{"title":"Risk factors for one-year mortality and the subsequent prognosis in older patients undergoing curative surgery for colorectal cancer: a retrospective multicenter study.","authors":"Shintaro Hashimoto, Tetsuro Tominaga, Keisuke Noda, Toshio Shiraishi, Mariko Yamashita, Hiroki Katayama, Shoko Tei, Taiji Hida, Hiroshi Maruta, Yuma Takamura, Rika Ono, Makoto Hisanaga, Mitsutoshi Ishii, Masaaki Moriyama, Hidetoshi Fukuoka, Kazuo To, Kaido Oishi, Hiroaki Takeshita, Terumitsu Sawai, Takashi Nonaka, Keitaro Matsumoto","doi":"10.1007/s00595-026-03384-z","DOIUrl":"10.1007/s00595-026-03384-z","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative complications may affect the long-term outcomes after colorectal cancer (CRC) surgery. This multicenter study compared prognostic factors for overall survival (OS) in younger (≤ 74 years) and older (≥ 75 years) patients after curative resection for CRC, focusing on the 1-year and post-1-year outcomes.</p><p><strong>Methods: </strong>We analyzed data from 1582 patients who underwent curative surgery for CRC at six hospitals between April 2016 and December 2019. Kaplan-Meier and Cox models were used to identify the risk factors for complications and survival.</p><p><strong>Results: </strong>Older patients had a significantly worse overall survival (OS) and survival beyond the 1-year landmark. Postoperative complications were associated with increased 1-year mortality in both age groups. In younger patients, survival beyond 1 year was associated with a positive N status and a low BMI. In contrast, in older patients, postoperative complications remained associated with survival beyond the 1-year landmark, along with a male sex, positive N status, and poor ASA-PS.</p><p><strong>Conclusions: </strong>The prolonged impact of complications on survival in older patients with CRC underscores the need for age-specific surgical strategies and proactive complication management.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2439-2446"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362359","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}
{"title":"Clinical impact of Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation status on recurrence patterns and the efficacy of local therapy after hepatectomy for colorectal liver metastases.","authors":"Kosuke Kanemitsu, Hiromitsu Hayashi, Yoshiyuki Tagayasu, Takumi Tanizaki, Yuki Adachi, Takashi Ofuchi, Takuya Tajiri, Yuki Kitano, Hirohisa Okabe, Masaaki Iwatsuki","doi":"10.1007/s00595-026-03377-y","DOIUrl":"10.1007/s00595-026-03377-y","url":null,"abstract":"<p><strong>Purposes: </strong>The Kirsten rat sarcoma viral oncogene homolog (KRAS) is defined as frequently mutated oncogenes in colorectal cancer. We aimed to clarify the clinical impact of KRAS mutation status on recurrence patterns, the surgical management of recurrent lesions, and prognostic outcomes after curative hepatectomy for colorectal liver metastases (CRLM).</p><p><strong>Methods: </strong>The subjects of this retrospective study were 190 patients who underwent curative (macroscopic R0 resection) hepatectomy for CRLM and had wild-type (62.1%) or mutant (37.9%) KRAS status.</p><p><strong>Results: </strong>KRAS mutations were associated with significantly worse overall survival (OS) and recurrence-free survival (RFS), as well as more aggressive recurrence patterns. Multivariate analysis identified KRAS mutation as an independent predictor of poor OS and RFS, whereas CEA ≥ 5 ng/mL was independently associated with OS but not RFS. Notably, patients from the mutant KRAS and wild-type KRAS groups who underwent local therapy (as repeat resection or ablation) for local recurrence had comparable OS. Conversely, among the patients who did not receive local therapy, those from the mutant KRAS group had significantly worse OS than those from the wild-type KRAS group.</p><p><strong>Conclusions: </strong>KRAS mutations are associated with aggressive recurrence patterns and a poor prognosis for patients with CRLM. However, survival following local therapy for recurrence appeared less pronounced regardless of KRAS status.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2447-2455"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362419","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}
