BMC Surgery最新文献

{"title":"Postoperative outcomes after splenectomy: a 20-year single-center experience in Colombia.","authors":"Carlos Eduardo Rey Chaves, Sebastián Díaz, David Gómez Garnica, Oscar Cardenas, Paula Noguera, Manuela Ortíz Marín, Vanessa Velandia, Danny Conde, María Camila Rojas Gómez, María Gómez Zuleta","doi":"10.1186/s12893-024-02637-3","DOIUrl":"10.1186/s12893-024-02637-3","url":null,"abstract":"<p><strong>Background: </strong>Splenectomy indications are well documented; however, several infectious complications and potentially life-threatening conditions could arise after splenectomy. We aim to describe a 20-year single-center experience of postoperative outcomes after splenectomy and perform a subgroup analysis according to approach and surgical setting with a 30-day, 90-day, and 1-year follow-up.</p><p><strong>Study design: </strong>A retrospective cohort study was conducted between 2003 and 2023. We included all patients aged 18 years and older who underwent splenectomy. A description of clinical and operative variables with infectious outcomes was performed. Subgroup analyses were performed between open or laparoscopic approach and surgical setting.</p><p><strong>Results: </strong>A total of 134 patients were included. Female patients constituted 52.99% (n = 71) of cases, with a mean age of 51.01 ± 20.79 years. The most frequent surgical indication for splenectomy was trauma in 31.34% (n = 42), and a laparoscopic approach was indicated in 41.79% (n = 56). Overwhelming post-splenectomy syndrome (OPSI) was evidenced in 2.24% (n = 3) of the population. Surgical characteristics such as operative time, intraoperative blood loss, and intensive care requirement and unit length of stay were higher in open and trauma patients.</p><p><strong>Conclusion: </strong>Our data describe the demographic, clinical and operative characteristics of patients undergoing splenectomy in Colombia, providing a solid basis for future research. The results obtained on overwhelming postsplenectomy syndrome (OPSI) and postoperative complications are comparable with those reported in the international literature, reinforcing the validity of our findings. Further prospective studies in this population are needed to optimize management strategies and improve clinical outcomes, particularly in higher risk subgroups.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"362"},"PeriodicalIF":1.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644834","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":"Using the follicular unit extraction technique in treatment of male androgenetic alopecia.","authors":"Fang Wang, Ying Chen, Chen Yang, Chao Li, Huifeng Zhang, Jie He, Meng Li, Ting Lei, Huibin Lei, Bei Liu, Wei Zhang","doi":"10.1186/s12893-024-02655-1","DOIUrl":"10.1186/s12893-024-02655-1","url":null,"abstract":"<p><strong>Background: </strong>The incidence of androgenetic alopecia in males is on the rise annually, with hair transplantation using follicular unit extraction (FUE) gaining increasing acceptance as an appropriate treatment for these individuals.</p><p><strong>Methods: </strong>A retrospective study was undertaken, involving 158 male patients diagnosed with androgenetic alopecia, who underwent treatment between January 2016 and December 2020 at the Medical Cosmetology Department of the First Affiliated Hospital of Xi'an Medical University. Demographic data and treatment characteristics were documented and analyzed. Clinical efficacy, operation-related complications, patient satisfaction rates, and quality of life scores were assessed and analyzed.</p><p><strong>Results: </strong>Following FUE hair transplantation, over 90% of the hair follicles survived in 158 patients, with more than 85% of patients achieving a hair follicle survival rate exceeding 95% at 12 months post-operation. Patient satisfaction rates exceeded 98%, while the complication rate was below 6%.</p><p><strong>Conclusion: </strong>Our findings demonstrate that FUE is a minimally invasive hair transplant technique associated with a high hair follicle survival rate and optimal hair density. This approach proves effective in treating male androgenetic alopecia and merits further clinical application.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"358"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631252","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":"Enhancing patient outcomes through nursing care in laparoscopic common bile duct exploration; a randomized control trail.","authors":"Linxiang He, Zhuming Chen, Zhen Wang, Yingchun Pan","doi":"10.1186/s12893-024-02657-z","DOIUrl":"10.1186/s12893-024-02657-z","url":null,"abstract":"<p><strong>Background: </strong>When compared to open surgery, laparoscopic common bile duct exploration (LCBDE) is known to cause less discomfort and a faster recovery. This study examines the effect of the Enhanced Recovery After Surgery (ERAS) strategy on LCBDE outcomes.