Updates in Surgery最新文献

{"title":"Comment on: \"An outcome analysis of utilizing contrast-free near-infrared autofluorescence imaging in thyroid cancer surgery: a retrospective study\".","authors":"Qi Xu, Xiaohui Chen","doi":"10.1007/s13304-025-02248-4","DOIUrl":"10.1007/s13304-025-02248-4","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"887-888"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051855","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":"Evaluating human ability to distinguish between ChatGPT-generated and original scientific abstracts.","authors":"Kylie J Nabata, Yasir AlShehri, Abdullah Mashat, Sam M Wiseman","doi":"10.1007/s13304-025-02106-3","DOIUrl":"10.1007/s13304-025-02106-3","url":null,"abstract":"<p><p>This study aims to analyze the accuracy of human reviewers in identifying scientific abstracts generated by ChatGPT compared to the original abstracts. Participants completed an online survey presenting two research abstracts: one generated by ChatGPT and one original abstract. They had to identify which abstract was generated by AI and provide feedback on their preference and perceptions of AI technology in academic writing. This observational cross-sectional study involved surgical trainees and faculty at the University of British Columbia. The survey was distributed to all surgeons and trainees affiliated with the University of British Columbia, which includes general surgery, orthopedic surgery, thoracic surgery, plastic surgery, cardiovascular surgery, vascular surgery, neurosurgery, urology, otolaryngology, pediatric surgery, and obstetrics and gynecology. A total of 41 participants completed the survey. 41 participants responded, comprising 10 (23.3%) surgeons. Eighteen (40.0%) participants correctly identified the original abstract. Twenty-six (63.4%) participants preferred the ChatGPT abstract (p = 0.0001). On multivariate analysis, preferring the original abstract was associated with correct identification of the original abstract [OR 7.46, 95% CI (1.78, 31.4), p = 0.006]. Results suggest that human reviewers cannot accurately distinguish between human and AI-generated abstracts, and overall, there was a trend toward a preference for AI-generated abstracts. The findings contributed to understanding the implications of AI in manuscript production, including its benefits and ethical considerations.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"615-621"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034085","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":"Estimation of physiologic ability and surgical stress (E-PASS) predicts postoperative complications after adrenalectomy.","authors":"Mehmet Vehbi Kayra, Mehmet Eflatun Deniz, Cevahir Ozer, Sibel Catalca, Serdar Toksoz, Hakan Yabanoglu","doi":"10.1007/s13304-025-02145-w","DOIUrl":"10.1007/s13304-025-02145-w","url":null,"abstract":"<p><p>The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score, initially developed for gastrointestinal surgery, is a validated system used to predict postoperative complications by evaluating preoperative and intraoperative factors. This study aims to assess the effectiveness of the E-PASS score in predicting postoperative complications following adrenalectomy. In this single-center retrospective study, we analyzed data from 202 patients who underwent adrenalectomy by a single surgeon between January 2017 and March 2024. 182 patients with complete data and who met the study criteria were included in the study. Demographic, clinical, intraoperative, and postoperative data were collected and analyzed, including preoperative complaints, ASA classification, ECOG performance status, presence of systemic diseases, type of surgery, and intraoperative details, such as blood loss and complications. Postoperative complications were classified using the Clavien-Dindo Classification. The mean age of the patients was 48.7 ± 13.6 years. The mean BMI was 24.1 kg/m². Postoperative complications were observed in 26.4% of patients, categorized as Grade 1 (54.1%), Grade 2 (25%), Grade 3 (16.7%), and Grade 4 (4.2%). Multivariate logistic regression identified higher BMI (OR = 1.394) and an E-PASS CRS score > - 0.0677 (OR = 6.17) as independent risk factors for complications. ROC curve analysis determined this CRS score cut-off with an AUC of 0.866 (CI 0.808-0.923; p < 0.001). The E-PASS scoring system effectively predicts postoperative complications in adrenalectomy. Its integration into clinical practice can enhance the identification of high-risk patients, optimize