{"title":"Status of groin hernia repair in Japan: analysis of the 2024 annual report from the National Clinical Database.","authors":"Tatsuya Tazaki, Hiroyuki Yamamoto, Masanori Sato, Saseem Poudel, Taketo Matsubara, Itsuro Nagae, Tsuyoshi Takagi, Ken Shirabe, Hideki Ueno, Takehiro Hachisuka, Kyosuke Miyazaki","doi":"10.1007/s00595-026-03386-x","DOIUrl":"10.1007/s00595-026-03386-x","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the data on groin hernia repair practice in Japan in 2024 and present the recent changes in open repair technique selection.</p><p><strong>Methods: </strong>We performed a retrospective descriptive analysis of groin hernia repairs registered in the National Clinical Database (NCD) of Japan in 2024, using nationwide data and a Japanese Hernia Society-registered subset with detailed procedure variables for 2021-2024.</p><p><strong>Results: </strong>In the nationwide dataset, inguinal laparo-endoscopic and open repairs accounted for 58.2% and 38.2% of all groin hernia repairs, respectively. Among open repairs in the Japanese Hernia Society-registered dataset, underlay mesh repair was the most common subtype of primary repair until 2023, but decreased over time. The proportion of anterior onlay mesh repairs increased from 21.8% in 2021 to 32.0% in 2024, while the proportion of plug-and-patch repairs remained stable at approximately 24%. For recurrent open repairs, plug-and-patch repair remained the most common subtype, accounting for approximately 37%-39%, whereas underlay mesh repair decreased from 28.4% in 2021 to 21.0% in 2024, and anterior onlay mesh repair increased from 17.7% in 2021 to 26.0% in 2024.</p><p><strong>Conclusions: </strong>Open groin hernia repair remains common in Japan, and its composition is shifting toward the use of anterior onlay mesh repair, although plug-and-patch and underlay mesh repairs are still performed widely.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2430-2438"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353603","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}
{"title":"Short-Term outcomes of robotic versus laparoscopic inguinal hernia repair performed by Endoscopic Surgical Skill Qualification System (ESSQS)-Qualified surgeons: A propensity Score-matched and weighted analysis.","authors":"Shuhei Ueno, Hirotaka Miyai, Yoshiaki Fujii, Mitsuki Nakazawa, Ryosuke Niwamoto, Tsuyoshi Saito, Takahisa Hirokawa, Masahiro Kimura, Shuji Takiguchi","doi":"10.1007/s00595-026-03366-1","DOIUrl":"10.1007/s00595-026-03366-1","url":null,"abstract":"<p><strong>Purposes: </strong>Robotic transabdominal preperitoneal repair (R-TAPP) is being adopted increasingly for inguinal hernia. However, there is limited evidence about how its short-term outcomes compare with those of laparoscopic TAPP (L-TAPP). We evaluated the safety and efficacy of R-TAPP at a single institution.</p><p><strong>Methods: </strong>We reviewed 980 inguinal hernia repairs (R-TAPP 82, L-TAPP 898) performed between January 2021 and July 2025 at our institution. The primary outcome was operative time and the secondary outcomes were intraoperative blood loss, postoperative hospital stay, complications, and chronic pain. This study was restricted to procedures performed by Endoscopic Surgical Skill Qualification System (ESSQS)-qualified surgeons, using propensity score matching (PSM) and inverse-probability of treatment weighting (IPTW) analysis.</p><p><strong>Results: </strong>The operative times for both unilateral and bilateral repairs were significantly shorter in the R-TAPP group than in the L-TAPP group (69.5 min vs. 96.0 min and 114.0 min vs. 150.0 min, respectively; both p < 0.001), even after PSM (69.0 min vs. 84.0 min, p < 0.001). Using IPTW, R-TAPP was associated with a 16.7 min reduction in operative time compared with L-TAPP (p < 0.001). Intraoperative blood loss was significantly lower with R-TAPP, but there were no significant differences in the other secondary outcomes.</p><p><strong>Conclusions: </strong>R-TAPP reduces the operative time required without compromising perioperative safety, supporting its use as a safe and efficient option for inguinal hernia repair.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2330-2339"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253374","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}
