BMC Surgery最新文献

{"title":"Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study.","authors":"Yunqing Zhang, Kun Lu, Qi Liu, Chun Liu, Shilong Su, Chunhua Yang","doi":"10.1186/s12893-025-02872-2","DOIUrl":"10.1186/s12893-025-02872-2","url":null,"abstract":"<p><strong>Background: </strong>Serum calcium is the critical coagulation factor in physiological coagulation, and hypocalcemia has been found to be associated with more blood loss in many diseases. The purpose of this study was to explore the effect of hypocalcemia on total blood loss (TBL) and blood transfusion in elderly patients with hip fracture.</p><p><strong>Patients and methods: </strong>Elderly patients with hip fracture undergoing surgery in our hospital were included in this study from January 2020 to May 2023. The demographic data, perioperative parameters, hemoglobin, hematocrit, and transfusion requirement were recorded and analyzed. Hypocalcemia was defined as an albumin-corrected calcium level of less than 2.15 mmol/L. TBL of each patient was calculated using the formulas of Nadler and Gross. Blood loss on the 1st and 5th postoperative days was calculated.</p><p><strong>Results: </strong>682 elderly patients with hip fracture were included in the study. On admission, the prevalence of hypocalcemia was 40.47%. Both the TBL on the first day (714.91 ± 396.05 ml vs. 640.31 ± 398.83 ml, P = 0.016) and the fifth day (1035.87 ± 528.77 ml vs. 859.92 ± 434.99 ml, P < 0.001) after operation in the hypocalcemia group were higher than those in the normocalcemia group. The preoperative, postoperative and perioperative blood transfusion rates of hypocalcemia patients were higher than those of the normocalcemia group.</p><p><strong>Conclusion: </strong>Hypocalcemia was associated with increased TBL and blood transfusion in elderly patients with hip fracture during the perioperative period.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"134"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789095","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":"Effect of Roux-en-Y gastric bypass on patients with type 2 diabetes mellitus and body mass index of 27.5-35 kg/m²-a single center retrospective cohort study.","authors":"Xiang Gao, Tao Wang, Jiahao Li, Weizheng Li, Liyong Zhu, Shaihong Zhu, Zhi Song, Pengzhou Li","doi":"10.1186/s12893-025-02879-9","DOIUrl":"10.1186/s12893-025-02879-9","url":null,"abstract":"<p><strong>Introduction: </strong>While Roux-en-Y gastric bypass (RYGB) has been extensively studied in patients with type 2 diabetes mellitus (T2DM) and preserved islet function, the significance of insulin resistance in guiding RYGB treatment remains unclear. This study aimed to evaluate the efficacy of RYGB in T2DM patients with a low body mass index (BMI, 27.5-35 kg/m²), insulin resistance, and impaired β-cell function.</p><p><strong>Methods: </strong>A retrospective cohort of 34 T2DM patients with low BMI who underwent RYGB at our institution was analyzed. Insulin resistance was assessed using hyperinsulinemic euglycemic clamp. The indicators related to glucose and lipid metabolism were also assessed and collected at baseline and 12 months postoperatively.</p><p><strong>Results: </strong>Significant reductions in BMI and HbA1c were observed within 12 months post-surgery (P < 0.05). Fasting plasma glucose decreased from 9.40 ± 3.12 mmol/L to 5.87 ± 2.67 mmol/L (P < 0.05). Complete remission rates were 31.25% for T2DM, 100% for hypertriglyceridemia, and 70% for hypertension. Multivariable logistic analysis identified shorter diabetes duration (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.83-0.95, P = 0.025), higher BMI (OR 1.14, 95% CI 1.06-1.34, P = 0.033), and lower peripheral glucose disposal rate (OR 0.95, 95% CI 0.93-0.97, P = 0.043) as independent predictors of diabetes remission.</p><p><strong>Conclusions: </strong>Patients with T2DM and low BMI who have insulin resistance may still benefit from RYGB, even if they exhibit impaired β cell function. Shorter duration of diabetes, higher BMI and lower peripheral glucose disposal rate were independent predictors of diabetes remission after RYGB.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"135"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789142","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":"Microsurgical encapsulated resection of brachial plexus schwannoma with intraoperative neuromonitoring to preserve neurological function: 36 cases report and literature review.","authors":"Jingsen Chen, Xiao Dong, Shenglong Cao, Hanghuang Jin, Haiying Hu, Taizhou","doi":"10.1186/s12893-025-02842-8","DOIUrl":"10.1186/s12893-025-02842-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of protecting neural function of microsurgical encapsulated resection of brachial plexus schwannoma with intraoperative neuromonitoring.