BMC Surgery最新文献

{"title":"Scoring system for emergency surgery in acute appendicitis patients.","authors":"Baolin Wang, Kexi Liao, Jianbo Dai, Jiexin Wu, Youxiang Guo, Zhanxiang Lei, Qing Zhao, Zhigang Wang, Yongfeng Zhang, Shuguo Zheng","doi":"10.1186/s12893-025-03110-5","DOIUrl":"10.1186/s12893-025-03110-5","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency appendectomy is no longer the only treatment option for uncomplicated appendicitis. Currently, there is no scoring system to determine whether acute appendicitis requires surgical intervention. This study aimed to develop a scoring system for emergency surgery in acute appendicitis (SESAA).</p><p><strong>Methods: </strong>Acute appendicitis cases from five primary hospitals were retrospectively analyzed. Clinical and imaging characteristics were selected for multivariate logistic regression analysis and transformed into a scoring system. A small-scale clinical case validation was conducted.</p><p><strong>Results: </strong>A total of 1788 cases were ultimately included, with 341 in the unnecessary operation group and 1447 in the necessary operation group. Based on clinical and imaging characteristics, a scoring system with a maximum score of 14 points was established. Patients with scores of 9 or above had a 91.9% likelihood of requiring emergency appendectomy, while 77.6% of those with scores of 4 or below could be managed with conservative treatment using antibiotics. A clinical case application test of 48 cases verified that the sensitivity and specificity of this scoring system were 94.8% and 63.6%, respectively.</p><p><strong>Conclusion: </strong>The scoring system aids clinicians, particularly in primary hospitals, in rapidly identifying patients who require emergency appendectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"409"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139234","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":"Effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors: a randomized controlled trial.","authors":"Naile Akıncı","doi":"10.1186/s12893-025-03187-y","DOIUrl":"10.1186/s12893-025-03187-y","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors.</p><p><strong>Design: </strong>This was a randomized controlled, single-blind trial. This study was conducted in accordance with the CONSORT statement.</p><p><strong>Methods: </strong>This study was conducted between January and September 2023 and included 62 patients (study group = 31, control group = 31) who met the inclusion criteria and underwent laparoscopic living donor nephrectomy in the transplant service of a private hospital in Istanbul province. A power analysis was performed to calculate the sample size and the power of the study (G*Power 3.1). Study data were collected using a patient information form, a postoperative patient follow-up and evaluation form to record the total number of bolus requests and administrations via of boluses with the PCA device and additional analgesic needs, and the Visual Analog Scale (VAS). The data obtained in the study were analyzed on the SPSS 22.0 statistical software.</p><p><strong>Results: </strong>Additional analgesic requirements did not differ significantly between groups where progressive muscle relaxation exercises were applied and the VAS score and bolus requirement were significantly lower than in the control group (p < 0.05). Anxiety levels were also significantly reduced in the experimental group compared to both their pre-test scores and the control group (p < 0.05). Although the time to resume oral intake did not differ significantly between the groups (X² = 5.020; p = 0.170 > 0.05), the time to start mobilization was significantly earlier in the experimental group (X² = 8.808; p = 0.012 < 0.05). As a result of the study, it was found that progressive muscle relaxation exercises reduced postoperative pain, bolus requirements, and anxiety in patients undergoing living donor nephrectomy. Additionally, these exercises facilitated earlier mobilization following surgery.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT06394245 (registered on 25 April 2024).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"410"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139135","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":"Treatment of severe scalp avulsion injury through microsurgical vascular anastomosis, subarea multi-tubenegative pressure drainage, and anchoring sutures: a case report.","authors":"Longshan Zhou, Han Wang, Renchao Yu, Qingshan Chen","doi":"10.1186/s12893-025-03164-5","DOIUrl":"10.1186/s12893-025-03164-5","url":null,"abstract":"<p><strong>Background: </strong>Severe scalp avulsion injury is a rare and surgically challenging due to extensive wounds, calvarial exposure, and associated soft tissue damage. Historically, management has evolved from skin grafting to microsurgical replantation; however, the scarcity of reported cases hinders consensus on optimal protocols. Currently, no definitive clinical guidelines exist for these complex injuries.</p><p><strong>Methods: </strong>We retrospectively reviewed the treatment process of a patient admitted to the Second People's Hospital of Liaocheng with a severe scalp avulsion injury. Surgical management included microsurgical vascular anastomosis of bilateral superficial temporal arteries and medial canthal artery, anchoring sutures, and subarea multi-tube negative pressure drainage (- 125 mmHg, 72 h). The clinical evaluation focused on scalp viability, hair regrowth density, and sensory recovery.