International journal of surgery最新文献_第5页

Infection control challenges of extrapulmonary tuberculosis in surgery: an overlooked risk. 手术中肺外结核感染控制的挑战：一个被忽视的风险。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003686

Jiao Shan, Wei Huai, Yulong Cao

引用次数: 0

From overlooked metric to clinical action: ascending aortic length as a translational breakthrough in elective thoracic aneurysm surgery. 从被忽视的指标到临床作用：升主动脉长度作为选择性胸动脉瘤手术的转化突破。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003685

Jinlin Wu, Meng Xiao, Duanduan Chen, Jie Chen, Guangyun Zhang

{"title":"From overlooked metric to clinical action: ascending aortic length as a translational breakthrough in elective thoracic aneurysm surgery.","authors":"Jinlin Wu, Meng Xiao, Duanduan Chen, Jie Chen, Guangyun Zhang","doi":"10.1097/JS9.0000000000003685","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003685","url":null,"abstract":"Background: Ascending aortic length (AAL) has long been overlooked in assessing the risk of adverse aortic events (AAE) in patients with ascending thoracic aortic aneurysm (ATAA). Our team was among the first globally to investigate AAL's role, and this work contributed to the update of international guidelines. Further, this study aimed to provide mechanistic evidence for AAL as a surgical indicator.Methods: AAL was measured from the aortic annulus to the origin of the innominate artery along the centerline. Patient-specific FSI models were constructed, and hemodynamic parameters including time-averaged wall shear stress (TAWSS), maximum wall shear stress (WSS), average wall stress (WS), maximum WS, oscillatory shear index (OSI), and particle residence time (PRT) were analyzed.Results: Compared with the control group (AAL <11 cm), patients with elongated AAL (≥11 cm) showed significantly disturbed hemodynamics: decreased TAWSS (0.8 vs 1.1 Pa, p = 0.002), increased average WS (177 644.5 vs 158 342.8 Pa, p<0.001), increased maximum WS (876 760.0 vs 770 420.0 Pa, p = 0.013), increased average OSI (0.2 ± 0.0 vs 0.1 ± 0.0, p = 0.002), and increased average PRT (2.7 vs 1.9, p<0.001). A strong dose-response relationship was observed when AAL was divided into quartiles (Q1-Q4), with TAWSS decreasing and WS, OSI, PRT increasing progressively with longer AAL (all p<0.001).Conclusion: Elongated AAL is associated with worsening hemodynamics in a proportional manner, confirming its validity as a surgical indicator for ATAA.","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300567","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}

引用次数: 0

Nomogram for predicting massive abdominal bleeding in duodenal fistula patients with uncontrolled abdominal infection after delayed transfer to tertiary centers: a multicenter prospective study. 一项多中心前瞻性研究：延迟转移至三级中心的十二指肠瘘患者腹腔感染不受控制后预测大量腹部出血的Nomogram。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003297

Fan Yang, Weiliang Tian, Juqiang Zhang, Wuhan Li, Zheng Yao, Shen Tao, Xin Xu, Risheng Zhao, Xinhao Chen, Jieyan Xu, Yunzhao Zhao, Qian Huang

{"title":"Nomogram for predicting massive abdominal bleeding in duodenal fistula patients with uncontrolled abdominal infection after delayed transfer to tertiary centers: a multicenter prospective study.","authors":"Fan Yang, Weiliang Tian, Juqiang Zhang, Wuhan Li, Zheng Yao, Shen Tao, Xin Xu, Risheng Zhao, Xinhao Chen, Jieyan Xu, Yunzhao Zhao, Qian Huang","doi":"10.1097/JS9.0000000000003297","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003297","url":null,"abstract":"Background: This study aimed to develop and validate a nomogram for predicting massive abdominal bleeding in patients with duodenal fistulas and uncontrolled abdominal infection following delayed transfer to tertiary centers.Methods: This multicenter (A, B, C, and D) prospective cohort study included 389 patients from four centers. A nomogram was developed using Least Absolute Shrinkage and Selection Operator regression and multivariate logistic analysis on data from 240 patients (from center A), and validated on 149 patients (from center B, C, and D). The model's performance was assessed using concordance index, calibration plots, and decision curve analysis.Results: Six predictors were identified: output ≥1000 mL/day, Sequential Organ Failure Assessment score on admission, infection invading the retroperitoneum, laparotomy requirement, endoscopic fistula diameter ≥2 cm, and International Society on Thrombosis and Haemostasis score ≥5. The nomogram showed good predictive accuracy, with concordance indices (C-indices) of 0.87 (95% CI: 0.80-0.91) in the development cohort and 0.82 (95% CI: 0.74-0.88. Calibration plots showed good agreement between predicted and observed bleeding rates.Conclusion: The developed nomogram offers a tailored approach to risk stratification for massive abdominal bleeding in duodenal fistula patients delayed transfer to tertiary centers. This tool might enhance clinical decision-making and improve patient outcomes.","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300685","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}

引用次数: 0

Letter to the editor Regarding "Comparison of oncological and functional outcomes in lower-limb osteosarcoma pediatric patients: a large single-center retrospective cohort study". 关于“儿童下肢骨肉瘤患者肿瘤和功能结局的比较：一项大型单中心回顾性队列研究”的致编辑信。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003646

Yuxuan Wu, Jianlan Wang

引用次数: 0

Letter to editor about prolonged versus short-term infusion of meropenem for the treatment of sepsis: a systematic review and meta-analysis. 致编辑的信：长期输注美罗培南与短期输注美罗培南治疗败血症的比较：一项系统回顾和荟萃分析。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003679

