International journal of surgery最新文献

{"title":"Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study.","authors":"Peng Liu, Ruili Li, Tongyu Zhang, Yueqiao Xu, Kun Yang, Yuxia Li, Chuanliang Han, Yang Yang, Changming Wang, Jie Lu, Hongqi Zhang","doi":"10.1097/JS9.0000000000002239","DOIUrl":"10.1097/JS9.0000000000002239","url":null,"abstract":"<p><strong>Background: </strong>Risk factors and mechanisms of cognitive impairment (CI) after aneurysmal subarachnoid hemorrhage (aSAH) are unclear. This study used a neuropsychological battery, MRI, ERP and CSF and plasma biomarkers to predict long-term cognitive impairment after aSAH.</p><p><strong>Materials and methods: </strong>214 patients hospitalized with aSAH (n = 125) or unruptured intracranial aneurysms (UIA) (n = 89) were included in this prospective cohort study. Neuropsychological tests were administered 7 to 24 months post-discharge. MRI, ERP, and CSF and plasma biomarkers were used to predict long-term CI, and area under ROC curves were calculated.</p><p><strong>Results: </strong>Patients with aSAH CI showed significant impairment across composite scores and cognitive domains on the neuropsychological battery vs. patients with aSAH No CI. On ALFF (MRI), the right medial orbitofrontal cortex (AUC = 0.78), right inferior frontal gyrus (AUC = 0.848), and right inferior parietal lobule (AUC = 0.868) distinguished aSAH CI from aSAH No CI. For ERP, consistent changes were found across specific EEG electrodes (FP1, F3, CP1, FP2, F4, CP2), including increased PA, prolonged PL and decreased ITPC. ITPC showed the highest sensitivity for distinguishing aSAH CI from aSAH No CI, followed by PA. Channel F4 (ITPC, AUC = 0.912, PA, AUC = 0.846), corresponding to the right inferior frontal gyrus, was the most sensitive for detecting CI, followed by channel CP2 (ITPC, AUC = 0.903, PA, AUC = 0.806), corresponding to the right inferior parietal lobule. CSF (Aβ42, Aβ40, p-tau181/Aβ42, p-tau181/total-tau, total-tau) and plasma biomarkers (Aβ-40, p-tau181) were significantly associated with long-term CI.</p><p><strong>Conclusion: </strong>ALFF, ERP, and CSF and plasma Aβ and tau levels and ratios have clinical utility for evaluating and predicting long-term cognitive impairment following aSAH. MRI may reveal the pathogenesis of cognitive impairment following aSAH. ERP can be administered at the bedside offering sensitive, non-invasive, repeatable, and sustainable monitoring, which is particularly suitable for immobile coma patients. ERP may represent a promising method to monitor neural function and its outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1977-1987"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046713","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":"Safety and efficacy of minimally invasive associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): a systematic review and meta-analysis.","authors":"Sean Loke, Benedict Ding Chao Ong, Joanna Ng, Alfred Wei Chieh Kow","doi":"10.1097/JS9.0000000000002240","DOIUrl":"10.1097/JS9.0000000000002240","url":null,"abstract":"<p><strong>Background: </strong>Liver malignancies present substantial challenges to surgeons due to the extensive hepatic resections required, frequently resulting in posthepatectomy liver failure. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was designed to increase the resectable liver volume, yet it is associated with significant mortality and morbidity rates. Recently, minimally invasive techniques have been incorporated into ALPPS, with the potential to improve the procedure's safety profile whilst maintaining efficacy.</p><p><strong>Materials and methods: </strong>This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase and Cochrane for all interventional studies that evaluated the operative outcomes of minimally invasive ALPPS compared to open ALPPS. Two independent reviewers appraised and extracted the summary data from published studies. Random effects meta-analyses were used for primary analysis.</p><p><strong>Results: </strong>Nine studies with 637 patients undergoing ALPPS were included. Meta-analyses indicated a statistically significant decreased risk of 90-day mortality (RR = 0.48, 95%CI: 0.29;0.80) and decreased overall length of hospital stay (MD = -8, 95%CI: -11.25;-4.74) in patients undergoing minimally invasive ALPPS compared to patients undergoing open ALPPS. No significant differences in terms of the rate of future liver remnant growth (MD = 11.37, 95%CI: -4.02;26.77) and risk of posthepatectomy liver failure (RR = 0.52, 95%CI: 0.09;2.97) were identified. Subgroup analyses identified a trend in lowering the risk of posthepatectomy liver failure in patients undergoing laparoscopic ALPPS compared to robotic ALPPS. In terms of oncologic surgical outcomes, 92% of patients undergoing minimally invasive ALPPS achieved negative margin resections, while 86% of patients undergoing open ALPPS achieved negative margin resections.