BMC Surgery最新文献

{"title":"Routine versus postoperative CRP/CT guided selective diverting ileostomy after laparoscopic low anterior resection for rectal cancer: a comparative randomized controlled trial.","authors":"Ahmed M Moaz, Khaled E Barakat, Walid Elshazly, Yasser Zaki, Amr Badawy, Bassem Kh Hegazy, Ahmed M Mohieldein","doi":"10.1186/s12893-026-04248-6","DOIUrl":"10.1186/s12893-026-04248-6","url":null,"abstract":"<p><strong>Background: </strong>Diverting ileostomy is routinely used to protect the anastomosis after laparoscopic low anterior resection (LAR) for rectal cancer, but it exposes most patients to stoma-related morbidity even though only a minority develop a true anastomotic leak. This trial evaluated whether a postoperative C-reactive protein (CRP) and computed tomography (CT) guided selective ileostomy strategy could reduce the rate of ileostomy formation compared with routine diversion.</p><p><strong>Methods: </strong>In this RCT, 200 patients with stage II or III middle or lower third rectal cancer undergoing laparoscopic LAR were randomized 1:1 to a CRP/CT-guided selective ileostomy group (n = 100) or a routine diverting ileostomy group (n = 100). In the CRP/CT group, serum CRP was measured daily from postoperative day 1; a threshold of 114 mg/L on day 3 or a rise greater than 15 mg/L per day triggered confirmatory contrast-enhanced CT, with ileostomy formed only if findings were suspicious for leak. The primary outcome was the stoma-free status throughout the 12-month follow-up.</p><p><strong>Results: </strong>Baseline demographic and tumor characteristics were similar between groups (all p > 0.05). Ileostomy formation was markedly lower in the CRP/CT group than the routine group (22.0% vs. 100.0%, p < 0.001). Anastomotic leak rates did not differ (0% vs. 1.0%, p = 1.000), nor did overall complication rates (31.0% vs. 32.0%, p = 0.879). Operative time (148.4 ± 14.0 vs. 166.6 ± 13.1 min, p < 0.001) and intraoperative blood loss (168.9 ± 28.2 vs. 197.3 ± 39.7 mL, p < 0.001) were significantly lower in the CRP/CT group. Stoma-related complications were far less frequent with the selective strategy (3.0% vs. 30.0%, p < 0.001). The CRP/CT group reported significantly better global health status, physical functioning, and emotional functioning scores (all p < 0.001).</p><p><strong>Conclusion: </strong>A postoperative CRP/CT-guided selective ileostomy strategy reduces the need for diverting ileostomy after laparoscopic low anterior resection for rectal cancer while improving operative outcomes and quality of life; however, confirmed leakage was infrequent in both groups. This approach may serve as an alternative to routine diversion in appropriately monitored surgical units.</p><p><strong>Trial registration: </strong>This trial was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07722533) on July 17, 2026.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185511","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":"Right upper lobectomy via selective right upper lobe isolation using a left-sided double-lumen tube placed in the right bronchus intermedius: a case report.","authors":"Shengwen Song, Lingli Ding, Han Xu","doi":"10.1186/s12893-026-04259-3","DOIUrl":"https://doi.org/10.1186/s12893-026-04259-3","url":null,"abstract":"<p><strong>Background: </strong>One-lung ventilation (OLV) using a left-sided double-lumen tube (DLT) in the left main bronchus is standard for right thoracic surgery. When the contralateral left lung is severely compromised, this approach forces OLV to rely on the dysfunctional lung and risks critical hypoxemia.</p><p><strong>Case presentation: </strong>An 84-year-old woman with a left diaphragmatic hernia causing approximately 70% compression and atelectasis of the left lung was scheduled for right upper lobectomy. Preoperative assessment indicated that standard DLT placement would necessitate complete right lung collapse, placing the patient at risk of life-threatening hypoxemia. A 32-Fr left-sided DLT was intentionally inserted into the right bronchus intermedius under fiberoptic bronchoscopy (FOB). The bronchial cuff was positioned at the orifice of the right upper lobe (RUL) bronchus to achieve selective occlusion. Ventilation was delivered through the tracheal lumen to the left lung and through the bronchial lumen to the right middle and lower lobes. The RUL collapsed completely. Intraoperative oxygenation remained stable, with SpO₂ greater than 95%. The patient underwent an uneventful thoracoscopic right upper lobectomy, was extubated immediately after surgery, and was discharged on postoperative day 6.