BMC Surgery最新文献

{"title":"Comparison of laparoscopic totally extraperitoneal repair with adjunct techniques and open surgery (TREPP) in female patients with incarcerated femoral hernia: a single-center retrospective cohort study.","authors":"An Zhang, Haisong Xu, Wenhao Huang, Peng Zhang, Yuehua Guo, Tianchong Wu","doi":"10.1186/s12893-025-03189-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03189-w","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"472"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276341","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":"One anastomosis gastric bypass (OAGB): a scoping review.","authors":"Jesús Elías Ortíz-Gómez, Alberto Iván González-Barajas, Jorge Alberto Guevara-Díaz, Javier Mancilla-Galindo, Ashuin Kammar-García, Manuel Alberto Guerrero-Gutierrez","doi":"10.1186/s12893-025-03215-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03215-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity has become a global health crisis, with bariatric surgery being among the most effective interventions for treatment-resistant obesity. One Anastomosis Gastric Bypass (OAGB) has gained popularity for its technical simplicity and promising outcomes. However, concerns remain regarding long-term complications, especially bile reflux and gastroesophageal reflux disease (GERD). This scoping review aimed to synthesize the current literature on OAGB, focusing on four domains: percentage excess weight loss (%EWL), remission of metabolic and cardiovascular conditions, postoperative complications, and incidence of GERD.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, and Web of Science (May 2025). We included randomized and non-randomized trials, systematic reviews, meta-analyses, and observational studies that reported at least one of the target outcomes in adults undergoing OAGB. Case reports, narrative reviews, case series, and retracted studies were excluded. Screening was performed using the Active Learning for Systematic Reviews (ASReview) tool. Data were charted narratively and summarized in tables. Definitions of outcomes and surgical variations were recorded where available. Risk of bias in novel randomized controlled trials was assessed using Cochrane's RoB 2.0 tool.</p><p><strong>Results: </strong>Sixty-seven studies were included out of 3791 records screened. OAGB showed higher or comparable %EWL versus Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and SADI-S, particularly in short- and mid-term follow-up. However, there was significant variability in how %EWL was defined and calculated, including inconsistent or absent definitions of ideal weight. Type 2 diabetes remission ranged from 76.8 to 100%, with meaningful improvements in hypertension, dyslipidemia, and obstructive sleep apnea. GERD incidence varied and was influenced by limb length, presence of hiatal hernia, and surgical technique. Longer biliopancreatic limbs enhanced weight loss but increased nutritional risk. Definitions and reporting of complications varied significantly.</p><p><strong>Conclusions: </strong>OAGB is an effective metabolic and bariatric procedure with favorable outcomes in weight loss and disease remission. However, heterogeneity in surgical techniques, outome definitions, and limited follow-up time to assess long-term outcomes emphasize the need for standardized reporting and further high-quality long-term studies to guide patient selection and decision making.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"471"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276330","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":"Continuity of outcome assessment throughout the lifecycle of surgical research: mapping core outcome domains measured in early phase and late phase studies.","authors":"Christin Hoffmann, Emma Sewart, Susanna Dodd, Sarah L Gorst, Jane M Blazeby, Kerry N L Avery, Shelley Potter, Rhiannon C Macefield","doi":"10.1186/s12893-025-03209-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03209-9","url":null,"abstract":"<p><strong>Background: </strong>Consistent outcome assessment in surgical research, from early phase studies (during introduction and refinement of new procedures) to late phase studies (to establish comparative effectiveness) needs improvement to ensure efficient and safe surgical care. This study explored the potential continuity of outcome domain assessment throughout the evaluation lifecycle of surgical interventions.</p><p><strong>Methods: </strong>Core outcome sets (COS) for late phase studies of surgical interventions were identified through COMET database searches. Core outcomes/outcome domains were extracted and mapped to core domains of a COS developed specifically for evaluating surgical innovation (COHESIVE COS). Outcomes/domains were categorised as \"definite match\" (clear similarity), \"possible match\" (potential similarity) and \"no match\" (no similarity) COHESIVE domain based on similarity in wording or meaning.</p><p><strong>Results: </strong>A total of 54 COS studies were included, yielding 573 core outcomes/domains. Most late phase core outcomes/domains (N = 519, 91%) showed clear or possible similarity. All late phase COS studies recommended measurement of COHESIVE domains 'Intended benefits' and 'Expected and unexpected disadvantages'. Some late phase outcomes/domains also showed similarity with early phase COHESIVE domains, including 'Problems with the device working', 'Patients' experience' and 'Operators'/surgeons' experience'. A minority of late phase outcomes/domains showed no similarity with COHESIVE domains (n = 54, 9%).