BMC Surgery最新文献

{"title":"Effect of abdominal drain on surgical site infection undergoing laparoscopic appendectomy for perforated appendicitis in adults: a propensity score matching analysis.","authors":"Hao Lu, Shikuan Li, Dawei Zhang, Shengqiang Wang, Hairui Liu, Chengzhi Wang, Honghao Peng","doi":"10.1186/s12893-025-03219-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03219-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of abdominal drain on the incidence of surgical site infection undergoing laparoscopic appendectomy for perforated appendicitis in adults.</p><p><strong>Methods: </strong>Clinical data of adult patients who were intraoperatively diagnosed with perforated appendicitis and underwent laparoscopic appendectomy at the Affiliated Hospital of Qingdao University between January 2019 and December 2024 were retrospectively analyzed. According to whether an abdominal drain was placed during surgery, the patients were categorized into an abdominal drain group and a non-abdominal drain group. A total of 128 patients were included, comprising 73 cases in the abdominal drain group and 55 cases in the non-abdominal drain group. Baseline demographic and clinical characteristics were collected. Propensity score matching (PSM) was employed to balance intergroup differences in clinical features.</p><p><strong>Results: </strong>After PSM, the baseline characteristics between the two groups showed no significant differences and were well-balanced (P > 0.05). The abdominal drain group exhibited significantly longer operative time (P = 0.010), duration of postoperative antibiotic use (P < 0.001), and length of stay (P < 0.001). Before matching, the overall surgical site infection (SSI) rates were 27% in the abdominal drain group and 23% in the non-abdominal drain group, with no statistically significant difference between the groups (P = 0.61). After matching, the overall SSI rate was 24% in both groups, and the difference remained statistically non-significant (P > 0.99).</p><p><strong>Conclusion: </strong>Our findings do not support routine abdominal drain placement in adults with perforated appendicitis undergoing laparoscopic appendectomy and align with current guideline trends. However, prospective multicenter randomized controlled trials are warranted.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"470"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259752","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}

{"title":"Complicated pharyngocutaneous fistula repair after head and neck cancer surgery: a case series of 7 patients.","authors":"Weihua Zhou, Huajun Feng, Sai Liang, Shengen Xu, Zhuoping Liang, Yuanyuan Wang, Gang Qin","doi":"10.1186/s12893-025-03223-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03223-x","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively analyze the repair of seven cases of complicated pharyngocutaneous fistula (PCF) to provide a reference for the treatment of complicated PCF.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of seven patients with complicated PCF from February 2017 to December 2021, including six males and one female, with a history of neck radiotherapy in two cases. The range of PCF mucosal defects was 1.0 cm × 2.0-5.0 cm × 7.0 cm. A pedicled flap or free flap was chosen for repair depending on the site and size of the defect. A total of eight flaps were used to repair complicated PCF defects.</p><p><strong>Results: </strong>One of the seven patients healed after conservative treatment. Among the five patients who underwent pedicled flap repair, three had first-intention healing, one had second-intention healing, and one had tumor recurrence with unhealed PCF. Free flap repair was performed in one case, which had first-intention healing.</p><p><strong>Conclusion: </strong>Early, prompt, and appropriate treatment can prevent a PCF from progressing to complicated PCF. The repair of the complicated PCF needs to be individualized according to the patient's local defect and the surgeon's clinical experience.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"467"},"PeriodicalIF":1.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259686","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}

