BMC Surgery最新文献

{"title":"Equity in the cardiothoracic surgical workforce: addressing training gaps and workforce distribution in Africa- a narrative review.","authors":"Samuel Mesfin Girma, Tsion Hiwot, Nanati Jemal Aliye, Elham Yimam, Ahmed K Awad","doi":"10.1186/s12893-025-02928-3","DOIUrl":"https://doi.org/10.1186/s12893-025-02928-3","url":null,"abstract":"<p><p>Cardiothoracic surgery (CTS) remains one of the least diverse surgical specialties, marked by significant gender and racial disparities. Despite increased medical school enrollment and the inclusion of more women and underrepresented minorities in the medical workforce, the number of locally trained cardiothoracic surgeons remains disproportionately low, particularly in regions with limited access to specialized care. This lack of diversity is compounded by systemic barriers such as limited exposure to the specialty, a shortage of mentors and role models, and the persistence of gender bias and discrimination. These factors contribute to a workforce that does not adequately reflect the demographic diversity of the patient population, further hindering access to quality care. To address these challenges, this article outlines several policy recommendations aimed at improving equity in CTS training and workforce development. Key strategies include increasing awareness and exposure to CTS among medical students, expanding training opportunities, and establishing regional centers of excellence. Gender equity should be prioritized through the implementation of zero-tolerance policies for discrimination and harassment, and financial incentives should be introduced to retain cardiothoracic professionals locally. Additionally, mentorship, collaboration, and international partnerships can enhance surgical skills and knowledge sharing across regions. Public health policies focusing on improving access to cardiothoracic services, particularly in underserved communities, are critical for reducing disparities. Enhanced community awareness campaigns, improved data collection, and strengthened healthcare infrastructure are vital to ensure equitable access to care. Ultimately, achieving equity in CTS requires collaborative efforts between governments, academic institutions, healthcare providers, and international partners, aimed at building a resilient and diverse cardiothoracic workforce capable of meeting the needs of diverse populations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"176"},"PeriodicalIF":1.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062848","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 importance of paranasal tomography in planning septorhinoplasty.","authors":"Sevilay Hançer Tecimer, Zeynep İskender Emekli, Pınar Tekin, Ayla Çimen","doi":"10.1186/s12893-025-02922-9","DOIUrl":"https://doi.org/10.1186/s12893-025-02922-9","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to emphasize the importance of paranasal tomography imaging before septorhinoplasty surgery. Preoperative evaluation of nasal bone structure, including medial and lateral bone thickness, guides osteotomy type selection and force application.</p><p><strong>Method: </strong>Preoperative paranasal sinus tomography scans of patients who were decided to undergo septorhinoplasty were retrospectively analyzed. Bilateral nasal bone length, medial and lateral bone thickness, pyriform aperture width and height were measured.</p><p><strong>Results: </strong>In 200 patients, the mean thickness of the right lateral osteotomy line was 1.66 ± 0.28 mm in males and 1.54 ± 0.25 mm in females, left lateral osteotomy line 1.67 ± 0.30 mm in males and 1.54 ± 0.28 mm in females. The mean thickness of the medial osteotomy line was 1.68 ± 0.36 mm in males and 1.58 ± 0.35 mm in females. The mean length of the nasal bone was 24.27 ± 4.1 mm in males and 22.78 ± 3.4 mm in females. The mean width of the pyriform aperture was 21.42 ± 2.19 mm in males and 20.49 ± 2.03 mm in females. The mean height of the pyriform aperture was 35.54 ± 4.76 mm in males and 33.93 ± 5.00 mm in females. The mean length of the right lateral nasal bone was 24.81 ± 2.75 mm in males and 21.14 ± 2.76 mm in females, the left lateral nasal bone was 23.91 ± 2.67 mm in males and 20.63 ± 2.69 mm in females. Nasal bone length, piriform aperture width and height, lateral bone thickness, lateral bone length mean values; statistically significant difference was observed between male and female patients (p < 0.05).