World Journal of Surgery最新文献

{"title":"Rapidly Growing Thyroid Masses in Adults: Urgent Diagnostic Challenges and Effective Management-Single-Center Experience and Literature Review.","authors":"María Miguélez González, Álvaro Fernández Sánchez, María Bernarda Álvarez Álvarez, Hernán Dario Quiceno Arias, Irene Osorio Silla","doi":"10.1002/wjs.70063","DOIUrl":"10.1002/wjs.70063","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2777-2781"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971697","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":"In-Hospital Mortality Trends and Association of Peripheral Artery Disease on Mortality Risk After Aortic Valve Replacements.","authors":"Erfan Faridmoayer, SeungJoon Noh, Aitua C Salami, Steven Medvedovsky, Sherene E Sharath, Panos Kougias","doi":"10.1002/wjs.70092","DOIUrl":"10.1002/wjs.70092","url":null,"abstract":"<p><strong>Introduction: </strong>Since 2011, transcatheter aortic valve replacement (TAVR) is an alternative to surgical valve replacement (SAVR). The objective was to describe predictors and trends of in-hospital mortality risk following SAVR and TAVR between 2011 and 2019. We also describe the underinvestigated association between peripheral artery disease (PAD) and mortality risk after TAVR.</p><p><strong>Methods: </strong>Using a retrospective cohort from the National Inpatient Sample database, we identified operations with TAVR and SAVR as primary or secondary procedures and indication of aortic stenosis. The primary outcome was postoperative in-hospital morality. Sample-weighted logistic regression was used to examine the association between operation type and in-hospital mortality with interaction terms to describe change in mortality over time.</p><p><strong>Results: </strong>Between 2011 and 2019, 129,305 patients were included: 82,583 (63.9%) SAVRs and 46,722 (36.1%) TAVRs. Influential predictors of mortality included age (odds ratio [OR] = 1.03 and p < 0.001), elective case status (OR = 0.55 and p < 0.001), and operation type (TAVR OR = 0.54 and p < 0.001). Procedure-related mortality risk changed significantly over time (p < 0.001). Initially (2011-2014), TAVR-associated mortality risk was higher than SAVR but this risk decreased substantially after 2014. PAD was not a significant predictor of in-hospital mortality among patients undergoing TAVR (OR = 0.98 and p = 0.91).</p><p><strong>Conclusion: </strong>TAVR-related mortality risk was initially higher than SAVR-related mortality, but this risk substantially decreased to below SAVR levels in the later period of study. In this cohort study, PAD was not a significant predictor of in-hospital mortality after TAVR.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2671-2679"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058474","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":"Simultaneous Splenic Artery Ligation During Adult Orthotopic Liver Transplantation Improves Surgical Outcomes.","authors":"Zichen Wang, Zhan Qu, Fan Mu, Lexuan Xu, Liangshuo Hu, Bo Wang, Jianhua Shi","doi":"10.1002/wjs.70024","DOIUrl":"10.1002/wjs.70024","url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension and hyperactivity of the spleen are common in patients with end-stage liver disease (ESLD), significantly impacting the prognosis of liver transplantation. Splenic artery ligation (SAL) is a method to improve splenic hyperactivity and regulate blood flow to the liver, though its efficacy remains controversial. This study aims to elucidate the impact of simultaneous SAL during orthotopic liver transplantation (OLT), with a focus on postoperative liver function recovery, splenic hyperactivity, postoperative complications, and further assessment of the effectiveness of SAL in improving outcomes for adult OLT.</p><p><strong>Methods: </strong>From July 2021 to August 2023, 332 OLTs were performed for patients with ESLD at the First Affiliated Hospital of Xi'an Jiaotong University. Among the cohort, intraoperative SAL was performed in 123 cases, whereas the remaining 209 patients did not receive this intervention. We performed propensity score matching (PSM) to compare postoperative recovery, complications, and survival rates between the two groups.</p><p><strong>Results: </strong>After PSM, recipients undergoing SAL demonstrated enhanced early postoperative liver function recovery, improved postoperative splenic function, reduced postoperative hepatic artery resistance index, and decreased occurrences of postoperative intra-abdominal hemorrhage, acute kidney injury, hepatic artery thrombosis, and infection compared to those not undergoing SAL. Univariate and multivariate analysis indicated that undergoing SAL during OLT was a protective factor against postoperative intra-abdominal hemorrhage (HR 0.148; 95% CI 0.032-0.696, p = 0.015) and hepatic artery thrombosis (HR 0.172; 95% CI 0.036-0.815, p = 0.027).