BMC Surgery最新文献

{"title":"Risk factors of axial symptoms after posterior cervical spine surgery: a meta-analysis.","authors":"Ke Zhang, Zhencheng Xiong, Yuhao Zhang, Ziyi Zhuang, Sizhen Zhan, Mingsheng Tan, Ping Yi","doi":"10.1186/s12893-025-03074-6","DOIUrl":"https://doi.org/10.1186/s12893-025-03074-6","url":null,"abstract":"<p><strong>Background: </strong>Axial symptoms are a frequent complication after posterior cervical spine surgery.While literature has documented risk factors for these symptoms, they are still debated. This study's objective was to explore the risk elements associated with axial symptoms following posterior cervical spine surgery.</p><p><strong>Methods: </strong>Our search encompassed The Cochrane Library, PubMed, Embase, and web of science databases, focusing on studies documenting complications related to cervical laminectomy and laminoplasty. In every study included, we documented axial symptom occurrences and computed Odds Ratios (ORs), 95% confidence intervals (Cls), Q values, and 12 values.</p><p><strong>Results: </strong>Nineteen different studies were finally included, and a summary of the key risk and protective factors identified in the included studies is provided below: preoperative neck pain (OR = 2.22,95%CI (1.48,3.33), P = 0.0001), facet joint destruction(OR = 2.32,95%CI (1.59,3.39),P < 0.0001), C2involvement(OR = 3.78,95%CI(2.04,7.01), P < 0.0001),C7spinous process (muscle) destruction (OR = 3.38,95%CI (1.13,10.08),P = 0.03), conventional posterior cervical spine surgery (OR = 6.18,95%CI (2.43,15.69),P = 0.0001) protective factors were as follows: Increase range of motion after cervical spine surgery (OR = 0.64,95%CI (0.44,0.92), P = 0.02), enlargement of the preoperative C2-7 Cobb angle (OR = 0.57,95%CI(0.39,0.82),P = 0.003).</p><p><strong>Conclusion: </strong>Preoperative neck pain, facet joints destruction, C7 spinous process(muscle)destruction, conventional posterior cervical spine surgery and C2 involvement were risk factors for postoperative axial symptoms after posterior cervical spine surgery, and a larger preoperative C2-C7 Cobb angle and increased postoperative cervical range of motion were protective factors for postoperative axial symptoms, however, gender, age, operation time, JOA score, C2-7 SVA, blood loss, and types of disease were not associated with postoperative axial symptoms. Considering the scarce volume of research available, this inference demands careful interpretation and necessitates expanded studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"380"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975892","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":"Effects of pericapsular nerve group block and fascia Iliaca compartment block on postoperative analgesia and early rehabilitation in elderly patients undergoing total hip arthroplasty.","authors":"Fenglei Li, Tao Liao, Jianhua Huang, Ronghua Xu","doi":"10.1186/s12893-025-03137-8","DOIUrl":"https://doi.org/10.1186/s12893-025-03137-8","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is a common procedure in elderly patients that requires effective postoperative analgesia to enhance recovery and minimize complications. This study compares the effects of pericapsular nerve group block (PENG) and fascia iliaca compartment Block (FICB) on postoperative analgesia and early rehabilitation in elderly patients undergoing THA.</p><p><strong>Methods: </strong>This retrospective observational study was conducted from January 2021 to December 2023 and included 216 elderly patients scheduled for THA. Patients were divided into two groups: PENG (n = 108) and FICB (n = 108). The efficacy and safety of the nerve blocks were assessed by procedure and onset times, intraoperative anesthetic use, postoperative pain (VAS scores), analgesic consumption, motor function recovery (Modified Bromage Scores), and adverse reactions. Statistical analysis was performed using SPSS software.</p><p><strong>Results: </strong>The PENG group required significantly lower doses of propofol (327.3 ± 90.5 mg vs. 353.4 ± 85.7 mg, p = 0.03) and remifentanil (1.1 ± 0.4 mg vs. 1.4 ± 0.5 mg, p < 0.001) than the FICB group. Postoperative VAS pain scores were lower in the PENG group at 8 h during activity (1.1 vs. 2.1, P < 0.05). The PENG group also showed fewer effective PCA presses (3.5 ± 1.4 vs. 4.3 ± 1.5, p < 0.001) and lower sufentanil consumption (62.3 ± 13.3 µg vs. 72.1 ± 13.6 µg, p < 0.001). The PENG group had a significantly lower incidence of quadriceps weakness (7% vs. 24%, p < 0.001) and faster recovery of motor function at all time points.