Gland surgery最新文献

{"title":"Clinical application of vacuum sealing drainage in patients with idiopathic granulomatous mastitis.","authors":"Meng Xu, Quanwu Sun, Peilan Ma, Rong Shi, Fengyan Lv","doi":"10.21037/gs-2026-0372","DOIUrl":"https://doi.org/10.21037/gs-2026-0372","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease with an unclear etiology. Patients with IGM remain at risk of recurrence even after clinical cure. We assessed the long-term clinical outcomes of segmental mastectomy paired with vacuum sealing drainage (VSD)-based integrated wound management for IGM patients eligible for surgical intervention.</p><p><strong>Methods: </strong>Patients were divided into two groups according to the clinical treatment protocol: 87 patients underwent segmental mastectomy combined with VSD (VSD comprehensive group), and 63 underwent segmental mastectomy combined with conventional drainage (conventional drainage group). Postoperative pain score, number of dressing changes, incision healing time, length of hospital stay, hospitalization cost, breast morphology, and 2-year recurrence rate were compared between groups.</p><p><strong>Results: </strong>Compared with the conventional drainage group, the VSD comprehensive group had a significantly lower 2-year recurrence rate [4.59% <i>vs.</i> 20.63%; odds ratio (OR) =0.185, 95% confidence interval (CI): 0.057-0.600; P=0.003] and a significantly higher rate of excellent breast morphology (68.97% <i>vs.</i> 49.21%; OR =2.294; 95% CI: 1.173-4.487; P=0.02). Significant intergroup differences were observed in pain score (5.989±0.896 <i>vs.</i> 3.984±0.813, P<0.001), number of dressing changes (14.862±3.638 <i>vs.</i> 10.730±5.074, P<0.001), incision healing time (38.081±7.007 <i>vs.</i> 19.048±12.681 days, P<0.001), length of hospital stay (9.931±1.797 <i>vs.</i> 8.984±2.703 days, P=0.01), hospitalization cost (¥12,186.471±1,348.616 <i>vs.</i> ¥11,628.571±1,274.002, P=0.01).</p><p><strong>Conclusions: </strong>Segmental mastectomy paired with VSD-based integrated wound management was associated with improved breast morphology and a lower 2-year postoperative recurrence rate in patients with IGM, although early postoperative recovery was slower and hospitalization cost was higher.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"259"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation and comparative psychometric evaluation of four patient-reported outcome measures for breast cancer-related lymphedema: measurement properties and clinical discrimination.","authors":"Yue Zhou, Yun Li, Qi Zhang, Yingying Zhang, Shuang Hao, Shengqun Hou, Liqin Chen, Xia Zhang, Ping Li, Qianqian Yu, Jiaying Zhu, Minghua Lai, Jiong Wu, Bingqiu Xiu","doi":"10.21037/gs-2026-0286","DOIUrl":"https://doi.org/10.21037/gs-2026-0286","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Breast cancer-related lymphedema (BCRL) can substantially impair health-related quality of life. Patient-reported outcome measures (PROMs) may complement objective limb measurements by capturing symptoms, functional limitations, and psychosocial consequences; however, comparative evidence on BCRL-specific PROMs and validated Chinese versions remains limited. This study aimed to cross-culturally adapt four BCRL-specific PROMs and compare their classical and Rasch measurement properties, known-groups validity, and exploratory discrimination relative to a circumference-based reference classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Upper Limb Lymphedema 27 (ULL-27), Lymphedema Quality of Life Questionnaire for Upper Limbs (LYMQOL-ARM), Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL), and Lymphedema Life Impact Scale Version 2 (LLIS) were translated and culturally adapted according to international standards. In total, 204 Chinese women treated for breast cancer participated: 104 completed ULL-27 and LYMQOL-ARM, and 100 completed Lymph-ICF-UL and LLIS. Content validity, internal consistency, construct validity, known-groups validity across BCRL stages, and Rasch measurement properties were evaluated. Exploratory receiver operating characteristic (ROC) analyses assessed discrimination relative to the study reference classification. PROM scores were also compared between axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) recipients who did not meet the circumference-based BCRL criterion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The four PROMs were generally comprehensible and culturally relevant. All subscales demonstrated adequate weighted likelihood estimation reliability (0.730-0.921) and high internal consistency (Cronbach's α &gt;0.90). Of 93 items, 79 (84.9%) showed acceptable fit, and all response-category thresholds were ordered. Evidence generally supported essential unidimensionality, although local dependence, floor effects, and selected measurement-invariance concerns were identified. LLIS and Lymph-ICF-UL scores differed most consistently across BCRL stages. The largest area under the curve (AUC) estimates were observed for Lymph-ICF-UL Symptoms [0.734; 95% confidence interval (CI): 0.633-0.834], LLIS Physical (0.725; 95% CI: 0.625-0.825), and