Surgery in practice and science最新文献

{"title":"Frequency of lactate elevation following pancreatic surgery and its relationship to postoperative complications","authors":"Lana Othman Mahmmud ,&nbsp;Vilhelmas Bartusevicius ,&nbsp;Åke Norberg ,&nbsp;Poya Ghorbani ,&nbsp;Jonathan Grip","doi":"10.1016/j.sipas.2025.100298","DOIUrl":"10.1016/j.sipas.2025.100298","url":null,"abstract":"<div><h3>Background</h3><div>Lactate is often elevated following major pancreatic surgery but the clinical relevance of this it not known.</div></div><div><h3>Methods</h3><div>A retrospective study including 491 consecutive patients undergoing major pancreatic surgery. Lactate upon arrival to post anaesthesia unit (L₀), the morning following surgery (L_POD1) and the highest value within those two time points (L_High) were examined. The primary outcome was postoperative complications (Clavien-Dindo IIIa-V) and the secondary outcomes were surgery specific complications and hospital length of stay.</div></div><div><h3>Results</h3><div>Median lactate values were: L01.7 mmol/L (IQR: 1.2 –2.6), LPOD11.3 mmol/L (IQR: 0.9 –1.9) and L_High 2.3 mmol/L (IQR 1.7 –3.1). There were no differences in lactate values at any measuring point between those developing complications and those that didn´t. AUROC analysis (0.531–0.581) and Youden´s index (0.08–0.17) indicated poor diagnostic performance. L_High &gt; 2.65 mmol/L was associated with Odds ratio 2.05 (1.34 –3.14) for developing postoperative complications. Plasma lactate was higher following total pancreatectomy compared to partial resection at all three time points.</div></div><div><h3>Discussion</h3><div>Plasma lactate elevation in common following pancreatic surgery; however, this is of limited clinical use to predict complications. The relatively higher lactate following total pancreatectomy might be due to hormonal deficits inherent to this procedure.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100298"},"PeriodicalIF":0.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study to investigate the effect of pressurized incision dressing on the occurrence of incisional infection after laparoscopic cholecystectomy","authors":"QingDa Wang,&nbsp;LouZong Sun,&nbsp;GuiGang Qiu,&nbsp;Nan Yang","doi":"10.1016/j.sipas.2025.100297","DOIUrl":"10.1016/j.sipas.2025.100297","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic cholecystectomy (LC) has been established as the gold standard for gallstone treatment due to its minimal invasiveness and rapid recovery. Despite the low incidence of complications after LC, postoperative incisional infections have received widespread attention from surgeons. This study aimed to evaluate whether pressurized incision dressing could reduce the occurrence of incisional infections.</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed 396 patients diagnosed with gallbladder stones who underwent LC at our institution between January 2022 and December 2023. Patients were divided into standard dressing group A (n=200) and pressurized dressing group B (n=196) based on different postoperative incisional treatments. Clinical outcomes were compared between the two groups. Additionally, subset analyses were conducted on patients with BMI ≥30 kg/m² and acute cholecystitis (AC) to further evaluate the differences in clinical outcomes with or without pressurized incision dressing.</div></div><div><h3>Results</h3><div>The incisional infection rate was 8.0 % (16/200) in the standard dressing group A and 6.1 % (12/196) in the pressurized dressing group B, with no significant difference. Among patients with BMI ≥30 kg/m², no significant difference in incisional infection rate was observed between standard dressing group A₁ and pressurized dressing group B₁ (<em>P</em>=0.52). However, in patients with AC, pressurized incision dressing significantly reduced the incisional infection rate (23.7 % in the standard dressing group A₂ vs. 9.8 % in the pressurized dressing group B₂, <em>P</em>=0.04).</div></div><div><h3>Conclusions</h3><div>Pressurized incision dressing can reduce the incidence of incisional infection after LC in patients with AC.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100297"},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements and challenges in robotic surgery: A holistic examination of operational dynamics and future directions","authors":"Abdullah Riad ,&nbsp;Majed Hadid ,&nbsp;Adel Elomri ,&nbsp;Ahmad Al-Ansari ,&nbsp;Mohamed Amine Rejeb ,&nbsp;Marwa Qaraqe ,&nbsp;Sarada Parsad Dakua ,&nbsp;Abdel Rahman Jaber ,&nbsp;Abdulla Al-Ansari ,&nbsp;Omar M. Aboumarzouk ,&nbsp;Abdelfatteh EL Omri","doi":"10.1016/j.sipas.2025.100294","DOIUrl":"10.1016/j.sipas.