</p><p><strong>Conclusions: </strong>Both PENG and FICB provided effective perioperative analgesia in elderly patients undergoing THA. However, PENG may offer advantages in reducing postoperative pain during activity and in preserving lower limb motor function, potentially facilitating earlier rehabilitation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"381"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976144","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":"Three-dimensional (3D) vascular reconstruction of the superior mesenteric vessels: a practical tool for the young surgeon approaching right hemicolectomy with CME technique.","authors":"Luca Scaravilli, Vincenza Paola Dinuzzi, Felicia Andrei, Andrea Carnevali, Giulia Maria Marini, Martina Pardo, Antonella Nisi, Ildo Scandroglio, Camillo Leonardo Bertoglio","doi":"10.1186/s12893-025-02945-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02945-2","url":null,"abstract":"<p><strong>Background: </strong>Right hemicolectomy with Complete Mesocolic Excision (CME) and Central Vascular Ligation (CVL) is a complex surgical procedure, partly due to the significant anatomical variability of the superior mesenteric vessels. Three-dimensional (3D) vascular reconstruction, through segmentation-a process that groups pixels with similar characteristics into segments-is a technique that enables the three-dimensional visualization of blood vessels from medical images, usually obtained through CT or magnetic resonance imaging. 3D vascular reconstruction of the superior mesenteric vessels obtained from preoperative images of surgical patients enhances preoperative anatomical understanding, making surgery safer, especially for young surgeons approaching this technique. The primary outcome of this study was to obtain an objective score reflecting surgical residents' understanding of the patient's vascular anatomy from 3D reconstructions of CT images. The secondary outcome was the subjective feedback from senior colorectal surgeons regarding pre-operative use of 3D vascular reconstructions.</p><p><strong>Methods: </strong>A total of 20 patients who underwent right hemicolectomy from 01/10/2023 to 30/09/2024 were included in the study. For each patient, 3D vascular reconstruction was obtained from preoperative CT images. Four surgical residents and two experienced colorectal surgeons were recruited. The residents' understanding of each patient's vascular anatomy was assessed after they looked at the standard pre-operative CT images first and then at their 3D reconstructions respectively. Moreover, the senior colorectal surgeons' opinion on the use of pre-operative 3D vascular reconstruction was assessed.</p><p><strong>Results: </strong>Overall, 3D reconstructions significantly improved residents' anatomical understanding compared to baseline testing (6.71 ± 2.27 vs. 5.26 ± 1.97; p < 0.0001). For three out of four residents examined, 3D vascular reconstruction was statistically superior to standard CT. Colorectal surgeons also gave positive feedback to the use of pre-operative 3D reconstruction.</p><p><strong>Conclusion: </strong>Three-dimensional vascular reconstruction models may help improve surgical trainees' anatomical understanding of mesenteric vascular anatomy compared to conventional CT image interpretation. 3D models may be a useful adjunct to 2D imaging for residents' training and pre-operative planning of CME surgery. More studies are needed to further evaluate the impact of using pre-operative 3D vascular reconstruction.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"378"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976050","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 effect of preoperative oral carbohydrate administration on postoperative glucometabolic response, subjective well being and quality of life in patients undergoing colorectal surgery: a randomized controlled double-blind study.","authors":"Murat Urkan, Cemile Celebi, Ulvi Mehmet Meral, Ikbal Cavdar","doi":"10.1186/s12893-025-03093-3","DOIUrl":"10.1186/s12893-025-03093-3","url":null,"abstract":"<p><strong>Background: </strong>Prolonged preoperative fasting may increase anxiety, insulin resistance, and surgical stress, whereas preoperative carbohydrate loading has been shown to improve metabolic response, reduce complications, and enhance recovery, as supported by ERAS protocols.</p><p><strong>Objectives: </strong>This study aimed to examine the effects of preoperative oral carbohydrate ingestion on postoperative glucometabolic response, subjective well-being, quality of life, and surgical clinical outcomes in patients undergoing colorectal surgery.</p><p><strong>Methods: </strong>A prospective, randomized controlled double-blind study was conducted in a hospital in the Aegean region of Türkiye, including 50 patients scheduled for elective colorectal surgery. Data were collected using a structured form that included sociodemographic information, perioperative laboratory values, subjective well-being indicators, and the SF-36 Quality of Life Scale. The intervention group received 800 mL of a carbohydrate drink until midnight and 400 mL two hours before surgery; the control group received the same volumes of water. Participants, outcome assessors, and statistical analysts were blinded to group assignments. The researcher who administered the drinks was aware of group allocation but was not involved in outcome evaluation or data analysis.