BMC Surgery最新文献

{"title":"Dose-dependent effects of heparin sodium injection in preventing peripherally inserted central catheter-related venous thrombosis during postoperative chemotherapy in non-small cell lung carcinoma patients.","authors":"Shanquan Li, Xiaolin Zhu, Shuang Liu, Yanting Ning","doi":"10.1186/s12893-025-02925-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02925-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the preventive effects of varying doses of heparin sodium injection on peripherally inserted central catheter (PICC)-related venous thrombosis during postoperative chemotherapy in patients with non-small cell lung carcinoma (NSCLC), and to analyze potential risk factors for the occurrence of venous thrombosis.</p><p><strong>Methods: </strong>This study was a single-center, single-blind, randomized controlled trial involving 425 NSCLC patients who underwent PICC placement at the Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital from July 2019 to July 2021. All patients received chemotherapy regimens of pemetrexed plus cisplatin or paclitaxel plus cisplatin. The patients were randomly divided into three groups: the control group (using 10 mL of 0.9% saline for catheter sealing), Group I (using 2 mL of 10 IU/mL heparin sodium injection for catheter sealing), and Group II (using 5 mL of 10 IU/mL heparin sodium injection for catheter sealing). The baseline characteristics of the three groups were compared using statistical methods, and Doppler ultrasound was performed on the 7th day after catheter placement to assess the occurrence of venous thrombosis. Further correlation analysis and multivariate logistic regression analysis were conducted to explore the risk factors for thrombosis.</p><p><strong>Results: </strong>The incidence rates of thrombosis in the three groups were 20.00% in the control group, 7.75% in Group I, and 2.10% in Group II, with statistically significant differences among the groups (P < 0.001). Additionally, correlation analysis of baseline characteristics and thrombosis occurrence revealed a significant association between different doses of heparin sodium injection and thrombosis (P < 0.001), while other baseline characteristics (such as age, sex, and weight) showed no significant differences in relation to thrombosis (P > 0.05). Multivariate logistic regression analysis indicated that heparin sodium injection was a protective factor against thrombosis, with Group I: OR = 0.312 (P = 0.003) and Group II: OR = 0.081 (P < 0.001), suggesting that the preventive effect was more pronounced in Group II. Safety evaluation did not reveal any severe adverse reactions.</p><p><strong>Conclusion: </strong>This study demonstrates that the use of heparin sodium injection is associated with a reduced incidence of PICC-related venous thrombosis in NSCLC patients during postoperative chemotherapy. At appropriate doses, heparin sodium injection exhibits favorable safety and may provide a potential clinical option for PICC patients at high risk of thrombosis.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"194"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993340","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 versus open distal gastrectomy with d2 lymphadenectomy in treatment of locally T4A gastric cancer: the protocol of a randomized controlled trial.","authors":"Tran Quang Dat, Dang Quang Thong, Doan Thuy Nguyen, Nguyen Viet Hai, Nguyen Lam Vuong, Nguyen Hoang Bac, Vo Duy Long","doi":"10.1186/s12893-025-02933-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02933-6","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) remains one of the leading causes of cancer-related mortality worldwide. While laparoscopic gastrectomy (LG) has been widely adopted for early and locally advanced gastric cancer (AGC), its safety and oncological efficacy in T4a GC remain unclear. To date, no randomized controlled trials have specifically examined the role of LG in the treatment of T4a GC. This study aims to provide robust evidence comparing the short- and long-term outcomes of laparoscopic distal gastrectomy (LDG) versus open distal gastrectomy (ODG) in resectable T4a GC.</p><p><strong>Methods: </strong>This is a phase III, randomized controlled, non-inferiority trial. Patients with clinical T4a GC (cT4aN0-3M0) suitable for distal gastrectomy with D2 dissection will be randomly assigned in a 1:1 ratio to undergo either LDG or ODG. A total 240 patients (120 each group) are required to statistically show non-inferiority of the LDG with respect to the primary end-point, 3-years disease-free survival (DFS). Secondary endpoints include morbiity, mortality, postoperative recovery, and quality of life.