Frontiers in Surgery最新文献

{"title":"Techniques to mitigate lead migration for percutaneous trials of cervical spinal cord stimulation.","authors":"Jonathan N Finney, Isaiah R Levy, Santosh Chandrasekaran, Jennifer L Collinger, Michael L Boninger, Robert A Gaunt, Eric R Helm, Lee E Fisher","doi":"10.3389/fsurg.2025.1458572","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1458572","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural spinal cord stimulation (SCS) is a clinical neuromodulation technique that is commonly used to treat neuropathic pain, with patients typically undergoing a one-week percutaneous trial phase before permanent implantation. Traditional SCS involves stimulation of the thoracic spinal cord, but there has been substantial recent interest in cervical SCS to treat upper extremity pain, restore sensation from the missing hand after amputation, or restore motor function to paretic limbs in people with stroke and spinal cord injury. Because of the additional mobility of the neck, as compared to the trunk, lead migration can be a major challenge for cervical SCS, especially during the percutaneous trial phase. The objective of this study was to optimize the implantation procedure of cervical SCS leads to minimize lead migration and increase lead stability during SCS trials.</p><p><strong>Methods: </strong>In this study, four subjects underwent percutaneous placement of three SCS leads targeting the cervical spinal segments as part of a clinical trial aiming to restore sensation for people with upper-limb amputation. The leads were maintained for up to 29 days and weekly x-ray imaging was used to measure rostrocaudal and mediolateral lead migration based on bony landmarks.</p><p><strong>Results and discussion: </strong>Lead migration was primarily confined to the rostrocaudal axis with the most migration occurring during the first week. Iterative improvements to the implantation procedure were implemented to increase lead stability across subjects. There was a decrease in lead migration for patients who had more rostral placement of the SCS leads. The average migration from the day of lead implant to lead removal was 29.7 mm for Subject 1 (lead placement ranging from T3-T4 to T1-T2), 41.9 mm for Subject 2 (T2-T3 to C7-T1), 1.9 mm for Subject 3 (T1-T2 to C7-T1), and 16.6 mm for Subject 4 (T1-T2 to C7-T1). We found that initial placement of spinal cord stimulator leads in the cervical epidural space as rostral as possible was critical to minimizing subsequent rostrocaudal lead migration.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1458572"},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966495","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 preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in noncirrhosis patients with colorectal liver metastasis.","authors":"Yixian Guo, Yufeng Wang, Runkun Liu, Hanqi Li, Guozhi Yin, Hang Tuo, Yifeng Zhu, Yiheng Wang, Wei Yang, Zhikui Liu","doi":"10.3389/fsurg.2025.1512843","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1512843","url":null,"abstract":"<p><strong>Background: </strong>Serum albumin level and body mass index (BMI), acting as indicators of nutritional status, are commonly applied to predict surgical outcomes in cancer patients. This study aimed to evaluate the impact of preoperative serum albumin level and BMI on the operative outcomes of noncirrhotic patients with colorectal cancer liver metastasis who underwent hepatectomy.</p><p><strong>Methods: </strong>This was a retrospective study of medical records from the period between January 2013 and December 2022. Preoperative malnutrition was defined as hypoalbuminemia with a serum albumin level of <35 g/L before surgery or a BMI of <18.5 kg/m² within 30 days before surgery. Multiple statistical methods were applied to analyze the data, including the two-independent sample <i>t</i>-test, analysis of variance, Chi-squared test, and multivariate analysis.</p><p><strong>Results: </strong>Among the 159 eligible patients, 42 (26.4%) were classified into the preoperative malnutrition group. The incidence of blood transfusion (45.24% vs. 18.80%, <i>P</i> = 0.040) was significantly higher in the malnutrition group. The drainage volume was significantly higher on the first day [65 (115) vs. 60 (80), <i>P</i> < 0.05] and the second day [50 (95) vs. 40 (79) <i>P</i> < 0.05] in the malnutrition group than that in the nonmalnutrition group. Postoperative hemoglobin levels were significantly lower in the malnutrition group (101.20 ± 2.43 vs. 108.76 ± 1.61, <i>P</i> = 0.015). Therefore, the incidence of grade Ⅱ or Ⅲ/Ⅳ complications was significantly higher in the malnutrition group (16.67% vs. 5.31% or 11.9% vs. 3.42%, <i>P</i> = 0.001), and the length of hospital stay was significantly extended [18 (12) vs. 15 (8), <i>P</i> = 0.002]. In the multivariate analysis, preoperative malnutrition [odds ratio (OR) = 5.548, 95% CI 1.508-20.413, <i>p</i> = 0.010] and operation time (OR = 1.009, 95% CI 1.002-1.016, <i>P</i> = 0.0011) were identified as independent predictors of postoperative complications.