BMC Surgery最新文献

{"title":"Single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) for bilateral inguinal hernia repair: initial experience.","authors":"Qing Huang, Xiaojun Wang, Li Hu, Xionghua Xiang, Changlei Qi, Ting Fei, Encheng Zhou","doi":"10.1186/s12893-024-02626-6","DOIUrl":"10.1186/s12893-024-02626-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to introduce and assess the safety and feasibility of single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) for bilateral inguinal hernia repair.</p><p><strong>Method: </strong>Forty-two SIL-TPP procedures for bilateral inguinal hernia repair were conducted from June 2018 to July 2022 at the First Affiliated Hospital of Ningbo University using standard laparoscopic instruments and a single-port device. Clinical data such as demographic intraoperative parameters and short-term postoperative outcomes were collected and analysed.</p><p><strong>Results: </strong>SIL-TPP was successful in 42 bilateral inguinal hernia patients, and no conversion occurred. Of these 42 patients, 38 were males and 4 were females. The average age was 57.4 ± 17 years. The participants' mean BMI was 22.67 ± 2.19 kg/m2 (range from 18.65 to 28.71 kg/m2). There were 4 types of bilateral hernias. The percentage of patients who underwent surgery before the SIL-TPP procedure in the same region was 21.43% (9/42). The mean operative time was 114 ± 34.24 min (range, 70-215 min). A total of 11 intraoperative complications occurred in 42 bilateral inguinal hernia patients, including unintentional peritoneum tears and hernia sac tears. No major complications occurred in the study. The postoperative complication rate was 2.38% (1/42). One patient experienced intestinal obstruction after the operation that resolved spontaneously without treatment. The surgical time in the SIL-TPP group decreased gradually as the number of operations increased. Moreover, the operation time trend decreased linearly (P < 0.0001, R²=0.42).</p><p><strong>Conclusion: </strong>SIL-TPP is a safe and feasible procedure for treating bilateral inguinal hernias. The SIL-TPP procedure requires distinct skills and has specific advantages in treating bilateral hernias. Large-scale randomized controlled studies comparing SIL-TPP with conventional single-port and three-port laparoscopic TEP for bilateral inguinal hernia are needed to confirm these results.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"386"},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787423","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 application value of 5 Fr non-contact hysteroscopy in the diagnosis and treatment of intrauterine diseases in perimenopausal and postmenopausal women.","authors":"Jun Huang, Cunsi Yin, Junli Wang","doi":"10.1186/s12893-024-02680-0","DOIUrl":"10.1186/s12893-024-02680-0","url":null,"abstract":"<p><strong>Objective: </strong>To explore the application value of 5 Fr non-contact hysteroscopy in the diagnosis and treatment of intrauterine diseases in perimenopausal and postmenopausal women.</p><p><strong>Methods: </strong>A total of 200 perimenopausal and postmenopausal patients who were to undergo hysteroscopy for intrauterine diseases from October 2022 to January 2024 were selected as the research objects, and the clinical data were retrospectively analyzed. According to the different treatment methods, these subjects were divided into a 5Fr non-contact hysteroscopic group (5Fr group) and a traditional hysteroscopic group (traditional group), with 100 cases in each group. The surgery-related indicators, postoperative-related indicators, intraoperative/postoperative disease diagnosis, and satisfaction of the patients in the two groups were compared.</p><p><strong>Results: </strong>Compared with the traditional group, the examination time of the 5Fr group was significantly shortened, and the proportion of intraoperative bleeding ≤ 5 mL was significantly increased (P < 0.05). Compared with the traditional group, the proportion of abnormal heart rate/blood pressure and nausea/vomiting, and pain score were significantly reduced in the 5Fr group (P < 0.05), while the proportion of postoperative bleeding time ≤ 1 week and postoperative abdominal pain time ≤ 2 h were significantly increased in the 5Fr group (P < 0.05). The satisfaction rate of the 5Fr group was 91.00% (41.00% relatively satisfied + 50.00% very satisfied), which was much higher than 75% (37.00% relatively satisfied + 38.00% very satisfied) in the traditional group (P < 0.05).