International journal of surgery最新文献

{"title":"A commentary on \"global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030\" [Letter].","authors":"Yujun He, Miao Zhou, Xiaoyi Wang, Xiaojun Li","doi":"10.1097/JS9.0000000000002355","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002355","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the advanced lung cancer inflammation index and all-cause mortality in the US MASLD/MetALD patient population: a cohort study.","authors":"Hang Li, Gaohui Chen, Shiting Bao, Guotai Lin, Fengwei Xie, Xiaoyu Tan, Mingyi Li, Shuo Fang, Wei Dai","doi":"10.1097/JS9.0000000000002374","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002374","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the Advanced Lung Cancer Inflammation Index (ALI) and all-cause mortality in patients with Metabolic Dysfunction-Associated Steatohepatitis and Metabolic-Associated Alcoholic Liver Disease and other combination etiology of steatosis (MASLD/MetALD & Mixed Etiology Steatosis) is not well-understood. Current evidence is insufficient to establish this association, yet it holds critical importance for healthcare and public health. Research into the link between ALI and all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis remains a topic of interest.</p><p><strong>Objective: </strong>This study investigated the association between ALI and all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis patients, and explored the clinical significance of this association.</p><p><strong>Methods: </strong>We conducted a cohort study using data from the National Health and Nutrition Examination Survey between 2007 and 2018, involving 4502 adult participants with MASLD/MetALD & Mixed Etiology Steatosis in the United States. Data collected included age, sex, race, education, marital status, poverty-to-income ratio, alanine aminotransferase levels, aspartate aminotransferase levels, high-density lipoprotein cholesterol, total cholesterol, diabetes mellitus, coronary heart disease, and stroke. Cox proportional hazards regression models were used to assess the relationship between ALI and all-cause mortality, with follow-up through 31 December 2019, from the National Center for Health Statistics.</p><p><strong>Results: </strong>The study found that ALI in patients was significantly negatively associated with the risk of all-cause mortality in U.S. adults with MASLD/MetALD & Mixed Etiology Steatosis. Participants with higher ALI levels had a significantly lower risk of all-cause mortality compared to those with lower ALI levels. After full adjustment, moderate ALI levels were associated with a 42% reduced risk (hazard ratio [HR]: 0.58, 95% confidence interval [CI]: 0.41-0.81), and high ALI levels were associated with a 49% reduced risk (HR: 0.51, 95% CI: 0.35-0.73) of all-cause mortality. No significant interactions were observed in subgroup analyses (P > 0.05).</p><p><strong>Conclusion: </strong>This study suggested that high ALI levels are associated with a reduced risk of all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis patients. These findings may have important clinical implications for healthcare providers managing MASLD/MetALD & Mixed Etiology Steatosis patients, emphasizing the potential role of ALI as a prognostic marker for all-cause mortality.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"90-Day mortality prediction in elective visceral surgery using machine learning: a retrospective multicenter development, validation and comparison study.","authors":"Christoph Riepe, Robin van de Water, Axel Winter, Bjarne Pfitzner, Lara Faraj, Robert Ahlborn, Maximilian Schulze, Daniela Zuluaga, Christian Schineis, Katharina Beyer, Johann Pratschke, Bert Arnrich, Igor M Sauer, Max M Maurer","doi":"10.1097/JS9.0000000000002372","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Machine Learning (ML) is increasingly being adopted in biomedical research, however, its potential for outcome prediction in visceral surgery remains uncertain. This study compares the potential of ML methods for preoperative 90-day mortality (90DM) prediction of an aggregated multi-organ approach to conventional scoring systems and individual organ models.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled patients undergoing major elective visceral surgery between 2014 and 2022 across two tertiary centers. Multiple ML models for preoperative 90DM prediction were trained, externally validated and benchmarked against the American Society of Anesthesiologists (ASA) score and revised Charlson Comorbidity Index (rCCI). Areas under the receiver operating characteristic (AUROC) and precision recall curves (AUPRC) including standard deviations were calculated. Additionally, individual models for esophageal, gastric, intestinal, liver, and pancreatic surgery were developed and compared to an aggregated approach.