Langenbeck's Archives of Surgery最新文献

{"title":"The effect of pre-operative MRI on the in-breast tumor recurrence rate of patients with breast cancer: a meta-analysis.","authors":"Mahdieh Khoshzaban Banisi, Hani Ghadri, Behnaz Soltani, Amirali Farshid, Bahar Behnam, Amir Abbas Rhouholamini, Amirhossein Mohammadi, Seyedeh Fatemeh Hamzavi, Ashkan Azizi, Niloofar Deravi, Masoud Noroozi, Amin Magsudy, Sina Seyedipour, Shima Behzad, Yaser Khakpour","doi":"10.1007/s00423-025-03691-y","DOIUrl":"https://doi.org/10.1007/s00423-025-03691-y","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of preoperative MRI on breast cancer recurrence and long-term outcomes remains undefined. Therefore, this study aims at determining the influence of preoperative MRI on in-breast tumor recurrence rates in cases of surgical treatment for breast cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed. Literature searches of PubMed, Scopus, and Google Scholar were conducted for studies up to February 2024. Two authors assessed the quality of the eligible studies and extracted their data.</p><p><strong>Results: </strong>The meta-analysis included 14 studies (2 RCTs, 12 cohort studies) with 12,889 patients with 5,451 undergoing preoperative MRI. Pooled hazard ratio for in-breast tumor recurrence was 0.95, using fixed effects and 0.94 using random effects models with 95% confidence intervals of 0.80-1.14 and 0.77-1.14, respectively. A trend towards lower recurrence rates in the MRI group was seen, but the reduction was not statistically significant.</p><p><strong>Conclusion: </strong>This meta-analysis found no significant reduction in in-breast tumor recurrence rates associated with preoperative MRI use in breast cancer patients, consistent with previous findings.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"120"},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780407","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":"Portal vein reconstruction with bovine pericardium: a comparative analysis of postoperative outcomes in pancreatic surgery.","authors":"Silvan Patalong, Annatina Weber, Elena Krombholz, Michael Frey, Dominique Sülberg, Andrea Wirsching, Antonio Nocito","doi":"10.1007/s00423-025-03689-6","DOIUrl":"10.1007/s00423-025-03689-6","url":null,"abstract":"<p><strong>Purpose: </strong>Extended pancreatic resections with venous reconstruction are increasingly performed for borderline resectable pancreatic cancer. Various venous reconstruction techniques have been described. At our center, reconstruction is performed using bovine pericardium patches. So far, few studies reported outcomes using this technique in the field of pancreatic surgery.</p><p><strong>Methods: </strong>Data of consecutive pancreatoduodenectomies between January 1st 2015 and December 31st 2023 were analyzed retrospectively. Postoperative complications were graded by the Clavien-Dindo Classification, Comprehensive Complication Index (CCI) and complications specific to pancreatic resections as recommended and published by the International Study Group of Pancreatic Surgery (ISGPS).</p><p><strong>Results: </strong>Pancreatoduodenectomy included portal vein resection (PVR) in 23 patients compared to 95 patients without PVR. Patient age and comorbidities were similarly distributed between groups. Pancreatic adenocarcinoma was more prevalent in the PVR-group compared to no-PVR (87% vs. 58%, p = 0.009). Operation time and blood loss were both increased with PVR (median: 416 min vs. 315 min and 300 ml vs. 150 ml, p < 0.001 for both comparisons). Within ISGPS defined complications, grade B delayed gastric emptying and grade A postoperative hemorrhage were increased with PVR (N = 22 vs. N = 1, p = 0.001 and N = 13 vs. N = 0, p = 0.007). All other ISGPS complications, overall complications, CCI, 30-day and 90-day mortality were similar between groups. Out of 23 patients with PVR, early and late thrombosis occurred in one patient each.</p><p><strong>Conclusion: </strong>Portal vein reconstruction with bovine pericardium is feasible with comparable overall morbidity and mortality compared to pancreatoduodenectomy without PVR.