</p><p><strong>Methods: </strong>36 patients with 36 brachial plexus schwannoma were retrospectively analyzed, who underwent surgical treatment in our department from June 2016 to December 2023. The age, gender, tumor size and location, preoperative symptoms, ultrasound and magnetic resonance imaging(MRI) findings, and postoperative functions of the patients were analyzed.</p><p><strong>Results: </strong>The common symptoms of brachial plexus schwannoma were palpable masses(36/36), local tenderness(30/36), sensory changes(10/36), and positive Tinel's sign(30/36). 11 tumors were located in the nerve roots, 10 in the trunks, 10 in the divisions and cords, and 4 in the branches, 1 intraspinal and extraspinal invasion extending from c5-c6 intervertebral foramen. Complete microsurgical encapsulated resection with intraoperative neuromonitoring was performed in all 36 patients. 6 patients developed neurogenic pain in the early postoperative period. 3 patients experienced transient postoperative motor dysfunction, which were alleviated after 6 months. According to an follow-up for at least 3 months, there were no recurrence happened in this study.</p><p><strong>Conclusions: </strong>The surgical technique of microsurgical encapsulated resection of brachial plexus schwannoma with intraoperative neuromonitoring is safe and may preserve neurological function.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"133"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789173","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":"Analgesic efficacy of a laparoscopic-guided transversus abdominis plane block versus no transversus abdominis plane block in bariatric gastric bypass surgery a retrospective analysis among 332 individuals.","authors":"Gianluca De Santo, Oliver Stumpf, Peter Look, Marc Abdelmalek, Rolf Lefering, René Mantke, Christoph Paasch","doi":"10.1186/s12893-025-02880-2","DOIUrl":"10.1186/s12893-025-02880-2","url":null,"abstract":"<p><strong>Background: </strong>To reduce opioid consumption and improve early mobility, the administration of a transversus abdominis plane block (TAP) was introduced in abdominal surgery decades ago. But the usefulness of this nerve block prior to laparoscopic Roux-Y gastric bypass (LRYGB) in patients with obesity is still under debate. Hence, the study at hand was conducted.</p><p><strong>Methods: </strong>In 2023 a retrospective single-centre analysis among patients who did or did not receive a laparoscopic (L) TAP block prior to LRYGB was performed. The primary objective was the early postoperative pain level (1 h) using the visual analog scale (VAS) after LRYGB. Main secondary objectives were the determination of the pain level from 1 to 80 h after surgery and the cumulative postoperative painkiller use.</p><p><strong>Results: </strong>A total of 111 individuals received and 202 did not receive a L-TAP block prior to LRYGB. The groups were homogeneous with respect to age, gender distribution and Body Mass Index. No L-TAP related complications occurred. After multivariate analysis the administration of the nerve block had no effect on relevant pain (VAS ≥ 6) from one to 80 h after LRYGB. One hour after surgery, the individuals who received the L-TAP suffered, with significance, from less pain (VAS score 2.77 vs. 3.84: p < 0.001) in comparison to those who did not receive the nerve block. No difference was revealed in terms of cumulative postoperative opioid painkiller use.</p><p><strong>Conclusion: </strong>The L-TAP block is a safe procedure and sufficiently reduces post-operative pain one hour after gastric bypass surgery, but does not bring any benefits in the further course.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"136"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788912","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":"Effect of vertebral rotation on adjacent segment degeneration after the early stage of lumbar fusion surgery.","authors":"Bin Ye, Yachao Ma, Zhipeng Tu, Peipei Huang, Zhou Yao, Zhe Wang, Zhuojing Luo, Xueyu Hu","doi":"10.1186/s12893-025-02871-3","DOIUrl":"10.1186/s12893-025-02871-3","url":null,"abstract":"<p><strong>Objective: </strong>Related studies have shown that the torsional vertebral after fused significantly increase adjacent disc stress and accelerate degeneration. This suggests that vertebral rotation (VR) may accelerate adjacent segment degeneration (ASD). To investigate: (1) the correlation between VR and radiographic adjacent segment degeneration (rASD) after the early stage of lumbar fusion (2), the incidence of rASD with different VR degrees (3), whether the incidence of rASD can be reduced by surgically reducing instrumented vertebrae (IV) rotation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the cases of 195 patients with lumbar degenerative disease (LDD) who were selected based on inclusion and exclusion criteria. The grade and angle of VR were measured for accurate analysis. The final follow-up evaluated the clinical improvement of the patients and the rASD. The impact of various factors on rASD was observed using univariate and multivariate logistic regression analyses. With different VR grades, Kaplan-Meier survival analysis was used to describe the incidence of rASD at various follow-up intervals.