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis provide evidence that minimally invasive ALPPS offers a safer alternative with reduced mortality and shorter hospital stays, while maintaining comparable efficacy in liver remnant growth and R0 resections. These findings highlight the potential of minimally invasive techniques to combat the criticism that ALPPS has been placed under.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2283-2290"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046716","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":"Surgical treatment of congenital pseudarthrosis of the tibia in children: CPAM-LRC consensus and guidelines.","authors":"Wenqi Song, Runhua Zhou, Pei Liu, Yanjie Guo, Lei Shao, Delin Liu, Jia Xu, Tianyi Wu, Zhong Bai, Chi Su, Fuyun Liu, Jun Liu, Qinglin Kang, Shengdi Lu","doi":"10.1097/JS9.0000000000002211","DOIUrl":"10.1097/JS9.0000000000002211","url":null,"abstract":"<p><strong>Purpose: </strong>Congenital pseudarthrosis of the tibia (CPT) is a rare condition typically manifesting within the first decade of life. The primary objectives of surgical intervention for CPT include achieving long-term bony union of the tibia, preventing or minimizing limb length discrepancies (LLD), avoiding mechanical axis deviations of the tibia and adjacent joints, and preventing refracture. This study aims to conduct a systematic review of current treatment methods for CPT to determine the most effective non-surgical and surgical management strategies for pediatric patients with this condition.</p><p><strong>Methods: </strong>A review of the literature was performed according to the PRISMA guidelines. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases was performed over the years 1989 to 2024. Randomized controlled trials, cohort studies and case-control studies on the surgical treatments of CPT in children were included. Random-effects models were used to estimate the pooled primary union rate, primary union time and refracture rate. Then a consensus statement of surgical treatment of CPT in children was achieved based on Delphi methodology which included 2 rounds of electronic questionnaires and 1 round of virtual consensus meeting.</p><p><strong>Results: </strong>Seventy-four studies were included, 23 of which on intramedullary rods (IMR) involving 364 patients, 15 on Ilizarov methods with 230 patients, and 23 studies combining IMR with Ilizarov involving 458 patients. The pooled primary union rate for IMR, Ilizarov method, and Ilizarov combined with IMR was 69% (95% CI: 0.55-0.82), 89% (95% CI: 0.77-0.98) and 85% (95% CI: 0.74-0.94), respectively. The pooled primary union time for IMR, Ilizarov method, and Ilizarov combined with IMR was 8.95 months (95% CI: 6.53-11.37), 7.14 months (95% CI: 5.53-8.74), and 5.62 months (95% CI: 4.89-6.35), respectively. The pooled refracture rate among primary unions for IMR, Ilizarov method, and Ilizarov combined with IMR was 85% (95% CI: 0.60-1.00), 81% (95% CI: 0.56-0.98), and 60% (95% CI: 0.26-0.90), respectively. After 2 rounds of electronic questionnaires and 1 round of virtual consensus meeting, a consensus statement and guidelines of surgical treatment of CPT in children was provided.</p><p><strong>Conclusion: </strong>The CPAM-LRC consensus panel provided recommendations to improve management of pediatric patients with CPT in clinical practice. Combined techniques for pediatric patients after fracture or the formation of pseudarthrosis commonly include excision of the pseudarthrosis site, external fixation, intramedullary fixation, and autogenous bone grafting. Vascularized fibular graft and cross-union can be considered a viable alternative to corticocancellous autograft. Use of recombinant bone morphogenic protein (rhBMP) is not currently conclusive.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 2","pages":"1689-1698"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399125","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":"Trends, age shifts, and potential delayed peaks post-pandemic of early-onset brain and central nervous system cancers in individuals aged 20-49: a cross-sectional study.","authors":"Haibo Teng, Ouying Yan, Chaoxin Xiao, Xin Wang, Zhiyong Liu, Jianguo Xu","doi":"10.1097/JS9.0000000000002207","DOIUrl":"10.1097/JS9.0000000000002207","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system (CNS) cancers are highly lethal and increasingly affect younger populations aged 20-49, posing significant challenges to global healthcare systems. Current research on early-onset CNS cancer trends is limited and outdated, with uncertain impacts from the COVID-19 pandemic. This study explores the epidemiology of early-onset CNS cancer and the pandemic's effects.