Surgery in practice and science最新文献

{"title":"Corrigendum to “Effects of verapamil on intestinal injury in a rat model of acute mesenteric ischemia” [Surgery in Practice and Science; Volume 21, June 2025, 100286]","authors":"Silvana N Wilken, Diego V Santos Rodrigues, Colin Price, Julia Jacobs, Jack Nelson, Patrick F Walker, Jonathan J Morrison","doi":"10.1016/j.sipas.2026.100348","DOIUrl":"10.1016/j.sipas.2026.100348","url":null,"abstract":"","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"26 ","pages":"Article 100348"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for surgical care in war-torn sudan: Feasibility, barriers, and ethical perspectives from a conflict zone","authors":"Alsadig Suliman,&nbsp;Lina SeedAhmed,&nbsp;Sara Hussein,&nbsp;Siddig Ali,&nbsp;Sabah Ahmed,&nbsp;Alkhansa Alkhider","doi":"10.1016/j.sipas.2026.100333","DOIUrl":"10.1016/j.sipas.2026.100333","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) offers transformative potential for clinical care, yet its deployment in conflict-affected, low-resource settings remains under-researched. This study evaluates AI awareness, barriers, and readiness among Sudanese surgeons amidst the nation's ongoing armed conflict.</div></div><div><h3>Methods</h3><div>A sequential explanatory mixed-methods design was employed. An online survey, adapted from validated instruments, assessed AI familiarity, perceived barriers, ethical concerns, and readiness among Sudanese general surgery residents and specialists. From October 2024 to June 2025, 185 completed responses were obtained from a stratified random sample of 195 eligible participants. Follow-up semi-structured interviews were conducted with 20 selected specialists. Quantitative data were analyzed using descriptive statistics, chi-square tests, and the Kruskal-Wallis test with Dunn’s post-hoc comparisons. Qualitative interviews were conducted until thematic saturation was achieved and analyzed thematically, with coding verified through inter-coder reliability.</div></div><div><h3>Results</h3><div>While AI awareness was moderate (68.7%), practical clinical exposure (9.4%) and advanced literacy (10.3%) were notably low. Surgeons identified AI’s primary utility in training (68.2%) and perioperative decision-making (65.4%). Significant barriers included infrastructure deficits (87.6%), training gaps (79.1%), and financial constraints (72.4%). Conflict-specific challenges were acute, with 92.5% reporting severe technology shortages and 78.3% citing unreliable power/internet. Qualitative themes highlighted AI’s potential for triage and resource allocation, though concerns regarding accountability and ethical governance persisted.</div></div><div><h3>Conclusion</h3><div>This study provides inaugural evidence on AI feasibility within an African zone. Despite infrastructure collapse, Sudanese surgeons show strong interest in AI for triage and diagnostics. To move forward, development must prioritize offline-compatible, context-adapted tools and robust governance frameworks. These findings provide a blueprint for integrating AI to bolster surgical resilience during humanitarian crises.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"25 ","pages":"Article 100333"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328570","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":"The impact of body mass index on predicting postoperative pancreatic fistula in relation to pancreatic texture and main pancreatic duct diameter after pancreaticoduodenectomy","authors":"Oleksandr Kvasivka,&nbsp;Ruslan Pareniuk,&nbsp;Andrii Moiseienko,&nbsp;Illia Pepenin,&nbsp;Kostiantyn Kopchak","doi":"10.1016/j.sipas.2026.100334","DOIUrl":"10.1016/j.sipas.2026.100334","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreaticoduodenectomy (PD) remains the primary radical treatment for malignant periampullary tumors. Clinically relevant postoperative pancreatic fistula (POPF) develops in 15–20% of patients. Body mass index (BMI) may influence the risk of this complication. The aim of our study was to assess the impact of BMI, pancreatic texture, and main pancreatic duct diameter on the risk of POPF after PD.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included 106 patients who underwent PD for malignant periampullary tumors between 2018 and 2024, performed by a single surgical team at a major center in Ukraine. Patients were grouped according to a classification proposed by the International Study Group for Pancreatic Surgery (ISGPS) based on pancreatic texture and duct diameter: Group A: not-soft texture, duct &gt; 3 mm. Group B: not-soft texture, duct ≤ 3 mm. Group C: soft texture, duct &gt; 3 mm. Group D: soft texture, duct ≤ 3 mm.</div></div><div><h3>Results</h3><div>Group A included 63 patients, Group B 9, Group C 8, and Group D 26. No significant association between BMI and POPF was found in Groups A, B, and C. However, in Group D, patients with BMI ≥ 25 had a significantly higher rate of POPF compared to those with BMI &lt; 25.