BMC Surgery最新文献

{"title":"Effect of interventions on surgical site infections in Sub-Saharan Africa: a systematic review.","authors":"Fekadeselassie Berhe, Tefera Belachew, Kalkidan Hassen","doi":"10.1186/s12893-025-02946-1","DOIUrl":"10.1186/s12893-025-02946-1","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSI) are a major concern due to their contributions to morbidity, economic loss, and death among individuals who underwent operations in healthcare institutions. To decrease this infection, various pharmacological and non-pharmacological interventions have been devised and implemented for major surgery patients. Pharmacological interventions include the provision of antibiotic prophylaxis and antiseptic agents, whereas non-pharmacological interventions encompass programmatic interventions such as protocols, policies, quality improvement initiatives, training, and education that are given at the institutional level. However, the effect of particularly non-pharmacological interventions on the reduction has not been comprehensively evaluated for over a decade. This systematic review attempts to synthesize a piece of evidence on the effect of non-pharmacological intervention in Sub-Saharan Africa on minimizing SSI and enhancing health outcomes.</p><p><strong>Methods: </strong>Databases including MEDLINE, Google Scholar, Cochrane Library, AJOL, Hinari, search platforms, and open-access repositories were accessed. Two investigators conducted a literature selection process, and the quality of selected articles was assessed using a JBI quality evaluation checklist.</p><p><strong>Results: </strong>A total of 11 studies that met the inclusion criteria were analyzed. Three main intervention categories were identified, which focused on improving adherence to protocol, policy change or induction, and delivery of multimodal strategies. These interventions led to a reduction in SSI rates in varying degrees (15% to 95%). Multimodal interventions are the most widely implemented and comprehensive approaches that integrate multiple evidence-based practices, which have demonstrated a substantial reduction of SSI in different surgical populations. The rates of improvement with these interventions were influenced by intervention type, patient characteristics, surgical urgency, healthcare setting, follow-up time, and criteria for measuring the outcomes that may influence the SSI rates.</p><p><strong>Conclusion: </strong>Interventions focusing on policy, protocol, and multimodal strategies can effectively reduce SSI rates, with the latter being the most effective. Patient and clinical characteristics, along with the healthcare setting, were influential factors affecting the interventions' impact on SSI. This systematic review is registered in PROSPERO, in the number CRD42024524963.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"216"},"PeriodicalIF":1.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095237","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":"Assessing artificial intelligence ability in predicting hospitalization duration for pleural empyema patients managed with uniportal video-assisted thoracoscopic surgery: a retrospective observational study.","authors":"Issa Alnajjar, Baraa Alshakarnah, Tasneem AbuShaikha, Tareq Jarrar, Abed Al-Raheem Ozrail, Yousef Abu Asbeh","doi":"10.1186/s12893-025-02959-w","DOIUrl":"10.1186/s12893-025-02959-w","url":null,"abstract":"<p><strong>Background: </strong>This retrospective observational research evaluates the potential applicability of artificial intelligence models to predict the length of hospital stay for patients with pleural empyema who underwent uniportal video-assisted thoracoscopic surgery.</p><p><strong>Methods: </strong>Data from 56 patients were analyzed using two artificial intelligence models. A Random Forest Regressor, the initial model, was trained using clinical data unique to each patient. Weighted factors from evidence-based research were incorporated into the second model, which was created using a prediction approach informed by the literature.</p><p><strong>Results: </strong>The two models tested showed poor prediction accuracy. The first one had a mean absolute error of 4.56 days and a negative R² value. The literature-informed model performed similarly, with a mean absolute error of 4.53 days and an R² below zero.