BMC Surgery最新文献

{"title":"Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit.","authors":"Hosam Hamed, Mohamed Elshobary, Tarek Salah, Ahmad M Sultan, El-Sayed Abou El-Magd, Ahmed M Elsabbagh, Ahmed Shehta, Mohamed Abdulrazek, Waleed Elsarraf, Mohamed A Elmorshedi, Mostafa Abdelkhalek, Usama Shiha, Hassan Magdy Abd El Razek, Mohamed Abdel Wahab","doi":"10.1186/s12893-024-02709-4","DOIUrl":"https://doi.org/10.1186/s12893-024-02709-4","url":null,"abstract":"<p><strong>Background: </strong>In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient's hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT.</p><p><strong>Methods: </strong>This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate.</p><p><strong>Results: </strong>The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020 min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate.</p><p><strong>Conclusion: </strong>The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient's hepatic artery is significantly compromised.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932524","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":"Comparative study of single-port single-channel and single-port multi-channel adrenalectomy in various maximum tumor diameters.","authors":"Pengcheng Zhang, Yuhan Pei, Yunlai Zhi, Fanghu Sun, Ninghong Song","doi":"10.1186/s12893-024-02746-z","DOIUrl":"https://doi.org/10.1186/s12893-024-02746-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Investigating the application of single-port single-channel and single-port multi-channel adrenalectomy in various maximum tumor diameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective analysis of clinical data from 218 adrenal tumors treated with single-port retroperitoneoscopic adrenalectomy at Lianyungang Clinical Medical College of Nanjing Medical University from September 2018 to November 2023. All adrenal tumors are benign lesions classified as T1 stage. Tumors were classified into three groups based on their maximum diameter: ≤3 cm (Group A), &gt;3 cm and ≤ 4 cm (Group B), and &gt; 4 cm and ≤ 5 cm (Group C). Based on the surgical approach, patients were divided into single-port single-channel and single-port multi-channel groups. Group A had an average tumor diameter of (2.32 ± 0.45) cm with 46 single-port single-channel and 53 single-port multi-channel cases; Group B had (3.42 ± 0.31) cm with 33 single-port single-channel and 45 single-port multi-channel cases; Group C had (4.60 ± 0.28) cm with 18 single-port single-channel and 23 single-port multi-channel cases. Comparisons were made between single-port single-channel and single-port multi-channel groups in terms of operation time, hospital stay, intraoperative bleeding, postoperative pain score, surgical complications, incision length (total length of all incisions), and the need for additional puncture holes for each tumor size group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 218 surgeries were successfully completed without conversion to open surgery. In Group A, no significant difference was observed between single-channel and multi-channel groups in terms of operation time and blood loss (P &gt; 0.05), but significant differences were found in hospital stay, pain score, subcutaneous emphysema incidence, and incision length (P &lt; 0.05). In Group B, there was no significant difference between single-channel and multi-channel groups regarding operation time and blood loss (P &gt; 0.05), but significant differences were observed in hospital stay, pain score, subcutaneous emphysema incidence, and incision length (P &lt; 0.05). In Group C, no significant difference was observed between single-channel and multi-channel groups in terms of hospital stay, blood loss, pain score, incision length, vascular injury, and subcutaneous emphysema incidence (P &gt; 0.05), but significant differences were found in operation time and the incidence of additional puncture holes (P &lt; 0.05). Postoperative follow-up ranged from 4 to 22 months, with an average of 11.5 months, and no complications were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Single-port single-channel laparoscopy has significant advantages in surgeries for tumors with a maximum diameter ≤ 4 cm, as it can directly reach the target organ, reduce separation operations, cause less damage, and has good cosmetic effects. For adrenal tumor surgeries with a maximum diameter &gt; 4 cm, the multi-channel technique is superior to the single-ch","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"6"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933386","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":"Ocular hypertension after silicone oil filling surgery for high myopia: a case-control study.","authors":"Xiaodan Lin, Shenghui Feng, Chunmei Chen, Yadan Xiong, Na Li, Ling Tong","doi":"10.1186/s12893-024-02704-9","DOIUrl":"https://doi.org/10.1186/s12893-024-02704-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine the correlation between specific clinical parameters, such as axial eye length, and the onset of ocular hypertension \"OH\" following the use of silicone oil filling in patients with high myopia.