Frontiers in Surgery最新文献

{"title":"Bibliometric study of research trends in dysphagia complicating following anterior cervical spine surgery.","authors":"Shang Qisong, Xiang Wei, Wu Yuanyuan, Song Xinghua","doi":"10.3389/fsurg.2025.1550816","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1550816","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the global research status and trends in the occurrence of dysphagia after cervical spine surgery using bibliometrics.</p><p><strong>Methods: </strong>All relevant research publications on dysphagia occurring after cervical spine surgery were retrieved from the Web of Science Core Collection database. Literature coupling, co-citation and co-occurrence analyses were subsequently visualised using VOSviewer, CiteSpace. WPS Office was applied for data summary processing.</p><p><strong>Results: </strong>Between 2000 and 2023, a total of 477 clinical studies met the inclusion criteria. The number of global publications has steadily increased in four stages over the last 19 years, with the United States having the most publications (=194), followed by China (=134) and South Korea (=34). The most contributing institutions were UNIVERSITY OF CALIFORNIA SYSTEM in the USA (<i>n</i> = 24) and SICHUAN UNIVERSITY in China (n-21). The most distinguished scholar was Liu,Hao (<i>n</i> = 15), followed by Albert (<i>n</i> = 10) and Yang,Yi (<i>n</i> = 9). Ten of the most cited papers were cited more than 65 times. The most important journal for research on the occurrence of dysphagia after cervical spine surgery was SPNIE (<i>n</i> = 445), followed by EUR SPINE J (<i>n</i> = 337) and SPINE J (<i>n</i> = 322), which analysed a number of factors including anatomy, patient information and the use of inbuilt objects. The top 20 most commonly used keywords were identified from 750 author keywords, with the highest number being dysphagia (<i>n</i> = 303), followed by fusion (<i>n</i> = 183) and spine surgery (182). In parallel with time zone and cluster analysis we found multiple high frequency keywords that appeared as early as 2006 and have continued to the present day, reflecting the enthusiasm of a large number of scholars who have researched this topic.</p><p><strong>Conclusion: </strong>This bibliometric study analyses the global research hotspots and trends in postoperative cervical spine complication dysphagia in terms of study type, patient information, surgical modality, surgical segment, most popular keywords, most cited papers, journals, authors, institutions, and countries, to guide future practice and direction, in order to help understand how to effectively prevent or reduce the incidence of this postoperative complication so as to achieve the goal of lowering the patient's healthcare costs, to balance social medical resources and reduce the financial burden of the government.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1550816"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987298","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":"Comparing the clinical outcomes of laparoscopic sleeve gastrectomy and hiatal hernia repair with or without fundoplication for weight loss and gastrointestinal reflux resolution.","authors":"Hussam Al Trabulsi, Dunia Al Trabulsi, Khadeja Alrefaie, Tala Muassess, Salman Yousuf Guraya","doi":"10.3389/fsurg.2025.1513695","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1513695","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence suggests that hiatal hernia should be repaired if found during laparoscopic sleeve gastrectomy (LSG), either to prevent new-onset post-operative gastro-esophageal reflux disease (GERD), or to treat pre-existing reflux symptoms. There is interest in performing laparoscopic Nissen's fundoplication (LNF) along with hiatal hernia repair (HHR) during LSG. This study aimed to determine whether hiatal crural repair alone is adequate for symptomatic control. We compared operative time, body mass index (BMI), and reflux symptoms between those undergoing LSG with HHR vs. LSG with HHR and LNF.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed clinical data of patients who underwent LSG with HHR. This cohort was divided into those with LNF (group 1) and without LNF (group 2). We collected patients' pre-operative BMI and GERD Questionnaire (GERD-Q) scores. We then compared pre-operative BMI and GERD-Q values with post-operative indices at 1-month, 3-months, and 6-months. The patients' medical records for operative findings and time between both groups was analyzed. Statistical analyses included Independent Samples <i>T</i>-tests, Paired <i>T</i>-tests, and correlation analysis.