{"title":"Clinical outcomes of unilateral biportal endoscopic discectomy for the treatment of far lateral lumbar disc herniation: a retrospective comparative study.","authors":"Shuo Yuan, Ziqian Ma, Ruiyuan Chen, Aobo Wang, Yu Xi, Tianyi Wang, Ning Fan, Peng Du, Lei Zang","doi":"10.1186/s12893-025-03210-2","DOIUrl":"https://doi.org/10.1186/s12893-025-03210-2","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aims to evaluate the efficacy and safety of unilateral biportal endoscopic discectomy (UBED) in patients with far lateral lumbar disc herniation (FLLDH).</p><p><strong>Methods: </strong>A total of 25 patients with single-level FLLDH who underwent UBED between April 2023 and January 2024 were retrospectively analyzed, while 30 patients with paracentral LDH served as the control group. Primary outcomes were assessed using operation time, hospital stay, volume of drainage, complications, postoperative hospitalization duration, visual analogue scale (VAS) scores for back pain (VAS-BP) and leg pain (VAS-LP), the Oswestry Disability Index (ODI), and the modified MacNab criteria. Demographic, symptom-related, and radiographic data were also analyzed.</p><p><strong>Results: </strong>Preoperative VAS-LP scores were significantly higher in the study group compared to the control group (p < 0.05). In the study group, the ODI, VAS-BP, and VAS-LP scores showed a significant decrease from preoperative values, indicating notable improvement (p < 0.05). Mean operative time was 96.4 min, and mean hospital stay time was 6.44 days. Graded by Macnab criteria, 22 (88%) of patients had good to excellent outcomes. There were no significant differences in complication rates or patient satisfaction between the two groups (p > 0.05). Furthermore, no significant deterioration in disc degeneration and adjacent segment degeneration was observed in either group (p > 0.05).</p><p><strong>Conclusion: </strong>FLLDH poses significant challenges in both diagnosis and surgical management for surgeons. UBED treatment can yield outcomes comparable to those seen in more common types of LDH, providing a safe and effective treatment for FLLDH with favorable surgical results, minimal complications, and sustained pain relief.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"457"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253435","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}

{"title":"Comparative outcomes of synthetic and biological mesh use in laparoscopic inguinal hernia repair: a systematic review and meta-analysis.","authors":"Candela Romano, Hugo Silva, Laura A Gray, Carla Ibarra, William Soto, Lorenzo G Fernandez, Jorge Vazquez Del Real, Rafael Pinto-Colmenarez, Victor Sebastian Arruarana, Daniela Fulginiti","doi":"10.1186/s12893-025-03151-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03151-w","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernias occur when abdominal contents protrude through the inguinal canal. Laparoscopic repair is often preferred due to reduced postoperative pain, quicker recovery, and better cosmetic results. While synthetic mesh remains the standard, concerns about complications have prompted interest in biological meshes, which may integrate better with tissue but are more expensive and lack long-term data.</p><p><strong>Methods: </strong>We conducted a meta-analysis of studies published between 2015 and 2025 that compared biological versus synthetic mesh in laparoscopic inguinal hernia repair among adults. Only randomized controlled trials and cohort studies published in English were included. The primary and secondary outcomes were hernia recurrence and postoperative complications.</p><p><strong>Results: </strong>Out of 6017 records, three studies involving 1372 participants met the inclusion criteria. All compared porcine small intestinal submucosa (SIS) biological mesh with synthetic mesh. SIS mesh was associated with longer operating times (SMD 0.45; 95% CI: 0.02-0.87; p = 0.039). However, there were not a statistically significant differences in recurrence (RR 12.73; p = 0.15), complications (RR 3.06; p = 0.55), or adverse events (RR 5.38; p = 0.21). Heterogeneity was high, and funnel plots suggested possible publication bias.</p><p><strong>Conclusion: </strong>Biological mesh did not show a clear benefit over synthetic mesh in laparoscopic inguinal hernia repair. While it may reduce chronic pain, it requires longer operative time and raises concerns about cost and long-term outcomes. Larger, high-quality studies are needed to clarify their role in clinical practice.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"458"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253490","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}

