Surgery open science最新文献

{"title":"Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients","authors":"Tyler Liang MD ,&nbsp;Areg Grigorian MD ,&nbsp;Robert Painter MD ,&nbsp;James Jeng MD ,&nbsp;Theresa Chin MD ,&nbsp;Laura F. Goodman MD MPH ,&nbsp;Yigit S. Guner MD ,&nbsp;Catherine Kuza MD ,&nbsp;Jeffry Nahmias MD MHPE","doi":"10.1016/j.sopen.2024.12.002","DOIUrl":"10.1016/j.sopen.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.</div></div><div><h3>Methods</h3><div>The 2017–2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.</div></div><div><h3>Results</h3><div>From 142,160 PTPs, 233 patients had UIA (&lt;1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p &lt; 0.001), length of stay (7 vs 2 days, p &lt; 0.001), and mortality (1.3 % vs. 0.1 %, p &lt; 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 30-34"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017996","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":"Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study","authors":"Qi Fan MM ,&nbsp;Pengcheng Wei MM ,&nbsp;Delin Ma MD ,&nbsp;Qian Cheng MD ,&nbsp;Jie Gao MD ,&nbsp;Jiye Zhu MD ,&nbsp;Zhao Li MD","doi":"10.1016/j.sopen.2024.12.004","DOIUrl":"10.1016/j.sopen.2024.12.004","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses.</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups (<em>P</em> &gt; 0.05). DFS was similar between groups (30.8 vs. 32.2 months, <em>P</em> = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, <em>P</em> = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (<em>P</em> = 0.044), time to recurrence (<em>P</em> = 0.002), tumor differentiation (P = 0.044), and satellite nodules (<em>P</em> = 0.019). Factors influencing OS included Child-Pugh classification (<em>P</em> = 0.040), time to recurrence (<em>P</em> = 0.002), and tumor differentiation (<em>P</em> = 0.032).</div></div><div><h3>Conclusions</h3><div><em>Re</em>-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 16-23"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018000","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":"A quantitative amplitude of vagus nerve obtained by intraoperative neuromonitoring predicts postoperative vocal cord paralysis among patients in thyroid/parathyroid surgery as a second option","authors":"Hiroshi Katoh MD, FACS ,&nbsp;Riku Okamoto MD ,&nbsp;Kanako Naito MD ,&nbsp;Tomoya Mitsuma MD ,&nbsp;Mariko Kikuchi MD ,&nbsp;Takaaki Tokito MD ,&nbsp;Takeshi Naitoh MD, FACS ,&nbsp;Naoki Hiki MD ,&nbsp;Yusuke Kumamoto MD ,&nbsp;Takafumi Sangai MD","doi":"10.1016/j.sopen.2024.12.009","DOIUrl":"10.1016/j.sopen.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>The advantage of intraoperative neuromonitoring (IONM) has been widely accepted in thyroid/parathyroid surgery. However, there are discrepancies of amplitudes on recurrent laryngeal nerve (RLN) palsy and vocal cord paralysis (VCP) because of amplitude variations among individuals. Accordingly, the universal usefulness of quantitative amplitude value <em>per se</em> among patients were assessed.</div></div><div><h3>Study design</h3><div>IONM using a 4-step method (Vagus nerve (V1)-RLN (<em>R</em>1)-R2-V2) was applied to 777 RLNs (510 patients). Forty-nine RLNs were excluded because of either loss of signal without preoperative VCP or combined RLN resection. The remaining 728 RLNs were evaluated. The optimal cut-offs of amplitudes or ratios of amplitude decrease on VCP were determined and evaluated. An independent recent cohort (177 RLNs) was analyzed for validation.</div></div><div><h3>Results</h3><div>Quantitative amplitudes of V2 or R2, and V2/V1 or R2/R1 ratio predicted VCP. The V2 of 117–216 μV predicted VCP with high (&gt;80 %) sensitivity and specificity. Interestingly, the AUC of ROC curve of V2 was the highest, and a cut-off 124 μV of V2 most excellently predicted VCP with the highest sensitivity, specificity, and both positive and negative predictive values. In dissociative analyses, a V2 cut-off 124 μV still excellently predicted VCP in all ranges of initial V1 ≥ 100 μV. In a validation cohort, the V2 of 126–205 μV (cut-off 197 μV) predicted VCP with both high (&gt;80 %) sensitivity and specificity.