Surgery open science最新文献

{"title":"Prediction of mortality after esophagectomy: A comprehensive analysis of various risk scores in a national esophageal center","authors":"Ahmed Al-Mawsheki ,&nbsp;Maximilian Bockhorn ,&nbsp;Sorin Miftode ,&nbsp;Fadl Alfarawan ,&nbsp;Asem Al-Salemi ,&nbsp;Catharina Fahrenkorg ,&nbsp;Nader- El-Sourani","doi":"10.1016/j.sopen.2025.08.001","DOIUrl":"10.1016/j.sopen.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Esophagectomy remains the cornerstone treatment for esophageal cancer but is associated with significant perioperative morbidity and mortality, even in specialized centers. Accurate preoperative risk assessment is crucial to improve patient outcomes, and various predictive models are available for risk stratification. This study aimed to validate and compare the performance of nine established predictive models in forecasting 30-day mortality following esophagectomy in a high-volume esophageal cancer center.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed of 101 patients who underwent esophagectomy between January 2020 and December 2023 was performed. Clinicopathological characteristics and mortality data were obtained. The predictive accuracy of nine risk models, including the Esophageal-POSSUM (O-POSSUM), Charlson Comorbidity Index (Charlson), Postoperative Estimation of Risk (PER), and Fuchs scores, was assessed using logistic regression, Hosmer-Lemeshow tests for calibration, and the area under the receiver operating characteristic curve (AUC) for discrimination. Mann-Whitney <em>U</em> tests were used to evaluate significant differences between survivors and non-survivors.</div></div><div><h3>Results</h3><div>The 30-day mortality rate was 8.91 %. The O-POSSUM and Charlson scores demonstrated the highest predictive accuracy with AUCs of 0.832 and 0.806, respectively. The PER and Fuchs models also showed significant associations with mortality but with moderate predictive ability. Models such as the American Society of Anesthesiologists (ASA) and Philadelphia scores demonstrated limited predictive utility. Significant differences in predictive performance were noted across patient subgroups.</div></div><div><h3>Conclusions</h3><div>The O-POSSUM and Charlson scores were reliable tools for predicting 30-day mortality after esophagectomy. Other models require further validation and refinement. Tailoring risk assessment models in specific clinical settings may enhance their predictive accuracy and contribute to improved patient outcomes.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 19-27"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325320","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":"Isolated right hepatic duct dilation – Type VI of Mirizzi syndrome?","authors":"Longchang Chen ,&nbsp;Yan Sun ,&nbsp;Quanda Liu","doi":"10.1016/j.sopen.2025.11.006","DOIUrl":"10.1016/j.sopen.2025.11.006","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 98-100"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693452","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":"Impact of inflammatory biomarkers and surgical interventions on one-month recovery after rib fractures: A propensity-matched cohort study","authors":"Xiaojiao Zhu ,&nbsp;Jianwei Han ,&nbsp;Chuan Long ,&nbsp;Wenjun Cao ,&nbsp;Suwei Xu ,&nbsp;Yingding Ruan","doi":"10.1016/j.sopen.2025.10.009","DOIUrl":"10.1016/j.sopen.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to assess the collective influence of inflammatory indicators and surgical interventions on the one-month postoperative recovery outcomes in patients with rib fractures.</div></div><div><h3>Methods</h3><div>A retrospective analysis involved 70 surgical and 278 non - surgical rib - fracture patients. Primary outcomes were thoracic complication incidence and post - discharge oral analgesic use at one month. Secondary outcomes included hospital stay length and total costs. We collected various data and conducted propensity score matching (1:2 ratio) to control for confounders, followed by multivariate analyses.</div></div><div><h3>Results</h3><div>After PSM (60 surgical vs. 117 non-surgical patients), surgical reduced hospital stay by 10.4 days (β = −10.36 days, 95 % confidence interval [95 % CI]: −16.03 to −4.70; <em>P</em> &lt; 0.001), but increase in total costs by 30,808.80 CNY (P &lt; 0.001). Pre-existing thoracic complications independently predicted higher one-month postoperative complications (OR[95 % CI] = 4.05 [1.08, 18.15]; <em>P</em> = 0.048), while comorbidities lowered risk (OR[95 %CI] = 0.29 [0.08, 0.89]; <em>P</em> = 0.043). Elevated systemic immune-inflammation index (SII) (Coef [95 % CI] = 528.03 [28.05, 1028.00]; <em>P</em> = 0.039) and neutrophil-to-lymphocyte ratio (NLR) (Coef[95 % CI] = 3.50 [0.62, 6.37]; <em>P</em> = 0.017) were positively correlated with Injury Severity Score (ISS). In surgical patients, a higher lymphocyte-to-monocyte ratio (LMR) independently predicted a lower likelihood of ongoing analgesic use at one month (OR[95 %CI] = 0.70 [0.46, 0.95]; <em>P</em> = 0.046).