BMC Surgery最新文献

{"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}

{"title":"Outcomes of cesarean myomectomy in Singleton compared with twin pregnancies: a 10-year retrospective cohort study.","authors":"Hyeonjin Na, Kyong-No Lee, Youjin Kim, Bo Young Kim, Mia Park, Soo Youn Song, Heon Jong Yoo, Young Bok Ko, Mina Lee, Geon Woo Lee, Byung Hun Kang","doi":"10.1186/s12893-025-02924-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02924-7","url":null,"abstract":"<p><strong>Background: </strong>To evaluate and compare the pregnancy outcomes after cesarean myomectomy in singleton and twin pregnancies.</p><p><strong>Methods: </strong>We retrospectively reviewed 100 pregnant women diagnosed with myoma who underwent cesarean myomectomy at Chungnam National University Hospital between January 2012 and July 2022. Of them, 77 were singleton pregnancies and 23 were twin pregnancies. Maternal characteristics, largest myoma size, number of myomas, and surgical outcomes were compared between two groups. Myomas were further categorized based on their size; large myomas were defined as lesions measuring ≥ 5 cm in diameter. Maternal characteristics, preoperative and postoperative hemoglobin levels, operative time, and length of hospital stay were compared between the two subgroups. Continuous variables were compared using the Mann-Whitney U test, and categorical variables were assessed using the chi-square test.</p><p><strong>Results: </strong>No significant differences were observed in the maternal characteristics, largest myoma size, number of myomas, or surgical outcomes between singleton and twin pregnancies. However, subgroup analysis based on the largest myoma size (≥ 5 vs. <5 cm) revealed significant differences in operative time (95.5 vs. 122.0 min, p < 0.001) and the need for transfusion (15.6% vs. 36.1%, p = 0.026). Otherwise, no significant differences were noted in the preoperative and postoperative hemoglobin levels or the need for massive transfusion (p > 0.999). No patient required interventions, such as the insertion of an intrauterine Foley balloon, uterine artery embolization, or hysterectomy.</p><p><strong>Conclusions: </strong>Cesarean myomectomy is safe and effective in both singleton and twin pregnancies, even in patients with large myomas.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"185"},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041636","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":"Incidence, outcomes and risk factors of postoperative urinary retention in patients undergoing primary total knee arthroplasty: a national inpatient sample database study.","authors":"Jing Li, Qiuhong Li, Jianping Zhang, Xianhui Chen, Lin Yang, Yang Zhang, Yuhang Chen","doi":"10.1186/s12893-025-02930-9","DOIUrl":"https://doi.org/10.1186/s12893-025-02930-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative urinary retention (POUR) was reported as a common complication in patients undergoing primary total knee arthroplasty (pTKA), but descriptions of its prevalence and negative outcomes vary widely and remain inadequately studied.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the National Inpatient Sample database from 2005 to 2014. The annual incidence, baseline characteristics, and inpatient outcomes of POUR after pTKA were recorded. Logistic regression analysis was performed to estimate potential predictors of POUR. Statistical significance was defined as P < 0.01.</p><p><strong>Results: </strong>A total of 1,228,621 patients undergoing pTKA were identified. The incidence of POUR after pTKA is increasing annually from 2005 (1.51%, 95%CI 1.44-1.59%) to 2014 (2.29%, 95%CI 2.21-2.37%), and the cumulative incidence of POUR was 1.91% (95%CI 1.89-1.93%). POUR was significantly associated with higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores, and higher medical costs. In patients experiencing pTKA, the Top 5 most significant risk factors for developing POUR were male gender (odds ratio [OR] = 3.40; 95% confidence interval [CI] 3.30-3.51; P < 0.0001), fluid and electrolyte disorders (OR = 2.02; 95% CI 1.94-2.10; P < 0.0001), age over 60 (OR = 1.97; 95% CI 1.89-2.05; P < 0.0001), paralysis (OR = 1.78; 95% CI 1.46-2.17; P < 0.0001), and psychoses (OR = 1.57; 95% CI 1.43-1.72; P < 0.0001). Although POUR did not result in higher inpatient mortality (0.1% vs. 0.07%, P = 0.1242), it may be associated with the occurrence of other complications such as acute myocardial infarction (0.42% vs. 0.20%, P < 0.0001), pulmonary embolism and infarction (0.80% vs. 0.42%, P < 0.0001), acute renal failure (6.06% vs. 1.49%, P < 0.0001), deep venous thrombosis (0.71% vs. 0.45%, P < 0.0001), acute posthemorrhagic anemia (28.89% vs. 19.45%, P < 0.0001), and infection (0.29% vs. 0.15%, P < 0.0001).</p><p><strong>Conclusions: </strong>Although POUR has no effect on inpatient mortality, our large-scale national study provides new insights that it increases postoperative complications and impairs clinical outcomes. Given the increasing incidence of POUR, early identification of high-risk patients, particularly those with identified comorbidities, should be prioritized. Preventive strategies, such as optimized perioperative fluid management, may help mitigate the risk of POUR. Future research should focus on developing preventive strategies to mitigate its impact.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"186"},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062861","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":"Venous thromboembolism in patients undergoing pancreatic cancer surgery (PaTR-VTE) with curative intent; protocol of a prospective observational study.","authors":"Maria P Ntalouka, Dimitrios Symeonidis, Paraskevi Kotsi, Efthymia Petinaki, Miltiadis Matsagkas, Konstantinos Tepetes, Dimitrios Zacharoulis, Eleni M Arnaoutoglou","doi":"10.1186/s12893-024-02665-z","DOIUrl":"https://doi.org/10.1186/s12893-024-02665-z","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is probably the most thrombotic malignancy, with an incidence of venous thromboembolism (VTE) of up to 18%. However, the exact pathophysiological mechanisms involved in the development of VTE in the setting of pancreatic cancer are not yet well understood. The primary endpoint of the study is to evaluate the neutrophil/lymphocyte ratio (NLR) and other coagulation biomarkers as predictors of VTE in patients with pancreatic cancer undergoing surgery with curative intent. The exact incidence of VTE, perioperative coagulation status of patients and the possible determinants of VTE in the aforementioned population are the secondary study objectives.