BMC Surgery最新文献

{"title":"Short-term outcomes of open versus laparoscopic surgery in patients with metachronous colorectal cancer.","authors":"Jiyun Li, Ruoxi Tian, Hengchang Liu, Haipeng Chen, Zhaoxu Zheng","doi":"10.1186/s12893-025-02769-0","DOIUrl":"10.1186/s12893-025-02769-0","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed the safety and efficacy of laparoscopic surgery in patients with metachronous colorectal cancer (MCRC). This study aims to evaluate the safety and outcomes of laparoscopic surgery in MCRC patients who have previously undergone colorectal cancer surgery.</p><p><strong>Methods: </strong>We compared the short-term outcomes of open versus laparoscopic surgery in patients with MCRC between October 2007 and October 2022.</p><p><strong>Results: </strong>Among the 59 MCRC patients, 25 underwent laparoscopic surgery, whereas 34 received open surgery. The proportion of patients who underwent prior open surgeries was significantly greater in the open group than in the laparoscopic group (91.2% vs. 24.0%, p < 0.001). Three patients (12.0%) in the laparoscopic group required conversion to laparotomy due to severe intra-abdominal adhesions, all of whom had a history of open surgery for colorectal cancer. Compared to the open surgery group, the laparoscopic group presented significantly less estimated blood loss (56.80 ± 115.47 vs. 136.47 ± 158.61 ml, p = 0.038), a shorter time to the first flatus (2.20 ± 0.76 vs. 3.50 ± 0.62 days, p < 0.001), a shorter time to the first stool (2.92 ± 0.64 vs. 4.32 ± 0.64 days, p < 0.001), and a shorter postoperative hospitalization duration (7.24 ± 2.42 vs. 10.79 ± 3.50 days, p < 0.001).</p><p><strong>Conclusion: </strong>Laparoscopic surgery for MCRC patients is a safe and less invasive alternative to open surgery, resulting in reduced estimated blood loss, faster recovery of bowel function, and shorter postoperative hospitalization.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"37"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029799","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":"Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution before wound closure during gastrointestinal surgery: a systematic review and meta-analysis.","authors":"Motoi Uchino, Koji Tamura, Shinsuke Nomura, Seiichi Shinji, Keita Kouzu, Hiroji Shinkawa, Tomohiro Ishinuki, Toru Mizuguchi, Hiroki Ohge, Seiji Haji, Junzo Shimizu, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Katsunori Suzuki, Motomu Kobayash, Masahiro Kobayashi, Yuki Hanai, Hiroshi Nobuhara, Hiroki Imaoka, Masahiro Yoshida, Toshihiko Mayumi, Hiroki Ikeuchi","doi":"10.1186/s12893-025-02774-3","DOIUrl":"10.1186/s12893-025-02774-3","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) can affect mortality, morbidity, and medical costs. Although it has recently been reported that washing with antiseptic/antibiotic solution can prevent SSI in clean surgery, the clinical impact in gastrointestinal surgery is still uncertain. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy of antiseptic/antibiotic solution during wound irrigation or peritoneal lavage in gastroenterological surgery.</p><p><strong>Methods: </strong>The database search used PubMed, MEDLINE, and Cochrane Library. The following inclusion criteria were set for the systematic review. 1) Studies comparing with or without antiseptic/antibiotic irrigation/lavage during gastrointestinal surgery. 2) Studies that described surgical site infections and adverse events. 3) Studies conducted after 2000.</p><p><strong>Results: </strong>A total of 8 randomized controlled studies (RCTs) and 3 observational studies were included in this meta-analysis. Three RCTs of wound irrigation with povidone iodine (PVI) solution revealed no significant difference between the PVI and control groups [RR 1.41, 95% CI (0.92 to 2.17): p = 0.69]. Three RCTs of peritoneal lavage with antibiotic solution showed no significant difference between the interventional group and control groups [RR 0.39, 95% CI (0.10 to 1.55): p = 0.18]. Regarding other antiseptic or antibiotic solutions, the number of studies and participants were too small for evaluation.