Surgery Today最新文献

Early thyroid-stimulating hormone dynamics predict outcomes in advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab. 早期促甲状腺激素动态预测晚期肝细胞癌用阿特唑单抗加贝伐单抗治疗的预后。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-12 DOI: 10.1007/s00595-026-03503-w

Michinori Matsumoto, Tomohiko Taniai, Tadashi Uwagawa, Koichiro Haruki, Yoshihiro Shirai, Kenei Furukawa, Shinji Onda, Masashi Tsunematsu, Mitsuru Yanagaki, Munetoshi Akaoka, Yuto Yamahata, Kanako Maeda, Kohei Okazaki, Yuta Yamada, Toru Ikegami

{"title":"Early thyroid-stimulating hormone dynamics predict outcomes in advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab.","authors":"Michinori Matsumoto, Tomohiko Taniai, Tadashi Uwagawa, Koichiro Haruki, Yoshihiro Shirai, Kenei Furukawa, Shinji Onda, Masashi Tsunematsu, Mitsuru Yanagaki, Munetoshi Akaoka, Yuto Yamahata, Kanako Maeda, Kohei Okazaki, Yuta Yamada, Toru Ikegami","doi":"10.1007/s00595-026-03503-w","DOIUrl":"https://doi.org/10.1007/s00595-026-03503-w","url":null,"abstract":"Purpose: Early predictive biomarkers for response to atezolizumab plus bevacizumab (Atez+Bev) in advanced hepatocellular carcinoma (HCC) remain unclear. We investigated the prognostic significance of early thyroid-stimulating hormone (TSH) dynamics and the aspartate aminotransferase-to-platelet ratio index (APRI) in patients receiving Atez+Bev.Methods: We retrospectively analyzed 32 patients with advanced HCC treated with Atez+Bev. TSH ratios after 1 and 2 treatment cycles were calculated relative to baseline. Cutoff values were determined using receiver operating characteristic analysis. Progression-free survival (PFS) was evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Landmark analysis was performed to minimize immortal time bias.Results: The objective response rate was 25%. Patients with a low TSH ratio after 1 cycle (< 1.23) showed shorter PFS than those with a high ratio. In exploratory multivariable analysis, APRI ≥0.81 (hazard ratio [HR] 3.17, 95% confidence interval [CI] 1.02-9.81, p=0.046) and TSH ratio after 1 cycle <1.23 (HR 2.76, 95% CI 1.01-7.54, p=0.040) were independently associated with shorter PFS. Landmark analysis showed a consistent association between early TSH dynamics and PFS.Conclusions: Early TSH dynamics and baseline APRI may be useful for exploratory risk stratification in advanced HCC treated with Atez+Bev, although these findings require validation in larger cohorts.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Visualizing pelvic splanchnic nerve and hypogastric nerve with magnetic resonance neurography in rectal cancer patients. 直肠癌患者盆腔植神经和胃下神经的磁共振神经成像。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-09 DOI: 10.1007/s00595-026-03501-y

Yuko Ikeda, Gaku Ohira, Koichi Hayano, Toru Tochigi, Yoshihiro Kurata, Atsushi Hirata, Hajime Yokota, Koji Matsumoto, Yoshiki Yamagishi, Tetsuro Maruyama, Koichiro Okada, Michihiro Maruyama, Shuto Kiyohiko, Hisahiro Matsubara

