BMC Surgery最新文献

{"title":"Comparative outcomes of proximal femur intramedullary nailing vs. cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in patients aged 75 and older: analysis of risk factors for postoperative all-cause mortality.","authors":"Yan Deng, Xiang-Ping Zhou, Bin Sun, Guo-Hui Li, Zuo-Ming Tong","doi":"10.1186/s12893-025-02866-0","DOIUrl":"https://doi.org/10.1186/s12893-025-02866-0","url":null,"abstract":"<p><strong>Background: </strong>As the population continues to age, the occurrence of intertrochanteric femoral fractures (IFFs) has steadily increased. The main aims of this investigation were to evaluate and compare the clinical outcomes, ambulatory ability, overall survival, and all-cause mortality between two cephalic screws combined with compression proximal-femoral intramedullary nailing internal fixation (IF) and long-stemmed cemented bipolar hemiarthroplasty (LCHA) in patients aged 75 years and older. The secondary objective was to investigate the relative independent risk factors contributing to postoperative all-cause mortality.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 251 elderly patients with IFF who underwent IF or LCHA between January 2018 and October 2022. We employed generalized estimation equations along with univariate and multivariate analyses to examine the impact of various surgical interventions and other pertinent factors on postoperative ambulatory ability and all-cause mortality outcomes. Associations between sex, age, number of comorbidities, aspartate aminotransferase (AST) levels, total blood transfusions, and mortality were analyzed via Cox proportional hazards models.</p><p><strong>Results: </strong>The analysis included a cohort of 120 patients from the IF group and 121 patients from the LCHA group. Statistically significant differences were not observed in the clinical outcomes, ambulatory ability, overall survival, or all-cause mortality after surgical treatment between the groups receiving IF and LCHA (p > 0.05). Nevertheless, among patients aged ≥ 85 years, the IF group demonstrated a lower rate of all-cause mortality than the LCHA group did (p < 0.05). As age increases and the number of preoperative comorbidities and the amount of perioperative transfusion increase, the preoperative AST level decreases, which is associated with a greater risk of postoperative death. (p < 0.05).</p><p><strong>Conclusions: </strong>In elderly patients aged 75-84 years with intertrochanteric femur fractures, both internal fixation (IF) and long-stemmed cemented hemiarthroplasty (LCHA) are viable treatment options. However, for patients aged 85 years and older, IF is associated with a relatively lower postoperative all-cause mortality rate and should be prioritized as a treatment modality. Additionally, preoperative AST levels may serve as a valuable predictor of postoperative all-cause mortality in elderly patients undergoing surgery for intertrochanteric femur fractures.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"130"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773569","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":"No differences in IVF pregnancy outcomes following hysteroscopic polypectomy using a manual hysteroscopic tissue removal device versus conventional resection.","authors":"Chen Wang, Yangqin Peng, Qinmei Wang, Yu Dong, Huimin Liu, Yaoshan Yao, Yuan Li, Ge Lin, Fei Gong, J Preston Parry, Nigel Pereira, India Morgan, Steven R Lindheim, Hui Chen","doi":"10.1186/s12893-025-02857-1","DOIUrl":"https://doi.org/10.1186/s12893-025-02857-1","url":null,"abstract":"<p><strong>Background: </strong>To compare in-vitro fertilization and embryo transfer (IVF-ET) pregnancy outcomes following endometrial polypectomy using either a manual mechanical hysteroscopic tissue resection device (mHTR) or traditional mechanical resection with scissors or polyp graspers resection.</p><p><strong>Methods: </strong>This retrospective study examined 189 infertile patients who had undergone polypectomy prior to IVF-ET at Reproductive and Genetic Hospital of CITIC-XIANGYA. Patients undergoing polypectomy using manual mHTR resection were compared to those having the procedure through traditional mechanical resection. The primary outcome was clinical pregnancy rate (CPR) following the first ET after hysteroscopic polypectomy. Secondary outcomes included miscarriage rates and the optimal time interval from polyp resection to ET.</p><p><strong>Results: </strong>One-hundred eleven (58.7%) patients underwent polypectomy via manual mHTR while 78 (41.3%) patients underwent traditional mechanical resection for polypectomy. Following the first ET, the positive pregnancy rate (80.2% vs. 79.5%; p = 1.000), CPR (70.3% vs. 74.4%; p = 0.652), and MR (11.5% vs. 12.1%; p = 1.000) were similar between those undergoing mHTR and traditional mechanical resection. After stratifying by the number of menstrual cycles from procedure (after next menses; 2 to 3 menstrual cycles; and > 3 menstrual cycles later), there was no differences in CPR when comparing the time from polypectomy and resection type.