American Surgeon最新文献_第9页

The Impact of Hemoglobin Concentration on Prognosis in Patients With Diabetic Foot: A Systematic Review and Meta-Analysis of Risk Factors for Adverse Outcomes and Clinical Management. 血红蛋白浓度对糖尿病足患者预后的影响：不良结局和临床管理危险因素的系统回顾和荟萃分析

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-04-15 DOI: 10.1177/00031348261443343

Da Wang, Hui Wang, Yue Wu, Jun Liu

{"title":"The Impact of Hemoglobin Concentration on Prognosis in Patients With Diabetic Foot: A Systematic Review and Meta-Analysis of Risk Factors for Adverse Outcomes and Clinical Management.","authors":"Da Wang, Hui Wang, Yue Wu, Jun Liu","doi":"10.1177/00031348261443343","DOIUrl":"10.1177/00031348261443343","url":null,"abstract":"BackgroundDiabetic foot (DF) complications, including diabetic foot ulcers (DFUs), lead to significant morbidity, disability, and economic burden. Hemoglobin (Hb) levels may influence the prognosis of DF patients, but their relationship with adverse clinical outcomes remains unclear. This systematic review and meta-analysis aimed to assess the association between hemoglobin concentration and the risk of adverse outcomes in diabetic foot patients, including amputation and mortality.MethodsWe followed PRISMA guidelines to conduct a systematic literature review. A meta-analysis was performed on observational studies assessing the impact of hemoglobin levels on amputation, mortality, and ulcer incidence. A random-effects model was applied, and risk bias was evaluated using the Newcastle-Ottawa Scale.ResultsA total of 22 observational studies involving 10,984 patients were included. Our meta-analysis revealed that lower hemoglobin levels were significantly associated with a higher risk of amputation (OR = 0.97, 95% CI: 0.94-0.99, P < .001), and lower hemoglobin concentrations were found in amputation cases compared to non-amputation cases (SMD = -0.14, 95% CI: -0.24 to -0.04, P < .01). However, no significant association was found between hemoglobin levels and mortality (OR = 0.99, 95% CI: 0.33-2.89, P > .05). Sensitivity and publication bias analyses indicated robust results.ConclusionLower hemoglobin levels were associated with higher odds of amputation in patients with diabetic foot. However, pooled effects were small and heterogeneity was substantial across studies; therefore, hemoglobin likely functions primarily as a marker of overall disease burden and perioperative risk rather than a proven modifiable target. Prospective interventional studies are needed to determine whether correcting anemia improves limb outcomes and survival.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2758-2767"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmasking Hyperammonemia: Psychomotor Slowing as a Diagnostic Trigger During PEG and Enteral Nutrition. 揭露高氨血症：精神运动减缓作为PEG和肠内营养的诊断触发因素。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-06-09 DOI: 10.1177/00031348261460479

Xiaoyi Zhao, Yue Shen, Qiang Zhan

引用次数: 0

Accessibility of and Engagement With Videos of Colorectal Cancer Surgery Patients' Treatment Experiences: A Multi-Platform Analysis Comparing Videos Produced by Patients and Medical Institutions. 大肠癌手术患者治疗经历视频的可及性与参与：患者与医疗机构视频的多平台对比分析

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-05-12 DOI: 10.1177/00031348261451726

