Journal of Investigative Surgery最新文献

{"title":"Causal Caution Before Declaring Superiority of Liver Resection Versus Radiofrequency Ablation for Very Early-Stage Hepatocellular Carcinoma.","authors":"Vishal G Shelat","doi":"10.1080/08941939.2026.2657643","DOIUrl":"https://doi.org/10.1080/08941939.2026.2657643","url":null,"abstract":"","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2657643"},"PeriodicalIF":3.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698856","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":"Percutaneous Endoscopic Lumbar Decompression for Lumbar Lateral Recess Stenosis: A Systematic Review.","authors":"Shanxi Wang, Jianbin Guan, Kaitan Yang, Haohao Liang","doi":"10.1080/08941939.2026.2624189","DOIUrl":"10.1080/08941939.2026.2624189","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to systematically assess and compare the efficacy, complication rates, and procedural characteristics of percutaneous interlaminar endoscopic discectomy (PIED), percutaneous transforaminal endoscopic discectomy (PTED), and unilateral biportal endoscopy (UBE) in the management of lateral recess stenosis (LRS).</p><p><strong>Methods: </strong>A systematic search was conducted across six databases from inception to March 2025 to identify studies on endoscopic lumbar decompression for LRS. Primary outcomes were pain reduction (VAS) and functional improvement (ODI); secondary outcomes were perioperative metrics, complication rates, and patient satisfaction. Narrative synthesis was applied due to heterogeneity. Study quality was assessed using the Cochrane Risk of Bias Tool, ROBINS-I, and the Downs and Black checklist.</p><p><strong>Results: </strong>Thirty-six studies involving 2341 patients with 6-60 months of follow-up were included. PIED achieved VAS reductions of 3-5 points and ODI reductions of 40-60%, but with higher complication rates, including dural tears (3-6%) and reoperation rates (5-9.7%). UBE produced VAS improvements of 5-7 points and ODI reductions of 50-70%, with satisfaction >92%, though operative times were longer (48-91 min) and dural tears occurred in 3-6%. PTED showed consistent pain relief (VAS 6-8 to 1-2) and ODI reductions >50%, with satisfaction 85-95%, short operative times (5-30 min), and low complication and reoperation rates (<5%). Overall study quality ranged from low to moderate risk of bias.</p><p><strong>Conclusions: </strong>PIED, PTED, and UBE all provide effective decompression for LRS. PTED demonstrates the most consistent balance of symptom improvement, safety, and efficiency, while each technique offers distinct advantages for individualized patient selection.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2624189"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165662","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":"Acupoint Stimulation After Anesthesia Induction Does Not Decrease Nausea and Vomiting After Hepatectomy: A Multi-Center Double-Blinded Clinical Trial.","authors":"Shan He, Zhifeng Lv, Hongxia Wang, Nannan Yu, Xiaoshuang Tuo, Yun Wang, Hailong Dong, Jingyi Cao, Yonghui Wang, Zhihong Lu","doi":"10.1080/08941939.2026.2653912","DOIUrl":"10.1080/08941939.2026.2653912","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated whether adding transcutaneous electrical acupoint stimulation (TEAS) to a double-antiemetic regimen during hepatectomy reduces the incidence of postoperative nausea and vomiting (PONV).</p><p><strong>Methods: </strong>In this multicenter double-blinded randomized controlled trial conducted across three tertiary hospitals in China, patients scheduled for elective hepatectomy were randomized to either the TEAS group (stimulation at PC6 during surgery) or the control group (no stimulation). The primary outcome was the incidence of PONV within 24 h postoperatively. Key secondary outcomes included the severity of PONV and pain after surgery.</p><p><strong>Results: </strong>Among 161 randomized patients, 159 completed the study. No significant difference was observed in the incidence of PONV within 24 h postoperatively between the TEAS and control groups (23.8% vs. 26.6%; OR, 95% CI: 0.86, 0.42-1.76). However, the TEAS group exhibited less patient controlled analgesia (PCA) attempts (2.7 vs 3.5) or deliveries (2.6 vs 3.5) by 24 h postoperatively. Recovery outcomes, including time to ambulation and to gastrointestinal function recovery, did not differ between groups.</p><p><strong>Conclusion: </strong>Intraoperative TEAS did not significantly reduce PONV incidence in hepatectomy patients receiving antiemetic therapy. Nonetheless, its potential to decrease the need for analgesics warrants further investigation to refine its role in perioperative care.