BMC Surgery最新文献

{"title":"Comparative study of free vas deferens separation for repair of inguinal hernia and transabdominal preperitoneal prosthesis for adult males.","authors":"Zhi-Wei Zhang, Chen Shaoji","doi":"10.1186/s12893-025-03134-x","DOIUrl":"10.1186/s12893-025-03134-x","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic inguinal hernia repair is now widely performed worldwide. However, there is no consensus on the most appropriate surgical operation for inguinal hernia in adult males. This study aims to evaluate the clinical efficacy and applicability of laparoscopic free vas deferens separation with transabdominal preperitoneal (LFVD-TAPP) repair for inguinal hernia in adult males, in comparison to the conventional transabdominal preperitoneal prosthesis (TAPP) approach.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 189 adult male patients who underwent laparoscopic inguinal hernia repair at the First Affiliated Hospital of Soochow University between February 2020 and January 2023. Patients were divided into two groups that included the LFVD-TAPP (n = 95) and the conventional TAPP (n = 94). Observation targets included surgical and postoperative recovery, complication rates, recurrence and chronic pain. Data were analyzed using SPSS 27.0, with statistical significance defined as p < 0.05.</p><p><strong>Results: </strong>No significant differences were found in baseline characteristics between groups. The LFVD-TAPP group showed significantly shorter operative times for both unilateral and bilateral hernias compared to the TAPP group (0.97 ± 0.20 h vs. 1.60 ± 0.21 h; 1.21 ± 0.17 h vs. 2.01 ± 0.30 h; P < 0.001). No significant differences were observed in postoperative blood loss, length of hospital stay, or hospitalization costs (P > 0.05). However, the LFVD-TAPP group exhibited a higher incidence of temporary groin induration (11 vs. 4; P < 0.05),but significantly lower rates of scrotal hematoma (5 vs. 17; P < 0.05), and chronic pain (6 vs. 11; P < 0.05). No differences were observed in other complications or recurrence rates. Follow-up over 12-24 months revealed no cases of ischemic orchitis, testicular atrophy, or ejaculatory dysfunction in the LFVD-TAPP group.</p><p><strong>Conclusions: </strong>LFVD-TAPP presents clinical advantages over conventional TAPP, including simplified intraoperative separation, reduced surgical difficulty, and lower rates of postoperative scrotal hematoma and chronic pain, without increasing the risk of recurrence. Therefore, the LFVD-TAPP provides better protection of the vas deferens, suggesting its potential for clinical application and broader promotion.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"429"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226137","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":"Epidemiology, presentation, and outcomes of sigmoid volvulus in malawi: an 11-Year retrospective review.","authors":"Thokozani Masina, James Alinafe Junior N'gombe, Florence Msiska, Patrick Masangano, Lucy Yemely Kaomba, Wakisa Mulwafu","doi":"10.1186/s12893-025-03188-x","DOIUrl":"10.1186/s12893-025-03188-x","url":null,"abstract":"<p><strong>Background: </strong>Sigmoid volvulus (SV) is a significant gastrointestinal condition in sub-Saharan Africa, although its epidemiology and outcomes are poorly understood.</p><p><strong>Objectives: </strong>To determine the prevalence, demographic characteristics, clinical presentation, and outcomes of SV in Malawi.</p><p><strong>Methods: </strong>An 11-year retrospective review of patients with SV at Queen Elizabeth Central Hospital, Malawi. Patient records were analysed for demographic characteristics, clinical presentation, mode of management, and outcomes.</p><p><strong>Results: </strong>We identified 301 cases of SV, with a prevalence of 27.3 cases per year. Males comprised 91.4% of cases, with a mean age of 51. Emergency presentations accounted for 69.8% of cases. Resection and primary anastomosis were the most common surgical procedures. The mortality rate was 11.3%, with non-viability of bowel being a significant predictor of mortality.</p><p><strong>Conclusions: </strong>SV contributes significantly to the disease burden, particularly among middle-aged males seen in the surgical department. It presents acutely, and resection and primary anastomosis are the primary surgical approaches. Non-viability of bowel was identified as a significant predictor of mortality, emphasising the need for prompt surgical intervention.</p><p><strong>Trial registration: </strong>Not Applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"450"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226194","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":"Endoscopic purse-string suture technique for postoperative drain-related leakage management in gastrointestinal surgery.","authors":"Guangxu Zhu, Lingai Kong, Xiuwen Liu, Shengjie Zhou, Shunyao Song, Baoqiang Shan, Youchao Xu, Qihang Sun, Xuren Lu, Qingshun Zhu, Bing Jiang, Cai Xu, Honglei Gao, Jianjun Qu","doi":"10.1186/s12893-025-03171-6","DOIUrl":"10.1186/s12893-025-03171-6","url":null,"abstract":"<p><strong>Background: </strong>Abdominal drain-associated fistulas (ADAFs) represent severe complications following gastrointestinal surgery, where conventional surgical reintervention carries invasiveness risks and extended recovery periods. This study evaluates the clinical efficacy and safety of endoscopic purse-string suturing for managing ADAFs.