Journal of Surgical Research最新文献

{"title":"Clinical Efficacy of the Indigo Thrombectomy Catheter in Acute Superior Mesenteric Artery Embolism: A Single-center Retrospective Analysis","authors":"Da Li MD,&nbsp;Xiaosong Zhang MS,&nbsp;Yusheng Wang MS,&nbsp;Hao Tang MS,&nbsp;He Huang MS,&nbsp;Xiaomin Huang BS,&nbsp;Honggang Zhang MD","doi":"10.1016/j.jss.2025.06.074","DOIUrl":"10.1016/j.jss.2025.06.074","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to evaluate the clinical efficacy and safety of the Indigo thrombectomy catheter in the treatment of acute superior mesenteric artery embolism (SMAE).</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective analysis of 15 patients who underwent endovascular thrombectomy using the Indigo Catheter between May 2023 and October 2024. The procedure was performed within 4 h of presentation. Patient baseline characteristics, procedural outcomes, and follow-up data were systematically collected and analyzed.</div></div><div><h3>Results</h3><div>Technical success, defined as complete thrombus removal, was achieved in all 15 patients (100%). The mean procedure duration was 48 min, and the average hospital stay was 8 d. Three patients exhibited preoperative signs of peritonitis and subsequently underwent laparoscopic exploration immediately after thrombectomy, with two requiring bowel resection due to intestinal necrosis. Additionally, one patient, who initially showed no signs of peritonitis, developed the condition on postoperative day 2 and later required bowel resection. All patients who underwent bowel resection survived. However, one patient succumbed during hospitalization due to severe postoperative embolic complications affecting the lower limb and renal artery, despite intensive management. The median follow-up duration for discharged patients was 6 mo (as of January 2025), with no reported recurrence of SMAE or mortality.</div></div><div><h3>Conclusions</h3><div>The Indigo thrombectomy catheter demonstrated high technical success rates and favorable clinical outcomes in the treatment of acute superior mesenteric artery embolism (SMAE). Endovascular thrombectomy may serve as a potential first-line intervention for carefully selected SMAE patients without severe peritonitis. Future multicenter studies with larger cohorts are warranted to further validate the safety and efficacy of this percutaneous strategy.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702959","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":"Perspectives on Commission on Cancer Standard 5.8 on Lung Cancer: A Qualitative Study","authors":"Alison S. Baskin MD ,&nbsp;Michael P. Stover MD ,&nbsp;Manvir Bains BS ,&nbsp;Kelsey B. Montgomery MD, MSPH ,&nbsp;Wendelyn M. Oslock MD, MBA ,&nbsp;Kristy K. Broman MD, MPH ,&nbsp;Lesly A. Dossett MD, MPH","doi":"10.1016/j.jss.2025.07.001","DOIUrl":"10.1016/j.jss.2025.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2021, the Commission on Cancer implemented Standard 5.8, which requires that lymph nodes be sampled from ≥1 hilar and ≥3 different mediastinal lymph node stations for all curative-intent lung cancer resections. While 80% compliance is expected of all Commission on Cancer–accredited hospitals, recent data illustrates only half of sites are currently meeting criteria. We evaluated perceived barriers and facilitators in implementing Standard 5.8.</div></div><div><h3>Methods</h3><div>In this multicenter qualitative study, 20 semistructured interviews were conducted across academic and community-based institutions. We interviewed key stakeholders, including thoracic surgeons, pathologists, operating room staff, a cancer liaison physician, and clinical data analysts. Thematic analysis was facilitated by the tailored implementation for chronic disease checklist.</div></div><div><h3>Results</h3><div>Themes were mapped to six tailored implementation for chronic disease domains. Most participants felt the guideline was not burdensome and did not alter their clinical practices. Although many agreed that a minimum threshold for lymph node evaluation should exist, some participants were uncertain of the supporting evidence and identified potential technical and clinical barriers to implementation. Interdisciplinary collaboration was a key facilitator to compliance, as well as alignment with professional society guidelines. Higher compliance rates were thought to be driven by increased monitoring and performance feedback, in addition to departmental leadership and support.