BMC Surgery最新文献

{"title":"Outcomes of targeted axillary radiation therapy with omission of axillary dissection in early breast cancer patients with one or two positive sentinel lymph nodes and extracapsular extension.","authors":"Ahmed Orabi, Asmaa G Ellaithy, Maha Guimei, Maher H Ibraheem, Waleed Mohamed M Fadlalla, Mohamed Fathy Abdelfattah Abdelrahman Elithy, Yasmine Hany Abdel Moamen Elzohery, Ahmed S Abdelmomen, Sherif Nasser Taha","doi":"10.1186/s12893-025-02974-x","DOIUrl":"10.1186/s12893-025-02974-x","url":null,"abstract":"<p><strong>Purpose: </strong>Axillary dissection has been shown to be equivalent to axillary radiotherapy in the AMAROS trial; however, extracapsular invasion of sentinel lymph nodes was not considered among the evaluated variables. The clinical significance of extracapsular extension (ECE) in one or two positive sentinel lymph nodes remains under investigation. This study aims to evaluate the impact of targeted axillary radiation therapy while omitting completion axillary lymph node dissection (ALND) in the presence of extracapsular extension.</p><p><strong>Methods: </strong>A retrospective study was conducted between 2016 and 2023 involving cT1-2N0 breast cancer patients who did not receive neoadjuvant chemotherapy and underwent either breast-conserving surgery or mastectomy, with extracapsular extension present in one or two positive sentinel lymph nodes.</p><p><strong>Results: </strong>Our study included 213 patients treated between 2016 and 2023, with a median follow-up of 48.07 months (range: 9.07-103.10 months). ECE was ≤ 2 mm in 201 patients (94.4%) and > 2 mm in 12 patients (5.6%). A total of 112 patients (52.6%) underwent completion ALND. Systemic recurrence occurred in 24 patients (11.3%), while local recurrence occurred in one patient (0.5%). The 5-year disease-free survival (DFS) rates were 86% in the completion axillary clearance (AC) group and 89% in the non-AC group. The estimated DFS rates for the entire study at 1, 3, and 5 years were 97%, 89%, and 86%, respectively.</p><p><strong>Conclusions: </strong>Within this single-institution study of early breast cancer patients with predominantly luminal A subtype and mostly limited ECE (≤ 2 mm) treated with targeted axillary radiation, omission of ALND did not result in inferior DFS compared to completion ALND. However, these findings are preliminary, hypothesis-generating, and limited by the retrospective design, short follow-up, and specific patient population studied. Prospective studies are needed to confirm these observations.</p><p><strong>Trial registration: </strong>Retrospectively registered after the approval of Baheya Ethical Committee, IRB no. 202,304,030,017.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"240"},"PeriodicalIF":1.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210048","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 ERAS pathway nursing on postoperative rehabilitation of patients undergoing gastrointestinal surgery: a meta-analysis.","authors":"Fengying Dong, Yan Li, Wenxia Jin, Zhebing Qiu","doi":"10.1186/s12893-025-02976-9","DOIUrl":"10.1186/s12893-025-02976-9","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically evaluate the impact of the Enhanced Recovery After Surgery (ERAS) pathway on postoperative outcomes-including hospital length of stay, complication rates, readmission, reoperation, and mortality-in patients undergoing gastrointestinal surgery, to provide evidence-based guidance for clinical practice.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Library, Embase, Web of Science and Scopus databases for randomized controlled trials (RCTs) and cohort studies on ERAS pathway in postoperative rehabilitation. Thirteen studies comprising a total of 5,603 patients were included. Literature screening and quality assessment followed the standards of Cochrane Collaboration and Newcastle-Ottawa scales. Statistical analysis was performed using R software to calculate the relative risk (RR), mean difference (MD) with 95% confidence interval (CI), and heterogeneity through the I² statistic, with significance set at P < 0.05. This systematic review and meta-analysis has been registered in the PROSPERO database (ID: CRD42024608876).</p><p><strong>Results: </strong>The ERAS pathway significantly shortened the postoperative hospital stay (MD = -3.16, 95% CI [-4.10, -2.21], P < 0.01) and reduced the incidence of postoperative complications (RR = 0.70, 95% CI [0.58, 0.84], P < 0.01). It also significantly reduced the readmission rates (RR = 0.75, 95% CI [0.58, 0.96], P = 0.02). However, there was no statistically significant difference in the impact of ERAS pathway on reoperation rate and mortality (RR = 0.59, 95% CI [0.01, 30.14], P = 0.62).