</p><p><strong>Methods: </strong>In March 2021 to May 2024, 400 patients with LCBDE participated in randomized research. The six patient groups were: Multimodal Pain Management (n = 50), Standard Pain Management (n = 50), ERAS (n = 50), Preoperative Assessment (n = 100), Standard Preoperative Assessment (n = 100), and Standard Care (n = 50). The patient's satisfaction, long-term recovery, pain, anxiety, and complication rates were among the outcomes that were measured.</p><p><strong>Results: </strong>After the intervention, the mean anxiety level of the ERAS group was significantly lower (P < 0.05), and their rates of complications were also decreased. Reduced postoperative pain scores, which were 5 on day 1 and decreased to 3 by day 3, were the consequence of the multimodal pain management strategy inside ERAS. A 90% satisfaction rating and an average recovery period of five days were reported by the ERAS group. Long-term results in ERAS showed that the average time to return to work was only 25 days, and there was a decreased incidence of chronic pain.</p><p><strong>Conclusion: </strong>The ERAS protocol enhances the short- and long-term course of recovery for patients with LCBDE, leading to increased satisfaction and better clinical outcomes. These results suggest that the ERAS method should be used as the gold standard for postoperative care for patients with LCBDE.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"360"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644832","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":"Single-incision laparoscopic hepaticojejunostomy with selective ductoplasty for type IV-A Choledochal cysts in children: a retrospective study.","authors":"Wei Liu, Tong Yin, Xinyuan Chen, Mei Diao, Long Li","doi":"10.1186/s12893-024-02648-0","DOIUrl":"10.1186/s12893-024-02648-0","url":null,"abstract":"<p><strong>Introduction: </strong>Type IV-A choledochal cyst (CDC) has been considered to have a poor prognosis due to the high incidence of postoperative anastomotic strictures and intrahepatic stones. This study aimed to evaluate the surgical outcomes of children with type IV-A CDC and to provide insights for clinical diagnosis and treatment.</p><p><strong>Methods: </strong>The study retrospectively analyzed patients from June 2015 to December 2018 at our center, 76 children were diagnosed with type IV-A CDC. All patients underwent single-incision laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy. The decision to perform ductoplasty was made by comprehensively considering the intrahepatic duct dilatation (IHDD) and stricture. All patients were followed up 1, 3, and 6 months postoperatively, and then every 1 year thereafter. Patients were categorized into two groups based on IHDD changes postoperatively: the long-term group (LTG), with IHDD persisting for over a year, and the short-term group (STG), where IHDD normalized within a year. Single/multiple factor logistic regression was used to analyse the factors influencing postoperative IHDD.</p><p><strong>Results: </strong>The median follow-up period was 80 months, with a range from 64 to 101 months. The decrease in postoperative liver function parameters, compared to preoperative levels, was statistically significant. Two patients (2.63%) developed bile leaks. One patient (1.32%) developed anastomotic stricture. All patients' IHDD returned to normal size. Fifty-six (73.7%) patients showed normalization of IHDD within one-year postoperatively. The median recovery time for IHDD in patients was 1.65 months, ranging from 3 days to 74 months postoperatively. There were significant differences in intrahepatic biliary sludge and stones and maximum diameter of IHDD between STG and LTG. Logistic regression was used to analyse the factors and found that intrahepatic biliary sludge and a wider maximum diameter of IHDD were risk factors for postoperative long-term IHDD in patients.</p><p><strong>Conclusion: </strong>Single-incision laparoscopic hepaticojejunostomy with selective ductoplasty are safe and effective for children with Type IV-A CDC. Long-term follow-up is recommended for children presenting with intrahepatic biliary sludge and larger IHDD.