</p><p><strong>Conclusion: </strong>Preoperative paranasal tomography provides essential data for osteotomy planning by identifying significant anatomical variations in nasal bone structure. Statistically significant difference was observed between male and female patients in these measurements. We believe that we emphasize that the evaluation of bone thickness before surgery is important when performing osteotomy. There is no study in the literature measuring lateral nasal bone length. Our study measured right and left lateral bone length for the first time.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"172"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056395","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":"Introducing enhanced recovery after surgery (ERAS) program in Rwanda: a step-by-step approach from KAP study to protocol development and preliminary implementation.","authors":"Martin Nyundo, Miguel Gasakure, Esperance Muhawenayo, King Kayondo, Paulin Banguti, Jean Damascene Twagirumukiza, Julien Gashegu, Olivier Detry","doi":"10.1186/s12893-025-02909-6","DOIUrl":"https://doi.org/10.1186/s12893-025-02909-6","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) programs improve postoperative outcomes through evidence-based practices. However, implementing ERAS in resource-limited settings like Rwanda remains challenging. This study aimed to introduce an ERAS program at the Centre Hospitalier Universitaire de Kigali (CHUK) by tailoring it to the local context.</p><p><strong>Methods: </strong>A multi-phase strategy was employed, beginning with a Knowledge, Attitudes, and Practices (KAP) study following an ERAS webinar to identify gaps in awareness and application of ERAS principles among perioperative care providers. Targeted training sessions were conducted to address these gaps, leading to the development of a locally adapted ERAS protocol.</p><p><strong>Results: </strong>The KAP study revealed limited awareness of ERAS protocols, including international Nil Per Os (NPO) guidelines, with only 45.7% of participants familiar with them and 48% unknowingly applying some ERAS elements. Early postoperative feeding was supported by 45.7%, and 92.5% agreed that preventing nausea and vomiting enhances recovery. Regarding opioid use, 88.4% supported selective use, while 81.5% disagreed with eliminating opioids entirely. Almost all respondents (97.7%) believed ERAS improved perioperative care, and 79.2% felt it reduced hospital expenses. Additionally, 85% of respondents recognized laparoscopic surgery as enhancing ERAS protocols. The insights gained informed the design of targeted training sessions and the development of a locally adapted ERAS protocol, supported by the formation of collaborative groups and ERAS champions.</p><p><strong>Conclusion: </strong>The introduction of ERAS at CHUK demonstrates the feasibility of implementing evidence-based surgical protocols in resource-limited settings. Addressing knowledge gaps and adapting protocols to the local context represent a promising step toward improving surgical care in Rwanda and enhancing perioperative management.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"173"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056001","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 clinical effect of floating island laminectomy technique for severe thoracic spinal stenosis and myelopathy caused by ossification of the ligamentum flavum: a retrospective study.","authors":"Cheng Zhong, Peng Xiu, Hua Chen, Yueming Song, Jiancheng Zeng, Tao Li","doi":"10.1186/s12893-025-02914-9","DOIUrl":"https://doi.org/10.1186/s12893-025-02914-9","url":null,"abstract":"<p><strong>Background: </strong>Severe thoracic ossification of the ligamentum flavum often leads to thoracic spinal canal stenosis and spinal cord injury, which generates severe symptoms. Generally, patients still require surgery and aggravated spinal cord function impairment is a common complication. We propose a novel surgical technique to remove the ossified ligamentum flavum with the adhesive dura as a floating island. The purpose of this study was to evaluate the clinical efficacy and safety of floating island in the treatment of severe ossification of ligamentum flavum.