</p><p><strong>Conclusions: </strong>ERAS protocols are associated with improved postoperative recovery in gastrointestinal surgery, including shorter hospital stays and reduced complication and readmission rates. Although no significant effects were found for reoperation or mortality, the overall evidence supports the broader clinical adoption of ERAS, with a need for further high-quality studies to address remaining uncertainties.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"239"},"PeriodicalIF":1.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210047","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":"Thermal effects of the anovo^® instrument arms hook electrode and curved scissors: an ex vivo study of safety and precision in monopolar electrosurgery.","authors":"Yuval Ramot, Sapir Hillel, Maor Mussan, Ronit Manor, Abraham Nyska","doi":"10.1186/s12893-025-02969-8","DOIUrl":"10.1186/s12893-025-02969-8","url":null,"abstract":"<p><strong>Background: </strong>Thermal damage during surgical procedures is a critical factor influencing patient safety and outcomes, particularly in minimally invasive laparoscopic surgeries. Advanced robotic-assisted surgical systems, such as the Anovo^® Surgical System, incorporate monopolar electrosurgical tools designed to optimize precision while minimizing collateral tissue damage. This study evaluates the thermal effects of the Anovo^® Hook Electrode and Curved Scissors compared to conventional off-the-shelf (OTS) tools.</p><p><strong>Methods: </strong>An ex vivo study was conducted using 288 tissue samples from a swine model, including liver, kidney, and muscle tissues. Thermal effects during monopolar cutting and coagulation were evaluated at three power settings (low, medium, high) and durations (5, 10, 15 s). Histological analysis was performed on all samples to assess coagulation necrosis and thermal spread. Statistical equivalence testing was applied to compare the Anovo^® devices with OTS tools.</p><p><strong>Results: </strong>The Anovo^® devices achieved precise and consistent thermal effects, meeting equivalence criteria in 97.57% of samples. Histological analysis confirmed well-defined coagulation zones with no unintended necrosis beyond the treated areas. Thermal spread increased proportionally with power settings and activation durations, but remained within clinically acceptable limits. The Anovo^® devices demonstrated performance comparable to, and occasionally superior to, OTS tools.</p><p><strong>Conclusion: </strong>The Anovo^® Hook Electrode and Curved Scissors provide safe and effective monopolar electrosurgical performance with precise thermal effects. These findings support their use in robotic-assisted laparoscopic surgeries and highlight their potential to enhance surgical precision and patient outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"236"},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180444","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":"Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model.","authors":"Chong Cao, Bo Xu, Yu Wang, Yikai Shao, Qiwei Shen, Xiaojian Fu, Rong Hua, Qiyuan Yao","doi":"10.1186/s12893-025-02960-3","DOIUrl":"10.1186/s12893-025-02960-3","url":null,"abstract":"<p><strong>Background: </strong>Gastric greater curvature plication combined with Nissen fundoplication (GGCP + Nissen) has been previously performed, but its efficacy remains uncertain.</p><p><strong>Methods: </strong>A single-center retrospective review was conducted on patients with obesity who underwent GGCP + Nissen or sleeve gastrectomy (SG) between January 2016 and December 2022. Both groups were matched for age, gender, and baseline BMI. In the animal experiments, GGCP + Nissen, SG, and sham procedures were performed on Goto-Kakizaki rats, a model of normal-weight rats with T2DM.</p><p><strong>Results: </strong>A total of 75 patients were included in this study, of whom 35 underwent GGCP + Nissen, and 40 underwent SG. Both groups were matched for age, gender, and baseline BMI. The percent total weight loss (%TWL) in the GGCP + Nissen and SG groups were 16.38 ± 3.69 and 25.05 ± 7.24 at 6 months (P < 0.05), 16.40 ± 4.96 and 26.85 ± 9.13 at 12 months (P < 0.05), and 12.46 ± 5.90 and 24.57 ± 8.61 at 24 months (P < 0.05), respectively. However, all 8 patients with preoperative reflux in the GGCP + Nissen group achieved complete resolution of symptoms postoperatively, whereas in the SG group, 10 patients developed new-onset reflux at 1 month, with 4 continuing to experience persistent symptoms at 24-month follow-up. In the animal experiments, both GGCP + Nissen and SG induced significant weight loss and improved glucose tolerance, with rats showing increased insulin sensitivity and secretion. However, the SG group performed better than the GGCP + Nissen group in terms of both weight loss and improvement of glucose tolerance.