Austin Jernigan, Nathan Hinkle, Justin Monroe, David Shibata, Ian Solsky

{"title":"Accessibility of and Engagement With Videos of Colorectal Cancer Surgery Patients' Treatment Experiences: A Multi-Platform Analysis Comparing Videos Produced by Patients and Medical Institutions.","authors":"Austin Jernigan, Nathan Hinkle, Justin Monroe, David Shibata, Ian Solsky","doi":"10.1177/00031348261451726","DOIUrl":"10.1177/00031348261451726","url":null,"abstract":"IntroductionVideos of colorectal cancer surgery patients sharing their treatment experiences have been produced by both patients and the medical community, underscoring their perceived value. Since patients and medical institutions likely have different motivations for creating these videos, it is important to study the characteristics of these videos to assess what value they have to efforts to better understand and enhance the patient experience.MethodsA formal search strategy was employed to identify videos on YouTube and TikTok wherein colorectal cancer surgery patients shared their experiences. Statistical analyses, including Fisher's Exact Test and the Mann-Whitney U test, were performed to compare the characteristics of videos produced by patients (P-videos) and the medical community (M-videos).Results491 videos were reviewed. Of these, 52.1% were classified as patient experience videos and 89.8% were created postoperatively. P-videos (n = 135) vs M-videos (n = 108) were more prevalent on TikTok (85.2% vs 18.5%) than YouTube (14.8% vs 81.5%). P-videos compared to M-videos also had more comments (median 92 (IQR 30-301) vs 12 (2-81.85), P < 0.001)), and were more often created during active cancer therapy (eg, adjuvant chemotherapy) (66.7% vs 14.8%, P < 0.001). These differences between groups remained statistically significant when stratifying by TikTok/YouTube.ConclusionThe accessibility of P-videos and M-videos differs by social media platform, which has implications for the type of content viewed by patients with different online habits. P-videos more often featured patients undergoing active treatment and garnered higher engagement, possibly suggesting that the public is drawn more to unfiltered patient narratives than the messaging of medical institutions.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2589-2600"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physiologic Status at Cannulation Is Associated With Survival in Trauma Patients Receiving ECMO. 插管时的生理状态与接受ECMO的创伤患者的生存相关。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-07-07 DOI: 10.1177/00031348261468308

Medoza Ameen, Isabella L Filippone, Julie M Reichert, Anthony Tepetitla, Eric Bradburn, Lindsey L Perea

引用次数: 0

Low Anastomotic Leakage After Esophagectomy Using a Standardized Narrow Gastric Conduit Reconstruction Protocol. 标准化窄胃管重建方案对食管切除术后吻合口低漏的影响。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 DOI: 10.1177/00031348261494196

Akira Matsumoto, Fumiaki Yano, Reika Yamashita, Takanori Kurogochi, Yuya Nyumura, Yujiro Tanaka, Tomoko Nakayoshi, Ken Eto

{"title":"Low Anastomotic Leakage After Esophagectomy Using a Standardized Narrow Gastric Conduit Reconstruction Protocol.","authors":"Akira Matsumoto, Fumiaki Yano, Reika Yamashita, Takanori Kurogochi, Yuya Nyumura, Yujiro Tanaka, Tomoko Nakayoshi, Ken Eto","doi":"10.1177/00031348261494196","DOIUrl":"https://doi.org/10.1177/00031348261494196","url":null,"abstract":"BackgroundAnastomotic leakage remains one of the most serious complications after esophagectomy and is associated with increased morbidity, mortality, and impaired long-term outcomes. Although various technical modifications have been proposed to reduce leakage, the potential role of standardizing the entire reconstructive procedure has received less attention. We evaluated outcomes after a standardized reconstruction protocol using a narrow gastric conduit and triangular stapled cervical esophagogastrostomy.MethodsWe retrospectively reviewed 115 consecutive patients who underwent subtotal esophagectomy followed by gastric conduit reconstruction with cervical anastomosis at 2 institutions between March 2018 and November 2024. The standardized protocol emphasized preservation of a well-perfused conduit segment, optimization of the reconstruction route, and triangular stapled cervical esophagogastrostomy. Anastomotic leakage was defined and classified according to the Esophagectomy Complications Consensus Group (ECCG) criteria.ResultsAnastomotic leakage was identified in 2 patients (1.7%; exact 95% confidence interval, 0.2%-6.1%), both classified as ECCG Type II. No Type III leaks occurred. Anastomotic stricture developed in 10 patients (8.7%), recurrent laryngeal nerve palsy in 12 (10.4%), and Clavien-Dindo grade IIIa or higher complications in 21 (18.3%). Thirty-day and 90-day mortality were 1.7% and 2.6%, respectively, with no deaths related to anastomotic leakage.DiscussionA standardized narrow gastric conduit reconstruction protocol was associated with a low observed rate of clinically identified anastomotic leakage. Because of the retrospective design, small number of events, and absence of a contemporaneous control group, superiority over historical benchmarks cannot be established.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261494196"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

