International journal of surgery最新文献

{"title":"Erratum: A new pragmatic classification system for thymoma-associated myasthenia gravis: A retrospective cohort study: Erratum.","authors":"","doi":"10.1097/JS9.0000000000005504","DOIUrl":"10.1097/JS9.0000000000005504","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/JS9.0000000000001981.].</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13322"},"PeriodicalIF":9.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Construct validation of machine learning models for predicting surgical site infection risk following ankle fracture surgery\".","authors":"Yu Fu","doi":"10.1097/JS9.0000000000004932","DOIUrl":"10.1097/JS9.0000000000004932","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13253-13254"},"PeriodicalIF":9.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal changes in circulating metabolites after metabolic and bariatric surgery and risk of incident coronary heart disease: evidence from prospective cohort and nested case-control studies.","authors":"Yulu Zheng, Zicheng Wang, Lei Wang, Charles R Flynn, Xiao-Ou Shu, Wayne J English, Jason M Samuels, You Chen, Loren Lipworth, Deepak Gupta, Qiuyin Cai, Wei Zheng, Danxia Yu","doi":"10.1097/JS9.0000000000005085","DOIUrl":"10.1097/JS9.0000000000005085","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) has notable cardiovascular benefits beyond weight loss.</p><p><strong>Methods: </strong>The Gut Microbiome in Metabolic Surgery Study (GUMMY) enrolled patients who underwent first-time Roux-en-Y gastric bypass or sleeve gastrectomy, with blood samples collected at pre- and 3- and 12-month post-surgery. Significant metabolite changes were identified using paired <i>Wilcoxon</i> signed-rank tests with a false discovery rate (FDR) < 0.05 and |log₂ fold change| > log₂1.5, comparing 3-month post- vs. pre-surgery (early phase) and 12- vs. 3-month post-surgery (late phase). Significantly changed metabolites were classified into three patterns: early changed, late sustained; early changed, late reversed; and early unchanged, late changed. Subsequently, a nested case-control study within the Southern Community Cohort Study (SCCS) assessed the associations between surgery-altered metabolites and incident coronary heart disease (CHD) risk using conditional logistic regression. The same untargeted metabolomic assay was conducted in GUMMY and SCCS plasma samples.</p><p><strong>Results: </strong>Among 115 surgical patients, the mean (SD) age was 44.9 (9.5) years, and 90 (78%) were women. Significant changes were observed in 224 metabolites, mainly encompassing sustained increases in bile acids and decreases in branched-chain amino acids, lactoyl, and lysine amino acids; reversed changes in some ketone bodies, phospholipids, lysophospholipids, and glycogen metabolites; late increases in taurine, caffeine, benzoate, and some tryptophan metabolites; and late decreases in ceramide metabolites and certain fatty acids. In the SCCS (<i>n</i> = 1194; 597 case-control pairs), 37 surgery-altered metabolites were significantly associated with incident CHD (FDR < 0.1), 28 with concordant effects, i.e., post-surgical increases were associated with reduced CHD risk and vice versa.</p><p><strong>Conclusions: </strong>MBS elicits substantial metabolomic alterations, with many altered metabolites associated with incident CHD. These findings provide mechanistic insights into the cardiovascular benefits of MBS and suggest potential therapeutic targets for CHD prevention.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13105-13115"},"PeriodicalIF":9.