Surgery最新文献

{"title":"Information for readers","authors":"","doi":"10.1016/S0039-6060(25)00351-4","DOIUrl":"10.1016/S0039-6060(25)00351-4","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109499"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261595","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":"Frequency of evaluation of celiac disease in patients with presumed primary hyperparathyroidism and impact on clinical outcomes","authors":"Alexa B. Lisevick MD ,&nbsp;Sophie Dream MD, MPH ,&nbsp;Tina W.F. Yen MD, MS ,&nbsp;Kara Doffek BS ,&nbsp;Tahseen Shaik BS ,&nbsp;Joseph Shaker MD ,&nbsp;Douglas B. Evans MD ,&nbsp;Tracy S. Wang MD, MPH","doi":"10.1016/j.surg.2025.109488","DOIUrl":"10.1016/j.surg.2025.109488","url":null,"abstract":"<div><h3>Background</h3><div>Patients with primary hyperparathyroidism and secondary hyperparathyroidism due to celiac disease may both present with high parathyroid hormone and normal calcium levels, but their management differs. This study aimed to assess the frequency of celiac disease evaluation among patients with presumed primary hyperparathyroidism and characterize the impact of preoperative evaluation among patients undergoing parathyroidectomy.</div></div><div><h3>Methods</h3><div>A single-institution cross-sectional study of adult patients evaluated for initial parathyroidectomy for presumed sporadic primary hyperparathyroidism from January 1, 2010, to July 1, 2024, was completed. All patients were assessed for preoperative celiac disease antibody testing. Among those who underwent parathyroidectomy, preoperative biochemical profiles, prevalence of multigland disease, and persistent disease were compared by celiac disease evaluation status.</div></div><div><h3>Results</h3><div>Of 2,415 patients (80% female, median age 64 years [55, 70]), 266 (11%) were evaluated for celiac disease, of whom 15 (6%) had positive celiac disease antibodies. Two of 15 patients were confirmed to have celiac disease, in whom primary hyperparathyroidism was recognized after celiac disease treatment. Patients evaluated for celiac disease were more likely female (88% vs 78%, <em>P</em> &lt; .005) and older (median age 65 years [55, 73] vs 63 years [55, 70], <em>P</em> = .04), less frequently presented with high serum calcium (97% vs 99%, <em>P</em> &lt; .005), had higher prevalence of multigland disease (38% vs 30%, <em>P</em> = .01), and similar prevalence of postoperative persistent disease (3% vs 2%, <em>P</em> = .38) compared with those not evaluated. Overall, 2,137 (89%) underwent parathyroidectomy. Patients managed nonoperatively were more frequently evaluated for celiac disease (10% vs 18%, <em>P</em> &lt; .005).</div></div><div><h3>Conclusions</h3><div>Celiac disease is infrequently diagnosed in patients with presumed primary hyperparathyroidism. Celiac disease diagnosis and treatment may facilitate recognition of primary hyperparathyroidism and should be considered in patients presenting with normocalcemia and high parathyroid hormone.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109488"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254677","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":"Cover 1(with editorial board)","authors":"","doi":"10.1016/S0039-6060(25)00349-6","DOIUrl":"10.1016/S0039-6060(25)00349-6","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109497"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261594","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 regarding \"Neoadjuvant chemotherapy improves overall survival in stage III but not in stage II colon cancer: A propensity score-matched analysis of the National Cancer Database\".","authors":"Qi Xu, Yuwan Gao","doi":"10.1016/j.surg.2025.109490","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109490","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109490"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286553","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":"No association between preprocedural fasting and witnessed pulmonary aspiration: A systematic review and meta-analysis","authors":"Stephanie Lam DO, MS ,&nbsp;Maxime P. Cannesson MD, PhD ,&nbsp;Antonia Osuna-Garcia MLIS ,&nbsp;Edward H. Livingston MD","doi":"10.1016/j.surg.2025.109483","DOIUrl":"10.1016/j.surg.2025.109483","url":null,"abstract":"<div><h3>Background</h3><div>Preprocedural fasting has been a standard component of preoperative care since 1946 when an association between gastric volume and aspiration was made. A large body of literature exists examining various fasting regimen effects on surrogate outcomes, but few studies have investigated aspiration itself as the primary outcome.