International journal of surgery最新文献

{"title":"An artificial intelligence-driven revolution in orthopedic surgery and sports medicine.","authors":"Jiekai Guan, Zuhao Li, Shihao Sheng, Qiushui Lin, Sicheng Wang, Dongliang Wang, Xiao Chen, Jiacan Su","doi":"10.1097/JS9.0000000000002187","DOIUrl":"10.1097/JS9.0000000000002187","url":null,"abstract":"<p><p>With the advancement of population aging, the incidence of orthopedic diseases increases annually. The early diagnosis and precise treatment of many orthopedic diseases still require advancements in technology to address effectively. With the rapid development of artificial intelligence (AI), this technology is expected to achieve early diagnosis and improved treatment of many diseases, providing revolutionary changes in clinical. However, the integration of AI in orthopedics is still in its infancy, and its existing intelligent algorithms have been clinically applied models and their advantages need to be further summarized to pave the way for future development and exploration. The review provides a concise overview of the basic concepts and mechanisms of AI in orthopedics, and summarizes orthopedic surgery and sports medicine in four areas of application and development, specifically, developing precision diagnostics, assisting treatment, monitoring assisted during rehabilitation, and enhancing educational research and data analysis. In this section, the main focus is on each aspect of the AI programs that are now used in clinical applications, and also comparing them to the purely manual results. In conclusion, the continued application and development of AI are anticipated to enhance our understanding of the diagnosis, progression, and prognosis of orthopedic diseases, ultimately laying the groundwork for more effective clinical applications.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2162-2181"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881989","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":"Chinese guidelines for ultrasound-guided thermal ablation of thyroid nodules (2024 edition).","authors":"Zhi-Yu Han, Jian-Ping Dou, Lin Zheng, Min Xu, Jie Ren, Hui Wang, Shu-Rong Wang, Wei-Wei Zhan, Jian-Qiao Zhou, Shu-Hang Xu, Wen Cheng, Man Lu, Dong Xu, Jie Yu, Fei Jing, Ming-An Yu, Song-Yuan Yu, Zhi-Gang Cheng, Cheng-Zhong Peng, Ying Che, Wei-de Dai, Zu-Bang Zhou, Hong Yang, Xiao-Ping Leng, Li-Ping Sun, Guang-Bin He, Guang-Zhi He, Zhi-Bin Cong, Qin-Ying Li, Qi-Yu Zhao, Bai Nan, Cun Liu, Jia Guo, Qian Li, Qiang Wei, Gang Wang, Ying Huang, De-Sheng Sun, Tian-An Jiang, Ping Liang","doi":"10.1097/JS9.0000000000002209","DOIUrl":"10.1097/JS9.0000000000002209","url":null,"abstract":"<p><p>The Chinese guidelines for ultrasound-guided thermal ablation of thyroid nodules (2024 edition) were jointly initiated by the Ultrasound Committee of Chinese Medical Association, the Interventional Ultrasound Committee of Chinese Association of Ultrasound in Medicine and Engineering, the Ultrasonic Intervention Committee of Chinese Colleges of Interventionalists, and the Oncological Intervention Committee of Chinese Research Hospital Association; 37 multidisciplinary experts in interventional ultrasound, ultrasound medicine, endocrinology, and thyroid surgery participated in the compilation of this guide, which expanded the depth and breadth of the perspective and enhanced the authority of the guide. Based on the systematic review of literature related to ultrasound-guided thermal ablation of thyroid nodules and the professional opinions of experts, the guidelines define the indications and contraindications of thermal ablation, including pre-ablation evaluation and preparation, thermal ablation techniques and operational procedures, post-ablation follow-up, therapeutic effect evaluation, complication prevention and treatment, and the writing of medical documents for ablation. According to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), a total of 17 objective and comprehensive recommendations were given. The publication and promotion of this guideline will play a positive role in promoting the standardization of ultrasound-guided thermal ablation of thyroid nodules.