Updates in Surgery最新文献

{"title":"Analysis of intra- and postoperative interventional endoscopic measures in 3000 bariatric surgical procedures over 15 years: a single center study.","authors":"Mana Kakuan, Andreas Plamper, Oliver Al-Taie, Andreas Kroh, Florian Vondran, Patrick H Alizai, Tom F Ulmer, Sophia M Schmitz, Karl P Rheinwalt","doi":"10.1007/s13304-025-02239-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02239-5","url":null,"abstract":"<p><p>In addition to preoperative diagnostic gastroscopy, some bariatric surgery patients require one or more differentiated endoscopic interventions as part of postoperative complication management. The aim of this study is to analyze endoscopic interventions regarding indication, type of procedure, material used, and outcome. We prospectively collected and retrospectively analyzed data over a period of 15 years from 2006 to 2021 of all consecutive patients who underwent an interventional upper gastrointestinal endoscopy after bariatric surgery at our center. The primary study objective was the type and frequency of the treatment. Secondary study objectives included clinical outcomes and postinterventional complications. Of 3000 bariatric procedures, 145 (4.8%), among them 11.1% (n = 54) of 485 Roux-en-Y gastric bypasses, 7.1% (n = 20) of 282 redo operations, 5.7% (n = 20) of 351 revisional operations, 3.3% (n = 13) of 398 sleeve gastrectomies, and 1.9% (n = 26) of 1394 one-anastomosis gastric bypasses, received an interventional endoscopy for postoperative complication management. 79.3% (n = 115) were female, mean age was 42.4 (± 10.7) years, mean BMI was 43.5 (± 9.8) kg/m². Complication after interventional endoscopy happened in 1.6%, revisional surgery was necessary in 0.5% (n = 3). Causes for endoscopic intervention were stenosis (52.4%), leakage/fistula (35.9%), intraluminal bleeding (13.1%), dumping syndrome (9.0%), and gallstones (1.4%). The performed interventions were balloon dilation (48.3%), stent therapy (33.1%), metallic clipping (12.4%), injection therapy (0.09%), bougienage (0.07%), vacuum therapy (0.06%), and pigtail therapy (0.04%). Endoscopic intervention is an effective and safe way of treating adverse events after bariatric surgery. Stenosis and leakage were the most frequent complications, with endoscopic balloon dilatation and stent therapy as the most frequent and successful treatment options. RYGB was the procedure with the most endoscopic interventional involvement. To better learn about outcomes of specific endoscopic techniques further studies preferably with larger multicenter samples are required.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice patterns and factors influencing surgical trainees' involvement in laparoscopic appendectomy in Northern Italy's largest educational network.","authors":"Stefano Piero Bernardo Cioffi, Michele Altomare, Alessandra Borghi, Andrea Spota, Martino Bussa, Federico Ambrogi, Stefano Granieri, Francesco Virdis, Stefania Cimbanassi","doi":"10.1007/s13304-025-02224-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02224-y","url":null,"abstract":"<p><p>Introduction Laparoscopic Appendectomy (LA) allows residents to get early exposure to minimally invasive techniques. Despite its importance, involving residents as primary surgeons is a complex process, influenced by more than just clinical factors. Mentorship, environment, and perceptions play crucial roles. This study aimed to explore rates of residents' involvement in LA, the factors influencing the decision-making, and how surgeons and residents perceive the process. Methods We analyzed data from the REsiDENT-1 trial, covering 653 LA performed between 2019 and 2023 in 24 hospitals affiliated with the University of Milan. Adults with intraoperative acute appendicitis were included. Univariable analysis and multivariable logistic regression explored factors impacting residents' involvement and clinical outcomes. A survey captured the perspectives of surgeons and residents. Results Residents approached 35.9% of the procedures, with longer operative times 67.14 (± 28.1) vs 71.68 (± 24.44), p = 0.001. Trainees were more involved in academic hospitals and emergency surgery units and less complex cases with lower complication rates. Residents' involvement was hampered by patients' complexity in the multivariable analysis. Surgeons prioritized non-technical factors such as punctuality and reliability, whereas residents highlighted clinical complexity as a key consideration for the decision-making of the operator. Both groups agreed that structured feedback systems could improve the educational and training experiences. Conclusion LA remains a crucial procedure for surgical training, balancing hands-on learning with patient safety. Structured mentorship in academic and emergency settings could allow safe resident involvement. Future improvements should focus on clear feedback processes, better access to simulations, and standardized competency-based training to prepare residents for independent practice.