</p><p><strong>Conclusions: </strong>While artificial intelligence holds promise in supporting clinical decision-making, this study demonstrates the challenges of predicting length of stay in pleural empyema patients due to significant clinical variability and the current limitations of AI-based models. Future research should focus on integrating larger, multi-center datasets and more advanced machine learning approaches to enhance predictive accuracy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"218"},"PeriodicalIF":1.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102947","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":"Evaluating the therapeutic efficacy and safety of alginate-based dressings in burn wound and donor site wound management associated with burn surgery: a systematic review and meta-analysis of contemporary randomized controlled trials.","authors":"Jiaqi Lou, Ziyi Xiang, Xiaoyu Zhu, Jingyao Song, Neng Huang, Jiliang Li, Guoying Jin, Shengyong Cui, Pei Xu, Xin Le, Youfen Fan, Sida Xu","doi":"10.1186/s12893-025-02956-z","DOIUrl":"10.1186/s12893-025-02956-z","url":null,"abstract":"<p><strong>Background: </strong>Alginate-based dressings are widely used in burn care for their absorptive and healing properties; however, inconsistencies in clinical outcomes remain.</p><p><strong>Methods: </strong>This study followed the PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) comparing alginate dressings to other treatments in burn patients and their donor sites. Inclusion criteria focused on prospective trials with measured outcomes such as healing time, pain scores, dressing change frequency, and adverse events. Data extraction and quality assessment adhered to standardized methods, and meta-analyses were performed using R 4.4.2 and Stata 15.0 with the GRADE approach to evaluate evidence certainty. Data were aggregated and reported as relative risk (RR), mean difference (MD) and standardized mean difference (SMD), with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Fifteen studies met the inclusion criteria. The meta-analysis revealed a significantly shorter healing time with alginate dressings versus controls, showing a MD of -1.09 days (95% CI: -1.67 to -0.31, p < 0.001, I² = 94.6%). Pain scores also favored alginate dressings, with a SMD of -1.37 (95% CI: -2.53 to -0.21, p = 0.000, I² = 90.9%). There was no significant difference in dressing change frequency, with an SMD of 2.18 (95% CI: -4.29 to -0.07, p = 0.000, I² = 94.0%). Adverse events showed a RR of 0.81 (95% CI: 0.50 to 1.30, p = 0.021, I² = 51.1%), indicating similar safety profiles in both groups.</p><p><strong>Conclusion: </strong>Our findings indicate that alginate dressings not only significantly reduce healing time but also offer clinically relevant benefits, including reduced pain and fewer dressing changes, making them a valuable option in burn wound management. However, their effect on dressing change frequency and adverse events remains comparable to control treatments. Despite the methodological limitations such as high heterogeneity and potential biases, alginate dressings maintain advantages in clinical settings. Standardization of evaluation criteria and long-term studies are necessary to enhance the understanding and application of alginate dressings in diverse burn wound and donor site wound care settings.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"215"},"PeriodicalIF":1.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086045","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 and evaluation of negative pressure wound therapy versus standard wound care in the treatment of diabetic foot ulcers.","authors":"Quan Guo","doi":"10.1186/s12893-025-02885-x","DOIUrl":"https://doi.org/10.1186/s12893-025-02885-x","url":null,"abstract":"<p><strong>Background: </strong>To explore the efficacy, safety, and cost implications of NPWT versus standard wound care (SWC) for Diabetic Foot Ulcers (DFUs).</p><p><strong>Methods: </strong>91 patients with DFUs were included in this retrospective study from May 2017 and February 2024. All patients were divided into NPWT (n = 44) and SWC (n = 47) groups based on the surgery methods. Arterial disease severity was assessed via ankle-brachial index (ABI) and Doppler ultrasound, with subgroups categorized as severe ischemia (ABI < 0.4), moderate ischemia (ABI 0.4-0.7), and normal/mild ischemia (ABI > 0.7). Baseline characteristics, wound parameters, healing progression, adverse events, costs, and subgroup outcomes by arterial disease status were compared between two groups.