Surgery最新文献

{"title":"Hyperlipasemia in the immediate postoperative period predicts postoperative pancreatic fistula after pancreatic resections.","authors":"Ughur Aghamaliyev, Jens Werner","doi":"10.1016/j.surg.2025.109433","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109433","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109433"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183560","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":"Invited commentary regarding: Portal flow modulation by splenic artery ligation to prevent posthepatectomy liver failure: A randomized controlled trial.","authors":"Jason Y Wang, Madhukar S Patel","doi":"10.1016/j.surg.2025.109429","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109429","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109429"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180256","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 the letter to the editor: Acceptability of palliative sleeve lobectomy with microscopic margin disease in patients with non-small cell lung cancer: A retrospective study.","authors":"Jianghao Ren, Ruijun Liu","doi":"10.1016/j.surg.2025.109432","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109432","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109432"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182192","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":"Use of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) to determine potentially preventable deaths after emergency general surgery","authors":"Sergei Bedrikovetski PhD ,&nbsp;Helena S. Kopunic PhD ,&nbsp;Nathan Procter PhD ,&nbsp;Ishraq Murshed MS ,&nbsp;Jahan Singh De Fontgalland BHlthMedSc ,&nbsp;Luke Traeger PhD ,&nbsp;Guy J. Maddern PhD","doi":"10.1016/j.surg.2025.109444","DOIUrl":"10.1016/j.surg.2025.109444","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing emergency general surgery procedures have significantly greater mortality rates than those undergoing the same procedures electively. However, the exact number of potentially preventable deaths after these procedures is unclear. This study aims to examine potentially preventable and nonpreventable deaths after 7 common emergency general surgery procedures and the clinical management issues associated with potentially preventable deaths.</div></div><div><h3>Methods</h3><div>A retrospective analysis of surgical deaths after 7 emergency general surgery procedures—laparotomy, colectomy, adhesiolysis, cholecystectomy, peptic ulcer repair, small bowel resection, and appendectomy—was conducted on Australian and New Zealand Audit of Surgical Mortality data between 2010 and 2022. Deaths were classified into 2 groups: potentially preventable or nonpreventable.</div></div><div><h3>Results</h3><div>Within the study period, 875 deaths (18.5%) were potentially preventable, and 3,848 deaths (81.5%) were not preventable. Potentially preventable deaths had significantly greater rates of overall postoperative complications (57.0% vs 37.0%, <em>P</em> &lt; .001) compared with nonpreventable deaths. The potentially preventable deaths group had also significantly greater rates of clinical management issues in the preoperative (38.6% vs 7.0%, <em>P</em> &lt; .001), intraoperative (21.4% vs 3.2%, <em>P</em> &lt; .001), and postoperative (20.5% vs 4.0%, <em>P</em> &lt; .001) phases of care.</div></div><div><h3>Conclusion</h3><div>Among the most common emergency general surgery procedures, approximately 20% of deaths are potentially preventable. For patients with potentially preventable deaths, the majority of clinical management issues occurred during the preoperative phase of care. The overall clinical management issues identified relate to 14 separate areas of patient care. Further quality improvement projects, such as enhanced recovery after surgery protocols, should address these areas of clinical management issues to improve future patient mortality rates.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109444"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138848","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":"From stress to strength: Integrating stress management training into surgical education.","authors":"Rahim Hirani, Rachelle J Lodescar, Mill Etienne","doi":"10.1016/j.surg.2025.109431","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109431","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109431"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174334","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":"Letter to the Editor: \"The future of combat trauma anesthesia in an austere environment (CTA in AE)\".","authors":"Fredrik Granholm, Derrick Tin","doi":"10.1016/j.surg.2025.109439","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109439","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109439"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162319","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":"Clinical implications of postoperative hyperamylasemia and postpancreatectomy acute pancreatitis after pancreatectomy: A systematic review and meta-analysis","authors":"Danhui Heo ,&nbsp;Swizel Ann Cardoso MBBS, MRCS, MSc ,&nbsp;Rayner Peyser Cardoso MBBS ,&nbsp;Nasser Eldin S.E. Ibrahim MBBS, FACS ,&nbsp;Umberto Cillo MD ,&nbsp;Giampaolo Perri MD, PhD ,&nbsp;Giovanni Marchegiani MD, PhD","doi":"10.1016/j.surg.2025.109443","DOIUrl":"10.1016/j.surg.2025.109443","url":null,"abstract":"<div><h3>Background</h3><div>Since its definition in 2022, postpancreatectomy acute pancreatitis has been increasingly recognized as a critical postoperative entity, but its clinical significance has not been evaluated through systematic review and meta-analysis. The aim of current study was to evaluate the clinical implications of postoperative hyperamylasemia and postpancreatectomy acute pancreatitis according to the International Study Group for Pancreatic Surgery consensus definition.</div></div><div><h3>Methods</h3><div>A systematic review with meta-analysis was conducted in PubMed, EMBASE, and Cochrane Library databases. Studies published between January 2022 and August 2024 that used the International Study Group for Pancreatic Surgery definitions for postoperative hyperamylasemia and postpancreatectomy acute pancreatitis were included. Risk ratios with 95% confidence intervals were calculated using a Mantel-Haenszel random-effects model.