BMC Surgery最新文献

{"title":"Clinical safety study of laparoscopic common bile duct exploration and primary suture in elderly patients: a new strategy for the treatment of stones.","authors":"Hai-Wen Ye, Fei Liu, Dai-Jiao Gu, Jie Liao, Rong-Sen Huang, Jun-Jiang Pan","doi":"10.1186/s12893-025-03146-7","DOIUrl":"10.1186/s12893-025-03146-7","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic common bile duct exploration and primary suture (LBEPS) offers advantages such as minimal invasion, shorter operative time, and faster postoperative recovery in the treatment of common bile duct stones.However, its safety in elderly patients remains controversial.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 128 patients with common bile duct stones who underwent LBEPS treatment in our hospital from December 2018 to March 2025.The patients were divided into an elderly group (≥ 65years, n = 55) and a non-elderly group (< 65years, n = 73) based on age.Baseline characteristics, operative time, postoperative complications, recurrence rate, and other indicators were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics, such as sex, body mass index(BMI), or stone diameter, between the two groups (P > 0.05). The diameter of the common bile duct was significantly larger in the elderly group compared to the non-elderly group (P < 0.05). There were no significant differences in alanine aminotransferase (ALT), aspartate aminotransferase(AST), total bilirubi (TB), direct bilirubin (DB), white blood cells (WBC), haemoglobin (HGB), or platelet (PLT) levels between the two groups before and after surgery(P > 0.05). However, the postoperative drainage time and total hospital stay were longer in the elderly group (P < 0.05). The presence of hepatitis B was identified as an independent risk factor for complications after LBEPS.</p><p><strong>Conclusion: </strong>The clinical application of LBEPS in elderly patients with common bile duct stones is safe and feasible.Elderly patients require a longer preoperative length of stay compared to non-elderly patients.Patients with common bile duct stones and concomitant hepatitis B are more prone to complications after LBEPS.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"401"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976098","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":"Return to normal activity after abdominal surgery: a pre-planned secondary analysis of a randomised controlled trial across seven low- and middle-income countries.","authors":"Omar Omar, Sivesh Kathir Kamarajah","doi":"10.1186/s12893-025-03079-1","DOIUrl":"https://doi.org/10.1186/s12893-025-03079-1","url":null,"abstract":"<p><strong>Background: </strong>Recovery after major surgery is a key priority identified by patients, communities and policymakers in low- and middle-income countries (LMICs), with important societal and financial implications. With global burden of surgical diseases rising, little is known about how well patients return to normal activities after surgery in these settings. This study aimed to describe patterns of return to normal activity after major abdominal surgery and identify associated factors in LMICs.</p><p><strong>Methods: </strong>This was a pre-planned analysis of a cluster-randomised randomised trial testing routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection in seven LMICs (India, Mexico, Rwanda, Benin, South Africa, Nigeria, Ghana). 961 patients were excluded because of incomplete missing primary outcome. The primary outcome measure was a patients self-reported full return to their normal activities at 30 days after surgery. Factors associated with return to normal activities within 30-days of surgery was explored using a Bayesian mixed-effects logistic regression model. Sensitivity analyses were performed accounting for missing data.</p><p><strong>Results: </strong>12,340 patients across 81 centres were included. Overall, 65.3% (8064/12340) patients had returned to normal activity by 30-days after surgery. Patients undergoing surgery for benign than cancer surgery (67.0% vs. 59.7%), minor compared to major surgery (71.0% vs. 63.5%), and non-midline compared to midline (74.9% vs. 58.7%) had higher rates of return to normal activities within 30-days from abdominal surgery. In an adjusted model, factors associated with return to normal activities are benign surgery (OR: 0.61, 95% CI: 0.53-0.71), minor surgery (OR: 0.56, 95% CI: 0.49-0.64), and non-midline operations (OR: 1.57, 95% CI: 1.41-1.75). When accounting for missing data, consistent findings were observed.</p><p><strong>Conclusions: </strong>With rising need for surgical care and non-communicable disease globally, this study highlights the groups of patients at critical need for improving return to normal activity or recovery after surgery in LMICs. Improving access and implementation of rehabilitation pathways, aligned to the World Health Organisation, may be crucial to improve financial risk protection to patient and reduce productivity loss to the economy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"399"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975884","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":"Waiting time and 30-day mortality association in elderly patients having hip fracture surgery.","authors":"Min-Zhe Xu, Ke Lu, Yao-Wei Ye, Si-Ming Xu, Qin Shi, Ya-Qin Gong, Chong Li","doi":"10.1186/s12893-025-03140-z","DOIUrl":"https://doi.org/10.1186/s12893-025-03140-z","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aims to investigate the possible independent association between 30-day mortality rate and the length of waiting time in older people who underwent underwent surgery for hip fractures.