International journal of surgery最新文献

{"title":"Surgical techniques for enhancing postoperative urinary continence in robot-assisted radical prostatectomy: a comprehensive review.","authors":"Yufei Yu, Robert E Reiter, Mo Zhang","doi":"10.1097/JS9.0000000000002414","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002414","url":null,"abstract":"<p><p>Prostate cancer (PCa) is one of the most common malignancies affecting the male reproductive system. Robot-assisted radical prostatectomy (RARP) has been a standard treatment for PCa for over 20 years. However, postoperative urinary incontinence remains a frequent complication for patients who undergo RARP. Numerous surgical techniques have been developed to improve postoperative continence recovery, broadly categorized into preservation and reconstruction methods. Preservation techniques include safeguarding the bladder neck, distal urethra, detrusor apron, retropubic space, neurovascular bundles, and controlling the dorsal venous complex. Reconstruction techniques aim to mitigate the impairment of urethral sphincter function caused by surgery. While these approaches substantially enhance post-RARP urinary continence recovery, challenges remain in tailoring surgical plans to individual patient needs. This review explores the application of these representative techniques, discusses their current limitations, and highlights potential directions for future advancement.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001191","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":"Antecubital versus femoral approach for adrenal venous sampling in the patients with primary aldosteronism: a randomized controlled trial.","authors":"Hui Dong, Hongwu Li, Yujie Zuo, Kaiwen Jiang, Wentao Ma, Yubao Zou, Wenjun Ma, Xiongjing Jiang","doi":"10.1097/JS9.0000000000002452","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002452","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Femoral vein access used to be the traditional approach for adrenal venous sampling (AVS) procedures, whereas antecubital vein access is the newly developed approach. Until now, no randomized trial for comparison of two approaches has been carried out.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the success rate, safety, and procedural parameters of AVS via an antecubital approach versus femoral approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This randomized clinical trial (RCT) was conducted between January 2022 and December 2023. The patients with primary aldosteronism (PA) aged 18-60 years were randomly assigned to femoral vein access group (FV) or antecubital vein access group (AV). The intention-to-treat analysis included all randomized patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;A total of 675 patients aged 18-60 years old with hypertension that were at increased risk for PA were screened, 183 of whom were confirmed with PA. Twenty-nine patients were excluded due to refusal of AVS, decline of participating in this trial, or contraindication to AVS. A total of 154 patients recruited in this trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Patients were randomly assigned to undergo AVS via femoral approach or antecubital approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary end point was the success rate of bilateral AVS. Secondary end points included the success rate of right, left sampling, procedure duration, fluoroscopy time, contrast volume, incidence of complications, and postsurgical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From January 2022 to December 2023, totally 154 patients with PA were randomized to FV group (77cases, mean age, 47.8 ± 8.1 years; 26 females [33.8%]) and AV group (77cases, mean age, 49.2 ± 8.6 years; 30 females [39%]). The baseline characteristics for the two groups were well balanced (P &gt; 0.05). There were no significant differences in the success rate of bilateral (89.6% vs 92.2%, P = 0.58),right (94.8% vs 97.4%, P = 0.68), and left (94.8% vs 94.8%, P = 1.00) sampling between two groups. The incidence of complications did not differ between the two groups (2.6% vs 1.3%, P = 1.00). The incidence of arterial mis-puncture was significantly higher in FV group than that in AV group (0% vs 9.1%, P = 0.02). The fluoroscopy time and contrast volume did not significantly differ between two groups. The procedure duration in AV group was significantly shorter than that of FV group (18.0 [IQR, 15.0-23.0] versus 20.0 [IQR, 17.0-25.5], P = 0.011). There was no significant difference in the proportion of patients who achieved complete clinical success (50.0% vs 45.9%, P = 0.725) and complete biochemical success (92.1% vs 91.9%, P = 1.000) after adrenalectomy between FV group and AV group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and relevance: &lt;/strong&gt;The trial showed AVS via AV approach or FV approach did not lead to significant differences in success rate and incidence of complications, as