</div></div><div><h3>Conclusions</h3><div>Mixed opinions regarding Standard 5.8 align with currently low national compliance rates. Participants emphasized the need for additional evidence to support the standard, underscoring the importance of future prospective studies. Support for strong interdisciplinary communication, regularly scheduled feedback, endorsement by cardiothoracic societies and departmental leadership may improve compliance.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 8-17"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702958","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":"Representation of Women as Editors of the Top Surgery Journals in the World.","authors":"Alizeh Abbas, Britney Corey, Herbert Chen","doi":"10.1016/j.jss.2025.04.052","DOIUrl":"https://doi.org/10.1016/j.jss.2025.04.052","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to examine the current representation of women on editorial boards of the top surgery journals in the world.</p><p><strong>Methods: </strong>We identified the top 80 surgery journals on a global scale using the Resurchify Surgery Journal Ranking. The names of each journal's editor-in-chief, deputy editors, and editorial board members were obtained from the journal's website. We used Google search and Gender API to determine the gender of each editorial board member. Descriptive statistical analyses were performed in Microsoft Excel.</p><p><strong>Results: </strong>A total of 76 journals representing 15 surgical subspecialties were included in the study. Overall, 6065 editors, 1588 deputy editors, and 4395 editorial board members were included. Only 5 (6.6%) journals had a woman editor-in-chief. The top journals with the highest representation of women deputy editors were Otolaryngology-Head and Neck Surgery (100%) and the American Journal of Surgery (75%), with third place shared among five journals. The editorial boards of American Journal of Surgery (61.4%) and the Journal of Neurology, Neurosurgery, and Psychiatry (51%) had the highest representation of women editorial board members. The subspecialties with the greatest representation of women editors were breast surgery (30%), ophthalmology (25.3%), and miscellaneous (22.8%). Six neurosurgery and seven orthopedic surgery journals had no women deputy editors or editorial board members.</p><p><strong>Conclusions: </strong>Women remain underrepresented on surgery journal editorial boards. Understanding the gender composition of editorial boards of prestigious surgery journals is a key step for developing strategies aimed at increasing women's representation in surgical leadership positions.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718130","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":"Effect of Preoperative Bowel Preparation and Diet on Anastomotic Healing and the Colon Microbiota: An Experimental Model","authors":"Kaan Sunter MD ,&nbsp;Aysegul Binay MD ,&nbsp;Mustafa A. Turhan MD ,&nbsp;Mehmet A. Koc MD ,&nbsp;Cihangir Akyol MD ,&nbsp;Zeynep C. Karahan MD ,&nbsp;Ibrahim E. Gecim MD","doi":"10.1016/j.jss.2025.06.061","DOIUrl":"10.1016/j.jss.2025.06.061","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal microbiota members, particularly <em>Enterococcus faecalis</em>, play significant roles in the pathogenesis of anastomotic leaks (ALs), with key mechanisms involving collagenase production and matrix metalloproteinase-9 (MMP-9) activation. Diet strongly affects microbiota composition, with Western diets (WDs) promoting dysbiosis, which may exacerbate AL. The effects of mechanical bowel preparation (MBP) and oral antibiotics on AL remain unclear. This experimental study explored the impact of preoperative diet and MBP on AL, focusing on the intestinal microbiota.</div></div><div><h3>Methods</h3><div>Sixty-four female Wistar albino rats were fed a WD or standard diet (SD) for 3 weeks before surgery. The rats were subsequently divided into subgroups according to MBP or oral antibiotic administration. <em>Enterococcus</em> colonies were analyzed throughout the procedure, and their correlation with AL was evaluated by assessing collagenase activity and MMP-9 tissue concentrations.</div></div><div><h3>Results</h3><div><em>Enterococcus</em> colony collagenase activity was significantly greater in the WD group than in the SD group (<em>P</em> = 0.024). Moreover, anastomotic burst pressures were nonsignificantly lower in the WD group. Finally, MMP-9 levels and collagenase activity were significantly lower in the groups that received either diet with oral antibiotics and MBP than in other subgroups (<em>P</em> = 0.045 and <em>P</em> = 0.007, respectively).