LLIS total score (0.680; 95% CI: 0.573-0.787); no pairwise AUC difference remained significant after Holm adjustment. Among circumference-negative participants, LLIS total, Physical, and Psychosocial scores and Lymph-ICF-UL Symptoms and Mental Function scores were significantly higher after ALND than after SLNB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Chinese versions of the four PROMs showed generally supportive but nonuniform measurement properties. LLIS and Lymph-ICF-UL performed comparatively well in distinguishing clinically defined BCRL stages, while LLIS Physical and Lymph-ICF-UL Symptoms show","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"257"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Improving quality of breast conservative surgery for lower quadrants cancer in small and medium sized breasts: Crescent technique versus J mammoplasty.","authors":"","doi":"10.21037/gs-2024b-6","DOIUrl":"https://doi.org/10.21037/gs-2024b-6","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/gs-24-74.].</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"272"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Habitat-based ultrasound radiomics for preoperative prediction of axillary lymph node metastasis in breast cancer: a two-center study.","authors":"Zimeng Fang, Xiaoyu Yan, Yunyun Zhan, Yu Bi, Xiabi Wu, Mingdi Fang, Yufan Zhang, Jiajia Wang, Mei Peng","doi":"10.21037/gs-2026-0363","DOIUrl":"https://doi.org/10.21037/gs-2026-0363","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative prediction of axillary lymph node metastasis (ALNM) remains challenging. This study investigates whether habitat-based ultrasound radiomics of suspicious axillary lymph nodes can predict preoperative ALNM in patients with breast cancer.</p><p><strong>Methods: </strong>This retrospective two-center study included 416 breast cancer patients with suspicious axillary lymph nodes and pathologically confirmed nodal status. Patients from the Second Affiliated Hospital of Anhui Medical University were randomly assigned to the training and internal validation cohorts at a ratio of 7:3, whereas patients from Taihe County People's Hospital constituted the external test cohort. Suspicious lymph nodes were manually segmented. Pixel-level features were clustered using the K-means algorithm to divide each node into four habitat subregions. Radiomics features were extracted from the intranodal region of interest and each habitat subregion to construct the intranodal radiomics, individual habitat, and habitat radiomics models. A combined nomogram integrating the optimal radiomics signature with independent clinical predictors was developed.</p><p><strong>Results: </strong>Cortical thickness and lymph node vascular pattern were independent predictors of ALNM. The habitat radiomics model outperformed the intranodal radiomics and individual habitat models, with areas under the receiver operating characteristic curve (AUCs) of 0.859, 0.809, and 0.791 in the training, internal validation, and external test cohorts, respectively. The combined nomogram achieved the highest AUCs of 0.866, 0.819, and 0.806 in the corresponding cohorts, and its clinical utility was confirmed by decision curve analysis.</p><p><strong>Conclusions: </strong>Habitat-based ultrasound radiomics improved ALNM prediction by capturing intranodal heterogeneity. The nomogram may provide a practical noninvasive tool for individualized preoperative assessment of suspicious axillary lymph nodes.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"247"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmural migration of an internal pancreaticojejunostomy stent causing delayed intra-abdominal sepsis: a case report.","authors":"Kamal Abi Mosleh, Ismail M Saleem, Caitlin Burns, Carolina Orsi, Hishaam Ismael","doi":"10.21037/gs-2026-0237","DOIUrl":"https://doi.org/10.21037/gs-2026-0237","url":null,"abstract":"<p><strong>Background: </strong>Internal pancreatic duct stents are commonly used during pancreaticojejunostomy (PJ) reconstruction following pancreaticoduodenectomy to facilitate drainage and potentially reduce postoperative pancreatic fistula (POPF). These stents are typically expected to migrate distally and pass without consequence. However, rare complications related to stent migration may occur and can present with atypical clinical and biochemical findings, creating diagnostic challenges.</p><p><strong>Case description: </strong>A 63-year-old woman underwent pancreaticoduodenectomy for pancreatic adenocarcinoma with placement of an internal PJ stent. Her initial postoperative course was uneventful, with normal drain amylase levels. On postoperative day (POD) eight, she presented with fever, leukocytosis, and abdominal pain. Computed tomography (CT) demonstrated peripancreatic fluid and gas collections suspicious for POPF; however, drain amylase levels remained low, creating diagnostic uncertainty. Despite initial nonoperative management, the patient's clinical status deteriorated, prompting exploratory laparotomy. Intraoperatively, the PJ anastomosis was intact, but diffuse enteric contamination was present. Intraoperative ultrasound revealed transmural migration of the pancreatic duct stent through the jejunal wall into the mesentery, resulting in a concealed perforation with extraluminal leakage of enteric contents. The stent was retrieved via controlled enterotomy, the defect was repaired, and the abdomen was irrigated. The patient subsequently improved with resolution of sepsis and was discharged in stable condition.