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, Robot-Assisted Surgeries (RAS) have advanced significantly, revolutionizing healthcare with better patient outcomes, faster recovery times, and greater surgical accuracy. However, challenges such as restricted maneuverability and communication issues persist, along with the need to evaluate surgeons' proficiency in RAS. Healthcare 5.0 seeks to enhance RAS by integrating technologies like advanced imaging, haptic feedback, and artificial intelligence.</div></div><div><h3>Objective</h3><div>This paper explores the Operational Management of Robotic-Assisted Surgeries (OM-RAS) by analyzing recent research. It assesses surgical robotics operations, workflow optimization, performance enhancement, and skill assessment. Additionally, it examines challenges and gaps in the RAS domain, providing a comprehensive research overview.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across databases such as Scopus, Web of Science, and Google Scholar, covering publications up to the third quarter of 2023. Search terms were selected using scientific criteria and validated by experts, resulting in a substantial document collection. A rigorous screening process, aligned with PRISMA 2020 standards, filtered the selection to 50 research papers, forming the foundation for detailed investigation.</div></div><div><h3>Findings</h3><div>OM-RAS is a multidimensional field influenced by emerging technologies that optimize workflows, enhance performance, and improve skill assessment in RAS. Despite superior outcomes, challenges such as implementation costs and seamless technology integration persist. Additionally, research gaps exist regarding RAS benefits, creating opportunities for efficiency enhancement in patient care. Further exploration of RAS procedure scheduling across different surgery types is essential.</div></div><div><h3>Conclusion</h3><div>Integrating advanced technologies into RAS has improved surgical outcomes, shortened hospital stays, and enhanced working environments. This study advocates for a holistic multi-criteria decision-making approach, considering factors like kinematics, imaging, Internet of Things/Tactile Internet (IoT/TI), and AI. It provides valuable insights, guiding future research and shaping OM-RAS studies.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100294"},"PeriodicalIF":0.6,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-surgeon outcomes of open radical cystectomy for muscle-invasive bladder cancer: Experience from a tertiary center in Azerbaijan","authors":"Rashad Sholan ,&nbsp;Rufat Aliyev ,&nbsp;Seymur Karimov ,&nbsp;Jamal Musayev ,&nbsp;Anar Almazkhanli ,&nbsp;Rahman Ismayilov","doi":"10.1016/j.sipas.2025.100296","DOIUrl":"10.1016/j.sipas.2025.100296","url":null,"abstract":"<div><h3>Objective</h3><div>Radical cystectomy is the standard treatment for muscle-invasive bladder cancer (MIBC). This study presents the first analysis of open radical cystectomy (ORC) outcomes in Azerbaijan, where robotic surgery is unavailable.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 106 patients with non-metastatic MIBC who underwent ORC with bilateral pelvic lymph node dissection and Bricker ileal conduit reconstruction, performed by a single surgeon between 2014 and 2024. Demographic data, comorbidities, operative metrics (duration, blood loss), complications, length of stay, and follow-up data were analyzed.</div></div><div><h3>Results</h3><div>The cohort's mean age was 64.2 years (72.6 % male), with common comorbidities including hypertension (33 %), diabetes (33 %), and coronary artery disease (24.5 %). The median operative time was 300 min and blood loss was 450 mL. Postoperative complications occurred in 9.4 %, primarily urinary tract infections. No intraoperative complications or in-hospital mortalities occurred. Longer hospital stays were associated with advanced age (<em>p</em> &lt; 0.001), higher body mass index (<em>p</em> = 0.042), longer operative time (<em>p</em> &lt; 0.001), and increased blood loss (<em>p</em> = 0.008). Of all patients, 58.5 % were followed for a median of 71.3 months with no observed recurrences. There were three non-cancer related deaths.</div></div><div><h3>Conclusion</h3><div>This initial report from Azerbaijan demonstrates acceptable perioperative outcomes for ORC in MIBC, despite the absence of robotic surgery. Our findings emphasize optimizing surgical efficiency, comorbidity management, and strengthening follow-up to enhance patient outcomes in resource-limited settings.