World Journal of Surgery最新文献

{"title":"Evaluating Gulf Cooperation Council Trauma Care Infrastructure: A Scoping Review of Key Components and Gaps.","authors":"Lubna Khan, Abbas Karim, Hachem Bey, Saud Naji Alzaid, Hani Ahmed Al-Qadhi, Yousif Habib Alabboudi, Ruben Peralta, Husham Bakry, Thamer Nouh, Shahin Mohseni, Hassan Mashbari","doi":"10.1002/wjs.70019","DOIUrl":"10.1002/wjs.70019","url":null,"abstract":"<p><strong>Background: </strong>Trauma systems are multifaceted frameworks that optimize patient care and outcomes. The development of trauma systems has been a regional priority in the Gulf Cooperation Council (GCC), yet implementation varies across countries. These variations contribute to measurable differences in system performance and patient outcomes. A systematic mapping of these disparities can guide efforts to harmonize standards and enhance trauma-care delivery throughout the region.</p><p><strong>Methods: </strong>A scoping review was conducted per PRISMA-ScR guidelines. PubMed, Scopus, and the Cochrane Library databases were searched for English-language publications (2000-2024) on prehospital emergency care, hospital-based trauma management, or post-hospital rehabilitation in GCC countries. Two reviewers independently screened and charted eligible studies; articles addressing only clinical outcomes without system-level discussion were excluded. Gray literature sources included Ministry of Health (MOH) websites, local news reports, and expert opinion.</p><p><strong>Results: </strong>Of 1758 studies, 51 were fully screened, and 43 met the inclusion criteria. All GCC countries, except for UAE, operate a single centralized EMS system via a uniform national emergency number. Fleet sizes range from 36 ambulances in Bahrain to over 1379 in Saudi Arabia, with mean response times ranging from 5.3 min in Qatar to 15 min nationally in Kuwait. Formal trauma centers are limited in the region: Bahrain has no formal trauma centers, Qatar and Kuwait each have one dedicated trauma center (level 1 and 2 equivalent, respectively), Oman has two (level 2 and level 3 equivalent), Saudi Arabia has two (level 1 equivalent), and the UAE has nine (levels 1-3 equivalent). Local trauma registries exist in all countries, with a national trauma registry only in Qatar. Posthospital rehabilitation, although variable in resources, is delivered through MOH networks in all countries and supplemented by private providers.</p><p><strong>Conclusion: </strong>Despite progress, gaps persist in trauma center accreditations, national registry development, and formation of integrated rehabilitation networks. Concerted improvements could further enhance trauma care delivery in the region with a desired improvement in overall outcomes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2921-2932"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745314","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":"Correction to \"Antrum Resection Versus Preservation Following Laparoscopic Sleeve Gastrectomy in the Treatment of Obesity: A Meta-Analysis of Randomized Controlled Trials and Systematic Review\".","authors":"","doi":"10.1002/wjs.70108","DOIUrl":"10.1002/wjs.70108","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2968"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076065","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":"Mucoepidermoid Carcinoma of the Breast: A Systematic Review of Clinicopathologic, Immunohistochemical, and Molecular Features.","authors":"Sami Akbulut, Yasin Dalda, Mariia Ivanova, Nicola Fusco","doi":"10.1002/wjs.70077","DOIUrl":"10.1002/wjs.70077","url":null,"abstract":"<p><strong>Background: </strong>Mucoepidermoid carcinoma (MEC) of the breast is a very rare salivary gland-like tumor, accounting for 0.2%-0.3% of all breast cancers (BC). This study aims to review the literature on MEC of the breast.</p><p><strong>Methods: </strong>This systematic review focuses on MEC of the breast, conducted in line with PRISMA 2020 guidelines and registered in PROSPERO under ID CRD420251089598. Searches were performed in PubMed, Medline, Scopus, Web of Science, and Google Scholar, using terms such as \"mucoepidermoid carcinoma,\" \"breast,\" and similar terms. No language restrictions were applied. Studies published between January 1, 1979, and July 1, 2025, were included.