International journal of surgery最新文献

{"title":"Cold scissors ploughing technique versus electrosurgical excision for hysteroscopic adhesiolysis: a multicenter randomized controlled trial.","authors":"Yichun Liu, Xiaoshi Xie, Pingping Xue, Fang Yuan, Yinghua Qi, Hui Wang, Ping Wang, Guanjun Lv, Kejuan Song, Zongzhi Yang, Ya-Nan Zhang, Lei Yan","doi":"10.1097/JS9.0000000000002182","DOIUrl":"10.1097/JS9.0000000000002182","url":null,"abstract":"<p><p>Intrauterine adhesions (IUAs) may lead to abnormal menstruation, infertility, and pregnancy-related complications. Hysteroscopic separation is the gold standard treatment for IUA and can be performed using a variety of instruments and methods, including cold scissors and electrotomy. However, it is unclear which method is more effective for relieving IUA, restoring uterine anatomy, and improving the pregnancy rate in women of childbearing age. This multicenter prospective randomized clinical trial included 218 women aged 20-40 years who were treated for IUA between 1 March 2021 and 30 June 2022 and followed for 1.5 years. The women were randomly assigned to a cold scissors group ( n  = 109) or electrosurgical excision group ( n  = 109). Second-look hysteroscopy was performed in all patients within 3-10 days after the end of the first postoperative menstrual period. The primary outcome was the change in American Fertility Society score. Secondary outcomes included postoperative menstrual blood loss, the recurrence rate, and the reproductive outcome. There was no significant difference in the curative effect of hysteroscopic adhesiolysis between the cold scissors group and the electrosurgical excision group (5 [interquartile range, 4-6] vs. 5 [interquartile range, 4-6], P  = 0.729) or in the postoperative recurrence rate (27.5% vs. 30.6%, relative risk 0.901, 95% confidence interval 0.594-1.366, P  = 0.623) or pregnancy outcomes between the two groups. Postoperative menstrual blood loss was significantly greater in the cold scissors group than in the electrosurgical excision group (65.1% vs. 48.1%, P  = 0.029). The treatment cost was significantly lower in the cold scissors group ( P  < 0.001). In conclusion, hysteroscopic adhesiolysis using cold scissors does not differ significantly from electrosurgery in terms of treatment efficacy, recurrence rate, pregnancy rate, or pregnancy-related complications in patients with IUA who have normal ovarian reserve and an endometrial thickness of ≥6 mm before ovulation. The cold scissors ploughing technique can increase menstrual blood loss and is a cost-effective procedure.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2002-2009"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882102","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 timing of surgical interventions following the implantation of coronary drug-eluting stents in patients undergoing gastrointestinal cancer surgery: a multicenter retrospective cohort study.","authors":"Ziyao Xu, Yingying Lai, Yan Zhou, Lipeng Qin, Xinyu Hao, Tian Li, Lei Gao, Xinxin Wang","doi":"10.1097/JS9.0000000000002199","DOIUrl":"10.1097/JS9.0000000000002199","url":null,"abstract":"<p><strong>Aim: </strong>We aim to investigate the optimal timing for surgical interventions to maximize patient benefit.</p><p><strong>Background: </strong>The guidelines recommending a minimum deferral of 6 months for non-cardiac surgeries following drug-eluting stent percutaneous coronary intervention (DES-PCI) do not adequately address the requirements for individuals undergoing gastrointestinal cancer surgery (GCS).</p><p><strong>Methods: </strong>The study encompassed 2501 patients treated from January 2017 to December 2021, all of whom underwent GCS within 1 year after DES-PCI. We conducted an analysis by comparing the occurrence of major adverse cardiovascular events (MACEs) within 30 days post-surgery at different time points.</p><p><strong>Results: </strong>This study enrolled a total of 2501 participants with meticulously recorded data who underwent DES-PCI and subsequently underwent GCS within 1 year post-implantation. The incidence rate of MACEs is 14.2%, including MI (5.1%), HF (5.8%), IS (3.2%), and cardiac death (0.2%), across all patients in this study. The threshold probability was determined using the Youden Index, resulting in a value of 0.320, corresponding to a \"time-to-surgery value\" of 87. Significant statistical differences were observed in the occurrence rates of MACEs for adjacent time intervals at 30 days ( P < 0.001), 90 days ( P < 0.009), and 180 days ( P < 0.001).</p><p><strong>Conclusions: </strong>The timing of surgical intervention following DES-PCI significantly influences the occurrence of MACEs at 1, 3, and 6 months. GCS may be appropriately advanced within the 6-month timeframe, but with the exception of emergency, efforts should be made to defer them beyond the initial month.