Surgery Today最新文献_第2页

Traumatic abdominal wall hernias: A 15-year single-center experience in diagnosis and management. 外伤性腹壁疝：15年单中心诊断和治疗经验。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-19 DOI: 10.1007/s00595-025-03179-8

Hye Young Woo, Kyoungwon Jung

{"title":"Traumatic abdominal wall hernias: A 15-year single-center experience in diagnosis and management.","authors":"Hye Young Woo, Kyoungwon Jung","doi":"10.1007/s00595-025-03179-8","DOIUrl":"10.1007/s00595-025-03179-8","url":null,"abstract":"Purpose: Traumatic abdominal wall hernia (TAWH) is a rare injury caused by high-energy blunt trauma. Its diagnosis is often missed, and the current management strategies remain inconsistent. This study aimed to describe the clinical characteristics, diagnostic challenges, and surgical outcomes of TAWH based on a 15-year experience at a high-volume trauma center in Korea.Methods: We retrospectively reviewed the records of patients diagnosed with TAWH between 2010 and 2024. The data included demographics, injury mechanisms, hernia features, surgical timing, and outcomes.Results: Of 17,852 patients with blunt abdominal trauma, 28 (0.16%) were diagnosed with TAWH. Although CT identified most hernias (96.4%), only 48.1% were noted in official radiology reports. Common hernia locations were lumbar (38.7%) and anterior (29.0%). Associated intra-abdominal injuries were present in 89.3% of cases. Surgical repair was performed in 22 patients, with 90.9% undergoing early repair during the index admission. Two patients underwent delayed mesh repair, without recurrence. Overall recurrence and surgical site infection rates were both 18.2%.Conclusion: TAWH remains under-recognized despite its strong association with high-energy trauma and clear CT detectability. Findings from this long-term single-center study support early repair when feasible and selective delayed mesh repair is performed in appropriate patients, underscoring the need for greater awareness among trauma providers.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"753-762"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Real-world short-term outcomes after distal pancreatectomy with en bloc celiac axis resection using the National clinical database of Japan. 使用日本国家临床数据库的远端胰腺切除术合并腹腔轴切除术后的实际短期结果。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-19 DOI: 10.1007/s00595-025-03170-3

Toru Nakamura, Takashi Sakamoto, Satoshi Hirano, Hiroyuki Yamamoto, Hiroshi Hasegawa, Yoshiro Fujii, Yoshihiro Kakeji, Ken Shirabe, Masafumi Nakamura, Masayuki Ohtsuka

{"title":"Real-world short-term outcomes after distal pancreatectomy with en bloc celiac axis resection using the National clinical database of Japan.","authors":"Toru Nakamura, Takashi Sakamoto, Satoshi Hirano, Hiroyuki Yamamoto, Hiroshi Hasegawa, Yoshiro Fujii, Yoshihiro Kakeji, Ken Shirabe, Masafumi Nakamura, Masayuki Ohtsuka","doi":"10.1007/s00595-025-03170-3","DOIUrl":"10.1007/s00595-025-03170-3","url":null,"abstract":"Purpose: To identify the risk factors for mortality and morbidity after distal pancreatectomy with en bloc celiac axis resection (DP-CAR) using prospectively registered data from the National Clinical Database (NCD).Methods: We retrospectively analyzed patients registered in the NCD between 2018 and 2021 who underwent DP-CAR. Surgical morbidity, mortality, and associated clinical factors were evaluated.Results: The study included 136 patients. Preoperative therapy included chemotherapy in 110 (80.9%) patients. The surgical mortality rate was 2.2% (3/136 patients). Recent weight loss (≥ 10% in the past 6 months) was significantly more prevalent in the mortality group than in the non-mortality group (33.3% [1/3] vs. 4.5% [6/133], respectively). Clavien-Dindo grade ≥ III complications occurred in 34.6% of the patients. Age ≥ 80 years old (odds ratio [OR], 8.75; 95% confidence interval [CI]: 1.21-63.43; p = 0.032) and portal vein resection (OR, 2.72; 95% CI: 1.04-7.13; p = 0.042) were identified as potential risk factors for severe postoperative complications. Recent weight loss (OR, 5.18; 95% CI: 0.96-27.8; p = 0.055) approached statistical significance.Conclusion: Although specific mortality risk factors could not be identified, the low mortality rate suggests that DP-CAR is safely performed in Japanese practice. Future efforts should focus on achieving zero DP-CAR-associated mortality.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"745-752"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551029","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