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1699-1710"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894350","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":"The efficacy of diltiazem, glyceryl trinitrate, nifedipine, minoxidil, and lidocaine for the medical management of anal fissure: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Cong Wang, Jing Ni, Yi Xiong, Jinlan Chen, Binting Li, Li Xu","doi":"10.1097/JS9.0000000000002263","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002263","url":null,"abstract":"<p><strong>Purpose: </strong>Anal fissure (AF) is a common anorectal condition causing pain, bleeding, and other perianal discomfort. This study conducts a network meta-analysis to compare the efficacy and side effect profiles of pharmacological treatments for AF, including diltiazem, glyceryl trinitrate, nifedipine, minoxidil, and Lidocaine.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review and network meta-analysis were performed. Randomized controlled trials (RCTs) comparing non-surgical treatments for AF were sourced from PubMed, Cochrane Library, Embase, and Medline. The primary outcome was AF healing, with secondary outcomes including recurrence rates, pain reduction (visual analog scale), and adverse effects. Statistical analysis utilized odds ratios and SUCRA (Surface Under the Cumulative Ranking) values for treatment ranking.</p><p><strong>Results: </strong>Twenty-two randomized controlled trials (RCTs) involving a total of 1,770 participants were included in the analysis. Nifedipine demonstrated the highest healing rate, followed by diltiazem and minoxidil. Lidocaine exhibited the lowest healing rate. Diltiazem had the lowest recurrence rate and was the most effective in pain reduction, whereas lidocaine had the highest recurrence rate and was the least effective in alleviating pain. The incidence of adverse effects with minoxidil was relatively low, second only to lidocaine, while glyceryl trinitrate had the highest rate of adverse effects.</p><p><strong>Conclusion: </strong>Nifedipine had the highest healing rate and should be considered as a first-line non-surgical treatment for anal fissures. Given the elevated incidence of adverse reactions associated with nitroglycerin, its use should be avoided in order to minimize the risk of significant toxicities and side effects. Additionally, because of its outstanding analgesic properties, diltiazem is recommended as the preferred option for patients with heightened sensitivity to pain, but more studies are needed to evaluate its efficacy.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058931","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":"The impact of different left heart decompression strategies and timing on VA-ECMO patients: a systematic review and network meta-analysis.","authors":"Wei Wang, Rui Tang, Tianxiang Gu, Enyi Shi","doi":"10.1097/JS9.0000000000002253","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002253","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058934","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":"Individualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial.","authors":"Zhaohua Pang, Shuang Liang, Nannan Zhou, Xiaoyan Zhu, Qulian Guo, Daniel I Sessler, Wangyuan Zou","doi":"10.1097/JS9.0000000000002289","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002289","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common postoperative complication, and hypotension may contribute. We therefore tested the primary hypothesis that individualized intraoperative blood pressure regulation reduces postoperative AKI in older surgical patients.</p><p><strong>Methods: </strong>We enrolled patients ≥60 years old scheduled for elective major abdominal surgery with invasive arterial pressure monitoring. All had goal-directed fluid management based on stroke volume variation and cardiac output, and administration of a starch. Participants were randomly assigned to: 1) individualized blood pressure management targeting a systolic blood pressure (SBP) within -20% and + 10% if baseline SBP was ≥ 130 mmHg or diastolic blood pressure was ≥ 80 mmHg, or otherwise, to target SBP within ± 10% of the baseline value; 2) maintenance of SBP ≥ 90 mmHg and MAP ≥ 65 mmHg. Metaraminol was used to achieve the blood pressure target. AKI incidence was assessed by Kidney Disease Improving Global Outcomes criteria during the initial 7 postoperative days.</p><p><strong>Results: </strong>192 patients were assigned to individualized (n = 96) or routine (n = 96) pressure management. 179 patients were included in the intention-to-treat analysis. Age averaged 68 ± 5 (SD) yr and 64% were male. Randomization to the individualized management reduced the area under MAP <65 mmHg [median difference: - 37 (-47 to -25) mmHg-min, P < 0.001]. The incidence of the AKI was 11% in patients assigned to individualized management versus 16 % in those assigned to routine management: relative risk 0.72 [95% CI 0.34 to 1.54], P = 0.396. Patients assigned to individualized pressure management had more urine output, a shorter postoperative mechanical ventilation duration, and faster recovery of bowel function.