</p><p><strong>Methods: </strong>A retrospective cohort analysis included 41 patients with postoperative ADAFs treated at Shandong Second Medical University and external referral centers between January 2015 and June 2024.</p><p><strong>Results: </strong>Endoscopic intervention achieved technical success in 87.8% (36/41) of cases, with clinical success observed in 63.4% (26/41). Subgroup analysis demonstrated significantly superior clinical outcomes in isolated ADAFs versus cases involving concurrent anastomotic disruption (90.0% vs. 39.1%, P = 0.001). Multivariate regression identified two independent predictors of reduced therapeutic efficacy: preoperative anastomotic stenosis (OR = 0.083, P = 0.041) and fistulous orifice diameter > 1 cm (OR = 0.039, P = 0.004). During 12-month follow-up, no mortality or fistula recurrence occurred. Postprocedural anastomotic stenosis developed in 4.9% (2/41) of patients, successfully managed through endoscopic balloon dilation (n = 1) and gastrointestinal stent placement (n = 1).</p><p><strong>Conclusion: </strong>Endoscopic purse-string suturing emerges as a minimally invasive, safe, and effective therapeutic strategy for ADAFs, particularly demonstrating optimal clinical performance in isolated drain-associated fistulas with orifices ≤ 1 cm diameter.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"439"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226212","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 investigation to the clinical application of personalized 3D printed guides combined with preoperative virtual iliosacral screws for the management of posterior pelvic ring injury.","authors":"Peishuai Zhao, Leyu Liu, Jiaqiang Chen, Renjie Li, Xiaopan Wang, Min Wu","doi":"10.1186/s12893-025-03193-0","DOIUrl":"10.1186/s12893-025-03193-0","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"438"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226134","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 with curative intent for locoregional recurrent colon cancer - a systematic review.","authors":"E Rademaker, A Stapasolla Vargas Garcia, I H J Sujecki, R M Brohet, H Swartjes, J H W de Wilt, N F M Kok, I H J T de Hingh, H L Van Westreenen, E C J Consten, P J Tanis","doi":"10.1186/s12893-025-03160-9","DOIUrl":"10.1186/s12893-025-03160-9","url":null,"abstract":"<p><p>Locoregional recurrence of colon cancer (LRCC) might still be amenable to treatment with curative intent with high survival outcomes, but little is known about patient selection, treatment strategy and corresponding long-term outcomes. This study aimed to review the literature on intentional curative treatment of LRCC and related long-term outcomes. MEDLINE, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials and Google Scholar were searched for publications in any language from 2010 to August 27th 2024. Studies reporting on treatment and survival of uni- or multifocal LRCC without peritoneal spread to another abdominal region after initial curative resection of colon cancer were included. This study was conducted according to the PRISMA and MOOSE recommendations and included independent study selection and data extraction by two reviewers. Of 2843 studies identified, 54 were included, which consisted of 2 consecutive population-based studies, 10 selected cohorts and 42 case studies. The latter were pooled into a case series. In the two consecutive series, treatment intention was curative in 22% and 81%, R0-resection 75% and 50%, and median overall survival 13 and 29 months, respectively. From all 12 cohorts, 495 of 635 (78%) were curatively treated (56% males) with time to LRCC ranging from 15 to 42 months. Neoadjuvant chemotherapy was administered in 6-100% and resection was multivisceral in 40-67%. Adjuvant chemotherapy was provided in 17-88% of the cases. Survival time was heterogeneously reported, limiting possibilities for pooled analysis. Within the pooled case series of 46 unique cases, 83% underwent R0-resection and 5-year overall survival was 86%. Literature regarding treatment and outcomes of LRCC is scarce with limited interpretability and generalizability. Treatment with curative intent can result in high survival rates, but selected cohorts and cases are at high risk of bias.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"423"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226175","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 and predictive modeling of intraoperative hypothermia in laparoscopic surgery patients.","authors":"Yan Cheng, Huasong Sheng","doi":"10.1186/s12893-025-03186-z","DOIUrl":"10.1186/s12893-025-03186-z","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"426"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226278","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 effect of using laparoscopic imaging screens of different sizes (55-inch vs. 27-inch) on surgical parameters in hysterectomy surgery: a retrospective cohort study.","authors":"Mustafa Can Sivas, Berna Aslan Cetin, Karolin Ohanoglu Cetinel, Ipek Emine Geyikoglu","doi":"10.1186/s12893-025-03168-1","DOIUrl":"10.1186/s12893-025-03168-1","url":null,"abstract":"<p><strong>Background: </strong>Monitors that can provide 2-dimensional (2D) or 3-dimensional (3D) images, as well as high-definition (HD) or 4 K-HD image quality, offer various conveniences to surgeons. While studies comparing 2D and 3D screens exist in the literature, studies are needed to investigate the effects of different monitor sizes on surgical success. This study aimed to examine the impact of screen size on surgical parameters in patients who have undergone a hysterectomy using either a 55-inch or a 27-inch monitor.