World Journal of Surgery最新文献

{"title":"Predictive Value of Follow-Up CT in Conservatively Managed Traumatic Brain Injury.","authors":"Hatem Marie, Dana Abdullatif Alkandari, Maximilian Peter Forssten, Yousef AlHussaini, Retaj Mohammad, Mohamed Lafi, Dhanisha Trivedi, Shahin Mohseni","doi":"10.1002/wjs.70588","DOIUrl":"https://doi.org/10.1002/wjs.70588","url":null,"abstract":"<p><p>Progression of intracranial hematoma on routine follow-up CT in conservative managed traumatic brain injury patients rarely leads to operative intervention. Initial Marshall score is. more predictive than progression of intracranial hematoma on routine follow-up CT for the need of surgical intervention (AUC 0.88 vs. 057, p=0.016).</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115732","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":"Socioeconomic Vulnerability as a Predictor of Burn Severity: Development of a Multidimensional Risk Model.","authors":"Laura Ordoñez-Arenas, Sergio Alzate-Ricaurte, Valeria Tobon, María Astudillo, Natalia Forero, Juan C Puyana, María F Escobar, Fernando Rodriguez-Holguín, Alberto García","doi":"10.1002/wjs.70599","DOIUrl":"https://doi.org/10.1002/wjs.70599","url":null,"abstract":"<p><strong>Background: </strong>Burn severity assessment traditionally relies on clinical and injury-related factors. However, the influence of social determinants of health on burn outcomes remains poorly understood. We aimed to develop a multidimensional prediction model of burn severity, defined as intensive care unit (ICU) admission, incorporating both clinical and social factors.</p><p><strong>Methods: </strong>A retrospective cohort study of burn patients aged ≥ 15 years admitted to a specialized burn center in Cali-Colombia between January 2023 and December 2024. Sociodemographic, clinical, and injury-related variables were collected from institutional records. The primary outcome was ICU admission. Variables associated with ICU admission were evaluated using multivariable logistic regression, and model performance was assessed through discrimination and calibration metrics.</p><p><strong>Results: </strong>A total of 160 patients were included, of whom 68 (42.5%) required ICU admission. Median age was 40 years (IQR 30.5-51.5), and 77.5% were male. In the multivariable model, greater total body surface area burned (OR 1.11, 95% CI 1.06-1.15; p < 0.001), higher heart rate on admission (OR 1.03, 95% CI 1.00-1.05; p = 0.030), and subsidized health insurance status (OR 3.50, 95% CI 1.38-8.87; p = 0.008) were independently associated with ICU admission. In the Colombian healthcare system, subsidized insurance primarily covers low-income and socioeconomically vulnerable populations. The model demonstrated excellent discrimination (AUC 0.892) and good calibration (Brier score 0.128).</p><p><strong>Conclusions: </strong>ICU admission following burn injury is influenced by a combination of injury severity, physiological response, and social vulnerability. Incorporating social determinants of health into burn severity assessment may improve early risk stratification and provide a more comprehensive framework for predicting critical care needs, particularly in resource-limited settings.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115779","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":"Per Protocol Analysis and Long-Term Outcomes of Laparoscopic Radical Resection for Gallbladder Cancer Compared With Open Method.","authors":"Tae Ho Hong, Kwang Yeol Paik, Yoon Kyung Woo, Jae Hyun Han, Jung Woo Lee, Jong Woo Lee, Dong Do You","doi":"10.1002/wjs.70535","DOIUrl":"10.1002/wjs.70535","url":null,"abstract":"<p><strong>Background: </strong>Although laparoscopic radical resection for gallbladder (GB) cancer has been attempted, only a limited number of studies have evaluated its outcomes using a per-protocol analytical approach.</p><p><strong>Methods: </strong>Between January 2010 and December 2019, 213 patients underwent surgery for gallbladder (GB) cancer at three institutions, of whom 203 consecutive patients with T2 or T3 disease were retrospectively analyzed. Protocol-adherent radical resection (per-protocol) was defined as wedge liver resection or IVb/V bisegmentectomy with the procurement of at least four lymph nodes. Propensity score matching was performed to compare the laparoscopic and open approaches.