International journal of surgery最新文献

{"title":"Comparison of different implant-based breast reconstruction strategies: A systematic review and Bayesian network meta-analysis.","authors":"Junlei Li, Bin Pan, Tengjiang Long, Zeyu Yang, Yingfan Chen, Ziying Yi, Yao Li, Yiceng Sun, Tingjie Yin, Xi Chen, Yinde Huang, Supeng Yin, Fan Zhang","doi":"10.1097/JS9.0000000000005090","DOIUrl":"10.1097/JS9.0000000000005090","url":null,"abstract":"<p><strong>Background: </strong>Implant-based breast reconstruction is the most common postmastectomy approach, but the optimal combination of implant plane (prepectoral vs. subpectoral) and timing (immediate vs. delayed) remains controversial.</p><p><strong>Methods: </strong>We systematically searched five databases through March 2025 and included observational studies that compared immediate subpectoral breast reconstruction (ISBR), delayed subpectoral breast reconstruction, immediate prepectoral breast reconstruction (IPBR), and delayed prepectoral breast reconstruction (DPBR). We performed pairwise meta-analyses and Bayesian network meta-analyses (NMA) using R (version 4.4.1). To enhance interpretability, the surface under the cumulative ranking curve (SUCRA) was used to assess the probability that each strategy was the optimal choice for each prespecified outcome.</p><p><strong>Results: </strong>Thirty-one retrospective studies were included. In the NMA, no statistically significant differences were found among the strategies for overall complications, hematoma, or necrosis. Compared with ISBR, IPBR was associated with lower risks of reoperation and wound dehiscence. ISBR was associated with the greatest risk of implant loss. In terms of volume, direct evidence favored DPBR over IPBR, and the SUCRA suggested that delayed strategies are advantageous. No statistically significant differences were observed across the BREAST-Q \"satisfaction with breasts,\" \"sexual well-being\" scales, and pain.</p><p><strong>Conclusions: </strong>Across strategies, overall safety is broadly comparable. Prepectoral reconstruction tends to reduce the reoperation rate and capsular contracture rate, whereas subpectoral approaches have fewer constraints regarding flap quality. Delayed reconstruction better supports volume optimization and flexibility, whereas immediate approaches have lower follow-up demands and costs. Surgical planning should integrate flap quality, recovery burden, and patient goals for more individualized treatment selection.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12903-12914"},"PeriodicalIF":9.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave ablation versus resection for small colorectal liver metastases: evolving evidence and clinical considerations.","authors":"Aime Ishimwe Mugisha","doi":"10.1097/JS9.0000000000005097","DOIUrl":"10.1097/JS9.0000000000005097","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12979-12980"},"PeriodicalIF":9.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative ADT combined with docetaxel for conversion therapy in large-volume and unresectable locally advanced or oligometastatic prostate cancer: a multicenter retrospective study (YHCG-001 study).","authors":"Xin Fei, Rui-Da Huang, Yi-Peng Xu, Wei Wu, Jin-Chao Chen, Jin-Feng Pan, Xiao-Long Jia, Zhong Zheng, Cheng Zhou, Rui Su, Zhen-Ya Zhao, Da-Wei Ren, Su-Ying Wang, Ming Zhao, Lin-Chun Liang, Yi Li, Zong-Ping Wang, Jun-Hui Jiang, Qi Ma","doi":"10.1097/JS9.0000000000005040","DOIUrl":"10.1097/JS9.0000000000005040","url":null,"abstract":"<p><strong>Background: </strong>The value of radical prostatectomy (RP) in large volume and unresectable locally advanced prostate cancer (LAPC) or oligometastatic prostate cancer (OMPC) is largely unknown. This retrospective study aims to evaluate the conversion efficacy and safety profile of preoperative androgen deprivation therapy combined with docetaxel (A + D) in patients with large-volume (≥60 mL) and initially unresectable LAPC or OMPC.</p><p><strong>Methods: </strong>Patients with LAPC or OMPC from three large tertiary medical centers (between April 2017 and October 2024) were included. Eligibility criteria included prostate volume ≥60 mL, unresectability, and an expected survival of more than 5 years, as confirmed by two senior urologists and one radiologist. All patients received preoperative A + D therapy (≥3 cycles), followed by reassessment for RP feasibility with multimodal therapy discussion. The primary endpoint was surgical conversion rate. Secondary endpoints included prostate-specific antigen (PSA) progression-free survival (PSA-PFS), overall survival (OS), PSA response rate, adverse events, pathological response, perioperative complications, urinary continence, and sexual function.