International journal of surgery最新文献

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4D CT-guided parathyroidectomy: improving operative efficiency in end-stage renal disease patients with medically refractory secondary hyperparathyroidism. 4D ct引导下甲状旁腺切除术:提高终末期肾病难治性继发性甲状旁腺功能亢进患者的手术效率。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-10 DOI: 10.1097/JS9.0000000000003598
Wen-Hui Chan, Yung-Yuan Chan, Yi-Fu Chen, Hao-Wei Kou, Ming-Yang Chen, Chun-Yi Tsai, Shang-Yu Wang, Ya-Chung Tian, Chun-Nan Yeh
{"title":"4D CT-guided parathyroidectomy: improving operative efficiency in end-stage renal disease patients with medically refractory secondary hyperparathyroidism.","authors":"Wen-Hui Chan, Yung-Yuan Chan, Yi-Fu Chen, Hao-Wei Kou, Ming-Yang Chen, Chun-Yi Tsai, Shang-Yu Wang, Ya-Chung Tian, Chun-Nan Yeh","doi":"10.1097/JS9.0000000000003598","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003598","url":null,"abstract":"<p><strong>Background: </strong>Parathyroidectomy for medically refractory secondary hyperparathyroidism in end-stage renal disease (ESRD) patients traditionally relies on experience-dependent surgical exploration due to limited preoperative localization capabilities. This study evaluates whether four-dimensional computed tomography (4D CT) provides significant improvements in surgical efficiency with measurable operative benefits.</p><p><strong>Methods: </strong>This retrospective comparative study analyzed 103 ESRD patients undergoing total or subtotal parathyroidectomy between January 2023 and December 2024. Patients were stratified into two groups: 4D CT-guided focused parathyroidectomy (n = 45) versus conventional imaging-guided surgery using ultrasound ± SPECT/CT (n = 58). Primary endpoints included operative time and intraoperative frozen section requirements. Secondary endpoints assessed diagnostic accuracy and positive predictive value of imaging modalities, with postoperative outcomes evaluated to ensure therapeutic equivalence.</p><p><strong>Results: </strong>The 4D CT group demonstrated significantly shorter operative times compared to conventional imaging (162.51 vs. 188.78 minutes, P = 0.014), representing a 13.9% reduction in surgical duration. Multiple frozen sections were required in 8.9% of 4D CT patients versus 31.0% of conventional patients (P = 0.013), demonstrating a 3.5-fold reduction in intraoperative histological confirmation needs. 4D CT showed superior diagnostic accuracy (75% vs. 33.33%) and positive predictive value (93.75% vs. 85.0%) compared to conventional imaging. Multivariate analysis identified 4D CT as the only independent predictor of reduced frozen section requirements (OR: 0.21, 95% CI, P = 0.009). Postoperative outcomes including biochemical control and complication rates were equivalent between groups, demonstrating that enhanced surgical efficiency did not compromise therapeutic effectiveness.</p><p><strong>Conclusions: </strong>Four-dimensional CT significantly enhances surgical efficiency in ESRD patients with medically refractory secondary hyperparathyroidism through improved preoperative localization. These efficiency gains are achieved while maintaining therapeutic effectiveness.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286163","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
Proposal of a novel model for identifying complete response and nonoperative management in DMMR colon cancer following neoadjuvant immunotherapy: a retrospective cohort study. 新辅助免疫治疗后DMMR结肠癌完全缓解和非手术治疗的新模型的提出:一项回顾性队列研究。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-10 DOI: 10.1097/JS9.0000000000003602
Le-En Liao, Li-Li Feng, Bi-Yun Chen, Bin-Yi Xiao, Jie-Hai Yu, Ze-Rong Cai, Wu Jiang, Guang-Yu Luo, Jing-Hua Tang, Zhen-Lin Hou, Chen-Zhi Zhang, Wei-Jian Mei, Wanjun Yang, Zhi-Zhong Pan, Kai Han, Xiao-Jian Wu, Pei-Rong Ding
{"title":"Proposal of a novel model for identifying complete response and nonoperative management in DMMR colon cancer following neoadjuvant immunotherapy: a retrospective cohort study.","authors":"Le-En Liao, Li-Li Feng, Bi-Yun Chen, Bin-Yi Xiao, Jie-Hai Yu, Ze-Rong Cai, Wu Jiang, Guang-Yu Luo, Jing-Hua Tang, Zhen-Lin Hou, Chen-Zhi Zhang, Wei-Jian Mei, Wanjun Yang, Zhi-Zhong Pan, Kai Han, Xiao-Jian Wu, Pei-Rong Ding","doi":"10.1097/JS9.0000000000003602","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003602","url":null,"abstract":"<p><strong>Background: </strong>The response to neoadjuvant immune checkpoint inhibition (neoICI) for mismatch repair-deficient (dMMR) colon cancer is often underestimated by radiological assessments. This study aims to develop a novel evaluation model to identify pathological complete response (pCR) and to select candidates for nonoperative management in locally advanced dMMR colon cancer following neoICI.