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Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study. 视频胸腔镜手术中吸入吲哚菁绿检测漏气部位的评估:一项前瞻性研究。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-13 DOI: 10.1186/s12893-025-02875-z
Zhenfan Wang, Xue Tian, Zihan Wei, Hao Xu, Kunshan He, Chongwei Chi, Songjing Zhao, Ruiheng Jiang, Fan Yang, Yun Li, Jian Zhou
{"title":"Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study.","authors":"Zhenfan Wang, Xue Tian, Zihan Wei, Hao Xu, Kunshan He, Chongwei Chi, Songjing Zhao, Ruiheng Jiang, Fan Yang, Yun Li, Jian Zhou","doi":"10.1186/s12893-025-02875-z","DOIUrl":"10.1186/s12893-025-02875-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the feasibility and clinical benefits of indocyanine green (ICG) inhalation for detecting air leak sites during video-assisted thoracoscopic surgery (VATS).</p><p><strong>Methods: </strong>Between February 2023 and May 2023, a total of 288 patients underwent VATS were enrolled in this study. Among the population, 72 patients received ICG inhalation test following the traditional submersion sealing test. And 216 patients only underwent the submersion sealing test were matched using 1:3 propensity score matching analysis. The results of ICG inhalation test and the clinical outcomes were compared.</p><p><strong>Results: </strong>In the ICG group, 48 air leak sites were detected in 25 patients (25/72, 34.7%). The conventional submersion sealing test identified 30 air leak sites, while the ICG inhalation test detected 47 sites. Among these detected air leak sites, 34 sites were repaired by suturing or stapling. The postoperative air leak rate in the ICG group (20.8%) was significantly lower than the control group (37.0%, P = 0.011). ICG inhalation test was a favorable factor for reducing postoperative air leaks (OR: 0.40; 95%CI: 0.20-0.78; P = 0.008).</p><p><strong>Conclusions: </strong>The ICG inhalation test facilitates the identification of air leak sites that may have been overlooked in the conventional submersion sealing test. This technique is useful to reduce postoperative air leaks for patients undergoing VATS.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2300067603 on January 13rd 2023.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"206"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
DRG payment for male reproductive system malignant tumor surgery: analysis and recommendations on resource consumption in a tertiary hospital in China. 男性生殖系统恶性肿瘤手术DRG支付:中国某三级医院资源消耗分析与建议
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-13 DOI: 10.1186/s12893-025-02940-7
Zhengyu Zhang, Xiaolin Yao, Ying Li, Ruiyin Dong, Wen Jin, Yunhe Li
{"title":"DRG payment for male reproductive system malignant tumor surgery: analysis and recommendations on resource consumption in a tertiary hospital in China.","authors":"Zhengyu Zhang, Xiaolin Yao, Ying Li, Ruiyin Dong, Wen Jin, Yunhe Li","doi":"10.1186/s12893-025-02940-7","DOIUrl":"10.1186/s12893-025-02940-7","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to examine the consistency of resource consumption (cost homogeneity) and influencing factors of the diagnosis-related group (DRG) \"major operations for malignant tumors of the male reproductive system with general complications or comorbidities\" (MA13) and offer recommendations for improving the efficacy of the grouping.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records and insurance settlement data of all MA13 patients admitted to a tertiary urology department from January 2021 to December 2024. Combined with semi-structured interviews with urologists, key clinical cost drivers were identified. Multiple linear regression analysis was utilized to assess the significance of these factors and their specific impact on various service costs. We provided recommendations for improving MA13 groupings and evaluated their effectiveness using the coefficient of variation (CV) and t-tests.</p><p><strong>Results: </strong>The CV for the MA13 group was 0.41. Age and robot-assisted surgery emerged as independent factors due to their statistically dominant effects (P < 0.001) in multivariate regression, whereas comorbidities and insurance type showed limited explanatory power (adjusted R<sup>2</sup> = 0.72). Subgrouping MA13 by age and robotics reduced intra-group heterogeneity (CV: 0.12-0.35 vs. 0.41), enabling equitable reimbursement for advanced surgical techniques while maintaining manageable DRG categories.