</p><p><strong>Results: </strong>In this study, 978 bariatric surgeries were performed. Of 431 LSG patients, 73 fulfilled the study criteria. Both groups showed significant reduction in BMI and GERD-Q scores post-operatively. Group 1 had a decrease in BMI from an average pre-operative value of 38.03-32.17 at 6 months (<i>p</i> < 0.001), and GERD-Q scores from 12.25 to 6.47 (<i>p</i> < 0.001). Group 2 showed a BMI decrease from 39.63 to 31.67 (<i>p</i> < 0.001) and GERD-Q scores from 11.54 to 6.93 (<i>p</i> < 0.001) at 6 months. Average operative time was similar in both groups, 76.41 and 79.15 min for group 1 and 2, respectively (<i>p</i> = 0.621).</p><p><strong>Conclusion: </strong>Our research with short-term results reports similar improvement in BMI and GERD symptoms in patients with LSG and HHR with or without LNF. A sound repair of hiatal crura combined with LSG leads to comparable outcomes to crural repair combined with LNF and LSG for weight loss and reflux resolution. Our short-term results do not support LNF in combination with LSG and HHR. Further research is essential to determine the long-term outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1513695"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009969","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":"Rare retroperitoneal hematoma after percutaneous endoscopic lumbar discectomy: a case report and literature review.","authors":"Haiyan Shao, Wenhao Zhu, Xiaochun Xiong, Jie Yu, Zhaoxiang Fan, Chenghong Zhou","doi":"10.3389/fsurg.2025.1503225","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1503225","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous endoscopic lumbar discectomy (PELD) has emerged as a first-line surgical option for the management of lumbar disc herniation (LDH). However, postoperative complications remain a concern. We present a rare case of retroperitoneal hematoma (RPH) following PELD.</p><p><strong>Case description: </strong>A 79-year-old woman who underwent PELD presented with pain in the left inguinal region, lower back, and abdomen, accompanied by hypotension and tachycardia. Abdominal computed tomography (CT) revealed a left-sided RPH. Digital subtraction angiography (DSA) identified a rupture of a left fourth lumbar segmental artery branch. Emergency coil embolization was performed to control the bleeding. Four weeks later, due to the persistence of the hematoma, hematoma evacuation was carried out. Following the procedure, the patient's symptoms resolved, and she experienced relief from discomfort in the left inguinal, lower back, and abdominal regions.</p><p><strong>Conclusion: </strong>DSA is critical for diagnosing lumbar arterial bleeding, and arterial embolization is an effective approach to hemostasis. Moreover, a comprehensive understanding of the lumbar intervertebral foraminal space anatomy and enhanced surgical techniques are essential to reduce the risk of retroperitoneal hematoma after PELD. Future studies should focus on optimizing the perioperative management process of PELD to enhance the safety of the procedure.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1503225"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996907","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":"Survival outcome and impact of delayed imatinib therapy in gastric gastrointestinal stromal tumors.","authors":"R Jansuwan, S Samphao, Wongsakorn Chaochankit","doi":"10.3389/fsurg.2025.1569677","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1569677","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the stomach being the predominant site. Surgical resection is the primary treatment for localized disease, but recurrence remains a concern, particularly in high-risk patients. Tyrosine kinase inhibitors (TKIs), such as imatinib, improve disease-free survival (DFS), yet their accessibility is often limited in resource-constrained settings.