</p><p><strong>Results: </strong>The results indicate that preoperative adjacent vertebrae (AV) rotation (OR = 1.852, 95% CI = 1.064-3.224, P = 0.029) and IV rotation at final follow-up (OR = 2.748, 95% CI = 1.458-5.177, P = 0.002) are the independent risk factors for rASD. The results of the Kaplan-Meier analysis showed that with different VR grades, the follow-up period was different when the cumulative incidence of rASD reached 50%. The AV rotation decreased in the patients whose IV rotation decreased after the operation (P < 0.001), and the incidence of rASD was also lower (P = 0.004), especial in the fused to S1 group.</p><p><strong>Conclusions: </strong>VR is a risk factor for rASD at the early stage of lumbar fusion surgery. Reducing VR during surgery can alleviate the speed of ASD and reduce the incidence of rASD in fused to S1.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"131"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789162","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":"Patient-specific instrumentation technology enhances clinical outcomes in total elbow arthroplasty.","authors":"Changgui Zhang, Hongquan Heng, Shu Deng, Xin Chen, Guangxing Chen, Hao Chen","doi":"10.1186/s12893-025-02864-2","DOIUrl":"10.1186/s12893-025-02864-2","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the outcomes of utilizing patient-specific instrumentation (PSI) technology, which incorporates personalized three-dimensional (3D) preoperative planning and customized 3D printing (3DP) osteotomy guides, against those achieved with traditional instruments in total elbow arthroplasty (TEA).</p><p><strong>Methods: </strong>A retrospective study was conducted to analyze the clinical data of 20 patients diagnosed with elbow arthritis who underwent TEA at the Center for Joint Surgery, The First Hospital Affiliated to Army Medical University, China, between January 2010 and July 2023. Patients were categorized into two groups according to the surgical techniques employed: 9 patients underwent personalized preoperative 3D planning and used customized 3DP osteotomy guides for TEA (3DP group); another 11 patients underwent TEA using traditional instruments and experience-based techniques (traditional group). The intraoperative fluoroscopy frequency, Mayo elbow performance score (MEPS), and Mayo elbow score before and after surgery in both groups were recorded. Additionally, in the 3DP group, changes in the imaging indicators such as the angle between the axis of humerus medullary cavity and the hinge axis of elbow (H-H angle), the angle between the axis of middle ulna medullary cavity and the hinge axis of elbow (MU-H angle), the angle between the axis of proximal ulna medullary cavity and the hinge axis of elbow (PU-H angle) were assessed before and after surgery.</p><p><strong>Results: </strong>No significant differences were observed in the baseline characteristics between the 3DP group and the traditional group (P > 0.05). We followed all patients for a period ranging from 12 to 36 months, with an average follow-up duration of 14.8 months. When comparing the two groups, the 3DP group required fewer intraoperative fluoroscopic view (P < 0.01). Postoperatively, the 3DP group showed notable improvements in the H-H angle, MU-H angle, and PU-H angle, all of which were significantly better than those in the traditional group (P < 0.01). Despite these advantages, the postoperative MEPS and Mayo elbow function scores did not differ significantly between the 3DP and traditional groups (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with traditional surgical methods, the use of PSI technology with preoperative 3D planning and customized 3DP osteotomy guides can significantly reduce the number of intraoperative fluoroscopies, which enhances both the efficiency and safety of TEA. PSI technology facilitates more accurate angle correction during elbow arthroplasty, ensuring precise osteotomies and effective correction of joint deformities.