</p><p><strong>Conclusion: </strong>This study suggests no differences in IVF pregnancy outcomes following hysteroscopic polypectomy regardless of surgical type using manual mHTR or traditional mechanical resection and the timing from resection.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"128"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773677","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":"Orienting global surgery initiatives toward advancing minimally invasive surgery in Africa: a commentary based on continent-wide reviews.","authors":"Adebayo Falola, Abdourahmane Ndong, Ademola Adeyeye","doi":"10.1186/s12893-025-02863-3","DOIUrl":"https://doi.org/10.1186/s12893-025-02863-3","url":null,"abstract":"<p><p>Surgical care has advanced with the introduction of minimally invasive surgery (MIS) techniques, which have resulted in a reduced length of hospital stay and improved patient outcomes with regard to morbidity, mortality, and aesthetics. Implementation in Africa remains limited due to economic, infrastructural, and training-related issues. Our previous reviews show that adoption of MIS in Africa has been highly variable. Only Egypt and South Africa, for example, have significantly reported robotic surgery programs. Despite present challenges, recent developments show that progress is being made. Advantages of MIS in resource-limited settings include fewer postoperative complications and shorter hospital stays, crucial for African patients who cannot afford unexpectedly extensive postoperative care and are also reliant on daily earnings. In the future, tele-robotic surgery can improve access to surgical care in under-served regions of the continent. Implementation barriers include the high cost of equipment, inadequate healthcare infrastructure, and limited training opportunities. Investment in the development of low-cost innovations, such as MIS equipment suited for resource-limited settings, local manufacturing or assembly of MIS equipment, and the establishment of training programs within the continent, is necessary to overcome these challenges. Policies supporting the integration of MIS into national healthcare plans are also required. The development of more robust MIS programs in Africa will not only enhance surgical care but will also contribute to the improvement of healthcare and economic outcomes across the continent. We present this commentary on the current state, challenges, and opportunities for the wider adoption of MIS across Africa, based on recent continent-wide reviews.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"129"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773678","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 site infection rate in spine surgery, incidence, and risk factors: a ten-year retrospective cohort review in a developing neurosurgical centre.","authors":"Dumura Jeneral Alfin, Danaan Joseph Shilong, Gyang Markus Bot, Wilfred Dengunu Salun","doi":"10.1186/s12893-025-02846-4","DOIUrl":"10.1186/s12893-025-02846-4","url":null,"abstract":"<p><strong>Background/objective: </strong>Surgical site infection (SSI) is the third common complication in spinal surgery and often results in poor clinical outcomes, prolonged hospital stays, and additional costs. This study estimated the incidence of SSI and identified risk factors in spine surgeries done within 10 years.</p><p><strong>Methodology: </strong>This was a retrospective cohort review of all patients who had spine surgery between January 2014 and December 2023. Patients' hospital records were retrieved, and relevant biodata and clinical information were obtained and entered into the Statistical Product and Service Solutions version 25. The incidence of SSI was computed and presented as a percentage, and a multivariable analysis to assess risk factors for SSI was done using the chi-square test and Fisher's exact test. The level of significance was set at a p-value < 0.05 and a 95% Confidence Interval.</p><p><strong>Results: </strong>The incidence of SSI was 11.7%; (24/206), predominantly caused by Staphylococcus Aureus (37.5%,P = 0.01) and largely (70%) occurred among patients admitted ≤ 48 h before surgery. The majority were superficial incisional SSIs (19/24,79.2%). They occurred commonly among patients operated for spondylotic disease (13/67,19.4%) and bacterial spondylitis (one out of the two patients) compared to the other spinal pathologies (p = 0.042). Similarly, infection rates were significantly higher in surgeries performed at the lumbar (14/63,22.2%) and thoracolumbar junction (4/31, 12.9%) compared to the cervical and thoracic spine (p = 0.009). This was found to increase the odds of developing SSI by 2.2 times (odds ratio: 2.20;CI:1.38-3.47, P = 0.001), The median duration of hospital stay was 36.5 days for patients with SSIs versus 23 days for patients without SSI (p = 0.008).