</div></div><div><h3>Conclusion</h3><div>Surgical rib - fracture stabilization shortens hospital stay but raises treatment costs. High SII and NLR, along with thoracic complications, are linked to post - op complications. LMR and HGB levels are associated with analgesic needs, which may aid in tailored pain management.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 49-62"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466284","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":"Clinical and financial outcomes associated with gastrointestinal complications among patients with type B aortic dissection","authors":"Troy N. Coaston MSCR ,&nbsp;Amulya Vadlakonda MD ,&nbsp;Esteban Aguayo MD ,&nbsp;Zihan Gao MHSc ,&nbsp;Syed Shaheer Ali ,&nbsp;Oh Jin Kwon MD ,&nbsp;Peyman Benharash MD","doi":"10.1016/j.sopen.2025.10.006","DOIUrl":"10.1016/j.sopen.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal complications (GIC) are an uncommon but serious sequelae of type B aortic dissection (TBAD), potentially contributing to increased mortality and healthcare resource utilization. Limited studies have characterized these complications among TBAD patients. The present work sought to evaluate the clinical and financial implications of GIC and identifies factors associated with their development.</div></div><div><h3>Methods</h3><div>All hospitalizations entailing a primary diagnosis of TBAD were identified in the 2016–2020 Nationwide Readmissions Database. Patients were stratified into those who developed GIC and those who did not. Outcomes included in-hospital mortality, length of stay (LOS), hospitalization costs, and the need for abdominal surgery. Multivariable logistic and linear regressions were employed to assess associations between patient, facility, and treatment factors with clinical and financial outcomes.</div></div><div><h3>Results</h3><div>Of 24,927 TBAD hospitalizations, 2.5 % developed GIC, and 24.0 % of these cases required an abdominal procedure. Patients with GIC were younger (median 61 vs. 67 years; <em>p</em> &lt; 0.001), more commonly male (67.4 vs. 56.6 %; p &lt; 0.001), and more likely to have Medicaid insurance (20.9 vs. 12.5 %; p &lt; 0.001). GIC were independently associated with increased odds of in-hospital mortality (adjusted odds ratio 4.54; 95 % CI 3.41–6.04), greater LOS (β 5.80 days; 95 % CI 3.88–7.72), and increased costs (β $41,000; 95 % CI $31000–51,000).</div></div><div><h3>Conclusions</h3><div>GIC in TBAD patients was associated with substantial clinical and financial burdens. Further study of early identification and targeted interventions is warranted to mitigate these complications and optimize resource utilization in this high-risk population.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 43-48"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466282","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":"2025-12-01","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":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(25)00103-4","DOIUrl":"10.1016/S2589-8450(25)00103-4","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Page i"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736265","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":"Mesenteric inclusion in Crohn's disease surgery: Promising breakthrough or tempest in a teapot? An updated meta-analysis","authors":"Mohamed Maatouk MD, MS ,&nbsp;Mohamed Ben Khalifa MD ,&nbsp;Nada Essid MD ,&nbsp;Aymen Mabrouk MD ,&nbsp;Mariem Nouira MD ,&nbsp;Moez Boudokhane MD ,&nbsp;Mounir Ben Moussa MD, PhD","doi":"10.1016/j.sopen.2025.10.010","DOIUrl":"10.1016/j.sopen.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Recently, renewed concern has been centered on the role of the mesentery in the development of Crohn's disease (CD). However, there are minimal data supporting the extended mesenteric excision (EME), which may lead to reticence in the adoption of this surgical option. This systematic review and meta-analysis aimed to compare the post-operative outcomes in patients undergoing EME vs limited mesenteric excision (LME) for CD.