perioperative management, and potentially reduce adverse outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"915-924"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for an international multicenter, prospective, observational, non-competitive, study to validate and optimise prediction models of 90-day and 1-year allograft failure after liver transplantation: The global IMPROVEMENT Study.","authors":"Alfonso W Avolio, Gabriele Spoletini, Umberto Cillo, Kristopher Croome, Gabriel Oniscu, Patrizia Burra, Martin De Santibanes, Hiroto Egawa, Mikel Gastaca, Zhiyong Guo, Quirino Lai, Paulo N Martins, Wojciech G Polak, Cristiano Quintini, Mohamed Rela, Gonzalo Sapisochin, Julio Wiederkehr, Riccardo Pravisani, Deniz Balci, Ian Leipnitz, Ilka Boin, Felix Braun, Lucio Caccamo, Stefania Camagni, Amedeo Carraro, Matteo Cescon, Zhishui Chen, Olga Ciccarelli, Luciano De Carlis, Deng Feiwen, Fabrizio Di Benedetto, Burcin Ekser, Giuseppe Maria Ettorre, Marta Garcia-Guix, Davide Ghinolfi, Michal Grat, Salvatore Gruttadauria, John Hammond, Zemin Hu, Sunhawit Junrungsee, Michael Lesurtel, Jean Yves Mabrut, Daniel Maluf, Vincenzo Mazzaferro, Gilberto Mejia, Artem Monakhov, Bunthoon Noonthasoot, Silvio Nadalin, Brian M Nguyen, Nguyen Quang Nghia, Madhukar Patel, Thamara Perera, Marcos Vinicius Perini, Carlo Pulitano, Renato Romagnoli, Ephrem Salame, Gupta Subhash, Surendran Sudhindran, Takashi Ito, Francesco Tandoi, Giuliano Testa, Timucin Taner, Giuseppe Tisone, Giovanni Vennarecci, Marco Vivarelli, Diana Giannarelli, Tina Pasciuto, Marco Maria Pascale, Vatche Agopian","doi":"10.1007/s13304-025-02078-4","DOIUrl":"10.1007/s13304-025-02078-4","url":null,"abstract":"<p><p>More liver transplants (LT) are performed worldwide thanks to extended criteria donors (ECD). This is paralleled by a supposed increased risk of allograft failure (AF) at 90 and 365 days. This study has been designed to portray the LT practice worldwide and investigate models of AF prediction and the impact of risk mitigation strategies for further improving graft and patient outcomes. This is a multicenter, international, non-competitive, observational two segment study on consecutive LTs over two periods (2017-2019 and 2022-2024). A steering committee of LT experts defined the study protocol. The prospective segment will enroll 750 patients from 15 high-volume LT centers (50 per center), and the retrospective segment will enrol 4200 patients from 56 LT centers (75 per center). To provide a snapshot of the LT activity globally and to develop new algorithms for the timely prediction of AF at 90 and 365 days post-LT. The study also aims (1) to validate the existing predictive models and (2) to investigate the best time for re-transplantation, paying attention to the differences in AF and Ischemic cholangiopathy according to the donor types and mitigation strategies implemented in the various settings. Since the adoption of machine perfusion has increased in different proportions worldwide, models will be adjusted according to this parameter. Finally, retrospective and prospective data will be available for further stratifications and modelling according to the degree of decompensation at transplant, gender match, postoperative complications and their management. This protocol was approved by Fondazione Policlinico Universitario Agostino Gemelli IRCCS Ethics Committee (study ID: 4571) and the Institutional Review Board of the University of California, Los Angeles. The provisional study protocol was submitted to the main scientific international societies in the transplant field. Results will be published in international peer-reviewed journals and presented at congresses.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"645-664"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An optimal protective ventilation strategy in lung resection surgery: a prospective, single-center, three-arm randomized controlled trial.","authors":"Seihee Min, Susie Yoon, Hyun Woo Choe, Haesun Jung, Jeong-Hwa Seo, Jae-Hyon Bahk","doi":"10.1007/s13304-025-02091-7","DOIUrl":"10.1007/s13304-025-02091-7","url":null,"abstract":"<p><p>Protective ventilation reduces ventilator-induced acute lung injury postoperatively; however, the optimal strategy for one-lung ventilation (OLV) remains unclear. This study compared three protective ventilation strategies with a postoperative partial pressure of oxygen (PaO₂)/fraction of inspired oxygen (FiO₂) ratio to reduce the incidence of immediate postoperative pulmonary complications (PPCs) in patients undergoing lung resection