BMC Surgery最新文献

{"title":"Study on the learning curve for thoracoscopic and laparoscopic radical resection of esophageal cancer.","authors":"Kexin Cao, Kun Li, Geng Zhang, Zhijun Chen, Jian Zhu","doi":"10.1186/s12893-025-02800-4","DOIUrl":"10.1186/s12893-025-02800-4","url":null,"abstract":"<p><strong>Background: </strong>The procedure for thoracoscopic and laparoscopic radical resection of esophageal cancer is complicated, so the operation time is long, which can easily negatively affect the self-confidence of young thoracic surgeons. This retrospective cohort study aimed to improve young thoracic surgeons' understanding of this type of surgery by analyzing the learning curve.</p><p><strong>Methods: </strong>From October 2017 to August 2018, 64 patients who underwent thoracoscopic and laparoscopic radical resection of esophageal cancer by a single team were reviewed by a retrospective cohort study. These patients were divided into four groups according to the date of operation. The baseline data, operation time, the amount of bleeding during the operation, and the number of lymph nodes sampled were compared. Then, the quality of the different stages of the operation was analyzed and evaluated.</p><p><strong>Results: </strong>There were no significant differences in the general baseline data, chest tube duration, or number of samples collected from the right laryngeal nodes among the four groups (p > 0.05). With the accumulation of experience, several key measures of surgical benefit were significantly different among the four groups. Specifically, the operation time became shorter, the amount of bleeding gradually decreased, the number of lymph nodes sampled gradually increased, and the number of left para-recurrent laryngeal nerve lymph nodes sampled gradually increased (p < 0.05).</p><p><strong>Conclusion: </strong>According to the learning curve, approximately 16 patients needed to complete this type of operation in 300 min, and 22 patients needed to be independently sampled from more than 20 lymph nodes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"111"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677272","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":"High-pressure distal colostogram in diagnosing anorectal malformations for male patients: our experience to get a high-quality image.","authors":"Anxiao Ming, Yifeng Shao, Mei Diao, Qi Li, Xu Li, Long Li","doi":"10.1186/s12893-025-02830-y","DOIUrl":"10.1186/s12893-025-02830-y","url":null,"abstract":"<p><strong>Objective: </strong>To summarize our experience with high-pressure distal colostogram (HPC) in diagnosing male anorectal malformations (ARMs) after colostomy.</p><p><strong>Method: </strong>A retrospective analysis was conducted on 103 male patients with anorectal malformations admitted to our hospital from January 2020 to June 2022. All children were found to have anal atresia after birth, with no obvious fistula in the perineum. A colostomy was performed 1-3 days after birth due to a suspected rectourethral fistula. A high-pressure distal colostogram was conducted on 98 patients who met the criteria and were included in this study. There were 68 cases of transverse colostomy, 13 cases of descending colostomy, and 17 cases of sigmoid colostomy. The average age is 3.60 ± 1.56(1.20-8.67) months. The type of anorectal malformation was confirmed during subsequent anorectoplasty.</p><p><strong>Results: </strong>74 (75.5%) patients showed the rectal bladder fistula or rectourethral fistula through a high-pressure distal colostogram, including 14 cases of rectal bladder fistula, 23 cases of rectal prostatic fistula, 37 cases of recto-bulbar fistula. Three children (3.1%) showed tiny fistulas to the perineum and were identified as having rectoperineal fistulas. Twenty-one (21.4%) patients could not show the fistula during the colostogram. These patients were placed with a catheter into the bladder, the contrast was injected into the bladder then the high-pressure distal colostogram was conducted to determine the fistula. Ten children (10.2%) showed a tapered configuration at the distal rectal pouch's anterior aspect before the fistula protruded into the urethra. Based on the position of the fistula and the urethra, 2 cases of rectaurethral prostatic fistula and 8 cases of rectourethral bulbar fistula were determined. Seven cases (7.1%) had a distal rectum extended to the anterior urethra through a fistula and ended subcutaneously at the junction of the penis and scrotum, diagnosed as a rectoperineal fistula. Four patients showed no obvious abnormalities in the external genitalia, while three patients had skin depression at the junction of the penis and scrotum. Four cases (4.1%) presented a symmetrical blind distal rectum extending towards the anus, these were identified as imperforate anus without fistula. The type of anorectal malformation and the location of the rectourethral fistula shown in the colostogram were consistent with the confirmed results during subsequent anorectoplasty.</p><p><strong>Conclusion: </strong>In conclusion, a properly performed high-pressure distal colostogram combined with voiding cystourethrogram (VCUG) can identify the type of anorectal malformations and the location of the fistula in males.