Frontiers in Surgery最新文献

{"title":"Development and external validation of a nomogram for predicting one-year survival in patients with non-traumatic subarachnoid hemorrhage.","authors":"Yiwei Lv, Zhongsheng Lu, Menghui He, Zihai Cheng, Qiang Zhang, Xiaoqing Jin, Pei Han","doi":"10.3389/fsurg.2025.1579429","DOIUrl":"10.3389/fsurg.2025.1579429","url":null,"abstract":"<p><strong>Background: </strong>Subarachnoid hemorrhage (SAH), a critical cerebrovascular emergency characterized by acute bleeding into the subarachnoid space, is associated with permanent neurological deficits, substantial mortality rates, and unfavorable clinical outcomes. Survivors frequently develop long-term complications including cognitive impairment, memory loss, and neuropsychiatric issues like depression, anxiety, and PTSD, significantly reducing quality of life. Despite advancements in acute-phase management, the long-term survival prognosis for non-traumatic SAH patients remains poorly characterized in current clinical research. Identifying reliable prognostic biomarkers and developing validated predictive models are crucial for enabling risk-stratified care and personalized treatments, improving evidence-based clinical practice.</p><p><strong>Method: </strong>This study analyzed baseline and clinical data from 825 non-traumatic SAH patients in the MIMIC-IV ICU database. Kaplan-Meier analysis and multivariate Cox regression identified independent survival risk factors, followed by nomogram model construction. The model's performance was evaluated using C-index, ROC curve (AUC), calibration curve, and DCA to assess discrimination, calibration, and clinical utility. External validation was performed using 290 non-traumatic SAH patients from Qinghai Provincial People's Hospital.</p><p><strong>Result: </strong>Multivariate Cox regression identified 11 independent risk factors for non-traumatic SAH survival: hospital stay length, age, respiratory rate, red blood cell count, platelets, potassium, sodium, anion gap, urea nitrogen, blood glucose, and sepsis. A nomogram model based on these factors showed strong discrimination, stratifying patients into risk categories. In the training cohort, the model achieved an AUC of 0.844 (95% CI: 0.815-0.872) and a C-index of 0.827 (95% CI: 0.803-0.851). In the external validation set, the model exhibited acceptable discriminatory performance, with an AUC of 0.807 (95% CI: 0.758-0.856) and a C-index of 0.851 (95% CI: 0.825-0.875).</p><p><strong>Conclusion: </strong>In this study, the survival prognosis of patients with non-traumatic subarachnoid hemorrhage (SAH) was found to be associated with eleven factors: length of hospital stay, patient age, respiratory rate, red blood cell count, platelet count, potassium levels, sodium levels, anion gap, urea nitrogen, blood glucose levels, and the presence of sepsis. The nomogram model we developed demonstrates superior predictive accuracy and can serve as a valuable tool for clinicians in rapidly identifying high-risk patients, facilitating personalized risk assessment, and guiding targeted medical interventions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1579429"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress and clinical application of all-inside reconstruction techniques: narrative review.","authors":"Yong Jiang, Dikun Qian, Qiming Lu, Yangbin Cao, Yi Ren, Jun Su","doi":"10.3389/fsurg.2025.1644737","DOIUrl":"10.3389/fsurg.2025.1644737","url":null,"abstract":"<p><p>All-inside reconstruction is a popular technique for cruciate ligament reconstruction in recent years. Compared with traditional reconstruction techniques, all-inside reconstruction is primarily performed through minimally invasive arthroscopic procedures, involving the creation of separate half-tunnels at the femoral and tibial ends, followed by fixation of the graft using adjustable suspension devices to achieve anatomical ligament reconstruction. Current research primarily focuses on anterior cruciate ligament (ACL) reconstruction in the knee joint, demonstrating advantages such as reduced surgical trauma, bone preservation, decreased postoperative pain, and accelerated rehabilitation. Extensive clinical studies have shown that all-inside reconstruction achieves comparable mid- to short-term clinical outcomes to traditional techniques, with superior performance in certain functional metrics. Additionally, all-inside reconstruction is associated with lower complication rates, smaller incisions that better preserve tendons, and reduced postoperative pain and discomfort. However, the technique also has limitations, such as a steep learning curve, potential graft micromotion due to suspension fixation, and tunnel widening. Therefore, this review aims to comprehensively elaborate on the developmental history, principles, applications across various joints, perioperative management, postoperative rehabilitation, efficacy evaluation, and biomechanical research outcomes of all-inside reconstruction. It will also discuss the clinical advantages and limitations based on the latest clinical studies, as well as future directions for improvement and research prospects.