International journal of surgery最新文献

{"title":"Comparison of percutaneous versus cutdown access in patients after endovascular abdominal aortic repair: a randomized controlled trial (SWEET-EVAR trial).","authors":"Yuhang Zhou, Jiarong Wang, Jichun Zhao, Ding Yuan, Chengxin Weng, Bin Huang, Tiehao Wang","doi":"10.1097/JS9.0000000000002233","DOIUrl":"10.1097/JS9.0000000000002233","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal choice of either percutaneous or cutdown access for endovascular abdominal aortic repair (EVAR) remains uncertain due to insufficient evidence, particularly regarding patient-centered outcomes (PCOs). This study aimed at comparing both clinician-reported outcomes (ClinROs) and PCOs of percutaneous versus cutdown access in patients after EVAR.</p><p><strong>Methods: </strong>The study was a single-blind, single-center, non-inferiority, randomized controlled trial. After eligibility screening, patients diagnosed with abdominal aortic diseases were randomly assigned to either the intervention group receiving percutaneous EVAR or the control group receiving cutdown EVAR. Primary ClinRO was access-related complications, and primary PCO was time return to normal life/work.</p><p><strong>Results: </strong>Overall, 120 patients (containing 240 accesses) were allocated to either intervention group ( n = 62) or control group ( n = 58). Percutaneous EVAR (10/124, 8.1%) was non-inferior and not superior to cutdown EVAR (17/116, 14.7%) regarding access-related complications ( P = 0.110; OR: 0.521, 95% CI: 0.225-1.157). As for PCOs, the recovery time back to normal life or work was superior in percutaneous EVAR compared to cutdown EVAR (16 vs. 28 days, P = 0.025; median difference: 7 days, 95% CI: 0-13 days). Moreover, percutaneous access did better in other PCOs, including a reduction in the duration of access-related pain (4 vs. 8 days, P = 0.001), decreased use of analgesics for access-related pain (0/61, 0% vs. 6/55, 10.9%; P = 0.026), and improved quality of life scores at 2 weeks following EVAR (0.876 vs. 0.782; P = 0.022). Prespecified subgroup analyses demonstrated percutaneous access significantly reduced the incidence of access-related complications compared to cutdown access in patients with thick subcutaneous tissue (1/42, 2.4% vs. 7/32, 21.9%; P = 0.026).</p><p><strong>Conclusion: </strong>In patients without massive common femoral artery calcification, percutaneous access may accelerate postoperative recovery and enhance patient experience and quality of life following EVAR, but did not provide obvious advantages regarding access-related complications.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2535-2545"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188964","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":"Neutrophil membrane-engineered Panax ginseng root-derived exosomes loaded miRNA 182-5p targets NOX4/Drp-1/NLRP3 signal pathway to alleviate acute lung injury in sepsis: experimental studies: Erratum.","authors":"","doi":"10.1097/JS9.0000000000002337","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002337","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 3","pages":"2765"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630395","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":"Virtual 3D models, augmented reality systems and virtual laparoscopic simulations in complicated pancreatic surgeries: state of art, future perspectives, and challenges.","authors":"Imán Laga Boul-Atarass, Carmen Cepeda Franco, José Domingo Sanmartín Sierra, Javier Castell Monsalve, Javier Padillo Ruiz","doi":"10.1097/JS9.0000000000002231","DOIUrl":"10.1097/JS9.0000000000002231","url":null,"abstract":"<p><p>Pancreatic surgery is considered one of the most challenging interventions by many surgeons, mainly due to retroperitoneal location and proximity to key and delicate vascular structures. These factors make pancreatic resection a demanding procedure, with successful rates far from optimal and frequent postoperative complications. Surgical planning is essential to improve patient outcomes, and in this regard, many technological advances made in the last few years have proven to be extremely useful in medical fields. This review aims to outline the potential and limitations of 3D digital and 3D printed models in pancreatic surgical planning, as well as the impact and challenges of novel technologies such as augmented/virtual reality systems or artificial intelligence to improve medical training and surgical outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2613-2623"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046743","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":"Charting the future of esophageal cancer translation: insights from clinical trial landscape.","authors":"Hujian Hong, Yijiang He, Yan Li, Yongyan Shen, Yanli Qu","doi":"10.1097/JS9.0000000000002254","DOIUrl":"10.1097/JS9.0000000000002254","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2731-2734"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059010","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 diabetes mellitus and postoperative cognitive dysfunction: a systematic review and meta-analysis.","authors":"Hongbo Liu, Jiali Chen, Jitao Ling, Yuting Wu, Pingping Yang, Xiao Liu, Jianping Liu, Deju Zhang, Xiaoping Yin, Peng Yu, Jing Zhang","doi":"10.1097/JS9.0000000000002156","DOIUrl":"10.1097/JS9.0000000000002156","url":null,"abstract":"<p><strong>Background: </strong>Postoperative cognitive dysfunction (POCD) is a typical consequence following surgery, particularly in cardiac surgeries. Despite its high incidence, the underlying etiology remains unclear. While diabetes mellitus (DM) has been associated with cognitive impairment, its specific function in POCD development remains unidentified. This study aims to evaluate the connection between DM and the risk of POCD.