"10.3389/fsurg.2025.1645832","DOIUrl":"10.3389/fsurg.2025.1645832","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar Mutism Syndrome (CMS) is a significant neurological complication following posterior fossa tumor surgery in children. The pathophysiological mechanisms of CMS remain elusive, and there is a growing interest in the potential influence of sex on its incidence. This study aims to evaluate sex as an independent risk factor for the development of CMS.</p><p><strong>Methods: </strong>A retrospective cohort study of 385 pediatric patients who underwent posterior fossa tumor surgery at Beijing Children's Hospital (2013-2024) was conducted. Comprehensive demographic, clinical, and pathological data were collected. Statistical analysis involved Chi-square tests for categorical variables, Kruskal-Wallis tests for non-parametric comparisons among groups, and logistic regression to identify independent predictors of CMS.</p><p><strong>Results: </strong>CMS occurred in 29.9% of all cases, with annual incidence ranging from 14.3% to 37.9%. Medulloblastoma was the most common pathology (38.4%), with a median maximal tumor diameter of 47.2 mm. Tumors were predominantly located at the midline (68.1%), and gross total resection was achieved in 86.3% of patients. Male patients exhibited a significantly higher incidence of CMS compared to females (73.0% vs. 53.0%, <i>p</i> = 0.003). Independent risk factors for CMS included male sex [OR 2.25; 95% CI (1.30-3.70)], midline tumor location [OR 7.47; 95% CI (2.79-19.98)], and medulloblastoma diagnosis [OR 2.11; 95% CI (1.24-3.59)].</p><p><strong>Conclusion: </strong>This study indicates a notable male predominance in CMS occurrence, suggesting the existence of sex-specific differences in cerebellar function and language development. These findings highlight the need for heightened monitoring and tailored interventions for male patients undergoing posterior fossa tumor surgery and suggest a potential biological basis for sex-specific differences in cerebellar function and vulnerability to surgical injury.</p><p><strong>Importance of the study: </strong>This study provides critical insights into the significant role of sex as an independent risk factor for Cerebellar Mutism Syndrome (CMS) following posterior fossa tumor surgeries in pediatric patients. By identifying male sex, midline tumor location, and medulloblastoma pathology as independent predictors, this research addresses a gap in understanding sex-based disparities in CMS development. These findings suggest potential gender-specific differences in cerebellar and language development, offering a foundation for future translational research and targeted clinical strategies. The results emphasize the need for heightened monitoring and tailored interventions, especially for male patients, to mitigate CMS risk and improve surgical outcomes in pediatric neurosurgery.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1645832"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199033","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":"Analysis of influencing factors on postoperative complications of closed approach autologous granular rib cartilage rhinoplasty and construction and verification of nomogram.","authors":"Ye Ju, Jinlei Wang, Xiaohong Shi, Wentao Chi, Chenguang Zhan","doi":"10.3389/fsurg.2025.1599790","DOIUrl":"10.3389/fsurg.2025.1599790","url":null,"abstract":"<p><strong>Objective: </strong>To construct a nomogram prediction model based on the risk factors of complications after augmentation rhinoplasty with autogenous granular costal cartilage through closed approach, and to explore its clinical application value.</p><p><strong>Methods: </strong>From June 2022 to June 2024, 214 patients in our hospital were selected and divided into training set (<i>n</i> = 150) and verification set (<i>n</i> = 64) according to the ratio of 7:3. In the training set, the risk factors of postoperative complications were analyzed by multivariate Logistic regression, and then the nomogram prediction model was constructed. The prediction efficiency of the model is evaluated by drawing ROC curve and calibration curve, and verified in the verification set. The decision curve analysis (DCA) was used to evaluate the clinical application value of the model.</p><p><strong>Results: </strong>Complications occurred in 31 cases (20.67%) in the training group and 13 cases (20.31%) in the verification group. There was no significant difference in the incidence and clinical characteristics between the two groups (<i>P</i> > 0.05). In the training set, older age, history of chronic diseases (chronic rhinitis), long operation time, large amount of bleeding during operation and thin skin on the back of nose were independent risk factors for complications (<i>P</i> < 0.05), and a nomogram prediction model was established accordingly. The model has good calibration and fitting degree in training set and verification set (C-index index is 0.857 and 0.848, average absolute error is 0.126 and 0.090, and <i>χ</i> ² of Hosmer-Lemeshow test is 7.137, <i>P</i> = 0.521 and <i>χ</i> ² = 5.923, <i>P</i> = 0.655). The ROC curve shows that the AUC of the training set and the validation set model for predicting postoperative complications are 0.851(95% CI: 0.764-0.937) and 0.855(95% CI: 0.675-1.000), and the sensitivity and specificity are 0.880, 0.725, 0.833 and 0.692, respectively.