BMC Surgery最新文献

{"title":"Does thoracoscopic repair of type C esophageal atresia require emergency treatment?","authors":"Chen Wang, Guoqing Cao, Kang Li, Yang Zhang, Mengxin Zhang, Xi Zhang, Shuiqing Chi, Yu Guo, Shuai Li, Shao-Tao Tang","doi":"10.1186/s12893-025-02798-9","DOIUrl":"10.1186/s12893-025-02798-9","url":null,"abstract":"<p><strong>Background: </strong>Thoracoscopic repair of esophageal atresia (EA) with tracheoesophageal fistula (TEF) has been performed with increasing frequency. Although many children have underwent surgery within three days after birth, the optimal timing for operation remains undetermined. This study aimed to investigate the appropriate timing for thoracoscopic repair of type C EA and its mid-term clinical outcomes.</p><p><strong>Method: </strong>We retrospectively analyzed 142 patients with EA between April 2009 and April 2023. A total of 109 patients with type C EA who underwent thoracoscopic one-stage repair surgery were included. The patients were divided into two groups based on surgical timing: the early repair group (< 5 days) and the delayed repair group (≥ 5 days). Patients in the two groups were matched using propensity score matching (PSM) to eliminate the imbalance between groups caused by confounding factors such as severe cardiac complications, gestational age, and birth weight.</p><p><strong>Result: </strong>The median age at surgery was 5 days (range: 1-16 days). After matching, 43 patients (out of 59) in the early repair group (group A) and 43 patients (out of 50) in the delayed repair group (group B) were included in the validation cohort. All cases (n = 86) successfully completed thoracoscopic one-stage repair surgery. Delayed surgery did not increase the incidence of preoperative and postoperative respiratory tract infections. Intraoperative and postoperative complications were comparable between the two groups. Intraoperative and postoperative complications were comparable between the two groups; however, patients in group B experienced a lower frequency of balloon dilation (1.8 ± 0.8 vs. 3.1 ± 1.1, P = 0.035) for anastomotic stricture during follow-up.</p><p><strong>Conclusions: </strong>With improvements in neonatal surveillance, appropriately delayed surgery does not increase the incidence of respiratory infections, allowing surgeons to optimize treatment plans.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"66"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415976","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":"Surgical techniques for modular one-stage emergent pancreaticoduodenectomy for blunt abdominal trauma: experiences from three centres and a review of the literature.","authors":"Xing Wang, Zitong Zhang, Zhenwei Shen, Tao Jin, Xiaodong Wang, Long Ren, Feng Zhan, Wei Zheng, Kai Li, Wei Cheng, Jingdong Li, Kai Zhang","doi":"10.1186/s12893-025-02776-1","DOIUrl":"10.1186/s12893-025-02776-1","url":null,"abstract":"<p><strong>Background: </strong>In this study, we report the use of a complex surgical intervention termed modular one-stage emergent pancreaticoduodenectomy (MOEPD) for the treatment of acute Grade IV or V pancreaticoduodenal injuries in haemodynamically stable patients. We summarize the experiences of surgeons performing MOEPD in 12 patients from 3 centres.</p><p><strong>Methods: </strong>From 2015 to 2021, the clinical data of patients with blunt abdominal trauma who underwent MOEPD were extracted from three Chinese centres. The patients' perioperative variables were assessed.</p><p><strong>Results: </strong>All twelve MOEPD cases were analysed. All patients had Grade IV or V pancreatoduodenal injuries and received intensive antishock treatment for haemodynamic stabilization. The mean age of the patients was approximately 45.2 years (22-74 years). Ten patients (83.3%) were male. In contrast to the ten patients who underwent pancreaticoduodenectomy (PD), two patients underwent laparoscopic pancreaticoduodenectomy (LPD). Two patients presented with a combination of severe abdominal injuries. None the patients died in the perioperative period. Five patients (41.7%) experienced postoperative complications. A postoperative pancreatic fistula (POPF) was detected in 16.7% of patients, both of whom recovered within 3-4 weeks with conservative drainage. All patients were released from the institutions after an average of 31.8 days (21-53 days). There was no statistically significant difference in the incidence of complications between the 20 reviewed studies and this group (60.7% vs. 41.7%, P = 0.33), but the mortality rate was lower in this group (26.6% vs. 0%, P = 0.04).</p><p><strong>Conclusions: </strong>The experiences at these 3 centres suggest that MOEPD may be a lifesaving procedure for haemodynamically stable patients with acute Grade IV or V pancreatoduodenal injuries, despite the small sample size of this study.