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"359"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644842","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 results among UBE-TLIF, MIS-TLIF and open TLIF for Meyerding grade I lumbar spondylolisthesis: a retrospective study.","authors":"Zhenyuan Lu, Dian Zhong, Yang Liu, Guosheng Zhao, Zhenyong Ke, Yang Wang","doi":"10.1186/s12893-024-02651-5","DOIUrl":"10.1186/s12893-024-02651-5","url":null,"abstract":"<p><strong>Background: </strong>The unilateral biportal endoscopic (UBE) technique has garnered significant attention for its little paraspinal iatrogenic damage, expedited recovery, and low complication rates. This method is also applicable to open transforaminal lumbar interbody fusion (TLIF). Therefore, this study aimed to conduct a comparative analysis of the outcomes associated with unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and TLIF for Meyerding grade I lumbar spondylolisthesis.</p><p><strong>Methods: </strong>The study examined the outcomes of 79 patients with Meyerding grade I lumbar spondylolisthesis who underwent single-level intervertebral fusion. Clinical assessments included the measurement of pain levels using the Visual Analogue Scale (VAS) for low back and leg pain, the Oswestry Disability Index (ODI), surgical data, and demographic information. Imaging techniques were utilized to evaluate the fusion rate.</p><p><strong>Results: </strong>The VAS-Back demonstrated a statistically significant improvement in Group UBE-TLIF compared to the other groups at the one-week postoperative evaluation (p < .05). Additionally, the UBE-TLIF group exhibited a significantly longer total operative time compared to the other groups (p < .05). However, it was noted that the Postop Hemovac drain were significantly greater in the MIS-TLIF and TLIF groups compared to the UBE-TLIF group (p < .05).</p><p><strong>Conclusions: </strong>The present research demonstrated the effectiveness of UBE-TLIF, MIS-TLIF, and TLIF as surgical approaches for treating Meyerding grade I lumbar spondylolisthesis. Among these methods, UBE-TLIF demonstrated a reduction in Postop Hemovac drain, and an increase in operative duration.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"355"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631203","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":"Incidence and risk factor analysis of moderate-to-severe pain after preoperative CT-guided hook-wire puncture localization of pulmonary nodules.","authors":"Jiajian Pan, Tianci Feng, Jiayi Wang, Ran Ma, Tianyue Ma, Yong Ge, Teng Sun, Shoujie Feng, Cheng Zhang, Hao Zhang","doi":"10.1186/s12893-024-02633-7","DOIUrl":"10.1186/s12893-024-02633-7","url":null,"abstract":"<p><strong>Background: </strong>Pain is a relatively common complication after hook-wire puncture localization. However, the problem of pain occurrence following this localization procedure has not been sufficiently examined. In this prospective study, we aimed to investigate the incidence and risk factors associated with acute pain after preoperative CT-guided hook-wire puncture localization of pulmonary nodules.</p><p><strong>Methods: </strong>Clinical data were collected prospectively from patients with small pulmonary nodules who underwent preoperative CT-guided hook-wire puncture localization between May 2022 and May 2023 at the Affiliated Hospital of Xuzhou Medical University. Patients were divided into two groups on the basis of the presence or absence of moderate-to-severe pain following the localization process. Univariate logistic analysis was conducted to analyse the clinical data of the two groups. Subsequently, the significant variables (P < 0.1) from the univariate analysis were subjected to multivariate logistic analysis, followed by the establishment of regression equations to determine the significant risk factors related to moderate-to-severe pain after hook-wire puncture localization.</p><p><strong>Results: </strong>A total of 281 patients with small pulmonary nodules undergoing preoperative CT-guided hook-wire puncture localization were finally included, with a mean age of 54.86 years (SD = 12.1 years) and female predominance (67.6%). In the resting state, 53% of the patients reported moderate-to-severe pain. Univariate analysis revealed that age (P = 0.085), the depth of localization needle insertion into the lung (P = 0.024) and the location of the chest wall puncture (P = 0.07) were associated with moderate-to-severe pain occurrence after hook-wire puncture localization (P < 0.1). Furthermore, multivariate logistic regression analysis demonstrated that the depth of localization needle insertion into the lung (OR = 0.953, 95% CI: 0.914-0.992, P = 0.02) and the location of the chest wall puncture (lateral chest wall vs. anterior chest wall: OR = 2.101, 95% CI: 1.166-3.784, P = 0.013; posterior chest wall vs. anterior chest wall: OR = 1.163, 95% CI: 0.895-2.971, P = 0.11) were independent predictors of moderate-to-severe pain incidence following CT-guided hook-wire puncture localization (P < 0.05).