</p><p><strong>Conclusions: </strong>Transmural migration of an internal PJ stent is a rare but serious complication that may present with intra-abdominal sepsis in the absence of elevated drain amylase levels. This case highlights an important diagnostic pitfall, as enteric contamination rather than pancreatic leakage may predominate. In patients with unexplained postoperative deterioration following pancreaticoduodenectomy, particularly when imaging is equivocal and biochemical markers are discordant, stent-related complications should be considered. Early recognition and prompt surgical intervention are critical for optimal outcomes.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"270"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of a machine learning prediction model for postoperative hemorrhage following modified radical mastectomy for breast cancer.","authors":"Weiyuan Chen, Xiaoxu Li, Xiaoman Zhang, Wenqi Shen","doi":"10.21037/gs-2026-0268","DOIUrl":"https://doi.org/10.21037/gs-2026-0268","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hemorrhage is a clinically meaningful complication of modified radical mastectomy (MRM), but existing risk-prediction models rely on logistic regression (LR), rarely provide interpretable individualized risk attribution, and have not been specifically developed or internally validated for MRM. We aimed to develop and internally validate machine learning models for predicting clinically significant postoperative hemorrhage after MRM.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients who underwent MRM at the Affiliated Hospital of Xuzhou Medical University between January 2022 and October 2024. Patients operated between January 2022 and December 2023 constituted the development cohort; patients operated between January and October 2024 constituted a strictly held-out temporal validation cohort. The primary endpoint was clinically significant hemorrhage, defined as unplanned reoperation for bleeding, transfusion for bleeding, or postoperative wound drainage exceeding 500 mL within any 24-hour period, ascertained over a 30-day postoperative follow-up window. Five algorithms-LR, decision tree (DT), random forest (RF), support vector machine (SVM), and extreme gradient boosting (XGBoost)-were trained on least absolute shrinkage and selection operator (LASSO)-selected predictors and evaluated by area under the curve (AUC), calibration metrics, decision curve analysis (DCA), and 1,000-iteration optimism-corrected bootstrap. Shapley additive explanations (SHAP) were used for model interpretation.</p><p><strong>Results: </strong>A total of 1,842 patients were analyzed, of whom 74 developed clinically significant postoperative hemorrhage. The XGBoost model achieved the best performance [temporal validation AUC 0.827, 95% confidence interval (CI): 0.734-0.920; sensitivity 0.737 and specificity 0.814 at the Youden-derived threshold; Brier score 0.036], outperforming RF (AUC 0.819), SVM (0.794), LR (0.783), and DT (0.738). The XGBoost model demonstrated good calibration and the highest decision-curve net benefit across threshold probabilities of 5-30%. SHAP analysis identified tumor size, age, operation time, neoadjuvant chemotherapy, lymph node metastasis, pathological stage, and preoperative anticoagulant use as the seven leading predictors.</p><p><strong>Conclusions: </strong>An XGBoost-based machine learning model predicted clinically significant postoperative hemorrhage after MRM and provided interpretable individualized risk estimates that may support early perioperative risk stratification and individualized hemostatic management. As a single-center study with internal (temporal) validation only and modest sensitivity, these findings should be regarded as exploratory, and multicenter external validation is required before clinical use.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"250"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of intraoperative mitoxantrone hydrochloride injection with incidental parathyroidectomy and parathyroid autotransplantation during gasless unilateral axillary endoscopic thyroidectomy: a propensity score-matched retrospective cohort study.","authors":"Qi Jiang, Yaozong Wang, Ziyan Wang, Audrey Y Su, Renkui Fu, Tianyu Li, Liangbo Dong, Ge Chen, Chen Lin","doi":"10.21037/gs-2026-0292","DOIUrl":"https://doi.org/10.21037/gs-2026-0292","url":null,"abstract":"<p><strong>Background: </strong>Preserving parathyroid glands during thyroidectomy remains challenging, particularly in remote-access procedures. Mitoxantrone hydrochloride injection (MHI) is a local lymphotropic tracer that may improve intraoperative discrimination of parathyroid glands during gasless unilateral axillary endoscopic thyroidectomy (GUAET), but evidence remains limited. We evaluated whether intraoperative MHI was associated with a lower rate of incidental parathyroidectomy (IP) during GUAET and described parathyroid autotransplantation (PAT) as a separate management outcome.