Journal of Surgical Research最新文献

{"title":"The Impact of a Surgical Career on the Relationship, Family, and Personal Well-being of Surgeons’ Partners","authors":"Christina M. Stuart MD ,&nbsp;Nicole M. Mott MD, MSCR ,&nbsp;Alison Halpern Mungo MD ,&nbsp;Zachary P. Asher PA-C ,&nbsp;Robert A. Meguid MD, MPH ,&nbsp;Elizabeth A. David MD, MAS","doi":"10.1016/j.jss.2025.02.019","DOIUrl":"10.1016/j.jss.2025.02.019","url":null,"abstract":"<div><h3>Babckground</h3><div>The demands of a surgical career have known impacts on surgeons’ well-being; however, the impact on their partners is unknown.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey of the partners of faculty and housestaff in a single department of surgery. Participants responded to questions assessing the impact of their partner's career on their relationship, family, and personal well-being adapted from the Stanford “Impact of Work on Personal Relationships” survey.</div></div><div><h3>Results</h3><div>There were 36 responses (response rate 55%). The majority were women (67%) with partners who are men (64%) and a relationship length of 10+ y (56%). The greatest impact was on the direct surgeon-partner relationship, with a median [interquartile range] impact score of 4 [3-4], indicating moderately severe impact, followed by 3 [2-4] for both family life and emotional well-being, indicating moderate impact. Nevertheless, 64% of partners agreed or strongly agreed that they would want their partner to choose a surgical career again.</div></div><div><h3>Conclusions</h3><div>A surgical career has significant impact on surgeons' partners. Future work should explore strategies to mitigate this impact on surgeons’ relationships and family life.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 37-44"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611444","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":"Surviving not Thriving After Gunshot Wound: Prospective Study of Quality of Life, PTSD, and Employment","authors":"Isaac W. Howley MD, MPH, FACS ,&nbsp;Diana S. Arthur BS ,&nbsp;Brian R. Czarkowski MD ,&nbsp;Alexis B. Hess MD ,&nbsp;Allison M. Stokes MD ,&nbsp;Saskya Byerly MD, FACS ,&nbsp;Andrew J. Kerwin MD, FACS ,&nbsp;Karen J. Derefinko PhD","doi":"10.1016/j.jss.2025.01.028","DOIUrl":"10.1016/j.jss.2025.01.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychosocial morbidity, including posttraumatic stress disorder (PTSD), depression, and failure to return to work, is common following gunshot wounds (GSWs). GSW victims with retained bullets experience increased rates of elevated blood lead, putting patients at risk for toxic effects on cognition and mood. This pilot study was performed to examine associations between retained bullets and employment and psychosocial outcomes after GSW.</div></div><div><h3>Methods</h3><div>Adult victims of interpersonal intentional GSW completed surveys using validated instruments to measure quality of life, PTSD, resilience, and substance use, and questions regarding employment during index hospitalization and at 1 and 3 mo. Survey data was linked to clinical records regarding injury severity and hospital course.</div></div><div><h3>Results</h3><div>Sixty-three patients completed the baseline survey; 43 completed all 3 surveys. Median age was 29 (interquartile range, 21-40), injury severity score 13 (9-17), and hospital length of stay 6 d (4-10). The patient population was overwhelmingly Black and male (both 87.3%). Laparotomy was performed in 28 patients (44%). Forty-nine patients (77.8%) were working prior to injury, 1 (2%) at 1 month, and 34 (54%) at 3 months. Eight (12.7%) screened PTSD + at baseline; 38 (60.3%) were PTSD + at 3 months. Three-month PTSD + patients were similar to PTSD-patients in all clinical and demographic variables. For 3-month PTSD + patients, all quality of life component scores were worse than for PTSD-patients. Presence of retained bullets was not associated with any differences in psychosocial outcome at 3 months.</div></div><div><h3>Conclusions</h3><div>GSW is associated with significant psychosocial morbidity, including a large decline in employment. PTSD affects approximately half of patients, consistent with prior reports. In this pilot study, PTSD + patients suffered from reduced quality of life.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 66-72"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620866","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":"V-domain Ig Suppressor of T cell Activation Expression During Hemorrhage or Sepsis-Induced Acute Respiratory Distress Syndrome: Insights From a Mouse Model","authors":"Baoji Hu MD ,&nbsp;Jihong Jiang MD ,&nbsp;Wen Pan PhD ,&nbsp;Chun-Shiang Chung PhD ,&nbsp;Chyna Gray PhD ,&nbsp;Yaping Chen BS ,&nbsp;Jianrong Guo MD ,&nbsp;Alfred Ayala PhD","doi":"10.1016/j.jss.2025.02.001","DOIUrl":"10.1016/j.jss.2025.02.