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"109"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677261","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":"Association between muscular tissue desaturation and acute kidney injury in patients after surgery for acute type A aortic dissection: a single-center retrospective study.","authors":"Long Zhao, Ling Peng, Qianli Huang, Wei Wei","doi":"10.1186/s12893-025-02852-6","DOIUrl":"10.1186/s12893-025-02852-6","url":null,"abstract":"<p><strong>Background: </strong>A significant association between muscular tissue oxygen saturation (SmtO₂), measured by near-infrared spectroscopy (NIRS), and postoperative complications has been observed in patients undergoing major surgery. However, the association between muscular tissue desaturation and acute kidney injury (AKI) has not yet been reported in patients following surgery for acute type A aortic dissection.</p><p><strong>Method: </strong>One hundred seventy-four adult patients who underwent total aortic arch replacement (TAAR) under cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) for acute type A aortic dissection were retrospectively analyzed. Muscular tissue oxygen saturation (SmtO₂) in the gastrocnemius muscle region and regional cerebral oxygen saturation (rScO₂) on the bilateral forehead were measured using near-infrared spectroscopy (NIRS).The thresholds defining muscular tissue desaturation were SmtO₂ < 80%, < 85%, and < 90% of baseline (relative changes compared to the baseline) and < 55% and < 50% (absolute values). Cerebral desaturation was defined as rScO₂ < 55%, < 50%, and < 80% baseline, on either the left or right side. The baseline, minimum, and mean values of SmtO₂ and rScO₂ were also extracted for analysis. The primary objective of this study was to investigate the association between muscular tissue desaturation and AKI.</p><p><strong>Result: </strong>AKI occurred in 71 (40.80%) of the 174 patients underwent TAAR under CPB and DHCA. SmtO₂ < 80% of baseline was associated with an increased risk of AKI (odds ratio [OR], 1.021; 95% confidence interval [CI], 1.001-1.041; P = 0.034). A receiver operating characteristic curve showed that the optimal cutoff for SmtO₂ < 80% baseline duration was 33.5 min in predicting AKI (sensitivity, 70.00%; specificity, 77.80%). The durations of SmtO₂ < 85% baseline (OR, 1.009; 95% CI, 0.996-1.021; P = 0.195) and < 90% baseline (OR,1.007; 95% CI, 0.996-1.018; P = 0.208) were not significantly associated with AKI. There were no significant differences in the durations of absolute SmtO₂ values < 55% and < 50% or in the minimum SmtO₂ between the two cohorts. Durations of left and right rScO₂ < 55%, < 50%, and < 80% baseline were not associated with AKI. Patients with AKI experienced significantly higher in-hospital mortality and more postoperative complications compared with non-AKI patients.</p><p><strong>Conclusion: </strong>Muscular tissue desaturation, defined as SmtO₂ < 80% of baseline monitored on the lower leg, was significantly associated with an increased risk of AKI in patients who underwent TAAR under CPB and DHCA. Cerebral desaturation, defined as absolute rScO₂ < 55% or < 50%, or < 80% baseline was not associated with AKI.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"108"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676924","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":"Comparing surgical outcomes between robot-assisted laparoscopic and open partial nephrectomy for allograft kidney tumors: a retrospective, single-center study.","authors":"Taro Banno, Yuki Kobari, Hironori Fukuda, Kazuhiko Yoshida, Toshihito Hirai, Kazuya Omoto, Junpei Iizuka, Tomokazu Shimizu, Hideki Ishida, Toshio Takagi","doi":"10.1186/s12893-025-02833-9","DOIUrl":"10.1186/s12893-025-02833-9","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is considered the best long-term option for patients with end-stage renal disease; however, immunosuppression increases the risk of developing malignancies. Approximately 0.2-0.5% of kidney transplant recipients experience renal cell carcinoma (RCC) in their allografts. Recently, nephron-sparing surgery has become widely accepted because of its favorable survival outcomes and low risk of recurrence.</p><p><strong>Methods: </strong>In this study, we retrospectively evaluated the peri- and postoperative outcomes of robot-assisted partial nephrectomy (RAPN) and open partial nephrectomy (OPN) for allograft RCC, analyzing five and six patients who underwent OPN and RAPN, respectively, from 1998 to 2023.</p><p><strong>Results: </strong>The estimated blood loss was significantly lower in the RAPN group than in the OPN group (6.5 mL [interquartile range (IQR): 1-15] vs. 350 mL [IQR: 139-560], P = 0.006), whereas the operative and renal arterial clamping times were similar. Additionally, the perioperative complication rate and severity were lower in the RAPN group, resulting in a significantly shorter postoperative hospital stay than the OPN group (3 days [IQR: 2-5] vs. 10 days [IQR: 8-12], P = 0.01). Postoperative renal function and oncological outcomes were similar between the two groups.