</p><p><strong>Conclusions: </strong>Supplementary payments for robot-assisted surgery should be considered to ensure equitable access to advanced technologies while maintaining cost-effectiveness. Stratified validation methods are essential for evaluating grouping effectiveness, which can help improve intra-group consistency and facilitate a more equitable distribution of medical resources.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"207"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction of surgical resectability after FOLFIRINOX chemotherapy for borderline resectable and locally advanced pancreatic cancer (PeRFormanCe): a multicenter prospective trial - trial protocol. 边缘可切除和局部晚期胰腺癌(PeRFormanCe)的FOLFIRINOX化疗后手术可切除性的预测:一项多中心前瞻性试验-试验方案。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-13 DOI: 10.1186/s12893-025-02938-1
Luís Filipe Abreu de Carvalho, Filip Gryspeerdt, Wim Ceelen, Karen Geboes, Suzane Ribeiro, Anne Hoorens, Nele Vandenbussche, Kathleen B M Claes, Clarisse Lecluyse, Aliaksandr Anisau, Johan Van Ongeval, Willem Lybaert, Lars Triest, Andrew Vervaecke, Steven Sas, Barbara Claerhout, Carolien Beyls, Mark Sie, Frederik Berrevoet
{"title":"Prediction of surgical resectability after FOLFIRINOX chemotherapy for borderline resectable and locally advanced pancreatic cancer (PeRFormanCe): a multicenter prospective trial - trial protocol.","authors":"Luís Filipe Abreu de Carvalho, Filip Gryspeerdt, Wim Ceelen, Karen Geboes, Suzane Ribeiro, Anne Hoorens, Nele Vandenbussche, Kathleen B M Claes, Clarisse Lecluyse, Aliaksandr Anisau, Johan Van Ongeval, Willem Lybaert, Lars Triest, Andrew Vervaecke, Steven Sas, Barbara Claerhout, Carolien Beyls, Mark Sie, Frederik Berrevoet","doi":"10.1186/s12893-025-02938-1","DOIUrl":"10.1186/s12893-025-02938-1","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy is used in borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) to increase resection rate and improve cancer outcome. However, there is a need for better prediction of resectability. The aim of this prospective, single arm study is to improve prediction of surgical resection by using radiomics and liquid biopsy.</p><p><strong>Methods: </strong>In this multicentric trial, 45 patients with BR or LA PADC will undergo neoadjuvant chemotherapy with FOLFIRINOX. An intention to treat analysis will be performed. The primary endpoint is the accuracy of the prediction of surgical resection. Secondary endpoints are overall survival and disease-free survival from the date of diagnosis, R0 and R1 resection rates, histopathological response, postoperative complications, patient reported outcomes with quality of life and health economic analysis. Translational research with multi-omics and radiomics based on computed tomography and magnetic resonance imaging aims to identify factors predictive of surgical resectability and survival. The primary hypothesis is that these strategies can increase the accuracy of predicting surgical resection.</p><p><strong>Discussion: </strong>Improved prediction of resectability is necessary in BR and LA PDAC. We aim to investigate whether a combination of clinical, radiological, and multi-omics profiling in liquid biopsies can successfully predict resectability and thus optimize the therapeutic decision tree.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05298722. Date of registration: March 28, 2022.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"204"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advances and challenges in the application of donor-derived cell-free DNA for diagnosis and treatment in liver transplantation: a narrative review. 供体来源的无细胞DNA在肝移植诊断和治疗中的应用进展和挑战:叙述性综述。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-13 DOI: 10.1186/s12893-025-02911-y
Yiwu Zhong, Xu Hu, Xiaoping Li, Yinbiao Qiao, Haoyu Li, Shijie Zhou, Shusen Zheng, Jianhui Li