</p><p><strong>Discussion: </strong>This study is the first prospective randomized trial specifically designed to compare laparoscopic and open approaches for T4a GC. By standardizing surgical techniques and ensuring experienced surgeons perform the procedures, this trial aims to establish whether LDG can provide equivalent oncological outcomes while reducing perioperative morbidity and enhancing postoperative recovery. The findings will provide high-quality evidence to inform future guidelines and clinical decision-making in the management of T4a gastric cancer.</p><p><strong>Trial registration: </strong>This study is registered at ClinicalTrials.gov (NCT04384757), version 6. Registration Date: 08/05/2020.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"193"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048965","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":"Safety and efficacy of flexible articulated instrument (ArtiSential^®) in laparoscopic surgery for rectal cancer.","authors":"Jong-Sung Ahn, Jesung Park, Seung-Bum Ryoo, Min-Jung Kim, Ji-Won Park, Seung-Yong Jeong, Kyu-Joo Park","doi":"10.1186/s12893-025-02841-9","DOIUrl":"https://doi.org/10.1186/s12893-025-02841-9","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery for rectal cancer remains challenging because of limited joint motion during dissection in the deep and narrow pelvis. Handheld multiarticulated instruments have been developed to address these limitations. This study aimed to assess the safety and efficacy of a flexible articulated instrument, the ArtiSential^® (Livsmed Co, Korea), at reducing the duration of laparoscopic rectal cancer surgery.</p><p><strong>Study design: </strong>We retrospectively reviewed patients who underwent laparoscopic low or ultralow anterior resection for primary mid to low rectal cancer (tumor distance from anal verge, ≤ 10 cm) performed by a single surgeon in 2012-2022. Patients were divided into groups based on the use of ArtiSential^® or straight device, and their clinical characteristics, surgical procedures, pathological findings, postoperative complications, and survival outcomes were analyzed.</p><p><strong>Results: </strong>The study included 93 patients (articulating group, 32; straight group, 61). Low anterior resection was predominant in both groups, while operative time was significantly shorter in the articulating group (148.08 ± 49.72 vs. 188.13 ± 57.86; p = 0.003). Total mesorectal excision quality and resection margin status did not differ between groups. Postoperative complications, including anastomotic leakage, length of hospital stay, 3-year recurrence-free survival rate (90.6% vs. 88.5%, p = 0.760), and overall survival rate (100% vs. 85.2%, p = 0.092), did not differ between groups.</p><p><strong>Conclusion: </strong>Use of the flexible articulated instrument (ArtiSential^®) can reduce operative time without impairing surgical quality or oncologic outcomes. These results suggest that laparoscopic rectal cancer surgery can be performed safely and effectively using a flexible articulated instrument.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"192"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048966","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 predictive efficacy of dynamic level changes of plasma endothelial microparticles and plasma soluble thrombomodulin on the prognosis of severe acute pancreatitis.","authors":"Hu Chen, Xiao Yuan","doi":"10.1186/s12893-025-02929-2","DOIUrl":"https://doi.org/10.1186/s12893-025-02929-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive efficacy of dynamic level changes of plasma endothelial microparticles (EMP) and plasma soluble thrombomodulin (sTM) on the prognosis of severe acute pancreatitis (SAP).