</p><p><strong>Results: </strong>At the 4-week assessment, the NPWT group exhibited significantly higher mean percentage reduction in wound area (35.01% vs. 32.53%, P = 0.033) and greater reduction in wound depth (2.74 mm vs. 2.14 mm, P = 0.032) compared to the SWC group. A notably higher proportion of NPWT patients achieved complete wound closure (52.27% vs. 27.66%, P = 0.029), resolution of infection (88.64% vs. 68.09%, P = 0.035), and neuropathy improvement (59.09% vs. 34.04%, P = 0.029). NPWT also showed lower wound infection rates (9.09% vs. 29.79%, P = 0.027) but higher skin irritation (31.82% vs. 10.64%, P = 0.026). Subgroup analysis revealed NPWT's superiority in both PAD-positive (48.0% vs. 20.0%, RR = 2.40, 95% CI: 1.12-5.15, P = 0.042) and PAD-negative subgroups (55.2% vs. 30.4%, RR = 1.82, 95% CI: 1.05-3.15, P = 0.031). Even in severe ischemia (ABI < 0.4), NPWT achieved higher closure rates (36.4% vs. 12.5%, P = 0.038). While total treatment costs were comparable (P = 0.084), NPWT reduced hospitalization days (16.05 vs. 21.38 days, P = 0.028) and drug costs (5229.33 RMB vs. 5915.5 RMB, P = 0.030).</p><p><strong>Conclusion: </strong>NPWT is more superior in safety, cost-efficiency, and long-term wound management compared to SWC.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"208"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081518","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":"TreatmENT of AnastomotiC LeakagE after colon cancer resection: the TENTACLE - Colon study.","authors":"Jobbe M G Lemmens, Sander Ubels, Nynke G Greijdanus, Kiedo Wienholts, Marleen M H J van Gelder, Albert Wolthuis, Jérémie H Lefevre, Kilian Brown, Matteo Frasson, Nicolas Rotholtz, Quentin Denost, Rodrigo O Perez, Tsuyoshi Konishi, Martin Rutegård, Susan L Gearhart, Thomas Pinkney, Muhammed Elhadi, Roel Hompes, Pieter J Tanis, Johannes H W de Wilt","doi":"10.1186/s12893-025-02954-1","DOIUrl":"10.1186/s12893-025-02954-1","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) is a common and severe complication after colon cancer resection, but studies investigating various treatment strategies and factors influencing outcomes are scarce.</p><p><strong>Objectives: </strong>(1) To identify predictive factors associated with 90-day mortality and 90-day Clavien-Dindo grade 4-5 complications amongst patients who developed AL following colon cancer resection with subsequent development and validation of prediction models, and (2) to explore and compare the effectiveness of various treatment strategies for AL following colon cancer resection, adjusting for type of index surgery, different leak entities and patient factors.</p><p><strong>Methods: </strong>The TENTACLE - Colon is an international multicentre retrospective cohort study. Consecutive patients with AL after colon cancer resection operated between 1 January 2018 and 31 December 2022 from participating centres will be included. The planned sample size is 2000 patients. The primary outcome is 90-day mortality and the co-primary composite endpoint is Clavien-Dindo grade 4-5 complications. Secondary outcomes include: hospital and intensive care unit length of stay, number of radiological and surgical reinterventions within one year after resection, mortality (in-hospital, 30-day, and 1-year), the comprehensive complication index, and 1-year stoma-free survival. For objective 1, regression models will be used to identify predictors associated with 90-day mortality and grade 4-5 complications. For objective 2, comparative analyses of various treatment strategies will be performed for the specified outcomes, adjusting for patient, tumour, resection and leakage characteristics.</p><p><strong>Trial registration: </strong>This study is registered at clinicaltrials.gov (NCT06528054) since July 30th, 2024.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"213"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081436","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 of postoperative outcomes between robotic-assisted and laparoscopic-assisted total gastrectomy: a comprehensive meta-analysis and systematic review.","authors":"Jianhua Chen, Fei Wang, Yong Wang, Jie Zhou, Yapeng Yang, Ziming Zhao, Rongfan Wu, Liuhua Wang, Jun Ren","doi":"10.1186/s12893-025-02934-5","DOIUrl":"10.1186/s12893-025-02934-5","url":null,"abstract":"<p><strong>Background: </strong>The application of robot-assisted technology in gastric cancer surgery is gradually gaining attention from surgeons. In this meta-analysis, our main objective was to assess whether robot-assisted techniques are more advantageous than laparoscopic-assisted technology in total gastrectomy.