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SurvGRN: a multi-feature fusion framework for bladder cancer survival prediction.","authors":"Qiangjian Zhang, Na Zhao, Kai Song, Xun Ye, Hongxin Xiang, ZhiWei Zhao, Li Qi, Qing Zhang, Rui Guo, Junwei He, Jiaxin Liang, Shi Fu, Haifeng Wang, Xiaogang Li, Yingxia Wang, Yingying Pu, Jian Wang, Chunming Guo","doi":"10.1097/JS9.0000000000004874","DOIUrl":"10.1097/JS9.0000000000004874","url":null,"abstract":"<p><p>Bladder cancer survival outcomes exhibit significant heterogeneity, influenced by multifaceted factors. While digital pathology-based survival models leveraging artificial intelligence show promise, they often overlook complementary data sources. Conversely, imaging lacks cellular detail, and genomics/proteomics entail complexity and cost. To integrate multidimensional data for enhanced survival prediction, we propose SurvGRN, a multi-feature fusion framework. SurvGRN synergistically combines clinical variables, transcriptomics, and digital pathology slides using a gated residual network architecture. Pathological features are extracted via multiple instance learning, while clinical and transcriptomic data are processed as static inputs. These features are dynamically fused using a long short-term memory (LSTM) network for comprehensive survival risk assessment. Evaluated on 400 bladder cancer patients, SurvGRN significantly outperformed existing methods: improving the C-index by 12.6% over DeepMISL; 20.6% and 7.1% over graph-based models (DeepGraphConv and Patch-GCN); and 5.4% and 4.0% over attention-based approaches (Surformer and HVTSurv). Ablation studies confirmed the contributions of pathology features (extracted via ResNet-50 pre-trained on bladder tissue), clinical/transcriptomic data, and the LSTM fusion. SurvGRN also enabled significant stratification of patients into distinct risk cohorts. This work demonstrates that holistic integration of multi-source data through tailored fusion architectures substantially improves bladder cancer survival prediction.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13092-13104"},"PeriodicalIF":9.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative safety and oncologic outcomes of robotic and laparoscopic total gastrectomy for advanced middle-upper gastric cancer: a multicenter retrospective study.","authors":"Hua-Long Zheng, Hong-Hong Zheng, Tai-Yuan Li, Li Zhang, Jun-Jun She, Bao-Qing Jia, Xin-Gan Qin, Shuang-Yi Ren, Hong-Liang Yao, Dong-Ning Liu, Han Liang, Fei-Yu Shi, Peng Li, Bo-Pei Li, Xin-Sheng Zhang, Kui-Jie Liu, Chao-Hui Zheng, Chang-Ming Huang, Ping Li","doi":"10.1097/JS9.0000000000005070","DOIUrl":"10.1097/JS9.0000000000005070","url":null,"abstract":"<p><strong>Background: </strong>Robotic total gastrectomy (RTG) has been proposed as a promising alternative to laparoscopic total gastrectomy (LTG) for advanced middle-upper gastric cancer (AMUGC) due to its potential to overcome anatomical challenges. However, the comparative evidence regarding both safety and long-term oncologic efficacy remains limited.</p><p><strong>Methods: </strong>This retrospective cohort study included 1099 patients with AMUGC who underwent RTG/LTG at eight high-volume centers in China between 2015 and 2019. Propensity score matching (PSM = 1:1) was used to balance clinicopathological characteristics between the two groups. The primary outcome was 3-year disease-free survival (DFS); secondary outcomes included 3-year overall survival (OS), 3-year cumulative incidence of recurrence (CIR), recurrence patterns, and operative outcomes.</p><p><strong>Results: </strong>In the PSM cohort, 229 patients were included in each group. RTG demonstrated lower overall postoperative complications (16.2% vs. 27.1%, <i>P</i> < 0.05), medical complications (6.6% vs. 17.0%, <i>P</i> < 0.05), and pneumonia rates (6.6% vs. 16.2%, <i>P</i> < 0.05). No differences were observed in 3-year DFS (73.7% vs. 68.1%, <i>P</i> = 0.230), 3-year OS (76.8% vs. 72.4%, <i>P</i> = 0.326), CIR (24.4% vs. 26.8%, <i>P</i> = 0.580), and recurrence patterns. In stage III, 3-year DFS was higher in the RTG group (67.4% vs. 54.5%, <i>P</i> = 0.047), but no significant differences were found in 3-year OS or CIR (all <i>P</i> > 0.05). Multivariate analysis confirmed that the surgical method was not significantly associated with 3-year DFS [hazard ratio (HR), 0.767; 95% confidence interval (CI), 0.542-1.086; <i>P</i> = 0.135] or 3-year OS (HR, 0.774; 95% CI, 0.534-1.122; <i>P</i> = 0.177).</p><p><strong>Conclusions: </strong>For AMUGC patients not receiving neoadjuvant chemotherapy, RTG demonstrated potential advantages in certain operative outcomes and non-inferior 3-year oncological outcomes compared with LTG. Prospective trials are needed to validate these findings.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13141-13153"},"PeriodicalIF":9.