</div></div><div><h3>Conclusions</h3><div>A quantitative V2 amplitude can predict postoperative VCP among individuals as a simple and a second option, that may be especially useful in some circumstances with unavoidable insufficient initial exposure of vagus nerve.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 57-65"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061503","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":"How to review a manuscript for journal publication: A primer for surgery residents","authors":"Nicholas J. Zyromski MD ,&nbsp;David Stewart MD","doi":"10.1016/j.sopen.2024.12.007","DOIUrl":"10.1016/j.sopen.2024.12.007","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 66-68"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061509","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":"Acknoledgement of Reviewers","authors":"","doi":"10.1016/S2589-8450(24)00136-2","DOIUrl":"10.1016/S2589-8450(24)00136-2","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Page I"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167065","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":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(24)00135-0","DOIUrl":"10.1016/S2589-8450(24)00135-0","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Page i"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167822","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":"Thoracic surgery - An underestimated dream job?","authors":"Romina Maria Roesch ,&nbsp;Raffaella Griffo ,&nbsp;Isabella Metelmann ,&nbsp;Lena Brendel ,&nbsp;Maria Ada Presotto ,&nbsp;Katrin Welcker ,&nbsp;Hauke Winter ,&nbsp;Laura Valentina Klotz","doi":"10.1016/j.sopen.2024.11.002","DOIUrl":"10.1016/j.sopen.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons.</div></div><div><h3>Methods</h3><div>Using the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.</div><div>The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded.</div></div><div><h3>Results</h3><div>Out of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine.</div></div><div><h3>Conclusion</h3><div>The development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 79-84"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720551","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":"See one, teach yourself one, do one: Barriers and opportunities in self-administered training and assessment for global surgical education","authors":"Olubunmi A. Fariyike ,&nbsp;Jacqueline Yao ,&nbsp;Mehdi Baqri ,&nbsp;Peggy Liao ,&nbsp;Catherine Mohr ,&nbsp;George Korir ,&nbsp;Taseer Feroze Din ,&nbsp;Adam L. Kushner ,&nbsp;Sherry M. Wren","doi":"10.1016/j.sopen.2024.11.001","DOIUrl":"10.1016/j.sopen.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine the most important perceived barriers to the implementation of self-administered training and assessment in surgical education according to subject matter experts. With these findings, design thinking was used to explore possible interventions and develop a theory of change for overcoming identified barriers. Specifically, implementation was focused on expanding the surgical skills of associate clinicians (ACs) in low-to-middle-income countries (LMICs).</div></div><div><h3>Methods</h3><div>A qualitative study with 10 field experts representing surgeons, educators, and engineers from the US, South America, and East and West Africa was conducted. Interviewees were selected through purposeful snowball sampling until thematic saturation. Semi-structured interviews were conducted over video conference or in-person. Open-ended responses were synthesized, coded, and used to identify key barriers for scaling simulation-based learning and self-administered training and assessment in low-resource settings.</div></div><div><h3>Results</h3><div>We identified four major barriers to widespread implementation of self-administered training and assessment: demonstration of the safety and quality of surgical care provided after self-administered training; validation of the principle of self-administered training and assessment; translation of simulation skills to surgical knowledge; and integration into existing task shifting and task sharing legal landscapes.