{"title":"Visualizing pelvic splanchnic nerve and hypogastric nerve with magnetic resonance neurography in rectal cancer patients.","authors":"Yuko Ikeda, Gaku Ohira, Koichi Hayano, Toru Tochigi, Yoshihiro Kurata, Atsushi Hirata, Hajime Yokota, Koji Matsumoto, Yoshiki Yamagishi, Tetsuro Maruyama, Koichiro Okada, Michihiro Maruyama, Shuto Kiyohiko, Hisahiro Matsubara","doi":"10.1007/s00595-026-03501-y","DOIUrl":"https://doi.org/10.1007/s00595-026-03501-y","url":null,"abstract":"Purpose: To evaluate the visualization rates of the hypogastric and pelvic splanchnic nerves using magnetic resonance neurography (MRN) and to identify associated factors.Materials and methods: This study included patients with rectal carcinoma who underwent preoperative MRN at our institution between December 2019 and September 2020. Two gastrointestinal surgeons evaluated the visibility of the hypogastric and pelvic splanchnic nerves on a per-nerve basis, with scores of \"excellent\" or \"good\" defined as successful visualization.Results: The visualization rates of the hypogastric and pelvic splanchnic nerves were 21.6% and 81.8%, respectively. A large visceral fat area at the umbilical level (p = 0.0150) was an independent factor affecting the visualization rate of the hypogastric nerves. Early clinical T stage (cT1-3) (p = 0.0255) and a large visceral fat area at the level of the upper edge of the femoral head (p = 0.0096) were independent factors affecting the visualization rate of the pelvic splanchnic nerves.Conclusion: MRN demonstrated a high visualization rate for the pelvic splanchnic nerves but a low rate for the hypogastric nerves. Visualization appeared to be influenced by the visceral fat area and inflammatory responses or edema in surrounding structures.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coronary bypass outcomes in chronic limb-threatening ischemia are significantly worse than in patients with non-critical lower extremity arterial disease. 慢性肢体威胁缺血患者的冠状动脉搭桥治疗结果明显差于非危重性下肢动脉疾病患者。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-09 DOI: 10.1007/s00595-026-03499-3

Kentaro Shirakura, Yuki Setogawa, Ryohei Ushioda, Daisuke Takeyoshi, Masahiro Tsutsui, Shinsuke Kikuchi, Nobuyoshi Azuma, Hiroyuki Kamiya, Shingo Kunioka

{"title":"Coronary bypass outcomes in chronic limb-threatening ischemia are significantly worse than in patients with non-critical lower extremity arterial disease.","authors":"Kentaro Shirakura, Yuki Setogawa, Ryohei Ushioda, Daisuke Takeyoshi, Masahiro Tsutsui, Shinsuke Kikuchi, Nobuyoshi Azuma, Hiroyuki Kamiya, Shingo Kunioka","doi":"10.1007/s00595-026-03499-3","DOIUrl":"https://doi.org/10.1007/s00595-026-03499-3","url":null,"abstract":"Purpose: Lower extremity arterial disease (LEAD) is a risk factor in patients undergoing coronary artery bypass grafting (CABG); however, the impact of chronic limb-threatening ischemia (CLTI), its most advanced stage, remains unclear. We evaluated early and long-term outcomes of CABG in CLTI.Method: We retrospectively analyzed 334 consecutive patients who underwent isolated CABG between 2014 and 2024. Patients were stratified into three groups: CLTI (n = 22), non-CLTI LEAD (n = 41), and non-LEAD (n = 271). The primary endpoint was long-term survival; the secondary endpoints were 30-day mortality and major adverse cardiac and cerebrovascular events.Results: The CLTI group had higher rates of diabetes mellitus (90.9%) and hemodialysis (86.4%) (p < 0.01). Thirty-day mortality was similar (9.1%, 2.4%, and 5.5%; p = 0.52), whereas five-year survival was significantly lower in the CLTI group (39.8% vs. 86.2% and 90.8%; p < 0.01). A Cox analysis showed that age, hemodialysis, and acute myocardial infarction were independent predictors of 5-year survival.Conclusions: CLTI predicts poor long-term survival because of comorbidities. In this high-risk population, individualized strategies balancing the extent of coronary revascularization against operative risk may achieve acceptable early outcomes, although the safety of incomplete/functional revascularization requires confirmation in larger cohorts.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term survival after multiple arterial coronary artery bypass grafting compared with percutaneous coronary intervention: a systematic review and meta-analysis. 多动脉冠状动脉旁路移植术与经皮冠状动脉介入治疗的长期生存率比较：一项系统回顾和荟萃分析。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-09 DOI: 10.1007/s00595-026-03502-x