</p><p><strong>Materials and methods: </strong>Patients with locally advanced dMMR colon cancer who received neoICI were enrolled from two centers in Southern China. In the discovery cohort, a novel model of immun-heralding complete response (iHCR) was developed. This model was validated in a cohort from the NEOCAP trial (NCT04715633) and another observation cohort, which included patients who adopted the nonoperative management.</p><p><strong>Results: </strong>A total of 156 patients with dMMR colon cancer who received neoICI were included. In the discovery cohort, 70 of 103 patients (67.9%) achieved pCR, although 92.9% still showed residual disease on CT scans. Negative endoscopic biopsy (P < 0.001), endoscopic tumor morphology with scar or normal mucosa (P < 0.001), and reductions of ≥50% in both tumor maximum diameter (P < 0.001) and depth (P = 0.009) were significantly correlated with pCR. The iHCR model, integrating dynamic radiological assessments, endoscopic morphology features, and biopsy results, achieved an AUC of 0.900 (95% CI, 0.810 to 0.990) in the sub-cohort with complete endoscopic and radiological information. In the validation cohort, stepwise refinement of the model further improved the AUC to 1.00. In the observation cohort (n = 32), the iHCR model predicted sustained clinical complete response with 100% concordance.</p><p><strong>Conclusion: </strong>The iHCR model can effectively predict pCR and identify candidates for the nonoperative management in dMMR colon cancer following neoICI.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286267","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
Integrated multi-omics in intracranial aneurysm sharpen the focus on therapeutic targets. 综合多组学在颅内动脉瘤的治疗靶点突出的焦点。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-10 DOI: 10.1097/JS9.0000000000003614
Haishuang Tang, Hanchen Liu, Shuo Wang
{"title":"Integrated multi-omics in intracranial aneurysm sharpen the focus on therapeutic targets.","authors":"Haishuang Tang, Hanchen Liu, Shuo Wang","doi":"10.1097/JS9.0000000000003614","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003614","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286311","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
Biomechanical Study of Osteochondral Lesions of the Talus and Autologous Osteochondral Transplantation. 距骨骨软骨病变及自体骨软骨移植的生物力学研究。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-10 DOI: 10.1097/JS9.0000000000003605
Ruihan Wang, Shiqin Yin, Jiabin Liu, Wenjing Luo, Zhiqiang Yong, Minglingzi Cheng, Wei Wang, Menglang Peng, Lei Zhang
{"title":"Biomechanical Study of Osteochondral Lesions of the Talus and Autologous Osteochondral Transplantation.","authors":"Ruihan Wang, Shiqin Yin, Jiabin Liu, Wenjing Luo, Zhiqiang Yong, Minglingzi Cheng, Wei Wang, Menglang Peng, Lei Zhang","doi":"10.1097/JS9.0000000000003605","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003605","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral lesions of the talus (OLT) frequently result in limited ankle joint functionality, necessitating prompt intervention. For large-area OLT, autologous osteochondral transplantation (AOT) is a prevalent treatment; however, standardized criteria for its implementation are lacking.</p><p><strong>Objective: </strong>This study aims to examine the influence of OLT on stress transmission within the talus, assess how OLT of varying sizes and depths affects the peak stress of talar cartilage, and identify the optimal timing for AOT to effectively restore the peak stress of talar cartilage, thereby offering guidance for AOT procedures.</p><p><strong>Methods: </strong>Initially, a finite element model of a healthy human ankle joint was developed, and OLT defect models of different sizes and depths were created in designated areas of the talar cartilage. The impact of OLT on talus stress transmission was analyzed through gait simulation. Subsequently, biomechanical experiments were performed to evaluate the variations in peak stress of the talar cartilage across OLT models with differing sizes and depths, as well as in the AOT repair model.</p><p><strong>Results: </strong>Finite element analysis indicated that OLT alters the distribution of stress within the talus. Biomechanical experiments demonstrated that OLT initially reduces the peak stress of the talar cartilage, which subsequently increases after reaching a critical threshold, with this variation remaining unaffected by the position of the ankle joint. The stress changes of talar cartilage mainly depend on the defect area rather than the depth. When the area reaches 120 mm2, AOT can effectively restore the stress level of talar cartilage.</p><p><strong>Conclusion: </strong>OLT affects the biomechanical properties of the ankle joint. When the defect area reaches 120 mm2, AOT can effectively restore the stress levels of the talar cartilage to normal.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286166","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
