Surgery open science最新文献

{"title":"The outcomes of right and left complicated colonic diverticulitis","authors":"Anh Tuan Nguyen ,&nbsp;Quang Tien Pham ,&nbsp;Hoi Van Tran ,&nbsp;Hoang Viet Truong ,&nbsp;Loc Huynh Tran","doi":"10.1016/j.sopen.2025.06.005","DOIUrl":"10.1016/j.sopen.2025.06.005","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of complicated colonic diverticulitis is increasing in Asia, with notable differences in management between right-sided (RCD) and left-sided (LCD) cases. This study compared treatment outcomes and identified risk factors for complications.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 181 patients diagnosed with complicated colonic diverculitis from January 2022 to September 2024, including 99 RCD and 82 LCD cases.</div></div><div><h3>Results</h3><div>The mean age in the RCD group was 43.31 ± 14.6 years, compared to 63.9 ± 12.9 years in the LCD group. Recurrence rates were higher in LCD than RCD (19.5 % vs. 7.1 %). Surgical intervention was more frequent in LCD cases (63.4 % vs. 9.2 %), with longer hospital stay (9.3 vs 4.9 days). All RCD perforations were managed with primary anastomosis. Hartmann's procedure was the most common approach for LCD, with primary resection and anastomosis performed in 26.9 %. Postoperative complications occurred in 27.8 % of LCD patients, including wound infections, intra-abdominal abscesses, and pneumonia. Three patients in the LCD group died during hospitalization. Fever, elevated CRP levels, surgery type, and prolonged hospital stays were independent risk factors.</div></div><div><h3>Conclusion</h3><div>Patients with complicated RCD were younger than those with LCD. Conservative treatment for RCD had a high success rate, while complicated LCD often required surgery due to peritonitis. Fever, CRP level, type of surgery, and hospital stay were independent risk factors for complications.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 31-35"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330750","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}

{"title":"Association of hospital for-profit status with clinical and financial outcomes following emergency general surgery","authors":"Izhar Mbarani MD ,&nbsp;Sara Sakowitz MD, MBA ,&nbsp;Amulya Vadlakonda MD ,&nbsp;Troy Coaston MSCR ,&nbsp;Esteban Aguayo MD ,&nbsp;Syed Shaheer Ali ,&nbsp;Konmal Ali ,&nbsp;Saad Mallick MD ,&nbsp;Peyman Benharash MD MS","doi":"10.1016/j.sopen.2025.06.003","DOIUrl":"10.1016/j.sopen.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>The impact of for-profit (FP) hospital ownership on healthcare outcomes has garnered increasing attention in recent years with limited work linking FP status with lower quality of care and higher costs. However, outcomes emergency general surgery (EGS) at FP hospitals remains unknown.</div></div><div><h3>Methods</h3><div>All non-elective adult (≥18 years) hospitalizations entailing EGS (appendectomy, cholecystectomy, laparotomy, large bowel resection, perforated ulcer repair, or small bowel resection), within 2 days of admission, were tabulated from the 2016 to 2021 National Inpatient Sample. Multivariable models were constructed to evaluate the independent associations between hospital FP status with key clinical and financial outcomes.</div></div><div><h3>Results</h3><div>Of an estimated 2,124,394 patients, 337,950 (16 %) were classified as FP. Compared to others, the FP cohort was younger, of lower comorbidity burden, and more frequently in the lowest income quartile. After risk adjustment, care at FP hospitals was associated with a greater likelihood of in-hospital mortality or any major complication (Adjusted Odds Ratio [AOR] 1.15, 95 % Confidence Interval [CI] 1.12–1.18), including infectious (AOR 1.22, 95 % CI 1.18–1.26), respiratory (AOR 1.26, 95 % CI 1.21–1.31), and renal sequelae (AOR 1.12, 95 % CI 1.08–1.16). While associated with reduced per-patient hospitalization costs (β -$2910, 95 % CI -3180,-2640), treatment at FP institutions was associated with increased odds of non-home discharge (AOR 1.09, 95 % CI 1.05–1.13).</div></div><div><h3>Conclusions</h3><div>Care at for-profit hospitals appears to be associated with greater risk of morbidity and nonhome discharge. Future work is needed to consider the factors contributing to greater morbidity, and developing interventions aimed at improving quality of care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 1-7"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264111","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 online teaching curricula on undergraduate basic surgical skills acquisition","authors":"Devansh Tandon ,&nbsp;Ayush Gupta ,&nbsp;Rhianna Patel ,&nbsp;Anushka Shukla ,&nbsp;Saran Singh Gill ,&nbsp;Rhea Elise Patel ,&nbsp;Keshav Krishnan ,&nbsp;Bishoy Yassa ,&nbsp;Shivansh Tandon ,&nbsp;Amar Rai ,&nbsp;Matt Boal ,&nbsp;Nader Francis","doi":"10.1016/j.sopen.2025.06.002","DOIUrl":"10.1016/j.sopen.2025.06.