BMC Surgery最新文献

{"title":"Comparative study of the learning curves for percutaneous endoscopic interlaminar lumbar discectomy and unilateral biportal endoscopy techniques.","authors":"Weidong Guo, Shikong Guo, Xiaoping Zhang, Weiliang Zhang, Guifeng Xia, Bo Liao","doi":"10.1186/s12893-025-02951-4","DOIUrl":"10.1186/s12893-025-02951-4","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive spinal surgery techniques, such as Percutaneous Endoscopic Interlaminar Lumbar Discectomy (PEID) and Unilateral Biportal Endoscopy (UBE), have been developed to reduce surgical morbidity and enhance patient recovery. Although both techniques demonstrate promising clinical outcomes, the learning curves required for surgeons to achieve proficiency with these methods remain unclear.</p><p><strong>Objective: </strong>To compare the learning curves of PEID and UBE in the treatment of lumbar disc herniation.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 173 patients who underwent either PEID (n = 94) or UBE (n = 79), performed by two independent surgeons between January 2020 and January 2022. Eligible patients were aged 18-75 years, diagnosed with lumbar disc herniation, and had no previous spinal surgeries at the affected level. Metrics analyzed included operative time, intraoperative blood loss, postoperative recovery, complication rates, and clinical outcomes, assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores.</p><p><strong>Results: </strong>The PEID group demonstrated significantly shorter operative times (99.96 ± 34.74 min vs. 116.52 ± 47.20 min, P < 0.05) and less blood loss (20.85 ± 11.06 ml vs. 80.19 ± 22.81 ml, P < 0.01) compared to the UBE group. Both techniques showed significant improvements in VAS and ODI scores postoperatively, with no significant differences between the groups at any follow-up points. Learning curve analysis revealed that operative times for PEID stabilized at approximately 70 min after about 40 cases, while UBE stabilized at around 65 min after approximately 35 cases. Complication rates were low, and patient satisfaction was high in both groups. According to the Modified MacNab criteria, 83% of patients in the PEID group and 79.7% in the UBE group achieved excellent outcomes, while only 5.3% and 3.8% of patients experienced fair or poor outcomes in the PEID and UBE groups, respectively.</p><p><strong>Conclusion: </strong>Both PEID and UBE are effective minimally invasive techniques for the treatment of lumbar disc herniation, offering comparable clinical outcomes and low complication rates. However, PEID is associated with shorter operative times and reduced intraoperative blood loss. Understanding the learning curves of these techniques is crucial for surgeons to improve proficiency and optimize patient outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"210"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of hysterectomy types and approaches on oncological survival in 2023 FIGO stage II endometrial carcinoma.","authors":"Jianhao Sun, Zhenzhen Wu, Jiayu Chen, Qinglei Hang, Yaqin Zhao, Juan Li, Jie Huang, Xiaoli Zhao, Ji Xia, Xinjuan Jiao, Qing Liu, Dan Lu","doi":"10.1186/s12893-025-02937-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02937-2","url":null,"abstract":"<p><strong>Background: </strong>The objective is to investigate the relationship between the type and approaches of hysterectomy and the oncological survival outcomes in women diagnosed with stage II endometrial carcinoma (EC), as classified by the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with 2009 FIGO early-stage (stages I and II) EC who underwent surgical treatment between 2018 and 2019. These patients were reclassified in accordance with the 2023 FIGO staging system, and those diagnosed with stage II EC under this system were selected as the study population. A non-inferiority test was employed for the analysis, with disease-free survival (DFS) serving as the primary outcome measure. DFS was evaluated using Kaplan-Meier curves, and comparisons were conducted through the log-rank test.</p><p><strong>Result: </strong>A cohort of 288 patients diagnosed with early-stage EC according to the 2009 FIGO staging system were re-evaluated and reclassified. Ultimately, the study encompassed a cohort of 80 patients diagnosed with stage II EC, as classified according to the 2023 FIGO staging system. 52 individuals underwent radical hysterectomy or modified radical hysterectomy (RH/mRH), while 28 patients received a simple hysterectomy (SH). The 5-year DFS was 84.62% for the RH/mRH group vs. 92.86% for the SH group (difference, 8.24% [95% CI, -5.44-21.92%]), which met the noninferiority criterion. Between the groups, the difference in 5-year DFS (p = 0.255) was not statistically significant. The laparoscope group comprised 62 cases, whereas the laparotomy group consisted of 18 cases. Between the groups, the difference in 5-year DFS (88.55% versus 83.33%, p = 0.538) was not statistically significant. This finding aligns with our observations of patients diagnosed with 2009 FIGO Stage II EC.</p><p><strong>Conclusion: </strong>In comparison to SH, RH/mRH did not confer a survival advantage for patients diagnosed with 2023 FIGO stage II EC.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"209"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081512","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 management of Caroli disease in a low-mid income country: a single-center study and review of literature.","authors":"Soukayna Bourabaa, Talha Laalou, Abderrahman Mansouri, Mohamed Hamid, Abdellatif Settaf","doi":"10.1186/s12893-025-02948-z","DOIUrl":"10.1186/s12893-025-02948-z","url":null,"abstract":"<p><strong>Introduction: </strong>Caroli disease is an uncommon congenital condition characterized by non-obstructive intrahepatic bile duct dilation. When coupled with liver fibrosis or cirrhosis, it is termed Caroli syndrome. This disorder can lead to the development of gallstones, inflammation of the bile ducts, and an elevated susceptibility to cholangiocarcinoma. Typically, Caroli disease presents with involvement in less than 20% of the liver, predominantly affecting a single lobe (either left or right). Monolobar disease can often be effectively addressed through liver resection, while bilobar disease may necessitate the consideration of liver transplantation.</p><p><strong>Methods: </strong>A retrospective study was undertaken involving patients diagnosed with Caroli disease who underwent liver resection. The research included cases from Surgery B Department at Ibn Sina University Hospital in Rabat, covering the period from January 2010 to January 2023.</p><p><strong>Results: </strong>Nine patients who underwent liver resection for Caroli disease were identified, with an average age of 54 years (range: 17-76), and 44.4% (n = 4) being females. The study comprised 6 cases with disease limited to the left lobe and 3 to the right. The average time interval between initial symptoms and the definitive diagnosis was 4 years (range: 0-24 years). Surgical procedures included left lobectomy in 4 cases, left hepatectomy in 3 cases, right hepatectomy in 1 case, and sub-segmentectomy in 2 cases. Biliodigestive anastomosis was performed in 4 cases. Complications occurred in 2 patients (22.2%), and synchronous cholangiocarcinoma was observed in a single case (11.1%).</p><p><strong>Conclusion: </strong>Consideration of Caroli disease as part of the differential diagnosis is crucial in cases of recurrent cholangitis. Liver resection stands out as the treatment of choice for patients with localized Caroli disease. The critical importance of early intervention is highlighted by the potentially fatal consequences of delayed diagnosis or treatment.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"214"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081431","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":"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}

{"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 R² = 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}

{"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}

{"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}

{"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}

{"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}

{"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}