Graft trimming with LigaSure™ and leak testing with Indigo carmine reduces blood loss significantly after reperfusion in pancreas transplantation. 用LigaSure™进行移植物修剪和用Indigo胭脂红进行泄漏测试可显著减少胰腺移植再灌注后的失血。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-20 DOI: 10.1007/s00595-025-03173-0

Hiroki Imamura, Yoshito Tomimaru, Hirofumi Akita, Toshinori Ito, Yosuke Mukai, Kazuki Sasaki, Shinichiro Hasegawa, Daisaku Yamada, Takehiro Noda, Hidenori Takahashi, Shogo Kobayashi, Yuichiro Doki, Hidetoshi Eguchi

{"title":"Graft trimming with LigaSure™ and leak testing with Indigo carmine reduces blood loss significantly after reperfusion in pancreas transplantation.","authors":"Hiroki Imamura, Yoshito Tomimaru, Hirofumi Akita, Toshinori Ito, Yosuke Mukai, Kazuki Sasaki, Shinichiro Hasegawa, Daisaku Yamada, Takehiro Noda, Hidenori Takahashi, Shogo Kobayashi, Yuichiro Doki, Hidetoshi Eguchi","doi":"10.1007/s00595-025-03173-0","DOIUrl":"10.1007/s00595-025-03173-0","url":null,"abstract":"Purpose: Bleeding after graft reperfusion is a significant challenge in pancreas transplantation (PTx). To reduce post-reperfusion bleeding, we developed a modified bench surgery technique, combining a vessel-sealing system (LigaSure™) with indigo carmine (IC) leak testing. This study evaluates the clinical efficacy and safety of this method.Methods: We reviewed, retrospectively, 54 consecutive PTx procedures, with (n = 25) or without (n = 29) the novel LigaSure™ plus IC (L + IC) method, performed between 2010 and 2024. Surgical outcomes, postoperative complications, graft loss, and glucose tolerance were compared between the control and L + IC groups. The safety of IC (9.0 µg/mL) for pancreatic islet cells was assessed through in vitro AO/PI staining and glucose-stimulated insulin secretion (GSIS) assays.Results: The L + IC group showed significantly less post-reperfusion bleeding than the control group (715 mL vs. 360 mL; p = 0.0122). Multivariate analysis identified that L + IC was independently associated with reduced post-reperfusion bleeding (odds ratio 0.2171, p = 0.0171). IC exposure did not impair islet cell viability or function. The HbA1c and C-peptide levels were comparable between the groups.Conclusion: Our novel L + IC bench surgery technique proved safe and effective for reducing bleeding after pancreas graft reperfusion. Further prospective multicenter studies should be carried out to confirm its impact on long-term surgical outcomes.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"781-788"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565620","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

Standardization using soft coagulation scissors and Maryland bipolar forceps techniques reduces the operative time and incidence of recurrent laryngeal nerve palsy in robot-assisted minimally invasive esophagectomy. 采用软凝剪刀和马里兰双极钳技术的标准化减少了机器人辅助微创食管切除术的手术时间和喉返神经麻痹的发生率。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-20 DOI: 10.1007/s00595-025-03197-6

Hironobu Goto, Yasufumi Koterazawa, Tomoaki Aoki, Yutaka Sugita, Taro Ikeda, Hitoshi Harada, Yasunori Otowa, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji

{"title":"Standardization using soft coagulation scissors and Maryland bipolar forceps techniques reduces the operative time and incidence of recurrent laryngeal nerve palsy in robot-assisted minimally invasive esophagectomy.","authors":"Hironobu Goto, Yasufumi Koterazawa, Tomoaki Aoki, Yutaka Sugita, Taro Ikeda, Hitoshi Harada, Yasunori Otowa, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji","doi":"10.1007/s00595-025-03197-6","DOIUrl":"10.1007/s00595-025-03197-6","url":null,"abstract":"Purpose: Minimally invasive esophagectomy (MIE) is the standard surgical procedure. Robot-assisted MIE (RAMIE) was developed to overcome the problems associated with conventional MIE. This study investigated whether or not standardizing surgical procedures for RAMIE using soft coagulation scissors and Maryland bipolar forceps could improve short-term outcomes.Methods: This study included 130 patients who underwent RAMIE. Clinicopathological characteristics and surgical outcomes were compared before and after standardization by two expert surgeons as well as between the standardized and trainee groups. A cumulative sum control chart (CUSUM) was used to evaluate changes in operative time.Results: The console time during the thoracic procedure was shorter in the standardized group than in the pre-standardized group (P < 0.001). The rate of recurrent laryngeal nerve palsy was lower in the standardized group than in the pre-standardized group (P = 0.039). No significant differences were observed between the standardized and trainee groups. In the standardized and trainee groups, CUSUM clearly indicated that the console time peak occurred in the 12th and 16th cases.Conclusions: Standardization of surgical procedures using an appropriate device for each surgical step could improve surgical outcomes in RAMIE. Furthermore, it may facilitate safer and more efficient surgical training.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"815-824"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565713","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