</p><p><strong>Results: </strong>The replanted scalp survived completely, with only minimal Linear scarring. Hair regrowth reached 95% density by day 13 and 100% at 12 months, with 92% sensory recovery observed at 12 months. No complications (thrombosis, infection, or necrosis) occurred. The patient expressed satisfaction with the aesthetic and functional outcomes.</p><p><strong>Conclusion: </strong>This case highlights the novel integration of microsurgical vascular repair, subarea negative pressure drainage, and anchoring sutures, which synergistically improved flap survival and reduced complications compared to traditional microsurgical replantation alone.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"408"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076479","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":"Outcomes of gastrectomy in octogenarians and nonagenarians: a comparative analysis in the era of minimally invasive surgery.","authors":"Kenjiro Ishii, Yusuke Akimoto, Osahiko Hagiwara, Toshiyuki Enomoto, Takaharu Kiribayashi, Koji Asai, Takuya Nagata, Manabu Watanabe, Yoshihisa Saida","doi":"10.1186/s12893-025-03156-5","DOIUrl":"10.1186/s12893-025-03156-5","url":null,"abstract":"<p><strong>Background: </strong>As the population of Japan continues to age rapidly, an increasing number of patients aged ≥ 80 years are undergoing surgery for gastric cancer. Although minimally invasive techniques have improved surgical safety, operative risks in the super-elderly population (≥ 85 years) remain a significant concern.</p><p><strong>Methods: </strong>This retrospective, single-center study analyzed 72 patients aged ≥ 80 years who underwent gastrectomy for gastric cancer at our hospital between January 2014 and August 2024. Patients were stratified into two groups: the super-elderly group (≥ 85 years, n = 26) and the younger-elderly group (80-84 years, n = 46). Clinical characteristics, perioperative outcomes, and postoperative complications were compared between the two groups. A p-value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age was 83.7 (range: 80-93) years. Comorbidities were common, particularly cardiovascular disease (19.4%) and diabetes mellitus (27.8%). Compared with the younger-elderly group, the super-elderly group had a longer preoperative hospital stay (5.8 vs. 4.5 days) but a shorter overall hospital stay (14.3 vs. 21.1 days). Minimally invasive surgery was less frequently performed in the super-elderly group (42.3% vs. 56.5%). Postoperative complications of Clavien-Dindo grade ≥ 2 occurred in 40.3% of all patients, with a lower incidence in the super-elderly group (34.6% vs. 43.5%). Mortality from non-cancer-related causes did not differ significantly between the groups.</p><p><strong>Conclusions: </strong>With appropriate preoperative optimization, gastrectomy can be performed safely in patients aged ≥ 85 years. Individualized treatment strategies that account for comorbidities are essential for achieving favorable outcomes in this expanding population.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"407"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994207","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":"Factors influencing surgical management and outcomes of colonic trauma: a prospective observational study at three hospitals in Sana'a City, Yemen.","authors":"Ali Lotf Al-Amy, Mohaned Yahia Al-Ajaly, Haitham Mohammed Jowah","doi":"10.1186/s12893-025-03159-2","DOIUrl":"10.1186/s12893-025-03159-2","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"406"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976112","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":"Total knee arthroplasty for ankylosed knees in the extended position with hemophilia: a medium- and long-term single-center experience.","authors":"Zhongyi Zhang, Yi Tang, Zhaokai Jin, Lei Chen, Xinyu Hu, Yichen Gong, Shineng Lin, Guoqian Chen, Shuaijie Lv, Peijian Tong","doi":"10.1186/s12893-025-03102-5","DOIUrl":"10.1186/s12893-025-03102-5","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is one of the curative methods for patients with end-stage ankylosed knees. However, the existing methods are difficult to enable patients with hemophilic ankylosed knees to recover good functional activities.</p><p><strong>Methods: </strong>Between January 2008 and December 2021, 22 male patients with ankylosed knees in the extended position due to hemophilia underwent TKA. The average age of the patients was 41.3 years (range, 19 to 52 years), and the average hospital stay was 33.4 days (range, 14 to 50 days). TKA was performed using quadriceps tendon Z-lengthening plasty, staged osteotomy, and comprehensive soft-tissue release. A variety of methods were used to evaluate the postoperative clinical outcomes and complications, including range of motion (ROM) assessment, Visual Analogue Scale (VAS), Knee Society Score (KSS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).</p><p><strong>Results: </strong>At the last follow-up, the average KSS increased from 75.14 ± 34.63 before surgery to 148.41 ± 27.74 (P < 0.001), the ROM increased from 0 to 86.14 ± 24.69 (P < 0.001), the WOMAC score changed from 28.05 ± 11.20 before surgery to 10.82 ± 11.00 (P < 0.001), and the average VAS score decreased from 2.86 ± 1.86 to 0.73 ± 1.20 (P < 0.001).