</p><p><strong>Results: </strong>The intervention group had shorter time to first flatulence (40.60 ± 4.52 vs 46.00 ± 4.22 h, p < 0.001), earlier defecation (68.64 ± 7.94 vs 81.84 ± 8.97 h, p < 0.001), earlier oral feeding (43.80 ± 4.84 vs 48.44 ± 3.87 h, p < 0.001), and shorter hospital stay (10.64 ± 1.52 vs 14.32 ± 3.69 days, p < 0.001) compared to the control group. Postoperative albumin levels were significantly higher and CRP levels significantly lower in the intervention group at 24 h. The SF-36 physical functioning score was significantly higher in the intervention group compared to the control group (82.00 ± 11.81 vs 61.40 ± 16.17, p < 0.001). No significant differences were found in insulin resistance (HOMA-IR), gastric volume, or pH between groups.</p><p><strong>Conclusion: </strong>Preoperative oral carbohydrate intake was associated with improved clinical recovery indicators and quality of life outcomes. In particular, it contributed to earlier return of bowel function, reduced postoperative discomfort, and significantly shorter hospital stay, indicating enhanced postoperative recovery in patients undergoing colorectal surgery.</p><p><strong>Trial registration: </strong>First registered on 30.05.2022, NCT05402592 by ClinicalTrials.gov.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"376"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884169","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 3D-printed screw mechanism as an alternative method to prevent wire migration in nonpalpable breast lesion localization.","authors":"Iksan Tasdelen, Adnan Gundogdu, Kaan Celik, Osman Cem Yilmaz, Levent Celik","doi":"10.1186/s12893-025-03123-0","DOIUrl":"https://doi.org/10.1186/s12893-025-03123-0","url":null,"abstract":"<p><strong>Background: </strong>Wire localization for nonpalpable breast lesions and pre-neoadjuvant chemotherapy (NAC) clips can lead to complications including wire migration, pneumothorax, and organ injury. This study evaluates the clinical efficacy and safety of a novel 3D-printed screw mechanism designed to prevent wire migration.</p><p><strong>Methods: </strong>This retrospective descriptive study included 104 patients with nonpalpable breast lesions and pre-NAC clips who underwent wire localization between March 2023 and August 2024. A screw mechanism was designed and manufactured using 3D printing technology with polylactic acid (PLA) material (4 g per device). The device features a 21.7 mm base diameter and elliptical wire hole (2.5 × 4 mm). Wire stability and complications were assessed through imaging and clinical follow-up.</p><p><strong>Results: </strong>The median age was 47 years (range: 33-82) and median BMI was 24.7 (17.9-40.8). Lesions were primarily located in the upper outer quadrant (49.9%). Among 68 patients receiving NAC, 44.1% achieved pathological complete response (ypT0N0). The screw mechanism successfully prevented wire migration during patient transport from radiology to operating room in all 104 cases (0% migration rate, 95% CI: 0-3.6%). No complications including pneumothorax, organ injury, or skin reactions were observed. The device was easily removed by simple unscrewing on the operating table before surgical skin preparation. Median device application time was 2-4 h.</p><p><strong>Conclusion: </strong>The 3D-printed screw mechanism effectively prevents wire migration and demonstrates excellent safety profile. Its simple design and ease of application make it a practical solution for improving patient safety during breast lesion localization procedures.</p><p><strong>Trial registration: </strong>Not applicable. This retrospective study did not require trial registration.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"377"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976006","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 bypass percentage on clinical outcomes following one-anastomosis gastric bypass: a one-year follow-up study.","authors":"Ramin Ebrahimian Jektaji, Seyed Soroush Moosavi, Moein Moghaddam Ahmadi","doi":"10.1186/s12893-025-03119-w","DOIUrl":"10.1186/s12893-025-03119-w","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"375"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876388","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":"Prognostic value of the combination of serial APACHE II with serum lactate for predicting post-operative mortality in gastrointestinal perforation peritonitis: a prospective cohort study.","authors":"Ram Prasad Subedi, Navin Kumar, Summi Karn, V Arunkumar, Nirmal Raj, Parth Maheshwari, Dipendra Singh, Sanketh Edem, Asish Das, Farhanul Huda, Somprakas Basu","doi":"10.1186/s12893-025-03099-x","DOIUrl":"10.1186/s12893-025-03099-x","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal perforation peritonitis is a life-threatening surgical emergency with high mortality. Early identification of patients at increased risk of poor outcomes is critical for optimizing care. In this study, we aimed to evaluate the prognostic value of combining serial Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and serial serum lactate levels in predicting 30-day postoperative mortality among patients undergoing emergency laparotomy for gastrointestinal perforation peritonitis.