BMC Surgery最新文献

{"title":"Distal vs. total pancreatectomy with celiac axis resection in patients with locally advanced/borderline resectable pancreatic carcinoma - a retrospective cohort study.","authors":"Alexandros Chrysos, Iakovos Amygdalos, Roman Marius Eickhoff, Katharina Joechle, Franziska Meister, Lea Hitpass, Philipp Bruners, Sebastian Cammann, Oliver Beetz, Felix Oldhafer, Martin von Websky, Thomas Vogel, Florian Wolfgang Rudolf Vondran, Georg Wiltberger","doi":"10.1186/s12893-026-04128-z","DOIUrl":"10.1186/s12893-026-04128-z","url":null,"abstract":"<p><strong>Background: </strong>Distal pancreatectomy with celiac axis resection (DP-CAR) is an established procedure for the resection of celiac-trunk-infiltrating carcinomas of the pancreatic corpus or cauda. In contrast, total pancreatectomy with celiac axis resection (TP-CAR) remains a controversial procedure, which is sporadically mentioned in the literature. This study aimed to compare perioperative and survival outcomes following TP-CAR with those of the established DP-CAR operation.</p><p><strong>Methods: </strong>Between January 2010 and December 2023, 17 patients underwent DP-CAR and 8 patients TP-CAR in our institution. Pre-, intra-, postoperative, histopathological and survival data were compared between the two groups.</p><p><strong>Results: </strong>The TP-CAR cohort was associated with higher rates of major complications (DP-CAR: 2[12%] vs. TP-CAR: 4[50%], p = 0.037) and stomach ischemia (DP-CAR: 1[5.9%] vs. TP-CAR: 3[37.5%], p = 0.044). Length of stay in the intensive care unit was longer for the TP-CAR group (DP-CAR:1[1-1] vs. TP-CAR:18[8-27] days, p < 0.001). One patient in our study died postoperatively, belonging to the DP-CAR group. Median overall survival (DP-CAR:21[95% CI:16-26] vs. TP-CAR 14[95% CI:11.4-16.6] months, p = 0.355) and disease-free survival (DP-CAR: 12[95% CI:9.2-14.8] vs. TP-CAR: 10.5[5.4-15.6] months, p = 0.659) were higher in the DP-CAR group, without statistically significant difference in the log-rank test.</p><p><strong>Conclusions: </strong>Compared to DP-CAR, TP-CAR was associated with higher morbidity and longer stay in the intensive care unit, while mortality remained low in this cohort. Given the limited sample size and the absence of significant survival differences, TP-CAR may be considered in highly selected patients with good performance status and adequate tumour regression after neoadjuvant chemotherapy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727221","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 30-day perioperative outcomes of sigmoid volvulus surgery in resource-limited setting in Northcentral Ethiopia.","authors":"Atalel Fentahun Awedew, Assefa Fentahun Emrie","doi":"10.1186/s12893-026-04123-4","DOIUrl":"10.1186/s12893-026-04123-4","url":null,"abstract":"<p><strong>Background: </strong>Sigmoid volvulus remains a leading cause of intestine obstruction in low middle income countries, particularly in volvulus belt countries. The objective of this study to explore the morbidity and mortality after sigmoid volvulus surgery in Northcentral Ethiopia.</p><p><strong>Methods: </strong>Hospital-based retrospective cohort study employed in Debre Tabor comprehensive specialised hospital Northcentral Ethiopia. A medical chart reviews were conducted from Jan1, 2016 to June 30,206. The collected data checked manually for completeness and consistency. The final data coded and entered to SPSS version 27 for data processing and analysis. Univariable and multivariable binary logistic regression analysis conducted to identified attributable factors for morbidity and mortality after sigmoid volvulus surgery. The result of the final model expressed in terms of adjusted Odd Ratios (AOR) and 95% CI and statistical significance declared if the p-value is less than 0.05.</p><p><strong>Result: </strong>Three hundred sixty-two patients were analysed. Mean age was 56.4(SD14.5), with male predominance (321/362,88.7%) and most patients had anesthesia low risk (ASA grade 2, 230/362,63.5%). Emergency procedures were performed in 187/362(51.7%). Gangrenous sigmoid was found for 139/362 (38·4%) patients, 139/187(74.3%) of patients who underwent emergency surgery. The overall 30-day complication rate was 80 (22.1%) of 362, and mortality was 19/362(5.5%). 30-day postoperative complications were significantly associated with ASA IV (adjusted odds ratio AOR = 13.1, 95%CI:12.6-66.3; p = 0.002), presence of comorbidity (AOR = 4.4, 2.0-9.9; p < 0.0001), emergency procedures (AOR = 11.7, 3.6-37.9; p = 0.025), and gangrenous bowel intraoperative viability (AOR = 2.5, 1.2-5.7; p = 0.25).</p><p><strong>Conclusion: </strong>More than half of patients underwent emergency surgery, and two-thirds of these had intraoperative gangrenous bowel. Perioperative complication rates were high among patients undergoing emergency surgery and among those with comorbidities and higher ASA grades, despite most patients being classified as low surgical risk. Improving access to bellwether surgery, strengthening processes of care, and building surgical capacity and health-system delivery could help achieve safe, equitable surgical care for sigmoid volvulus.