Surgery最新文献

{"title":"Effects of pyrroloquinoline quinone (PQQ) on skin wound healing in mice","authors":"Farshid Davoodi DVSc ,&nbsp;Rahim Mohammadi DVSc ,&nbsp;Siamak Asri-Rezaei DVSc ,&nbsp;Mehdi Behfar DVSc ,&nbsp;Omid Dezfoulian PhD ,&nbsp;Abbas Raisi DVSc","doi":"10.1016/j.surg.2025.109453","DOIUrl":"10.1016/j.surg.2025.109453","url":null,"abstract":"<div><h3>Objective</h3><div>Wound healing is a dynamic process that begins following the destruction of the skin's normal anatomy. This study evaluated effects of pyrroloquinoline quinone on skin wounds in mice.</div></div><div><h3>Methods</h3><div>Thirty-six male mice were randomly divided in to 3 groups: (1) Sham group, where wounds were created but no treatment was administered; (2) Soybean oil, where soybean oil was applied topically to wounds for 9 days; and (3) pyrroloquinoline quinone group, where pyrroloquinoline quinone dissolved in soybean oil was applied topically. Four mice per group were used in an incisional wound model for biomechanical testing. Hematoxylin and eosin, Masson trichrome, immunohistochemical staining of caspase 3, vascular endothelial growth factor and tumor growth factor beta, oxidative stress biomarkers, and Western blot assay for tumor necrosis factor alpha and nuclear factor kappa B were performed on days 7 and 14. Biomechanical parameters were evaluated on day 10 post wounding.</div></div><div><h3>Results</h3><div>Pyrroloquinoline quinone significantly reduced the wound area. In the treatment group, malondialdehyde and total oxidant status significantly reduced and total antioxidant capacity was increased compared with other groups. Levels of hydroxyproline was significantly higher in the pyrroloquinoline quinone group in comparison to 2 other groups. In Western blot assay, tumor necrosis factor alpha significantly reduced in the treatment group. Histopathologic evaluation confirmed improved wound healing in the pyrroloquinoline quinone group, with reduced expression of caspase 3 and tumor growth factor beta. Vascular endothelial growth factor expression increased on day 7 but decreased on day 14 in the pyrroloquinoline quinone group. Biomechanical parameters including, strain, ultimate strength, and maximum energy stored, showed significant improvements.</div></div><div><h3>Conclusion</h3><div>These findings suggested that pyrroloquinoline quinone may accelerate wound healing in mice.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109453"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240219","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":"Impact of care fragmentation on survival in locally advanced rectal cancer: Identifying vulnerable populations","authors":"Daniel Aryeh Metzger MD ,&nbsp;Haley Harris BA ,&nbsp;Isabelle Tan BA ,&nbsp;Andrea Mesiti MD ,&nbsp;Ying Li MS ,&nbsp;Julianna Brouwer MPH ,&nbsp;Dawn Chirko MD ,&nbsp;Alessio Pigazzi MD, PhD ,&nbsp;Steven Chao MD ,&nbsp;Heather Yeo MD, MHS, MBA, MS","doi":"10.1016/j.surg.2025.109471","DOIUrl":"10.1016/j.surg.2025.109471","url":null,"abstract":"<div><h3>Background</h3><div>Treatment for locally advanced rectal cancer requires multidisciplinary coordination. Studies examining care fragmentation, in which a patient receives cancer treatment at multiple facilities, are limited. This study aimed to determine the demographic, clinical, and hospital subgroups impacted by care fragmentation.</div></div><div><h3>Methods</h3><div>Patients with stage II-III rectal cancer treated with surgery, chemotherapy, and radiation (2009–2019) were selected from the National Cancer Database and divided into fragmented care and unified care groups. Overall survival was compared. Demographic, disease characteristic, and hospital type subgroups were analyzed to determine differential impact of care fragmentation.