</p><p><strong>Methods: </strong>A total of 31 patients with thoracic spinal stenosis and myelopathy caused by thoracic ossification of the ligamentum flavum from January 2019 to April 2022 were included in the study and were followed up at 1, 3, 6, and 12 months, respectively. All patients were treated with floating island laminectomy technique. Neurological function was assessed by the modified Japanese Orthopaedic Association (mJOA) scoring system before and after operation and the rate of improvement was calculated. Perioperative complications were also recorded in this study.</p><p><strong>Results: </strong>All 31 patients were successfully managed by the same professional surgery team. The average operative time was 207.74 ± 58.54 min, the average hospital stay duration was 6.8 ± 1.27 days and the average intra-operative blood loss was 406.45 ± 217.85 ml. The average mJOA score at 1 month, 3 months, 6 months and 12 months after surgery increased from 4.68 ± 0.60 to 6.71 ± 0.73, 7.35 ± 0.76, 8.45 ± 0.85 and 9.06 ± 0.81, respectively. The average mJOA score after surgery was significantly higher than before (P < 0.001). The average recovery rate was (32.41 ± 8.55)%, (42.57 ± 9.00)%, (60.12 ± 11.07)% and (69.76 ± 11.38)% for 1 month, 3 months, 6 months and 12 months after surgery, respectively. Postoperative complications included dural tear in 3 cases (9.7%), defect in 1 case (3.2%) and cerebrospinal fluid leakage in 3 cases (9.7%). There was no recurrence of ossification or postoperative thoracic vertebra deformity in patients with aggravated neurological injury.</p><p><strong>Conclusion: </strong>The floating island laminectomy method for the treatment of thoracic ossification of the ligamentum flavum is safe and feasibility, which can effectively avoid the aggravation of neurological symptoms and enable patients to obtain satisfactory neurological function improvement and functional recovery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"174"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027972","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 profile and treatment outcome of patients with ileo-sigmoid knotting, an experience from Ethiopian setting: a six years review.","authors":"Dawit Alemayehu Bitewa, Tirufat Dagmawi, Mandante Bogale, Mezgebu Miskir, Dagmawi Abiy, Megbar Dessalegn","doi":"10.1186/s12893-025-02859-z","DOIUrl":"https://doi.org/10.1186/s12893-025-02859-z","url":null,"abstract":"<p><strong>Background: </strong>Ileo-sigmoid knotting (ISK) is a rare cause of intestinal obstruction, characterized by the twisting of the ileum around the sigmoid colon or vice versa. This study aimed to assess the clinical characteristics and treatment outcomes of patients undergoing laparotomy for ISK at a tertiary hospital in Ethiopia.</p><p><strong>Methods: </strong>This is an institution based cross sectional study conducted at Debre Markos Comprehensive Specialized Hospital in Debre Markos City, Northwest Ethiopia. A six-year study was conducted at Debre Markos Comprehensive Specialized Hospital by revewing the medical records of 42 patients operated for ISK between March 31, 2018, and April 1, 2024. Data were extracted, processed, and analyzed using Epi-Data 4.6 and STATA 17.0. Fisher's exact test was used to determine statistical significance (p-value ≤ 0.05).</p><p><strong>Results: </strong>Thirty-eight patients (90.5%) had complete medical records, with a mean age of 39.2 years (SD ± 10.2) and a male predominance (M: F = 3.2:1). Accurate preoperative diagnosis was achieved in only 5.3% of cases, with the majority being misdiagnosed as small or large bowel obstruction. Gangrene of both the ileum and sigmoid colon was observed in 71.1% of cases. The most commonly performed procedure (68.4%) was resection of both segments with primary ileo-ileal and colorectal anastomosis. Postoperative complications occurred in 52.6% of patients, the most common one being anemia (31.6%). Mortality was 7.9% and was significantly associated with anastomotic leaks (p = 0.045). The average hospital stay was 8.2 days (IQR: 6-37).</p><p><strong>Conclusions and recommendation: </strong>The accuracy of preoperative diagnosis of ileo-sigmoid knotting in this study is lower. However, ileo-sigmoid knotting had high postoperative morbidity and mortality. This study highlights the need for heightened awareness for preoperative diagnosis and prompt surgical treatment. We recommend a prospective multicentric study to guide on appropriate operative decision making in ISK patients.