</p><p><strong>Conclusion: </strong>This study found a relatively high incidence of SSI, which was predominantly superficial incisional SSI, caused by Staphylococcus Aureus, particularly among patients admitted within 48 h before surgery. Significant risk factors for these infections are patients operated on for spondylotic disease and those who had lumbar or thoracolumbar spine surgeries.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"127"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765573","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 effect of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice.","authors":"Shoulin Zhang, Shaopeng Huang, Zheng Xing, Youwen Song, Fujian Yuan","doi":"10.1186/s12893-025-02807-x","DOIUrl":"10.1186/s12893-025-02807-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice, focusing on improvements in liver function, bile duct patency time, and reduction of postoperative complications.</p><p><strong>Methods: </strong>181 patients with malignant obstructive jaundice were retrospectively selected from a hospital in Ganzhou City, Jiangxi Province, from April 2021 to May 2024, of which 132 underwent routine percutaneous liver puncture biliary drainage and 49 underwent percutaneous liver puncture biliary drainage combined with metal stent implantation as the observation group.</p><p><strong>Results: </strong>The clinical efficacy of the observation group was higher (P < 0.05), and the bile duct patency time was longer (P < 0.05). The AST, ALT, DBIL and TBIL levels were decreased 1 week and 1 month after surgery, and the decrease was more significant in the observation group (P < 0.05). In addition, the incidence of postoperative complications (bile duct infection and electrolyte disturbance) in the observation group was lower (P < 0.05).</p><p><strong>Conclusion: </strong>Percutaneous hepatic puncture biliary drainage combined with metal stent implantation has significant clinical efficacy, which can effectively improve the clinical symptoms of patients, prolong the biliary patency time, reduce the level of bilirubin, promote the improvement of liver function, and lower the incidence of postoperative complications.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"126"},"PeriodicalIF":1.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744367","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":"Comparative efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.","authors":"Shichao Liu, Jingyu Zhou","doi":"10.1186/s12893-025-02856-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02856-2","url":null,"abstract":"<p><strong>Purpose: </strong>Existing studies have suggested that the efficacy and safety of tubular microdiscectomy (TMD) and percutaneous transforaminal endoscopic discectomy (TED) for lumbar disc herniation (LDH) are similar to those of open microdiscectomy (OMD). However, there are no head-to-head randomized controlled trials (RCTs) making indirect or integrated comparisons of the efficacy and safety of TMD and TED for LDH. A network meta-analysis (NMA) of RCTs was used to compare the clinical efficacy and safety of OMD, TMD and TED for LDH in this research.</p><p><strong>Methods: </strong>We systematically searched the Cochrane Library, PubMed, and Embase databases from their inceptions through March 2023 for eligible literature. The following search terms were used: \"transforaminal endoscopic discectomy,\" \"microdiscectomy,\" \"endoscopic,\" \"minimally invasive,\" \"tubular microdiscectomy,\" \"spinal disease,\" and \"randomized clinical trial\". The primary outcomes were the Oswestry disability index (ODI) score and the visual analog scale (VAS) score for leg pain, complications, and reoperation. Direct comparison meta-analyses and NMA were carried out.</p><p><strong>Results: </strong>Eight RCTs (1391 patients) met the inclusion criteria. Pairwise meta-analysis showed that compared to OMD, TED has advantages in terms of VAS score (SMD=-1.10 95% CI - 1.85 to -0.34, P = 0.005) and ODI score (SMD=-5.17 95% CI - 8.04 to -2.31, P = 0.004). In contrast, the comparative analysis revealed no statistically significant differences between TMD and OMD across all outcome measures. By comparing TED to OMD and TMD to OMD, it was found that there was no significant difference in the complication and reoperation rates. NMA indicated that there was no significant difference in any of the outcomes between TED and TMD. Trend analyses of rank probabilities showed the cumulative probabilities of the most effective treatments, as measured by primary outcomes (VAS score, ODI score, reoperation and complication rates), were TED (95%, 77%, 23%, 58%), TMD (4%, 22%, 54%, 36%), and OMD (1%, 1%, 23%, 6%).