The Goddard score for emphysema predicts the postoperative prognosis in pancreatic cancer. 肺气肿的戈达德评分预测胰腺癌术后预后。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-18 DOI: 10.1007/s00595-025-03188-7

Yuta Yamada, Kenei Furukawa, Koichiro Haruki, Yoshihiro Shirai, Masashi Tsunematsu, Shinji Onda, Mitsuru Yanagaki, Munetoshi Akaoka, Tomohiko Taniai, Toru Ikegami

{"title":"The Goddard score for emphysema predicts the postoperative prognosis in pancreatic cancer.","authors":"Yuta Yamada, Kenei Furukawa, Koichiro Haruki, Yoshihiro Shirai, Masashi Tsunematsu, Shinji Onda, Mitsuru Yanagaki, Munetoshi Akaoka, Tomohiko Taniai, Toru Ikegami","doi":"10.1007/s00595-025-03188-7","DOIUrl":"10.1007/s00595-025-03188-7","url":null,"abstract":"Purpose: Chronic inflammation contributes to carcinogenesis and pulmonary emphysema is characterized by chronic pulmonary inflammation. We hypothesized that the severity of emphysema, quantitatively assessed using the Goddard score (GS), correlates with outcomes following surgical treatment for pancreatic cancer.Methods: We retrospectively analyzed 191 patients who underwent surgery for pancreatic cancer between 2013 and 2022. GS was assessed using routine preoperative computed tomography. Univariate and multivariate analyses were performed to evaluate the impact of GS on oncological outcomes.Results: A high GS (≥ 7) was identified in 46 (24.1%) patients, who were significantly older and had a lower body mass index than patients with a low GS. In the multivariate analysis, a high GS emerged as an independent predictor of both a worse disease-free survival (DFS) (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.06-2.36; p = 0.01) and worse overall survival (OS) (HR, 1.80; 95% CI, 1.09-2.97; p = 0.02). Other independent risk factors included a poor DFS, sarcopenia, lymph node metastasis, poor tumor differentiation, poor OS, poor tumor differentiation, lack of adjuvant chemotherapy, and postoperative complications.Conclusion: The GS, a simple radiological index of emphysema, may serve as a novel preoperative prognostic indicator in patients undergoing pancreatic cancer surgery.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"736-744"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542679","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

Abdominal reconstruction by sublay reinforcement after radical resection of abdominal desmoid tumors. 腹壁硬纤维瘤根治术后腹腔强化重建。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-06 DOI: 10.1007/s00595-025-03165-0

Shiwei Yang, Yong Wang, Bing Wu, Yongyang Yu, Lie Yang, Shahid Ali, Junting Li, Wenzhang Lei, Zongguang Zhou, Wang Yong

引用次数: 0

Using protease inhibitors to prevent intraperitoneal adhesions: effects of nafamostat mesylate, UAMC-00050, GM6001, and enoxaparin in the cecal ligation and puncture model and the ischemic button model. 应用蛋白酶抑制剂预防腹腔粘连：甲磺酸那莫他酯、UAMC-00050、GM6001、依诺肝素在盲肠结扎穿刺模型和缺血性钮扣模型中的作用

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-14 DOI: 10.1007/s00595-025-03166-z

Philip Plaeke, Joris De Man, Gun-Soo Hong, Michelle de Bruyn, Ingrid De Meester, Philippe G Jorens, Koen Augustyns, Joerg C Kalff, Sven Wehner, Guy Hubens, Benedicte De Winter