</p><p><strong>Conclusions: </strong>Intentional placement of a left-sided DLT into the right bronchus intermedius is a feasible strategy for selective RUL isolation when standard OLV is contraindicated due to severe contralateral lung compromise. Preoperative computed tomography (CT)-based airway assessment and fiberoptic bronchoscopic guidance are recommended for safe implementation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170468","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":"Early prediction of severe morbidity after liver resection using serum albumin and ALBI-score in a mixed patient cohort.","authors":"Sophie Seiffer, Lars Stellmacher, Aaron Schindler, Uta Pietsch, Thomas C Wiemers, Hans-Jonas Meyer, Robert Sucher, Daniel Seehofer, Hans-Michael Tautenhahn, Uwe Scheuermann","doi":"10.1186/s12893-026-04190-7","DOIUrl":"10.1186/s12893-026-04190-7","url":null,"abstract":"<p><strong>Background: </strong>Early identification of patients at risk for severe morbidity after liver resection (LR) remains challenging. Serum albumin and albumin-bilirubin (ALBI) score reflect liver function, but their prognostic value in the immediate postoperative period is not well defined. This study evaluated perioperative serum albumin and ALBI as early predictors of severe postoperative morbidity in a heterogeneous LR cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 150 adult patients undergoing LR at a tertiary center (2016-2018), excluding patients receiving perioperative albumin substitution. Albumin and ALBI were measured preoperatively and on postoperative day 1 (POD1). Associations with intraoperative variables and postoperative outcomes were evaluated. Severe morbidity (Clavien-Dindo ≥ IIIb) within 90 days was the primary endpoint. Predictive performance was evaluated using ROC analysis and logistic regression with bootstrap internal validation.</p><p><strong>Results: </strong>Severe morbidity occurred in 23 patients (15.3%), including four deaths (2.7%). Albumin and ALBI deteriorated significantly from preoperative values to POD1 (P < 0.001) and their relative changes correlated inversely with intraoperative volume substitution (albumin: ρ = -0.380, ALBI: ρ = -0.376; P < 0.001 each). On POD1, both parameters demonstrated good discrimination for severe morbidity (AUC 0.776 for albumin; AUC 0.783 for ALBI). Exploratory thresholds for albumin < 29.4 g/L or ALBI > - 1.56 were associated with higher postoperative complication rates (albumin: 66.7% vs. 29.8%, ALBI: 68.8% vs. 30.5%; P < 0.001 each) and prolonged hospitalization (albumin: 21.8 vs. 10.1 days, ALBI: 22.3 vs. 10.4 days, P < 0.001 each). In multivariate analysis, POD1 albumin (OR 0.859, 95% CI 0.726-0.998; P = 0.047) and POD1 ALBI (OR 6.275, 95% CI 1.417-33.684; P = 0.015) independently predicted severe morbidity. Adding POD1 ALBI improved the discrimination of both the ACS NSQIP surgical risk calculator and the Breitenstein score (ΔAUC 0.094 and 0.181; P = 0.029 and 0.005).</p><p><strong>Conclusions: </strong>ALBI on POD1 independently predicted severe morbidity after LR and may provide a simple tool for early postoperative risk stratification based on routine laboratory data. External validation is required before routine implementation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082683","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":"Laparoscopic versus open emergency colonic resection for obstruction: a multicentre retrospective cohort study.","authors":"Joline de Groof, Silvia Marchesi, Ellie Pearce, Timothy Rockall, Tomas Vedin, Erik Agger","doi":"10.1186/s12893-026-04220-4","DOIUrl":"10.1186/s12893-026-04220-4","url":null,"abstract":"<p><strong>Background: </strong>Despite its established benefits in elective colorectal surgery, the adoption of laparoscopy in the emergency setting remains limited. This retrospective international multicentre study assesses laparoscopic and open colonic resection in patients with acute benign or malignant colonic obstruction.</p><p><strong>Methods: </strong>Patients were included between 2022 and 2023. Intraperitoneal free air on imaging was an exclusion criterion. Primary outcomes were the Comprehensive Complication Index (CCI) and length of stay (LOS). Secondary outcomes included postoperative pain management, re-operation, 30- and 90-day mortality, R0-resection and lymph node yield when applicable, intraoperative bleeding, anastomosis and operative time.