BMC Surgery最新文献

{"title":"Clinical effect of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice.","authors":"Shoulin Zhang, Shaopeng Huang, Zheng Xing, Youwen Song, Fujian Yuan","doi":"10.1186/s12893-025-02807-x","DOIUrl":"10.1186/s12893-025-02807-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice, focusing on improvements in liver function, bile duct patency time, and reduction of postoperative complications.</p><p><strong>Methods: </strong>181 patients with malignant obstructive jaundice were retrospectively selected from a hospital in Ganzhou City, Jiangxi Province, from April 2021 to May 2024, of which 132 underwent routine percutaneous liver puncture biliary drainage and 49 underwent percutaneous liver puncture biliary drainage combined with metal stent implantation as the observation group.</p><p><strong>Results: </strong>The clinical efficacy of the observation group was higher (P < 0.05), and the bile duct patency time was longer (P < 0.05). The AST, ALT, DBIL and TBIL levels were decreased 1 week and 1 month after surgery, and the decrease was more significant in the observation group (P < 0.05). In addition, the incidence of postoperative complications (bile duct infection and electrolyte disturbance) in the observation group was lower (P < 0.05).</p><p><strong>Conclusion: </strong>Percutaneous hepatic puncture biliary drainage combined with metal stent implantation has significant clinical efficacy, which can effectively improve the clinical symptoms of patients, prolong the biliary patency time, reduce the level of bilirubin, promote the improvement of liver function, and lower the incidence of postoperative complications.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"126"},"PeriodicalIF":1.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744367","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 efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.","authors":"Shichao Liu, Jingyu Zhou","doi":"10.1186/s12893-025-02856-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02856-2","url":null,"abstract":"<p><strong>Purpose: </strong>Existing studies have suggested that the efficacy and safety of tubular microdiscectomy (TMD) and percutaneous transforaminal endoscopic discectomy (TED) for lumbar disc herniation (LDH) are similar to those of open microdiscectomy (OMD). However, there are no head-to-head randomized controlled trials (RCTs) making indirect or integrated comparisons of the efficacy and safety of TMD and TED for LDH. A network meta-analysis (NMA) of RCTs was used to compare the clinical efficacy and safety of OMD, TMD and TED for LDH in this research.</p><p><strong>Methods: </strong>We systematically searched the Cochrane Library, PubMed, and Embase databases from their inceptions through March 2023 for eligible literature. The following search terms were used: \"transforaminal endoscopic discectomy,\" \"microdiscectomy,\" \"endoscopic,\" \"minimally invasive,\" \"tubular microdiscectomy,\" \"spinal disease,\" and \"randomized clinical trial\". The primary outcomes were the Oswestry disability index (ODI) score and the visual analog scale (VAS) score for leg pain, complications, and reoperation. Direct comparison meta-analyses and NMA were carried out.</p><p><strong>Results: </strong>Eight RCTs (1391 patients) met the inclusion criteria. Pairwise meta-analysis showed that compared to OMD, TED has advantages in terms of VAS score (SMD=-1.10 95% CI - 1.85 to -0.34, P = 0.005) and ODI score (SMD=-5.17 95% CI - 8.04 to -2.31, P = 0.004). In contrast, the comparative analysis revealed no statistically significant differences between TMD and OMD across all outcome measures. By comparing TED to OMD and TMD to OMD, it was found that there was no significant difference in the complication and reoperation rates. NMA indicated that there was no significant difference in any of the outcomes between TED and TMD. Trend analyses of rank probabilities showed the cumulative probabilities of the most effective treatments, as measured by primary outcomes (VAS score, ODI score, reoperation and complication rates), were TED (95%, 77%, 23%, 58%), TMD (4%, 22%, 54%, 36%), and OMD (1%, 1%, 23%, 6%).