{"title":"Ultrasound-guided manual reduction for incarcerated obturator hernia: a bridge to elective surgery or a pragmatic non-operative strategy.","authors":"Masahiro Tanaka, Kiyoshi Suzumura, Tomonori Tsuchiya, Kazumi Nishimae, Dan Zhang, Taisuke Yamamoto, Fumiya Fukui, Atsuto Nonomura, Chikako Kato, Masaki Terasaki, Yoshichika Okamoto","doi":"10.1007/s00595-026-03348-3","DOIUrl":"10.1007/s00595-026-03348-3","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated ultrasound-guided manual reduction as an initial management strategy for incarcerated obturator hernia, both as a bridge to elective surgery and as a pragmatic non-operative option in severely frail patients.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients who underwent attempted manual reduction for incarcerated obturator hernia between 2012 and 2025, excluding those with suspected bowel necrosis. The reduction success, associated factors, and subsequent outcomes were assessed.</p><p><strong>Results: </strong>Manual reduction was successful in 39/46 lesions (84.8%) without procedure-related complications. Early presentation tended to be associated with successful reduction (median 12 vs. 48 h, p = 0.057). Compared with emergency surgery after failed reduction (n = 7), elective surgery following successful reduction (n = 24) was associated with lower bowel resection rates (0% vs. 42.9%, p = 0.008), higher mesh use (100% vs. 57.1%, p = 0.008), and a shorter postoperative stay (4 vs. 12 days, p = 0.002). Among the eight severely frail patients managed non-operatively, seven (87.5%) met the predefined clinical endpoints.</p><p><strong>Conclusion: </strong>Ultrasound-guided manual reduction appears to be feasible in selected patients with incarcerated obturator hernia, serving as a bridge to elective mesh repair under favorable conditions. In carefully selected severely frail individuals, it may also represent a pragmatic non-operative management option.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2202-2210"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158256","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}
{"title":"Sex differences in the risk profiles for anastomotic leakage following surgery for rectal cancer.","authors":"Tatsunosuke Harada, Masakatsu Numata, Yosuke Atsumi, Toshiyuki Fukuda, Shota Izukawa, Suguru Nukada, Keisuke Kazama, Koji Numata, Teni Godai, Nobuhiro Sugano, Hiroyuki Mushiake, Akio Higuchi, Yusuke Katayama, Yo Mikayama, Yusuke Suwa, Mayumi Ozawa, Tsutomu Sato, Norio Yukawa, Aya Saito, Takaki Yoshikawa","doi":"10.1007/s00595-026-03353-6","DOIUrl":"10.1007/s00595-026-03353-6","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify sex-specific differences in the risk profiles of anastomotic leakage (AL) after rectal cancer surgery, for which sex is widely recognized as an important risk factor.</p><p><strong>Methods: </strong>This retrospective multicenter study included 1,854 patients (1,196 men and 658 women) who underwent rectal cancer surgery with anastomosis between 2015 and 2025 at our institution. Patients were stratified by sex, and risk factors for AL (grade ≥ B) were analyzed separately using logistic regression. Interaction analyses between sex and perioperative factors were also conducted.</p><p><strong>Results: </strong>AL occurred more frequently in men than in women (9.9% vs. 4.1%, respectively). In sex-stratified multivariate analyses, an anastomotic site ≤ 5 cm from the anal verge and transanal tube placement were identified as independent risk factors for AL in men, whereas minimally invasive surgery and the use of indocyanine green fluorescence imaging were associated with a reduced risk of AL. In women, a preoperative C-reactive protein-to-albumin ratio ≥ 0.07 and operative period were independent risk factors for AL. A significant interaction was observed between sex and low anastomosis rates.</p><p><strong>Conclusion: </strong>Sex-specific differences in AL risk profiles have been suggested. Sex-specific risk assessment may contribute to more individualized strategies for diverting stoma decision-making.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2236-2247"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164543","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}