</p><p><strong>Results: </strong>Among 31 enrolled patients, the mean age was 67.71 ± 6.69 years, and 29 (93.55%) successfully underwent RP. The mean follow-up duration was 42.83 ± 23.58 months (up to October 2024). Median PSA-PFS was 49 months (95% CI: 24.20-73.79 months), and median OS was not reached. Hematologic toxicity was the most common adverse event during chemotherapy. After A + D therapy, median prostate tumor volume decreased from 67.50 mL to 25.81 mL, and median PSA declined from 168 to 0.49 ng/mL. After RP, 11 patients (37.93%) experienced a downgrade in Gleason score, and 14 patients (48.28%) experienced a downgrade in T-stage. Positive surgical margins were found in 11 patients (37.93%). Perioperative complications included blood transfusion (11.11%), rectal injury (3.70%), lymphorrhea (7.41%), and fever >38.5°C (3.70%). The 1-year urinary continence rate was 89.66%, while 100% of patients experienced sexual dysfunction.</p><p><strong>Conclusion: </strong>Preliminary data suggest that preoperative A + D therapy followed by RP may be integrated into multimodal management for large-volume, initially unresectable LAPC and OMPC, demonstrating promising conversion efficacy and clinical outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12856-12865"},"PeriodicalIF":9.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Equivalence of oral and intravenous tranexamic acid in knee arthroplasty: a systematic review and meta-analysis of randomized clinical trials\".","authors":"Weinan Ping, Changle Ren, Yantao Zhao","doi":"10.1097/JS9.0000000000005137","DOIUrl":"10.1097/JS9.0000000000005137","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13307-13308"},"PeriodicalIF":9.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of vascular aging and insulin resistance with cardiovascular outcomes in China: PURE cohort study.","authors":"Qiujing Cai, Biyan Wang, Minghai Yan, Zhiguang Liu, Xinyue Lang, Emma A van Reekum, Philip Joseph, Sumathy Rangarajan, Lap Ah Tse, Salim Yusuf, Bo Hu, Wei Li","doi":"10.1097/JS9.0000000000005089","DOIUrl":"10.1097/JS9.0000000000005089","url":null,"abstract":"<p><strong>Background: </strong>Although vascular aging and insulin resistance (IR) are recognized contributors to cardiovascular disease (CVD) pathophysiology, their independent and joint associations with CVD outcomes have not been fully clarified in large population-based cohorts. Evidence regarding their complementary rather than mediating roles remains limited.</p><p><strong>Methods: </strong>We used data from the Prospective Urban Rural Epidemiology (PURE) China study, a large prospective cohort comprising 47 931 individuals from 12 provinces across China. Vascular aging was assessed using estimated pulse wave velocity and categorized into supernormal (SVA), healthy (HVA), and early vascular aging (EVA) based on cohort percentiles. IR was evaluated using the triglyceride-glucose (TyG) index. The primary outcome was major CVD events (myocardial infarction, stroke, and heart failure). Cox frailty models with center-level random effects were used to estimate adjusted hazard ratios (aHRs).</p><p><strong>Results: </strong>A total of 40 513 participants with complete information were included in the current study. Over a median follow-up of 11.9 years (interquartile ranges 9.5-12.5), 3615 major CVD events, 829 CVD deaths, and 2344 all-cause deaths occurred. Compared with HVA, EVA was associated with substantially higher risks of major CVD events [aHR = 2.17, 95% confidence interval (CI): 1.99-2.35], CVD mortality (aHR = 4.07, 95% CI: 3.47-4.76), and all-cause mortality (aHR = 2.93, 95% CI: 2.65-3.23), while SVA showed consistently lower risks. Furthermore, higher TyG index levels were independently associated with major CVD event risk in a dose-response manner. Exploratory analyses revealed no significant mediation by the TyG index or interaction between vascular aging and TyG levels. Joint analysis revealed that individuals with both EVA and high TyG had the greatest major CVD risk (aHR = 2.20, 95% CI: 1.75-2.77).</p><p><strong>Conclusions: </strong>EVA and IR were independently associated with higher CVD risk, highlighting the need for integrated vascular-metabolic risk assessment in clinical practice, although further validation is warranted.