BMC Surgery最新文献

{"title":"A nomogram for predicting 3-year total weight loss percentage following LSG: insights from visceral adipose tissue inflammatory methylation sites.","authors":"Zhehong Li, Liang Wang, Zheng Wang, Qiqige Wuyun, Buhe Amin, Dongbo Lian, Guangzhong Xu, Nengwei Zhang, Dezhong Wang","doi":"10.1186/s12893-025-03073-7","DOIUrl":"10.1186/s12893-025-03073-7","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a chronic low-grade inflammatory condition. Laparoscopic sleeve gastrectomy (LSG) is a widely recognized intervention for weight management; however, the percentage of total weight loss (%TWL) achieved varies significantly among patients.</p><p><strong>Objective: </strong>This study aims to develop a nomogram based on methylation sites associated with the inflammatory (INF) in intraoperative visceral adipose tissue (VAT) to predict %TWL at three years post-LSG.</p><p><strong>Methods: </strong>Patients undergoing LSG were categorized into two groups based on their%TWL three years post-LSG: satisfactory (%TWL ≥25) and unsatisfactory (%TWL<25). Comparative analyses of 850K methylation microarrays from VAT samples were performed to identify methylation sites associated with INF-related genes. Differentially methylated sites were analyzed using least absolute shrinkage and selection operator, random forest, and support vector machine with recursive feature elimination analyses to identify key predictive methylation sites. A nomogram was subsequently developed using these hub methylation sites. The model's performance was assessed through receiver operating characteristic (ROC) curve analysis with bootstrap resampling, calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC).</p><p><strong>Results: </strong>Among 25 patients (11 satisfactory and 14 unsatisfactory), 151 differential INF-related methylation sites were identified. Two hub methylation sites, cg14027957 and cg20666492, were selected as predictors for the nomogram. Internal validation demonstrated excellent predictive performance, with an area under the curve (AUC) of 96.8%. The model also showed strong calibration and clinical utility.</p><p><strong>Conclusion: </strong>The nomogram, based on two hub methylation sites, effectively predicts%TWL outcomes three years post-LSG. Its high predictive accuracy and clinical relevance suggest significant potential for guiding personalized treatment strategies in patients undergoing LSG.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"319"},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734896","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":"Evaluating the necessity of right hemicolectomy in high-risk appendiceal neuroendocrine tumors: a retrospective analysis.","authors":"Tolga Canbak, Olgun Erdem, Aylin Acar, Fatih Başak","doi":"10.1186/s12893-025-03037-x","DOIUrl":"10.1186/s12893-025-03037-x","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"320"},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734899","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 diabetic paradox differs in patients with prediabetes and normal glucose regulation after colorectal surgery.","authors":"John D Mannion, Assar Rather, Adrianne Fisher, Margaret McEvilly, Kelly Gardner, Gary Siegelman","doi":"10.1186/s12893-025-03040-2","DOIUrl":"10.1186/s12893-025-03040-2","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"316"},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734903","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":"Association between thickness of subcutaneous fat and incisional surgical site infection following appendectomy: a systematic review and meta-analysis on observational studies.","authors":"Mansour Bahardoust, Yasaman Asadi Kalbibaki, Sara Shiraghaie, Shabnam Rashidi, Mohammadsadra Shamohammadi, Ali Hashemi Kiapay, Meisam Haghmoradi, Babak Goodarzy, Adnan Tizmaghz","doi":"10.1186/s12893-025-03010-8","DOIUrl":"10.1186/s12893-025-03010-8","url":null,"abstract":"<p><strong>Background: </strong>The relationship between thickness of subcutaneous fat (TSF) and surgical site infection (SSI), as one of the most common complications after appendectomy, has been inconsistent in different studies, which may be due to the low power of these studies. This meta-analysis aimed to investigate the relationship between SSI and TSF after open surgery (OS) and laparoscopic surgery (LS) in patients with appendicitis.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Google Scholar, and Web of Science databases were searched based on mesh terms to find relevant studies from the beginning of 2000 to 2024. The mean TSF during surgery was defined as exposure, and SSI after OS or laparoscopy appendectomy was defined as an outcome. The heterogeneity between studies was assessed using Cochran's Q and I2 tests. Meta-regression was employed to manage the heterogeneity. Nine studies, including 4,439 patients, were included.