</p><p><strong>Methods: </strong>This study retrospectively selected 128 eligible SAP patients admitted to our hospital from May 2021 to April 2023. According to the final outcome, the patients were grouped as the survival group (n = 95) and death group (n = 33). The EMP, sTM and microcirculation related indexes (lactic acid level, central venous pressure (CVP), mean arterial pressure (MAP)) of SAP patients were monitored at admission, 24 h, 48 h and 72 h after admission. Pearson was adopted to analyze the correlation between EMP and sTM levels with microcirculation disorder related indicators. The levels of EMP and sTM were compared between the survival group and the death group. The EMP high level group was ≥ 150.00 ng / mL, and the EMP low level group was < 150.00 ng / mL. The sTM high-level group was ≥ 300.00 ng / mL, and the low-level group was < 300.00 ng / mL. The differences in survival curves between different groups were compared by Kaplan-Meier. AUC was used to analyze the prognostic value of EMP and sTM levels alone and in combination in SAP patients.</p><p><strong>Results: </strong>Compared with admission, the levels of EMP, sTM, lactic acid and CVP in 128 SAP patients were all significantly increased at 24 h, 48 h and 72 h after admission, but the MAP was largely decreased (p < 0.05). EMP and sTM were positively correlated with lactic acid and CVP respectively, but negatively correlated with MAP (p < 0.05). The death group had much higher levels of EMP and sTM than the survival group (p < 0.05). From the perspective of 1-year survival rate, the high-level group of EMP was lower than the low-level group (p < 0.05) and the high-level group of sTM was lower than the low-level group (p < 0.05). ROC curve analysis confirmed that the sensitivity and specificity of combined detection were 92.39% and 90.54%, respectively, with the AUC of 0.903 (95%CI:0.863-0.928), which was significantly higher than that of single detection (p < 0.05).</p><p><strong>Conclusion: </strong>The levels of EMP and sTM were significantly increased in SAP patients, which were closely related to microcirculation disorders and poor prognosis. The combined detection of EMP and sTM has significant prognostic value in SAP.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"195"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023975","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":"Measurement of the femoral neck anteversion angle using a three-dimensional reconstruction in the fixed coordinate system based on the basal anterior cortex of the femoral neck: an observational study.","authors":"Ruibao Yang, Jie Lin, Guibin Han, Guangliang Jiang, Yingsheng Deng","doi":"10.1186/s12893-025-02860-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02860-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the accessibility of 3D reconstruction in the fixed coordinate system(3D-R-FCS) based on the basal anterior cortex of the femoral neck in measuring the femoral neck anteversion angle (FNAA).</p><p><strong>Methods: </strong>CT and EOS examinations were performed on 40 femoral samples synthesized by Sawbone. Two evaluators were responsible for measurement of the FNAA based on four different methods, including EOS 3D reconstruction, 3D-R-FCS, Reikerås, and Murphy methods.</p><p><strong>Results: </strong>Measurement of the FNAA based on EOS, 3D-R-FCS based on the basal anterior cortex of the femoral neck, and the Reikerås and Murphy methods were 6.53°±4.28°, 7.08°±4.58°, 3.03°±4.44°, and 11.9°±4.91°, respectively. No statistical difference was detected for the FNAA measurements between EOS and the 3D-R-FCS based on the basal anterior cortex of the femoral neck (P > 0.05). However, a statistical difference was detected between the Reikerås and Murphy methods and EOS (P < 0.05). The value of the ‌intraclass correlation coefficients (ICCs) for the 4 methods measured by evaluator A were 0.89, 0.99, 0.75, and 0.81, respectively, while the ICCs measured by evaluator B were 0.91, 0.98, 0.71, and 0.79, respectively. The correlation coefficients between the two evaluators were 0.89, 0.99, 0.75, and 0.83, respectively.</p><p><strong>Conclusion: </strong>The consistency of the scores for the FNAA measurement based on the 3D-R-FCS within and between the evaluators was the highest among the four methods and correlated well with the EOS measurement, which may potentially provide a more stable method for the measurement in clinical practice.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"190"},"PeriodicalIF":1.