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921595","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":"Comment on \"Early outcomes of transverse perineal support in obstructed defecation syndrome with pathological perineal descent\": a historical and methodological clarification.","authors":"Jacques Beco","doi":"10.1186/s12893-026-04093-7","DOIUrl":"10.1186/s12893-026-04093-7","url":null,"abstract":"<p><p>The recent study by Basiouny et al. on transverse perineal support for obstructed defecation syndrome highlights the importance of objective assessment of pathological perineal descent. We wish to provide a historical and methodological clarification regarding the measurement device used in the study. The instrument illustrated as a \"perineometer\" may correspond to the previously described Perineocaliper^®, a device developed for the clinical measurement of perineal descent. Although objective measurement of perineal descent was first introduced by Henry and Parks using a different instrument, the Perineocaliper represents a distinct development. In addition, the term perineometer has traditionally been used in urogynecology for devices measuring pelvic floor muscle contraction strength. Accurate identification and terminology of measurement devices may improve methodological clarity and facilitate comparison between studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686124","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 Braun-modified single loop versus isolated Roux-en-y reconstruction on clinical outcomes following pancreaticoduodenectomy.","authors":"Yildiray Daduk, Sabri Ozdas","doi":"10.1186/s12893-026-04086-6","DOIUrl":"10.1186/s12893-026-04086-6","url":null,"abstract":"<p><strong>Background: </strong>The optimal reconstruction technique following pancreaticoduodenectomy (PD) remains a subject of debate. The objective of this study was to compare the clinical effects of isolated Roux-en-Y and Braun modified single loop (BMSL) reconstruction techniques following PD on delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), length of hospital stay, and other postoperative outcomes.</p><p><strong>Methods: </strong>Two hundred thirteen patients who underwent standard open PD (with distal gastrectomy) for periampullary or pancreatic head adenocarcinoma between 2018 and 2025 were analyzed retrospectively. These were categorized into isolated Roux-en-Y (n = 100) and BMSL (n = 113) groups. Risk factors were identified using univariate analysis and Firth's penalized logistic regression to account for rare event bias.</p><p><strong>Results: </strong>The incidence of clinically relevant (CR-POPF, Grade B) was higher in the Roux-en-Y group than in the BMSL group (7% vs. 1.7%), although the difference was not statistically significant (p = 0,072). However, isolated biochemical leak rates were similar (12% vs. 8%; p = 0.322). In contrast, a significantly lower incidence of DGE was observed in the BMSL group (p = 0.032), together with a shorter mean postoperative hospital stay (10.1 ± 2.3 vs. 11.25 ± 2.7 days; p < 0.001). Firth's penalized logistic regression analysis identified diabetes mellitus and a prolonged operative time as independently associated with the development of both POPF and DGE (p < 0.05). Additionally, diabetes mellitus was independently correlated with DGE development in the BMSL group (OR: 20.75, 95% CI: 5.86-73.44; p < 0.000003). However, this finding requires cautious interpretation due to the wide confidence interval. Low serum albumin levels were independently associated with the development of POPF (p < 0.01).</p><p><strong>Conclusions: </strong>BMSL reconstruction was associated with lower DGE rates and a shorter hospital stay. No significant difference was observed between the groups' CR-POPF rates. The POPF-related findings should therefore be interpreted with care due to the low event rate and absence of any Grade C cases.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913943","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":"Tranexamic acid in primary total knee arthroplasty: a systematic review and meta-analysis of blood loss, transfusion, and deep vein thrombosis.","authors":"Jiawei Feng, Shuhui Liang, Liyang Yang, Xiao Chen, Meng Zhang, Jincheng Huang, Yi Jin","doi":"10.1186/s12893-026-04060-2","DOIUrl":"https://doi.org/10.1186/s12893-026-04060-2","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) has been widely used in primary total knee arthroplasty (TKA) to reduce perioperative blood loss, but the pooled evidence regarding blood loss, transfusion, and deep vein thrombosis (DVT) remains to be further clarified. The purpose of this meta-analysis was to evaluate the efficacy and safety of TXA in primary TKA.