Surgery TodayPub Date : 2026-10-01Epub Date: 2026-06-15DOI: 10.1007/s00595-026-03368-z
Oluwakorede Akele, Evans Osuji, Vaishvik Patel, Muhammad Kamal, Peter Kiernan, Rabindra Dhakal, Michel El Khoury, Rohit Shahani
{"title":"Routine Versus Selective Temporary Epicardial Pacing Wire Placement: A Scoping Review.","authors":"Oluwakorede Akele, Evans Osuji, Vaishvik Patel, Muhammad Kamal, Peter Kiernan, Rabindra Dhakal, Michel El Khoury, Rohit Shahani","doi":"10.1007/s00595-026-03368-z","DOIUrl":"10.1007/s00595-026-03368-z","url":null,"abstract":"<p><p>Temporary epicardial pacing wires (TEPWs) are used widely for rhythm management in cardiac surgery. However, their routine placement is being debated increasingly because of low utilization and potential procedural risks. We compared routine versus selective TEPW placement practices and assessed the utilization, complications, and predictors of pacing need. A scoping review was conducted in accordance with the PRISMA-ScR guidelines. We searched PubMed, Embase, Scopus, and Cochrane Library until June 2025. Studies were included if they examined TEPW strategies in adult or pediatric cardiac surgery and reported outcomes related to wire use, complications, or predictors of pacing need. Eleven studies involving 16,874 patients (14,957 adults, 1,917 children) were included. Routine placement rates ranged from 73.5% to 89.9%, but utilization was low at 2.9%-29.6%. Selective strategies showed higher utilization of 30%-100% with fewer unused wires. Predictors of the need for TEPW included intraoperative arrhythmias, prolonged CPB, and complex procedures. Complications were rare. Thus, routine TEPW placement often leads to unnecessary wire use. Selective strategies based on intraoperative and clinical predictors may optimize patient care. Developing a risk-based tool could enhance decision-making and reduce procedural burden.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2140-2148"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253400","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}
{"title":"Cisplatin versus carboplatin as adjuvant chemotherapy for completely resected non-small cell lung cancer: a multicenter retrospective cohort study.","authors":"Masatsugu Hamaji, Ryo Miyata, Jiro Takeuchi, Naoki Ozu, Takuya Kohama, Ryota Sumitomo, Mamoru Takahashi, Takehisa Fukada, Megumi Kobayashi, Yosuke Kumaya, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.1007/s00595-026-03375-0","DOIUrl":"10.1007/s00595-026-03375-0","url":null,"abstract":"<p><strong>Purpose: </strong>The current guidelines recommend cisplatin-based adjuvant chemotherapy for patients with completely resected stage II-III non-small cell lung cancer (NSCLC). Carboplatin-based chemotherapy is occasionally selected, although there is limited evidence of its long-term outcomes. We conducted this study to compare the long-term outcomes of cisplatin- based chemotherapy with those of carboplatin-based chemotherapy.</p><p><strong>Methods: </strong>A retrospective chart review was performed to identify patients aged ≥ 18 years with performance status 0-1, complete resection, and pathological stage II-IIIA NSCLC (7th edition) between 2014 and 2016 in our multi-institutional database. Patients were classified into two groups: the cisplatin-based adjuvant chemotherapy group and the carboplatin-based adjuvant chemotherapy group. To adjust for baseline differences, inverse probability of treatment weighting (IPTW) based on propensity scores was applied. The primary outcome was recurrence-free survival (RFS) and the secondary outcomes were cancer-specific survival (CSS) and overall survival (OS).</p><p><strong>Results: </strong>A total 342 patients were included, of whom 195 received cisplatin-based adjuvant chemotherapy and 147 received carboplatin-based chemotherapy. After IPTW adjustment, the hazard ratios for RFS, CSS, and OS were 1.10 (95% confidence interval [CI]: 0.82-1.49, p = 0.526), 1.11 (95% CI: 0.68-1.82, p = 0.675), and 1.46 (95% CI: 0.96-2.22, p = 0.08), respectively.</p><p><strong>Conclusions: </strong>Carboplatin-based adjuvant chemotherapy may be considered for selected patients deemed unfit to receive cisplatin.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2370-2377"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273291","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}
