BMC Surgery最新文献_第2页

Implementation of six sigma management to standardize surgical hand disinfection practices. 实施六西格玛管理，规范外科手部消毒操作。

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-27 DOI: 10.1186/s12893-025-02854-4

Ping Jiang, Yan Liu, Hai-Yan Gu, Qin-Xia Li, Ling-Bo Xue

{"title":"Implementation of six sigma management to standardize surgical hand disinfection practices.","authors":"Ping Jiang, Yan Liu, Hai-Yan Gu, Qin-Xia Li, Ling-Bo Xue","doi":"10.1186/s12893-025-02854-4","DOIUrl":"10.1186/s12893-025-02854-4","url":null,"abstract":"Objective: The aim of this study is to evaluate the effectiveness of Six Sigma management in standardizing surgical hand disinfection practices among medical personnel.Methods: The Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) framework was utilized to assess and enhance the accuracy and effectiveness of surgical hand disinfection. Factors contributing to low accuracy and a high defect rate in disinfection practices were systematically analyzed. Key issues identified included limited awareness of infection control protocols, insufficient knowledge of proper surgical hand disinfection practices, and inadequate oversight of surgical staff. Interventions based on this analysis included the use of text and video reminders, reinforcement of medical personnel training, implementation of enhanced camera-based monitoring and supervision, and the establishment of a reward-and-penalty evaluation system.Results: Post-intervention analysis revealed that the accuracy of surgical hand disinfection among medical personnel increased from 42.94 to 82.97%, with surgeons demonstrating the greatest improvement, achieving a 47.70% increase. The overall defect rate decreased substantially, with the most notable reduction observed in incomplete hand coverage with disinfectant, which decreased by 2.75%. Additionally, the average number of bacterial colonies on the hands of medical staff decreased from 4.44 ± 2.51 CFU/cm2 to 2.68 ± 0.54 CFU/cm2, and the qualification rate improved markedly from 71.67 to 98.33%. All observed improvements were statistically significant.Conclusion: The application of Six Sigma management effectively enhances the accuracy and quality of surgical hand disinfection, reduces procedural defects, and enhances disinfection outcomes in clean surgical procedures.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"118"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732654","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}

引用次数: 0

Usefulness of intraoperative colonoscopy and synchronous scoring system for determining the integrity of the anastomosis in left-sided colectomy: a single-center retrospective cohort study.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-27 DOI: 10.1186/s12893-025-02836-6

Sung Hwan Cho, Hyun Sung Kim, Byung-Soo Park, Gyung Mo Son, Su Bum Park, Mi Sook Yun

{"title":"Usefulness of intraoperative colonoscopy and synchronous scoring system for determining the integrity of the anastomosis in left-sided colectomy: a single-center retrospective cohort study.","authors":"Sung Hwan Cho, Hyun Sung Kim, Byung-Soo Park, Gyung Mo Son, Su Bum Park, Mi Sook Yun","doi":"10.1186/s12893-025-02836-6","DOIUrl":"10.1186/s12893-025-02836-6","url":null,"abstract":"Objectives: The aim of this study is to evaluate the utilization of intraoperative colonoscopy (IOC) for determining the integrity of the anastomosis and to establish an IOC scoring system.Methods: A retrospective cohort study was conducted from January 2021 to June 2024, we analyzed the clinical data of 160 patients registered in a database who underwent laparoscopic left-sided colectomy at Pusan National University Yangsan Hospital. IOC was performed on all patients, and Mucosal color (MC), stapled line bleeding (BL), proximal redundancy (PR), and bowel preparation (BP) were evaluated and scored as variables. Logistic regression analysis was used to evaluate risk factors for anastomotic leakage (AL) and Cohen's kappa was applied to assess the reproducibility of the evaluation.Results: Of 160 patients, 10 (6.25%) experienced AL. All the IOC variables had kappa values of 0.8 or higher, indicating good agreement. The logistic regression analysis revealed significant differences in the MC 2 (P = 0.017, OR 12.86), PR 2 (P = 0.001, OR 27.64), BP 2 (p = 0.016, OR 10.50) PR 2 score (P = 0.016, OR 10.50) and the sum of the scores (p = 0.001, OR 3.51).Conclusion: IOC can be performed as a reference procedure to assess the integrity of the anastomosis during left-sided colorectal surgery.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"116"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722030","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}