National Changes in Timing and Rates of Surgical Stabilization of Rib Fractures (SSRF): SSRF Occurring Early and More Often. 全国肋骨骨折手术稳定时间和率的变化（SSRF）： SSRF发生的早期和更频繁。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-05-08 DOI: 10.1177/00031348261448906

Michael J de Virgilio, Areg Grigorian, Peter D Nguyen, Sebastian Schubl, Mallory Jebbia, Jacob Kirkorowicz, Hanaan Salamah, Catherine Kuza, Jeffry Nahmias

{"title":"National Changes in Timing and Rates of Surgical Stabilization of Rib Fractures (SSRF): SSRF Occurring Early and More Often.","authors":"Michael J de Virgilio, Areg Grigorian, Peter D Nguyen, Sebastian Schubl, Mallory Jebbia, Jacob Kirkorowicz, Hanaan Salamah, Catherine Kuza, Jeffry Nahmias","doi":"10.1177/00031348261448906","DOIUrl":"10.1177/00031348261448906","url":null,"abstract":"Surgical stabilization of rib fractures (SSRF) has garnered increased attention recently for treatment of blunt chest trauma (BCT). This study evaluated temporal trends in rates and timing of SSRF in isolated BCT patients, hypothesizing increased rates of early SSRF and SSRF overall. The 2017-2023 Trauma Quality Improvement Program (TQIP) database was queried for patients with ≥2 rib fractures and abbreviated injury scale <2 in non-chest regions to delineate an isolated BCT cohort. Patients were stratified by timing of SSRF from arrival: early (≤72 h), intermediate (>72-≤ 120 h), and late (>120 h). The primary outcome was annual rate of SSRF. Of 371,193 isolated BCT patients, 17 966 (4.8%) underwent SSRF from 2017 to 2023. The median age of patients undergoing SSRF increased from 58 years in 2017 to 61 years in 2023 (P < 0.001). There was an increased rate of SSRF performed from 2017 to 2023 (n = 1,594, 3.5% vs n = 3,435, 5.5%, P < 0.001). When stratified by timing, early (1.8% [2017]; 3.4% [2023], P < 0.001) and intermediate SSRF (0.9% [2017]; 1.3% [2023], P < 0.001) increased over time, whereas late SSRF remained similar across 2017 to 2023 (late: 0.8%; 0.8%, P = 0.25). For all SSRF patients, median overall length of stay (LOS) decreased over time (12 [IQR: 8-17] days [2017]; 11 [IQR: 8-16] days [2023]; P < 0.001). This study demonstrates a nearly 60% relative national increase in SSRF from 2017 to 2023, with a progressively older patient cohort and shorter LOS. This was predominantly attributable to increased early (≤72 h) and intermediate (>72-≤120 h) SSRF cases, aligning with existing guidelines.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2729-2735"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coated Polypropylene Mesh Is Not an Independent Predictor of Wound Morbidity in Open Abdominal Wall Reconstruction. 涂层聚丙烯网片不是开放式腹壁重建中伤口发病率的独立预测因子。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-06-09 DOI: 10.1177/00031348261460468

Samantha W Kerr, Victoria L Walker, Lucy R Hinton, Gregory T Scarola, Sullivan A Ayuso, Vedra A Augenstein, B Todd Heniford