</p><p><strong>Method: </strong>In this retrospective analysis, we reviewed 214 eyes from 432 patients diagnosed with severe myopia, all of whom underwent vitrectomy and were treated with silicone oil filling. The study aimed to document the incidence and timing of postoperative ocular hypertension \"OH\" while assessing various factors, including demographic details, medical history, additional surgical interventions, and findings from supplementary examinations (such as axial length, silicone oil emulsification, and anterior chamber penetration). Binary logistic regression was employed as the primary statistical method to identify significant predictors and their relationship with \"OH\". This approach allowed for a comprehensive analysis of the impact of the duration of silicone oil presence in the eye on \"OH\" occurrence, providing a detailed understanding of the factors influencing post-surgical outcomes.</p><p><strong>Result: </strong>The study revealed a statistically significant increase in postoperative axial length (29.21 ± 0.85 mm) compared to the preoperative length (28.31 ± 0.82 mm), corresponding to an incidence rate of 37.38% (80 cases) for \"OH\". Logistic regression analysis identified the following variables as significantly associated with an increased risk of \"OH\" post-silicone oil filling: scleral buckling, aphakic status, silicone oil emulsification, and silicone oil penetration into the anterior chamber. The odds ratios (OR) for these variables were 1.397, 0.672, 1.859, and 1.364, respectively, indicating their predictive value for \"OH\" risk.</p><p><strong>Conclusion: </strong>The development of \"OH\" post-silicone oil filling is strongly correlated with changes in the anterior segment anatomy and the dynamics of aqueous humor flow, particularly in eyes without the natural lens. Recognizing these risk factors highlights the importance of thorough preoperative evaluation and individualized postoperative care to reduce the incidence of OH in patients with high myopia, thereby improving surgical outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"7"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932844","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":"Role of laparoscopic surgery in blunt abdominal trauma; retrospective analysis in a tertiary trauma center.","authors":"Rifan Alyami, Ahad E Alotaibi, Leen Almohayya, Ajyad Al Jawad, Raghad Almukhayzim, Abeer Alhoumedan, Rakan S Aldusari","doi":"10.1186/s12893-024-02744-1","DOIUrl":"https://doi.org/10.1186/s12893-024-02744-1","url":null,"abstract":"<p><strong>Purpose: </strong>Trauma is a significant health concern globally and is one of the leading causes of illness and death. The laparoscopic approach has gained popularity in trauma care since its inception, becoming increasingly favored for both diagnostic and therapeutic purposes. This study aims to reduce unnecessary laparotomies and assess the effectiveness of laparoscopy in managing patients with blunt abdominal trauma.</p><p><strong>Methods: </strong>The study is a descriptive retrospective study using the medical records of patients with blunt abdominal trauma who were managed with laparoscopy in the Department of General Surgery, King Abdulaziz Medical City in Riyadh. The study period was from 2019 to 2023 and included patients > 18 years with abdominal blunt injury, hemodynamically stable patients, and responding to resuscitation. The relationship between laparoscopic procedures according to the patient's demographic and characteristics was conducted using the Fischer Exact test and independent sample t-test. Values were considered significant with a p-value of less than 0.05.</p><p><strong>Results: </strong>In this study, 74 patients were included, with 94.6% being males. The average age of the patients was 36.3 years (standard deviation of 12.5 years). The primary cause of trauma was motor vehicle accidents (MVAs), accounting for 91.9% of cases. The most common surgical approach used was laparotomy, performed in 71.6% of patients. Additionally, CT scans revealed that solid organ injuries were the most frequently detected type of injury, occurring in 41.9% of cases. Following surgery, 78.4% of the patients underwent therapeutic procedures after laparotomy, while 37.8% received therapeutic interventions post-laparoscopy.