</p><p><strong>Methods: </strong>This retrospective cohort study included gastric GIST patients who underwent surgical resection between 2015 and 2020 at a tertiary referral center. DFS and overall survival (OS) were analyzed using Kaplan-Meier curves and Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 86 patients were included, with 40 (46%) classified as high-risk. The 5-year DFS was significantly lower in high-risk patients (40% vs. 95.7%, <i>p</i> < 0.001). Imatinib therapy group was associated with worse DFS in high-risk patients (<i>p</i> = 0.003), likely due to delayed initiation after recurrence rather than adjuvant use. Significant predictors of poor DFS included smoking (<i>p</i> < 0.001), prolonged operative time (<i>p</i> = 0.034), and advanced tumor stage (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Delayed imatinib therapy negatively impacts DFS in high-risk gastric GIST patients, highlighting the need for improved access to early TKI treatment. Additionally, smoking cessation and optimized perioperative management may enhance survival outcomes. Addressing modifiable risk factors and ensuring timely posoperative treatment could improve prognosis in this population.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1569677"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962668","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":"Impact of embolization on stereotactic radiosurgery outcomes for intracranial arteriovenous malformations Spetzler-Martin grades III-V: a systematic review and meta-analysis.","authors":"Christopher Lauren, I Wayan Niryana, Tjokorda Gde Bagus Mahadewa","doi":"10.3389/fsurg.2025.1563256","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1563256","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial arteriovenous malformations (AVMs) classified as Spetzler-Martin (SM) grades III-V present significant therapeutic challenges due to their complex angioarchitecture and high risk of morbidity. Stereotactic radiosurgery (SRS) is a minimally invasive modality for nidus obliteration, often combined with embolization to reduce nidus size and address high-risk vascular features. However, the impact of pre-SRS embolization on obliteration rates, post-SRS hemorrhage, and mortality remains controversial. This systematic review and meta-analysis aim to evaluate the effects of embolization on SRS outcomes in high-grade AVMs.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive search of PubMed, ScienceDirect, Cochrane, and Google Scholar was conducted. Studies comparing SRS alone versus SRS with embolization in SM grade III-V AVMs were included. Primary outcomes were obliteration rates, post-SRS hemorrhage, and mortality. Data extraction and quality assessment were performed using the Newcastle-Ottawa Scale, and pooled analysis was conducted using Review Manager (RevMan) software.</p><p><strong>Results: </strong>Out of 4,186 identified studies, five high-quality cohort studies met inclusion criteria. Pooled analysis showed that SRS alone resulted in higher obliteration rates than SRS with embolization (OR: 2.06, 95% CI: 0.92-4.65; <i>p</i>=0.08), though not statistically significant. Post-SRS hemorrhage rates were comparable (OR: 3.07, 95% CI: 0.72-13.08; <i>p</i> = 0.13), and mortality rates showed no significant difference (OR: 0.21, 95% CI: 0.01-4.62; <i>p</i> = 0.32).</p><p><strong>Discussion: </strong>Although embolization aids in nidus volume reduction, it may hinder radiosurgical efficacy by altering nidus architecture and introducing shielding effects. SRS alone demonstrated superior obliteration rates with fewer technical concerns. Individualized treatment planning remains essential, balancing embolization benefits against its potential drawbacks. Future studies should explore advancements in embolic agents and imaging techniques to optimize multimodal strategies for high-grade AVMs.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1563256"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994013","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":"Radiotherapy has a survival advantage over surgery in patients with choroidal melanoma: a retrospective cohort study of 6,871 patients.","authors":"Yifan Wu, Lu Shi, Zhiqiang Ye, Yi Zhou, Feiran Wang, Yulan Zhang","doi":"10.3389/fsurg.2025.1577775","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1577775","url":null,"abstract":"<p><strong>Background: </strong>Choroidal melanoma is a rare yet aggressive ocular malignancy, accounting for approximately 85% of all ocular melanomas. This study aimed to investigate the association between treatment modalities and the risk of all-cause mortality and choroidal melanoma-specific mortality, thereby comparing the effects of different treatment modalities on patient prognosis.