Journal of Investigative Surgery最新文献

{"title":"Comparison of Perioperative Outcomes Between V-NOTES and Total Laparoscopic Hysterectomy: A Retrospective Analysis.","authors":"Serkan Sarikaya, Mine Islimye Taskin, Tuba Bozhuyuk Sahin, Gurhan Guney, Mehmet Kececioglu, Selim Afsar, Sergul Selvi Guney","doi":"10.1080/08941939.2025.2488131","DOIUrl":"https://doi.org/10.1080/08941939.2025.2488131","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study compared the perioperative outcomes of vaginal natural orifice transluminal endoscopic surgery (V-NOTES) and total laparoscopic hysterectomy (TLH).</p><p><strong>Materials and methods: </strong>This analysis included 62 patients: 32 underwent V-NOTES and 30 underwent TLH. Patients with a body mass index (BMI) >30, a history of endometriosis, multiple cesarean sections, or a uterine size >12 week were excluded. Perioperative data-including visual analog scale (VAS) scores, analgesia use, mobilization time, hospitalization duration, and hemoglobin deficit-were compared using independent sample <i>t</i> tests and Mann-Whitney <i>U</i> tests.</p><p><strong>Results: </strong>There were no significant differences in BMI, number of pregnancies, or operative time (<i>p</i> > 0.05). VAS scores at 6 and 24 h were significantly lower in the V-NOTES group (<i>p</i> < 0.001). Patients in the V-NOTES group required less analgesia, had shorter mobilization and hospitalization periods, and returned to daily activities sooner (<i>p</i> < 0.001). However, the hemoglobin deficit was higher in the V-NOTES group (1.85 g/dl vs. 0.7 g/dl, <i>p</i> < 0.001). The neutrophil-to-lymphocyte ratio (NLR) was lower in the V-NOTES group (<i>p</i> = 0.013), whereas the platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) did not differ significantly between the two groups.</p><p><strong>Conclusion: </strong>V-NOTES offers advantages such as reduced postoperative pain and faster recovery compared to TLH. The higher hemoglobin deficit observed with V-NOTES may be related to the surgeon's experience. Further randomized studies are warranted to validate these findings and define appropriate patient selection criteria.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2488131"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Immunophenotype in the Diagnosis of Mesenteric Ischemia in Rats: An Experimental Study.","authors":"Aydin Eray Tufan, Pinar Yazici, Elif Tufan, Anil Akkus, Ozlem Ton Eryilmaz, Ufuk Oguz Idiz, Fatih Ozcelik, Cemal Kaya","doi":"10.1080/08941939.2025.2506621","DOIUrl":"https://doi.org/10.1080/08941939.2025.2506621","url":null,"abstract":"<p><strong>Aim: </strong>Acute mesenteric ischemia (AMeI) is a mortal intestinal emergency with vascular origin. Mortality and morbidity can be prevented by early diagnosis and prompt intervention. In this study, an AMeI rat model was established to investigate the efficacy of immunophenotyping to reveal a biomarker of AMeI.</p><p><strong>Material and methods: </strong>Twenty-one adult female Sprague-Dawley rats were divided into three groups. In the Sham group (Group 1), after laparotomy, the superior mesenteric artery (SMA) was found, and no further intervention was performed. In the ischemia-reperfusion group (Group 2), SMA was occluded only for 45 min whereas in Group 3(ischemia group), SMA was permanently occluded. Peripheral blood mononuclear cells were quantified for T cell subsets using flow cytometry.</p><p><strong>Results: </strong>Regarding hematological biomarkers, only mean platelet volume (MPV) values in Group 3 were significantly higher compared to Group 2 (<i>p = 0.0134</i>). Platelet lymphocyte ratio values and D dimer levels were higher in Group 3 compared to the sham Group (<i>p = 0.0219</i>, <i>p = 0.0012</i>; respectively). No statistically significant difference was detected between groups considering the subtypes of lymphocytes surface antigens. However, in the correlation matrix analysis, significant correlations were observed between Chiu histopathological stage of ileum mucosa and CD45+ and CD4 + CD8 + [Spearman <i>r</i> = 0.571 (95% CI: 0.172-0.809) <i>p = 0.0068</i> and Spearman <i>r</i> = 0.4908 (95% CI: 0.061-0.767) <i>p = 0.0239</i>]. Likewise, a positive linear correlation was found between MPV, D-dimer and Chiu score [Spearman <i>r</i> = 0.5155 (95% CI: 0.094 - 0.780; <i>p</i> = 0.0168) and <i>r</i> = 0.7828 (95% CI: 0.520 - 0.910; <i>p</i> < 0.0001), respectively].