{"title":"Advances and challenges in the application of donor-derived cell-free DNA for diagnosis and treatment in liver transplantation: a narrative review.","authors":"Yiwu Zhong, Xu Hu, Xiaoping Li, Yinbiao Qiao, Haoyu Li, Shijie Zhou, Shusen Zheng, Jianhui Li","doi":"10.1186/s12893-025-02911-y","DOIUrl":"10.1186/s12893-025-02911-y","url":null,"abstract":"<p><p>In the field of liver disease treatment, liver transplantation (LT) has become an effective option for end-stage liver disease. However, issues such as immune rejection and graft damage remain important factors influencing the success rate of liver transplantation and patients' quality of life. In recent years, with the advancement of genetic testing technologies, the study and application of donor-derived cell-free DNA (dd-cfDNA) in LT diagnosis and treatment have gradually gained attention. This review explores the research advancements in dd-cfDNA within liver transplant management, evaluating its potential applications throughout the liver transplantation process, while exploring the challenges faced by current studies and outlining future research directions. As a strategic tool for postoperative monitoring in LT, dd-cfDNA shows promising potential in areas such as immune rejection, graft damage, immunosuppressant adjustment, complication monitoring, and personalized treatment, and is poised to become a reliable biomarker in LT management.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"203"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early cranioplasty versus traditional cranioplasty enhances surgical outcomes in patients with malignant cerebral infarction after decompressive craniectomy. 早期颅骨成形术与传统颅骨成形术相比可提高恶性脑梗死患者减压颅骨切除术后的手术效果。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-13 DOI: 10.1186/s12893-025-02943-4
Zhifeng Yan, Zecheng Xue, Maolin Wang, Linjun Wang, Hongmin Che, Zhongnan Yan
{"title":"Early cranioplasty versus traditional cranioplasty enhances surgical outcomes in patients with malignant cerebral infarction after decompressive craniectomy.","authors":"Zhifeng Yan, Zecheng Xue, Maolin Wang, Linjun Wang, Hongmin Che, Zhongnan Yan","doi":"10.1186/s12893-025-02943-4","DOIUrl":"10.1186/s12893-025-02943-4","url":null,"abstract":"<p><strong>Background: </strong>A growing cohort of malignant cerebral infarction (MCI) patients after decompressive craniectomy (DC) required cranioplasty (CP). However, few studies have reported the effect of CP on functional improvements in post-DC MCI patients. The aim of this study was to determine whether early CP for post-DC MCI patients enhances surgical outcomes and alters overall complication rate.</p><p><strong>Methods: </strong>86 post-DC MCI patients after CP were divided into the early CP cohort and the traditional CP cohort according to the time span from DC to CP. Complications, NIHSS, mBI, mRS, and CRS-r were assessed, and early CP and traditional CP were defined as occurring less than or more than 3 months after DC.</p><p><strong>Results: </strong>Complications were observed in 9 patients (24.32%) in the early CP cohort and 14 patients (28.57%) in the traditional CP cohort (p > 0.05). NIHSS, mRS, mBI, and CRS-r between pre-operation and post-operation did significantly differ (p < 0.05). Between the two cohorts, operative time, intraoperative blood loss, post-operative parameters (NIHSS, mBI and mRS), ∆NIHSS, and ∆mBI did significantly differ (p < 0.05), while post-operative CRS-r did not significantly differ (p > 0.05). There was a linear relationship between ∆NIHSS and the time span from DC to CP (r = 0.505, p < 0.0001), and there was a linear relationship between ∆BI and the time span from DC to CP (r = -0.568, p < 0.0001).</p><p><strong>Conclusions: </strong>Our study demonstrated that, first, CP has a favorable effect on improving neurological function, ability to perform daily living, and consciousness in post-DC MCI patients; second, early CP does not alter the overall complication rate and is as safe as traditional CP; third, compared to traditional CP, early CP reduces operative time and intraoperative blood loss, promotes improvements in neurological function and ability to perform daily living, and enhances these improvements.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"205"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model. 基于影像学模型的胸腔镜下老年肺癌患者术后肺不张风险评估。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-12 DOI: 10.1186/s12893-025-02939-0
Bin Liu, Xi Chen, Wuchang Deng