</p><p><strong>Conclusion: </strong>Preoperative malnutrition in patients who underwent hepatectomy for colorectal cancer liver metastasis was associated with worse surgical outcomes, especially aggrandizing the emergence of postoperative complications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1512843"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979243","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":"Self-made spoon-shaped tool for removal of magnetic foreign bodies from the bladder: a case report.","authors":"Zhi Yuan Zhang, Huan Deng, Qi Chun Liang, Yi He Wang","doi":"10.3389/fsurg.2025.1528819","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1528819","url":null,"abstract":"<p><strong>Background: </strong>Foreign bodies retained in the urethra or bladder present a rare but complex challenge in adult urological practice. Magnetic beads, in particular, are difficult to manage due to their mutual attraction and the large quantities often involved. The presence of such beads complicates removal procedures, especially in male patients with a long urethra. We describe a novel and simple method for retrieving magnetic beads from the bladder.</p><p><strong>Case description: </strong>A 23-year-old man presented with painful urination after inserting approximately 40 small magnetic beads into his urethra for sexual stimulation. Pelvic computed tomography confirmed the presence of multiple metallic bodies in the bladder. Given his preference for a minimally invasive approach and opposition to open surgery, we devised a novel retrieval method. To remove the foreign bodies in a minimally invasive manner, we used orthopedic wire to create a spoon-shaped extractor, which was inserted through a resectoscopic sheath. Using direct cystoscopic visualization, the extractor successfully removed up to six beads at a time. A total of 48 beads were retrieved from the bladder, and the patient was discharged on the second postoperative day, with no complications or residual symptoms.</p><p><strong>Conclusions: </strong>The self-made extractor reduced the risks associated with removing spherical foreign bodies and shortened the overall surgical time. This new device offers valuable insights into the efficient removal of spherical objects from the bladder, making it suitable for primary care settings where conventional instruments may be limited.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1528819"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986589","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":"Top 100 most-cited articles on pelvic organ prolapse: a visualization and bibliometric analysis.","authors":"Lu Yang, Qin Tao, Huaye Wu, Litong Yin, Xuemei Wu, Ying Xiong, Xiaoqin Gan, Yonghong Lin, Xia Yu","doi":"10.3389/fsurg.2025.1485426","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1485426","url":null,"abstract":"<p><strong>Introduction: </strong>Bibliometric analysis is a scientometric method that allows the quantitative analysis of publications. This study used the Web of Science database to perform a bibliometric analysis of the 100 most-cited articles in the field of pelvic organ prolapse (POP) to identify the key research themes and emerging topics within this area.</p><p><strong>Methods: </strong>We collected pertinent publications from the Web of Science Core Collection (WoSCC). The search was conducted using the following keywords: \"pelvic organ prolapse\", \"pelvic organ prolapse\" or \"pelvic organ prolapses\". The search included all publication dates up to June 27, 2024, without any article type restrictions, and the articles were sorted based on their citation count. The top 100 articles with the most citations were included in the subsequent analyses. Several tools, including the Bibliometrix program in R, CiteSpace software, the Online Analysis Platform of Literature Metrology (https://bibliometric.com), and an online interface by Bibliometrix, were used to analyze the data.</p><p><strong>Results: </strong>The top 100 most cited articles in the field of POP were cited 26,894 times in total. These articles were published between 1993 and 2019, and the majority of them were published during the 10-year period from 2001 to 2010. The United States and the University of California, San Francisco, produced the most publications on this topic. The American Journal of Obstetrics and Gynecology had the greatest influence on POP research. The most prolific author in this field was Barber MD (<i>n</i> = 7). Epidemiological research and treatment, particularly in the area of tissue engineering, were the main focus and current trends in POP research.</p><p><strong>Conclusion: </strong>This study revealed key research areas and current research hotspots for POP, with a particular focus on epidemiological studies and surgical interventions, especially in the field of tissue engineering. It is suggested that the future research in this field should pay more attention to epidemiological research and treatment, so as to better understand the risk factors of the disease and the characteristics of the affected population, and expect high-quality curative effect and prevention.