</div></div><div><h3>Conclusions</h3><div>An SD, especially combined with MBP and oral antibiotics, plays a critical role in reducing the risk of AL by modulating collagenase activity in <em>E faecalis</em> and MMP-9 tissue concentrations in rats. Thus, dietary interventions may improve surgical outcomes; however, further clinical studies are necessary to validate these results in human populations.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 516-525"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694355","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":"The Hidden Toll: Demographic Changes in Suicide Attempts During the Coronavirus Disease-19 Era","authors":"Dylan Hunter AS,&nbsp;Jeffry Nahmias MD MHPE,&nbsp;Negaar Aryan MD,&nbsp;Matthew Dolich MD,&nbsp;Lourdes Swentek MD,&nbsp;Anushka Bagga MD,&nbsp;Areg Grigorian MD","doi":"10.1016/j.jss.2025.06.053","DOIUrl":"10.1016/j.jss.2025.06.053","url":null,"abstract":"<div><h3>Introduction</h3><div>The coronavirus disease-19 (COVID-19) pandemic, characterized by social isolation and economic disparity, has impacted mental health in the United States. While prior studies have linked the pandemic to increased rates of intentional penetrating trauma, the impact of self-inflicted injuries has not been thoroughly examined. We hypothesize an increased national rate of suicide attempts post-COVID-19 compared to previous years and aim to investigate shifts in demographics of trauma patients attempting suicide.</div></div><div><h3>Methods</h3><div>The Trauma Quality Improvement Program database was divided into prepandemic (2017-2019) and pandemic years (2020-2022). Bivariate analyses were performed.</div></div><div><h3>Results</h3><div>From 73,967 patients, those presenting in the COVID era had a statistically decreased rate of suicide attempts (1.3% <em>versus</em> 1.4%, <em>P</em> &lt; 0.001) compared to prepandemic. Most suicide attempts occurred with knives in both groups (pandemic 50.9% <em>versus</em> prepandemic 50.2%, <em>P</em> = 0.06), who also had similar injury severity scores (median, 8). However, pandemic suicide attempts more commonly occurred in Blacks (13.3% <em>versus</em> 11.9%, <em>P</em> &lt; 0.001), Hispanics (13.4% <em>versus</em> 12.0%, <em>P</em> &lt; 0.001), young adults (age 20-39 y) (51.8% <em>versus</em> 49.9%, <em>P</em> &lt; 0.001), and individuals with mental health disorders (50.6% <em>versus</em> 48.2%, <em>P</em> &lt; 0.001). The mortality rate remained similar between cohorts (pandemic 19.8% <em>versus</em> prepandemic 19.5%, <em>P</em> = 0.26).</div></div><div><h3>Conclusions</h3><div>The pandemic was associated with a similar rate of suicide attempts among trauma patients but has led to a shift in demographics. Specifically, increased suicide attempts among Blacks, Hispanics, young adults, and those with mental health disorders. This highlights the pandemic's secondary impact and reinforces the need for targeted preventative measures for these populations during periods of increased stress.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 509-515"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694375","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":"Predictors of Survival in Patients With Severe Traumatic Brain Injury Undergoing Extracorporeal Membrane Oxygenation","authors":"Wardah Rafaqat MD ,&nbsp;Yasmin Arda MD ,&nbsp;Zoha Z. Fazal MBBS ,&nbsp;May Abiad MD ,&nbsp;Emanuele Lagazzi MD ,&nbsp;Vahe S. Panossian MD ,&nbsp;Ikemsinachi C. Nzenwa MD ,&nbsp;Haytham M.A. Kaafarani MD, MPH ,&nbsp;George C. Velmahos MD PhD ,&nbsp;Michael P. DeWane MD ,&nbsp;Benjamin C. Renne MD","doi":"10.1016/j.jss.2025.06.021","DOIUrl":"10.1016/j.jss.2025.06.021","url":null,"abstract":"<div><h3>Introduction</h3><div>The selection of patients for Extracorporeal Membrane Oxygenation (ECMO) needs to be optimized, especially in patients with severe traumatic brain injury (TBI). We aimed to identify predictors of survival in severe TBI patients. We also characterized trends of ECMO use in patients with severe TBI.