</p><p><strong>Results: </strong>Out of 144 patients, 73 were eligible. Forty-three (58.9%) patients underwent open and 30 (41.1%) laparoscopic resections. Obstructions were equally distributed between the right and left colon. Patients in the open group were older (77.1 vs. 61.7 years, p < 0.001). Clavien-Dindo II-V complications were more common (69.8% vs. 33.3%, p = 0.002) and the CCI was higher (27.1 vs. 7.9, p < 0.001) after open surgery. LOS was significantly longer after open surgery (14 (IQR 8-19) vs. 6 (IQR 5-9) days (p < 0.001)). Postoperative pain was managed with patient-controlled opioids and/or oral analgesics in 86.7% after laparoscopic surgery while an epidural was used in 76.7% after open surgery (p < 0.001). Other secondary outcomes were comparable between the groups.</p><p><strong>Conclusion: </strong>Laparoscopic emergency resection in patients with acute benign or malignant colonic obstruction was associated with lower postoperative morbidity, shorter LOS and less intensive postoperative analgesic requirements in a selected cohort. However, these findings should be interpreted cautiously given substantial differences in baseline characteristics and surgeon specialization between groups.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002729","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":"Unilateral biportal endoscopic lumbar fusion versus minimally invasive transforaminal lumbar interbody fusion for single-level mild to moderate lumbar spondylolisthesis: a retrospective study.","authors":"Fanlei Meng, Chuntong Zang, Meng Gao, Haopeng Luan, Naiguo Wang","doi":"10.1186/s12893-026-04176-5","DOIUrl":"10.1186/s12893-026-04176-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the early clinical outcomes and radiographic outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-level mild to moderate lumbar spondylolisthesis (LS).</p><p><strong>Methods: </strong>Clinical data of patients with single-level lumbar spondylolisthesis who underwent ULIF or MIS-TLIF at Shandong Provincial Hospital Affiliated to Shandong First Medical University between January 2018 and August 2025 were retrospectively analyzed, including 33 patients in the ULIF group and 33 patients in the MIS-TLIF group. The baseline characteristics, perioperative parameters and radiographic outcomes were compared between the two groups.</p><p><strong>Results: </strong>All surgeries were successfully completed in all patients. The operative time was significantly longer in the ULIF group than in the MIS-TLIF group (P < 0.05). However, the ULIF group had significantly less intraoperative blood loss, postoperative drainage volume, and shorter postoperative hospital stay compared with the MIS-TLIF group (all P < 0.05). In the early postoperative period, the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly lower in the ULIF group than in the MIS-TLIF group (P < 0.05). Compared with preoperative baseline values, the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores improved significantly at all postoperative time points in both groups (all P < 0.05). Nevertheless, the VAS scores for low back pain and leg pain at 3 days postoperatively were significantly lower in the ULIF group than in the MIS-TLIF group (P < 0.05). Radiographically, all radiographic parameters improved significantly postoperatively in both groups compared with preoperative values (P < 0.05), with no statistically significant differences observed between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>The efficacy of ULIF in the treatment of single-level mild to moderate lumbar spondylolisthesis is comparable to that of MIS-TLIF. However, the ULIF group is associated with less intraoperative blood loss, less postoperative drainage, and faster postoperative recovery, albeit with a longer operative time.