</p><p><strong>Methods: </strong>Data from patients diagnosed with choroidal melanoma between 2004 and 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 6,871 cases were included in the analysis. Univariate analysis, stratified analysis, and multiple regression analysis were performed to evaluate all-cause mortality and choroidal melanoma-specific mortality across different treatment modalities. Survival curves for the overall and stratified populations were generated using the Kaplan-Meier method. Choroidal melanoma-specific mortality was estimated using the competing risk regression method of Fine and Gray.</p><p><strong>Results: </strong>In the fully adjusted model, the radiotherapy-only group exhibited a 45% reduction in all-cause mortality (HR = 0.55, 95% CI = 0.50-0.60, <i>p</i> < 0.0001) and a 54% reduction in choroidal melanoma-specific mortality (HR = 0.46, 95% CI = 0.41-0.52, <i>p</i> < 0.0001) compared to the surgery-only group. The radiotherapy group demonstrated superior long-term survival outcomes compared to other treatment modalities, with the highest 5-year overall survival (OS) rate of 0.7769 (95% CI = 0.7651-0.7889) and 10-year OS rate of 0.6203 (95% CI = 0.6038-0.6372). Additionally, the radiotherapy group achieved the highest 5-year choroidal melanoma-specific survival (CSS) rate of 0.8615 (95% CI = 0.8514-0.8717) and 10-year CSS rate of 0.7715 (95% CI = 0.7567-0.7866).</p><p><strong>Conclusions: </strong>Among patients diagnosed with choroidal melanoma, those who underwent radiotherapy alone exhibited significantly higher overall survival (OS) and choroidal melanoma-specific survival rates compared to those who received surgical intervention alone. However, for patients with advanced disease or evidence of metastatic spread, the individualization of treatment regimens remains critically important.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1577775"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988786","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":"Hip arthroscope-assisted percutaneous reduction and fixation of displaced subcapital femoral neck fracture.","authors":"Dajiang Du, Che Zheng, Mengxin Xue, Jiewei Chen, Yiyang Ma, Yun Gao, Changqing Zhang","doi":"10.3389/fsurg.2025.1555752","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1555752","url":null,"abstract":"<p><p>Reduction quality is associated with fracture prognosis. Displaced subcapital femoral neck fracture has highest possibility of avascular necrosis of femoral head and non-union among the femoral neck fractures, which commonly necessitate revisions or hip replacement. This study introduces for the first time of using hip arthroscope to directly visualize and assist the reduction of displaced subcapital femoral neck fracture when closed reduction is unsatisfactory. Due to the minimally invasive advantage of arthroscopic assistance, radiation exposure or intraoperative bleeding can be reduced, open reduction is avoided so that the blood supply of femoral head can be preserved. Through direct visualization, the complete removal of hematoma and fracture debris can be achieved, which is not possible with closed reduction, and can potentially reduce the risk of non-union during bone healing.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1555752"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991130","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":"Fluorescein sodium as a marker for focused ultrasound-induced blood-brain barrier disruption: a case report in a porcine model.","authors":"Yuan Xu, Thomas J On, Mark C Preul","doi":"10.3389/fsurg.2025.1559195","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1559195","url":null,"abstract":"<p><p>Transcranial low-intensity focused ultrasound (FUS) enables noninvasive, targeted, and reversible blood-brain barrier (BBB) disruption, facilitating drug delivery and liquid biopsy of the brain. Using fluorescein sodium (FNa) with macroscopic widefield fluorescence and microscopic confocal laser endomicroscopy (CLE) imaging, we assessed BBB permeability after applying a frameless, electromagnetic-guided FUS system in a porcine model and confirmed with established MRI protocol and conventional histology. Both macroscopic and microscopic FNa fluorescence imaging findings correlated with contrast-enhanced MRI, providing direct evidence of BBB disruption. This approach demonstrates the utility of FNa for evaluating BBB permeability in preclinical studies.