BMC Surgery最新文献

{"title":"Heart-shaped tension-reducing suturing versus conventional interrupted suturing alleviates perineal pain, accelerates resolution of suture reactions, and improves scar quality in primiparous women undergoing perineal repair.","authors":"Ju Li, Ling Li, Hui Zhou, Ya Nan Shao, Hong Mei Zhu, Yue Ning Zhu, Jing Wang, Tie Cheng Sun, Li Lin","doi":"10.1186/s12893-026-04050-4","DOIUrl":"10.1186/s12893-026-04050-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of the heart-shaped tension-reducing suture (HSTRS) versus interrupted suture (IS) in scar quality and postoperative pain relief in primiparous women.</p><p><strong>Methods: </strong>In this study, 142 women were allocated to HSTRS (n = 61) or IS (n = 81). Pain score was assessed via NRS at multiple timepoints; suture reactions were graded (0-III), and scar quality was evaluated using VSS, OSAS, and PSAS at 42 days, 90 days, and 180 days.</p><p><strong>Results: </strong>The HSTRS group showed significantly lower pain scores (P < 0.0001), faster resolution of suture reactions, and superior scar outcomes across all scales and timepoints (P < 0.01).</p><p><strong>Conclusions: </strong>HSTRS significantly improves perineal scar quality, alleviates postoperative perineal pain, and accelerates resolution of suture reactions compared with interrupted suturing, supporting its application for better postpartum perineal recovery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473826","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":"Free-style perforator-based hatchet flap: a novel and innovative approach for superior aesthetic outcomes in facial defect reconstruction.","authors":"YiChun Ding, TingTing Wang, Lin Zhang, Hao Ding, XinYi Li, XiaoJing Li","doi":"10.1186/s12893-026-04054-0","DOIUrl":"10.1186/s12893-026-04054-0","url":null,"abstract":"<p><strong>Background: </strong>The face, with its distinct subunits, demands particularly high aesthetic standards for defect reconstruction. Although traditional hatchet flaps are commonly used, they are limited by a constrained rotation arc and susceptibility to dog-ear deformities, compromising aesthetic outcomes. This study introduces and investigates a novel free-style perforator-based hatchet flap technique designed to overcome these limitations and enhance aesthetic outcomes.</p><p><strong>Patients and methods: </strong>Patients treated at a single center between October 2020 and April 2024 were included. The key innovation involves preoperative Doppler ultrasound mapping of perforating vessels combined with a \"free-style\" design principle, liberating the flap from constrained rotation and reducing the risk of dog-ear deformities associated with traditional hatchet methods. This approach enables an increased rotational arc. Outcomes were evaluated at follow-up using the Visual Analog Scale (VAS), Observer Scar Assessment Scale (OSAS), and Patient Scar Assessment Scale (PSAS).</p><p><strong>Results: </strong>This retrospective analysis included 65 patients (32 free-style, 33 traditional). All free-style flaps survived, whereas partial necrosis occurred in three traditional flaps. The free-style group showed improved aesthetic outcomes, including higher VAS scores, lower OSAS scores, shorter mean scar length, and lower PSAS scores, indicating greater patient satisfaction with scar appearance.</p><p><strong>Conclusion: </strong>The free-style perforator-based hatchet flap, facilitated by preoperative perforator mapping, was associated with better aesthetic outcomes and higher patient satisfaction compared to the traditional technique in this retrospective cohort.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473740","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":"Correction: Early outcomes of total hip arthroplasty using point-of-care manufactured patient-specific instruments: a single university hospital's initial experience.","authors":"Hieu Pham Trung, Nang Vo Sy Quyen, Nam Vu Tu, Dung Tran Trung, Toan Duong Dinh","doi":"10.1186/s12893-026-04024-6","DOIUrl":"10.1186/s12893-026-04024-6","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473801","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 incidence, causes, risk factors, and predictive nomogram of 30-day unplanned reoperation after spinal surgery: a multi-center retrospective study.","authors":"Jiao Jiao Dai, Wei Chen Dong, Shuo Wang, Yu Xin Tian, Da Ming Liu, Pan Li, Zi Xiang Wu, Wei Lei, Yang Zhang, Hai Yang