BMC Surgery最新文献

{"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}

{"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}

{"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}

{"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}

{"title":"The accuracy of C-ARM in evaluating pelvic incidence and lumbar lordosis during surgery compared with EOS radiography after lumbar fixation.","authors":"Hasan Toghraei Semiromi, Mohammadreza Chehrassan, Mansour Bahardoust, Hasan Ghandhari, Abbas Esmaeli, Farshad Nikouei","doi":"10.1186/s12893-025-02921-w","DOIUrl":"https://doi.org/10.1186/s12893-025-02921-w","url":null,"abstract":"<p><strong>Background: </strong>Achieving the global spinal alignment, especially the pelvis, in spine surgeries is considered the most important factor in the success of these surgeries, which requires an accurate evaluation of the correction angles measured during surgery. This study aimed to evaluate the accuracy of the mobile C-arm X-ray machine (C-ARM) for measuring lumbar lordosis (LL) and pelvic incidence (PI) parameters during lumbar fixation.</p><p><strong>Methods: </strong>In this prospective study, 59 lumbar fixation candidates who underwent surgery between 2020 and 2022 at our medical center, were examined. PI and LL parameters were measured at the fusion site with fluoroscopy, during surgery with C-ARM, and after surgery with EOS locally.</p><p><strong>Results: </strong>The mean age was 54.69 ± 17.62 years. 42 (71.2%) were female. The mean PI based on intraoperative C-ARM and post-surgery EOS findings were 54.57 ± 11.19 and 54.83 ± 11.17, respectively, which this difference was not statistically significant (P = 0.9). The mean LL estimate based on C-ARM and EOS findings was similar (P: 0.44).A significant positive linear correlation was observed for the mean PI (r: 0.97, p: 0.001) and LL (r: 0.99, p: 0.001).</p><p><strong>Conclusion: </strong>The mean PI and LL angle during operation (measured with C-ARM) was similar to the mean of these parameters in EOS imaging findings after surgery. C-ARM can be used as a convenient device in the operating room with high precision to measure PI and LL values in spine surgeries.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"197"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056179","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 impact of death and dying on surgeons in a tertiary cancer centre in Singapore.","authors":"Si Ying Tan, Jun Rong Tan, Yun Ting Ong, Yaoyi Ng, Annushkha Sinnathamby, Nur Amira Binte Abdul Hamid, Simon Yew Kuang Ong, Lalit Kumar Radha Krishna","doi":"10.1186/s12893-025-02881-1","DOIUrl":"https://doi.org/10.1186/s12893-025-02881-1","url":null,"abstract":"<p><strong>Background: </strong>Demands upon surgeons are increasing, especially in the care of the terminally ill. Fronting patient care, supporting families and guiding multi-disciplinary care teams facing the loss of patients see surgeons experiencing moral distress, compassion fatigue, vicarious trauma and secondary traumatic stress with the blurring of professional and personal boundaries. The full extent of these 'costs of caring' upon a surgeon remains unclear despite evidence of their compromises to patient care. To understand the costs of caring, semi-structured interviews are proposed to achieve the primary aim of understanding 'What is known about the costs of caring on surgeons in Singapore?' and the secondary aim, 'What is the impact of the costs of caring on a surgeon's professional identity?'.</p><p><strong>Methods: </strong>Twelve surgeons of various subspecialties from a tertiary cancer centre in Singapore were interviewed between 21st June 2022 and 18th December 2023. Transcripts were analysed using Krishna's Systematic Evidence-Based Approach.</p><p><strong>Results: </strong>The key domains identified were: (1) motives for surgical career; (2) forms of emotional distress experienced; (3) impact of challenging experiences on personhood; and (4) buffer mechanisms.</p><p><strong>Conclusions: </strong>The costs of caring impact surgeons' professional identities; shape their 'internal compasses' or the way they deliberate and assess their responsibilities; and influence patient safety and family support. The costs of caring and the 'internal compass' are moulded by the surgeon's traits, maturing competencies, growing insights, clinical experience and sociocultural context. Without holistic, longitudinal and personalised support in both the personal and professional spheres, the costs of caring compromise surgeons' confidence and professional identities.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"196"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044961","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}