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, the Cochrane Library, and relevant additional sources were searched to identify randomized controlled trials (RCTs) comparing TXA with a control regimen in primary unilateral TKA. The primary outcomes were blood loss, transfusion, and DVT. Continuous outcomes were pooled as mean differences (MDs) with 95% confidence intervals (CIs), and dichotomous outcomes were pooled as risk ratios (RRs) or odds ratios (ORs) with 95% CIs. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects models were applied for meta-analysis. For the blood-loss outcome, an additional robustness analysis was performed using an empirical Bayes random-effects model with Knapp-Hartung standard error adjustment to evaluate whether the result was sensitive to model assumptions, given that methodological choices in random-effects meta-analysis may influence statistical significance when substantial heterogeneity is present.</p><p><strong>Results: </strong>A total of 17 studies were included in the systematic review and meta-analysis. TXA was associated with significantly reduced blood loss compared with control (MD = -423.28 mL, 95% CI -536.90 to -309.66; P < 0.001), although substantial heterogeneity was observed (I² = 93.44%). Leave-one-out sensitivity analysis showed that the pooled effect remained significant after exclusion of individual studies; exclusion of one influential study reduced heterogeneity to 81.88%. The Knapp-Hartung-adjusted robustness analysis yielded a similar significant effect estimate. TXA also significantly reduced transfusion risk (RR = 0.55, 95% CI 0.45 to 0.68; P < 0.001), with no significant heterogeneity (I² = 0.0%). No significant difference was found between the TXA and control groups in the incidence of DVT (OR = 0.75, 95% CI 0.47 to 1.22; P = 0.25), and heterogeneity was low (I² = 0.0%). Funnel plot inspection suggested possible asymmetry for blood loss and transfusion; however, Egger's test was not significant for blood loss (P = 0.842), whereas significant small-study effects were detected for transfusion (P = 0.002).</p><p><strong>Conclusions: </strong>The current evidence indicates that TXA in primary TKA significantly reduces blood loss and transfusion requirements with no detected increase in DVT risk in the available randomized evidence. The blood loss analysis showed substantial heterogeneity, whereas the transfusion and DVT analyses were more consistent across studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116721","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":"Delphian lymph node metastasis as a marker of extensive nodal involvement in papillary thyroid cancer.","authors":"Sezer Akbulut, Tugba Matlim Ozel, Aykut Celik, Huseyin Karatay, Murat Altay, Serkan Sari","doi":"10.1186/s12893-026-04089-3","DOIUrl":"10.1186/s12893-026-04089-3","url":null,"abstract":"<p><strong>Background: </strong>Delphian lymph node (DLN) metastasis has been proposed as a potential indicator of more extensive regional lymph node involvement in papillary thyroid cancer (PTC). However, its clinical significance and relationship with regional lymph node metastasis remain incompletely understood.</p><p><strong>Materials and methods: </strong>This retrospective study included 529 patients with histopathologically confirmed PTC who underwent thyroid surgery with varying extents of central and lateral neck dissection according to disease characteristics. The study evaluated clinicopathological factors associated with DLN metastasis and analyzed the relationship between DLN involvement and regional lymph node metastasis, with a particular focus on central compartment subregions. Univariate and multivariate logistic regression analyses were performed to identify independent predictors.</p><p><strong>Results: </strong>The DLN was identified in 60.1% of patients, and metastasis was detected in 29.6% of the identified DLNs. DLN metastasis was significantly associated with younger age, male sex, tumor size > 1 cm, advanced clinical nodal status, and bilaterality. A strong association was observed between DLN metastasis and both right and left paratracheal lymph node involvement (both p < 0.001). On multivariate analysis, tumor size > 1 cm (OR = 8.18, p = 0.002) and both right and left paratracheal lymph node metastases (OR = 7.71 and OR = 5.58, respectively; both p < 0.001) emerged as independent predictors of DLN metastasis. Other clinicopathological variables did not retain statistical significance after adjustment.