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994214","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":"Machine learning-based prediction of postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.","authors":"Qianchang Wang, Zhe Wang, Fangfeng Liu, Zhengjian Wang, Qingqiang Ni, Hong Chang","doi":"10.1186/s12893-025-02935-4","DOIUrl":"https://doi.org/10.1186/s12893-025-02935-4","url":null,"abstract":"<p><strong>Background: </strong>Clinically relevant postoperative pancreatic fistula (CR-POPF) following laparoscopic pancreaticoduodenectomy (LPD) is a critical complication that significantly worsens patient outcomes. However, the heterogeneity of its risk factors and the clinical utility of predictive models remain to be fully elucidated. This study aims to systematically analyze the risk factors for CR-POPF and develop an optimized predictive model using machine learning algorithms, providing an evidence-based approach for individualized risk assessment in patients undergoing LPD.</p><p><strong>Methods: </strong>A retrospective study was conducted, including 210 patients with periampullary cancer who underwent laparoscopic pancreaticoduodenectomy (LPD) at the Hepatobiliary Surgery Center, Olympic Stadium Campus, Shandong Provincial Hospital Affiliated to Shandong First Medical University, from January 2017 to January 2024. Patients were classified into the clinically relevant pancreatic fistula (CR-POPF) group (n = 34) and the non-clinically relevant pancreatic fistula (non-CR-POPF) group (n = 176) according to the 2016 criteria of the International Study Group of Pancreatic Surgery (ISGPS). Potential risk factors were identified through intergroup comparisons, and independent risk factors were determined using univariate and multivariate logistic regression analyses. Based on these findings, a predictive model for CR-POPF was developed using machine learning algorithms.</p><p><strong>Results: </strong>CR-POPF was associated with higher BMI, monocyte levels, platelet count, total bilirubin, AST, ALT, and lower albumin. Pathological diagnosis of ampullary carcinoma and soft pancreatic texture were significantly more common in the CR-POPF group. Multivariate analysis identified soft pancreatic texture as an independent predictor (OR = 4.99, 95% CI: 1.93-12.86). Among all models, the random forest model showed the best performance (AUC = 0.747, sensitivity = 0.917, specificity = 0.574), using only preoperative variables such as age, gender, BMI, hypertension, diabetes, hemoglobin, platelets, AST, and ALT.</p><p><strong>Conclusion: </strong>Soft pancreatic texture was identified as an independent risk factor for postoperative pancreatic fistula following laparoscopic pancreaticoduodenectomy (LPD). The random forest model based on preoperative clinical variables enables individualized risk prediction, offering value for preoperative planning and postoperative care.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"191"},"PeriodicalIF":1.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038995","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 retrospective cohort study comparing perioperative clinical outcomes and radiographic results between patients undergoing TLIF and OLIF surgeries.","authors":"Qingyang Huang, Weiguo Zhu, Peng Cui, Shuaikang Wang, Di Han, Peng Wang, Shibao Lu","doi":"10.1186/s12893-025-02920-x","DOIUrl":"https://doi.org/10.1186/s12893-025-02920-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the perioperative outcomes, clinical manifestations, and radiographic indicators in patients who underwent oblique lateral lumbar fusion (OLIF) and posterior instrumentation, compared with those who underwent posterior transforaminal lumbar interbody fusion (TLIF) and instrumentation.</p><p><strong>Methods: </strong>In this retrospective cohort analysis, elderly patients diagnosed with L4-5 lumbar spinal stenosis between July 2022 and July 2023 at our institution who underwent OLIF and posterior instrumentation (OLIF group), compared with those who underwent posterior TLIF and instrumentation (TLIF group). Enhanced Recovery After Surgery (ERAS) protocol was implemented for all patients. The perioperative data, patient-reported outcomes (PROs), radiographic assessments, and complications were gathered immediately after surgery and again at the 1-year follow-up. The perioperative outcomes and immediately postoperative and follow-up radiographic outcomes were compared between the two groups.