</p><p><strong>Conclusion: </strong>5Fr non-contact hysteroscopy had similar clinical effects to the traditional hysteroscopy, and the 5Fr non-contact hysteroscopy technology made up for the shortcomings of the traditional hysteroscopy, which could significantly reduce the pain and intraoperative bleeding of patients, and improve patient satisfaction.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"384"},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of CUSUM analysis in assessing learning curves in robot-assisted sacrocolpopexy performed by experienced gynecologist.","authors":"Kena Park, Ji Young Kwon, Eun-Hee Yoo, Seon Hwa Lee, Jeong Min Song, Seung Yeon Pyeon","doi":"10.1186/s12893-024-02691-x","DOIUrl":"10.1186/s12893-024-02691-x","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the learning curve of robotic-assisted sacrocolpopexy by applying CUSUM analysis based on operation time, complication rate and conversion rate to open laparotomy.</p><p><strong>Methods: </strong>A retrospective study was conducted with 50 consecutive robotic-assisted sacrocolpopexy surgeries performed from June 2018 and June 2023 by a single experienced gynecologist. Baseline patient demographics, intraoperative parameters and postoperative outcomes were collected. Cumulative sum (CUSUM) of robotic-assisted sacrocolpopexy operation time was analyzed to determine breakpoints between learning phases using piecewise linear regression. This allowed the detection of subtle shifts in surgical parameters and ultimately surgeon proficiency and competency. Continuous variables, such as age, length of hospitalization and op time, were reported as mean (standard deviation). One-way analysis of variance was employed to compare continuous variables. Categorical variables were expressed as percentages and analyzed using the chi-square test.</p><p><strong>Results: </strong>The regression identified breakpoints at case 8.47 (95% CI 8.0, 9.0) and case 34.41 (95% CI 32.7, 36.1), with an R² value of 0.87, which agrees with that of the second-order polynomial equation. The breakpoints were rounded to the next whole number at case 9 and 35. The Learning, Proficiency, and Competency phases consisted of 9, 26, and 15 cases, respectively in this consecutive series. This suggests that the surgeon achieved proficiency after the first 9 cases and competency after 35 cases. There were no intraoperative nor short-term post-operative complications during the span of this study. Furthermore, there were no conversions to open laparotomy. CUSUM analysis based on complication and conversion rate, therefore, was not available.</p><p><strong>Conclusion: </strong>According to CUSUM analysis, surgical proficiency of robotic-assisted sacrocolpopexy was attained after the first 9 cases, and stabilization of operation time was achieved after 35 cases. This statistical tool has proven to be useful in objectively assessing learning curves for new surgical techniques, and the transition from laparoscopic sacrocolpopexy to robotic-assisted sacrocolpopexy seems achievable. This, however, may vary with each surgeon's manual dexterity and experience level. Further investigation with several surgeons and institutions is needed to define a more accurate and generalized learning curve of robotic-assisted sacrocolpopexy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"385"},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781238","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 model for predicting AKI after cardiopulmonary bypass surgery in Chinese patients with normal preoperative renal function.","authors":"Xuan Lin, Li Xiao, Weibin Lin, Dahui Wang, Kangqing Xu, Liting Kuang","doi":"10.1186/s12893-024-02683-x","DOIUrl":"https://doi.org/10.1186/s12893-024-02683-x","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a predictive model for acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery in Chinese patients with normal preoperative renal function.</p><p><strong>Method: </strong>From January 1, 2015, to September 1, 2022, a total of 1003 patients were included in the analysis as a development cohort. We used the ratio of 7:3 to divide the patients into a training group (n = 703) and a testing group (n = 300). In addition, a total of 178 patients were collected as an external validation cohort from January 1, 2023, to May 1, 2023. In the training group, independent risk factors for postoperative AKI were identified through the least absolute shrinkage and selection operator (LASSO) regression and multifactor logistic regression analysis. A nomogram predictive model was then established. The area under the curve (AUC) of receiver operating characteristic (ROC) curve, as well as calibration curve and decision curve, were used for validation of the model.