International journal of surgery最新文献

{"title":"Relative fat mass as a novel predictor of gallstone risk: opportunities and caveats.","authors":"Senda Zhong","doi":"10.1097/JS9.0000000000002369","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002369","url":null,"abstract":"","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":"143763660","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 safety and efficacy of stent-assisted coiling for acutely ruptured cerebral aneurysms: a multicenter prospective registry study (SAVE).","authors":"Gaozhi Li, Shenghao Ding, Jiale Wang, Kuang Zheng, Wenshuai Li, Guohua Mao, Xiaobo Liu, Zheming Zhang, Dianshi Jin, Lang Liu, Qinhua Guo, Qingyuan Liu, Xiaohua Zhang, Edgar Samaniego, Rose Du, Yaohua Pan, Jieqing Wan, Bing Zhao","doi":"10.1097/JS9.0000000000002357","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002357","url":null,"abstract":"<p><strong>Background: </strong>Stent-assisted coiling (SAC) is a reasonable treatment for ruptured cerebral aneurysms that are not amenable to primary coiling. However, the safety and efficacy of SAC for acutely ruptured cerebral aneurysms need to be further determined.</p><p><strong>Purpose: </strong>To evaluate the safety and efficacy of SAC for acutely ruptured cerebral aneurysms.</p><p><strong>Methods: </strong>This was a prospective, multicenter study of consecutive patients with acutely ruptured cerebral aneurysms treated with SAC within 72 hours after presentation. The primary outcome was treatment-related thromboembolic complications within 30 days of treatment; the secondary outcomes were hemorrhagic complications and aneurysm recurrence. A favorable clinical outcome was defined as a modified Rankin scale (mRS) of 0 to 2 at 6 months after treatment.</p><p><strong>Results: </strong>Of the 315 patients, 278 patients with 278 acutely ruptured aneurysms were included in the study. Treatment-related thromboembolic complications occurred in 32 patients (11.5%), including nine (3.2%) patients with intraoperative thrombosis and 23 (8.3%) patients with postoperative ischemia. Hemorrhagic complications occurred in 13 (4.7%) patients, including one (0.4%) patient with intraoperative hemorrhage and 12 (4.3%) patients with postoperative hemorrhage. Aneurysm rebleeding occurred in two (0.7%) patients. A total of 251 (251/275, 91.3%) patients had favorable clinical outcomes at the 6-month follow-up. The rate of aneurysm recurrence was 7.2%. Patients with a worse WFNS grade tended to have thromboembolic complications (21.2% vs. 10.2%, P = 0.079) and hemorrhagic complications (12.1% vs. 3.7%, P = 0.054). Treatment-related thromboembolic complications and hemorrhagic complications were independent predictors of unfavorable clinical outcomes.</p><p><strong>Conclusions: </strong>Most patients had favorable clinical outcomes, with a low risk of intraoperative complications, aneurysm rebleeding, and a high rate of aneurysm occlusion. SAC for acutely ruptured aneurysms is a safe and effective procedure, especially in patients with good clinical conditions before treatment.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719157","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 existing evidence for the use of extracellular vesicles in the treatment of osteoporosis: a review.","authors":"Zixiang Geng, Tiancheng Sun, Long Yuan, Yongfang Zhao","doi":"10.1097/JS9.0000000000002339","DOIUrl":"10.1097/JS9.0000000000002339","url":null,"abstract":"<p><p>Osteoporosis is a systemic metabolic bone disease characterized by decreased bone mass, microstructural deterioration, and increased fracture risk. The crucial role of extracellular vesicles (EVs) in the occurrence and development of osteoporosis has garnered attention, with vesicle-based treatments showing significant promise. Compared to conventional osteoporosis medications, EVs possess characteristics of naturalness, selectivity, and adaptability, and more importantly, they have negligible side effects. Hence, this review discusses the applications of natural and engineered EVs in osteoporosis are comprehensively outlined. Unfortunately, the absence of consensus on the extraction, purification, characterization, and storage of EVs has resulted in a lack of clinical evidence supporting their application in patients with osteoporosis. Although significant progress is still needed before the clinical use of EVs can be achieved, their substantial potential remains undeniable. Moreover, considering the complexity of bone metabolism in osteoporosis and the heterogeneity of EVs, further investigation into the functional subpopulations of different exosomes will facilitate their application.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630386","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 analgesic modalities after cesarean section: a network meta-analysis and systematic review.","authors":"Yimeng Jing, Shishun Zhao, Wenlai Guo, Lu Qin, Yaxin Li, Di You","doi":"10.1097/JS9.0000000000002352","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002352","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section is one of the most common surgical procedures. Currently, there are many analgesic methods available after cesarean section, but the optimal analgesic method after cesarean section is not clear.