</p><p><strong>Results: </strong>7,711 cases encompassing 78 features were included. Overall 90DM was 4% (n = 309). An XBoost classifier demonstrated the best performance and high robustness following external validation (AUROC: 0.86 [0.01]; AUPRC: 0.2 [0.04]). All models outperformed the ASA score (AUROC: 0.72; AUPRC: 0.08) and rCCI (AUROC: 0.81; AUPRC: 0.11). rCCI, patient age and C-reactive protein emerged as most decisive model weights. Models for gastric (AUROC: 0.88 [0.13]; AUPRC: 0.24 [0.26]) and intestinal surgery (AUROC: 0.87 [0.05]; AUPRC: 0.17 [0.09]) revealed the highest organ-specific performances, while pancreatic surgery yielded the lowest results (AUROC: 0.66 [0.08]; AUPRC: 0.22 [0.12]). A combined multi-organ approach (AUROC: 0.84 [0.04]; AUPRC: 0.21 [0.06]) demonstrated superiority over the weighted average across all organ-specific models (AUROC: 0.82 [0.07]; AUPRC: 0.2 [0.13]).</p><p><strong>Conclusion: </strong>ML offers robust preoperative risk stratification for 90DM in elective visceral surgery. Leveraging training across multi-organ cohorts may improve accuracy and robustness compared to organ-specific models. Prospective studies are needed to confirm the potential of ML in surgical outcome prediction.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of brain and central nervous system cancer: a systematic analysis of incidence, deaths, and DALYS with predictions to 2040.","authors":"Qi Zhang, Honghao Yu, Jue Zhong, Weiting Cheng, Yiwei Qi","doi":"10.1097/JS9.0000000000002359","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002359","url":null,"abstract":"<p><strong>Background: </strong>Brain and central nervous system (CNS) cancers present significant health challenges globally, characterized by increasing incidence and mortality rates. This study utilizes data from the Global Burden of Disease (GBD) 2021 to analyze trends and project future burdens.</p><p><strong>Methods: </strong>We calculated age-standardized rates (ASRs) of incidence, mortality, and disability-adjusted life years (DALYs) for brain and CNS cancers from 1990 to 2021. Trends were analyzed using estimated annual percentage change, and future projections were made with an Autoregressive Integrated Moving Average (ARIMA) model. Correlations between the socio-demographic index (SDI) and ASR were also examined.</p><p><strong>Results: </strong>The study revealed a 106% increase in incidence and a 63.67% rise in deaths over the study period. The ARIMA model predicts declines in incidence, mortality, and DALYs by 2040. Higher incidence rates were observed in high SDI regions, while greater mortality occurred in low SDI areas, indicating significant disparities.</p><p><strong>Conclusion: </strong>These findings underscore the need for targeted interventions and sustained healthcare investments to manage the global burden of brain and CNS cancers effectively. The projected declines suggest potential effectiveness of current public health strategies but highlight the importance of addressing socio-demographic disparities.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxicological insights and safety considerations of vorasidenib in grade 2 astrocytoma and oligodendroglioma-research letter.","authors":"Gabriel Vinícius Rolim Silva, M Aktaruzzaman, Umberto Laino Fulco, Taha Alqahtani, Magdi E A Zaki, Jonas Ivan Nobre Oliveira","doi":"10.1097/JS9.0000000000002356","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002356","url":null,"abstract":"<p><p>Vorasidenib, a dual inhibitor of isocitrate dehydrogenase 1 and 2 (IDH1/2), has shown promise as a therapeutic agent following its recent FDA approval for the treatment of grade 2 astrocytomas and oligodendrogliomas harboring IDH mutations in patients 12 years of age and older following surgery. While Vorasidenib offers significant potential in targeting altered metabolic pathways in low-grade gliomas, its comprehensive toxicologic and safety profile has not been adequately explored. This research letter addresses this critical gap by presenting an in silico analysis of the potential toxicologic effects of Vorasidenib. Using computational tools - ADMETlab 3.0, FAF-Drugs 4.1, DeepPK, vNN-ADMET, Pred-hERG 5.0, ADVERPred, PreADMET, and ADMET-AI - and databases such as ChEMBL, PubChem, and ChemSpider, we evaluated the key physicochemical properties and predicted ADMET profiles of Vorasidenib, along with a comparative analysis of two other drugs, namely Ivosidenib and Enasidenib. Our results suggest potential risks associated with drug-induced liver injury (DILI) and hepatotoxicity, with structural properties indicative of hepatocellular damage during and after treatment. The low clearance rates associated with the low maximum recommended dose suggest that Vorasidenib may accumulate in the bloodstream over time, increasing the likelihood of toxic reactions. In addition, the predictive models indicate concerns for neurotoxicity, nephrotoxicity and cardiotoxicity, including potential blockade of hERG channels leading to QT interval prolongation and cardiac arrhythmias. Importantly, the analysis also indicates risks of genotoxicity and carcinogenicity, raising concerns about promoting additional tumor formation in patients already prone to malignancies. These results emphasize the need for further preclinical and clinical studies to validate the safety of Vorasidenib. A comprehensive understanding of the toxicologic profile is critical to ensure that the therapeutic benefit for patients with IDH1/2-mutated low-grade gliomas is not compromised by potential adverse effects. Careful monitoring of patients and tailored therapeutic strategies are essential to optimize clinical outcomes and guide physicians in the safe use of Vorasidenib in clinical practice.