{"title":"How do Japanese medical students use social media? A large multicenter survey of platform preferences and career decision-making.","authors":"Takehito Yamamoto, Koya Hida, Shin Ishihara, Soichi Murakami, Yusuke Yamane, Tatsuya Kinjo, Misako Kinoshita, Kenta Horimukai, Atsushi Otsuka, Hideki Takami, Kazutaka Obama","doi":"10.1007/s00595-026-03328-7","DOIUrl":"10.1007/s00595-026-03328-7","url":null,"abstract":"<p><strong>Purpose: </strong>Social media has emerged as an important tool for disseminating information to medical students; however, their platform preferences and usage purposes remain unclear.</p><p><strong>Methods: </strong>We conducted a multicenter web-based survey of medical students from eight Japanese medical schools in 2025, assessing their overall social media use, platform preferences by purpose, daily usage time, and the perceived usefulness of social media for career decision-making.</p><p><strong>Results: </strong>A total of 1,515 students participated in this study. YouTube (71.6%), Instagram (65.1%), and X (43.7%) were frequently used platforms, whereas Facebook (1.9%) was rarely used. Platform use differed by academic year: YouTube use was significantly higher among early-year students, whereas X use was significantly more common among advanced-year students (P = 0.043 and P < 0.001, respectively). Overall, 763 respondents (50.4%) perceived social media as useful for career decision-making, with X being used most frequently for this purpose, followed by YouTube and Instagram; this perception was significantly more common among the early-year students (P = 0.005).</p><p><strong>Conclusions: </strong>These findings provide valuable insights for educators and professional organizations seeking to engage medical students through social media. Understanding these trends is especially important as Japan faces a shortage of surgeons.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2192-2200"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158223","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}
{"title":"Timing and motivation behind the decision to become a surgeon: Gender and optimal recruitment insights.","authors":"Junko Mukohyama, Genki Watanabe, Yoshiyuki Kiyasu, Daisuke Koike, Jun Watanabe, Saseem Poudel, Atsushi Tanikawa, Takashi Kohmura, Yoshiko Yamaoka-Fujikawa, Keiko Hosoya, Hiroko Watayo, Mitsue Saito, Norihiko Ikeda, Akinobu Taketomi","doi":"10.1007/s00595-026-03361-6","DOIUrl":"10.1007/s00595-026-03361-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to clarify the timing and motivations behind decisions to pursue a surgical career and identify optimal recruitment strategies.</p><p><strong>Methods: </strong>A nationwide questionnaire was administered to newly certified surgical trainees. Respondents were classified into two groups based on when they decided to pursue surgery: before junior residency (BJR) or during/after junior residency (DJR). The backgrounds and motivations were compared.</p><p><strong>Results: </strong>Among the 758 respondents (53.8%), 25.6% were female. Male trainees were more likely to decide to pursue surgery before medical school (18.7% vs. 9.4%, p = 0.003), whereas female trainees more often decided during their PGY-2 (35.4% vs. 24.1%, p = 0.002). The DJR group included more women (30.3% vs. 21.7%, p = 0.014) and residents from urban areas (46.6% vs. 36.7%, p = 0.008). The BJR group was more influenced by the images of surgeons and family. Among female residents, those in the DJR group were more influenced by recruitment from the surgeons.</p><p><strong>Conclusions: </strong>This study demonstrated sex differences in the timing and motivation for pursuing a surgical career. Understanding the optimal timing and appealing factors for recruiting surgeons, particularly women, could inform more effective recruitment strategies.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2311-2318"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253356","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}
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