</p><p><strong>Methods: </strong>Patients who underwent laparoscopic hysterectomy and salpingectomy/salpingo-oophorectomy between May 2022 and July 2023 were retrospectively screened. Two groups were created. GroupA consisted of patients who underwent surgery using a 55-inch (140 cm) monitor with both 2D and 4 K-HD features. GroupB consisted of patients whose surgery was performed using a 27-inch (69 cm) monitor with both 2D and 4 K-HD features. A total of 72 women (n(GroupA) = 36, n(GroupB) = 36) were included in the study.</p><p><strong>Results: </strong>No statistically significant difference was observed between groups regarding age, number of cesarean sections, or body mass index (p > 0.05). Additionally, no statistically significant difference was found between groups regarding the total surgery duration (GroupA, GroupB; (126.86 ± 50.42), (128.97 ± 44.29), p = 0.851, respectively). When evaluating the percentage decrease in hemoglobin values before and after surgery, no statistically significant difference was observed between groups (GroupA, GroupB; (-0.11 ± 0.06), (-0.11 ± 0.07), p = 0.746, respectively). There were no statistically significant differences between groups regarding hematocrit changes, frequency of intraoperative complications, postoperative infections, the time to first gas passage, and length of hospital stay (p > 0.05).</p><p><strong>Conclusions: </strong>In laparoscopic monitor systems with 4 K-HD resolution, the screen size, whether 27-inches or 55-inches, may not significantly affect surgical parameters.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"425"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226375","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":"Surgeon well-being: a systematic review of stressors, mental health, and resilience.","authors":"Eniola Z Otukoya, Akram Amiri, Ehsan Alimohammadi","doi":"10.1186/s12893-025-03180-5","DOIUrl":"10.1186/s12893-025-03180-5","url":null,"abstract":"<p><strong>Background: </strong>Surgeons work in high-pressure environments, predisposing them to psychological distress. High rates of burnout and workforce shortages highlight the critical importance of understanding and improving surgeon well-being to sustain healthcare delivery. The multifactorial challenges to surgeon well-being remain insufficiently addressed. This study systematically synthesizes evidence on occupational stressors, burnout, mental health challenges, and resilience strategies among surgeons, and identifies evidence-based interventions to enhance well-being and workforce sustainability.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and Google Scholar (2000-2025) identified peer-reviewed studies on surgeon well-being, burnout, mental health, and resilience. Editorials and non-empirical studies were excluded. Sixty-six studies were included following application of inclusion/exclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework screening. A narrative synthesis identified thematic domains and intervention outcomes. Primary outcomes included the prevalence of burnout, anxiety, and depression among surgeons, sources of occupational stress, and descriptions of interventions promoting resilience or institutional wellness.</p><p><strong>Results: </strong>The literature search identified 534 records through database searching, and an additional 22 records from other sources. After removing duplicates, 356 records remained. 253 records were excluded after initial screening. 103 full-text articles were assessed for eligibility, and 27 were excluded, leaving 76 studies for qualitative synthesis. Surgeons experience high levels of burnout (30-60%) and elevated risks of anxiety, depression, and attrition. Key stressors include long work hours, high patient responsibility, and insufficient institutional support. Individual-level strategies (e.g., mindfulness, physical activity, peer support) offer some benefit but are insufficient alone. Organizational interventions-such as flexible scheduling, resilience training, and embedded mental health services-show promise but are inconsistently implemented. Stigma and licensing concerns remain systemic barriers to seeking help.</p><p><strong>Conclusions: </strong>Surgeon well-being is crucial for both provider and patient outcomes. Addressing this requires coordinated efforts at the individual, institutional, and policy levels. Prioritizing surgeon well-being is essential for safeguarding the surgical workforce and ensuring quality patient care in modern healthcare systems.