</div></div><div><h3>Methods</h3><div>Randomized clinical trials comparing outcomes from preprocedural fasting regimens and observational studies of witnessed aspiration events published between January 1, 2016, and December 1, 2023, were reviewed. The main primary outcome was clinical aspiration. Secondary outcomes included gastric volume and pH. Random effects meta-analysis was performed on the outcomes data. Trial sequential analysis was performed to determine the likelihood that further studies of fasting effects on aspiration events will change conclusions drawn from the current analysis.</div></div><div><h3>Results</h3><div>Of the 3,580 initial references found in the initial search, 17 were included in the analysis. Of these, 9 reported outcomes for aspiration events. Clinical aspiration was not affected by the various preprocedural fasting regimens. Odds ratio for aspiration events = 1.17 (95% confidence interval: 0.32–4.23, <em>P</em> = .81, <em>I</em>² = 0%, <em>n</em> = 8 studies, 801 patients in experimental groups, and 990 patients in control groups). Aspiration was rare, occurring in 4 of 801 patients (incidence of 0.50%) in experimental groups and 7 of 990 patients (0.71%) in control groups. Trial sequential analysis of aspiration studies showed little likelihood of finding a significant effect of new fasting regimens on aspiration. Most studies reported gastric volume and/or pH as a surrogate outcome for aspiration. The surrogate outcomes gastric volume and pH have never been shown to correlate with human anesthesia-related aspiration.</div></div><div><h3>Conclusion</h3><div>There was no association between liberal fasting policies and witnessed aspiration. Further study of more liberal fasting policies is unlikely to find an association. Most of the prior fasting-aspiration-fasting literature relied on surrogate outcomes that have never been shown to correlate with clinical aspiration. The lack of evidence demonstrating a relationship between fasting and aspiration suggests that fasting policies might be liberalized. Preprocedural fasting might be replaced by bedside gastric ultrasound examination of gastric volume.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109483"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254678","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":"Generative artificial intelligence and scientific publishing: Turning noise into trust","authors":"Julio Mayol MD, PhD,&nbsp;Caitlin W. Hicks MD, MS, FACS, FAHA, DFSVS,&nbsp;Steven D. Wexner MD, PhD","doi":"10.1016/j.surg.2025.109496","DOIUrl":"10.1016/j.surg.2025.109496","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109496"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261597","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: \"Development and validation of a nomogram to predict the need for a bailout procedure in laparoscopic cholecystectomy: A multicenter study of 1,898 cases\".","authors":"Yutaka Suzuki, Masao Yoshida, Yoshihiro Sakamoto","doi":"10.1016/j.surg.2025.109485","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109485","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109485"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286554","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":"Preoperative prediction model for benign and malignant gallbladder polyps on the basis of machine-learning algorithms","authors":"Jiange Zeng MS ,&nbsp;Weiyu Hu MD ,&nbsp;Yubing Wang MS ,&nbsp;Yumin Jiang MS ,&nbsp;Jiechao Peng MS ,&nbsp;Jian Li MS ,&nbsp;Xueqing Liu MS ,&nbsp;Xinyue Zhang MS ,&nbsp;Bin Tan MS ,&nbsp;Dianpeng Zhao MS ,&nbsp;Kun Li MS ,&nbsp;Shimei Zhang MS ,&nbsp;Jingyu Cao MD ,&nbsp;Chao Qu MD","doi":"10.1016/j.surg.2025.109427","DOIUrl":"10.1016/j.surg.2025.109427","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to differentiate between benign and malignant gallbladder polyps preoperatively by developing a prediction model integrating preoperative transabdominal ultrasound and clinical features using machine-learning algorithms.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on clinical and ultrasound data from 1,050 patients at 2 centers who underwent cholecystectomy for gallbladder polyps. Six machine-learning algorithms were used to develop preoperative models for predicting benign and malignant gallbladder polyps. Internal and external test cohorts evaluated model performance. The Shapley Additive Explanations algorithm was used to understand feature importance.