</p><p><strong>Conclusion: </strong>Individualized blood pressure management markedly reduced hypotension. As expected in a pilot trial, the 28% reduction in AKI was not statistically significant. However, the reduction was clinically meaningful and suggests that a full trial is warranted.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058883","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":"Comparison of the efficacy of neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients: meta-analysis of randomized controlled trials.","authors":"De-Xing Zeng, Ruo-Nan Liu, Xian-Kun Ren, Peng Zhang, Ling-Han Tang, Ling Tan, Rehman Zia Ur, Mao-Ru Zhao, Peng Guo, Pan Zhang, Jun Du, Xian Qin, Shi-Yan Wan, Lu-Qian Deng, Ya-Jun Luo, Zi-Lin Liu, Jiang-Wei Xiao","doi":"10.1097/JS9.0000000000002262","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002262","url":null,"abstract":"<p><strong>Background: </strong>Preoperative neoadjuvant chemoradiotherapy (nCRT) is considered to be the standard treatment strategy for locally advanced rectal cancer (LARC); however, the risk of adverse events and postoperative recurrence remains significant. This study aimed to evaluate the non-inferiority of neoadjuvant chemotherapy (nCT) compared with nCRT in patients with LARC and to assess the possibility of eliminating radiotherapy on the basis of guaranteed efficacy.</p><p><strong>Materials and methods: </strong>We searched the PubMed, Embase, and Cochrane Library databases to identify randomized controlled trials (RCTs) comparing the efficacy of nCRT and nCT for LARC. The study protocol was registered with the Prospective Register of Systematic Reviews (PROSPERO).</p><p><strong>Results: </strong>A total of 2706 patients from 7 studies were included in the meta-analysis. There was no significant difference in overall survival (OS) or disease-free survival (DFS) between the nCT and nCRT groups. This study demonstrated a lower rate of infection (OR = 0.53, 95% CI = 0.34-0.82; P = 0.005), anastomotic leak (OR = 0.55, 95% CI = 0.34-0.87; P = 0.01), tumor regression grade (TRG) 0-1 (OR = 0.50, 95% CI = 0.36-0.69; P < 0.0001), preventive diverting ileostomy (OR = 0.41, 95% CI = 0.17-1.02; P = 0.05) and leukopenia (OR = 0.50, 95% CI = 0.25-1.01; P = 0.05) in the nCT group. However, there was no significant difference in the other toxic events, such as intestinal obstruction, urinary complications, diarrhoea, and surgical or pathological outcomes, such as clinical fistula, sphincter preservation, postoperative mortality (≤ 60 d), R0 resection, ypStage 0-I, positive circumferential resection margin (CRM +) or pathological complete response (pCR) between the two groups.</p><p><strong>Conclusion: </strong>This study indicated that OS and DFS were not lower in the nCT group than in the nCRT group. In addition, the nCT group had fewer complications. Preoperative nCT is expected to become a standard treatment option for most patients with stage II-III LARC. It is worth noting that radiotherapy can not be ignored for some patients who need to ensure the conversion effect of neoadjuvant therapy and strongly request to preserve organ function.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059011","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":"Construction of an Artificially Intelligent Model for Accurate Detection of HCC by Integrating Clinical, Radiological, and Peripheral Immunological Features.","authors":"Yangyang Wang, Shengqiang Chi, Yu Tian, Xueyao Li, Hang Zhang, Yiting Xu, Chao Huang, Yiwei Gao, Gaowei Jin, Qihan Fu, Wanyue Cao, Cao Chen, Haonan Ding, Yuquan Zhang, Yupeng Hong, Junjian Li, Xu Sun, Enliang Li, Yuhua Zhang, Weiyun Yao, Runtian Liu, Yongfei Hua, Haifeng Huang, Minghui Xu, Bo Zhang, Weifeng Tao, Tianxing Yang, Yuming Gao, Xiaoguang Wang, Cheng Lin, Jingsong Li, Qi Zhang, Tingbo Liang","doi":"10.1097/JS9.0000000000002281","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002281","url":null,"abstract":"<p><strong>Background: </strong>Integrating comprehensive information on hepatocellular carcinoma (HCC) is essential to improve its early detection. We aimed to develop a model with multi-modal features (MMF) using artificial intelligence (AI) approaches to enhance the performance of HCC detection.