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"430"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226436","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 novel approach to the minimally invasive application of a tension band for transverse patellar fractures assisted by a nice knot.","authors":"Zhixiang Gao, Shaowei Sun, Shaoyun Zhang, Kai Yao, Xiaofeng Zheng, Wei Yu, Yixin Dai, Lijuan Liu, Cong Xiao","doi":"10.1186/s12893-025-03166-3","DOIUrl":"10.1186/s12893-025-03166-3","url":null,"abstract":"<p><strong>Background: </strong>The tension band internal fixation is a well-established surgical technique employed for the managing of transverse patellar fractures. Nevertheless, there is a lack of comprehensive documentation on minimally invasive tension band fixation in academic literature. In this study, we investigated the utilization of Nice knot assistance during the procedure and assessed its impact on clinical outcomes in comparison to traditional open surgery.</p><p><strong>Methods: </strong>Fourty-two patients with transverse patellar fractures participated in this study, twenty of whom underwent minimally invasive surgery and twenty-two underwent open surgery. In the minimally invasive group, intraoperative tension band internal fixation was performed using Nice knot assisted reduction. Postoperative knee pain, knee mobility, operative time, complications, number of intraoperative C-arm fluoroscopy scans, length of hospital stay (in days), and Bostman score were recorded for each patient in both groups.</p><p><strong>Results: </strong>The minimally invasive group had significantly longer operating times compared to the open surgery group (65.9 ± 9.3 min VS 60.8 ± 7.3 min, P = 0.054). Fluoroscopy during surgery was notably more frequent in the minimally invasive group compared to the open surgery group (4.1 ± 0.8 vs. 2.5 ± 0.6, P < 0.001). The patients had significantly higher VAS scores in the open surgery group compared to the minimally invasive group at multiple postoperative time points. The difference was not significant at 3 months (P = 0.025 ). Furthermore, the minimally invasive group exhibited a higher mean knee flexion angle and the Bostman score compared to the open surgical group.There were complications in 4 patients (18.2%) in the open surgery group and 2 patients (10.0%) in the minimally invasive surgery group, with no significant difference between the two groups (p = 0.752).</p><p><strong>Conclusions: </strong>It has been demonstrated that using the Nice knot in the minimally invasive treatment of transverse patellar fractures improves the reduction effect and decreases the incidence of iatrogenic fractures.Patients who underwent minimally invasive surgery experienced early postoperativepain reduction, improved knee range of motion, improved Bostman scores, early postoperative, discharge and incidence of complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"421"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226147","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":"Explainable prediction of hypothermia risk in laparoscopic surgery: a retrospective cross-sectional study using machine learning.","authors":"Wenyu Su, Xiaoli Wang, Huiyu Jia, Wenjing Chang, Shan Jiang, Huaiju Ge, Shihong Dong, Jie Yu, Guifeng Ma, Yingtao Meng","doi":"10.1186/s12893-025-03071-9","DOIUrl":"10.1186/s12893-025-03071-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to develop multiple machine learning models for predicting hypothermia risk in laparoscopic surgery and to perform interpretability analysis of the best-performing model. Our goal is to provide robust decision support for clinicians and ensure safe and effective patient care during surgical procedures.</p><p><strong>Methods: </strong>This study included 1,030 patients who underwent laparoscopic surgery at Shandong Provincial Cancer Hospital, affiliated with Shandong First Medical University, between July 2023 and June 2024. We employed the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm for feature selection. We explored the performance of five machine learning algorithms-logistic regression (LR), decision tree (DT), random forest (RF), support vector machine (SVM), and extreme gradient boosting (XGBoost)-to predict hypothermia risk during laparoscopic surgery. Finally, we conducted an interpretability analysis of the top-performing model using Shapley Additive Explanations (SHAP).</p><p><strong>Results: </strong>LASSO identified nine risk factors: BMI, ASA classification, total volume of intravenous fluids, irrigating fluids during the operation, volume of CO₂, blood loss, ambient temperature, long-term alcohol consumption, and type of surgery. Performance comparison among the five models revealed that the XGBoost model performed the best, with an accuracy of 0.762 (95% CI: 0.717-0.807) and an area under the curve (AUC) of 0.835 (95% CI: 0.794-0.872). The model achieved a specificity of 0.749 (95% CI: 0.683-0.816) and a sensitivity of 0.773 (95% CI: 0.713-0.824). The F1 score was 0.778 (95% CI: 0.735-0.828). SHAP analysis revealed that the four most influential factors for hypothermia risk during laparoscopic surgery were operating room temperature, rinsing fluids during the operation, volume of CO2, and blood loss.</p><p><strong>Conclusions: </strong>This study developed an efficient and interpretable predictive model for the risk of hypothermia in patients undergoing laparoscopic surgery. This model supports clinical decision-making and contributes to the overall goal of providing personalized care in the surgical environment.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"433"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226178","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}