</p><p><strong>Results: </strong>Age, body mass index (BMI), emergent surgery, CPB time, intraoperative use of adrenaline, and postoperative procalcitonin (PCT) were identified as important risk factors for AKI after CPB surgery (P < 0.05). The nomogram predictive model demonstrated good discrimination (AUC: 0.772 (95%CI: 0.735 - 0.809), 0.780 (95% CI: 0.724 - 0.835), and 0.798 (95% CI: 0.731 - 0.865)), calibration (Hosmer and Lemeshow goodness of fit test: P-value 0.6941, 0.9539, and 0.2358), and clinical utility (the threshold probability values in the decision curves are respectively > 12%, > 10%, and 16% ~ 75%) in the training, testing, and external validation groups.</p><p><strong>Conclusion: </strong>The predictive model, which was established in Chinese patients with normal preoperative renal function, has high accuracy, calibration, and clinical utility. Clinicians can utilize this model to predict and potentially reduce the incidence of AKI after CPB surgery in the Chinese population.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"383"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774142","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 proximal gastrectomy with tubular esophagogastric anastomosis and total gastrectomy with Roux-en-Y reconstruction in the treatment of adenocarcinoma of the esophagogastric junction of Siewert type II/III at stage II.","authors":"Zhixing Zhang, Tiantian Zhao, Yixing Wang, Fei Xue, Yansong Pu, Qingguo Du, Yunhua Wu","doi":"10.1186/s12893-024-02685-9","DOIUrl":"10.1186/s12893-024-02685-9","url":null,"abstract":"<p><strong>Background: </strong>Tubular anastomosis is commonly used in proximal gastrectomy; however, its use in stage II esophagogastric conjugate cancer is currently unclear. In this study, we investigated the short- and long-term clinical outcomes of Siewert II/III adenocarcinoma of the esophagogastric junction after modified proximal gastrectomy with tubular esophagogastric anastomosis compared with total gastrectomy with Roux-en-Y reconstruction.</p><p><strong>Methods: </strong>We collected the clinical data of patients who underwent proximal gastrectomy tubular esophagogastric anastomosis (PG-TEA) and total gastrectomy Roux-en-Y reconstruction (TG-RY) from October 2015 to October 2018. The clinical characteristics, postoperative quality of life, nutritional status, and long-term survival outcomes of the two groups were compared.</p><p><strong>Results: </strong>There were 43 patients in the PG-TEA group and 80 patients in the TG-RY group, and there was no significant difference between the baseline data of the groups. The operation time of the PG-TEA group was shorter, there was less intraoperative bleeding, and the feeding time was earlier, which was conducive to postoperative recovery. Reflux esophagitis was more evident in the PG-TEA group than in the TG-RY group, and there was no significant difference in the incidence of anastomotic ulcers or other complications. Three months after surgery, the nutritional status of the PG-TEA group was better than the TG-RY group. By the 6th postoperative month, there was no significant difference between the two groups. Regarding quality of life, the PG-TEA group was superior to the TG-RY group in terms of diarrhea and dumping syndrome. In addition, the PG-TEA group had higher satisfaction with daily life and higher-quality meals. There was no significant difference in overall survival between the two groups.</p><p><strong>Conclusions: </strong>Proximal gastrectomy tubular gastroesophageal anastomosis is a surgical procedure for stage II Siewert type II and III AEG. It achieves similar clinical outcomes to those after total gastrectomy and can be further applied in the clinic.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"382"},"PeriodicalIF":1.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755658","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":"Evolution of minimally invasive cholecystectomy: a narrative review.","authors":"Changjin Nam, Jun Suh Lee, Ji Su Kim, Tae Yoon Lee, Young Chul Yoon","doi":"10.1186/s12893-024-02659-x","DOIUrl":"10.1186/s12893-024-02659-x","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy, being a prevalent abdominal surgical procedure, has transitioned through various innovative stages aimed at reducing the procedure's invasiveness. These stages encompass Single-Incision Laparoscopic Cholecystectomy (SILC), Mini Laparoscopic Cholecystectomy (MLC), Natural Orifice Transluminal Endoscopic Surgery (NOTES), and Robotic-Assisted Laparoscopic Cholecystectomy (RALC). The purpose of this review is to trace the evolution of minimally invasive cholecystectomy techniques, assess their status, and identify emerging trends and challenges in the field.