</p><p><strong>Conclusions: </strong>GGCP + Nissen was inferior to SG both in weight loss and improvement of glucose tolerance, although GGCP + Nissen could lead a substantial weight loss and improve GERD efficiently.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"237"},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182828","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":"Clavien-Dindo classification for assessment of complications after 1465 unselected otorhinolaryngology and head and neck surgeries in a university hospital: a retrospective observational study.","authors":"Leonie Glombitza, Jonas Ballmaier, Mussab Kouka, Thomas Bitter, Orlando Guntinas-Lichius","doi":"10.1186/s12893-025-02970-1","DOIUrl":"10.1186/s12893-025-02970-1","url":null,"abstract":"<p><strong>Background: </strong>Assessment of surgical complications is an important part of quality control on departments of otorhinolaryngology and head and neck surgery. Nevertheless, standardized assessment of surgical complications with easy-to-use instruments is not yet clinical routine.</p><p><strong>Methods: </strong>Data from all 1,465 otorhinolaryngology and head and neck surgeries (male 60.3%; median age: 52 years) performed in 2020 at a department of otorhinolaryngology of a tertiary university hospital were analyzed. The postoperative complications were graded with the Clavien-Dindo classification (CDC).</p><p><strong>Results: </strong>The most frequent types of surgery were: diagnostic endoscopy (19.4%), ear surgery (14.8%) and oral/pharyngeal surgery (12.1%). Two-hundred seven patients (14.1%) had CDC complications, mostly CDC grade II (6.9%) and CDC grade III (5.1%). Due to multivariate analysis, smoking was an important predictor of postoperative CDC complication (Odds ratio [OR] = 1.526; confidence interval [CI] = 1.037 to 2.244). The risk of re-admission was higher for patients with postoperative complications (OR = 2.859; CI = 2.119 to 3.8591). Compared to a diagnostic endoscopy, the incidence of postoperative complications was highest for esophageal surgery (highest risk: OR = 23.580; CI = 7.619 to 72.978), thyroid surgery (second highest risk: OR = 21.060; CI = 4.838 to 91.665), and salivary gland surgery (OR = 15.330; CI = 5.215 to 45.070).</p><p><strong>Conclusions: </strong>The CDC grading is a useful tool for grading all kind of otorhinolaryngology and head and neck surgery complications. CDC is well suited for comparing different types of otorhinolaryngology and head and neck surgeries with each other and also patients of different hospitals.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"235"},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180272","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":"Research progress in the treatment of gallstones with laparoscopic and endoscopic surgery: a narrative review.","authors":"Yue Zhang, Xinyu Dai, Ruifeng Duan, Lijuan Wei","doi":"10.1186/s12893-025-02977-8","DOIUrl":"10.1186/s12893-025-02977-8","url":null,"abstract":"<p><p>Cholelithiasis, the formation of stones in the gallbladder, is a common surgical condition with an increasing incidence. Laparoscopic cholecystectomy has become the gold standard for the treatment of symptomatic gallstones due to its favorable outcomes. However, with increasing recognition of the gallbladder's importance, this procedure no longer aligns with patients' desire to preserve the organ. Technological advancements and surgical innovations have led to emerging approaches such as natural orifice transluminal endoscopic surgery (NOTES), robot-assisted laparoscopic cholecystectomy, and cholangioscopy. This narrative review examines the current landscape of surgical interventions for gallstones, highlighting both gallbladder-preserving and removal approaches, and aims to provide insight into their respective outcomes and clinical implications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"238"},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181343","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 single-piece and multiple-piece cartilage grafts for the repair of large tympanic membrane perforations: a randomized controlled trial.","authors":"Jian Yang, Zhengcai Lou","doi":"10.1186/s12893-025-02967-w","DOIUrl":"10.1186/s12893-025-02967-w","url":null,"abstract":"<p><strong>Objective: </strong>We compared graft success rates, hearing outcomes, and operation times between single-piece cartilage grafts (SPCGs) and multiple-piece cartilage grafts (MPCGs) in patients with large tympanic membrane (TM) perforations.</p><p><strong>Study design: </strong>Single-center blinded randomized controlled trial.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Materials and methods: </strong>Patients with large TM perforations exceeding 50% of the TM area were recruited and randomly assigned to the SPCG or MPCG group. Graft success rates, hearing outcomes, operation times, and complications were evaluated at 12 months postoperatively.