</p><p><strong>Results: </strong>The pooled estimate from nine studies indicated that an increase in TSF was significantly associated with an increased risk of SSI(OR: 1.32, 95% CI: 1.12, 1.52, I²: 82.4%, p: 0.001). Subgroup analysis showed that TSF in patients undergoing OS was significantly associated with increased risk of SSI (OR: 1.82, 95% CI: 1.27, 2.38, I²: 84.3%, P: 0.001). In contrast, in patients undergoing LS, mean TSF was not significantly associated with increased risk of SSI (OR: 1.09, CI: 0.90, 1.28, I²: 53.1%, P: 0.001).</p><p><strong>Conclusion: </strong>TSF was significantly associated with an increased risk of SSI after OS, while it was not significantly associated with an increased risk of SSI in laparoscopically operated patients. Considering TSF during surgery to choose the appropriate surgical method and post-treatment care can help prevent and reduce the risk of SSI after appendectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"312"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692128","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":"Breast reconstruction using hand-meshed free dermal autograft: a case series.","authors":"Sayyed Mohammad Reza Hakimian, Habibollah Mahmoodzadeh","doi":"10.1186/s12893-025-03055-9","DOIUrl":"10.1186/s12893-025-03055-9","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction with implants immediately after mastectomy has attracted great attention in recent years. Acellular dermal matrices (ADM) are commonly used for breast reconstruction. However, it has drawbacks such as high cost, infection, and seroma formation. Herein, we present a method for implant-based breast reconstruction using hand-meshed free dermal autograft in pre-pectoral (harvested corium-covered implant (HACCIM)) and partial subpectoral implant-based breast reconstruction procedures.</p><p><strong>Methods: </strong>A total of 22 patients, including 17 patients with unilateral and 5 patients with bilateral breast reconstruction were included in this study. Twenty-seven breasts underwent one-stage pre-pectoral (n = 11) and partial subpectoral (n = 16) implant-based breast reconstructive surgery using patients-derived hand-meshed free dermal autograft. Patients' characteristics, clinical and operative data, and outcomes of interest were examined and recorded.</p><p><strong>Results: </strong>The median age and BMI of patients who underwent breast reconstruction were 44.5 years (ranging from 34 to 65 years) and 24.97 kg/m² (ranging from 20.57 to 32.87 kg/m²) respectively. The follow-up duration ranged from 2 to 13 months (Median: 8 months). The mean time of free dermal autograft harvest and preparation was 30.26 ± 6.22 min. Superficial skin flap necrosis was observed in 8 breasts (29.63%) with 4 breasts in the partial subpectoral group and 4 in the pre-pectoral group. All minor skin flap necroses were managed successfully by outpatient care. Implant failure occurred in 4 breasts (14.81%), comprising 3 breasts in the partial subpectoral group and one in the pre-pectoral group. Three of the patients who showed implant failure had a history of radiation therapy, and the last one had full-thickness skin flap necrosis related to skin-sparing mastectomy.</p><p><strong>Conclusions: </strong>Our study indicated that free dermal autograft can be utilized safely in one-stage pre-pectoral and subpectoral implant-based breast reconstruction. Further interventional studies are required to affirm our findings.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"310"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692129","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 outcomes of rib graft use in rhinoplasty: a meta-analysis.","authors":"Qian Wang, Jing Liu, Zhixing Chen","doi":"10.1186/s12893-025-03022-4","DOIUrl":"10.1186/s12893-025-03022-4","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"314"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692131","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":"Can liver venous system diameters predict difficulty of laparoscopic liver resection?","authors":"Wojciech A Serednicki, Anna Grochowska, Wacław Hołówko, Anna Dąbrowska, Natalia Janik, Michał Pędziwiatr","doi":"10.1186/s12893-025-03051-z","DOIUrl":"10.1186/s12893-025-03051-z","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic liver resection is a feasible and fast-disseminating, yet demanding technique that requires careful preoperative preparation. Due to its varying difficulty, many scales were developed to evaluate possible intraoperative difficulties and to select cases properly, especially during the learning curve. Our aim was to seek additional radiological parameters, such as liver venous system diameters, that may be useful in assessing possible intraoperative difficulties and predicting postoperative outcomes.</p><p><strong>Methods: </strong>A retrospective study included 85 patients who underwent laparoscopic liver resection with previous computed tomography or magnetic resonance. Patients were divided into 3 groups of varying difficulty according to the Institute Mutualiste Montsouris (IMM) scale. Using syngo.via radiological system, the diameters of portal vessels and inferior vena cava were measured. Statistical analysis was performed to assess the correlation between measured radiological parameters and perioperative outcomes.