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"132"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of proximal femur intramedullary nailing vs. cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in patients aged 75 and older: analysis of risk factors for postoperative all-cause mortality.","authors":"Yan Deng, Xiang-Ping Zhou, Bin Sun, Guo-Hui Li, Zuo-Ming Tong","doi":"10.1186/s12893-025-02866-0","DOIUrl":"10.1186/s12893-025-02866-0","url":null,"abstract":"<p><strong>Background: </strong>As the population continues to age, the occurrence of intertrochanteric femoral fractures (IFFs) has steadily increased. The main aims of this investigation were to evaluate and compare the clinical outcomes, ambulatory ability, overall survival, and all-cause mortality between two cephalic screws combined with compression proximal-femoral intramedullary nailing internal fixation (IF) and long-stemmed cemented bipolar hemiarthroplasty (LCHA) in patients aged 75 years and older. The secondary objective was to investigate the relative independent risk factors contributing to postoperative all-cause mortality.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 251 elderly patients with IFF who underwent IF or LCHA between January 2018 and October 2022. We employed generalized estimation equations along with univariate and multivariate analyses to examine the impact of various surgical interventions and other pertinent factors on postoperative ambulatory ability and all-cause mortality outcomes. Associations between sex, age, number of comorbidities, aspartate aminotransferase (AST) levels, total blood transfusions, and mortality were analyzed via Cox proportional hazards models.</p><p><strong>Results: </strong>The analysis included a cohort of 120 patients from the IF group and 121 patients from the LCHA group. Statistically significant differences were not observed in the clinical outcomes, ambulatory ability, overall survival, or all-cause mortality after surgical treatment between the groups receiving IF and LCHA (p > 0.05). Nevertheless, among patients aged ≥ 85 years, the IF group demonstrated a lower rate of all-cause mortality than the LCHA group did (p < 0.05). As age increases and the number of preoperative comorbidities and the amount of perioperative transfusion increase, the preoperative AST level decreases, which is associated with a greater risk of postoperative death. (p < 0.05).</p><p><strong>Conclusions: </strong>In elderly patients aged 75-84 years with intertrochanteric femur fractures, both internal fixation (IF) and long-stemmed cemented hemiarthroplasty (LCHA) are viable treatment options. However, for patients aged 85 years and older, IF is associated with a relatively lower postoperative all-cause mortality rate and should be prioritized as a treatment modality. Additionally, preoperative AST levels may serve as a valuable predictor of postoperative all-cause mortality in elderly patients undergoing surgery for intertrochanteric femur fractures.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"130"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No differences in IVF pregnancy outcomes following hysteroscopic polypectomy using a manual hysteroscopic tissue removal device versus conventional resection.","authors":"Chen Wang, Yangqin Peng, Qinmei Wang, Yu Dong, Huimin Liu, Yaoshan Yao, Yuan Li, Ge Lin, Fei Gong, J Preston Parry, Nigel Pereira, India Morgan, Steven R Lindheim, Hui Chen","doi":"10.1186/s12893-025-02857-1","DOIUrl":"10.1186/s12893-025-02857-1","url":null,"abstract":"<p><strong>Background: </strong>To compare in-vitro fertilization and embryo transfer (IVF-ET) pregnancy outcomes following endometrial polypectomy using either a manual mechanical hysteroscopic tissue resection device (mHTR) or traditional mechanical resection with scissors or polyp graspers resection.</p><p><strong>Methods: </strong>This retrospective study examined 189 infertile patients who had undergone polypectomy prior to IVF-ET at Reproductive and Genetic Hospital of CITIC-XIANGYA. Patients undergoing polypectomy using manual mHTR resection were compared to those having the procedure through traditional mechanical resection. The primary outcome was clinical pregnancy rate (CPR) following the first ET after hysteroscopic polypectomy. Secondary outcomes included miscarriage rates and the optimal time interval from polyp resection to ET.</p><p><strong>Results: </strong>One-hundred eleven (58.7%) patients underwent polypectomy via manual mHTR while 78 (41.3%) patients underwent traditional mechanical resection for polypectomy. Following the first ET, the positive pregnancy rate (80.2% vs. 79.5%; p = 1.000), CPR (70.3% vs. 74.4%; p = 0.652), and MR (11.5% vs. 12.1%; p = 1.000) were similar between those undergoing mHTR and traditional mechanical resection. After stratifying by the number of menstrual cycles from procedure (after next menses; 2 to 3 menstrual cycles; and > 3 menstrual cycles later), there was no differences in CPR when comparing the time from polypectomy and resection type.</p><p><strong>Conclusion: </strong>This study suggests no differences in IVF pregnancy outcomes following hysteroscopic polypectomy regardless of surgical type using manual mHTR or traditional mechanical resection and the timing from resection.