</p><p><strong>Methods: </strong>We searched Pubmed, Embase, Web of Science, and Cochrane Library databases for clinical studies published before October 2023 comparing robotic-assisted total gastrectomy (RATG) and laparoscopic-assisted total gastrectomy (LATG) for gastric cancer. Non-clinical studies, data unavailability, or fewer than 50 included cases were excluded. The Newcastle-Ottawa Scale was used to assess the risk of bias by determining the quality of the observational studies. Statistical meta-analysis and drawing were performed using the Software Review Manager version 5.3 and Stata version 16.0. P < 0.05 was considered significant.</p><p><strong>Results: </strong>Nine studies that included 1,864 patients with gastric cancer were included, published between 2012 and 2023. The results of the analysis showed that RATG has advantages in the following aspects: intraoperative blood loss was 17.69 ml lower in the RATG group than in the LATG group (WMD: -17.69,95% CI:-20.90 ∼ -14.49; P < 0.05); In terms of the number of resected lymph nodes, the RATG group had 2.65 more than the LATG group (WMD: 2.65,95% CI:0.88 ∼ -4.42); P < 0.05); the time to start liquid and postoperative hospital stays were 0.62 and 0.90 days shorter in the RATG group than in the LATG group, respectively (WMD: -0.62,95%CI: -1.06 ∼ -0.19; P < 0.05), (WMD: -0.90,95%CI: -1.43 ∼ -0.37; P < 0.05)); the incidence of major complications and pancreas fistula in the RATG group was 0.59% and 0.17% lower than in the LATG group, respectively (OR: 0.59,95% CI: 0.38 ∼ 0.93; P < 0.05), (OR: 0.17,95% CI: 0.03 ∼ 0.94; P < 0.05). However, the analysis showed that the operative time in the RATG group was 30.96 min longer than in the LATG group (WMD: 30.96,95% CI: 21.24 ∼ 40.69; P < 0.05).</p><p><strong>Conclusions: </strong>Based on the results of this meta-analysis, we concluded that robotic-assisted technology may be a worthwhile technique to apply in the surgical treatment of total gastrectomy. However, this meta-analysis has the limitations that the included studies were all non-randomized controlled trials and published in Asian countries, and more high-quality randomized controlled trials are needed for further validation in the future.</p><p><strong>The registered name and registration number: </strong>The study protocol for this meta-analysis is registered on the PROSPERO website under registration number CRD42024500512.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"212"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081501","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 efficiency of patient-specific instrumentation and technological assistance in cementless total hip arthroplasty via the direct anterior approach.","authors":"Laurentiu Cosmin Focsa, Giacomo Galanzino, Philippe Gerard, Vincent Le Strat, Luc Lhotellier, Thomas Aubert","doi":"10.1186/s12893-025-02950-5","DOIUrl":"10.1186/s12893-025-02950-5","url":null,"abstract":"<p><strong>Background: </strong>Patient-specific instrumentation for total hip arthroplasty (PSI-THA) is an emerging technology that improves the accuracy of femoral neck osteotomy and implant positioning. Unlike conventional 2D radiograph-based planning, PSI-THA leverages 3D CT reconstructions for personalized, technology-assisted positioning. This study sought to assess the intraoperative efficiency of PSI-THA in terms of surgery duration and blood loss by comparing PSI incorporating image-based guides and 3D planning with conventional surgery and 2D planning for cementless THA performed via the direct anterior approach (DAA).</p><p><strong>Methods: </strong>Two consecutive cohorts of 100 patients each were retrospectively analysed. All patients underwent cementless THA with a straight quadrangular stem and a ceramic-on-ceramic head and liners. Two-dimensional templating was performed for the first cohort, whereas a 3D template with CT-based PSI for femoral neck osteotomy and acetabular cup positioning was performed for the second cohort. A laser guidance system was employed to increase implant placement accuracy. Operating time and intraoperative blood loss were compared between the groups.