BMC Surgery最新文献

{"title":"Advanced age is significantly associated with poor outcomes of thoracic endovascular aortic repair: a systematic review and meta-analysis.","authors":"Jiajun Li, Peilin Zou, Yongzhi Zhou, Jing Wang, Yucong Zhang, Xinyu Tan, Man Liu, Min Hu","doi":"10.1186/s12893-025-02990-x","DOIUrl":"https://doi.org/10.1186/s12893-025-02990-x","url":null,"abstract":"<p><strong>Background: </strong>Whether advanced age is a risk factor for poor outcomes of thoracic endovascular aortic repair (TEVAR) remains unclear. This study aimed to evaluate the association between advanced age and outcomes after TEVAR.</p><p><strong>Methods: </strong>To identify studies regarding TEVAR and age, the PubMed and Web of Science databases were systematically searched in July 2023. The associations between advanced age and outcomes of TEVAR for individuals with any types of thoracic aortic diseases were assessed according to the odds ratio (OR) or hazard ratio (HR). The ages of patients who suffered from adverse events after TEVAR were also compared. Study quality was assessed by using the Newcastle‒Ottawa Scale.</p><p><strong>Results: </strong>A total of 70 studies with 52,605 patients were included in this meta-analysis. All enrolled studies were considered high-quality. Overall, advanced age was significantly associated with higher risk of postoperative mortality (p < 0.0001) and neurological complications (p = 0.006), especially delirium (p = 0.009), spinal cord ischemia (p = 0.02) and overall neurological complications (p = 0.007). Notably, the age of patients experiencing postoperative stroke was slightly older than those did not (p = 0.05). However, advanced age was not significantly associated with an elevated risk of postoperative overall complications (p = 0.59) or adverse aortic remodeling events (p = 0.34), including aortic dilation (p = 0.43) or false lumen dilation (p = 0.52). Moreover, patients who experienced acute kidney injury after TEVAR were significantly younger than those who did not (p = 0.04).</p><p><strong>Conclusion: </strong>Advanced age is associated with poor outcomes of TEVAR, including postoperative mortality and neurological complications, though overall complications and aortic remodeling outcomes are similar. Additionally, AKI was even more frequent in younger patients. It is important to evaluate risk and benefit before deciding to perform TEVAR on older patients. Optimized peri-operative management should be developed and provided for older patients.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"289"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565434","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":"The BMI impact on thyroidectomy-related morbidity; a case-matched single institutional analysis.","authors":"Sascha Vaghiri, Jasmin Mirheli, Dimitrios Prassas, Stephen Fung, Sami Alexander Safi, Georg Fluegen, Wolfram Trudo Knoefel, Levent Dizdar","doi":"10.1186/s12893-025-03018-0","DOIUrl":"https://doi.org/10.1186/s12893-025-03018-0","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with an increased risk of postoperative morbidity. We aimed to analyze the impact of BMI on surgical complications in patients undergoing thyroidectomy.</p><p><strong>Methods: </strong>This retrospective study was conducted in a single academic center. A total of 484 patients with open total thyroidectomy were considered eligible. These patients were divided in the non-obese (BMI < 30 kg/m²) and obese (BMI ≥ 30 kg/m²) groups. A 1:2 case matching based on demographic (age and gender) and clinical (benign/malignant disease) variables was performed to generate homogenous study groups. A comparative analysis was carried out to show the differences between the two groups in terms of the occurrence of surgery-related outcomes.</p><p><strong>Results: </strong>After case matching, 193 non-obese and 98 obese patients were included in the final analysis. There was no statistically significant difference in the rate of primary outcomes in the non-obese and obese groups: hypoparathyroidism (transient: 29% versus 21.4%, p = 0.166; permanent: 11.4% versus 15.3%, p = 0.344, respectively) and recurrent laryngeal nerve palsy (transient: 13.9% versus 11.2%, p = 0.498; permanent: 3.1% versus 2.0%, p = 0.594, respectively). A BMI ≥ 30 kg/m² was associated with a significantly longer operative time (p = 0.018), while other secondary outcomes were not significantly affected by BMI.</p><p><strong>Conclusions: </strong>Despite prolonged operative times in obese patients, total thyroidectomy could be performed safely and without increased risk of surgery-related morbidity, regardless of BMI.