International journal of surgery最新文献

{"title":"Letter to the editor:\"Deep learning-driven multi-hierarchical granularity integration for surgical scene understanding: experimental study\".","authors":"Zuomin Wang, Qinwei Liu, Wangdong Deng","doi":"10.1097/JS9.0000000000003532","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003532","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":"145251277","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":"Total thymectomy is oncologically superior to partial thymectomy in patients with thymic carcinoma: insights from a multicenter real-world data analysis.","authors":"Tatsuya Hayashi, Mikio Okazaki, Toshiharu Mitsuhashi, Hidetaka Yamamoto, Tomohiro Habu, Kazuhiko Shien, Ken Suzawa, Hiromasa Yamamoto, Tomoaki Otsuka, Mototsugu Watanabe, Takeshi Kurosaki, Eiji Yamada, Eisuke Matsuda, Tatsurou Hayashi, Toshiya Fujiwara, Makio Hayama, Hiroyuki Tao, Masaomi Yamane, Hidetoshi Inokawa, Yuji Hirami, Kazuhiro Washio, Takahiko Misao, Motohiro Yamashita, Yoshifumi Sano, Masao Nakata, Osamu Kawamata, Shinishi Toyooka","doi":"10.1097/JS9.0000000000003600","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003600","url":null,"abstract":"<p><strong>Background: </strong>Although total thymectomy has been the standard surgical approach for thymic epithelial tumors, an increasing number of recent reports suggest that partial thymectomy for early-stage thymomas may yield outcomes comparable to those of total thymectomy. However, whether partial thymectomy is a viable alternative for thymic carcinoma remains unclear.</p><p><strong>Materials and methods: </strong>A total of 106 patients with thymic carcinoma underwent curative intended resection at 19 institutions between January 2010 and December 2021. Excluding 14 patients with incomplete resection, 92 patients with thymic carcinoma who underwent total (n = 73) or partial thymectomy (n = 19) were compared. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan-Meier curves and Cox proportional hazard models. Overlap weighting was applied to adjust for potential confounding factors.</p><p><strong>Results: </strong>Among patients with clinical-stage I disease, 79.3% were upstaged to stage II or higher postoperatively. Unadjusted analyses revealed no statistically significant differences in OS and RFS between the total and partial thymectomy groups, although a trend toward poorer outcomes in the partial thymectomy group was observed. After overlap weighting, partial thymectomy was associated with significantly poorer OS (p = 0.0027) and higher recurrence risk (p < 0.0001). Early postoperative recurrence occurred more frequently in the partial thymectomy group.</p><p><strong>Conclusion: </strong>Partial thymectomy was associated with significantly worse survival and recurrence outcomes in thymic carcinoma. Given the limitations of preoperative diagnosis, total thymectomy should remain the preferred surgical approach for undiagnosed thymic epithelial tumors to achieve optimal oncologic control and minimize the risk of recurrence.</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":"145286035","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":"Comparison of safety and effectiveness between endoscopic ultrasound-guided and ultrasound-guided pancreatic biopsy in focal pancreatic disease: a multi-center, retrospective, propensity score analysis.","authors":"Weilu Chai, Qiang Lu, Dong Xu, Kai Li, Weina Wan, Li Yu, Ran Li, Tian'an Jiang","doi":"10.1097/JS9.0000000000003591","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003591","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS) and ultrasound (US) are the two primary imaging modalities used to guide pancreatic needle biopsy. This study aimed to compare the diagnostic performance and complications associated with EUS- and US-guided pancreatic biopsies.</p><p><strong>Methods: </strong>A total of 2517 consecutive patients who underwent 2583 cases of EUS- or US-guided pancreatic biopsy for focal pancreatic disease between January 2017 and December 2023 at seven university teaching hospitals were included. The endpoints evaluated were diagnostic inaccuracy, complications, and repeat biopsies for each method. The propensity score matching (PSM) method was used for the analysis.</p><p><strong>Results: </strong>For the entire cohort, diagnostic inaccuracies were observed in 7.0% of cases in the EUS-guided biopsy group compared to 3.5% in the US-guided biopsy group, representing a statistically significant difference (p = 0.001). The rates of major (p = 1.000) and minor complications (p = 0.309) were similar between the two groups. The rate of repeat biopsies was significantly higher in the EUS-guided biopsy group than in the US-guided biopsy group (5.0% vs. 2.8%, p = 0.024). However, after balancing lesion characteristics using PSM, no significant differences were observed between the EUS- and US-guided biopsies in diagnostic inaccuracy (7.2% vs. 8.5%, p = 0.600), major complications (0.5% vs. 0%, p = 0.499), minor complications (1.7% vs. 0.2%, p = 0.069), or repeat biopsy rate (5.5% vs. 6.5%, p = 0.656). Subgroup analysis revealed that among patients with exophytic and backward growth pancreatic lesions, both diagnostic inaccuracy (7.1% vs. 33.3%, p = 0.001) and the repeat biopsy rate (10.7% vs. 27.8%, p = 0.029) were significantly lower in the EUS-guided biopsy group compared to the US-guided biopsy group.