</p><p><strong>Clinical trial registration: </strong>ClinicalTrial.gov (NCT05396716), https://clinicaltrials.gov.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2653912"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722967","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":"Response to Letter Regarding: Survival Outcome Was Better with Liver Resection than with Percutaneous Radiofrequency Ablation in Patients with Very Early-Stage Hepatocellular Carcinoma: A Single-Center Retrospective Study.","authors":"Yi-Hao Yen, Yueh-Wei Liu","doi":"10.1080/08941939.2026.2659993","DOIUrl":"10.1080/08941939.2026.2659993","url":null,"abstract":"","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2659993"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729329","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":"Baseline Physiological Reserve Provides Greater Explanatory Value Than Discharge-Attained Strength Change for Early Postoperative Outcomes After Elective Abdominal Surgery.","authors":"Sergii Girnyi, Virginia Boccardi, Elena Montanari, Eugenia Semeraro, Alessandra Marano, Mauro Santarelli, Ruslan Duka, Robert Molchanov, Silvia Malerba, Francesco Paolo Prete, Mario Testini, Francesco Pizza, Luigi Marano","doi":"10.1080/08941939.2026.2719065","DOIUrl":"10.1080/08941939.2026.2719065","url":null,"abstract":"<p><strong>Background: </strong>Acute perioperative handgrip strength change measured at discharge (Δacute) is often interpreted as a marker of vulnerability. However, it is discharge-anchored, influenced by peri-discharge conditions, and not measured at a standardized postoperative timepoint. We examined whether Δacute was independently associated with prolonged length of stay (LOS) after elective abdominal surgery once baseline physiological reserve was considered.</p><p><strong>Methods: </strong>Adults undergoing elective abdominal surgery were prospectively enrolled in a multicenter observational cohort. Handgrip strength (HGS) was assessed at admission and discharge, and frailty using the Fried phenotype. Δacute was defined as discharge minus admission HGS. The primary outcome was LOS >10 days. Associations were examined using correlation and multivariable logistic regression, with sensitivity analyses addressing extreme values and non-normal distributions.</p><p><strong>Results: </strong>Among 223 patients (median age, 65 years), 48 (21.5%) had prolonged LOS. Frailty status (OR 2.63, 95% CI 1.47-4.70) and oncologic surgery were independently associated with prolonged LOS, whereas admission HGS was not significant after adjustment. Δacute showed substantial interindividual variability, correlated inversely with admission HGS (r = -0.325, <i>p</i> < 0.001), and differed by surgical context, but was not associated with prolonged LOS in univariable or multivariable analyses.</p><p><strong>Conclusions: </strong>Discharge-anchored Δacute was not independently associated with prolonged LOS after accounting for baseline reserve and surgical context. Because both Δacute and LOS may be influenced by discharge timing and institutional practices, these findings do not establish that acute strength change reflects postoperative perturbation rather than intrinsic vulnerability.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2719065"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794225","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":"Joint-Specific Effects of Previous Arthroscopic Surgery on the Risk of Infection Following Knee, Hip, and Shoulder Arthroplasty: A Meta-Analysis Based on Observational Studies.","authors":"Huan Liu, Bo Wu, Zhengqi Chang, Xiuli Wang","doi":"10.1080/08941939.2026.2702155","DOIUrl":"10.1080/08941939.2026.2702155","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of a prior history of arthroscopic surgery on the risk of postoperative infection following knee, hip and shoulder arthroplasty.</p><p><strong>Methods: </strong>Searched relevant literature from four major English databases up to August 10, 2025. A total of 31 observational studies were included. The generalized linear mixed model was used to pool effect sizes and calculate the odds ratios (OR) for postoperative infection after joint arthroplasty. Subgroup analyses stratified by joint type were performed, and the pooled incidence rates of infection were synthesized.