Surgery open science最新文献

{"title":"Use of a microvascular anastomotic coupler device for kidney transplantation in rats","authors":"Henrik Lauer,&nbsp;Jana Ritter,&nbsp;Patrick Nachtnebel,&nbsp;Kathrin Simmendinger,&nbsp;Emily Lerchbaumer,&nbsp;Vladyslav Kavaka,&nbsp;Dominik Steiner,&nbsp;Jonas Kolbenschlag,&nbsp;Adrien Daigeler,&nbsp;Johannes C. Heinzel","doi":"10.1016/j.sopen.2025.01.008","DOIUrl":"10.1016/j.sopen.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Allogenic kidney transplantation has been the gold standard treatment for end-stage renal disease. In the research setting, rat models are widely utilized to refine surgical techniques and enhance graft viability. One critical factor affecting transplantation outcomes is the efficiency of the venous anastomosis. This study evaluates the utility of a microvascular coupling device for venous anastomosis in a rat kidney transplantation model.</div></div><div><h3>Material and methods</h3><div>Experimental allogenic kidney transplantations were conducted in male Brown Norway rats (<em>n</em> = 10) as donors and Lewis rats as recipients (<em>n</em> = 17), housed according to institutional guidelines. A microvascular coupling device was used for renal venous anastomosis, and creatinine levels were measured postoperatively to assess kidney function. Procedure times, ischemia duration, and postoperative complications were recorded and analyzed.</div></div><div><h3>Results</h3><div>The venous anastomosis time averaged 6.6 ± 2.2 min. Total ischemia time averaged 42.4 ± 4.9 min. Early postoperative serum creatinine levels were slightly elevated about references thresholds, which normalized by postoperative day 3. Four animals died after successful transplantation due to urethral complications and postrenal failure (23.5 %). Other postoperative mortality was primarily linked to complications unrelated to thrombosis (<em>n</em> = 3, 17.6 %).</div></div><div><h3>Conclusion</h3><div>The use of a microvascular coupling device for venous anastomosis in rat kidney transplantation significantly reduces procedure time and ischemia duration, contributing to more consistent graft outcomes. The simplification of the venous anastomosis process and reduced operative time justify the use of coupling devices. This technique holds promise for advancing preclinical transplant research and improving reproducibility in microsurgical procedures.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 16-22"},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146127","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":"Perceptions and attitudes of medical students toward opioid education: A qualitative study","authors":"Angelina Luciano ,&nbsp;Mara Schenker ,&nbsp;Dawn L. Comeau ,&nbsp;Courtney R. Yarbrough ,&nbsp;Nicholas A. Giordano","doi":"10.1016/j.sopen.2025.01.007","DOIUrl":"10.1016/j.sopen.2025.01.007","url":null,"abstract":"<div><h3>Objective</h3><div>Explore the perceptions and attitudes of medical students regarding their education in opioid prescribing for pain management.</div></div><div><h3>Design</h3><div>Three focus group discussions elicited open-ended, information-rich responses from medical students attending multiple institutions. Thematic analysis identified common themes from focus group transcript data.</div></div><div><h3>Setting</h3><div>Rollins School of Public Health at Emory University, Atlanta, Georgia, USA.</div></div><div><h3>Participants</h3><div>Medical students (<em>n</em> = 12) from four medical schools in the United States.</div></div><div><h3>Results</h3><div>Focus group participants indicated they experienced changes in their perceptions and attitudes about opioids during their time in medical school, gradually recognizing the importance of treating pain while avoiding overprescribing and opioid-related harms. Discussions revealed that the curriculum on opioid medications and their prescription in medical school is limited and varied, with most opportunities for learning arising during preclinical years. The quantity and quality of the opioid-related education experienced by participants during medical school impacted their perceived knowledge about opioids and, consequently, their confidence in treating pain. Participants noted that important gaps in their knowledge about opioid prescribing persist, which may influence their future prescribing habits. While participants understood they had insufficient knowledge about opioid prescribing, they anticipated there would be additional learning during their residency programs.