</p><p><strong>Results: </strong>Protocol-adherent radical resection was achieved in 14 of 76 patients (18.4%) in the laparoscopic group and in 76 of 127 patients (59.8%) in the open surgery group. The primary unmet criterion for radical resection was an insufficient lymph node yield (60/76, 78.9%) in the laparoscopic group. After 1:1 propensity score matching (54 pairs), the 5-year overall survival (OS) rate did not differ between the laparoscopic and open approaches (46.1% vs. 49.9%; hazard ratio 0.90, 95% confidence interval 0.55-1.47; p = 0.668), whereas the disparity in oncological adequacy persisted (protocol-adherent radical resection 20.4% vs. 70.4%). Among patients who achieved protocol-adherent radical resection (N = 90), the exploratory comparison of 5-year OS between the laparoscopic (N = 14) and open (N = 76) groups showed no significant difference (61.5% vs. 53.3%; p = 0.288). Multivariate analysis in patients with protocol-adherent radical resection identified N stage and elevated CA 19-9 levels as independent prognostic factors for OS.</p><p><strong>Conclusions: </strong>Regardless of whether a laparoscopic or open approach is used, radical surgery-including appropriate hepatic resection with the retrieval of at least four lymph nodes-is essential for improving long-term prognosis in patients with GB cancer. N stage and elevated CA 19-9 levels were independently associated with overall survival.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"3065-3073"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809009","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":"High Undertriage in Geriatric Trauma in a Developing Trauma System: Implications for Trauma Team Activation Criteria.","authors":"Muhamad Izwan Ismail, Japsimranjit Kaur, Rizasohaini Baseri, Norfarizan Azmi","doi":"10.1002/wjs.70551","DOIUrl":"10.1002/wjs.70551","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults are at increased risk of adverse outcomes after trauma but are frequently undertriaged because age-related physiological changes may mask injury severity. We evaluated the performance of our institutional trauma team activation (TTA) criteria in patients aged ≥ 65 years within a developing trauma system.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using a trauma registry at a tertiary referral hospital in Malaysia between July 2024 and December 2025. Consecutive trauma patients aged ≥ 65 years admitted to the trauma surgery unit were included. Patients were stratified according to TTA status. Severe injury was defined as an Injury Severity Score (ISS) > 15. The primary outcomes were TTA sensitivity, specificity, and undertriage. Secondary outcomes included mortality, intensive care unit (ICU) admission, and operative intervention.</p><p><strong>Results: </strong>A total of 114 geriatric trauma patients were included, of whom 59 (51.8%) sustained severe injury (ISS > 15). TTA was activated in 17 patients (14.9%). The institutional TTA criteria demonstrated a sensitivity of 28.8% and specificity of 100%, with an undertriage rate of 43.3% and no overtriage. Overall in-hospital mortality was 14.0% (16/114) and was higher among patients undergoing TTA (64.7% vs. 5.2%, p < 0.001), reflecting greater injury severity. Severe traumatic brain injury accounted for 68.8% of deaths, and five of the sixteen deaths (31.3%) occurred in patients who did not meet TTA criteria.</p><p><strong>Conclusion: </strong>Current TTA criteria demonstrated low sensitivity for identifying severely injured geriatric trauma patients, resulting in substantial undertriage despite excellent specificity. Missed patients frequently sustained severe traumatic brain injury without meeting existing activation criteria. These findings support prospective evaluation of geriatric-specific modifications to trauma triage, including age-adjusted physiological thresholds and lower thresholds for trauma team activation in older adults.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"3111-3118"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819645","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":"Laparoendoscopic Rendezvous for Difficult Cholecystocholedocholithiasis: A Prospective Cohort Study With Computed Tomography-Based Risk Stratification.","authors":"Saleh K Saleh, Shimaa S Elsharkawy, Ayman M Hassanen","doi":"10.1002/wjs.70575","DOIUrl":"10.1002/wjs.70575","url":null,"abstract":"<p><strong>Background: </strong>Selective biliary cannulation at endoscopic retrograde cholangiopancreatography (ERCP) is difficult in up to 40% of native papillae and drives post-ERCP pancreatitis (PEP) and incomplete common bile duct (CBD) clearance. Laparoendoscopic rendezvous (LERV) passes an antegrade transcystic guidewire across the papilla during laparoscopic cholecystectomy, a duodenoscope then completing sphincterotomy and extraction in one anesthetic. This study evaluated LERV in cholecystocholedocholithiasis pre-stratified as anticipated difficult cannulation by preprocedural computed tomography (CT).