BMC Surgery最新文献

{"title":"Time from drainage to surgery is an independent predictor of morbidity for moderate-to-severe acute cholecystitis: a multivarirble analysis of 259 patients.","authors":"Dai Kujirai, Yujiro Isobe, Hirofumi Suzumura, Kenji Matsumoto, Yuichi Sasakura, Toshiaki Terauchi, Masaru Kimata, Hiroharu Shinozaki, Kenji Kobayashi","doi":"10.1186/s12893-024-02688-6","DOIUrl":"10.1186/s12893-024-02688-6","url":null,"abstract":"<p><strong>Background: </strong>Acute cholecystitis (AC) is an acute inflammatory disease of the gallbladder and one of the most frequent causes of acute abdominal pain. Early cholecystectomy is recommended for mild cholecystitis. However, the optimal surgical timing for moderate-to-severe cholecystitis requiring percutaneous transhepatic gallbladder drainage (PTGBD) remains unclear. We hypothesized that early elective surgery after PTGBD would reduce surgical morbidity.</p><p><strong>Methods: </strong>A retrospective analysis was performed on adult patients who underwent elective surgery for AC after PTGBD at our hospital between January 2011 and December 2020. Patient demographics, perioperative findings, and postoperative morbidity and mortality rates were also investigated. The patients were divided into two groups based on postoperative morbidity, and univariable analysis was performed for preoperative factors. Multivariable logistic regression analysis was performed for the potential independent variables.</p><p><strong>Results: </strong>A total of 891 patients were screened for eligibility, and 259 were included in the analysis. Among these patients, 32 developed postoperative morbidity; however, there was no postoperative mortality. Multivariable analysis revealed that the time from PTGBD to surgery was an independent predictor of surgical morbidity (odds ratio, 1.05; 95% confidence interval: 1.01-1.10).</p><p><strong>Conclusion: </strong>In early elective surgery for moderate-to-severe AC requiring PTGBD, a shorter interval from biliary drainage to surgery may decrease surgical morbidity.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"389"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865994","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":"Role of surgical vaginoscopy through no-touch hysteroscope in the treatment of female reproductive polyps.","authors":"Haixia Li, Baojun Yang, Wanli Gao, Chunyu Huang, Chunxia Li, Hui Zhao, Limin Feng","doi":"10.1186/s12893-024-02673-z","DOIUrl":"10.1186/s12893-024-02673-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The study aims to investigate the application of surgical vaginoscopy via a no-touch hysteroscopic approach for the management of female genital polyps. The primary objective is to assess the feasibility of this technique in treating intrauterine pathologies in both pregnant and non-pregnant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of forty-six patients diagnosed with genital polyps underwent operative vaginoscopy at a university-affiliated hospital between April 1, 2017 and May 31, 2023. A retrospective analysis was conducted on the collected data, encompassing patient complaints, clinical presentations, surgical outcomes, and pathological diagnoses. Additionally, the success rate of the vaginoscopic procedures was determined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-six patients with an average age of 33.0 ± 8.8 years were included in this study. Among them, 25 were non-pregnant (3 with and 22 without a sexual history). The most common clinical manifestation was irregular vaginal bleeding (11/25, 44%) followed by conscious vaginal protrusion (10/25, 40%). Among the 21 pregnant patients, the main symptom was irregular vaginal bleeding during pregnancy (100%). The postoperative pathological diagnoses included 11 endometrial polyps, 33 cervical polyps, 1 multiple vaginal polyps, and 1 vaginal stump polyps. The coincidence rate between the intraoperative vaginoscopic diagnosis and postoperative pathological diagnosis was 100%. Among the non-pregnant patients, 11 were diagnosed with endometrial polyps, with an average length of 2.2 ± 1.2 cm, 1 patient had vaginal residual polyps after total hysterectomy, with a polyp length of 0.3-0.7 cm, and 1 had multiple vaginal polyps, with a length of 0.5-3 cm. Twelve patients had cervical polyps with an average length of 3.4 ± 1.2 cm. Twenty-one pregnant patients were diagnosed with cervical polyps, the average length of 2.4 ± 1.4 cm. All patients successfully underwent vaginoscopic surgery, for an average surgical duration of 23.5 ± 14.9 min, a bleeding volume of 1-10 mL(4.5 ± 3.4 mL), and an average hospitalisation of 2.7 ± 1.3 days. Throughout the surgical procedures, no complications were encountered, including water intoxication or uterine perforation. Postoperatively, no patients experienced