BMC Surgery最新文献

{"title":"Incidence and risk factor analysis of moderate-to-severe pain after preoperative CT-guided hook-wire puncture localization of pulmonary nodules.","authors":"Jiajian Pan, Tianci Feng, Jiayi Wang, Ran Ma, Tianyue Ma, Yong Ge, Teng Sun, Shoujie Feng, Cheng Zhang, Hao Zhang","doi":"10.1186/s12893-024-02633-7","DOIUrl":"10.1186/s12893-024-02633-7","url":null,"abstract":"<p><strong>Background: </strong>Pain is a relatively common complication after hook-wire puncture localization. However, the problem of pain occurrence following this localization procedure has not been sufficiently examined. In this prospective study, we aimed to investigate the incidence and risk factors associated with acute pain after preoperative CT-guided hook-wire puncture localization of pulmonary nodules.</p><p><strong>Methods: </strong>Clinical data were collected prospectively from patients with small pulmonary nodules who underwent preoperative CT-guided hook-wire puncture localization between May 2022 and May 2023 at the Affiliated Hospital of Xuzhou Medical University. Patients were divided into two groups on the basis of the presence or absence of moderate-to-severe pain following the localization process. Univariate logistic analysis was conducted to analyse the clinical data of the two groups. Subsequently, the significant variables (P < 0.1) from the univariate analysis were subjected to multivariate logistic analysis, followed by the establishment of regression equations to determine the significant risk factors related to moderate-to-severe pain after hook-wire puncture localization.</p><p><strong>Results: </strong>A total of 281 patients with small pulmonary nodules undergoing preoperative CT-guided hook-wire puncture localization were finally included, with a mean age of 54.86 years (SD = 12.1 years) and female predominance (67.6%). In the resting state, 53% of the patients reported moderate-to-severe pain. Univariate analysis revealed that age (P = 0.085), the depth of localization needle insertion into the lung (P = 0.024) and the location of the chest wall puncture (P = 0.07) were associated with moderate-to-severe pain occurrence after hook-wire puncture localization (P < 0.1). Furthermore, multivariate logistic regression analysis demonstrated that the depth of localization needle insertion into the lung (OR = 0.953, 95% CI: 0.914-0.992, P = 0.02) and the location of the chest wall puncture (lateral chest wall vs. anterior chest wall: OR = 2.101, 95% CI: 1.166-3.784, P = 0.013; posterior chest wall vs. anterior chest wall: OR = 1.163, 95% CI: 0.895-2.971, P = 0.11) were independent predictors of moderate-to-severe pain incidence following CT-guided hook-wire puncture localization (P < 0.05).</p><p><strong>Conclusion: </strong>Moderate-to-severe pain is prevalent in patients with pulmonary nodules who undergo preoperative CT-guided hook-wire puncture localization. The depth of needle insertion into the lung and the location of the chest wall puncture are significant predictors of moderate-to-severe pain onset.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"356"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631249","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":"Retroperitoneal pancreas transplantation with a Roux-en-Y duodenojejunostomy for exocrine drainage.","authors":"Mogeli Sh Khubutiya, Ilya V Dmitriev, Nikita S Zhuravel, Aslan G Balkarov, Roman V Storozhev, Yuri A Anisimov, Alexander S Kondrashkin, Nonna V Shmarina","doi":"10.1186/s12893-024-02658-y","DOIUrl":"10.1186/s12893-024-02658-y","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic transplantation is the only definitive surgical treatment for diabetes mellitus. Currently, most transplant centers use enteric exocrine drainage of pancreatic secretions; however, experts disagree on which part of the gastrointestinal tract is preferable for enteric anastomosis. We analyzed the outcomes of retroperitoneal pancreatic transplantation with enteric drainage of pancreatic secretions.</p><p><strong>Materials and methods: </strong>We evaluated the outcomes of 60 simultaneous retroperitoneal pancreas-kidney transplantations. Based on the type of enteric anastomosis, the patients were divided into two groups: the study group consisted of 10 patients who underwent enteric drainage via Roux-en-Y duodenojejunostomy, and the control group included 50 patients who underwent exocrine drainage via duodenoduodenal anastomosis. No statistically significant differences were observed between the groups in terms of the main parameters.