well a","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964541","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":"Neoadjuvant hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin for resectable single large hepatocellular carcinoma.","authors":"Zili Hu, Min Deng, Yizhen Fu, Zhongguo Zhou, Huanwei Chen, Minshan Chen, Yaojun Zhang","doi":"10.1097/JS9.0000000000002437","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002437","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients diagnosed with single large hepatocellular carcinoma (HCC) often face a daunting prognosis and pose a treatment challenge. In this study, we aimed to evaluate the effectiveness of neoadjuvant hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil, and leucovorin (FOLFOX) in patients with single large HCC.</p><p><strong>Methods: </strong>397 patients with resectable single, ≥7 cm HCC from three centers in China between January 2016 and December 2021 were included, 268 patients underwent hepatectomy alone and 129 patients underwent neoadjuvant HAIC. The log-rank test was used to compare the overall survival (OS) and disease-free survival (DFS) by intension-to-treat analysis between the two groups.</p><p><strong>Results: </strong>The 1-, 3-, and 5-year OS rates were 83.3%, 62.9%, and 53.8% in the surgery alone group, and 97.5%, 80.7%, and 64.7% in the neoadjuvant HAIC group. The 1-, 3-, and 5-year DFS rates were 48.8%, 32.5%, and 26.2% in the surgery alone group, and 71.5%, 61.7%, and 59.5% in the neoadjuvant HAIC group. The neoadjuvant HAIC group showed significantly longer OS (hazard ratio [HR], 0.506; 95% confidence interval [CI], 0.347-0.734; P < 0.001) and DFS (HR, 0.466; 95% CI, 0.357-0.609; P < 0.001) than the surgery alone group. There was no HAIC-related death in the neoadjuvant HAIC group.</p><p><strong>Conclusions: </strong>Neoadjuvant FOLFOX-HAIC significantly improved the OS and DFS with acceptable toxicities in HCC patients with resectable single, ≥7 cm tumor.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015668","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 osteoporosis-fracture cascade: new insights into vertebral fracture prevalence and financial costs in China.","authors":"Guoliang Ma, He Yin, Liguo Zhu","doi":"10.1097/JS9.0000000000002433","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002433","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965515","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 socioeconomic status and multimorbidity indices across 15 countries: a multi-regional cohort study.","authors":"Xi Li, Yaping Wang, Liyuan Tao, Wenzhan Jing, Chuyao Jin, Weizhong Yang, Jue Liu","doi":"10.1097/JS9.0000000000002482","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002482","url":null,"abstract":"<p><p>Multimorbidity poses a major threat to health systems. Given no internationally accepted definition of multimorbidity, little is known about multimorbidity burden worldwide and whether it varies across socioeconomic status (SES). We used individual-level data from four prospective cohorts between 2000 and 2022 to examine the association of SES with multimorbidity (measured by simple disease counts and four multimorbidity indices) using Cox proportional hazards models. Among 28 766 participants aged over 50 years, the incidence of multimorbidity ranged from 7.82 (95% confidence interval [CI] = 2.08-29.47) per 100 person-years to 29.01 (24.41-34.49) per 100 person-years. Low SES was related to an increased risk of multimorbidity, ranging from 5% (hazard ratio [HR] = 1.05; 95% CI = 1.00-1.11, defined by multimorbidity-weighted index) to 85% (HR = 1.85; 95% CI = 1.67-2.04, measured by simple disease counts), with a pooled HR of 1.04-1.27. Sociodemographic factors should be taken into consideration in multimorbidity prevention and management strategies.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965481","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":"Stem cell therapy for osteoarthritis: advances and challenges in clinical trials.","authors":"Jiayi Lu, Shuqin Deng, Haojin Cheng, Jianyu Zhu","doi":"10.1097/JS9.0000000000002462","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002462","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989849","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 trial landscape reveals paradigm shifts in renal cell carcinoma therapy (research letter).","authors":"Yunfeng Zhang, Jun Li, Xing Wang, Ruizhen Huang, Honglin Hu","doi":"10.1097/JS9.0000000000002444","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002444","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988042","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":"An artificial intelligence model for nuclear grading of clear cell renal cell carcinoma using whole slide images: a retrospective, multicentre, diagnostic study.","authors":"Qingyuan Zheng, Li Wei, Yang Zhou, Rui Yang, Panpan Jiao, Haonan Mei, Kai Wang, Xinmiao Ni, Xiangxiang Yang, Jiejun Wu, Junjie Fan, Tian Liu, Jingping Yuan, Xiaodong Weng, Xiuheng Liu, Zhiyuan Chen","doi":"10.1097/JS9.0000000000002484","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002484","url":null,"abstract":"<p><strong>Background: </strong>The pathological assessment of International Society of Urological Pathology (ISUP) nuclear grading is crucial for the management of clear cell renal cell carcinoma (ccRCC). We aimed to develop an artificial intelligence (AI)-based, high-efficiency, and high-accuracy ccRCC ISUP Grading Diagnostic System (RIGDAS) and evaluate its clinical application value.