World Journal of Surgery最新文献

{"title":"Correction to \"Guidelines for Essential Trauma Care: Second Edition (2026)\".","authors":"","doi":"10.1002/wjs.70471","DOIUrl":"10.1002/wjs.70471","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2508"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388238","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":"Indicators for Monitoring Recovery From Surgery to Discharge Using Accelerometer in Patients With Esophageal Cancer.","authors":"Takahiro Yamane, Yoshikazu Kimura, Manami Tetsutani, Shota Yamamura, Airu Ito, Moe Tanuma, Mina Honjoh, Yoshiko Moriwaki, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Yoshikazu Matsuoka, Mizuki Morita, Hiroshi Morimatsu","doi":"10.1002/wjs.70472","DOIUrl":"10.1002/wjs.70472","url":null,"abstract":"<p><p>Esophageal cancer is a highly invasive malignancy necessitating esophagectomy, which is associated with considerable postoperative morbidity and prolonged hospitalization. Enhanced Recovery After Surgery (ERAS) protocols recommend early mobilization to facilitate recovery; however, objectively assessing physical activity during hospitalization remains challenging. Traditional methods, such as the 6-min walk test or patient-reported questionnaires can be burdensome, or may not accurately reflect recovery. Accelerometer-based measurement provides a low-burden, objective approach, but previous studies focused on the immediate postoperative period or long after discharge, leaving the recovery trajectory from surgery to discharge underexplored.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2434-2437"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377228","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":"Impact of Intraoperative Ergonomic Microbreaks on Surgeons' Well-Being and Performance: A Systematic Review.","authors":"Gabriel Heierli, Fabian Grass, Luís C Pereira, Jean Pellegrini, David Fuks, Dieter Hahnloser, Martin Hübner","doi":"10.1002/wjs.70490","DOIUrl":"https://doi.org/10.1002/wjs.70490","url":null,"abstract":"<p><strong>Background: </strong>Surgeons face a considerable risk of work-related musculoskeletal disorders (WMSDs). Repetitive movements and poor ergonomic conditions can cause pain, particularly in the back, neck, arms, and shoulders. WMSDs not only impact surgeons' quality of life but may also affect surgical performance, absenteeism, and healthcare costs. To reduce WMSDs, intraoperative microbreaks (MBs) with active stretching exercises have been proposed. The aim of this review was to study ergonomic intraoperative MB interventions and their effect on surgeons' symptoms, well-being and performance and to define the features of efficacious interventions.</p><p><strong>Method: </strong>A systematic review of clinical trials evaluating physical or psychological impact of intraoperative microbreaks on surgeons was conducted in MEDLINE, Embase and Google Scholar until October 2024. Outcomes of interest included pain, discomfort, fatigue, dexterity, mental focus, stress as well as objective measures.</p><p><strong>Results: </strong>Ten clinical trials (284 study subjects) were retained for final analysis (8 crossover trials and 2 randomized controlled trials). Methodology and assessed outcomes varied considerably between studies. Similarly, interventions were heterogenous in terms of duration, interval, or set of exercises. 6 out of the 10 trials showed at least one improved outcome after the implementation of MBs. The most frequently assessed outcomes were pain and discomfort (improved in 5/8 studies), mental focus (improved in 3/3 studies), and accuracy (improved in 1/3 studies). Five studies evaluated operative duration, all showing no prolonged operating time associated with MBs.</p><p><strong>Conclusion: </strong>Microbreaks might have a positive impact on surgeons' well-being and performance. There is a clear need though for standardization of interventions and outcome measures. The long-term effects of microbreaks and the most efficacious intervention need yet to be defined.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654350","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":"Reply to Letter to the Editor: From General Preparedness to Injury-Pattern-Specific Trauma Resource Planning.","authors":"Timothy C Hardcastle, Charles Mock, Christine Gaarder","doi":"10.1002/wjs.70444","DOIUrl":"10.1002/wjs.70444","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2504-2505"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158306","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":"Surgery for Benign Tracheoesophageal Fistula: Analysis of Short- and Long-Term Outcomes.","authors":"Marco Mammana, Giulia Pagliarini, Chiara Catelli, Vincenzo Verzeletti, Giovanni Maria Comacchio, Marco Schiavon, Andrea Dell'Amore, Federico Rea","doi":"10.1002/wjs.70446","DOIUrl":"10.1002/wjs.70446","url":null,"abstract":"<p><strong>Background: </strong>Adult, benign tracheoesophageal fistula is a life-threatening condition. The aim of this study is to report our experience with its surgical treatment, including short- and long-term outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center review of patients who underwent surgical repair of tracheoesophageal fistula at a single center from 1997 to 2023. We compared clinical characteristics and outcomes between patients operated on by different surgical techniques. Furthermore, we analyzed long-term outcomes including survival, decannulation rate, and resumption of oral intake.