</div></div><div><h3>Conclusions</h3><div>There is room for improvement for medical school instruction on the safe and effective use of opioids for pain management in the United States. Medical students themselves have expressed a desire for enhanced opioid education. Strengthening opioid education has implications across various healthcare environments, particularly in settings with prevalent opioid prescribing.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 23-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372206","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":"Propensity matched analysis of DPA or DPL used within the first hour for severely hypotensive blunt trauma patients","authors":"Mallory Jebbia MD,&nbsp;Jeffry Nahmias MD MHPE,&nbsp;Sebastian Schubl MD,&nbsp;Matthew Dolich MD,&nbsp;Michael Lekawa MD,&nbsp;Allen Kong MD,&nbsp;Areg Grigorian MD","doi":"10.1016/j.sopen.2025.01.005","DOIUrl":"10.1016/j.sopen.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Prior single-center reports advocate for use of diagnostic peritoneal aspiration or lavage (DPA/DPL) to identify blunt trauma patients (BTPs) with intra-abdominal hemorrhage who require emergent surgery. Despite this, concerns exist over the potential for DPA/DPL to delay transfer to the operating room (OR). We hypothesized that DPA/DPL application in severely hypotensive BTPs would lead to increased OR transfer time and in-hospital mortality.</div></div><div><h3>Methods</h3><div>The 2017–2019 TQIP database was queried for adult BTPs presenting with severe hypotension (systolic blood pressure &lt;70 mmHg) who underwent any operative intervention within two-hours. Using a 1:2 propensity-score model, patients who underwent DPA/DPL within one-hour of arrival were compared with those who did not, controlling for age, sex, comorbidities, ≥6 units of packed red cells within 4 h, and injury profile.</div></div><div><h3>Results</h3><div>From 5514 patients, 62 (1.1 %) underwent DPA/DPL. We matched 52 DPA/DPL patients to 104 patients not undergoing DPA/DPL. There were no differences in the matched variables between cohorts (all p &gt; 0.05). Compared to those not undergoing DPA/DPL, patients undergoing DPA/DPL had a higher rate/risk of in-hospital complications (59.6 % vs. 39.4 %, p = 0.02) (OR 2.27, CI 1.15–4.47, p = 0.02) but statistically similar rate/risk of death (65.4 % vs. 50.0 %, p = 0.07) (OR 1.89, CI 0.95–3.76, p = 0.07). Time to OR was similar between both groups (DPA/DPL 39 min vs. non-DPA/DPL 42 min, p = 0.87).</div></div><div><h3>Conclusion</h3><div>DPA or DPL used within the first hour of arrival does not appear to delay time to OR and does not increase risk of death. This challenges concerns over potential DPA/DPL-associated delays and heightened mortality risks.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 1-4"},"PeriodicalIF":1.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147236","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":"Innovative strategies in bile duct repair: Assessing efficacy and safety across varied graft techniques - A systematic review","authors":"Anung Noto Nugroho ,&nbsp;Soetrisno Soetrisno ,&nbsp;Ambar Mudigdo ,&nbsp;Kristanto Yuli Yarso ,&nbsp;Dono Indarto ,&nbsp;Akmal Zhahir Wahyudi ,&nbsp;Enrico Ananda Budiono ,&nbsp;Auliya Yudia Yasyfin","doi":"10.1016/j.sopen.2025.01.006","DOIUrl":"10.1016/j.sopen.2025.01.006","url":null,"abstract":"<div><div>Bile duct injuries (BDI) from surgical procedures pose significant clinical challenges, requiring precise interventions for optimal outcomes. This systematic review explores the utilization of grafts in the repair of bile duct injuries, aiming to gain insights from existing literature. Graft-based techniques show promise in improving postoperative outcomes, but their efficacy varies. A systematic search was conducted across PubMed, Science Direct, and Scopus following the PRISMA 2020 Checklist, focusing on studies published until February 19, 2024. The inclusion criteria involved research using grafts to treat bile duct injuries in pig, swine, or mini-pig models. Out of 2231 studies identified, eleven met the inclusion criteria. These studies evaluated various graft techniques, including autologous tissue with biodegradable stents, decellularized grafts, patches, prosthetic grafts, bacterial cellulose film, and heterogeneous materials. Each method had distinct advantages and limitations, particularly regarding postoperative outcomes and histological findings. This review highlights the need for further research to determine the most effective graft-based strategies for BDI repair and improve patient care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 5-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146143","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":"Introduction from the New Editor of Diversity, Justice and Action","authors":"Mohammad Y. Zaidi","doi":"10.1016/j.sopen.2025.01.004","DOIUrl":"10.1016/j.sopen.2025.01.004","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 29-30"},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372207","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 retrospective study assessing RefluxStop surgery for gastroesophageal reflux disease: Clinical outcomes in 79 patients from Germany","authors":"Thorsten Lehmann MD,&nbsp;Mantas Šimkus MD,&nbsp;Christoph Oehler MD","doi":"10.1016/j.sopen.2024.12.003","DOIUrl":"10.1016/j.sopen.