</div></div><div><h3>Results</h3><div>In total, 63,299 patients were included, of whom 41,978 (66.3%) received fragmented care and 21,321 (33.7%) received unified care. Median age was 60 years (interquartile range, 51–68 years), and 62.2% were male. Overall, fragmented care was associated with shorter survival (<em>P</em> = .0017), increased treatment delays (13.7% vs 12.4% in unified care; <em>P</em> &lt; .001) and decreased neoadjuvant therapies (<em>P</em> &lt; .001). Fragmented care was significantly associated with decreased survival in 5 subgroups: female patients (adjusted hazard ratio, 1.152, <em>P</em> &lt; .001), patients with clinical Stage III disease (adjusted hazard ratio, 1.094, <em>P</em> = .001), patients with Medicaid (adjusted hazard ratio, 1.212, <em>P</em> = .006), patients ≥100 miles from the hospital (adjusted hazard ratio, 1.377, <em>P</em> = .013), and patients treated at academic centers (adjusted hazard ratio, 1.225, <em>P</em> &lt; .001). Unified care at academic centers was associated with significantly improved overall survival compared to fragmented care at academic centers and treatment at nonacademic centers (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Care fragmentation is associated with worse survival outcomes in patients with locoregional rectal cancer, with certain subgroups being particularly vulnerable. Addressing the socioeconomic and logistical barriers that contribute to care fragmentation will be crucial in improving patient outcomes.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109471"},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240218","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":"Reply to the letter \"comment on 'portal flow modulation by splenic artery ligation to prevent posthepatectomy liver failure: A randomized controlled trial\".","authors":"Sunhawit Junrungsee, Asara Thepbunchonchai, Worakitti Lapisatepun, Anon Chotirosniramit","doi":"10.1016/j.surg.2025.109480","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109480","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109480"},"PeriodicalIF":3.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249681","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: Author's reply.","authors":"Camilo Ramírez-Giraldo, Antonio Pesce, Andrés Isaza-Restrepo","doi":"10.1016/j.surg.2025.109479","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109479","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109479"},"PeriodicalIF":3.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249680","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":"Short-term outcomes of robot-assisted ultralow anterior resection and robot-assisted rectectomy with transanal anastomosis for rectal cancer in Japan: A multicenter retrospective cohort study (ROSEMARY study)","authors":"Masaaki Miyo MD, PhD ,&nbsp;Akio Shiomi MD, PhD ,&nbsp;Sang-Woong Lee MD, PhD ,&nbsp;Yosuke Fukunaga MD, PhD ,&nbsp;Junichiro Hiro MD, PhD ,&nbsp;Yusuke Kinugasa MD, PhD ,&nbsp;Akinari Nomura MD ,&nbsp;Riki Ohno MD, PhD ,&nbsp;Kazushige Kawai MD, PhD ,&nbsp;Masayoshi Yasui MD, PhD ,&nbsp;Yushi Yamakawa MD, PhD ,&nbsp;Hiroki Takahashi MD, PhD ,&nbsp;Takuya Miura MD, PhD ,&nbsp;Kohei Murata MD, PhD ,&nbsp;Masanori Kotake MD, PhD ,&nbsp;Hidetoshi Katsuno MD, PhD ,&nbsp;Akihiro Kobayashi MD, PhD ,&nbsp;Mitsuru Yokota MD, PhD ,&nbsp;Nobuhisa Matsuhashi MD, PhD ,&nbsp;Mitsuyoshi Tei MD, PhD ,&nbsp;Ichiro Takemasa MD, PhD","doi":"10.1016/j.surg.2025.109414","DOIUrl":"10.1016/j.surg.2025.109414","url":null,"abstract":"<div><h3>Background</h3><div>The complex procedures of ultralow anterior resection and intersphincteric resection require precise manipulation at the deepest pelvis, where the advantages of robotic surgery in particular could be leveraged, despite limited reports of such procedures. We aimed to evaluate the short-term outcomes of robot-assisted ultralow anterior resection and robot-assisted intersphincteric resection at 31 institutions in Japan.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study was performed by a total of 31 institutions with the largest number of robot-assisted rectal cancer surgeries based on the survey conducted by the Japan Society for Endoscopic Surgery. We retrospectively analyzed a cohort of patients who had undergone robot-assisted ultralow anterior resection or robot-assisted intersphincteric resection for rectal cancer between January 2020 and December 2021.