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: \"Efficacy and safety of terlipressin infusion during liver surgery: a meta-analysis\".","authors":"Renu Sah, Ankita Mathur, Venkata Dileep Kumar Veldi","doi":"10.1007/s13304-025-02257-3","DOIUrl":"https://doi.org/10.1007/s13304-025-02257-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Systemic Inflammation Response Index (SIRI) Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), and Systemic Immune Inflammation Index (SII) for predicting prognosis of acute diverticulitis.","authors":"Yasin Alper Yıldız","doi":"10.1007/s13304-025-02241-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02241-x","url":null,"abstract":"&lt;p&gt;&lt;p&gt;There are many applications to emergency services due to acute colonic diverticulitis. It is necessary to decide whether these patients are complicated, to quickly predict their prognosis, and to decide whether medical or invasive treatment is necessary. We planned to research effectiveness NLR, NLR, SII, and SIRI values calculated using hemogram data can predict the prognosis of acute diverticulitis. We managed a retrospective scanning with patients who applied with a diagnosis of acute diverticulitis between 06/2020 and 04/2023. Demographic data (age, gender, previous surgery, comorbid diseases), tomographic Hinchey classification, location of diverticulitis, applied treatment, and obtained from blood parameters at presentation to the emergency department WBC, CRP, NLR, dNLR, SII, SIRI parameters were recorded from the electronically registered patient files. According to the Hinchey classification, those with Hinchey 0 and 1a were included in the noncomplicated group A class because they were followed up with outpatient medical follow-up. Those with Hinchey 1b,2,3,4 were included in the complicated GROUP B class. Differences in WBC, CRP, NLR, dNLR, SIRI, SII values between the complicated and noncomplicated groups were evaluated statistically. There were 286 patients with acute diverticulitis on the dates indicated. The number of patients eligible for the study was eighty-two. According to Hinchey's classification, 56 patients had noncomplicated acute diverticulitis (SAD) and 26 patients had complicated diverticulitis (CAD). These diagnoses were given based on tomography findings and clinical evaluations. The hospital stay was longer in the CAD group compared to the SAD group (p &lt; 0.001) statistically significantly. The rate of surgical procedures and percutaneous interventions in the CADs was higher than SADs (p: 0.040) statistically significantly. WBC (white blood cell), NLR, dNLR, SIRI, SII and CRP parameters were higher in CADs than in SADs as statistically significant. Spearman's correlation analysis showed between the Hinchey classification and the NLR, dNLR, SII, SIRI, CRP, WBC parameters with high correlation as positive. Determination of values SIRI (2.42), NLR (3.35), SII (907.44) dNLR (4.63), CRP (15.25) WBC (11.16) and specificity and fractionation of these values ROC analysis was performed for this purpose. Highest AUC (area under the curve) value was found in WBC [0.807 0.703-0.910)], SIRI [0.786 (, 0.681-0.892)], SII [0.767 (0.654-0.880)], NLR [0.740 (0.624-0.854)], dNLR [0.739 (0.625-0.853)]. This study showed that there are SII, SIRI dNLR, NLR, CRP, and WBC values in patients presenting with acute diverticulitis a very high correlation with Hinchey classification in distinguishing complicated and non-complicated acute diverticulitis (p &lt; 0.01). These data were higher in CADs than in SADs statistically significantly. The use of these data can both prevent unnecessary radiation in patients suspected of acute diverticulitis","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A standardized technique for laparoscopic total colectomy in acute severe ulcerative colitis: a technical note.","authors":"Carlo Alberto Manzo, Caterina Baldi, Leonardo Lorusso, Valerio Celentano, Gianluca Matteo Sampietro","doi":"10.1007/s13304-025-02247-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02247-5","url":null,"abstract":"<p><p>Ulcerative colitis (UC) often necessitates total colectomy in cases of medically refractory disease or complications, with over one-third of patients undergoing surgery despite advances in medical therapy. Standardization in colectomy techniques is crucial to improving surgical outcomes, enhancing reproducibility, and addressing variability in practices. This study revisits laparoscopic total colectomy, emphasizing a \"critical view of safety\" approach to streamline the procedure, reduce anatomical disorientation, and overcome steep learning curves for trainees. The proposed technique divides the procedure into two phases: left colectomy and right/transverse colectomy, each featuring five standardized critical views. These views provide a clear framework for key anatomical landmarks, including the pancreas, splenic hilum, Gerota's fascia, and middle colic vessels. Patient positioning and trocar placement are also standardized to ensure procedural consistency. The adoption of this refined, minimally invasive approach aligns with ECCO guidelines, offering advantages, such as fewer