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1724-1734"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882158","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":"Pharmacovigilance insights into medication-induced risk of dural arteriovenous fistula.","authors":"Hao Liu, Yujia Zou, Qiongchi Zhang, Jinghao Zhao, Jingtao Wu, Xinyu Li, Yongzhong Cheng, Hongyu Wei, Haopeng Li, Shuai Cao","doi":"10.1097/JS9.0000000000002214","DOIUrl":"10.1097/JS9.0000000000002214","url":null,"abstract":"<p><strong>Background: </strong>Dural arteriovenous fistulas (DAVFs) pose a significant health threat owing to their high misdiagnosis rate. Case reports suggest that DAVFs or related acute events may follow medication use; however, drug-related risk factors remain unclear. In clinical practice, the concomitant use of multiple drugs for therapy is known as \"polypharmacy situations,\" further increasing the risk of drug-induced DAVF. Real-world studies linking medications and DAVF can alert clinicians to their possibilities and contribute to clinical decision-making and patient education.</p><p><strong>Method: </strong>This study investigated adverse events spanning a decade from the FAERS database, employing pharmacovigilance analysis to systematically assess the risk of drug-induced DAVF. Furthermore, the clinical characteristics of these drug-related DAVFs, such as demographic information, complications, and outcomes, were characterized.</p><p><strong>Result: </strong>This study generated a broad spectrum of drugs associated with DAVFs. A total of 355 DAVF events, involving 161 drugs across 73 categories, were compiled from millions of records. We identified eight classes of drugs for thorough investigation. Pharmacovigilance analysis revealed that tamoxifen, methylprednisolone, betamethasone, prednisone, rebif, ustekinumab, natalizumab, baclofen, dabigatran etexilate, and bupivacaine have the potential to induce DAVFs. Cerebrovascular thrombotic and embolic events emerge as the most prominent co-adverse events of drug-induced DAVFs. Analyses based on drug-disease targets suggested that the regulation of angiogenesis could be a potential mechanism in tamoxifen-induced DAVFs. Apart from medications with gender-specific prescription patterns, most medications exhibit a high risk of DAVF in adult male cohorts. Five patients with drug-related DAVFs experienced severe (fatal) outcomes, with four reports attributed to tamoxifen.</p><p><strong>Conclusion: </strong>These findings highlight the diverse range of drugs implicated in the occurrence or progression of DAVF. Drugs such as tamoxifen, corticosteroids, multiple sclerosis medications, and oral anticoagulants require particular attention. Future research should focus on elucidating the underlying mechanisms and risk factors, such as thrombosis, contributing to drug-induced DAVF to inform preventive strategies and optimize patient care.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 2","pages":"1847-1859"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399122","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":"Using the hospital frailty risk score to assess oesophago-gastric cancer patient outcomes: a retrospective cohort study.","authors":"Alexander Harris, Towhid Imam, Rob Konstant-Hambling, Helene Flint, Simon Conroy, Sacheen Kumar, William Allum","doi":"10.1097/JS9.0000000000002144","DOIUrl":"10.1097/JS9.0000000000002144","url":null,"abstract":"<p><strong>Background: </strong>The inclusion of clinical frailty in the assessment of patients planned for major surgery has proven to be an independent predictor of outcome. Since approximately half of all patients in the UK diagnosed with oesophagogastric (OG) cancer are over 75 years of age, assessment of frailty may be important in selection for surgery.</p><p><strong>Materials and methods: </strong>This retrospective cohort study applied the Hospital Frailty Risk Score to data obtained from the NHS Secondary Uses Service electronic database for patients aged 75 years or older undergoing oesophagectomy and gastrectomy between April 2017 and March 2020. Descriptive statistics were performed to assess the effect of patient frailty on length of stay, 30-day readmission, and 30-day mortality rates. These outcomes were compared with those published by the National Oesophago-Gastric Cancer Audit.</p><p><strong>Results: </strong>Over 90% of the 1775 patients identified according to the age and resection criteria exhibited some degree of frailty. The median length of stay and 30-day readmission rate increased as patient frailty increased following both oesophagectomy and gastrectomy, as did the 30-day mortality rate following gastrectomy.