</div></div><div><h3>Results</h3><div>A total of 1,250 patients were enrolled in this study, 40 were excluded, and finally 1,210 (886 robot-assisted ultralow anterior resection and 324 robot-assisted intersphincteric resection) were included in the analysis. The median operating time was 364 minutes (interquartile range, 277–479 minutes) and blood loss 17 mL (interquartile range, 0–50 mL), and conversion to laparotomy occurred in only 1 patient in robot-assisted ultralow anterior resection. A total of 109 (9.0%) patients had postoperative complications of Clavien-Dindo grade III or higher grade within 30 days after operation, with anastomotic leakage being the most common (3.4%), followed by ileus (1.3%), and mortality within 30 days after operation was a rare event, with only 1 death.</div></div><div><h3>Conclusion</h3><div>The ROSEMARY study demonstrated the feasibility and safety of robot-assisted ultralow anterior resection and robot-assisted intersphincteric resection for low rectal cancer.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109414"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221658","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":"Importance of social deprivation by neighborhood on the pathway from referral to kidney transplantation","authors":"Jenna N. Whitrock MD, MS ,&nbsp;Catherine G. Pratt MD, MS ,&nbsp;Alexandra B. Kinzer MD ,&nbsp;Aaron M. Delman MD, MS ,&nbsp;Adam D. Price MD ,&nbsp;Changchun Xie PhD ,&nbsp;Madison C. Cuffy MD, MBA ,&nbsp;Latifa S. Silski MD ,&nbsp;Ralph C. Quillin III MD ,&nbsp;Shimul A. Shah MD, MHCM","doi":"10.1016/j.surg.2025.109459","DOIUrl":"10.1016/j.surg.2025.109459","url":null,"abstract":"<div><h3>Background</h3><div>Despite the known impact of social deprivation on kidney transplant access, no instrument exists that quantifies the likelihood of receiving a transplant using neighborhood-level socioeconomic deprivation.</div></div><div><h3>Methods</h3><div>Patients referred for kidney transplant evaluation from July 2017 and January 2022 were evaluated. Patients' addresses were geocoded using the DeGAUSS (Decentralized Geomarker Assessment for Multi-Site Studies) system, and deprivation index was generated. An internally validated prediction score was created to quantify a patient's risk of not being waitlisted or transplanted after referral.</div></div><div><h3>Results</h3><div>Of the 4,852 patients referred for kidney transplant, 3,816 (78.6%) were never successfully waitlisted or transplanted. Patients from the highest deprivation quartile were less likely to be waitlisted or transplanted (84.0%, <em>n</em> = 1,007/1,199) than those from the lowest deprivation quartile (74.3%, <em>n</em> = 893/1,202). Patients who were male, older, spent more time on dialysis, and had higher deprivation levels were less likely to be waitlisted or transplanted (area under the curve 71.2%). Assigning scores based on odds ratios allowed creation of the Kidney Transplant Access Prediction score, which assigns points for male sex, deprivation index ≥46, age ≥57, being on hemodialysis, and spending ≥24 months on dialysis. A score ≥4 had a 93.7% rate of never being waitlisted or transplanted and identified those at highest risk with a 72% sensitivity on validation testing.</div></div><div><h3>Conclusion</h3><div>Using factors known at referral, we have created a prediction tool to evaluate who is less likely to successfully receive a kidney transplant. Using this model, centers can develop targeted interventions, which can increase equitable access to kidney transplantation.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109459"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221659","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":"Young-derived M2-like macrophages ameliorate hindlimb ischemia injury by promoting neovascularization in aged mice","authors":"Junyu Chen PhD ,&nbsp;Minghong Chen PhD ,&nbsp;Xuerui Wang PhD ,&nbsp;Meilian Yao MD ,&nbsp;Jing Chen MD ,&nbsp;Jian Zhang MD ,&nbsp;Tianyi Long MD","doi":"10.1016/j.surg.2025.109460","DOIUrl":"10.1016/j.surg.2025.109460","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral artery disease, an age-related ischemic disease, primarily affects the elderly. Cell therapy is a promising treatment for peripheral artery disease. This study aims to investigate the effects of macrophages derived from young mice on neovascularization and recovery in a hindlimb ischemia model of aged mice.