</p><p><strong>Conclusions: </strong>RAPN for allograft RCC demonstrated advantages in terms of estimated blood loss and postoperative hospital stay compared with OPN, even though the patients' backgrounds were not adjusted. Therefore, RAPN may be a viable option for managing T1 allograft tumors.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"103"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651613","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":"Postoperative ileus and associated factors in patients following major abdominal surgery in Ethiopia: a prospective cohort study.","authors":"Fasika Chanie Animaw, Melash Belachew Asresie, Amanuel Sisay Endeshaw","doi":"10.1186/s12893-025-02839-3","DOIUrl":"10.1186/s12893-025-02839-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ileus is a complication of abdominal surgery, resulting in significant morbidity and patient discomfort, dissatisfaction, and great economic burden. However, clinical studies regarding POI are very limited in Ethiopia and other Sub-Saharan countries. The main objective of this study is to assess the incidence and associated factors of postoperative ileus among adult patients who underwent abdominal surgery at hospitals in Northwest Ethiopia.</p><p><strong>Methods and materials: </strong>A multicenter hospital-based prospective cohort study was conducted on patients who underwent major abdominal surgeries at specialized hospitals in Bahir Dar from November 20, 2023, to January 20, 2024. A total of 252 were selected by consecutive sampling techniques and included in the final analysis. Data were collected using EpidData version n4.6 and analyzed by STATA version 17. Bivariable and multivariable binary logistic regression were fitted to identify the explanatory variables.</p><p><strong>Results: </strong>The incidence of postoperative ileus at hospitals in Bahir Dar was 16.27% (95% CI: 12.19%, 21.38%). Age > 60 years (adjusted odds ratio (AOR) = 3.81, 95% CI: 1.41, 10.33), BMI < 18.5 kg/m² (AOR = 11.54, 95% CI: 67.55), and intestinal surgery (AOR = 3.27, 95% CI: 1.01, 11.77) were significantly associated with postoperative ileus. On the other hand, being female was associated with a decreased likelihood of postoperative ileus (AOR = 61%, AOR = 0.39, 95% CI: 0.15, 0.97).</p><p><strong>Conclusion: </strong>Postoperative ileus among patients who underwent major abdominal surgery in Bahir Dar was comparable with global reports. Old age, low body mass index, and intestinal surgeries were significant determinant factors for postoperative ileus. Being female is associated with a decreased likelihood of postoperative ileus.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"102"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651623","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":"Application of chain body temperature management checklist in robotic surgery for urology: a randomised controlled trial.","authors":"Yue Guo, Rui-Xia Hao, Hong-Xia Duan, Na Xu, Ling Wei, Xiu-Mei Wang","doi":"10.1186/s12893-025-02816-w","DOIUrl":"10.1186/s12893-025-02816-w","url":null,"abstract":"<p><strong>Objective: </strong>To explore the management effect of a chain temperature management checklist in preventing hypothermia in patients undergoing urological robotic surgery during the perioperative period.</p><p><strong>Methods: </strong>A total of 152 patients undergoing urological robotic surgery were enrolled in this study between March and September 2021 and again between March and September 2022. All patients were randomly divided into the control group (n = 76) and the intervention group (n = 76). The incidence of hypothermia and chills were compared between the two groups of patients, as well as implementation omission rates, thermal comfort scores and nurse satisfaction scores, following the construction and implementation of a chain temperature management checklist.</p><p><strong>Results: </strong>The incidence of hypothermia and chills in the intervention group (10.5% and 13.2%, respectively) was lower than that in the control group (38.2% and 40.8%, respectively). The implementation omission rate in the intervention group (1.3%) was also lower than that in the control group (30.3%). The thermal comfort score in the intervention group (8.76 ± 1.31) was higher than that in the control group (5.78 ± 1.43). Additionally, the nurse satisfaction score was higher in the intervention group (98.89 ± 2.43) than in the control group (89.57 ± 3.75). The differences were all statistically significant (p < 0.05).</p><p><strong>Conclusion: </strong>Using a chain temperature management checklist in the temperature management of patients undergoing urological robotic surgery can reduce the incidence of low body temperature and shivering, decrease the rate of implementation omissions and improve patient thermal comfort and nurse satisfaction.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"101"},"PeriodicalIF":1.