</p><p><strong>Results: </strong>The rate of surgical complications did not differ significantly between the groups (p > 0.05). Clavien IVb complications occurred only in the control group (n = 4.8%). The in-hospital pancreatic graft survival rate in both groups was 80%, whereas the recipient survival rates were 90% and 84%, in the study and control groups, respectively (p < 0.05).</p><p><strong>Conclusion: </strong>Retroperitoneal pancreatic transplantation with exocrine drainage via a Roux-en-Y duodenojejunostomy is an effective alternative technique that reduces the rate of severe surgical complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"357"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631251","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":"Pancreaticoduodenectomy for octogenarians under postoperative rehabilitation enhanced ERAS protocol.","authors":"Naoki Iwanaga, Yoshinori Takeda, Ryuji Yoshioka, Yoshihiro Mise, Hiroyuki Sugo, Akio Saiura","doi":"10.1186/s12893-024-02656-0","DOIUrl":"10.1186/s12893-024-02656-0","url":null,"abstract":"<p><strong>Background: </strong>Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022. All patients were managed using the enhanced recovery after surgery (ERAS) protocol, and elderly patients or those with loss of muscle mass or frailty underwent additional perioperative rehabilitation. Postoperative short-term outcomes were compared between the octogenarians and non-octogenarians.</p><p><strong>Results: </strong>We reviewed 251 patients including 44 octogenarians (17.5%). Octogenarians had higher rates of comorbidity (78.9% vs. 55.1%, P = 0.049) and sarcopenia (31.8% vs. 16.4%, P = 0.018) and a more impaired nutritional status than non-octogenarians and received postoperative rehabilitation more frequently (86.4% vs. 44.0%, P < 0.001, respectively). Under the rehabilitation-enhanced ERAS protocol, the postoperative major complication rate (25.0% vs. 24.6%, P = 0.960), the length of hospital stay (LOS) (P = 0.435), and the length of functional recovery (LOFR) (P = 0.110) did not differ between the two groups. In the multivariate analysis, age ≥ 80 years was not determined as a risk factor for major complications.</p><p><strong>Conclusions: </strong>Despite the poor functional and nutritional status of octogenarians, their postoperative major complication rates, LOS, and LOFR after PD were comparable with those of non-octogenarians under the rehabilitation-enhanced ERAS protocol.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"353"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631250","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":"Ethanol sclerotherapy in pediatric rectal prolapse: efficacy, complications, and influencing factors.","authors":"Mehdi Forooghi, Fateme Ziyaee, Hamidreza Foroutan, Ali Bahador, Ali Tadayon, Omidreza Azh, Maryam Ranjbar, Pardis Bostanian, Sara Mostafavi, Sina Jamzad, Amir Mohammad Ghiasi Nezhad, Narges Ansary, Mahsa Rouhafshari, Mohammadreza Khazaie, Hossein Fatemian, Rezvan Moradi","doi":"10.1186/s12893-024-02653-3","DOIUrl":"10.1186/s12893-024-02653-3","url":null,"abstract":"<p><strong>Introduction: </strong>Rectal prolapse is prevalent in children and the elderly, impacting quality of life significantly. Traditional surgical interventions carry risks, especially in pediatric patients. Ethanol sclerotherapy offers a less invasive alternative, inducing fibrosis and thickening of the rectal wall. Despite its potential benefits, procedural complications are possible, emphasizing the need for careful patient selection and procedural expertise. This study aims to evaluate the safety and efficacy of sclerotherapy in treating rectal prolapse in a tertiary referral center in southern Iran.</p><p><strong>Methods: </strong>Patient records from Nemazee Hospital covering January 2014 to December 2023 were retrospectively analyzed. Pediatric patients undergoing ethanol sclerotherapy for rectal prolapse were included. Data on demographics, presentation, procedures, and outcomes were collected. Ethical approval was obtained, and specific inclusion/exclusion criteria were applied. Statistical analyses were conducted using SPSS version 26.