</p><p><strong>Conclusion: </strong>Although the recovery of range of motion is lower than normal and there is a relatively high incidence of complications, TKA can still significantly improve the flexion and extension functions, mobility, and quality of life of patients with ankylosed knees.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"405"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976113","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 review of the United States global surgery program landscape by website analysis.","authors":"Lauren E Cox, Cassandra M D'Amico, Shriya Bhoothapuri, Joseph A Q Karam, Rachel W Davis, Mike M Mallah","doi":"10.1186/s12893-025-02979-6","DOIUrl":"10.1186/s12893-025-02979-6","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, since the 2015 Lancet Commission on Global Surgery (LCoGS) highlighted the global burden of disease attributable to a lack of safe surgical care, medical degree-granting institutions across the United States (US) have worked to increase engagement in global surgery. The research team aimed to analyze the current landscape and provide an overview of all US-based global surgery programs. It was predicted that most medical institutions in the US would not have established programs. For those with global surgery programs, their mission statements and demonstrated output were classified according to a list of five domains, including bidirectionality, education, partnerships, research, and service. These domains were generated from the priorities outlined by the LCoGS 2030 objectives as there is no universally accepted gold standard for quality evaluation in global surgery education. The team hypothesized that mission statements for existing programs would meet a majority, but not all, of the five domains, and that programs would demonstrate less output than their projected goals.</p><p><strong>Methods: </strong>The team conducted a qualitative analysis of all global surgery programmatic offerings across the US. A list of terms was established to analyze the websites published for each US allopathic (MD) and osteopathic (DO) program. An Excel matrix was produced that outlined all desired information. The domains were used to organize and classify the collected data.</p><p><strong>Results: </strong>Out of 194 US MD- and DO- granting institutions, 39 had global surgery programs. Twenty-five programs had missions that addressed three to four of the domains and 12 programs projected pursuit of all five domains. Of the 12 programs that projected this mission to meet all five objectives, six demonstrated tangible output in all five areas. Bidirectionality was the most common domain not addressed by programs in either their mission statement or output.</p><p><strong>Conclusions: </strong>Global surgery is a nascent field, and as predicted, the majority of medical institutions do not have a global surgery program. Furthermore, institutions with programs and well-defined missions did meet a majority of the five domains. Contrary to the team's prediction, most existing programs demonstrated equal or greater output than their expressed goals.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"404"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976041","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":"Assessment of surgical precision and safety in oncoplastic breast-conserving surgery for breast cancer under the guidance of imaging.","authors":"Han Qiu, Qian Liu, Jing Tian","doi":"10.1186/s12893-025-03130-1","DOIUrl":"10.1186/s12893-025-03130-1","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast-conserving surgery (OBCS) has become an essential component of breast cancer treatment. Imaging guidance in breast surgery has the potential to enhance surgical precision. Despite increasing recognition, a comprehensive evaluation of its specific impact on OBCS for breast cancer is needed. This study aims to evaluate the impact of the application of imaging guidance in OBCS on the accuracy and safety of breast cancer surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included patients treated for breast cancer, divided into the OBCS group (Group A, n = 65) and the imaging-guided OBCS group (Group B, n = 69). Demographics, perioperative parameters, surgical margins, and postoperative complications of the study population were evaluated to assess the impact of imaging guidance on OBCS. Pearson correlation analysis was conducted to explore the relationship between various indicators and imaging-guided OBCS.</p><p><strong>Results: </strong>A total of 134 patients were included. Compared to Group A, Group B showed significant reductions in operation time, intraoperative blood loss, excised breast weight, and length of stay. Additionally, Group B had narrower surgical margins and fewer postoperative complications, including hematoma, wound dehiscence, subcutaneous bleeding, and fluid accumulation. Correlation analysis revealed a strong negative association between imaging-guided OBCS and various surgical indices, highlighting the potential benefits of imaging guidance in enhancing surgical precision and patient outcomes.</p><p><strong>Conclusion: </strong>The findings of this study support the potential of imaging-guided OBCS to enhance surgical precision and safety in breast cancer management, offering benefits across multiple aspects of surgical care and patient prognosis.