</p><p><strong>Conclusion: </strong>Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution did not have enough efficacy for preventing SSI during gastroenterological surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"38"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029873","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":"State-of-the-art anesthesia practices: a comprehensive review on optimizing patient safety and recovery.","authors":"Guolu Fu, Lili Xu, Huaqing Chen, Jinping Lin","doi":"10.1186/s12893-025-02763-6","DOIUrl":"10.1186/s12893-025-02763-6","url":null,"abstract":"<p><strong>Objective: </strong>This review explores recent advancements in anesthesia care, focusing on the integration of innovative practices to enhance patient outcomes across the perioperative period.</p><p><strong>Methods: </strong>Following the framework of Whitmore and Knafl, we systematically searched six databases (PubMed, Google Scholar, EMBASE, CINAHL, OVID, and Cochrane Library) for studies published from January 2020 to January 2024, relating to advancements in anesthesia care, best practice implementation, and patient outcomes. After independent screening and data extraction by two reviewers, the review focuses on innovations in anesthetic drugs, monitoring technologies, anesthesia techniques, and evidence-based practices in anesthesia and clinical guidelines.</p><p><strong>Results: </strong>Of the 25,984 studies retrieved, 26 met inclusion criteria. Recent developments in anesthetic drugs have improved safety and efficacy, reducing complications. Advanced monitoring devices, such as multiparameter and brain function monitors, have enhanced patient safety through real-time assessments. Innovations in regional anesthesia and ultrasound-guided nerve blocks have led to better pain management, reduced recovery time, and minimized morbidity. Additionally, evidence-based practices like comprehensive preoperative assessment, patient education, and multidisciplinary teamwork significantly improved patient outcomes.</p><p><strong>Conclusion: </strong>Integrating the latest innovations and best practices in anesthesia care is essential for optimizing patient outcomes. Ongoing research and adoption of advanced technologies are crucial to addressing current challenges and enhancing anesthesia quality. This review emphasizes the importance of a holistic approach from preoperative preparation to postoperative recovery to achieve optimal patient outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"32"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014833","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":"Application of fourier transform infrared vibrational spectroscopy in identifying early biochemical changes in lipid profiles of individuals undergoing Roux-en-y gastric bypass.","authors":"Amanda Motta de Bortoli, Márcia Helena Cassago Nascimento, Blanca Elena Guerrero Daboin, Beatriz Bobbio de Brito, Luiza Recla Pessotti, Paulo Roberto Filgueiras, Andressa Bolsoni Lopes, Valerio Garrone Barauna, Fabiano Kenji Haraguchi","doi":"10.1186/s12893-024-02707-6","DOIUrl":"10.1186/s12893-024-02707-6","url":null,"abstract":"<p><strong>Background: </strong>Fourier transform infrared spectroscopy (FTIR) is an analytical technique increasingly applied in biological analysis. This study investigates the application of FTIR to identify early biochemical changes, particularly in lipid profiles, in individuals undergoing Roux-en-Y gastric bypass (RYGB).</p><p><strong>Methods: </strong>An observational study involving patients from a university hospital's Bariatric and Metabolic Surgery Program, with evaluations performed before (T0) and two months after (T1) RYGB. Biochemical parameters, anthropometric data, and body composition were assessed. FTIR spectra were pre-processed and analyzed using Principal Component Analysis and Partial Least Squares Discriminant Analysis. The normality of the data was evaluated using the Kolmogorov-Smirnov test, followed by paired T-tests or Wilcoxon tests as appropriate. Spearman correlation analysis of spectral information with biochemical parameters was also performed. A significance level of p < 0.05 was set for all tests. The university hospital's Research Ethics Committee approved the study (protocol CAAE 59075722.7.0000.5071).</p><p><strong>Results: </strong>The study evaluated 29 individuals (86.2% female) with a mean age of 41.2 ± 7.8 years. Significant differences were observed in anthropometric parameters and body composition (p < 0.001). Additionally, early improvements in the lipid profile were noted, with significant decreases in triglycerides, total cholesterol, and LDL cholesterol (p < 0.05) just two months post-surgery. FTIR identified correlations between biochemical parameters and specific spectral regions at T0 and T1. Notably, serum triglycerides showed a significant correlation with the lipid-specific spectral region (1796-1685 cm^- 1) at both time points (p < 0.05).