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of surgical start time on the quality of surgery for middle and low rectal cancer: a post hoc analysis of the real trial.","authors":"Guodong He, Zhang Zhuojian, Weitang Yuan, Taiyuan Li, Bo Tang, Baoqing Jia, Yanbing Zhou, Wei Zhang, Ren Zhao, Cheng Zhang, Longwei Cheng, Xiaoqiao Zhang, Fei Liang, Ye Wei, Qingyang Feng, Jianmin Xu","doi":"10.1097/JS9.0000000000002345","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002345","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Surgical start time is considered to influence the quality of surgery due to surgeon fatigue. High-quality studies on middle and low rectal cancer are lacking. The analysis aims to find out the influence of surgical start time on the quality of surgery for middle and low rectal cancer, and whether robotic surgery could avoid the influence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This study was a post hoc analysis of the REAL (robotic vs. laparoscopic surgery for middle and low rectal cancer) study, a multicenter, randomized, controlled, unblinded, parallel group, superiority trial. This analysis included the modified intention-to-treat population of the REAL study, who were divided into Group I (the surgeon's first surgery of the day), Group II (the surgeon's second surgery of the day), and Group III (the surgeon's third and subsequent surgeries of the day) based on surgical information registered in the REAL study. The primary outcome was the percentage of patients with a positive circumferential resection margin. The second outcomes were the macroscopic completeness of resection the incidence of intraoperative complications and 30-day postoperative complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1171 patients from the REAL study were included and divided into three groups: 547 (46.7%) in Group I (the surgeon's first surgery), 420 (35.9%) in Group II (the surgeon's second surgery), and 204 (17.4%) in Group III (the surgeon's third and subsequent surgeries). There was a lower percentage of circumferential resection margin (CRM)-positive patients in Group I (3.9%) than in Group II (6.6%, unadjusted P = 0.069) and Group III (8.1%, unadjusted P = 0.027, adjusted P = 0.081). Group I also had fewer intraoperative complications (5.3%) than Group II (8.3%, unadjusted P = 0.060) and Group III (9.3%, unadjusted P = 0.046, adjusted P = 0.138). Macroscopic completeness of resection was not significantly different among the three groups (complete rate: Group I vs. Group II, 94.9% vs. 92.4%, unadjusted P = 0.254; Group I vs. Group III, 94.9% vs. 92.6%, unadjusted P = 0.334; Group II vs. Group III, 92.4% vs. 92.6%, unadjusted P = 0.488). The incidence of 30-day postoperative complications showed no significant difference among the three groups (Group I vs. Group II, 18.5% vs. 20.0%, unadjusted P = 0.547; Group I vs. Group III, 18.5% vs. 22.1%, unadjusted P = 0.268; Group II vs. Group III, 20.0% vs. 22.1%, unadjusted P = 0.551). The quality of robotic surgery was not significantly influenced by surgical start time. For laparoscopic surgery, Group I had a lower CRM positivity rate (4.3%) than Group II (9.4%, unadjusted P = 0.029, adjusted P = 0.087) and Group III (10.4%, unadjusted P = 0.031, adjusted P = 0.047).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;According to this post hoc analysis of the REAL study, for middle and low rectal cancer surgery, surgical start time could influence surgical quality by affecting surgeon","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery and technical skill decay: a literature review.","authors":"Marta de Andres Crespo, Panagis Michael Lykoudis, Fiona Pwint-Oo Myint, Pasquale Berlingieri","doi":"10.1097/JS9.0000000000002313","DOIUrl":"10.1097/JS9.0000000000002313","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of surgical trainees are taking time out of clinical training for research, parental leave or other interests. A comprehensive review was carried out to evaluate the current evidence on whether and how such time results in surgical skill decay.</p><p><strong>Methods: </strong>A PubMed, Embase, Web of Science, and Cochrane Library search was performed using the phrase: (\"skills decay\" OR \"skills fade\") AND \"surgery.\" All relevant literature was analyzed and summarized.</p><p><strong>Results: </strong>A total of 41 relevant articles were identified. The skills that are most adversely affected by time out of training are technical operative skills and, within those, speed and accuracy in operations. Factors that affect skill decay include the complexity of the task itself, the degree of overlearning (i.e., the skill of the surgeon prior to time out of training) and the retention interval (i.e., the length of time for which the trainee is out of training and whether or not spaced practice is carried out). The articles suggest that simulation may be of assistance in mitigating skill decay; however, this has yet to be fully investigated.</p><p><strong>Conclusions: </strong>As an increasing number of surgical trainees are taking time away from clinical training for academic research, higher degrees, parental leave, or other interests, further research is required to investigate how to mitigate the resulting surgical skill decay, potentially through the use of simulation.