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>This study reports outcomes of the RefluxStop procedure treating gastroesophageal reflux disease (GERD) in clinical practice at a high-volume regional hospital in Germany.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 79 patients with chronic GERD that underwent the RefluxStop procedure, comprising high mediastinal dissection, loose cruroplasty, esophagogastroplication between vagal trunks, and fundus invagination of the RefluxStop implant. The primary outcome was GERD Health-Related Quality-of-Life (GERD-HRQL) score and improvement from baseline. Secondary outcomes included proton pump inhibitor (PPI) use and intra- and postoperative complications, including dysphagia, esophageal dilatation, and reoperation.</div></div><div><h3>Results</h3><div>Baseline characteristics (<em>n</em> = 79) included large hiatal hernia &gt;3 cm (32.4 %) and previous antireflux surgery (20.3 %). At mean (SD) follow-up of 11 (4.4) months ranging from 4 to 19 months, the median (IQR) and mean (SD) improvements in GERD-HRQL score were 100 % (90.2–100 %) and 92.4 % (13.9 %) from baseline, respectively. Significant reduction in PPI use was observed from a baseline of 94.9 % to 2.5 % at follow-up. All cases of preoperative dysphagia (7.6 %) completely resolved. New-onset, mild dysphagia occurred in one subject (1.3 %) at final follow-up. One subject (1.3 %) experienced asymptomatic device migration into the stomach, likely due to surgical technique with a much too tight invagination, with subsequent conversion to Toupet fundoplication.</div></div><div><h3>Conclusion</h3><div>Analysis of this cohort that underwent RefluxStop surgery indicates excellent safety and effectiveness over this short-term follow-up. Significant improvements in quality of life and PPI use were observed in a population where half had either large hiatal hernia &gt;3 cm or reoperation for previously failed antireflux surgery, a demographic with usually much higher complication rates.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 9-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017992","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":"Surgical procedures and techniques in robot-assisted retrograde para-aortic lymphadenectomy","authors":"Xinyou Wang,&nbsp;Jing Na,&nbsp;Ya Li,&nbsp;Shichao Han,&nbsp;Jun Wang","doi":"10.1016/j.sopen.2024.12.008","DOIUrl":"10.1016/j.sopen.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>To study the robotic-assisted abdominal aorta lymphadenectomy at the level of the left renal vein, aimed at standardizing and optimizing the surgical procedure.</div></div><div><h3>Methods</h3><div>All surgical procedures are guided by the theory of membrane anatomy, operating within the intermembrane spaces of embryonic compartments.</div></div><div><h3>Results</h3><div>Using robotic assistance in an inverted position to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein enables safe and reliable lymph node removal, combined with the concept of membrane anatomy, not only minimizes surgical bleeding but also helps reduce complications, such as vascular and intestinal injuries.</div></div><div><h3>Conclusion</h3><div>Utilizing robotics to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein can achieve a more meticulous and refined surgical outcome. Precise surgical techniques contribute to standardizing and optimizing surgical procedures, thereby facilitating the learning process.</div></div><div><h3>Trial registration</h3><div>No trial involve.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 35-41"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101169","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(25)00007-7","DOIUrl":"10.1016/S2589-8450(25)00007-7","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Page i"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100523","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":"NIH funding for the pediatric surgeon-scientist: An analysis of current trends","authors":"Colton D. Wayne MD ,&nbsp;Zachary Dumbauld BS ,&nbsp;Ethan Mills BS ,&nbsp;Diana L. Farmer MD ,&nbsp;Gail E. Besner MD","doi":"10.1016/j.sopen.2024.12.005","DOIUrl":"10.1016/j.sopen.2024.12.005","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Previous studies highlighted the success of pediatric surgeons in obtaining NIH funding. Given increasing clinical demands, we sought to analyze the current state of NIH funding for pediatric surgeon-scientists.