</p><p><strong>Conclusion: </strong>FTIR can effectively monitor biochemical changes in RYGB surgery patients. The spectral range associated with lipid functional groups (1796 -1675 cm⁻¹) showed a significant relationship with serum triglyceride levels before and after RYGB. Additionally, various biochemical parameters exhibited strong correlations with other spectral regions, implying that the serum spectral profile can indicate biochemical variations at different post-surgery stages.</p><p><strong>Trial registration: </strong>Brazilian Registry of Clinical Trials (Rebec), September 5, 2022, protocol RBR-26chs2g.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"33"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014763","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":"Experience in the treatment of type C congenital esophageal atresia using a staged approach.","authors":"Yong Zhao, Shihui Tan, An Wang, Shuangshuang Li, Junmin Liao, Dingding Wang, Kaiyun Hua, Yichao Gu, Yanan Zhang, Jinshi Huang","doi":"10.1186/s12893-025-02771-6","DOIUrl":"10.1186/s12893-025-02771-6","url":null,"abstract":"<p><strong>Background: </strong>In select patients with type C esophageal atresia, primary anastomosis is not appropriate and a staged approach is required. We aim to summarize our experience in the management of type C EA using a staged approach.</p><p><strong>Methods: </strong>A retrospective chart-review of patients with type C EA admitted to Beijing Children's Hospital between July 2020 to October 2023 were conducted. Those diagnosed with type C EA who were not amendable to primary anastomosis were included for analysis. Clinical information was recorded, and follow- up was performed.</p><p><strong>Results: </strong>Seven (five boys) patients with type C EA who received staged repair were included in the study. Initial surgeries included thoracotomy and thoracoscopy. 71% (5/7) patient had complications after the initial surgery, including pyopneumothorax, pneumonia, recurrent tracheoesophageal fistula (rTEF), and anastomotic leak. Esophageal elongation techniques were applied in 3 patients. All delayed anastomosis were performed thoracoscopically, except for in one case where spontaneous fistulization occurred and no anastomosis were necessary. Complications after delayed anastomosis included recurrent esophageal pulmonary fistula (rEPF) in 50% (3/6), anastomotic leak in 33% (2/6), and esophageal stricture in all (6/6) patients. After a median follow-up of 14 months (range: 2-24), all patients were in generally good condition.</p><p><strong>Conclusion: </strong>Primary operations should be kept simple and minimal in patients diagnosed with type C EA who are not appropriate for primary anastomosis. Internal traction is an effective method that allows for subsequent anastomosis. Intraoperative indocyanine green fluorescence can aid in fistula determination and anastomosis.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"35"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014807","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":"Incentivizing environmental sustainability for surgical healthcare at a systems level.","authors":"Elizabeth Christophel, Russell Seth Martins, Kyle Tafuri, Faiz Y Bhora","doi":"10.1186/s12893-024-02738-z","DOIUrl":"10.1186/s12893-024-02738-z","url":null,"abstract":"<p><p>The healthcare sector contributes up to 4.6% of global greenhouse gas emissions. The surgical system contributes predominantly. Despite this, many hospitals have been slow to adopt sustainable practices. This editorial discusses strategies to incentivize surgical healthcare systems to prioritize more sustainable operations, using examples from other industries as well as healthcare systems from more sustainable nations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"34"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014832","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 learning curve for laparoscopic-assisted single-port mediastinoscopic esophagectomy: an analysis of proficiency.","authors":"Wenhao Li, Xiangfeng Gan, Liangzhan Lv, Yingmeng Wu, Weizhao Huang, Yi Liang, Qingdong Cao","doi":"10.1186/s12893-025-02772-5","DOIUrl":"10.1186/s12893-025-02772-5","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic-assisted single-port mediastinoscopic esophagectomy is a safe and effective emerging minimally invasive esophagectomy, but little has been reported about the learning curve for this technology. The goal of the study was to determine the number of procedures to achieve different levels of proficiency on the learning curve.