Surgery最新文献

{"title":"Letter to the editor regarding: \"Deep sternal wound infection after cardiac surgery: A combination of 2 distinct infection types, deep incisional surgical-site infection and mediastinitis: Results of a retrospective study\".","authors":"Yangbiao Chen, Tingting Chen, Liangchen Qu","doi":"10.1016/j.surg.2025.109340","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109340","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109340"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor on: \"Comparative analysis of treatment modalities for solitary, small (≤3 cm) hepatocellular carcinoma: A systematic review and network meta-analysis of oncologic outcomes\".","authors":"Woo Jin Choi, Gonzalo Sapisochin","doi":"10.1016/j.surg.2025.109339","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109339","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109339"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood product use in emergency resuscitative thoracotomy: A nationwide analysis","authors":"Vahe S. Panossian MD,&nbsp;Ikemsinachi C. Nzenwa MBChB, MSc,&nbsp;Emanuele Lagazzi MD,&nbsp;Wardah Rafaqat MBBS,&nbsp;Majed El Hechi MD,&nbsp;Joshua Ng-Kamstra MD,&nbsp;Matthew Bartek MD, MPH,&nbsp;Charudutt N. Paranjape MBBS,&nbsp;Michael P. DeWane MD,&nbsp;John O. Hwabejire MD, MPH,&nbsp;George C. Velmahos MD, PhD,&nbsp;Haytham M.A. Kaafarani MD, MPH","doi":"10.1016/j.surg.2025.109326","DOIUrl":"10.1016/j.surg.2025.109326","url":null,"abstract":"<div><h3>Background</h3><div>Emergency resuscitative thoracotomy survival rates range widely depending on the mechanism of injury and signs of life at presentation. Given ongoing shortages of blood products, we sought to examine blood product use across this patient population and corresponding survival.</div></div><div><h3>Methods</h3><div>We identified patients in the American College of Surgeons-Trauma Quality and Improvement Program (2017–2019) undergoing an emergency resuscitative thoracotomy within 30 minutes of hospital arrival. The primary outcome was the number of packed red blood cells units transfused within 4 hours. Secondary outcomes were the number of units of plasma and platelets transfused and overall survival. The number of uvnits of blood products transfused to observe 1 survivor was calculated by dividing the total number of units transfused by the number of survivors.</div></div><div><h3>Results</h3><div>A total of 1,231 patients were included. The median age was 36, 84.6% were male, 69.2% had penetrating trauma, and 40.4% presented with signs of life. The overall survival was 7.3%, and the median number of packed red blood cells transfused within 4 hours was 3.7 [interquartile range, 1.0–9.4]. Patients with penetrating trauma and signs of life had a survival rate of 17.1% and received a median of 8.0 [3.0–17.0] packed red blood cells. Patients presenting with blunt trauma and no signs of life had a 1.1% survival and received a median of 2.0 packed red blood cells [0.9–6.0]. For patients with stab wounds arriving with signs of life, a total number of 30 packed red blood cell units was transfused to observe 1 survivor. For blunt trauma without signs of life, a total of 485 units were transfused to observe 1 survivor.</div></div><div><h3>Conclusion</h3><div>Given the near futility of emergency resuscitative thoracotomy in patients with blunt trauma presenting with no signs of life, coupled with the ongoing national shortage of blood, we recommend allocating transfusion resources to patients with penetrating trauma and to patients with blunt trauma presenting with signs of life.