Qiu","doi":"10.1186/s12893-026-04031-7","DOIUrl":"10.1186/s12893-026-04031-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aims to elucidate the demographic characteristics, incidence, causes, and risk factors of unplanned reoperations post-spinal surgery (URPS) within 30 days, and to develop and validate a nomogram-based prediction model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively analysed data from patients who underwent spinal surgery at three tertiary hospitals between January 2013 and January 2023, with a particular focus on those requiring unplanned reoperation within 30 days postoperatively. Demographic characteristics, incidence rates, and temporal patterns of URPS were assessed. A detailed review of causes and presenting symptoms across different postoperative intervals was also performed. Furthermore, we investigated risk factors for URPS and constructed a predictive nomogram.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 77,026 individuals included, 476 cases of URPS within 30 days were identified, comprising 258 males (54.2%) and 218 females (45.8%). Patient ages ranged from 4 to 84 years, with a mean of 48.98 ± 14.75 years. The overall incidence of URPS was 0.62%, showing a gradual annual increase. The leading causes were surgical site infection (SSI) and symptomatic epidural haematoma (SEH), which predominantly manifested as signs of surgical infection, radicular pain, and motor paralysis. The acute phase (postoperative days 2-10) represented the most critical period for symptom presentation, whereas SEH occurred mainly during the hyper-acute phase (days 0-1). Independent risk factors for URPS included drinking (p = 0.027, OR: 1.36, 95% CI: 1.040-1.790), diabetes mellitus (DM) (p &lt; 0.001, OR: 2.056, 95% CI: 1.580-2.676), length of hospital stay (LOS) ≥ 7 days (p &lt; 0.001, OR: 2.269, 95% CI: 1.566-3.288), first operation time (FOT) ≥ 3 h (p = 0.008, OR: 1.396, 95% CI: 1.093-1.783), drainage volume (DV) ≥ 300 ml (p &lt; 0.001, OR: 5.156, 95% CI: 3.854-6.899), and disease type (DT) (p &lt; 0.001, OR: 1.571, 95% CI: 1.382-1.787). The predictive nomogram demonstrated good discriminative ability, with an area under the receiver operating characteristic curve (AUC) of 0.752 (95% CI: 0.726-0.778). Calibration curves showed excellent agreement between predicted and observed probabilities (Hosmer-Lemeshow test, p = 0.892, Brier score = 0.185, R&lt;sup&gt;2&lt;/sup&gt; = 0.232), and decision curve analysis (DCA) confirmed net clinical benefit across a wide range of threshold probabilities. Patients who experienced URPS had significantly higher nomogram scores than those who did not (p &lt; 0.001), validating the model's risk-stratification capacity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study delineates the incidence, causes, and independent risk factors for URPS within 30 days. The newly developed nomogram exhibits good discrimination, favourable calibration, and superior net clinical benefit, enabling accurate individualized prediction of short-term unplanned reoperation. This predictive tool can assist clinicians in preoperative risk str","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457519","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 and safety of low-temperature plasma ablation combined with collagenase in the treatment of lumbar disc herniation.","authors":"Deng-Hui Li, Gao-Feng Wu, Ze-Yu Huang, Zhong-Hua Zhang","doi":"10.1186/s12893-026-04022-8","DOIUrl":"10.1186/s12893-026-04022-8","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) is a common cause of radicular pain and disability. Evidence regarding the incremental effectiveness of combining plasma-based intradiscal decompression with collagenase chemonucleolysis remains limited.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included consecutive hospitalized adults with imaging-confirmed LDH treated between July 2021 and July 2025. Patients underwent low-temperature plasma ablation alone (control group, n = 108) or plasma ablation plus intradiscal collagenase (observation group, n = 116). The primary outcomes were longitudinal Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores assessed at baseline, 1 week, 1 month, 3 months, and 6 months. Linear mixed-effects models evaluated treatment group, time, and group × time interactions after adjustment for clinical and imaging covariates. Secondary outcomes included clinically meaningful improvement, symptomatic imaging-confirmed recurrence, reintervention, perioperative characteristics, and complications. Propensity score matching and sensitivity analyses were performed.