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018524","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":"Preoperative biliary stenting is associated with increased bacterial contamination and postoperative inflammation in pancreatic head resections.","authors":"Sara Al-Madhi, Aristotelis Perrakis, Sara Acciuffi, Fuad Al-Qahom, Maximilian Dölling, Seong Jeong, Peter Lemmer, Maksym Boruta, Mohammad Othman Alhomsi, Mihailo Andric, Frank Meyer, Roland S Croner, Mirhasan Rahimli","doi":"10.1186/s12893-026-04167-6","DOIUrl":"10.1186/s12893-026-04167-6","url":null,"abstract":"<p><strong>Background: </strong>The role of preoperative biliary drainage (PBD) in patients with resectable pancreatic head cancer remains controversial. Although traditionally used to reduce hyperbilirubinemia, increasing evidence suggests an association with higher postoperative morbidity. This study evaluated the impact of preoperative biliary stenting on microbial contamination, postoperative inflammatory response, and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective single-center study included 102 patients with preoperative cholestasis and hyperbilirubinemia who underwent pancreatic head resection between March 2017 and January 2024. Patients were divided into a stent group (n = 66) and a no-stent group (n = 36). Intraoperative bile cultures, perioperative parameters, postoperative complications, and serial laboratory values were analyzed.</p><p><strong>Results: </strong>Patients who underwent preoperative stenting showed significantly higher rates of positive intraoperative bile cultures (75.8% vs. 5.6%, p < 0.001), longer operative times (360.4 vs. 319.8 min, p = 0.038), and prolonged time to surgery (51.2 vs. 23.8 days, p = 0.001). Among culture-positive patients, contamination was predominantly polymicrobial (80.8%, 140 isolates in total), with Enterobacterales (43.6%) and Enterococcus species (35.7%) as the most frequent isolates and Candida species detected in 19.2% of these patients. Postoperative CRP levels were significantly higher in the stent group on postoperative days 3 and 5. Abdominal wound dehiscence occurred exclusively in stented patients (12.1% vs. 0%, p = 0.048). Rates of other complications, ICU stay, and hospital length of stay were comparable between groups.</p><p><strong>Conclusion: </strong>Preoperative biliary stenting is associated with predominantly polymicrobial bacterial bile contamination, longer operative times, increased postoperative inflammatory response and wound-related complications, while pancreas-specific complications were not significantly increased. These findings support a selective rather than routine use of biliary drainage in patients with resectable pancreatic cancer, and suggest that the microbial spectrum, including the detection of Candida species in nearly one fifth of culture-positive patients, should be considered when planning perioperative antimicrobial strategies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857714","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":"Correction: Effect of ABO blood group on postoperative overall survival and recurrence-free survival rate in patients with hepatocellular carcinoma after hepatectomy: a multi-center retrospective cohort study.","authors":"Mansour Bahardoust, Maryam Zolfaghari Dehkharghani, Pouya Ebrahimi, Maryam Najafirashed, Safa Mousavi, Meisam Haghmoradi, Mohsen Khaleghian, Adnan Tizmaghz","doi":"10.1186/s12893-026-04041-5","DOIUrl":"10.1186/s12893-026-04041-5","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851778","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":"Outpatient Total Extraperitoneal (TEP) for inguinal hernia repair following federal German outpatient operation procedure reform: a preliminary single-center descriptive study of same-day discharge, unplanned admission, and patient-reported outcomes.","authors":"Julia Michel, Krzysztof Nowakowski, Fabian Nimczewski, Jens Hoeppner, Zsolt Madarasz","doi":"10.1186/s12893-026-04161-y","DOIUrl":"10.1186/s12893-026-04161-y","url":null,"abstract":"<p><strong>Background: </strong>Outpatient hernia repair is becoming increasingly important, particularly with the adoption of minimally invasive techniques such as total extraperitoneal repair (TEP). Following the 2022 reform of the federal German outpatient operation procedure (AOP) catalog, our institution implemented a planned outpatient TEP pathway for selected patients with unilateral inguinal hernia.</p><p><strong>Methods: </strong>This preliminary retrospective single-center study included a core cohort of 108 patients who were successfully discharged on the day of surgery after planned outpatient TEP repair between January 2022 and May 2025. A separate analysis included all 153 patients initially scheduled for outpatient TEP repair, of whom 45 required unplanned inpatient admission. Of the 108 patients in the core cohort, 65 (60.2%) completed structured telephone follow-up interviews. Patient-reported outcomes were evaluated exclusively in this subgroup.