</p><p><strong>Methods: </strong>In this prospective cohort study, 120 adult patients diagnosed with gastrointestinal perforation peritonitis and undergoing emergency laparotomy were enrolled after obtaining ethical approval and informed consent. APACHE II scores and serum lactate levels were recorded at three time points: preoperatively (baseline), 6 h postoperatively, and 24 h postoperatively. The primary objective of this study was a combination of serial APACHE II and serial serum lactate level (baseline, 6 h and 24 h post-operatively) and its correlation with post-operative mortality in emergency laparotomy for hollow viscus perforation peritonitis. Data were analysed to compare clinical variables between survivors and non-survivors. Receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses were used to assess the predictive performance of individual and combined markers.</p><p><strong>Results: </strong>The 30-day postoperative mortality rate was 35%. Significant differences in age, serial APACHE II scores, and serial serum lactate levels were observed between survivors and non-survivors. A serum lactate level of ≥ 1.88 mmol/L had a sensitivity of 81% and specificity of 69.2% (AUC: 0.817; p = 0.0001). APACHE II scores of ≥ 11.16 yielded a sensitivity of 76.2% and specificity of 91% (AUC: 0.915; p = 0.0001). Both serial lactate levels and APACHE II scores were independent predictors of 30-day mortality. The combination of serial APACHE II scores and serum lactate (cutoff ≥ 11.95) had a sensitivity of 85%, specificity of 82%, and an AUC of 0.919 (p = 0.0001), making it the preferred predictor for 30-day post-operative mortality.</p><p><strong>Conclusions: </strong>The combination of serial APACHE II scores and serial serum lactate levels provides superior prognostic accuracy for predicting 30-day postoperative mortality in patients undergoing emergency laparotomy for gastrointestinal perforation peritonitis. This approach may facilitate early identification of high-risk patients and guide clinical decision-making.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"374"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876389","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":"Clinical and paraclinical differences between pediatric patients requiring surgical versus Non-Surgical treatment for intussusception: A retrospective study at a referral center in Iran.","authors":"Zinat Soleimanpour, Sara Memarian, Mohammad Mehdi Rajabi, Zahra Zamani, Hosein Alimadadi, Behdad Gharib","doi":"10.1186/s12893-025-03131-0","DOIUrl":"10.1186/s12893-025-03131-0","url":null,"abstract":"<p><strong>Background: </strong>Intussusception is a common cause of bowel obstruction in children, often requiring prompt intervention to prevent complications. While non-surgical reduction is the preferred treatment, some patients require surgical management. Identifying factors associated with the need for surgery is essential to optimize patient outcomes. This study aimed to examine the clinical and paraclinical differences between pediatric patients who received surgical versus non-surgical treatment for intussusception.</p><p><strong>Methods: </strong>This retrospective study reviewed the medical records of pediatric patients diagnosed with intussusception at the Children's Medical Center, Tehran, Iran, between April 2018 and March 2020. Out of 571 pediatric patients diagnosed with intussusception, 165 were included in the analysis-55 who underwent surgery and 110 who were treated non-surgically. Demographic, clinical, and laboratory data were analyzed to identify factors influencing surgical intervention. Statistical analyses were performed using independent t-tests, chi-square tests, and Fisher's exact tests, with significance set at P < 0.05.</p><p><strong>Results: </strong>Patients who underwent surgery were significantly younger than those treated non-surgically (2.68 ± 1.65 vs. 3.88 ± 3.51 years; P < 0.001), with a higher proportion of cases under one year of age (P = 0.004). Laboratory parameters, including white blood cell count (P = 0.53), erythrocyte sedimentation rate (P = 0.69), and C-reactive protein levels (P = 0.55), did not differ significantly between the groups. Among clinical symptoms, the presence of bloody stools was significantly associated with surgical intervention (P < 0.001). Sonographic findings showed that ileocolic intussusception was more common in the surgical group (P < 0.001).</p><p><strong>Conclusion: </strong>Younger age, the presence of bloody stools, and ileocolic intussusception were associated with a higher likelihood of surgical reduction in pediatric intussusception. Recognizing these risk factors may facilitate early diagnosis and support better treatment decision-making.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"373"},"PeriodicalIF":1.