</p><p><strong>Methods: </strong>This is a retrospective cohort study. Data were collected from 818 individuals aged 65 years and above who underwent surgery for hip fractures between January 2017 and July 2022 at the Affiliated Kunshan Hospital of Jiangsu University. The exposure variable was the length of waiting time, while the outcome variable was the 30-day mortality rate following hip fracture surgery. Potential covariates were analyzed including month of admission to hospital, week of admission to hospital, hip fracture category, body mass index (BMI), American Society of Anesthesiologists (ASA) score, age, surgery, gender, operation time and laboratory data. The association was finally analyzed using logistic regression models.</p><p><strong>Results: </strong>Our findings revealed a positive association between 30-day mortality rate and waiting time in older people who underwent surgery for hip fractures. The obtained results showed an increase in the 30-day mortality by 13.6% (OR, 1.136; 95% CI, 1.027 to 1.256; P-value = 0.0136) when there was an addition of 10 h of waiting time after the adjustment of the covariates. The results showed a nonlinear relationship of the 30-day mortality and waiting time, while the inflection point for the waiting time in the smoothed curve was observed at 42. 428 h. Furthermore, when waiting time was < 42. 428 h, we did not detect an increase in the probability of 30-day mortality. However, a waiting time of more than 42. 428 h may increase the risk of 30-day mortality.</p><p><strong>Conclusions: </strong>Our study provides evidence of a clear positive association between waiting time before hip fracture surgery and 30-day mortality risk in older individuals. The waiting time of 42. 428 h may represent a threshold for higher risk of mortality.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"397"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976116","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":"Single-incision laparoscopic cholecystectomy with inflexible laparoscopic instruments and laparoscopy: a single-center experience of 533 cases.","authors":"Zhiquan Chen, Liufan Zha, Jinhong Wu, Huanbing Zhu, Xiang Pan, Chao Li, Yangming Hou, Dan Ye, Daren Liu","doi":"10.1186/s12893-025-03124-z","DOIUrl":"https://doi.org/10.1186/s12893-025-03124-z","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) has been widely performed as the gold standard for BGDs. Single-incision laparoscopic cholecystectomy (SILC) was considered as an option for minimizing surgical injuries and improving outcomes. However, the benefit of this novel technique, especially with conventional and inflexible instruments and laparoscopy, is still controversial.</p><p><strong>Materials and methods: </strong>This retrospective cohort study analyzed 958 consecutive cases (533 SILC vs. 425 CLC) from January 2023 to March 2024. SILC was performed via a single transumbilical incision with straight and inflexible instruments whereas CLC with traditional three-port strategy. Information of patients' demographic characteristics and pathological diagnoses was collected and analyzed. Comparative outcomes assessment included validated measures: SF-36 QoL indices, VAS pain scores, Vancouver Scar Scale assessments, hospitalization duration, and Clavien-Dindo complication grading.</p><p><strong>Results: </strong>Cases from two groups showed similar demographic characteristics and pathological diagnoses. They also had comparable surgical time, estimated intraoperative blood loss and hospital costs. Sixteen cases required supplementary trocars for technical challenges. The SILC group exhibited superior scar satisfaction, though no significant intergroup differences existed in hospitalization duration, postoperative pain scores, or wound infection rates. Longitudinal analysis revealed reduced chronic pain and diarrhea incidence in SILC patients. Six-month postoperative SF-36 assessments showed significant improvements in SILC recipients for Bodily Pain, Vitality, and Role-Emotional domains.</p><p><strong>Conclusion: </strong>The present study demonstrated SILC with conventional and inflexible instruments to be safe and feasible. SILC was found to be non-inferior to CLC. This technique demonstrated certain advantages, particularly in improving patient satisfaction with wound pain and appearance, while maintaining comparable surgical outcomes, hospital stay duration, and postoperative complication rates to those of CLC.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"396"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975895","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":"Risk prediction models for complications after flap repair surgery: a systematic review and meta-analysis.","authors":"Jiebin Yang, Xinya Qin, Lili Hou, Yamei Liu","doi":"10.1186/s12893-025-03072-8","DOIUrl":"https://doi.org/10.1186/s12893-025-03072-8","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the performance and applicability of risk prediction models for complications after flap repair and to provide guidance for building and refining models.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, the Cochrane Library, CNKI, SinoMed, VIP and Wanfang were searched for studies on risk prediction models for flap complications. The search period is from inception to December 28, 2024. The PROBAST tool was used to evaluate the quality of the prediction model research, and Stata 18 software was employed to meta-analyze the predictors of the models.