</p><p><strong>Results: </strong>One hundred thirty patients were evaluated, with a mean age of 10.74 ± 5.320 years. Most patients experienced constipation (56.9%). 74.2% responded well to sclerotherapy, with 12.9% needing a second injection. Complications were minimal, with bleeding being the most common (4.6%). Recurrence occurred in 18.6% of cases. Male patients showed a higher total complication rate (P = 0.010). Diarrhea-dominant patients had no recurrences post-sclerotherapy. Age significantly influenced treatment response and recurrence (P = 0.017, P = 0.035).</p><p><strong>Conclusion: </strong>Male predominance contradicted global pediatric rectal prolapse ratios, possibly influenced by cultural factors. Sclerotherapy remains effective, though response rates vary. Older age correlated with lower response rates and higher recurrence. Constipation-dominant prolapse was associated with increased recurrence risk. Male patients had a higher complication rate, highlighting the need for tailored management strategies.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"354"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631248","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":"Diagnostic imaging, therapeutic interventions and suggestions for thoracic duct congestion in postoperative hepatic lymphorrhea: a retrospective analysis of 20 cases.","authors":"Xin Liu, Zhong Liu, Wenbin Shen, Song Xia, Yuguang Sun, Kun Chang, Jianfeng Xin, Ran An, Chen Liang, Chenxiao Zhou","doi":"10.1186/s12893-024-02650-6","DOIUrl":"10.1186/s12893-024-02650-6","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively evaluate thoracic duct (TD) congestion in hepatic lymphorrhea (HL) and propose treatment suggestions.</p><p><strong>Methods: </strong>Retrospectively analyze cases of postoperative HL admitted from August 2007 to November 2023. Twenty cases were enrolled and followed up. The medical history, ascites characteristics, lymphoscintigraphy, direct lymphangiography, and other clinical data were reviewed.</p><p><strong>Results: </strong>Twenty patients with ascites after cholecystectomy or radical gastrectomy were included. There were 15 patients with cirrhosis and 5 patients with hepatitis. Ascites were light yellow even if the patients had a non-low-fat diet. Triglyceride level mean of ascites was 0.61 ± 0.20 mmol/L. There were 94.1% (16/17) of patients whose ascitic cholesterol ≥ 45 mg/dL or SAAG < 11.0 g/L. Mild abdominal radioactivity was shown in 89.5% (17/19) patients. Left subclavian-jugular venous angle radioactivity was observed in 84.2% (16/19) patients. In 10% (2/20) cases, lipiodol presenting as oil droplets traveled upwards quickly and flowed into the vein rapidly. In 90% (18/20) cases, tortuous and dilated thoracic duct, stagnant lipiodol, and poor flow into the vein were demonstrated. One patient refused treatment and died soon. By thoracic duct outlet reconstruction combined with other treatments, 16 patients were cured and the ascites of another 3 patients were controlled.</p><p><strong>Conclusions: </strong>TD congestion and elevated lymphatic pressure could be caused by increased lymph flow and TD outlet stenosis. TD decompression by outlet reconstruction may be an alternative approach to HL.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"352"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631247","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 strategies based on DTI visualisation for stereotactic minimally invasive surgery in the treatment of moderate-volume thalamo-basal ganglia cerebral haemorrhage: a protocol for a multicenter prospective study.","authors":"Shiqiang Yang, Yanwei Liu, Shiqiang Wang, Hua Peng, Xin Qi, Zhonghai Cai, Xuhui Hui, Anqiang Yang","doi":"10.1186/s12893-024-02644-4","DOIUrl":"10.1186/s12893-024-02644-4","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertensive intracerebral hemorrhage (HICH) is a condition associated with significant morbidity, mortality, and disability, particularly among the elderly population. The management of moderate thalamic-basal ganglia cerebral hemorrhage primarily relies on conservative approaches. Nevertheless, the rate of long-term disability remains high. In recent years, there has been significant advancement in minimally invasive surgery and diffusion tensor imaging techniques. Consequently, the utilization of Diffusion Tensor Imaging (DTI) technology in patients with cerebral haemorrhage allows for the identification of the haematoma's location in relation to the Corticospinal Tract (CST). This enables the development of precise puncture pathways that can be visualized, thereby avoiding any potential damage to the CST.