</p><p><strong>Method: </strong>An extensive review was performed to explore the evolution and characteristics of SILC, MLC, NOTES, and RALC. The approach involved an in-depth examination of literature available on PubMed, coupled with a critical assessment of surgical outcomes, associated complications, and technical hurdles posed by these methods.</p><p><strong>Results: </strong>SILC, despite its potential for reduced scarring, exhibits an elevated risk of bile duct damage and incisional hernia occurrences. MLC, mirroring the standard technique closely, presents minor benefits without amplifying postoperative complications, hence, positing itself as a feasible choice for routine elective cholecystectomy. NOTES, although still facing technical challenges, the hybrid transvaginal procedure is gaining clinical interest. RALC, heralded for its augmented precision and dexterity, emerges as a potential future avenue, although necessitating further exploration to ascertain its efficacy and safety.</p><p><strong>Conclusion: </strong>The progression of laparoscopic cholecystectomy methodologies embodies the surgical society's aspiration to minimize invasiveness whilst enhancing patient outcomes. This review endeavors to offer a structured discourse on SILC, MLC, NOTES, and RALC, aspiring to aid the ongoing deliberation on the judicious selection of surgical techniques in clinical practice.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"378"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752141","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":"Incidental findings in preoperative computed tomography images of robotic-assisted total joint replacement: a multi-center retrospective study.","authors":"Yutian Lei, Danqing Zhang, Sen Luo, Ruomu Cao, Jian Wang, Yongping Cao, Hua Tian, Shigui Yan, Xu Gao, Peng Yan, Zeyu Liu, Yang Chen, Kunzheng Wang, Run Tian, Pei Yang","doi":"10.1186/s12893-024-02663-1","DOIUrl":"10.1186/s12893-024-02663-1","url":null,"abstract":"<p><strong>Background: </strong>The majority of robot-assisted total joint arthroplasties necessitate preoperative computed tomography (CT) scans. Incidental findings in these CT scans can introduce complexity into clinical treatment decisions. Consequently, this study sought to document the nature and frequency of incidental findings identified in preoperative CT imaging conducted for robot-assisted total joint arthroplasty, along with their impact on planned surgical procedures.</p><p><strong>Methods: </strong>This investigation constitutes a retrospective review encompassing patients who underwent primary robot-assisted total hip arthroplasty between January 2020 and January 2022 at the Second Affiliated Hospital of Xi'an Jiaotong University, the First Affiliated Hospital of Peking University, and Nanfang Hospital. It also includes patients who underwent robot-assisted total knee arthroplasty during the same period at the Second Affiliated Hospital of Xi'an Jiaotong University, the Third Affiliated Hospital of Peking University, Nanfang Hospital, and the Second Affiliated Hospital of Zhejiang University. All CT examinations were initially interpreted by proficient musculoskeletal radiologists. Subsequently, the findings in the examination reports, whether significant or non-significant, were compiled and categorized.</p><p><strong>Results: </strong>A total of 218 patients, median age 63, were evaluated; 90 had incidental findings (41.3%), with 56 (25.7%) significant. Males were more likely to have findings (P = 0.001). Nine needed additional imaging, and five required intervention.Our study highlights the impact of unexpected CT findings on surgical planning, which can delay or cancel surgeries and affect patient outcomes. It also urges surgeons to review medical histories and perform thorough examinations before surgery to prevent serious consequences.</p><p><strong>Conclusions: </strong>Radiologists often find incidental findings in preoperative CT scans for robot-assisted joint arthroplasty, with a 41.3% incidence rate. About 25.7% of these findings need physician follow-up, and under 5% require intervention, potentially causing delays or cancellations of procedures, while undetected findings could lead to fatal outcomes.Unexpected preoperative CT findings can enhance patient management and prevent complications, necessitating their inclusion in surgical protocols. Systematic assessment improves safety and outcomes, urging surgeons to review medical history and perform thorough examinations pre-surgery.