Updates in Surgery最新文献

{"title":"Prognostic nomogram for early-onset locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy: a SEER analysis.","authors":"Yi-Kai Kao, Pin-Chun Chen, Po-Wen Yang, Chia-Hung Chen, Chih-I Chen","doi":"10.1007/s13304-026-02890-6","DOIUrl":"https://doi.org/10.1007/s13304-026-02890-6","url":null,"abstract":"<p><strong>Objective and rationale: </strong>Early-onset locally advanced rectal cancer presents unique challenges in treatment and prognosis. This study aimed to develop and validate a prognostic nomogram for patients aged 18-50 years with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, addressing the lack of tailored prognostic tools for this growing patient population.</p><p><strong>Methods: </strong>Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed 2,853 patients who received neoadjuvant chemoradiotherapy between 2010 and 2020. Patients were divided into training (n = 1,990) and validation (n = 863) cohorts. Cox proportional hazard regression models identified prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Nomograms were constructed and validated using Harrell's C-index and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Independent predictors of poor OS and CSS included male sex, unmarried status (particularly divorced/separated/widowed), non-Hispanic black and American Indian/Alaskan native races, advanced T stage, increased positive regional nodes, and positive carcinoembryonic antigen (CEA). The nomogram demonstrated good discriminative ability in the validation cohort, with area under the curve (AUC) values of 0.767 and 0.742 for 3-year OS and CSS, respectively, and 0.705 and 0.697 for 5-year OS and CSS, respectively.</p><p><strong>Conclusions: </strong>The developed nomogram and identified prognostic factors provide valuable tools for individualized risk stratification and treatment optimization in young patients with locally advanced rectal cancer. These findings can aid in clinical decision-making and patient counseling. However, further external validation and prospective evaluations are necessary to confirm the clinical utility of this prognostic model in diverse healthcare settings.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208141","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":"Comment on \"predictors of time to surgical recurrence after ileal or ileocolonic resection in Crohn's disease: role of integrin αvβ6 and development of a predictive nomogram\".","authors":"Sahir Omrani, Zied Hadrich, Ghada Gharbi","doi":"10.1007/s13304-026-02893-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02893-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184806","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":"Lymph node yield in T1N0M0 colorectal cancer: a threshold built on unstable ground.","authors":"Yu Zhang","doi":"10.1007/s13304-026-02883-5","DOIUrl":"https://doi.org/10.1007/s13304-026-02883-5","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184777","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":"Nipple or skin-sparing mastectomy flap: can preoperative breast-MRI predict post-operative complications?","authors":"L I Sgaramella, A Pasculli, F P Prete, F Cofone, M Moschetta, M Maruccia, R Elia, M Telegrafo, V De Ruvo, M Bisceglie, M M Miccoli, F Palma, C Testini, G Giudice, M Testini, A Gurrado","doi":"10.1007/s13304-026-02843-z","DOIUrl":"https://doi.org/10.1007/s13304-026-02843-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the role of skin flap thickness (SFT), measured by preoperative breast magnetic resonance imaging (MRI), in predicting postoperative complications after nipple-sparing or skin-sparing mastectomy, and to assess its value in guiding reconstructive strategy selection.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study including patients who underwent preoperative breast MRI and nipple-sparing or skin-sparing mastectomy for breast cancer or BRCA1/2 mutations between January 2019 and August 2025. Demographic, clinical, and perioperative data were collected. Patients were stratified into two groups based on mean preoperative SFT: >8 mm (Group A) and <8 mm (Group B). Postoperative complications were recorded and analyzed using univariate and multivariate models.</p><p><strong>Results: </strong>Sixty patients (mean age 47.5 ± 9.1 years) and 80 breasts (40 unilateral, 20 bilateral procedures) were included. Group A comprised 54 breasts (67.5%), while Group B included 26 (32.5%). Postoperative hospital stays and incision type differed significantly between groups (p < 0.05). Overall postoperative morbidity was 16.25%. Partial nipple-areola complex necrosis (11.5%) and hematoma (7.7%) occurred significantly more often in Group B compared to Group A (both p < 0.05). Multivariate analysis confirmed preoperative SFT <8 mm as an independent predictor of these complications (odds ratio 13.40, p = 0.012).</p><p><strong>Conclusion: </strong>Preoperative magnetic resonance imaging assessment of skin flap thickness reliably identifies patients at increased risk of postoperative complications. Integrating this parameter into surgical planning may support personalized reconstructive decision-making and improve clinical outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184760","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":"Letter to the editor: Subcutaneous Onlay Laparoscopic Approach (SCOLA) for ventral hernia with concomitant diastasis recti: a single-center experience.","authors":"Zenan Chen, Yuxuan Huang, Jian Zhang","doi":"10.1007/s13304-026-02895-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02895-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184814","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":"Considerations regarding a meta-analysis investigating the efficacy and safety of robotic-assisted thoracic surgery after neoadjuvant therapy in non-small cell lung cancer.","authors":"Bin Jiao, Lei Wang","doi":"10.1007/s13304-026-02879-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02879-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184735","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":"Comment on \"Compliance with an enhanced recovery pathway and postoperative outcomes in elderly colorectal cancer patients: a real-world cohort and structural pathway analysis\".","authors":"Dixit Gautam, Netali, Abhishek Mathur","doi":"10.1007/s13304-026-02808-2","DOIUrl":"https://doi.org/10.1007/s13304-026-02808-2","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184751","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":"Global research trends and emerging hotspots in endoscopic sleeve gastroplasty: a bibliometric and visualization analysis.","authors":"Chenglou Zhu, Lanfang Liu, Ronglong Zhang, Naiqing Liu","doi":"10.1007/s13304-026-02886-2","DOIUrl":"https://doi.org/10.1007/s13304-026-02886-2","url":null,"abstract":"<p><p>This bibliometric study systematically explores the global research status, evolutionary trends and emerging research hotspots of endoscopic sleeve gastroplasty (ESG), aiming to