</div></div><div><h3>Methods</h3><div>Monocytes were isolated from the bone marrow of young mice and cultured <em>in vitro</em> to generate bone marrow–derived macrophages. After polarization, young-derived M2-like bone marrow–derived macrophages were obtained. Aged mice were divided into 3 groups: saline group, young-derived nonpolarized bone marrow–derived macrophages group, and young-derived M2-like bone marrow–derived macrophages group. Hindlimb ischemia was induced in aged mice via femoral artery ligation. Three days after surgery, saline, young-derived nonpolarized bone marrow–derived macrophages, or young-derived M2-like bone marrow–derived macrophages were intramuscularly injected into the ischemic hindlimb. Doppler imaging, ischemia and mobility scores, and histological analysis were used to assess blood flow, functional recovery, and tissue repair. Neovascularization was further evaluated using micro–computed tomography and immunofluorescence staining.</div></div><div><h3>Results</h3><div>Compared with the saline group, aged mice in the young-derived M2-like bone marrow–derived macrophages group exhibited notable blood flow recovery, along with corresponding improvements in tissue and functional recovery. In addition, in terms of neovascularization, the young-derived M2-like bone marrow–derived macrophages group demonstrated a richer vascular bed, with significant increases in both arteriogenesis and angiogenesis, as well as enhanced endothelial cell function.</div></div><div><h3>Conclusion</h3><div>M2-like macrophages derived from young mice enhance neovascularization of aged mice with ischemia, leading to improved blood perfusion and tissue functional recovery. This suggests that macrophages represent a promising new therapeutic strategy for peripheral artery disease in the elderly.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109460"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221660","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":"Development and validation of an electronic quality measure for postoperative respiratory failure","authors":"Garth H. Utter MD, MSc, FACS ,&nbsp;Monika Ray PhD ,&nbsp;Shao-You Fang PhD ,&nbsp;Irina Tokareva BSN, RN, MAS ,&nbsp;Mia Nievera MSN, RN ,&nbsp;Meghan S. Weyrich MPH ,&nbsp;Anna Michie MHS, PMP ,&nbsp;Michelle Lefebvre BSN, RN ,&nbsp;Chana West MSN, RN ,&nbsp;Katie Magoulick MPH, MSW, LGSW ,&nbsp;Michelle Schreiber MD ,&nbsp;Patrick S. Romano MD, MPH","doi":"10.1016/j.surg.2025.109467","DOIUrl":"10.1016/j.surg.2025.109467","url":null,"abstract":"<div><h3>Background</h3><div>Postoperatively, prolonged mechanical ventilation or unplanned intubation—collectively, “postoperative respiratory failure”—has high morbidity and mortality risk, but hospitals' automated ability to detect this complication is currently limited.</div></div><div><h3>Study Design</h3><div>We developed an electronic clinical quality measure for postoperative respiratory failure on the basis of input from clinical and quality experts. Using 2022 structured electronic health record data from 12 diverse hospitals encompassing 2 common electronic health record vendors, we retrospectively evaluated criteria for postoperative respiratory failure after an operation during an elective hospitalization. We sampled all denominator-eligible cases meeting postoperative respiratory failure criteria, and a subset that did not, from each center. Trained nurse abstractors reviewed medical records using a standard instrument. We assessed the positive and negative predictive value of the measure (with 95% confidence intervals), and the discrimination and calibration of its risk model.</div></div><div><h3>Results</h3><div>Among 95 records flagged by the measure and 310 denominator-eligible records not flagged, the postoperative respiratory failure electronic clinical quality measure numerator criteria had a positive predictive value of 88.7% (95% confidence intervals, 80.6–94.2%) and negative predictive value of 99.7% (95% confidence intervals, 98.2–100%). False-positive results frequently involved easily correctible respiratory therapist documentation errors. Risk-adjusted rates of postoperative respiratory failure across hospitals ranged from 0.0 to 16.8/1,000 hospitalizations. The risk model, which included 8 comorbidities, 6 laboratory tests, and American Society of Anesthesiologists physical status classification, had a c-statistic of 0.91.