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1485426"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999836","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":"Prescribing preoperative weight loss prior to major non-bariatric surgery for patients with elevated weight: a national provider survey (PREPARE provider survey).","authors":"Tyler McKechnie, Alex Thabane, Phillip Staibano, Maisa Saddik, Olivia Kuszaj, Manon Guez, Dennis Hong, Aristithes Doumouras, Cagla Eskicioglu, Sameer Parpia, Mohit Bhandari","doi":"10.3389/fsurg.2025.1529116","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1529116","url":null,"abstract":"<p><strong>Background: </strong>The surgical patient with obesity presents several challenges in intraoperative and postoperative care. We designed this cross-sectional survey to assess surgeon willingness to prescribe preoperative very low energy diets (VLEDs) and practice patterns in prescribing preoperative weight loss interventions for patients with obesity undergoing non-bariatric abdominal surgery.</p><p><strong>Methods and findings: </strong>We conducted a cross-sectional survey of practicing surgeons in Canada who perform major non-bariatric abdominal surgery, reported in accordance with the Consensus-Based Checklist for Reporting of Survey Studies and utilizing non-probability convenience sampling. The primary outcome was willingness to prescribe preoperative VLED to obese patients undergoing major non-bariatric abdominal surgery for both benign and malignant indications. We created a multivariable proportional odds model to identify factors associated with willingness to prescribe VLEDs. A total of 78 participants completed and returned the survey (response rate 10.9%; mean age 43.54 ± 8.13 years; 48.72% female). Most surgeons (79.5%) felt that obesity significantly impacted the technical difficulty of their operations. We identified a disconnect between those surgeons who were willing prescribe VLEDs vs. those who actually prescribed them (78.2% vs. 30.8%, respectively). Approximately half of the surgeons reported being unfamiliar with VLEDs. Regression analysis identified practicing in academic institutions was associated with increased willingness to prescribe [odds ratio (OR) 3.71, 95% confidence intervals (CI) 1.01-13.7, <i>p</i> < 0.01].</p><p><strong>Conclusion: </strong>Although the majority of surgeons feel that obesity adversely impacts perioperative care, only one-third routinely discuss preoperative VLEDs with their patients. Opportunities to increase awareness and evaluate the impact of VLEDs on patient outcomes remain high.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1529116"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005881","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 systematic review of implant materials for facial reconstructive and aesthetic surgery.","authors":"Martin Kauke-Navarro, Leonard Knoedler, Helena Baecher, Khalil Sherwani, Samuel Knoedler, Omar Allam, Fortunay Diatta, Michael Alperovich, Ali-Farid Safi","doi":"10.3389/fsurg.2025.1548597","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1548597","url":null,"abstract":"<p><strong>Background: </strong>Assessing facial plastic surgery techniques is essential for improving patient safety and outcomes through evidence-based practices. Despite the extensive use of facial implants, there is a scarcity of thorough research on their long-term effects and safety profiles.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, analyzing studies from 1970 to 2024 on various implant materials for facial reconstruction and augmentation. The databases searched for this review included PubMed, Web of Science, Google Scholar, and EMBASE. Inclusion criteria were full-text articles in English, focusing on alloplastic materials for craniofacial skeleton replacement or augmentation.</p><p><strong>Results: </strong>We included 117 studies with 4,273 patients and a mean follow-up of 34 months (range: 15 days to 25 years). Of these, 56% focused on reconstruction, 33% on aesthetics, and 10% on both. Patient ages ranged from 6 months to 85 years, with most studies addressing the orbital (29%), chin (22%), and malar (19%) regions. 67% of studies evaluated potential complications and found an overall rate of 4.4%. Nerve injuries (2.1%) and infections (1.0%) were the most frequent issues, with hematoma, implant displacement, and bone resorption rates at 1.4%, 0.59%, and 0.68%, respectively. Patient-specific implants (PSIs) showed promise in reducing complications such as infections, suggesting that customization to patient anatomy may provide benefits. The highest rate of complication-free postoperative recovery was observed with polyethylene facial implants.