</p><p><strong>Results: </strong>A prior arthroscopic surgery significantly increased the risks of overall infection (OR = 1.33, 95%CI: 1.14-1.56) and deep infection (OR = 1.38, 95%CI: 1.17-1.63) after joint arthroplasty, with obvious heterogeneity among different joints. A history of knee arthroscopy was associated with elevated postoperative infection risks, and prior shoulder arthroscopy markedly increased the risk of deep infection. No significant correlation was observed between hip arthroscopy and infection risk. The pooled overall and deep postoperative infection rates were both 2% in this population.</p><p><strong>Conclusion: </strong>Clinicians should attach importance to this joint-specific risk when formulating treatment plans. Further studies focusing on the shoulder joint are required to validate the present findings.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2702155"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900554","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":"A Randomized Trial Evaluating Intraoperative Ischemic Preconditioning of Parathyroid Glands During Total Thyroidectomy: A Signal for Earlier Parathyroid Function Recovery.","authors":"Qixuan Sheng, Ping Zhang, Tiantian Zhang, Ziwang Wang, Qiang Wang, Wei Li, Siluo Zha, Wensheng Rao, Bin Wang, Wei Zhang, Xinyun Xu, Chengxiang Shan","doi":"10.1080/08941939.2026.2613617","DOIUrl":"10.1080/08941939.2026.2613617","url":null,"abstract":"<p><strong>Background: </strong>Ischemic preconditioning of parathyroid glands (IPCP) is biologically plausible but clinical evidence is limited. In this single-center randomized trial (ChiCTR2000039788), we compared IPCP versus control during total thyroidectomy with central neck dissection.</p><p><strong>Methods: </strong>A total of 135 patients with differentiated thyroid carcinoma were analyzed (IPCP, <i>n</i> = 67; control, <i>n</i> = 68). IPCP consists of three cycles of 60-second occlusion followed by 60-second reperfusion of the ipsilateral superior and inferior thyroid arteries. The baseline characteristics, postoperative hypoparathyroidism (hypoPTH) and hypocalcemia, early parathyroid function recovery (PFR), and surgical complications, were compared between groups.</p><p><strong>Results: </strong>The incidence of postoperative hypoPTH and protracted hypoPTH was not significantly different between the IPCP and control groups (50.8% vs 41.2%, <i>p</i> = 0.265; 6.0% vs 14.7%, <i>p</i> = 0.096). An exploratory analysis showed a higher rate of early PFR in the IPCP group (88.2% vs 64.3%; <i>p</i> = 0.025). The incidence of postoperative hypocalcemia was similar between groups (79.1% vs 82.4%; <i>p</i> = 0.632). Fewer inadvertent parathyroidectomy occurred in the IPCP group, though this difference was not statistically significant (4.5% vs 8.8%; <i>p</i> = 0.505). Other surgical complications were comparable.</p><p><strong>Conclusions: </strong>IPCP did not reduce postoperative hypoPTH in this randomized trial. Earlier PFR is exploratory and warrants further investigation in adequately powered trials.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2613617"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086042","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":"Feasibility and Safety of Lyophilized Thrombin Powder for Hemostasis in Intraoperative Ruptured Intracranial Aneurysms During Endovascular Treatment: A Prospective Cohort Study.","authors":"Wei Ma, Zehao Wang, Hui Ming, Changchun Jiang, Tianyou Zhang","doi":"10.1080/08941939.2026.2637246","DOIUrl":"10.1080/08941939.2026.2637246","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical value, safety, and feasibility of lyophilized thrombin powder (LTP) for hemostasis in patients experiencing intraoperative aneurysms rupture (IAR) during endovascular treatment.</p><p><strong>Methods: </strong>This prospective study analyzed 29 consecutive patients who experienced IAR during endovascular treatment and received LTP for hemostasis between January 2022 and October 2024. Data collected included patient demographics, aneurysm characteristics, IAR details, and hemostatic efficacy. Clinical outcomes and complications were systematically evaluated at 1, 3, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>A total of 29 patients were enrolled in this study, including 13 men and 16 women, with a median age of 64 years (interquartile range: 45.0-69.0). The intraoperative dosage of LTP ranged from 50 to 200 IU. In all cases (100%), effective hemostasis was achieved, and no postoperative rebleeding occurred. During the hospitalization, complications occurred in 10 (34.5%) patients. These included hemorrhagic hydrocephalus in 1 (3.4%) patient, vasospasm in 5 (17.2%), transient ischemic attack in 1 (3.4%), ischemic stroke in 2 (6.9%), and death in 1 (3.4%). At the 3-month follow-up, 26 (89.7%) patients showed favorable functional outcomes (modified Rankin Scale score 0-2). At both 6-month and 1-year follow-ups, 28 (96.6%) patients maintained favorable outcomes. The overall complication rate at 6 months was 15.7% (3/19), and the mortality rate at 1 year was 3.4% (1/19) patient.