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"171"},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027968","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 the second surgery in staged bilateral total knee arthroplasty: a patient-determined interval approach.","authors":"Yang Lv, Zhijian Pan, Chunjian Zi, Hongliang Liu, Xin Li, Dingkun Lin, Da Guo, Xiaojie Zheng","doi":"10.1186/s12893-025-02915-8","DOIUrl":"https://doi.org/10.1186/s12893-025-02915-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The decision to perform a second surgery in staged bilateral total knee arthroplasty (BTKA) remains undetermined. While previous studies have investigated the timing of the second surgery, they have not reached a consensus on the optimal interval and lack self-controlled comparisons between the first and second surgeries to minimize bias. This study aimed to address these gaps by evaluating postoperative outcomes across patient-determined intervals and conducting internal comparisons between sequential surgeries to optimize the timing of the second procedure in staged BTKA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed 528 patients (1,056 knees) who underwent staged BTKA between January 1, 2015, and December 31, 2019. Considering the different intervals, all patients were divided into 3 groups using 3 different cut-off points: group A (≤ 180 days), group B (&gt; 180 days and ≤ 365 days), and group C (&gt; 365 days). Comparison was done among the 3 groups for the second arthroplasties (A2 vs. B2 vs. C2). In each group, comparison was conducted between two surgeries (A1 vs. A2, B1 vs. B2, and C1 vs. C2, respectively).All data were retrieved retrospectively.This study utilized the propensity score matching (PSM)was performed to minimize confounding factors when comparing outcomes among groups.The matching variables included age, sex, BMI, height, comorbidities (hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease, liver cirrhosis, and smoking status), ASA score (American Society of Anesthesiologists classification), and surgeon (C.X.W. or G.D.). Patients with same Kellgren-Lawrence (K-L) grades (grade 4)were included during the initial screening to ensure homogeneity in osteoarthritis severity. We evaluated demographics and clinical outcomes, major complications, and hospital adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were no statistically significant differences in any of the clinical outcomes, major complications, and hospital adverse events among the 3 groups (A2 vs. B2 vs. C2)( all P &gt; 0.05). When C1 and C2 were compared, LOS (12.23 ± 3.41 vs 10.12 ± 2.76, P &lt; 0.0001), drainage volume (115.62 ± 45.67 vs 101.26 ± 49.28, P = 0.003), additional morphine analgesics consumption (131.52 ± 259.11 vs 69.78 ± 159.89, P = 0.016), and the rate of hospital adverse events (58.33% vs 46.15%, P = 0.026) were significantly better in group C2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The time frame of staged BTKAs has no influence on postoperative outcomes when the intervals are determined by patients. However, prolonging the interval between the surgeries may be beneficial for a faster recovery after the second knee arthroplasty. Benefits such as reduced intraoperative blood loss, lower postoperative analgesic use, and shorter hospital stays are especially evident when the interval exceeds one year, showing statistically significant differences. Therefore, if patients are willing to wait","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"170"},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055085","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 textbook outcomes between laparoscopic and open total gastrectomy for gastric cancer.","authors":"Yasir Musa Kesgin, Sezer Bulut, Burak Atar, Ahmet Sürek, Turgut Dönmez, Alpen Yahya Gümüşoğlu, Mehmet Karabulut","doi":"10.1186/s12893-025-02891-z","DOIUrl":"https://doi.org/10.1186/s12893-025-02891-z","url":null,"abstract":"<p><strong>Introduction: </strong>While surgery remains an important part of the multimodal treatment of gastric cancer, laparoscopy is increasingly being used in these procedures. The aim of our study is to compare open and laparoscopic total gastrectomy using the concept of 'textbook outcome', which has become popular as an important and comprehensive tool in evaluating the quality of surgical treatment.