</p><p><strong>Methods: </strong>This prospective, non-interventional observational study is conducted according to the STROBE concept. It has been approved by the ethical committee and registered (NCT05964621) and will include eligible patients with primary pancreatic cancer with resectable or borderline resectable disease undergoing surgery with curative intent. Exclusion criteria are: Refusal to participate, previous thromboembolic event < 6 months, ASA score > 3, patients deemed inoperable intraoperatively and the concurrent presence of a second primary malignancy. Three blood samples are taken from all patients (preoperatively, immediately after the operation, and before discharge) and the serum values of the following parameters are determined: Haemoglobin, white blood cells, INR, liver and kidney function tests, von Willebrand factor, factors VIII and XI, D-dimers, fibrinogen, platelet function, Adamts 13 and anti-Xa. One month after the procedure, scheduled screening for asymptomatic deep vein thrombosis (DVT) is performed with a lower extremity ultrasound triplex study. In addition, thromboembolic events (DVT, pulmonary embolism (PE)) diagnosed during the hospital stay period are recorded. Low molecular weight heparin will be routinely administered from the first postoperative day, with the dosage, i.e. prophylactic or therapeutic titrated according to the patient's history of cardiovascular disease. According to the literature, the pooled specificity of the admission NLR for 30-day VTE and PE prediction is 80.5%, while the VTE rates after pancreatectomy is 1.5%. Based on a 95% confidence level and a precision of 0.1, the estimated sample size for the specificity outcome is 62 patients.</p><p><strong>Discussion: </strong>The aim of this study is to identify predictors of postoperative VTE in patients undergoing pancreatic cancer surgery. The results could lead to an optimization of perioperative care.</p><p><strong>Trial registration: </strong>NCT05964621. Registered on July, 2023 clinicaltrials.org.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"183"},"PeriodicalIF":1.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039005","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":"Clinical efficacy of suture bridge versus hollow screw fixation for PCL tibial avulsion fractures: a comparative study.","authors":"Jin-Song Pu, Lin Zheng, Chang-Chun Jian","doi":"10.1186/s12893-025-02926-5","DOIUrl":"https://doi.org/10.1186/s12893-025-02926-5","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the clinical outcomes of the suture bridge technique and hollow screw fixation in treating posterior cruciate ligament (PCL) tibial avulsion fractures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 40 patients treated between January 2013 and December 2023. Patients were divided into two groups: the suture bridge group (20 cases) and the hollow screw group (20 cases). Both groups underwent minimally invasive surgery with a small posteromedial arc incision. The suture bridge technique utilized high-strength sutures and suture anchors, while the hollow screw group employed 3.5 mm hollow screws. Postoperative outcomes were assessed using Lysholm, Tegner and International Knee Documentation Committee (IKDC) scores, with radiographic imaging performed at regular intervals to monitor fracture healing.</p><p><strong>Results: </strong>Both groups showed significant improvements in Lysholm, Tegner and IKDC scores postoperatively (P < 0.05). The Tegner score in the suture bridge group was slightly higher than that in the hollow screw group (P = 0.038). The postoperative drainage volume in the suture bridge group was slightly higher than that in the hollow screw group (P = 0.011), with no significant differences in surgical time, intraoperative blood loss or joint mobility (P > 0.05). Most fractures healed within 3 to 6 months. In the suture bridge group, two cases of malunion were observed due to small bone fragment displacement. In the hollow screw group, two cases of screw head retraction and one case of bone fragment displacement were noted.</p><p><strong>Conclusion: </strong>Both the suture bridge technique and hollow screw fixation are effective for treating PCL tibial avulsion fractures, each with unique advantages and potential complications. The suture bridge technique provides secure fixation, particularly for comminuted fractures, and is suitable for pediatric patients to avoid growth plate injury.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"180"},"PeriodicalIF":1.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058509","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":"5G remote robotic-assisted transcervical thyroidectomy: the first case report in the world.","authors":"Shaojie Wu, Nan Wu, Yongqiang Wang, Ren Jing, Yang Wu, Shijian Yi","doi":"10.1186/s12893-025-02927-4","DOIUrl":"https://doi.org/10.1186/s12893-025-02927-4","url":null,"abstract":"<p><strong>Background: </strong>The incidence of thyroid malignancies is increasing due to the development of detection techniques. The demand for aesthetics and precision has led surgeons to innovate in surgery, and with the development of 5G technology, telesurgery has become a reality.</p><p><strong>Case presentation: </strong>We present the case of a 37-year-old woman with a physical examination that revealed a nodule of about 0.5*0.5 cm in size in the left lobe of the thyroid gland, with preoperative puncture pathology suggestive of papillary carcinoma. A 5G remote robotic thyroidectomy was performed from Shanghai to Shenzhen.</p><p><strong>Conclusions: </strong>We believe this paper reports the world's first 5G tele-robotic-assisted transthoracic breast approach thyroidectomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"182"},"PeriodicalIF":1.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062831","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}