World Journal of Surgery最新文献

{"title":"Preoperative Manual Detorsion in Children With Intravaginal Testicular Torsion: A Single-Center Experience.","authors":"Maria Ruffoli, Anna Lavinia Bulotta, Giovanni Boroni, Susanna Milianti, Filippo Parolini, Luca Giacomo Tonegatti, Pierluigi Pedersini, Stefano Calza, Daniele Alberti","doi":"10.1002/wjs.70455","DOIUrl":"10.1002/wjs.70455","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2380-2382"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219852","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":"Training Global Leaders in Perioperative Equity: An Evaluation of the CHESA Fellowship.","authors":"Hudson Lin, Rachel Schwartz, Megha R Aepala, Nour M Aissaoui, Jacob Serrano, Fred Bulamba, Aleena Jacob, Cathy Kilyewala, Phyllis Kisa, Michael S Lipnick, Mary T Nabukenya, Patti Orozco, Doruk Ozgediz, Sriranjani P Padmanabhan, Cornelius Sendagire, Lia Jacobson","doi":"10.1002/wjs.70481","DOIUrl":"10.1002/wjs.70481","url":null,"abstract":"<p><strong>Background: </strong>Few programs exist to train learners in advancing equity in perioperative care. In response, the UCSF Center for Health Equity in Surgery and Anesthesia (CHESA) launched the CHESA Fellowship in 2021. This 18-month, non-ACGME fellowship uses asynchronous modules, expert-led seminars, mentored research, and community building to equip fellows with the skills to advance perioperative equity worldwide.</p><p><strong>Methods: </strong>This report describes the fellowship's structure and evaluates its early impact on alumni career development. We conducted a mixed-methods fellowship evaluation comprising alumni and end-of-year surveys, focus groups, and a list of fellow-authored publications. Surveys assessed skill development, scholarly output, and satisfaction with curriculum elements. Qualitative data from focus groups were coded to highlight fellows' experiences and identify areas for improvement.</p><p><strong>Results: </strong>Since 2021, CHESA has trained 80 fellows across 18 countries and 12 specialties; 71.3% are from LMICs and 48.8% are female. Surveys demonstrated strong satisfaction with faculty mentorship, project work, and community-building. Fellows reported acquiring skills in academic writing, mentorship, and leadership, with 53.8% developing new collaborations with co-fellows and 75.0% integrating fellowship learning into their clinical practice. Among alumni, 76.5% reported advancement into new leadership roles or clinical positions. Across cohorts, alumni published 364 manuscripts during or after the fellowship, with 58.8% focusing on health equity. Fellow and faculty feedback identified needs for enhanced research support and faculty development, which were incorporated into subsequent program iterations.</p><p><strong>Conclusion: </strong>The CHESA Fellowship offers an innovative model for building global perioperative leadership. The part-time, virtual format allows fellows to complete the program alongside clinical duties, while seed grants for LMIC fellows support locally driven scholarly projects. By prioritizing cross-border collaborations between fellows, building long-term partnerships with LMIC institutions, and ensuring diversity across geography, specialty, and sex, the fellowship balances accessibility with mentorship and community-building. Alumni report high satisfaction and translate their training into academic, clinical, and advocacy outcomes that advance perioperative equity.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2329-2337"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431054","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":"The Top Five Advances in Solid Organ Transplantation in the Past Fifty Years.","authors":"Stephen J Wigmore, Diana A Wu","doi":"10.1002/wjs.70380","DOIUrl":"10.1002/wjs.70380","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2121-2124"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783195","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":"Trauma Surgeons' Impactful Last Half Century.","authors":"Martin E Wullschleger, Emma M Possfelt-Moeller, Krista L Kaups, Gustavo P Fraga, Ranjith N Ellawala","doi":"10.1002/wjs.70370","DOIUrl":"10.1002/wjs.70370","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2140-2145"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783219","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":"Emergency Care Needs in an Asymmetric Conflict: A Facility-Based Cohort Study From Israel on October 7, 2023.","authors":"Maximilian P Nerlander, Mohammad Abu Issa, Mor Saban, Gili Givaty, Yaniv Ovadia","doi":"10.1002/wjs.70516","DOIUrl":"https://doi.org/10.1002/wjs.70516","url":null,"abstract":"<p><strong>Background: </strong>Due to the deteriorating global security situation, many countries are preparing their health systems for armed conflict. Wartime health care delivery is challenging due to the loss of territorial control and attacks on Emergency Medical Services (EMS). The objectives of this study were to use Emergency Department (ED) data from the hospital closest to the areas of fighting during the October 7, 2023, attacks in Israel, to determine what patient factors relate to status as dead on arrival (DoA), high acuity, and to explore the epidemiology of injury patterns.</p><p><strong>Methods: </strong>This is a retrospective cross-sectional cohort study. All patients presenting with injuries from the October 7, 2023, attacks, from 06h30 until 24h00, were included. Variables included demographics, patient classification (civilian or combatant), mode of arrival, condition, injury mechanism and injury location. Two logistic regression models with backward elimination were used to determine the patient factors associated with DoA and high acuity.