World Journal of Surgery最新文献

{"title":"Predictive Value of the Red Cell Distribution Width-To-Albumin Ratio for Clinical Outcomes in Patients With Peptic Ulcer Perforation.","authors":"Suleyman Utku Celik, Yasin Gulap, Mehmet Bahadir Demir, Mehmet Mert Demircioglu, Hilmi Erencan Polat, Sacit Altug Kesikli","doi":"10.1002/wjs.12515","DOIUrl":"https://doi.org/10.1002/wjs.12515","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer perforation is a potentially life-threatening complication of peptic ulcer disease. Several scoring systems have been developed to predict outcomes in these patients. The red cell distribution width-to-albumin ratio (RAR) has shown promise as a prognostic marker in various conditions, yet its role in peptic ulcer perforation remains unclear. This study aimed to evaluate the predictive value of RAR in patients with peptic ulcer perforation.</p><p><strong>Methods: </strong>This retrospective study was conducted between 2016 and 2024 on patients who underwent surgery for peptic ulcer perforation. Patient demographics, clinical features, laboratory values, and surgical outcomes were analyzed. The main outcomes were major postoperative complications and 30-day mortality. Multivariate regression analysis was used to identify independent predictors of these outcomes. The ability of RAR to predict outcomes was also assessed.</p><p><strong>Results: </strong>The study included 187 patients with a median age of 49.7 years, of whom 78.6% were males. Major complications occurred in 18.1% of the patients and the 30-day mortality rate was 9.6%. Multivariate analysis identified age, surgical delay, elevated C-reactive protein and RAR as independent predictors of major complications. For 30-day mortality, only age and RAR remained significant in the multivariate model. Receiver operating characteristic curve analysis showed that RAR had high diagnostic accuracy for predicting both major complications (AUC = 0.883) and mortality (AUC = 0.944).</p><p><strong>Conclusion: </strong>With its high sensitivity and specificity for predicting major complications and mortality in patients with peptic ulcer perforation, RAR has significant potential as a prognostic marker in conjunction with traditional risk factors in clinical practice.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493561","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":"Does Mammography Density Change the Response to Neoadjuvant Chemotherapy and Predict a Pathological Complete Response Rate?","authors":"Upander Kumar, Anand Kumar Mishra, Kul Ranjan Singh, Anit Parihar, Nancy Raja, Mithun Raam, Ashwinee Rahalkar, Pooja Ramakant","doi":"10.1002/wjs.12502","DOIUrl":"https://doi.org/10.1002/wjs.12502","url":null,"abstract":"<p><strong>Background: </strong>Pathological complete response (PCR) is the surrogate marker of the outcome of a breast cancer patient. Breast cancer (BC) patients have variable responses to neoadjuvant chemotherapy (NACT). The effect of chemotherapy on mammographic density (MD) is unclear in the literature. Also, MD and PCR correlation is not extensively studied. The aim of the present study is to find MD's potential as a PCR predictor in a resource-constrained setting.</p><p><strong>Methods: </strong>The study included all patients of BC-related surgery from January 2018 to June 2021 with follow-up till June 2023. MD was classified by the American College of Radiology (ACR) (classes A-D) based on breast composition. The chi-square test and logistic regression analysis were used to calculate p-values.</p><p><strong>Results: </strong>Out of 557 patients, 554 were female with a mean age 46.8 years (premenopausal 54.5%). ACR grades of MD A, B, C, and D were 18.1% (n = 101), 56% (n = 312), 21.5% (n = 120), and 4.3% (n = 24), respectively. The odds of having PCR with MD B, C, and D were 0.51, 0.04, and 0.03, respectively, with respect to MD A. There was a significant inverse association of PCR and Ki-67 with MD on multivariate analysis. HER2 positive, TNBC, Ki 67 > 15%, and grade 3 had significantly high PCR.</p><p><strong>Conclusion: </strong>MD had an inverse correlation with PCR and Ki-67. Low MD, HER2 positive, TNBC, high Ki-67 subtypes, and grade 3 were good predictors for PCR.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484153","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":"Detection Rate and Concordance of 4D-MDCT, US, and Tc99m MIBI Imaging in the Detection of Ectopic and Intrathyroidal Parathyroid Adenomas.","authors":"Trevor Abts, Thinh Vu, Nancy D Perrier, Yunyi Wang, Jing Ning, J Matthew Debnam","doi":"10.1002/wjs.12512","DOIUrl":"https://doi.org/10.1002/wjs.12512","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism is often caused by parathyroid adenomas (PAs), which can be ectopic (EPAs) or intrathyroidal (ITPAs). Accurate localization is crucial for effective surgical intervention. This study aimed to determine the detection rate of four-dimensional multidetector computed tomography (4D-MDCT), ultrasonography (US), and technetium 99 m sestamibi scintigraphy (MIBI) in detecting EPAs and ITPAs. Additionally, we explored the role of ultrasound-guided fine-needle aspiration (US-FNA) and evaluated correlations between parathyroid hormone (PTH) levels, adenoma size, and detection performance.