</p><p><strong>Conclusion: </strong>Frailty is a dynamic state and increasing age alone should not be a barrier to receiving the most appropriate treatment. Introducing standardized assessment of clinical frailty for patients with OG cancer to identify this cohort of patients earlier might enable targeted screening for frailty syndromes. This could facilitate the enhanced delivery of more holistic, frailty-attuned, approaches to person-centred care, and evidence-based treatment pathways for improved patient outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 2","pages":"1684-1688"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399128","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":"Evaluating pathological complete response as an surrogate endpoint for long-term survival in patients with non-small cell lung cancer: a systematic review and meta-analysis.","authors":"Chao Li, Gaohaer Kadeerhan, Tongtong Zhang, Zaiwuli Yeerjiang, Yikun Yang, Jun Meng, Dongwen Wang","doi":"10.1097/JS9.0000000000002183","DOIUrl":"10.1097/JS9.0000000000002183","url":null,"abstract":"<p><strong>Purpose: </strong>Pathologic complete response (pCR) is deemed to associate with event-free survival (EFS) and overall survival (OS), however, whether it is suitable to serve as a surrogate endpoint for long-term survival in clinical trials of neo-adjuvant treatment for resectable NSCLC trials is still controversy. We aim to evaluate the role of pCR and its viability as a surrogate endpoint for EFS and OS in NSCLC.</p><p><strong>Methods: </strong>To investigate the association of pCR and EFS and OS, we performed a meta-analysis involving randomized clinical trials that have reported complete information on pCR rates with hazard ratios (HRs) for EFS and OS. A standard meta-analysis was conducted to determine the relationship between pCR rates and EFS and OS. Additionally, weighted regression analysis was performed to assess the associations between log relative risk (RR) for pCR and log HRs for EFS and OS, with the coefficient of determination (R 2 ) being used to quantify the correlations. Furthermore, the surrogate threshold effect (STE) was also used to evaluate the minimum value of the RR for pCR necessary to confidently predict a non-null effect on HRs for EFS and OS.</p><p><strong>Results: </strong>The meta-analysis included 14 randomized clinical trials. The high pCR rate group had significant improvement of EFS (HR = 0.69, 95%CI 0.55-0.86) and OS (HR = 0.82, 95%CI 0.72-0.94). A strong association was found between log RR for pCR and log HR for EFS (R 2  = 0.76; 95%CI 0.48-1.00) and a moderate correlation between log RR for pCR and log HR for OS (R 2  = 0.54; 95%CI 0.04-1.00). The STEs for pCR were 4.534 and 10.278 for EFS and OS, respectively. In the subgroup analysis, similar results were only observed in a partial set of comparisons.</p><p><strong>Conclusions: </strong>A high pCR rate was associated with a long-term survival outcome. Strong association and moderate association were found between pCR and EFS, pCR and OS, respectively, which supports the application of pCR as a surrogate endpoint for long-term survival in RCTs for resectable NSCLC.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2216-2226"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882106","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":"Label-free discrimination analysis of breast cancer tumor and adjacent tissues of patients after neoadjuvant treatment using Raman spectroscopy: a diagnostic study.","authors":"Yifan Wu, Xinran Tian, Jiayi Ma, Yanping Lin, Jian Ye, Yaohui Wang, Jingsong Lu, Wenjin Yin","doi":"10.1097/JS9.0000000000002201","DOIUrl":"10.1097/JS9.0000000000002201","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Breast-conserving surgery (BCS) plays a crucial role in breast cancer treatment, with a primary focus on ensuring cancer-free surgical margins, particularly for patients undergoing neoadjuvant treatment. After neoadjuvant treatment, tumor regression can complicate the differentiation between breast cancer tumor and adjacent tissues. Raman spectroscopy, as a rapid and non-invasive optical technique, offers the advantage of providing detailed biochemical information and molecular signatures of internal molecular components in tissue samples. Despite its potential, there is currently no research on using label-free Raman spectroscopy to distinguish between breast cancer tumors and adjacent tissues after neoadjuvant treatment. This study intends to distinguish between tumor and adjacent tissues after neoadjuvant treatment in breast cancer through label-free Raman spectroscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, the intraoperative frozen samples of breast cancer tumor and adjacent tissue were collected from patients who underwent neoadjuvant treatment during surgery. The samples were examined using Raman confocal microscopy, and Raman spectra were collected by LabSpec6 software. Spectra were preprocessed by Savitz-Golay filter, adaptive iterative reweighted penalized least squares and MinMax normalization method. The differences in Raman spectra between breast cancer tumor and adjacent tissues after neoadjuvant treatment were analyzed by Wilcoxon rank-sum test, with a Bonferroni correction for multiple comparisons. Based on the support vector machine (SVM) method in machine learning, a predictive model for classification was established in the total group and subgroups of different hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status and Ki-67 expression level. The