Langenbeck's Archives of Surgery最新文献

{"title":"Influence of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.","authors":"Ling Zhao, Yuxin Zhang, Xinde Chen, Chunyuan Zhang","doi":"10.1007/s00423-025-03816-3","DOIUrl":"https://doi.org/10.1007/s00423-025-03816-3","url":null,"abstract":"<p><strong>Objective: </strong>This study is aiming at analyzing the effects of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Ninety patients who underwent laparoscopic cholecystectomy were retrospectively selected. According to different anesthesia methods, they were allocated into an intervention group and a control group, with 45 patients in each. The control group received incisional infiltration anesthesia alone, while the intervention group received intercostal nerve block with preemptive anesthesia combined with incisional infiltration. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 4, 8, 12, and 24 h postoperatively at rest, and during mobilization at 8, 12, and 24 h. Postoperative analgesia conditions, as well as the operative time, length of hospital stay, time to first ambulation, and awakening time of the two groups, were compared. The incidence of adverse events was also compared.</p><p><strong>Results: </strong>The intervention group reported lower resting VAS scores at 4, 8, 12, and 24 h and lower movement-related VAS scores at 8, 12, and 24 h (all P < 0.05). The number of cases with VAS ≥ 4 at 4 h, 8 h, 12 h, and 24 h postoperatively in the control group was higher than that in the intervention group (P = 0.020, 0.033, 0.034, 0.019). Moreover, the proportion of patients who did not receive additional tramadol in the intervention group was higher at 4 h, 8 h, 12 h, and 24 h postoperatively [2/13 (15.38%) vs. 2/24 (8.33%); 5/16 (31.25%) vs. 3/28 (10.71%); 7/13 (53.85%) vs. 4/26 (15.38%); 4/10 (40.00%) vs. 3/22 (13.64%)]. There was no significant difference in the operative time between the two groups (P = 0.065). The length of hospital stay, time to first ambulation, and awakening time in the intervention group were all shorter than those in the control group (P < 0.05). The incidence of adverse events did not differ significantly between groups (8.89% vs. 13.33%, P = 0.739).</p><p><strong>Conclusion: </strong>Preemptive analgesia with intercostal nerve block & incisional infiltration anesthesia offers effective pain control in laparoscopic cholecystectomy, reducing the use of postoperative drugs, with a favorable safety profile.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"233"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742436","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 application of tenodermodesis in the treatment of chronic mallet finger in young basketball players.","authors":"Cem Sever, Bekir Eray Kilinc, Ahmet Eren Sen, Ali Varol, Yunus Oc","doi":"10.1007/s00423-025-03798-2","DOIUrl":"10.1007/s00423-025-03798-2","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to evaluate the outcomes of tenodermodesis in the treatment of chronic mallet finger deformity and to assess its clinical benefits for athletes.</p><p><strong>Materials and methods: </strong>This study analyzed 15 semi-professional and professional basketball players, aged 13-21, who underwent tenodermodesis for chronic mallet finger between 2015 and 2018. Inclusion criteria included failed conservative treatment for at least six weeks or deformities present for over 10 weeks. Outcomes were measured using Crawford's classification to assess functionality and recovery.</p><p><strong>Results: </strong>The average age of the patients was 16.5 years. Of the injuries, 60% involved the dominant hand, and the fourth finger was the most commonly affected. All patients returned to active sports within an average of 7.4 weeks. Excellent outcomes were achieved in 86% of cases, with minor residual extension deficits in 20%. No major complications were reported, and no further surgical interventions were required.</p><p><strong>Conclusion: </strong>Tenodermodesis is a reliable, effective surgical technique for chronic mallet finger deformities, especially in young athletes. It allows for a rapid return to sports with excellent functional and aesthetic outcomes, making it an ideal option for active individuals.