discomforts such as fever or moderate to severe abdominal pain. Furthermore, all non-pregnant women were monitored for a two-month period following surgery, and throughout this interval, there were no reports of abnormal vaginal bleeding, unusual vaginal discharge, or abdominal pain. None of the 21 pregnant women experienced abnormal vaginal bleeding after the surgery. Nineteen of them delivered at full term, and one underwent caesarean delivery at 31 weeks owing to placental abruption. All the newborns had Apgar scores of 10, 10, and 10, and one had a miscarriage at 18 weeks of gestation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Vaginoscopic surgery through no-touch hysteroscope represen","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"390"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865992","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 efficacy of norepinephrine application in Mammotome-assisted minimally invasive resection for benign breast neoplasm: A retrospective study.","authors":"Yafei Sun, Zipeng Xu, Jing Hu, Lina You, Chaobo Chen","doi":"10.1186/s12893-024-02701-y","DOIUrl":"10.1186/s12893-024-02701-y","url":null,"abstract":"<p><strong>Objective: </strong>Although Mammotome-assisted minimally invasive resection (MAMIR) has been widely accepted for treating breast benign nodules, the procedure remains very technical and challenging. The present study aimed to assess the efficacy of norepinephrine application in MAMIR concerning intraoperative hemorrhage, postoperative pain and postoperative hospitalization.</p><p><strong>Methods: </strong>A total of 306 patients with breast nodules admitted at the Xishan people's Hospital of Wuxi City between June 2021 and July 2023 were included in this retrospective cohort study. The patient's age, comorbidities (hypertension and diabetes), and characteristics of the breast nodule (number, unilateral or bilateral nature, inner quadrant volume and total volume) were all meticulously documented. Operation time, intraoperative hemorrhage, postoperative hospitalization and Visual analogue scale(VAS) score (postoperative 6-hour pain score) were recorded. Based on the application of norepinephrine, patients were categorized into non-NPP(norepinephrine) and NPP group. Univariate and multivariate analyses were performed to estimate the odds ratio (OR) and the 95% confidence intervals (CIs) for outcomes.</p><p><strong>Results: </strong>A total of 155 who accepted MAMIR were included in this study. The NPP group exhibited reduced intraoperative bleeding, diminished postoperative pain, and a shorter duration of hospitalization (p < 0.05). Univariable analysis indicated that usage of norepinephrine during operation helped to reduce intraoperative hemorrhage (OR = 0.14, 95%CI: 0.07-0.31), alleviate postoperative pain(OR = 0.03, 95%CI: 0.01-0.09) and shorten hospital stay(OR = 0.50, 95%CI: 0.26-0.95). Furthermore, multivariate analysis identified the usage of norepinephrine during MAMIR as an independent factor associated with reducing intraoperative hemorrhage (OR = 0.11, 95%CI: 0.05-0.26) and relieving postoperative pain (OR = 0.02, 95%CI: 0.004-0.08) after adjusting for other factories.</p><p><strong>Conclusions: </strong>Norepinephrine could help to reduce postoperative hospitalization and intraoperative hemorrhage, also relieve postoperative pain for breast benign nodules resection, which was an independent protective factor for relieving postoperative pain and reducing intraoperative hemorrhage.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"393"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865993","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":"Laser-guided percutaneous microwave ablation for lung nodules: a promising approach with reduced operation time.","authors":"Yuejuan Zhang, Zijian Li, Cheng Ding, Jun Zhao, Li Ye, Ziqing Shen, Xinyu Song","doi":"10.1186/s12893-024-02698-4","DOIUrl":"10.1186/s12893-024-02698-4","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary nodule ablation is an effective method for treating pulmonary nodules. This study is based on the traditional CT-guided percutaneous microwave ablation (MWA) of pulmonary nodules. By comparing laser guidance technology with freehand method, this study aims to explore the safety and efficacy and patients' pain scores of these two approaches.</p><p><strong>Methods: </strong>This study retrospectively analyzed 126 patients who underwent CT-guided percutaneous lung ablation at the First Affiliated Hospital of Soochow University from April 2020 to April 2024. Based on the guidance method, we divided those patients into the laser guidance group and the freehand group. The primary outcome such as operation time, the number of ablation needle adjustments, postoperative pain scores, postoperative hospital stay, and postoperative complications were analyzed.