{"title":"Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model.","authors":"Bin Liu, Xi Chen, Wuchang Deng","doi":"10.1186/s12893-025-02939-0","DOIUrl":"10.1186/s12893-025-02939-0","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a leading cause of death in the elderly. Thoracoscopic surgery, though minimally invasive, poses a greater risk of postoperative atelectasis in this group owing to age and comorbidities. The aim of this study was to identify risk factors for atelectasis in elderly lung cancer patients and develop a nomogram model for clinical prediction.</p><p><strong>Methods: </strong>Clinical data from 322 elderly patients with lung cancer were retrospectively analysed and split into a training set (n = 226) and a validation set (n = 96) at a 7:3 ratio. Independent risk factors for postoperative atelectasis were identified via univariate and multivariate logistic regression. A nomogram prediction model was constructed and evaluated for discrimination (ROC curves), calibration (Hosmer-Lemeshow test, calibration curves), and clinical utility (decision curve analysis, DCA).</p><p><strong>Results: </strong>The multivariate logistic regression analysis revealed that the independent risk factors for postoperative atelectasis (P < 0.05) were age ≥ 70 years, a smoking history, decreased preoperative forced expiratory volume in one second (FEV1), and lobectomy. The areas under the ROC curves of the nomogram model were 0.826 (95% CI: 0.767-0.885) and 0.918 (95% CI: 0.802-0.991) in the training and validation sets, respectively. The calibration curves demonstrated a strong consistency between the predicted and observed outcomes. The DCA curves revealed that the model provided a high net clinical benefit when the threshold probability ranged from 0.07 to 0.60, with a maximum net benefit of 73%.</p><p><strong>Conclusion: </strong>The independent risk factors identified for postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery are age ≥ 70 years, smoking history, reduced preoperative FEV1, and lobectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"202"},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single versus double symphyseal plating in management of tile C1-2 and C1-3 pelvic ring injuries: a randomized controlled trial. 单联合钢板与双联合钢板治疗C1-2和C1-3骨盆环损伤:一项随机对照试验
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-09 DOI: 10.1186/s12893-025-02936-3
Islam Sayed Moussa, Ibrahim Mahmoud Abdelmonem, Amr Mohammed Nagy
{"title":"Single versus double symphyseal plating in management of tile C1-2 and C1-3 pelvic ring injuries: a randomized controlled trial.","authors":"Islam Sayed Moussa, Ibrahim Mahmoud Abdelmonem, Amr Mohammed Nagy","doi":"10.1186/s12893-025-02936-3","DOIUrl":"10.1186/s12893-025-02936-3","url":null,"abstract":"<p><strong>Background: </strong>Single superior symphyseal plating is the most effective method for managing vertically unstable Tile C1-2 and C1-3 pelvic ring injuries. However, high rates of implant failure were more frequently observed in obese patients (body mass index < 30). The study aimed to determine the potential reduction in implant failure rates by adding an anterior symphyseal plate in obese patients (class I).</p><p><strong>Methods: </strong>The study was designed as a prospective, randomized controlled trial with a single-blind methodology, conducted at a level 1 trauma center. The study involved 36 patients with Tile C1-2 and C1-3 injuries, and class I obesity between February 2022 and May 2023. All cases had posterior and anterior ring fixation, with 18 cases having superior symphyseal plating and 18 cases having additional anterior plating (Groups A and B). The primary outcomes were radiological, functional outcomes, and implant failure rates.</p><p><strong>Results: </strong>Patients in group A were followed up for an average of 13.39 months, and those in group B for 13.7 months. Group A exhibited a significantly shorter operative time with a mean difference of 30 min (p < 0.001), as well as lower reoperation rates (p = 0.03). Both groups had similar final clinical and radiological outcomes (p = 0.44 and 0.78) and implant failure rates (p = 0.18) at the last follow-up.</p><p><strong>Conclusion: </strong>The authors found that using a single high-quality symphyseal plate effectively addresses symphyseal diastasis in vertically unstable Tile C1-2 and C1-3 pelvic ring injuries among patients with class I obesity. This method lowers morbidity by reducing operation times and minimizing reoperation rates, while the inclusion of an additional anterior plate does not enhance the final radiological and clinical outcomes.</p><p><strong>Level of evidence: </strong>Therapeutic Level I study.</p><p><strong>Trial registration: </strong>Ain Shams University's ethical committee retrospectively registered and approved this trial (FWA 000017585 FMASU R65/2022). It was organized and operated according to the guidelines of the International Council on Harmonization (ICH) in Anesthesiology and the Islamic Organization for Medical Sciences (IOMS). The United States Office for Human Research Protections and the United States Code of Federal Regulations operate under Federal Wide Assurance No. 000017585 (retrospectively registered). Our study was registered at ClinicalTrials.gov with clinical trial number NCT06439108 with clinical trial registry ({05/30/2024}.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"200"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New technique of end to side two layered and stented duct to mucosa pancreaticojejunostomy with omental wrapping during Whipple operation. Whipple手术中网膜包裹的胰空肠粘膜端侧双层支架管吻合术新技术。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-09 DOI: 10.1186/s12893-025-02893-x