</p><p><strong>Conclusion: </strong>Blood levels of CD45+ and CD4 + CD8+ were proved to be higher in study groups. Remarkable positive linear correlation with histopathological changes may also play a predictive role to investigate the role of these markers in larger samples.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2506621"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Log Odds of Positive Lymph Nodes with Overall Survival in Patients with Primary Malignant Anorectal Melanoma: A Population-Based Study.","authors":"Shaofeng Liu, Guixiang Wang, Xiaoping Niu, Wei Wang","doi":"10.1080/08941939.2025.2493886","DOIUrl":"https://doi.org/10.1080/08941939.2025.2493886","url":null,"abstract":"<p><strong>Background: </strong>Malignant anorectal melanoma (AM) is a rare tumor characterized by its aggressive behavior. To date, there has been no comprehensive investigation into the association between the log odds of positive lymph nodes (LODDS) and the prognosis of patients with malignant AM who have undergone surgical intervention.</p><p><strong>Methods: </strong>Data were extracted from the Surveillance, Epidemiology and End Results (SEER) database for patients diagnosed with primary malignant AM who have undergone surgical intervention between 2000 and 2021. The Kaplan-Meier (KM) method with the log-rank test was used to compare survival curves between different LODDS groups. Multivariate Cox models were employed to evaluate the independent association between LODDS and overall survival (OS). An analysis to explore the potential influence of unmeasured confounders on the relationship between LODDS and OS was conducted using the E value.</p><p><strong>Results: </strong>The study included a total of 126 eligible patients. KM analysis revealed that patients with low LODDS exhibited significantly improved OS compared to those with high LODDS (<i>p</i> < 0.001). The multivariate Cox analysis demonstrated that LODDS was independently associated with OS. The calculated E value suggested that the potential impact of unmeasured confounders on the association between LODDS and OS was likely minimal.</p><p><strong>Conclusion: </strong>The findings indicate that LODDS is independently associated with the prognosis of patients with AM undergoing surgical intervention. These results may enhance clinicians' understanding of the prognosis of this rare malignancy and provide a basis for guiding therapeutic decisions.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2493886"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study.","authors":"Shuying Fang, Yuandan Xia, Jianbo Jin, Jiaren Zhang, Lei Lu","doi":"10.1080/08941939.2025.2515054","DOIUrl":"https://doi.org/10.1080/08941939.2025.2515054","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the operative outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH). We also aimed to determine the feasibility of performing vNOTES hysterectomy in primary hospitals.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 54 patients with indications for hysterectomy related to benign uterine disease without prolapse, between September 1, 2020, and November 30, 2024. The patients were categorized into two groups: vNOTES hysterectomy and TLH (<i>n</i> = 27 each). Surgical outcomes, including operative time, blood loss, recovery parameters, and complications, were assessed.</p><p><strong>Results: </strong>Preoperative baseline characteristics were comparable between the two groups. The vNOTES group had a longer mean operative time (187.6 vs. 154.4 min, <i>p</i> < 0.05) and greater median blood loss (100 vs. 30 mL, <i>p</i> < 0.05) compared to the TLH group. However, there were no significant differences in conversion rates, uterine weights, complications, 24-h pain scores, hospital stay, costs, or readmission rates. The vNOTES group demonstrated shorter times to postoperative ambulation, earlier return of bowel function (anal exhaust), and reduced urinary catheter insertion duration (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>vNOTES hysterectomy is feasible in primary hospitals, with surgical outcomes comparable to those of TLH. Patients who underwent vNOTES experienced faster recovery, indicating that it serves as a potential minimally invasive alternative to TLH. However, the small sample size warrants further studies to validate these findings.