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109326"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative hepatic insufficiency despite preoperative portal vein embolization: Not just about the volumetrics","authors":"Amy Y. Li MD ,&nbsp;M. Usman Ahmad MD ,&nbsp;Marc C. Sofilos RT ,&nbsp;Rachel M. Lee MD, MS ,&nbsp;Shishir K. Maithel MD ,&nbsp;Tiffany C. Lee MD ,&nbsp;Seetharam Chadalavada MD, MS ,&nbsp;Shimul A. Shah MD ,&nbsp;Alexandra W. Acher MD ,&nbsp;Daniel E. Abbott MD ,&nbsp;Paul Wong MD ,&nbsp;Jonathan Kessler MD ,&nbsp;Laleh G. Melstrom MD, MS ,&nbsp;Russell Kirks MD ,&nbsp;Flavio G. Rocha MD ,&nbsp;Daniel J. Delitto MD, PhD ,&nbsp;Byrne Lee MD ,&nbsp;Brendan C. Visser MD ,&nbsp;George A. Poultsides MD, MS","doi":"10.1016/j.surg.2025.109345","DOIUrl":"10.1016/j.surg.2025.109345","url":null,"abstract":"<div><h3>Background</h3><div>Future liver remnant hypertrophy is the primary endpoint of portal vein embolization before major hepatectomy. However, even when adequate future liver remnant is achieved, postoperative hepatic insufficiency is not universally averted. We aimed to identify preoperative risk factors of postoperative hepatic insufficiency despite the use of portal vein embolization.</div></div><div><h3>Methods</h3><div>Patients who underwent portal vein embolization followed by major hepatectomy at 6 academic medical centers were retrospectively reviewed. Postoperative hepatic insufficiency was defined as postoperative peak bilirubin &gt;7 mg/dL. Preoperative variables associated with postoperative hepatic insufficiency were analyzed.</div></div><div><h3>Results</h3><div>From 2008 to 2019, 164 patients underwent portal vein embolization followed by major hepatectomy. Twenty (12%) patients developed postoperative hepatic insufficiency. On univariate analysis, postoperative hepatic insufficiency was associated with older age, performance status, preoperative biliary drainage, smaller pre- and post-portal vein embolization future liver remnant volumes, diagnosis of cholangiocarcinoma/gallbladder cancer, and preoperative cholangitis. There was significant future liver remnant hypertrophy noted even in the setting of postoperative hepatic insufficiency (from 27% to 39%); however, degree of hypertrophy &gt;5% (100% vs 93%, <em>P</em> = .6) and kinetic growth rate &gt;2%/week (95% vs 82%, <em>P</em> = .3) did not differ between the postoperative hepatic insufficiency and non-postoperative hepatic insufficiency groups. On multivariate analysis, the diagnosis of cholangiocarcinoma/gallbladder cancer and preoperative cholangitis (postoperative hepatic insufficiency incidence 34% and 62%, respectively), but not future liver remnant volumetrics, were independently associated with postoperative hepatic insufficiency. Postoperative hepatic insufficiency raised post-hepatectomy 90-day mortality from 3.5% to 45% and hospitalization from 7 days to 16 days (both <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Postoperative hepatic insufficiency still occurs in 12% of patients after major hepatectomy despite preoperative portal vein embolization. In addition to traditional volumetric information, surgeons should be aware of preoperative cholangitis and cholangiocarcinoma/gallbladder cancer as powerful predictors of this fatal complication.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109345"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of procalcitonin for detecting anastomotic leak in older adults with colorectal cancer: A delayed type cross-sectional study","authors":"Camilo Ramírez-Giraldo MD ,&nbsp;Antonio Pesce PhD ,&nbsp;Alejandro González-Muñoz MD ,&nbsp;Nicolás Navarro-Pulido MD ,&nbsp;Marian Ochoa-Patarroyo MD ,&nbsp;Juan Carlos Vallejo-Soto MD ,&nbsp;Carlos Figueroa-Avendaño MD ,&nbsp;Andrés Isaza-Restrepo MSc","doi":"10.1016/j.surg.2025.109336","DOIUrl":"10.1016/j.surg.2025.109336","url":null,"abstract":"<div><h3>Background</h3><div>The utility of procalcitonin for detecting anastomotic leaks after colorectal surgery in older adults has not been well documented. As the immune system undergoes changes with age, procalcitonin levels may differ at baseline, and its diagnostic performance could vary when an anastomotic leak occurs after colorectal surgery in older adult patients with cancer. The aim of this study is to evaluate the diagnostic performance of procalcitonin on postoperative day 3 for detecting anastomotic leaks in older adults with colorectal cancer.