</p><p><strong>Results: </strong>A total of 301 patients were included. A majority (67.8%) arrived at the ED informally instead of by ambulance (23.9%). A total of 26.6% were DoA. Informal arrival was associated with DoA (OR 10.73, CI [4.18-36.55]). Injuries by firearms and thoracic injuries had higher odds of high acuity (OR 4.15 95% CI [1.67-11.50] and OR 4.35 95% CI [1.49-12.95]), while extremity injuries had lower odds (OR 0.41 95% CI [0.17-0.99]). Firearm-related injuries were more common among combatants compared to civilians (55.3% vs. 35.1%, p ≤ 0.05). Extremity injuries accounted for more than half of injuries in both civilians and combatants (52.3% vs. 59.5%, p = 0.31).</p><p><strong>Conclusion: </strong>In an armed conflict with loss of territorial control and reduced EMS access, healthcare planners may need to anticipate significant prehospital death and that many patients arrive at hospital informally. Prehospital death may be reduced by expanding lay bystander skills in trauma care as these may access patients before ambulances do. Due to survival bias, patients with firearm-related injuries may have more urgent care needs upon reaching hospital than patients with explosion-related injuries. Given the higher survivability of extremity injuries, these may be overrepresented among patients who reach hospital.</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":"148654358","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":"Fighting for Life: Five Advances in Neonatal Surgery Over 50 Years.","authors":"Tahmina Banu, Nirav Patel, Tanvir Kabir Chowdhury, Doruk Ozgediz, Kokila Lakhoo","doi":"10.1002/wjs.70310","DOIUrl":"10.1002/wjs.70310","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2152-2155"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663281","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 Surgical Education Innovations for Low-Resource Settings Over the Last 50 years.","authors":"Udit Choubey, Cassandra Mbanje, Rajeeka Singh Tak, Jessica Davies, Mariela Rivera","doi":"10.1002/wjs.70443","DOIUrl":"10.1002/wjs.70443","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2188-2194"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206343","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 Global Education in Surgery Over the Last 50 Years.","authors":"Adolfo Leyva-Alvizo, Eric O'Flynn, Somprakas Basu, Geoff Ibbotson, Mariana Tejeda-Díaz","doi":"10.1002/wjs.70368","DOIUrl":"10.1002/wjs.70368","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2184-2187"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718567","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":"ERAS-Enhanced Recovery After Surgery: The ERAS Society Story.","authors":"Olle Ljungqvist, Mary Brindle, Martin Hubner, Gregg Nelson, Ulf Gustafsson","doi":"10.1002/wjs.70378","DOIUrl":"10.1002/wjs.70378","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2160-2164"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783095","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":"The Safety of In-Hospital Delay and the Utility of dNLR in Elderly Patients With Acute Appendicitis.","authors":"Offir Ben-Ishay, Noa Carmon, Roi Abramov, Hayim Gilshtein","doi":"10.1002/wjs.70447","DOIUrl":"10.1002/wjs.70447","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients with acute appendicitis face high rates of complicated disease, yet the impact of in-hospital timing and the utility of simple biomarkers remain debated. We aimed to assess whether in-hospital timing influences severity and to evaluate the derived neutrophil-to-lymphocyte ratio (dNLR) as a risk-stratification tool.</p><p><strong>Methods: </strong>A retrospective study of 412 patients (184 aged ≥ 65 years; 228 younger controls) undergoing appendectomy (2010-2019) was conducted. We analyzed Patient Interval (symptom onset to admission) and Hospital Interval (admission to incision). Appendicitis was graded as uncomplicated or complicated (gangrenous/perforated). Multivariable regression and categorical sensitivity analyses (0-6, 6-12, 12-18, > 18 h) were used to identify predictors of severity.</p><p><strong>Results: </strong>Elderly patients had higher rates of complicated appendicitis (29.4% vs. 9.2%) and morbidity (13.0% vs. 1.3%). While night-shift admission increased time to diagnosis, it did not increase complications. Hospital Interval was shorter in the elderly (13.5 vs. 15.4 h) but was not an independent predictor of complications and showed no adverse trend across time categories. In the elderly, dNLR ≥ 4.0 independently predicted complicated disease (AUC 0.65) alongside age, fever, and Patient Interval. Mortality spiked to 8.3% in patients ≥ 85 years, driven by medical complications.</p><p><strong>Conclusions: </strong>Disease severity in geriatric appendicitis appears to be largely determined prior to admission. Within the limitations of this observational design, short in-hospital delays for optimization or logistical reasons were not associated with increased perforation or morbidity. Furthermore, a dNLR ≥ 4.0 helps identify high-risk patients, suggesting that an \"optimize then operate\" approach-prioritizing physiological stabilization may be a safe and reasonable strategy for clinically stable elderly patients.</p><p><strong>Trial registration: </strong>Research Registry (UIN: researchregistry11765).</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2306-2312"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362525","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}