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634772","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":"Indications and clinical outcomes of percutaneous cholecystostomies in acute cholecystitis: a study from Qatar.","authors":"Mohamed Said Ghali, Syed Muhammad Ali, Khadija Jaffar Siddig Gibreal, Rajvir Singh, Mona S Shehata, Raed M Al-Zoubi, Ahmad Zarour","doi":"10.1186/s12893-025-02765-4","DOIUrl":"10.1186/s12893-025-02765-4","url":null,"abstract":"<p><strong>Introduction: </strong>Acute cholecystitis (AC) is a prevalent condition in emergency departments (EDs). Standard care involves early laparoscopic cholecystectomy; however, in cases of delayed presentation, high surgical risk, or during situations like the COVID-19 pandemic, percutaneous cholecystostomy (PC) serves as an alternative management strategy. This study reports our center's experience with PC in managing AC, providing insights from a unique geographical context.</p><p><strong>Methods: </strong>We conducted a retrospective review of 97 patients undergoing PC operation from June 1, 2016, to January 1, 2021. The data collected included demographic details, indications for PC, clinical outcomes, ICU admissions, overall mortality, and long-term follow-up.</p><p><strong>Results: </strong>The cohort comprised 61.9% male patients with a mean age of 67.2 ± 15.5 years. The primary comorbidity was hypertension (83.5%), and 88.6% had an ASA (American Society of Anesthesiologists) score of ≥ III. The main cause of AC was calculous type, and 15.2% of cases were acalculous cholecystitis. Main Tokyo Guidelines 18 (TG 18) grade was grade II and was found in 56.4% of patients. The readmission rate was 33.1% and overall mortality rate was 34% during follow-up. The native population in Qatar were older and burdened with more co-morbidities. High risk of surgery was the main indication for PC, followed by delayed presentation of AC. Patients with delayed presentations were younger (p = 0.051), had higher albumin levels (p = 0.005), and had lower ICU admission rates (p = 0.002) and mortality (p = 0.014) than those with multiple comorbidities. The overall Mortality rates post-PC were 34%, predominantly attributed to underlying conditions rather than the PC procedure itself. Patients who proceeded to post-PC cholecystectomy were younger, had higher albumin levels, and experienced fewer readmissions (p < 0.05).</p><p><strong>Conclusion: </strong>In high-risk patients or when surgical risk is prohibitive, PC is a viable and effective alternative for AC management. Post-PC cholecystectomy was associated with favorable outcomes, suggesting PC as a bridge to surgery in selected patients. This study highlights the role of PC in a high-risk population within our regional setting.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"100"},"PeriodicalIF":1.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634788","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":"Clinical efficacy of allograft bone combined with calcium phosphate bone powder in repairing bone defects of benign bone tumors: A retrospective controlled study.","authors":"Qiang Liu, Jianping Zheng, Long Ma, Dawei Chu, Zongqiang Yang, Ningkui Niu, Jiandang Shi","doi":"10.1186/s12893-025-02823-x","DOIUrl":"10.1186/s12893-025-02823-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of repairing bone defects caused by benign bone tumors using allograft bone combined with calcium phosphate bone powder.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 55 patients (aged 10-61 years, mean 35 ± 13.2) with benign bone tumors treated at our hospital from June 2020 to December 2022. The bone defects in these cases were created after surgical curettage of the tumor lesions, which included common benign tumors such as osteochondroma, giant cell tumor of bone, and enchondroma. Patients were divided into two groups based on bone graft materials: a simple allograft bone group (n = 30) and a combined group using allograft bone with calcium phosphate bone powder (n = 25). Preoperative data, surgical time, intraoperative blood loss, postoperative complications, imaging findings, limb function, and quality of life (KPS scores) were analyzed.</p><p><strong>Results: </strong>All 55 patients were followed for 12-30 months (mean 13.45 ± 5.18). All incisions healed by primary intention without complications such as graft nonunion, fractures, or tumor recurrence. The combined group showed a significantly shorter healing time (t = 4.280, P < 0.05) and higher KPS scores at 6 months postoperatively (X² = 3.646, P < 0.05) compared to the simple group. However, no significant differences were observed between groups in healing rate, residual bone defects, or limb function at 12 months postoperatively (P > 0.05).