</p><p><strong>Conclusion: </strong>While laparoscopic techniques have been used for decades in abdominal surgeries, a consensus on their effectiveness and accuracy in diagnosing blunt abdominal injuries in trauma settings is still lacking. Laparoscopy is considered safe and feasible for hemodynamically stable patients, and our findings suggest it is equally effective in trauma cases for those who can tolerate the procedure. We recommend conducting further studies with larger sample sizes and more variables to provide sufficient data to accurately assess the efficacy and safety of laparoscopy in trauma situations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"8"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933053","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 warm sitz bath and electronic bidet with a lower-force water flow for postoperative management after hemorrhoidectomy (BIDLOW).","authors":"Yoon-Hye Kwon, Seung-Bum Ryoo, Heung-Kwon Oh, Jae Bum Lee, Hyung-Joong Jung, Kee-Ho Song, Seung Chul Heo, Rumi Shin, Joongyub Lee, Kyu Joo Park","doi":"10.1186/s12893-024-02737-0","DOIUrl":"https://doi.org/10.1186/s12893-024-02737-0","url":null,"abstract":"<p><strong>Aim: </strong>Electronic bidets can be a substitute for sitz baths, but no study has examined the use of electronic bidets to manage anal problems.</p><p><strong>Methods: </strong>A randomized, controlled, single-blind, multicenter, parallel group trial was performed. Patients who underwent hemorrhoidectomy were randomly assigned (1:1) to use the electronic bidet or warm sitz baths for 7 days after hemorrhoidectomy. The primary endpoint was the difference in the anal pain VAS score for 7 days posthemorrhoidectomy.</p><p><strong>Results: </strong>Patients were assigned to the electronic bidet (51) or sitz bath (50) groups. Twenty-six patients dropped out after randomization, and the final analysis included 34 patients in the electronic bidet group and 41 in the sitz bath group. The VAS score for anal pain 7 days posthemorrhoidectomy did not differ between the electronic bidet and sitz bath groups (38.3 ± 21.9 vs. 42.0 ± 21.1, p = 0.453). The upper limit of the 95% confidence interval of the VAS score in the electronic bidet group (81.22) was greater than the margin of noninferiority (46.20).</p><p><strong>Conclusion: </strong>The VAS scores after hemorrhoidectomy did not differ between the electronic bidet and sitz bath groups, but the noninferiority of the electronic bidet to sitz baths for anal pain 7 days posthemorrhoidectomy was not verified.</p><p><strong>Trial registration: </strong>The trial was registered on ClinicalTrials.gov (Registration number: NCT02353156, date: 02/02/2015).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"5"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932244","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":"Characteristics of abdominal herniation and its associations among patients operated in a Sudanese tertiary hospital: a retrospective review.","authors":"Ahmed Abdellateef Hassan Bakry, Khabab Abbasher Hussien Mohamed Ahmed, Mohammed Mahmoud Fadelallah Eljack, Ghassan E Mustafa Ahmed","doi":"10.1186/s12893-024-02741-4","DOIUrl":"https://doi.org/10.1186/s12893-024-02741-4","url":null,"abstract":"<p><strong>Background & aims: </strong>Hernia is a very common surgical condition affecting all ages and both sexes. Data regarding abdominal wall hernias is essential to hernia management in an institution. With the absence of data regarding the prevalence, characteristics, and associations of abdominal wall hernias in Sudanese patients, we aimed to describe and find the possible differences in the spectrum of abdominal hernias, their rates, and associated predisposing factors.</p><p><strong>Methodology: </strong>This was a retrospective cross-sectional chart review of surgical patients admitted at a Sudanese tertiary teaching Hospital, Department of Surgery, from January 2019-December 2021. Data were collected from the medical records using a checklist. The data obtained included age, gender, occupation, chronic medical conditions, past medical history (PMH), and year of admission. Data were analyzed using SPSS 22.</p><p><strong>Results: </strong>Results showed that between January 2019 and December 2021, a total of 1158 patients were admitted to the department of surgery, and abdominal hernia had a frequency of 16.23% (n = 188). There was a male predominance (55.3%), ages below 20 years constituted the majority of cases (45.2%), and those between (50-60 years) were the least. The most frequent subtype was the inguinal hernia. The association between sociodemographic variables, PMH, chronic medical conditions, and the diagnosis was found to be statistically significant. The rate of recurrence was found to be 10.1%.