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"232"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731973","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":"Development and validation of an inflammatory-based nomogram for predicting arteriovenous fistula maturation failure in end-stage renal disease patients.","authors":"Bin Zhao, Gang Fu, Shen Zhan, Lihong Zhang, Rui Cui, Shanshan Guo, Jia Li, Hu Lu, Yuzhu Wang","doi":"10.1007/s00423-025-03819-0","DOIUrl":"10.1007/s00423-025-03819-0","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Arteriovenous fistula (AVF) is regarded as the most effective vascular access for hemodialysis in patients with end-stage renal disease (ESRD).However, research investigating the relationships between the systemic inflammation response index (SIRI), the triglyceride-glucose index combined with body mass index (TyG-BMI), and the high-sensitivity C-reactive protein to albumin ratio (HRR) with AVF maturation is still limited.</p><p><strong>Methods: </strong>We included all ESRD patients undergoing first-time AVF creation between March and August 2024 at Haidian Hospital, Beijing (n = 249). To evaluate predictors of AVF maturation failure, we analyzed preoperative clinical/laboratory data and follow-up ultrasound assessments using restricted cubic spline models for dose-response relationships (SIRI, TyG-BMI, HRR). Multivariable Cox models identified independent risk factors, and a predictive nomogram was developed and validated through C-index and calibration plots.</p><p><strong>Results: </strong>This study included 249 patients (73.5% AVF maturation rate). Restricted cubic spline analysis revealed linear associations between AVF maturation and SIRI (p-overall = 0.047), TyG-BMI (p-overall = 0.039), and HRR (p-overall = 0.026). Multivariable Cox regression identified three independent predictors: SIRI (HR = 1.69, 95%CI:1.45-1.96), TyG-BMI (HR = 2.68, 95%CI:1.62-4.41), and HRR (HR = 1.44, 95%CI:1.28-1.61) (all p < 0.001). The biomarker-based nomogram showed strong predictive accuracy, with calibration curves demonstrating excellent observed-versus-expected agreement.</p><p><strong>Conclusion: </strong>Non-maturation of AVF was independently associated with three inflammation-based biomarkers, namely SIRI, TyG-BMI, and HRR. High predictive accuracy was demonstrated by the nomogram incorporating these markers, supporting its use for the early identification of high-risk patients.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"231"},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731972","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 effect of preoperative oral carbohydrate intake on perioperative well-being in patients undergoing hip and lower extremity orthopedic surgery under spinal anesthesia: a randomized controlled trial.","authors":"Maryam Ghaffari, Mahboubeh Rezaei, Mohammadreza Zarei, Akram Yazdani, Mohammad Ali Saadati","doi":"10.1007/s00423-025-03797-3","DOIUrl":"10.1007/s00423-025-03797-3","url":null,"abstract":"<p><strong>Background: </strong>The administration of preoperative oral carbohydrate (POC) has been shown to enhance patient well-being and expedite postoperative recovery. Nevertheless, evidence regarding its efficacy in orthopedic patients remains insufficient and warrants further investigation. This study aimed to address gaps by evaluating the effect of preoperative oral dextrose (POD) intake on perioperative well-being parameters (including thirst, hunger, anxiety, pain, nausea, and vomiting) in patients undergoing hip and lower extremity surgeries with spinal anesthesia.</p><p><strong>Methods: </strong>In this randomized controlled trial, 70 adult patients scheduled for orthopedic surgery were assigned to either the dextrose (POD intake) group or the fasting group (routine fasting periods of 8-10 h). Perioperative subjective well-being, including measures of thirst, hunger, anxiety, pain, nausea, and vomiting, was evaluated using the Visual Analogue Scale (VAS) both preoperatively and at multiple postoperative time points (T0, T6h, and T24h). Adverse postoperative events were monitored for 24 h following surgery.</p><p><strong>Results: </strong>Significant improvements in perioperative thirst and pain scores were observed in the dextrose group compared to the fasting group (p = 0.041 and p = 0.003, respectively). The dextrose group consistently reported lower VAS scores for thirst, hunger, pain, and anxiety across all time points (T0, T6h, T24h) (p < 0.001). No significant differences were found between groups for nausea or vomiting (p > 0.05).</p><p><strong>Conclusion: </strong>The administration of preoperative oral carbohydrate (POC) showed no clinically significant impact on perioperative nausea or vomiting in orthopedic patients. However, it significantly improved other perioperative well-being parameters such as thirst, hunger, anxiety, and pain, highlighting its potential to enhance patient comfort and recovery outcomes.