Hesham A Elmeligy, Ahmed M Azzam, Yousra Ossama, Mahmoud Rady
{"title":"New technique of end to side two layered and stented duct to mucosa pancreaticojejunostomy with omental wrapping during Whipple operation.","authors":"Hesham A Elmeligy, Ahmed M Azzam, Yousra Ossama, Mahmoud Rady","doi":"10.1186/s12893-025-02893-x","DOIUrl":"10.1186/s12893-025-02893-x","url":null,"abstract":"<p><strong>Background: </strong>A leaking pancreaticojejunal anastomosis is typically the cause of major problems following pancreaticoduodenectomy. To stop fistula formation, omental flaps were positioned around the pancreaticojejunal anastomosis.</p><p><strong>Methods: </strong>Forty-eight individuals who had pancreaticoduodenectomy procedures performed between March 2022 and March 2024 were examined. Based on the placement of a stent and omental flaps around the pancreaticojejunal anastomosis, the patients were split into two groups: group A, consisting of twenty-four patients, did not get omental wrapping and stenting, and group B, consisting of twenty-four patients, received omental wrapping with stent inside the pancreaticojejunal anastomosis. To evaluate the efficacy of the omental flap operation in preventing postoperative pancreatic fistula and other complications, perioperative data from both groups was examined.</p><p><strong>Results: </strong>There were no discernible variations in the clinical traits of the two groups. Group B experienced considerably lower occurrences of postoperative pancreatic fistula (20.8% vs. 4.2%), post-pancreatectomy hemorrhage (4.2% vs. 0%), biliary fistula (4.2% vs. 0%), and delayed gastric emptying (12.5% vs. 4.2%). Group B had a considerably lower overall morbidity rate (41.7% vs. 8.3%) and shorter hospital stay (15.3 vs. 10.9 days) than to group A.</p><p><strong>Conclusion: </strong>Following pancreaticoduodenectomy, pancreatic stent and omental flaps around the pancreatic anastomosis can lower the risk of postoperative pancreatic fistula, post-pancrectomy bleeding, and delayed gastric emptying. This straightforward and efficient treatment can decrease the overall morbidity following pancreaticoduodenectomy.</p><p><strong>Trial registration: </strong>The trial registration was recorded as ClinicalTrial.gov Identifier No.: NCT06630910 on 10/05/2024. Our study also adheres to the Declaration of Helsinki.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"201"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimal timing for cholecystectomy: unveiling insights from a decade-long study on acute cholecystitis and symptomatic cholecystolithiasis. 胆囊切除术的最佳时机:从一项长达十年的研究中揭示急性胆囊炎和症状性胆囊结石的见解。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-07 DOI: 10.1186/s12893-025-02851-7
Azhy Muhammed Dewana, Amanj Jalal Namq, Baderkhan Saeed Ahmed, Ahmed Abdulkadir Baban
{"title":"Optimal timing for cholecystectomy: unveiling insights from a decade-long study on acute cholecystitis and symptomatic cholecystolithiasis.","authors":"Azhy Muhammed Dewana, Amanj Jalal Namq, Baderkhan Saeed Ahmed, Ahmed Abdulkadir Baban","doi":"10.1186/s12893-025-02851-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02851-7","url":null,"abstract":"<p><strong>Background: </strong>Acute calculus cholecystitis affects 10 to 20% of untreated individuals. Thus, the surgical community has argued for decades over whether an earlier or later cholecystectomy is better for this condition.</p><p><strong>Objectives: </strong>To compare surgical results, morbidity, and mortality and determine the best timing for surgical intervention among patients with gallstones.