</div></div><div><h3>Conclusion</h3><div>Increased BMI was significantly associated with a higher risk of POPF only in patients with a soft pancreatic texture and a main pancreatic duct diameter ≤ 3 mm.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"25 ","pages":"Article 100334"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387398","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":"Commentary on “Predictors of post-operative complications following thyroid surgery at a tertiary hospital in Tanzania”: Clarifying mechanisms and clinical implications","authors":"Vaishali Rahuldeep Khobragade","doi":"10.1016/j.sipas.2026.100336","DOIUrl":"10.1016/j.sipas.2026.100336","url":null,"abstract":"","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"25 ","pages":"Article 100336"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387480","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":"Predictors of post-operative complications following thyroid surgeries at a tertiary hospital in Tanzania","authors":"Albert Lazaro ,&nbsp;Mungeni Misidai ,&nbsp;Daniel Kitua ,&nbsp;Abdulrahaman Amin ,&nbsp;Charles Komba ,&nbsp;Ally Mwanga ,&nbsp;Larry Akoko ,&nbsp;Nashivai Kivuyo","doi":"10.1016/j.sipas.2025.100323","DOIUrl":"10.1016/j.sipas.2025.100323","url":null,"abstract":"<div><h3>Background</h3><div>Thyroid disorders pose a substantial burden in low- and middle-income countries (LMICs), where late presentation and limited access to specialized care often result in advanced disease at surgery. Despite thyroidectomy being the definitive treatment for many thyroid conditions, data on surgical outcomes and complication rates from sub-Saharan Africa remain scarce. This study aimed to describe the clinical characteristics, surgical approaches, and in-hospital postoperative outcomes of patients undergoing thyroidectomy at a tertiary hospital in Tanzania, and to identify factors associated with postoperative complications.</div></div><div><h3>Materials and Methods</h3><div>This was a hospital-based retrospective cohort study involving patients who underwent thyroid surgery between January 2018 and December 2023. Data were retrieved from case notes and surgical records in the hospital’s medical records department. Sociodemographic and clinical characteristics were analyzed as predictor variables, while postoperative in-hospital complications were the primary outcomes. Multivariable logistic regression was performed to identify independent predictors of complications.</div></div><div><h3>Results</h3><div>A total of 405 patients underwent thyroidectomy during the study period, with a female predominance (89.6%) and a mean age of 48 ± 13 years. The majority presented with anterior neck swelling (98.5%), and 24% had retrosternal extension. Benign pathology accounted for 77% of cases. The overall complication rate was 15.3%, with hypocalcemia (4%) and superior laryngeal nerve injury (3%) being the most common. The mortality rate was 0.5%. Independent predictors of in-hospital complications included total thyroidectomy (aOR: 3.12; 95% CI: 1.08–9.02) and symptom duration exceeding 10 years (aOR: 4.12; 95% CI: 1.60–10.58).</div></div><div><h3>Conclusion</h3><div>Postoperative morbidity following thyroidectomy in this setting was primarily driven by delayed presentation and the extent of surgery. Targeted interventions to promote early diagnosis and optimize perioperative care are essential to improve patient outcomes.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100323"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754224","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":"The textbook outcome of pancreaticoduodenectomy for adenocarcinoma of the pancreas in a high-volume centre","authors":"Muhammad Anas Bin Akhtar,&nbsp;Sibgha Aimon,&nbsp;Syed Tatheer Abbas,&nbsp;Aamir Ali Syed,&nbsp;Fatima Tu Zahara,&nbsp;Shahid Khattak,&nbsp;Shahzaib Asif,&nbsp;Sana Hussain,&nbsp;Taha Ahmad,&nbsp;Sayed Moosa Kazim","doi":"10.1016/j.sipas.2026.100330","DOIUrl":"10.1016/j.sipas.2026.100330","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic adenocarcinoma remains a leading cause of cancer-related mortality, with only 15–20% of patients eligible for resection at diagnosis. Pancreaticoduodenectomy (PD) is the standard surgical treatment, yet achieving optimal outcomes is challenging. Textbook Outcome (TO), a composite measure of quality, has emerged as a superior indicator of surgical success compared to individual parameters. This study evaluates TO in PD for pancreatic adenocarcinoma at a high-volume center and its impact on survival.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis conducted at a tertiary cancer center. TO was defined by negative resection margins, ≥12 lymph nodes retrieved, ICU stay &lt;72 h, hospital stay ≤14 days, no readmission within 30 days, no major complications (Clavien-Dindo grade ≥3), and no postoperative pancreatic fistula grade B or C. Patients who underwent pancreaticoduodenectomy for adenocarcinoma pancreas were included. Patients with incomplete data for TO were excluded.