World Journal of Surgery最新文献

{"title":"The Suitability of the South African Triage Scale (SATS) in Triaging Patients With Penetrating Neck Injuries at a High-Level Trauma Center, in the Western Cape, South Africa.","authors":"Thomas Steve Jessop, Lindi Martin, Hendrick J Lategan, Julie M Dixon, Nee-Kofi Moul-Millman, Elmin Steyn","doi":"10.1002/wjs.12578","DOIUrl":"https://doi.org/10.1002/wjs.12578","url":null,"abstract":"<p><strong>Background: </strong>Penetrating injuries are the most common mechanism of serious injury in Cape Town, with penetrating neck injuries (PNIs) having a mortality rate of 10%. The South African Triage Scale (SATS) is commonly used and designed for general emergency departments in South Africa. This study aimed to assess the suitability of the SATS for triaging patients with PNIs at a high-level trauma center, Tygerberg Hospital (TBH).</p><p><strong>Methods: </strong>This secondary analysis utilized data from a multicentre prehospital observational study. Adult patients (≥ 18 years) with PNIs managed at the TBH Trauma Center between October 2022 and March 2023 were included. Patients dead on arrival were excluded. The original arrival triage categorization was reviewed and re-calculated based on a correct application of the SATS.</p><p><strong>Results: </strong>Seventy patients (mean age: 32 years, SD: 10) were included. Mechanisms of injury were stab or cut (78.6%) and gunshot wound (21.4%). The most common SATS colors recorded were Orange (61.4%), and Yellow (17.1%), with recalculation of SATS (R-SATS) resulting in \"Orange\" (81.4%) and \"Red\" (18.6%). Under-triage occurred in 25.7% of cases. A significant difference was noted between SATS and R-SATS categories (p < 0.01). There was no significant association between TBH SATS or R-SATS category and need for resuscitation, urgent surgical intervention, and 7-day mortality (p > 0.05).</p><p><strong>Conclusion: </strong>No association could be shown between the SATS colors and life-saving interventions and mortality. Furthermore, findings suggest that the SATS is not optimally applied at TBH. Consideration for a simpler, better-performing tool to optimize triage of patients with traumatic injuries, including PNIs is needed.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812534","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: LigaSure Versus Conventional Milligan MORGAN Hemorrhoidectomy in Nigerian Patients With Symptomatic Hemorrhoids.","authors":"Shahzeb Ali, Magdalena O'Connor Manson, Giordano Perin","doi":"10.1002/wjs.12572","DOIUrl":"https://doi.org/10.1002/wjs.12572","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812527","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":"Genome-Wide Association Study Identifies a Locus at 17p13 to Be Associated With Intestinal Malrotation.","authors":"Apostolos Gaitanidis, Mathias A Christensen, Ander Dorken Gallastegi, Kerry A Breen, George C Velmahos, Haytham M A Kaafarani, Maha R Farhat","doi":"10.1002/wjs.12575","DOIUrl":"https://doi.org/10.1002/wjs.12575","url":null,"abstract":"<p><strong>Background: </strong>Intestinal malrotation is a congenital malformation of the embryonic gut that may cause midgut volvulus either in children or adults. Our understanding of its genetic background stems from reports of syndromic or familial forms and no genome-wide association studies (GWAS) have been reported. We perform the first GWAS to identify common variants associated with this malformation.</p><p><strong>Methods: </strong>Subjects were enrolled and genotyped as part of the Mass General Brigham Biobank and individuals with diagnosis of intestinal malrotation were identified. Single nucleotide polymorphisms (SNPs) with minor allele frequency ≥ 5% were examined for association with intestinal malrotation using mixed linear model association analysis. SNPs that surpassed the significance threshold (p < 5E-08) were further examined in a separate validation cohort.</p><p><strong>Results: </strong>The derivation cohort included 11,106 individuals (70 [0.6%] cases), and the validation cohort included 4134 individuals (21 [0.5%] cases). Five exonic SNPs in two loci at chromosomes 17p13 (lead SNP rs75147837, beta = 0.0044, and p = 7.97E-10) and 10q26 (lead SNP rs3121846, beta = 0.0057, p = 3.28E-08) had p < 5E-08. After validation, 2 SNPs at 17p13 were associated with the phenotype (rs72631499 adjusted-p = 0.010 and rs148094507 adjusted-p = 0.014). eQTL (expression Quantitative Trait Loci) analysis mapped 6 genes to the identified locus (PITPNA, TRARG1, INPP5K, YWHAE, PITPNA-AS1, and FAM57A).</p><p><strong>Conclusion: </strong>We report results from the first GWAS on intestinal malrotation. A locus at 17p13 is associated with intestinal malrotation and may guide genetic guidance and improve our understanding of this malformation. Rs72631499 was found to be a binding site for HNF4A, a transcription factor that plays important roles in normal embryonic gut development.