Surgery最新文献

{"title":"Comment on: \"Portal flow modulation by splenic artery ligation to prevent posthepatectomy liver failure: A randomized controlled trial\".","authors":"Renu Sah, Ankita Mathur, Venkata Dileep Kumar Veldi","doi":"10.1016/j.surg.2025.109436","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109436","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109436"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249679","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 \"Development and validation of a nomogram to predict the need for bailout procedure in laparoscopic cholecystectomy: A multicenter study of 1,898 cases\".","authors":"Yuhang Zhou, Bang Wang, Minhui Xu","doi":"10.1016/j.surg.2025.109465","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109465","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109465"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187969","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: \"Association of mental health assessment with postoperative outcomes following major surgery in older individuals\".","authors":"Mohammadali Ranjbar, Hesam Nozari, Amirhossein Keshavarz","doi":"10.1016/j.surg.2025.109435","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109435","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109435"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187968","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 a machine learning–based model for predicting intraoperative blood loss during burn surgery","authors":"Fangqing Zuo MD, MS , Jiaqing Su MD, MS , Yang Li MS , Haiming Xin MD, PhD , Chunhao Li BN , Lina Huang BE , Lijuan Zhang MD , Junda Li MD , Zhuo Zeng MD, MS , Yu Chen BSMT , Yali Gong MS , Jing Chen MD, PhD , Yingying Lan MS , Yajie Chen BSMT , Cheng Zhang BSMT , Yizhi Peng MD, PhD , Gaoxing Luo MD, PhD , Zhiqiang Yuan MD, PhD","doi":"10.1016/j.surg.2025.109445","DOIUrl":"10.1016/j.surg.2025.109445","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative blood loss is a critical issue in the care of patients with burns. The timely identification of patients at elevated risk for substantial blood loss during surgical procedures is imperative.</div></div><div><h3>Methods</h3><div>Demographic data, laboratory test results, and surgical factors of patients were collected. For predicting intraoperative blood loss >750 mL, the original cohort was randomly divided in an 8:2 ratio, with the larger group allocated for the model development and the smaller for internal validation. Six machine-learning algorithms, including logistic regression, decision tree, random forest, K-nearest neighbor, support vector machine, and extreme gradient boosting were used to develop the prediction models. The performance of the models was assessed by 8 metrics as well as density curve, calibration curve and decision curve. A scoring system was designed to assess the performance efficacy. Validation was conducted in another 2 cohorts. The optimal prediction model acquired. Ultimately, a web-based calculator to estimate the incidence of intraoperative blood loss >750 mL was created.</div></div><div><h3>Results</h3><div>A total of 395 burn surgeries from 2 hospitals were analyzed, with 245 surgeries for modeling, 89 surgeries for the internal-external validation, and 61 surgeries for the external validation. The model features consist of 8 clinical variables. The random forest model gained the greatest total metrics score of 36, followed by the support vector machine, extreme gradient boosting, K-nearest neighbor, logistic regression, and decision tree models with total scores of 33, 32, 28, 24, and 18, respectively. Specifically, the random forest model performed superior in most metrics compared to the other models, achieving greater accuracy (0.776), recall (0.930), F1 score (0.868), as well as the lowest log loss (0.423), and Brier score (0.142). Meanwhile, the random forest model demonstrated strong performance with an area under the curve of 0.784 (95% confidence interval, 0.779–0.789), ranking second only slightly behind the extreme gradient boosting model, which achieved the greatest area under the curve of 0.785 (95% confidence interval, 0.780–0.790). Other models showed comparatively lower area under the curve values. The density curve, calibration plot, histogram with mean predicted probabilities against counts and decision curve of the random forest model also performed well. In the internal-external validation cohort, the random forest reached the greatest total metrics score of 35. In the external validation cohort, the random forest again secured the greatest composite metrics score, amounting to 38. Overall, the random forest model was found to be the optimal model for predictive accuracy. In addition initial hemoglobin, time to start surgery after burn injury, initial platelets, % total body surface area excised and grafted, and duration of surgery were the fi","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109445"},"PeriodicalIF":3.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170653","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":"Association of hospital volume with outcomes for reoperative coronary artery bypass grafting","authors":"Baran Khoraminejad BA ,&nbsp;Sara Sakowitz MS, MPH ,&nbsp;Troy Coaston BS ,&nbsp;Giselle Porter BS ,&nbsp;Saad Mallick MD ,&nbsp;Esteban Aguayo MD ,&nbsp;Peyman Benharash MD, MS","doi":"10.1016/j.surg.2025.109441","DOIUrl":"10.1016/j.surg.2025.109441","url":null,"abstract":"<div><h3>Introduction</h3><div>Outcomes following reoperative coronary artery bypass graft surgery are widely underexplored. Evaluating a contemporary national cohort, we assessed acute clinical and financial sequelae following reoperative coronary artery bypass graft surgery at the patient and hospital levels.</div></div><div><h3>Methods</h3><div>The 2016–2021 Nationwide Readmissions Database was queried to identify all adult (≥18 years) hospitalizations for elective isolated coronary artery bypass graft surgery. Patients with a history of coronary artery bypass graft surgery were categorized as ReOp (others: Non-ReOp). Centers in the highest quartile were considered high-volume centers. Multivariable regression models were built to assess the independent association of ReOp with clinical and financial outcomes.</div></div><div><h3>Results</h3><div>Of ∼470,546 patients, 5.0% were classified as ReOp. On average, ReOp was older (70 [63–76] vs 67 years [60–73], <em>P</em> &lt; .001), more often female (26.7 vs 21.7%, <em>P</em> &lt; .001), and of a higher Elixhauser comorbidity index (5 [4–7] vs 4 [3–5], <em>P</em> &lt; .001).</div><div>Following risk adjustment, ReOp was linked with comparable likelihood of in-hospital mortality (adjusted odds ratio 0.87, 95% confidence interval 0.74–1.03). However, ReOp faced greater odds of infection (adjusted odds ratio 1.72, 95% confidence interval 1.60–1.85), thromboembolism (1.85, 1.45–2.36), and stroke (1.35, 1.12–1.64). ReOp was also linked with greater costs (β +$9,845, 95% CI 8,888–0,802).</div><div>At high-volume centers, 5.1% of coronary artery bypass graft surgery recipients were ReOp. Reoperation was associated with greater adjusted odds of major complications (adjusted odds ratio 1.19, 95% confidence interval 1.12–1.27) and increased hospitalization expenditures (β +$6,782, 95% confidence interval 5,725–7,837).</div></div><div><h3>Conclusion</h3><div>The increased risk of facing major perioperative outcomes following reoperative coronary artery bypass graft surgery persists at centers despite case volume. Further studies are needed to develop optimal perioperative care pathways for these patients.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"184 ","pages":"Article 109441"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170654","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 role of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography-derived parameters as prognostic factors in patients undergoing resection for pancreatic ductal adenocarcinoma\".","authors":"Saad Ahmed Mughal, Aman Advani","doi":"10.1016/j.surg.2025.109438","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109438","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109438"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182594","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":"Rethinking turnover times: The right kind of wrong.","authors":"Javier A Blanco, Mitchell H Tsai, Justin S Routman","doi":"10.1016/j.surg.2025.109430","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109430","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109430"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181294","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":"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}