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1644737"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185536","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":"Ultrasound-assisted periareolar oncoplastic approach in breast surgery: a focus on surgical technique.","authors":"Alessandro De Luca, Domenico Tripodi, Lucio Fortunato, Federica Pediconi, Claudio Cannistrà, Nicola Rocco, Massimo Vergine, Maria Ida Amabile","doi":"10.3389/fsurg.2025.1623894","DOIUrl":"10.3389/fsurg.2025.1623894","url":null,"abstract":"<p><strong>Introduction: </strong>Breast conservation surgery (BCS) combined with post-operative radiotherapy is the standard and preferred treatment for early-stage breast cancer (eBC), offering survival outcomes comparable to mastectomy while improving body image and quality of life. Oncoplastic breast surgery (OBS) has evolved from BCS to allow more extensive tissue removal while maintaining oncological safety and reducing the risk of post-surgical deformities. The ultrasound (US)-assisted periareolar approach in breast surgery offers several potential benefits, including reduced scarring, improved cosmetic outcomes, and enhanced surgical precision, particularly for non-palpable or small lesions, and potentially better nipple sensation preservation. This study aim to describe an US-assisted periareolar OBS approach for eBC patients with small to moderate breast ptosis.</p><p><strong>Methods: </strong>Here we present a focus on surgical technique consisting in OBS combining a US-assisted periareolar approach with volume displacement in small- to moderate- ptosic breasts. Margin resection adequacy, surgical complications and patient satisfaction using the Breast-Q questionnaire were assessed.</p><p><strong>Results: </strong>Thirty-two patients were considered. A negative margin of excision was achieved in all cases, and patients routinely received post-operative hypofractionated radiotherapy. Seroma was the most common complication (12.5%), while breast fat necrosis and minor wound infections occurred in 6% and 3% of cases, respectively. At a median follow-up of 12 months (range 6-18), post-treatment breast retraction occurred in 3 patients (9%), all of whom underwent fat grafting to improve outcomes. The average satisfaction score as determined by Breast-Q module was 78.6, rising to 81.3 for those who underwent contralateral mammaplasty.</p><p><strong>Discussion: </strong>The combination of imaging, the use of oncoplastic surgical techniques and an appropriate post-operative management may provide the surgeon new tools for the treatment of eBC. In selected cases, the US-assisted periareolar oncoplastic approach is a versatile technique that can be easily adapted for tumors in any location of the breast.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1623894"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185561","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":"Three surgical techniques using different energy sources for anatomical endoscopic enucleation of the prostate.","authors":"Xin Yi, Gongliang Zhu, Biyu Zhu, Junrong Zou, Jingyi Zhu, Xiaofeng Zou, Guoxi Zhang","doi":"10.3389/fsurg.2025.1668140","DOIUrl":"10.3389/fsurg.2025.1668140","url":null,"abstract":"<p><p>Although transurethral resection of the prostate (TURP) remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH), this approach is associated with a high recurrence rate and numerous postoperative complications. Recently, advancements in equipment and surgical techniques have led to the increased clinical application of anatomical endoscopic enucleation of the prostate (AEEP). The primary devices used in AEEP include bipolar plasma systems, holmium lasers, and thulium lasers. This article presents a narrative review evaluating the performance of these three energy sources in surgery and provides a comparative analysis of their advantages and disadvantages.