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DeepGuide: a novel wavelength-specific navigation system for membrane visualization in surgery.","authors":"Zehong Chen, Xuejie Li, Zongheng Zheng, Jianpei Liu, Jiafeng Fang, Jianglong Huang, Tufeng Chen, Hongbo Wei","doi":"10.1097/JS9.0000000000002370","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002370","url":null,"abstract":"<p><strong>Background: </strong>Membrane anatomy (MA) has become pivotal in modern surgery, enabling surgeons to operate within avascular natural planes to minimize concomitant injury. However, intraoperative identification of membranous structures remains challenging. Poor membrane visualization compromises both radical resection and functional preservation, underscoring the need for innovative solutions.</p><p><strong>Methods: </strong>In this study, we develop a innovative tool, DeepGuide, to help surgeon make membrane visualization during surgery. Moreover, we design a single-arm prospective study to validated its effectiveness. A total of 60 patients undergoing laparoscopic radical resection for gastrointestinal tumors at The Third Affiliated Hospital of Sun Yat-sen University were enrolled. Primary outcomes included signal-to-background ratio (SBR), mesenteric integrity, absorbance of membrane specimens, and immunofluorescence staining of collagen components.</p><p><strong>Results: </strong>DeepGuide significantly improved mesenteric integrity rates from 75% (conventional laparoscopy) to 98%. SBR under DeepGuide (2.30 ± 0.15) surpassed conventional lighting (1.32 ± 0.16). Absorbance analysis revealed reduced light absorption at 385 nm. Immunofluorescence confirmed collagen I/III enrichment in mesenteric submucosa, aligning with 385 nm-excited autofluorescence properties.</p><p><strong>Conclusion: </strong>DeepGuide revolutionizes intraoperative membrane visualization without requiring contrast agents. It enhances surgical precision and supports MA principles. These findings highlight DeepGuide's potential to redefine standards in oncologic surgery.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Junction Plakoglobin - A Dual-Role Player in Cancer Biology.","authors":"Wei Ding, Jiaao Sun, Shiyan Song, Yuying Cui, Feng Chen, Qihang Yuan, Wei Shang","doi":"10.1097/JS9.0000000000002365","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002365","url":null,"abstract":"<p><p>Junction plakoglobin (JUP) is a critical cell adhesion molecule implicated in mediating cell-cell adhesion. Cancer, characterized by the loss of normal cellular regulation, results in unchecked proliferation and the breakdown of cell-cell junctions, facilitating malignant cell invasion into surrounding tissues. Recent studies have highlighted the involvement of JUP in the transduction of various intercellular signaling pathways, underscoring its significant role in tumor initiation, progression, and prognosis. In contrast to its homolog β-catenin, the interplay between JUP and cancer remains underexplored. To clarify JUP's role and underlying mechanisms in cancer progression, this review examines recent advancements, focusing on JUP's regulation of key cancer-related signaling pathways, such as Wnt/β-catenin, p53, and cadherin-mediated pathways. The review also investigates JUP's relevance across various cancer types, including those of the reproductive, digestive, and urinary systems. Mechanistically, JUP exhibits context-dependent actions in different cancers, demonstrating dual roles in tumorigenesis. Lastly, the potential of JUP as a target for early diagnosis, effective treatment, and prognostic prediction in cancer is evaluated. In conclusion, targeting JUP offers a promising avenue for cancer therapy, providing valuable insights for future research.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular dysfunction following tetralogy of Fallot correction: anatomical determinants and therapeutic strategies.","authors":"Qiang Fan, Yabo Wang, Qi An, Yunfei Ling","doi":"10.1097/JS9.0000000000002367","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002367","url":null,"abstract":"<p><p>Right ventricular dysfunction following surgical correction of tetralogy of Fallot (TOF) remains a major determinant of long-term morbidity and mortality in survivors. Despite advancements in surgical techniques, residual anatomical abnormalities - including pulmonary regurgitation, right ventricular outflow tract obstruction, abnormal coronary artery anatomy, scar formation, and tricuspid regurgitation - synergistically drive ventricular remodeling and functional decline. This review synthesizes evidence on the pathophysiological interplay of these anatomical substrates. Key imaging modalities, such as 3D late gadolinium enhancement cardiac magnetic resonance, and artificial intelligence tools enhance risk stratification for ventricular arrhythmias. We propose a hierarchical management framework prioritizing hemodynamic stabilization, electrophysiological substrate modification and individualized strategies for concomitant lesions considerations. This work aims to bridge anatomical insights with therapeutic innovations, offering a roadmap for improving longevity and quality of life in repaired TOF patients.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}