</p><p><strong>Results: </strong>A total of 120 patients participated in this study, with 60 patients assigned to the OLIF group and 60 to the TLIF group. With respect to outcomes, the length of stay was notably shorter in the OLIF group compared to the TLIF group (P < 0.001). Patients in the OLIF group exhibited significantly reduced postoperative drainage volume (P < 0.001), first ambulation on the postoperative day (POD) (P < 0.001), drain placement duration (P < 0.001), and urinary catheter retention (P = 0.037) compared to those in the TLIF group. Furthermore, there were statistically significant differences between the two groups in the incidence of postoperative deep venous thrombosis (DVT) (1 vs. 8, P = 0.015), urinary tract infection (2 vs. 11, P = 0.008), pulmonary infection (2 vs. 10, P = 0.015), and nausea and vomiting (3 vs. 11, P = 0.023). With respect to radiographic measurements, At the 1-year follow-up, the posterior disc height (PDH) and intervertebral disc angle (IDA) demonstrated statistically increase in the OLIF group. The sagittal vertical axis (SVA) was statistically decrease and Lumbosacral lordosis (LL) was statistically increase in the OLIF group.</p><p><strong>Conclusion: </strong>OLIF was demonstrated to have significant advantages in terms of perioperative, clinical outcomes and radiographic parameters for L4-5 lumbar spinal stenosis for elderly patients, comapred with TLIF.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"188"},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036425","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":"Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study.","authors":"Ying Tang, Chun-Ling Fang, Jun-Rong Huang, Xiao-Mei Chen, Xin Cai, Jia Wu, Hui-Quan Hu, Jun Li, Yue-Xi Luo","doi":"10.1186/s12893-025-02906-9","DOIUrl":"https://doi.org/10.1186/s12893-025-02906-9","url":null,"abstract":"<p><strong>Background: </strong>This study was aimed at evaluating the postoperative outcomes of vaginal natural orifice transluminal endoscopic hysterectomy (vNOTEH).</p><p><strong>Methods: </strong>This prospective cohort study was conducted for comparing recovery outcomes, the time to first anal exhaust and return-to-work (RTW) time in vNOTEH versus laparoscopic hysterectomy (LH) groups. Linear regression analysis and cox proportional hazards regression were employed for analyzing the association between the recovery outcomes and surgical procedures.</p><p><strong>Results: </strong>Altogether 330 patients were enrolled, with 92 in vNOTEH group whereas 238 in LH group according to the surgical procedure. Among them, 22 patients undergoing vNOTEH and 76 patients receiving LH returned to work. The operation time, the first anal exhaust time, RTW time, postoperative hospitalization of vNOTEH group remarkably decreased relative to LH group (P<0.05). Linear regression analysis indicated that the vNOTES approach was related to the time to first anal exhaust. Besides, Kaplan-Meier curve demonstrated the shorter median time to first anal exhaust in vNOTEH group than that in LH group (48.0 h vs. 69.0 h, P < 0.001). For patients who returned to work, multivariate Cox logistic regression revealed that surgical approach and postoperative hospitalization were significantly related to the RTW time. Furthermore, Kaplan-Meier curve showed that the median RTW time significantly decreased in vNOTEH subgroup relative to that in LH subgroup (2.0 months vs.3.0 months, P = 0.011).</p><p><strong>Conclusions and relevance: </strong>vNOTES in women might be advantageous in the earlier recovery of intestinal function and the earlier return to work after hysterectomy compared with laparoscopy.</p><p><strong>Trial registration: </strong>This study has been registered at https://www.chictr.org.cn with registration NO. ChiCTR2200063125 on Sep 27, 2022. The minimal postoperative follow up period was 1 month.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"189"},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062844","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 potential for de-escalation radical surgery in women with stage IB2 cervical cancer (FIGO 2018): a multi-institutional experience of 63,926 cases over a 14-year period in China.","authors":"Jiaxin Fu, Pengfei Li, Jilong Yao, Zhonghai Wang, Shaoguang Wang, Qiubo Lv, Xiaonong Bin, Jinghe Lang, Chunlin Chen, Ping Liu","doi":"10.1186/s12893-025-02917-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02917-6","url":null,"abstract":"<p><strong>Objective: </strong>To compare the long-term survival outcomes, recurrence patterns and morbidity of type B and type C radical hysterectomy (RH) for stage IB2 cervical cancer (FIGO 2018).