</p><p><strong>Conclusion: </strong>DLN metastasis reflects the extent of central nodal disease in PTC, particularly paratracheal involvement, and serves as a marker of overall nodal burden. DLN status may support intraoperative decision-making and contribute to individualized surgical strategies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913916","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":"Real-world data on patient-reported outcomes and potential factors associated with pain after thyroid/parathyroid surgery: a prospective QUIPS registry analysis of a large cohort - sparking new pain management concepts.","authors":"Lilit Flöther, Taras Shpyruk, Philipp Burow, Michael Bucher, Annett Christel, Rick Schneider, Kerstin Lorenz, Andreas Wienke, Lars Kurch, Winfried Meissner, Johannes Dreiling","doi":"10.1186/s12893-026-04101-w","DOIUrl":"10.1186/s12893-026-04101-w","url":null,"abstract":"<p><strong>Background: </strong>Although thyroid and parathyroid surgeries are common elective procedures in Germany, postoperative pain management remains unstandardized. This prospective study sought to quantify postoperative pain intensity after thyroid and parathyroid surgery and to examine factors associated with postoperative pain.</p><p><strong>Methods: </strong>We prospectively enrolled 217 adult inpatients undergoing non-oncologic thyroid or parathyroid surgery between September 2021 and September 2022 into the QUIPS (Quality Improvement in Postoperative Pain Management) registry. On postoperative day one (POD1), patient-reported outcomes were assessed using the standardized QUIPS questionnaire, including an 11-point numeric rating scale (NRS) ranging from 0 to 10. Demographic, perioperative, and treatment-related variables were summarized descriptively, and associations with postoperative outcomes were examined using univariable, unadjusted group comparisons.</p><p><strong>Results: </strong>Postoperative pain was reported by 96.8% of the patients, with a mean maximum NRS score of 4.89 ± 2.76 and a mean pain-on-exertion score of 3.88 ± 2.32. In the univariable, unadjusted analyses, higher maximum pain scores were observed among women, patients younger than 65 years, patients with pre-existing chronic pain, and patients classified as ASA I. Maximum pain scores differed according to the type of surgery and were highest after total thyroidectomy. Pain on exertion and pain-related mood impairment also differed across operative-duration groups, with the highest values observed after procedures lasting 121-180 min. Individualized preoperative information on postoperative pain management was associated with higher patient satisfaction and a lower reported desire for additional analgesia.</p><p><strong>Conclusion: </strong>Moderate pain was frequently reported after thyroid and parathyroid surgery, with pain intensity varying according to patient- and procedure-related characteristics in unadjusted analyses. Our findings support the implementation of standardized approaches to postoperative pain management and preoperative patient education.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654835","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":"Endovenous laser ablation versus ligation plus stripping or sclerotherapy for primary lower limb varicose veins: a multicentric three-arm propensity score matched analysis.","authors":"Walied Khereba, Almetwaly Ragab, Osama Moeen, Mohamed Ahmed Agena, Elsayed Hadhoud, Reda Othman Abbas, Ahmed Atef, Maisa A Abdel Wahab, Sameh E Elimam, Ahmed Khairy Sakr, Shimaa M Elhalafawy, Ahmed Ibrahim Badran, Ahmed T M Radwan, Elsayed Mohamed Abd El-Hamid, Amr Bakr Mahmoud Elashry, Mohamed Emad Eldin","doi":"10.1186/s12893-026-03822-2","DOIUrl":"10.1186/s12893-026-03822-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Varicose veins (VVs) are one of the most common consequences of chronic venous disease. The present multicentric three-arm study aimed to compare the clinical outcomes of endovenous laser ablation (EVLA) versus ligation plus stripping or sclerotherapy for primary lower limb VVs.</p><p><strong>Patient and methods: </strong>The study included 300 patients with VVs. They received EVLA (GI, n = 100), ligation plus stripping (GII, n = 100) or ligation plus sclerotherapy (GIII, n = 100). Groups were matched using propensity score. The primary outcome measures were 1-year total occlusion and recurrence rates.</p><p><strong>Results: </strong>At 1 year follow up, no significant differences were found between the total occlusion rates for GI (75.0%), GII (76.0%) and GIII (83.0%). It was demonstrated that GII had significantly higher recurrence rate (24.0%) as compared to GI (6.0%) and GIII (5.0%). It was also found that GII group had significantly higher frequency of ecchymosis, hematoma and surgical site infection as compared to the other two groups. In contrast, GI had significantly higher frequency of skin ulceration/burn as compared to the other two groups. Also, it was found that GIII had significantly lower frequency of deep vein thrombosis than GI and GII.</p><p><strong>Conclusion: </strong>Ligation plus sclerotherapy achieved slightly better total occlusion rate in comparison to EVLA and ligation plus stripping while avoiding important side effects related to them mainly traumatic and thermal injury effects and recurrence.