</p><p><strong>Results: </strong>Overall, 60 patients underwent fistula repair during the study period. The main etiology was post-intubation injury (78.3%). The airway defect was repaired by direct suture, airway resection-anastomosis or flap/patch interposition in 8 (13.3%), 30 (50.0%) and 22 (36.7%) cases, respectively. The esophageal defect was repaired by double-layered suture in 56 (93.3%) cases and esophageal diversion in 4 (6.7%). Morbidity was observed in 32 patients (53.3%), including fistula relapse in 2 cases. In-hospital mortality occurred in two patients (3.3%). The overall survival, the cumulative incidence of decannulation, and of resumption of oral feeding at 5 years were 70.5%, 68.4%, and 86.6%, respectively.</p><p><strong>Conclusions: </strong>Surgical correction of tracheoesophageal fistula is challenging and requires an individualized approach. Healing of the fistula can be achieved in the majority of cases, including patients with extensive defects or under mechanical ventilation. Long-term outcomes are less satisfactory, and seem to be determined mainly by patients' comorbidities.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2289-2298"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158362","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":"Analysis of Intraoperative Complications and Outcomes Associated With Obesity During Elective Laparoscopic Cholecystectomy.","authors":"Thomas Coates, Marek Bak, Ashray Rajagopalan, Filip Pesevski, Anjana Ravi, Daniel Croagh, Geraldine Ooi","doi":"10.1002/wjs.70470","DOIUrl":"10.1002/wjs.70470","url":null,"abstract":"<p><strong>Background: </strong>As obesity becomes more common, understanding its risks in routine operations is increasingly important. This study assessed the impact of obesity on intraoperative complications during elective laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Retrospective data on elective laparoscopic cholecystectomies across a single metropolitan health network were collected from July 2021-June 2023. Patients were stratified into WHO-defined obesity classes. Intraoperative complication (measured by ClassIntra classification), intraoperative and postoperative outcomes were compared.</p><p><strong>Results: </strong>There were 713 patients included. Intraoperative complications graded as ClassIntra 1 and 2 were 11.0% and 6.1% for non-overweight patients and rose to 35.3% and 13.2% respectively for class III obesity (p < 0.001). Increasing obesity class was independently associated with higher intraoperative complication severity, with a 2.59-fold increase in the odds of a more severe complication category per class increase (p < 0.001). Obesity was associated with increased operative duration (p = 0.006) but did not increase the risk of postoperative morbidity (p = 0.88).</p><p><strong>Conclusion: </strong>Obesity significantly increases the risks of intraoperative complications in patients undergoing elective cholecystectomy, as measured by the ClassIntra classification, and contributes to increased operative duration. Despite this, postoperative morbidity remains low with no significant difference in length of stay, complications or readmissions across obesity classes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2299-2305"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296522","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":"Top 5 Advances in the Last 50 Years: Malignant Gastric and Esophageal Surgery.","authors":"Luís Santos Castro, Lorenzo Ferri","doi":"10.1002/wjs.70306","DOIUrl":"10.1002/wjs.70306","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2081-2084"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663243","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":"Adding Artificial Intelligence to the Surgeon's Domain.","authors":"Jacob Hubbuch, Blake DiPaola, Danielle S Walsh","doi":"10.1002/wjs.70376","DOIUrl":"10.1002/wjs.70376","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2195-2199"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783074","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":"Clinical Recommendations for Remote Robotic Assisted Surgery From the CRSA 2025 International Consensus Conference.","authors":"Yuman Fong, Dimitri A Raptis, Louis Kavoussi, Sherry M Wren, Dennis Fowler, Mehran Anvari, Francesco Bianco, Xiao Liang, Zheyong Li, Xiaoyu Yin, Micaela Piccoli, Saad Aldousari, John Marks, Baiyong Shen, Clifford Ko, Jelle Ruurda, Barbara Seeliger, Jeroen Hagendoorn, Rahila Essani, R Matthew