</p><p><strong>Conclusion: </strong>For LDH, TED outperformed OMD in clinical efficacy, while TMD matched OMD outcomes. All modalities showed similar complication/reoperation rates. Probabilistic analyses revealed TED as preferable for younger patients (enhanced pain control, shorter stays), whereas TMD better suited elderly comorbid patients for reoperation risk mitigation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"125"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744369","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 outcomes of reoperation for congenital mitral valve diseases in children.","authors":"Yixuan Cai, Yaping Shan, Gang Chen, Yaping Mi, Hui Zhong, Huifeng Zhang, Ming Ye","doi":"10.1186/s12893-025-02855-3","DOIUrl":"10.1186/s12893-025-02855-3","url":null,"abstract":"<p><strong>Backgrounds: </strong>We aimed to study the outcomes of mitral valve (MV) reoperations in children with congenital MV diseases and to summarize our treatment experience.</p><p><strong>Methods: </strong>In this single-center retrospective study, we enrolled 24 patients aged < 18 years who underwent MV reoperation from among 265 patients who underwent MV repair between January 2013 and July 2023. MV reoperations were based on the types of MV disease. Cox regressions were used to analyze the risk factors for death and second MV reoperation.</p><p><strong>Results: </strong>A total of 5 patients underwent second MV reoperations. 3 patients experienced early death, and 1 experienced late death. The 3- and 5-year survival rates of the entire cohort were 86.6% ± 7.3% and 72.1% ± 14.5%, respectively. Patients who had the double-orifice MV technique applied during MV reoperation were significantly more prone to receive mechanical MV replacement (P < 0.0001). The use of double-orifice MV technique during MV reoperation was identified as an independent risk factor for second MV reoperation (HR = 8.136, 95%CI = 1.099-60.240; P = 0.040).</p><p><strong>Conclusions: </strong>The reoperation of the MV in children with congenital MV diseases poses a formidable challenge, manifested by a high postoperative mortality rate and re-intervention rate. Patiently and meticulously repair based on the types of MV disease has demonstrated the capacity to enhance and sustain stable valve function and cardiac function in the vast majority of children. The use of the double-orifice MV technique did not achieve ideal therapeutic results in children with complex valve lesions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"121"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732583","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":"Impact of negative lymph node removal on survival in esophageal cancer: a systematic review and meta-analysis.","authors":"Mansour Bahardoust, Seyedmohammadreza Torabi, Danyal Yarahmadi, Mohammad Mahdi Kakoienejad, Fatemeh Abbasi, Mohammadsadra Shamohammadi, Meisam Haghmoradi, Babak Goodarzy, Adnan Tizmaghz","doi":"10.1186/s12893-025-02858-0","DOIUrl":"https://doi.org/10.1186/s12893-025-02858-0","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have reported that a high number of negative lymph nodes (NLNs) removed can be associated with improved survival in esophageal cancer( EC) after surgery; however, the effect size of a high number of removed NLNs on survival rates has been reported to vary, which may be due to the small sample size of early studies. This meta-analysis aimed to evaluate the effect of the high number of NLNs removed on the survival rate of patients with EC after surgery.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases with relevant Mesh terms to find studies that investigated the effect of the number of NLNs resected on the survival of EC patients after surgery until February 17, 2025. This systematic review was conducted based on the PRISMA 2020 checklist. Cochran's I² was used to evaluate heterogeneity between studies. Publication bias was evaluated using the Egger test. Heterogeneity between studies was controlled by meta-regression. Finally, eight studies involving 5,521 EC patients were included.</p><p><strong>Results: </strong>The survival rate in patients whose number of removed NLNs ≥ 19 was significantly better than those with removed NLNs < 19 (HR: 0.88, 95% CI: 0.81, 0.95, I² = 84.4). Subgroup analysis of 8 studies showed that the protective effect of the high number of removed NLNs) ≥ 19 (was greater in adenocarcinoma patients than in SCC (Pooled HR: 0.63 vs. 0.88).</p><p><strong>Conclusion: </strong>The high number of NLNs removed (≥ 19) during surgery was associated with improved survival after surgery, especially in patients with adenocarcinoma. Removing ≥ 19 NLNs significantly improves survival in EC patients, particularly those with adenocarcinoma. This threshold should be incorporated into surgical guidelines.