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2515054"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our Results of Hyperbaric Oxygen or Pars Plana Vitrectomy in Central Retinal Artery Obstruction.","authors":"S Doğruya, B T Altınbay, Ö C Kayıkçıoğlu, M Altınışık, E Kurt, Ö R Kayıkçıoğlu","doi":"10.1080/08941939.2025.2503811","DOIUrl":"https://doi.org/10.1080/08941939.2025.2503811","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to present the results of patients with central retinal artery obstruction (CRAO) who underwent 23-G pars plana vitrectomy (PPV) or hyperbaric oxygen therapy (HBOT) following emergency medical therapy.</p><p><strong>Method: </strong>The files of 15 patients with acute CRAO were retrospectively reviewed. Comprehensive ophthalmological examinations of the patients were performed. Seven patients received HBOT, and eight patients received PPV following emergency medical treatment. The patient's demographic characteristics, initial and final visual acuity, intraocular pressure were examined.</p><p><strong>Results: </strong>The mean age was 65.2 ± 9.9 years in the hyperbaric oxygen therapy group and 58.7 ± 12.8 years in the PPV group. There was no statistically significant difference between the group receiving HBOT and the group undergoing PPV regarding age, initial visual acuity, final visual acuity, visual gain difference between visual acuity improvements, intraocular pressure, and time lag for treatment initiation (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Although some improvement in visual acuity was observed in both treatment groups - particularly in patients who underwent PPV - this change did not reach statistical significance. Therefore, despite timely intervention, the overall visual outcomes in CRAO remain poor.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2503811"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antrum Preservation Versus Antrum Resection in Laparoscopic Sleeve Gastrectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Chao Niu, Bo Li, Hongwei Wan, Wendi Jin, Zhiping Zhang, Wanfu Zhang, Xiaogang Li","doi":"10.1080/08941939.2025.2477099","DOIUrl":"10.1080/08941939.2025.2477099","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of laparoscopic sleeve gastrectomy (LSG) with antrum preservation (AP) and antrum resection (AR) on weight loss and postoperative complications.</p><p><strong>Methods: </strong>A meta-analysis of randomized controlled trials (RCTs) followed PRISMA guidelines. The databases searched included PubMed, Web of Science, Embase Medline, and the Cochrane Library up to October 2022. Extracted data included operation time, hospital stay, excess weight loss, total weight loss, body mass index (BMI), weight, and complications.</p><p><strong>Results: </strong>Eleven RCTs were included with 843 patients: 422 with AR and 421 with AP. The AR group exhibited higher total weight loss at 3 months (<i>p</i> = 0.02), 6 months (<i>p</i> < 0.001), and 1 year (<i>p</i> < 0.001) postoperatively. They also showed greater excess weight loss at 6 months (<i>p</i> < 0.001), 1 year (<i>p</i> < 0.001), and 2 years (<i>p</i> = 0.03). BMI reduction was more significant in the AR group at 3 (<i>p</i> = 0.007) and 6 months (<i>p</i> < 0.001). The AR group lost weight more rapidly at 3 months (<i>p</i> = 0.05), 6 months (<i>p</i> = 0.04), and 1 year (<i>p</i> < 0.001). No significant differences were found in operation time, hospital stay, bleeding, staple line disruption, Clavien-Dindo complications, or remission rates of diabetes, hypertension, arthritis/back pain, hyperlipidemia, or gastroesophageal reflux disease (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>LSG with AR offers better short-term weight loss than AP without increasing surgical complications, but the long-term effects and complications need further investigation in larger RCTs.