</div></div><div><h3>Methods</h3><div>We conducted a diagnostic test study on the basis of a delayed-type cross-sectional design in older adults (≥65 years old) with colorectal cancer. Postoperative day 3 procalcitonin levels were tested. The reference standard was anastomotic leak. We calculated the receiver operating characteristic curve and its area under the curve.</div></div><div><h3>Results</h3><div>The incidence of anastomotic leak was 7.7%. On postoperative day 3, the receiver operating characteristic demonstrated an area under the curve of 0.68 (95% confidence interval, 0.58–0.78) for the prediction of an anastomotic leak using procalcitonin levels. The cutoff point with the greatest diagnostic performance, according to the Youden index, was 0.61 ng/mL, with a sensitivity of 0.69, specificity of 0.62, a positive likelihood ratio of 1.86, and a negative likelihood ratio of 0.48 for predicting an anastomotic leak. The area under the curve was 0.78 when ileostomies were excluded and 0.81 when evaluating grade C leaks.</div></div><div><h3>Conclusion</h3><div>Our study reveals that procalcitonin levels on postoperative day 3 are a poor diagnostic marker for identifying anastomotic leaks in older adults with colorectal cancer, with an improvement in performance for the grade C anastomotic leak subgroup.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109336"},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique aspects of trauma due to thermobaric artillery weapon systems (specifically the Russian TOS-1A) during the war in Ukraine","authors":"Aaron Epstein MD ,&nbsp;Kostianyn V. Humeniuk MD ,&nbsp;Miroslav V. Nagnibedyuk MD ,&nbsp;Steven D. Schwaitzberg MD, FACS ,&nbsp;Global Surgical and Medical Support Group (GSMSG)","doi":"10.1016/j.surg.2025.109310","DOIUrl":"10.1016/j.surg.2025.109310","url":null,"abstract":"<div><div>This paper examines the unique trauma inflicted by the TOS-1A thermobaric weapon system during the conflict in Ukraine. The study aims to analyze the nature and severity of injuries caused by this thermobaric weapon system, comparing them with more conventional thermal injuries. Thermobaric weapons, like the TOS-1A, generate high temperatures and pressure waves without the fragmentation typical of traditional explosives, causing extensive internal and external damage. Data were collected from Role 2 mobile hospitals in various regions, focusing on individuals with thermal injuries. The study categorized patients into 2 groups: those with thermal trauma associated with weapons other than those specifically injured by TOS-1A weapons. The findings revealed that injuries from TOS-1A resulted predominantly in third- and fourth-degree burns, with significant upper respiratory tract damage and barotrauma. These injuries were more severe than general thermal injuries, which included a broader range of burn degrees. The study highlights the critical need for injury prevention and specialized medical response and treatment for such trauma, emphasizing the inefficacy of traditional protective structures against thermobaric weapons. The paper concludes with recommendations for improving survival rates, including prompt evacuation and advanced medical care in specialized burn centers.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109310"},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of 4-dimensional computed tomography in predicting single-gland parathyroid disease—Can we abandon intraoperative parathyroid monitoring?","authors":"Michael S. Lui MD ,&nbsp;Jason C. Fisher MD ,&nbsp;Natalie Berger MD ,&nbsp;Alex J. Gordon MD ,&nbsp;Kyla Wright MD ,&nbsp;Vinh Nguyen MD ,&nbsp;Michael J. Persky MD ,&nbsp;Babak Givi MD ,&nbsp;Carolyn D. Seib MD ,&nbsp;John D. Allendorf MD ,&nbsp;Jason D. Prescott MD ,&nbsp;Kepal N. Patel MD ,&nbsp;Insoo Suh MD","doi":"10.1016/j.surg.2025.109327","DOIUrl":"10.1016/j.surg.2025.109327","url":null,"abstract":"<div><h3>Background</h3><div>Four-dimensional computed tomography is routinely used to localize parathyroid disease, with consistently excellent parathyroid gland localization rates reported. This study evaluated whether pairing 4-dimensional computed tomography results with preoperative clinical variables can accurately predict single-gland disease in primary hyperparathyroidism.