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"286"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565354","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 factors influencing post-appendectomy outcomes in adults: a single-center prospective study in the North of Palestine.","authors":"Alaa Zayed, Khaled Demyati, Abdulsalam Alkaiyat, Alaa Omari, Eliana Masri, Zain Saqfalhait, Yazan N A Abdallah, Obayda Darawsha, Mohammed Hajhamad","doi":"10.1186/s12893-025-03007-3","DOIUrl":"https://doi.org/10.1186/s12893-025-03007-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute appendicitis is one of the most common surgical emergencies, predominantly affecting young adults who form the backbone of the workforce. While its diagnosis and treatment are well-studied, limited research exists on the perioperative factors affecting post-operative outcomes and health-related quality of life in resource-limited settings like Palestine. Understanding these factors is essential to enhance patient care and recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, single-center observational study was conducted at Secondary Surgical Hospital, Nablus, Palestine, from April 2021 to February 2022. Patients aged ≥ 18 years diagnosed with acute appendicitis and treated surgically were included. Data were collected using structured forms covering preoperative (sociodemographics, clinical characteristics, imaging, and laboratory findings), intraoperative (timing, technique, and surgical findings), and postoperative (pain using Visual Analogue Scale), complications, and Health-Related Quality of Life using European Quality of Life-5 Dimensions-3 Levels variables. Follow-ups were conducted at discharge, one week, and two weeks post-surgery. Statistical analyses were performed using SPSS, with p &lt; 0.05 considered significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ninety-three patients participated, with a mean age of 31.14 years (63.4% ≤ 31 years, 65.6% male). Sociodemographic factors, including smoking (41.9%), educational level (76.4% grade 12 or less), and COVID-19 history (18.3%), were significantly associated with post-operative outcomes. Complicated appendicitis was observed in 43.3% of cases, particularly in older patients and those with delayed presentation (&gt; 48 h, 16.3%). Pain was assessed postoperatively with scores that were significantly higher in females (VAS &gt; 7, p &lt; 0.001) and showed gradual improvement within 24 h post-surgery. Health-Related Quality of Life improved significantly over two weeks, with the European Quality of Life-5 Dimensions-3 Levels index rising from 0.569 at discharge to 0.827 at two weeks. Gender, age, and delayed presentation were strongly associated with worse outcomes, including increased anxiety, reduced mobility, and prolonged recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Perioperative factors such as age, gender, smoking, educational level, and pre-hospital delay significantly impact pain and HRQoL after appendectomy. Females and older patients experienced worse outcomes, highlighting the need for tailored care. These findings underscore the importance of addressing sociodemographic disparities and optimizing perioperative management. Tailored surgical planning should prioritize early intervention in high-risk groups such as females, older adults, and patients with delayed presentation to reduce complications and improve recovery. Furthermore, the significant role of anxiety and depression in post-operative outcomes suggests that stress-reduction strategies and ment","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"290"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565353","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":"Evaluation of the effectiveness of preoperative 3D reconstruction combined with intraoperative augmented reality fluorescence guidance system in laparoscopic liver surgery: a retrospective cohort study.","authors":"Peiwei Wang, Shaofan Wang, Peng Luo","doi":"10.1186/s12893-025-02989-4","DOIUrl":"https://doi.org/10.1186/s12893-025-02989-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of preoperative 3D reconstruction combined with intraoperative augmented reality fluorescence guidance system in laparoscopic liver surgery by establishing a retrospective cohort study.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from March 2023 to December 2024, with patients' data from the medical record system. Patients were divided into two groups according to their surgical protocols: 46 cases in the control group (conventional laparoscopic liver surgery) and 50 cases in the observation group (preoperative 3D reconstruction combined with intraoperative augmented-reality fluorescence guiding system in laparoscopic liver surgery). We compared perioperative indexes (operation time, intraoperative bleeding, time to first flatus, drainage tube removal time, hospitalization time), preoperative and postoperative liver function indexes [alanine aminotransferase (ALT), albumin (ALB), total bilirubin (TBIL)], stress indexes [angiotensin II (AT II), norepinephrine (NE), epinephrine (AD)], and complication rates between the two groups.