</p><p><strong>Results: </strong>VAS and ODI scores decreased over time in both groups (both time effects, P < 0.001), with significant group × time interactions for VAS (P = 0.002) and ODI (P = 0.006). At 6 months, the adjusted mean differences favored the observation group for VAS (- 0.54; 95% CI, - 0.81 to - 0.27) and ODI (- 5.10% points; 95% CI, - 7.47 to - 2.73). Six-month VAS responder rates were 91.2% and 96.3% (RR, 1.06; 95% CI, 0.98-1.13), while ODI responder rates were 83.2% and 91.6% (RR, 1.10; 95% CI, 0.99-1.22), respectively. Recurrence and reintervention were numerically less frequent in the observation group, but confidence intervals were wide and crossed 1. Overall complications occurred in 11.1% and 7.8% of patients, respectively (RR, 0.70; 95% CI, 0.31-1.59).</p><p><strong>Conclusions: </strong>Plasma ablation combined with intradiscal collagenase was associated with modestly lower VAS and ODI scores over 6 months than plasma ablation alone. Differences in clinically meaningful response rates were not statistically significant, and low event numbers precluded firm conclusions regarding recurrence, reintervention, or comparative safety.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457610","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":"Laparoscopic enterolithotomy for large gallstone ileus in an elderly high-risk patient: a case report.","authors":"Marei Alshandeer","doi":"10.1186/s12893-026-04045-1","DOIUrl":"10.1186/s12893-026-04045-1","url":null,"abstract":"<p><strong>Background: </strong>Gallstone ileus is an uncommon complication of cholelithiasis leading to mechanical small bowel obstruction that typically affects geriatric populations with significant baseline medical conditions. The optimal management approach is highly debated, specifically when choosing between simple emergency enterolithotomy alone or a complex one-stage definitive biliary procedure in high-risk patients.</p><p><strong>Case presentation: </strong>A 79-year-old male with an ECOG performance status of 2, ASA Class IV risk classification, and known severe ischemic heart disease presented with acute mechanical small bowel obstruction. Preoperative contrast-enhanced computed tomography (CT) and subsequent emergency laparoscopic exploration identified an oversized, calcified intraluminal gallstone measuring 7 × 4 cm impacted within the terminal ileum. A laparoscopic enterolithotomy was successfully performed without a concomitant biliary intervention. The immediate postoperative course was complicated by an acute non-ST-elevation myocardial infarction (NSTEMI) detected via postoperative ECG. Following successful stabilization, the patient recovered gastrointestinal function and was safely discharged home after one week with structured outpatient cardiology follow-up.</p><p><strong>Conclusions: </strong>This case shows that an isolated laparoscopic enterolithotomy can serve as a technically feasible option for large gallstone ileus in selected high-risk patients when executed by experienced hands. However, clinicians must maintain extensive vigilance regarding perioperative cardiovascular strain, as the surgical resolution of obstruction must be balanced against severe potential cardiac complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450181","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":"Feasibility and outcomes of emergency laparoscopic TAPP repair for strangulated inguinal hernia.","authors":"Osman Gökhan Gökdere, Sacit Altuğ Kesikli","doi":"10.1186/s12893-026-04044-2","DOIUrl":"10.1186/s12893-026-04044-2","url":null,"abstract":"<p><strong>Background: </strong>The use of laparoscopy for strangulated inguinal hernia remains controversial, especially when bowel ischemia is suspected. This study evaluated the feasibility and outcomes of emergency laparoscopic TAPP repair in patients with strangulated inguinal hernia and examined preoperative factors associated with bowel resection.</p><p><strong>Methods: </strong>We reviewed all patients who were first treated laparoscopically for a strangulated inguinal hernia from April 2024 to December 2025. If laparoscopic reduction failed and conversion was needed, those cases were described separately. The same TAPP technique was used for all, with either a 12 × 15 cm or 15 × 15 cm polypropylene mesh fixed with nonabsorbable tacks. We used univariable analysis to look at factors linked to bowel resection, and described recurrence during follow-up.