</p><p><strong>Patients and methods: </strong>This prospective cohort study was conducted in Erbil Teaching Hospital, Erbil, Iraq, from January 2013 to December 2023 on 767 patients with acute cholecystitis or symptomatic cholecystolithiasis. Patients underwent various types of cholecystectomy (early, intermediate, late, and elective) based on when surgery was conducted after the onset of symptoms. Then, medical treatments were advised, and they were followed up for six weeks. Finally, patients' physical health, postoperative infection severity and complications were assessed, despite reporting patients' age, gender, operation type, chances of conversions, durations of procedure, and hospital stay.</p><p><strong>Results: </strong>Most patients were females (72.1%), experienced laparoscopic technique (98.44%), and had ASA II (n = 548, 71.44%). The mean age of patients was 48.40 ± 67.14 years, the mean operation time was 50 ± 30.89 min, and the mean hospitalization time before and after operation was 1.0 ± 0.47 and 2.75 ± 1.63 days, respectively. Most patients from the intermediate group (n = 83) opted for a postponed strategy. Chronic inflammation (grade 0 infection severity) was highest in most patients of the delayed (67.2%) and intermediate groups (53.01%). Most patients had no complications (score 0), and the least had severe complications.</p><p><strong>Conclusion: </strong>Delayed surgical intervention was harmless and may even be superior to immediate treatment for acute cholecystitis. The morbidity and mortality hazard remains high even in the most severe cases, especially for individuals who received early and intermediate therapy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"199"},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of topical moxifloxacin on therapeutic laparoscopy-induced wound healing: a double-blind, randomized clinical trial. 外用莫西沙星治疗腹腔镜伤口愈合的疗效:一项双盲、随机临床试验。
IF 1.6 3区 医学
BMC Surgery Pub Date : 2025-05-06 DOI: 10.1186/s12893-025-02932-7
Behrooz Heydari, Ali Basiratian, Farahnaz Hoseinzade, Saeed Kargar, Vahid Ramezani, Amirhossein Zahmatkesh, Fatemeh Saghafi
{"title":"Efficacy of topical moxifloxacin on therapeutic laparoscopy-induced wound healing: a double-blind, randomized clinical trial.","authors":"Behrooz Heydari, Ali Basiratian, Farahnaz Hoseinzade, Saeed Kargar, Vahid Ramezani, Amirhossein Zahmatkesh, Fatemeh Saghafi","doi":"10.1186/s12893-025-02932-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02932-7","url":null,"abstract":"<p><strong>Background: </strong>Wound healing is crucial for maintaining healthy skin and preventing complications. Topical administration is a preferred method for delivering therapeutic medicines at the surgery site, as it is simple, affordable, and does not result in systemic harm or antibiotic resistance. Moxifloxacin (MXF), a broad-spectrum antibiotic with anti-inflammatory effects, seems to be effective against bacteria and accelerates wound healing. This study aims to determine the therapeutic effect of topical MXF on wound healing after therapeutic laparoscopy.</p><p><strong>Methods: </strong>This double-blind clinical trial involved 80 patients with therapeutic laparoscopy-induced wounds, randomly assigned to either 0.5% MXF cream or placebo, 24 h after surgery. The primary outcome was wound healing assessment using the REEDA index. Patients were followed by 1, 3, and 5 days of inclusion.</p><p><strong>Results: </strong>Of the 80 study participants included, 50 were women (62.5%), with the mean (SD) age of the participants being 49.5 (19.8) years in the MXF group and 45.8 (17.8) years in the control group. The severity of redness, oedema, and discharge in the MXF group was significantly lower on the first, third, and fifth days of treatment. The case group showed a significant decrease in ecchymosis from the third day of treatment compared to the control group, and no significant difference was observed in wound approximation rate. Hence, topical MXF therapy yielded a significant decrease in REEDA index MXF (P-Value < 0.0001). No treatment-related serious adverse events occurred in the MXF group vs. the comparator group.</p><p><strong>Conclusions: </strong>The results of the current clinical trial demonstrated that the use of topical MXF could be a potential option to expedite therapeutic laparoscopy-induced wound healing by reducing redness, oedema, ecchymosis, and discharge with a satisfactory safety profile.</p><p><strong>Trial registration: </strong>IRCT20181208041882N5, 25/10/2021 ( https://en.irct.ir/trial/46768 ).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"198"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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