</p><p><strong>Results: </strong>The laser guidance group had a significantly shorter mean operation time compared to the freehand group (39.3 ± 13.65 min vs. 43.82 ± 19.12 min, p < 0.01), and in the laser guidance group, fewer ablation needle adjustments were required than in the freehand group (3.3 ± 1.34 time vs. 4.37 ± 1.39 times, p < 0.001). As compared to the freehand group, the laser guidance group had fewer cases of mild pneumothorax (13.16% vs. 38.33%, p < 0.05). The postoperative pain score at 1 h and 1 day of the two groups showed no statistical difference.</p><p><strong>Conclusion: </strong>Both methods are safe and effective. The laser guidance technology significantly reduces the number of puncture adjustments and the operation time compared to the freehand method. Laser guidance technology effectively reduces the incidence of mild pneumothorax.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"391"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865991","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":"Analysis of risk factors and establishment of prediction model for lower extremity deep vein thrombosis after lumbar fusion surgery.","authors":"Yixiang Zhao, Xiangzhen Kong, Kangle Song, Zhenchuan Liu, Yuanqiang Zhang, Lei Cheng","doi":"10.1186/s12893-024-02689-5","DOIUrl":"10.1186/s12893-024-02689-5","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity deep vein thrombosis (LEDVT) is a common complication after orthopedic surgery. Currently, a reliable assessment tool is lacking to evaluate the risk of postoperative LEDVT in patients undergoing lumbar fusion surgery. This study aims to explore the risk factors for LEDVT formation after lumbar fusion surgery and establish a predictive model for it.</p><p><strong>Methods: </strong>Data of patients admitted for multi-center spinal surgery from May 2022 to September 2023 were retrospectively collected. Patients were divided into DVT and non-DVT groups based on the occurrence of LEDVT after surgery. Potential risk factors were initially identified through intergroup comparative analysis and single-factor logistic regression, which were considered candidate indicators. LASSO regression was applied to select candidate indicators, and the filtered variables were included in a multivariable logistic regression model. Nomogram and dynamic nomogram were constructed to visualize the model, and the model was subsequently validated.</p><p><strong>Results: </strong>Factors including weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins were included in the multivariable logistic regression model. The results showed that the model had an area under the receiver operating characteristic curve of 0.870, 0.777 and 0.750 for the training set, internal validation set, and external validation set, respectively. Nomograms and web-based dynamic nomograms were created based on the multivariable logistic regression model. The model exhibited good performance in calibration curves and decision analysis.</p><p><strong>Conclusion: </strong>The study identified weakened lower extremity muscle strength, intraoperative blood loss, walking impairment, and Venous reflux/ Varicose veins as risk factors for LEDVT formation following lumbar fusion surgery. The predictive tool established based on the logistic regression model demonstrated good performance and can be considered for assessing the risk of LEDVT formation after lumbar fusion surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"392"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865989","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: Evolution of minimally invasive cholecystectomy: a narrative review.","authors":"Changjin Nam, Jun Suh Lee, Ji Su Kim, Tae Yoon Lee, Young Chul Yoon","doi":"10.1186/s12893-024-02715-6","DOIUrl":"10.1186/s12893-024-02715-6","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"387"},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848081","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 totally preperitoneal hernioplasty (SIL-TPP) for bilateral inguinal hernia repair: initial experience.","authors":"Qing Huang, Xiaojun Wang, Li Hu, Xionghua Xiang, Changlei Qi, Ting Fei, Encheng Zhou","doi":"10.1186/s12893-024-02626-6","DOIUrl":"10.1186/s12893-024-02626-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to introduce and assess the safety and feasibility of single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) for bilateral inguinal hernia repair.</p><p><strong>Method: </strong>Forty-two SIL-TPP procedures for bilateral inguinal hernia repair were conducted from June 2018 to July 2022 at the First Affiliated Hospital of Ningbo University using standard laparoscopic instruments and a single-port device. Clinical data such as demographic intraoperative parameters and short-term postoperative outcomes were collected and analysed.