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"67"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415983","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":"Survival analysis of time to decannulation and failure drivers among tracheostomy patients in Rwanda.","authors":"Theogene Kubahoniyesu, Gadeline Tuyishime","doi":"10.1186/s12893-025-02790-3","DOIUrl":"10.1186/s12893-025-02790-3","url":null,"abstract":"<p><strong>Background: </strong>Tracheostomy is essential for patients requiring prolonged ventilation, but studies on decannulation in Sub-Saharan Africa, including Rwanda, are limited. This study assesses decannulation success rates and identifying factors influencing the outcomes at the University Teaching Hospital of Kigali(CHUK).</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study. Data on 62 patients who underwent tracheostomy at CHUK from October 2022 to October 2023 and reached decannulation were analyzed. Survival analysis was conducted using R, employing Kaplan-Meier (KM) curves to estimate median time to decannulation and Cox proportional hazards models to determine factors affecting outcomes. Bboth adjusted hazard ratio (AHR) and their confidence intervals (CI) were reported.</p><p><strong>Results: </strong>Decannulation failure observed from 22 patients (35.5%). The median time to decannulation was 60 days (Interquartile range (IQR): 46-74). KM indicated a shorter decannulation median time for elective tracheostomies (60 days, IQR: 43-77) compared to emergency ones (180 days, IQR: 151-209) and for females (60 days, IQR: 49-71) Compared to males (68 days, IQR:52-84). Elective tracheostomy was significantly associated with decannulation success, with an adjusted hazard ratio (AHR) of 0.19 (95% CI: 0.04-0.91, P = 0.039), indicating lower hazard for decannulation failure compared to emergency type. However, this finding is exploratory and should be interpreted cautiously. Age of a patient increased with less hazard to decannulation failure; however, the association was not statistically significant.</p><p><strong>Conclusions: </strong>Male Patients and those undergoing elective tracheostomies had a longer median time to decannulation. The findings highlight the importance of strategic planning in determining the timing and type of tracheostomy, with a focus on optimizing conditions for elective procedures whenever possible to improve patient outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"64"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415985","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":"Correction: Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy.","authors":"Xianda Chai, Xianxian Qian, Huan Wang, Ziqi Zhou, Lingling Tang, Jing Zhang, Longfei Yue","doi":"10.1186/s12893-025-02793-0","DOIUrl":"10.1186/s12893-025-02793-0","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"65"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415974","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":"Prevalence, factors associated, and histological pattern of incidental enlarged mesenteric lymph nodes among patients undergoing laparotomy at referral hospitals in central Tanzania; a cross-sectional study.","authors":"Devotha Josephat Rweyemamu, Masumbuko Yatembela Mwashambwa","doi":"10.1186/s12893-024-02745-0","DOIUrl":"10.1186/s12893-024-02745-0","url":null,"abstract":"<p><strong>Background: </strong>There are different causes of Incidental Enlarged MesentericLlymph Nodes (IMLN) found during laparotomy, which most of the time influence the postoperative course. These causes are variable across the globe, but the node pattern in our locality and the factors associated with the incidental enlarged mesenteric lymph nodes are not yet established. Due to the lack of an established protocol in our locality, there have been some mismanaged cases that led to several postoperative complications. Therefore, this study aimed to evaluate the prevalence, factors associated with, and histological pattern of incidental mesenteric lymphadenopathy.</p><p><strong>Methodology: </strong>The 885 patients were conveniently recruited in the study. The incidental enlarged mesenteric lymph nodes were taken during surgery, processed and histologically analyzed as per pathological protocol. Obtained data were filled out and analyzed using SPSS version 27. Binary logistic regression was used to examine clinical data, with a significance level of p < 0.05, to determine the factors linked to lymph node enlargement.</p><p><strong>Results: </strong>It was seen that 58.08% of the study group, with a mean age of 30.5 years, were between the ages of 21 and 40. Males accounted for 71.53% of the total, while 252 individuals were female, giving a M: F ratio of 2.5:1. The prevalence of incidental mesenteric lymphadenopathy was 12.5%. Associated factors of Incidental Mesenteric Lymphadenopathy in this study were HIV, smoking, nomadic pastoralism, and surgical indication. HIV-positive patients were 7 times more likely to have IML with a 95% CI [2.975, 16.741], and (p < .0001), smokers were 10 times more likely to have IMLN, 95% CI [3.745, 28.458], and (p < .0001), nomadic pastoralists were 3 times more likely to have IMLN, 95% CI [1.647, 5.882], and (p < .0001) and patients who were operated upon peritonitis were 3 times more likely to have IMLN, 95% CI [2.040, 7.572], and (p < .0001). Of the incidental lymphadenopathy (N = 111), 23.42% had granulomatous tuberculous lesions, and 9.01% of lymph nodes harbored malignancy. About 47% of patients had histologically confirmed reactive lymph nodes, while 