Surgery最新文献

{"title":"Prospects of probiotic Escherichia coli Nissle 1917 in the treatment of septic shock.","authors":"Ya-Jie Wang, Yi-Sheng Pan","doi":"10.1016/j.surg.2024.109031","DOIUrl":"10.1016/j.surg.2024.109031","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109031"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898268","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":"Comment on \"Effect of systemic FOLFOXIRI plus bevacizumab treatment of colorectal peritoneal metastasis on local and systemic immune cells\".","authors":"Xiaoxia Liu, Chong-Jie Zhang","doi":"10.1016/j.surg.2024.109012","DOIUrl":"10.1016/j.surg.2024.109012","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109012"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910777","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":"Advancing the understanding of conversional and revisional metabolic bariatric surgery outcomes on obstructive sleep apnea.","authors":"Chen Zhou, Chenglong Liang","doi":"10.1016/j.surg.2024.109013","DOIUrl":"10.1016/j.surg.2024.109013","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109013"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910825","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 impact of frailty on long-term functional outcomes in severely injured geriatric patients\".","authors":"Xianwen Shi, Lingjia Xu","doi":"10.1016/j.surg.2024.108957","DOIUrl":"10.1016/j.surg.2024.108957","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"108957"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792326","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":"Model of End-Stage Liver Disease–alpha-fetoprotein–tumor burden (MELD-AFP-TBS) score to stratify prognosis after liver resection for hepatocellular carcinoma","authors":"Jun Kawashima MD ,&nbsp;Miho Akabane MD ,&nbsp;Mujtaba Khalil MD ,&nbsp;Selamawit Woldesenbet MD ,&nbsp;Yutaka Endo MD ,&nbsp;Kota Sahara MD ,&nbsp;Andrea Ruzzenente MD ,&nbsp;Francesca Ratti MD ,&nbsp;Hugo P. Marques MD ,&nbsp;Sara Oliveira MD ,&nbsp;Jorge Balaia MD ,&nbsp;François Cauchy MD ,&nbsp;Vincent Lam MD ,&nbsp;George A. Poultsides MD ,&nbsp;Minoru Kitago MD ,&nbsp;Irinel Popescu MD ,&nbsp;Guillaume Martel MD ,&nbsp;Ana Gleisner MD ,&nbsp;Tom Hugh MD ,&nbsp;Matthew Weiss MD ,&nbsp;Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FSSO, FRACS (Hon.)","doi":"10.1016/j.surg.2025.109388","DOIUrl":"10.1016/j.surg.2025.109388","url":null,"abstract":"<div><h3>Introduction</h3><div>Morphologic criteria, such as the Barcelona Clinic Liver Cancer staging system often fail to accurately predict long-term survival among patients undergoing liver resection for hepatocellular carcinoma. We sought to develop a continuous risk score that incorporates established markers of tumor biology and liver function to improve the prediction of overall survival.</div></div><div><h3>Methods</h3><div>Data from a multi-institutional database were used to identify patients who underwent curative-intent hepatectomy for hepatocellular carcinoma. A predictive score for overall survival was developed using weighted beta-coefficients from a multivariable Cox regression model.</div></div><div><h3>Results</h3><div>Among 850 patients, 595 (70.0%) were assigned to the training cohort, and 255 (30.0%) to the test cohort. In the training cohort, multivariable analysis identified the Model of End-Stage Liver Disease (hazard ratio, 1.04; 95% confidence interval, 1.01–1.07), log-transformed alpha-fetoprotein (hazard ratio, 1.07; 95% confidence interval, 1.02–1.13), and tumor burden score (hazard ratio, 1.07; 95% confidence interval, 1.03–1.11) as independent predictors of worse overall survival. The Model of End-Stage Liver Disease–alpha-fetoprotein–tumor burden score, based on the Cox model, stratified patients into low-risk (<em>n</em> = 466, 78.3%) with a 5-year OS of 70.5% and high-risk (<em>n</em> = 129, 21.7%) with a 5-year OS of 47.0% (<em>P</em> &lt; .001). In the test cohort, the Model of End-Stage Liver Disease–alpha-fetoprotein–tumor burden score demonstrated superior discriminative accuracy (C-index: 0.72, time-dependent area under the curve 1-year: 0.80, 3-year 0.76, 5-year 0.70) compared with the Barcelona Clinic Liver Cancer staging system (C-index: 0.53, time-dependent area under the curve 1-year: 0.61, 3-year 0.55, 5-year 0.56). An online tool was made accessible at <span><span>https://jk-osu.shinyapps.io/MELD_AFP_TBS/</span><svg><path></path></svg></span>.</div></div><div><h3>Conclusion</h3><div>The Model of End-Stage Liver Disease–alpha-fetoprotein–tumor burden score provides a novel, accurate tool for prognostic stratification of patients with hepatocellular carcinoma, identifying high-risk patients who may benefit from alternative treatments to improve outcomes.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109388"},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891840","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":"Is preoperative smoking status a predictor of postoperative outcomes after esophagectomy for squamous cell carcinoma in a high-volume centre?","authors":"Alexandre Lintis MD ,&nbsp;Thibault Voron MD, PhD ,&nbsp;Guillaume Passot MD, PhD ,&nbsp;Sebastien Degisors MD ,&nbsp;Marguerite Messier MD ,&nbsp;Clarisse Eveno MD, PhD ,&nbsp;Guillaume Piessen MD, PhD ,&nbsp;Julie Veziant MD, PhD","doi":"10.1016/j.surg.2025.109379","DOIUrl":"10.1016/j.surg.2025.109379","url":null,"abstract":"<div><h3>Background</h3><div>Smoking is a major risk factor for esophageal squamous cell carcinoma (ESCC) and is linked to increased postoperative morbidity. However, its impact on long-term survival remains unclear. This study evaluated the influence of preoperative smoking status on postoperative complications and survival following esophagectomy for ESCC in a high-volume center.