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876387","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 single-center retrospective cohort study on the efficacy and safety of temporary endoscopic nasobiliary drainage in patients with unresectable malignant biliary obstruction with endoscopic biliary stent.","authors":"Huan Liu, Chuanke Shi, Zhideng Yan","doi":"10.1186/s12893-025-03132-z","DOIUrl":"10.1186/s12893-025-03132-z","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic biliary stent (EBS) is the preferred palliative treatment for patients with unresectable malignant biliary obstruction (MBO). We tried endoscopic nasobiliary drainage (ENBD) within 2 weeks after EBS to improve the adverse events and stent patency time after endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Methods: </strong>A total of 285 eligible patients with unresectable MBO were divided into EBS group and EBS + ENBD group. Clinical outcomes and adverse events were compared.</p><p><strong>Results: </strong>The EBS + ENBD group (n = 74) was similar to the EBS group (n = 211) in clinical characteristics and improvement in liver function after ERCP. The two groups were also similar in terms of stent clinical success rate, incidence of postoperative cholangitis, postoperative bleeding and postoperative pancreatitis. 69 patients in the EBS group and 10 patients in the EBS + ENBD group were followed up continuously. The results showed that the EBS + ENBD group was higher than the EBS group in terms of stent patency time (246.1 days, 95% CI, 141.3-351.0 days vs. 195.3 days, 95% CI, 163.0-227.5 days; P = 0.420), but it was not statistically significant.</p><p><strong>Conclusion: </strong>For patients with unresectable MBO, compared with EBS alone, ENBD placement after EBS for temporary biliary drainage may improve liver function and reduce adverse events.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"371"},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856885","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 impact of sarcopenia on the efficacy of posterior surgical treatment for degenerative lumbar scoliosis.","authors":"Juyi Lai, Xinbei Li, Huangsheng Tan, Hualong Feng, Zhi Ming Lan, Zhitao Sun, Jian Wang, Yuanfei Fu, Shenghua He","doi":"10.1186/s12893-025-03075-5","DOIUrl":"10.1186/s12893-025-03075-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of sarcopenia on the clinical outcomes of patients undergoing posterior surgical treatment for degenerative lumbar scoliosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data from 76 patients with degenerative lumbar scoliosis, who meet the selection criteria between January 2019 and December 2023. The patients were categorized into a sarcopenia group (31 cases) and a non-sarcopenia group (45 cases) based on the diagnostic criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Operative time, intraoperative blood loss, hospital stay duration, incision length, incision healing time, and complications were compared between the sarcopenia and non-sarcopenia groups. The improvement in clinical symptoms was evaluated using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). To assess the scoliosis correction effect, measurements were taken for the coronal Cobb angle (CCA), C7 plumb line-center sacral vertical line (C7-CSVL), lumbar lordosis (LL), and C7 plumb line-sagittal vertical axis (C7-SVA).</p><p><strong>Results: </strong>All patients successfully underwent the surgical procedure. The average operation time in the sarcopenia group was 256.27 ± 28.09 (180-350) min, which was not significantly different from the 249.82 ± 24.35(185-320) min in the non-sarcopenia group (p > 0.05). The average intraoperative blood loss in the sarcopenia group was 786.25 ± 38.19 (420-1365) mL, compared to 810.62 ± 45.47 (456-1780) mL in the non-sarcopenia group (p > 0.05). The average incision length in the sarcopenia group was 12.57 ± 1.29 (10-16)cm, compared to 12.83 ± 2.03 (9-20)cm in the non-sarcopenia group (p > 0.05). The incision healing time in the sarcopenia group required an average of 15.72 ± 1.74 (12-25)d, which longer than the 10.18 ± 1.05 (10-14 ) d in the non-sarcopenia group (p < 0.05). The average hospital stay in the sarcopenia group was 13.46 ± 1.37 (8-26) d, which was also longer than the 8.33 ± 0.92 (6-12)d in the non-sarcopenia group (p < 0.05). The complication rate in the sarcopenia group was 29.03% (9/31), which was higher than the 13.33% (6/45) in the non-sarcopenia group (p < 0.05). The VAS and ODI scores of both groups at the last follow-up were significantly improved compared to preoperative levels (p < 0.05). At the last follow-up, the ODI in the non-sarcopenia group was better than that in the sarcopenia group (p < 0.05). There was no statistically significant difference between the two groups in terms of VAS scores at the last follow-up (p > 0.05). Both groups demonstrated significant improvements in CCA, C7-CSVL, LL, and C7-SVA compared to preoperative levels (p < 0.05). However, no statistically significant differences were observed between the groups at the final follow-up (p > 0.05).</p><p><strong>Conclusion: </strong>Sarcopenia does not significantly affect the radiological outcom","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"372"},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856886","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}