Hidefumi Nishida, Ryota Nakamura, Rihito Tamaki, Kohei Abe, Mahbubur Rahman

{"title":"Long-term survival after multiple arterial coronary artery bypass grafting compared with percutaneous coronary intervention: a systematic review and meta-analysis.","authors":"Hidefumi Nishida, Ryota Nakamura, Rihito Tamaki, Kohei Abe, Mahbubur Rahman","doi":"10.1007/s00595-026-03502-x","DOIUrl":"https://doi.org/10.1007/s00595-026-03502-x","url":null,"abstract":"Background: Multiple arterial coronary artery bypass grafting (CABG) has been associated with superior long-term outcomes compared with single arterial CABG. However, randomized trials comparing percutaneous coronary intervention (PCI) with CABG have largely evaluated single arterial grafting strategies, leaving evidence comparing multiple arterial CABG with PCI limited.Methods: This systematic review and meta-analysis was registered prospectively in PROSPERO (CRD42025106759). MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies published from inception through September 30, 2025, that compared outcomes between multiple arterial CABG and PCI in patients with multivessel coronary artery disease. Study-level meta-analyses and reconstructed individual patient data (IPD) meta-analyses were performed. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular and cerebrovascular events (MACCE).Results: Ten observational studies were included. Study-level meta-analysis showed higher all-cause mortality with PCI (hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.51-2.09), consistent with reconstructed IPD analysis (HR 2.05, 95% CI 1.86-2.27). PCI was also associated with increased MACCE (study-level HR 2.48, 95% CI 1.91-3.21; IPD HR 2.94, 95% CI 2.56-3.39).Conclusion: In multivessel coronary artery disease, multiple arterial CABG was associated with significantly lower long-term mortality and MACCE than PCI, supporting its consideration in heart team decision-making.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-assisted surgery for rectal cancer with persistent descending mesocolon: analysis of vascular anatomical features and short-term outcomes. 机器人辅助手术治疗直肠癌伴持续性肠系膜下降：血管解剖特征及近期疗效分析

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-06 DOI: 10.1007/s00595-026-03444-4

Aya Narumi, Marie Hanaoka, Shunsaku Nakagawa, Mari Nakagawa, Shinichi Yamauchi, Hiroyasu Kagawa, Masanori Tokunaga, Yusuke Kinugasa

{"title":"Robot-assisted surgery for rectal cancer with persistent descending mesocolon: analysis of vascular anatomical features and short-term outcomes.","authors":"Aya Narumi, Marie Hanaoka, Shunsaku Nakagawa, Mari Nakagawa, Shinichi Yamauchi, Hiroyasu Kagawa, Masanori Tokunaga, Yusuke Kinugasa","doi":"10.1007/s00595-026-03444-4","DOIUrl":"https://doi.org/10.1007/s00595-026-03444-4","url":null,"abstract":"Purpose: Persistent descending mesocolon (PDM) is a rare congenital anomaly characterized by a medial shift of the descending colon and vascular variations that can complicate colorectal surgery. This study aimed to clarify the PDM-associated vascular anatomy and describe the short-term outcomes of robot-assisted surgery.Methods: We retrospectively analyzed 541 patients with primary rectal cancer who underwent robot-assisted surgery (2017-2024) and compared the short-term outcomes between the PDM and non-PDM groups. The vascular anatomy, including inferior mesenteric artery (IMA) branching patterns and marginal artery defects, was assessed in 501 patients using preoperative enhanced computed tomography.Results: PDM was identified in 22 patients (4.1%) in this study. The short-term outcomes were comparable between the groups. The PDM group had a significantly higher prevalence of radial IMA branching patterns and a higher frequency of marginal artery defects than the non-PDM group (9% vs. 2%).Conclusion: PDM is associated with a higher prevalence of radial IMA branching patterns. Marginal artery defects were observed more frequently among patients with PDM; however, this finding requires cautious interpretation because of the small number of affected cases and potential verification bias. Appropriate identification and management of vascular variations may contribute to acceptable short-term outcomes of robot-assisted surgery in patients with PDM.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility of laparoscopic inguinal hernia repair in extremely- and very-low-birth-weight infants: a single-center retrospective study. 极低和极低出生体重儿腹腔镜腹股沟疝修补的可行性：一项单中心回顾性研究。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-05 DOI: 10.1007/s00595-026-03497-5

Hiroshi Nouso, Reisuke Imaji, Hinako Watanabe, Momoko Sumida, Hiroshi Okano, Terutaka Tanimoto

