BMC Surgery最新文献

{"title":"New technique of end to side two layered and stented duct to mucosa pancreaticojejunostomy with omental wrapping during Whipple operation.","authors":"Hesham A Elmeligy, Ahmed M Azzam, Yousra Ossama, Mahmoud Rady","doi":"10.1186/s12893-025-02893-x","DOIUrl":"10.1186/s12893-025-02893-x","url":null,"abstract":"<p><strong>Background: </strong>A leaking pancreaticojejunal anastomosis is typically the cause of major problems following pancreaticoduodenectomy. To stop fistula formation, omental flaps were positioned around the pancreaticojejunal anastomosis.</p><p><strong>Methods: </strong>Forty-eight individuals who had pancreaticoduodenectomy procedures performed between March 2022 and March 2024 were examined. Based on the placement of a stent and omental flaps around the pancreaticojejunal anastomosis, the patients were split into two groups: group A, consisting of twenty-four patients, did not get omental wrapping and stenting, and group B, consisting of twenty-four patients, received omental wrapping with stent inside the pancreaticojejunal anastomosis. To evaluate the efficacy of the omental flap operation in preventing postoperative pancreatic fistula and other complications, perioperative data from both groups was examined.</p><p><strong>Results: </strong>There were no discernible variations in the clinical traits of the two groups. Group B experienced considerably lower occurrences of postoperative pancreatic fistula (20.8% vs. 4.2%), post-pancreatectomy hemorrhage (4.2% vs. 0%), biliary fistula (4.2% vs. 0%), and delayed gastric emptying (12.5% vs. 4.2%). Group B had a considerably lower overall morbidity rate (41.7% vs. 8.3%) and shorter hospital stay (15.3 vs. 10.9 days) than to group A.</p><p><strong>Conclusion: </strong>Following pancreaticoduodenectomy, pancreatic stent and omental flaps around the pancreatic anastomosis can lower the risk of postoperative pancreatic fistula, post-pancrectomy bleeding, and delayed gastric emptying. This straightforward and efficient treatment can decrease the overall morbidity following pancreaticoduodenectomy.</p><p><strong>Trial registration: </strong>The trial registration was recorded as ClinicalTrial.gov Identifier No.: NCT06630910 on 10/05/2024. Our study also adheres to the Declaration of Helsinki.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"201"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing for cholecystectomy: unveiling insights from a decade-long study on acute cholecystitis and symptomatic cholecystolithiasis.","authors":"Azhy Muhammed Dewana, Amanj Jalal Namq, Baderkhan Saeed Ahmed, Ahmed Abdulkadir Baban","doi":"10.1186/s12893-025-02851-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02851-7","url":null,"abstract":"<p><strong>Background: </strong>Acute calculus cholecystitis affects 10 to 20% of untreated individuals. Thus, the surgical community has argued for decades over whether an earlier or later cholecystectomy is better for this condition.</p><p><strong>Objectives: </strong>To compare surgical results, morbidity, and mortality and determine the best timing for surgical intervention among patients with gallstones.</p><p><strong>Patients and methods: </strong>This prospective cohort study was conducted in Erbil Teaching Hospital, Erbil, Iraq, from January 2013 to December 2023 on 767 patients with acute cholecystitis or symptomatic cholecystolithiasis. Patients underwent various types of cholecystectomy (early, intermediate, late, and elective) based on when surgery was conducted after the onset of symptoms. Then, medical treatments were advised, and they were followed up for six weeks. Finally, patients' physical health, postoperative infection severity and complications were assessed, despite reporting patients' age, gender, operation type, chances of conversions, durations of procedure, and hospital stay.</p><p><strong>Results: </strong>Most patients were females (72.1%), experienced laparoscopic technique (98.44%), and had ASA II (n = 548, 71.44%). The mean age of patients was 48.40 ± 67.14 years, the mean operation time was 50 ± 30.89 min, and the mean hospitalization time before and after operation was 1.0 ± 0.47 and 2.75 ± 1.63 days, respectively. Most patients from the intermediate group (n = 83) opted for a postponed strategy. Chronic inflammation (grade 0 infection severity) was highest in most patients of the delayed (67.2%) and intermediate groups (53.01%). Most patients had no complications (score 0), and the least had severe complications.</p><p><strong>Conclusion: </strong>Delayed surgical intervention was harmless and may even be superior to immediate treatment for acute cholecystitis. The morbidity and mortality hazard remains high even in the most severe cases, especially for individuals who received early and intermediate therapy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"199"},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of topical moxifloxacin on therapeutic laparoscopy-induced wound healing: a double-blind, randomized clinical trial.","authors":"Behrooz Heydari, Ali Basiratian, Farahnaz Hoseinzade, Saeed Kargar, Vahid Ramezani, Amirhossein Zahmatkesh, Fatemeh Saghafi","doi":"10.1186/s12893-025-02932-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02932-7","url":null,"abstract":"<p><strong>Background: </strong>Wound healing is crucial for maintaining healthy skin and preventing complications. Topical administration is a preferred method for delivering therapeutic medicines at the surgery site, as it is simple, affordable, and does not result in systemic harm or antibiotic resistance. Moxifloxacin (MXF), a broad-spectrum antibiotic with anti-inflammatory effects, seems to be effective against bacteria and accelerates wound healing. This study aims to determine the therapeutic effect of topical MXF on wound healing after therapeutic laparoscopy.