perioperative complications, shorter hospital stays, and preserved fertility. This method minimizes inter-surgeon variability, facilitating reproducibility in elective and emergency settings. Collaborative multi-disciplinary care among surgeons, gastroenterologists, and specialized nurses further supports timely surgical decision-making and improved post-operative outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preoperative use of biologics on 30-day surgical morbidity and mortality in patients with Crohn's disease undergoing ileocolectomy: National Surgical Quality Improvement Program database analysis.","authors":"Fady Daniel, Zakaria El Kouzi, Jamil Mrad, Mohamad Ali Ibrahim, Ala I Sharara, Walaa El Sheikh, Mohamad Khalife, Hani Tamim","doi":"10.1007/s13304-025-02238-6","DOIUrl":"https://doi.org/10.1007/s13304-025-02238-6","url":null,"abstract":"<p><p>Preoperative use of biologics has been inconsistently reported to be associated with increased frequency of infectious and surgical anastomotic complications in inflammatory bowel disease patients. We aimed to evaluate the rates of 30-day postoperative morbidity and mortality in Crohn's disease patients exposed preoperatively to biologics. Data were collected from the NSQIP (National Surgical Quality Improvement Program). Crohn's disease patients undergoing open or laparoscopic ileocolectomy were identified using corresponding ICD 10 and CPT Codes from the NSQIP Participant Use Data File (PUF) for 2021. Patients were divided based on the preoperative use of biologics (group 1) and (group 2) for whom no biologics were used. A total of 910 patients (female n = 473; 52%, mean age of 42.3 ± 16.1) were included. The group 1 patients were significantly younger (40.30 years ± 15.33) than group 2 (43.58 years ± 16.8, p = 0.002) and had significantly slightly higher ASA III and IV scores (97.4% vs. 97.2%, p = 0.004). On the other hand, group 2 had a significantly higher prevalence of hypertension (20.2% vs. 12.8%, p = 0.003) and chronic obstructive pulmonary disease (2.6% vs. 0%, p = 0.001). No significant difference in remaining preoperative variables, surgical approach (laparoscopic vs. open), and comorbidities were found between the two groups. Only a significant prevalence of deep vein thrombosis and thromboembolism was found in patients exposed to biologics (1.1% vs. 0%, p = 0.027). Crohn's disease patients undergoing ileocolectomy and exposed preoperatively to biologics did not show a significant increase in 30-day postoperative morbidity and mortality. The outcomes did not support the concept that biological agents increase septic complications.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of modified frailty index-5 to major complications after videothoracoscopic pulmonary resections.","authors":"Muhammet Sayan, Mahir Fattahov, Fevzi Oguzhan Temirkaynak, Nazmiye Koska, Bengisu Artiran, Muhammet Tarik Aslan, Gunel Ahmadova, Aysegul Kurtoglu, Irmak Akarsu, Ismail Cuneyt Kurul, Ali Celik","doi":"10.1007/s13304-025-02232-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02232-y","url":null,"abstract":"<p><p>Although minimally invasive methods have become widespread, pulmonary resections due to lung cancer continue to be an important cause of postoperative morbidity. Herein, we have investigated the predicting efficacy of modified frailty index-5 (MFI-5) for postoperative complications in patients who underwent pulmonary resection by VATS for non-small cell lung cancer (NSCLC). We retrospectively reviewed the data of patients who underwent VATS lobectomy/segmentectomy for NSCLC. MFI-5 score was calculated according to hypertension, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and functional independence status. Major postoperative complications were determined based on Clavien-Dindo classification. The predictive efficacy of MFI-5 score for major complications was tested by univariate and multivariate logistic regression analysis. A total of 336 patients were included in the study. The mean age was 65.6 ± 9.8 years. MFI-5 score was zero in 126 (37.5%) patients and positive in 210 patients. The major complication rate was 25.9%. Multivariate analysis showed that 2 and higher MFI-5 score significantly predicted the presence of postoperative major complications (p: 0.004, OR: 4.3, 1.58-12.5 95% CI). The MFI-5 score can significantly predict the presence of major postoperative complications, including 30-day mortality, in patients undergoing VATS pulmonary resection for NSCLC. Clinical registration 2024-324, approved by Gazi University Local Ethics Committee.