20.72% had an inflammatory pattern. CONCLUSION AND RECOMMENDATION: The major factors associated with incidental enlarged mesenteric lymph nodes are smoking, comorbidities such as HIV and diabetes, malignancies, and infections such as tuberculosis. The common histological pattern is reactive nodes though there are potentially fatal nodes that were discovered including those that harbored malignancies and infections such as Tuberculosis. Therefore, to rule out potentially fatal illnesses and comorbidities that can be treated early to spare patients from extended hospital stays and potentially disastrous results, comprehensive investigations should be conducted in the event of incidentally enlarged mesenteric lymph nodes are found during a laparotomy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"61"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400390","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":"Effectiveness of an integrated cerebral protection protocol in type A aortic dissection surgery: an inverse probability treatment weighting analysis.","authors":"Fei-Min Shen, Yi-Min Lin, Ming-Cheng Huang, Jin-Ping Liu, Ling-Chen Huang, Liang-Wan Chen, Xiao-Fu Dai","doi":"10.1186/s12893-025-02783-2","DOIUrl":"10.1186/s12893-025-02783-2","url":null,"abstract":"<p><strong>Background: </strong>Cerebral protection strategies in type A aortic dissection (TAAD) surgery are critical yet inconclusive. We propose an integrated cerebral protection protocol. This study aimed to evaluate the effectiveness of this protocol.</p><p><strong>Methods: </strong>From January 2020 to December 2022, 85 patients were treated with an integrated protocol incorporating bilateral antegrade cerebral perfusion (ACP) and moderate hypothermia, with measures to prevent the shedding of thrombus or endothelial debris (BACP group), while traditional protocols were applied to 273 additional patients (UACP group). Inverse probability treatment weighting (IPTW) was performed to balance baseline characteristics. Three logistic regression models were used to evaluate the relationship between the two cerebral protection strategies and neurologic complications. Stepwise logistic regression was further employed to identify risk factors for cerebral complications.</p><p><strong>Results: </strong>Baseline characteristics were balanced after IPTW adjustment. The BACP group had a significantly shorter operative time (364.79 vs. 397.61 min, P = 0.022), significantly fewer neurologic complications (5.6% vs. 15.9%, P = 0.032), and transient neurologic injury (3.0% vs. 12.5%, P = 0.035). Binary multivariable logistic regression analysis showed that the cerebral complication risk was 3.14 times greater with the traditional protocol compared to the integrated protocol (odds ratio[OR]:3.14, 95%confidence interval[CI]:1.19-8.27, P = 0.020). Stepwise logistic regression confirmed that cerebral complications were dramatically increased with unilateral ACP (OR:2.99, 95%CI:1.14-7.82, P = 0.025), while bilateral ACP had a significant impact on decreasing cerebral complications.</p><p><strong>Conclusions: </strong>Our integrated protocol effectively minimizes postoperative cerebral complications. Moderate hypothermia combined with BACP and measures to prevent brain debris could be adopted as an effective strategy for cerebral protection in TAAD surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"62"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400456","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":"Ultrasound outcomes and surgical parameters of the double-layer purse-string uterine closure technique in cesarean delivery: a systematic review and meta-analysis of randomized trials.","authors":"Mahsan Nabighadim, Maryam Vaezi, Mahsa Maghalian, Mojgan Mirghafourvand","doi":"10.1186/s12893-025-02796-x","DOIUrl":"10.1186/s12893-025-02796-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A cesarean scar defect is a structural abnormality in the myometrium at the site of a prior cesarean incision, primarily influenced by the closure technique. Purse-string uterine suturing (PSUS) may reduce the incidence of cesarean scar defects and improve uterine integrity. However, the literature presents inconsistent findings, necessitating a systematic evaluation. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to assess the impact of PSUS on ultrasound outcomes and surgical parameters related to cesarean scars.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review and meta-analysis involved a search for relevant publications in English and Persian across multiple databases, including PubMed, the Cochrane Library, Google Scholar, Scopus, Web of Science, and SID. The search was unrestricted by date and included all available publications up to August 8, 2024. The risk of bias in the included studies was evaluated using the Risk of Bias 2 (ROB2) tool, while the certainty of the evidence was assessed through the GRADE approach. Meta-regression was employed to investigate potential risk factors for cesarean scar defects, and trial sequential analysis was conducted to mitigate Type I and Type II errors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 353 studies were identified through the search