</p><p><strong>Results: </strong>Median age was 57 years (95% CI: 53-60). The most common presentation was a palpable breast mass (64.7%), followed by incidental detection via mammography (10.6%). Tumors were located in the left breast (49.4%) and in the right breast (43.5%). The most frequent tumor localization was the upper-outer quadrant (20.0%). Median tumor size was 21 mm (95% CI: 19-30). Modified radical mastectomy (30.6%) was the most common surgical approach, followed by breast-conserving surgery with sentinel or level dissection (29.4%), and simple mastectomy or its variants (17.6%). Immunohistochemistry revealed positivity for P63 (52.9%), CK5/6 (41.2%), CK7 (45.9%), Ki67 (44.7%), ER (24.7%), PR (4.7%), and HER2 (9.4%) with TNBC phenotype (36.5%), genetic alterations (16.5%), and distant metastasis (9.4%). Follow-up data revealed 7 deaths, of which 5 were due to MEC, and these five patients consistently exhibited poor prognostic features. Compared to the 63 survivors with follow-up data, they showed significantly higher rates of axillary lymph node positivity (p = 0.005) and advanced N stage (p = 0.001); in addition, all five had high-grade tumors (p = 0.001) and documented distant metastases (p < 0.001).</p><p><strong>Conclusion: </strong>Breast MEC is a rare malignancy with generally favorable prognosis in low-grade cases, but high-grade tumors show more aggressive behavior. In this study, all disease-related deaths occurred in high-grade tumors with axillary node involvement, advanced N stage, and distant metastasis-highlighting their prognostic significance. CK5/6, CK7, and P63 were frequently positive, whereas hormone receptors were usually negative. Close follow-up is essential, especially for high-grade tumors.</p><p><strong>Review registration: </strong>This systematic review was prospectively registered in the PROSPERO database under the registration number CRD420251089598.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2630-2643"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971653","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":"Know Pain, Know Gain. Is Subxiphoid Video-Assisted Thoracoscopic Surgery Ready for Prime Time?","authors":"Shah-Hwa Chou, Yu-Wei Liu","doi":"10.1002/wjs.70097","DOIUrl":"10.1002/wjs.70097","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2669-2670"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041574","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":"Comparison of Subxiphoid and Intercostal Uniportal Video-Assisted Thoracoscopic Surgery for Early Thymoma, Lung Cancer, and Pneumothorax: A Retrospective Single-Center Study.","authors":"Guang-Zhi Kuang, Hai Hu, Song-Mao Ouyang, Jun-Tao Tan","doi":"10.1002/wjs.70065","DOIUrl":"10.1002/wjs.70065","url":null,"abstract":"<p><strong>Background: </strong>Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique for early thymoma, early-stage non-small cell lung cancer (NSCLC), and primary spontaneous pneumothorax (PSP). The subxiphoid uniportal VATS (SU-VATS) approach offers potential advantages over the intercostal uniportal VATS (IU-VATS) by reducing nerve injury and postoperative pain.</p><p><strong>Methods: </strong>A single-center retrospective study at The Fifth Hospital of Ganzhou included 756 patients who underwent SU-VATS or IU-VATS between January 2018 and September 2024. The propensity score matching (1:1) resulted in two cohorts of 192 patients each. Primary outcomes were inflammatory markers (Hs-CRP and WBCs) on postoperative day 1 (POD1) and visual analog scale (VAS) pain scores on POD1, POD3, POD7, and POD30. Secondary outcomes included operative time, blood loss, drainage duration, hospital stay, and complications.</p><p><strong>Results: </strong>SU-VATS significantly reduced Hs-CRP (5.35 vs. 9.65 mg/L, p < 0.001) and WBCs (6.48 vs. 10.67 × 10⁹/L, p = 0.004) on POD1. VAS scores were lower in SU-VATS on POD1 (1.48 vs. 3.21, p < 0.001), POD3 (1.19 vs. 2.73, p < 0.001), and POD7 (1.07 vs. 1.86, p < 0.001), with no difference by POD30 (0.32 vs. 0.36, p = 0.160). Operative time, blood loss, drainage duration, hospital stay, and complication rates were similar between groups.</p><p><strong>Conclusions: </strong>SU-VATS reduces early postoperative inflammation and pain without compromising operative efficiency or safety compared to IU-VATS. These findings support adopting the subxiphoid approach as a preferred minimally invasive technique in thoracic surgery.