</p><p><strong>Results: </strong>Of the 62 patients initially approached laparoscopically, 11 (17.7%) required conversion to open repair because reduction was not possible. Two of these 11 needed bowel resection due to bowel ischemia. The main group for analysis included 51 patients who had a completed TAPP repair. Bowel resection was needed in 5 of these patients (9.8%; 95% CI 3.3-21.4%). Longer symptom duration and higher CRP levels were strongly linked to needing bowel resection. During a median follow-up of 16 months (IQR, 10.5-20 months), 6 patients (11.8%; 95% CI 4.4-23.9%) had recurrence. There were no deaths.</p><p><strong>Conclusion: </strong>Emergency laparoscopic TAPP repair appears feasible and safe in well-chosen patients with strangulated inguinal hernia, as long as laparoscopic reduction is possible. Longer symptoms and higher CRP levels were linked to a greater need for bowel resection, but these findings should be viewed with caution because of the small number of cases. These findings support a laparoscopic-first approach in appropriately selected patients, but more research from larger, multicenter studies is needed to confirm these findings and improve patient selection.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450202","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":"Diagnostic confirmation of adult sinonasal rhabdomyosarcoma through comprehensive immunohistochemical profiling: a case report.","authors":"Bijan Khademi, Alireza Yousefi, Milad Bagheri, Shayan Yousufzai, Negar Fatehi","doi":"10.1186/s12893-026-04032-6","DOIUrl":"10.1186/s12893-026-04032-6","url":null,"abstract":"<p><strong>Background: </strong>Adult sinonasal rhabdomyosarcoma (RMS) is an exceptionally rare and aggressive malignancy originating from mesenchymal cells. It poses a significant diagnostic challenge due to its morphological and immunohistochemical overlap with other small round blue cell tumors, such as neuroendocrine carcinoma and olfactory neuroblastoma. Accurate diagnosis requires a high index of suspicion, advanced imaging, and comprehensive histopathology aided with immunohistochemistry (IHC) for specific myogenic markers like Myogenin and MyoD1.</p><p><strong>Case presentation: </strong>A 27-year-old male presented with recurrent epistaxis and headache. MRI revealed an enhancing ethmoidal mass with intracranial extension. Following endoscopic surgery, initial pathology suggested neuroendocrine carcinoma. However, a detailed IHC panel showed strong nuclear positivity for MyoD1 and myogenin, confirming RMS. The tumor had a high Ki-67 index (~ 70%). FISH testing was negative for FOXO1 rearrangement, favoring embryonal subtype. Postoperative imaging confirmed complete resection. The patient received adjuvant chemotherapy and radiotherapy.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic difficulty of sinonasal RMS. A definitive diagnosis is contingent upon integrating imaging findings with histopathology and an extensive IHC panel to identify myogenic differentiation. Once confirmed, prompt, multimodal therapy administered through a specialized multidisciplinary center is critical for managing this aggressive neoplasm and optimizing patient outcome.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438747","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 ERAS compliance and postoperative outcomes after right colectomy for colon cancer: a single-center cohort study.","authors":"Mustafa Anıl Turhan, Suleyman Utku Celik, Mehmet Ali Koc, Kaan Sunter, Suheyla Karadag Erkoc, Menekse Ozcelik, Sevda Unver, Neslihan Alkis, Cihangir Akyol","doi":"10.1186/s12893-026-04038-0","DOIUrl":"10.1186/s12893-026-04038-0","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) protocols improve perioperative care in colorectal surgery; however, evidence specifically linking ERAS compliance to outcomes after right colectomy is limited. This study aimed to evaluate the association between overall and phase-specific ERAS compliance and postoperative outcomes after elective right colectomy for colon cancer.</p><p><strong>Methods: </strong>This retrospective analysis of a prospectively maintained institutional ERAS database included consecutive adults who underwent elective standard or extended right colectomy for colon cancer between January 2021 and December 2025. Compliance was assessed at the patient level using 24 predefined ERAS elements across pre-admission, preoperative, intraoperative, and postoperative phases. The primary outcome was length of stay (LOS), and the secondary outcome was major postoperative complications (Clavien-Dindo grade ≥IIIa). Correlation analyses, group comparisons using a prespecified 75% overall compliance threshold, and multivariable logistic and linear regression analyses were performed.