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812525","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: Impact of Small Tumor Size on Prognosis in T3N1 Colon Cancer.","authors":"Constantine Ezeme, Pratik Bhattacharya, Giordano Perin","doi":"10.1002/wjs.12574","DOIUrl":"https://doi.org/10.1002/wjs.12574","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804331","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":"Hand Grip Strength and Body Composition According to the Sarcopenic Obesity Guidelines: Impact on Postoperative Complications in Patients With Gastric Cancer.","authors":"Yoko Saino, Ryota Matsui, Koshi Kumagai, Satoshi Ida, Hiromi Matsuo, Aya Fujihara, Misuzu Ishii, Naoki Moriya, Kazuhiro Nomura, Rie Tsutsumi, Hiroshi Sakaue, Souya Nunobe","doi":"10.1002/wjs.12581","DOIUrl":"https://doi.org/10.1002/wjs.12581","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of sarcopenic obesity (SO) in patients with gastric cancer has been inconsistent among studies examining postoperative complications because diagnostic methods have not been standardized. This study aimed to clarify the differences in the prevalence of obesity with and without low hand grip strength (HGS) according to the diagnostic criteria proposed using the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) and identify the optimal model for predicting postoperative complications.</p><p><strong>Methods: </strong>Patients who underwent radical gastrectomy for gastric cancer between April 2015 and March 2023 were included. According to the ESPEN/EASO diagnostic criteria, patients with a body mass index ≥ 25 kg/m² who met the screening criteria were assessed for percent body fat (PBF) and skeletal muscle mass (SMM) adjusted by weight (SMM/W) and HGS. Depending on the respective cutoff values, six models of low SMM-obesity without HGS and six models of low HGS-obesity with HGS were set. The incidence of postoperative complication with the Clavien-Dindo classification grade 2 or higher was compared across models. Multivariate logistic regression analysis was performed to determine the risk model for postoperative complications, with significance set at p < 0.05.</p><p><strong>Results: </strong>The analysis included 1762 patients with a median age of 67.0 years; 1123 were men (63.7%). The prevalence of low SMM-obesity was significantly higher (5.4%-17.3%) than that of low HGS-obesity (1.2%-2.3%). Among those with low SMM-obesity, PBF > 20.2% for men and > 31.7% for women as well as SMM/W ≤ 42.9% for men and ≤ 35.6% for women had the highest postoperative complication incidence number of cases. This model was an independent risk factor for postoperative complications in the multivariate analysis (odds ratio: 1.671, 95% confidence interval: 1.204-2.299, and p = 0.002).</p><p><strong>Conclusions: </strong>In obese patients with gastric cancer, the preoperative prevalence of low HGS-obesity or low SMM-obesity differed significantly. One of the low SMM-obesity model was associated with postoperative complication after gastrectomy.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804326","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":"Resilience Amidst Instability: A Critical First Step in Improving Patient Safety Culture in Conflict-Affected Zones.","authors":"Malerie S Pratt, Thomas G Weiser","doi":"10.1002/wjs.12561","DOIUrl":"https://doi.org/10.1002/wjs.12561","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796643","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":"Prospective Evaluation of Multimodal Prehabilitation in Esophagogastric Cancer Surgery: Enhancing Patient Outcomes.","authors":"Azhar Perwaiz, Archit Gupta, Vijay Mittal, Amanjeet Singh, Adarsh Chaudhary","doi":"10.1002/wjs.12567","DOIUrl":"https://doi.org/10.1002/wjs.12567","url":null,"abstract":"<p><strong>Background: </strong>The significance of prehabilitation in contemporary esophagogastric surgical procedures is yet to be fully understood, due to heterogeneity in the available research. This research was conducted to assess the impact of a structured home-based multimodal prehabilitation approach on the postsurgical outcomes of patients undergoing surgery for esophagogastric cancer.</p><p><strong>Methods: </strong>This study was a prospective, nonrandomized investigation carried out on individuals scheduled for curative esophagogastric cancer surgery. Participants underwent a home-based, multimodal prehabilitation regimen that incorporated structured physical exercises, nutritional support, psychological counseling, and assistance in quitting smoking and alcohol use. The primary outcome measured was the incidence of postoperative pneumonia, defined according to the revised Uniform Pneumonia Scoring system from day 1 to day 4 post-surgery.</p><p><strong>Results: </strong>A total of 94 patients were analyzed. A total of 50 patients underwent multimodal prehabilitation for a minimum of 2 weeks with a compliance rate of more than 60% and were included in the intervention group, whereas the rest 44 with compliance less than 60% or unwilling to undergo prehabilitation were included in the control group. A statistically significant difference was seen in the incidence of postoperative pneumonia between the two groups.</p><p><strong>Conclusion: </strong>Structured multimodal prehabilitation done for 2 weeks before surgery improves outcomes in patients undergoing esophagogastric cancer surgery.