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2662-2668"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971659","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":"History, Ethics, and Pragmatism: Evaluating Quality of Life and Social Reintegration Through Recurrent Short-Term Reconstructive Surgery Missions in Tanzania.","authors":"Barnabas Tobi Alayande","doi":"10.1002/wjs.70058","DOIUrl":"10.1002/wjs.70058","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2801-2802"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875491","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":"New-Onset Postoperative Sarcopenia After Gastrectomy Predicts Long-Term Prognosis in Gastric Cancer Patients.","authors":"Kazufumi Umemoto, Kentaro Kato, Hiroyuki Yamamoto, Naoya Okada, Takumi Yamabuki, Minoru Takada, Yoshiyasu Ambo, Satoshi Hirano","doi":"10.1002/wjs.70039","DOIUrl":"10.1002/wjs.70039","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a risk factor for increased postoperative complications and shortened survival. Although gastrectomy increases the risk for the development of postoperative sarcopenia, the association between postoperative sarcopenia after gastrectomy and long-term survival remains unclear. In this study, changes in body composition before and after gastrectomy were analyzed using bioelectrical impedance analysis to evaluate their association with prognosis.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study of radical surgery for gastric cancer, performed at Teine Keijinkai Hospital between January 2018 and December 2023, was conducted. The association of preoperative and newly developed sarcopenia with long-term survival after gastrectomy was examined.</p><p><strong>Results: </strong>Of 328 surgical patients, 255 patients for whom data could be acquired were analyzed. Forty-nine patients (19.2%) had sarcopenia preoperatively, and all of these patients still had sarcopenia after gastrectomy. Of the 206 patients who did not have sarcopenia before gastrectomy, 159 remained sarcopenia-free 6 months after gastrectomy, and 47 patients (18.4%) developed sarcopenia after gastrectomy. The preoperative sarcopenia and postoperative sarcopenia groups had significantly shorter overall survival (p < 0.0001 and p = 0.0005, respectively) than those in the nonsarcopenia group.</p><p><strong>Conclusions: </strong>Postoperative sarcopenia was a negative prognostic factor, comparable to preoperative sarcopenia.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2846-2853"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804991","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":"Surgical Site Infection (SSI) Prevention Bundle to Reduce the Incidence of Post-Mastectomy SSI Among Breast Cancer Patients at an Academic Medical Center: Effectiveness and Cost Consequence Analysis.","authors":"Sindhu Nair Vijaya Seharan, Suniza Jamaris, Tania Islam, Sasheela Ponnampalavanar, Fatiha Hana Shabaruddin, Nur Aishah Mohd Taib","doi":"10.1002/wjs.70068","DOIUrl":"10.1002/wjs.70068","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSI) are common healthcare-associated infections. The incidence of post-mastectomy SSI varies from 1% to 30%, which is significantly higher compared to the expected incidence of 2% for clean surgeries. This study aimed to assess the effectiveness and the cost implications of implementing a SSI prevention bundle as well as identify the risk factors associated with SSI among breast cancer patients undergoing mastectomy at an academic medical center.</p><p><strong>Method: </strong>A pre-post intervention study was conducted at the Universiti Malaya Medical Center (UMMC), a tertiary teaching hospital in Malaysia. The pre-intervention baseline SSI rates were obtained retrospectively (July 2015 to June 2016), and the post-implementation SSI rates were collected prospectively (July 2017 and September 2018). The implementation of the SSI prevention bundle was based on the quality implementation framework. The SSI prevention bundle consists of preoperative, intraoperative, and postoperative evidence-based preventive measures adapted from the Global Guidelines for the Prevention of SSI by the World Health Organization.