</p><p><strong>Results: </strong>The operation time of patients in the observation group was shorter than that of patients in the control group (110.75 ± 20.56 vs. 122.35 ± 20.48 min, 95% CI of difference: 2.52-20.68 min, p = 0.013), and the amount of intraoperative bleeding was less (300.80 ± 32.70 vs. 320.76 ± 35.84 mL, 95% CI of difference: 7.62-32.30 mL, p = 0.002). There was no statistically significant difference in the comparison of time to first flatus, drain removal time, hospitalization time and complication rate between the two groups (p > 0.05). Preoperatively, the comparison of ALT, ALB, TBIL, AT II, NE, AD levels of patients in the two groups were not statistically significant (p > 0.05); postoperatively, the AT II, NE, AD levels of patients in the observation group were lower than those of patients in the control group, with statistically significant differences (p < 0.001), while the differences in ALT, ALB, TBIL levels were not statistically significant (p > 0.05). For malignant cases, the R0 resection rate was similar between groups (92.3% vs. 89.5%, p = 0.724).</p><p><strong>Conclusion: </strong>Preoperative 3D reconstruction combined with intraoperative augmented reality fluorescence guidance system is potentially beneficial for laparoscopic liver surgery, which can modestly shorten the operation time, reduce intraoperative bleeding, and alleviate postoperative stress reactions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"288"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565435","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":"Individualized surgical management of supratentorial hypertensive intracranial hemorrhage: a retrospective study using 3D Slicer and diffusion tensor imaging.","authors":"Haifeng Lin, Haiyan Zhao, Jianmin Wang, Enqi Wu, Taiping An","doi":"10.1186/s12893-025-03008-2","DOIUrl":"https://doi.org/10.1186/s12893-025-03008-2","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the outcomes of individualized surgical interventions tailored to patients with non-traumatic supratentorial intracranial hemorrhage.</p><p><strong>Methods: </strong>A retrospective cohort study reviewed patients with intracranial hemorrhage who underwent surgical intervention between January 2020 and December 2023. All patients received pre- and post-operative brain computed tomography scans. Three-dimensional (3D) anatomical models of the brain and hematoma were generated using the 3D Slicer software to determine the optimal surgical trajectory in most patients. In addition, some patients underwent magnetic resonance diffusion tensor imaging. Surgical strategies for hematoma evacuation were selected based on each patient's neurological status, hemorrhage location, and hematoma volume. Post-operative neurological function was assessed using the modified Rankin scale.</p><p><strong>Results: </strong>A total of 196 patients were included in the study. Among them, 97 patients underwent surgical drilling with catheter drainage, 37 patients received small bone window craniotomy with hematoma removal via the Sylvian fissure, 6 patients underwent neuroendoscopic hematoma evacuation, 31 patients received small bone window craniotomy via the cortex, and 25 patients underwent lateral ventricular puncture with drainage. The proportion of patients with an mRS score ≤ 3 was 48.0% at three months and 70.3% at one year post-operatively. Compared with patients who underwent conventional drilling and hematoma drainage, those who received hematoma evacuation guided by 3D Slicer modeling demonstrated better neurological function at three and twelve months post-operatively. Post-operative measurements of the posterior limb of the internal capsule were significantly higher than pre-operative measurements, indicating improved microstructural integrity of white matter tracts and enhanced neurological function. The incidences of post-operative re-bleeding and infection were low, at 2.5% and 1.0%, respectively.</p><p><strong>Conclusions: </strong>Individualized surgical management, considering patient neurological status, hemorrhage location, and hematoma volume, and utilizing 3D Slicer modeling and diffusion tensor imaging analysis, should be considered for hematoma evacuation in patients with supratentorial intracranial hemorrhage.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"284"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561705","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":"The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome.","authors":"Julia Zimmermann, Julia Walter, Mircea Gabriel Stoleriu, Julia Kovács, Gökce Yavuz, Fuad Damirov, Niels Reinmuth, Martina Merk, Rudolf A Hatz, Amanda Tufman, Christian P Schneider","doi":"10.1186/s12893-025-02995-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02995-6","url":null,"abstract":"<p><strong>Backgrounds: </strong>Lung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment.</p><p><strong>Methods: </strong>This retrospective study reviewed data from all lung cancer patients who underwent lobectomy or segmentectomy at the Lung Cancer Center Munich between 2011 and 2020. We compared numerical outcomes between patients with minimally invasive surgery and patients with thoracotomy using t-test, and categorical outcomes using Chi2-test or fishers exact test when cell counts were < 6. We used multivariate Cox Regression to model the association between comorbidities and overall survival.</p><p><strong>Results: </strong>1658 patients (556 minimally invasive,1102 thoracotomy) were included. Across the entire population the comorbidity with the strongest association to death was chronic lymphatic leukemia (HR = 5.15, p = < 0.001), followed by pulmonary fibrosis (HR = 4.06, p = < 0.001), mild liver disease (HR = 2.18, p = 0.02), peripheral arterial disease (HR = 1.48, p = 0.04) and chronic obstructive pulmonary disease (HR = 1.42, p = < 0.01). In the minimally invasive surgery group chronic lymphatic leukemia was most strongly associated with death (HR = 14.31, p = 0.01). This was followed by mild liver disease (HR = 5.01, p = 0.01) and myocardial infarction (HR = 2.45, p = 0.04). Whereas in the thoracotomy group the strongest associations were fibrosis (HR = 4.20, p = < 0.001) and COPD (HR = 1.51,p = < 0.01).</p><p><strong>Conclusion: </strong>Most of the comorbidities analyzed do not have a major impact on all-cause mortality after lung surgery. Those that do have a high impact tend to have a very low prevalence.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"285"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565355","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":"Morphological predictors of lymph node metastasis in early gastric cancer.","authors":"Halil Alper Bozkurt, Leman Damla Ercan, Inan Guden, Melek Buyuk, Mehmet Ilhan, Ali Fuat Kaan Gok, Mustafa Kayihan Gunay","doi":"10.1186/s12893-025-03019-z","DOIUrl":"https://doi.org/10.1186/s12893-025-03019-z","url":null,"abstract":"<p><strong>Background: </strong>The ability to predict the presence of lymph node metastasis has gained significant importance in recent years due to changes in treatment strategies. Ensuring the absence of lymph node metastasis is crucial in the management of early gastric cancer. This consideration can help avoid radical treatments and facilitate organ-sparing approaches. This study aimed to retrospectively evaluate early gastric adenocarcinoma (T1a-b) cases treated with radical surgery and identify the factors that affect lymph node metastasis.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 360 patients who underwent surgery for gastric adenocarcinoma were reviewed, and 41 patients diagnosed with early gastric cancer were included in the study. The relationship between patient age, gender, tumor stage, tumor size, tumor location, histological subtype, lymphovascular invasion, perineural invasion, ulceration, tumor-infiltrating lymphocytes, and lymph node metastases was analyzed. A cumulative risk score was developed using significant predictors to stratify patients into risk groups.</p><p><strong>Results: </strong>The study cohort consisted of 41 patients, with a mean age of 63 years and 66% male. Notably, none of the 14 patients with T1a exhibited lymph node metastasis, whereas 10 of 27 (37%) patients with T1b presented with lymph node metastasis. Univariate analysis revealed that tumor stage (p = 0.009), tumor differentiation (p = 0.043), and lymphovascular invasion (p = 0.006) were significant predictors of lymph node metastasis. Multivariate analysis identified a significant association between lymphovascular invasion (p = 0.024) and tumor size (p = 0.05) with lymph node metastasis. The proposed risk scoring system effectively stratified patients into low, intermediate, and high-risk groups.</p><p><strong>Conclusion: </strong>Examination of radical surgical specimens suggests that organ-preserving methods based on expanded ESD criteria could be a viable option for our population. Tumor stage, histological subtype, tumor size, and lymphovascular invasion were identified as factors influencing the incidence of lymph node metastasis, with tumor stage and lymphovascular invasion emerging as primary determinants. The exploratory scoring model may aid in risk-based clinical decision-making, particularly in selecting candidates for non-surgical treatment.