</p><p><strong>Methods: </strong>This double-blind clinical trial involved 80 patients with therapeutic laparoscopy-induced wounds, randomly assigned to either 0.5% MXF cream or placebo, 24 h after surgery. The primary outcome was wound healing assessment using the REEDA index. Patients were followed by 1, 3, and 5 days of inclusion.</p><p><strong>Results: </strong>Of the 80 study participants included, 50 were women (62.5%), with the mean (SD) age of the participants being 49.5 (19.8) years in the MXF group and 45.8 (17.8) years in the control group. The severity of redness, oedema, and discharge in the MXF group was significantly lower on the first, third, and fifth days of treatment. The case group showed a significant decrease in ecchymosis from the third day of treatment compared to the control group, and no significant difference was observed in wound approximation rate. Hence, topical MXF therapy yielded a significant decrease in REEDA index MXF (P-Value < 0.0001). No treatment-related serious adverse events occurred in the MXF group vs. the comparator group.</p><p><strong>Conclusions: </strong>The results of the current clinical trial demonstrated that the use of topical MXF could be a potential option to expedite therapeutic laparoscopy-induced wound healing by reducing redness, oedema, ecchymosis, and discharge with a satisfactory safety profile.</p><p><strong>Trial registration: </strong>IRCT20181208041882N5, 25/10/2021 ( https://en.irct.ir/trial/46768 ).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"198"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The accuracy of C-ARM in evaluating pelvic incidence and lumbar lordosis during surgery compared with EOS radiography after lumbar fixation.","authors":"Hasan Toghraei Semiromi, Mohammadreza Chehrassan, Mansour Bahardoust, Hasan Ghandhari, Abbas Esmaeli, Farshad Nikouei","doi":"10.1186/s12893-025-02921-w","DOIUrl":"https://doi.org/10.1186/s12893-025-02921-w","url":null,"abstract":"<p><strong>Background: </strong>Achieving the global spinal alignment, especially the pelvis, in spine surgeries is considered the most important factor in the success of these surgeries, which requires an accurate evaluation of the correction angles measured during surgery. This study aimed to evaluate the accuracy of the mobile C-arm X-ray machine (C-ARM) for measuring lumbar lordosis (LL) and pelvic incidence (PI) parameters during lumbar fixation.</p><p><strong>Methods: </strong>In this prospective study, 59 lumbar fixation candidates who underwent surgery between 2020 and 2022 at our medical center, were examined. PI and LL parameters were measured at the fusion site with fluoroscopy, during surgery with C-ARM, and after surgery with EOS locally.</p><p><strong>Results: </strong>The mean age was 54.69 ± 17.62 years. 42 (71.2%) were female. The mean PI based on intraoperative C-ARM and post-surgery EOS findings were 54.57 ± 11.19 and 54.83 ± 11.17, respectively, which this difference was not statistically significant (P = 0.9). The mean LL estimate based on C-ARM and EOS findings was similar (P: 0.44).A significant positive linear correlation was observed for the mean PI (r: 0.97, p: 0.001) and LL (r: 0.99, p: 0.001).</p><p><strong>Conclusion: </strong>The mean PI and LL angle during operation (measured with C-ARM) was similar to the mean of these parameters in EOS imaging findings after surgery. C-ARM can be used as a convenient device in the operating room with high precision to measure PI and LL values in spine surgeries.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"197"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of death and dying on surgeons in a tertiary cancer centre in Singapore.","authors":"Si Ying Tan, Jun Rong Tan, Yun Ting Ong, Yaoyi Ng, Annushkha Sinnathamby, Nur Amira Binte Abdul Hamid, Simon Yew Kuang Ong, Lalit Kumar Radha Krishna","doi":"10.1186/s12893-025-02881-1","DOIUrl":"https://doi.org/10.1186/s12893-025-02881-1","url":null,"abstract":"<p><strong>Background: </strong>Demands upon surgeons are increasing, especially in the care of the terminally ill. Fronting patient care, supporting families and guiding multi-disciplinary care teams facing the loss of patients see surgeons experiencing moral distress, compassion fatigue, vicarious trauma and secondary traumatic stress with the blurring of professional and personal boundaries. The full extent of these 'costs of caring' upon a surgeon remains unclear despite evidence of their compromises to patient care. To understand the costs of caring, semi-structured interviews are proposed to achieve the primary aim of understanding 'What is known about the costs of caring on surgeons in Singapore?' and the secondary aim, 'What is the impact of the costs of caring on a surgeon's professional identity?'.</p><p><strong>Methods: </strong>Twelve surgeons of various subspecialties from a tertiary cancer centre in Singapore were interviewed between 21st June 2022 and 18th December 2023. Transcripts were analysed using Krishna's Systematic Evidence-Based Approach.</p><p><strong>Results: </strong>The key domains identified were: (1) motives for surgical career; (2) forms of emotional distress experienced; (3) impact of challenging experiences on personhood; and (4) buffer mechanisms.</p><p><strong>Conclusions: </strong>The costs of caring impact surgeons' professional identities; shape their 'internal compasses' or the way they deliberate and assess their responsibilities; and influence patient safety and family support. The costs of caring and the 'internal compass' are moulded by the surgeon's traits, maturing competencies, growing insights, clinical experience and sociocultural context. Without holistic, longitudinal and personalised support in both the personal and professional spheres, the costs of caring compromise surgeons' confidence and professional identities.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"196"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}