</p><p><strong>Conclusions: </strong>In recipients with severe splenomegaly and splenic hyperactivity identified during preoperative assessments, simultaneous SAL during OLT is deemed safe and effective, warranting consideration during the surgical procedure.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2909-2920"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971677","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 Scoping Review on Goals of Care Discussions in Surgery: How Are We Doing and How Can We Do Better?","authors":"Amanda Mac, Yerin Lee, Selena Zhang, Abu Sadat Mohammad Nurunnabi, Marina Englesakis, Karen Devon","doi":"10.1002/wjs.70070","DOIUrl":"10.1002/wjs.70070","url":null,"abstract":"<p><strong>Background: </strong>Discussing GOC is essential to ensuring that patients' treatment recommendations and care plans are aligned with their preferences, priorities, and values. This review aims to characterize the existing literature on the quality, practices, and frameworks of goals of care (GOC) discussions in surgery to identify gaps and propose strategies for improvement.</p><p><strong>Methods: </strong>MEDLINE, MEDLINE In-Process/ePubs, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and ClinicalTrials.Gov were searched using terms related to GOC, surgery, and best practices or education. The search strategy was run from inception to July 29, 2022. Studies regarding the quality of GOC discussions in surgery were included.</p><p><strong>Results: </strong>The search identified 14,254 articles from which 37 were included for review. Key findings included (1) the reactive nature of GOC discussions and initiating conversations in response to acute health changes, (2) ambiguity around patient autonomy and the surgeon's duty to prioritize surgical treatment, (3) surgeons as curators of information, and (4) tendency of surgeons to provide a set of standard treatment pathways and determine specific care decisions rather than establish understanding of patients' long-term goals.</p><p><strong>Conclusion: </strong>Further research is needed to determine best practices for caregiver and next-of-kin involvement and expand the diversity of reported experiences to include patients from diverse ethnic backgrounds and genders and individuals from rural and lower-resource communities. Findings from this review have important implications for improving GOC conversations to ensure they support patient-centered care.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2828-2836"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971548","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":"Incidence, Risk Factors, and Prediction Model of Parastomal Hernia After Abdominoperineal Resection for Rectal Cancer.","authors":"Jiyun Li, Jichuan Quan, Zixing Zhu, Dedi Jiang, Zhixun Zhao, Mingguang Zhang, Jianjun Bi, Qiang Feng, Zheng Wang, Haitao Zhou, Wei Pei, Qian Liu, Zhaoxu Zheng, Minjie Wang, Jianwei Liang","doi":"10.1002/wjs.70071","DOIUrl":"10.1002/wjs.70071","url":null,"abstract":"<p><strong>Background: </strong>Parastomal hernia (PSH) is a frequent complication of abdominoperineal resection (APR), yet large-scale studies characterizing its long-term incidence and tools for individualized risk stratification remain lacking. To determine the long-term incidence, independent risk factors, and develop a clinical prediction model for PSH after APR in rectal cancer patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 836 patients with rectal adenocarcinoma who underwent APR and permanent end colostomy at a high-volume tertiary center (2014-2018). PSH was diagnosed according to the European Hernia Society criteria. Independent risk factors were identified using Cox regression, and a nomogram was developed to predict 1- to 5-year PSH probabilities. Model discrimination was assessed using time-dependent AUC.</p><p><strong>Results: </strong>During a median follow-up period of 85 months, 207 patients (24.8%) developed PSH, with a cumulative incidence of 26.2% at 5 years. Independent risk factors included female sex (HR = 2.28, 95% CI: 1.73-3.01), age ≥ 60 years (HR = 5.17, 95% CI: 3.72-7.18), BMI ≥ 24 kg/m² (HR = 2.10, 95% CI: 1.57-2.80), and transperitoneal stoma route (HR = 4.11, 95% CI: 2.63-6.41; all P < 0.001). The nomogram demonstrated strong discrimination with 1-, 2-, 3-, 4-, and 5-year AUCs of 0.65, 0.70, 0.76, 0.80, and 0.83, respectively.</p><p><strong>Conclusion: </strong>This study provides evidence on PSH incidence and risk factors, introducing a nomogram for personalized risk stratification. The nomogram allows clinicians to identify high-risk patients and tailor preventive strategies, such as extraperitoneal stoma creation or prophylactic mesh placement, to reduce PSH burden.