</p><p><strong>Methods: </strong>A network meta-analysis of randomized controlled trials was used to search Embase, PubMed, Web of Science, and Cochrane databases. Outcomes included time to first postoperative request for analgesia, postoperative medication-supplemented analgesia, pain scores at four postoperative time points, postoperative complications (nausea and vomiting, itching, and level of sedation), and patient satisfaction.</p><p><strong>Result: </strong>A total of 110 randomized controlled trials involving 8871 pregnant women were finally included. A total of 17 postoperative analgesic techniques for cesarean delivery were included. Compared with the control group, all modalities except wound infiltration prolonged the time to the first request for analgesia. Transversal abdominal block-type and lumbar quadratus block-type analgesia were effective in decreasing the need for opioids in postoperative patients. Wound infiltration and transverse fascial block decreased the need for nonopioid medications in postoperative patients. The traditional analgesic modalities of intrathecal morphine (IM) and epidural morphine have the best analgesic effect, and the analgesic effect of the type of transversal abdominal block and the type of lumbar square muscle block in local anesthesia is better than that of other local anesthesia modalities. The lateral transversus abdominis block and posterior and anterior lumbar square muscle block can effectively reduce postoperative complications with the best effect. In terms of patient satisfaction, IM with conventional Petit transverse abdominal block was the best.</p><p><strong>Conclusions: </strong>Regional nerve block is a safe and effective postoperative analgesic modality; QLB III, which is used to use opioids as postoperative supplemental analgesia, is the safest and most effective analgesic modality, and those who are used to use non-opioids as postoperative supplemental analgesia can choose transversus fasciae block as a postoperative analgesic modality.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719363","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":"Nanosecond pulsed electric field ablation as first-line curative therapy for hepatocellular carcinoma in high-risk locations a prospective multicenter.","authors":"Min Xu, Wu Zhang, Danxia Xu, Gang Dong, Zhigang Ren, Tuerganaili Aji, Jiansong Ji, Qiyu Zhao, Jinhua Pan, Xinhua Chen, Tian'An Jiang","doi":"10.1097/JS9.0000000000002361","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002361","url":null,"abstract":"<p><strong>Background: </strong>Preclinical studies have shown that nanosecond pulsed electric field ablation (nsPEF) is a novel nonthermal ablation modality that can eradicate tumors near critical structures. We conducted the prospective multicenter trial to investigate the efficacy and safety of nsPEF for hepatocellular carcinoma (HCC) in high-risk locations.</p><p><strong>Materials and methods: </strong>This study was conducted at five hospitals in China. Patients with HCC fulfilling the Milan criteria and located immediately adjacent to (<0.5 cm) the portal vein, hepatic vein, diaphragm, gastrointestinal tract, liver capsule, or gallbladder were enrolled. The primary endpoint was the complete ablation rate at 1 month, and adverse events. The secondary endpoints included local tumor progression (LTP), recurrence-free survival (RFS), and overall survival (OS).</p><p><strong>Results: </strong>From March, 2020, to June, 2022, 192 patients were enrolled (148 males [77.1%]; median age 58.5 years [interquartile range, 51.0-66.0 years]. The median follow-up duration was 33.5 months. The technical success rate was 99.5%. Complete ablation was achieved in 91.7% of the 217 tumors. Complete ablation rates at 1 month were significantly higher in tumors < 2 cm vs. ≥ 2 cm (90.1% vs. 71.7%, p = 0.002). The estimated 1-, 2- and 3-year cumulative incidences of LTP were 9.8%, 13.8%, and 15.7%, respectively. The maximum tumor diameter [hazard ratio (HR) = 2.62, p = 0.014] and age (HR = 0.42, p = 0.026) were independent predictive factors for LTP. The RFS rates at 1-, 2- and 3-year were 72.2%, 51.7%, and 43.5%, respectively. No periprocedural thermal damage was observed. Grade ≥ 3 treatment-related adverse events occurred in nine (5.6%) patients.</p><p><strong>Conclusion: </strong>To our knowledge, this was the first prospective trial demonstrating that nsPEF was effective and relatively safe for HCC in high-risk locations, and may serve as an alternative therapeutic option for HCC suboptimal for thermal ablation.