</p><p><strong>Results: </strong>The SSI rate dropped by 70% after implementing the SSI prevention bundle. Only 6.9% (11 out of 159 cases) developed SSI after the implementation of the SSI prevention bundle, compared to 23.1% (27 out of 117 cases) before its implementation. The mean cost per patient treated for SSI in the outpatient clinic setting (n = 29) was MYR904 ± 991 [USD $217 ± 238] while the mean cost per patient was MYR13,059 ± 5475 [USD $3134 ± 1315] for those treated within the inpatient setting (n = 9). The additional implementation cost of the SSI prevention bundle was MYR48 [USD $12] per patient. Multivariate logistic regression analysis revealed that patients undergoing surgery without the SSI bundle (OR: 5.28, 95% CI:1.76-15.82, p value = 0.003) and obesity (OR: 6.34, 95% CI:1.44-30.00, p value = 0.02) were significant risk factors of SSI.</p><p><strong>Conclusion: </strong>The SSI prevention bundle was effective in reducing the incidence of SSI amongst breast cancer patients undergoing mastectomy, with improved patient outcomes and cost-savings. Continuous monitoring within departmental quality key performance indicators and hospital infection control programmes will ensure sustained outcomes in the prevention of SSI.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2884-2900"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076146","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 of Postoperative Myocardial Injury After Gastric Cancer Surgery May Contribute to the Early Detection of Postoperative Complications.","authors":"Yasunori Matsumoto, Shinichiro Iida, Yuri Nishioka, Ryota Otsuka, Koichi Hayano, Yoshihiro Kurata, Takeshi Toyozumi, Tadashi Shiraishi, Nobufumi Sekino, Hisahiro Matsubara","doi":"10.1002/wjs.70090","DOIUrl":"10.1002/wjs.70090","url":null,"abstract":"<p><p>Receiver operation curve (ROC) analysis on CRP, D-Amy, and WBC on POD 1 and 3 with inflammatory complications as outcome. CRP 5.0 mg/dL (AUC: 0.748), D-Amy 560 U/L (AUC: 0.683), and WBC 7000/μL (AUC: 0.467) on POD 1; CRP 14.0 mg/dL (AUC: 0. 885), D-Amy 134 U/L (AUC: 0.796), and WBC 9900/μL (AUC: 0.701) on POD 3. In multivariate analysis, MINS positivity was a predictor of inflammatory complications, independent of CRP on POD1 (OR 17.62, 95% CI 3.76-109.88, p = 0.0002). AUC: area under the curve and POD: postoperative day.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2880-2883"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041538","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":"Effectiveness of Inflatable Warming Blankets for Preventing Perioperative Hypothermia in Children: A Meta-Analysis.","authors":"Pei-Ying Ye, Xiao-Yun Chen, Xi-Chun Wu, Jin-Xia Nian","doi":"10.1002/wjs.70038","DOIUrl":"10.1002/wjs.70038","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of inflatable heating blankets compared to noninflatable insulation methods in preventing perioperative hypothermia in children through a meta-analysis.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, Cochrane Library, Embase, Nursing Database (CINAHL), China National Knowledge Infrastructure Database (CNKI), VIP Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), Wanfang Database were conducted for studies published up to December 2023. Eligible studies were independently screened and appraised by two reviewers. Data were extracted and pooled using RevMan 5.4 for meta-analysis.</p><p><strong>Results: </strong>Seven studies comprising 417 pediatric patients from three countries were included. Meta-analysis showed that inflatable heating blankets significantly improved intraoperative core body temperature compared to noninflatable methods (SMD = 1.79, 95% CI: 1.19-2.39, p < 0.01; moderate-certainty evidence), and significantly shortened postoperative recovery time (SMD = -1.66, 95% CI: -2.80 to -0.53, p < 0.01; moderate-certainty evidence). The incidence of hypothermia appeared lower in the inflatable group (RR = 0.10, 95% CI: 0.03-0.36, p = 0.24), but this difference was not statistically significant and is supported by low-certainty evidence due to imprecision and risk of bias. Similarly, the reduction in postoperative shivering (RR = 0.15, 95% CI: 0.04-0.55, p = 0.26) showed a favorable trend but was also based on low-certainty evidence.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that inflatable heating blankets are more effective than noninflatable insulation methods in maintaining intraoperative normothermia and reducing postoperative recovery time in pediatric surgical patients. Although trends toward lower rates of hypothermia and shivering were observed, these differences were not statistically significant and should be interpreted with caution.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2807-2815"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971657","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}