</p><p><strong>Clinical trial registration: </strong>Clinical trial registration time: 19/05/2022, clinical trial registration number: ChiCTR2200060115.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"380"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755661","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 the cost and care outcomes by group related to the diagnosis of bariatric surgery.","authors":"Beatriz Böger, Guilherme de Souza Ribeiro, Bianca Fontana Aguiar, Jolline Lind, Anne Karine Bosetto Fiebrantz, Moacir Pires Ramos, João Henrique Felicio de Lima, Jaime Luis Lopes Rocha","doi":"10.1186/s12893-024-02682-y","DOIUrl":"10.1186/s12893-024-02682-y","url":null,"abstract":"<p><strong>Background: </strong>To conduct a comprehensive assessment of real patient data undergoing the procedure within a healthcare provider, integrating both costs and care stages related to bariatric surgery, emphasizing the relevance of analysis by Diagnosis-related group (DRG).</p><p><strong>Methods: </strong>Prospective study of patients coded by DRG within a network of providers accredited to a Brazilian healthcare provider. All patients coded with metabolic and bariatric surgery (MBS) between 01/2019 and 06/2023 and undergoing gastrectomy procedure were included for analysis. The cost base used was derived from administrative payment information of the healthcare provider. Analyses were presented as mean, median, and standard deviation. Levene, Student's t-test, Kendall's tau, and Pearson's chi-square tests were used.</p><p><strong>Results: </strong>The study included a total of 1408 patients who underwent MBS in four prominent hospitals in the area during the specified period. Among these patients, an average of 74.8% were female, with a mean age of 37.31 years and a mean body mass index (BMI) of 40.3 kg/m2. Furthermore, 88.9% of the patients underwent gastric bypass. Although there were few acquired complications during hospital admission there were vascular complications following infusion, transfusion, and therapeutic injection, 22.45% (n = 11), hemorrhage and hematoma complicating procedure not classified elsewhere, 8.16% (n = 4), leakage, 8.16% (n = 4), and one death during this study. There were 67 readmissions within 30 days (4,75%). The total costs incurred throughout the patient's journey, covering hospitalization and one-year post-procedure, exhibited a median value of $4,078.53. Additionally, a notable positive association was observed between post-discharge expenses and age, indicating a tendency for costs to rise as patients grow older.</p><p><strong>Conclusion: </strong>The identified results highlight the complexity and challenges associated with bariatric surgery, including patient management and substantial costs involved. Therefore, a more comprehensive and personalized approach in postoperative management and resource allocation may be necessary to optimize clinical and economic outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"381"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755659","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":"Impact of Intraoperative Nanocarbon Staining and parathyroid autotransplantation on parathyroid injury and recovery in adult thyroidectomy: a retrospective cohort study.","authors":"Chen Chen, Xiaole Wang, Gang Liu, Yi Huang","doi":"10.1186/s12893-024-02679-7","DOIUrl":"10.1186/s12893-024-02679-7","url":null,"abstract":"<p><strong>Background: </strong>Thyroid surgeries are intricate operations that carry the risk of damaging the parathyroid glands, which can result in hypocalcemia and potential long-term hypoparathyroidism. Innovative surgical techniques including Intraoperative Nanocarbon Staining (INS), aim to enhance the preservation of parathyroid glands. This study assesses the effectiveness of INS combined with parathyroid autotransplantation in reducing postoperative complications and preserving parathyroid function.</p><p><strong>Methods: </strong>This retrospective cohort study assessed patients aged ≥ 18 who underwent thyroid surgery at a tertiary care hospital from January 2017 to December 2022. We compared the incidence of postoperative parathyroid injury, recovery rates of parathyroid function, and the incidence of permanent hypoparathyroidism between groups. Data on patient demographics, diagnosis, surgical details, parathyroid hormone levels, and calcium levels were collected and analyzed using chi-square tests, t-tests, and logistic regression.