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2477099"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Inflammatory Markers in HBV-Related HCC After Hepatectomy Based on a Clinical Database.","authors":"Tao Zhou, Jiongze Fang, Jing Huang, Xi Yu, Yuying Shan, Shengdong Wu, Shuqi Mao, Caide Lu","doi":"10.1080/08941939.2025.2475020","DOIUrl":"https://doi.org/10.1080/08941939.2025.2475020","url":null,"abstract":"<p><strong>Objective: </strong>Hepatitis B virus (HBV) remains an important risk factor for hepatocellular carcinoma (HCC), and inflammation plays an essential role in tumor development. This study aimed to investigate the impact of inflammatory markers in the postoperative outcomes of patients with HBV-related HCC, providing valuable prognostic indicators after hepatectomy.</p><p><strong>Methods: </strong>We retrospectively analyzed 222 patients with HBV-related HCC after surgical resection. The ROC curve was used to calculate biomarker cutoff values. The Kaplan-Meier method was used to estimate overall survival (OS) and recurrence-free survival (RFS), and univariate and multivariate analyses were used to identify the prognostic factors.</p><p><strong>Results: </strong>The Kaplan-Meier analysis revealed that patients with high albumin-bilirubin (ALBI) score, aspartate aminotransferase to platelet ratio index (APRI), and monocyte to lymphocyte ratio (MLR) had worse OS, while those with high ALBI score and MLR had shorter RFS. Multivariate Cox regression analysis identified alpha-fetoprotein >400 ng/mL (hazard ratio [HR]: 2.447, 95% confidence interval [CI]: 1.273-4.706, <i>p</i> = 0.007), alanine aminotransferase (HR: 0.377, 95% CI: 0.171-0.834, <i>p</i> = 0.016), platelet to lymphocyte ratio (HR: 0.385, 95% CI: 0.196-0.755, <i>p</i> = 0.006), systemic inflammatory response index (HR: 1.844, 95% CI: 1.049-3.239, <i>p</i> = 0.033), ALBI score (HR: 1.808, 95% CI: 1.020-3.203, <i>p</i> = 0.043), APRI score (HR: 3.193, 95% CI: 1.662-6.137, <i>p</i> < 0.001), tumor diameter (HR: 1.083, 95% CI: 1.012-1.160, <i>p</i> = 0.022), and portal vein tumor thrombosis (PVTT) (HR: 6.083, 95% CI: 2.774-13.338, <i>p</i> < 0.0001) as independent predictors for OS. MLR (HR: 2.285, 95% CI: 1.290-4.048, <i>p</i> = 0.005) and PVTT (HR: 2.672, 95% CI: 1.280-5.579, <i>p</i> = 0.009) were confirmed as significant prognostic markers of RFS in patients with HBV-related HCC.</p><p><strong>Conclusions: </strong>ALBI score, APRI, and MLR are effective prognostic predictors in patients with HBV-related HCC after curative resection. Close monitoring and adjuvant therapies should be considered for high-risk patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2475020"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical Resection of Differentiated Thyroid Cancer in Elderly Patients: Evaluation of the Efficacy of the Immunocolloidal Gold Strip Method Combined with Nanocarbon Negative Imaging Tracing Technology for Parathyroid Gland Imaging.","authors":"YanBin Liu, LiJuan Zuo, YunChao Xin, YaChao Liu, ZeDong Tian, XiaoLing Shang","doi":"10.1080/08941939.2024.2447850","DOIUrl":"10.1080/08941939.2024.2447850","url":null,"abstract":"<p><strong>Objective: </strong>Extant imaging methods used for the proper identification of the parathyroid glands to prevent post-operative hypothyroidism associated with the resection of differentiated thyroid cancer (DTC) are limited by factors such as low specificity, high cost, and technical complexity. This study, therefore, sought to investigate the efficacy of the immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology for parathyroid gland imaging during radical resection of DTC in elderly patients.