</p><p><strong>Results: </strong>A total of 16 studies were included, 28 risk prediction models were constructed, and the area under the receiver operating characteristic curve (AUC) ranged from 0.655 to 0.964, with 16 prediction models performing well (AUC > 0.7). Eleven articles underwent model calibration, 16 were validated internally, and 3 were validated externally. The results of the PROBAST review revealed that all 16 studies were at high risk of bias. The incidence rate of flap complications was 14.8% (95% CI, 10.7 - 19.0%). Body mass index (BMI), smoking history, long flap reconstruction time, diabetes mellitus, hypertension, and postoperative infection were independent risk factors for complications after flap repair (P < 0.05).</p><p><strong>Conclusion: </strong>The risk prediction model for complications after flap repair has certain predictive value, but the overall risk of bias is high, and there is a lack of external validation; thus, it needs to be further enhanced and optimized to increase its prediction accuracy and clinical practicability.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"398"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975869","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":"TiRobot-assisted percutaneous vertebroplasty in the management of middle and upper thoracic osteoporotic vertebral compression fracture.","authors":"Juyi Lai, Huangsheng Tan, Pengwei Deng, Yinbo Wang, Yong Huang, Hualong Feng, Zhiming Lan, Zhitao Sun, Jian Wang, Yuanfei Fu, Shenghua He","doi":"10.1186/s12893-025-03049-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03049-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical efficacy and safety of TiRobot-assisted PVP surgery in the treatment of middle and upper thoracic OVCF. We also aimed to determine (1) changes in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before and after treatment, (2) imaging changes of the fractured vertebra, (3) operation time and intraoperative blood loss, (4) frequency of puncture and fluoroscopy, hospital stay, radiation exposure of patient and surgeon, and (5) bone cement leakage and distribution and operation-related complications.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 62 patients with OVCF of the middle and upper thoracic vertebrae (T1-T8) who underwent PVP surgery in Shenzhen Traditional Chinese Medicine Hospital from January 2017 to January 2023. Of them, 30 and 32 patients underwent TiRobot-assisted PVP surgery (robot group) and conventional C-arm-assisted PVP surgery (conventional group), respectively. VAS and ODI scores and the anterior height and local kyphotic angle of the fractured vertebra were compared before surgery and 3 days, 1 month, and 1 year after surgery. Simultaneously, the operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, cement distribution, and complication were compared between the two groups.</p><p><strong>Results: </strong>VAS score and ODI score at 3 days, 1 month, and 1 year after surgery were significantly improved in both groups compared with those before surgery (p < 0.05). The VAS score of the robot group was lower than that of the conventional group 3 days after surgery (p < 0.05), with no significant difference observed before and after surgery (p > 0.05). No significant difference was observed in anterior height and local kyphotic angle of fractured vertebra between the two groups before and after the surgery (p > 0.05). The operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, and cement distribution of the robot group were all better than those of the conventional group (p < 0.05). Simultaneously, the incidence of complications in the robot group was 3.33% (1/30) lower than that of the conventional group (15.62%) (5/32) (p < 0.05).</p><p><strong>Conclusions: </strong>Compared with traditional PVP surgery, the use of TiRobot-assisted PVP in the treatment of middle and upper thoracic OVCF has the advantages of accuracy, safety, and low-radiation exposure, which can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"395"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976080","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 prehabilitation strategies on psychological state, glucose metabolism, and postoperative outcomes in patients undergoing laparoscopic sleeve gastrectomy.","authors":"Yan Zhang, Bingquan Gao, Xiaocheng Zhang, Linru Zhao, Xu Han, Miaomiao Zhang, Guihua Zhang","doi":"10.1186/s12893-025-02973-y","DOIUrl":"10.1186/s12893-025-02973-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the effects of prehabilitation strategies on the psychological state and glucose metabolism markers in patients undergoing laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>A total of 120 eligible patients undergoing elective LSG between January 2024 and December 2024 were enrolled in the study. They were randomly assigned to either the control group or the observation group, with 60 patients in each group. The control group received routine care interventions, while the observation group received prehabilitation strategies. The outcomes were compared between the two groups, including body mass index (BMI), body fat percentage (PBF), visceral fat area (VFA), waist-to-hip ratio (WHR), basal metabolic rate (BMR), glucose metabolism markers, psychological state, and incidence of postoperative complications, measured both one day before and six months after the intervention.