International journal of surgery最新文献

{"title":"Three-dimensional reconstruction combined with weightbearing CT for preoperative planning of subtalar arthroereisis in pediatric flexible flatfoot: a prospective cohort study.","authors":"Jieyuan Zhang, Shaoling Fu, Cheng Wang, Jiazheng Wang, Chenglin Wu, Shutao Zhang, Wenqi Gu, Jian Zou, Xin Ma, Zhongmin Shi","doi":"10.1097/JS9.0000000000003097","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003097","url":null,"abstract":"<p><strong>Background: </strong>Current research on the use of subtalar arthroreisis (SA) for pediatric flexible flatfoot primarily focuses on biomechanical modeling and three-dimensional (3D) printing, while studies combining 3D reconstruction with weightbearing CT (WBCT) for preoperative planning of SA remain limited. This study aims to evaluate the feasibility and clinical efficacy of 3D reconstruction technology combined with WBCT in the preoperative planning of SA in pediatric flexible flatfoot.</p><p><strong>Methods: </strong>A prospective cohort study of 261 pediatric flexible flatfoot patients undergoing SA from Jan 2023 to Aug 2023 divided into planning group (with preoperative planning), and non-planning group (without preoperative planning). The planning group utilized the posterior arch angle, anterior arch angle, lateral longitudinal arch angle, medial longitudinal arch angle, and Meary's angle for preoperative rotation guidance and HyProCure size prediction, while the non-planning group relied on intraoperative trial molding. Data included demographics, surgical details, imaging indicators, clinical outcomes, and complications.</p><p><strong>Results: </strong>In this study, 197 patients underwent 18-month follow-up, with 95 patients in the preoperative planning group and 102 patients in the non-planning group. Concerning patient outcomes, the postoperative imaging indicators in the planning group demonstrated excellent consistency with preoperative analysis reports. After controlling baseline characteristics, both groups showed significant clinical improvements, with the planning group outperforming the non-planning group in imaging and clinical outcomes, though not significantly. The planning group had shorter operative times and fewer intraoperative fluoroscopy exposures. Some patients in the non-planning group showed incomplete correction of imaging indicators, delayed wound healing, sinus tarsi pain, with 3 requiring HyProCure removal and 4 needing size adjustments. No major complications occurred in the planning group.</p><p><strong>Conclusion: </strong>Preoperative planning integrating 3D reconstruction with WBCT presents a feasible and effective approach for pediatric flexible flatfoot patients undergoing SA. This approach can serve as a means to optimize surgical outcomes, minimize intraoperative fluoroscopy exposure and operative time, and mitigate the risks of complications and reoperation.</p><p><strong>Level of evidence: </strong>Level II, Prospective cohort study.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707480","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":"A commentary on \"application of Artificial Intelligence lesion labeling system-assisted endoscopic submucosal dissection for the treatment of esophageal lesions in a low-volume center: a prospective cohort study\".","authors":"Tao He, Lijuan Zuo, Shanming Sun","doi":"10.1097/JS9.0000000000003077","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003077","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690154","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":"Comment on \"Differential prognostic impact of liver resection by the site of concurrent extrahepatic diseases in patients with colorectal cancer liver metastases\".","authors":"Xin-Chao Yang, Ya-Hui Sun, Xiong-Hui He","doi":"10.1097/JS9.0000000000002974","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002974","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690202","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":"Expanding the clinical utility of a pathomics-based AI model for predicting 9p loss in oral leukoplakia and head and neck squamous cell carcinoma.","authors":"Jing Li, Jian Chen, Zhongjun Yang","doi":"10.1097/JS9.0000000000002956","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002956","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690211","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":"Immunotherapy in central nervous system tumour.","authors":"Yutao Huang, Yi Liu, Hui Zeng, JingJing Yang, Zongping Li, Jianguo Xu, Liyuan Jin, Xiaoyin Liu, Liangxue Zhou","doi":"10.1097/JS9.0000000000002993","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002993","url":null,"abstract":"<p><p>Immunotherapy, defined as strategies that enhance host antitumor immunity by activating innate and adaptive immune responses, has demonstrated remarkable efficacy in hematologic malignancies. However, its application in solid tumours, particularly those affecting the central nervous system (CNS) such as gliomas, brain metastases, primary CNS lymphoma (PCNSL), and medulloblastomas, has been considerably slower. Major barriers to immunotherapy in these contexts include the physical and functional constraints imposed by the blood-brain barrier, tumour immune evasion, immunosuppressive microenvironments, tumour heterogeneity, and therapeutic resistance. Emerging consensus challenges the traditional notion of CNS immune privilege, recognising that distinct anatomical sites within the CNS-including the brain parenchyma, meninges, choroid plexus, perivascular spaces, and calvarial bone marrow-exert diverse immunological functions that modulate local and systemic immunity. This review comprehensively summarizes the immune landscape of different CNS compartments and its impact on immunotherapeutic efficacy, delves into the mechanisms of immune evasion and suppression in CNS, reviews the clinical trials conducted on immunotherapy for CNS tumours, meticulously analyzes the factors contributing to the variability in the efficacy of different immunotherapy modalities across various CNS tumours, critically evaluates current challenges in CNS tumour immunotherapy, and highlights innovative strategies including genomics- and immune profiling-guided personalized immunotherapies, combination regimens integrating immunomodulation with conventional treatments, and novel delivery approaches to overcome the blood-brain barrier. Our aim is to provide an integrated theoretical framework and forward-looking perspectives to facilitate translational advances and optimise precision immunotherapy for CNS tumours.