Journal of Surgical Research最新文献

{"title":"Telestration With Augmented Reality in Surgery: A Comprehensive Systematic Review and Meta-analysis","authors":"Minaam Farooq MD ,&nbsp;Umar Akram MBBS ,&nbsp;Laiba Sarfraz MBBS ,&nbsp;Zain Ali Nadeem MBBS ,&nbsp;Hira Arshad Jawed MD ,&nbsp;Shamas Ghazanfar MD ,&nbsp;Hannan A. Maqsood MD","doi":"10.1016/j.jss.2025.07.065","DOIUrl":"10.1016/j.jss.2025.07.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Augmented reality (AR) telestration has the potential to completely transform surgical teaching and training. In contrast to traditional telestration and telestration without AR, this systematic review and meta-analysis attempted to thoroughly assess the effect of telestration with AR on a variety of performance metrics, including task completion time, error rates, GOALS task-specific scores, Objective Structured Assessments of Technical Skills (OSATS) task-specific scores, and Global Operative Assessment of Laparoscopic Skills (GOALS) global scores.</div></div><div><h3>Methods</h3><div>Six relevant publications were included after a thorough literature search was carried out on March 2024 across relevant databases. To evaluate the impact of telestration with AR on performance indicators, meta-analyses were carried out, and statistical analysis produced pooled effect sizes and 95% confidence intervals (CIs). The I2 statistic was used to assess heterogeneity.</div></div><div><h3>Results</h3><div>The meta-analysis showed that when comparing telestration with AR to traditional approaches and without AR, the meta-analysis showed significant gains across several performance parameters. In particular, there was an improvement of 4.99 points (95% CI 0.90 to 9.08; I2 = 81%) in the task-specific OSATS scores and 1.67 points (95% CI 0.57 to 2.78; I2 = 0%) in the Global OSATS scores. Moreover, there was a 1.67 point (95% CI 0.57 to 2.78; I2 = 0%) rise in GOALS Global scores and 1.04 points (95% CI 0.25 to 1.83; I2 = 0%) in the task-specific GOALS scores. Notably, a mean difference of −10.99 (95% CI -34.07 to 56.05; I2 = 68%) was seen in the job completion time when telestration with AR was used. Error rates, however, showed no discernible decrease (mean difference: −18.92, 95% CI −57.93 to 20.08; I2 = 85%). Heterogeneity was explained in task-specific OSATS scores (<em>P</em> = 0.003) and task completion time (<em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>In conclusion, there is strong evidence from this systematic review and meta-analysis to suggest that telestration with augmented reality can improve surgical training outcomes. The technology has the potential to completely transform surgical education, as seen by the notable gains in task-specific scores for both GOALS and OSATS that have been observed, together with the large reductions in task completion times. To address the observed variation and investigate other factors influencing performance results, such as learning curves and long-term skill retention, more research is necessary.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 690-700"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review of Operative Management of Thoracic Malignancies in Patients With Psychiatric Comorbidities","authors":"Jeremy J. Rosenbaum BS ,&nbsp;Shefali Varma BS ,&nbsp;Matthew Kirkpatrick PhD ,&nbsp;Brooks V. Udelsman MD, MHS","doi":"10.1016/j.jss.2025.08.006","DOIUrl":"10.1016/j.jss.2025.08.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychiatric comorbidities are increasingly recognized in patients with thoracic malignancies. We undertook this scoping review to characterize the management of thoracic malignancies in patients with psychiatric illness and uncover any disparities in operative treatment or perioperative outcomes.</div></div><div><h3>Methods</h3><div>We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Full-text English articles were identified in PubMed, Embase, and APA PsycInfo published between January 01, 2000, and August 01, 2024. Eligible articles included experimental, quasiexperimental, and observational studies that involved adult patients with psychiatric conditions, thoracic malignancies, and surgical interventions. Data on diagnostic stage, guideline-based interventions, and patient health outcomes were extracted and analyzed.