</p><p><strong>Trial registration: </strong>Iranian Registry of Clinical Trials, IRCT20191017045139N2. Registered on 28 January 2024.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"230"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707963","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":"Cardiac tumors: clinical presentation, diagnosis, reatment, and results.","authors":"Chonggang Wang, Xiaoyang Li, Lirui Yang, Wenbin Zhang","doi":"10.1007/s00423-025-03817-2","DOIUrl":"10.1007/s00423-025-03817-2","url":null,"abstract":"<p><p>Cardiac tumors are a heterogeneous group of diseases that include primary and metastatic tumors. Among primary tumors, benign tumors account for the majority, and the incidence of malignant tumors is low. In contrast, the incidence of metastatic tumors is significantly higher than that of primary tumors. The clinical features of cardiac tumors are diverse, and symptoms vary depending on the tumor type. Therefore, the diagnosis method of cardiac tumors must adopt multi-modal detection methods to ensure the accuracy of diagnosis. Treatment of cardiac tumors mainly involves surgical resection of the primary tumor to ensure complete resection. For metastatic tumors, it is crucial to consider the primary tumor when surgically resecting metastases. Depending on the characteristics of the tumor, appropriate radiation therapy or chemotherapy can improve quality of life and extend survival.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"228"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698933","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":"Management of complicated primary intestinal lymphoma in the emergency setting. Experience at quaternary hospital.","authors":"Manuel José Torres-Jurado, Jaime López-Sánchez, Andrés E Valera-Montiel, Laura Vicente-González, Jacobo Trébol-López, José Edecio Quiñones-Sampedro, Francisco Blanco-Antona","doi":"10.1007/s00423-025-03821-6","DOIUrl":"10.1007/s00423-025-03821-6","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"229"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698934","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":"Intraoperative differentiation of pancreatic neoplastic lesions using optical coherence tomography (OCT).","authors":"Markus Kist, Paul Strenge, Tobias Keck, Andreas Weber, Peter Bronsert, Thaer S A Abdalla, Ulrich Friedrich Wellner, Michael Thomaschewski","doi":"10.1007/s00423-025-03810-9","DOIUrl":"10.1007/s00423-025-03810-9","url":null,"abstract":"<p><strong>Purpose: </strong>The diagnostic methods for accurately differentiating the dignity of pancreatic neoplasms are limited. Worrisome features on MRI and endosonography guide the way to resection or conservative treatment with a relevant rate of failure. Intraoperative minimal invasive optical coherence tomography could be a solution for this challenge. The aim of this study is to investigate whether optical coherence tomography is suitable for differentiating of pancreatic neoplastic lesions.</p><p><strong>Methods: </strong>In this exploratory study, four patient's specimens of pancreatic resections (white adipose tissue, intraductal papillary mucinous neoplasm (IPMN), pancreatic ductal adenocarcinoma (PDAC) based on IPMN and neuroendocrine pancreatic carcinoma) were prospectively examined ex vivo immediately after resection in the operating room using an optical coherence tomography system (Callisto 930nm, Thorlabs GmbH). In detail, the study investigated whether and in what way endocrine tumors, adenocarcinomas, premalignant and benign cysts differ morphologically in optical coherence tomography imaging compared to healthy pancreatic tissue. The final histopathological findings of the pancreatic specimens served as a reference and were correlated.</p><p><strong>Results: </strong>The samples examined ranged from typical fatty tissue, intraductal papillary mucinous neoplasm (IPMN), a moderate differentiated (G2) pancreatic ductal adenocarcinoma (PDAC) based on an intraductal papillary mucinous neoplasm (IPMN) and a neuroendocrine pancreatic carcinoma. Optical coherence tomography was feasible to replicate key histological characteristics and tissue architecture in correlation to conventional Hematoxylin-eosin histology.</p><p><strong>Conclusion: </strong>Optical coherence tomography imaging has the potential to differentiate between benign, pre-malignant and malignant pancreatic pathologies by morphology and should be examined in larger collectives.