strategy, with 8 studies included in the analysis. The meta-analysis demonstrated a significant reduction in the rate of cesarean scar defects in the PSUS group compared to the control group (risk ratio [RR] 0.45, 95% confidence interval [CI] 0.36 to 0.58; 8 trials, 751 participants, I² = 0%, indicating no heterogeneity). Additionally, a shorter uterine incision length was observed in the PSUS group compared to the control group (MD -3.84, 95% CI -4.97 to -2.71; 4 trials, 438 participants, I² = 80%, suggesting substantial heterogeneity). The PSUS group also exhibited greater residual myometrium thickness (RMT) than the control group (MD 1.33, 95% CI 0.72 to 1.94; 5 trials, 417 participants, I² = 92%, indicating considerable heterogeneity). However, no statistically significant differences were found between the PSUS and control groups regarding operation time (p = 0.10, I² = 67%, suggesting moderate heterogeneity), length (p = 0.14, I² = 98%, indicating considerable heterogeneity), height (p = 0.10, I² = 76%, suggesting substantial heterogeneity) of incision defects, or blood loss during the procedure (p = 0.94, I² = 0%, indicating no heterogeneity).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The use of PSUS during cesarean sections significantly reduces the occurrence of cesarean scar defects, indicating a clear clinical benefit with moderate certainty. However, the evidence for other ultrasound evaluation outcomes and surgical parameters remains of low to very low certainty. Therefore, further research is essential to validate these findings and assess the long-term clinical implications of integ","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"60"},"PeriodicalIF":1.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374844","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":"One stage transanal versus one stage laparoscopic-assisted transanal endorectal pull-through in managing Hirschsprung's disease in pediatric age group; a retrospective study.","authors":"Ahmed Elrouby, Sameh Shehata, Saber Waheeb, Ahmed Khairi, Doaa AbdAl-Aziz, Baher Looka","doi":"10.1186/s12893-025-02768-1","DOIUrl":"10.1186/s12893-025-02768-1","url":null,"abstract":"<p><strong>Background: </strong>The management of Hirschsprung's disease has evolved from the conventional route to the minimally invasive route in one stage either from the pure transanal route or with the assistance of laparoscopy. Our study compared the surgical and functional outcomes of both approaches.</p><p><strong>Methods: </strong>Our retrospective study included 72 pediatric patients presented with Hirschsprung's Disease to Elshatby University Hospital, 40 patients were treated by TAERPT (Group A) and 32 patients were treated by LAERPT (Group B). The two groups were compared as regards the personal data, the operative data, and the post-operative outcomes including the time of passage of stools, time of tolerating oral feeding, the duration of hospital stay, and the development of any early postoperative complications. Moreover, the frequency of defecation, constipation, enterocolitis, anastomotic stricture, and continence were assessed.</p><p><strong>Results: </strong>The age at operation was significantly lower (p < 0.001^*) in patients of Group A (13.95 ± 18.18) than in patients of Group B (32.03 ± 16.20). The total operative duration was not different between the two groups, however, a significantly shorter duration of the anal part (p < 0.001^*) in Group B (47.81 ± 18) than in Group A (96.50 ± 38.60) was recorded. A significantly longer colonic segment (p < 0.001^*) was resected in Group A (28 ± 4.05) than in Group B (22.70 ± 8.12). The hospital stay was significantly shorter in Group B (5.78 ± 2.41) than in Group A (7.20 ± 2.78). (p = 0.001*) The excised segment revealed a proximal aganglionic zone in four patients denoting a missed segment; three in Group B and only one patient in Group A. There were no differences as regards the early and late follow-up parameters.</p><p><strong>Conclusions: </strong>Endorectal pull-through for the treatment of Hirschsprung's disease could be approached either completely transanal or with the assistance of laparoscopy with nearly similar surgical and functional outcomes, however a longer operative duration with a shorter anal stage is recorded with the laparoscopic assistance. Furthermore, a shorter hospital stay could be achieved with the aid of laparoscopy.</p><p><strong>Trial registration: </strong>Protocol ID: 0306356, Registration number: NCT06419998, 20/05/2024 - Retrospectively registered.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"59"},"PeriodicalIF":1.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374839","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 an artificial intelligence preoperative planning system for assisting in revision surgery after artificial total hip arthroplasty.","authors":"Jiaqing Zhu, Shanbin Zheng, Jiahao Sun, Bowen Ma, Chiyu Zhang, Chao Zhang, Jirong Shen, Tianwei Xia","doi":"10.1186/s12893-024-02752-1","DOIUrl":"10.1186/s12893-024-02752-1","url":null,"abstract":"<p><strong>Objective: </strong>To explore the early efficacy of an artificial intelligence preoperative planning system (AIHIP system) for assisting in hip revision surgery.