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"118"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772583","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":"Evaluation of the validity of pancreatoduodenectomy in older patients with distal cholangiocarcinoma in terms of recurrence.","authors":"Wataru Izumo, Hiromichi Kawaida, Ryo Saito, Yuki Nakata, Hidetake Amemiya, Yudai Higuchi, Takashi Nakayama, Kazunori Takahashi, Suguru Maruyama, Koichi Takiguchi, Katsutoshi Shoda, Kensuke Shiraishi, Shinji Furuya, Yoshihiko Kawaguchi, Daisuke Ichikawa","doi":"10.1007/s00423-025-03694-9","DOIUrl":"10.1007/s00423-025-03694-9","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study investigated the validity of pancreatoduodenectomy (PD) with regard to recurrence in older patients with distal cholangiocarcinoma (DC).</p><p><strong>Methods: </strong>We compared 28 patients aged ≥ 75 years and 65 patients aged < 75 years who underwent PD for DC, and evaluated the relationship between age, clinicopathological factors, and outcomes.</p><p><strong>Results: </strong>Postoperative mortality and morbidity rates did not differ between the groups. Although there were no significant differences in 5-year recurrence, disease-specific survival, and overall survival rates between the groups (45.4, 58.1, and 51.7% in patients ≥ 75 years and 50.3%, 62.7%, and 58.1% in patients < 75 years; P = 0.73, 0.44, and 0.24, respectively), the median time from recurrence to death (RTD) in older patients was significantly shorter than that in younger patients (0.5 years vs. 1.3 years, P = 0.013). In multivariate analysis, age ≥ 75 years (hazard ratio [HR]: 3.0), controlling nutritional status (CONUT) score ≥ 4 (HR: 2.5), poorly-differentiated adenocarcinoma or adenosquamous carcinoma (HR: 3.2), and failure to implement treatment after recurrence (HR: 5.3) were independent risk factors for a short time from RTD. Furthermore, at the time of recurrence, older patients had significantly poorer serum albumin levels, prognostic nutrition index, Glasgow prognostic score, and CONUT score. Age ≥ 75 years (odds ratio: 0.19) was an independent risk factor for implementation of treatment after recurrence.</p><p><strong>Conclusions: </strong>PD in older patients may be acceptable; however, the median time from RTD was shorter owing to lower nutritional status and rates of treatment implementation after recurrence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"119"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772649","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":"Recurrence patterns and management of locally recurrent rectal cancer: a retrospective cohort study.","authors":"P Hakenberg, G Kalev, S Seyfried, C Reißfelder, J Hardt","doi":"10.1007/s00423-025-03692-x","DOIUrl":"10.1007/s00423-025-03692-x","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of locally recurrent rectal cancer (LRRC) is still challenging because of inhomogeneous patient cohorts regarding previous treatments as well as different recurrence patterns and locations. The aim of this study was to investigate the treatments and surgical approaches tailored to them.</p><p><strong>Methods: </strong>We included all patients who were treated for LRRC without distant metastasis at the University Medical Center Mannheim, Germany, between 2010 and 2021. We collected data from our electronic clinical data management system regarding the initial diagnosis and treatment, as well as the locations and treatment of the recurrent tumor.</p><p><strong>Results: </strong>We identified a total of 666 patients who were curatively treated for rectal cancer of whom 36 patients (5.4%) developed LRRC without distant recurrence. Most patients (26/36) had a tailored therapy regimen that included surgery with or without perioperative radiation and/or chemotherapy. The most common site of local relapse was around the former colorectal anastomosis (15/36, 41.7%). The operative procedures ranged from anterior resection to multi-organ resection and exenteration. A complete resection (R0) could be achieved in twelve patients (12/22. 54.5%). The 3- and 5-year overall survival rates were 79% and 72%, respectively.</p><p><strong>Conclusion: </strong>Most local recurrences occur at the anastomotic site and are mostly eligible for curative surgical therapy with good long-term survival.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"116"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764296","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":"Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.","authors":"Guadagni Simone, Comandatore Annalisa, Furbetta Niccolò, Di Franco Gregorio, Bechini Bianca, Vagelli Filippo, Ramacciotti Niccolò, Gaeta Raffaele, Pollina Luca Emanuele, Palmeri Matteo, Di Candio Giulio, Morelli Luca","doi":"10.1007/s00423-025-03684-x","DOIUrl":"10.1007/s00423-025-03684-x","url":null,"abstract":"<p><strong>Background: </strong>High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.