</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for ESCC between 1996 and 2019 were retrospectively categorized as smokers (S-group) or non-smokers (NS-group). A subgroup analysis was performed to compare active and former smokers. Primary outcomes included major postoperative complications (Clavien-Dindo ≥ III), pulmonary complications, and postoperative mortality at 30 and 90 days. Long-term outcomes included overall survival (OS) and recurrence-free survival (RFS).</div></div><div><h3>Results</h3><div>Among 694 patients, 97 (14%) were in the NS-group and 597 (86%) in the S-group. Smokers had significantly higher major morbidity rates (37% vs 23%, <em>P</em> = .002), including major pulmonary complications (29% vs 21%, <em>P</em> = .03). Active smoking was associated with increased 30-day mortality (<em>P</em> = .006) and higher rates of acute respiratory distress syndrome (<em>P</em> = .012) compared to former smokers. OS and RFS did not differ significantly between groups. The absence of post-operative smoking data limits long-term outcome interpretation.</div></div><div><h3>Conclusion</h3><div>Smoking was associated with increased perioperative morbidity, particularly pulmonary complications, but its effect on long-term survival remains uncertain. Structured smoking cessation programs should be integrated into perioperative care. Future studies should incorporate postoperative smoking status to better assess its impact on survival.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109379"},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881397","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":"Patterns of care and surgical outcomes for early-stage rectal cancer in the United States","authors":"Julia Kohn MD ,&nbsp;Anthony I. Squillaro MD ,&nbsp;Alexander Troester MD ,&nbsp;Sarah L. Mott MS ,&nbsp;Melanie Quick BS ,&nbsp;Lindsay Welton MD ,&nbsp;Christine Jensen MD ,&nbsp;Imran Hassan MD ,&nbsp;Paolo Goffredo MD","doi":"10.1016/j.surg.2025.109374","DOIUrl":"10.1016/j.surg.2025.109374","url":null,"abstract":"<div><h3>Background</h3><div>Although limited trials have demonstrated the feasibility of rectal-preserving approaches in clinical T1-3N0 adenocarcinoma, local excision after neoadjuvant therapy has been associated with high rates of morbidity. We hypothesized that this strategy would be comparable to the standard, total mesorectal excision. The aim of this study was to describe trends of early-stage rectal cancer management.</div></div><div><h3>Methods</h3><div>cT1-3N0 rectal cancers in the National Cancer Database (2006–2018) were grouped into 5 treatments: total mesorectal excision, total neoadjuvant therapy + local excision, neoadjuvant chemoradiotherapy + local excision, total neoadjuvant therapy + total mesorectal excision, and neoadjuvant chemoradiotherapy + total mesorectal excision. Morbidity was defined as a combination of readmissions and 30- and 90-day mortality.</div></div><div><h3>Results</h3><div>We identified 22,793 patients. Neoadjuvant chemoradiotherapy + local excision had the highest proportion of patients ≥70 years (41%) and those with comorbidities (Charlson-Deyo score ≥2, 9%). Median stay was 1 day for local excision and 5 days for total mesorectal excision. Overall composite morbidity was 9%, which, after adjustment, was not statistically different between local excision and total mesorectal excision (odds ratio = 0.45, 95% confidence interval: 0.17–1.19). Among local excision patients, 56% had pathologic complete response, 33% were pStage I, and 12% pStage II-III. In multivariable analysis, all strategies had similar overall survival compared with total mesorectal excision, except for neoadjuvant chemoradiotherapy + local excision, which was associated with worse prognosis (hazard ratio = 1.57, 95% confidence interval: 1.21–2.03).</div></div><div><h3>Conclusion</h3><div>Although infrequent, neoadjuvant chemoradiotherapy/total neoadjuvant therapy + local excision were associated with high rates of tumor downstaging, suggesting that rectal-preserving strategies are feasible. However, 1 in 8 patients had more advanced disease, which may have compromised future total mesorectal excision planes. Together with the similar morbidity and relatively worse prognosis of neoadjuvant chemoradiotherapy + local excision, these observations should prompt careful patient selection for this approach, while cautioning against its widespread use.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"183 ","pages":"Article 109374"},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881402","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 on \"Impact of biliary drainage method before pancreaticoduodenectomy on short- and long-term outcomes in patients with periampullary carcinoma and obstructive jaundice: A multicenter retrospective analysis\".","authors":"Jiawei Zhang, Xiangbo Chen","doi":"10.1016/j.surg.2025.109380","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109380","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109380"},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054732","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: Methodologic and statistical considerations for comparative studies on radical antegrade modular pancreatosplenectomy.","authors":"Xiang Zhou, Shunqi Xie","doi":"10.1016/j.surg.2025.109371","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109371","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109371"},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982946","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: \"The impact of complication-sensitive risk models on hospital benchmarking for failure to rescue\".","authors":"Venkata Dileep Kumar Veldi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.surg.2025.109382","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109382","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109382"},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044641","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}