</div></div><div><h3>Methods</h3><div>We conducted a systematic search from January 2018 to January 2025 for studies reporting outcomes in patients undergoing EME compared with LME for CD. A pooled meta-analysis was performed. The risk of bias was examined using the ROBINS-I v2 and RoB2 tool.</div></div><div><h3>Results</h3><div>Nine studies were included in final analysis, comprising two randomized controlled trials, enrolling a total of 4823 patients. Definitions of EME differ, with some studies preserving the ileocolic trunk and others resecting the mesentery with proximal ligation. No significant difference in surgical or endoscopic recurrence was observed between EME and LME. Concerning secondary outcomes, including overall morbidity, intra-abdominal abscess, anastomotic leak and hospital stay, the two groups showed no significant differences.</div></div><div><h3>Conclusions</h3><div>EME appears as safe as the LME in terms of morbidity, but does not significantly reduce surgical or endoscopic recurrence. Due to the absence of a precise definition of the EME procedure in CD and the need of further high-quality research, the approach of EME still lacks sufficient validation and cannot be broadly recommended for routine clinical practice.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 89-97"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623886","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 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":"2025-12-01","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":"Collagenolytic Enterococcus faecalis induces DDR1 signaling, proliferation and altered immune infiltrate in colorectal peritoneal metastases","authors":"Richard Jacobson ,&nbsp;Sean Dineen ,&nbsp;John Mullinax ,&nbsp;Ryan Martin ,&nbsp;Sidharth Mishra ,&nbsp;Michelle Maurin ,&nbsp;Ramani Soundararajan ,&nbsp;Timothy Nywening ,&nbsp;Andreas Karachristos ,&nbsp;Hariom Yadav ,&nbsp;Timothy Yeatman ,&nbsp;Jason Fleming","doi":"10.1016/j.sopen.2025.10.011","DOIUrl":"10.1016/j.sopen.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Intratumoral pathogens are an emerging paradigm in metastatic colorectal cancer (CRC). Overgrowth of <em>Enterococcus faecalis</em> was shown to promote local recurrence in the colon, in a fashion dependent on collagenolytic virulence factors. The role of intratumoral enterococci in metastatic CRC is presently unknown.</div></div><div><h3>Methods</h3><div>We screened resected human metastatic CRC from the liver, lungs, and peritoneal surface for intratumoral bacteria with 16 s rRNA sequencing. We probed the effects of <em>E. faecalis</em> on CRC biology in vitro<em>,</em> with a focus on collagenolysis and the putative receptor for cleaved collagen, discoidin domain receptor 1 (DDR1) in CT26 CRC cells. We used a syngeneic, orthotopic mouse model of colorectal peritoneal metastases to measure the impact of <em>E. faecalis</em> on tumor bulk and immune infiltrate.</div></div><div><h3>Results</h3><div>Resected metastatic CRC from 70 patients were screened for intratumoral bacteria. <em>Enterococcus</em> species were identified in 10/13 patients with CRC peritoneal metastases and were enriched in peritoneal compared to non-peritoneal metastases. <em>E. faecalis</em> and CRC cells demonstrated cooperative collagenolysis in a fashion dependent on the secreted virulence factors GelE and SprE<em>.</em> Bacterial-induced collagenolysis led to increased DDR1 phosphorylation and downstream effects, specifically proliferation and endocytosis of cleaved collagen. In the mouse model, cell counts indicate intratumoral <em>E. faecalis</em> altered the immune compartment of the tumor microenvironment.</div></div><div><h3>Discussion</h3><div>Collagenolytic <em>E. faecalis</em> induce DDR1 pathway activation in CRC cells, alter the immune landscape in mouse models, and are enriched in human CRC peritoneal metastases. Further work is required to determine whether eradication of intratumoral bacteria can change tumor biology.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 65-72"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528539","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":"Health-related quality of life after HPB surgery","authors":"Victor M. Zaydfudim","doi":"10.1016/j.sopen.2025.10.007","DOIUrl":"10.1016/j.sopen.2025.10.007","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 63-64"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466283","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}