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2680-2688"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971743","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":"MRI-Based Assessment of Margin Status Determinants, Preoperative Predictors, and Prognostic Outcomes in Breast-Conserving Surgery Following Neoadjuvant Therapy.","authors":"Xinyu Liu, Yan Liu, Tao Ma, Shichao Zhang, Lei Liu, Shunan Wang, Yi Zhang, Xu Liu, Jin Zhang","doi":"10.1002/wjs.70072","DOIUrl":"10.1002/wjs.70072","url":null,"abstract":"<p><strong>Background and purpose: </strong>This MRI-based study investigates factors influencing and predictors of margin status in neoadjuvant therapy followed by patients with breast-conserving surgery (NAT-BCS) and evaluates associated locoregional/distant control outcomes.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 117 consecutive patients with breast cancer (BC) who underwent NAT-BCS between June 2014 and June 2024. All patients received magnetic resonance imaging (MRI) examinations both before and after NAT.</p><p><strong>Results: </strong>Univariate analysis identified factors influencing surgical margin status as molecular subtype (with HER2+ showing the lowest positive rate, followed sequentially by triple-negative breast cancer (TNBC), Luminal B HER2+, Luminal A, and Luminal B HER2-), nonmass enhancement (NME) on pre-NAT MRI, axillary lymph node metastasis, post-NAT MRI shrinkage pattern, postoperative pathological complete response (pCR) status, pN status, and lymphovascular invasion (LVI); however, multivariate analysis demonstrated that only LVI independently affected margin status, and NME on pre-NAT MRI independently predicted margin status, with 106 patients ultimately undergoing BCS, exhibiting a locoregional recurrence (LRR) rate of 1.9% (2/106) and a distant metastasis (DM) rate of 2.8% (3/106).</p><p><strong>Conclusion: </strong>The presence of NME on pre-NAT MRI could be a predictor for margin status, possibly informing surgical strategy formulation. Concurrently, LVI might represent a distinct determinant influencing margin outcomes. NAT-BCS therapy has achieved favorable local-regional and distant control outcomes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2620-2629"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971669","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 Diabetes Mellitus Following Pancreatic Injury: A Systematic Review.","authors":"V P C van Zon, M C Tol, P Krijnen, V A L Huurman, D A Ruess, I B Schipper","doi":"10.1002/wjs.70056","DOIUrl":"10.1002/wjs.70056","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic trauma is rare, accounting for only 0.2% of all trauma cases, and reports on long-term endocrine outcomes are scarce. Patients who undergo pancreatic resection may develop diabetes mellitus.</p><p><strong>Objectives: </strong>To summarize the available literature reporting the incidence of diabetes mellitus (DM) after pancreatic trauma and to evaluate potential influences on the incidence rates.</p><p><strong>Patients and methods: </strong>We searched in PubMed and Embase for studies published between 1990 and July 2025 that enrolled patients with trauma of the pancreas and reported data on new-onset DM.</p><p><strong>Results: </strong>Out of 906 identified records, six studies with a total of 297 patients with pancreatic trauma. The overall cumulative incidence of new-onset DM is 5.7% (95% confidence interval [CI]: 3.4%-9.0%). DM developed in 8.2% (95% CI: 4.4%-13.6%) of patients who underwent (partial) pancreatic resection and in 2.9% (95% CI: 0.8%-7.4%) of patients treated nonoperatively. For low-grade injuries, the incidence of DM was 5.5% (95% CI: 2.0%-11.5%) compared to 11.1% (95% CI: 4.9%-20.7%) for high-grade injuries. The time until new-onset diabetes mellitus was detailed in one study with 15 patients.</p><p><strong>Conclusion: </strong>Based on the available literature, the estimated overall incidence of DM after pancreatic trauma is 5.7%. High-grade pancreatic injury seems to increase the risk of developing new-onset DM, which is possibly influenced by their frequent surgical treatment.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2940-2951"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875492","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":"A Simple Solution for a Complex Problem: The \"Sterile Cockpit\" to Improve Ward Rounds.","authors":"Ellie Treloar, Matheesha Herath, Meryl Altree, Sam Potter, Matthew Penhall, David Walsh, Lauren Kennedy, Martin Bruening, Suzanne Edwards, Jesse D Ey, Emma L Bradshaw, Guy J Maddern","doi":"10.1002/wjs.70074","DOIUrl":"10.1002/wjs.70074","url":null,"abstract":"<p><strong>Background: </strong>Ward-round quality impacts patient outcomes, and poor conduct results in increased rates of preventable adverse events. Despite being a core component of patient outcomes, there is minimal literature informing best practice. The aviation industry has mitigated human error using a \"Sterile Cockpit\" to reduce interruptions and non-essential activities. This study investigated the impact of a \"Sterile Cockpit\" intervention on surgical ward rounds.