Surgery open science最新文献

{"title":"Age-stratified trends and outcomes of inpatient cholecystectomy for acute cholecystitis in the United States","authors":"Ayesha P. Ng,&nbsp;Joseph E. Hadaya,&nbsp;Sara Sakowitz,&nbsp;Zihan Gao,&nbsp;James Wu,&nbsp;Peyman Benharash","doi":"10.1016/j.sopen.2024.12.006","DOIUrl":"10.1016/j.sopen.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The elderly population in the United States is rapidly expanding. Older patients over age 65 with acute cholecystitis may face greater perioperative risk compared to younger patients undergoing urgent laparoscopic cholecystectomy. We aimed to characterize trends in utilization and outcomes of inpatient cholecystectomy across the United States stratified by age.</div></div><div><h3>Methods</h3><div>All adults undergoing nonelective, laparoscopic cholecystectomy for acute cholecystitis in the 2012–2021 National Inpatient Sample were identified. Patients were stratified into 4 age groups: 18–49, 50–64, 65–79, and 80+ years. Major adverse events included in-hospital mortality and complications. Multivariable mixed regression was used to evaluate the association of age group with outcomes. Interaction terms were used to analyze differences in risk-adjusted outcomes over time.</div></div><div><h3>Results</h3><div>Of 2,015,699 patients, 41.7 % were aged 18–49, 24.7 % were 50–64, 23.5 % were 65–79, and 10.2 % were 80+ years. Patients aged 65–79 and 80+ had major adverse event rates of 25 % and 34 %, respectively, compared to 5–14 % among younger patients (<em>p</em> &lt; 0.001). After adjustment, patients over age 65 demonstrated nearly 2-fold greater odds of major adverse events (including repair of bile duct injury) and conversion to an open operation compared to younger patients. Patients aged 65–79 comprised an increasing proportion of cholecystectomy cases over time, from 20.0 % in 2012 to 27.5 % in 2021 (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Outcomes following cholecystectomy for acute cholecystitis among older patients remained significantly worse compared to younger patients over the past decade, with complication rates of 25–34 %. Preoperative counseling about the increased risk of complications following cholecystectomy for older patients is warranted.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 24-29"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017994","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":"Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal","authors":"Brian Williams MD ,&nbsp;Aubrey Swinford MD ,&nbsp;Jordan Martucci MD ,&nbsp;Johnny Wang MD ,&nbsp;Jordan R. Wlodarczyk MD ,&nbsp;Abhinav Gupta MD ,&nbsp;Kyle G. Cologne MD ,&nbsp;Sarah E. Koller MD ,&nbsp;Christine Hsieh MD ,&nbsp;Marjun P. Duldulao MD ,&nbsp;Joongho Shin MD","doi":"10.1016/j.sopen.2025.01.002","DOIUrl":"10.1016/j.sopen.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods.</div></div><div><h3>Methods</h3><div>This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported.</div></div><div><h3>Results</h3><div>Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days.</div></div><div><h3>Conclusion</h3><div>Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 69-74"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100636","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":"Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults","authors":"Dietrich Doll ,&nbsp;Susanne Haas ,&nbsp;Ida Kaad Faurschou ,&nbsp;Theo Hackmann ,&nbsp;Henrike Heitmann ,&nbsp;Myriam Braun-Münker ,&nbsp;Christina Oetzmann von Sochaczewski","doi":"10.1016/j.sopen.2025.01.001","DOIUrl":"10.1016/j.sopen.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.</div></div><div><h3>Methods</h3><div>Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.</div></div><div><h3>Results</h3><div>Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; <em>p</em> &lt; 0.0001). The subgroup of individuals aged 16–18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.</div></div><div><h3>Conclusions</h3><div>Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 50-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100638","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 usefulness of presepsin in the early detection of anastomotic leakage after esophagectomy","authors":"Yoshiro Imai,&nbsp;Ryo Tanaka,&nbsp;Kentaro Matsuo,&nbsp;Hidero Yoshimoto,&nbsp;Mitsuhiro Asakuma,&nbsp;Hideki Tomiyama,&nbsp;Sang-Woong Lee","doi":"10.1016/j.sopen.2025.01.003","DOIUrl":"10.1016/j.sopen.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Anastomotic leakage is a severe complication of esophagectomy, therefore early detection is crucial. Presepsin is a biomarker for early diagnosis of infectious complications. This study assessed presepsin as a biomarker for anastomotic leakage after esophagectomy, compared to C-reactive protein (CRP), white blood cells (WBCs), and neutrophils (Neuts).</div></div><div><h3>Materials and methods</h3><div>This study enrolled 27 patients between October 2019 and December 2020. Levels of presepsin, CRP, WBCs, and Neuts were measured preoperatively and on postoperative days (PODs) 1, 3, 5, and 7.</div></div><div><h3>Results</h3><div>Five patients had anastomotic leakage. Their presepsin levels on POD 7 were significantly higher and tended to be higher on POD 5 (<em>p</em> = 0.04 and <em>p</em> = 0.06, respectively) compared to those without leakage. The area under the curve values for presepsin were highest on PODs 5 and 7 (0.89 and 0.83). Optimal cut-off values for presepsin were 400 pg/mL (sensitivity 100 %; specificity 81.9 %) on POD 5 and similar on POD 7.</div></div><div><h3>Conclusions</h3><div>Presepsin levels on PODs 5 and 7 effectively detect anastomotic leakage after esophagectomy, making it a valuable, simple, non-invasive early detection test.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 75-80"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100637","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":"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}