</p><p><strong>Methods: </strong>In this multicentre, retrospective, diagnostic study, consecutive ccRCC patients who underwent partial or complete nephrectomy between 1 June 2014 and 1 June 2024 across three Chinese hospitals and two public cohorts were included. Pathological slides from these surgeries were collected and digitized into whole slide images for model development and validation. The primary endpoint was the area under the receiver operating characteristic curve (AUC) of RIGDAS. Additionally, the performance and review time of pathologists assisted with RIGDAS were evaluated.</p><p><strong>Results: </strong>A total of 5,697 slides from 1,807 ccRCC patients were collected and digitized for training and validating RIGDAS. Across the training and validation datasets, RIGDAS achieved an AUC ranging from 0.943 (95% confidence interval [CI], 0.927-0.971) to 0.980 (0.960-1.989). In the human-AI comparison and collaboration study, RIGDAS achieved an accuracy (0.930 [0.907-0.951]) that was 3.3-4.3% higher than the accuracy of two junior pathologists (0.897 [0.883-0.916], P = 0.004; 0.887 [0.871-0.904], P = 0.001) and was comparable to the accuracy of two senior pathologists (0.960 [0.948-0.977] and 0.970 [0.961-0.986], both P > 0.05). Furthermore, RIGDAS significantly improved the diagnostic accuracy of the two junior pathologists to the level of the senior pathologists (P > 0.05) and greatly reduced the slide review time for all four pathologists (20.5-45.1%, all P < 0.0001).</p><p><strong>Conclusion: </strong>RIGDAS demonstrated decent ability in diagnosing ISUP nuclear grading in ccRCC, reducing the likelihood of misdiagnosis by pathologists, and decreasing the time required for pathological slide review, highlighting its potential for clinical application.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982788","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 \"Artificial neural network model enhancing the accuracy of clinical evaluation for high-risk population of lymph node metastasis in non-intestinal type early gastric cancer: a multicenter real-world study in China\".","authors":"Ling-Zhi Huang, Hong-Jiao Wu, Xing-Chen Zhou","doi":"10.1097/JS9.0000000000002493","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002493","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018453","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":"Safety evaluation of inotuzumab ozogamicin: a pharmacovigilance study based on the FAERS database.","authors":"Xueyu Duan, Yongkun Deng, Lei Li, Zhaoheng Yin, Limei Yu","doi":"10.1097/JS9.0000000000002435","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002435","url":null,"abstract":"<p><strong>Objective: </strong>Given inotuzumab ozogamicin (InO) relatively recent market introduction and ongoing new drug surveillance period, further research is needed on its adverse drug events (ADEs) in the real world.</p><p><strong>Methods: </strong>Retrieve and analyze ADE reports associated with InO from the FAERS database, covering the period from 2004Q1 to 2024Q3, and employ the reporting odds ratio (ROR) methodology to conduct signal detection for InO-related ADEs.</p><p><strong>Results: </strong>This study analyzed 1007 (2725 ADEs) patients, focusing on critical issues like veno-occlusive liver disease (VOD) (n = 97, ROR = 486.02), infections (n = 20, ROR = 3.27), and febrile neutropenia (n = 57, ROR = 20.43). Additionally, it also revealed some new ADEs, including sepsis (n = 35, ROR = 7.14), cytokine release syndrome (n = 22, ROR = 36.78), graft-versus-host disease (n = 20, ROR = 62.21), enterocolitis infectious (n = 3, ROR = 69.07), pneumonia fungal (n = 6, ROR = 30.76), and multiple organ dysfunction syndrome (n = 21, ROR = 10.65), among others. Consequently, it is imperative to exercise increased vigilance regarding these potential ADEs in the clinical administration of InO.</p><p><strong>Conclusion: </strong>This study underscores the potential ADEs and associated risks with the clinical application of InO, with particular emphasis on the risks of VOD, infections, and febrile neutropenia. The implementation of a vigilant monitoring strategy is crucial for the early detection and timely management of these potential complications.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023915","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}