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of intraoperative indocyanine green roadmap as a safety measure in emergent laparoscopic cholecystectomy.","authors":"R Carramiñana-Nuño, V Borrego-Estella, A Millán-Mateos, L Medina-Mora, M Gasós-García, D Otero-Romero, M M Soriano-Liébana, N Lete-Aguirre, P Palacios-Gasós","doi":"10.1007/s13304-025-02240-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02240-y","url":null,"abstract":"<p><p>Acute cholecystitis is a growing pathology, with high surgical risk due to the related patients' comorbidity. The gold standard treatment is laparoscopic cholecystectomy, which, despite its high volume, still presents elevated rates of biliary tract injury. Standardization of the procedure and accurate identification of the anatomical structures of the biliary tree are the key in avoiding severe complications associated with this injury. Innovation in minimally invasive technologies, such as infrared indocyanine green as a radiotracer to delimit the biliary anatomy, could reduce the rate of biliary tract lesions. A single-center case-control study was conducted, including patients undergoing emergency surgery between November 2023 and November 2024 for acute cholecystitis (Tokyo Guidelines 2018 criteria). Eighty-seven patients were allocated into two groups: emergency laparoscopic cholecystectomy with or without intraoperative indocyanine green cholangiography. The primary aim was to evaluate ICG's impact on reducing bile duct injury. Secondary outcomes included operative time, hospital stay, and conversion rates. The mean operative time (93 min vs. 104.6 min, p = 0.087), ASA scale (p = 0.302) and Charlson comorbidity index (2.55 vs. 2.84; p = 0.58) were not significantly different when comparing both groups. The control group showed duplicated preoperative CRP values as compared to the ICG group (138.24 mg/l vs. 71.02 mg/l; p = 0.06), and a higher median hospital stay (5 days ± 3 vs. 3 days ± 1.75; p = 0.001). The control group showed a greater need for conversion to open surgery (14.3% vs. 0%; p = 0.015). Trends towards fewer bile duct injuries (0% vs. 4.1%; p = 0.208) and fewer complications (15.87% vs. 18.4%; p = 0.752) in the ICG group were not statistically significant. The use of ICG may reduce the need for conversion to open surgery and median hospital stay. However, its use has not been proven to reduce bile duct injury, postoperative complications, or operative time.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on emergency general surgery outcomes: a retrospective analysis of seven procedures.","authors":"Nihal Sriramaneni, Julia Botvinov, Aziz M Merchant","doi":"10.1007/s13304-025-02225-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02225-x","url":null,"abstract":"<p><p>Current research has examined emergency general surgery (EGS) rates and COVID-19 complications for some procedures, but none have explored complications for all seven EGS procedures before and during the pandemic. Our study addresses this gap, aiming to understand how pandemic-related challenges impact patient outcomes. Utilizing data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) spanning 2018 to 2021, we conducted a retrospective cohort study with analysis of open and laparoscopic partial colectomy, enterectomy, cholecystectomy, operative management of peptic ulcer disease, adhesiolysis, appendectomy, and laparotomy. Patient outcomes, including 30-day mortality and morbidity, were assessed. The likelihood of complications in EGS has risen compared to pre-COVID levels. Specifically, there is a greater risk of morbidity in open EGS cases intra-COVID compared to laparoscopic, particularly in colectomy and appendectomy procedures. Conversely, laparoscopic procedures have seen a decrease in readmissions, notably in cases involving cholecystectomy and colectomy. The study highlights a rise in complications for EGS intra-COVID, with open procedures demonstrating higher risks than laparoscopic counterparts.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditional survival after liver resection for early-stage hepatocellular carcinoma.","authors":"Yi-Hao Yen, Sin-Hua Moi, Yueh-Wei Liu, Chee-Chien Yong, Chih-Chi Wang, Wei-Feng Li, Chih-Yun Lin","doi":"10.1007/s13304-025-02226-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02226-w","url":null,"abstract":"<p><p>Conditional survival (CS) is a measure of prognosis of patients who have already survived several years since diagnosis. However, few studies have investigated the CS of patients who underwent liver resection (LR) for early-stage hepatocellular carcinoma (HCC). We enrolled 942 consecutive patients who underwent LR for HCC with pathology-defined American Joint Committee on Cancer (AJCC) 7th edition stage 1 or 2 disease. The three-year CS was calculated as CS = S(x + 3)/S(x) and represented the probability of surviving an additional three years, given that the patient had already survived x years. The one-, three-, and five-year survival rates were 97.1%, 86.7%, and 76.1%, respectively, and were lower in cases with AJCC stage 2 disease, alpha-fetoprotein level of ≥ 20 ng/ml, presence of cirrhosis, anti-hepatitis C virus positivity, age > 65 years, and Model for End-Stage Liver Disease score of > 9. However, the three-year CS indicated that these variables were associated with shortened survival only in the first two years. From the third year after LR, the probability of survival of patients was similar between subgroups. CS is useful for providing a dynamic evaluation of survival during postoperative follow-up.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}