Surgery open science最新文献

{"title":"The association of malnutrition with clinical and financial outcomes of traumatic injuries in older adults: A national retrospective analysis","authors":"Troy N. Coaston MSCR ,&nbsp;Konmal Ali BS ,&nbsp;Amulya Vadlakonda MD ,&nbsp;Deep J. Mehta ,&nbsp;Sara Sakowitz MD, MPH ,&nbsp;Dariush Yalzadeh BS ,&nbsp;Areti Tillou MD ,&nbsp;Peyman Benharash MD ,&nbsp;on behalf of the Academic Trauma Research Consortium (ATRIUM)","doi":"10.1016/j.sopen.2025.09.008","DOIUrl":"10.1016/j.sopen.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is an often underrecognized condition among older adults and carries significant relevance among patients hospitalized with traumatic injuries. The present study aimed to evaluate the association of malnutrition with clinical and financial outcomes among older adult patients admitted with external trauma.</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study of the 2016–2021 National Inpatient Sample including older adults (≥65 years) hospitalized with traumatic injuries. Patients were stratified by nutritional status (<em>Malnourished</em> and <em>Non-Malnourished</em>). Risk-adjusted logistic and linear regression models were constructed to evaluate the association of malnutrition with outcomes including inpatient mortality, clinical complications, and hospitalization costs.</div></div><div><h3>Results</h3><div>Of 6,587,907 older adults admitted with traumatic injuries, 7.5 % had malnutrition. The prevalence of malnutrition rose from 5.8 % to 8.6 % over the study period (nptrend&lt;0.001). Patients with malnutrition were more commonly of the lowest income quartile (25.5 vs 24.5 %), non-White (19.4 vs 16.9 %), and male (41.3 vs 39.1 %, all <em>p</em> &lt; 0.001). Following risk-adjustment, malnutrition was linked with increased odds of inpatient mortality (Adjusted Odds Ratio [AOR] 1.92, 95 % Confidence Interval [CI] 1.86–1.98) and infectious complications (AOR 2.30, 95 % CI 2.25–2.35) as well as greater inpatient costs (β + $7400, 95 % CI $7100-7600).</div></div><div><h3>Conclusion</h3><div>Malnutrition among older adults is associated with poorer clinical outcomes and increased financial burden. Rising prevalence and significant disparities underscore the need for increased screening and culturally relevant nutritional interventions to promote quality, equity, and sustainability in trauma care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 13-18"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108033","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":"HOW I DO IT: Breaking boundaries in surgical education by delivering expert feedback to residents anytime and anywhere. The LAPPCLINIC project.","authors":"Diego Sanhueza R. MD ,&nbsp;Cristián Jarry T. MD, MSc ,&nbsp;Julián Varas C. MD, MSc","doi":"10.1016/j.sopen.2025.09.007","DOIUrl":"10.1016/j.sopen.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>To describe <em>LAPPCLINIC</em>, an innovative web-based platform designed to enhance surgical education through remote and asynchronous feedback by video-analysis of residents' own surgical procedures.</div></div><div><h3>Design</h3><div>We provide a detailed description of the platform workflow, highlighting key features for enhancing surgical education.</div></div><div><h3>Setting</h3><div>An ongoing multicenter study involving seven surgical residency programs across Chile.</div></div><div><h3>Participants</h3><div>First-year surgical residents from seven different Chilean programs, with feedback provided by five surgeons, experienced in surgical education, who are beyond their learning curves in laparoscopic cholecystectomy and trained in structured quality-feedback delivery.</div></div><div><h3>Conclusion</h3><div><em>LAPPCLINIC</em> implementation has shown strong resident acceptance and significantly higher evaluation of feedback quality compared to traditional OR-based teaching.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 7-10"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108032","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":"Why Transanal Opening of Intersphincteric Space (TROPIS) is effective in high complex anal fistula?","authors":"Pankaj Garg","doi":"10.1016/j.sopen.2025.09.005","DOIUrl":"10.1016/j.sopen.2025.09.005","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 11-12"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108094","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":"Association of operative approach with adverse events following hepatic resections","authors":"Arjun Chaturvedi ,&nbsp;Esteban Aguayo ,&nbsp;Oh. Jin Kwon ,&nbsp;Kevin Tabibian ,&nbsp;Barzin Badiee ,&nbsp;Saad Mallick ,&nbsp;Daniel Tabibian ,&nbsp;Peyman Benharash","doi":"10.1016/j.sopen.2025.09.004","DOIUrl":"10.1016/j.sopen.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite growing use of minimally invasive surgery (MIS) for hepatocellular carcinoma (HCC), contemporary national data contrasting MIS with open hepatectomy are sparse.