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the Trauma Quality Improvement Program (TQIP) database for 2010-2020 and selected patients ≥18 years old with an Abbreviated Injury Score Head ≥3 who underwent ECMO. We excluded patients without signs of life on arrival or prehospital cardiac arrest, patients transferred out or discharged against medical advice, and patients with ECMO use &gt;14 d after admission. Our primary outcome was predictors of survival to discharge using a stepwise regression analysis. Our secondary outcome was to analyze the trends in ECMO use among TBI patients.</div></div><div><h3>Results</h3><div>We included 289 patients, of whom 164 (57%) survived to discharge. In the regression analysis, bilateral pulmonary laceration and in-hospital cardiac arrest were predictors of mortality, while age &lt;50 years and anticoagulant use were protective. The proportion of patients with TBI undergoing ECMO gradually increased, with no significant change in mortality rates. An increasing proportion of ECMO cases were performed at community and nonteaching sites compared to academic sites during the study period.</div></div><div><h3>Conclusions</h3><div>ECMO is increasingly being utilized in trauma patients with TBI. Young patients without pulmonary laceration and absolute contraindications to anticoagulation may benefit most from ECMO.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 526-536"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703848","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":"The Performance of ChatGPT-4.0 and ChatGPT-4omni on Answering Thyroid Question: A Multicenter Study","authors":"Siyin Guo BS ,&nbsp;Genpeng Li MD ,&nbsp;Juxiang Gou BS ,&nbsp;Yanping Gong MD ,&nbsp;Wanjun Zhao MD ,&nbsp;Zhiqiang Li MS ,&nbsp;Xianwei Yang MD ,&nbsp;Zhenni Liu MS ,&nbsp;Zhihui Li MD ,&nbsp;Jianyong Lei MD","doi":"10.1016/j.jss.2025.06.066","DOIUrl":"10.1016/j.jss.2025.06.066","url":null,"abstract":"<div><h3>Introduction</h3><div>Although ChatGPT-4.0 exhibits increasing potential in medical applications, its more recent version, ChatGPT-4omni, has not yet been evaluated for how well it responds to patient questions on thyroid health. In this study, the performance of ChatGPT-4.0 and ChatGPT-4omni in answering questions on the thyroid was examined.</div></div><div><h3>Methods</h3><div>To test the performance of ChatGPT-4.0 and ChatGPT-4omni, we first obtained 28 thyroid-related questions from the Huayitong app, a convenient medical app that was officially released by West China Hospital of Sichuan University. We also added two interventional questions to the total of 30 questions. On June 28, 2024, we entered these queries into ChatGPT-4.0 and ChatGPT-4omni in Chinese to generate 60 Chinese replies. Finally, from July 1 to 15, 2024, we asked 60 patients, 29 surgeons, and 37 nurses from 21 tertiary care units nationwide to rate the two sources’ responses on a 5-point Likert scale in terms of time, word count, response speed, accuracy, comprehensiveness, empathy, and satisfaction.</div></div><div><h3>Results</h3><div>When answering 30 questions, ChatGPT-4omni answered more words (437.30 [110.20] characters <em>versus</em> 750.50 [611.50-817.25] characters; <em>P</em> &lt; 0.001), took less time to respond (27.58 [7.22] seconds <em>versus</em> 20.68 [4.38] seconds; <em>P</em> &lt; 0.001), and was faster (15.69 [13.90–16.92]) character/second <em>versus</em> 34.26 [5.03] character/second; <em>P</em> &lt; 0.001) than ChatGPT-4.0. Responses from ChatGPT-4omni were rated as more accurate, comprehensive, sympathetic, and satisfied than those from ChatGPT-4.0 by patients, thyroid surgeons, and thyroid surgery nurses (all <em>P</em> values &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>ChatGPT-4omni outperformed ChatGPT-4.0 in answering common thyroid-related questions. However, further study and optimization are needed to achieve an efficient integration of ChatGPT in clinical settings.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 500-508"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687134","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":"Enhancing Pre-clerkship Students' Readiness for Surgery: A Kern's Framework-Guided Workshop","authors":"Emily Lan-Vy Nguyen HBSc ,&nbsp;Prachikumari Patel MBBS, MSc ,&nbsp;Ahmer Irfan MBChB ,&nbsp;Jason Aubrey MBBS ,&nbsp;Taylor M. Coe MD ,&nbsp;Hala Muaddi MD, PhD ,&nbsp;Roxana Bucur BSc ,&nbsp;Nadia Rukavina MSc ,&nbsp;Chaya Shwaartz MD","doi":"10.1016/j.jss.2025.06.057","DOIUrl":"10.1016/j.jss.2025.06.057","url":null,"abstract":"<div><h3>Background</h3><div>The transition from preclinical years to surgical clerkship is challenging, as traditional curricula emphasize didactic learning over technical and interpersonal skills. We developed a novel, structured workshop based on Kern's Six-Step Guide to Curriculum Design to enhance medical learners' clerkship readiness.