</p><p><strong>Methods and analysis: </strong>Diffusion Tensor Imaging (DTI) is a method used to assess the structural and physiological characteristics of biological tissue by examining the diffusion behavior of water molecules.In the central nervous system, limb paralysis will be inevitable if the corticospinal tract is damaged. By employing DTI imaging techniques on individuals, it becomes possible to visualize the spatial relationship between the hematoma and the CST. This approach allows avoidance of the CST during preoperative planning of the puncture path, thus reducing secondary injuries caused by the procedure. The primary objective of this study was to assess the ability of patients in the minimally invasive surgery group and the conservative group to perform activities of daily living after 6 months of treatment. In addition, secondary outcomes included assessment of hematoma resorption/clearance ratios, cytokine levels, complication rates, and therapeutic indexes at different treatment durations, as well as long-term safety and efficacy at 2-3 years of follow-up. Furthermore, subgroup analysis, and sensitivity analysis were conducted to further analyze the data. Logistic single-variate and multivariate regression analyses were applied to understand the adverse factors affecting prognosis.</p><p><strong>Ethics and dissemination: </strong>The clinical study was reviewed and approved by the Ethics Committee of the First People's Hospital of Yibin. The ethical number is: 2023 Review (64).</p><p><strong>Registration number: </strong>This protocol is registered in the Prospective Registry of Chinese Clinical Trial Registries (PROCCTR). The full date of first registration is 28/12/2023. The registration number for PROCCTR is ChiCTR2300079252.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"351"},"PeriodicalIF":1.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631235","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":"Laparoscopic versus open lumbar sympathectomy in critical limb threatening ischemia patients in Egypt.","authors":"Wael E Shaalan, Ali A Elemam, Hassan Lotfy, Ahmad R Naga, Mohamed I Mohamed, Yomna E Dean, Tamer N Abdelbaki","doi":"10.1186/s12893-024-02618-6","DOIUrl":"10.1186/s12893-024-02618-6","url":null,"abstract":"<p><strong>Purpose: </strong>The treatment of critical limb-threatening ischemia (CLTI) is revascularization. Lumbar sympathectomy (LS) could be attempted when this is not amenable. Using laparoscopic techniques to perform LS adds the advantages of minimally invasive surgery.</p><p><strong>Methods: </strong>Twenty-four patients, presenting with non-reconstructable CLTI and rest pain, were randomly divided into group I (14 patients) who underwent retroperitoneoscopic lumbar sympathectomy (RPLS) and group II (10 patients) who had conventional open lumber sympathectomy (COLS).</p><p><strong>Results: </strong>RPLS patients had shorter hospital stays, fewer intraoperative complications, and less postoperative pain. However, the mean operative time was significantly longer (86.4 ± 9.1 min, p-value: 0.02) in the RPLS group but decreased with each subsequent case after that. The differences in post-operative capillary refill time, ABI, TBI, and TcPO2 were not statistically significant between both groups (p-values: 0.97, 0.13, 0.32, 0.10, respectively). However, the difference in the quality-of-life score was statistically significant; the mean (± SD) SF-36 score increased from 48 ± 6.8 to 81 ± 4.4 (p-value < 0.001) in RPLS group compared to 52 ± 8.8 to 59 ± 1.2 (p-value: 0.52) in COLS group.</p><p><strong>Conclusion: </strong>RPLS is feasible, safe, and has the advantages of minimally invasive surgery: minimal blood loss, less intraoperative complications, shorter hospital stay, and less postoperative pain. However, the operative time in RPLS cases is longer than in the COLS; training on the procedure is recommended to improve the learning curve.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"350"},"PeriodicalIF":16.