</p><p><strong>Methods: </strong>The clinical data of 25 patients (26 hips) who underwent hip revision between June 2019 and December 2023 and who met the selection criteria were retrospectively analyzed. There were 13 males and 12 females; the ages ranged from 44 to 90 years, with a mean of 69.1 years. The patients' replacement of prosthesis model, operation time, hospitalization time, postoperative time out of bed, etc., as well as the occurrence of adverse events such as postoperative infection, fracture, and loosening of the prosthesis were recorded. The Harris Hip score (HHS) was used to evaluate the function of the affected limbs preoperatively, and 1 week and 6 months postoperatively, and hip mobility was compared preoperatively and 6 months postoperatively.</p><p><strong>Results: </strong>All 25 patients were followed up for 6 to 59 months, with an average of 25.3 months. Except for one patient who developed a thigh hematoma (treated with incision and drainage and decompression) and hip dislocation in one hip (repaired), the remaining patients experienced no adverse events such as loosening of the prosthesis or infection. The postoperative acetabular cup type matching degree completely matched 25 hips, not matching 1 hip (+ 2 number), for a matching rate of 96.15%; the femoral stem type matching degree completely matched 25 hips, generally matching 1 hip (-1 number), for a matching rate of 100%. The Harris scores were 54.7 ± 9.6 and 89.6 ± 7.0 at 1 week and 6 months after surgery, respectively, which were significantly improved (P < 0.05) compared with the preoperative scores of 33.5 ± 8.3, and further improved at 6 months after surgery compared with the 1-week period (P < 0.05). The patients' hip function was evaluated according to the Harris score at 6 months after surgery, and they were assigned to 23 good hips and 3 medium hips, which could satisfy daily life needs. Hip mobility at 6 months after surgery was 111.15 ± 9.72°, and the difference was statistically significant compared with the preoperative value of 79.42 ± 17.51° (t = -8.077, P < 0.001).</p><p><strong>Conclusion: </strong>AIHIP system-assisted treatment of THA postoperative revision patients can improve the precision of revision surgery, and reduce the difficulty of surgery, in patients with good postoperative recovery and satisfactory early outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"58"},"PeriodicalIF":1.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371158","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 caring for the dying and their families on surgeons - an AI assisted systematic scoping review.","authors":"Jun Rong Tan, Yun Ting Ong, Victoria Jia En Fam, Annushkha Sinnathamby, Nila Ravindran, Yaoyi Ng, Lalit Kumar Radha Krishna","doi":"10.1186/s12893-025-02792-1","DOIUrl":"10.1186/s12893-025-02792-1","url":null,"abstract":"<p><strong>Context: </strong>Surgeons are taking central roles in caring for patients leaving them prone to the emotional turmoil and grief of patients and families and the moral, psychological and existential distress of members of the interprofessional team and trainees. This has implications on patient safety and surgeon welfare.</p><p><strong>Objectives: </strong>A systematic scoping review was carried out to address the primary research question \"what is known of the effects of caring for the dying and the impact of patient's death on surgeons?\". It is hoped that the insights gained will better guide support and assessment of surgeons in their evolving roles.</p><p><strong>Methods: </strong>Guided by the Systematic Evidence-based Approach (SEBA), we conducted a systematic scoping review (SSR). This review included articles published between 1st January 2000 and 2nd September 2024 on Pubmed, Embase, Scopus, Google Scholar, ERIC databases. To enhance trustworthiness and enhance the comprehensiveness of our review the articles identified were also evaluated using ChatGPT 4o and Notebook LM. The findings of these assistive processes were compared with the independent thematic and content analysis carried out by the two research teams.</p><p><strong>Results: </strong>In total, 4966 titles and abstracts were identified, 174 full-text articles were reviewed, and 26 full-text articles analysed. With the findings of the assistive analysis by the AI tools echoing the findings of the research teams- two key domains were identified: (1) the impact on personhood, (2) predisposing factors.</p><p><strong>Conclusion: </strong>This AI assisted SSR in SEBA confirms that surgeons do suffer from the cumulative effects of caring for dying patients and their families and from the death of the patient and supporting the family and members of the interprofessional team and trainees. Without timely and personalized support surgeons are prone to depression, burnout, and substance abuse, and compromises to patient and family experiences, outcomes, safety and satisfaction. The need for effective longitudinal and personalized assessment tools is clear.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"56"},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257094","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}