International journal of surgery最新文献

{"title":"Efficacy and safety of intra-arterial thrombolysis after endovascular reperfusion for acute ischemic stroke: a systematic review and meta-analysis of randomized trials.","authors":"Yu Guo, Guang Yang, Yuwei Ding, Chao Liu, Zhiyuan Shen, Hengzhu Zhang, Qiangji Bao, Wenmiao Luo","doi":"10.1097/JS9.0000000000002404","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002404","url":null,"abstract":"<p><strong>Objective: </strong>This pooled analysis aims to evaluate the efficacy and safety of intra-arterial thrombolysis (IAT) following near-complete to complete reperfusion by endovascular thrombectomy (EVT) in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO).</p><p><strong>Methods: </strong>We conducted a search of PubMed, Embase, and Cochrane databases to identify randomized controlled trials (RCTs) investigating the adjunct benefit of IAT in patients with AIS-LVO who had achieved a score on the Thrombolysis In Cerebral Infarction (TICI) scale of 2b-3 after EVT. Efficacy outcomes encompassed excellent functional outcome, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 days, and functional independence (mRS 0-2). Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality at 90 days. A network meta-analysis (NMA) was performed to evaluate the effects of different types of intra-arterial thrombolytic agents on mRS 0-1.</p><p><strong>Results: </strong>A total of 7 RCTs were included in the analysis, involving 2,128 patients. Relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model. The pooled results indicated that adjunctive IAT did not significantly improve the rate of functional independence (RR 1.04, 95% CI 0.96-1.13, P = 0.29). However, there was a significant increase in excellent functional outcome with adjunctive IAT (RR 1.23, 95% CI 1.11-1.36, P < 0.001). The pooled analysis did not demonstrate any differences between EVT + IAT and EVT only in rates of sICH (RR 1.23, 95% CI 0.81-1.85, P = 0.33) or 90-day mortality (RR: 0.98, 95% CI: 0.82-1.18; P = 0.86). The NMA found no significant difference in achieving mRS 0-1 among arterial adjunctive alteplase, tenecteplase, and urokinase following successful reperfusion.</p><p><strong>Conclusions: </strong>IAT as an adjunct to successful EVT appears to enhance excellent functional outcome in patients with AIS-LVO without a significant increase in sICH and mortality.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971330","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":"Same-day discharge vs. inpatient stay in laparoscopic sleeve gastrectomy: a systematic review and meta-analysis.","authors":"Zina Mobarak, Shahd Mobarak, Salma Mahmoud, Hussameldin M Nour, Ashok Menon","doi":"10.1097/JS9.0000000000002396","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002396","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric operation globally. Same-day discharge (SDD) LSG is now becoming increasingly common, with many studies reporting this to be safe when compared to a postoperative inpatient (IP) stay. This systematic review and meta-analysis aims to compare outcomes between patients undergoing LSG as SDD and IP.</p><p><strong>Materials and methods: </strong>A systematic review and meta-analysis was conducted according to the PRISMA guidelines. A search strategy was developed and used to search the MEDLINE/Pubmed, Cochrane library, EMBASE, and Scopus databases. The primary outcome measures were mortality, emergency room (ER) visits, readmission, and reoperation. Secondary outcomes were morbidity, postoperative leak, length of stay of rehospitalization, cancellation of planned day-case, reasons for cancellations, postoperative pulmonary embolism (PE), and postoperative deep vein thrombosis (DVT). Pooled odds ratios with 95% confidence intervals were calculated for outcomes using fixed- or random-effects models.</p><p><strong>Results: </strong>11 studies were identified and included in the qualitative analysis, with a total of 138 001 patients in the SDD (25 069) or IP (112 932) groups. Seven studies with a total of 3737 patients were included in the meta-analysis. The number of ER visits was significantly higher in the IP group compared to the SDD group (OR = 1.52, 95% CI: 1.09-2.13, P = 0.01). There was no significant difference in the readmission rate (OR = 1.48, 95% CI: 0.80-2.76, P = 0.21) or the reoperation rate (OR = 0.62, 95% CI: 0.12-3.25, P = 0.58). Mortality and morbidity were low in all studies where they were reported and were largely similar across the groups.</p><p><strong>Conclusion: </strong>Overall, SDD LSG when compared to IP LSG is safe and not associated with higher mortality, morbidity, readmission, reoperation rates, or ER visits.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995780","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":"Global variations and socioeconomic inequalities in lifetime risk of lip, oral cavity, and pharyngeal cancer: a population-based systematic analysis of GLOBOCAN 2022.","authors":"Yuhao Li, Jiehua Tian, Yile You, Ru Chen, Rongshou Zheng, Shengfeng Wang, Freddie Bray","doi":"10.1097/JS9.0000000000002408","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002408","url":null,"abstract":"<p><strong>Background: </strong>In 2021, the World Health Organization (WHO) identified poor oral health as a major health expenditure burden. While lip, oral cavity, and pharyngeal cancers (LOCP) are an important group of diseases threatening oral health, there have been limited studies assessing global variations in lifetime risks (LR) according to socioeconomic inequalities.