</p><p><strong>Methods: </strong>In a single-centered prospective cohort study (June 2025-June 2026; NCT07008170), 80 consecutive adults underwent contrast-enhanced multidetector CT before surgery; the diagnosis rested on ultrasound, selective magnetic resonance cholangiopancreatography (MRCP) and biochemical criteria, MRCP not being universally available locally. Six radiologic predictors were recorded: worrisome periampullary diverticulum (PAD) score (0-2), papilla bulging, choledochoduodenal (CD) angle, distal CBD diameter, papilla location and a far-distal CBD stone. The primary outcome was technical success, a feasibility endpoint analyzed separately from duct clearance; secondary outcomes were CBD clearance, PEP, morbidity, and 60-day recurrence.</p><p><strong>Results: </strong>Mean age was 52.4 ± 13.1 years and 56.3% were women. Technical success was 92.5% (74/80; 95% CI 84.6-97.2) and in-admission complete CBD clearance 95.0% (76/80). PEP occurred in 3/80 (3.8%; all mild), post-sphincterotomy bleeding and bile leak in 2/80 each (2.5%), cholangitis in 3/80 (3.8%) and perforation in 1/80 (1.3%), with no 30-day mortality. Technical success fell stepwise with the cumulative number of CT risk factors (Cochran-Armitage p < 0.001); a worrisome PAD score of 2 (odds ratio 9.4, 95% CI 1.7-52.8; p = 0.011) and a CD angle ≤ 20° (odds ratio 6.8, 95% CI 1.3-35.4; p = 0.024) independently predicted failure.</p><p><strong>Conclusions: </strong>In a cohort whose papillary anatomy was characterized beforehand by CT, LERV achieved high in-admission CBD clearance with a low rate of mild PEP and no mortality. The CT features were associated with, but did not themselves produce, technical success; read from a CT already obtained for a clinical indication they may assist case selection, theater planning and consent. Where MRCP is universally available these measurements should be validated on that platform, and the associations require external validation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT07008170 (registered 15 June 2025).</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2927-2936"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026088","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":"Effect of Prophylactic Incisional Negative Pressure Wound Therapy on Surgical Site Infection After Emergency Laparotomy: An Updated Meta-Analysis With Trial Sequential Analysis.","authors":"Ana Luíza Rocha Soares Menegat, Brenda Luana Rocha Soares Menegat, Sara Bravin, Jacopo Lin, Henrique Wiederkehr","doi":"10.1002/wjs.70526","DOIUrl":"10.1002/wjs.70526","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing emergency laparotomy are at high risk of surgical site infections (SSI), which contribute substantially to postoperative morbidity. Incisional negative pressure wound therapy (iNPWT) has been shown to reduce the incidence of SSI following elective surgery, however, its effectiveness in the emergency setting remains uncertain. Therefore, we conducted a systematic review and meta-analysis to evaluate the effectiveness of iNPWT in reducing SSI after emergency laparotomy.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane through November 2025 for randomized controlled trials (RCTs) and observational studies comparing iNPWT to standard dressings after emergency laparotomy. Odds ratios (OR) and mean differences (MD) were pooled for relevant outcomes with 95% confidence intervals using random-effects and inverse variance weighting. A two-tailed p-value < 0.05 was considered significant. Prespecified subgroup analyses restricted to RCTs were performed. Statistical heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Fifteen studies (6 RCTs and 9 observational) including 3369 patients were analyzed. It was found that iNPWT was associated with significantly lower odds of overall (OR 0.36; p = 0.0003), superficial, and deep SSI, with consistent findings in RCT-only analysis (OR 0.41; p = 0.0221). iNPWT was also associated with lower odds of seroma (OR 0.57; p = 0.0325), with consistent results observed in RCT-only analyses (OR 0.54; p = 0.025). Hospital length of stay was shorter in the iNPWT group (MD -1.49 days; p = 0.04), and iNPWT was associated with lower odds of wound dehiscence (OR 0.47; p = 0.0062), however, these findings were not confirmed in RCT-only analyses. Postoperative complications, classified according to the Clavien-Dindo system, did not differ between groups (OR 0.93; p = 0.4973). Overall mortality was comparable between groups, although iNPWT was associated with higher follow-up mortality. This finding was not confirmed in RCTs.