{"title":"Pelvic unlocking closed reduction device for treatment of severe traumas combined with pelvic fractures: a retrospective case series of 13 patients.","authors":"Jie Chen, Zhuangzhuang Zhang, Yiping Weng, Zhongjie Yu, Rongbin Sun, Yu Zhang","doi":"10.1186/s12893-025-03199-8","DOIUrl":"10.1186/s12893-025-03199-8","url":null,"abstract":"<p><strong>Background: </strong>Closed reduction and internal fixation is the key to early and minimally invasive treatment of pelvic fractures in patients with severe trauma. Although the pelvic unlocking closed reduction device has been promoted to a certain extent, the therapeutic effect and surgical strategies for treating severe trauma have not been clearly clarified. Our study was aimed to explore the therapeutic effect and surgical strategy skills of the pelvic unlocking closed reduction device in treating severe traumas combined with pelvic fractures.</p><p><strong>Methods: </strong>Data were retrospectively collected from 13 patients with severe traumas undergoing pelvic unlocking closed reduction for pelvic fractures in our hospital between July 2021 and December 2022. Seven males and six females aged 48(18~69), 46.4±16.7 years were involved. The operation time, times of fluoroscopy, and blood loss were recorded intraoperatively. Postoperative complications, and fracture healing time were recorded. The Matta and Majeed scales were used to evaluate fracture reduction and clinical efficacy respectively.</p><p><strong>Results: </strong>The time from injury to surgery was 7(4~14), 8.2±3 days. No wound infection, loosening or breakage of internal fixation, or loss of reduction occurred. The clinical healing time was 3(3~5), 3.5±0.7 months. Three cases suffered paresthesia on unilateral anterolateral thigh. According to the postoperative imaging Matta scores, 12 cases were excellent and 1 case was good, with an excellent rate of 12/13. At the last follow-up, the Majeed functional scores were excellent in all 13 cases.</p><p><strong>Conclusions: </strong>For patients with severe trauma combined with pelvic fracture, the pelvic unlocking and reduction device can be used for minimally invasive internal fixation at an early stage as long as their vital signs are stable. In this study, we summarized and advocated the 'turn-back order' reduction and internal fixation philosophy of 'posterior-ring unlocking - anterior ring to posterior ring reduction stabilization - posterior ring to anterior ring internal fixation placement' in pelvic closed reduction and internal fixation surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"456"},"PeriodicalIF":1.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245574","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":"A comparison study of two fecal diversion methods based on novel intestinal stents for preventing anastomotic leakage after middle and lower rectal cancer surgery.","authors":"Dayong Wei, Xiong Zhou, Lian Bai, Jia Liu","doi":"10.1186/s12893-025-03201-3","DOIUrl":"10.1186/s12893-025-03201-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the feasibility and safety of two intestinal fecal diversion methods using novel stents to prevent anastomotic leakage after surgery for middle and lower rectal cancer, and to compare their advantages and disadvantages for clinical application.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 101 patients who underwent laparoscopic radical resection(LAR) for rectal cancer at Yongchuan Hospital from June 2021 to March 2024. Patients were divided into three groups: 26 in the ileum group (using terminal ileal stents) ,54 in the in situ group (using rectal in situ covered stents) and 21 in the control group. Preoperative, surgical, and postoperative data were compared among the three groups.</p><p><strong>Results: </strong>No significant differences were found in baseline characteristics, surgical data, or the occurrence of postoperative anastomotic leakage or other complications. The in situ group showed no statistically significant differences from the control group in the postoperative hospital stay(12.6 ± 3.7 vs. 11.4 ± 2.9days, p > 0.05 ), total cost of hospitalization (48903.58 ± 7094.14 vs. 82205.77 ± 12222.41yuan, p > 0.05). Moreover, the ileum group in these comparisons performed worse than the control group. After incorporating data related to stoma closure surgery, the in situ group and ileum group showed significant advantages in overall hospitalization costs(59085.88 ± 7460.79 vs. 48903.58 ± 7094.14 vs. 81418.32 ± 11186.78yuan, p < 0.05), and the in-situ group also had shorter overall hospital stay(17.6 ± 5.0 vs. 22.2 ± 4.0days, p < 0.05).</p><p><strong>Conclusions: </strong>Both fecal diversion methods showed acceptable rates of postoperative anastomotic leakage and can avoid a second stoma closure surgery. The in situ covered stent method seemed better as it not only saved hospitalization time and costs but also made postoperative management simpler and more efficient.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"453"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240237","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 spatial perception in robot-assisted minimally invasive surgery with edge-preserving depth estimation and pose tracking.","authors":"Bo Guan, Jianchang Zhao, Bo Yi, Jianmin Li","doi":"10.1186/s12893-025-03198-9","DOIUrl":"10.1186/s12893-025-03198-9","url":null,"abstract":"<p><strong>Background: </strong>Enhancing the safety of robot-assisted minimally invasive surgery (RAMIS) is critically dependent on improving the robot's spatial understanding of the surgical scene. However, the quality of laparoscopic images is often negatively affected by factors such as uneven lighting, blurred textures, and occlusions, all of which can interfere with the accurate acquisition of depth information.