引用次数: 0

Robotic resection of mediastinal tumors: surgical approach and procedure.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-26 DOI: 10.1186/s12893-025-02843-7

Hiroe Aoshima, Motoka Omata, Hiroaki Shidei, Akira Ogihara, Shota Mitsuboshi, Tamami Isaka, Takako Matsumoto, Masato Kanzaki

{"title":"Robotic resection of mediastinal tumors: surgical approach and procedure.","authors":"Hiroe Aoshima, Motoka Omata, Hiroaki Shidei, Akira Ogihara, Shota Mitsuboshi, Tamami Isaka, Takako Matsumoto, Masato Kanzaki","doi":"10.1186/s12893-025-02843-7","DOIUrl":"10.1186/s12893-025-02843-7","url":null,"abstract":"Background: Mediastinal tumors (MTs) develop in various sites within the thoracic cavity, and the robotic surgical approach for MTs varies depending on the tumor location. This study aimed to assess the optimal approach for robotic surgery for MTs.Methods: From April 2012 to May 2023, 141 cases of MTs removed by robotic surgery were noted. Of these, 130 cases, excluding those with combined lung resection, combined chest wall resection, and biopsy, were investigated for the MT location, surgical approach, operative time, and console time.Results: Of the participants, 61 were male and 69 were female, with a median age of 60 (16-85) years and a median tumor diameter of 23 (2.5-150) mm. Additionally, 5 upper MTs, 99 anterior MTs, 22 middle MTs, and 4 posterior MTs were observed. The median operative and console time was 146 (38-371) and 76 (14-239) min, respectively. All cases, except for one case of the upper and middle MTs, were operated in the lateral position via a lateral approach. Of the 99 anterior MTs, 87, 9, and 3 were operated via lateral approach, subxiphoid approach, and single incision, respectively. Of the 87 patients who underwent the lateral approach, 78 and 12 underwent surgery in the 30° lateral decubitus position and lateral positions, respectively.Conclusions: Standardizing the robotic surgery approach for MTs on the basis of tumor location enhances procedural safety and feasibility.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"115"},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721999","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}

引用次数: 0

A retrospective cross-sectional study of therapeutic results of single port thoracoscopy in patients with lung collapse due to trauma: comparison of entirely recovered and re-thoracoscopy needed patients.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-25 DOI: 10.1186/s12893-025-02834-8

Mojtaba Ahmadinejad, Hedieh Soltani, Mojtaba Foroohi, Nafiseh Yousefi Manesh, Hooravash Mohajerani, Izadmehr Ahmadinejad, Javad Zebarjadi Bagherpour