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1668140"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185558","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: Chronic subdural hematoma secondary to primary central nervous system lymphoma.","authors":"Xinli Mu, Zhihui Song, Qihong Wang, Hongsheng Yue, Xin He","doi":"10.3389/fsurg.2025.1593112","DOIUrl":"10.3389/fsurg.2025.1593112","url":null,"abstract":"<p><p>A 69-year-old man presented with a 15-day history of right-sided motor impairment and slurred speech. Twenty-one days earlier, he was misdiagnosed at a local hospital with a routine chronic subdural hematoma (CSDH) and underwent burr-hole drainage, but his symptoms progressively worsened postoperatively, leading to aphasia and prompting his admission to our hospital. Further MRI and contrast-enhanced imaging revealed hematoma organization, brain herniation, and an intracranial mass lesion. The patient underwent craniotomy for tumor resection and evacuation of the organized hematoma. The patient received structured rehabilitation and limb positioning therapy during hospitalization to support motor recovery and prevent complications, and was discharged on postoperative day 13 with improved limb function but persistent aphasia. Histopathological analysis confirmed non-germinal center diffuse large B-cell lymphoma (DLBCL) within the hematoma, supported by immunohistochemical and FISH findings, including CD20(+), PAX-5(+), MUM-1(+), and Ki-67(+, 60%). The patient underwent four cycles of rituximab and high-dose methotrexate, resulting in lesion resolution on follow-up MRI, with motor aphasia persisting. This case represents a rare instance of primary central nervous system lymphoma (PCNSL) initially presenting as CSDH, with progression to hematoma organization and brain herniation. This case provides new insights and experience in recognizing and managing rare clinical presentations of primary central nervous system lymphoma.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1593112"},"PeriodicalIF":1.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185580","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":"Intravascular embolization with spinal decompression and vertebral shaping for acute cauda equina syndrome from aggressive vertebral hemangioma: a case report and literature review.","authors":"Qing-Quan Chen, Hong-Shen Wang, Hui Wang, Jin-Shui Chen, Jie Xiao, Xiu Yang","doi":"10.3389/fsurg.2025.1647623","DOIUrl":"10.3389/fsurg.2025.1647623","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of a multidisciplinary approach for the treatment of aggressive vertebral hemangioma with acute cauda equina compression.</p><p><strong>Case description: </strong>A 37-year-old female patient with aggressive vertebral hemangioma presented with sudden loss of muscle strength in both lower limbs (grade I-II) and difficulty in urination and defecation. Magnetic resonance imaging and digital subtraction angiography confirmed a vascular tumor within and around the L4 vertebra, causing cauda equina compression. The treatment involved staged vascular embolization (of the third lumbar artery and branches of the sacral artery) combined with L4 vertebroplasty, laminectomy decompression, and pedicle screw fixation. Postoperative pain was immediately relieved. After 3 months of rehabilitation, muscle strength in both lower limbs recovered to grade 3, with significant improvement in spontaneous urination and defecation. Imaging studies showed complete relief of spinal canal compression.</p><p><strong>Conclusions: </strong>Aggressive spinal hemangioma may require multidisciplinary collaboration, and staged vascular embolization combined with spinal decompression and stabilization surgery can effectively improve neurological function. Early intervention is crucial for achieving favorable outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1647623"},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185542","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":"Immunomodulatory factors CRP/albumin ratio and NLR predict post-spinal surgery infection.","authors":"Chang Yuping, Wei Rong, Li Fengjuan, Liu Chunhua, Dong Zhenghui","doi":"10.3389/fsurg.2025.1627141","DOIUrl":"10.3389/fsurg.2025.1627141","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this work is to investigate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) combined with the C-reactive protein/albumin (CRP/ALB) ratio for postoperative infections in patients undergoing spinal surgery.