</p><p><strong>Conclusion: </strong>There was a high rate of abdominal Herniation, and a difference between subtypes of abdominal herniation regarding demographic data, past medical history, and comorbidities.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"3"},"PeriodicalIF":1.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928453","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":"Perioperative outcomes in an age-adapted analysis of the German StuDoQ|Pancreas registry for PDAC.","authors":"Tengis Tschaidse, Felix O Hofmann, Bernhard Renz, Maximilian Hungbauer, Carsten Klinger, Heinz J Buhr, Waldemar Uhl, Sören Torge Mees, Tobias Keck, Christoph Reissfelder, Michael Ghadimi, Jan G D'Haese, Jens Werner, Matthias Ilmer","doi":"10.1186/s12893-024-02647-1","DOIUrl":"10.1186/s12893-024-02647-1","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) typically occurs in an older patient population. Yet, early-onset pancreatic cancer (EOPC) has one of the fastest growing incidence rates. This study investigated the influence of age and tumor location on postoperative morbidity and mortality in a large, real-world dataset.</p><p><strong>Methods: </strong>Patients with confirmed PDAC undergoing pancreatic surgery between 01/01/2014 and 31/12/2019 were identified from the German StuDoQ|Pancreas registry. After categorization into early- (EOPC; < 50 years), middle- (MOPC; 50 -70 years), and late-onset (LOPC; > 70 years), and stratification into pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), differences in morbidity and mortality as well as clinicopathologic parameters were analyzed.</p><p><strong>Results: </strong>In total, 3011 patients were identified. No difference in the occurrence of postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH) or delayed gastric emptying (DGE) between different age groups and resection techniques was detected. However, in patients undergoing PD, major complications (Clavien-Dindo ≥ 3a) were observed more frequently in LOPC (30,7%) than in MOPC (26,2%) and EOPC (16,9%; p < 0,01). Mortality almost tripled from EOPC (2,4%) to MOPC (3,6%) to LOPC (6,6%, p < 0,01) and significantly higher failure to rescue (FTR) rates could be observed (EOPC 14,3%, MOPC 13,6%; LOPC 21,6%; p < 0,05). In centers with DGAV certification for pancreatic surgery, the risk of complications was significantly decreased in PD (OR 0,79; 95% CI 0,65-0,94; p = 0,010).</p><p><strong>Conclusion: </strong>Age has a pronounced impact on the perioperative outcomes after pancreatic resections of PDAC. This effect is more prevalent in PD compared to DP. Pancreatic surgery-specific complications, such as POPF, DGE or PPH do not occur more frequently in the elderly. Overall, the risk of major complications and mortality increases in elderly patients mainly secondary to higher FTR rates.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"4"},"PeriodicalIF":1.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928481","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":"Influence of the wet-ear state on the outcomes of tympanic membrane repair under ear endoscopy: a prospective case-control study.","authors":"Jun Zhang, Qinglin Bai, Na Zhao, Cong Li, Jia Yang","doi":"10.1186/s12893-024-02714-7","DOIUrl":"10.1186/s12893-024-02714-7","url":null,"abstract":"<p><strong>Background: </strong>To prospectively determine whether tympanoplasty for tympanic membrane perforation (TMP) in wet ears impacts recovery.</p><p><strong>Methods: </strong>We prospectively enrolled 32 TMP patients (2021-2023) and divided them into the wet-ear (14 patients) and dry-ear groups (18 patients), according to the presence of middle-ear secretions/edema. All patients underwent high-resolution thin-slice computed tomography, ear endoscopy, and pure tone audiometry.</p><p><strong>Results: </strong>Perforation healing was similar in the dry- ear (94.44%) and wet-ear groups (85.7%, P = 0.5685). At 3 months, dry ears were achieved in 94.44% and 92.86% of patients in the dry- and wet-ear groups, respectively (P > 0.05). The air-bone gap (ABG) at 3 months was similar in the dry-ear (9.4047 ± 4.3415 dB) and wet-ear groups (6.5278 ± 5.4552 dB, P = 0.1171). In both groups, the mean air-conduction threshold, bone-conduction threshold, and ABG significantly decreased postoperatively (P < 0.05).</p><p><strong>Conclusion: </strong>Tympanoplasty for TMP in wet ears does not adversely affect healing.