</p><p><strong>Methods: </strong>This study retrospectively analyzed data from consecutive surgeries performed by the same surgeon at the same center from 2016 to 2021. Learning curves were quantitatively assessed by unadjusted cumulative sums, different segments were derived using jointpoint linear regression analysis, and variables were compared between subgroups using trend analysis.</p><p><strong>Results: </strong>The learning curve could be divided into 3 different proficiency stages: the 1st-91st, 91st-125th, and 125th-182nd procedures comprised the preliminary, transition, and proficient stages, respectively. Compared with the preliminary stage, the procedure time [275 (250-300) vs 178.5 (161.5-205.0) min, P < .001], bleeding volume [100 (100-200) vs 50 (50-80) mL, P < .001], postoperative hospital stays [15 (13-31) vs 13 (11-17) d, P = .006], and the incidence of anastomotic fistula(20.9% vs 5.2%, P = .017) were significantly lower in the proficiency stage, whereas the number of harvested total lymph nodes [17 (12-23) vs 22 (16-29), P = .002], total mediastinal lymph nodes [7 (5-11) vs 13 (9-18), P < .001] and the rate of recurrent laryngeal nerve lymph node harvest (71.4% vs 96.6%, P < .001) was significantly higher.</p><p><strong>Conclusions: </strong>There may be 3 stages of varying proficiency in the learning curve of laparoscopic-assisted single-port mediastinoscopic esophagectomy. Approximately 91 consecutive procedures were required to overcome the preliminary stage, whereas proficiency in this technique required approximately 125 consecutive procedures.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"29"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014544","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 efficacy of open transanal drainage tube against anastomotic leakage in left-sided colorectal cancer surgery: a propensity score matching study.","authors":"Gen Tsujio, Tatsunari Fukuoka, Atsushi Sugimoto, Ken Yonemitsu, Yuki Seki, Hiroaki Kasashima, Yuichiro Miki, Mami Yoshii, Tatsuro Tamura, Masatsune Shibutani, Takahiro Toyokawa, Shigeru Lee, Kiyoshi Maeda","doi":"10.1186/s12893-025-02775-2","DOIUrl":"10.1186/s12893-025-02775-2","url":null,"abstract":"<p><strong>Background/aim: </strong>The effectiveness of a transanal drainage tube (TAT) for the prevention of anastomotic leakage after double stapling technique (DST) anastomosis in colorectal cancer has been reported. Previously, TATs had been placed and connected to drainage bags. It was considered that a higher decompression effect could be expected by inserting an open-type TAT, without connection to a drainage bag. In this study, the relation between anastomotic leakage and the application of this type of TAT in left-sided colorectal cancer surgery was investigated, using propensity score matching (PSM).</p><p><strong>Materials and methods: </strong>From January 2016 to July 2023, 233 consecutive patients underwent radical surgery for sigmoid colon and rectal cancers and reconstruction using DST at Osaka Metropolitan University Hospital. Patients were divided into two groups: those who had a closed TAT inserted (CLOSED group), and those who had an open TAT inserted (OPEN group).</p><p><strong>Results: </strong>Overall, open TATs were inserted in 43 patients, and closed TATs were inserted in 190 patients. PSM was performed between the OPEN and CLOSED groups on the basis of the following 13 factors: age, sex, BMI, diabetes mellitus (DM), smoking history, modified Glasgow prognostic score (mGPS), ASA-PS, location of distal tumor edge, operative procedure, surgical approach, operative time, intraoperative blood loss, and pathological stage. The multivariate analysis of significant factors identified a BMI of 25 or more, a location of distal edge on middle to lower rectum, and a closed TAT, as independent risk factors for anastomotic leakage (HR: 8.72; p = 0.038, HR: 10.06; p = 0.034 and HR: 17.43; p = 0.033).