</p><p><strong>Conclusion: </strong>High similarity between outcome domains recommended in early and late phase evaluations of surgical interventions demonstrates continuity of outcome domain assessment throughout the surgical innovation lifecycle is possible. Harmonising outcome measurement throughout the research pathway can streamline evaluation, enhancing access to beneficial treatment and improving early detection of harms.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"473"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276354","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":"Improvements in cholesterol efflux capacity of HDL after bariatric surgery in patients with obesity: a meta-analysis.","authors":"Tannaz Jamialahmadi, Elaheh Mirhadi, Željko Reiner, Saheem Ahmad, Bodor Bin Sheeha, Safia Obaidur Raba, Wael Almahmeed, Amirhossein Sahebkar","doi":"10.1186/s12893-025-03233-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03233-9","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"474"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified ureteroileal anastomosis can reduce the incidence of ureteroileal anastomotic stricture.","authors":"Shijie Zhang, Hao Liang, Lei Liu, Peixin Li, Qingya Yang, Sifeng Qu, Jingchao Liu, Benkang Shi, Nianzhao Zhang, Jun Chen","doi":"10.1186/s12893-025-03226-8","DOIUrl":"10.1186/s12893-025-03226-8","url":null,"abstract":"<p><strong>Background: </strong>Ileal conduit is widely used as a urinary diversion procedure after radical cystectomy. However, ureteroileal anastomotic stricture (UIAS) remains a threatening complication. Here we introduce a novel technique, Chen ureteroileal anastomosis, and compare its postoperative complications to Bricker anastomosis, with a specific focus on the incidence of UIAS.</p><p><strong>Methods: </strong>A rat model was established to investigate morphological and histological alterations of the ileum in urine-stimulated environment. A double-center retrospective cohort of 124 patients undergoing laparoscopic radical cystectomy with ileal conduit between February 2017 to December 2023 was analyzed. All surgeries were performed by a regular surgical team. The demographic characteristics, clinicopathological characteristics, perioperative indicators, and postoperative complications between the two groups were recorded, assessed and compared by an independent committee.</p><p><strong>Results: </strong>Following long-term exposure to urine, the muscular layer of the rat ileum underwent thinning and fibrosis. The two groups were comparable in all demographic and clinicopathological variables. No significant differences were observed in terms of operation time, transfusion rate, length of stay and follow-up time. Median follow-up time was 35 months (IQR, 24-42) in the Chen group and 38 months (IQR, 26-48) in the Bricker group. The rate of UIAS was significantly lower in the Chen group (1.7% vs. 13.6%, p = 0.036, 95%CI: -0.208, -0.030). Other complications were comparable.</p><p><strong>Conclusions: </strong>In this study, we observed that Chen ureteroileal anastomosis significantly reduced the incidence of UIAS compared with Bricker ureteroileal anastomosis. No difference was observed in other postoperative complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"462"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259695","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 meta-analysis of efficacy and safety of parietal pleurectomy versus pleural abrasion in treating spontaneous pneumothorax.","authors":"Kai Yang, Chen Wang, Qi Wang, Yongzhi Liu, Wei Cao, Jinlong Zhang, Haochi Li, Dacheng Jin, Yunjiu Gou","doi":"10.1186/s12893-025-03157-4","DOIUrl":"10.1186/s12893-025-03157-4","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"464"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259783","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":"Nomogram predictive model for the incidence and risk factors of persistent fever after cardiovascular surgery.","authors":"Feng Zang, Guangxu Mao, Ziyao Quan, Yongfeng Shao, Sheng Zhao, Liyun Wang, Zhanjie Li, Zhongqiu You, Lu Liu, Wensen Chen","doi":"10.1186/s12893-025-03161-8","DOIUrl":"10.1186/s12893-025-03161-8","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"466"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259711","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":"Development and validation of a nomogram for predicting 30-day major complications in elderly patients undergoing major abdominal surgery.","authors":"Maimaiti Mijiti, Tingting Yuan, Kurexi Adilai, Taati Zhaenhaer, Rui Yan","doi":"10.1186/s12893-025-03227-7","DOIUrl":"10.1186/s12893-025-03227-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors related to postoperative major complications in elderly patients undergoing major abdominal surgery, and to construct and validate a nomogram risk prediction model.</p><p><strong>Methods: </strong>This study analyzed data from 380 elderly patients who underwent major abdominal surgery at the Affiliated Cancer Hospital of Xinjiang Medical University between April and November 2023. The cohort was randomly divided into training and validation sets. Variable selection was performed using Lasso regression, followed by univariate and multivariate logistic regression to identify predictors of major postoperative complications. A nomogram-based risk prediction model was subsequently developed and its predictive performance rigorously evaluated.</p><p><strong>Results: </strong>This study analyzed clinical data from 370 elderly patients undergoing major abdominal surgery, of whom 104 (28.1%) developed major complications. Patients were randomly divided into training (n = 259) and validation (n = 111) cohorts in a 7:3 ratio. Using Lasso regression followed by univariate and multivariate logistic regression, gender, ASA classification, CFS, and CCI were identified as significant predictors of major postoperative complications (p < 0.05). The predictive model demonstrated strong performance, with AUCs of 0.884 (95%CI: 0.840-0.929) in the training cohort and 0.855 (95%CI: 0.784-0.927) in the validation cohort.