</p><p><strong>Methods: </strong>We analyzed incidence, mortality, and disability-adjusted life years (DALYs) rates for early-onset CNS cancer (age 20-49) from 2019 to 2021 using GBD 2021 data. The global data were categorized into five regions based on the Socio-Demographic Index (SDI), reflecting income, education, and fertility rates. Trends over the past 30 years were examined using estimated annual percentage change (EAPC), average annual percentage change (AAPC), and joinpoint analysis, with a focus on 2019-2021. The Bayesian age-period-cohort (BAPC) model predicted post-pandemic impacts on CNS cancer metrics.</p><p><strong>Results: </strong>In 2021, global cases of early-onset CNS cancer rose to 50 201.7 (95% UI, 42 864.1-58 187.5), with deaths increasing to 25 023.1 (95% UI, 20 973.8-29 670.8) and DALYs reaching 1 483 019.4 (95% UI, 1 240 923.4-1 756 043.3). The incidence rate increased to 2.1 (95% UI, 1.8-2.5), while mortality rates remained stable at 1.1 (95% UI, 0.9-1.2), and DALY rates decreased to 62.6 (95% UI, 52.4-74.1). Over the past two decades, the incidence of early-onset CNS cancer has steadily increased, particularly in regions with a high SDI and in emerging economies. Although there was a decline in early-onset CNS cancer-related metrics during the pandemic, it is anticipated that global incidence rates will peak between 2035 and 2040.</p><p><strong>Conclusion: </strong>This study provides a comprehensive overview of early-onset CNS cancer trends. Despite stable mortality rates, the increasing incidence suggests a growing global burden, with a delayed peak expected due to the pandemic. These findings highlight the need for preventive and control policies targeting early-onset CNS cancer.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1760-1772"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882161","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":"Oral microbiota as a biomarker for predicting the risk of malignancy in indeterminate pulmonary nodules: a prospective multicenter study.","authors":"Qiong Ma, Chun-Xia Huang, Jia-Wei He, Xiao Zeng, Yu-Li Qu, Hong-Xia Xiang, Yang Zhong, Mao Lei, Ru-Yi Zheng, Jun-Jie Xiao, Yu-Ling Jiang, Shi-Yan Tan, Ping Xiao, Xiang Zhuang, Li-Ting You, Xi Fu, Yi-Feng Ren, Chuan Zheng, Feng-Ming You","doi":"10.1097/JS9.0000000000002152","DOIUrl":"10.1097/JS9.0000000000002152","url":null,"abstract":"<p><strong>Background: </strong>Determining the benign or malignant status of indeterminate pulmonary nodules (IPN) with intermediate malignancy risk is a significant clinical challenge. Oral microbiota-lung cancer (LC) interactions have qualified oral microbiota as a promising non-invasive predictive biomarker in IPN.</p><p><strong>Materials and methods: </strong>Prospectively collected saliva, throat swabs, and tongue coating samples from 1040 IPN patients and 70 healthy controls across three hospitals. Following up, the IPNs were diagnosed as benign (BPN) or malignant pulmonary nodules (MPN). Through 16S rRNA sequencing, bioinformatics analysis, fluorescence in situ hybridization (FISH), and seven machine learning algorithms (support vector machine, logistic regression, naïve Bayes, multi-layer perceptron, random forest, gradient-boosting decision tree, and LightGBM), we revealed the oral microbiota characteristics at different stages of HC-BPN-MPN, identified the sample types with the highest predictive potential, constructed and evaluated the optimal MPN prediction model for predictive efficacy, and determined microbial biomarkers. Additionally, based on the SHAP algorithm interpretation of the ML model's output, we have developed a visualized IPN risk prediction system on the web.</p><p><strong>Results: </strong>Saliva, tongue coating, and throat swab microbiotas exhibit site-specific characteristics, with saliva microbiota being the optimal sample type for disease prediction. The saliva-LightGBM model demonstrated the best predictive performance (AUC = 0.887, 95%CI: 0.865-0.918), and identified Actinomyces, Rothia, Streptococcus, Prevotella, Porphyromonas , and Veillonella as biomarkers for predicting MPN. FISH was used to confirm the presence of a microbiota within tumors, and external data from a LC cohort, along with three non-IPN disease cohorts, were employed to validate the specificity of the microbial biomarkers. Notably, coabundance analysis of the ecological network revealed that microbial biomarkers exhibit richer interspecies connections within the MPN, which may contribute to the pathogenesis of MPN.