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690213","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":"Letter to the editor: commentary on \"prevalence of colonoscopy-related adverse events in older adults aged over 65 years: a systematic review and meta-analysis\".","authors":"Dexin Wang, Yongping Mu, Jinzhong Yu","doi":"10.1097/JS9.0000000000002905","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002905","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690219","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":"Mindfulness in surgeons.","authors":"Valentina Bianchi, Carmen Nesci, Filomena Misuriello, Edoardo Piras, Anna Modica, Maria Michela Chiarello, Giuseppe Brisinda","doi":"10.1097/JS9.0000000000002909","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002909","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690238","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":"Preoperative blood-brain barrier disruption increased risk of postoperative cognitive decline after coronary artery bypass grafting: a prospective cohort study.","authors":"Weijing Wang, Sen Zhang, Lu Yu, Tianjie Wang, Guanxi Wang, Fei Xu, Shujuan Li","doi":"10.1097/JS9.0000000000002902","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002902","url":null,"abstract":"<p><strong>Background: </strong>Cognitive decline after coronary artery bypass grafting (CABG) surgery is common and significantly impacts the long-term prognosis of coronary artery disease (CAD) patients. Nevertheless, the mechanisms of postoperative cognitive decline (POCD) and its early neuroimaging indicators remain unclear.</p><p><strong>Objectives: </strong>To explore whether blood-brain barrier disruption (BBBD) of computed tomography perfusion (CTP) is associated with POCD in patients with CABG.</p><p><strong>Methods: </strong>The study involved 116 participants (mean age 63.85 ± 8.10 years) with CAD who underwent CABG surgery as part of the IACV Study. A CT perfusion (CTP) scan was performed before the surgery to assess the permeable surface (PS) values of the frontal and temporal lobes. The Montreal Cognitive Assessment (MoCA) neurological scale was used to measure cognitive function before the surgery and again before discharge.</p><p><strong>Results: </strong>Overall, 24 (20.69%) developed POCD. All patients underwent the same anesthesia and postoperative analgesia, with no difference in postoperative blood loss and days of hospital discharge between the two groups. Patients with POCD exhibited higher permeability surface (PS) in the right frontal lobe [0.20 (0.10, 0.30) vs 0.13 (0.07, 0.18), p = 0.009] and left frontal lobe [0.23 (0.11, 0.28) vs 0.14 (0.08, 0.22), p = 0.030]. A notable decrease in total MoCA scores from 20.7 to 14.0 was seen in patients with POCD. Each 0.05 ml/100 g/min increase in PS of the right frontal lobe was associated with 1.32 times increase in the risk of developing POCD. Higher baseline PS values correlated with a greater decline in MoCA scores post-surgery (ρ = - 0.231, p = 0.0214).</p><p><strong>Conclusions: </strong>Almost one-fifth of patients develop POCD following CABG surgery, and preoperative elevation of frontal lobe PS is associated with POCD. These findings suggest that CTP-PS may serve as an imaging biomarker to identify patients at high risk for POCD.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690253","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":"OPEN, Hybrid, Minimally Invasive, And Robotic-Assisted Transthoracic Esophagectomy For Cancer A Network Meta-Analysis Of Randomized Trials.","authors":"Alberto Aiolfi, Francesco Cammarata, Gianluca Bonitta, Davide Bona, Luigi Bonavina","doi":"10.1097/JS9.0000000000002985","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002985","url":null,"abstract":"<p><strong>Background: </strong>The surgical approach to esophageal cancer is evolving. Open (OE) and hybrid esophagectomy (HE) have been standard treatments for years but minimally invasive (MIE) and robotic-assisted esophagectomy (RAMIE) have recently emerged with promising perspectives.</p><p><strong>Purpose: </strong>Compare short-term outcomes among different techniques for transthoracic esophagectomy.</p><p><strong>Methods: </strong>Systematic review and random effect Frequentist network meta-analysis. Included were randomized controlled trials (RCTs) reporting short-term outcomes for transthoracic OE, HE, MIE, and RAMIE in adult patients undergoing esophagectomy for cancer. Primary outcomes were anastomotic leak, pulmonary complications (PCs), and in-hospital mortality. Risk ratio (RR), standardized mean difference (SMD), and 95% confidence intervals (CI) were used as pooled effect size measures. PROSPERO (XXXXXXXXXXXX).</p><p><strong>Results: </strong>Eight RCTs (1776 patients) were included. Overall, 493 patients (27.8%) underwent OE, 494 (27.9%) HE, 447 (25.3%) MIE, and 338 (19.2%) RAMIE. Adenocarcinoma was diagnosed 65.8% of patients while neoadjuvant therapy was completed in 64.1%. Ivor-Lewis or McKeown esophagectomy were performed in 43.3% and 56.7% of patients, respectively. MIE and RAMIE were associated with a reduced risk of PCs compared to OE (RR = 0.46; 95% CI 0.29-0.71 and RR = 0.48; 95% CI 0.33-0.71) and HE (RR = 0.54; 95% CI 0.34-0.86 and RR = 0.57; 95%CI 0.37-0.87). Additionally, MIE and RAMIE showed significantly reduced intraoperative blood loss and hospital length of stay compared to OE and HE. Among surgical approaches, anastomotic leak, in-hospital mortality, together with the other perioperative and oncological outcomes were equivalent.</p><p><strong>Conclusions: </strong>MIE and RAMIE were associated with significantly reduced postoperative PCs, intraoperative blood loss and shorter hospital stays compared to OE and HE. MIE and RAMIE showed equivalent perioperative outcomes and oncological radicality.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698526","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":"Commentary on \"evaluation of the comparative efficacy and safety of surgical strategies for long bone defects: a network meta-analysis\".","authors":"Yongxu Zhang, Rongchuan Cao, Zhen Wang, Wenji Song","doi":"10.1097/JS9.0000000000002925","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002925","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690203","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}