{"title":"Using protease inhibitors to prevent intraperitoneal adhesions: effects of nafamostat mesylate, UAMC-00050, GM6001, and enoxaparin in the cecal ligation and puncture model and the ischemic button model.","authors":"Philip Plaeke, Joris De Man, Gun-Soo Hong, Michelle de Bruyn, Ingrid De Meester, Philippe G Jorens, Koen Augustyns, Joerg C Kalff, Sven Wehner, Guy Hubens, Benedicte De Winter","doi":"10.1007/s00595-025-03166-z","DOIUrl":"10.1007/s00595-025-03166-z","url":null,"abstract":"Purpose: Intraperitoneal adhesions, a major cause of post-surgical intestinal obstruction, arise from an imbalance between proteases of the coagulation and fibrinolysis pathways. This study aimed to reduce early adhesion formation by using the protease inhibitors, nafamostat mesylate (NFM), UAMC-00050, enoxaparin, and GM6001, in the cecal ligation and puncture (CLP) model and the ischemic button (IB) model in mice.Methods: Mice subjected to CLP received NFM (1, 10, or 20 mg/kg), UAMC-00050 (1 or 5 mg/kg), enoxaparin (1, 5, or 10 mg/kg), or GM6001 (100 mg/kg) in preventive, delayed, and combined setups. Adhesion severity was assessed 48 h post-CLP based on the extent, tenacity, and surgical access time. NFM and enoxaparin were tested further for 7 days in the IB model. Protease activity and gene expression were analyzed in NFM-treated mice.Results: CLP induced adhesions more strongly than the sham procedure. Preventive NFM reduced the adhesion extent by 49.8%. Repeated enoxaparin administration reduced the extent, tenacity, and access time (-46%). UAMC-00050 and GM6001 had no effect. In the IB model, enoxaparin, but not NFM, reduced the adhesion surface area and tenacity.Conclusions: Enoxaparin and NFM reduced adhesions effectively, suggesting that coagulation inhibition plays a key role. These findings suggest that selective protease inhibitors, when administered in a timely manner, could reduce intraperitoneal adhesions.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"673-689"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in thyroid surgery in Japan from 2014 to 2023: report on the National Clinical Database. 2014 - 2023年日本甲状腺手术趋势：国家临床数据库报告

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-17 DOI: 10.1007/s00595-025-03126-7

Yoko Omi, Hiroyuki Yamamoto, Naoyoshi Onoda, Chisato Tomoda, Takahiro Okamoto, Shinichi Suzuki, Hisato Hara, Iwao Sugitani

{"title":"Trends in thyroid surgery in Japan from 2014 to 2023: report on the National Clinical Database.","authors":"Yoko Omi, Hiroyuki Yamamoto, Naoyoshi Onoda, Chisato Tomoda, Takahiro Okamoto, Shinichi Suzuki, Hisato Hara, Iwao Sugitani","doi":"10.1007/s00595-025-03126-7","DOIUrl":"10.1007/s00595-025-03126-7","url":null,"abstract":"Purpose: Endocrine surgery encompasses various organ systems, but thyroid surgery represents the major component. The Japanese Association of Thyroid Surgeons published nationwide data on thyroid cancer surgery until 2005, since when no further reports have been published. Thus, we analyzed thyroid surgery trends using data from the National Clinical Database (NCD) from 2014 to 2023.Methods: We analyzed cases of thyroid surgery, for malignant and benign conditions, recorded in the NCD. A detailed analysis of papillary thyroid carcinoma (PTC) cases was conducted in 2014, 2019, and 2023 to assess TNM classification, surgical procedures, complications, and outcomes.Results: The number of thyroid surgery facilities and the number of thyroid surgeries being performed have both declined since 2020. A trend toward more hemithyroidectomies and fewer total thyroidectomies for PTC is evident. The number of surgeries for cancers < 1 cm and lateral node dissection for PTC have also decreased. Endoscopically assisted surgery has increased continuously, accounting for > 4% of thyroid operations in 2020. The incidence of permanent hypoparathyroidism has decreased and perioperative mortality is rare.Conclusion: The changes in surgical trends are aligned with guideline updates and shifts in surgical practice. Future efforts will refine data collection and utilize the NCD to improve thyroid surgical quality and research.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"721-727"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Benefits and risks of simultaneous versus staged laparoscopic resection for colorectal cancer with synchronous liver metastases. 同时与分期腹腔镜切除结直肠癌伴同步肝转移的益处和风险。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-20 DOI: 10.1007/s00595-025-03186-9

Shigenori Ei, Takashi Kaizu, Yoshiki Fujiyama, Kazuharu Igarashi, Nobuyuki Nishizawa, Hiroshi Tajima, Hiroyuki Furuya, Takeshi Naitoh, Yusuke Kumamoto