</p><p><strong>Materials and methods: </strong>We obtained national incidence and mortality estimates of LOCP in 185 countries from the GLOBOCAN database of the International Agency for Research on Cancer (IARC), corresponding all-cause mortality, population data, and the Human Development Index (HDI, with higher values indicating superior socioeconomic level) through the United Nations, alongside oral health-related data through WHO and INDEXBOX. LR were calculated using the adjusted multiple primary method.</p><p><strong>Results: </strong>In 2022, the global LR of developing and dying from LOCP were 0.92% (95% CI: 0.92%-0.92%) and 0.48% (95% CI: 0.48%-0.48%), respectively, with the highest burden associated with cancers of the lip and oral cavity. The LR of being diagnosed with LOCP or dying from the disease were 2.24 (95% CI: 2.22-2.25) and 2.30 (95% CI: 2.27-2.33) times higher among males relative to females. The highest LR for lip and oral cavity, salivary gland, oropharynx, and hypopharynx cancers were largely concentrated in Australia/New Zealand, Europe, and North America; whereas nasopharynx cancer was more frequent in parts of Asia and Africa. The LR of developing and dying from LOCP were positively associated with HDI, dental healthcare expenditure, areca nut consumption, the availability of refined sugar, and early screening for oral diseases, and negatively associated with the prevalence of severe periodontal disease. Although the LR of LOCP decreased with age, the rate of decline was relatively slow until the age of 50, and even at age 70, there remained non-negligible risks.</p><p><strong>Conclusion: </strong>Global variations in the LR of developing and dying from LOCP by subsite, sex and age reveal significant disparities by world region, socioeconomic levels and oral healthcare factors.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001183","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":"Patient-reported outcomes by individuals with differentiated thyroid cancer who underwent minimal-access versus conventional open thyroidectomy: a real-world propensity score-matching study.","authors":"Yuqin Zhou, Hao Tian, Guozhi Zhang, Baoquan Hu, Yingjiao Wang, Wenting Yan, Xiujuan Wu, Kongyong Zhang, Jun Deng, Yan Liang, Xiaowei Qi, Lin Ren, Yi Zhang","doi":"10.1097/JS9.0000000000002418","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002418","url":null,"abstract":"<p><strong>Background: </strong>Minimal-access surgery has been widely used in differentiated thyroid cancer (DTC) management and its therapeutic effectiveness is well-proven. However, little is known about how minimal-access thyroidectomy affects patient-reported outcomes (PRO).</p><p><strong>Materials and methods: </strong>In this real-world cross-sectional study, 6221 patients with DTC who underwent minimal-access or conventional open thyroidectomy were included and required to fill out PRO questionnaires, including the Thyroid Cancer-Specific Quality of Life, the European Organisation for Research and Treatment of Cancer's Core Quality of Life Questionnaire, and Fear of Progression Questionnaire-Short Form. Of the 3586 patients who completed the questionnaires entirely, 915 and 2671 belonged to the minimal-access and open groups, respectively. To reduce bias and balance confounding factors, propensity score matching was performed, after which 1818 patients were equally divided between the two groups.</p><p><strong>Results: </strong>Compared with the open group, the minimal-access group reported better PRO in terms of the THYCA-QOL summary score (P < 0.001), neuromuscular (P = 0.038), voice (P < 0.001), concentration (P = 0.044), sympathetic (P = 0.002), throat/mouth (P < 0.001), and scar (P < 0.001), feeling chilly (P < 0.001), and tingling hands/feet (P = 0.002). Subgroup analysis demonstrated that minimal-access thyroidectomy can be optimal for most patients from the PRO perspective. Moreover, longitudinal PRO comparisons indicated that at ≤6 months postoperatively, the open group experienced more problems in neuromuscular, voice, sympathetic, throat/mouth, scar, feeling chilly, tingling hands/feet, headache, and lower global health status scores (all P < 0.05). However, except for voice, scar and tingling hands/feet, nearly all the differences disappeared after 7 months postoperatively. Intergroup comparisons suggested that the minimal-access group required less time to recover to a stable state.</p><p><strong>Conclusions: </strong>The minimal-access group exhibited significantly superior postoperative PRO compared to the open group. Furthermore, the PRO trajectories of the two groups differed, with the minimal-access group demonstrating a considerably shorter recovery time. If better PRO is desired, minimal-access thyroidectomy may be preferred.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004506","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":"Acute Pain Service for Postoperative Pain in Adults: a network meta-analysis.","authors":"Lu Chen, Xixia Feng, Ling Ye, Jiaqi Yang, Ruihao Zhou, Yong Qiu, Guo Chen, Tao Zhu","doi":"10.1097/JS9.0000000000002419","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002419","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain significantly impacts patients' quality of life and recovery. Although acute pain services (APS) have been implemented in many hospitals worldwide, no study has directly compared the efficacy of different APS subtypes in managing acute postoperative pain.