</p><p><strong>Conclusions: </strong>This study confirmed that both EUS-guided and US-guided pancreatic biopsies are safe and effective for patients with focal pancreatic disease. After PSM, diagnostic inaccuracy, repeat biopsy and complication rates were similar, but EUS-guided biopsy was preferred for lesions with exophytic and backward growth morphology.</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":"145251248","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":"Letter to the editor: \"high variability in the assessment of physical function following total hip arthroplasty: a systematic review\".","authors":"Guoying Jiang, Shigang Li, Guobing Wang","doi":"10.1097/JS9.0000000000003615","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003615","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":"145286246","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":"Commentary: Unveiling the Prognostic Potential of C-Reactive Protein to Albumin Ratio in Valvular Heart Disease-A Step Toward Personalized Risk Stratification.","authors":"Yuru Fu, Yuanyuan Wang","doi":"10.1097/JS9.0000000000003542","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003542","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":"145251226","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 twenty-year outcome of ascending aorta replacement and total arch replacement comparison in debakey type i acute aortic dissection.","authors":"Chun-Yang Huang, Chiao-Po Hsu, Ying-Ting Kuo","doi":"10.1097/JS9.0000000000003530","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003530","url":null,"abstract":"<p><strong>Background: </strong>The mortality rate of acute DeBakey type I aortic dissection increases by 1% to 2% every hour after the first presentation if left untreated. However, the long-term outcomes of ascending aorta replacement (AR) versus total arch replacement (TAR) remain unclear. This study evaluated and compared the long-term outcomes between AR and TAR.</p><p><strong>Materials and methods: </strong>This retrospective study included 398 patients with acute DeBakey type I aortic dissection who underwent surgical repair between March 2002 and October 2024. Patient data were extracted from medical records, and patients were stratified into 2 groups (AR and TAR groups) according to surgical procedure. Inverse probability of treatment weighting was applied for further analysis.</p><p><strong>Results: </strong>Higher incidences of acute kidney injury (32.3% vs 20.6%, P = .029), new-onset stroke (9.5% vs 3.7%, P = .016), and bleeding (30.1% vs 16.2%, P = .007) and longer hospital stays (34.4 vs. 25.7 days, P = .042) were observed in the TAR group than in the AR group immediately postoperation. In long-term follow-up, no significant differences were observed between the groups regarding reintervention or mortality events. In addition, the risk of relative mortality associated with TAR was more apparent in patients older than 65 years.</p><p><strong>Conclusion: </strong>No significant differences were observed between TAR and AR in terms of 30-day mortality, reintervention events, aorta-related mortality, or overall mortality under the tear-oriented policy for acute DeBakey type I aortic dissection. Notably, older patients undergoing TAR had poorer overall survival outcomes than those undergoing AR did, particularly among patients older than 65 years.</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":"145251256","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":"Feasibility of robotic liver resection compared with laparoscopic and open liver resection for hepatocellular carcinoma: a network meta-analysis.","authors":"Sang-Hoon Kim, Ki-Hun Kim, Hugo Pinto-Marques, João Santos Coelho","doi":"10.1097/JS9.0000000000003528","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003528","url":null,"abstract":"<p><strong>Background: </strong>Robotic liver resection (RLR) has gained popularity in the treatment of hepatocellular carcinoma (HCC); however, its efficacy compared to laparoscopic liver resection (LLR) and open liver resection (OLR) remains unclear.</p><p><strong>Methods: </strong>Comprehensive literature search of electronic databases from January 2010 to December 2024 identified studies comparing RLR, LLR, or OLR. Operative, postoperative, and survival data were extracted, and pooled odd ratios or hazard ratios with 95% confidence intervals were calculated using a frequentist network meta-analysis including RLR, LLR and OLR.