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"227"},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659570","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":"Evaluating antimicrobial sutures in laparoscopic abdominal surgery - lessons from the NOVOTILAC LAC trial.","authors":"Aali J Sheen","doi":"10.1007/s00423-025-03771-z","DOIUrl":"10.1007/s00423-025-03771-z","url":null,"abstract":"<p><p>Surgical site infections (SSIs) remain a clinically significant complication in laparoscopic abdominal surgery, particularly in clean-contaminated procedures such as appendectomy and cholecystectomy. This review examines the findings of the NOVOTILAC LAC trial, a multicentre, double-blind, randomised controlled study evaluating the efficacy of chlorhexidine-coated sutures in reducing SSIs. Although the primary endpoint-30-day SSI rate-did not reach statistical significance, secondary outcomes, including post-operative pain, scar satisfaction, and quality of life, offer a broader perspective on patient recovery. The trial's comprehensive design and inclusion of both elective and emergency cases enhance its relevance to real-world surgical practice. While limitations remain due to low baseline SSI rates and statistical power, the study contributes meaningful data to the evolving landscape of antimicrobial suture technology and underscores the need for further targeted research in high-risk populations.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"225"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659569","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":"Standardization of surgical procedure for initially unresectable locally advanced pancreatic head cancer.","authors":"Tatsuaki Sumiyoshi, Kenichiro Uemura, Ryuta Shintakuya, Kenjiro Okada, Kenta Baba, Takumi Harada, Shinya Nakamura, Koji Arihiro, Yasutaka Ishii, Shiro Oka, Shinya Takahashi","doi":"10.1007/s00423-025-03745-1","DOIUrl":"10.1007/s00423-025-03745-1","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"226"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659571","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":"Long-term outcomes after Ivor-Lewis versus McKeown esophagectomy with two-field lymphadenectomy for resectable middle or lower thoracic esophageal squamous cell carcinoma.","authors":"Shihong Zhou, Ying Zhang, Jinlin Cao, Jianxin Xu, Wenzhen Xu, Gang Yang, Wang Lv, Jian Hu","doi":"10.1007/s00423-025-03779-5","DOIUrl":"10.1007/s00423-025-03779-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare long-term survival outcomes between Ivor-Lewis and McKeown esophagectomy with two-field(thoracic-abdominal) lymphadenectomy in resectable middle or lower thoracic esophageal squamous cell carcinoma.</p><p><strong>Methods: </strong>Patients with resected middle or lower thoracic esophageal squamous cell carcinoma undergoing Ivor-Lewis or McKeown esophagectomy with two-field lymphadenectomy were enrolled and categorized into two respective groups. Propensity score matching was performed to minimize selection bias. And subgroup analyses, including stratification by tumor invasion area of thoracic esophagus, were conducted to compare survival outcomes via Kaplan-Meier method.</p><p><strong>Results: </strong>Totally 281 cases were included(Ivor-Lewis group: n = 199; McKeown group: n = 82). Neither the incidence/severity of complications nor survival outcomes differed significantly between the two surgical approaches in either the full cohort or the propensity score matching cohort. In patients with middle-upper or middle thoracic esophagus invasion, Ivor-Lewis esophagectomy demonstrated superior overall survival(P = 0.004). Conversely, for patients with middle-lower or lower thoracic esophagus invasion, McKeown esophagectomy showed survival advantages in both overall survival(P = 0.001) and disease-free survival(P = 0.006).</p><p><strong>Conclusion: </strong>For resectable middle or lower thoracic esophageal squamous cell carcinoma treated with two-filed lymphadenectomy, Ivor-Lewis esophagectomy provides long-term survival in patients with middle-upper or middle thoracic esophageal invasion, whereas McKeown esophagectomy demonstrated significant survival benefits for patients with middle-lower or lower thoracic esophageal invasion.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"223"},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642909","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}