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute respiratory distress syndrome (ARDS) is a life-threatening pulmonary condition with significant mortality, largely due to a lack of therapeutic interventions grounded in its molecular pathophysiology. Immune checkpoint regulators, such as the V-domain Ig Suppressor of T cell Activation (VISTA), may provide novel immunotherapeutic strategies for ARDS by modulating the immune response, a concept extensively explored in cancer and autoimmune diseases. Investigating VISTA in the context of ARDS could unveil new therapeutic avenues.</div></div><div><h3>Methods</h3><div>We used a mouse model of indirect ARDS by subjecting C57BL/6J mice to hemorrhage followed by cecal ligation and puncture. Systemic and localized inflammatory conditions were assessed using samples from blood, lung, and peritoneal fluid. Lung pathology was quantified by scoring hematoxylin and eosin-stained sections. Flow cytometry, enzyme-linked immunosorbent assay, and reverse transcription-polymerase chain reaction analyses concentrated on macrophages, neutrophils, endothelial cells, and epithelial cells to elucidate VISTA expression patterns.</div></div><div><h3>Results</h3><div>Hemorrhage or cecal ligation and puncture–treated mice exhibited hallmark symptoms of indirect ARDS, including elevated levels of inflammatory cytokines and chemokines. Notably, VISTA expression was substantially upregulated on various cell types, including blood monocytes, lung macrophages, and both circulating and lung-infiltrating neutrophils, as well as on pulmonary epithelial cells and endothelial cells.</div></div><div><h3>Conclusions</h3><div>Our model replicates critical inflammatory and physiologic changes leading to ARDS, with the elevated expression of VISTA on immune and parenchymal cells suggesting its central involvement in lung injury. The findings propose VISTA as both a potential biomarker for lung damage and as a promising target for ARDS therapy.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 73-85"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Recognition in Transplant Surgery Equitable? A Two-decade Analysis of Transplant Award Recipients","authors":"Nathalia Castillo BS ,&nbsp;Alejandro C. Ortiz MD ,&nbsp;Dominique Betterbed BS ,&nbsp;Nathan Oommen BS, MBA ,&nbsp;Yang Yu MPP ,&nbsp;Naoru Koizumi PhD ,&nbsp;Jorge Ortiz MD","doi":"10.1016/j.jss.2025.02.016","DOIUrl":"10.1016/j.jss.2025.02.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Awards from medical societies aim to recognize contributions and support academic growth. However, women and individuals from marginalized backgrounds are often underrepresented. This analysis examined the demographics of award recipients and award committee members from the American Society of Transplant Surgeons and American Society of Transplantation over 2 decades.</div></div><div><h3>Materials and methods</h3><div>Six American Society of Transplant Surgeons (ASTS) awards from 1995 to 2023 and 15 The American Society of Transplantation (AST) awards from 2000 to 2023 were assessed. Publicly available databases provided demographic data for recipients and committee members, categorized by race/ethnicity (non-Hispanic White, Black, Asian, and Hispanic) and sex (male and female). Recipients' highest degrees attained, professions, and institution affiliations were also gathered. The NIH's Research Portfolio Online Reporting Tool was used to examine the amount of NIH funding allocated to the recipients' affiliated institutions.</div></div><div><h3>Results</h3><div>76.8% of recipients were non-Hispanic White, 14.4% Asian, 6.1% Hispanic, and 2.8% Black. The majority of awardees were surgeons at 37%, while 78% held MD credentials. The proportion of female award recipients was increased by 19% for AST and 33% for ASTS over the examined timeframe. No significant shifts were observed in the racial composition of award recipients for both AST and ASTS. More awards were given to individuals affiliated with institutions ranked in the top quartile for NIH funding for both AST and ASTS awards (<em>P</em> = 0.039; <em>P</em> = 0.018).