independent test set was used to evaluate the performance of the model, and the area under curve (AUC) of the receiver operating characteristic (ROC) curve, sensitivity, specificity and accuracy of different models were obtained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;This study comprised 4260 Raman spectra of breast cancer tumor and adjacent frozen tissue samples from 142 breast cancer patients treated with neoadjuvant treatment. The Raman peaks associated with nucleotides and their metabolites in the Raman spectra of breast cancer tumor tissues were higher in intensities than those of adjacent tissues after neoadjuvant therapy (676 cm -1 : Bonferroni adjusted P &lt; 0.0001; 724 cm -1 : P &lt; 0.0001; 754 cm -1 : P &lt; 0.0001), and the Raman peaks from amide III bands were more intense (1271 cm -1 : P &lt; 0.01). Multivariate curve resolution-alternating least squares (MCR-ALS) decomposition of Raman spectra revealed reduced lipid content and increased collagen and nucleic acid content in breast cancer tumor tissues compared to adjacent tissues following neoadjuvant therapy. The predictive model based on the Raman spect","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1788-1800"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882110","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":"Robotic vs. laparoscopic gastrectomy for patients with locally advanced gastric cancer: a meta-analysis of randomized controlled trials and propensity-score-matched studies.","authors":"Wang Huang, Gang Tang, Hao Sun","doi":"10.1097/JS9.0000000000002185","DOIUrl":"10.1097/JS9.0000000000002185","url":null,"abstract":"<p><strong>Background: </strong>The role of robotic surgery for the treatment of locally advanced gastric cancer remains controversial. This meta-analysis aimed to compare the short-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for patients with locally advanced gastric cancer using data collected from randomized controlled trials (RCTs) and propensity score-matched (PSM) studies.</p><p><strong>Materials and methods: </strong>We searched PubMed, Cochrane Library, EMBASE, and Web of Science databases for RCTs and PSM studies comparing RG and LG. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Fifteen studies encompassing one RCT and 14 PSM studies were included, with a total of 5079 patients (RG group: 2279 patients; LG group: 2800 patients). Although RG was associated with a longer operative time (MD, 19.82 min), patients may benefit from reduced blood loss (MD, -28.91 mL), shorter length of stay (MD, -0.69 days), lower morbidity (RR, 0.82), major complications (RR, 0.71), blood transfusion rate (RR, 0.60), conversion rate (RR, 0.38), and higher number of harvested lymph nodes (MD, 3.25). There were no significant differences observed in readmission (RR, 0.89), mortality (RR, 0.75), reoperation (RR, 0.71), and R0 resection (RR, 0.99) between the groups. In addition, RG shortened the time to first flatus (MD, -0.38 days), the time to first liquid intake (MD, -0.31 days), and the time to first soft diet intake (MD, -0.20 days).</p><p><strong>Conclusions: </strong>RG seems associated with improved short-term outcomes and enhanced postoperative recovery in locally advanced gastric cancer compared to LG. In the future, RG may become a safe and effective alternative to LG. Further research is needed to investigate long-term outcomes and confirm the promising advantages of RG in locally advanced gastric cancer.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2240-2256"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894385","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":"Single-cell and spatial transcriptomic analyses reveal heterogeneity characteristics and specific cell subtype regulators in growth hormone-secreting pituitary adenomas.","authors":"Yu Zhang, Lifeng Wang, Xingcheng Yi, Xin Ma, Hongyu Wu, Mingzhao Zhang, Zhenqi Yang, Lizhen Ma, Zenghua Mi, Weijia Zhi, Cong Fu, Pinan Liu, Zhijun Yang","doi":"10.1097/JS9.0000000000002178","DOIUrl":"10.1097/JS9.0000000000002178","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone-secreting pituitary adenomas (GHPA) display diverse biological behaviors and clinical outcomes, necessitating the identification of tumor heterogeneity and prognostically relevant markers.</p><p><strong>Methods: </strong>In this study, we performed single-cell RNA sequencing (scRNA-seq) on 10 GHPA samples, four of which also underwent spatial transcriptome sequencing, and used scRNA-seq data from four normal pituitary samples as controls. Cell subtype characterization in GHPA was analyzed using multiple algorithms to identify malignant bias regulators, which were then validated using a clinical cohort.