</div></div><div><h3>Methods</h3><div>Patients with primary hyperparathyroidism who underwent both 4-dimensional computed tomography imaging and parathyroidectomy between January 2019 and September 2021 at a large academic health system were included. Patient demographics, preoperative characteristics, and peri- and postoperative data were collected. The accuracy of 4-dimensional computed tomography in correctly identifying patients with single-gland disease with and without preoperative calcium and parathyroid hormone levels was calculated. Single-gland disease was defined by intraoperative parathyroid hormone decrease &gt;50% and a hypercellular gland on pathology.</div></div><div><h3>Results</h3><div>One hundred seventy-five patients had 4-dimensional computed tomography results suggestive of single gland disease. One hundred fifty-two patients (87%) were predicted correctly to have single-gland disease. The predictive accuracy increased when stratifying by preoperative calcium (≥10.5 mg/dL, ≥11 mg/dL, and ≥12 mg/dL) and parathyroid hormone levels (≥65 pg/mL, ≥100 pg/mL, and ≥200 pg/dL). The accuracy further increased when stratifying by age (≤50 years). Accuracy for single gland disease was 100% when combined with any of the following: (1) calcium ≥12 mg/dL, (2) parathyroid hormone ≥200 pg/dL, or (3) calcium ≥11 mg/dL in patients ≤50 years.</div></div><div><h3>Conclusion</h3><div>Four-dimensional computed tomography alone accurately predicted single gland disease in 87% of patients with primary hyperparathyroidism. When combined with preoperative calcium, parathyroid hormone and age thresholds, predictive accuracy for single-gland disease approached 100%. Given the high likelihood of single-gland disease in these scenarios, clinicians may consider offering focused unilateral parathyroidectomy without intraoperative parathyroid hormone monitoring in selected patients.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109327"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological outcomes of palliative minimally invasive distal pancreatectomy for unexpected metastatic pancreatic ductal adenocarcinoma: A single-center experience","authors":"Yejong Park MD, PhD ,&nbsp;Dae Wook Hwang MD, PhD ,&nbsp;Jae Hoon Lee MD, PhD ,&nbsp;Ki Byung Song MD, PhD ,&nbsp;Eunsung Jun MD, PhD ,&nbsp;Woohyung Lee MD, PhD ,&nbsp;Min Kyu Sung MD, PhD ,&nbsp;Song Cheol Kim MD, PhD","doi":"10.1016/j.surg.2025.109331","DOIUrl":"10.1016/j.surg.2025.109331","url":null,"abstract":"<div><h3>Background</h3><div>The benefits of palliative minimally invasive distal pancreatectomy for patients with unexpectedly metastatic pancreatic ductal adenocarcinoma have not been previously studied. This retrospective study compared the outcomes of palliative minimally invasive distal pancreatectomy with those of minimally invasive biopsy in these patients.</div></div><div><h3>Methods</h3><div>We reviewed the records of 46 patients with unexpected metastasis of left-sided pancreatic ductal adenocarcinoma that were discovered during surgery between 2005 and 2019. Nineteen patients underwent palliative resection (minimally invasive distal pancreatectomy group), whereas 27 patients underwent only minimally invasive biopsy (minimally invasive biopsy group). Demographic, clinical, and operative data, as well as survival rates, were compared between the 2 groups.</div></div><div><h3>Results</h3><div>Major complications (Clavien-Dindo grade ≥3) were comparable between the 2 groups (11.8% vs 5.6%; <em>P</em> = .603). Postoperative chemotherapy was administered to 84.2% of the minimally invasive distal pancreatectomy group and 77.8% of the minimally invasive biopsy group (<em>P</em> = .716). The minimally invasive distal pancreatectomy group had a higher completion rate of first-line palliative chemotherapy (42.9% vs 8.7%; <em>P</em> = .007) and a higher 2-year survival rate (36.8% vs 18.8%; <em>P</em> = .004). In multivariate analysis, survival was associated with completion of first-line chemotherapy (hazard ratio: 2.962; <em>P</em> = .003) and maintenance chemotherapy for over 12 months (hazard ratio: 2.339; <em>P</em> = .010). Gastric outlet obstruction was less prevalent in the minimally invasive distal pancreatectomy group (5.3% vs 25.9%, <em>P</em> = .037).