</div></div><div><h3>Results</h3><div>A total of 5050 studies were identified and screened by two reviewers: 235 met the criteria for full-text review and 31 were included for data extraction. Among the included articles, 26 assessed lung cancer and seven assessed esophageal cancer. The most frequently investigated psychiatric comorbidities were substance use disorder (<em>n</em> = 13), alcohol use disorder (<em>n</em> = 12), depression (<em>n</em> = 11), anxiety (<em>n</em> = 8), psychotic disorders (<em>n</em> = 7), and cognitive disorders (<em>n</em> = 7). Although the nature of the observed disparities varied by specific conditions, the presence of a psychiatric comorbidity was associated with delayed diagnoses, lower rates of surgical intervention, longer length of stay, increased perioperative morbidity, and higher mortality rates.</div></div><div><h3>Conclusions</h3><div>Psychiatric illness is common in patients with thoracic malignancy with heterogeneous effects on treatment and outcomes. There is a need for targeted treatment plans to alleviate the identified disparities and optimize care.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 671-689"},"PeriodicalIF":1.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Adhesive Drapes on Groin Surgical Site Infection Prevention in Vascular Surgery","authors":"Justin M. Robbins MD ,&nbsp;Brian Schutter BS ,&nbsp;Charles Cush BS ,&nbsp;Dawn Szeltner MS MPH ,&nbsp;Haley Ehrlich MD ,&nbsp;Timothy Crawford PhD ,&nbsp;Michaella Thomas DO ,&nbsp;Muhammud Rishi MD ,&nbsp;Louisa Pecchioni MD ,&nbsp;Jonathan Velasco MD","doi":"10.1016/j.jss.2025.08.005","DOIUrl":"10.1016/j.jss.2025.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Iodine impregnated adhesive drapes have been shown to reduce incidence of surgical site infection (SSI) in cardiothoracic surgery. A Cochrane review of its use in multiple specialties found significantly more SSIs in the adhesive group <em>versus</em> control. No studies have evaluated their use in vascular surgery and infrainguinal SSIs which this study sought to evaluate.</div></div><div><h3>Methods</h3><div>This was a retrospective study evaluating patients with any infrainguinal vascular surgical procedure from 2013 to 2023. We evaluated demographics, intraoperative variables including use of adhesive drapes and the occurrence of SSI up to 90 d postoperatively. Patients were excluded if they presented with already infected site.</div></div><div><h3>Results</h3><div>A total of 1292 patients with average age of 62.1 ± 8.8 and majority were male. Eighty percent had adhesive drapes used and 18.1% had an SSI with 79.6% being superficial and 20.4% deep. Patients were more likely to have SSI if they had higher body mass index (BMI), were female, or had diabetes. A multivariable logistic regression model examined association of adhesive drapes on SSI. There was no difference in the odds of an SSI for those with adhesive drapes compared to those without (odds ratio = 0.86; 95% confidence interval: 0.57-1.30). On secondary analysis, there was a significant interaction between adhesive drape use and BMI (<em>P</em> = 0.007) with a higher odd of SSI found in patients with higher BMI.</div></div><div><h3>Conclusions</h3><div>This study showed no significant difference in SSI rates with Ioban use but showed that BMI may impact its preventative benefit. Future multicenter prospective randomized trials will be needed to better elucidate its true impact on SSI prevention.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 662-670"},"PeriodicalIF":1.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Distribution and Application of Anti-neutrophil Cytoplasmic Antibodies in Patients With Macrovascular Diseases\". Published in: Journal of Surgical Research,Volume 314, October 2025, Pages 122-126.","authors":"Jingjing Cui, Xiaoyan Li, Yue Hu, Yongyang Pang, Jingbo Zhang, Jin Meng, Fangfang Li, Xin Liu","doi":"10.1016/j.jss.2025.08.002","DOIUrl":"10.1016/j.jss.2025.08.002","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Survivability of Noncardiac Pediatric Patients Requiring Extracorporeal Cardiopulmonary Resuscitation","authors":"Shanquell M. Dixon MD,&nbsp;Samantha M. Koenig MD, MPH,&nbsp;Chinwendu Onwubiko MD, PhD,&nbsp;Robert T. Russell MD, MPH,&nbsp;Scott A. Anderson MD,&nbsp;Martha McBride MSN, CRNP,&nbsp;Eric A. Sparks MD","doi":"10.1016/j.jss.2025.08.008","DOIUrl":"10.1016/j.jss.2025.08.