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100296"},"PeriodicalIF":0.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency general surgery: The prevalence of non-operative consultations and importance of a registry","authors":"Nisha Narula ,&nbsp;Shanen M. Mulles ,&nbsp;Aziz M. Merchant ,&nbsp;Kenechi Onwubalili ,&nbsp;Lauren Cue ,&nbsp;Michele Fiorentino ,&nbsp;Nina Awan ,&nbsp;Joseph B. Oliver ,&nbsp;Dustin Cummings ,&nbsp;Michael E. Shapiro ,&nbsp;Anne C. Mosenthal ,&nbsp;David H. Livingston ,&nbsp;Nina E. Glass","doi":"10.1016/j.sipas.2025.100295","DOIUrl":"10.1016/j.sipas.2025.100295","url":null,"abstract":"<div><h3>Introduction</h3><div>An emergency general surgery (EGS) service is a crucial component of care in a hospital. Current reviews of EGS focus on procedural-based or diagnosis-driven reviews of administrative data. However, patients evaluated by an EGS service may or may not undergo surgery. Therefore, we sought to determine the feasibility of maintaining an EGS registry to include those who do and do not undergo surgery and determine the contribution of nonoperative care to the service.</div></div><div><h3>Methods</h3><div>Demographic and clinical data for operative and nonoperative general surgery consult patients extracted from the local medical record were entered into a registry over 12 months from 2018 to 2019. We used descriptive statistics to demonstrate differences in demographics and clinical presentation between operative and nonoperative groups.</div></div><div><h3>Results</h3><div>1065 EGS patients were captured into the registry, only 40 % of whom required an operation. Insurance status and race/ethnicity were different between operative and nonoperative groups. Reasons for consultation varied broadly with the largest group (20 %) being for hepatopancreaticobiliary disease.</div></div><div><h3>Discussion</h3><div>Providing insight into the important contribution of nonoperative care on EGS burden, we present data from an institutional EGS registry. EGS registries can provide direction for future studies to guide optimal management of EGS patients, especially in resource-limited settings.</div></div><div><h3>Conclusion</h3><div>Maintaining registries poses challenges but given its importance and the need to determine the contribution of patients who do not undergo procedures to the service load, resources are necessary to ensure they continue.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100295"},"PeriodicalIF":0.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study","authors":"Grace EM Kennedy ,&nbsp;Ramy Rashed ,&nbsp;Joshua Lau ,&nbsp;Maham Khan ,&nbsp;Mohammad Abdelmonem ,&nbsp;Sathya Lakpriya ,&nbsp;Bryony Ford ,&nbsp;Ahmed El-Bakoury","doi":"10.1016/j.sipas.2025.100293","DOIUrl":"10.1016/j.sipas.2025.100293","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Posterior pelvic ring disruption has been associated with high-energy trauma, and significant morbidity and mortality. We aimed to determine functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries at a major trauma centre.</div></div><div><h3>Methods</h3><div>Patients who underwent sacroiliac screw fixation at our institution, between 1^st January 2013 – 1^st April 2020 were identified from a database. Electronic systems were accessed to obtain information regarding patient demographics, injuries sustained, and interventions performed. Patients were contacted via telephone regarding clinical outcomes (EQ5D3L, EQVAS and Majeed scores). Radiographical outcomes were assessed using the Keshishyan cross-measure method.</div></div><div><h3>Results</h3><div>115 patients were identified. The mean age at injury was 51.6 years (17–84 years). Most injuries resulted from falls and road traffic collisions (83.5 %). Eighty patients (69.6 %) sustained additional non-pelvic injuries and twenty-nine (25.2 %) underwent a non-pelvic procedure, most commonly limb or clavicle fracture fixation (<em>N</em> = 19). Thirty-day and 12-month all-cause mortality rates were 0.9 % and 1.7 %, respectively. Clinical outcomes were obtained for 82/105 possible patients (78.1 %). Regarding EQ5D3L, 36/82 patients (43.9 %) reported a full health status; only six patients reported severe problems. The mean Majeed score was 70.3. 