</p><p><strong>Results: </strong>Among all 153 patients initially scheduled for outpatient TEP repair, 108 (70.6%) were successfully discharged on the day of surgery, whereas 45 (29.4%) required unplanned inpatient admission. Among the 108 same-day discharged patients, seven perioperative complications (four intraoperative and three postoperative) were recorded, with no life-threatening bleeding, emergency reoperation, or ICU admission. Patient-reported outcomes were available for 65 of these 108 patients (60.2%). Among respondents, 95.4% stated that they would choose outpatient surgery again, and overall satisfaction was 4.6 ± 0.8 on a 5-point Likert scale (63 valid responses).</p><p><strong>Conclusion: </strong>This preliminary single-center experience provides descriptive information on the early implementation of an outpatient TEP pathway under the German AOP framework. Although patients who successfully completed same-day discharge and responded to follow-up reported high satisfaction and perceived safety, the 29.4% unplanned inpatient admission rate, exclusion of admitted patients from the patient-reported outcome analysis, and 60.2% response rate substantially limit conclusions regarding the overall safety, acceptability, and successful implementation of the programme. Prospective multicenter studies with predefined admission criteria and systematic follow-up of all patients are required.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841837","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":"Prophylactic endoluminal vacuum-assisted therapy in high-risk ultra-low rectal anastomoses: a retrospective comparative study of feasibility and clinical outcomes.","authors":"Nour Alkhanji, Eslam Elmaghraby, Saleh Lahes, Mohammed Abdulla, Wolfram Trudo Kneofel, Nadja C Lehwald-Tywuschik","doi":"10.1186/s12893-026-03771-w","DOIUrl":"10.1186/s12893-026-03771-w","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) remains a major cause of morbidity and mortality after ultra-low anterior resection (uLAR) for rectal cancer, when the anastomosis is located ≤ 5 cm from the anal verge, in patients with additionally risk factors. This study proposes the prophylactic endoluminal vacuum-assisted therapy (pEVAT) as a feasible strategy that may reduce AL incidence and promote healing in this subgroup of patients.</p><p><strong>Methods: </strong>Thirty-three patients multiple established risk factors for AL who underwent uLAR with a diverting stoma were retrospectively analyzed. Thirteen patients received pEVAT intraoperatively using a polyurethane sponge, while twenty patients served as the control group. The main outcomes included AL rate, secondary outcomes were anastomotic stenosis, other postoperative complications, length of hospital stay as well as stoma reversal.</p><p><strong>Results: </strong>Anastomotic leakage occurred in 7.7% of patients receiving pEVAT versus 30% in the control group. Unadjusted risk estimation demonstrated lower odds of leakage in the pEVAT group, but the difference was not statistically significant. Anastomotic stenosis was also observed in 7.7% of the pEVAT group compared to 35% of controls. The stoma reversal rate was higher in the pEVAT group (76.9% vs. 55%). Mean hospital stay was shorter (26 vs. 36 days). No mortality occurred in the pEVAT group, and complications were limited.</p><p><strong>Conclusion: </strong>Prophylactic EVAT is a feasible and safe approach that may have a protective role against anastomotic complications in selected high-risk patients undergoing uLAR. Larger, prospective, and ideally randomized studies are required to clarify its clinical effect in this subgroup.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841864","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":"Correction: The application of mini T-plate and high-strength suture wires in the surgical treatment of posterior cruciate ligament avulsion fractures: a retrospective case series.","authors":"Chenhao Sun, Shihan Wang, Pengtao Chen, Yao Lu, Kuijing Han, Pei Zhang, Yilang He, Yuan Liang, Yongchao Fang","doi":"10.1186/s12893-026-04145-y","DOIUrl":"10.1186/s12893-026-04145-y","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808529","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}