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the growing use of online teaching in medical education, undergraduate surgical skills training remains predominantly face-to-face, with limited structured curricula and resources. Consequently, many students lack confidence performing basic procedures independently. While online programmes offer a potential alternative, comparative evidence is limited. This service evaluation assessed the effectiveness of online surgical skills teaching on student skill acquisition and confidence.</div></div><div><h3>Methods</h3><div>Medical students who participated in five UK national surgical skills programmes between 2022 and 2024 were selected, having received either online or face-to-face instruction. Skill acquisition was measured using the Objective Structured Assessment of Technical Skills (OSATS) tool and confidence was measured pre- and post-training via a Likert scale. Non-parametric data were analysed using the Mann-Whitney <em>U</em> test, with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Of 133 participants, 82 received online and 51 face-to-face training. Fifty-six percent were in their first or second year of study. No significant differences were found in continuous (<em>p</em> = 0.0652) or mattress suturing (<em>p</em> = 0.143), while interrupted suturing scores were significantly higher in the online group (<em>p</em> = 0.0143). Both modalities significantly improved confidence (<em>p</em> &lt; 0.0001), with no significant difference between groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that online surgical skills teaching is as effective as face-to-face methods, with both positively impacting skill acquisition and confidence. A hybrid approach, integrating online and face-to-face teaching, could optimise learning by combining the scalability of online instruction with essential practical experience, enhancing medical students' confidence and technical proficiency in surgical skills.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 8-14"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298246","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":"Comparison of machine learning and Cox regression models for prognostic analysis in hepatocellular carcinoma patients with distant metastasis","authors":"Hailan Li ,&nbsp;Junbo Wang ,&nbsp;Xin Ming ,&nbsp;Mingsha Zhou ,&nbsp;Li Zhou","doi":"10.1016/j.sopen.2025.06.007","DOIUrl":"10.1016/j.sopen.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>With the development of conversion therapy, there has been a significant improvement in advanced stage hepatocellular carcinoma (HCC) patients' survival outcomes. Accurate prognostic assessment of patients with distant metastasis (DM) is therefore pivotal in improving quality of life, guiding treatment, and optimizing patient management.</div></div><div><h3>Methods</h3><div>This study extracted patients with distant metastatic HCC from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression were used to identify prognostic factors. Then, Cox regression, DeepSurv, Decision Tree, and Random Survival Forests models were used to predict overall survival. Model performance was evaluated by area under the curve (AUC), decision curve analysis, calibration curve, and Brier score. The visualization of Cox regression and machine learning algorithms utilized nomogram and Shapley additive explanations, respectively.</div></div><div><h3>Results</h3><div>The study included 3051 HCC patients with DM. Factors such as tumor size, lung metastasis, N stage, ace, chemotherapy, radiotherapy, AFP, fibrosis, treatment interval, and number of metastases were independently associated with patient prognosis. Among all models, Cox regression and Random Survival Forest models showed stable performance, achieving AUCs of 0.746/0.760, 0.745/0.749, and 0.729/0.718 at 3, 6, and 12 months, respectively. Meanwhile, Cox regression showed the lowest Brier score (0.180 and 0.125) at 6 and 12 months.</div></div><div><h3>Conclusions</h3><div>Cox regression and Random Survival Forest models demonstrated robust prognostic performance for HCC, with Cox regression exhibiting superior temporal stability. The Cox-based nomogram provides an intuitive tool for rapid 3-, 6-, and 12-month survival stratification in metastatic HCC patients.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 36-44"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481481","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":"Sex and racial disparities in clinical outcomes and healthcare costs among hospitalized older adult fall patients: A nationwide analysis","authors":"Miles J. Gibbons ,&nbsp;Saad Mallick ,&nbsp;Troy Coaston ,&nbsp;Nguyen Le ,&nbsp;Syed Shaheer Ali ,&nbsp;Arjun A. Chaturvedi ,&nbsp;Sara Sakowitz ,&nbsp;Peyman Benharash","doi":"10.1016/j.sopen.2025.07.003","DOIUrl":"10.1016/j.sopen.