Intraoperative evaluation of metastatic SLNs with NIRF imaging assisted by artificial intelligence in breast cancers. 人工智能辅助下NIRF成像对乳腺癌转移性sln的术中评价。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-10 DOI: 10.1097/JS9.0000000000003547
Xue-Qi Fan, Jing-Wen Bai, Shi-Long Yu, Xiao Shen, Lei Niu, Wen-He Huang, Gui-Mei Wang, Zhi-Cheng Du, Xue Zhao, Fang-Hong Zhang, Chen-Hui Yang, Guo-Jun Zhang
{"title":"Intraoperative evaluation of metastatic SLNs with NIRF imaging assisted by artificial intelligence in breast cancers.","authors":"Xue-Qi Fan, Jing-Wen Bai, Shi-Long Yu, Xiao Shen, Lei Niu, Wen-He Huang, Gui-Mei Wang, Zhi-Cheng Du, Xue Zhao, Fang-Hong Zhang, Chen-Hui Yang, Guo-Jun Zhang","doi":"10.1097/JS9.0000000000003547","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003547","url":null,"abstract":"<p><strong>Background: </strong>Near-infrared fluorescence (NIRF) imaging with indocyanine green is widely employed for sentinel lymph node (SLN) biopsy in breast cancer but cannot assess SLN metastatic status. Current intraoperative assessment relies on frozen section (FS) analysis, which is time-consuming, causes tissue loss, and suffers from limited sensitivity with a high false-negative rate (FNR).</p><p><strong>Materials and methods: </strong>Preclinical data included fluorescence images from 4T1-Luc and MDA-MB-231-Luc mouse lymph node metastasis models. Clinical data comprised 35 breast cancer patients in a prospective clinical trial (NCT.). Intraoperative ICG-based NIRF imaging was performed, and four convolutional neural networks (Vgg19, Efficientnet, Resnet, Densenet) were evaluated.</p><p><strong>Results: </strong>In the mouse test set, the proposed approach achieved an area under the receiver operating characteristic curve (AUC) of 0.799 (95%CI: 0.787-0.810) for cohort 1 and 0.804 (95% CI: 0.793-0.816) for cohort 2. In the clinical cohort comprising 35 patients and 114 excised SLNs (16 metastatic, 98 non-metastatic), it demonstrated robust performance in detecting metastatic SLNs, with an AUC of 0.898 (95% CI: 0.892-0.903). The LymphNet approach, which aggregates predictions from multiple SLN images, yielded an FNR of 18.75%, comparable to FS analysis (FNR: 13.5-31.3%). LymphNet avoids tissue loss and streamlines the workflow, with the model's prediction process requiring less than 10 seconds. For the first time, we observed a marked reduction or complete absence of fluorescence in metastatic SLNs infiltrated by breast cancer cells.</p><p><strong>Conclusion: </strong>This study establishes a novel, efficient tool for intraoperative SLN metastatic assessment.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286292","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
Multi-omics dissection of high TWAS-active endothelial pathogenesis in pulmonary arterial hypertension: bridging single-cell heterogeneity, machine learning-driven biomarkers, and developmental reprogramming. 肺动脉高压中高twas活性内皮发病机制的多组学解剖:弥合单细胞异质性、机器学习驱动的生物标志物和发育重编程。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-09 DOI: 10.1097/JS9.0000000000003601
Zerong Li, Huayang Li, Wenmei Qiao, Siming Yu, Bin Fan, Ming Yang, Leyan Zhou, Fang Qiu, Zhongkai Wu, Jinping Wang
{"title":"Multi-omics dissection of high TWAS-active endothelial pathogenesis in pulmonary arterial hypertension: bridging single-cell heterogeneity, machine learning-driven biomarkers, and developmental reprogramming.","authors":"Zerong Li, Huayang Li, Wenmei Qiao, Siming Yu, Bin Fan, Ming Yang, Leyan Zhou, Fang Qiu, Zhongkai Wu, Jinping Wang","doi":"10.1097/JS9.0000000000003601","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003601","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary Arterial Hypertension (PAH) is a leading cause of cardiovascular-related mortality worldwide. The emergence of single-cell RNA sequencing (scRNA-seq) has enhanced the ability to dissect cellular heterogeneity in PAH at a granular level. Transcriptome-wide association studies (TWAS) leverage expression quantitative trait loci (eQTL) and genome-wide association study (GWAS) data to identify novel susceptibility genes whose genetically predicted expression correlates with disease risk. However, no study has systematically integrated TWAS with scRNA-seq to unravel the pathogenesis of PAH at single-cell resolution.