</p><p><strong>Materials and methods: </strong>A total of 1,092 participants were enrolled from 16 centers. These participants were allocated into the training, internal validation, and external validation cohorts. Peripheral blood specimens were collected prospectively and subjected to mass cytometry analysis. Clinical and radiological data were obtained from electrical medical records. Various AI methods were employed to identify pertinent features and construct single-modal models with optimal performance. The XGBoost algorithm was utilized to amalgamate these models, integrating multi-modal information and facilitating the development of a fusion model. Model evaluation and interpretability were demonstrated using the SHapley Additive exPlanations method.</p><p><strong>Results: </strong>We constructed the electronic health record, BioScore, RadiomicScore, and DLScore models based on clinical, radiological, and peripheral immunological features, respectively. Subsequently, these single-modal models were amalgamated to develop an all-in-one MMF model. The MMF model exhibited enhanced performance compared to models comprising only single-modal features in detecting HCC. This superiority in performance was confirmed through the internal and external validation cohorts, yielding area under the curve (AUC) values of 0.985 and 0.915, respectively. Additionally, the MMF model improved the detection ability in subpopulations of HCCs that were negative for alpha-fetoprotein and those with small size, with AUC values of 0.974 and 0.996, respectively.</p><p><strong>Conclusions: </strong>Integrating multi-modal features improved the performance of the model for HCC detection.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059012","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":"Prevalence of colonoscopy-related adverse events in older adults aged over 65 years: a systematic review and meta-analysis.","authors":"Qing Lu, Xiu-He Lv, Li Tang, Hai-Lin Yan, Bi-Han Xia, Zhu Wang, Jin-Lin Yang","doi":"10.1097/JS9.0000000000002282","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002282","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the occurrence of colonoscopy-related adverse events (AEs) in adults aged over 65 years, as there has been a significant increase in the prevalence of colonoscopies among the elderly compared to two decades ago.</p><p><strong>Methods: </strong>A comprehensive search was conducted on June 3rd, 2024, using the PubMed, Embase, and Cochrane Library databases. Meta-analyses were performed using the generalized linear mixed model, and the results were presented as pooled rates with relevant 95% confidence intervals (CIs).</p><p><strong>Results: </strong>We retrieved a total of 15,417 records and included 13 population-based studies. The overall rates of colonoscopy-related perforation and bleeding in the elderly population were 7.8 (95% CI 5.5-11.2; I2 = 94%) and 23.5 (95% CI 9.0-61.3; I2 = 100%) per 10,000 colonoscopies, respectively. The \" > 80 years\" group had a significantly higher risk of perforation (RR 2.55; 95% CI 1.15-5.66; I2 = 79%) and bleeding (RR 1.23; 95% CI 1.02-1.48; I2 = 0%) compared to the \"65-80 years\" group. For screening colonoscopies, the rates of perforation and bleeding were 8.5 (95% CI 7.1-10.2; I2 = 0%) and 27 (95%CI 9.0-81.0; I2 = 99%) per 10,000 colonoscopies, respectively. For diagnostic colonoscopies, the rates of perforation and bleeding were 18 (95% CI 16.2-20.0; I2 = 1%) and 16 (95% CI 8.1-31.3; I2 = 98%) per 10,000 colonoscopies, respectively. Compared to non-therapeutic colonoscopies, therapeutic procedures exhibited higher rates of both perforation (1.5 vs. 0.4 per 10,000 colonoscopies) and bleeding (7.1 vs. 0.5 per 10,000 colonoscopies). The prevalence of cardiopulmonary AEs in elderly population is relatively high, although the definition used vary across different studies.</p><p><strong>Conclusions: </strong>We conducted a comprehensive analysis on the prevalence of AEs related to colonoscopy in older adults. Overall, the AEs rates remain low. However, we emphasize the importance of enhancing safety protocols to further minimize risks, ensuring that the benefits of colonoscopy continue to outweigh the risks, especially for patients over the age of 80.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058922","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":"The influence of familiarity between the surgeon and their assistant on patient outcomes: a prospective observational cohort study.","authors":"Daniel R Stelzl, Stephanie Polazzi, Jean-Christophe Lifante, Tanujit Dey, Antoine Duclos","doi":"10.1097/JS9.0000000000002269","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002269","url":null,"abstract":"<p><strong>Background: </strong>The inverse relationship between increased surgical team familiarity and reduced operative time is established, but its effect on patient outcomes remains uncertain.