</p><p><strong>Conclusion: </strong>This study presents a new predictive strategy for the clinic to determine MPNs from BPNs, which aids in the surgical decision-making for IPN.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2055-2071"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894379","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 association between domestic water hardness and kidney stone disease: a prospective cohort study from the UK Biobank.","authors":"Jiahao Zhang, Hongcheng Luo, Haoliang Wu, Yuxin Qian, Zhicheng Tang, Juan Wang, Zhibiao Li, Hanxiong Zheng, Fucai Tang, Zhaohui He","doi":"10.1097/JS9.0000000000002198","DOIUrl":"10.1097/JS9.0000000000002198","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Kidney stone disease is a common surgical disease and a significant public health issue, which may be influenced by environmental factors such as domestic water hardness and its related minerals. Previous studies have shown inconsistent and controversial results regarding the impact of domestic water hardness on kidney stone formation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective cohort study analyzed data from 288 041 participants in the UK Biobank with no prior history of kidney stones from 2006 to 2024. The exposures were domestic water hardness, calcium concentration, calcium carbonate concentration, and magnesium concentration. The main outcomes were the disease status and onset time of kidney stone diseases. The confounding factors of model adjustment included age, sex, ethnicity, economic level, education level, Townsend Deprivation Index, Index of Multiple Deprivation, assessment center, body mass index, drug history influencing the metabolism of calcium and magnesium, and water intake based on the directed acyclic graph of causal hypothesis. The association between domestic water hardness and kidney stones was assessed using the Cox regression models, sensitivity analyses, subgroup and interactive analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the follow-up period, 3298 participants (1.14%) developed kidney stones. In all participants, the mean concentration of calcium, calcium carbonate, and magnesium was 52.61, 135.01, and 4.66 mg/L, respectively. In Cox regression models, higher magnesium levels (Q4, &gt; 5 mg/L) in natural water use can reduce the risk of kidney stones [HR and 95% CI: 0.88 (0.80-0.97) in model 3], but no significant correlation was found in domestic water hardness, calcium concentration, and calcium carbonate concentration in the overall models. Four sensitivity analyses further supported the overall results in the overall models. In subgroup analysis, hard water and calcium concentration in domestic water can increase the 18%-34% incidence risk of kidney stones in participants over 60 years old and female participants; high magnesium concentration (&gt;5 mg/L) in domestic water can decrease the 10%-28% risk of kidney stones in males, participants ≤ 45 years old, and participants without renal failure. Magnesium interacted with other minerals, and its protective effects were more significant in hard water (HR: 0.73, 95% CI: 0.61-0.87), a high concentration of CaCO 3 (HR: 0.62, 95% CI: 0.50-0.78), and calcium (HR: 0.48, 95% CI: 0.33-0.71) in domestic water.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings suggested that magnesium levels in water can decrease kidney stone risk, but in the overall population, domestic water hardness, calcium concentration, and calcium carbonate concentration have no significant impact on the formation of kidney stones. Interestingly, hard water and its calcium concentration can promote the formation risk of kidney stones in participants &gt; 60 years old and ","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1957-1967"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948942","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":"A novel suture-free nephroplication with 4D-printed biodegradable bag for giant hydronephrosis: initial experience from hydromechanics and clinical application.","authors":"Fuxun Zhang, Yong Jiao, Lele Zhang, Zijie Meng, Yang Xiong, Yunhua Ji, Zhirong Luo, Qi Xue, Xuyan Guo, Xiao Tan, Lei Chen, Jiankang He, Bo Zhang","doi":"10.1097/JS9.0000000000002213","DOIUrl":"10.1097/JS9.0000000000002213","url":null,"abstract":"<p><strong>Background: </strong>Giant hydronephrosis as an rare condition is often caused by chronic ureteral obstruction. Nephroplication is a crucial procedure to improve urinary drainage in the kidney-sparing surgery for patients with giant hydronephrosis. However, traditional nephroplication via suturing kidney has technical difficulty and many potential risks.