</div></div><div><h3>Conclusions</h3><div>Among the two transplant surgery societies, recognition of female recipients has significantly increased. However, equitable recognition of individuals from underrepresented backgrounds remains insufficient. Further progress is needed to acknowledge the contributions of those from diverse backgrounds and professions.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 45-53"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611426","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":"Hospital and Patient Level Predictors for 90-d Readmission Following Burn Injury","authors":"Jacob M. Dougherty BS ,&nbsp;Eva S. Blake BA ,&nbsp;Christopher J. Rittle BS ,&nbsp;Zhaohui Fan MD, MPH ,&nbsp;Raymond A. Jean MD, MHS ,&nbsp;Bryant W. Oliphant MD, MBA, MSc ,&nbsp;Mark R. Hemmila MD ,&nbsp;Naveen F. Sangji MD, MPH","doi":"10.1016/j.jss.2025.02.025","DOIUrl":"10.1016/j.jss.2025.02.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Predictors and contributing factors for hospital readmission following burn injury are currently not well described. Previous studies evaluating readmission following burn injury have been limited to specific patient subpopulations or to a short-term period after injury, for example, 30 d. We describe predictors for all cause, 90-d hospital readmission following burn injury among the US adult population.</div></div><div><h3>Methods</h3><div>An observational cohort study was conducted using the Healthcare Cost and Utilization Project 2017-2020 Nationwide Readmissions Database data. Individuals ≥18 y of age at the time of admission were included in the study, and International Classification of Diseases, Tenth Revision diagnosis codes were utilized to identify burn injury. Patient demographics, payor status, total charges, comorbidities, markers of socioeconomic status, and hospital characteristics were included in a multivariable logistic regression analysis to identify predictors for hospital readmission within 90-d postdischarge.</div></div><div><h3>Results</h3><div>We identified 153,760 patients with a burn injury in the study period, of whom 20.8% required a readmission within 90 d postdischarge. Increased age, the presence of a comorbid condition, and lower socioeconomic status increased the likelihood of 90-d readmission. At the hospital level, admission to a private investor-owned and smaller bed size hospitals were associated with an increased likelihood of readmission.</div></div><div><h3>Conclusions</h3><div>Identification of factors that lead to increased likelihood of 90-d readmission following hospitalization for a burn injury may be beneficial in clinical decision making, allowing for more individualized care and minimization of unplanned readmissions.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 54-61"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611446","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":"Navigating Surgical Societies as Minority Women: The Intersectionality of Race and Gender","authors":"Gopika SenthilKumar PhD ,&nbsp;Callisia N. Clarke MD, MS ,&nbsp;Lindsay E.Y. Kuo MD, MBA ,&nbsp;Priyanka V. Chugh MD, MS ,&nbsp;Chantal R. Reyna MD ,&nbsp;Sophie Y. Dream MD, MPH","doi":"10.1016/j.jss.2025.02.022","DOIUrl":"10.1016/j.jss.2025.02.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical societies continue to play a crucial role in promoting changes that increase diversity, equity, and inclusion within academic surgery. Recent work has begun to shed light on the limitations of the commonly utilized “one-sized fits all” approach to addressing challenges faced by minorities.</div></div><div><h3>Methods</h3><div>In this article, we explore the unique experiences of minority women at the intersectionality of race, ethnicity, cultural practices, sexual orientation, and gender. We then share key insights from a “Society of Asian Academic Surgeons (SAAS) Sips” event that we hosted on the topic.</div></div><div><h3>Results</h3><div>Numerous factors synergistically amplify disparities faced by minority women in academic surgery. The Society of Asian Academic Surgeons Sips event provided a necessary and safe space to begin discussing challenges that arise at the intersectionality of belonging to multiple underrepresented groups, and such events need to be reproduced more regularly.</div></div><div><h3>Conclusions</h3><div>Future work that aims to understand factors that affect personal and professional experiences of minority women from a wide diversity of cultures, and address unique barriers within specific groups, are needed to create a more inclusive surgical culture.