</p><p><strong>Results: </strong>We constructed the first single-cell and spatial transcriptome profiles of GHPA, which contained 87 862 cells and revealed 16 tumor cell subtypes. Among the tumor cells, we identified distinct developmental trajectories and three malignant-biased subtypes (PIT1_C05, PIT1_C06, and PIT1_C10). The spatial distribution characteristics of these malignant-biased cells may influence the growth characteristics and prognosis of GHPA. We screened specific regulatory transcription factors, including FOXO1, GTF2IRD1, and MAX. Clinical cohort validation indicated that FOXO1 might be associated with tumor invasion and progression, while high expression of MAX could result in poor endocrine outcomes.</p><p><strong>Conclusion: </strong>GHPA exhibits rich heterogeneity and diverse cell subtypes, with specific transcription factors potentially regulating cell malignant bias, thereby influencing tumor characteristics and prognosis.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2072-2088"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948939","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 global, regional, and national burden of paralytic ileus and intestinal obstruction, 1990 to 2021: a cross-sectional analysis from the 2021 global burden of disease study.","authors":"Tingfen Han, Tingting Wang, Yuping Ye, Cao Ying, Xuequan Wang, Shuai Liu","doi":"10.1097/JS9.0000000000002189","DOIUrl":"10.1097/JS9.0000000000002189","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Paralytic ileus and intestinal obstruction (PIAIO) pose significant public health concerns, given the notable scarcity of current research on their disease burden and trends. This study evaluated the global burden of PIAIO from 1990 to 2021 and forecasted their future burden over the next three decades.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using the latest data from Global Burden of Disease Study (GBD) 2021, we obtained the prevalence, incidence, mortality and disability adjusted life years (DALYs) data for these conditions, along with their corresponding age-standardized rate (ASR) indicators. Data were stratified by time, location, age and socio-demographic index (SDI). This study employed comprehensive analyses over 32 years (1990-2021) to reveal trends in PIAIO, using advanced statistical methods including estimated Annual percentage change (EAPC), Joinpoint regression, health inequity analysis (slope index and concentration index), decomposition analysis, frontier analysis and predictive modeling (Nordpred method).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 2021, the global age-standardized rates for prevalence (ASPR), incidence (ASIR), mortality (ASMR), and DALYs (ASDR) were 7.38 (95%UI: 7.12-7.65), 191.92 (95%UI: 185.41-198.80), 2.88 (95%UI: 2.52-3.22), and 84.49 (95%UI: 72.58-94.16), respectively. High SDI regions exhibited high ASPR, high ASIR, but low ASDR and ASMR. Males generally exhibited higher prevalence and incidence rates across most age groups, while females showed higher mortality and DALY rates in specific age brackets. The epidemiological indicators of the age group under 5 years old and the elderly are relatively high. The joinpoint regression analysis indicated fluctuating increases in ASPR and ASIR, and nearly linear declines in ASMR and ASDR over the past 32 years. Health inequity analyses of the slope indices of ASPR and ASIR suggested an exacerbation of inequality in certain health indicators over the past 32 years, while those of ASMR and ASDR indicate potential improvements in inequality in certain health outcomes. Concentration index analysis confirms a significant reduction in inequality for ASPR and ASIR, with marginal changes for ASMR and ASDR, highlighting persistent health disparities in certain areas despite overall improvements. The decomposition analysis of global and across SDI regions indicated that population and aging have increased the DALYs burden, while epidemiological changes have reduced the disease burden. The frontier analysis suggested greater potential for improvement in low SDI regions. Nordpred predictive analysis forecasts a slight increase in ASPR and ASIR by 2050, with a significant in ASMR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PIAIO represent substantial global health and economic challenges. Anticipated population growth and aging will exacerbate burdens, highlighting the urgency of addressing critical need for targeted prevention and control strategies. Health system mana","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1773-1787"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948947","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":"Explainable endoscopic artificial intelligence method for real-time in situ significant rectal lesion characterization: a prospective cohort study.","authors":"Niall P Hardy, Pol MacAonghusa, Jeffrey Dalli, Jonathan P Epperlein, Paul Huxel, Mohammad F Khan, Alice Moynihan, Sergiy Zhuk, Johanna J Joosten, David Nijssen, Alberto Arezzo, Juriaan Tuynman, Peter M Neary, Roel Hompes, Ronan A Cahill","doi":"10.1097/JS9.0000000000002244","DOIUrl":"10.1097/JS9.0000000000002244","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2313-2316"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948984","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}