</p><p><strong>Methods: </strong>Data from all patients undergoing EGs-ITA from January 2013 to June 2023 were collected from an institutional database and retrospectively analyzed. Additionally, data on the volume of all MOSs performed in the same 10-year period were retrieved.</p><p><strong>Results: </strong>This study included 32 patients, averaging three EGs-ITA performed annually. The anastomotic leak rate was 6.2%. The median hospital stay was 12 days, and 30- and 90-day mortality rates were 3.1% and 6.2%, respectively. The mean harvested lymph nodes were 26.3 ± 10.2. Re-admission and locoregional recurrence occurred in 6.2% and 9.3% of patients, respectively. During the study period, the surgical team managed over 400 MOSs annually.</p><p><strong>Conclusion: </strong>Exposure to high volume and broad range of MOSs appears beneficial for achieving favorable outcomes in esophagogastric junction and distal esophageal cancer surgeries, even in centers with lower volumes of these specific procedures. This finding underscores the potential for excellent surgical results in settings with substantial overall volumes in major oncologic procedures, as an alternative to high-volume specialization in a single surgery type.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"115"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764289","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":"Insufficient weight loss after bariatric surgery and its predictors: Tehran Obesity Treatment Study (TOTS).","authors":"Minoo Heidari Almasi, Maryam Barzin, Maryam Mahdavi, Alireza Khalaj, Danial Ebrahimi, Majid Valizadeh, Farhad Hosseinpanah","doi":"10.1007/s00423-025-03682-z","DOIUrl":"10.1007/s00423-025-03682-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the factors related to insufficient weight loss (IWL) following bariatric surgery.</p><p><strong>Methods: </strong>The data for 3456 individuals who had bariatric surgery were obtained prospectively. A bioelectrical impedance analyzer was used to measure body composition changes and compare them between the sufficient (SWL) and IWL groups. The generalized estimated equation approach was used to assess changes in fat mass (FM), fat-free mass (FFM), FFM loss/weight loss percentage (FFML/WL%), and excess weight loss percentage (EWL%). Multivariate logistic regression models were used for IWL to establish independent baseline factors.</p><p><strong>Results: </strong>IWL was recorded in 8% of the cases. The data analysis revealed substantial differences in the changes in FM%, FFM%, FFML/WL%, and EWL% between the SWL and IWL groups after six months of follow-up. The IWL group demonstrated a greater FFML/WL% (Ptime before & after 6 months < 0.05). An older age, a higher baseline BMI, diabetes mellitus (DM), non-smoking, and sleeve gastrectomy (SG) were the predictors of IWL.</p><p><strong>Conclusion: </strong>the significant predictors of IWL included older age, a higher baseline BMI, DM, SG, and non-smoking.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"114"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764293","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":"Transarterial embolization of gastroduodenal peptic ulcer bleeding: a single-center study of safety and efficacy.","authors":"Cihan Ozen, Muhanad Al-Hashimi, Mogens Tornby Stender, Ole Thorlacius-Ussing, Anders Christian Larsen","doi":"10.1007/s00423-025-03695-8","DOIUrl":"10.1007/s00423-025-03695-8","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and efficacy of transarterial embolization (TAE) in patients with bleeding gastroduodenal peptic ulcers with an emphasis on prophylactic TAE (pTAE).</p><p><strong>Methods: </strong>This retrospective cohort study was conducted from 1 January 2010 to 30 June 2022. The primary outcome was rebleeding rate after TAE. Secondary outcomes were frequency and severity of complications, 30-day mortality rate, and overall survival.