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789100","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":"Pancreatic Fat Accumulation Impacts Postoperative Survival in Patients With Pancreatic Ductal Adenocarcinoma.","authors":"Yasunari Fukuda, Chikato Koga, Soichiro Minami, Satoshi Ishikawa, Atsushi Gakuhara, Shuichi Fukuda, Naotsugu Haraguchi, Jinichi Hida, Tomoko Wakasa, Yutaka Kimura","doi":"10.1002/wjs.12576","DOIUrl":"https://doi.org/10.1002/wjs.12576","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic fat accumulation, that is, fatty pancreas (FP), has gained attention because it contributes to pancreatic carcinogenesis. However, the impact of FP on the survival of patients with pancreatic cancer has not yet been elucidated.</p><p><strong>Methods: </strong>Overall, 87 consecutive patients who were pathologically diagnosed with pancreatic ductal adenocarcinoma and underwent potentially curative pancreatectomy were eligible for analysis. Histological pancreatic fat fraction (HPFF) was evaluated using hematoxylin & eosin-stained slides of tumor and non-tumor sections of the resected specimen, and quantified using imaging analysis software. The optimal HPFF value threshold for FP presence was determined using receiver operating characteristics curve analysis. The prognostic significance of FP was identified by a Cox proportional hazard model adjusted for the established prognostic covariates.</p><p><strong>Results: </strong>Fat accumulation within the invasive tumor front was scarce, with the median value for HPFF being 10.1% in the non-tumor portion (range: 2.2%-45.8%). Patients with FP (HPFF value ≥ 11.3%) in the non-tumor portion had significantly inferior overall survival (OS) and recurrence-free survival (RFS) than those without FP (HPFF value < 11.3%) (log-rank test: p = 0.012 and p = 0.00060, respectively). In the multivariate analyses, the presence of FP emerged as an independent inferior prognostic indicator (OS: hazard ratio [HR] 2.32, p = 0.0015; PFS: HR 2.33, p = 0.00080), together with lymph node metastases, presence of lymphatic involvement, and absence of adjuvant chemotherapy.</p><p><strong>Conclusion: </strong>The present study indicates a possible prognostic role for pancreatic fat accumulation in patients with pancreatic adenocarcinoma.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781343","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":"Multimodal Prehabilitation for Colorectal Cancer Patients: Study Protocol of a Nationwide Multicentre Study With Uniform Prehabilitation Protocols.","authors":"C R Sabajo, J P Dieleman, J W T Dekker, B van den Heuvel, J M Klaase, G D Slooter","doi":"10.1002/wjs.12565","DOIUrl":"https://doi.org/10.1002/wjs.12565","url":null,"abstract":"<p><strong>Background: </strong>The aim of prehabilitation is to optimize patient specific modifiable risk factors before major surgery, in order to enhance the individual resilience. Due to the lack of universal guidelines, prehabilitation has been conducted in various ways, making it difficult to estimate its effect. In the Netherlands, proposed uniform prehabilitation protocols were developed. The aim of this study is to analyse clinical outcomes of prehabilitation when implemented as standard of care according to the proposed uniform protocols.</p><p><strong>Methods: </strong>Uniform prehabilitation protocols were created based on the multimodal program of the PREHAB randomized controlled trial. All hospitals in the Netherlands that implemented prehabilitation according to the proposed protocols, for patients undergoing elective colorectal surgery, will be asked to participate. This study will recruit 535 patients who underwent prehabilitation and 535 one-to-one nearest neighbour propensity score matched patients who did not undergo prehabilitation (historical cohort). Clinical outcomes will be compared between the prehabilitation group and the historical cohort group using regression analyses. The primary outcome of interest is 90-day presence of postoperative complications. In addition, length of hospital stay and readmissions will be analysed.</p><p><strong>Discussion: </strong>Prehabilitation has been proven to reduce the risk of complications and hospital length of stay. Prehabilitation has however been defined in various ways, since there is no standardized program. This multicentre cohort study will estimate the clinical effect of prehabilitation implemented as standard of care according to proposed uniform protocols. Furthermore, the presented protocols can be used by other hospitals to set up a prehabilitation program.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773697","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":"Invited Commentary to \"Prevalence and Impact of Postoperative Sexual Dysfunction After Major Emergency Abdominal Surgery: A Prospective Cohort Study\".","authors":"Sven Petersen","doi":"10.1002/wjs.12571","DOIUrl":"https://doi.org/10.1002/wjs.12571","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773632","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}