</p><p><strong>Methods: </strong>Using TWAS analysis, we identified a set of candidate genes genetically associated with PAH. We then evaluated the differential activity of these genes across PAH cell types at single-cell resolution using AUCell, Ucell, ssGSEA, and AddModuleScore algorithms. A subset of endothelial cells exhibiting elevated TWAS activity was identified via quartile-based stratification and designated as the high TWAS activity state (HTS) group. Multi-dimensional analyses, including observed-to-expected ratio (RO/E), CellChat, CytoTRACE, and scMetabolism, were employed to characterize the functional and communicative properties of HTS cells. Machine learning algorithms were integrated to identify signature genes of the HTS subpopulation, and a benchmarked random forest model was trained to predict HTS status. We performed immunohistochemistry and qRT-PCR validation of the signature genes (KLF2, RASIP1 and DEPP1) in PAH and control lung tissues to support their expression patterns.</p><p><strong>Results: </strong>We demonstrated that HTS endothelial cells are strongly associated with PAH pathogenesis, exhibiting significant tissue tropism, enhanced roles in intercellular communication, and a progenitor-like function in endothelial differentiation. Machine learning-based feature selection revealed three robust signature genes: KLF2, RASIP1, and DEPP1. These genes demonstrated exceptional predictive power for identifying HTS cells, suggesting their potential as drivers of endothelial dysfunction in PAH. The random forest model, benchmarked against multiple algorithms, achieved high accuracy in predicting PAH progression using these genes. Immunohistochemical analysis of pulmonary artery and qRT-PCR result of lung tissues addressed the elevated expression of KLF2, RASIP1 and DEPP1 in arterial wall post-PAH.</p><p><strong>Conclusion: </strong>This study elucidates endothelial cell heterogeneity in PAH and establishes the central role of HTS cells in disease progression, cellular crosstalk, and developmental reprogramming. Our findings bridge the gap between GWAS and scRNA-seq methodologies and provide a transformative framework for understanding PAH mechanisms.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251225","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
SPP1 in Notochord Cells Modulates Intervertebral Disc Degeneration Through CD44 Recognition by Macrophages Based on Single Cell Transcriptome Analysis. 基于单细胞转录组分析的脊索细胞SPP1通过巨噬细胞识别CD44调控椎间盘退变
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-09 DOI: 10.1097/JS9.0000000000003454
Qiuwei Li, Peilin Jin, Chenhao Zhao, Renjie Zhang, Cailiang Shen
{"title":"SPP1 in Notochord Cells Modulates Intervertebral Disc Degeneration Through CD44 Recognition by Macrophages Based on Single Cell Transcriptome Analysis.","authors":"Qiuwei Li, Peilin Jin, Chenhao Zhao, Renjie Zhang, Cailiang Shen","doi":"10.1097/JS9.0000000000003454","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003454","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is a major cause of spinal disorders, often leading to chronic pain and mobility issues. Mechanical stress is a key factor in IVDD progression, but the underlying mechanisms remain unclear. In this study, we improved a rat intervertebral disc pressure model to explore how mechanical stress affects IVDD, focusing on notochord cell populations and their interactions in the degenerative process.</p><p><strong>Methods: </strong>We developed a custom pressure device for rats, validated using imaging techniques. Following pressure application, single-cell transcriptomics was employed to analyze dynamic changes in notochord cells in both surgical and sham groups. Gene expression profiles were analyzed for immune regulation, matrix metabolism, and intercellular signaling. We also studied the SPP1 signaling pathway and its interaction with CD44.Finally, we combined Mendelian randomization(MR) and human GEO sequencing data to support our results.</p><p><strong>Results: </strong>Pressure application resulted in significant structural damage and abnormal changes in matrix components, worsening over time. Single-cell analysis revealed differences in notochord cell populations between surgical and sham groups, with increased immune regulation and matrix metabolism activity. The SPP1-CD44 signaling pathway was activated in degenerated discs, especially in CD44-expressing cells, underscoring its role in matrix remodeling and inflammation.MR and human GEO sequencing data also support these ideas.