</p><p><strong>Methods: </strong>According to the inclusion criteria, 380 patients who underwent spinal surgery treatment in the Sixth Affiliated Hospital of Xinjiang Medical University between January 2020 and December 2023 were retrospectively screened and divided into two groups based on whether they were infected after surgery. The two groups were 1. infected group (<i>n</i> = 79) and 2. uninfected group (<i>n</i> = 301). The following variables were reviewed in both groups: gender, age, body mass index, hypertension, diabetes mellitus, coronary artery disease, history of smoking, history of alcohol consumption, duration of surgery, site of surgery, presence of blood transfusion, presence of internal fixation, NLR and CRP/ALB ratio. A one-way analysis was performed on these factors, and those with a <i>P</i> < 0.05 were replaced with a binary logistic analysis in order to investigate the factors associated with postoperative infection.</p><p><strong>Results: </strong>Comparative analysis revealed significant between-group differences (<i>P</i> < 0.05) in age, diabetes status, operative duration, blood transfusion, internal fixation use, postoperative NLR, and CRP/ALB ratio. Binary logistic regression identified six independent risk factors: advancing age (OR = 1.145, 95% CI 1.098-1.203), prolonged operative time (OR = 1.020, 95% CI 1.010-1.030), intraoperative blood transfusion (OR = 2.941, 95% CI 1.245-7.211), internal fixation placement (OR = 8.022, 95% CI 2.710-25.615), elevated postoperative NLR (OR = 1.870, 95% CI 1.531-2.324), and increased CRP/ALB ratio (OR = 2.178, 95% CI 1.673-2.943). All associations reached statistical significance (<i>P</i> < 0.001 unless specified).</p><p><strong>Conclusion: </strong>The results indicate that age, duration of surgery, blood transfusion, internal fixation, postoperative NLR and postoperative CRP/ALB are risk factors for the development of infection after spinal surgery. Surgeons should perform a thorough assessment of their patients in order to more accurately predict their likelihood of infection and to provide a basis for individualised treatment plans to reduce the risk of postoperative infections.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1627141"},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185526","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":"Outcome analysis of the autologous bone grafts for reconstructing acetabular bone defects in total hip arthroplasty for developmental dysplasia of the hip.","authors":"Yong Zhang, Yingjie Lu, Yijian Zhang, Huilin Yang, Ming Jiang, Lixin Huang","doi":"10.3389/fsurg.2025.1655246","DOIUrl":"10.3389/fsurg.2025.1655246","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to retrospectively investigate the short- or medium-term clinical outcomes in patients with Hartofilakidis type II developmental dysplasia of the hip (DDH) after structural bone grafting of the autologous femoral head with a non-cemented prosthesis during total hip arthroplasty (THA).</p><p><strong>Material and methods: </strong>A total of 80 patients (80 hips), including 46 men and 34 women, were enrolled. The age of the patients ranged from 44 to 61 years (mean age: 50.85 ± 9.22 years). The resected femoral head was utilized as a bone graft for the reconstruction of acetabular bone defects above the acetabulum. Preoperative and postoperative leg length discrepancies (LLD) and Harris Hip Score scores were also measured. Lastly, complication occurrence was recorded.</p><p><strong>Results: </strong>The LLD decreased from 22.13 ± 11.22 mm before surgery to 4.27 ± 2.15 mm after surgery (<i>P</i> < 0.001). The vertical distance of the hip rotation center reduced from 41.14 ± 12.17 mm before surgery to 20.76 ± 9.91 mm after surgery (<i>P</i> < 0.001). The horizontal distance of the hip rotation center diminished from 40.20 ± 13.33 mm before surgery to 22.61 ± 6.88 mm after surgery (<i>P</i> < 0.001). The HHS score increased significantly from 43.75 ± 12.67 preoperatively to 90.15 ± 8.91 at the final follow-up (<i>P</i> < 0.001). None of the patients experienced fractures during the operation, and there were no postoperative complications such as hematomas or wound infections.</p><p><strong>Conclusion: </strong>Structural bone grafting is an effective method for restoring acetabular bone volume and ensuring good acetabular prosthesis coverage in adult patients with DDH who present with intraoperative bone loss during THA.