</p><p><strong>Results: </strong>In total, 61 patients with large TM perforations were included. The mean operation time was significantly longer in the MPCG group (47.2 ± 3.8 min) than in the SPCG group (32.6 ± 4.1 min). All patients completed a 12-month follow-up. Postoperatively, residual perforation was observed in one patient (3.3%) in the SPCG group and in two patients (6.5%) in the MPCG group. The graft success rates were 96.7% (29/30) and 93.5% (29/31) in the SPCG and MPCG groups, respectively. The postoperative air-bone gap (ABG) exhibited significant improvement compared to preoperative values in both groups. In addition, no significant inter-group differences were observed in preoperative or postoperative ABG values. Although the mean ABG gain did not differ significantly between the groups, the SPCG group demonstrated greater hearing improvement compared to the MPCG group. None of the patients developed postoperative otitis media with effusion or graft retraction.</p><p><strong>Conclusions: </strong>Endoscopic myringoplasty using the SPCG and MPCG techniques demonstrated comparable graft outcomes. However, the operation time of the SPCG technique was significantlyshorter.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR) ChiCTR2300078776 (registered on 18 December 2023).</p><p><strong>Statistical analyses: </strong>Statistical analyses were performed using SPSS version 19 (IBM Corp.). Continuous variables are presented as means ± standard deviations, whereas categorical variables are presented as numbers or percentages. The chi-squared test was used to compare categorical variables. The Wilcoxon and Mann-Whitney U-tests were used to compare non-parametric variables between the two groups. Analyses of variance were used to compare preoperative and postoperative ABG and BC variables, with preoperative hearing status included as a covariate. P-values < 0.05 were considered statistically significant.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"233"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175403","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 arthroscopy-assisted versus open reduction and fixation for treating scaphoid fractures.","authors":"Xiaolong Du, Xuehai Ou, Jidong Liang, Chao Liu, Qianjin Zheng, Shaoyan Shi","doi":"10.1186/s12893-025-02961-2","DOIUrl":"10.1186/s12893-025-02961-2","url":null,"abstract":"<p><strong>Objectives: </strong>Scaphoid fractures represent the most common type of carpal fracture. This study aimed to retrospectively evaluate and compare the therapeutic efficacy of wrist arthroscopy-assisted fixation versus conventional open reduction with fixation for scaphoid fractures.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study involving 159 patients with acute scaphoid fractures. Participants were stratified into two groups: the open reduction with fixation group (underwent open reduction and fixation) and the Arthroscopy group (received wrist arthroscopy-assisted fixation). Comparative analyses included operative duration, hospitalization length, fracture union time, and Visual Analog Scale (VAS) pain scores. Wrist functionality and range of motion were assessed using the Mayo wrist joint function scoring scale. Additionally, patient satisfaction was evaluated through a standardized questionnaire.</p><p><strong>Results: </strong>Following propensity score matching (PSM), 54 matched pairs were analyzed. Baseline characteristics showed no significant intergroup differences. The Arthroscopy group exhibited statistically superior outcomes, including shorter operative time, reduced hospitalization, accelerated fracture union, and lower postoperative VAS scores. Mayo Wrist Scores were significantly higher in the Arthroscopy group, indicating better functional recovery. Furthermore, the Arthroscopy group demonstrated a lower overall complication rate and significantly improved scores in both physical and psychological assessment domains.</p><p><strong>Conclusions: </strong>Wrist arthroscopy-assisted fixation significantly enhances postoperative recovery, yielding superior functional outcomes, reduced complications, and higher patient satisfaction compared to the open reduction with fixation group. This technique represents a promising approach for optimizing scaphoid fracture management.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"232"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175398","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":"Suture lasso combined with lateral plate in comminuted transolecranon fracture-dislocations of the elbow.","authors":"Tongtong Li, Zengliang Wang, Guoyun Bu, Shucai Bai, Chen Li, Fei Chen, Peng Yang, Xuelei Wei","doi":"10.1186/s12893-025-02972-z","DOIUrl":"10.1186/s12893-025-02972-z","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the effectiveness of suture lasso combined with lateral plate in comminuted transolecranon fracture-dislocations of the elbow.