</p><p><strong>Conclusion: </strong>This study provides insights into IVDD mechanisms, focusing on the role of the SPP1-CD44 pathway in disc degeneration. We suggest that targeting this pathway may offer potential therapeutic strategies for degenerative spinal diseases.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251297","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 about'duration of surgical antibiotic prophylaxis and surgical site infection in orthopaedic surgery: a prospective cohort study'. 致编辑的关于“骨科手术中外科抗生素预防和手术部位感染的持续时间:一项前瞻性队列研究”的信。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-09 DOI: 10.1097/JS9.0000000000003535
Jiayi Dou, Zhongcheng An, Tongfu Luo
{"title":"Letter to the editor about'duration of surgical antibiotic prophylaxis and surgical site infection in orthopaedic surgery: a prospective cohort study'.","authors":"Jiayi Dou, Zhongcheng An, Tongfu Luo","doi":"10.1097/JS9.0000000000003535","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003535","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251199","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
Risk factors for morbidity in both donor and recipient following minimally invasive donor hepatectomy: a systematic review. 微创供肝切除术后供体和受体发病率的危险因素:一项系统综述。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-09 DOI: 10.1097/JS9.0000000000003524
Sang-Hoon Kim, Ki-Hun Kim, Surendran Sudhindran, Dieter C Broering
{"title":"Risk factors for morbidity in both donor and recipient following minimally invasive donor hepatectomy: a systematic review.","authors":"Sang-Hoon Kim, Ki-Hun Kim, Surendran Sudhindran, Dieter C Broering","doi":"10.1097/JS9.0000000000003524","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003524","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive donor hepatectomy (MIDH), including laparoscopic, laparoscopic-assisted, and robotic donor hepatectomy, is an evolving technique in living donor liver transplantation, but its technical complexity presents potential risks for both donors and recipients. This study purposes to systematically review and identify key risk factors for donor and recipient morbidity after MIDH.</p><p><strong>Methods: </strong>A systematic search of electronic databases was performed to identify studies published between January 2001 and December 2024 that reported significant risk factors for donor and recipient complications after MIDH. Risk factors for overall or major complications, biliary complications (bile leak or biliary stricture), or open conversion were summarized using odds ratios or hazard ratios with 95% confidence intervals derived from multivariate analysis.</p><p><strong>Results: </strong>In total, eight studies reported significant risk factors for donor or recipient after MIDH. Risk factors for donor complications included unfavorable anatomical characteristics (short hepatic ducts, multiple hepatic ducts/arteries/veins, and large graft) and operative factors (increased operative time and blood loss). Conversion from laparoscopic to open was related to high BMI. Recipient risk factors included biliary variations, portal vein thrombosis, hepaticojejunostomy, prolonged operative time, massive transfusion, and high MELD scores. Robotic surgery was linked to favorable donor and recipient outcomes.</p><p><strong>Conclusion: </strong>Risk factors for donor and recipient morbidity after MIDH include anatomical, operative, procedural, donor, and recipient factors. Notably, biliary variation of graft is key contributor for both donor and recipient morbidity. Given the limited studies on risk factors, multicenter studies with larger sample sizes are essential to validate these findings.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251208","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 comments on the manuscript entitled: surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: a case series. 致编辑对手稿评论的信题为:腹腔镜微型胃旁路手术技术与梗阻性无钉袋的创造:一个病例系列。
IF 10.1 2区 医学
International journal of surgery Pub Date : 2025-10-09 DOI: 10.1097/JS9.0000000000003155
Galymjan Duysenov
{"title":"Letter to the editor comments on the manuscript entitled: surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: a case series.","authors":"Galymjan Duysenov","doi":"10.1097/JS9.0000000000003155","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003155","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251237","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
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