</p><p><strong>Methods: </strong>Gastric cancer patients underwent total gastrectomy with curative intent between July 2018 and January 2024 in a single center were included in this retrospective study. Exclusion criteria were emergency surgery, recurrent or metastatic disease, conversion to open, robotic gastrectomy. Patients divided to two groups as open and laparoscopic groups and compared in terms of demographic data, tumor characteristics, operative data and textbook outcome.</p><p><strong>Results: </strong>A total of 94 patients were enrolled in the study, while the majority of whom were male (73.4%, n = 69). Laparoscopic surgery was found longer but there was no significant difference in the incidence of anastomotic leak and other postoperative complications between the two groups. The textbook outcome rate was 50.8% in the open group while 51.5% in the laparoscopic total gastrectomy group (p = 0.949). The most significant variables associated with the inability to achieve the textbook outcome were readmissions, reinterventions and postoperative complications.</p><p><strong>Conclusion: </strong>Achievement of textbook outcomes was found to be similar between the open and laparoscopic groups. Laparoscopic total gastrectomy can be safely preferred taking into account patient status, surgeon expertise and center conditions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"169"},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046960","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 combined transposition of the inferior oblique muscle belly without disinsertion and contralateral inferior oblique recession for treating asymmetric inferior oblique muscle overaction (IOOA).","authors":"Xiaolin Yin, Lei Jin, Qian Li, Te Fu, Longge Sun","doi":"10.1186/s12893-025-02882-0","DOIUrl":"https://doi.org/10.1186/s12893-025-02882-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the efficacy of inferior oblique belly transposition (IOBT) combined with contralateral inferior oblique recession in treating bilateral asymmetric inferior oblique overaction (IOOA).</p><p><strong>Methods: </strong>A retrospective study was conducted on 23 patients with asymmetric IOOA. IOBT was performed on the less affected eye of the patient, while the contralateral inferior oblique recession was conducted on the more affected eye. Pre- and post-operative changes in the vertical deviation, V-value, fovea-disc angle (FDA), and inferior oblique muscle function were compared. Follow-up duration ranged from 3 to 8 months.</p><p><strong>Results: </strong>The V-pattern was corrected in all cases, and the V-value improved from 14.57 ± 4.50 preoperatively to 4.09 ± 2.17 postoperatively (t = 12.640, P < 0.001). The preoperative vertical deviation (5 m) significantly decreased from 8.04 ± 3.08 to 1.57 ± 1.90 postoperatively (t = 8.713, P < 0.001). Similarly, the lesser side FDA reduced from 11.39° ± 2.39° before surgery to 6.62° ± 1.11° after surgery (t = 11.132, P < 0.001). On the greater side, the FDA also showed significant improvement, reducing from 14.39° ± 2.45° preoperatively to 7.43° ± 1.23° postoperatively (t = 11.231, P < 0.001). No patients experienced anti-elevation syndrome (AES) or complications such as reverse head tilt postoperatively.</p><p><strong>Conclusion: </strong>IOBT combined with contralateral inferior oblique recession could effectively treat asymmetric IOOA in patients with ocular asymmetry.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"167"},"PeriodicalIF":1.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045120","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":"Transcatheter arterial embolization for acute nonvariceal upper Gastrointestinal bleeding in children: a single-center retrospective study.","authors":"Rong Zhang, Shi Biao Wang, Jian Feng He, Tian Hong Cai, Yang Mei Chen, Teng Hui Zhan","doi":"10.1186/s12893-025-02908-7","DOIUrl":"https://doi.org/10.1186/s12893-025-02908-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to provide a preliminary report on the outcomes of transcatheter arterial embolization (TAE) in pediatric patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB) to establish optimal practices for this intervention and explore its potential value in improving the management of pediatric patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on children with NVUGIB who underwent TAE at a single institutional center between February 2022 and April 2024. Comprehensive data were collected, including patient demographics, clinical manifestations, diagnostic and therapeutic procedures, intraoperative findings, and follow-up outcomes.