</p><p><strong>Results: </strong>SIL-TPP was successful in 42 bilateral inguinal hernia patients, and no conversion occurred. Of these 42 patients, 38 were males and 4 were females. The average age was 57.4 ± 17 years. The participants' mean BMI was 22.67 ± 2.19 kg/m2 (range from 18.65 to 28.71 kg/m2). There were 4 types of bilateral hernias. The percentage of patients who underwent surgery before the SIL-TPP procedure in the same region was 21.43% (9/42). The mean operative time was 114 ± 34.24 min (range, 70-215 min). A total of 11 intraoperative complications occurred in 42 bilateral inguinal hernia patients, including unintentional peritoneum tears and hernia sac tears. No major complications occurred in the study. The postoperative complication rate was 2.38% (1/42). One patient experienced intestinal obstruction after the operation that resolved spontaneously without treatment. The surgical time in the SIL-TPP group decreased gradually as the number of operations increased. Moreover, the operation time trend decreased linearly (P < 0.0001, R²=0.42).</p><p><strong>Conclusion: </strong>SIL-TPP is a safe and feasible procedure for treating bilateral inguinal hernias. The SIL-TPP procedure requires distinct skills and has specific advantages in treating bilateral hernias. Large-scale randomized controlled studies comparing SIL-TPP with conventional single-port and three-port laparoscopic TEP for bilateral inguinal hernia are needed to confirm these results.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"386"},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787423","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 application value of 5 Fr non-contact hysteroscopy in the diagnosis and treatment of intrauterine diseases in perimenopausal and postmenopausal women.","authors":"Jun Huang, Cunsi Yin, Junli Wang","doi":"10.1186/s12893-024-02680-0","DOIUrl":"10.1186/s12893-024-02680-0","url":null,"abstract":"<p><strong>Objective: </strong>To explore the application value of 5 Fr non-contact hysteroscopy in the diagnosis and treatment of intrauterine diseases in perimenopausal and postmenopausal women.</p><p><strong>Methods: </strong>A total of 200 perimenopausal and postmenopausal patients who were to undergo hysteroscopy for intrauterine diseases from October 2022 to January 2024 were selected as the research objects, and the clinical data were retrospectively analyzed. According to the different treatment methods, these subjects were divided into a 5Fr non-contact hysteroscopic group (5Fr group) and a traditional hysteroscopic group (traditional group), with 100 cases in each group. The surgery-related indicators, postoperative-related indicators, intraoperative/postoperative disease diagnosis, and satisfaction of the patients in the two groups were compared.</p><p><strong>Results: </strong>Compared with the traditional group, the examination time of the 5Fr group was significantly shortened, and the proportion of intraoperative bleeding ≤ 5 mL was significantly increased (P < 0.05). Compared with the traditional group, the proportion of abnormal heart rate/blood pressure and nausea/vomiting, and pain score were significantly reduced in the 5Fr group (P < 0.05), while the proportion of postoperative bleeding time ≤ 1 week and postoperative abdominal pain time ≤ 2 h were significantly increased in the 5Fr group (P < 0.05). The satisfaction rate of the 5Fr group was 91.00% (41.00% relatively satisfied + 50.00% very satisfied), which was much higher than 75% (37.00% relatively satisfied + 38.00% very satisfied) in the traditional group (P < 0.05).</p><p><strong>Conclusion: </strong>5Fr non-contact hysteroscopy had similar clinical effects to the traditional hysteroscopy, and the 5Fr non-contact hysteroscopy technology made up for the shortcomings of the traditional hysteroscopy, which could significantly reduce the pain and intraoperative bleeding of patients, and improve patient satisfaction.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"384"},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781331","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":"Application of CUSUM analysis in assessing learning curves in robot-assisted sacrocolpopexy performed by experienced gynecologist.","authors":"Kena Park, Ji Young Kwon, Eun-Hee Yoo, Seon Hwa Lee, Jeong Min Song, Seung Yeon Pyeon","doi":"10.1186/s12893-024-02691-x","DOIUrl":"10.1186/s12893-024-02691-x","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the learning curve of robotic-assisted sacrocolpopexy by applying CUSUM analysis based on operation time, complication rate and conversion rate to open laparotomy.