clarify the future research priorities in this field. Based on the publications retrieved from the Web of Science Core Collection from its inception to April 13, 2026, the study adopted CiteSpace 6.4.R1, VOSviewer 1.6.18 and BiblioVista software to comprehensively analyze the publication characteristics of ESG research, including publication trends, source journals, contributing countries and institutions, productive authors, citation rules, as well as keyword co-occurrence, cluster distribution and citation burst features. A total of 273 eligible publications from 95 academic journals were included in the final analysis, and the number of relevant studies has grown rapidly since 2018. Among all publication sources, Obesity Surgery contributed the most ESG-related papers, while the United States dominated the field with 154 publications and 4,463 cumulative citations. Highly cited and co-cited literatures primarily focused on the technical feasibility, weight-loss efficacy, clinical safety and long-term clinical outcomes of ESG. Keyword analysis revealed that the current research mainstream mainly covers four core themes: weight-loss outcomes evaluation, clinical safety assessment, endoscopic gastric remodeling technology, and comparative analysis between ESG and laparoscopic sleeve gastrectomy (LSG). Temporal evolution and citation burst analyses further demonstrated the developmental trajectory of ESG research, which has shifted from early-stage technical exploration to clinical effect verification and comparative research, with growing attention paid to standardized clinical application in recent years. Overall, ESG research has achieved rapid development and gradually transformed toward evidence-based clinical evaluation, with current studies centering on the efficacy, safety, comparative clinical value and standardized application of the technique. Future ESG research should focus on conducting high-quality randomized controlled trials, formulating unified evaluation standards for clinical outcomes, carrying out long-term patient follow-up studies, and optimizing the scientific selection criteria for applicable patients.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171017","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":"Association between left colic artery preservation and surgical outcomes after laparoscopic radical resection for rectal cancer: a propensity score-matched analysis.","authors":"Hongqiang Zhang, Wenjie Li, Shuai Wang, Zan Fu","doi":"10.1007/s13304-026-02873-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02873-7","url":null,"abstract":"<p><p>To evaluate the association between left colic artery (LCA) preservation during laparoscopic rectal cancer resection and the incidence of anastomotic leakage (AL) and perioperative outcomes. Clinical data were retrospectively collected from patients who underwent laparoscopic rectal cancer resection at the First Affiliated Hospital of Nanjing Medical University between July 2020 and February 2023. Patients were divided into an LCA-preservation group and a non-preservation group according to whether the left colic artery (LCA) was preserved intraoperatively. A 1:1 propensity score matching analysis was performed to balance baseline covariates, including sex, age, body mass index, comorbidities, American Society of Anesthesiologists classification, TNM stage, tumor differentiation, distance from the anal verge, and tumor size. Postoperative outcomes were subsequently compared between the two groups. A total of 500 patients were included, comprising 341 patients in the LCA-preservation group and 159 in the non-preservation group. Before matching, patients in the non-preservation group had more advanced TNM stages and a higher incidence of AL than those in the LCA-preservation group. After propensity score matching, baseline characteristics were well balanced between the two groups. The incidence of AL remained significantly higher in the non-preservation group than in the LCA-preservation group (P = 0.038). Operative time was significantly longer in the LCA-preservation group (P = 0.026), whereas no significant differences were observed in intraoperative blood loss, drainage volume on postoperative day 1, or postoperative length of hospital stay. In laparoscopic rectal cancer resection, LCA preservation was associated with a lower incidence of anastomotic leakage, potentially through the maintenance of proximal bowel perfusion. Although this technique may prolong operative time, it does not appear to increase other major perioperative adverse outcomes, supporting its potential clinical value.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149489","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":"Treatment profile and prognostic modeling in early-stage Merkel cell carcinoma: a retrospective cohort study.","authors":"Can Li, Jingxuan Huang, Wenbin Guan, Beiyao Zhu","doi":"10.1007/s13304-026-02881-7","DOIUrl":"https://doi.org/10.1007/s13304-026-02881-7","url":null,"abstract":"<p><p>Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine skin cancer. The prognostic associations of different treatment approaches remain incompletely defined. This study aimed to characterize treatment patterns, evaluate survival outcomes, and develop prognostic models for early-stage MCC. We analyzed SEER data from 2004 to 2021 for patients aged > = 20 years with node-negative, non-metastatic primary cutaneous MCC. Associations with overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox regression and inverse probability of treatment weighting (IPTW). A Fine-Gray competing-risk analysis was additionally performed for MCC-specific mortality in relation to adjuvant radiation therapy. Prognostic models were developed using Cox regression and XGBoost and evaluated using Harrell's C-index and time-dependent AUCs. Among 5742 patients, surgery was the predominant treatment modality. In direct comparisons among surgical approaches, gross excision showed only a modest and model-dependent association with OS and no consistent association with CSS relative to wide excision, whereas Mohs micrographic surgery (MMS) was associated with higher hazards of all-cause and MCC-specific mortality. Adjuvant radiation therapy was associated with improved OS but not CSS. In the competing-risk analysis, the adjusted subdistribution hazard of MCC-specific death was modestly higher among patients receiving adjuvant radiation (sHR 1.17, 95% CI 1.02-1.34; P = 0.026). In the testing cohort, the Cox and XGBoost models achieved OS C-indices of 0.66 and 0.67, respectively. Treatment modality was associated with survival outcomes in early-stage MCC, although the observational treatment comparisons should be interpreted cautiously because of potential residual confounding. Cox and XGBoost models showed comparable prognostic discrimination in the testing cohort and may support further development of risk-stratification approaches.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148739","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}