{"title":"Coated Polypropylene Mesh Is Not an Independent Predictor of Wound Morbidity in Open Abdominal Wall Reconstruction.","authors":"Samantha W Kerr, Victoria L Walker, Lucy R Hinton, Gregory T Scarola, Sullivan A Ayuso, Vedra A Augenstein, B Todd Heniford","doi":"10.1177/00031348261460468","DOIUrl":"10.1177/00031348261460468","url":null,"abstract":"BackgroundBarrier-coated meshes were developed to minimize adhesion formation between the PM and adjacent viscera. However, prior data has shown an increased infectious risk associated with rapidly absorbable coated PM vs uncoated PM in open preperitoneal AWR (OPPAWR). This study evaluated differences in wound and mesh infection rates between coated and uncoated PM in patients undergoing OPPAWR.Materials and MethodsA prospectively maintained, tertiary hernia center database was queried for patients undergoing OPPAWR with PM in CDC class 1/2 wounds. Using 1:1 propensity-score matching (PSM), coated and uncoated groups were matched on factors known to influence outcomes. Multivariable regression models determined independent predictors of wound and infectious complications.ResultsOf 1450 patients with coated and uncoated PM, 382 pairs were well-matched. Propensity-score matching covariates were similar (all P > 0.05). The coated group had higher rates of wound infection (6.3% vs 3.1%), postoperative IV antibiotics (8.6% vs 4.7%), percutaneous drain placement (6.8% vs 3.1%), and mesh infection (2.4% vs 0.0%) (all P < 0.05), but no significant difference in composite wound complications (20.4% vs 16.5%; P = 0.162). Multivariable regression showed panniculectomy (OR: 1.87, 95% CI: 1.25-2.82; P = 0.003) and BMI (OR: 1.05, 95% CI: 1.02-1.08; P = 0.002) were independent predictors of wound complications, but coated mesh was not (OR: 0.78, 95% CI: 0.53-1.15; P = 0.211). In the infectious model regression, panniculectomy remained an independent predictor (OR: 2.01, 95% CI: 1.24-3.25; P = 0.005), while coated mesh again was not (OR: 0.65, 95% CI: 0.41-1.04; P = 0.074).DiscussionIn the largest reported cohort, following complex OPPAWR, multivariable regression demonstrated that coated PM did not independently predict wound or infectious complications.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2523-2530"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Building the Conversation: Editorial Stewardship in Contemporary Surgical Publishing. 建立对话：当代外科出版的编辑管理。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-06-30 DOI: 10.1177/00031348261466124

Don K Nakayama

{"title":"Building the Conversation: Editorial Stewardship in Contemporary Surgical Publishing.","authors":"Don K Nakayama","doi":"10.1177/00031348261466124","DOIUrl":"10.1177/00031348261466124","url":null,"abstract":"Academic publishing in surgery has undergone profound change during the past several decades. Expansion of medical schools, residency programs, international academic centers, and digital publishing platforms has produced unprecedented growth in manuscript submissions and intensified competition for professional attention. Journals are judged both by readership, as measured by article downloads, and by scientific influence, as reflected in scholarly citation. At The American Surgeon, these changes prompted development of editorial frameworks designed to identify contributions most likely to matter to practicing surgeons and subsequent investigators. Many manuscripts contained observations whose significance was underrecognized by their authors. This observation led to the Hidden Publishable Idea (HPI), a framework for identifying contributions most useful to readers. Once identified, the HPI often revealed methodological limitations that imposed an evidentiary ceiling, preventing definitive conclusions while suggesting new hypotheses for future investigation. Analysis of downloads and citations suggested that readership and scholarly adoption are related but distinct outcomes. This observation led to development of the CitDL matrix, a two-by-two framework based on high and low download and citation performance. The editorial objective was not simply manuscript acceptance, but identification and development of contributions that could move manuscripts toward greater readership, greater scholarly engagement, or both. These concepts represent adaptive responses to the contemporary challenge of helping useful ideas find their audience and contribute to the advancement of surgical practice and science.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2768-2772"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of Response-Based Watch-and-Wait and Surgical Management After Total Neoadjuvant Therapy for Rectal Cancer: A Systematic Review and Meta-analysis. 直肠癌全新辅助治疗后基于反应的观察等待和手术治疗的结果：系统回顾和荟萃分析。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 Epub Date: 2026-05-24 DOI: 10.1177/00031348261455078