</p><p><strong>Methods: </strong>We performed a single-center retrospective cohort study of consecutive patients who underwent GUAET at a tertiary referral center in China between July 2020 and May 2024. Patients who received intraoperative MHI were compared with patients who underwent the same procedure without MHI. The primary outcome was IP. Secondary outcomes included PAT, short-term biochemical hypoparathyroidism [parathyroid hormone (PTH) <15 pg/mL], hypocalcemia (calcium <2.11 mmol/L), lymph node metrics, and postoperative symptoms. Nearest-neighbor 1:2 propensity score matching without replacement was performed using a 0.25-standard deviation caliper.</p><p><strong>Results: </strong>The study included 129 patients (31 in the MHI group and 98 in the control group). Propensity score matching yielded 93 patients (31 MHI and 62 controls). In the matched cohort, MHI was associated with a lower rate of IP [4/31 (12.9%) <i>vs.</i> 24/62 (38.7%); odds ratio (OR), 0.235; 95% confidence interval (CI), 0.073-0.754; P=0.02] and a higher rate of PAT [15/31 (48.4%) <i>vs.</i> 3/62 (4.8%); OR, 18.438; 95% CI, 4.746-71.630; P<0.001]. Rates of postoperative day 1 and month 1 hypoparathyroidism and hypocalcemia were similar between groups. Lymph node yield, positive lymph node counts, and postoperative symptom rates were also comparable.</p><p><strong>Conclusions: </strong>During GUAET, intraoperative MHI was associated with fewer IPs and more frequent PAT after propensity score matching. No clear differences were observed in short-term biochemical recovery, lymph node metrics, or postoperative symptoms.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"260"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond tumor biology: can host nutritional status refine prediction of early recurrence after pancreatic cancer surgery?","authors":"Takehiro Okabayashi","doi":"10.21037/gs-2026-0422","DOIUrl":"https://doi.org/10.21037/gs-2026-0422","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"245"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting the 39% clinical complete response rate in SURE-02: why the assessment pathway matters.","authors":"Shugo Yajima, Hitoshi Masuda","doi":"10.21037/gs-2026-0415","DOIUrl":"https://doi.org/10.21037/gs-2026-0415","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"271"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 postoperative hyperamylasemia and post-pancreatectomy acute pancreatitis following pancreaticoduodenectomy in a single-center cohort.","authors":"Ativitch Asavachaisuvikom, Pongsatorn Tangtawee, Narongsak Rungsakulkij, Wikran Suragul, Somkit Mingphruedhi, Paramin Muangkaew","doi":"10.21037/gs-2026-0374","DOIUrl":"https://doi.org/10.21037/gs-2026-0374","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of postoperative hyperamylasemia (POH) and post-pancreatectomy acute pancreatitis (PPAP) following pancreaticoduodenectomy (PD) is understudied. Hence, we aimed to determine the incidence, risk factors, and short-term clinical impact of post-PD POH and PPAP.</p><p><strong>Methods: </strong>A retrospective, single-center, observational study was conducted with consecutive adult patients who underwent surgery between January 2012 and September 2025. POH and PPAP were defined and graded using the 2022 International Study Group of Pancreatic Surgery (ISGPS) consensus criteria.</p><p><strong>Results: </strong>Among the 244 participants, 25.4% developed POH and 31.1% developed PPAP. Those with PPAP demonstrated significantly higher rates of clinically relevant postoperative pancreatic fistula (CR-POPF), postoperative complications (Clavien-Dindo classification ≥3), and longer hospital and intensive care unit (ICU) stays compared to those without PPAP. There was no difference in the 90-day mortality rate. Perioperative factors were significantly associated with PPAP in the univariate analysis, including male sex [odds ratio (OR) =1.83; 95% confidence interval (CI): 1.05-3.17; P=0.03] and the presence of preoperative biliary drainage (OR =1.84; 95% CI: 1.01-3.35; P=0.047). Two intraoperative characteristics were identified as significant risk factors for PPAP: soft pancreatic texture (OR =2.58; 95% CI: 1.39-4.81; P=0.003) and a narrower pancreatic duct (OR =0.77; 95% CI: 0.66-0.99; P=0.002). CR-POPF was associated with an increased incidence of PPAP (OR =11.13; 95% CI: 5.61-22.07; P=0.001). In the multivariate analysis, male sex (OR =2.49; 95% CI: 1.13-5.51; P=0.02) and CR-POPF (OR =17.55; 95% CI: 7.13-43.19; P<0.001) were identified as risk factors for PPAP.</p><p><strong>Conclusions: </strong>PPAP is associated with an increased risk of adverse outcomes. It has potential as an indicator of surgical morbidity and of prolonged hospital and ICU stays.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"15 9","pages":"249"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}