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Application of extracorporeal life support during cardiac arrest is termed extracorporeal cardiopulmonary resuscitation (eCPR). Mortality in pediatric patients undergoing eCPR for noncardiac conditions remains high and factors influencing survival are not well-defined. We hypothesized that eCPR survivors are more likely to have less severe electrolyte derangements prior to cannulation than nonsurvivors.</div></div><div><h3>Methods</h3><div>A retrospective review of extracorporeal membrane oxygenation (ECMO) data at our free-standing children's hospital from January 2013 through December 2023 was performed. Variables evaluated included demographics, diagnosis, blood gas values, CPR time, and survival. Kruskal–Wallis test was used to compare precannulation labs and CPR duration in those who survived to the nonsurvivors.</div></div><div><h3>Results</h3><div>We identified 21 patients who underwent CPR during ECMO cannulation over a 10-year period. The most common diagnosis was respiratory failure (<em>n</em> = 8, 38%). The median duration of CPR prior to successful ECMO initiation was 60 min (interquartile range 15-80). Veno-arterial ECMO (<em>n</em> = 20, 95%) was the most common method of cannulation. The median ECMO run time was 84 h (interquartile range 27-183). A single patient died during ECMO cannulation (<em>n</em> = 1, 4.7%). Eight patients survived to discharge (38%). Higher pH, partial pressure of arterial oxygen, and bicarbonate levels prior to cannulation were associated with survival (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>In this study, precannulation pH, partial pressure of arterial oxygen, and bicarbonate median values were significantly higher in those who survived compared to the nonsurvivors. Precannulation characteristics that may influence survivability can potentially assist with decision making regarding inclusion and exclusion criteria for eCPR candidates.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 657-661"},"PeriodicalIF":1.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Board Games to Box Trainers: Gamified Feedback in Laparoscopy Training for Medical Students","authors":"Abbas A. Karim BS ,&nbsp;Clifford Snyder MPAS, PA-C ,&nbsp;Sarah Lund MD ,&nbsp;Shannon Delao ST ,&nbsp;Alexander Perez MD, MSHCT ,&nbsp;Joshua Roshal MD","doi":"10.1016/j.jss.2025.07.060","DOIUrl":"10.1016/j.jss.2025.07.060","url":null,"abstract":"<div><h3>Introduction</h3><div>Feedback plays a pivotal role in surgical training. Gamification offers a way to make the feedback process more efficient by automating and expediting feedback delivery, which might otherwise be difficult to provide. Prior data suggest that negative feedback may play a greater role in improving performance on laparoscopic skills tasks, whereas positive feedback may enhance learner satisfaction, confidence, and engagement. Automated immediate feedback systems are a potential gamification tool capable of reinforcing correct behaviors, identifying errors, and fueling motivation for surgical skills practice. By gamifying negative feedback and capitalizing on its immediacy, we investigate whether this approach can lead to changes in practice patterns and enhance learners' motivation to practice. Moreover, this study evaluates the impact of a laparoscopic skills simulator that delivers this automated, immediate, negative-only feedback on medical students’ Fundamentals of Laparoscopic Surgery peg transfer task performance.</div></div><div><h3>Methods</h3><div>Forty-eight laparoscopy-naïve medical students were randomly divided into two groups: (A) which trained with a modified 'Operation' board game featuring an auditory buzzer and (B) which used the same trainer with the buzzer disabled. Both groups practiced using laparoscopic Maryland dissectors within the box trainer apparatus, with solely the training board features differing. We tracked the total practice time each participant spent with their assigned simulator and measured preintervention and postintervention performance on the Fundamentals of Laparoscopic Surgery peg transfer task (McGill Inanimate System for Training and Evaluation of Laparoscopic Skills metrics).