</p><p><strong>Method: </strong>We retrospectively reviewed 13 patients with comminuted transolecranon fracture-dislocations of the elbow. Our study included 6 males and 7 females with a mean of age 54.3 years. All the patients had comminuted fracture of proximal ulna and coronoid fracture of Regan-Morrey type II/III. Among them, 4 cases were combined with radial head fractures. The patients were treated with open reduction and internal fixation with suture lasso combined with lateral plate based on the traditional mode.</p><p><strong>Results: </strong>The mean follow-up was 15.7 ± 5.8 months (range 12-33 months). During the follow-up period, the fracture and joint alignment were good, and there was no loosening of internal fixation. X-ray films showed that the fracture healing time was 3-6 months, with an average of 3.8 ± 0.9 months. Mild postoperative heterotopic ossification was observed in 2 cases. There was 1 case of poor wound healing and 1 case of ulnar nerve stimulation. At the last follow-up, the average Mayo elbow function score and Broberg-Morrey score were 91.5 ± 9.2 and 94.7 ± 6.5 points respectively. The result was classified as excellent in 9, good in 3, and fair in 1 patient. The excellent and good rate was 92.3%.</p><p><strong>Conclusions: </strong>Our study suggested that suture lasso combined with lateral plate based on the traditional internal fixation mode was highly effective for the treatment of transolecranon fracture-dislocations of the elbow. Especially for the patient with comminuted proximal ulna, the restoration and fixation of coronoid process were quite important to increase the stability of the elbow joint and lead to good clinical efficacy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"234"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175350","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":"Relationship between high-sensitivity C-reactive protein to lymphocyte ratio (hs-CLR) and incision complications following medial opening-wedge high tibial osteotomy for knee osteoarthritis.","authors":"Chenni Ji, Jiaxiang Cheng, Hang Su, Yanbin Zhu, Min Zou","doi":"10.1186/s12893-025-02968-9","DOIUrl":"10.1186/s12893-025-02968-9","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory and markers have a vital role in the development and prediction of adverse events following surgical procedures. This study aims to examine the relationship between high-sensitivity C-reactive protein to lymphocyte ratio (hs-CLR) and incision complications (ie, poor healing of superficial incisions, wound infection) following medial opening-wedge high tibial osteotomy (MOWHTO) for unicompartmental knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>This retrospective study analyzed patients who underwent MOWHTO for varus KOA between January 2021 and June 2024 in two tertiary referral hospitals. Baseline characteristics and laboratory test results were obtained through a review of inpatient medical records. The primary outcome measure was the incidence of incision complications occurring within 30 days postoperatively, determined by examining both inpatient records and outpatient follow-up documentation after discharge. To explore the relationship between hs-CLR and incision complications, we employed restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) curves, as well as univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>There were 528 participants, including 190 males and 338 females, with a mean age of 56.2 ± 6.5 years. Within the 30 days following surgery, 48 patients (9.1%; 95% CI, 6.6% to 11.5%) experienced incision complications. Both the unadjusted and adjusted RCS analyses revealed the consistently significant nonlinear relationship (P < 0.05). ROC curve analysis identified an optimal hs-CLR cut-off value of 1.83, accordingly categorizing patients into low hs-CLR (n = 298) and high hs-CLR (n = 230) groups. Multivariate analyses employing two adjustment techniques demonstrated a significant relationship between a hs-CLR ≥ 1.83 and an increased risk of incision complications, with an odds ratio of 8.08 (95% CI, 3.16 to 20.63; P < 0.001) for \"fully adjusted model\" and of 8.99 (95%CI, 3.92 to 20.63; P < 0.001) for \"backward elimination model\".</p><p><strong>Conclusion: </strong>This study demonstrated a robust association between preoperative hs-CLR and the risk of postoperative incision complications following MOWHTO for varus KOA. Although the observed odds ratios were substantial, the wide confidence intervals highlight the need for validation through larger, multicenter studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"230"},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152676","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}