</p><p><strong>Methods: </strong>To address these challenges, we develop a depth estimation and pose tracking method that incorporates a dual-stream Transformer stereo matching network and a vision-based tracking technique.</p><p><strong>Results: </strong>Experimental results indicate that the proposed method can effectively maintain the boundary information of anatomical structures and demonstrate better performance in the robustness of laparoscope pose tracking.</p><p><strong>Conclusions: </strong>This paper presents a robotic-assisted minimally invasive surgery navigation framework that achieves accurate scene depth estimation and pose tracking, thereby enhancing the robot's spatial understanding of the surgical environment.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"455"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240291","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":"Analysis of serum inflammatory factors, immune status, and prognosis in patients with different degrees of femoral neck fractures.","authors":"Hao Weng, Liang Zhu, Zhu Mei, Mingxian Wu, Qiang Xu","doi":"10.1186/s12893-025-03120-3","DOIUrl":"10.1186/s12893-025-03120-3","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"454"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240312","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":"Laparoscopic management of giant abdominal cystic lymphangiomas: experience from the queen Fabiola children's university hospital.","authors":"Irene Nadine Kouna Tsala, Anna Poupalou, Helena Reusens, Gregory Rodesch, Eric Tobie Ntsobe, Eduardo Vieira Cardoso, Taisia Bollettini, Gianluca Gentilucci, Cyrille Leger Abega, Nasroola Damry, Basile Essola, Pierre Lingier","doi":"10.1186/s12893-025-03153-8","DOIUrl":"10.1186/s12893-025-03153-8","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"428"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226174","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 continuous intercostal nerve block for postoperative analgesia after uniportal thoracoscopic surgery.","authors":"Li-Xiang Zhang, Li Lin, Yuan-Liang Zheng","doi":"10.1186/s12893-025-03197-w","DOIUrl":"10.1186/s12893-025-03197-w","url":null,"abstract":"<p><strong>Background: </strong>Effective postoperative pain control is essential for recovery after surgery. This study aimed to evaluate the safety and efficacy of a modified continuous intercostal nerve block (MCINB) compared to conventional intravenous analgesia pump (IAP) for pain management following uniportal thoracoscopic lung resection.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent uniportal thoracoscopic lung resection at our center between January 2020 and December 2023. Patients were divided into two groups based on the actual analgesia method used postoperatively: MCINB and IAP. The MCINB technique involved placing a multi-orifice catheter in the intercostal space under thoracoscopic guidance, with continuous infusion of local anesthetic. We compared postoperative numeric rating scale (NRS) pain scores at rest and during coughing, patient satisfaction with pain management, frequency of rescue analgesic use, analgesic-related side effects, catheter-related complications, length of hospital stay, and total medical costs.</p><p><strong>Results: </strong>Among the 458 included patients, 196 received MCINB, and 262 received IAP. Linear mixed-effects model analysis showed that NRS pain scores at rest and during coughing were significantly lower in the MCINB group over the postoperative period (p < 0.001), with post hoc comparisons revealing no significant difference immediately after surgery and on the day of discharge (p > 0.05). At other time points, the median NRS scores in the MCINB group remained within the mild pain range. Patient satisfaction with pain management was significantly higher in the MCINB group than in the IAP group (90.3% vs. 65.6%, p < 0.001). Additionally, the MCINB group had a shorter hospital stay, lower total medical costs, reduced rescue analgesic use, and fewer analgesic-related side effects (p < 0.001). The incidence of intercostal catheter dislodgement and blockage was 1% (2/196) each, with no severe catheter-related complications reported.</p><p><strong>Conclusion: </strong>MCINB appears to be a safe and effective option for early postoperative pain management after uniportal thoracoscopic surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"448"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226201","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}