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719135","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":"Assessing antibiotic effectiveness for reducing postoperative infectious complications in acute cholecystitis: a multicenter randomized controlled trial.","authors":"Sung Eun Park, Tae Yoon Lee, Chang Ho Seo, Eui Soo Han, Tae Ho Hong","doi":"10.1097/JS9.0000000000002346","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002346","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute cholecystitis (AC) often receive antibiotics to reduce the risk of infectious complications after cholecystectomy. This study investigated the clinical significance of antibiotic use in patients with mild-to-moderate AC who required emergency laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>This multicenter, double-blind, randomized controlled trial was conducted at four centers between February 2023 and January 2024. Patients with AC eligible for emergency laparoscopic cholecystectomy were randomly assigned to the antibiotic or placebo group. The antibiotic group received 1 g of intravenous cefazolin daily for three days during hospitalization and oral antibiotics for 4 days after discharge, whereas the placebo group received 10 mL of intravenous normal saline during their hospital stay. The primary endpoint was the rate of infectious complications.</p><p><strong>Results: </strong>An imputed per-protocol analysis of 370 patients (185 in each group) found comparable postoperative infection rates between the antibiotic group (7.6%, 14 patients) and placebo group (7%, 13 patients), showing no statistically significant difference ( P = 0.842). Overall, the non-infectious complication rates did not differ significantly between the two groups: 21 (11.5%) cases in the antibiotic group vs. 30 (16.2%) cases in the placebo group ( P = 0.591). Considering a non-inferiority margin of 10%, the absence of antibiotic treatment did not result in worse clinical outcomes than the antibiotic treatment.</p><p><strong>Conclusions: </strong>Administering antibiotics, even in sufficient doses, did not significantly reduce the risk of infectious complications in patients with AC compared to the group that did not receive antibiotics.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719355","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":"AutoFRS: an externally validated, annotation-free approach to computational preoperative complication risk stratification in pancreatic surgery - an experimental study.","authors":"Fiona R Kolbinger, Nithya Bhasker, Felix Schön, Daniel Cser, Alex Zwanenburg, Steffen Löck, Sebastian Hempel, André Schulze, Nadiia Skorobohach, Hanna M Schmeiser, Rosa Klotz, Ralf-Thorsten Hoffmann, Pascal Probst, Beat Müller, Sebastian Bodenstedt, Martin Wagner, Jürgen Weitz, Jens-Peter Kühn, Marius Distler, Stefanie Speidel","doi":"10.1097/JS9.0000000000002327","DOIUrl":"10.1097/JS9.0000000000002327","url":null,"abstract":"<p><strong>Background: </strong>The risk of postoperative pancreatic fistula (POPF), one of the most dreaded complications after pancreatic surgery, can be predicted from preoperative imaging and tabular clinical routine data. However, existing studies suffer from limited clinical applicability due to a need for manual data annotation and a lack of external validation. We propose AutoFRS (automated fistula risk score software), an externally validated end-to-end prediction tool for POPF risk stratification based on multimodal preoperative data.</p><p><strong>Materials and methods: </strong>We trained AutoFRS on preoperative contrast-enhanced CT imaging and clinical data from 108 patients undergoing pancreatic head resection and validated it on an external cohort of 61 patients. Prediction performance was assessed using the area under the receiver operating characteristic curve (AUC) and balanced accuracy. In addition, model performance was compared to the updated alternative fistula risk score (ua-FRS), the current clinical gold standard method for intraoperative POPF risk stratification.</p><p><strong>Results: </strong>AutoFRS achieved an AUC of 0.81 and a balanced accuracy of 0.72 in internal validation and an AUC of 0.79 and a balanced accuracy of 0.70 in external validation. In a patient subset with documented intraoperative POPF risk factors, AutoFRS (AUC: 0.84 ± 0.05) performed on par with the uaFRS (AUC: 0.85 ± 0.06). The AutoFRS web application facilitates annotation-free prediction of POPF from preoperative imaging and clinical data based on the AutoFRS prediction model.</p><p><strong>Conclusion: </strong>POPF can be predicted from multimodal clinical routine data without human data annotation, automating the risk prediction process. We provide additional evidence of the clinical feasibility of preoperative POPF risk stratification and introduce a software pipeline for future prospective evaluation.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719358","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":"Clinical efficacy and chemoresistance analysis of precision neoadjuvant chemotherapy for borderline resectable pancreatic cancer: a prospective, single-arm pilot study.","authors":"Yonggang He, Yinan Zhu, Weiwei Wang, Yuanyue Yi, Zheng Wang, Chongyu Zhao, Jing Li, Xiaobing Huang, Lu Zheng","doi":"10.1097/JS9.0000000000002342","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002342","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NAC) can improve the survival outcomes of patients with pancreatic cancer, but for borderline resectable pancreatic cancer (BRPC) the proportion of conversion to surgery remains unsatisfactory. This single-arm pilot study aimed to assess the clinical efficacy and safety of NAC based on patient-derived organoids (PDOs) for BRPC.