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"124"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742586","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":"An innovative animal experimental model of rib fracture with bone displacement.","authors":"Chien-An Liao, Shih-Ching Kang, Tai-Horng Young, Chien-Hung Liao, Chi-Hsun Hsieh, Yi-Teng Fong, Chun-Chieh Chuang, Chih-Hao Chen","doi":"10.1186/s12893-025-02861-5","DOIUrl":"https://doi.org/10.1186/s12893-025-02861-5","url":null,"abstract":"<p><strong>Background: </strong>Rib fractures, the most common blunt chest trauma worldwide, have been evaluated in multiple retrospective cohort studies. Histology laboratories using innovative techniques are crucial to improving patient outcomes; animal models are especially valuable in this regard. Currently, the creation of animal models of fractures involves cutting to avoid lethal pleural injury and induce linear fractures incompatible with real-world morphology. Suitable models with bone displacement, which are common surgical targets, are limited. Therefore, we aimed to develop an animal experimental model that aligns with real-world clinical conditions and allows for more in-depth research on blunt chest trauma.</p><p><strong>Methods: </strong>We conducted an animal study using New Zealand rabbits to create fractures with displacement, without injuring the pleura. A facial bone drill was used to create several fracture holes in the ribs that were carefully dissected using a rongeur and scissors. After reaching the border between the bone and pleura, they were separated through blunt dissection with scissors. Fractures were created without injuring the pleura, and a rongeur was used to displace the bones.</p><p><strong>Results: </strong>Seven rabbits successfully underwent surgery, with each awakening without pleural injury and pneumothorax. Surgery effectiveness was primarily assessed using chest computed tomography (CT) to evaluate types of rib fractures. CT was performed in the second week and second and third months postoperatively. All rabbits exhibited visibly displaced rib fractures, and no additional chest complications were observed.</p><p><strong>Conclusions: </strong>This innovative animal model allowed us to study pathophysiological changes following rib fracture. Future studies investigating new medical materials and surgical procedures will benefit from this animal model.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"123"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744365","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 robot-assisted laparoscopic radical prostatectomy via modified extraperitoneal approach and transvesical approach.","authors":"Zhi Xian Xiao, Xi Yan Lan, Si Yan Miao, Run Fu Cao, Kai Hong Wang","doi":"10.1186/s12893-025-02853-5","DOIUrl":"10.1186/s12893-025-02853-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcomes of two different surgical approaches for treating localized prostate cancer: extraperitoneal robot-assisted radical prostatectomy (Ep-RARP) and transvesical robot-assisted radical prostatectomy (Tv-RARP).</p><p><strong>Methods: </strong>This study collected and analyzed data from patients with localized prostate cancer who underwent robot-assisted radical prostatectomy (RARP) within the same surgical team between October 2018 and March 2024. The cohort included two groups: the Ep-RARP group (37 cases) and the Tv-RARP group (29 cases). The primary outcomes analyzed were postoperative drainage time, length of hospital stay, surgical margin status, postoperative complications, urinary continence, and erectile function.</p><p><strong>Results: </strong>The baseline characteristics of the two groups of patients were consistent (p > 0.05), making them comparable. The Ep-RARP group had a significantly shorter hospital stay (7 days [5.5-8] vs. 9 days [9-10], p < 0.001) and shorter drain retention time (7 days [6-8] vs. 8 days [7-10], p < 0.001). There were no significant differences in intraoperative blood loss, blood transfusion requirements, and surgical complications. The duration of catheterization was similar in both groups (7 days [7-8] vs. 7 days [7-8], p = 0.135), as well as the distribution of Gleason scores, pathological staging (T1, T2), and positive surgical margin rate (p > 0.05). No significant differences were found in immediate postoperative urinary control rates (Tv-RARP: 20 [68.97%] vs. Ep-RARP: 26 [70.27%], p = 0.909), 3-month urinary control rates (Tv-RARP: 27 [93.10%] vs. Ep-RARP: 35 [94.59%], p = 1.000), or 6-month urinary control rates (Tv-RARP: 29 [100%] vs. Ep-RARP: 37 [100.00%], p = 1.000). The biochemical recurrence rate at 6 months was also comparable (Ep-RARP: 1 [2.70%] vs. Tv-RARP: 1 [3.45%], p = 1.000). Postoperative erectile function recovery at 3 and 6 months was similar between the two groups (3 months: Ep-RARP: 14 [37.84%] vs. Tv-RARP: 12 [41.40%], p = 0.804; 6 months: Ep-RARP: 18 [48.64%] vs. Tv-RARP: 17 [58.62%], p = 0.464).