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1559195"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009893","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":"Clinical comparison between direct anterior approach and posterior lateral approach in total hip arthroplasty and risk factors for lateral femoral cutaneous nerve injury.","authors":"Jian-Feng Yan, Le Zhao, Qiang Li","doi":"10.3389/fsurg.2025.1482731","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1482731","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical outcomes of total hip arthroplasty (THA) using the lateral decubitus direct anterior approach (DAA) vs. the traditional posterior lateral approach (PLA), and to explore the risk factors and predictive models for lateral femoral cutaneous nerve (LFCN) injury following DAA-THA.</p><p><strong>Methods: </strong>Two hundred patients undergoing primary unilateral THA were randomly assigned to the DAA group and the PLA group, with 100 cases in each group. Clinical data, surgical parameters, postoperative pain scores, and other relevant data were recorded, and the differences between the two groups in terms of treatment outcomes and postoperative recovery were analyzed.</p><p><strong>Results: </strong>Compared to the PLA group, patients in the DAA group had shorter incisions, reduced blood loss and drainage, shorter hospital stays, decreased postoperative inflammatory markers, and lower pain scores. However, the incidence of postoperative LFCN injury was higher in the DAA (DAA:24patients, 24%, PLA:2patients, 2%) group, although most cases resolved within one year. Univariate analysis showed that diabetes, preoperative serum CK levels, serum IL-6, and TNF-α levels at postoperative day 3 were associated with early LFCN injury, while diabetes, BMI, and postoperative inflammation were significantly associated with persistent LFCN injury. Binary logistic regression analysis identified serum IL-6 and TNF-α levels at postoperative day 3 as independent risk factors for persistent LFCN injury. The established predictive model demonstrated good discrimination.</p><p><strong>Conclusion: </strong>Despite slightly longer surgical duration, DAA demonstrated significant advantages in reducing early pain, blood loss, and hospital stay. However, postoperative LFCN injury warrants attention, especially in patients with diabetes and postoperative inflammatory reactions.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1482731"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961325","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 impact of suction duration on lung collapse during one-lung ventilation.","authors":"Lihua Hang, Jiajun Ju, Yulin Li, Min He","doi":"10.3389/fsurg.2025.1532176","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1532176","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of suction duration on lung collapse when using a bronchial blocker (BB) during single-port video-assisted thoracoscopic surgery (VATS) with one-lung ventilation (OLV).</p><p><strong>Methods: </strong>This study included 112 patients (39 males, 73 females; aged 18-75 years) with ASA physical status I or II undergoing single-port VATS under general anesthesia. Patients were randomized into four groups: control (0 s), 30 s, 60 s, and 90 s suction groups (-30 cmH₂O; <i>n</i> = 28/group). Lung collapse scores (LCS) were recorded immediately after thoracoscope entry (T0) and at 10 min (T10). The expression of nitric oxide synthase 3 (NOS-3) mRNA in lung tissue was analyzed using PCR. Lung injury pathology scores, the wet-to-dry weight ratio (W/D) of lung tissue, intraoperative hypoxemia, perioperative pulmonary complications, and use of disconnection techniques for inadequate collapse were documented.</p><p><strong>Results: </strong>At T₀, LCS in the 30 s, 60 s, and 90 s groups were significantly higher than in the control group (<i>P</i> < 0.05), with no differences among the suction groups. At T₁₀, LCS in the 60 s and 90 s groups were significantly higher than in the control group (<i>P</i> < 0.05), while no significant differences were observed between the 30 s and control groups. NOS-3 mRNA expression, lung injury pathology scores, and W/D ratios were comparable across groups. No severe hypoxemia or pulmonary complications occurred. Rescue techniques were required in four control group patients and one patient in the 30 s group but not in the 60 s and 90 s groups (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Suction at -30 cmH₂O for 60 s immediately after pleural incision during one-lung ventilation with a bronchial blocker in single-port VATS significantly improves lung collapse quality without causing lung injury, making it a clinically recommended practice.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1532176"},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964279","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}