</div></div><div><h3>Discussion</h3><div>Increasing surgical capacity in LMICs is an urgent need that could be expanded with carefully developed self-administered training and assessment for ACs. The implementation process will be variable depending on local culture and regulations but is dependent on an international community of local champions to first produce a common body of evidence supporting the technology's utility and then to generate local excitement for its integration into existing systems.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 74-78"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700181","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":"Management of Colorectal Cancer with Synchronous Liver Metastases: A systematic review of national and International Clinical Guidelines (CoSMIC-G)","authors":"Anthony K.C. Chan PhD FRCS,&nbsp;Ajith K. Siriwardena MD FRCS","doi":"10.1016/j.sopen.2024.10.009","DOIUrl":"10.1016/j.sopen.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The contemporary management of patients with colorectal cancer and synchronous liver metastases is complex. This study appraises the recommendations made by national/international guidelines for the diagnosis and management of patients with synchronous liver metastases from colorectal cancer.</div></div><div><h3>Methods</h3><div>A systematic review of national and international guidelines published between 2011 and 2024 was carried out using PubMed, OvidSP and Guidelines International Network databases. The quality of guidelines was evaluated using the Appraisal of Guidelines for Research &amp; Evaluation II (AGREE II) instrument. Guidelines were assessed for the quality of advice for specific scenarios. The protocol was registered with PROSPERO (CRD42021243744).</div></div><div><h3>Results</h3><div>The search strategy returned ninety unique articles with 11 guidelines eligible for inclusion. Of these, one (9 %) guideline defined ‘synchronous disease’ at outset, eight (73 %) recommended neoadjuvant chemotherapy as first intervention. Seven (64 %) guidelines supported synchronous hepatic resection with colectomy. One (9 %) recommended against synchronous surgery.</div></div><div><h3>Conclusions</h3><div>This study demonstrates important variations between international clinical guidelines on diagnostic workup and management of synchronous liver metastases in colorectal cancer. [167 words].</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 61-66"},"PeriodicalIF":1.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656674","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":"Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction","authors":"Felix O. Hofmann ,&nbsp;Victoria S. Engelstädter ,&nbsp;Ughur Aghamaliyev ,&nbsp;Mathilda M. Knoblauch ,&nbsp;Elise Pretzsch ,&nbsp;Maximilian Weniger ,&nbsp;Jan G. D'Haese ,&nbsp;Bernhard W. Renz ,&nbsp;Jens Werner ,&nbsp;Matthias Ilmer","doi":"10.1016/j.sopen.2024.10.005","DOIUrl":"10.1016/j.sopen.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>After pylorus-resecting pancreatoduodenectomy (PrPD), delayed gastric emptying (DGE) might partially be attributed to biliary reflux. We investigated whether the incidence of primary DGE is reduced after Roux-en-Y instead of Billroth-II reconstruction.</div></div><div><h3>Methods</h3><div>Patients undergoing PrPD from 2016 to 2019 at a high-volume center were identified. Excluding causes of secondary DGE, we matched patients with Roux-en-Y and Billroth-II reconstruction in a 1:2 ratio and compared primary DGE.</div></div><div><h3>Results</h3><div>In 24 vs. 48 (Roux-en-Y vs. Billroth-II) patients, DGE (grade B/C) incidence (20.8 % vs. 18.8 %; <em>P</em> = 1.000), nasogastric tube requirement (median 2 vs. 2 days; <em>P</em> = 0.844) and time to solid food intake (7 vs. 7 days; <em>P</em> = 0.933) were comparable. Univariable logistic regression showed no association between DGE and Roux-en-Y reconstruction (OR 1.47; <em>P</em> = 0.524), in contrast to age (1.08; <em>P</em> = 0.030) and pancreatic biochemical leak (4.98; <em>P</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>Primary DGE did not differ between Roux-en-Y and Billroth-II reconstruction after PrPD. Instead, age and postoperative pancreatic biochemical leak were associated with higher DGE risk.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 46-52"},"PeriodicalIF":1.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656743","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}