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"2"},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928455","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 comparison of post-proximal gastrectomy digestive tract reconstruction methods.","authors":"Yang Xia, Nengquan Sheng, Zhigang Wang, Qingchao Zhu","doi":"10.1186/s12893-024-02748-x","DOIUrl":"10.1186/s12893-024-02748-x","url":null,"abstract":"<p><strong>Objective: </strong>Proximal gastrectomy (PG) is commonly used to remove proximal gastric cancer leading to gastroesophageal reflux and requires digestive tract reconstruction. This study is to compare the performance of esophagogastrostomy (EG), jejunal interposition (JI), and double tract reconstruction (DTR) on post-PG reconstruction effectiveness.</p><p><strong>Methods: </strong>A retrospective study was conducted using the clinical data of 94 PG patients who underwent digestive tract reconstruction by EG (37 patients), JI (29 patients) or DTR (28 patients). The safety of the reconstruction procedure and the incidence of surgical complications were evaluated using the Reflux Symptom Index (RSI), Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scale score, gastroscopy, barium meal examination of digestive tract, and 24-h pH monitoring.</p><p><strong>Results: </strong>The DTR group showed significantly lower GERD-Q scores (p < 0.05) and RSI scores (p < 0.05) compared to the EG and JI groups. This indicates that DTR is more effective in preventing reflux esophagitis. The pre- and post-surgical GERD-Q scores assessed by esophageal 24-h pH acidity measurements and Los Angeles Grading were reduced in all patient groups, with the DTR group showing better results than the other two (p < 0.05). The results of the EORTC QLQ-STO22 questionnaire indicated that the DTR group had a higher overall health status score than the other two groups (p < 0.001).</p><p><strong>Conclusion: </strong>EG had a short surgical duration and less bleeding. JI reduced the prevalence of reflux esophagitis. DTR presented improved prevention of reflux esophagitis and enhanced quality of life.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928483","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":"Mid-term outcomes of moderate-severe cystocele repairing with autologous fascia lata harvested through a small incision.","authors":"Bo Yu, Junfang Yang, Qingyang Nie, Kun Zhang, Jinsong Han, Yiting Wang","doi":"10.1186/s12893-024-02742-3","DOIUrl":"10.1186/s12893-024-02742-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To investigate the mid-term outcomes of transvaginal repair for moderate-severe cystocele using autologous fascia lata harvested through a single small incision.</p><p><strong>Methods: </strong>Between February and October 2022, 35 patients with moderate to severe cystocele undergoing transvaginal repair with autologous fascia lata were included. Patient demographics and perioperative data were collected, with follow-ups through outpatient visits or phone calls. Patients were evaluated by subjective perception of vaginal bulging, physical examination, Pelvic Floor Distress Inventory (PFDI-20) Questionnaire, patient satisfaction, Patient Global Impression of Improvement (PGI-I) scores, regret rate, willingness to recommend, complications, and harvesting site issue.</p><p><strong>Results: </strong>The patient's mean age was 60.44 ± 6.01 years. Fascia lata harvesting took 32.92 ± 19.72 min, reconstruction surgery lasted 141.21 ± 37.89 min. Follow-up duration was 15.94 ± 2.46 months. 5.7% (2/35) of the patients reported a non-interfering vaginal bulge not requiring treatment. Objective recurrence rate was 4.26% (1/24, Aa or Ba>0) PFDI-20 was significantly improved (P < 0.0001). All 35 patients (100%) were highly satisfied, with PGI-I score very much improved or improved. No patient regretted. 97.14% (34/35) would recommend the procedure. One patient developed poor wound healing at the vaginal apex. One patient developed thromboembolic event. Harvest site: 2.86% (1/35) developed a non-bothersome thigh bulge, 17.14% (6/35) noted an impact on wound appearance, and 8.57% (3/35) reported mild paresthesia.</p><p><strong>Conclusion: </strong>Autologous fascia lata for cystocele treatment shows promising mid-term outcomes, safely and effectively enhancing QoL with high satisfaction. Despite concerns about leg scarring, no patient regretted and would recommend the procedure. Long-term outcomes require larger follow-up studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"427"},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907648","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}