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>The impact of patient sex and race on clinical in-hospital outcomes and expenditures of falls in older adults remain underexplored. This study examines sex- and race-based disparities of fall-related hospitalizations.</div></div><div><h3>Study design</h3><div>All hospitalizations for adults (≥65 years) from falls were identified (National Inpatient Sample, 2017–2021). Patients were stratified into sex and racial groups (White and Non-White). Multivariable logistic (dichotomous variables) and linear (continuous variables) regression modeling compared clinical in-hospital outcomes, resource utilization, and hospital costs stratified by sex and race.</div></div><div><h3>Results</h3><div>An estimated 5,870,482 (survey-weighted) older adults experienced a fall-related hospital admission, with annual incidence rising from 1,108,024 to 1,210,547 (<em>P</em> &lt; 0.001). Unadjusted in-hospital mortality was lower for females compared to males (2.5 vs 4.5 %, P &lt; 0.001). Following risk-adjustment, females had lower odds of in-hospital mortality (AOR: 0.59, 95 %CI: 57–0.60, <em>P</em> &lt; 0.001) and costs (β = −$1344, 95 %CI: −1321 to −1267, <em>P</em> &lt; 0.001).</div><div>On crude analysis, in-hospital mortality was higher in Non-White patients (3.4 vs 3.2 %, <em>P</em> &lt; 0.001). Mean LOS was longer for Non-White (6.31 ± 7.69 days) compared to White patients (5.65 ± 5.93 days, P &lt; 0.001). Following risk-adjustment, Non-White patients had higher odds of in-hospital mortality compared to White patients (AOR: 1.16, 95 %CI: 1.08–1.24, <em>P</em> &lt; 0.001) and higher median costs (β = $2304, 95 %CI: 1897.90-2710.16, P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Sex and race are associated with differences in clinical in-hospital outcomes and expenditures in older adult fall hospitalizations, suggesting potential variations in treatment, recovery, and access to care. Further research is needed to better understand these disparities and inform strategies for more equitable care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 120-125"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908473","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 frailty with perioperative outcomes after mastectomy with and without immediate breast reconstruction","authors":"Gizem Bilgili ,&nbsp;Sara Sakowitz ,&nbsp;Konmal Ali ,&nbsp;Dariush Yalzadeh ,&nbsp;Barzin Badiee ,&nbsp;Melissa Justo ,&nbsp;Mediget Teshome ,&nbsp;Edward Nahabet ,&nbsp;Peyman Benharash","doi":"10.1016/j.sopen.2025.08.004","DOIUrl":"10.1016/j.sopen.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Frailty has been recognized as an independent risk factor for adverse postoperative outcomes. Coding based frailty instruments such as the Modified Frailty Index (mFI-5) are increasingly incorporated into risk models to provide better prediction of mortality, and complications. However, few have examined the large-scale utility of mFI-5 in the context of mastectomy and breast reconstruction.</div></div><div><h3>Methods</h3><div>All elective adult (≥ 18 years) hospitalizations in women for mastectomy, with and without immediate breast reconstruction (IBR) were identified in the 2016–2022 National Inpatient Sample. Patients with an mFI-5 score ≥ 2 were considered Frail. Multivariable regression models were constructed to evaluate the association of frailty with major complications, length of stay (LOS) and inpatient costs.</div></div><div><h3>Results</h3><div>Of an estimated 150,215 patients, 14 % were considered <em>Frail</em>. The proportion of frail patients was increased from 13 % to 16 % during the study period. Relative to others, <em>Frail</em> had a greater mean Elixhauser Index (4.49 ± 1.51 vs 1.89 ± 1.29, <em>P</em> &lt; 0.001), was more commonly of Black race (23.7 vs 11.8 %, P &lt; 0.001) and of the lowest income quartile (29.8 vs 17.1 %, P &lt; 0.001).</div><div>Following comprehensive risk adjustment, frailty was associated with increased odds of infectious (AOR 2.36, CI 1.35–4.13), respiratory (AOR 2.05, CI 1.44–2.92), and renal (AOR 5.62, CI 4.16–7.60) complications. Moreover, frailty was associated with greater length of stay, but no difference in hospitalization costs.</div></div><div><h3>Conclusions</h3><div>Frailty remains associated with greater postoperative complications and length of stay. Status of frailty as ascertained by the mFI-5 may be useful in stratifying patient risk among those receiving mastectomy.