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606910","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 low-pressure and standard-pressure pneumoperitoneum laparoscopic cholecystectomy in patients with cardiopulmonary comorbidities: a double blinded randomized clinical trial.","authors":"Feng Tian, Xiaowei Sun, Yang Yu, Ning Zhang, Tao Hong, Lu Liang, Bihui Yao, Lei Song, Changhong Pei, Yu Wang, Wenlong Lu, Qiang Qu, Junchao Guo, Taiping Zhang, Xiaodong He","doi":"10.1186/s12893-024-02606-w","DOIUrl":"10.1186/s12893-024-02606-w","url":null,"abstract":"<p><strong>Background: </strong>The benefits of low-pressure laparoscopic cholecystectomy (LPLC) in patients with cardiopulmonary comorbidities remain unclear. This study aimed to explore the feasibility and pulmonary effects of LPLC in patients with cardiopulmonary comorbidities.</p><p><strong>Methods: </strong>This was a multicenter, parallel, double-blind, randomized controlled trial. Eligible patients included patients with cardiac or pulmonary comorbidities, who were randomly assigned (1:1) to undergo LPLC (10 mmHg) or standard-pressure laparoscopic cholecystectomy (SPLC) (14 mmHg). The primary outcome was postoperative partial pressure of carbon dioxide (CO₂). Surgical safety variables, patient recovery, pulmonary function parameters, and surgeon comfort were also compared between groups.</p><p><strong>Results: </strong>This study enrolled 144 participants, with 124 participants extracted for the final analysis (62 in LPLC and 62 in SPLC group, respectively). The median postoperative PaCO2 was similar in the LPLC (43.3 mmHg) and SPLC (43.0 mmHg) groups (p = 0.988). Pulmonary parameters including postoperative pH, PaCO2, HCO3, and lactate levels were similar between the two groups. Postoperative base excess was significantly higher in the LPLC group (- 0.6 mmol/L [- 6.9 ~ 7.5] vs. -1.9 mmol/L [- 6.6 ~ 5.4]; p = 0.031). There was no between-group difference regarding intraabdominal operative time, rate of intraoperative bile spillage, blood loss, surgeon comfort during surgery, and conversion rate. Moreover, postoperative major complication rates, the median time to the first flatus, postoperative hospital stay, or mean postoperative visual analog scale score for pain were similar in both groups.</p><p><strong>Conclusions: </strong>This study found no reduction of partial pressure of CO₂ with LPLC compared with SPLC for patients with cardiopulmonary comorbidities. LPLC with a pneumoperitoneum pressure of 10 mmHg may be safe and feasible for these patients when performed by experienced surgeons, although it does not improve pulmonary parameters.</p><p><strong>Registration: </strong>The trial is retrospectively registered at ClinicalTrials.gov (NCT04670952) on December 17, 2020.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"348"},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591956","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":"Correlation between the ease of cage plates implantation and endplate Hounsfield unit value during ACDF: a retrospective study.","authors":"Guozheng Jiang, Luchun Xu, Yongdong Yang, Jianbin Guan, Yukun Ma, Ningning Feng, Ziye Qiu, Zeyu Li, Guanlong Wang, Jiaojiao Fan, Yi Qu, Xing Yu","doi":"10.1186/s12893-024-02649-z","DOIUrl":"10.1186/s12893-024-02649-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between the implantation status of the ROI-C cervical cage plates and the Hounsfield unit(HU) value of the target vertebral endplate during anterior cervical decompression and fusion (ACDF)surgery.</p><p><strong>Methods: </strong>Review of patient data undergoing ACDF from January 2018 to December 2021. Data on gender, age, body mass index, history of hypertension, diabetes, hyperlipidemia, smoking, alcohol consumption, cervical cage plates status, and HU values of the cervical vertebral endplate. Logistic regression analysis was used to evaluate the relationship between the HU values and the plates status.