</div></div><div><h3>Results</h3><div>Eleven studies were included in the meta-analysis. Postoperative hyperamylasemia was associated with increased postoperative pancreatic fistula rates (risk ratio, 0.33; 95% confidence interval, 0.21–0.51; <em>P</em> &lt; .001). Postpancreatectomy acute pancreatitis was associated with greater rates of postoperative pancreatic fistula (risk ratio, 0.24; 95% confidence interval, 0.17–0.35; <em>P</em> &lt; .001), postoperative pancreatic hemorrhage (risk ratio, 0.39; 95% confidence interval, 0.26–0.59; <em>P</em> &lt; .001), delayed gastric emptying (risk ratio, 0.57; 95% confidence interval, 0.41–0.79; <em>P</em> = .007), Clavien-Dindo classification IIIa or greater complications (risk ratio, 0.38; 95% confidence interval, 0.25–0.58; <em>P</em> &lt; .001), mortality (risk ratio, 0.42; 95% confidence interval, 0.27–0.65; <em>P</em> = .001), and longer hospital stays (mean difference, −7.76 days; 95% confidence interval, −12.52 to 3.00; <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>This first meta-analysis exploring their clinical significance demonstrates that both postoperative hyperamylasemia and postpancreatectomy acute pancreatitis are associated with increased postoperative complications after pancreatectomy. The adoption of these definitions in clinical practice could significantly impact the postoperative course by early stratifying patients at higher risk for additional morbidity.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109443"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138766","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":"Complication-sensitive models for hospital benchmarking with failure to rescue-Reply.","authors":"Arjun Verma, Peyman Benharash","doi":"10.1016/j.surg.2025.109437","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109437","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109437"},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143648","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":"Indocyanine green quantification in full robotic esophagectomy using an unsupervised learning approach","authors":"Lukas Pollmann MD ,&nbsp;Sebastian Weberskirch MD ,&nbsp;Moritz Petry MSc ,&nbsp;Sebastian Kubasch MD ,&nbsp;Nicola Sariye Pollmann MD ,&nbsp;Eike Bormann MSc ,&nbsp;Andreas Pascher MD ,&nbsp;Mazen Juratli PhD ,&nbsp;Jens Peter Hölzen MD","doi":"10.1016/j.surg.2025.109405","DOIUrl":"10.1016/j.surg.2025.109405","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative indocyanine green imaging has emerged as a powerful tool for assessing gastric conduit perfusion during open and minimally invasive esophagectomy. Although delayed perfusion correlates with the development of anastomotic leakage, indocyanine green assessments have high surgeon-dependent interuser variability. Therefore, quantitative indocyanine green analysis is recommended. We present a quantitative indocyanine green analysis using an unsupervised, self-organizing map cluster network during robotic-assisted minimally invasive esophagectomy.</div></div><div><h3>Methods</h3><div>In total, 70 patients treated with robotic-assisted minimally invasive esophagectomy, intraoperative indocyanine green imaging, and prophylactic endoluminal vacuum therapy were included in the study. The occurrence of anastomotic leakage, cycles of endoluminal vacuum therapy, patient comorbidities, and arteriosclerosis shown on preoperative computed tomography scans was recorded. The recorded videos of intraoperative indocyanine green imaging were clustered using an unsupervised, self-organizing map network, and an indocyanine green perfusion score was determined.</div></div><div><h3>Results</h3><div>The indocyanine green perfusion score, as well as patient age and body mass index, correlated with an increased risk of anastomotic leakage in the univariate analysis. Other comorbidities and the extent of arteriosclerosis in preoperative computed tomography scans did not differ in patients with and without anastomotic leakage.</div></div><div><h3>Conclusion</h3><div>An unsupervised learning approach to quantify intraoperative indocyanine green imaging could aid the prediction of anastomotic leakage after robotic-assisted minimally invasive esophagectomy in future treatments. However, the value of this approach needs to be clarified in a randomized, controlled prospective study.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109405"},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123271","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":"Comparative learning curves and outcomes of robotic versus laparoscopic transabdominal preperitoneal inguinal hernia repair","authors":"Leonardo Solaini MD ,&nbsp;Davide Cavaliere MD ,&nbsp;Riccardo Turrini MD ,&nbsp;Sara Pellegrini MD ,&nbsp;Giuseppe Rocco MD ,&nbsp;Francesco Pasini MD ,&nbsp;Giulia Bonini MD ,&nbsp;Daniela Di Pietrantonio MD ,&nbsp;Giorgio Ercolani MD, PhD","doi":"10.1016/j.surg.2025.109415","DOIUrl":"10.1016/j.surg.2025.109415","url":null,"abstract":"<div><h3>Background</h3><div>Transabdominal preperitoneal inguinal hernia repair is a common surgical procedure that can be performed using either robotic or laparoscopic approaches. Understanding the learning curve for each method is crucial for optimizing surgical outcomes and training. This study aims to compare the learning curves of each approach and to evaluate the outcomes of the proficiency phases.</div></div><div><h3>Methods</h3><div>All consecutive transabdominal preperitoneal procedures performed in 2 centers were included. The learning curves, based on operative time, of 5 surgeons (2 performing robotic transabdominal preperitoneal and 3 performing laparoscopic transabdominal preperitoneal) were analyzed using cumulative sum analysis and compared after pooling the data according to the surgical approach. In addition, a comparison of the outcomes of the postlearning phase was conducted.</div></div><div><h3>Results</h3><div>A total of 463 transabdominal preperitoneal procedures were included (248 robotic approach). The laparoscopic transabdominal preperitoneal learning curve indicated a learning phase up to the 39th procedure, and the robotic up to the 29th. Comparing the postlearning phase data revealed similar postoperative complication rates (14/187 vs 3/103, <em>P</em> = .126) with comparable baseline characteristics. In addition, the median operative time was significantly lower in the robotic group than in the laparoscopic group (59 vs 65 minutes, <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that robotic and laparoscopic transabdominal preperitoneal have distinct learning curves, with the robotic approach reaching proficiency slightly faster. Postlearning phase safety outcomes were similar between the 2 techniques. The robotic approach also had a significantly shorter operative time than the laparoscopic approach. These findings suggest that both approaches are safe, and the choice of method may depend on surgeon preference and experience.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109415"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106637","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}