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"287"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management and outcomes of corrosive esophageal injuries: a prospective study from Sana'a, Yemen.","authors":"Mohammed Mohammed Al-Shehari, Yasser Abdurabo Obadiel, Ahmed Hamood Al-Helali, Haitham Mohammed Jowah","doi":"10.1186/s12893-025-03027-z","DOIUrl":"https://doi.org/10.1186/s12893-025-03027-z","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"272"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561722","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":"Clinical application of preoperative volumetric measurement for interventional precise embolization in the treatment of hypersplenism caused by liver cirrhosis.","authors":"Yin-Bao Hu, Lei Duan, Guang-Yu Liu, Xiao-Ming Wang","doi":"10.1186/s12893-025-03028-y","DOIUrl":"10.1186/s12893-025-03028-y","url":null,"abstract":"<p><strong>Objective: </strong>Volume measurement software is not routinely utilized in clinical practice before splenic artery embolization. To explore the function of such software measurement in this context, we conducted a retrospective study.</p><p><strong>Methods: </strong>We divided patients into two groups: 38 patients in Group A underwent three-dimensional reconstruction using Revolution CT, and 37 patients in Group B underwent imaging with normal CT technology. We compared the changes in liver function test results and haematological parameters between these two groups.</p><p><strong>Results: </strong>A total of 75 patients who underwent splenic artery embolization from January 2018 to January 2023 were included. The preoperative baseline data were not significantly different (all P values > 0.05). Both groups showed improvements in liver function and hypersplenism-related parameters. Within 2 weeks after surgery, Group A had significantly greater WBC (5.54 ± 1.92 × 10^9/L) and PLT (65.80 ± 20.12 × 10^9/L) counts than Group B (WBC: 4.14 ± 1.96 × 10^9/L; PLT: 52.70 ± 14.78 × 10^9/L; P < 0.05), indicating better control of hypersplenism. At 2 months postintervention, Group A demonstrated more favourable improvements in postintervention splenic volume (reduced from 1045 ± 122.9 cm³ to 489.5 ± 84.93 cm³), portal vein diameter (from 1.51 ± 0.19 cm to 1.28 ± 0.13 cm), and portal vein flow velocity (increased from 17.70 ± 5.25 cm/s to 23.56 ± 6.40 cm/s) than Group B. Moreover, a 53.2% splenic volume reduction was noted in Group A, which was significantly greater than the 31.4% reduction in Group B. Additionally, Group A had fewer adverse reactions, with lower liver/gastrointestinal toxicity (χ²=4.242, P = 0.039) and fever severity (χ²= 4.805, P = 0.028).</p><p><strong>Conclusions: </strong>This study suggests that using Revolution CT prior to splenic artery embolization provides an effective method for managing hypersplenism, enhancing liver function, and reducing the risk of complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"270"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561658","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":"Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery.","authors":"Linjiang Yang, Liang Zhong, Xu Deng, Hao Fang, Siqin Li, Yi Li","doi":"10.1186/s12893-025-03017-1","DOIUrl":"10.1186/s12893-025-03017-1","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopy, a minimally invasive gynecological procedure, requires effective sedation for patient comfort and surgical success. Remimazolam Besylate, a new ultra-short-acting benzodiazepine, offers potential for safe sedation, but the optimal dose for postoperative outcomes is unclear. This study evaluated the effects of different doses of Remimazolam Besylate on postoperative sedation, pain, and adverse reactions in hysteroscopic surgery patients.</p><p><strong>Methods: </strong>From June 2020 to June 2022, 90 patients undergoing hysteroscopic surgery under general anesthesia were randomly divided into three subgroups (A, B, C; n = 30 each). Subgroup A received 0.2 mg/kg, Subgroup B received 0.3 mg/kg, and Subgroup C received 0.4 mg/kg of Remimazolam Besylate intravenously during anesthesia induction. Postoperative outcomes, including pain stress mediators (PGE2 and 5-HT), Pain Visual Analogue Scale (VAS) scores, Ramsay Sedation scores, and adverse events, were compared among the subgroups.</p><p><strong>Results: </strong>Subgroup A (0.2 mg/kg) showed significantly higher levels of PGE2 and 5-HT at 2, 12, and 24 h postoperatively compared to Subgroups B (0.3 mg/kg) and C (0.4 mg/kg). VAS scores at 2 and 12 h were higher in Subgroup A, while Ramsay Sedation scores were lower. Subgroup C had a significantly higher incidence of adverse reactions compared to Subgroups A and B.</p><p><strong>Conclusion: </strong>Remimazolam Besylate at a dose of 0.3 mg/kg is optimal for anesthesia induction in hysteroscopic surgery, providing effective sedation, reduced postoperative pain, and a lower incidence of adverse reactions compared to higher doses. This dose is recommended for achieving balanced sedation and safety outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"278"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561700","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}