</div></div><div><h3>Conclusion</h3><div>Palliative minimally invasive distal pancreatectomy may improve survival and facilitate the continuation of chemotherapy in selected patients with unexpected metastatic pancreatic ductal adenocarcinoma. However, the small sample size and potential selection bias limit the generalizability of these findings. Larger, prospective, multicenter studies are needed to confirm the role of minimally invasive distal pancreatectomy and to establish optimal management strategies for these patients.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109331"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical care of burned patients is typical in war: Adapting old dogma for maximal survival","authors":"Peter Sienko BS,&nbsp;Gary A. Vercruysse MD, FACS","doi":"10.1016/j.surg.2025.109306","DOIUrl":"10.1016/j.surg.2025.109306","url":null,"abstract":"<div><div>During the wars in Iraq and Afghanistan, US troops experienced burns were stabilized and quickly evacuated out of theater to Germany and then to the US Army Institute of Surgical Research in San Antonio, Texas. This was not true of casualties involving non-US or non-North Atlantic Treaty Organization soldiers and medical systems. In such situations, soldiers and civilians alike were treated in North Atlantic Treaty Organization medical treatment facilities and/or were transferred to host nation health care facilities until they healed or died from their wounds. Before 1970, most burns worldwide were treated conservatively and managed with some form of resuscitation and dressing changes. Debridement and skin grafting were reserved for burn wounds that became infected or granulated after separation of the burn wound eschar. This treatment algorithm was developed because of a lack of modern equipment (such as a dermatome or skin mesher) and partly because of adherence to dogmatic principles adopted for the previous century of battlefield burn wound treatment. Modern burn care standards in developed countries have advanced dramatically in the last several decades. However, employing these standards in under-resourced and overburdened hospital systems, such as those in the combat environment, will lead to a waste of resources and unnecessary loss of life. The following is a primer to burn care in war, tailored for providers in austere systems, that will maximize survival, help obviate the need for intensive care unit care, and save valuable resources and hospital bedspace.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109306"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma registry: The first step for global trauma systems development initiated by disaster and conflict zones","authors":"Francesca A. Voza MD ,&nbsp;Enrique Ginzburg MD","doi":"10.1016/j.surg.2025.109309","DOIUrl":"10.1016/j.surg.2025.109309","url":null,"abstract":"<div><div>The systematic collection of casualty data has been crucial in developing integrated trauma systems. Electronic repositories such as the Joint Theater Trauma Registry have facilitated evidence-based guidelines and protocols, enhancing trauma care globally. While civilian patient care has seen improved outcomes, readiness for modern and massively destructive weaponry requires a new set of guidelines. The critical need is for meticulous data collection, interdisciplinary collaboration, standardized terminology for effective global data analysis and continuous trauma registries for quick needs assessment in conflict zones and guidance for future studies. Comprehensive use and standardization of trauma registry remains essential for medical teams' preparedness in the face of modern large scale combat operations.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"182 ","pages":"Article 109309"},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}