</p><p><strong>Conclusion: </strong>For LDH, TED outperformed OMD in clinical efficacy, while TMD matched OMD outcomes. All modalities showed similar complication/reoperation rates. Probabilistic analyses revealed TED as preferable for younger patients (enhanced pain control, shorter stays), whereas TMD better suited elderly comorbid patients for reoperation risk mitigation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"125"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744369","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 outcomes of reoperation for congenital mitral valve diseases in children.","authors":"Yixuan Cai, Yaping Shan, Gang Chen, Yaping Mi, Hui Zhong, Huifeng Zhang, Ming Ye","doi":"10.1186/s12893-025-02855-3","DOIUrl":"10.1186/s12893-025-02855-3","url":null,"abstract":"<p><strong>Backgrounds: </strong>We aimed to study the outcomes of mitral valve (MV) reoperations in children with congenital MV diseases and to summarize our treatment experience.</p><p><strong>Methods: </strong>In this single-center retrospective study, we enrolled 24 patients aged < 18 years who underwent MV reoperation from among 265 patients who underwent MV repair between January 2013 and July 2023. MV reoperations were based on the types of MV disease. Cox regressions were used to analyze the risk factors for death and second MV reoperation.</p><p><strong>Results: </strong>A total of 5 patients underwent second MV reoperations. 3 patients experienced early death, and 1 experienced late death. The 3- and 5-year survival rates of the entire cohort were 86.6% ± 7.3% and 72.1% ± 14.5%, respectively. Patients who had the double-orifice MV technique applied during MV reoperation were significantly more prone to receive mechanical MV replacement (P < 0.0001). The use of double-orifice MV technique during MV reoperation was identified as an independent risk factor for second MV reoperation (HR = 8.136, 95%CI = 1.099-60.240; P = 0.040).</p><p><strong>Conclusions: </strong>The reoperation of the MV in children with congenital MV diseases poses a formidable challenge, manifested by a high postoperative mortality rate and re-intervention rate. Patiently and meticulously repair based on the types of MV disease has demonstrated the capacity to enhance and sustain stable valve function and cardiac function in the vast majority of children. The use of the double-orifice MV technique did not achieve ideal therapeutic results in children with complex valve lesions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"121"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732583","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":"Impact of negative lymph node removal on survival in esophageal cancer: a systematic review and meta-analysis.","authors":"Mansour Bahardoust, Seyedmohammadreza Torabi, Danyal Yarahmadi, Mohammad Mahdi Kakoienejad, Fatemeh Abbasi, Mohammadsadra Shamohammadi, Meisam Haghmoradi, Babak Goodarzy, Adnan Tizmaghz","doi":"10.1186/s12893-025-02858-0","DOIUrl":"https://doi.org/10.1186/s12893-025-02858-0","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have reported that a high number of negative lymph nodes (NLNs) removed can be associated with improved survival in esophageal cancer( EC) after surgery; however, the effect size of a high number of removed NLNs on survival rates has been reported to vary, which may be due to the small sample size of early studies. This meta-analysis aimed to evaluate the effect of the high number of NLNs removed on the survival rate of patients with EC after surgery.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases with relevant Mesh terms to find studies that investigated the effect of the number of NLNs resected on the survival of EC patients after surgery until February 17, 2025. This systematic review was conducted based on the PRISMA 2020 checklist. Cochran's I² was used to evaluate heterogeneity between studies. Publication bias was evaluated using the Egger test. Heterogeneity between studies was controlled by meta-regression. Finally, eight studies involving 5,521 EC patients were included.</p><p><strong>Results: </strong>The survival rate in patients whose number of removed NLNs ≥ 19 was significantly better than those with removed NLNs < 19 (HR: 0.88, 95% CI: 0.81, 0.95, I² = 84.4). Subgroup analysis of 8 studies showed that the protective effect of the high number of removed NLNs) ≥ 19 (was greater in adenocarcinoma patients than in SCC (Pooled HR: 0.63 vs. 0.88).</p><p><strong>Conclusion: </strong>The high number of NLNs removed (≥ 19) during surgery was associated with improved survival after surgery, especially in patients with adenocarcinoma. Removing ≥ 19 NLNs significantly improves survival in EC patients, particularly those with adenocarcinoma. This threshold should be incorporated into surgical guidelines.