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12806-12817"},"PeriodicalIF":9.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the canyons: a blueprint for translating gut microbiota research into clinical oncology.","authors":"Kai-Li Mao, Jun-Jie Xu, Huan-Hao Zhou","doi":"10.1097/JS9.0000000000005100","DOIUrl":"10.1097/JS9.0000000000005100","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13288-13289"},"PeriodicalIF":9.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional substitution and long-term dependency in BCI-FES-based neurorehabilitation.","authors":"Feng Ye, Jianguo Xu, Hao Liu","doi":"10.1097/JS9.0000000000005124","DOIUrl":"10.1097/JS9.0000000000005124","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 7","pages":"13297-13298"},"PeriodicalIF":9.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor \"Feasibility of sentinel basin mapping after non-curative endoscopic resection for early gastric cancer: a prospective multicenter cohort study (SENORITA 2 Trial)\".","authors":"Zimeng Wang, Zhi Zheng, Yueyang Jian, Jun Zhang, Jie Yin, Peng Li, Shutian Zhang","doi":"10.1097/JS9.0000000000005057","DOIUrl":"10.1097/JS9.0000000000005057","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12963-12964"},"PeriodicalIF":9.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between medication possession index and functional prognosis in patients with rheumatoid arthritis: a national longitudinal cohort study from CHARLS.","authors":"Zhongbin Xia, Wen Ye, Qianmingyue Zhang, Xinrong Pan","doi":"10.1097/JS9.0000000000005048","DOIUrl":"10.1097/JS9.0000000000005048","url":null,"abstract":"<p><strong>Objectives: </strong>To prospectively investigate the association between the Medication Possession Index (MPI) and the risk of incident functional dependence in middle-aged and older rheumatoid arthritis (RA) patients in China.</p><p><strong>Methods: </strong>This national longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2495 RA patients (mean age 67 · 5 ± 10 · 9 years; 36 · 5% male) without baseline functional dependence were included. MPI (range: 0-1), a composite, cross-sectional measure of pharmacotherapeutic coverage for 12 chronic conditions, was calculated at baseline. Complex survey weights were incorporated in all Cox models using survey::svycoxph(), and missing covariates were addressed via multiple imputation (<i>m</i> = 10). Participants were categorized by MPI quartiles (Qa:lowest to Qd:highest). The primary outcome was incident functional dependence (assistance needed in activities of daily living/instrumental activities of daily living). Multivariate Cox proportional hazards models and restricted cubic splines (RCS) were used to assess associations and dose-response relationships.</p><p><strong>Results: </strong>Over 8530 person-years (median follow-up 3-4 years), 918 functional dependence events occurred (incidence rate: 10.8/100 person-years). Higher MPI quartiles were associated with higher functional independence survival (log-rank <i>P</i> = 1.3 × 10^-4). Compared to Qa, Qd was associated with a 29% reduced risk in the fully adjusted model (HR = 0.71, 95% CI:0.59-0.87; <i>P</i><0.001), with a significant inverse linear trend (<i>P</i>-trend<0.001). RCS confirmed a monotonic dose-response relationship (<i>P</i>-nonlinearity = 0.18). The association was robust across multiple sensitivity analyses.</p><p><strong>Conclusion: </strong>Higher MPI, reflecting better overall treatment coverage across multiple conditions, is independently associated with a reduced risk of functional dependence in middle-aged and older RA patients, showing a monotonic dose-response relationship. MPI shows potential as a pragmatic indicator of overall healthcare engagement for identifying high-risk patients who may benefit from interventions aimed at improving treatment coverage and health management.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12818-12826"},"PeriodicalIF":9.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on \"A novel approach to cancer rehabilitation: assessing the influence of exercise intervention on postoperative recovery and survival rates\".","authors":"Li Wang, Jiahui Wu, Yingming Song","doi":"10.1097/JS9.0000000000005033","DOIUrl":"10.1097/JS9.0000000000005033","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"112 6","pages":"12985-12986"},"PeriodicalIF":9.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}