</p><p><strong>Materials and methods: </strong>A prospective cohort study including operations by attending surgeons between 1 November 2020 and 31 December 2021 across fourteen surgical departments from four French university hospitals. Surgical team familiarity was measured as the cumulative number of previous operations performed by the same dyad of attending and assisting surgeons. Composite of adverse events within 30 days of surgery encompassed major surgical complication, unplanned reoperation, extended ICU stay, and death. We used multivariable generally estimated equations to model the association between patient outcomes and surgical team familiarity, using a logarithmic function. The model considered the clustering of operations within surgeons.</p><p><strong>Results: </strong>Our analysis included 8546 operations by 1109 surgical team dyads, involving 45 attending surgeons and 369 assisting surgeons. We observed a significant inverse association between surgical team familiarity and composite adverse events odds ratio [OR] 0.92 (95% confidence interval [95% CI] 0.87-0.98), major surgical complications OR 0.93 (95% CI 0.88-0.99), and unplanned reoperations OR 0.88 (95% CI 0.78-0.99), with non-significant trends observed for extended ICU stays OR 0.88 (95% CI 0.75-1.04) and deaths OR 0.87 (95% CI 0.74-1.03). Within the first 15 collaborations, this was illustrated by a reduction in the occurrence of composite adverse events from 23.0% (95% CI 22.1%-24.0%) to 16.5% (95% CI 14.1%-18.8%), major surgical complications from 21.3% (95% CI 20.3%-22.2%) to 15.3% (95% CI 13.0%-17.5%), unplanned reoperations from 8.8% (95% CI 8.6%-9.1%) to 5.2% (95%CI 4.2%-6.1%), extended ICU stays from 4.3% (95% CI 4.1%-4.5%) to 3.1% (95% CI 2.0%-4.1%), and deaths from 2.3% (95% CI 2.1%-2.5%) to 1.4% (95% CI 0.9%-1.8%).</p><p><strong>Conclusions and relevance: </strong>This study emphasizes that heightened familiarity among surgical teams is associated with a significant reduction in major adverse events. Building stable operating room teams should be a management priority to enhance patient outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058938","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":"Effect of virtual reality intervention on hospitalized patients with acute pain after thoracoscopic surgery: a pilot randomized clinical trial.","authors":"Weibo Cao, Fan Ren, Tong Li, Fei Ma, Yuan Shi, Xuanguang Li, Cancan Cao, Ning Zhou, Hanyi Li, Haochuan Yu, Fuling Mao, Gang Chen, Lingling Zu, Li Wei, Qing Li, Yuanyuan Zhang, Lin Su, Wei Cui, Li Wu, Yuxin Zheng, Jing Li, Chunyan Wang, Renhua Ju, Chongliang Fang, Ling Yin, Yi Lu, Qiang Zhang, Song Xu","doi":"10.1097/JS9.0000000000002264","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002264","url":null,"abstract":"<p><p>The study investigates the effectiveness of immersive virtual reality (VR) as a nonpharmaceutical approach to manage postoperative pain in patients following thoracoscopic surgery. In this single-center, triple-arm pilot randomized controlled trial (RCT), 61 postsurgical patients with a postoperative pain numerical rating scale (NRS) score ≥4 after receiving standard analgesia were included and assigned to either a quantum clinics-VR (QTC-VR) group, a Placebo-VR group, or a control group. The QTC-VR group engaged in a daily 10-minute interactive pain relief 3D-VR program, while the Placebo-VR group watched a daily 10-minute relaxation-based 2D film through VR headsets for three days following surgery. 61 postsurgical patients were randomized and allocated (21 in the QTC-VR group, 20 in the Placebo-VR group, and 20 in the control group) in the final intention-to-treat (ITT) analyses. Compared with patients receiving Placebo-VR intervention, patients reported significantly lower pain scores following the daily QTC-VR intervention on postoperative days 1 (mean difference, -0.889; 95% CI, -1.464 to -0.314; P < 0.001), 2 (mean difference, -0.631; 95% CI, -1.211 to -0.051; P = 0.014), and 3 (mean difference, -0.798; 95% CI, -1.345 to -0.251; P < 0.001), respectively. Additionally, patients receiving QTC-VR intervention also reported high satisfaction and tolerable adverse events with their treatment. In conclusion, this pilot RCT demonstrates that QTC-VR might be a promising intervention for pain management post-thoracoscopic surgery, warranting further validation in ongoing phase III trials.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059070","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}