</p><p><strong>Results: </strong>The study included 198 patients, with 101 in the intervention group and 97 in the control group. Baseline characteristics such as sex ratio, age, BMI, and preoperative calcium levels showed no significant differences between groups. The intervention group demonstrated a significantly shorter duration of intravenous calcium supplementation (median 2 vs. 3 days, p < 0.001) and higher calcium nadir levels (median 8.36 vs. 7.85 mg/dL, p < 0.001) compared to controls. Furthermore, the incidence of postoperative parathyroid injury and permanent hypoparathyroidism was lower in the intervention group (15.84% vs. 20.62%, p = 0.045 and 4.95% vs. 15.46%, p = 0.003, respectively). Multivariate analysis revealed factors such as Blood iPTH monitoring level (OR 1.053, 95% CI 1.009-1.099, P = 0.018) and surgery type (Near Total Thyroidectomy) (OR 0.447, 95% CI 0.202-0.990, P = 0.047) were positively associated with surgical success. The intervention group also showed higher surgery success rates (OR 2.054, 95% CI 1.017-4.150, P = 0.045).</p><p><strong>Conclusion: </strong>The application of INS and parathyroid autotransplantation during thyroidectomy significantly improves postoperative parathyroid gland function, reducing the incidence of permanent hypoparathyroidism. These findings support the incorporation of these techniques into standard surgical practice for thyroidectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"379"},"PeriodicalIF":1.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755660","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 qualitative [18F]FDG PET/CT in predicting clinical outcomes of post-surgical differentiated thyroid cancer patients with elevated thyroglobulin and negative radioiodine whole-body scan.","authors":"Le Ngoc Ha, Nguyen Thi Phuong, Mai Hong Son","doi":"10.1186/s12893-024-02675-x","DOIUrl":"10.1186/s12893-024-02675-x","url":null,"abstract":"<p><strong>Background: </strong>[¹⁸F]FDG PET/CT has been widely used as a diagnostic tool in detection and localization of recurrent non-avid radioiodine lesions in post-operative differentiated thyroid cancer (DTC) patients with elevated serum thyroglobulin but negative radioiodine whole-body scan (TENIS) syndrome. The aim of our study was to evaluate the role of [¹⁸F]FDG PET/CT in prediction on outcomes of these DTC patients.</p><p><strong>Methods: </strong>Post-operative DTC patients with TENIS syndrome were collected in the department of nuclear medicine, Hospital 108 from 2019 to 2023. Patients underwent [¹⁸F]FDG PET/CT with standard protocol following EANM guideline for tumor imaging version 2.0. The qualitative [¹⁸F]FDG PET/CT imaging characteristics were classified into three categories: (i) negative [¹⁸F]FDG PET/CT, (ii) minimal [¹⁸F]FDG PET/CT volume of lesions, (iii) extensive [¹⁸F]FDG PET/CT volume of lesions. Progression-free survival (PFS) and overall survival (OS) were the end point of the study. The prognosis of qualitative [¹⁸F]FDG PET/CT in predicting PFS and OS was illustrated by Kaplan-Meier survival analysis. The independent factors predicting PFS and OS were determined by univariate and multivariate analysis using logistic regression.</p><p><strong>Results: </strong>There were 164 consecutive patients, 51.2% female and 48.8% female. The most common histopathological type was papillary accounting for 91.5%. The median time of follow-up was 33.3 months, (range 6.57 - 82.5). There was 70 (36.6%) progressions and 12 (7.35%) deaths. Negative [¹⁸F]FDG PET/CT uptake patients had median PFS with median 57.1 months which was higher than that of minimal category (46.2 months), and extensive category (37.6 months) (p < 0,001). 1-year OS and 5-year OS in extensive PET/CT category was 97.8% and 86.2% respectively which were significantly lower than that of negative and minimal categories (p = 0.053). In multivariate analysis, age at the time of diagnosis, pulmonary, bone metastases and extensive [¹⁸F]FDG PET/CT volume of lesions were the independent factor predicting PFS. Bone metastasis was only the factor could predict OS in multivariate analysis.</p><p><strong>Conclusions: </strong>The minimal and negative [¹⁸F]FDG PET/CT categories had better prognosis than extensive category in PFS and OS. Extensive [¹⁸F]FDG PET/CT category was an independent factor for predicting PFS. Bone metastasis was only the independent factor that could predict both PFS and OS.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"377"},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733629","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}