</p><p><strong>Conclusion: </strong>Both extraperitoneal and transvesical robot-assisted radical prostatectomy are feasible approaches for localized prostate cancer, offering comparable oncologic control and functional outcomes. However, the extraperitoneal approach demonstrates advantages in terms of shorter surgery time, drain retention time, and hospital stay.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"120"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732651","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":"Risk factors of postoperative complications and in-hospital mortality after hip fracture among patients older than 80 years old: a retrospective study.","authors":"Huawen Zhang, Lulu Ma, Xuerong Yu","doi":"10.1186/s12893-025-02862-4","DOIUrl":"https://doi.org/10.1186/s12893-025-02862-4","url":null,"abstract":"<p><strong>Induction: </strong>The mortality and morbidity in hip fracture is a big healthcare burden. How to identify risk patients preoperatively is important. The aim of study was to evaluate the risk factors of postoperative complications and mortality in patients older than 80 years old after hip fracture surgery.</p><p><strong>Methods: </strong>Patients older than 80 years old with the diagnosis of hip fracture who had surgical treatment from February 2013 to June 2021 at a single center in China were included for analysis. The primary outcome were postoperative complications and in-hospital mortality. Binary logistic regression was used to confirm the relationship between preoperative factors and postoperative complications/mortality.</p><p><strong>Results: </strong>498 patients were included for analysis. 176 patients developed 265 episodes of complications and the incidence of postoperative complication was 35.3%. Postoperative pulmonary infection was the most common complication, followed by cardiovascular complications and postoperative delirium. And there were 10 postoperative in-hospital deaths (2.0%). Preoperative Charlson comorbidity index(CCI) was associated with postoperative complications (OR = 1.243, 95%CI 1.020-1.516, P = 0.031) and mortality (OR = 2.303, 95%CI 1.351-3.925, P = 0.002). However, American society of Anesthesiologists (ASA) score was not an independent risk factor for postoperative complication and mortality.</p><p><strong>Conclusion: </strong>CCI was the risk factor of poor postoperative outcome for patients older than 80 years old after hip fracture surgery. And CCI can be used as the potential tool of risk stratification for this group of patients.</p><p><strong>Trial registration: </strong>This study had been registered in www.chictr.org.cn and the registration ID was ChiCTR2400085291 on June 4th 2024.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"122"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743128","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 geometric localization technique and CT-guided percutaneous localization technique for peripheral GGO in wedge resection: a randomized controlled trial.","authors":"Xuemin Zhao, Mengjun Bie","doi":"10.1186/s12893-025-02848-2","DOIUrl":"10.1186/s12893-025-02848-2","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative localization of ground glass opacity (GGO) is a major clinical challenge. We previously introduced a novel method called geometric localization technique (GLT). We aimed to compare GLT and the mostly common used technique-CT guided percutaneous localization technique (CPLT) in terms of the effectiveness, safety and accuracy.</p><p><strong>Methods: </strong>In a randomized controlled trial, patients who were diagnosed with pulmonary GGO and underwent wedge resection were randomized into GLT group (localized using GLT method) and CPLT group (localized using CPLT method). Baseline data, localization related data, successful localization rate, complications, operation related data and pathological results of patients were prospectively collected. Statistical analysis was performed between the two groups.