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 136-143"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026353","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":"Timely staged hepatectomy following transarterial embolization versus emergency hepatectomy for spontaneous hepatocellular carcinoma rupture","authors":"Shuai Liu,&nbsp;Xiangyao Kong,&nbsp;Yuanchuan Gong,&nbsp;Zetao Wu,&nbsp;Luoluo Wang,&nbsp;Yi Ruan,&nbsp;Xinhua Zhou","doi":"10.1016/j.sopen.2025.09.001","DOIUrl":"10.1016/j.sopen.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of timely staged hepatectomy (SH) following transarterial embolization (TAE) versus emergency hepatectomy (EH) for spontaneous rupture of hepatocellular carcinoma (SR-HCC).</div></div><div><h3>Methods</h3><div>Between January 2018 and December 2023, 109 patients with SR-HCC were admitted to our center receive SH (34 cases) or EH (75 cases). Performing 1:1 optimal matching propensity score matching (PSM) analysis, resulting in 34 patients in SH group and 34 patients in EH group. We compared perioperative data, peritoneal metastasis rates, recurrence rates, complication rates, and long-term survival outcome between the two matched groups.</div></div><div><h3>Results</h3><div>After PSM, baseline characteristics were well balanced between the SH and EH groups (standardized mean difference [SMD] &lt; 0.1). Compared with the matched EH group, the SH group had a shorter intraoperative hepatic vascular clamping time, significantly less perioperative blood loss and transfusion volume, and a lower in-hospital mortality rate (<em>P</em> &lt; 0.05). No significant differences were observed between the two groups in postoperative complication rates and peritoneal metastasis rates (<em>P</em> &gt; 0.05). The SH group exhibited a trend toward improved recurrence-free survival (RFS) (Log-rank χ2 = 3.2, <em>P</em> = 0.074), although this did not reach statistical significance. Similarly, overall survival (OS) was comparable between the groups (Log-rank χ2 = 1.78, <em>P</em> = 0.183).</div></div><div><h3>Conclusion</h3><div>Compared with EH, SH demonstrates superior perioperative safety, characterized by less surgical trauma and lower in-hospital mortality, without increasing postoperative complications and the risk of peritoneal metastasis. Therefore, SH may be considered the preferred treatment for SR-HCC, especially in cases of hemodynamic instability or impaired hepatic functional reserve.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 159-165"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048744","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":"Laparoscopy versus open surgery in truncal vagotomy with gastrojejunostomy for peptic pyloric stenosis: a retrospective study of 151 patients","authors":"Souhaib Atri ,&nbsp;Mahdi Hammami ,&nbsp;Amine Sebai ,&nbsp;Ahmed ben Mahmoud ,&nbsp;Nadia Rabhi ,&nbsp;Dhouha Cherif ,&nbsp;Houcine Maghrebi ,&nbsp;Amine Makni ,&nbsp;Anis Haddad ,&nbsp;Montassar Kacem","doi":"10.1016/j.sopen.2025.08.003","DOIUrl":"10.1016/j.sopen.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Peptic ulcer disease continues to be a major health concern. Surgical intervention is usually reserved for complications, such as pyloric stenosis, leading to gastric outlet obstruction. We compared the outcomes of laparoscopic and open surgery.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study comparing Laparoscopic Truncal vagotomy and Gastrojejunostomy with open procedure. We examined the medical records of 151 patients treated for peptic pyloric stenosis at La Rabta Hospital in Tunis, Tunisia, from January 2000 to December 2018. The study focused on benign gastric outlet obstruction due to peptic ulcer disease, with patient progress monitored for over 24 months.</div></div><div><h3>Results</h3><div>A hundred and fifty-one patients treated for peptic ulcer stenosis by gastojejunostomy and truncal vagotomy were included in the study, featuring 52 cases of LTVGJ 99 cases ofOTVGJ. The male-to-female ratio was 5.2, with a mean age of 48 years for both groups. Perioperative outcomes revealed that OTVGJ had a shorter mean operative time (95 min) compared to LTVGJ (115 min), while the median hospital stay was longer for OTVGJ (7.9 days) versus LTVGJ (5.5 days). Both groups exhibited similar rates of delayed gastric emptying and postoperative gastrointestinal symptoms, with no cases of leakage or operative mortality. Diabetes was the only significant risk factor for delayed gastric emptying.</div></div><div><h3>Conclusion</h3><div>Laparoscopic truncal vagotomy and gastrojejunostomy for gastric outlet obstruction secondary to peptic ulcer disease is a safe and effective modality, offers low morbidity and satisfactory clinical status on long term follow up.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 166-170"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048745","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}