Walsh, Dmitry Oleynikov, Stephanie B Jones, Vivek Bindal, Hyun Koo Kim, Woo Jin Hyung, Laleh Melstrom, Daniel Hashimoto, Francesco Celotto, Liaohai Leo Chen, Bryan M Burt, Kelly Lafaro, Fernando Elli, Yusef Kudsi, Francesca Ratti, Erik Wilson, Paolo Pietro Bianchi, Annette Morgan, Stephen T Bartlett, Laila Rashidi, Liu Yu, Bill Gawkins, Piet Hinoul, Bill Peine, Yanghee Woo, Mustafa Raoof, Daniel Jones, Supriya Deshpande, Jordana Bernard, Yulun Wang, Dieter C Broering, Pier Cristoforo Giulianotti","doi":"10.1002/wjs.70468","DOIUrl":"10.1002/wjs.70468","url":null,"abstract":"<p><strong>Background: </strong>Implementation of remote robotic-assisted surgery (rRAS) has the potential to significantly improve access to high-quality surgical care for patients worldwide. Advances in robotic systems and telecommunications now enable highly reliable, low latency, and cybersecure connectivity. These technological developments, together with the broader adoption of telemedicine, have driven an increasing interest in the implementation of rRAS.</p><p><strong>Methods: </strong>The Clinical Robotic Surgery Association (CRSA) convened a conference to develop international clinical recommendations for rRAS using the Danish Model of Consensus. The society identified five key issue categories and invited a panel of experts to address specific questions for each. Panel members and a jury of 10 unbiased, non-expert in rRAS professionals participated in a day-long conference on November 19, 2025 (Los Angeles, USA). During the conference, participants presented, discussed, and reached consensus on specific guidelines relevant to each category. Immediately after the conference, the jury reviewed and approved the recommended guidelines.</p><p><strong>Results: </strong>Multiple recommendations were approved for each of the following categories: Operating Models, Roles and Responsibilities (2 recommendations), Clinical Pathway (2 recommendations), Emergency Management (8 recommendations), Technical Considerations (5 recommendations), and Medico-legal and Ethical Considerations (4 recommendations).</p><p><strong>Conclusions: </strong>There was consensus that with recent advances in telecommunication and robotic technologies, rRAS can be offered safely and effectively if the identified safeguards are realized. Adoption of rRAS is expected to continue advancing rapidly.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2274-2288"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438178","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":"Function-Driven Versus Size-Driven Decision-Making: Real-World Evaluation of the European Society of Endocrinology Criteria in Adrenal Surgery.","authors":"Matija Buzejic, Milan Jovanovic, Branislav Rovcanin, Marina Stojanovic, Katarina Tausanovic, Nikola Slijepcevic, Jovan Ilic, Vladan Zivaljevic","doi":"10.1002/wjs.70518","DOIUrl":"https://doi.org/10.1002/wjs.70518","url":null,"abstract":"<p><strong>Background: </strong>The increasing detection of adrenal incidentalomas has intensified the need for clearly defined surgical indications. The 2023 European Society of Endocrinology (ESE) guidelines introduced a paradigm shift from size-based to function-based criteria for adrenalectomy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including consecutive patients who underwent adrenal surgery between 2012 and 2023. Patients were reevaluated according to the ESE 2023 recommendations to determine whether historical surgical indications aligned with contemporary guideline-defined criteria. Patients were classified as ESE-positive (ESE YES) or ESE-negative (ESE NO) based on hormonal activity and histopathological findings.</p><p><strong>Results: </strong>The study included 797 consecutive patients who underwent adrenalectomy for adrenal masses. According to the ESE 2023 criteria, 541 (67.9%) patients were classified as ESE-positive. Hormonal hypersecretion was present in 458 (57.8%) patients. Patients with clinically significant adrenal pathology were significantly more likely to have hormonally active tumors (81.7% vs. 4.3%, χ² = 474.1, df = 1, p < 0.001). Median tumor diameter did not differ significantly between groups (4.5 cm [IQR 4.0-6.0] in the ESE-positive group and 4.5 cm [IQR 3.5-6.0] in the ESE-negative group (p = 0.118). Median age was similar between the ESE-positive and ESE-negative groups (55 years [IQR 44.5-63.0] vs. 56 years [IQR 41.0-62.0], p = 0.292).</p><p><strong>Conclusion: </strong>Hormonal activity is strongly associated with clinically significant adrenal pathology according to the ESE 2023 criteria, whereas tumor size alone does not appear to reliably discriminate between patients who do and do not fulfill guideline-defined indications for surgery. These findings provide real-world evidence supporting function-driven decision-making and reinforce the contemporary paradigm shift away from size-based surgical indications.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654413","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}