</div></div><div><h3>Results</h3><div>A total of 269 patients were included. Complete TO was achieved in 56.9% of patients. Most achieve outcome was negative margins (R0) in 94.8%, and ≥12 lymph nodes were retrieved in 92.6%. Least achieved outcome was hospital stays &gt;14 days in 85%. Overall Survival in patients achieving TO vs those who did not achieved TO was 49 ± 1 month vs 40 ± 2 months respectively. (<em>p</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>Our tertiary cancer center demonstrated better TO rates compared to international published literature, reinforcing the importance of structured quality metrics in pancreatic surgery. TO serves as a robust predictor of long-term survival and should be integrated into surgical audits to enhance patient-centered care.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100330"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173543","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":"Acknowledgement of reviewers in 2025 for Surgery in Practice and Science","authors":"Artur Rebelo,&nbsp;Jörg Kleeff","doi":"10.1016/j.sipas.2026.100328","DOIUrl":"10.1016/j.sipas.2026.100328","url":null,"abstract":"","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100328"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385319","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":"Pressure trends and diagnosis of acute compartment syndrome","authors":"Yasser Bouklouch ,&nbsp;Justin Matta ,&nbsp;William T Obremskey ,&nbsp;Ross Leighton ,&nbsp;Mitchell Bernstein ,&nbsp;Edward J Harvey","doi":"10.1016/j.sipas.2026.100327","DOIUrl":"10.1016/j.sipas.2026.100327","url":null,"abstract":"<div><h3>Objectives</h3><div>Acute compartment syndrome (ACS) is a serious condition resulting from increased intracompartmental pressure (ICP) within a closed muscle compartment. There is a lack of understanding of continuous pressure trends despite being an accepted method for tracking disease. It was hypothesized that trends in pressure would determine risk of ACS.</div></div><div><h3>Methods</h3><div>This is a retrospective review of collected data from two prospective cohort trials. Anonymized ICP pressures from 147 trauma patients with extremity fractures were gathered. Patient data from multicenter level one trauma academic hospitals was analyzed. Data was taken from trauma patients that received a continuous real-time pressure device. Statistical and observational analysis were carried out to examine trends in patients with and without resultant acute compartment syndrome.</div></div><div><h3>Results</h3><div>Patients that developed ACS did not always have significantly higher absolute ICPs that exceed the theoretical critical 30 mmHg threshold for fasciotomy. Patients with ACS showed a consistent upward trend over time (average increase of 0.674 mmHg per hour). In contrast, non-ACS patients, even those that exceeded the previous postulated 30mmHg threshold, exhibit a natural and gradual decline in ICP over time (average decline of 0.285 mmHg per hour).</div></div><div><h3>Conclusions</h3><div>This research highlights the limitations of single-point pressure measurements and underscores the benefits of continuous ICP monitoring for timely ACS diagnosis. Continuous pressure data enables better clinical decision-making, reducing the risk of both unnecessary and delayed fasciotomies. This study emphasizes the need for integrating continuous pressure monitoring into standard practice to improve the management and outcomes of patients at risk for ACS.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100327"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078133","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":"Comment on “Improving consenting practice in trauma and orthopaedics: A single centre original mixed methods study”","authors":"Ankit Batra ,&nbsp;Prashant Kokiwar ,&nbsp;Priyanka Aher ,&nbsp;Indu Singh","doi":"10.1016/j.sipas.2025.100325","DOIUrl":"10.1016/j.sipas.2025.100325","url":null,"abstract":"","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100325"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927089","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":"Comment on “Predictors of post-operative complications following thyroid surgeries at a tertiary hospital in Tanzania”","authors":"Chandana Maji,&nbsp;Hariharan Srinivasan,&nbsp;Aishwarya Biradar,&nbsp;Reenoo Jauhari","doi":"10.1016/j.sipas.2026.100331","DOIUrl":"10.1016/j.sipas.2026.100331","url":null,"abstract":"","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100331"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173613","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}