{"title":"A retrospective cross-sectional study of therapeutic results of single port thoracoscopy in patients with lung collapse due to trauma: comparison of entirely recovered and re-thoracoscopy needed patients.","authors":"Mojtaba Ahmadinejad, Hedieh Soltani, Mojtaba Foroohi, Nafiseh Yousefi Manesh, Hooravash Mohajerani, Izadmehr Ahmadinejad, Javad Zebarjadi Bagherpour","doi":"10.1186/s12893-025-02834-8","DOIUrl":"10.1186/s12893-025-02834-8","url":null,"abstract":"Introduction: Lung collapse can occur for various reasons, especially trauma. Single-port thoracoscopy is a treatment method that has not been discussed in detail. This study aimed to investigate the results of single-port thoracoscopy as a treatment for trauma-induced lung collapse.Methods: This descriptive retrospective cross-sectional study included 100 patients with lung collapse following trauma who were referred to the Madani Hospital. Demographic data, underlying causes and injuries, respiratory and consciousness state, pain level, recurrence rate, hospitalization period, complications, and narcotic and non-narcotic analgesics, re-thoracoscopy, and thoracotomy requirements were evaluated.Results: The mean age of patients was 38 ± 16 years, and 65% were male. Single port thoracoscopy has suitable therapeutic effects, low complications, less pain, and reduced need for painkillers. Patients with more concomitant injuries, longer duration from trauma to performing thoracoscopy, intubation requirement, bilateral lung involvement, and lower GCS, required re-thoracoscopy, which has been associated with more extended hospitalization, suffering from more pain, need to receive narcotics and thoracotomy, and frequency of narcotic and non-narcotic agents. These results demonstrate the efficacy of the single port thoracoscopy in uncomplicated and initially completely recovered patients, and the re-thoracoscopy requirement and complications are based on the underlying cause and medical circumstances.Conclusion: Single port thoracoscopy is practical for improving the quality of management of patients with lung collapse following trauma. Future studies should compare different methods.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"114"},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711866","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}

引用次数: 0

Effect of mild-to-moderate COVID‑19 on the incidence and risk factors for deep vein thrombosis in patients with hip fracture: a retrospective study.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-24 DOI: 10.1186/s12893-025-02831-x

Haoran Li, Jian Xing, Zhe Song, Zhiqiang Fan, Hongquan Wen, Shaobo Liang, Qiang Yan, Haoxuan Feng, Shuang Han, Na Yang, Pengfei Wang, Kun Zhang

{"title":"Effect of mild-to-moderate COVID‑19 on the incidence and risk factors for deep vein thrombosis in patients with hip fracture: a retrospective study.","authors":"Haoran Li, Jian Xing, Zhe Song, Zhiqiang Fan, Hongquan Wen, Shaobo Liang, Qiang Yan, Haoxuan Feng, Shuang Han, Na Yang, Pengfei Wang, Kun Zhang","doi":"10.1186/s12893-025-02831-x","DOIUrl":"10.1186/s12893-025-02831-x","url":null,"abstract":"Purpose: This retrospective study aimed to investigate the effect of mild-to-moderate COVID-19 on the risk of deep vein thrombosis (DVT) in patients with hip fractures. Hip fractures are common in the elderly, and previous research has shown that they accounted for 58.3% of traumatic fractures in older inpatients during the COVID-19 pandemic in China. Meanwhile, the relationship between COVID-19 and DVT is complex. Some studies have reported that the incidence of DVT in critically ill COVID-19 patients can be as high as 46%, and 20% in those with moderate-to-severe cases. However, the impact of mild-to-moderate COVID-19 on DVT risk in hip fracture patients remains unclear.Methods: Adult patients who underwent surgery for hip fractures between December 8, 2022, and January 9, 2023, were included in the study. All patients were tested for SARS-CoV-2 nucleic acid and were assessed for DVT preoperatively using doppler ultrasonography (DUS). Logistic regression was used to identify risk factors for DVT.Results: The records of 98 patients with hip fractures, were included in the analysis, of whom 63 were SARS-CoV-2 positive and 35 were SARS-CoV-2 negative. Pre-operative DUS showed that 36/98 patients (37%) had DVT, including 25/63 (40%) patients with COVID-19, and 11/35 (31%) patients without COVID-19. Multivariable logistic regression analysis showed that pre-operative leukocyte count and platelet-to-lymphocyte ratio (PLR) were independent risk factors for DVT, whereas mild-to-moderate COVID-19 was not an independent risk factor for DVT. In patients with hip fractures, COVID-19 did not significantly increase the risk of DVT.Conclusions: Therefore, in patients with hip fractures, DVT prevention measures should be implemented routinely, regardless of COVID-19 status.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"113"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701923","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}

引用次数: 0

Kidney transplantation in Lupus Nephritis: a comprehensive review of challenges and strategies.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-22 DOI: 10.1186/s12893-025-02832-w