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library databases for studies of DM and risk with POCD, collecting data up to 14 September 2023. We assessed publication bias, heterogeneity, and study quality, adhering to PRISMA and AMSTAR guidelines.</p><p><strong>Results: </strong>Our study comprised 38 trials involving 8748 individuals, with 7734 patients undergoing follow-up. The pooled results showed that individuals with DM had an increased incidence of POCD compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26-1.65). The incidence of POCD was significantly higher in the group of patients with an average age older than 65 years (RR: 1.69, 95% CI: 1.30-2.20) compared with diabetic patients with an average age younger than 65 years (RR: 1.29, 95% CI: 1.09-1.64). Compared with diabetic patients undergoing cardiac surgery (RR: 1.33, 95% CI: 1.15-1.53), patients receiving non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI: 1.43-2.84).</p><p><strong>Conclusion: </strong>Current evidence underscores that diabetic patients face a significantly higher risk of POCD compared to their nondiabetic counterparts. Further research is warranted to clarify the precise mechanisms of this relationship and explore potential preventive strategies for diabetic patients.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2633-2650"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894390","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 technique for rapid localization of pulmonary nodules on-site in operating room followed by lung resection: a case series.","authors":"Wei Huang, Chengcheng Zhang, Weibiao Zeng, Dong Lin, Jiang Fan, Liang Wu","doi":"10.1097/JS9.0000000000002256","DOIUrl":"10.1097/JS9.0000000000002256","url":null,"abstract":"<p><strong>Background: </strong>The localization of pulmonary nodules is crucial for surgical intervention. However, a safe, simple, and efficient method remains elusive. This study aims to evaluate the safety and feasibility of a newly developed preoperative localization method for pulmonary nodules called Rapid Localization of Pulmonary Nodules On-Site (RLPN-OS).</p><p><strong>Methods: </strong>This study is a single-center, single-arm prospective investigation that collects and analyses the clinical data of patients who underwent RLPN-OS and lung resection, primarily evaluating the safety and feasibility of this technique.</p><p><strong>Results: </strong>A total of 200 lung nodules from 190 patients who underwent RLPN-OS and partial lobectomy were included in this study. The success rate of localization was 98.0%, and minor intercostal bleeding was observed in 3 (1.5%) cases. All targeted lesions were located and resected successfully. No patients reported experiencing anxiety or pain during or after the procedure.</p><p><strong>Conclusions: </strong>This novel RLPN-OS technology represents a safe, feasible, patient-friendly, and cost-effective method for lung nodule localization. It has the potential to serve as an alternative to traditional CT-guided percutaneous localization techniques.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2331-2337"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059007","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":"Daily physical activity habits influence surgeons' stress in the operating room: a prospective cohort study.","authors":"Sarah C Skinner, Jake A Awtry, Léa Pascal, Stéphanie Polazzi, Jean-Christophe Lifante, Antoine Duclos","doi":"10.1097/JS9.0000000000002258","DOIUrl":"10.1097/JS9.0000000000002258","url":null,"abstract":"<p><strong>Background: </strong>Exercise training improves heart rate variability, and evidence suggests it can mitigate the detrimental effects of stress. This study aims to evaluate the relationship between surgeons' physical activity habits and their stress, assessed as heart rate variability, at the start of surgery.</p><p><strong>Materials and methods: </strong>This multispecialty prospective cohort study included surgeons from fourteen cardiac, endocrine, digestive, gynecologic, orthopedic, thoracic, and urologic surgical departments of four university hospitals. Surgeons wore accelerometers 24/7 from 1 November 2020 to 31 December 2021 to quantify the mean daily step counts and daily sedentary time for 7 days prior to each operation. RMSSD, the root mean square of successive differences between normal heart beats, is a heart rate variability (HRV) metric that reflects cardiac vagal tone. We evaluated RMSSD during the first 5 minutes of surgeries performed over five 15-day periods. Data were analyzed using a multivariable linear mixed model with a random effect for surgeons.</p><p><strong>Results: </strong>We analyzed 722 surgeries performed by 37 surgeons (median age = 47 (IQR 42-55); 29 (78.4%) male). On average (SD), surgeons walked 9762 (2447) steps and were sedentary 391 (102) minutes daily. The model showed a positive relationship between steps and cardiac vagal tone, with an increase in lnRMSSD (0.028, 95% CI 0.003 to 0.053, P = 0.026) for every 1000 more steps per day, but not for sedentary behavior. Surgeon professors presented lower lnRMSSD (-0.437, -0.749 to -0.126, P = 0.006), as did surgeons who spent less total time operating over the study period (-0.337, -0.646 to -0.027, P = 0.033), compared to their counterparts.</p><p><strong>Conclusions: </strong>Higher daily step counts the week before surgery were associated with increased cardiac vagal tone, indicating lower stress levels at the beginning of surgery. This relationship highlights the influence of physical activity on surgeons' stress in the operating room.