</p><p><strong>Results: </strong>Statistical analysis showed no correlation between portal and splenic vein diameter and perioperative outcomes in all patient population and in each of the IMM groups. Superior mesenteric vein (SMV) diameter correlated positively with intraoperative complication rate, but only in the IMM 2 group. Intraoperative Oslo complication rate was higher in < 10 mm splenic vein diameter group and the Clavien-Dindo complication rate was higher in < 13 mm SMV population, but only in the IMM 2 group.</p><p><strong>Conclusions: </strong>Our study presents that portal system veins and inferior vena cava (IVC) diameter have low relevance to perioperative outcomes and don't seem to be a good predictor of intraoperative blood loss and complication rate. However, they may be useful in selected difficulty groups, therefore further studies addressing this issue may be beneficial.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"313"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692130","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 indocyanine green fluorescence imaging on skin flap necrosis: a systematic review and meta-analysis.","authors":"Lin Chun, Zhiping Fu, YingJun Zheng, Haomin Lin, Yue Hu, Donglun Li","doi":"10.1186/s12893-025-03048-8","DOIUrl":"10.1186/s12893-025-03048-8","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"311"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692132","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":"VacStent as a novel therapeutic approach for esophageal perforations and anastomotic leaks- a systematic review of the literature.","authors":"Dimitrios Kehagias, Sameh Abogabal, Charalampos Lampropoulos, Muhammad Ijlal Haider, Ioannis Kehagias, Prashant Jain, Vincent Wong","doi":"10.1186/s12893-025-03067-5","DOIUrl":"10.1186/s12893-025-03067-5","url":null,"abstract":"<p><strong>Background: </strong>Perforation and anastomotic leak (AL) of the esophagus remain a dreaded complication for surgeons, endoscopists and patients. The VacStent is a novel endoscopic device, combining the benefits of a self-expandable metallic stent (SEMS) and endoscopic vacuum therapy (EVT). This systematic review aims to investigate the efficacy and clinical outcomes associated with the use of the VacStent.</p><p><strong>Methods: </strong>A systematic literature review was conducted in PubMed and Google Scholar electronic databases using keywords and Medical Subject Headings terms. Peer-reviewed studies in English language that reported the use of VacStent for transmural defects of any cause of the esophagus and gastroesophageal junction (GEJ) were included. Data regarding technical details of the VacStent, outcomes, and complications were extracted and presented in a narrative synthesis. Clinical success was defined as closure of the defect without requiring further intervention.</p><p><strong>Results: </strong>Of the 153 articles identified after searching, nine studies were deemed eligible and included in the final analysis. The methodological quality of the included studies was generally moderate. Sixty-five patients underwent VacStent treatment for the following indications: AL (70%), Boerhaave syndrome (10%), iatrogenic perforation (10%), and other causes (10%). The mean interval between VacStent changes was 5.3 (2-8) days. Prior endoscopic interventions, including SEMS, clips, and EVT, had been performed in 25 patients (38%). The mean duration of VacStent therapy was 8.8 ± 8.3 days. On average, each patient received between one and three VacStents. Technical success was achieved in all 65 cases (100%), while clinical success was observed in 50 patients (77%). Approximately 70% of patients were able to tolerate a liquid diet during treatment, and no major complications were reported.</p><p><strong>Conclusions: </strong>The VacStent appears as a promising tool, integrating the benefits of both EVT and SEMS, while allowing oral intake. The included studies present preliminary data, warranting cautious interpretation. Further evidence is required to delineate the clinical utility and appropriate indications for VacStent therapy.</p><p><strong>Trial registration: </strong>PROSPERO database (UIN: CRD420251012718).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"309"},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683472","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 the efficacy of single-port laparoscopy combined with fascial puncture needle-assisted external abdominal wall ligation of the spermatic vein versus traditional three-port laparoscopy in the treatment of adolescent varicocele: a single-center retrospective study.","authors":"Guiping Yao, Zhiwei Wang, Fengming Ji, Jinrong Li, Kun Zhang, Zipeng Hao, Qiurong Li, Dewei Zhang, Chenghao Zhanghuang, Bing Yan","doi":"10.1186/s12893-025-03046-w","DOIUrl":"10.1186/s12893-025-03046-w","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"308"},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683471","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}