</p><p><strong>Conclusion: </strong>This model is helpful for the clinical prediction of major postoperative complications in elderly patients undergoing major abdominal surgery and assists clinicians in choosing individualized treatment plans to reduce the incidence of serious complications and improve the quality of postoperative recovery of patients.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"463"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259722","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":"Development and validation of an interpretable shap-based machine learning model for predicting postoperative complications in laryngeal cancer.","authors":"Changling Li, Chenyang Xu, Jinzhuang Xu, Wenhua Song, Zhenbin Yu, Ziwei Zhang, Dongmin Wei, Wenming Li, Ye Qian, Dapeng Lei","doi":"10.1186/s12893-025-03213-z","DOIUrl":"10.1186/s12893-025-03213-z","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative complications remain a major concern in laryngeal cancer surgery, often requiring invasive interventions or intensive care. This study aimed to develop and validate an interpretable machine learning (ML) model to preoperatively predict Clavien-Dindo Grade ≥ III complications and support risk-informed perioperative decision-making.</p><p><strong>Methods: </strong>We conducted a retrospective study using a temporally split cohort of laryngeal cancer patients. Postoperative complications were graded using the Clavien-Dindo (CD) classification. Eight ML algorithms were trained and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Model interpretability was assessed using SHapley Additive exPlanations (SHAP). A web-based calculator was deployed for clinical use.</p><p><strong>Result: </strong>The random forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.935 in the training set and 0.842 in the test set. The model demonstrated robust sensitivity and specificity for both surgical and medical complications. Calibration curves indicated strong agreement between predicted and actual outcomes. SHAP analysis identified eight key predictors-such as vocal cord mobility, tumor subsite, and nutritional status-that contributed most to risk estimation. A user-friendly web calculator was developed and is accessible at: https://qilushiny.shinyapps.io/qilupredicate/ .</p><p><strong>Conclusion: </strong>We developed a clinically interpretable ML model that accurately predicts major postoperative complications in patients undergoing laryngeal cancer surgery. This tool provides individualized risk assessments that can guide surgical planning, optimize perioperative strategies, and enhance shared decision-making. Prospective multicenter validation is needed to confirm its utility in routine practice.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"469"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259747","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":"Degenerative lumbar spinal stenosis with osteoporotic vertebral fracture involving endplate: a retrospective study.","authors":"Qiang Zhang, Zhe Chen, Yazhou Lin, Jianru Qiu, Libo Xu, Wenjian Wu, Yu Liang","doi":"10.1186/s12893-025-03145-8","DOIUrl":"10.1186/s12893-025-03145-8","url":null,"abstract":"<p><strong>Objective: </strong>Degenerative lumbar spinal stenosis (LSS) accompanied by osteoporotic vertebral fractures (OVFs) involving the endplate is relatively uncommon and presents therapeutic challenges. This study aims to evaluate the clinical outcomes of surgical treatment in such cases.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on nine patients diagnosed with LSS and endplate-involved OVFs who underwent surgery at Ruijin Hospital between July 2015 and December 2022. Patients received either decompression with kyphoplasty or fusion with kyphoplasty. All patients were followed for a minimum of 12 months. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) scores. Radiographic evaluations, including X-rays and CT scans, were used to assess implant stability, cage subsidence, and fusion status.</p><p><strong>Results: </strong>The study included 1 male and 8 female patients, aged 72 to 81 years (mean: 76.3 ± 5.2 years). Two patients underwent decompression and kyphoplasty, six underwent fusion and kyphoplasty, and one patient received posterolateral fusion and kyphoplasty due to an enlarged disc space and cage instability. Significant postoperative improvements in VAS and JOA scores were observed and maintained throughout the follow-up period. Radiological follow-up exceeding 12 months revealed no intervertebral height loss or segmental instability in patients who underwent decompression and kyphoplasty. All patients in the fusion group achieved successful fusion without notable complications such as implant loosening or cage subsidence. The patient who underwent posterolateral fusion also experienced no complications, including screw loosening, vertebral height loss, or hardware failure.</p><p><strong>Conclusion: </strong>Degenerative LSS combined with OVF involving the endplate is a complex clinical condition. Both decompression with kyphoplasty and fusion with kyphoplasty are effective surgical strategies, providing significant and sustained clinical improvement.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"459"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259757","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}