surgery. Eighty-seven patients with ASA physical status I-III requiring OLV for lung resection surgery were randomized into three groups according to the applied ventilation strategies: low tidal volume (V_T) of 4 mL/kg of predicted body weight (PBW) (LV group), medium V_T of 6 mL/kg of PBW (MV group), and high V_T of 8 mL/kg of PBW (HV group). All patients received 5 cmH₂O of positive end-expiratory pressure (PEEP). The primary outcome was the mean difference of PaO₂/FiO₂ ratio after surgery. The radiologic findings of acute lung injuries were also evaluated. The incidence of immediate PPCs was determined by PaO₂/FiO₂ ratio of < 300 mmHg and/or newly developed radiological findings within 72 h after surgery. The MV group showed the highest PaO₂/FiO₂ ratio at 6 h postoperatively (P = 0.010). There were no significant among-group differences in radiological findings in 3 postoperative days. The MV group showed the lowest incidence of immediate PPCs among the three groups (P = 0.007). During OLV in lung resection surgery, protective ventilation at a V_T of 6 mL/kg with PEEP of 5 cmH₂O may achieve a higher postoperative PaO₂/FiO₂ ratio, reducing the incidence of immediate PPCs.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"925-935"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined robotic/open pancreaticoduodenectomy in the young aged < 50 years.","authors":"Bor-Uei Shyr, Bor-Shiuan Shyr, Mu-Shan Shih, Shih-Chin Chen, Shin-E Wang, Yi-Ming Shyr","doi":"10.1007/s13304-025-02082-8","DOIUrl":"10.1007/s13304-025-02082-8","url":null,"abstract":"<p><p>Impact of age on surgical and survival outcomes after combined robotic/open pancreaticoduodenectomy (CR/OPD) has not been extensively studied. This study aimed to evaluate the surgical and survival outcomes of patients aged < 50 years who underwent CR/OPD. A comparative study was conducted on patients who underwent CR/OPD divided into two groups: the young (age < 50 years) and the old (age ≥ 50 years). A total of 555 patients were included in this study, with 53 (9.5%) in the young group and 502 (90.5%) in the old group. Periampullary adenocarcinomas were less common in the young group (32.1% vs. 76.5%), whereas solid and pseudopapillary tumors (9.4% vs. 1.0%) and neuroendocrine tumors (15.1% vs. 3.6%) were more common. Soft pancreatic parenchyma (77.4% vs. 76.5%) and non-dilated (≤ 3 mm) pancreatic ducts (77.4% vs. 62.5%) were more prevalent in the young group. The young group had a shorter length of stay (median, 16 vs. 20 days). No significant differences were observed in the other surgical outcomes and risks, including postoperative pancreatic fistula (POPF) (7.5% vs. 8.0%). Survival outcomes for overall periampullary adenocarcinoma favored the young group, with a 5-year survival rate of 76.4% vs. 46.7% in the old group. In conclusion, RPD in the young patients (< 50 years) is associated with comparable surgical outcomes and favorable survival outcomes for periampullary adenocarcinoma compared with the older patients (≥ 50 years). These findings highlight the feasibility and safety of RPD in the young population, although the prevalence of soft pancreatic parenchyma and non-dilated pancreatic ducts was higher in the young group.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"725-734"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012130","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":"An outcome analysis of utilizing contrast-free near-infrared autofluorescence imaging in thyroid cancer surgery: a retrospective study.","authors":"Sohail Bakkar, Mohammad Allan, Basem Halaseh, Angeliki Chorti, Theodosis Papavramidis, Gianluca Donatini, Paolo Miccoli","doi":"10.1007/s13304-025-02123-2","DOIUrl":"10.1007/s13304-025-02123-2","url":null,"abstract":"<p><strong>Background: </strong>Hypoparathyroidism is the most common complication of thyroid surgery. The best way to assume normal parathyroid gland (PTG) function is to preserve them in situ, undamaged. Near-infrared autofluorescence (NIRAF)-imaging has been introduced as a potentially useful adjunct in thyroid surgery.</p><p><strong>Objective: </strong>To assess the surgical outcomes of NIRAF-imaging utility in thyroid surgery.</p><p><strong>Methods: </strong>The clinical records of patients who underwent surgery for papillary thyroid carcinoma (PTC) in a 7-month period were retrospectively reviewed. The primary endpoint was to assess NIRAF's impact on postoperative hypoparathyroidism. Secondary endpoints included its impact in preventing inadvertent PTG resection, time to resolution of postoperative hypoparathyroidism, and additional benefits in therapeutic central compartment neck dissection (tCCND).