</p><p><strong>Conclusion: </strong>LTP demonstrates favorable safety and feasibility as an adjunct hemostatic measure for IAR. It may be considered when conventional hemostasis fails, though further validation of its efficacy and safety through large-scale, multicenter studies is warranted.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2637246"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355372","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":"DNA Methylation-Regulated FAM107A Affects Colorectal Carcinogenesis by Inhibiting FOXM1.","authors":"Yue Liu, Jinwei Sun, Yuhua Shi, Lisheng Wang, Xinyue Zhang, Lizhou Chen","doi":"10.1080/08941939.2026.2633933","DOIUrl":"10.1080/08941939.2026.2633933","url":null,"abstract":"<p><strong>Introduction: </strong>Family with sequence similarity 107 member A (FAM107A) has been reported to inhibit cancer cell proliferation and migration and enhance apoptosis; however, to our knowledge, the association between FAM107A and colorectal cancer (CRC) has not been explored.</p><p><strong>Methods: </strong>CCK-8 assay, colony formation, EdU, flow cytometry assays were used to detect the cellular aggressive behaviors. FAM107A promoter methylation was analyzed by bioinformatics tools. The interaction between DNMT1 and FAM107A was explored by RT-qPCR, Western blot and ChIP assay.</p><p><strong>Results: </strong>Overexpression of FAM107A inhibited CRC cell proliferation (<i>p</i> < .001). Furthermore, FAM107A overexpression induced apoptosis (<i>p</i> < .001) and cycle arrest in CRC cells. The direct binding of DNMT1 with FAM107A promoter was demonstrated and DNMT1 silencing enhanced FAM107A expression (<i>p</i> < .001). In addition, FOXM1 overexpression stimulated cell proliferation (<i>p</i> < .05, <i>p</i> < .001) while suppressing cell apoptosis (<i>p</i> < .01) <i>in vitro</i>, and promoted tumor growth (<i>p</i> < .01, <i>p</i> < .001) in a Caco-2 cell subcutaneous nude model <i>in vivo</i>, which was reversed by FAM107A up-regulation (<i>p</i> < .05, <i>p</i> < .01, <i>p</i> < .001).</p><p><strong>Discussion: </strong>These results hypothesize that the occurrence and development of CRC are mainly mediated by the DNMT1/FAM107A/FOXM1 axis.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2633933"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473847","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 Intraoperative Fluid Exposure with Time to First Flatus after Laparoscopic Radical Resection for Colorectal Cancer: A Retrospective Cohort Study.","authors":"Huanhuan Lv, Jinghui Qi, Guanhua Li, Xiaoli Zhao, Wenhui Zhao","doi":"10.1080/08941939.2026.2696112","DOIUrl":"https://doi.org/10.1080/08941939.2026.2696112","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative fluid exposure may influence early bowel recovery after laparoscopic colorectal cancer surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included adults who underwent laparoscopic radical resection for colorectal cancer at a single tertiary center between January 2021 and September 2025. Total intraoperative fluid input and estimated net fluid balance (input minus urine output and blood loss) were analyzed per 500 mL increase. The primary outcome was time to first flatus; secondary outcomes were delayed flatus (≥3 days), time to first defecation, and postoperative length of stay.</p><p><strong>Results: </strong>Among 203 patients, 47 (23.2%) had delayed flatus. Higher total input was associated with longer time to first flatus (aIRR 1.046, 95% CI 1.005-1.089; <i>p</i> = 0.027), as was estimated net balance (aIRR 1.044, 95% CI 1.005-1.085; <i>p</i> = 0.026). Associations with delayed flatus, defecation time, and length of stay were not statistically significant in adjusted models.</p><p><strong>Conclusions: </strong>Greater intraoperative fluid input and more positive estimated net balance were associated with a modest delay in return of flatus after laparoscopic radical colorectal cancer surgery. These retrospective findings are hypothesis-generating and require prospective validation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2696112"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411723","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}