</p><p><strong>Results: </strong>87 patients were included. The overall rebleeding rate after TAE was 13/87 (15%). The rebleeding rate was non-significantly higher in the therapeutic TAE (tTAE) group (31%) when compared to the pTAE group (12%). Minor complications were observed in 14/87 patients (16%) and severe complications were observed in 6/87 patients (7%). The complication rate did not differ between the tTAE and pTAE groups. The 30-day overall mortality rate was 19/87 (22%). The 30-day mortality rate was non-significantly higher in the tTAE-group (31%) when compared to the pTAE group (20%). Of the 19 mortalities within 30-days, three were considered procedure-related. The overall median survival rate was 21 months (95% CI: 9.8 - 31). A non-significant higher median survival of 46.7 months (95% CI 1.2 - 74.9) was observed in the tTAE group when compared to 20.5 months (95% CI 7.1-29.1) in the pTAE group.</p><p><strong>Conclusion: </strong>TAE is safe and efficient but is associated with a high 30-day mortality rate and poor overall survival owing to a high burden of comorbidity and disease-related rather than TAE-related complications. Further studies are needed to clarify the gain and selection criteria for pTAE.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"117"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772587","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":"Beyond the decade: unveiling long-term weight and co-morbidity outcomes up to 10 years post laparoscopic sleeve gastrectomy.","authors":"Salman Al Sabah, Eliana Al Haddad, Iman Qadhi, Muneerah AlMuhaini, Abrar AlAwtan, Omar A AlQabandi, Ali AlKhayat, Ammar F Saleem, Mousa Behbehani","doi":"10.1007/s00423-025-03680-1","DOIUrl":"10.1007/s00423-025-03680-1","url":null,"abstract":"<p><strong>Introduction: </strong>Despite its effectiveness, long-term data on the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for morbid obesity are sparce.</p><p><strong>Methods: </strong>We collected data through phone interviews and hospital records for patients who had LSG, including those that then underwent revisional bariatric surgery, assessing their weight outcomes, associated health conditions, and complications.</p><p><strong>Results: </strong>2982 patients (72% female) were included in the study, with a maximum follow-up reached of 13 years. The mean pre-operative age and body mass index (BMI) were 34.7 ± 11.3 years and 45.5 ± 7.7 kg/m2, respectively. The prevalence of obesity classes were as follows: Class I, 3.1%; Class II, 19.2%; and Class III, 75.9%. BMI at nadir was 32.35 Kg/m2 equating to a mean nadir excess weight loss (EWL) of 67.03%. Weight outcomes at 13 years post-LSG showed a mean BMI of 31.83 kg/m² and total weight loss (TWL) percentage of 31.43%. Weight loss outcomes varied according to pre-operative obesity class, with class I achieving the highest percentage EWL and class III observing the highest TWL at the end of one year. Weight regain occurred in 1.3% of the patient population, with class III experiencing the highest weight regain at 13 years. Significant reductions in comorbidities were observed, while complication rates were low, with 0.4% bleed, 0.5% leak, and 7.9% GERD.</p><p><strong>Conclusion: </strong>LSG demonstrates sustained weight loss and resolution of comorbidities with low complication rates. The influence of initial obesity class on weight loss was found to be significant in the first 18 months post-LSG.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"112"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753242","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":"Multi-Indicator analysis of the impact of preoperative inflammatory states on complications following pancreatoduodenectomy.","authors":"Jiajie Feng, Yongjiang Zhou, Hongyin Liang, Yiwen Zhao, Kexin Jiang, Ruiwu Dai","doi":"10.1007/s00423-025-03676-x","DOIUrl":"10.1007/s00423-025-03676-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pancreatoduodenectomy (PD) is a complex surgery with a high rate of postoperative complications, for which effective preoperative indicators are currently lacking. Inflammatory indices such as the pan-immune-inflammation value (PIV), platelet-neutrophil product (PPN), and platelet-albumin ratio (PAR) have shown potential as biomarkers for postoperative prognosis in various cancers. However, their predictive value for complications in open-PD (OPD) patients remains underexplored. This study aims to investigate the relationship between these inflammatory indices and postoperative complications, identify new preoperative biomarkers, and provide a theoretical basis for improving perioperative management in OPD patients.