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622230","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":"Prevalence and risk factors associated with inadvertent intraoperative hypothermia in patients undergoing trauma surgery: a single-center retrospective study.","authors":"Yue Li, Hansheng Liang, Liang Sun, Xinyue Gao, Yi Feng","doi":"10.1186/s12893-026-04065-x","DOIUrl":"10.1186/s12893-026-04065-x","url":null,"abstract":"<p><strong>Background: </strong>Trauma has emerged as a major cause of death worldwide. Inadvertent perioperative hypothermia (IPH) is closely related to the prognosis of trauma patients. However, risk factors related to intraoperative hypothermia have not been defined in this population.</p><p><strong>Objective: </strong>This study aimed to analyze the risk factors and predictive value of these factors related to inadvertent intraoperative hypothermia in adults undergoing trauma surgery under general anesthesia.</p><p><strong>Methods: </strong>Patients aged 18 years or older who underwent trauma surgery under general anesthesia at a tertiary hospital from January 2023 to May 2025 were retrospectively enrolled. The demographic, anesthesia-related and surgery-related data of the patients were collected. Inadvertent intraoperative hypothermia was identified as a core temperature monitored in nasopharynx < 36℃. Univariate and multivariate analyses were used to identify factors associated with inadvertent intraoperative hypothermia. The area under the receiver operating characteristic (ROC) curve was used to verify the discriminative ability of multivariate logistic regression results.</p><p><strong>Results: </strong>A total of 885 patients were analyzed, the incidence of inadvertent intraoperative hypothermia was 23.3% (95% CI 20.6%-26.2%). The risk factors associated with inadvertent intraoperative hypothermia included low body mass index (BMI) (OR = 0.932, 95%CI 0.887-0.979, P = 0.005), low base line body temperature (OR = 0.076, 95%CI 0.048-0.121, P < 0.001), longer duration of surgery (OR = 1.221, 95%CI 1.011-1.476, P = 0.039), large volume of fluid infusion (OR = 1.033, 95%CI 1.000-1.067, P = 0.048) and combined positions (OR = 2.093, 95%CI 1.035-4.231, P = 0.040). ROC curve analysis showed that baseline body temperature (AUC: 0.793, 95%CI 0.757-0.829) had highest predictive efficiency for inadvertent intraoperative hypothermia among above-mentioned five factors. Meanwhile, the combination of all risk factors had the highest predictive efficacy (AUC: 0.835, 95%CI 0.804-0.866).</p><p><strong>Conclusions: </strong>This study represents the first report on the incidence rate of inadvertent intraoperative hypothermia in patients undergoing trauma surgery and identify key risk factors including lower baseline body temperature, longer duration of surgery, lower BMI, more fluid infusion and combined positions. We also contribute the multifactor model demonstrated superior predictive value for inadvertent intraoperative hypothermia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026534","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":"Modified Kraske Procedure for retrorectal tumors: Early postoperative outcomes and surgical site infection rates in a single-center experience.","authors":"Adem Bayraktar, Cemil Burak Kulle, Ozan Pastacıgil, Halil Alper Bozkurt, Melek Büyük, Neslihan Berker, İlker Özgür, Metin Keskin, Mehmet Türker Bulut","doi":"10.1186/s12893-026-03987-w","DOIUrl":"https://doi.org/10.1186/s12893-026-03987-w","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to evaluate the early postoperative morbidity rates with a particular focus on surgical site infection rates, in patients undergoing resection for retrorectal tumors with the modified Kraske Procedure.</p><p><strong>Methods: </strong>This descriptive observational case series study included patients who underwent resection for retrorectal tumors performing the modified Kraske Procedure between August 2006 and August 2025. Patients with recurrent disease or a history of pelvic radiotherapy or chemotherapy were excluded. The primary outcome was early postoperative morbidity, especially in terms of surgical site infections, which was defined as complications occurring within the first 30 days after surgery.</p><p><strong>Results: </strong>Among 35 patients operated for retrorectal tumors, 23 (65.7%) patients underwent a resection performing the modified Kraske Procedure and were included in the analysis. The majority of patients were female (82.6%), with a mean age of 40.3 ± 15.8 years. The mean tumor size was 42.5 ± 10.0 mm, and most lesions were benign (87%). Postoperative complications occurred in three (13%) patients, with surgical site infection observed in only one (4.3%) patient. The mean length of hospital stay was 3.8 ± 1.9 days.</p><p><strong>Conclusion: </strong>The modified Kraske Procedure was associated with a low surgical site infection rate and acceptable early postoperative morbidity in this series. This technique may represent a feasible surgical modification for selected retrorectal tumors and warrants further evaluation in comparative studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}