{"title":"Benefits and risks of simultaneous versus staged laparoscopic resection for colorectal cancer with synchronous liver metastases.","authors":"Shigenori Ei, Takashi Kaizu, Yoshiki Fujiyama, Kazuharu Igarashi, Nobuyuki Nishizawa, Hiroshi Tajima, Hiroyuki Furuya, Takeshi Naitoh, Yusuke Kumamoto","doi":"10.1007/s00595-025-03186-9","DOIUrl":"10.1007/s00595-025-03186-9","url":null,"abstract":"Purpose: To compare the advantages and disadvantages of simultaneous laparoscopic hepatocolorectal resection and staged resection for colorectal cancer with synchronous liver metastasis.Methods: Patients with colorectal cancer and synchronous liver metastases who underwent laparoscopic surgery were divided into simultaneous (n = 38) and staged (n = 56) resection groups and their short-term outcomes and medical expenses were then retrospectively compared.Results: The postoperative hospital stay was significantly shorter and the total medical costs were lower in the simultaneous group. However, the major complication rate (Clavien-Dindo classification ≥ 3a) was higher in the simultaneous group (28.9% vs. 12.5%, P = 0.047). After performing propensity score-adjusted logistic regression, simultaneous resection remained significantly associated with major complications (odds ratio, 5.11; P = 0.006). In a univariate analysis, the platelet count < 150,000/µL, liver metastasis diameter ≥ 3 cm, and difficulty score ≥ 6 were identified as potential risk factors for major complications in the simultaneous group. In a multivariate analysis, a difficulty score ≥ 6 was a significant risk factor (odds ratio, 9.63; P = 0.004).Conclusions: Simultaneous laparoscopic resection reduces the surgical burden and medical costs but carries a heightened perioperative risk. Staged resection should therefore be considered for patients with risk factors, particularly for those requiring hepatectomy with a difficulty score of ≥ 6.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"789-798"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565624","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

Preoperative risk assessment using GNRI and mFI-5 enhances prediction of postoperative complications in older adults with colorectal cancer. 使用GNRI和mFI-5进行术前风险评估可提高老年结直肠癌患者术后并发症的预测。

IF 1.6 4区医学

Surgery Today Pub Date : 2026-05-01 Epub Date: 2025-11-19 DOI: 10.1007/s00595-025-03180-1

Kazushi Hara, Shoichi Urushibara, Satoshi Nagai, Hiroshi Watanabe, Sadamu Takahashi, Yasuro Kurisu

{"title":"Preoperative risk assessment using GNRI and mFI-5 enhances prediction of postoperative complications in older adults with colorectal cancer.","authors":"Kazushi Hara, Shoichi Urushibara, Satoshi Nagai, Hiroshi Watanabe, Sadamu Takahashi, Yasuro Kurisu","doi":"10.1007/s00595-025-03180-1","DOIUrl":"10.1007/s00595-025-03180-1","url":null,"abstract":"Purpose: Frailty and malnutrition, which are common in older adult patients with colorectal cancer (CRC), adversely affect outcomes. Although the Geriatric Nutritional Risk Index (GNRI) and the Modified Frailty Index (mFI-5) are established tools, their combined predictive value for postoperative complications remains unclear. Therefore, we investigated whether their combination improved risk prediction.Methods: We analyzed 399 CRC ≥ 65 years of age who underwent curative surgery. Preoperative assessment included frailty (mFI-5 ≥ 2) and nutritional risk (GNRI < 98). Patients were stratified into low- (no factors), intermediate- (one factor), and high-risk (both factors) groups. Clavien-Dindo grade ≥ II complications were analyzed by multivariate logistic regression to identify predictive factors.Results: Infectious complications increased significantly across the low-, intermediate-, and high-risk groups (13.3%, 14.6%, and 30.2%, respectively), with overall complication rates of 20.7%, 22.2%, and 45.3%, respectively. The median postoperative stay increased with increased risk (12, 14, and 18 days, respectively). Anastomotic leakage was more frequent, though not to a statistically significant extent, in high-risk patients. High-risk status independently predicted infectious and overall complications.Conclusions: Combined GNRI and mFI-5 assessments facilitated effective stratification of postoperative risk in older adults with CRC. These assessments may help in routine preoperative evaluations and support individualized perioperative care.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"763-771"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551019","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