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 62-65"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611445","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":"Prior Emergency Department Utilization Association With Nonaccidental Trauma in Children","authors":"R. Scott Eldredge MD ,&nbsp;Jefferson Lin MS ,&nbsp;Stephanie Zimmerman MD ,&nbsp;Lucia Mirea PhD ,&nbsp;Gevork Harootunian PhD ,&nbsp;Lois W. Sayrs PhD ,&nbsp;David M. Notrica MD","doi":"10.1016/j.jss.2025.02.010","DOIUrl":"10.1016/j.jss.2025.02.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Physical child abuse (PCA) is believed to occur in an escalating manner with multiple episodes occurring over time. This pattern may potentially lead to multiple emergency department (ED) visits, often to different EDs. The aim of this study was to evaluate prior ED utilization as a risk factor for PCA in children.</div></div><div><h3>Materials and methods</h3><div>A retrospective case-control study was conducted of children evaluated for potential PCA at a level I pediatric trauma center. Cases included patients deemed probable PCA by the hospital forensic team. Demographic data of cases was transferred to the Center for Health Information and Research for statewide matching with accidental injury controls based on age and time of injury. Additional information on all prior ED visits (for any reason) in the state within 4 y was extracted for all cases and controls. Logistic regression assessed the relationship of prior ED utilization with PCA for patients with ≥1 prior ED visits.</div></div><div><h3>Results</h3><div>Of the total 518 patients identified, only 303 (58%) had at least one prior ED visit and were analyzed. PCA cases <em>versus</em> accidental injury controls were more likely to be younger (1.5 ± 1.8 <em>versus</em> 1.9 ± 2.0 y, <em>P</em> = 0.04), have Medicaid (86% <em>versus</em> 72%, <em>P</em> = 0.01), and ≥2 prior ED visits (62% <em>versus</em> 48%, odds ratio 1.76 [1.11-2.8] <em>P</em> = 0.02). On multivariable logistic regression controlling for patient age, race, and payer status, each additional prior ED visit increased the odds of PCA by 19% (adjusted odds ratio 1.19 [1.03 – 1.39], <em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Frequency of prior ED utilization is an independent risk factor for PCA. Each prior ED utilization increases a patient's odds for child abuse by 19%. A history of multiple prior ED may be used to help predict nonaccidental trauma.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 19-25"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601708","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":"Pediatric Resuscitative Thoracotomy in Infants, Children, and Early Adolescents: A Scoping Review","authors":"Alexandria L. Soto MA ,&nbsp;Akosua D. Odei BA ,&nbsp;Cathlyn K. Medina BA ,&nbsp;Steven W. Thornton MD ,&nbsp;Samantha Kaplan PhD ,&nbsp;Emily Greenwald MD ,&nbsp;Elisabeth T. Tracy MD","doi":"10.1016/j.jss.2025.02.002","DOIUrl":"10.1016/j.jss.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent publications sought to define the role of resuscitative thoracotomy (RT) in the pediatric population; however, few studies guide its use in young children and infants. This review characterizes the presentation and outcomes of patients ≤15 y old undergoing RT.</div></div><div><h3>Methods</h3><div>A scoping review querying publications in PubMed, Embase, and Scopus prior to March 2024 was conducted using Covidence software. Eligible articles reported outcomes of patients aged ≤15 y old receiving RT for traumatic injury. The exclusion criteria included non-English, data in aggregate with patients &gt;15 y old or lack of outcomes. Eligible articles underwent data extraction for mechanism of injury, hospital presentation, procedure details, and survival.</div></div><div><h3>Results</h3><div>The search imported 1550 articles, 294 underwent full-text review, and 26 were included. Notably, 85 articles were excluded for failing to separate pediatric and adult outcomes. Reviewed literature reported on 459 pediatric patients, of which 81 survived (17.6%). Age reporting varied as follows: 10 articles reported the exact age, 5 reported age buckets, and 11 reported an age range only. Of the survivors with known ages, three were &lt;1 y old, seven were 1-4 y old, ten were 5-9 y old, and 39 were 10-15 y old.</div></div><div><h3>Conclusions</h3><div>The utility and indications for pediatric RT are understudied in the youngest children. Current literature is limited by inconsistent reporting and poor data granularity. Establishing universal reporting guidelines for pediatric RT will help build complete, uniform databases. A preliminary reporting checklist is proposed to improve data sharing in pediatric RT literature, serving as a first step toward developing evidence-based protocols for young children and infants undergoing RT.