</div></div><div><h3>Materials and Methods</h3><div>Conducted in 2023 and 2024 at a single Canadian institution, the workshop featured five stations: <em>Introduction to the OR, The Surgical Ward, The Surgical Consult, Technical Skills,</em> and <em>Thriving in Surgical Clerkship</em>. A multidisciplinary team of surgeons, trainees, nurses, and a clinical clerk facilitated clinical vignettes, small-group discussions, and operative simulations. Learners’ confidence and knowledge were assessed through pre- and postworkshop questionnaires, and suturing skills were evaluated using a validated tool. Comparative analyses were performed using Paired T-tests and Wilcoxon signed-rank tests.</div></div><div><h3>Results</h3><div>Fifty-nine (95.2%) medical students were included in the analysis after removing incomplete responses. Forty-one students (69.0%) had little (less than five times) or no exposure to an OR in the last year. Learners’ overall median confidence improved significantly post-workshop [2.0 (IQR: 2.1-3.2) <em>versus</em> 6.4 (IQR: 6.3-6.8) <em>P =</em> 0.005], as did their suturing skills (11 ± 4.8 <em>versus</em> 23 ± 2.4, <em>P</em> &lt; 0.0001). Fifty-one learners (86.4%) agreed that the workshop decreased their anxiety around clerkship. All agreed that the workshop should be offered again.</div></div><div><h3>Conclusions</h3><div>Our workshop effectively addressed gaps in surgical education by applying Kern's framework, near-peer teaching, and simulation-based learning. The curriculum combined theoretical knowledge and clinical skills, thereby significantly improving clerkship preparedness and serves as a scalable model for surgical education.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 479-487"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687135","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":"A Preoperative Model for Predicting Lymphovascular Invasion in Pancreatic Ductal Adenocarcinoma","authors":"Yiping Zou MD ,&nbsp;Yuexiang Liang MD ,&nbsp;Xiaoqing Ma MD ,&nbsp;Shiye Ruan MD ,&nbsp;Yifei Wang MD ,&nbsp;Jun Yu PhD ,&nbsp;Song Gao MD","doi":"10.1016/j.jss.2025.06.081","DOIUrl":"10.1016/j.jss.2025.06.081","url":null,"abstract":"<div><h3>Introduction</h3><div>Lymphovascular invasion (LVI) is a pathological feature associated with poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). The objective of this study is to develop a preoperative model for predicting LVI in PDAC patients.</div></div><div><h3>Methods</h3><div>One Thousand and Nine patients from three tertiary hospitals were enrolled in this study. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of LVI. A nomogram was constructed based on the results of the multivariate analysis.</div></div><div><h3>Results</h3><div>The present study identified age &lt;65, cachexia, preoperatively assessed CA19-9 levels, lymph node metastasis reported in imaging, and increased tumor size as independent high-risk predictors of LVI in PDAC. The nomogram, incorporating these predictors, demonstrated good predictive performance in both the development and validation cohorts. The high-LVI-risk patients experienced worse recurrence-free survival and overall survival compared to their low-LVI risk counterparts. Notably, patients with high LVI risk demonstrated prolonged survival following neoadjuvant chemotherapy, whereas survival in patients with low LVI risk did not show significant extension after neoadjuvant chemotherapy.</div></div><div><h3>Conclusions</h3><div>A successful establishment and evaluation of a preoperative model predicting LVI in PDAC was achieved. The application of this model holds potential benefits for guiding clinical decisions regarding the utilization of neoadjuvant therapy.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"313 ","pages":"Pages 488-499"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687136","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":"Response Regarding: \"Prior Emergency Department Utilization and Nonaccidental Trauma in Children\".","authors":"R Scott Eldredge, Lois W Sayrs, David M Notrica","doi":"10.1016/j.jss.2025.06.045","DOIUrl":"https://doi.org/10.1016/j.jss.2025.06.045","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707897","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}