Kerong Jiang, Yongsheng Pan, Dan Pu, Lijuan Shi, Xiaoliang Xu, Minfeng Bai, Xiaqiong Gong, Jie Guo, Ming Li

{"title":"Kidney transplantation in Lupus Nephritis: a comprehensive review of challenges and strategies.","authors":"Kerong Jiang, Yongsheng Pan, Dan Pu, Lijuan Shi, Xiaoliang Xu, Minfeng Bai, Xiaqiong Gong, Jie Guo, Ming Li","doi":"10.1186/s12893-025-02832-w","DOIUrl":"10.1186/s12893-025-02832-w","url":null,"abstract":"PURPOSE OF REVIEW: Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE), significantly impacting patient outcomes. Despite advances in immunosuppressive therapies, many patients progress to end-stage renal disease (ESRD), and kidney transplantation becomes essential for improving survival. However, the unique characteristics of autoimmune diseases make the timing of kidney transplantation and post-transplant management challenging. This review evaluates authoritative guidelines and recent studies to identify optimal timing for kidney transplantation and effective pre- and post-transplant management measures for patients with LN. RECENT FINDINGS: Advancements in immunosuppressive therapies, including calcineurin inhibitors, Voclosporin, and biologic agents such as belimumab, have significantly improved LN management. Emerging biomarkers, such as urinary MCP-1 and BAFF, offer promising tools for monitoring LN activity and predicting recurrence risk post-transplantation. Current guidelines emphasize the importance of achieving disease quiescence before transplantation, while new evidence supports the benefits of preemptive transplantation and personalized immunosuppressive regimens in improving patient and graft survival. This review highlights the latest evidence and strategies for optimizing kidney transplantation outcomes in LN patients, focusing on timing, immunosuppression, and disease monitoring.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"112"},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694015","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}

引用次数: 0

The accuracy of the risk assessment scale for pressure ulcers in adult surgical patients: a network meta-analysis. 成人手术患者压疮风险评估量表的准确性：网络荟萃分析。

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-21 DOI: 10.1186/s12893-024-02739-y

Yanfen Shang, Fei Wang, Yuqian Cai, Qi Zhu, Xingsun Li, Rongrong Wang, Tao-Hsin Tung

{"title":"The accuracy of the risk assessment scale for pressure ulcers in adult surgical patients: a network meta-analysis.","authors":"Yanfen Shang, Fei Wang, Yuqian Cai, Qi Zhu, Xingsun Li, Rongrong Wang, Tao-Hsin Tung","doi":"10.1186/s12893-024-02739-y","DOIUrl":"10.1186/s12893-024-02739-y","url":null,"abstract":"Background: This study aims to synthesize existing evidence regarding the accuracy of different scales to assess the risk of intraoperative acquired pressure injury (IAPI), thus providing guidance for the accurate clinical screening of IAPI risk and helping to prevent and reduce the occurrence of IAPI.Methods: We searched the following electronic databases to identify relevant studies on scales to assess the risk of IAPIs among adults: PubMed, the Cochrane Library, Embase, Web of Science, CNKI, VIP, the WanFang Database, and the Chinese Biomedical Literature Database. Two authors independently screened the literature, evaluated the quality of the included studies, and extracted the data. The QUADAS-2 tool was used to rate the quality of evidence. ANOVA was performed via Stata and R software to implement diagnostic network meta-analysis via the Bayesian method to evaluate the predictive power of the dominance index.Results: A total of 24 studies (6721 patients) were included, and the incidence of IAPIs was 12.30% (827/6721). Six IAPI risk assessment tools were used, and their rankings on the basis of the Bayesian dominance index were as follows: the ELPO Scale, 3.12 (95% CI: 0.14, 9); the Norton Scale, 2.63 (95% CI: 0.14, 11); the Waterlow Scale, 2.44 (95% CI: 0.14, 7); the Munro Scale, 2.39 (95% CI: 0.20, 7); the Scott Triggers tool, 1.55 (95% CI: 0.11, 5); and the Braden Scale, 0.36 (95% CI: 0.09, 3).Conclusions: We found that the ELPO Scale has good diagnostic test accuracy, and it is recommended that clinical workers prioritize the use of this scale in assessing the risk of pressure injuries among surgical patients, thereby enhancing the effectiveness of risk assessment for pressure injuries among surgical patients.Trial registration: This study has been registered on PROSPERO (CRD42023470664).","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"104"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677278","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}