</p><p><strong>Results: </strong>The demographic characteristics of the two groups were comparable. The average operating time was 45.7 min (SD: 16.11) in the conventional group and 31.9 min (SD: 9.92) in the PSI group (p < 0.001). Blood loss was also significantly lower in the PSI group (319 ml) than in the conventional group (407 ml; p < 0.017).</p><p><strong>Conclusions: </strong>Compared with conventional planning, PSI with 3D planning and technological assistance significantly reduced the operating time by an average of over 10 min as well as the amount of blood loss. The improved planning and execution accuracy of PSI minimizes the need for intraoperative adjustments, improves confidence in implant positioning, and reduces the need for compromises and the identification of multiple landmarks, underscoring the value of this planning technology in DAA THA.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"211"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081433","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":"Comparative study of the learning curves for percutaneous endoscopic interlaminar lumbar discectomy and unilateral biportal endoscopy techniques.","authors":"Weidong Guo, Shikong Guo, Xiaoping Zhang, Weiliang Zhang, Guifeng Xia, Bo Liao","doi":"10.1186/s12893-025-02951-4","DOIUrl":"10.1186/s12893-025-02951-4","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive spinal surgery techniques, such as Percutaneous Endoscopic Interlaminar Lumbar Discectomy (PEID) and Unilateral Biportal Endoscopy (UBE), have been developed to reduce surgical morbidity and enhance patient recovery. Although both techniques demonstrate promising clinical outcomes, the learning curves required for surgeons to achieve proficiency with these methods remain unclear.</p><p><strong>Objective: </strong>To compare the learning curves of PEID and UBE in the treatment of lumbar disc herniation.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 173 patients who underwent either PEID (n = 94) or UBE (n = 79), performed by two independent surgeons between January 2020 and January 2022. Eligible patients were aged 18-75 years, diagnosed with lumbar disc herniation, and had no previous spinal surgeries at the affected level. Metrics analyzed included operative time, intraoperative blood loss, postoperative recovery, complication rates, and clinical outcomes, assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores.</p><p><strong>Results: </strong>The PEID group demonstrated significantly shorter operative times (99.96 ± 34.74 min vs. 116.52 ± 47.20 min, P < 0.05) and less blood loss (20.85 ± 11.06 ml vs. 80.19 ± 22.81 ml, P < 0.01) compared to the UBE group. Both techniques showed significant improvements in VAS and ODI scores postoperatively, with no significant differences between the groups at any follow-up points. Learning curve analysis revealed that operative times for PEID stabilized at approximately 70 min after about 40 cases, while UBE stabilized at around 65 min after approximately 35 cases. Complication rates were low, and patient satisfaction was high in both groups. According to the Modified MacNab criteria, 83% of patients in the PEID group and 79.7% in the UBE group achieved excellent outcomes, while only 5.3% and 3.8% of patients experienced fair or poor outcomes in the PEID and UBE groups, respectively.</p><p><strong>Conclusion: </strong>Both PEID and UBE are effective minimally invasive techniques for the treatment of lumbar disc herniation, offering comparable clinical outcomes and low complication rates. However, PEID is associated with shorter operative times and reduced intraoperative blood loss. Understanding the learning curves of these techniques is crucial for surgeons to improve proficiency and optimize patient outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"210"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081514","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":"Comparative analysis of hysterectomy types and approaches on oncological survival in 2023 FIGO stage II endometrial carcinoma.","authors":"Jianhao Sun, Zhenzhen Wu, Jiayu Chen, Qinglei Hang, Yaqin Zhao, Juan Li, Jie Huang, Xiaoli Zhao, Ji Xia, Xinjuan Jiao, Qing Liu, Dan Lu","doi":"10.1186/s12893-025-02937-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02937-2","url":null,"abstract":"<p><strong>Background: </strong>The objective is to investigate the relationship between the type and approaches of hysterectomy and the oncological survival outcomes in women diagnosed with stage II endometrial carcinoma (EC), as classified by the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with 2009 FIGO early-stage (stages I and II) EC who underwent surgical treatment between 2018 and 2019. These patients were reclassified in accordance with the 2023 FIGO staging system, and those diagnosed with stage II EC under this system were selected as the study population. A non-inferiority test was employed for the analysis, with disease-free survival (DFS) serving as the primary outcome measure. DFS was evaluated using Kaplan-Meier curves, and comparisons were conducted through the log-rank test.