</p><p><strong>Conclusion: </strong>Allograft bone combined with calcium phosphate bone powder is superior to allograft bone alone for repairing bone defects following curettage of benign bone tumors, promoting faster healing and better postoperative functional recovery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"99"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical long-term outcomes of Hirschsprung Disease in the Democratic Republic of Congo: a case series of 31 patients in a resource-limited setting.","authors":"Fabrice Gulimwentuga Cikomola, Arsene Daniel Nyalundja, Alliance Wani Bisimwa, Bijoux Safi Matabaro, Franck Masumbuko Mukamba, Costa Musilimu Sudi, Paul Budema Munguakonkwa, Leon-Emmanuel Mukengeshayi Mubenga, Kinja Nyamugabo, Désiré Munyali Alumeti, Théophile Kabesha, Marc Miserez, Dieudonné Mushengezi Sengeyi","doi":"10.1186/s12893-024-02684-w","DOIUrl":"10.1186/s12893-024-02684-w","url":null,"abstract":"<p><strong>Background: </strong>Hirschsprung disease (HD) contributes significantly to the burden of disease related to conditions amenable to pediatric surgery within the Democratic Republic of Congo (DRC). However, it has received less clinical attention due to limited resources. We aimed at assessing the long-term follow-up outcomes following an innovate resection approach in South Kivu, eastern DRC.</p><p><strong>Methods: </strong>In this case series, the authors elucidate the admissions for HD spanning from 2016 to 2021 at a Pediatric Surgical Center in the DRC. All patients underwent surgical management. Due to the absence of an extemporaneous biopsy, the resection margin was defined by a formula developed by the authors: 5 cm for patients under 5 years, 5 cm plus 1 cm per age from 6-10 years, and 5 cm plus 0.5 cm per age above 10 years. Post-operative mortality and complication rates were equally computed. Descriptive statistics were calculated for continuous variables. Discharge-to-Follow-up data were visualized using time-to-event curves.</p><p><strong>Results: </strong>Thirty-one patients aged 195 (interquartile range: 18-669) days were included in this study. Thirteen (58.93%) were from mining areas. The patients were surgically managed and follow-up for a year. 6.45% died in the 30-day post-operative period and 19.35% were lost to follow-up. The complaints were recorded from the fourth month following the surgery with most of the patients complained about fecal soiling (58.06%). The overall complaint rate was 80% (95%CI:56.20%-90.69%). The overall rate of incontinence was different compared to those with fecal soiling (p = 0.04). Although lacking statistical significance, the length of stay (LoS) post-surgery predicting an 9% increased incidence of complaints during the follow-up period (adjusted Hazard Ratio: 1.09, 95% CI:0.97-1.23).</p><p><strong>Conclusion: </strong>HD cause avertable morbidity in South Kivu. These data suggest that the long-term outcome in HD can be mitigated through appropriate surgical management during the operative and intervention aimed at optimizing the LoS.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"96"},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617806","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 characteristics of surgical site infection with class I incision in neurosurgery.","authors":"Yifei Li, Ling Gao, Shanhong Fan","doi":"10.1186/s12893-025-02825-9","DOIUrl":"10.1186/s12893-025-02825-9","url":null,"abstract":"<p><strong>Objective: </strong>Surgical site infections (SSIs) were recognized to be the most common complication of neurological surgery, with substantial life quality threats to patients and additional cost burdens to healthcare facilities. This study sought to expound the infection characteristics of class I incision and provide clinical indication for the prevention and treatment of SSIs.</p><p><strong>Methods: </strong>A 2-year retrospective analysis was conducted according to patients who performed neurological surgery with class I incision in a tertiary comprehensive hospital in Shaanxi Province, China. Case mix index (CMI)-adjusted and national nosocomial infection surveillance (NNIS) risk index-adjusted SSI rate were utilized for analytical standardization. The SSIs were specifically analyzed according to various departments, surgeons, and surgical classifications.</p><p><strong>Findings: </strong>6046 surgical cases were finally included in our study. The majority of the American Society of Aneshesiologists (ASA) score and NNIS risk index of surgeries were allocated in level 2 and score 1. Our study found 121 SSI cases, with the crude infection rate of 2.00%. 95.04% were organ/space infection. The most of the infection were found in the surgeries with score 1 (68.60%) of the NNIS risk index. The main surgical classification was resection of space occupying lesions (61.96%). The highest crude and NNIS risk index adjusted infection were individually found in hybrid operation (11.67%) and endoscopy-assisted resection of space occupying lesions (13.33%). 21 of 54 surgeons were found to have SSIs. We found the main pathogenic bacteria was Staphylococcus epidermidis (22.81%), and the commonly prophylactic used antibiotics was Cefazolin (51.95%).</p><p><strong>Conclusion: </strong>Our study found the main infection was among surgeries with score 1 of NNIS risk index and the surgical classification of endoscopy-assisted resection of space occupying lesions. We indicated specific attention should be paid to the surgeon and surgical classification with highest infection rate to control and prevent SSIs.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"97"},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617807","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}