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of 28 patients with 29 EPAs and 27 patients with 27 ITPAs who underwent 4D-MDCT, US (including cine Doppler US and US-FNA), and/or MIBI at our institution. Data were collected on demographics, laboratory values, imaging findings, and intraoperative findings. The detection rate was calculated for each imaging modality and their combination. Logistic regression models were used to assess the relationship between PTH level, adenoma size, and detection performance.</p><p><strong>Results: </strong>The detection rate of EPAs was 96% for 4D-MDCT, 97% for MIBI, and 46% for US. The detection rate of ITPAs was 96% for US, 65% for 4D-MDCT, and 58% for MIBI. Combined multimodality imaging with results concordant between two or more modalities achieved an overall detection rate of 87%. For ITPAs, smaller PA size was associated with significantly worse MIBI detection performance (p < 0.05). The PTH level was not associated with detection performance.</p><p><strong>Conclusions: </strong>Our study highlights the superior detection rate of 4D-MDCT and MIBI for EPAs and US for ITPAs. Combining imaging modalities enhances the diagnostic detection rate.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484148","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":"Author's Reply: Vacuum-Assisted Closure Significantly Reduces Surgical Postoperative Complications Compared With Primary Abdominal Closure in Patients With Secondary Peritonitis: A Comparative Retrospective Study.","authors":"Pooya Rajabaleyan, Ask Vang, Sören Möller, Sardar Khalaf, Anna Gosvig Ladegaard, Niels Qvist, Mark Bremholm Ellebæk","doi":"10.1002/wjs.12518","DOIUrl":"https://doi.org/10.1002/wjs.12518","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473033","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":"Antrum Resection Versus Preservation Following Laparoscopic Sleeve Gastrectomy in the Treatment of Obesity: A Meta-Analysis of Randomized Controlled Trials and Systematic Review.","authors":"Jinlong Luo, Furui Zhong, Hua Yang, Lie Yang","doi":"10.1002/wjs.12500","DOIUrl":"https://doi.org/10.1002/wjs.12500","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic sleeve gastrectomy (LSG) has been proven to be an effective surgical method for managing morbid obesity. However, the extent of the antral excision remains controversial. In this meta-analysis, we evaluated the safety and efficacy of LSG with antral resection (AR) and antral preservation (AP).</p><p><strong>Materials and methods: </strong>The PubMed, Embase, Cochrane Library, and Google Scholar databases were systematically searched for randomized clinical trials (RCTs) from their inception dates to March 2024. The main outcomes were the percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and BMI at 3, 6, 12, and 24 months postsurgery.</p><p><strong>Results: </strong>Fourteen RCTs comprising 1222 patients were included in the study. The %EWL was significantly lower in the AP group at 6 (mean difference [MD]: -5.65 and p = 0.003), 12 (MD: -5.08 and p < 0.00001), and 24 (MD: -5.23 and p = 0.0004) months. The %TWL was significantly lower in the AP group at 3 (MD: -4.63 and p = 0.02), 6 (MD: -3.98 and p < 0.0001), and 12 (MD: -4.63 and p < 0.00001) months. BMI was lower in the AR group at 3 (MD: 1.81 and p = 0.007) and 6 (MD: 2.39 and p = 0.002) months. No significant difference was found in surgical time and de novo gastroesophageal reflux disease; however, the AP group demonstrated significantly longer hospital stays and a lower rate of late vomiting.</p><p><strong>Conclusion: </strong>LSG with AR yields better weight loss than LSG with AP but may lead to a higher rate of late vomiting.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469207","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 T2 Translational Science Modified Delphi Study: The Ethical Triage and Treatment of Entrapped and Mangled Extremities in Resource-Scarce Environments.","authors":"Eric S Weinstein, Zachary Gilbert, James Gosney, Brielle Weinstein, Hannah B Wild, Joseph Cuthbertson, Melissa Leming, Rachel Semmons, Dónal O'Mathúna, Carl Montan, Richard Gosselin, Frederick Skip Burkle","doi":"10.1002/wjs.12486","DOIUrl":"https://doi.org/10.1002/wjs.12486","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of ethical triage and treatment guidelines for the entrapped and mangled extremity (E&ME) in resource-scarce environments (RSE): mass casualty incidents, low- to middle-income countries, complex humanitarian emergencies including conflict, and prolonged transport times (RSE). The aim of this study is to use a modified Delphi (mD) approach to produce statements to develop treatment guidelines of the E&ME in RSE.</p><p><strong>Method: </strong>Experts rated their agreement with each statement on a 7-point linear numeric scale. Consensus amongst experts was defined as a standard deviation ≤ 1. Statements attaining consensus after the first round moved to the final report. Those not attaining consensus moved to the second round in which experts were shown the mean response of the expert panel and their own response for the opportunity to reconsider their rating for that round. Statements attaining consensus after the second round moved to the final report. This process was repeated in the third round. Statements attaining consensus were moved to the final report. The remaining statements did not attain consensus.</p><p><strong>Results: </strong>Seventy-seven experts participated in the first, 75 in the second, and 74 in the third round. Twenty-three statements attained consensus. Twenty-one statements did not attain consensus.