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"403"},"PeriodicalIF":1.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975978","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":"Perioperative lactate levels as prognostic indicators in patients undergoing early excision and grafting for extensive burns.","authors":"Xinyi Li, Xiaodan Dong, Jianhua Luo, Lin Wang, Yang Cao, Yan Zhang, Bing Liang","doi":"10.1186/s12893-025-03133-y","DOIUrl":"10.1186/s12893-025-03133-y","url":null,"abstract":"<p><strong>Background: </strong>Elevated lactate levels are reliable biomarkers of tissue hypoperfusion and metabolic stress. However, their prognostic significance in extensive burn patients undergoing early excision and grafting (EEG) remains unclear. This study aimed to evaluate the prognostic value of perioperative lactate levels in predicting clinical deterioration following EEG in patients with extensive burns.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult burn patients with ≥ 50% total burn surface area (TBSA) or ≥ 20% full-thickness burns treated between March 2021 and September 2023 were included. Patients were categorized into Deterioration and Non-Deterioration groups based on changes in Sequential Organ Failure Assessment (SOFA) scores. Statistical analyses included univariate and multivariate logistic regression, as well as receiver-operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Of 82 patients, 37.8% were classified into the Deterioration Group. Compared with the Non-Deterioration Group, these patients presented with a significantly higher burn index (BI), larger surgical area, and greater intraoperative blood transfusion volumes. Temporal trends in lactate levels appeared to differ between groups: lactate levels peaked on POD1 and returned to baseline by postoperative Day 3(POD3) in the Non-Deterioration Group, whereas they remained persistently elevated in the Deterioration Group. Among all perioperative time points, lactate levels on POD3 were significantly higher in the Deterioration Group (2.88 ± 0.65 mmol/L vs. 2.27 ± 0.68 mmol/L, p < 0.001) and were independently associated with clinical deterioration clinical deterioration (OR 2.97, 95% CI 1.18-8.71, p = 0.031). POD3 lactate levels demonstrated the highest discriminatory performance for identifying postoperative deterioration (AUC = 0.761, 95% CI 0.656-0.866).</p><p><strong>Conclusions: </strong>Among perioperative lactate levels in patients undergoing EEG for extensive burns, POD3 lactate levels were significantly associated with clinical deterioration and may serve as a useful marker to guide early risk assessment and supportive interventions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"402"},"PeriodicalIF":1.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975395","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 chest radiograph and surface measurement to predict cavoatrial junction position of totally implantable venous-access port.","authors":"Meng-Ling Li, Di-Tian Zhang, Peng-Fei Li","doi":"10.1186/s12893-025-03150-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03150-x","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting cavoatrial junction (CAJ) position is important for totally implantable venous-access port (TIVAP) application, which could reduce complications.</p><p><strong>Methods: </strong>Clinical information of 117 breast cancer (BRCA) patients who underwent TIVAP implantation was collected. The length of the implanted catheter was determined by a chest radiograph method in the test group, as follows: total catheter insertion length was L, and the distance from the pre-puncture point to the right sternoclavicular joint was measured as L1; the distance from the right sternoclavicular joint to 1.5 vertebral bodies under the trachea carina in the chest radiograph was measured as L2; the preset catheter length was L = L1 + L2. The length of the implanted catheter was determined by a surface measurement method in the control group, as follows: total length of catheter insertion was L; the distance from the pre-puncture point to the right sternoclavicular joint was measured as L1; the distance from the third anterior intercostal space of the right sternoclavicular joint was measured on the body surface as L2; the preset catheter length was L = L1 + L2. CAJ positioning rate and complication rate were compared between the two method groups. Logistic regression analysis, receiver operating characteristic, and decision curve analysis were performed to evaluate the predictive value of the chest radiograph.</p><p><strong>Results: </strong>For BRCA patients, the chest radiograph was exhibited more accurately in predicting CAJ position. Subgroup analysis indicated a remarkably higher CAJ position rate in the chest radiograph method group regardless of age, while no significant difference between the two measurement groups for patients with BMI > 24.9 kg/m² was observed.</p><p><strong>Conclusion: </strong>The chest radiograph method could more effectively predict the CAJ position than the surface measurement in the overall cohort. However, subgroup analysis revealed that this advantage was not statistically significant in patients with BMI > 24.9 kg/m², suggesting reduced efficacy in high-BMI populations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"400"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976079","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}