49/59 patients (86.0 %) returned to their pre-injury employment. A significant association was found between the clinical outcomes (EQ5D3L index, EQVAS, Majeed score) and the pre-operative asymmetry value and deformity index but not the post-operative asymmetry value and deformity index. One patient (0.9 %) required revision for infection, 12 patients (10.4 %) reported post-operative lower limb paraesthesia, and one patient (0.9 %) experienced a post-operative deep vein thrombus.</div></div><div><h3>Conclusions</h3><div>Most patients with pelvic ring injuries experienced high-energy trauma, often resulting in multiple injuries and operative interventions. Nevertheless, mortality rates were low, and most patients experienced either mild or no functional difficulties. The magnitude of the pelvic deformity pre-operatively correlates with post-operative clinical scores.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100293"},"PeriodicalIF":0.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversal of Hartmann’s procedure: The impact of timing – a single-tertiary-center experience","authors":"Sascha Vaghiri ,&nbsp;Maria Chara Stylianidi ,&nbsp;Laura Engelmann ,&nbsp;Eslam Elmaghraby ,&nbsp;Levent Dizdar ,&nbsp;Wolfram Trudo Knoefel ,&nbsp;Hermann Kessler ,&nbsp;Dimitrios Prassas","doi":"10.1016/j.sipas.2025.100292","DOIUrl":"10.1016/j.sipas.2025.100292","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal timing for Hartmann’s reversal remains a topic of ongoing debate. This study aimed to assess postoperative outcomes in patients undergoing early versus late Hartmann’s reversal at a tertiary academic center in Germany.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted, including all patients who underwent Hartmann’s reversal between January 2008 and July 2020. Patients were stratified into early (ER) and late (LR) reversal groups using a median cut-off value of 159 days. Operative outcomes including major morbidity and overall postoperative complications were compared between both groups. Factors associated with major postoperative morbidity were detected using uni- and multivariate regression models.</div></div><div><h3>Results</h3><div>A total of 133 patients classified into the ER (n = 67, 50.38%) and LR (n = 66, 49.62%) groups were analyzed. There were no significant differences in overall morbidity (ER 56.72% versus LR 39.39%, p = 0.057) and major morbidity rates (Clavien-Dindo ≥ IIIa) (ER 28.36% versus LR 21.21%, p = 0.423) between both groups. On multivariate analysis, smoking (p = 0.006), chronic renal disease (p = 0.003) and anastomotic configuration (p = 0.003) were identified as significant factors contributing to major morbidity after Hartmann’s reversal.</div></div><div><h3>Conclusion</h3><div>Hartmann’s reversal is still associated with an increased risk of postoperative complications. However, timing of Hartmann’s reversal does not seem to influence postoperative morbidity. Of note, patient-related modifiable factors as well as the anastomotic configuration are important determinants of major complication occurrence.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100292"},"PeriodicalIF":0.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in surgical care for low- and middle-income countries: Challenges, opportunities, and the path forward","authors":"William Nkenguye","doi":"10.1016/j.sipas.2025.100290","DOIUrl":"10.1016/j.sipas.2025.100290","url":null,"abstract":"<div><div>The application of Artificial Intelligence (AI) and Machine Learning (ML) in surgical care has significantly advanced healthcare delivery in high-income countries (HICs), yet remains underutilized in lower- and middle-income countries (LMICs). With a growing burden of surgical diseases, limited surgical expertise, and constrained healthcare resources, AI and ML offer transformative potential in optimizing surgical workflows, improving patient outcomes, and expanding access to specialized care. This manuscript explores the current status, challenges, and future prospects of AI and ML in surgical care for LMICs, emphasizing the critical need for investment, capacity building, and policy development to bridge the healthcare gap.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100290"},"PeriodicalIF":0.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous adenocarcinoma of the transverse colon and gastroesophageal junction: a case report","authors":"Adam Avas ,&nbsp;Astrid Schümatschek ,&nbsp;Julia Mühlhäusser ,&nbsp;Martin Bolli ,&nbsp;Markus Gass ,&nbsp;Francesco Mongelli","doi":"10.1016/j.sipas.2025.100289","DOIUrl":"10.1016/j.sipas.2025.100289","url":null,"abstract":"<div><h3>Introduction</h3><div>Esophageal cancer is a malignancy with a rapidly increasing incidence in recent decades. The presence of a second synchronous tumor poses challenges when a curative approach is offered.