引用次数: 0

Anterior subcutaneous internal fixator (INFIX) versus plate fixation for anterior ring injury in Tile C pelvic fractures: a retrospective study. 前部皮下内固定器（INFIX）与钢板固定治疗 Tile C 骨盆骨折前环损伤：一项回顾性研究。

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-21 DOI: 10.1186/s12893-025-02844-6

Shenbo Huang, Shuai He, Guy Romeo Kenmegne, Yijie Yin, You Yu, Yue Fang

{"title":"Anterior subcutaneous internal fixator (INFIX) versus plate fixation for anterior ring injury in Tile C pelvic fractures: a retrospective study.","authors":"Shenbo Huang, Shuai He, Guy Romeo Kenmegne, Yijie Yin, You Yu, Yue Fang","doi":"10.1186/s12893-025-02844-6","DOIUrl":"10.1186/s12893-025-02844-6","url":null,"abstract":"Objectives: . The purpose of this study was to compare the reduction effect and clinical outcomes of anterior subcutaneous internal fixation (INFIX) and steel plate-screw internal fixation in the treatment of anterior ring injury in Tile C pelvic fractures.Methods: . In this retrospective study, the clinical outcomes of 46 patients treated using INFIX and 44 patients treated with steel plate-screw internal fixation were analyzed and compared. All patients underwent anterior and posterior fixation. The Matta imaging scoring system was used to evaluate the postoperative reduction accuracy; the Majeed scoring system was applied to obtain functional outcomes in clinical follow-up. All potential complications were identified and evaluated accordingly.Results: Both groups of patients were followed up for a period of 13-36 months, with an average of 27 months. The procedure time and blood loss in the INFIX group were significantly lower than those in the plate group(t = - 2.327, P = 0.023;t = - 4.053, P = 0.000; there was no statistically significant difference in the Majeed score and Matta score between the two groups after surgery (P > 0.05).Conclusions: . INFIX treatment for anterior ring injury in Tile C pelvic fractures can achieve good therapeutic effects. Compared to internal fixation with plates and screws, it has advantages such as shorter surgical time and less blood loss. INFIX may be more suitable for obese patients, young women of childbearing age, or patients with urinary system injuries.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"110"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676933","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}

引用次数: 0

Benefits of prophylactic veno-arterial extracorporeal membrane oxygenation for high-risk cardiac interventions.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-21 DOI: 10.1186/s12893-025-02835-7