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-infrared fluorescence cholangiography in emergency cholecystectomy: a team-based adjunct rather than a standalone safety tool.","authors":"Jie Zhang","doi":"10.1097/JS9.0000000000005060","DOIUrl":"10.1097/JS9.0000000000005060","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13257-13258"},"PeriodicalIF":9.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Wallace versus Bricker anastomosis for urinary diversion after radical cystectomy: a systematic review and meta-analysis.","authors":"Lang Xin, Shize Zhang, Libin Sun","doi":"10.1097/JS9.0000000000005110","DOIUrl":"10.1097/JS9.0000000000005110","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13261-13262"},"PeriodicalIF":9.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic sleeve gastroplasty video annotation: analysis of the learning curve of three annotators to achieve procedure proficiency.","authors":"Maria Vannucci, Matyas Fehervari, Hutan Ashrafian, Mohamed El Sharkawy, Nicolien Heikens, María Rita Rodríguez-Luna, Silvana Perretta","doi":"10.1097/JS9.0000000000005019","DOIUrl":"10.1097/JS9.0000000000005019","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic interventional skills acquisition generally relies on apprenticeship-based training. Limitations of this learning model include the availability of trainers and human-factor biases. Increased routine surgical and endoscopic video recording and storage promote video-based learning (VBL) methods. VBL could shorten the learning curve by increasing trainer availability and democratizing training access for procedures such as endoscopic sleeve gastroplasty (ESG), which is carried out by a few expert operators. The aim of this work was to evaluate video annotation as a learning tool for ESG.</p><p><strong>Methods: </strong>Videos of ESG performed at a single center were collected and annotated. An annotation manual developed by an ESG expert was used by three annotators with different levels of endoscopic and ESG expertise. Pairwise Cohen's kappa was used to assess inter-rater reliability (IRR). Completion of the learning curve for each phase and feature of ESG was calculated as the probability of accordance among annotators and estimated by a moving average optimization model with an expectation-maximization algorithm.</p><p><strong>Results: </strong>In total, 40 ESG videos were annotated. IRR pairwise kappa scores ranged between 0.44 (Annotator 1 and 3) and 0.58 (Annotator 2 and 3). Learning curve analysis showed that a different number of procedures need to be annotated to master the various phases of ESG, with the \"other suture phase\" needing the highest number of procedures (<i>n</i> = 36). The overall learning curve showed variability across different aspects of ESG, with an overall average of 28.40 procedures needed to achieve proficiency.</p><p><strong>Conclusions: </strong>The learning process differs among trainees, as mirrored in the variable number of procedures needed to master ESG. Tailoring training for different trainees could lead to the shortening of learning curves. Some features of ESG are mastered more quickly; however, careful and repeated practice is essential for minimizing errors in more complex features. VBL could play a role in the democratization of high-level learning.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13001-13007"},"PeriodicalIF":9.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the comment on \"Prolonged versus short-term infusion of meropenem for the treatment of sepsis: a systematic review and meta-analysis\".","authors":"Yi-Ge Qiu, Jian Qu","doi":"10.1097/JS9.0000000000005000","DOIUrl":"10.1097/JS9.0000000000005000","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12944-12946"},"PeriodicalIF":9.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Artificial Intelligence in melanoma research: a bibliometric analysis\".","authors":"Hongfang Zheng, Yixiao Lu","doi":"10.1097/JS9.0000000000005078","DOIUrl":"10.1097/JS9.0000000000005078","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13292-13294"},"PeriodicalIF":9.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}