</p><p><strong>Results: </strong>A total of 17 cases (12.1%) had misplaced implants during surgery. There were statistical differences in gender, long-term smoking history, drinking history, and cervical vertebral endplate HU values between the abnormal implantation group and the normal implantation group (P < 0.05). The cervical vertebral endplate HU values in the abnormal implantation group were significantly higher than those in the normal implantation group (729.3 ± 36.2 HU vs. 484.4 ± 59.2 HU, P < 0.001). In the logistic regression analysis, cervical endplate HU value (OR 1.081; 95% CI 1.016-1.375) was an independent factor influencing improper plate implantation. The area under the ROC curve (AUC) for the cervical endplate HU value in predicting implantation difficulty was 0.836 (P < 0.05), with an optimal threshold of 724 HU (sensitivity 83.2%; specificity 90.4%).</p><p><strong>Conclusions: </strong>The cervical vertebral segment endplate HU value can independently predict whether the implantation of the plates is misplaced during ACDF surgery.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"349"},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591958","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 laparoscopic radical resection of right-sided colon cancer by different surgical approaches: network-meta-analysis.","authors":"Mingyi Li, Jie Hu, Liwei Suo, Hui Wu, Ziming Li, Xiaoyi Xu, Shifeng Zhang","doi":"10.1186/s12893-024-02603-z","DOIUrl":"10.1186/s12893-024-02603-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;There are a growing number of surgical approaches for laparoscopic radical resection of right-sided colon cancer, while there are relatively few comparative analyses of the different surgical approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the safety and efficacy of different surgical approaches (intermediate approach, caudolateral approach, caudolateral combined with intermediate approach) for laparoscopic radical resection of right-sided colon cancer by conducting a network meta-analysis (NMA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We searched PubMed, Web of science and China National Knowledge Infrastructure (CNKI) databases. We reviewed the Chinese and English literature on controlled studies of laparoscopic radical resection of right-sided colon cancer including intermediate approach, caudolateral approach and caudolateral combined with intermediate approach, reported from the establishment of the database to September 2023. The inclusion and exclusion criteria were independently conducted by two researchers and relevant data was extracted from the qualifying literature and analyzed using Stata15 software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine controlled studies of relevance including 715 patients were screened with right-sided colon cancer. Net meta-analysis showed that compared with the intermediate approach, the caudolateral approach was superior to the intermediate approach in terms of operation time (SMD = 0.75, 95% CI = 0.38 ~ 1.12, P = 0.0001), and bleeding volume (SMD = 1.15, 95% CI = 0.18 ~ 2.13, P = 0.002), while the difference was not statistically significant among the caudolateral approach compared with the intermediate approach in terms of the number of lymph node dissection, postoperative complication rate, time to first postoperative flatus and postoperative hospitalization. Compared with the intermediate approach, the combined approach was superior to the intermediate approach in terms of operation time (SMD = -0.87, 95% CI = -1.22 ~ -1.52, P &lt; 0.05), bleeding volume (SMD = -1.09, 95% CI = -1.98 ~ -0.19, P &lt; 0.05), the number of lymph node dissection (SMD = 0.21, 95% CI = 0.01 ~ 0.41, P &lt; 0.05), and postoperative complication rate (RR = 2.24, 95% CI = 1.21 ~ 4.13, P &lt; 0.05), while the difference was no statistically significant among the combined approach compared with the intermediate approach in terms of time to first postoperative flatus and postoperative hospitalization. Compared with the caudolateral approach, there was no statistically significant difference between the caudolateral approach and the combined approach in terms of operation time, bleeding volume, the number of lymph node dissection, postoperative complication rate, time to first postoperative flatus and postoperative hospitalization. According to the results of the surface under the cumulative ranking curve (SUCRA), the caudolateral approach and the combined approach were superior to the intermediate approach in terms ","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"24 1","pages":"347"},"PeriodicalIF":1.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584599","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}