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1655246"},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185593","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: Endoscopic cystectomy vs. lumbar interbody fusion for liquid- and gas-filled discal cysts: a case series and literature review.","authors":"Haoyun Huang, Guangye Li, Junwen Deng, Rigao Chen, Yi Zhou","doi":"10.3389/fsurg.2025.1646605","DOIUrl":"10.3389/fsurg.2025.1646605","url":null,"abstract":"<p><p>Lumbar discal cysts are uncommon lesions that mimic disc herniation but require distinct therapeutic strategies because of their unique pathophysiologies. However, the current literature lacks consensus on the adoption of optimal surgical approaches. This study reviews the surgical management and pathological mechanisms of primary lumbar discal cysts, emphasizing the distinction between liquid- and gas-filled subtypes that require tailored therapeutic strategies due to their differing pathophysiologies and association with spinal instability. We report successful surgical outcomes in three patients: one with a liquid cyst treated with endoscopic resection and two with gas-filled cysts managed with endoscopic cystectomy or lumbar interbody fusion, respectively. All patients experienced significant symptomatic relief and complete cyst resolution on imaging. A concurrent PubMed literature review (1990-2025) on primary gas-filled and liquid disc cysts informed the analysis. Liquid cysts predominantly occur in young patients, and these are associated with annular fiber damage and disc herniation, causing symptoms primarily through direct compression; endoscopic cystectomy is an effective treatment. Conversely, gas-filled cysts are more common in old patients, and these are strongly linked to disc degeneration and the vacuum phenomenon. Symptoms arise not only from cyst compression but also potentially from concurrent spinal stenosis and vertebral instability. Therefore, the surgical strategy for gas-filled cysts must consider the factor of spinal stability: endoscopic cystectomy is suitable for stable spines, while interbody fusion surgery is more appropriate when instability is present. We conclude that surgical intervention is effective for disc cysts, but the optimal approach must be individualized on the basis of cyst subtype and the presence of spinal instability, as informed by clinical presentation and imaging features.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1646605"},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185603","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":"Association between hospital volume and outcomes in ovarian cancer: a systematic review.","authors":"Qing Luo, Yan Wang, Xiaoyun Zhang","doi":"10.3389/fsurg.2025.1635555","DOIUrl":"10.3389/fsurg.2025.1635555","url":null,"abstract":"<p><strong>Background: </strong>Hospital surgical volume has been proposed as a determinant of ovarian cancer (OC) outcomes, but findings remain inconsistent.</p><p><strong>Objective: </strong>To systematically assess the association between hospital volume and outcomes in OC patients.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Cochrane Library was conducted through January 2025. Fifteen observational studies involving over 100,000 OC patients were included and qualitatively synthesized.</p><p><strong>Results: </strong>Thirteen of fifteen studies demonstrated that treatment in high-volume hospitals was significantly associated with improved overall survival (OS). Reported benefits included a 5-year OS increase from 22.3% to 55.0%, and up to 3% OS gain per 20 additional surgeries per year. High-volume centers also showed lower perioperative and 90-day mortality (e.g., 0.9% vs. 2.5%), and reduced failure-to-rescue rates. Two studies reported longer progression-free survival (PFS) in high-volume settings. Surgical quality indicators-such as complete cytoreduction and lymphadenectomy-were consistently higher in high-volume hospitals. Despite slightly higher complication rates, these centers had shorter hospital stays and better complication management.</p><p><strong>Conclusions: </strong>Higher hospital surgical volume is associated with better survival, lower mortality, and superior surgical quality in OC patients. Centralization of OC care may optimize outcomes and should be considered in policy planning.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1635555"},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185570","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}