</div></div><div><h3>Methods</h3><div>APSA membership in August 2023 was filtered for Regular/Associate members and referenced through NIH RePORTER. Data included history of prior/active NIH funding, award type/institute, and funding pathways. Demographics collected included level of professorship, post-graduate degrees, and gender. Academic productivity was assessed by PubMed publications. In addition, a survey was distributed to Regular/Associate APSA members.</div></div><div><h3>Results</h3><div>1079 APSA Regular/Associate members were identified. <u>Total (previous/current) funding</u>: 149 (13.8 %) surgeons had previous/current NIH funding, 145 with complete funding information. There were 371 previous/current grants totaling $387,148,625. 31.7 % of funded surgeons held Chair/Chief positions, 77.9 % were male, and 84.1 % had M.D. degree only. 282 (76.0 %) grants were independent, and 42 (11.3 %) were mentored. 100 (69.0 %) funded surgeons obtained independent investigator awards, 33 (22.8 %) with and 67 (46.2 %) without prior training/mentored grants. <u>Current funding</u>: 52 (4.8 %) surgeons had current NIH funding, with 80 grants totaling $44,232,644. 73 (91.25 %) were independent while 7 (8.75 %) were mentored awards. <u>Academic productivity</u>: Assessment revealed 7197 total publications (range = 0–207, mean = 49.6). <u>Survey:</u> results highlighted perceived challenges and suggested improvements.</div></div><div><h3>Conclusions</h3><div>Compared to a 2013 study by King et al., the percent of funded APSA members has trended downward; however, the number of funded pediatric surgeon-scientists and dollar amount of active NIH funds has increased. Concentrated efforts are needed to support surgical trainees and junior faculty, particularly females, to pursue research and academic pediatric surgery.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 42-49"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100639","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":"The succession of One Day Surgery with Breast Cancer Home Recovery Program by the National Cancer Institute (ODS BHR NCI) during the COVID-19 pandemic in Thailand","authors":"Chayanoot Rattadilok ,&nbsp;Napaphat Poprom ,&nbsp;Vipavee Niyomnaitham ,&nbsp;Oradee Phadhana-anake ,&nbsp;Jirawadee Ruamjaroenchai ,&nbsp;Napat Saigosoom ,&nbsp;Wimonporn Papathe ,&nbsp;Suttida Thuranutch ,&nbsp;Araya Chanwet","doi":"10.1016/j.sopen.2024.12.001","DOIUrl":"10.1016/j.sopen.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most common cancer among women. In response to the need to hospital stays and minimize waiting time for surgery, particularly during the COVID-19 pandemic, the National Cancer Institute developed the One Day Surgery with Breast cancer Home Recovery program (ODS BHR NCI). The aim of study is to assess the success rate of breast cancer surgeries conducted through this program and to evaluate the incidence of complications.</div></div><div><h3>Method</h3><div>The cohort study includes all breast cancer patients who underwent surgery through the ODS BHR NCI program between August 2021 to November 2023. Eligible participants were under 70 years of age. The patients received comprehensive care and education from a multidisciplinary team, adhering to the program's guidelines. Their postoperative outcomes were monitored on the 1^st, 3^rd, and 5^th days following discharge.</div></div><div><h3>Result</h3><div>A total of 206 patients participated in the ODS BHR NCI program during the COVID-19 pandemic in Thailand. The mean age and BMI were 54.21 ± 9.74 years and 24.18 ± 4.02, respectively. The success rate was 99.02 %, with only one case involving a serious complication. Minor complications were reported in 20 cases, including anesthesia-related issues and minor surgical complications. Notably, no patients were diagnosed with COVID-19 following their surgery.</div></div><div><h3>Conclusion</h3><div>Breast cancer surgeries performed under the ODS BHR NCI program achieved a high success rate. The development of pre-, intra-, and post-operative care protocols, alongside comprehensive patient education, has potential to reduce complications and provide an effective model for extending systemic care to a wider range of patients.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 1-8"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017998","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}