</div></div><div><h3>Methods</h3><div>Adults (≥18 y) undergoing hepatectomy for HCC in the American College of Surgeons National Surgical Quality Improvement Program (2015–2022) were studied. MIS (laparoscopic or robotic) resections were compared with open operations. Entropy balancing harmonized covariates, and multivariable logistic or linear models produced adjusted odds ratios (AOR) for major adverse events (MAE; composite of mortality and serious complications), liver-specific complications, and 30-day readmission.</div></div><div><h3>Results</h3><div>Among 5832 hepatectomies, 27.0 % were MIS, rising from 18.8 % in 2015 to 36.1 % in 2022 (<em>p</em> &lt; 0.001). After adjustment, MIS was associated with markedly lower odds of MAE (AOR 0.36, 95 % CI 0.29–0.46), postoperative liver failure (AOR 0.34, 0.20–0.58), bile leak (AOR 0.49, 0.28–0.89), need for invasive intervention (AOR 0.29, 0.18–0.47), and 30-day readmission (AOR 0.61, 0.44–0.86). In the subset undergoing major resections, MIS retained protective associations for MAE (AOR 0.26, 0.15–0.46) and readmission (AOR 0.28, 0.11–0.80).</div></div><div><h3>Conclusions</h3><div>In a large, contemporary U.S. cohort, MIS hepatectomy was independently associated with fewer perioperative complications, liver-specific adverse events, and readmissions compared with open surgery—even for major resections. These findings support continued expansion of minimally invasive hepatectomy and targeted training to extend its benefits to appropriately selected patients with resectable HCC.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050534","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 9 year retrospective review of motorcycle accidents at a level 1 trauma center in Riyadh","authors":"Hussam Alhathlol ,&nbsp;Khalid Alsikhan ,&nbsp;Turki Alharbi ,&nbsp;Ibrahim Alsamaani ,&nbsp;Ali Alhathloul ,&nbsp;Rifan Alyami","doi":"10.1016/j.sopen.2025.09.006","DOIUrl":"10.1016/j.sopen.2025.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Motorcycle accidents are a significant cause of morbidity and mortality worldwide, with an increasing trend observed in Saudi Arabia. These accidents often result in severe injuries, leading to long-term disability or death, highlighting the need for better understanding and management in trauma centers. These findings highlight the vulnerability of motorcyclists on the roads and underscore the critical need to address motorcycle safety in order to reduce the burden of road traffic accidents.</div></div><div><h3>Methods</h3><div>This retrospective study assessed the rate, injury patterns, and outcomes of motorcycle accidents at King Abdulaziz Medical City (KAMC) in Riyadh, a level 1 trauma center, from January 2016 to December 2024. A total of 415 adult patients were included, with data on demographics, injury types, and treatment outcomes collected from hospital records. Multivariable logistic regression was performed to identify predictors of intensive care unit (ICU) admission, intubation, and surgical intervention.</div></div><div><h3>Results</h3><div>The cohort consisted predominantly of young males (84.1 %), with the highest incidence observed in the 18–35 age group. Common injuries included fractures (86.7 %), brain injuries/bleeding (38.1 %), and cut/open wounds (27.5 %). Although the incidence peaked in 2023, no statistically significant trend was observed over the study period. Moreover, a surgical intervention was required in 69.9 % of the cases, with 28.2 % experiencing long-term disability, which was defined based on discharge disposition and documented rehabilitation needs Factors significantly associated with ICU admission and intubation included head injuries, chest injuries, and facial trauma.</div></div><div><h3>Conclusion</h3><div>Motorcycle accidents continue to pose a significant public health challenge in Saudi Arabia, with young male motorcyclists being the most vulnerable group. The high incidence of fractures and brain injuries emphasizes the importance of improving safety measures to reduce the severity of injuries.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 144-150"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049331","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":"Predictive value of ultrasound BIRADS in conjunction with cytological and histopathological outcomes in breast disease management","authors":"Hussein Hadi Jaber ,&nbsp;Qutaiba Abd El-Razaq Muner","doi":"10.1016/j.sopen.2025.08.005","DOIUrl":"10.1016/j.sopen.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer represents the leading cause of cancer-related mortality among Iraqi women (19.5 % of female cancers). Ultrasound BI-RADS classification integrated with tissue sampling requires population-specific validation for optimal diagnostic accuracy.</div></div><div><h3>Objective</h3><div>To evaluate the diagnostic accuracy of ultrasound BI-RADS classification when correlated with cytological and histopathological findings in predicting malignancy risk among Iraqi women.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional analytical study was conducted from February 2024 to February 2025 at two tertiary care teaching hospitals with specialized breast units in Baghdad, Iraq. One hundred sixty women aged ≥18 years with breast lesions classified as BI-RADS 3–5 underwent ultrasound evaluation, fine needle aspiration cytology (FNAC), and core needle biopsy (CNB) or surgical excision when indicated. Both participating radiologists completed formal BI-RADS training workshops by the Iraqi Radiological Society in 2023. Diagnostic performance metrics were calculated using histopathological confirmation as the reference standard.