BMC Surgery最新文献

{"title":"Perioperative comparison of uniportal versus multiportal video-assisted thoracoscopic surgery for complex segmentectomy of the lower lung lobe.","authors":"Xinyu Wang, Yuming Wang, Min Cao, Yujie Fu, Wenbiao Pan, Qing Ye, Xiaojing Zhao, Zhiyong Sun","doi":"10.1186/s12893-025-02944-3","DOIUrl":"10.1186/s12893-025-02944-3","url":null,"abstract":"<p><strong>Background: </strong>Resection of basal segmentectomy through uniportal video-assisted thoracoscopic surgery (U-VATS) is technically challenging for thoracic surgeons. Compared with multiportal VATS (M-VATS), the safety and feasibility of U-VATS for complex segmentectomy of lower lung lobe need further validation. In this study, we aimed to compare the perioperative outcomes of U-VATS with M-VATS in the treatment of complex segmentectomy of lower lung lobe for stage IA lung cancer.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 168 patients (116 U-VATS and 52 M-VATS) undergoing complex lower lobe segmentectomy for stage IA NSCLC from January 2021 to May 2023. The demographics of the enrolled patients were collected and propensity score matching (PSM) was used to reduce the heterogeneity of baseline characteristics. Perioperative outcomes were compared between the two groups.</p><p><strong>Results: </strong>After matching, 50 cases were yielded in each group. There was no 30-day postoperative mortality and conversion to open in both groups. The U-VATS exhibited shorter postoperative hospital stays (P = 0.034) and a trend toward reduced postoperative drainage (P = 0.081) compared to the M-VATS group. Pain score on postoperative day 2 in the U-VATS group was lower than M-VATS group (P = 0.004). There were no significant differences in resection margins, operation time and postoperative complications between the two groups.</p><p><strong>Conclusions: </strong>U-VATS provides comparable perioperative safety and efficacy to M-VATS for complex lower lobe segmentectomy, with advantages in accelerated recovery and reduced postoperative pain. U-VATS complex segmentectomy of lower lung lobe is a safe and feasible technique for experienced thoracic surgeons, which deserves support and popularity.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"220"},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112319","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":"Development and validation of a nomogram for in-stent restenosis within 2 years in patients after iliac or femoral artery stent placement.","authors":"YunSong Li, JiaTao Li, Yu Huang, Liang Li, PengKai Cao, XianChao Zhang, FengKai Wang, YaQi Wang, XiangDong Liu, YanRong Zhang","doi":"10.1186/s12893-025-02955-0","DOIUrl":"10.1186/s12893-025-02955-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the risk factors for in-stent restenosis (ISR) within 2 years after iliac or femoral artery stent placement.</p><p><strong>Methods: </strong>Clinical data of 237 patients diagnosed with peripheral arterial disease (PAD) and receiving iliac or femoral artery stent placement for the first time in the Third Hospital of Hebei Medical University from January 2015 to December 2022 were analyzed. Patients were randomized into training and validation set (7:3). Logistic regression was used to perform univariate and multivariate analysis on the possible factors of ISR, identify independent risk factors, establish a risk nomogram prediction model, and internally verify the predictability and accuracy of the model.</p><p><strong>Results: </strong>Binary logistic regression analysis showed that diabetes, hyperlipidemia, hyperfibrinogenemia and below-the-knee run-offs were independent risk factors for ISR within 2 years after iliac or femoral artery stent placement in patients with PAD. Based on these factors, the risk prediction model is established. The c index of the model was 0.856. The results showed that the risk prediction model has good accuracy in predicting ISR within 2 years after iliac or femoral artery stent placement.</p><p><strong>Conclusions: </strong>The risk prediction model based on the 4 risk factors of diabetes, hyperlipidemia, hyperfibrinogenemia and below-the-knee run-offs has good predictive performance.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"221"},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121379","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":"Investigation of the effects of laparoscopic sleeve gastrectomy and laparoscopic one anastomosis gastric bypass on metabolic syndrome components.","authors":"Vahit Mutlu, Mahmut Arif Yüksek, Bülent Koca, Gökhan Selçuk Özbalcı","doi":"10.1186/s12893-025-02952-3","DOIUrl":"10.1186/s12893-025-02952-3","url":null,"abstract":"<p><strong>Background: </strong>Obesity and accompanying comorbidities are serious diseases that impair the quality of life and even threaten human life. Today, the most effective method for providing sustainable weight loss in the treatment of obesity is Bariatric and Metabolic Surgery procedures. In our study, we aimed to compare the therapeutic effects of Laparoscopic Sleeve Gastrectomy (LSG) and One Anastomosis Gastric Bypass (OAGB) on metabolic syndrome components. We also planned to investigate the complications after bariatric and metabolic surgery, whether the patients had recurrent weight gain, and the short, medium and long-term effects.</p><p><strong>Methods: </strong>Patients who underwent bariatric and metabolic surgery with the diagnosis of obesity between December 2012-January 2020 were retrospectively analyzed. 561 patients who were followed up at 3, 6 months, 1, 2 and 3 years after the operation were included in the study. The effects of bariatric and metabolic surgery on metabolic syndrome components were evaluated as partial and complete remission according to the status at the last follow-up. Statistical analysis were performed by SPSS 18. Results were reported as mean ± standard deviation. P < 0.05 was accepted as statistical significance.</p><p><strong>Results: </strong>In 516 patients who underwent LSG and 45 patients who underwent OAGB, a decrease in BMI and an increase in EWL(%) values were observed at the 3rd month, 6th month, 1st year and 2nd year controls. In the 3rd year controls of patients who underwent LSG, recurrent weight gain was observed, therefore there was an increase in BMI and a decrease in EWL(%) values compared to the 2nd year. In patients who underwent OAGB, a decrease in BMI continued at the 3rd year, while an increase in EWL(%) values was observed. Thanks to both LSG and OAGB; a remission was achieved at the rates of DM, HT, HL/DL, OSAS, hypothyroidism in the early period. As the follow-up period extended, the rate of patients showing complete recovery decreased for DM(p = 0.0001). No change was observed during the follow-up period for other parameters. CONCLUSıON: Therapeutic effects of LSG and OAGB on metabolic syndrome components have been demonstrated in our study. However, when DM remission and sustainable weight loss are evaluated, OAGB is more effective in the long term.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"217"},"PeriodicalIF":1.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102994","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":"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}