</div></div><div><h3>Conclusion</h3><div>Postoperative respiratory failure can be measured with high validity from readily available, structured electronic health record data. A postoperative respiratory failure electronic clinical quality measure would not be dependent on administrative claims data or collection by trained abstractors, offering the potential to inform quality improvement in elective perioperative care.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109467"},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212396","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":"It's all in your head: Safety of weight-based, targeted enoxaparin prophylaxis in intracranial hemorrhage patients","authors":"Lisa M. Kurth MD ,&nbsp;William A. Marshall MD ,&nbsp;Lauren E. Stone MD ,&nbsp;Brian R. Hirshman MD ,&nbsp;Kevin Box PharmD ,&nbsp;Laura N. Haines MD ,&nbsp;Alan M. Smith MPH, PhD ,&nbsp;Todd W. Costantini MD ,&nbsp;Allison E. Berndtson MD","doi":"10.1016/j.surg.2025.109476","DOIUrl":"10.1016/j.surg.2025.109476","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies have demonstrated that 30-mg twice-daily enoxaparin dosing is inferior to weight-based, anti-Xa–targeted dosing for venous thromboembolism prophylaxis in trauma patients. Despite this, many trauma guidelines continue to support universal low-dose enoxaparin (30 mg twice daily) in patients with traumatic brain injury for fear of expansion of intracranial hemorrhage and adverse neurologic outcomes. We hypothesized that weight-based, anti-Xa–targeted dosing is safe in trauma patients with intracranial hemorrhage.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients admitted to a level 1 trauma center with intracranial hemorrhage from 2015 to 2022. Intracranial hemorrhage patients who received weight-based subcutaneous enoxaparin dosing (50–59 kg, 30 mg twice daily; 60–99 kg, 40 mg twice daily; ≥100 kg, 50 mg twice daily) and had a peak anti-Xa level assessed (goal 0.2–0.4 IU/mL) were included. Enoxaparin was cleared to start 48 hours after a stable head computed tomography. Charts were reviewed to assess for intracranial hemorrhage expansion after initiation of enoxaparin.</div></div><div><h3>Results</h3><div>Of the 509 intracranial hemorrhage patients included, there were 8 patients (1.6%) with intracranial hemorrhage expansion. Of patients given enoxaparin 30 mg twice daily, 1 (1.8%) developed intracranial hemorrhage expansion; the patient also had an initial supra-prophylactic anti-Xa level. Seven patients (1.7%) administered 40 mg twice daily developed intracranial hemorrhage expansion; none of these patients were supra-prophylactic according to their anti-Xa levels. No patients given 50 mg developed intracranial hemorrhage expansion after enoxaparin initiation.</div></div><div><h3>Conclusions</h3><div>In this single-center retrospective study, initial weight-based enoxaparin dosing in patients with stable intracranial hemorrhages did not result in significant clinical neurologic deterioration, directly challenging current venous thromboembolism prophylaxis guidelines for patients with traumatic brain injury. These results should serve as a platform for multicenter prospective data collection to ultimately determine the safety and efficacy of weight-based enoxaparin prophylaxis regimens in traumatic brain injury patients.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109476"},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221657","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":"Reply to the letter \"Splenic artery ligation in hepatectomy: Unanswered questions and the need for higher-quality evidence\".","authors":"Sunhawit Junrungsee, Asara Thepbunchonchai, Worakitti Lapisatepun, Anon Chotirosniramit","doi":"10.1016/j.surg.2025.109473","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109473","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109473"},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249682","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}