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 26-36"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601741","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":"Metronomic Photodynamic Therapy With Immune Checkpoint Inhibitors Does Not Affect Nontarget Lesions","authors":"Takao Sugihara MD, PhD ,&nbsp;Hironori Tsujimoto MD, PhD ,&nbsp;Yujiro Itazaki MD ,&nbsp;Seiichiro Fujishima MD ,&nbsp;Keita Kouzu MD, PhD ,&nbsp;Yoshihisa Yaguchi MD, PhD ,&nbsp;Hiroyuki Horiguchi MD, PhD ,&nbsp;Hideki Ueno MD, PhD ,&nbsp;Yuji Morimoto MD, PhD","doi":"10.1016/j.jss.2025.02.014","DOIUrl":"10.1016/j.jss.2025.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICIs) have extended survival in various cancers, especially when combined with chemotherapy. This effect is thought to involve tumor-specific antigen release and T cell reactivation. The “abscopal effect,” where radiation leads to tumor shrinkage at distant sites, may also be enhanced by ICIs, although this is not fully understood. Photodynamic therapy (PDT), a localized treatment, has shown potential for inducing abscopal effects, but no studies have investigated this in metronomic PDT (mPDT), which uses low fluence rates over extended periods. This study aimed to evaluate if mPDT exerts the abscopal effect and whether the addition of ICIs can enhance this effect.</div></div><div><h3>Methods</h3><div>Colon-26 tumor-bearing mice were treated with conventional (cPDT) or mPDT, with or without anti-PD-L1 antibodies. Tumor growth in target and nontarget lesions was measured, and immune cell infiltration was analyzed by flow cytometry.</div></div><div><h3>Results</h3><div>When combined with anti-PD-L1, cPDT significantly reduced tumor size in nontarget lesions and increased the infiltration of CD4⁺, CD8⁺, and CD3⁺ cells in these areas. In contrast, mPDT did not elicit a comparable antitumor response or promote CD4⁺, CD8⁺, and CD3⁺ cell infiltration in nontarget lesions.</div></div><div><h3>Conclusions</h3><div>While cPDT combined with ICIs successfully reduced tumor size in nontarget lesion, mPDT did not, suggesting a limited capacity to induce systemic immune responses. Further research is needed to optimize mPDT for systemic cancer therapy.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 9-18"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601742","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":"Midterm Efficacy of Sclerosing Foam Combined With Endovenous Laser Treatment for Varicose Veins of the Lower Extremities","authors":"Guili Wang MD, PhD ,&nbsp;Donglin Lu MD ,&nbsp;Ding Wu MD,&nbsp;Xiaoli Wang MD,&nbsp;Qingyi Meng MD, PhD,&nbsp;Zhaoxuan Liu MD, PhD","doi":"10.1016/j.jss.2025.02.004","DOIUrl":"10.1016/j.jss.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to assess the midterm efficacy and symptoms of sclerosing foam combined with endovenous laser ablation in treating lower-extremity varicose veins.</div></div><div><h3>Methods</h3><div>This study analyzed 838 patients (985 limbs) with varicose veins in one or both lower extremities, treated at our center from September 2020 to June 2022. All patients underwent sclerosing foam combined with endovenous laser ablation. Closure of the great saphenous vein trunk and branches, as well as postoperative efficacy and symptoms, were monitored. The mean follow-up time was 13.8 mo, with data collected through outpatient visits and telephone follow-ups.</div></div><div><h3>Results</h3><div>The procedural success rate was 100%. Based on the results of continuous follow-up over 12 mo following surgery, 12, seven, and six of all 985 legs still required repeat foam sclerosis of varicose veins, induration, and venous edema, respectively. At 1 wk and 6 mo postprocedure, incomplete closure of the great saphenous vein trunk (opened, fluxed, and refluxed) occurred in 1.9% (19 limbs) and 2.8% (28 limbs), respectively. Ten patients with local varicose vein recurrence did not seek further treatment.</div></div><div><h3>Conclusions</h3><div>Midterm follow-up results demonstrated favorable efficacy of sclerosing foam combined with endovenous laser for treating varicose veins. Major postoperative symptoms included the need for additional sclerosing foam injections, venous edema, and pain.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 3-8"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593543","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}