{"title":"Feasibility of laparoscopic inguinal hernia repair in extremely- and very-low-birth-weight infants: a single-center retrospective study.","authors":"Hiroshi Nouso, Reisuke Imaji, Hinako Watanabe, Momoko Sumida, Hiroshi Okano, Terutaka Tanimoto","doi":"10.1007/s00595-026-03497-5","DOIUrl":"https://doi.org/10.1007/s00595-026-03497-5","url":null,"abstract":"Purpose: Inguinal hernia (IH) occurs frequently in extremely- and very-low-birth-weight (ELBW/VLBW) infants. This study evaluates the feasibility of performing laparoscopic repair (LR) near neonatal intensive care unit (NICU) discharge, by comparing its perioperative outcomes with those of open repair (OR) in ELBW/VLBW infants.Methods: We retrospectively reviewed infants with birth weight < 1500 g who were diagnosed with IH during NICU hospitalization and underwent IH repair between 2015 and 2023. LR was performed using the laparoscopic percutaneous extraperitoneal closure (LPEC) technique. We compared the patient characteristics, operative variables, and postoperative outcomes between the groups.Results: Among a total of 49 infants, 31 underwent OR and 18 underwent LR. The LR group had a higher body weight at surgery, a lower prevalence of chronic lung disease, and different sex distribution. Operative and anesthesia times were similar for unilateral repair but shorter with LR for bilateral repair. There were no significant differences in postoperative complications. Three infants from the OR group underwent subsequent umbilicoplasty, and one developed a metachronous contralateral hernia.Conclusion: LR appears technically feasible with acceptable short-term outcomes and may allow contralateral evaluation and concomitant umbilicoplasty. However, baseline imbalances, the small sample size, and limited follow-up preclude conclusions regarding superiority or equivalence to OR.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A practical strategy for skeletal chest wall reconstruction after resection of malignant chest wall lesions: a single-institution experience. 恶性胸壁病变切除后骨骼胸壁重建的实用策略：单一机构的经验。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-05 DOI: 10.1007/s00595-026-03492-w

Ryusei Yoshino, Kengo Takahashi, Nozomi Hatanaka, Akane Ito, Shunsuke Yasuda, Masahiro Kitada

{"title":"A practical strategy for skeletal chest wall reconstruction after resection of malignant chest wall lesions: a single-institution experience.","authors":"Ryusei Yoshino, Kengo Takahashi, Nozomi Hatanaka, Akane Ito, Shunsuke Yasuda, Masahiro Kitada","doi":"10.1007/s00595-026-03492-w","DOIUrl":"https://doi.org/10.1007/s00595-026-03492-w","url":null,"abstract":"Purpose: No standardized strategy exists for skeletal chest wall reconstruction after the resection of malignant chest wall lesions. We reviewed our single-institution experience with defect-specific material selection and perioperative outcomes.Methods: The subjects of this retrospective study were 20 patients who underwent reconstruction after resection of malignant chest wall lesions between January 2014 and June 2025. Procedures were categorized as skeletal chest wall reconstruction or adjacent or combined thoracic structure reconstruction. Defects, materials, margins, complications, recurrence, and survival were analyzed.Results: Fifteen patients underwent skeletal chest wall reconstruction and five underwent adjacent or combined thoracic structure reconstruction. Polypropylene mesh was used for selected anterior, lateral, or extensive skeletal defects when stable fixation and sufficient soft-tissue coverage were achievable. In the 20-patient cohort, resection margin status was R0 in 11 patients and R1 in 9, recurrence developed in 8, and the median postoperative hospital stay was 12 days. MRSA empyema developed in one patient, requiring open-window thoracostomy, vacuum-assisted closure therapy, and thoracoplasty.Conclusions: Skeletal chest wall reconstruction should be individualized according to defect-specific factors. Polypropylene mesh may be feasible for selected defects when adequate fixation, appropriate tension, and sufficient soft-tissue coverage can be achieved. The flowchart is a practical institutional framework rather than a validated algorithm.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction: Is stent graft placement superior to transarterial embolization in the treatment of patients with extraluminal post-pancreatectomy hemorrhage? 更正：在胰腺切除术后腔外出血患者的治疗中，支架置入是否优于经动脉栓塞？

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-05 DOI: 10.1007/s00595-026-03491-x

Yuki Hisano, Hirohisa Okabe, Hiromitsu Hayashi, Katsuhiro Ogawa, Shota Uemura, Shinsei Yumoto, Takashi Matsumoto, Daisuke Ogawa, Yuki Adachi, Takuya Tajiri, Takanobu Yamao, Rumi Itoyama, Yuki Kitano, Tatsunori Miyata, Yoshitaka Tamura, Toshinori Hirai, Masaaki Iwatsuki