</p><p><strong>Methods: </strong>This prospective experimental study involved audio-visually recording ward rounds. The intervention was a novel \"Sterile Cockpit\" zone involving the allocation of roles, no interruptions, one speaker at a time, invitation for nursing/allied health contribution, and \"checkback\" of the plan. The control group was a normal ward round. The primary outcomes were accuracy of documentation and patient satisfaction. Other outcomes included the number of parallel conversations, interruptions, and time at the bedside.</p><p><strong>Results: </strong>71 control and 70 \"Sterile Cockpit\" ward rounds were audio-visually recorded. The \"Sterile Cockpit\" group had significantly more accurate documentation of case notes (63.6%, SD = 3.45% vs. 77.9%, SD = 3.4, mean difference 14.2, 95% CI: 4.75, 23.7, p = 0.003), increased nurse presence (45% vs. 68%, mean difference 0.38, 95% CI: 0.19, 0.75, p = 0.005), higher patient satisfaction (p = 0.011), reduced interruptions (mean) (0.4, SD = 0.9, vs. 0.2, SD = 0.4, IRR = 0.39, 95% CI: 0.16, 0.96 p = 0.039), and reduced parallel conversations (1.5 vs. 0.4, p < 0.001). Patient notes were completed more contemporaneously, with no additional time taken.</p><p><strong>Conclusions: </strong>The \"Sterile Cockpit\" is a no-cost intervention that demonstrates improved patient and process-based outcomes. This design is readily adaptable across specialties with the capacity to improve healthcare quality.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2769-2776"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034309","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":"Utilizing the Conversion Concept Based on Disease Status Following Atezolizumab Plus Bevacizumab Treatment for Hepatocellular Carcinoma.","authors":"Shohei Komatsu, Toshifumi Tada, Kazuki Terashima, Nobuaki Ishihara, Masaki Omori, Takanori Matsuura, Eisuke Ueshima, Keitaro Sofue, Yuzo Kodama, Takumi Fukumoto","doi":"10.1002/wjs.70061","DOIUrl":"10.1002/wjs.70061","url":null,"abstract":"<p><strong>Background: </strong>The introduction of atezolizumab plus bevacizumab (Ate/Bev) has improved hepatocellular carcinoma (HCC) treatment, enabling the concept of \"ABC conversion,\" where curative treatments follow Ate/Bev. However, the optimal post-Ate/Bev treatment strategy remains unclear.</p><p><strong>Methods: </strong>This study evaluated 149 patients with unresectable HCC treated with Ate/Bev and categorized them into six groups: drug-free, surgery, radiotherapy, transcatheter arterial chemoembolization/hepatic arterial infusion chemotherapy (TACE/HAIC), chemotherapy, and best supportive care (BSC). The surgery, radiotherapy, and TACE/HAIC groups were classified as \"local conversion\" and further subdivided into two subtypes based on the therapeutic intent: \"curative local conversion\" and \"palliative local conversion.\"</p><p><strong>Results: </strong>The 3-year overall survival (OS) rates for patients in the drug-free, surgery, radiotherapy, TACE/HAIC, chemotherapy, and BSC groups were 100.0%, 66.7%, 52.6%, 41.0%, 13.6%, and 10.1%, respectively (p < 0.001). No significant differences were observed between the surgery and TACE/HAIC groups (3-year OS: 66.7% vs. 41.0% and p = 0.441) or between the radiotherapy and TACE/HAIC groups (3-year OS: 52.6% vs. 41.0% and p = 0.838). Patients who underwent local conversion had a significantly better median survival time (28.0 vs. 16.3 months and p < 0.001). The 3-year OS rates for patients who underwent curative and palliative local conversion were 68.6% and 37.0%, respectively. Although curative local conversion demonstrated better prognosis than that noted with palliative local conversion, the difference was not statistically significant (p = 0.155).</p><p><strong>Conclusion: </strong>Local conversion after Ate/Bev treatment may potentially improve survival rates. Even when curative local conversion is not feasible, palliative local conversion may still offer clinical benefits.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2854-2862"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883863","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":"Risk Factors for Nosocomial Infections Following Surgical Repair of Esophageal Atresia.","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Wiem Rhaiem, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1002/wjs.70084","DOIUrl":"10.1002/wjs.70084","url":null,"abstract":"<p><p>This study identified cardiac comorbidities, prematurity, low 5-min Apgar score, and prolonged postoperative intubation as independent risk factors for NIs following surgical repair of EA. We believe that these results would be of great value in clinical practice. They provide a valuable framework for the early identification of high-risk neonates, who would be targets for enhanced infection surveillance, appropriate perioperative strategies, and reinforced hygiene protocols.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2816-2818"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034230","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}