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2505-2515"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189048","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":"Bots in white coats: are large language models the future of patient education? A multicenter cross-sectional analysis.","authors":"Ughur Aghamaliyev, Javad Karimbayli, Athanasios Zamparas, Florian Bösch, Michael Thomas, Thomas Schmidt, Christian Krautz, Christoph Kahlert, Sebastian Schölch, Martin K Angele, Hanno Niess, Markus O Guba, Jens Werner, Matthias Ilmer, Bernhard W Renz","doi":"10.1097/JS9.0000000000002250","DOIUrl":"10.1097/JS9.0000000000002250","url":null,"abstract":"<p><strong>Objectives: </strong>Every year, around 300 million surgeries are conducted worldwide, with an estimated 4.2 million deaths occurring within 30 days after surgery. Adequate patient education is crucial, but often falls short due to the stress patients experience before surgery. Large language models (LLMs) can significantly enhance this process by delivering thorough information and addressing patient concerns that might otherwise go unnoticed.</p><p><strong>Material and methods: </strong>This cross-sectional study evaluated Chat Generative Pretrained Transformer-4o's audio-based responses to frequently asked questions (FAQs) regarding six general surgical procedures. Three experienced surgeons and two senior residents formulated seven general and three procedure-specific FAQs for both preoperative and postoperative situations, covering six surgical scenarios (major: pancreatic head resection, rectal resection, total gastrectomy; minor: cholecystectomy, Lichtenstein procedure, hemithyroidectomy). In total, 120 audio responses were generated, transcribed, and assessed by 11 surgeons from 6 different German university hospitals.</p><p><strong>Results: </strong>ChatGPT-4o demonstrated strong performance, achieving an average score of 4.12/5 for accuracy, 4.46/5 for relevance, and 0.22/5 for potential harm across 120 questions. Postoperative responses surpassed preoperative ones in both accuracy and relevance, while also exhibiting lower potential for harm. Additionally, responses related to minor surgeries were minimal, but significantly more accurate compared to those for major surgeries.</p><p><strong>Conclusions: </strong>This study underscores GPT-4o's potential to enhance patient education both before and after surgery by delivering accurate and relevant responses to FAQs about various surgical procedures. Responses regarding the postoperative course proved to be more accurate and less harmful than those addressing preoperative ones. Although a few responses carried moderate risks, the overall performance was robust, indicating GPT-4o's value in patient education. The study suggests the development of hospital-specific applications or the integration of GPT-4o into interactive robotic systems to provide patients with reliable, immediate answers, thereby improving patient satisfaction and informed decision-making.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2376-2384"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059008","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":"Exercise-based cardiac rehabilitation for patients undergoing coronary artery operation: a systematic review and meta-analysis based on current randomized controlled trials.","authors":"Yan Shi, Huiqing Xu, Jige Dong","doi":"10.1097/JS9.0000000000002268","DOIUrl":"10.1097/JS9.0000000000002268","url":null,"abstract":"<p><strong>Background: </strong>Currently, exercise-based cardiac rehabilitation (CR) has been receiving increasing interest for its potentially beneficial effects on the health related quality of life (HRQoL) and outcomes of patients with coronary heart disease (CHD). The aim of this study was to evaluate the effect of exercise-based CR on patients after coronary artery bypass graft (CABG) and percutaneous coronary interventions (PCI).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to 1 December 2023 for relevant studies that evaluated the effect of exercise-based CR on patients after CABG and PCI. Our primary outcomes included mortality, complications, hospital admissions, and HRQoL between patients receiving exercise-based CR and usual care. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2 and Stata 12.0.</p><p><strong>Results: </strong>We finally indicated and included 25 randomized controlled trials (RCTs) with 4106 participants for the present analysis. Our pooled results indicated that, compared to usual care, exercise-based CR did not increase the all-cause (relative risk, RR: 0.84; 95% confidence interval, CI: 0.54-1.31) and cardiovascular (RR: 0.98; 95% CI: 0.38-2.54) mortality for patients after coronary artery operation. Similarly, exercise-based CR had an equal effect on coronary artery complications for patients after coronary artery surgery, including CABG (RR: 0.60; 95% CI: 0.32 ‒ 1.15) and PCI (RR: 0.92; 95% CI: 0.55-1.54). It was indicated that exercise-based CR significantly reduced the incidence of myocardial infarction (MI) by half with an RR of 0.50 (95% CI: 0.28-0.90). In addition, exercise-based CR also significantly reduced all-cause hospital admissions with an RR of 0.74 (95% CI: 0.62-0.88). Compared to usual care, exercise-based CR obviously improved HRQoL of patients after coronary artery operation evaluated with SF-36 summary scores (standardized mean difference, SMD: 0.24; 95% CI: 0.11-0.38) and SF-36 8 domains (SMD: 0.35; 95% CI: 0.24-0.46).</p><p><strong>Conclusions: </strong>Our analysis indicated that exercise-based CR had a significant effect on the improvement of HRQoL in patients after coronary artery surgeries without increasing mortality or the incidence of re-intervention with operations.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2708-2721"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189025","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":"Advancing aesthetic outcomes: A critical analysis of autologous free flap reconstruction post-minimally invasive mastectomy: Erratum.","authors":"","doi":"10.1097/JS9.0000000000002318","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002318","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 3","pages":"2762"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630387","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}