</p><p><strong>Results: </strong>One day before the intervention, there were no significant differences between the two groups in BMI, PBF, VFA, WHR, and BMR (P > 0.05). However, six months after the intervention, the observation group showed significantly lower BMI, PBF, VFA, WHR, and BMR compared to the control group (P < 0.05). Furthermore, at six months post-surgery, the observation group had significantly lower HbA1c levels compared to the control group (P < 0.05), while the difference in fasting blood glucose (FBG) was not statistically significant (P > 0.05). Regarding psychological state, the observation group showed significantly lower scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) six months after the intervention (P < 0.05). Additionally, the incidence of postoperative minor complications was significantly lower in the observation group compared to the control group (P < 0.05).</p><p><strong>Conclusion: </strong>Prehabilitation strategies can effectively improve the psychological state, reduce glycated hemoglobin levels, promote weight loss, and reduce the incidence of minor postoperative minor complications in patients undergoing laparoscopic sleeve gastrectomy. These strategies appear to be safe and effective, and could be considered for wider clinical adoption.</p><p><strong>Clinical registration number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"394"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976092","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":"Real-world safety of irreversible electroporation therapy for tumors with nanoknife: MAUDE database analysis.","authors":"Jia-Cheng Xiang, Zhi-Yu Xia, Jian-Xuan Sun, Shao-Gang Wang, Qi-Dong Xia","doi":"10.1186/s12893-025-03136-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03136-9","url":null,"abstract":"<p><strong>Background: </strong>Irreversible electroporation (IRE) is a non-thermal ablation technique using high-voltage, low-energy pulses to induce cell membrane perforation and cell death. As an emerging therapy, IRE has gained increasing application in local tumor treatment, with Nanoknife being the most widely used device. Despite its relative safety compared to traditional therapies, potential adverse reactions still merit the attention of clinicians.</p><p><strong>Methods: </strong>We analyzed all IRE-related adverse event reports in the Manufacturer and User Facility Device Experience (MAUDE) database, focusing on event types, Clavien-Dindo Grades, the timing of adverse events and temporal trends across cancers.</p><p><strong>Results: </strong>Device malfunctions with Nanoknife were a significant issue but have declined recently. In pancreatic cancer, gastrointestinal injuries (mainly hemorrhagic lesions) were most commonly reported. In liver cancer, arrhythmias were frequent, with no new cases in recent years. In prostate cancer, rectal fistula was the most common adverse event, with an increasing number of cases being reported.</p><p><strong>Conclusions: </strong>Theoretically, the Nanoknife is expected to exhibit favorable safety profiles. However, ongoing attention to device maintenance, treatment standardization, and postoperative management is needed to further enhance its safety.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"390"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975407","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 Port implantation in persistent left superior vena cava with azygos vein variation: a case report and literature review.","authors":"Li Zhang, Jingjin Wu","doi":"10.1186/s12893-025-03144-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03144-9","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"389"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976096","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":"Impact of surgical care pathways on efficiency and outcomes in orthopedic operating rooms: a historical control study.","authors":"Tao He, Xiaojun Zhu, Guanghao Chi, Huan Chen, Min Hao, Xin Huang, Guanrong Wang","doi":"10.1186/s12893-025-03135-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03135-w","url":null,"abstract":"<p><strong>Objective: </strong>The impact of surgical care pathways (CP) on efficiency and patient outcomes in orthopedic operating rooms (OR) is unclear, and we aim to optimize nursing strategies and enhance service quality.</p><p><strong>Methods: </strong>From July 2019 to June 2024, 3,836 patients undergoing orthopedic surgery at a single Grade 3 Chinese hospital were retrospectively analyzed and divided into two equal groups, with or without CP (1,918 patients in each group). The effectiveness of CP was assessed by comparing surgical site infection (SSI) rates, pathogens, OR turnover times, and patient satisfaction. Statistical analyses included between-group comparisons and multivariate logistic regressions.</p><p><strong>Results: </strong>Baseline characteristics were balanced across groups (SMD < 0.1). Overall SSI rates were 2.1%, significantly lower in the CP group than in the Non-CP group (1.6% vs. 2.6%, P < 0.05), and translating to a 43% risk reduction (OR 0.57, 95% CI: 0.36-0.88, P < 0.05). Gram-positive bacterial infections notably decreased (OR 0.331, 95% CI: 0.093-0.959, P < 0.05). CP implementation also improved OR turnover times (95% CI: 0.504-0.839, P < 0.001) and patient satisfaction (95% CI: 1.038-2.301, P < 0.05). No significant differences were observed in other nursing quality indicators.</p><p><strong>Conclusion: </strong>Standardized CPs are effective in significantly reducing the incidence of postoperative SSIs, particularly those caused by Gram-positive bacteria, thereby enhancing infection control. Furthermore, these pathways improve OR operational efficiency and patient satisfaction, supporting reforms in OR management practices.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"392"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976095","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}