</div></div><div><h3>Results</h3><div>Fifty-two percent (52%; 25 of 48) of participants used the practice trainer at least once. Both groups practiced the same number of times, but during sessions group B practiced for significantly longer than group A (<em>P</em> = 0.03). Neither the amount of time practiced (B = −0.17, <em>P</em> = 0.44) nor the study group (B = 0.19, <em>P</em> = 0.40) was significantly associated with a greater improvement in performance.</div></div><div><h3>Conclusions</h3><div>The ‘Operation’ trainer's automated negative-only feedback delivery mechanism discouraged laparoscopic skills practice among novices. While the ‘Operation’ trainer's automated negative-only feedback delivery mechanism decreased novice learners' practice duration at any given session, it did not appear to impact motivation to practice again. Future studies should evaluate the roles of mixed, immediate feedback delivery models and appropriately calibrating task difficulty to achieve desirable difficulty in cultivating practice habits.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 647-656"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICG-FA for Anastomotic Leak Prevention During Minimally Invasive Colorectal Surgery: A Meta-analysis","authors":"Muhammad Imran MBBS ,&nbsp;Shahr Yar MBBS, MRCS ,&nbsp;Mansab Ali MBBS, FCPS, FACS ,&nbsp;Amir Usman MBBS, FCPS, FACS ,&nbsp;Shujaat Ali MBBS ,&nbsp;Adeel Sarwar MBBS, MD ,&nbsp;Shah Bano MBBS ,&nbsp;Hala Anwar MBBS ,&nbsp;Kashmala Anwar MBBS ,&nbsp;Ghazala S. Virk MD ,&nbsp;Muhammad Shehryar Hussain MBBS","doi":"10.1016/j.jss.2025.07.051","DOIUrl":"10.1016/j.jss.2025.07.051","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leakage is a serious complication after colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) allows real-time perfusion assessment and may reduce leak rates; however, recent larger randomized clinical trials reported conflicting results. This meta-analysis aimed to clarify the effectiveness of ICG-FA in reducing anastomotic leakage and related complications following minimally invasive colorectal surgery.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across the databases to identify relevant studies. The search results were imported into Covidence for article eligibility screening, and all relevant outcomes data were synthesized using risk ratios (RRs) or mean differences with 95% confidence intervals (CIs) in meta-analysis models using RevMan 5.4. <span><span>CRD420251031138</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Six randomized clinical trials involving 3264 participants were included. ICG-FA significantly reduced the risk of overall anastomotic leakage (RR: 0.66, 95% CI [0.53-0.83], <em>P</em> = 0.0005) and complications (RR: 0.88, 95% CI [0.78-0.99], <em>P</em> = 0.03). Subgroup analysis showed a significant reduction in leakage for left-sided anastomoses (RR: 0.57, 95% CI [0.44-0.75], <em>P</em> &lt; 0.0001) but not for right-sided ones (RR: 0.90, 95% CI [0.53-1.51], <em>P</em> = 0.68). No significant differences were found in Clavien–Dindo ≥3 complications, reoperation rates, or hospital stay. However, the ICG-FA group had a longer operation time (mean difference: 5.57, 95% CI [1.56-9.58], <em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>ICG-FA significantly reduces anastomotic leakage and overall complications in minimally invasive colorectal surgery, especially for left-sided anastomoses. However, its use is associated with a slightly longer operative time. Further research is needed to confirm its role in right-sided procedures and long-term outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 636-646"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Management for Pediatric Chronic Wounds: A Systematic Review of the Current Literature","authors":"Ayesha A. Qureshi MD ,&nbsp;Catherine C. Kennedy BHSc ,&nbsp;Seraph Han-Yin Lin BM ,&nbsp;Alexander Vasko MBA ,&nbsp;Gregory D. Pearson MD, FAAP, FACS ,&nbsp;Richard E. Kirschner MD, FAAP, FACS ,&nbsp;Jenny C. Barker MD, PhD","doi":"10.1016/j.jss.2025.07.025","DOIUrl":"10.1016/j.jss.2025.07.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic wounds affect approximately 10.5 million individuals annually in the United States. Although recent studies have highlighted a surge in chronic wound cases among younger populations, the collective burden of pediatric chronic wounds remains understudied. This study aims to elucidate the epidemiology and management of pediatric chronic wounds.