Dandan Weng, Wanjun Ye, Jiansen Lv

引用次数: 0

Letter to editor about Association between the advanced lung cancer inflammation index and all-cause mortality in the US MASLD/MetALD patient population: a cohort study. 致编辑的信：美国MASLD/MetALD患者群体中晚期肺癌炎症指数与全因死亡率之间的关系：一项队列研究

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003676

Ke Cao, Dandan Weng, Zhe Li

引用次数: 0

Advancing postoperative mortality prediction in gastrectomy: a machine learning approach using NSQIP data. 推进胃切除术术后死亡率预测：使用NSQIP数据的机器学习方法。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-14 DOI: 10.1097/JS9.0000000000003688

Dong-Won Kang, Shouhao Zhou, Chanhyun Park, Russell Torres, Abhinandan Chowdhury, Suman Niranjan, Charles Vining, Colette Pameijer, Chan Shen

{"title":"Advancing postoperative mortality prediction in gastrectomy: a machine learning approach using NSQIP data.","authors":"Dong-Won Kang, Shouhao Zhou, Chanhyun Park, Russell Torres, Abhinandan Chowdhury, Suman Niranjan, Charles Vining, Colette Pameijer, Chan Shen","doi":"10.1097/JS9.0000000000003688","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003688","url":null,"abstract":"Background: Accurate prediction of mortality risk in gastrectomy is critical to optimize surgical management and improve patient outcomes. This study aims to develop machine learning (ML) models for predicting 30-day postoperative mortality following gastrectomy and identify key predictors.Methods: We utilized the NSQIP Participant Use Data File from 2017 to 2022 to develop ML models: (1) random forest, (2) gradient-boosted tree, and (3) XGBoost model. A simple logistic regression model was further developed to compare the model prediction. We trained each model using a comprehensive set of variables available in the NSQIP data (Model C) or 17 variables included in the existing ACS NSQIP risk calculator (Model L). We used the area under the receiver operating characteristics curve to evaluate the model performance and employed SHapley Additive exPlanations algorithms on the best performing model to identify the most impactful predictors.Results: Of 7,954 patients who underwent gastrectomy, approximately 4.3% of patients died within 30 days following gastrectomy. In both Model C and Model L, the XGBoost model showed the best performance, followed by the random forest. The Model C outperformed the Model L, and all ML models outperformed simple logistic regression. In XGBoost model, preoperative blood urea nitrogen was the most important predictor, followed by age.Conclusion: The XGBoost model demonstrated the highest predictive performance for 30-day postoperative mortality following gastrectomy. Preoperative laboratory variables and age were key predictors. Incorporating ML-based models into clinical practice has the potential to enhance perioperative decision-making and improve patient outcomes after gastrectomy.","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300834","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}

引用次数: 0

Letter to the editor--Supervising the recurrence of pancreatic ductal adenocarcinoma using CtDNA-based MIR129-2 methylation detection. 致编辑的信——使用基于ctdna的MIR129-2甲基化检测监测胰腺导管腺癌的复发。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-13 DOI: 10.1097/JS9.0000000000003627

Man Sun, Dan Zang, Jun Chen

引用次数: 0

Optimizing limb salvage in critical mangled extremities: one-step acute repair with bilateral anterolateral thigh perforator flaps. 优化肢体抢救在严重断肢：一步急性修复双侧大腿前外侧穿支皮瓣。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-13 DOI: 10.1097/JS9.0000000000003612

Yining Lan, Luqi Guo, Dedi Tong, Jiuzuo Huang, Nanze Yu, Fengzhou Du, Xiao Long

{"title":"Optimizing limb salvage in critical mangled extremities: one-step acute repair with bilateral anterolateral thigh perforator flaps.","authors":"Yining Lan, Luqi Guo, Dedi Tong, Jiuzuo Huang, Nanze Yu, Fengzhou Du, Xiao Long","doi":"10.1097/JS9.0000000000003612","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003612","url":null,"abstract":"Background/objectives: Complex distal extremity trauma often involves both extensive soft tissue loss and vascular injury. While the anterolateral thigh (ALT) free flap is a mainstay for limb salvage, large defects may exceed the capacity of a single flap and are associated with higher complication rates. We report a one-stage bilateral ALT free-flap reconstruction strategy designed to provide stable wound coverage and improve functional outcomes.Methods: In six patients with severe distal extremity trauma (affecting upper or lower limbs) treated from 2018 to 2020, one-stage reconstruction was performed using bilateral ALT free flaps. Flaps were inset via tandem or parallel vascular configurations based on recipient vessel status. Functional outcomes were assessed by DASH scores (upper limbs) or LEFS (lower limbs) with 5 years of follow-up. Four patients had postoperative photon-counting CT (PCCT) angiography to assess anastomotic patency.Results: All flaps survived without major complications. By final follow-up, all patients had achieved stable soft-tissue coverage and satisfactory functional recovery. Functional outcome scores improved in every case, and notably the pediatric patient attained normal gait and limb development after reconstruction. The four patients underwent PCCT angiography were confirmed patent anastomoses and robust perfusion.Conclusions: One-stage bilateral ALT free-flap reconstruction is a safe and feasible approach for complex distal extremity trauma. It provides reliable wound coverage and facilitates timely functional recovery while avoiding the morbidity of staged procedures. Long-term outcomes demonstrate sustained flap viability and functional gains, supporting this approach to avoid staged procedures and improve limb salvage.","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300673","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}

引用次数: 0

Letter to the editor on "Association between post-trauma platelet-lymphocyte ratio and nonunion in patients with extremity fractures: a multicenter retrospective cohort study". 致编辑的信“创伤后血小板淋巴细胞比例与四肢骨折患者骨不连的关系：一项多中心回顾性队列研究”。

IF 10.1 2区医学

International journal of surgery Pub Date : 2025-10-13 DOI: 10.1097/JS9.0000000000003636

Yongmei Jiang, Yunxia Du

引用次数: 0