</p><p><strong>Objective: </strong>This network meta-analysis aimed to evaluate the effectiveness of various APS models in alleviating postoperative pain in adults undergoing surgery.</p><p><strong>Methods: </strong>Four English-language databases (PubMed, Web of Science, Embase, and Cochrane Library) and three Chinese-language databases (CNKI, WANFANG, and SinoMed) were searched to identify randomized controlled trials (RCTs) that compared the efficacy of different pain management models for postoperative pain in adult patients. Statistical analyses were conducted using R version 4.4.2 and Stata version 18.</p><p><strong>Results: </strong>A total of 38 studies were included in this network meta-analysis. All APS subtypes demonstrated superior pain relief compared to the traditional ward doctor-nurse model. These included nurse-based anesthesiologist specialist-supervised APS (NBASS-APS; SMD: - 1.99, 99%CI: - 2.55, - 1.43), nurse-based anesthesiologist-supervised APS (NBAS-APS; SMD: - 1.44, 99%CI: - 2.18, - 0.70), pain management multidisciplinary team (PMDT; SMD: - 1.31, 99%CI: - 1.74, - 0.87), and conventional APS (C-APS; SMD: - 0.83, 99%CI: - 1.43, - 0.24). Surface under the cumulative ranking (SUCRA) analysis identified NBASS-APS as having the highest probability of achieving optimal pain relief (98.0%), followed by NBAS-APS (65.9%), PMDT (58.0%), C-APS (28.1%), and the traditional model (0.1%).</p><p><strong>Conclusion: </strong>APS models are significantly more effective than the traditional ward doctor-nurse model in relieving postoperative pain, with NBASS-APS emerging as the most promising approach, followed by NBAS-APS, PMDT, and C-APS.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002466","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 \"The mediating effect of blood biomarkers in the associations between inflammatory bowel disease and incident psychiatric disorders: a prospective cohort study\".","authors":"Ru Man, Tianyu Song, Yongduo Yu, Wenping Wang","doi":"10.1097/JS9.0000000000002426","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002426","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995755","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":"P2X7 receptor promotes the growth and metastasis of gastric cancer by activating P13/AKT/GSK-3 beta signaling (experimental research).","authors":"Wen-Jun Zhang, Hong-Liang Luo, Ji-Peng Liu, Yong-Sheng Xu, Wen-Long Wang, Chao Huang","doi":"10.1097/JS9.0000000000002406","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002406","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the role of P2X7 receptor (P2X7R) in the proliferation and metastasis of gastric cancer (GC).</p><p><strong>Methods: </strong>The functional role and possible mechanism of P2X7R in the progression of GC were investigated through in vitro and in vivo experiments.</p><p><strong>Results: </strong>The results showed that ATP and its analogue BzATP increased calcium current in AGS and HGC-27 cells, while P2X7R antagonists A438079 and AZD9056 decreased the ATP-induced calcium influx. Activation of P2X7R increased the glycogen accumulation in GC cells, enhanced the stress ability of actin fibers and cell morphology changes, and promoted the proliferation, migration and invasion of GC cells. Conversely, the application of A438079, AZD9056 or siP2X7R inhibited the proliferation, migration and invasion of GC cells. Moreover, activation of P2X7R increased the expression levels of EMT/metastasis related genes MMP-2, MMP-9, N-cadherin, Zeb1, Vimentin and Snail, hut decreased the E-cadherin expression. While A438069, AZD9056, LY294002 or siP2X7R reversed the expression of the above genes. Activation of P2X7R activated P13/AKT/GSK-3beta signaling to promote the proliferation, migration and invasion of GC. Additionally, in vivo experiments showed that ATP activated P2X7R to induce the growth of tumors.</p><p><strong>Conclusions: </strong>Our conclusion is that activation of P2X7R promotes the proliferation, metastasis and EMT of GC cells by activating P13/AKT/GSK-3beta signaling, and indicates that P2X7R may become a new potential target for GC treatment.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001967","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":"Mutations in the influenza virus, primarily H5N1, enhance the virus's virulence, favor receptor interaction, and increase drug resistance.","authors":"Chiranjib Chakraborty, Arpita Das, Manojit Bhattacharya, Md Aminul Islam","doi":"10.1097/JS9.0000000000002403","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002403","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007995","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 exosomes research in cancer translational medicine.","authors":"Rajib Dhar, Vinoth Kumarasamy, Vetriselvan Subramaniyan","doi":"10.1097/JS9.0000000000002413","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002413","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063919","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 \"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":"Niu Ding, Tao Chen, Yanping Chen","doi":"10.1097/JS9.0000000000002412","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002412","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987516","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}