</p><p><strong>Conclusion: </strong>This review highlights variability in implant performance. The increased use of PSI suggests improved outcomes, warranting further investigation. Standardized outcome reporting and further research are needed to enhance comparability and guide clinical practice.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier (CRD42024501754).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1548597"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962685","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":"Short-term therapeutic efficacy analysis of drug-coated balloon combined with chocolate balloon for the treatment of femoropopliteal artery lesions.","authors":"Rong Zhang, Chao Yun Jiang, Tian Hong Cai, Jiang Feng He, Kai Chen, Teng Hui Zhan","doi":"10.3389/fsurg.2025.1419127","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1419127","url":null,"abstract":"<p><strong>Background: </strong>To report our experience of short-term results of drug-coated balloon (DCB) combined with chocolate balloon in the treatment of femoropopliteal artery lesions.</p><p><strong>Methods: </strong>From June 2021 to December 2022, patients with femoropopliteal artery lesions (Rutherford classification 2-6) who underwent DCB combined with Chocolate PTA balloon catheter treatment were included. Clinical data of the patients were collected, and follow-up was conducted at 3, 6, and 12 months. The primary patency rate and the freedom from clinically-driven target lesion revascularization (f-TLR) rate were calculated by Kaplan-Meier survival curves.</p><p><strong>Results: </strong>This study included a total of 43 patients (mean age 72.84 ± 10.19 years, male proportion 67.4%) with 47 lesions. Among them, 17 lesions (36.2%) presented severe stenosis with an average lesion length of 110.41 ± 47.67 mm. Thirty lesions (63.8%) were identified as chronic total occlusions (CTO), with an average occlusion length of 104.13 ± 61.12 mm. The Kaplan-Meier survival curve estimated a primary patency rate of 87.2% at 6 months and 78.7% at 12 months. The f-TLR rate at 12 months was 85.1%, estimated by Kaplan-Meier survival curve. The mean ankle-brachial index (ABI) increased from 0.53 ± 0.12 before the surgery to 0.87 ± 0.12 at 12 months postoperatively, and this difference was statistically significant (<i>p</i> < 0.001). A total of 91.5% of patients (43/47) showed a decrease in Rutherford classification at 12 months postoperatively. The proportion of patients with Rutherford class 4-6 decreased from 70.2% (33/47) preoperatively to 4.3% (2/47) at 12 months postoperatively, and this difference was statistically significant (<i>p</i> < 0.001). Among the limbs, 34 (72.3%) experienced dissection during the surgery, with 29 cases classified as type B or lower dissection and 5 cases classified as type C or higher (severe dissection) (10.6%). Two limbs (4.3%) required the use of salvage stents. There were no procedure- or device-related deaths within the 12-month period. Twelve limbs (25.5%) underwent minor amputations (toe amputations).</p><p><strong>Conclusion: </strong>The combination of DCB and chocolate balloon angioplasty has achieved satisfactory patency rates and f-TLR results in 1-year follow-up for the treatment of femoropopliteal artery lesions. However, further confirmation of these findings is needed through multicenter data and long-term follow-up results.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1419127"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of flexible ureteroscopy with flexible and navigable suction ureteral access sheath and mini-percutaneous nephrolithotripsy for the treatment of impacted upper ureteral stones: a retrospective study.","authors":"Haiyang Tang, Yulong Che, Zhanpeng Wu, Fangchao Yuan, Jiayu Liu, Jie Li","doi":"10.3389/fsurg.2025.1562428","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1562428","url":null,"abstract":"<p><strong>Background and objective: </strong>The treatment of impacted upper ureteral stones remains a significant challenge for urologists. Standard treatment protocols often favor Mini-Percutaneous Nephrolithotripsy (Mini-PCNL). It has been supposed to be associated with a higher stone clearance rate and a lower incidence of ureteral stricture compared to Flexible Ureteroscopy (FURS). Recently, FURS with flexible and navigable suction ureteral access sheath (FANS) has emerged as a promising alternative. The aim of this study was to compare the efficacy and safety of the FURS with FANS and Mini-PCNL for treating the impacted upper ureteral stones.</p><p><strong>Method: </strong>A retrospective study of 80 patients treated with FURS with FANS (Group A, <i>n</i> = 43) or Mini-PCNL (Group B, <i>n</i> = 37) was conducted in our center (from June 2023 to August 2024). Primary outcomes included stone-free rate (SFR), hemoglobin drop, hospital stay, and complications (Clavien-Dindo classification) in 3 months.