</p><p><strong>Methods: </strong>A retrospective study was conducted with 50 consecutive robotic-assisted sacrocolpopexy surgeries performed from June 2018 and June 2023 by a single experienced gynecologist. Baseline patient demographics, intraoperative parameters and postoperative outcomes were collected. Cumulative sum (CUSUM) of robotic-assisted sacrocolpopexy operation time was analyzed to determine breakpoints between learning phases using piecewise linear regression. This allowed the detection of subtle shifts in surgical parameters and ultimately surgeon proficiency and competency. Continuous variables, such as age, length of hospitalization and op time, were reported as mean (standard deviation). One-way analysis of variance was employed to compare continuous variables. Categorical variables were expressed as percentages and analyzed using the chi-square test.</p><p><strong>Results: </strong>The regression identified breakpoints at case 8.47 (95% CI 8.0, 9.0) and case 34.41 (95% CI 32.7, 36.1), with an R² value of 0.87, which agrees with that of the second-order polynomial equation. The breakpoints were rounded to the next whole number at case 9 and 35. The Learning, Proficiency, and Competency phases consisted of 9, 26, and 15 cases, respectively in this consecutive series. This suggests that the surgeon achieved proficiency after the first 9 cases and competency after 35 cases. There were no intraoperative nor short-term post-operative complications during the span of this study. Furthermore, there were no conversions to open laparotomy. CUSUM analysis based on complication and conversion rate, therefore, was not available.</p><p><strong>Conclusion: </strong>According to CUSUM analysis, surgical proficiency of robotic-assisted sacrocolpopexy was attained after the first 9 cases, and stabilization of operation time was achieved after 35 cases. This statistical tool has proven to be useful in objectively assessing learning curves for new surgical techniques, and the transition from laparoscopic sacrocolpopexy to robotic-assisted sacrocolpopexy seems achievable. This, however, may vary with each surgeon's manual dexterity and experience level. Further investigation with several surgeons and institutions is needed to define a more accurate and generalized learning curve of robotic-assisted sacrocolpopexy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"385"},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781238","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 model for predicting AKI after cardiopulmonary bypass surgery in Chinese patients with normal preoperative renal function.","authors":"Xuan Lin, Li Xiao, Weibin Lin, Dahui Wang, Kangqing Xu, Liting Kuang","doi":"10.1186/s12893-024-02683-x","DOIUrl":"https://doi.org/10.1186/s12893-024-02683-x","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a predictive model for acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery in Chinese patients with normal preoperative renal function.</p><p><strong>Method: </strong>From January 1, 2015, to September 1, 2022, a total of 1003 patients were included in the analysis as a development cohort. We used the ratio of 7:3 to divide the patients into a training group (n = 703) and a testing group (n = 300). In addition, a total of 178 patients were collected as an external validation cohort from January 1, 2023, to May 1, 2023. In the training group, independent risk factors for postoperative AKI were identified through the least absolute shrinkage and selection operator (LASSO) regression and multifactor logistic regression analysis. A nomogram predictive model was then established. The area under the curve (AUC) of receiver operating characteristic (ROC) curve, as well as calibration curve and decision curve, were used for validation of the model.</p><p><strong>Results: </strong>Age, body mass index (BMI), emergent surgery, CPB time, intraoperative use of adrenaline, and postoperative procalcitonin (PCT) were identified as important risk factors for AKI after CPB surgery (P < 0.05). The nomogram predictive model demonstrated good discrimination (AUC: 0.772 (95%CI: 0.735 - 0.809), 0.780 (95% CI: 0.724 - 0.835), and 0.798 (95% CI: 0.731 - 0.865)), calibration (Hosmer and Lemeshow goodness of fit test: P-value 0.6941, 0.9539, and 0.2358), and clinical utility (the threshold probability values in the decision curves are respectively > 12%, > 10%, and 16% ~ 75%) in the training, testing, and external validation groups.</p><p><strong>Conclusion: </strong>The predictive model, which was established in Chinese patients with normal preoperative renal function, has high accuracy, calibration, and clinical utility. Clinicians can utilize this model to predict and potentially reduce the incidence of AKI after CPB surgery in the Chinese population.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"383"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774142","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}