</p><p><strong>Conclusion: </strong>Moderate-to-severe pain is prevalent in patients with pulmonary nodules who undergo preoperative CT-guided hook-wire puncture localization. The depth of needle insertion into the lung and the location of the chest wall puncture are significant predictors of moderate-to-severe pain onset.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"356"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631249","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":"Retroperitoneal pancreas transplantation with a Roux-en-Y duodenojejunostomy for exocrine drainage.","authors":"Mogeli Sh Khubutiya, Ilya V Dmitriev, Nikita S Zhuravel, Aslan G Balkarov, Roman V Storozhev, Yuri A Anisimov, Alexander S Kondrashkin, Nonna V Shmarina","doi":"10.1186/s12893-024-02658-y","DOIUrl":"10.1186/s12893-024-02658-y","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic transplantation is the only definitive surgical treatment for diabetes mellitus. Currently, most transplant centers use enteric exocrine drainage of pancreatic secretions; however, experts disagree on which part of the gastrointestinal tract is preferable for enteric anastomosis. We analyzed the outcomes of retroperitoneal pancreatic transplantation with enteric drainage of pancreatic secretions.</p><p><strong>Materials and methods: </strong>We evaluated the outcomes of 60 simultaneous retroperitoneal pancreas-kidney transplantations. Based on the type of enteric anastomosis, the patients were divided into two groups: the study group consisted of 10 patients who underwent enteric drainage via Roux-en-Y duodenojejunostomy, and the control group included 50 patients who underwent exocrine drainage via duodenoduodenal anastomosis. No statistically significant differences were observed between the groups in terms of the main parameters.</p><p><strong>Results: </strong>The rate of surgical complications did not differ significantly between the groups (p > 0.05). Clavien IVb complications occurred only in the control group (n = 4.8%). The in-hospital pancreatic graft survival rate in both groups was 80%, whereas the recipient survival rates were 90% and 84%, in the study and control groups, respectively (p < 0.05).</p><p><strong>Conclusion: </strong>Retroperitoneal pancreatic transplantation with exocrine drainage via a Roux-en-Y duodenojejunostomy is an effective alternative technique that reduces the rate of severe surgical complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"357"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631251","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":"Pancreaticoduodenectomy for octogenarians under postoperative rehabilitation enhanced ERAS protocol.","authors":"Naoki Iwanaga, Yoshinori Takeda, Ryuji Yoshioka, Yoshihiro Mise, Hiroyuki Sugo, Akio Saiura","doi":"10.1186/s12893-024-02656-0","DOIUrl":"10.1186/s12893-024-02656-0","url":null,"abstract":"<p><strong>Background: </strong>Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022. All patients were managed using the enhanced recovery after surgery (ERAS) protocol, and elderly patients or those with loss of muscle mass or frailty underwent additional perioperative rehabilitation. Postoperative short-term outcomes were compared between the octogenarians and non-octogenarians.</p><p><strong>Results: </strong>We reviewed 251 patients including 44 octogenarians (17.5%). Octogenarians had higher rates of comorbidity (78.9% vs. 55.1%, P = 0.049) and sarcopenia (31.8% vs. 16.4%, P = 0.018) and a more impaired nutritional status than non-octogenarians and received postoperative rehabilitation more frequently (86.4% vs. 44.0%, P < 0.001, respectively). Under the rehabilitation-enhanced ERAS protocol, the postoperative major complication rate (25.0% vs. 24.6%, P = 0.960), the length of hospital stay (LOS) (P = 0.435), and the length of functional recovery (LOFR) (P = 0.110) did not differ between the two groups. In the multivariate analysis, age ≥ 80 years was not determined as a risk factor for major complications.</p><p><strong>Conclusions: </strong>Despite the poor functional and nutritional status of octogenarians, their postoperative major complication rates, LOS, and LOFR after PD were comparable with those of non-octogenarians under the rehabilitation-enhanced ERAS protocol.