</p><p><strong>Conclusion: </strong>A modified Delphi technique was used to establish consensus regarding the numerous complex factors influencing treatment of the E&ME in RSEs. Twenty-three statements attained consensus and can be incorporated into guidelines to advance the ethical treatment of the E&ME in RSEs.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469203","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":"Modified APPEND Score for the Diagnosis of Acute Appendicitis in a New Zealand Pasifika Population.","authors":"Renato Pitesa, Andrew G Hill, Andrew D MacCormick","doi":"10.1002/wjs.12510","DOIUrl":"https://doi.org/10.1002/wjs.12510","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing acute appendicitis often requires biochemical and imaging support which may not be feasible in low- and middle-income countries (LMICs). The APPEND score, developed in New Zealand, includes C-reactive protein (CRP) which in resource-limited settings, may be hindered by slow processing times. This study aims to evaluate a modified APPEND score (mAPPEND), excluding CRP for diagnosing appendicitis in a New Zealand Pasifika cohort.</p><p><strong>Methods: </strong>This secondary analysis utilized data from two cohorts (2011 and 2017) from Middlemore Hospital, Auckland. Patients aged ≥ 15 years with right iliac fossa pain for < 7 days were included, excluding those with prior appendicectomy or generalized peritonitis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and diagnostic performance was assessed using receiver operating characteristic curve analysis, comparing the area under the curve (AUC) for both scores.</p><p><strong>Results: </strong>Among 143 Pasifika patients, the AUC for the APPEND and mAPPEND scores were comparable (0.84 vs. 0.85 respectively, p = 0.41). The mAPPEND score demonstrated high diagnostic accuracy with scores between 1 and 2 showing high sensitivity (100% and 97%) and NPV (90% and 92%), scores 4-5 showing high specificity (94% and 100%, respectively) and PPV (90% and 100%, respectively), and a score of 3 being the most efficient with a sensitivity of 82% and specificity of 71%.</p><p><strong>Conclusion: </strong>The mAPPEND score maintains high diagnostic accuracy for appendicitis in a New Zealand Pasifika population. This modified score is a simple and viable tool in settings where CRP testing is unfeasible, supporting its use in Pacific Island countries.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450233","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":"Shouldice Versus TAPP for Inguinal Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Caio Mendonça Magalhães, Eric Pasqualotto, William Silva Barbosa, Sergio Mazzola Poli de Figueiredo","doi":"10.1002/wjs.12514","DOIUrl":"https://doi.org/10.1002/wjs.12514","url":null,"abstract":"<p><strong>Introduction: </strong>Inguinal hernia (IH) repair is one of the most common surgical procedures worldwide. Among the various techniques available, the Shouldice (SHD) technique is mainly used for nonmesh open repair whereas, the transabdominal preperitoneal (TAPP) approach is a commonly performed minimally invasive method. Despite its widespread use, a direct comparison between the two techniques is lacking. Therefore, this study aims to evaluate the short and long-term outcomes of SHD and TAPP for elective IH repair.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, and Cochrane Library on April 16. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled for continuous and binary endpoints, respectively. Heterogeneity was assessed with I² statistics.</p><p><strong>Results: </strong>Thirteen RCTs comprising 2214 patients were included. Of these, 1089 patients (49%) underwent SHD repair and 1125 (51%) patients underwent TAPP repair. The mean BMI was reported in four studies ranging from 23 to 25.7 kg/m². Data regarding hernia sizes were not available. Compared with TAPP, SHD significantly reduced seroma (RR 0.20; 95% CI 0.04-0.90; p = 0.04; and I² = 0%) and increased chronic pain (RR 2.13; 95% CI 1.31-3.46; p < 0.01; and I² = 0%) and 1-day postoperative pain (MD 2.01; 95% CI 0.72-3.29; p < 0.01; and I² = 97%). However, there were no significant differences between the groups in recurrence (RR 0.94; 95% CI 0.66-1.35; p = 0.75; and I² = 12%), hematoma (RR 1.08; 95% CI 0.80-1.46; p = 0.63; and I² = 0%), urinary retention (RR 0.82; 95% CI 0.49-1.36; p = 0.43; and I² = 0%), and testicular atrophy (RR 3.28; 95% CI 0.79-13.54; p = 0.10; and I² = 0%).</p><p><strong>Conclusion: </strong>SHD repair demonstrated a lower occurrence of seromas; however, it was associated with a higher occurrence of both acute and chronic postoperative pain compared to TAPP in patients with a normal BMI. No significant differences were observed between the two techniques in terms of hernia recurrence, hematoma formation, urinary retention, or testicular atrophy rates.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450237","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 Editor: Vacuum-Assisted Closure: Clinical Promise or Resource Challenge?","authors":"Michele Schiano di Visconte","doi":"10.1002/wjs.12496","DOIUrl":"https://doi.org/10.1002/wjs.12496","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415330","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 \"Most Interesting Journey\" to America for the International Society of Surgery in 1914.","authors":"David E Clark","doi":"10.1002/wjs.12495","DOIUrl":"https://doi.org/10.1002/wjs.12495","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383394","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}