</p><p><strong>Results: </strong>A total of 69 studies, comprising 1 randomized controlled, 3 prospective, and 65 retrospective-matched studies, involving 13,257 patients were analyzed. This network meta-analysis showed that RLR had significantly lower blood loss than both OLR and LLR, with comparable operative time, RBC transfusion rates, Pringle maneuver use, Pringle time, and R1 resection rates. RLR showed similar rates of overall and major complications and hospital stay duration as LLR, with significant benefits over OLR. No significant differences in 90-day mortality were found among the three groups. For long-term outcomes, RLR showed no significant advantage over LLR or OLR in overall and recurrence-free survival, though it generally ranked higher with a greater P-score.</p><p><strong>Conclusions: </strong>This network meta-analysis suggests that RLR is a feasible surgical treatment option for HCC, offering perioperative and long-term outcomes comparable to LLR, with reduced postoperative morbidity and shorter hospital stays compared to OLR. However, further studies are needed to confirm RLR's efficacy due to its limited sample size.</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":"145251240","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":"Letter to the editor: methodological considerations for oropharyngeal cancer surgical approach comparison: enhancing patient-centered evidence.","authors":"Han-Jie Long, Gui Yang, Qi-Wei Liang","doi":"10.1097/JS9.0000000000003589","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003589","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":"145251204","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":"Letter to the Editor on \"Correlation analysis of postoperative cognitive function and event-related potentials in patients undergoing general anesthesia\".","authors":"Na Liu, Xianglong Yang, Yufei Wang","doi":"10.1097/JS9.0000000000003543","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003543","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":"145251210","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 prospective cohort study on the efficacy of conservative and surgical treatments for patients with ADDwoR of the temporomandibular joint.","authors":"Pinyin Cao, Yao Liu, Jiannan Zhao, Xingyu Lyu, Xiaoqing Li, Haozhe Chen, Peng Wang, Zhan Su, Guomin Wu, Mengjie Wu, Nan Jiang, Ruiye Bi, Songsong Zhu","doi":"10.1097/JS9.0000000000003500","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003500","url":null,"abstract":"<p><strong>Background: </strong>The treatment options for anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint are conservative and surgical treatments; however, current therapeutic strategies for ADDwoR remain highly heterogeneous. This study aimed to evaluate the effectiveness of these two treatment options in symptom alleviation and orofacial functional restoration.</p><p><strong>Methods: </strong>The age of the patients was 18 years or older, and they underwent treatment for ADDwoR of the temporomandibular joint from December 2022 to February 2024, with patients providing 12-month follow-up data on pain, mouth-opening capacity and chewing efficiency. The difference in the change in joint pain levels between the two methods was assessed from the baseline to the 12-month follow-up period. Mouth-opening capacity and chewing efficiency were assessed by pain-free maximum mouth opening (MMO) and the temporomandibular joint chewing function self-test.</p><p><strong>Results: </strong>A total of 218 participants (mean [SD] age = 31.9 [12.9] years; 195 [89%] women) were included in this study, and the conservative treatment group and surgical treatment group included 123 individuals (mean [SD] age = 32.9 [12.7] years; 113 [92%] women) and 95 individuals (mean [SD] age = 30.6 [13.1] years; 82 [86%] women), respectively. Both the conservative treatments (mean change = - 2.45 [95% CI = - 3.031 to -1.864] points) and surgical treatments (mean change = - 2.24 [95% CI -2.867 to -1.603] points) resulted in a clinically important pain reduction at 12 months. However, there was no significant difference in the effects of conservative and surgical treatments on pain reduction (P = 0.5737). The results of the secondary outcomes were mostly in line with those of the primary outcomes. Interestingly, among middle-aged and elderly patients with limited mouth opening, surgical treatments demonstrated a superior restoration of mouth-opening capacity compared to conservative treatments (P = 0.0049).</p><p><strong>Conclusions: </strong>In this cohort study of individuals with ADDwoR of the temporomandibular joint, both conservative and surgical treatments significantly improved clinically relevant pain, mouth-opening capacity and chewing efficiency in patients. And surgical intervention demonstrated superior efficacy in enhancing mouth opening among middle-aged and elderly patient.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274638","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}