</div></div><div><h3>Case presentation</h3><div>We report a case of a 68-year-old Caucasian male diagnosed with synchronous adenocarcinomas of the transverse colon and the gastroesophageal junction (GEJ), Siewert Type II. The diagnosis followed the presentation of dysphagia and was confirmed through esophagogastroduodenoscopy and colonoscopy. The patient underwent a staging work-up. This has revealed no distant metastases, leading to a decision for curative treatment with multimodal therapy. Neoadjuvant chemotherapy with the FLOT regimen was administered, followed by thoracoabdominal esophagectomy and extended right hemicolectomy. Histopathological and molecular profiling analyses revealed that the tumor of the colon was a metastasis of the GEJ tumor.</div></div><div><h3>Clinical discussion</h3><div>This case demonstrates the diagnostic and therapeutic challenges posed by rare metastatic pattern of the GEJ. Despite thorough preoperative staging, the metastatic nature of the colonic lesion was only revealed postoperatively in our case. This emphasizes the need for molecular profiling in selected cases to enhance diagnostic accuracy and guide treatment decisions more effectively.</div></div><div><h3>Conclusion</h3><div>Colonic metastases from esophageal cancer are exceedingly rare, with only a few cases reported. In this case, according to the postoperative staging (M1) a palliative chemotherapy might have been more appropriate. This case highlights the importance of comprehensive diagnostic workups and the need for molecular profiling of synchronous lesions. Molecular diagnostic may be considered as a part of decision-making, as it can significantly impact treatment strategies and outcomes.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100289"},"PeriodicalIF":0.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal cancer surgery in Ethiopia: postoperative mortality and long-term survival","authors":"Mintesinot Birhanu Senbeta ,&nbsp;Sileshi Abiy ,&nbsp;Hirbo Samuel ,&nbsp;Nigist Birhanu","doi":"10.1016/j.sipas.2025.100288","DOIUrl":"10.1016/j.sipas.2025.100288","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer remains the leading cause of death worldwide, with esophageal cancer being the sixth leading cause of cancer-related deaths. For individuals with esophageal cancer, esophagectomy is the most effective treatment option available and has a high risk of both death and morbidity. Moreover, despite advances in preoperative optimization, surgery, and anesthesia techniques as well as the introduction of neoadjuvant therapy, the mortality and morbidity associated with esophagectomy remain high.</div></div><div><h3>Objective</h3><div>To assess the survival status and predictors of postoperative survival in patients who underwent esophageal surgery for esophageal malignancies at selected hospitals from to 2018–2023 in Ethiopia, Addis Ababa.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study. After acquiring data from the chart review, the data were analyzed using R version 4.3.3. Descriptive statistics for categorical variables were reported as frequencies and percentages. Kaplan-Meier curves and log-rank tests were used to estimate the survival curve and the difference in survival among groups within each covariate. After esophageal surgery, the impact of each covariate on time to death was assessed using the Cox proportional hazard model.</div></div><div><h3>Results</h3><div>One hundred eighty-three patients who underwent esophageal surgeries for esophageal malignancy at four governmental hospitals in Addis Ababa over 5 years were included. The mean age was 53.8 years. 120 (65.6 %) had a tumor size &lt;3.3 cm, and squamous cell carcinoma accounted for 154 (84.2 %) cases. Epidural analgesia was the most commonly used analgesic technique, 40 (21.9 %). The 30-day mortality was 10.9 %. The overall 1-, 2-, 3-, 4-, and 5-year survival rates were 53 %, 30.6 %, 19.5 %, 19.5 %, and 13 %, respectively. The median survival was 17 months. ASA score of &gt; III (AHR = 2.14, 95 % CI: 1.12–4.12), cervical anastomotic leak (AHR = 3.29, 95 % CI: 1.44–7.52), and sepsis (AHR = 3.70, 95 % CI: 1.46–9.38) were identified as predictors of postoperative mortality in the multivariate Cox regression model.</div></div><div><h3>Conclusion</h3><div>In Ethiopia, patients who underwent surgery for esophageal cancer had low 5-year survival rates.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100288"},"PeriodicalIF":0.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}