</p><p><strong>Results: </strong>Both groups achieved comparable SFR (90.7% vs. 83.78%, <i>P</i> = 0.351). Group A had significantly lower hemoglobin drop (3.65 ± 8.39 vs. 7.89 ± 9.39 g/L, <i>P</i> = 0.036) and shorter hospital stays (1.79 ± 1.08 vs. 3.81 ± 1.37 days, <i>P</i> < 0.001). Complication rates were similar, but Group A had a higher rate of second-stage operation (18.6% vs. 8.1%, <i>P</i> = 0.174) and neither group required reoperation for ureteral stricture or rupture at 3 months post-surgery.</p><p><strong>Conclusion: </strong>FURS with FANS is a safe and effective alternative to Mini-PCNL for impacted upper ureteral stones larger than 10 mm, offering shorter recovery times and lower bleeding. However, its higher second-stage operation rate necessitates further investigation.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1562428"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961247","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":"Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm.","authors":"Francesca Pirola, Raymond Kim, Richard Douglas","doi":"10.3389/fsurg.2025.1549915","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1549915","url":null,"abstract":"<p><p>Nasal valve obstruction (NVO) remains challenging to diagnose and treat. This review explores the persisting controversies of NVO management, emphasising the lack of consensus in diagnostic criteria and treatment protocols among otolaryngologists and facial plastic surgeons. Recent surveys highlight the central dilemma: for many patients who have both septal deviation and NVO, a septoplasty alone provides adequate symptomatic improvement. However, some with this combination of problems continue to be troubled by nasal obstruction if only a septoplasty is performed. This underscores the critical question of when NVO necessitates specific surgical intervention. The varying diagnostic approaches that have been used and the limited outcome data currently available conspire to make this question difficult to answer with certainty. This review will also address the role of the inferior turbinates in NVO management, proposing their inclusion in NVO surgical planning. Other techniques will also be discussed for their potential impact on nasal valve dynamics. Both endonasal and open approaches to correcting the caudal septum need to be considered when discussing NVO repair. A treatment algorithm for NVO will be presented as a practical guide for the management of this condition.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1549915"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015382","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":"Comparative study of individualized 3D-printing navigation technology and free-hand isthmus method in lumbar CBT screw implantation.","authors":"Hanlin Hu, Zhenghao Lu, Xiaowen Gao, Jun Ou, Jiong Wang","doi":"10.3389/fsurg.2025.1520481","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1520481","url":null,"abstract":"<p><strong>Objectives: </strong>Traditional cortical bone trajectory (CBT) screws in the lumbar spine offer greater holding strength and are well-suited for patients with osteoporosis. However, the screw implantation procedure is challenging and associated with significant risk. This study aimed to assess whether individualized 3D-printing navigation technology provides higher accuracy and better clinical outcomes compared to the free-hand isthmus method for lumbar CBT screw implantation.</p><p><strong>Methods: </strong>From September 2020 to August 2023, a total of 41 patients who underwent CBT screw surgery were retrospectively collected. Among them, 23 patients underwent the free-hand isthmus method (Group A), while 18 patients underwent the individualized 3D-printing navigation technique (Group B). All imaging and clinical data for these patients were collected in a blinded manner.</p><p><strong>Results: </strong>During the surgery, 185 CBT screws were implanted into the lumbar spines of 41 patients-78 in Group A and 107 in Group B. After the surgery, the majority of implanted screws (86.5%) were classified as grade 0, indicating satisfactory implantation. Compared to Group A, Group B had fewer screws classified as grade 1 or grade 2 (<i>p</i> = 0.045), indicating higher accuracy in screw implantation. Additionally, Group B also had a shorter operation duration (<i>p</i> = 0.02), fewer fluoroscopy exposures (<i>p</i> < 0.01), and less blood loss (<i>p</i> = 0.03). In addition, compared to Group A, individuals in Group B showed significant improvement in back pain symptoms at both 3 and 6 months (<i>p</i> = 0.01 and <0.01), as well as in physical activity at 3 months (<i>p</i> = 0.02) postoperatively. No significant difference in postoperative complications was observed between the two groups.</p><p><strong>Conclusion: </strong>Compared to the free-hand isthmus method, lumbar CBT screw implantation with individualized 3D-printing navigation technology shows higher accuracy, shorter operative time, reduced intraoperative fluoroscopy and blood loss, and better clinical outcomes at three months post-surgery.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1520481"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009816","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}