</div></div><div><h3>Results</h3><div>The main study cohort included 660 patients with benign polyps and 285 patients with malignant polyps, randomly divided into a 3:1 stratified training and internal test cohorts. The external test cohorts consisted of 73 benign and 32 malignant polyps. In the training cohort, the Shapley Additive Explanations algorithm, on the basis of variables selected by Least Absolute Shrinkage and Selection Operator regression and multivariate logistic regression, further identified 6 key predictive factors: polyp size, age, fibrinogen, carbohydrate antigen 19-9, presence of stones, and cholinesterase. Using these factors, 6 predictive models were developed. The random forest model outperformed others, with an area under the curve of 0.963, 0.940, and 0.958 in the training, internal, and external test cohorts, respectively. Compared with previous studies, the random forest model demonstrated excellent clinical utility and predictive performance. In addition, the Shapley Additive Explanations algorithm was used to visualize feature importance, and an online calculation platform was developed.</div></div><div><h3>Conclusion</h3><div>The random forest model, combining preoperative ultrasound and clinical features, accurately predicts benign and malignant gallbladder polyps, offering valuable guidance for clinical decision-making.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109427"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240216","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 comment on our manuscript \"Effect of systemic FOLFOXIRI plus bevacizumab treatment of colorectal peritoneal metastasis on local and systemic immune cells\".","authors":"Catharina Müller, Rudolf Oehler","doi":"10.1016/j.surg.2025.109474","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109474","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109474"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275920","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":"A novel surgical classification system for ileocolic Crohn's disease: “It is not just ileocolic disease”","authors":"Mehmet Gulmez MD ,&nbsp;Pranav Hinduja MBBS ,&nbsp;Daniel J. Wong MD, MHS ,&nbsp;Eren Esen MD ,&nbsp;Olivia Delau MS ,&nbsp;Arman Erkan MD ,&nbsp;Andre da Luz Moreira MD, PhD ,&nbsp;Michael J. Grieco MD ,&nbsp;Feza H. Remzi MD","doi":"10.1016/j.surg.2025.109426","DOIUrl":"10.1016/j.surg.2025.109426","url":null,"abstract":"<div><h3>Background</h3><div>Crohn’s disease (CD) often affects the terminal ileum, leading to complications such as stricture, fistula, and abscesses, necessitating surgery in up to 80% of patients. Early and effective treatment is crucial to prevent disease progression and improve outcomes, although timing between medical and surgical treatments is challenging.</div></div><div><h3>Methods</h3><div>This study reviewed patients who underwent ileocolic resection for CD at our quaternary inflammatory bowel disease center from September 2016 to September 2023. A novel classification system categorized the severity and complexity of ileocolic CD. Preoperative characteristics, operative variables, and postoperative outcomes were analyzed to assess the impact of disease complexity.</div></div><div><h3>Results</h3><div>Among the 301 patients (median age 33.3 years, 48.5% female), 56.8% had complex ileocolic CD. Complex disease was associated with greater blood loss, longer hospital stays, longer operative time, and greater rates of open surgery and conversion compared with noncomplex disease (<em>P</em> &lt; .01). Diversion rates were significantly greater in complex cases (<em>P</em> &lt; .01). Emergent operations were more common among complex cases (<em>P</em> &lt; .01). Delayed referral and increased complexity correlated with inferior surgical outcomes and greater stoma rates.</div></div><div><h3>Conclusion</h3><div>The proposed classification system stratifies patients on the basis of CD severity and complexity, facilitating better preoperative planning and communication among multidisciplinary teams. Early surgical intervention, when appropriate, may reduce morbidity and improve outcomes in patients with ileocolic CD. This system highlights the importance of timely referrals and standardizing the management approach for complex CD.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109426"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240217","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}