</p><p><strong>Methods: </strong>We analyzed data from 309 patients who underwent open-PD (OPD). Six preoperative inflammatory indices-platelet-to-lymphocyte ratio (PLR), PIV, PPN, PAR, neutrophil-to-HDL ratio (NHR), and neutrophil-albumin ratio (NAR)-were assessed for their association with postoperative complications using logistic regression and restricted cubic spline analysis. Predictive performance was evaluated with ROC curves and decision curve analysis.</p><p><strong>Results: </strong>PLR, PIV, and PPN were significantly linked to most outcomes and had good predictive performance. NHR was associated with severe complications. PAR effectively predicted hemorrhage (AUC = 0.684) and delayed gastric emptying (DGE) (AUC = 0.701). Combining indices enhanced predictive accuracy.</p><p><strong>Conclusions: </strong>PLR, PIV, and PPN are key preoperative indicators for OPD patients, with PAR also useful for predicting complications like hemorrhage and DGE.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"111"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753324","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":"Surgical and postoperative management of congenital heart disease: a systematic review of observational studies.","authors":"Ramin Ghasemi Shayan, Mahsa Fatollahzadeh Dizaji, Fakhrosadat Sajjadian","doi":"10.1007/s00423-025-03673-0","DOIUrl":"10.1007/s00423-025-03673-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Congenital heart disease (CHD) remains a critical concern in pediatric and adult cardiovascular care, requiring continuous advancements in surgical techniques and perioperative strategies. While survival rates have improved, challenges persist in optimizing long-term neurodevelopmental outcomes, addressing disparities in healthcare access, and overcoming systemic barriers to implementing best practices. This systematic review integrates recent evidence on predictive factors, perioperative innovations, and economic challenges affecting CHD management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted, analyzing data from 27 observational studies, including retrospective and prospective cohort studies, as well as case reports, sourced from diverse geographic and clinical settings. Studies were selected based on strict inclusion criteria, emphasizing clear surgical outcomes, perioperative advancements, and neurodevelopmental follow-up. Data were extracted and synthesized to identify key trends in CHD surgery, anesthetic management, and long-term patient care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Key findings include: • Neurodevelopmental Outcomes: Long-term follow-up studies identified associations between prolonged ICU stays, intraoperative cerebral oxygenation deficits, and developmental delays. Hearing loss was reported in 21.6% of post-surgical patients, significantly impacting cognitive and language abilities. • Predictive Factors for Postoperative Outcomes: Hemoglobin saturation, lactate levels, and platelet counts were statistically associated with adverse postoperative outcomes (p &lt; 0.05), reinforcing the need for preoperative risk stratification. • Fast-Track Extubation and Resource Optimization: Early extubation protocols reduced ICU stays by an average of 20%, with a 15% decrease in postoperative complications. However, financial disincentives and inadequate reimbursement models limited their widespread adoption, particularly in low-resource settings. • Tailored Anesthetic Techniques: Individualized anesthesia strategies, including neuroprotective approaches and blood conservation techniques, improved outcomes in high-risk CHD populations, reducing complication rates by up to 10%. • Global Disparities in CHD Care: Studies from low-income countries revealed significantly higher rates of malnutrition, delayed surgical interventions, and postoperative complications. These disparities highlight the urgent need for global policy reforms to improve healthcare equity in CHD management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This review highlights the necessity of integrating predictive analytics, multidisciplinary approaches, and healthcare system reforms to enhance CHD management. While advancements in surgical techniques and perioperative care yield promising outcomes, persistent challenges-including healthcare disparities, financial constraints, and long-term neurodevelopmental risks-require targeted int","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"113"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753332","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}