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across Embase, PubMed, and Web of Science databases on articles published after 2000 that specified chronicity of wounds in pediatric patients. The exclusion criteria included case reports, review articles, and proceedings.</div></div><div><h3>Results</h3><div>Sixteen articles met the inclusion criteria. Pilonidal sinus disease emerged as the most studied chronic wound etiology (38%), followed by dermatological disorders such as epidermolysis bullosa, pyoderma gangrenosum, and cutaneous nontuberculous mycobacterium (25%). Traumatic wounds were covered in three articles (19%), whereas burns, pressure ulcers, and osteomyelitis each represented 13% of the studies. This review revealed an interdisciplinary framework, with pediatric surgery being the most common specialty, alongside dermatology and allied health professionals. Most studies examined epidemiology, assessing demographics, nutrition status, and comorbidities, including diabetes mellitus, obesity, hidradenitis suppurativa, and myelomeningocele. Management strategies frequently discussed surgical procedures and wound dressings, whereas self-management and educational initiatives were described to enhance patient care.</div></div><div><h3>Conclusions</h3><div>This systematic review synthesizes current evidence on epidemiology and management approaches for pediatric chronic wounds. Addressing this public health concern requires equitable allocation of resources toward research focused on prevention and enhanced treatment strategies.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 608-625"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of a New Patch to Externally Reinforce Colorectal Anastomosis: An Experimental Study","authors":"Clara Gené Škrabec MD ,&nbsp;Manel Cremades Pérez MD, PhD ,&nbsp;Laia Gatell MD ,&nbsp;Christine Weis PhD ,&nbsp;Jesús M. Izco PhD ,&nbsp;Anna Maria Rodriguez Rivero PhD ,&nbsp;Teresa Zuñiga MSc ,&nbsp;David Parés MD, PhD, FACS ,&nbsp;Joan Francesc Julián Ibáñez MD, PhD","doi":"10.1016/j.jss.2025.07.047","DOIUrl":"10.1016/j.jss.2025.07.047","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leak (AL) is a serious complication in colorectal surgery, associated with increased morbidity, mortality, and healthcare costs. Technological advances have yet to eliminate AL, which occurs from 5% to 14% of cases involving anastomosis. This study introduces and evaluates a new collagen-cyanoacrylate patch designed to externally reinforce colonic anastomoses with the aim to contain anastomotic leaks. The objective of the study is to evaluate the feasibility and safety of a novel collagen-cyanoacrylate patch to reinforce colonic anastomosis in a porcine model.</div></div><div><h3>Methods</h3><div>A preclinical study adhering to Good Laboratory Practices was conducted on 12 Landrace x Large White pigs. Following a previously validated model for a deficient anastomosis, a 21-mm defect was created at a colorectal anastomosis to simulate an AL. Pigs were randomized to receive either reinforcement with the collagen-cyanoacrylate patch or no reinforcement. Safety and feasibility were assessed, analyzing the integration of the patch in colorectal structures. In addition, as secondary outcomes, we assessed clinical monitoring, behavioral observations, blood tests for inflammatory markers, and histopathological analysis.</div></div><div><h3>Results</h3><div>The collagen-cyanoacrylate patch was easily applied, adhered effectively to the bowel surface, successfully sealed the defect, and was naturally degraded during the healing process. No significant differences in stenosis or adhesions were observed between the experimental and control groups, although minor variations in inflammatory and infectious markers were noted. All animals exhibited a 100% survival rate, and no clinical signs of AL were observed.</div></div><div><h3>Conclusions</h3><div>The use of collagen-cyanoacrylate patch is feasible, safe, and has good clinical outcomes, showing promise in preventing colonic AL. Further studies using an adequate anastomotic leak model or clinical studies are needed to confirm efficacy.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 626-635"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On The Cover","authors":"","doi":"10.1016/S0022-4804(25)00520-7","DOIUrl":"10.1016/S0022-4804(25)00520-7","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Page ix"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}