</p><p><strong>Results: </strong>Among 151 included patients, 76 (50.3%) developed any postoperative complication, 14 (9.3%) had major postoperative complications, and 10 (6.6%) were readmitted within 30 days. Overall ERAS compliance was inversely correlated with LOS (ρ = -0.329, p < 0.001). Preoperative (ρ = -0.248, p = 0.002) and postoperative (ρ = -0.301, p < 0.001) phase-specific compliance were also associated with shorter LOS. Patients with overall compliance ≥ 75% had shorter LOS than those with lower compliance, whereas major complication rates were similar. In exploratory multivariable analysis, higher preoperative compliance was independently associated with lower odds of major postoperative complications (OR 0.936, 95% CI 0.884-0.991; p = 0.024). Older age (B = 0.183, p = 0.022) and lower overall compliance (B = -0.265, p = 0.006) were independently associated with longer LOS.</p><p><strong>Conclusions: </strong>Higher ERAS compliance was associated with shorter length of stay, though the contribution of postoperative compliance may partly reflect recovery status rather than an independent causal effect. Higher preoperative adherence was independently associated with lower odds of major complications in exploratory multivariable analysis. These findings support strengthening preoperative optimization and consistent pathway execution to improve recovery after right colectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A four-year analysis of the predictors of overnight stay in day-case laparoscopic cholecystectomy and the prevention strategies within two centers in the UK: a double-centric retrospective observational study.","authors":"Mohamed Abuahmed, Rahi Karmarkar, Muhammad Naeem, Rahel Rashid, George Eskandar, Merene Varghese, Mayank Mishra, Jeremy Wilson, Conor Magee","doi":"10.1186/s12893-026-03867-3","DOIUrl":"10.1186/s12893-026-03867-3","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the mainstay treatment of benign gallbladder disease, most commonly gallstones. Although the recent guidelines of British Association of Day-Surgery (BADS) and World Society of Emergency Surgery (WSES) recommend same-day discharge (i.e. day-case surgery), there is still a considerable proportion of cases that get admitted unexpectedly overnight. The primary aim of this study is to determine the predictors of overnight stay and consequently develop prevention strategies.</p><p><strong>Materials and methods: </strong>This was a retrospective study involving 913 patients who underwent intended day-case LC between 2020 and end of 2023, in two centers in the UK; Wirral University Teaching Hospitals (WUTH) and the Royal Wolverhampton (RWT) NHS Trusts using electronic data records. We evaluated the predictors of overnight stay among demographics, indication of surgery, as well as the predictors of conversion to open surgery, which absolutely resulted in unexpected admission.</p><p><strong>Results: </strong>Nine hundred and thirteen patients were included in this study. Increased age, female gender and anesthesia ASA III grade patients were found to be predictors of unexpected admission (p < 0.001). In addition, the presence of acute cholecystitis and CBD stones as indications for surgery predicted overnight stay as well (p < 0.001). Moreover, age and the presence of choledocholithiasis/cholangitis (post ERCP/ passes out stones) were associated with conversion to open surgery, which resulted in 100% overnight stay (p = 0.013, p = 0.004, respectively), where older patients and those who had CBD stones had 1.05 times and 6.79 times higher odds of conversion, respectively. Furthermore, increased age and male gender were more likely to have a drain inserted (p = 0.004, p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Although many of the predictors of overnight stay insertion were non-modifiable risks like age, gender and ASA grade, strictly following the guidelines concerning the management of postoperative symptoms like pain, nausea and vomiting as well as the prioritisation of day-cases in the operative list may play a role in avoiding overnight stay. Nevertheless, these factors did not significantly alter the outcomes in our study.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438780","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}