</p><p><strong>Methods: </strong>A total of 100 elderly patients with DTC were enrolled and randomly divided into two groups: the control group and the observation group. The control group underwent conventional radical thyroidectomy with bilateral cervical lymph node dissection, while the observation group received the immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology for parathyroid gland imaging during the surgery. The baseline characteristics, intraoperative findings, postoperative parathyroid hormone (PTH), and serum calcium levels, as well as postoperative complications, were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in age, gender, body mass index, comorbidities, or smoking history between the two groups. The observation group had a significantly higher number of parathyroid glands identified during surgery compared with the control group. The postoperative PTH and serum calcium levels at postoperative days 1 and 3 and at 6 months were significantly higher in the observation group than those in the control group. The incidence of postoperative hypoparathyroidism was significantly lower in the observation group.</p><p><strong>Conclusion: </strong>The immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology is effective in identifying and preserving parathyroid glands during radical resection of DTC in elderly patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2447850"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-to-Hemoglobin Ratio and Monocyte-to-Hemoglobin Ratio Predict Prolonged Length of Stay in Patients Undergoing Surgery for Pelvic or Acetabular Fractures.","authors":"Wei-Gang Pan, Yu-Ching Chou, Tsu-Te Yeh","doi":"10.1080/08941939.2025.2515067","DOIUrl":"https://doi.org/10.1080/08941939.2025.2515067","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the neutrophil-to-hemoglobin ratio (NHR) and monocyte-to-hemoglobin ratio (MHR) as predictors of prolonged hospital stay in patients undergoing surgery for pelvic or acetabular fractures.</p><p><strong>Methods: </strong>We retrospectively reviewed records of patients aged ≥ 18 years who underwent open reduction and internal fixation (ORIF). NHR and MHR were calculated from blood samples at admission and 24 hours postoperatively. Prolonged hospital length of stay (LOS) was defined as ≥ 25 days (75th percentile). Optimal cutoffs were determined by ROC curve analysis. Multivariable logistic regression identified associations between clinical variables and prolonged LOS.</p><p><strong>Results: </strong>Among 172 patients (mean age 44.5), postoperative NHR > 0.46 and MHR > 0.02 were independently associated with prolonged LOS in patients with acetabular fractures (aOR = 5.90 and 5.42, respectively). No significant associations were found in pelvic fractures.</p><p><strong>Conclusions: </strong>Elevated postoperative NHR and MHR are strongly associated with prolonged LOS in patients with acetabular fractures and may assist in perioperative risk stratification and clinical decision-making.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2515067"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis.","authors":"Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang","doi":"10.1080/08941939.2025.2520992","DOIUrl":"10.1080/08941939.2025.2520992","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery.</p><p><strong>Methods: </strong>A systematic search was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases, covering articles from the inception of these databases until September 2024. The primary outcome was the incidence of anastomotic leakage.</p><p><strong>Results: </strong>The PA group exhibited a higher incidence of anastomotic leakage compared to the stoma surgery group (odds ratios (OR) = 5.86, <i>p</i> = 0.05). However, in cases of perforated diverticulitis (OR = 3.80, <i>p</i> = 0.19) and malignant obstruction (OR = 5.40, <i>p</i> = 0.23), the PA group did not show an increased risk of anastomotic leakage. In terms of other outcomes, the reoperation rate in the PA group was higher compared to the stoma surgery group (OR = 1.89, <i>p</i> < 0.001). However, there were no statistically significant differences in the mortality rate (OR = 1.04, <i>p</i> = 0.80) or the incidence of postoperative complications (OR = 1.50, <i>p</i> = 0.27) between the two groups.</p><p><strong>Conclusion: </strong>Primary anastomosis without a protective stoma is generally safe and can be considered a viable option in emergency left colon surgery.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2520992"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}