</p><p><strong>Conclusion: </strong>An open TAT may be effective in preventing anastomotic leakage in left-sided colorectal cancer surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"31"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014834","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":"Efficacy of ursodeoxycholic acid in reducing the necessity of cholecystectomy due to pre-existing and subsequently formed gallstones in patients who underwent laparoscopic sleeve gastrectomy.","authors":"Muhammed Taha Demirpolat, Muhammet Oğuz Celikkaya, Suleyman Cağlar Ertekin, Fatih Basak, Abdullah Sisik","doi":"10.1186/s12893-025-02767-2","DOIUrl":"10.1186/s12893-025-02767-2","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to investigate whether ursodeoxycholic acid (UDCA) would reduce the necessity of cholecystectomy in patients diagnosed with asymptomatic gallstones after laparoscopic sleeve gastrectomy (LSG) and in patients diagnosed with asymptomatic gallstones before LSG.</p><p><strong>Methods: </strong>Between July 2020 and November 2022, at least 2-year follow-ups of patients who underwent LSG for obesity were retrospectively analyzed. Patients with pre-existing asymptomatic gallstones during preoperative evaluation, those with UDCA treatment (group 1), and observation group (group 2). Patients with newly formed gallstones in postoperative outpatient clinic follow-up, those with UDCA treatment (group A), and those without UDCA treatment (group B).</p><p><strong>Results: </strong>A total of 425 patients included. At the end of the first year, patients who had newly formed gallstones after LSG had a higher total weight loss percentages (TWL%) (39.8 ± 6.1) compared to those who did not develop gallstones (37.9 ± 7.4), which were statistically significant (p = 0.004). Among patients who developed gallstones postoperatively, UDCA treatment was associated with a significantly lower cholecystectomy rate in patients with newly formed gallstones postoperatively (p = 0.025), while no significant difference was shown in patients with preoperative gallstones (p = 0.631).</p><p><strong>Conclusion: </strong>UDCA is a promising option for reducing the need for cholecystectomy in patients with post-LSG gallstones, but it appears ineffective for pre-existing gallstones.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"30"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014805","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 influence of body mass index on efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES) for the treatment of lumbar degenerative diseases: a retrospective cohort study.","authors":"Chenyang Zhuang, Yun Xu, Hong Lin, Yutong Gu","doi":"10.1186/s12893-025-02761-8","DOIUrl":"10.1186/s12893-025-02761-8","url":null,"abstract":"<p><strong>Background: </strong>To investigate and quantify the influence of body mass index (BMI) on the efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES), a novel minimally invasive surgical technique in the treatment of lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A total of 55 patients suffering from single-level LDH with or without high iliac crest, scoliosis or calcification, who underwent PTES in our department from January 2019 to December 2021 were retrospectively analyzed. Patients were divided into two groups according to BMI. The operative events of two groups including X-ray projection, operation time, blood loss and length of stay were compared. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy and outcomes of the surgery. Differences in complications and recurrences between two groups were also analyzed.</p><p><strong>Results: </strong>55 patients were divided into obese and nonobese groups according to their BMI (33.03 vs. 23.07). There was no significant difference in X-ray projection (times), operation time (mins), blood loss (mL) and length of stay (days) between two groups (7/5-11 vs. 5/5-10, 58.17 ± 9.20 vs. 53.65 ± 10.06, 6.41 ± 1.43 vs. 5.50 ± 2.45, 3.17 ± 1.44 vs. 2.96 ± 0.53, P > 0.05). Both groups demonstrated a significant decrease in ODI (12.01 ± 3.57% vs. 67.16 ± 9.25%, 13.92 ± 4.24% vs. 68.10 ± 9.27%, P < 0.05) and VAS (0.10 ± 0.48 vs. 8.38 ± 0.94, 0.22 ± 0.56 vs. 8.38 ± 0.86) at 24 months after the operation compared with which at the preoperative status. No significant difference in the improvement of the clinical outcomes was found between the two groups in ODI or VAS (P > 0.05).</p><p><strong>Conclusions: </strong>With the simple orientation, easy puncture and reduced steps, PTES is an effective and safe method to both obese and normal patients with LDH.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"28"},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014343","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}