</div></div><div><h3>Results</h3><div>Mean participant age was 48.2 ± 9.7 years. BI-RADS distribution included: category 3 (25.0 %), 4A (18.8 %), 4B (12.5 %), 4C (12.5 %), and 5 (31.2 %). Overall malignancy rate was 40.0 %, varying by BI-RADS category: 2.5 % (category 3), 10.0 % (4A), 25.0 % (4B), 55.0 % (4C), and 88.0 % (category 5). ROC analysis demonstrated good discriminative ability (AUC = 0.85, 95 % CI: 0.79–0.91). At the optimal threshold (BI-RADS ≥4A), sensitivity was 98.4 % and specificity 40.6 %. Inter-modality agreement showed substantial concordance between FNAC and histopathology (κ = 0.76) and almost perfect agreement between CNB and histopathology (κ = 0.92). The integration of BI-RADS with tissue sampling demonstrated a 35–40 % reduction in unnecessary biopsies.</div></div><div><h3>Conclusions</h3><div>Ultrasound BI-RADS classification demonstrates good diagnostic performance in the Iraqi population, with increasing malignancy rates corresponding to higher BI-RADS categories. The integration of BI-RADS with tissue sampling techniques provides reliable diagnostic accuracy for breast disease management in resource-limited settings.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 171-178"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048746","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":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(25)00084-3","DOIUrl":"10.1016/S2589-8450(25)00084-3","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Page i"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094740","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":"Removal notice to “Surgical procedures and techniques in robot-assisted retrograde para-aortic lymphadenectomy” [Surg Open Sci 23 (2025) 35–41′]","authors":"Xinyou Wang,&nbsp;Jing Na,&nbsp;Ya Li,&nbsp;Shichao Han,&nbsp;Jun Wang","doi":"10.1016/j.sopen.2025.07.002","DOIUrl":"10.1016/j.sopen.2025.07.002","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Page 186"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094743","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":"Association of hospital profit status with operative rates for acute appendicitis","authors":"Konmal Ali BS ,&nbsp;Sona Mahrokhi MD ,&nbsp;Amulya Vadlakonda MD ,&nbsp;Troy Coaston MS ,&nbsp;Melissa Justo MD ,&nbsp;Deep Mehta ,&nbsp;Edward Livingston MD ,&nbsp;Peyman Benharash MD","doi":"10.1016/j.sopen.2025.09.003","DOIUrl":"10.1016/j.sopen.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Although appendicitis can now be treated nonoperatively, the uptake of nonoperative management of appendicitis (NOM) has been slow. We explored patient and hospital factors that might explain variation in appendectomy and NOM rates.</div></div><div><h3>Methods</h3><div>All adult hospitalizations for appendicitis were tabulated from the 2019–2022 Nationwide Readmissions Database. Initial, exploratory analyses revealed that appendectomy rates were lower in not-for-profit (NFP) relative to for-profit (FP) hospitals. Bayesian logistic regression and Fairlie decomposition were employed to explain the bases for these differences.</div></div><div><h3>Results</h3><div>There were 4394 NFP and 818 FP hospitals. When compared with FP facilities, NFP hospitals had a smaller proportion of appendicitis cases treated by appendectomy (82.9 ± 11.8 v. 89.7 ± 8.0) (mean ± SD) (Cohen's d: −0.70) and less than one-half the amount of charges $44,713 [30,217, 65,442] vs. $93,078 [64,171, 129,301] (median ± IQR) (Cohen's d &gt; −0.7, medium effect size). When estimated from regression equations, the gap between NFP and FP hospital appendectomy rates was 7.5 %. Total charges explained almost all of the gap between NFP and FP hospital appendectomy rates (0.068/0.090 = 75 %) of the gap. The presence of complicated appendicitis and EGS volume reduced the gap by −0.013 (−0.013/0.090 = 14 %).</div></div><div><h3>Conclusion</h3><div>Appendectomy rates for the treatment of appendicitis were greater in FP hospitals with almost all the difference in the rates explained by much higher charges observed in FP hospitals. The potential for greater profit from appendectomy as compared with NOM of appendicitis may explain why appendectomy is more common in FP hospitals.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 151-158"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048743","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":"Corrigendum to “Video-based learning for basic surgical skills - A randomized trial” [Surg Open Sci, volume 26, June 2025, pages 94–106]","authors":"I. Dantas ,&nbsp;I. Jorge ,&nbsp;A. Nicolau ,&nbsp;M. Vales ,&nbsp;C. Coutinho ,&nbsp;S. Rodrigues ,&nbsp;P. Febra ,&nbsp;V.N. Lopes","doi":"10.1016/j.sopen.2025.05.007","DOIUrl":"10.1016/j.sopen.2025.05.007","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Page 184"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094741","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}