</p><p><strong>Results: </strong>A total of 266 cases with NVUGIB were admitted to the institutional center, with 14 cases (5.26%) undergoing TAE. There were 10 males and 4 females. The average age was 7.21 ± 4.77 years old, and the average hospital stay was 13.14 ± 8.69 days. Nine cases (64.29%) had hematochezia, 2 cases (14.29%) had hematemesis, 3 cases (21.42%) had both hematochezia and hematemesis. Six cases (42.86%) had no significant medical history, 3 cases (21.42%) had previous Helicobacter pylori infections, 2 cases (14.29%) had previous lymphomas, and 1 case (7.14%) each had immune disorders, gastroenteritis, and fever. The mean preoperative minimum hemoglobin level was 57.85 ± 21.25 g/L. All cases underwent gastroenteroscopy before TAE. Ten cases (71.43%) had duodenal bulb ulcers, 3 cases (21.43%) had duodenal ulcers, and 1 case (7.14%) had multiple ulcers in the gastric antrum. Bleeding was visible on endoscopy in 6 cases (Forrest Classification Ib,42.86%) (Table 2; Fig. 2), which were treated. All cases underwent TAE, and the timing of TAE averaged 4.29 ± 4.53 days. The responsible vessel was identified intraoperatively in all cases: gastroduodenal artery in 7 cases (50%) and pancreaticoduodenal artery in 7 cases (50%). A pseudoaneurysm was found in 2 cases (14.29%). Embolization of the responsible vessel was performed in all cases, using platinum coils alone in 8 cases (57.14%) and platinum coils combined with gelatin sponge in 6 cases (42.8%). All cases were followed up for an average of 13.69 ± 8.77 months, and no recurrence was detected.</p><p><strong>Conclusion: </strong>TAE represents a promising intervention for pediatric patients with acute NVUGIB. Nevertheless, optimal timing, embolization techniques, and selection of embolizing agents necessitate further comprehensive investigation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"168"},"PeriodicalIF":1.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044965","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 and incidence of adverse reactions of nasal endoscopic surgery in the treatment of chronic rhinosinusitis with nasal polyps.","authors":"Shengwei Chen, Chubiao Lin, Zhonghong Fang","doi":"10.1186/s12893-025-02905-w","DOIUrl":"https://doi.org/10.1186/s12893-025-02905-w","url":null,"abstract":"<p><strong>Background: </strong>To research and examine the efficacy of nasal endoscopic surgery in management of chronic sinusitis with nasal polyps, as well as how it affects the likelihood of adverse responses.</p><p><strong>Methods: </strong>The collecting of samples was scheduled to take place between January 2020 and December 2022. The traditional surgery team consisted of 80 clients with chronic sinusitis and nasal polyps. Retrospective analysis of clinical information of two teams of clients with chronic sinusitis and nasal polyps who underwent surgery using different techniques, contrast of the surgical conditions, postoperative complications, recovery time, and postoperative pain scores between the two teams, as well as postoperative serum inflammatory factor indexes, immune function indexes, sleep state indexes, and quality of life grades of the two teams before and after.</p><p><strong>Results: </strong>The study team had procedure in less time than traditional surgery team(P < 0.05), and they experienced less intraoperative blood loss than traditional surgery team. The values in study team were lower than those in traditional surgery team in terms of overall incidence rate of postoperative adverse responses(P < 0.05). The grades of four aspects of quality of life in two teams after the operation greatly improved from those before operation. The grades of four aspects of quality of life in the two teams after operation greatly improved from those before operation, all P < 0.05.</p><p><strong>Conclusion: </strong>In contrast to conventional open sinus surgery, using nasal endoscope on clients with chronic sinusitis and nasal polyps can successfully remove polyps from nasal cavity, open sinuses, and lower risk of intraoperative problems.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"165"},"PeriodicalIF":1.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992143","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}