</p><p><strong>Conclusion: </strong>In patients undergoing emergency laparotomy, iNPWT was associated with reduced odds of SSI and wound-related complications compared with standard dressings. Although iNPWT was associated with higher follow-up mortality, this finding was not confirmed in RCT-only analyses.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2848-2860"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759680","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 Population-Based Study of Incidence, Presentation, Treatment and Short-Term Outcomes of Acute Thromboembolic Ischemia in the Lower Limbs.","authors":"Jørgen B Vennesland, Kjetil Søreide, Jan Terje Kvaløy, Andreas Reite, Morten Vetrhus","doi":"10.1002/wjs.70539","DOIUrl":"10.1002/wjs.70539","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the current epidemiology and short-term outcomes in patients with acute lower limb ischemia (ALI) in a well-defined Norwegian population.</p><p><strong>Methods: </strong>A retrospective, single-center, observational cohort study in a defined population catchment area. All patients with ALI from the catchment area were included in the period from January 2000 to December 2019. Age- and sex-adjusted incidence rates were calculated using population demographics from Statistics Norway.</p><p><strong>Results: </strong>A total of 359 patients were identified, and 356 (99.2%) were included in the analyses. Two-thirds were males (n = 216, 60.7%), with males presenting at a younger age than females (median age 71, quartiles 63-81 yrs vs. median age 79 quartiles 67-87; respectively; p < 0.001). The age- and sex-adjusted incidence rate for the period was 7.9/100.000/year (95% confidence interval 7.1-8.8) with no significant change throughout the period. Patient distribution according to Rutherford classification was 110 (31%) class 1, 130 (36.6%) class 2a, 100 (28.2%) class 2b and 15 (4.2%) class 3. The level of occlusion was supra-inguinal in 105 patients (29.5%) and infra-inguinal in 251 (70.5%). Thrombosis was the most common cause of ischemia, observed in 243 patients (68.3%). Bilateral ischemia was recorded in 21 (5.9%) patients. In 196 (55.1%) the treatment was surgical, in 135 (37.9%) endovascular. Four patients (1.1%) underwent primary amputation, whereas 11 (3.1%) and 10 (2.8%) were managed with conservative or palliative treatment, respectively. In the first 90 days, major adverse limb events were noted in 115 patients (32.3%) and general complications in 73 (20.5%). Overall, a major amputation was performed in 47 (13.2%) within 90-days. 90-days mortality was 78 (21.9%).</p><p><strong>Conclusion: </strong>The incidence of ALI remained stable over the study period in this defined Nordic population, although embolic occlusions became increasingly common. ALI remained associated with substantial short-term morbidity and mortality, and females presented with more advanced ischemia and poorer amputation-free survival.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"3119-3128"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841151","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":"Hill Classification Predicts Postoperative Pneumonia After Minimally Invasive Distal Gastrectomy for Gastric Cancer.","authors":"Shotaro Nagano, Junya Kitadani, Keiji Hayata, Taro Goda, Shinta Tominaga, Tomoki Nakai, Naoki Fukuda, Keisuke Hanada, Manabu Kawai","doi":"10.1002/wjs.70576","DOIUrl":"10.1002/wjs.70576","url":null,"abstract":"<p><p>Postoperative pneumonia still occurs and is a poor prognostic factor despite advances in minimally invasive gastrectomy. Aspiration is considered a principal mechanism of postoperative pneumonia after gastrectomy. Because the reconstruction method after gastrectomy influences bile reflux, postoperative reflux may contribute to aspiration and thereby increase the risk of pneumonia. Hill classification is an endoscopic grading system used to evaluate the function of the gastroesophageal flap valve and has been reported to reflect the severity of gastroesophageal reflux.