引用次数: 0

Feasibility of robotic-assisted right colectomy using the "squeezing approach". “挤压入路”机器人辅助右结肠切除术的可行性。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-05 DOI: 10.1007/s00595-026-03498-4

Kengo Shibata, Nobuki Ichikawa, Tadashi Yoshida, Yosuke Ohno, Ken Imaizumi, Shunji Sano, Akinobu Taketomi

{"title":"Feasibility of robotic-assisted right colectomy using the \"squeezing approach\".","authors":"Kengo Shibata, Nobuki Ichikawa, Tadashi Yoshida, Yosuke Ohno, Ken Imaizumi, Shunji Sano, Akinobu Taketomi","doi":"10.1007/s00595-026-03498-4","DOIUrl":"https://doi.org/10.1007/s00595-026-03498-4","url":null,"abstract":"Purpose: To evaluate the initial outcomes regarding the safety and feasibility of robotic-assisted right colectomy (RRC) using the squeezing approach compared to conventional laparoscopic right colectomy (LRC).Methods: We retrospectively compared the short-term surgical outcomes of 118 consecutive patients who underwent right colectomy using the squeezing approach for colon cancer (70 LRC and 48 RRC) at our institution between April 2022 and December 2025.Results: The median operative time was significantly longer in the RRC group than in the LRC group (219.0 min vs. 189.0 min, p < 0.0001). However, the median estimated blood loss was equivalent and minimal in both groups (0.0 mL vs. 0.0 mL, p = 0.9035). There was no significant difference in the median number of harvested lymph nodes (21.5 vs. 23.0, p = 0.7506). RRC demonstrated safety, with outcomes comparable to LRC in terms of the rate of conversion to open surgery (2.1% vs. 5.7%, p = 0.6194), Clavien-Dindo Grade II complications (8.3% vs. 11.4%, p = 0.741), and Grade III complications (2.1% vs. 2.9%, p = 1.000).Conclusions: The squeezing approach enables safe and feasible RRC, thereby achieving perioperative outcomes comparable to LRC, even during the initial implementation phase.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between preoperative tracheal deviation and postoperative complications of thyroidectomy for giant multinodular goiter: a single-center retrospective cohort study. 巨大多结节性甲状腺肿甲状腺切除术术前气管偏离与术后并发症的关系：一项单中心回顾性队列研究。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-05 DOI: 10.1007/s00595-026-03496-6

Mehmet Fatih Özsaray, Turgay Şimşek, Nuh Zafer Cantürk

{"title":"Association between preoperative tracheal deviation and postoperative complications of thyroidectomy for giant multinodular goiter: a single-center retrospective cohort study.","authors":"Mehmet Fatih Özsaray, Turgay Şimşek, Nuh Zafer Cantürk","doi":"10.1007/s00595-026-03496-6","DOIUrl":"https://doi.org/10.1007/s00595-026-03496-6","url":null,"abstract":"Purpose: To evaluate the association between preoperative computed tomography (CT)-measured tracheal deviation and postoperative composite complications after thyroidectomy for giant multinodular goiter.Methods: This retrospective cohort included 90 patients with a CT-measured maximum thyroid diameter ≥10 cm. Tracheal deviation was categorized as ≤5 mm, 6-10 mm, or >10 mm. Thyroid volume was calculated using the ellipsoid formula. Because no composite complications occurred in the ≤10-mm group, Firth bias-reduced logistic regression was performed. An exploratory model was adjusted additionally for age, sex, thyroid volume, gland distribution, thyroid functional status, thyroid autoantibody status, and retrosternal extension.Results: Composite complications occurred in 16 patients (17.8%), all from the >10-mm group. The median thyroid volume increased significantly across the deviation groups (210.5, 249.0, and 389.2 mL; p<0.001). Univariable Firth analysis showed a strong association between tracheal deviation >10 mm and composite complications (OR 50.90, 95% CI 6.44-6582.01; p<0.001). In the adjusted model, the association remained positive but was not significant (OR 8.91, 95% CI 0.28-1704.62; p=0.224).Conclusions: Tracheal deviation >10 mm identified patients at high crude risk for postoperative complications, but an independent association beyond thyroid volume, retrosternal extension, and other clinical factors was not demonstrated. Tracheal deviation should be interpreted together with other CT features of giant multinodular goiter.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0