</p><p><strong>Conclusion: </strong>The nomogram prediction model based on risk factors is helpful for early prediction of complications after augmentation rhinoplasty, providing guidance for clinical decision-making, helping to reduce the risk of complications and improving the surgical effect and patient satisfaction.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1599790"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198978","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":"Analysis of the feasibility and health-economics value of simultaneous bilateral pulmonary surgery.","authors":"Xiaoyun Li, Kaili Huang, Mingyu Fan, Xiaojun Tang","doi":"10.3389/fsurg.2025.1652685","DOIUrl":"10.3389/fsurg.2025.1652685","url":null,"abstract":"<p><strong>Background and objective: </strong>The increased use of chest CT for clinical diagnosis and screening has improved the detection of early-stage lung cancer and the identification of bilateral lung lesions. Despite this, consensus on the feasibility of simultaneous vs. staged bilateral surgery for patients with bilateral lesions remains elusive, necessitating further investigation. This study assessed the safety, feasibility, and health-economics value of simultaneous bilateral pulmonary surgery by comparing perioperative clinical indicators and medical costs with those of unilateral surgery and simulated staged bilateral surgery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using clinical data from 78 patients who underwent simultaneous bilateral pulmonary surgery at the Lung Cancer Center of West China Hospital of Sichuan University by the same medical team from January 2016 to October 2024. An equal number of patients who underwent unilateral surgery during the same period served as controls. Perioperative indicators were compared between these groups, and medical expenses were assessed against those of a second control group undergoing simulated staged surgery.</p><p><strong>Results: </strong>All surgeries in both the simultaneous group and the control group were completed successfully, with patients discharged after recovery. The average surgical duration for the 78 patients in the simultaneous group was greater than that in the control group (195.8 ± 58.8 min vs. 136.83 ± 49.1 min; <i>P</i> < 0.001), as was the intraoperative blood loss (143.6 ± 92.8 ml vs. 93.62 ± 63.944 ml; <i>P</i> = 0.009). There were no significant differences in postoperative metrics between the two groups, including average duration of ICU stay (1.15 ± 0.42 days vs. 1.09 ± 0.35 days; <i>P</i> = 0.423), duration of drainage tube indwelling (2.47 ± 0.86 days vs. 2.15 ± 0.88 days; <i>P</i> = 0.079), duration of antibiotic use (2.83 ± 1.20 days vs. 2.45 ± 0.99 days; <i>P</i> = 0.096) or duration of hospital stay (5.40 ± 1.50 days vs. 4.91 ± 1.47 days; <i>P</i> = 0.114). The major complication rates were comparable between the two groups, with no statistically significant difference (14.1% vs. 10.3%, <i>P</i> = 0.562). The hospitalization costs of the simultaneous group were lower than those of the staged group but higher than those of the unilateral group (68,920 ± 13,384 yuan vs. 81,030 ± 10,515 yuan vs. 48,556 ± 10,371 yuan, <i>F</i> = 111.920, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>When indications are appropriately adhered to, simultaneous bilateral lung surgery for patients with bilateral pulmonary lesions is both safe and feasible; it reduces medical costs, increases diagnostic and treatment efficiency, conserves medical resources, and offers significant health-economics benefits.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1652685"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198980","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":"Posterior pelvic ring fixation: evolution of surgical approaches and evidence-based outcomes for unstable fractures.","authors":"Haiyan Zhou, Liming Cheng","doi":"10.3389/fsurg.2025.1653169","DOIUrl":"10.3389/fsurg.2025.1653169","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of a novel percutaneous posterior minimally invasive approach for unstable posterior pelvic ring fractures (Tile Type C).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 19 consecutive patients treated between 2015 and 2022 at a tertiary trauma center. Inclusion criteria included: 1) adults with Tile C1.1-C1.3 fractures; 2) hemodynamic stability; and 3) minimum 12-month follow-up. Surgical technique featured bilateral 4-cm incisions, subperiosteal tunneling, and anatomically contoured locking plates. Primary outcomes were radiographic union (Matta criteria) and functional recovery (Majeed Pelvic Score).</p><p><strong>Results: </strong>The study demonstrated excellent outcomes across all evaluated parameters. All 19 patients achieved bony union within 15.8 ± 4.5 weeks, with 94.7% (18/19) obtaining excellent functional recovery (Majeed score >80). No neurovascular complications or implant failures occurred during the 20-month follow-up. All patients successfully progressed through rehabilitation, achieving full weight-bearing by 12 weeks postoperatively.</p><p><strong>Conclusion: </strong>The percutaneous posterior approach provides effective stabilization for rotationally unstable pelvic fractures with minimal morbidity. While demonstrating advantages in blood loss, operative time, and early mobilization compared to traditional techniques, its applicability remains limited to Tile C1 patterns without vertical instability.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1653169"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185573","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}