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"3032-3036"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931213","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":"Physiological Emergency Surgery Acuity Score Predicts Mortality and Anastomotic Leak in Emergency Laparotomy: An External Validation Study.","authors":"Wade Hopper, Anthony J Duncan, Mentor Ahmeti","doi":"10.1002/wjs.70562","DOIUrl":"10.1002/wjs.70562","url":null,"abstract":"<p><strong>Background: </strong>The Physiological Emergency Surgery Acuity Score (PESAS) predicts 30-day mortality but has not been externally validated in emergency general surgery (EGS) patients. The study aim was to evaluate PESAS discrimination for predicting mortality and anastomotic leak in patients receiving emergency laparotomy.</p><p><strong>Methods: </strong>We retrospectively evaluated PESAS in a single-center cohort of adults receiving exploratory laparotomy for emergent, nontraumatic indications. PESAS and 30-day mortality were calculated for all patients. Discrimination of PESAS for 30-day mortality was assessed using area under receiver operator curve (AUROC). Secondary analysis was conducted in similar fashion for the outcome of anastomotic leak requiring reoperation.</p><p><strong>Results: </strong>In 1086 patients with 160 cases of 30-day mortality (14.7%), PESAS showed strong discrimination for the primary outcome (AUROC 0.86; 95% CI 0.83-0.88) with acceptable calibration-in-the-large. In an exploratory secondary analysis of 414 patients who received bowel anastomosis with 21 cases of leak (5.1%), PESAS also showed good discrimination for anastomotic leak (AUROC 0.82; 95% CI 0.73-0.90). Observed mortality rates showed clear inflection points at PESAS values of 5 and 10, respectively, corresponding to mortality exceeding 10% and 50%.</p><p><strong>Conclusions: </strong>PESAS demonstrates good discrimination, calibration-in-the-large, and net benefit as an ordinal risk stratification tool for prediction of 30-day mortality among patients undergoing emergency laparotomy, with exploratory analysis suggesting promise for predicting anastomotic leak. Because it is derived entirely from objective physiologic variables, it may be well-suited for automated risk stratification in EGS populations. Further patient-level calibration is needed to justify expanded use.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2877-2885"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897553","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":"Comparison of Long-Term Health-Related Quality of Life After Mastectomy and Breast Conserving Therapy.","authors":"Sanna Järvinen, Tiina Jahkola, Hanna Ihalainen, Jussi P Repo, Susanna Kauhanen, Pauliina Homsy","doi":"10.1002/wjs.70517","DOIUrl":"10.1002/wjs.70517","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer and its treatments have a significant impact on patients' health-related quality of life (HRQL). The aim of this study was to compare HRQL in a long-term, cross-sectional assessment after breast conserving therapy (BCT) and mastectomy without reconstruction, using the BREAST-Q.</p><p><strong>Materials and methods: </strong>Altogether 500 patients who had undergone either mastectomy or BCT between 06/2016 and 8/2018 were approached. The postoperative HRQL was assessed using the BREAST-Q Breast Conserving Therapy and Mastectomy Modules.</p><p><strong>Results: </strong>A total of 171 (34%) women participated, 85 of whom had undergone BCT and 86 mastectomy without reconstruction. The mean (SD) time from surgery to the survey was 3.3 (1) years. The mean age of the participants did not differ in the groups (p = 0.45). Compared to those who had undergone mastectomy, women with a history of BCT reported better psychosocial well-being (78 (19) vs. 66 (17), p < 0.01), sexual well-being (61 (20) vs. 41 (22), p < 0.01) and physical well-being of the chest (86 (16) vs. 77 (20), p < 0.01). They were also more satisfied with their breasts (72 (22) vs. 52 (17), p < 0.01) and reported fewer radiotherapy side effects (7 (1) vs. 8 (3), p = 0.01).</p><p><strong>Conclusions: </strong>These data suggest that the long-term HRQL remains high after both BCT and mastectomy. However, women with a history of BCT reported higher psychosocial, sexual, and physical well-being and greater satisfaction with their breasts than those with a history of mastectomy.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2787-2795"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881797","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}