</p><p><strong>Results: </strong>A total of 455 patients in our hospital were enrolled in this study from 2022-7-6 to 2024-2-22, including 228 patients in the GLT group and 227 patients in the CPLT group. There were significant differences in terms of the successful localization rate (99.6% vs. 94.3%, χ2 = 10.667, P = 0.001), the rate of sufficient resection margin (99.6% vs. 87.2%, χ2 = 28.110, P < 0.001), and incidence of localization-related complications (0 vs. 17.6%, χ2 = 114.251, P < 0.001) between GLT group and CPLT group. In the GLT group, the distance between GGO and marked visceral pleural point was 3.9 ± 3.1 mm. In the CPLT group, the distance from punctured pleural point to GGO and the distance from anchor to GGO were 18.3 ± 11.4 mm and 4.1 ± 3.5 mm, respectively. In CPLT, one dislocation and thirteen dislodgement occurred. In multivariate regression analysis, only the localization technique was independently correlated with the successful localization rate (OR = 13.105; 95% CI: 1.688, 101.713; P = 0.014). Gender (OR = 0.239; 95% CI: 0.099, 0.579; P = 0.002), nodule size (OR = 0.864; 95% CI: 0.758, 0.984; P = 0.028), depth of nodules (OR = 0.908; 95% CI: 0.861, 0.957; P < 0.001) and the localization technique (OR = 40.809; 95% CI: 5.357, 310.855; P < 0.001) were independent variables in determining the rate of sufficient resection margin.</p><p><strong>Conclusions: </strong>Compared with CPLT, GLT has at least comparable outcomes in terms of effectiveness and accuracy; good safety profile was the advantage of GLT.</p><p><strong>Trial registration: </strong>ChiCTR2200060527 (  https://www.chictr.org.cn ), 2022/6/4, prospectively registered.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"117"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732649","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 effects of obesity on surgical complications and postoperative prognosis of epithelial ovarian cancer: a meta-analysis.","authors":"Jingjing Sheng, Chu Li, Jiali Zhang, Zujian Jin, Yun Xiao Zhou, Yiping Huang","doi":"10.1186/s12893-025-02770-7","DOIUrl":"10.1186/s12893-025-02770-7","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively evaluate and compare surgical outcomes of obese patients versus non-obese patients for surgical complications and postoperative prognosis due to epithelial ovarian cancer (EOC).</p><p><strong>Methods: </strong>Studies were obtained from database search systems of Medline (PubMed) and Embase. Data were analyzed by the meta-analysis method and the random-effect or fixed-effect model. The heterogeneity between the studies was evaluated by I2 index and the data were analyzed using STATA version 15.1 and Review Manager version 5.4.</p><p><strong>Results: </strong>14 studies with 4858 cases of proven epithelial ovarian cancer who underwent extensive surgery were included. Obesity may be a risk factor of the low surgical complex score (RR1.08, 95% CI 1.01-1.15, p = 0.05), but had no manifesting difference in the surgical complications score compared non-obesity group (RR 0.50, 95% CI 0.07-3.79, p = 0.501 and RR 0.60, 95% CI 0.22-1.63, p = 0.316). Obesity EOC patients who undergone surgery tended to be correlated with surgical complications, such as wound infection (RR 2.71, 95% CI 1.59-4.61, p = 0.000), intestinal complications (RR 2.09, 95% CI 1.00-4.35, p = 0.000), and 30-readmission rate (RR 1.84, 95% CI 1.16-2.93, p = 0.000). Obese patients were more likely to have shorter prognosis free survival (PFS) (SMD 0.62-year, 95% CI-0.13 to 0.15), but the results did not discover a significant difference in overall survival (OS)between obesity and non-obesity. (SMD 0.01-year, 95% CI-0.13 to 0.15) CONCLUSIONS: Obesity affects the difficulty of ovarian cancer surgery, and a negative relationship between obesity and surgical complications is observed. Obesity is a potential risk factor for prognosis of EOC patients. Attention is played on determining what kind of case should be benefit most from this surgery to minimize the rates of operative complications and postoperative mortality.</p><p><strong>Prospero registration number: </strong>CRD 42,023,434,781.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"119"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732655","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":"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":"<p><strong>Objective: </strong>The aim of this study is to evaluate the effectiveness of Six Sigma management in standardizing surgical hand disinfection practices among medical personnel.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}