</p><p><strong>Methods: </strong>Based on FOUR-C database, patients who underwent type B or C RH in 47 hospitals from 2004 to 2018 were reviewed. Univariate and multivariate analyses were performed to compare 5-year overall survival (OS) and recurrence-free survival (RFS), recurrence patterns and morbidity between the two groups after propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 1308 patients were enrolled in this study, 840 and 468 patients underwent type B and type C. There was no difference in 5-year survival outcomes between groups type B and type C, either before or after matching (OS: unmatched 95.6% vs. 93.3%, matched 95.6 vs. 93.0%, P>0.05; RFS: unmatched: 90.5% vs. 90.1%, matched: 91.2% vs. 89.7%, P>0.05). Type B group had a shorter operative time, less blood loss, earlier recovery of intestinal function, eariler removal of catheter and shorter hospitalization (P<0.01). Intraoperative complications were similar (0.1% vs. 0.2%, P>0.05), but postoperative complications occurred more frequently in the type C group (8.3% vs. 12.1%, P < 0.05), especially lymphocysts and urinary retention. The surgical dissection does not appear to influence tumor recurrences significantly (P>0.05).</p><p><strong>Conclusions: </strong>For cervical cancer patients with stage IB2, type B RH demonstrated comparable long-term oncological outcomes and recurrence patterns to type C RH, while being associated with fewer intra-and postoperative complications. Type B RH is a feasible and appropriate surgical option, but the conclusions need to be confirmed by prospective studies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"187"},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009388","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":"Short- and long-term outcomes after perioperative EOX therapy versus upfront surgery for gastric cancer: a single-centre propensity score-matched cohort study.","authors":"Johan Back, Ville Sallinen, Akseli Bonsdorff, Arto Kokkola, Pauli Puolakkainen","doi":"10.1186/s12893-025-02919-4","DOIUrl":"https://doi.org/10.1186/s12893-025-02919-4","url":null,"abstract":"<p><strong>Introduction: </strong>Despite radical surgery, gastric cancer (GC) survival rates remain low in Western countries. Randomised trials suggest that perioperative chemotherapy downstages disease, improving long-term survival without increasing complications. We compared outcomes for upfront surgery (US) versus surgery combined with perioperative EOX (epirubicin, oxaliplatin, capecitabine) therapy for short- and long-term survival.</p><p><strong>Methods: </strong>We analysed 310 patients who underwent curative intent gastrectomy for GC at a single tertiary centre from 2006 to 2017. Patients were assigned to the EOX group (n = 105) or the US group (n = 205). Propensity score matching (PSM) was utilised to balance baseline characteristics, clinical stage, surgery type, and histology. Short-term outcomes included the Comprehensive Complication Index (CCI) and 30-day mortality, while long-term outcomes were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS).</p><p><strong>Results: </strong>After PSM, 102 patients remained in each group. The EOX group exhibited significantly lower preoperative haemoglobin levels compared to the US group, but other baseline characteristics were comparable. Tumour-related outcomes favoured the EOX group, with significantly smaller tumours (P < 0.001), fewer metastatic lymph nodes (P = 0.004), and lower tumour stages overall. Splenectomy was more common in the US group (40.2% versus 23.5%, P = 0.011). Postoperative complications were similar between groups, although ICU admissions were more frequent in the EOX group (16.7% versus 6.9%, P = 0.030). Thirty-day mortality rates were low and comparable (1.0% in the EOX group versus 2.0% in the US group, P = 1.000). Long-term outcomes, including overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS), showed no significant differences between the groups.</p><p><strong>Conclusions: </strong>Perioperative EOX therapy is as safe as upfront surgery and significantly reduces metastatic lymph nodes and tumour size, suggesting its role in downstaging the disease. However, despite these promising oncological responses, this benefit does not translate into improved long-term survival.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"184"},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044958","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}