</p><p><strong>Result: </strong>A cohort of 288 patients diagnosed with early-stage EC according to the 2009 FIGO staging system were re-evaluated and reclassified. Ultimately, the study encompassed a cohort of 80 patients diagnosed with stage II EC, as classified according to the 2023 FIGO staging system. 52 individuals underwent radical hysterectomy or modified radical hysterectomy (RH/mRH), while 28 patients received a simple hysterectomy (SH). The 5-year DFS was 84.62% for the RH/mRH group vs. 92.86% for the SH group (difference, 8.24% [95% CI, -5.44-21.92%]), which met the noninferiority criterion. Between the groups, the difference in 5-year DFS (p = 0.255) was not statistically significant. The laparoscope group comprised 62 cases, whereas the laparotomy group consisted of 18 cases. Between the groups, the difference in 5-year DFS (88.55% versus 83.33%, p = 0.538) was not statistically significant. This finding aligns with our observations of patients diagnosed with 2009 FIGO Stage II EC.</p><p><strong>Conclusion: </strong>In comparison to SH, RH/mRH did not confer a survival advantage for patients diagnosed with 2023 FIGO stage II EC.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"209"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081512","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":"Surgical management of Caroli disease in a low-mid income country: a single-center study and review of literature.","authors":"Soukayna Bourabaa, Talha Laalou, Abderrahman Mansouri, Mohamed Hamid, Abdellatif Settaf","doi":"10.1186/s12893-025-02948-z","DOIUrl":"10.1186/s12893-025-02948-z","url":null,"abstract":"<p><strong>Introduction: </strong>Caroli disease is an uncommon congenital condition characterized by non-obstructive intrahepatic bile duct dilation. When coupled with liver fibrosis or cirrhosis, it is termed Caroli syndrome. This disorder can lead to the development of gallstones, inflammation of the bile ducts, and an elevated susceptibility to cholangiocarcinoma. Typically, Caroli disease presents with involvement in less than 20% of the liver, predominantly affecting a single lobe (either left or right). Monolobar disease can often be effectively addressed through liver resection, while bilobar disease may necessitate the consideration of liver transplantation.</p><p><strong>Methods: </strong>A retrospective study was undertaken involving patients diagnosed with Caroli disease who underwent liver resection. The research included cases from Surgery B Department at Ibn Sina University Hospital in Rabat, covering the period from January 2010 to January 2023.</p><p><strong>Results: </strong>Nine patients who underwent liver resection for Caroli disease were identified, with an average age of 54 years (range: 17-76), and 44.4% (n = 4) being females. The study comprised 6 cases with disease limited to the left lobe and 3 to the right. The average time interval between initial symptoms and the definitive diagnosis was 4 years (range: 0-24 years). Surgical procedures included left lobectomy in 4 cases, left hepatectomy in 3 cases, right hepatectomy in 1 case, and sub-segmentectomy in 2 cases. Biliodigestive anastomosis was performed in 4 cases. Complications occurred in 2 patients (22.2%), and synchronous cholangiocarcinoma was observed in a single case (11.1%).</p><p><strong>Conclusion: </strong>Consideration of Caroli disease as part of the differential diagnosis is crucial in cases of recurrent cholangitis. Liver resection stands out as the treatment of choice for patients with localized Caroli disease. The critical importance of early intervention is highlighted by the potentially fatal consequences of delayed diagnosis or treatment.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"214"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081431","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}