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"124"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742586","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":"An innovative animal experimental model of rib fracture with bone displacement.","authors":"Chien-An Liao, Shih-Ching Kang, Tai-Horng Young, Chien-Hung Liao, Chi-Hsun Hsieh, Yi-Teng Fong, Chun-Chieh Chuang, Chih-Hao Chen","doi":"10.1186/s12893-025-02861-5","DOIUrl":"https://doi.org/10.1186/s12893-025-02861-5","url":null,"abstract":"<p><strong>Background: </strong>Rib fractures, the most common blunt chest trauma worldwide, have been evaluated in multiple retrospective cohort studies. Histology laboratories using innovative techniques are crucial to improving patient outcomes; animal models are especially valuable in this regard. Currently, the creation of animal models of fractures involves cutting to avoid lethal pleural injury and induce linear fractures incompatible with real-world morphology. Suitable models with bone displacement, which are common surgical targets, are limited. Therefore, we aimed to develop an animal experimental model that aligns with real-world clinical conditions and allows for more in-depth research on blunt chest trauma.</p><p><strong>Methods: </strong>We conducted an animal study using New Zealand rabbits to create fractures with displacement, without injuring the pleura. A facial bone drill was used to create several fracture holes in the ribs that were carefully dissected using a rongeur and scissors. After reaching the border between the bone and pleura, they were separated through blunt dissection with scissors. Fractures were created without injuring the pleura, and a rongeur was used to displace the bones.</p><p><strong>Results: </strong>Seven rabbits successfully underwent surgery, with each awakening without pleural injury and pneumothorax. Surgery effectiveness was primarily assessed using chest computed tomography (CT) to evaluate types of rib fractures. CT was performed in the second week and second and third months postoperatively. All rabbits exhibited visibly displaced rib fractures, and no additional chest complications were observed.</p><p><strong>Conclusions: </strong>This innovative animal model allowed us to study pathophysiological changes following rib fracture. Future studies investigating new medical materials and surgical procedures will benefit from this animal model.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"123"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of robot-assisted laparoscopic radical prostatectomy via modified extraperitoneal approach and transvesical approach.","authors":"Zhi Xian Xiao, Xi Yan Lan, Si Yan Miao, Run Fu Cao, Kai Hong Wang","doi":"10.1186/s12893-025-02853-5","DOIUrl":"10.1186/s12893-025-02853-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcomes of two different surgical approaches for treating localized prostate cancer: extraperitoneal robot-assisted radical prostatectomy (Ep-RARP) and transvesical robot-assisted radical prostatectomy (Tv-RARP).</p><p><strong>Methods: </strong>This study collected and analyzed data from patients with localized prostate cancer who underwent robot-assisted radical prostatectomy (RARP) within the same surgical team between October 2018 and March 2024. The cohort included two groups: the Ep-RARP group (37 cases) and the Tv-RARP group (29 cases). The primary outcomes analyzed were postoperative drainage time, length of hospital stay, surgical margin status, postoperative complications, urinary continence, and erectile function.</p><p><strong>Results: </strong>The baseline characteristics of the two groups of patients were consistent (p > 0.05), making them comparable. The Ep-RARP group had a significantly shorter hospital stay (7 days [5.5-8] vs. 9 days [9-10], p < 0.001) and shorter drain retention time (7 days [6-8] vs. 8 days [7-10], p < 0.001). There were no significant differences in intraoperative blood loss, blood transfusion requirements, and surgical complications. The duration of catheterization was similar in both groups (7 days [7-8] vs. 7 days [7-8], p = 0.135), as well as the distribution of Gleason scores, pathological staging (T1, T2), and positive surgical margin rate (p > 0.05). No significant differences were found in immediate postoperative urinary control rates (Tv-RARP: 20 [68.97%] vs. Ep-RARP: 26 [70.27%], p = 0.909), 3-month urinary control rates (Tv-RARP: 27 [93.10%] vs. Ep-RARP: 35 [94.59%], p = 1.000), or 6-month urinary control rates (Tv-RARP: 29 [100%] vs. Ep-RARP: 37 [100.00%], p = 1.000). The biochemical recurrence rate at 6 months was also comparable (Ep-RARP: 1 [2.70%] vs. Tv-RARP: 1 [3.45%], p = 1.000). Postoperative erectile function recovery at 3 and 6 months was similar between the two groups (3 months: Ep-RARP: 14 [37.84%] vs. Tv-RARP: 12 [41.40%], p = 0.804; 6 months: Ep-RARP: 18 [48.64%] vs. Tv-RARP: 17 [58.62%], p = 0.464).</p><p><strong>Conclusion: </strong>Both extraperitoneal and transvesical robot-assisted radical prostatectomy are feasible approaches for localized prostate cancer, offering comparable oncologic control and functional outcomes. However, the extraperitoneal approach demonstrates advantages in terms of shorter surgery time, drain retention time, and hospital stay.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"120"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732651","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}