</p><p><strong>Materials and methods: </strong>We devised a novel suture-free nephroplication by using a 4 dimension (4D)-printed biodegradable bag. Structures of the bag were observed by a scanning electron microscope. Hydromechanical analysis was conducted to explore the mechanism of this novel surgery. Patients with giant hydronephrosis caused by ureteropelvic junction obstruction (UPJO) were recruited. Computed tomography (CT) and renal emission computed tomography (ECT) were used to evaluate the renal morphology and function in preoperative examination and follow-up.</p><p><strong>Results: </strong>4D-printed biodegradable bag was fabricated using polycaprolactone (PCL). Hydromechanical analysis indicated that reduced space of renal pelvis after the nephroplication could improve urinary drainage. Finally, three patients were recruited, and underwent this novel suture-free nephroplication successfully. Postoperative CT and renal ECT performed at three months after the operation revealed significant recovery of affected kidney. Among them, the glomerular filtration rate (GFR) of affected kidneys in two patients increased from less than 10 mL/min to 13.11 mL/min and 14.30 mL/min respectively, indicating the significant recovery of split renal function.</p><p><strong>Conclusions: </strong>This is a novel suture-free nephroplication for treating benign giant hydronephrosis, in which the 4D-printed biodegradable bag simplified and standardized surgical procedures significantly. Initial experience from clinical application is encouraging, suggesting that the nephrectomy for patients with benign giant hydronephrosis might be avoided. Future investigations on long-term outcomes of this new surgery are warranted.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2304-2308"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948954","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":"Postoperative acute pain trajectory and chronic postsurgical pain after abdominal surgery: a prospective cohort study and mediation analysis.","authors":"Dong Xu Chen, Yu Yang Zhang, Jing Liu, Yu Chen","doi":"10.1097/JS9.0000000000002218","DOIUrl":"10.1097/JS9.0000000000002218","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the trajectories of acute postoperative pain intensity during the initial 5 days after abdominal surgery, and to analyze their association with the risk of developing chronic postsurgical pain (CPSP).</p><p><strong>Methods: </strong>We enrolled patients with elective abdominal surgery with pain measurements taken across postoperative days 1 through 5. Since postoperative pain is often unavoidable and its initial intensity is closely related to the invasiveness of the surgery, focusing on the overall pain trajectory may be more meaningful than evaluating pain at a single time point. Therefore, the primary outcome of this study was to identify distinct pain trajectories. Secondary outcome was the incidence of CPSP between differences pain trajectories. Lastly, mediation analyses were performed to explore the mediating role of the quality of recovery and subacute pain on the studied associations.</p><p><strong>Results: </strong>The final analysis encompassed 1170 patients (36.75% female) with a median age of 55 years. Two distinct clusters were identified: with movement (high: 533 [45.56%]; low: 637 [54.44%]) and at rest (high: 363 [31.03%]; low: 807 [68.97%]). Patients in the high pain trajectory group (during movement [odds ratio [OR] 2.04, 95% CI 1.56-2.68] or at rest [OR 1.90, 95% CI 1.44-2.53]) exhibited nearly doubled risk of CPSP. Moreover, these patients exhibited a significantly poorer recovery quality. Mediation analyses revealed that the poor recovery quality at postoperative 5 days (17.62%-18.57%) and higher subacute pain at postoperative 1 month (29.46%-32.75%) were significant mediators in the association between adverse postoperative acute pain trajectory patterns and CPSP.</p><p><strong>Conclusion: </strong>This study highlights the clinical significance of postoperative pain trajectory profiles in predicting the risk of CPSP, emphasizing postoperative acute pain trajectory as a critical indicator and subacute pain as a significant mediator. The findings underscore the potential for tailored pain management strategies targeting acute pain trajectories to reduce such risk.