Xiao-Chai Lv, Yi Dong, Lei Wang, Yan-Ting Hou, Liang-Wan Chen

{"title":"Benefits of prophylactic veno-arterial extracorporeal membrane oxygenation for high-risk cardiac interventions.","authors":"Xiao-Chai Lv, Yi Dong, Lei Wang, Yan-Ting Hou, Liang-Wan Chen","doi":"10.1186/s12893-025-02835-7","DOIUrl":"10.1186/s12893-025-02835-7","url":null,"abstract":"Background: Complex high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve implantation (TAVI) are challenging and frequently associated with life-threatening complications. We evaluated the benefits of prophylactic extracorporeal membrane oxygenation (ECMO)-supported interventions and the risks of this approach.Methods: From March 2020 to September 2021, 11 patients underwent TAVI, and 15 patients underwent PCI supported with prophylactic ECMO. Clinical characteristics and outcomes in terms of the requirement of ECMO were evaluated.Results: Cannulation was femoro-femoral in all patients. TAVI was performed via transfemoral access. In the TAVI group, mean patient age was 72 ± 7.84 years and 63.64% were male. During valve implantation, supportive ECMO flow was maintained at 3.24 ± 0.19 L/min. The additional median time in the ICU was 2 (1-4) days. Patients were discharged from the hospital after 16 (15-27) days. All of them were successfully weaned off V-AECMO. Only 1 patient died of respiratory and cardiac arrest 10 days after the operation. During PCI, ECMO flow was maintained at 3.35 ± 0.22 L/min. The average age of the patients in this group was 59 ± 10.80 years, and the ejection fraction was 42.59 ± 16.34%. Fourteen patients were successfully weaned off veno-arterial ECMO and survived to hospital discharge. No ECMO-related, peripheral cannulation-related or life-threatening bleeding complications were observed in the two groups. The median follow-up was 6 months, and there was 1 late death.Conclusion: Based on this experience, we consider ECMO support to be a viable alternative and effective approach for complex high-risk cardiac interventions.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"107"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677039","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}

引用次数: 0

The pringle maneuver for Budd-Chiari syndrome-related orthotopic liver transplantation: an experience from a large referral center.

IF 1.6 3区医学

BMC Surgery Pub Date : 2025-03-21 DOI: 10.1186/s12893-025-02829-5

Kourosh Kazemi, Alireza Shamsaeefar, Hamed Nikoupour, Sahar Sohrabi Nazari, Erfan Sheikhbahaei, Ali Esparham, Mehran Jafari, Mohammad Eslamian, Saman Nikeghbalian

{"title":"The pringle maneuver for Budd-Chiari syndrome-related orthotopic liver transplantation: an experience from a large referral center.","authors":"Kourosh Kazemi, Alireza Shamsaeefar, Hamed Nikoupour, Sahar Sohrabi Nazari, Erfan Sheikhbahaei, Ali Esparham, Mehran Jafari, Mohammad Eslamian, Saman Nikeghbalian","doi":"10.1186/s12893-025-02829-5","DOIUrl":"10.1186/s12893-025-02829-5","url":null,"abstract":"Background: Orthotopic liver transplantation (OLT) in Budd-Chiari Syndrome (BCS)-related liver cirrhosis is quite technically challenging due to the difficult handling of an enlarged and congested liver along with the risk of massive intraoperative bleeding. Therefore, we aimed to evaluate the efficacy of occluding the hepatic blood inflow tract by the Pringle maneuver (PM) at the beginning of the hepatectomy phase of BCS-related OLT procedure.Methods: The current retrospective study of prospectively collected data was conducted between 2010 and 2022 in our referral center for OLT. Patients were divided into PM (after 2018) and non-PM (NPM, before 2018) groups. Intraoperative blood loss, packed red blood cell (PC) transfusion, operation time, 30-day mortality, and liver and renal function indexes were collected retrospectively.Results: From a total of 3539 records, a total of 55 patients included in this study; the PM and NPM groups consisted of 17 and 38 patients, respectively. The mean intraoperative blood loss (1418 ± 621 vs. 2240 ± 1591 ml, p = 0.04) and amount of PC transfusion (418 ± 423 vs. 1263 ± 1557 ml, p = 0.03) were significantly lower in the PM group. In the NPM group, duration of operation (282 ± 52 vs. 257 ± 32 min) and 30-day mortality rate (16% vs. 0%) were higher, which are statistically nonsignificant but clinically noteworthy.Conclusion: Using the PM can be an effective approach to reducing intraoperative bleeding, PC transfusion, and the length of surgery during OLT for BCS. It decreases the incoming blood to the congested liver, helps porta hepatis collaterals to shrink, and eases the division of hepatic ligaments and diaphragmatic attachments during the hepatectomy phase. These factors potentially facilitate the procedure for surgeons.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"106"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677283","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}

引用次数: 0