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"353"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631250","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":"Ethanol sclerotherapy in pediatric rectal prolapse: efficacy, complications, and influencing factors.","authors":"Mehdi Forooghi, Fateme Ziyaee, Hamidreza Foroutan, Ali Bahador, Ali Tadayon, Omidreza Azh, Maryam Ranjbar, Pardis Bostanian, Sara Mostafavi, Sina Jamzad, Amir Mohammad Ghiasi Nezhad, Narges Ansary, Mahsa Rouhafshari, Mohammadreza Khazaie, Hossein Fatemian, Rezvan Moradi","doi":"10.1186/s12893-024-02653-3","DOIUrl":"10.1186/s12893-024-02653-3","url":null,"abstract":"<p><strong>Introduction: </strong>Rectal prolapse is prevalent in children and the elderly, impacting quality of life significantly. Traditional surgical interventions carry risks, especially in pediatric patients. Ethanol sclerotherapy offers a less invasive alternative, inducing fibrosis and thickening of the rectal wall. Despite its potential benefits, procedural complications are possible, emphasizing the need for careful patient selection and procedural expertise. This study aims to evaluate the safety and efficacy of sclerotherapy in treating rectal prolapse in a tertiary referral center in southern Iran.</p><p><strong>Methods: </strong>Patient records from Nemazee Hospital covering January 2014 to December 2023 were retrospectively analyzed. Pediatric patients undergoing ethanol sclerotherapy for rectal prolapse were included. Data on demographics, presentation, procedures, and outcomes were collected. Ethical approval was obtained, and specific inclusion/exclusion criteria were applied. Statistical analyses were conducted using SPSS version 26.</p><p><strong>Results: </strong>One hundred thirty patients were evaluated, with a mean age of 10.74 ± 5.320 years. Most patients experienced constipation (56.9%). 74.2% responded well to sclerotherapy, with 12.9% needing a second injection. Complications were minimal, with bleeding being the most common (4.6%). Recurrence occurred in 18.6% of cases. Male patients showed a higher total complication rate (P = 0.010). Diarrhea-dominant patients had no recurrences post-sclerotherapy. Age significantly influenced treatment response and recurrence (P = 0.017, P = 0.035).</p><p><strong>Conclusion: </strong>Male predominance contradicted global pediatric rectal prolapse ratios, possibly influenced by cultural factors. Sclerotherapy remains effective, though response rates vary. Older age correlated with lower response rates and higher recurrence. Constipation-dominant prolapse was associated with increased recurrence risk. Male patients had a higher complication rate, highlighting the need for tailored management strategies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"354"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631248","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":"Diagnostic imaging, therapeutic interventions and suggestions for thoracic duct congestion in postoperative hepatic lymphorrhea: a retrospective analysis of 20 cases.","authors":"Xin Liu, Zhong Liu, Wenbin Shen, Song Xia, Yuguang Sun, Kun Chang, Jianfeng Xin, Ran An, Chen Liang, Chenxiao Zhou","doi":"10.1186/s12893-024-02650-6","DOIUrl":"10.1186/s12893-024-02650-6","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively evaluate thoracic duct (TD) congestion in hepatic lymphorrhea (HL) and propose treatment suggestions.</p><p><strong>Methods: </strong>Retrospectively analyze cases of postoperative HL admitted from August 2007 to November 2023. Twenty cases were enrolled and followed up. The medical history, ascites characteristics, lymphoscintigraphy, direct lymphangiography, and other clinical data were reviewed.</p><p><strong>Results: </strong>Twenty patients with ascites after cholecystectomy or radical gastrectomy were included. There were 15 patients with cirrhosis and 5 patients with hepatitis. Ascites were light yellow even if the patients had a non-low-fat diet. Triglyceride level mean of ascites was 0.61 ± 0.20 mmol/L. There were 94.1% (16/17) of patients whose ascitic cholesterol ≥ 45 mg/dL or SAAG < 11.0 g/L. Mild abdominal radioactivity was shown in 89.5% (17/19) patients. Left subclavian-jugular venous angle radioactivity was observed in 84.2% (16/19) patients. In 10% (2/20) cases, lipiodol presenting as oil droplets traveled upwards quickly and flowed into the vein rapidly. In 90% (18/20) cases, tortuous and dilated thoracic duct, stagnant lipiodol, and poor flow into the vein were demonstrated. One patient refused treatment and died soon. By thoracic duct outlet reconstruction combined with other treatments, 16 patients were cured and the ascites of another 3 patients were controlled.</p><p><strong>Conclusions: </strong>TD congestion and elevated lymphatic pressure could be caused by increased lymph flow and TD outlet stenosis. TD decompression by outlet reconstruction may be an alternative approach to HL.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"352"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631247","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}