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1968-1976"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189157","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":"Autoimmune diseases and risk of gastrointestinal cancer: an umbrella review of meta-analyses of observational studies.","authors":"Xiao Bai, Yunran Guo, Xinmao Zhu, Dongqiu Dai","doi":"10.1097/JS9.0000000000002219","DOIUrl":"10.1097/JS9.0000000000002219","url":null,"abstract":"<p><strong>Background: </strong>Several autoimmune diseases (ADs) are considered risk factors for gastrointestinal (GI) cancers. This study pooled and appraised the evidence associating ADs with GI cancer risks.</p><p><strong>Methods: </strong>Three databases were examined from initiation through 26 January 2024. Evidence was determined by the criteria including the P -value of random-effects, small-study effects, excess significance bias, heterogeneity, and 95% prediction interval.</p><p><strong>Results: </strong>Fourteen meta-analyses including 211 primary studies describing 31 associations were selected. Inflammatory bowel disease (IBD) and Crohn's disease (CD) are strong risk factors (with effect sizes of 10.33 and 12.12, respectively) for small bowel cancer (SBC), as indicated by highly suggestive evidence. Another highly suggestive evidence is that gastric cancer (GC) risk was elevated in individuals suffering from pernicious anemia (PA, effect size: 2.80). Suggestive evidence emerged that the risks of colorectal cancer (CRC) were decreased in patients with rheumatoid arthritis (RA, effect size: 0.79) but increased in patients with IBD (effect size: 1.82).</p><p><strong>Conclusions: </strong>This study finds three highly suggestive pieces of evidence of IBD and CD patients with higher SBC risk and PA patients with higher GC risk. Future studies should identify these associations to provide more personalized cancer screenings for patients with ADs.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 2","pages":"2273-2282"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399115","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":"Chinese guidelines for ultrasound-guided thermal ablation of thyroid nodules (2024 edition).","authors":"Zhi-Yu Han, Jian-Ping Dou, Lin Zheng, Min Xu, Jie Ren, Hui Wang, Shu-Rong Wang, Wei-Wei Zhan, Jian-Qiao Zhou, Shu-Hang Xu, Wen Cheng, Man Lu, Dong Xu, Jie Yu, Fei Jing, Ming-An Yu, Song-Yuan Yu, Zhi-Gang Cheng, Cheng-Zhong Peng, Ying Che, Wei-de Dai, Zu-Bang Zhou, Hong Yang, Xiao-Ping Leng, Li-Ping Sun, Guang-Bin He, Guang-Zhi He, Zhi-Bin Cong, Qin-Ying Li, Qi-Yu Zhao, Bai Nan, Cun Liu, Jia Guo, Qian Li, Qiang Wei, Gang Wang, Ying Huang, De-Sheng Sun, Tian-An Jiang, Ping Liang","doi":"10.1097/JS9.0000000000002209","DOIUrl":"10.1097/JS9.0000000000002209","url":null,"abstract":"<p><p>The Chinese guidelines for ultrasound-guided thermal ablation of thyroid nodules (2024 edition) were jointly initiated by the Ultrasound Committee of Chinese Medical Association, the Interventional Ultrasound Committee of Chinese Association of Ultrasound in Medicine and Engineering, the Ultrasonic Intervention Committee of Chinese Colleges of Interventionalists, and the Oncological Intervention Committee of Chinese Research Hospital Association; 37 multidisciplinary experts in interventional ultrasound, ultrasound medicine, endocrinology, and thyroid surgery participated in the compilation of this guide, which expanded the depth and breadth of the perspective and enhanced the authority of the guide. Based on the systematic review of literature related to ultrasound-guided thermal ablation of thyroid nodules and the professional opinions of experts, the guidelines define the indications and contraindications of thermal ablation, including pre-ablation evaluation and preparation, thermal ablation techniques and operational procedures, post-ablation follow-up, therapeutic effect evaluation, complication prevention and treatment, and the writing of medical documents for ablation. According to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), a total of 17 objective and comprehensive recommendations were given. The publication and promotion of this guideline will play a positive role in promoting the standardization of ultrasound-guided thermal ablation of thyroid nodules.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"1699-1710"},"PeriodicalIF":12.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894350","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}