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"128"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orienting global surgery initiatives toward advancing minimally invasive surgery in Africa: a commentary based on continent-wide reviews.","authors":"Adebayo Falola, Abdourahmane Ndong, Ademola Adeyeye","doi":"10.1186/s12893-025-02863-3","DOIUrl":"10.1186/s12893-025-02863-3","url":null,"abstract":"<p><p>Surgical care has advanced with the introduction of minimally invasive surgery (MIS) techniques, which have resulted in a reduced length of hospital stay and improved patient outcomes with regard to morbidity, mortality, and aesthetics. Implementation in Africa remains limited due to economic, infrastructural, and training-related issues. Our previous reviews show that adoption of MIS in Africa has been highly variable. Only Egypt and South Africa, for example, have significantly reported robotic surgery programs. Despite present challenges, recent developments show that progress is being made. Advantages of MIS in resource-limited settings include fewer postoperative complications and shorter hospital stays, crucial for African patients who cannot afford unexpectedly extensive postoperative care and are also reliant on daily earnings. In the future, tele-robotic surgery can improve access to surgical care in under-served regions of the continent. Implementation barriers include the high cost of equipment, inadequate healthcare infrastructure, and limited training opportunities. Investment in the development of low-cost innovations, such as MIS equipment suited for resource-limited settings, local manufacturing or assembly of MIS equipment, and the establishment of training programs within the continent, is necessary to overcome these challenges. Policies supporting the integration of MIS into national healthcare plans are also required. The development of more robust MIS programs in Africa will not only enhance surgical care but will also contribute to the improvement of healthcare and economic outcomes across the continent. We present this commentary on the current state, challenges, and opportunities for the wider adoption of MIS across Africa, based on recent continent-wide reviews.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"129"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infection rate in spine surgery, incidence, and risk factors: a ten-year retrospective cohort review in a developing neurosurgical centre.","authors":"Dumura Jeneral Alfin, Danaan Joseph Shilong, Gyang Markus Bot, Wilfred Dengunu Salun","doi":"10.1186/s12893-025-02846-4","DOIUrl":"10.1186/s12893-025-02846-4","url":null,"abstract":"<p><strong>Background/objective: </strong>Surgical site infection (SSI) is the third common complication in spinal surgery and often results in poor clinical outcomes, prolonged hospital stays, and additional costs. This study estimated the incidence of SSI and identified risk factors in spine surgeries done within 10 years.</p><p><strong>Methodology: </strong>This was a retrospective cohort review of all patients who had spine surgery between January 2014 and December 2023. Patients' hospital records were retrieved, and relevant biodata and clinical information were obtained and entered into the Statistical Product and Service Solutions version 25. The incidence of SSI was computed and presented as a percentage, and a multivariable analysis to assess risk factors for SSI was done using the chi-square test and Fisher's exact test. The level of significance was set at a p-value < 0.05 and a 95% Confidence Interval.</p><p><strong>Results: </strong>The incidence of SSI was 11.7%; (24/206), predominantly caused by Staphylococcus Aureus (37.5%,P = 0.01) and largely (70%) occurred among patients admitted ≤ 48 h before surgery. The majority were superficial incisional SSIs (19/24,79.2%). They occurred commonly among patients operated for spondylotic disease (13/67,19.4%) and bacterial spondylitis (one out of the two patients) compared to the other spinal pathologies (p = 0.042). Similarly, infection rates were significantly higher in surgeries performed at the lumbar (14/63,22.2%) and thoracolumbar junction (4/31, 12.9%) compared to the cervical and thoracic spine (p = 0.009). This was found to increase the odds of developing SSI by 2.2 times (odds ratio: 2.20;CI:1.38-3.47, P = 0.001), The median duration of hospital stay was 36.5 days for patients with SSIs versus 23 days for patients without SSI (p = 0.008).</p><p><strong>Conclusion: </strong>This study found a relatively high incidence of SSI, which was predominantly superficial incisional SSI, caused by Staphylococcus Aureus, particularly among patients admitted within 48 h before surgery. Significant risk factors for these infections are patients operated on for spondylotic disease and those who had lumbar or thoracolumbar spine surgeries.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"127"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}