</p><p><strong>Methods: </strong>Biopsy samples from BRPC patients were collected for generating PDOs. Gemcitabine plus nab-paclitaxel (GnP) as NAC was initially administrated for one cycle, and then the treatment regimen was adjusted based on the PDO drug sensitivity testing. The primary endpoint was the objective response rate (ORR). Secondary endpoints included R0 resection rate, NAC-related adverse events (AEs) and postoperative complications. Exploratory objectives were to assess the chemoresistance to gemcitabine.</p><p><strong>Results: </strong>Totally 19 of 25 patients were eligible for the study, among whom 16 achieved partial response and received surgical resection, with the ORR of 84.2% (16/19). The R0 resection rate was 81.3% (13/16). During NAC, 8 (42.1%, 8/19) patients experienced different grades of AEs, mainly including grade 2 myelosuppression (26.3%), cutaneous pruritus (5.3%), and diarrhea (5.3%). scRNA-seq analysis of duct cells showed that the transcriptome in aneuploid cells may affect gemcitabine resistance via multiple pathways, among which up-regulation of drug-resistant genes (OLFM4, AGR2, MUC5AC, MUC1, HMGA1, REG4, IL17RB, GCNT3, AKR1B10, ITGA6, HMGCS2, and SQLE) and down-regulation of sensitive genes (SIK1, HEXIM1, SPINT2, GADD45 and TIMP2) played crucial roles. Changes in the interactions between cancer cells and other cell groups may also involve in gemcitabine resistance.</p><p><strong>Conclusion: </strong>PDO-based NAC shows a promising resectable rate in BRPC patients, with good tolerance. Potential drug-resistant and sensitive genes and cell-cell interaction changes may participate in the development of gemcitabine resistance.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719361","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":"Long-term neurodevelopmental outcomes should be addressed in robot-assisted abdominal surgery in small infants.","authors":"Yun Zhang, Ting Gong, Xiaojuan Zhang","doi":"10.1097/JS9.0000000000002366","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002366","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718983","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":"Impact of pecto-intercostal fascial block on postoperative fatigue in elderly patients undergoing off-pump coronary artery bypass grafting: a randomized clinical trial.","authors":"Xinghe Wang, Meiyan Zhou, Qian Liu, Fangming Shen, Zhe Zhang, Long Wang, Yu Qi, Jia Sun, Liwei Wang","doi":"10.1097/JS9.0000000000002353","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002353","url":null,"abstract":"<p><strong>Background: </strong>Postoperative fatigue syndrome (POFS) is a common yet often under-recognized consequence of surgical interventions, particularly in cardiac surgery. POFS is associated with prolonged recovery times, extended hospital stays, and increased healthcare costs. Current strategies for preventing POFS have demonstrated limited success. This study aims to evaluate the impact of pecto-intercostal fascial block (PIFB) on the incidence of POFS in elderly patients undergoing off-pumpcoronary artery bypass graft (CABG) surgery.</p><p><strong>Methods: </strong>In this randomized controlled trial, 110 elderly patients scheduled for off-pump CABG surgery were randomly assigned to either the PIFB group (n = 55; 0.4% ropivacaine) or the control group (n = 55; normal saline). The primary outcome was the incidence of POFS, which was assessed using the ICFS-10 scale. Secondary outcomes included postoperative pain scores, opioid consumption, extubation time, duration of ICU and hospital stay, and Quality of Recovery (QoR-15) scores.</p><p><strong>Results: </strong>The incidence of POFS was significantly lower in the PIFB group compared to the control group on postoperative days 1 (69.0% vs. 92.7%, P = 0.004), 3 (63.6% vs. 83.6%, P = 0.030), and 5 (52.7% vs. 72.7%, P = 0.048), with no significant differences observed by day 7 and 8 weeks. Pain scores were also markedly lower in the PIFB group at three time points: immediately after extubation, 12 hours post-surgery, and 24 hours post-surgery (P < 0.001, P < 0.001, and P = 0.002, respectively). Furthermore, opioid consumption was reduced by an average of 11.1 mg (P < 0.001). Patients in the PIFB group experienced significantly shorter extubation times (5.5 ± 1.8 hours vs. 8.6 ± 2.1 hours, P < 0.001), ICU stays (31.8 ± 7.3 hours vs. 39.4 ± 7.5 hours, P < 0.001), and hospital stays (8.2 ± 1.1 days vs. 8.8 ± 1.2 days, P = 0.007). QoR-15 scores were significantly higher in the PIFB group on postoperative days 1, 3, and 5 (P < 0.001, P = 0.003, and P = 0.037, respectively). Notably, no PIFB-related adverse events were reported in either group.</p><p><strong>Conclusions: </strong>PIFB significantly alleviated early POFS, enhanced pain management, reduced opioid consumption, and accelerated recovery, thereby improving the overall quality of recovery in elderly patients undergoing off-pump CABG.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718875","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}