</p><p><strong>Results: </strong>Fifty consecutive patients underwent surgery for PTC. Total thyroidectomy was performed in 42 patients. Whereas concomitant tCCND was performed in 8 patients. PTG-detection rate was 93% for NIRAF versus 87% for the surgeon (p = 0.04). NIRAF prevented inadvertent resection of 16 PTGs (p < 0.001). In tCCND, the detection rate of NIRAF was 100% versus 81% for the surgeon (p < 0.01). The rate of transient hypoparathyroidism applying NIRAF was 12% versus 15% (historical cohort) (p = 0.6). However, a significantly prompter resolution of hypoparathyroidism was demonstrated using NIRAF (average time of 2.7 weeks vs. 12.3 weeks; p < 0.0001).</p><p><strong>Conclusion: </strong>Although NIRAF did not significantly minimize the overall risk of postoperative transient hypoparathyroidism, it demonstrated a trend toward improvement. It also led to prompter resolution of hypoparathyroidism and lowered the risk for inadvertent PTG resection. Therefore, NIRAF seems to be a promising surgical adjunct.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"879-886"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123735","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":"Humans-written versus ChatGPT-generated abstracts: beyond the discussion on \"who wrote it\".","authors":"Shigeki Matsubara","doi":"10.1007/s13304-025-02160-x","DOIUrl":"10.1007/s13304-025-02160-x","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"623-624"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543524","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: \"Preoperative hemoglobin to albumin ratio as a prognostic predictor for patients with colorectal cancer surgery\".","authors":"Dongxing Zhang, Qifang Shi","doi":"10.1007/s13304-025-02176-3","DOIUrl":"10.1007/s13304-025-02176-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"771-772"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634837","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":"Diagnosis and management of caustic ingestion: an interdisciplinary nationwide cross-sectional survey from the Italian society of endoscopic surgery and new technologies (SICE), the Italian society of digestive endoscopy (SIED), the world society of emergency surgery-Italy chapter (WSESit), and the Italian society of surgical endoscopy and digestive diseases (ISSE).","authors":"Alessio Giordano, Manuela Mastronardi, Mauro Podda, Luigi Bonavina, Diego Cuccurullo, Gabriele Anania, Carlo Bergamini, Giuseppe Galloro, Cesare Hassan, Maria Caterina Parodi, Ferdinando Agresta, Giulia Montori, Massimo Sartelli, Fausto Catena, Paola Fugazzola, Luca Ansaloni, Emanuele Marciano, Girolamo Geraci, Attilio Maurano, Manuela Avellino, Arianna Massella, Beatrice Orlandini","doi":"10.1007/s13304-025-02166-5","DOIUrl":"10.1007/s13304-025-02166-5","url":null,"abstract":"<p><p>Caustic ingestion (CI) in adults represents a potentially life-threatening condition. Diagnosis and management of CI in real life remain challenging. The aim of the survey is to evaluate on a national scale the multidisciplinary management of these patients. 24-item online Survey was sent to the mailing lists and social media of Italian Society of Endoscopic Surgery and New Technologies, Italian Society of Digestive Endoscopy, World Society of Emergency Surgery-Italy Chapter, and Italian Society of Surgical Endoscopy and Digestive Diseases. Overall, 240 subjects answered to the survey, corresponding to 22.1% of the total members of the scientific societies involved. 131 (54.5%) respondents evaluated fewer than ten CI patients per year. The recommendations provided by the WSES and SIED guidelines were followed by 133 (55.2%) and 83 (34.4%) participants, respectively. Emergency surgery was advocated by 180 (77.6%) of the respondents for patients with transmural necrosis or signs of perforation, using minimally invasive surgery in 47% of the cases and considering initial esophagojejunal anastomosis as safe in 33 (14.2%) of the responses. Our study is the first to provide real-life data on how the management of CI varies across Italian physicians, according to regional, institutional, and specialty-related factors. This survey highlights the need for standardized and uniform guidelines.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"843-858"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626190","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}