Bernardo Fontel Pompeu, Beatriz D'Andrea Pigossi, Luís Eduardo Braz de Moraes Alves, Gabriel Leal Barone, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Claudia Theis, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga

{"title":"Outcomes of Response-Based Watch-and-Wait and Surgical Management After Total Neoadjuvant Therapy for Rectal Cancer: A Systematic Review and Meta-analysis.","authors":"Bernardo Fontel Pompeu, Beatriz D'Andrea Pigossi, Luís Eduardo Braz de Moraes Alves, Gabriel Leal Barone, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Claudia Theis, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1177/00031348261455078","DOIUrl":"10.1177/00031348261455078","url":null,"abstract":"BackgroundTotal neoadjuvant therapy (TNT) increases clinical complete response rates in locally advanced rectal cancer (RC), allowing response-based management strategies such as watch-and-wait (WW) as an alternative to total mesorectal excision (TME). Outcomes associated with WW after TNT remain incompletely defined. This study aimed to compare oncologic and organ-preservation outcomes between WW and surgical management following TNT.MethodsA systematic search was conducted in PubMed, Scopus, and Cochrane Central up to April 2025. Observational studies comparing WW and TME following TNT were included. Pooled odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with I2 statistics. Secondary outcomes included tumor regrowth, salvage surgery, and permanent stoma. Risk of bias was evaluated using ROBINS-I.ResultsSix studies comprising 793 patients were analyzed. WW showed no significant difference compared with TME regarding local recurrence (OR 1.36, 95% CI 0.07-26.17; I2 = 80%), distant metastases (OR 0.62, 95% CI 0.29-1.33; I2 = 49%), 5-year disease-free survival (HR 0.97, 95% CI 0.71-1.31; I2 = 51.7%), or overall survival (HR 1.03, 95% CI 0.81-1.30; I2 = 27.9%). Permanent stoma rates were lower with WW (OR 0.12, 95% CI 0.01-1.23; I2 = 71%), becoming significant after sensitivity analysis (OR 0.04, 95% CI 0.01-0.19).ConclusionWW after TNT offers oncologic outcomes comparable to TME, with high organ preservation and reduced surgical morbidity in highly selected patients.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2576-2588"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Price of Less Surgery: Completion Thyroidectomy After Lobectomy for Low-Risk Papillary Thyroid Carcinoma. 少手术的代价：低风险甲状腺乳头状癌肺叶切除术后完成甲状腺切除术。

IF 1 4区医学

American Surgeon Pub Date : 2026-10-01 DOI: 10.1177/00031348261494195

Min Ming, Zhiyong Zhang, Jianyu Song, Hua Wang

{"title":"The Price of Less Surgery: Completion Thyroidectomy After Lobectomy for Low-Risk Papillary Thyroid Carcinoma.","authors":"Min Ming, Zhiyong Zhang, Jianyu Song, Hua Wang","doi":"10.1177/00031348261494195","DOIUrl":"https://doi.org/10.1177/00031348261494195","url":null,"abstract":"BackgroundOptimal surgical extent for cT1-2N0 papillary thyroid carcinoma (PTC) remains debated.MethodsThis study included 400 consecutive low-risk cT1-2N0 PTC patients (tumor ≤4 cm, clinically node-negative) who underwent initial total thyroidectomy (TT, n = 250) or lobectomy (LT, n = 150) between 2020 and 2024. The primary descriptive outcome was completion thyroidectomy rate in the LT group; the primary oncologic outcome was recurrence-free survival (RFS). Multivariable regression and propensity score matching identified predictors and adjusted comparisons.ResultsTT was associated with longer operative time, hospital stay, and drainage volume (all P < 0.001). Temporary and permanent hypoparathyroidism were significantly higher after TT (25.2% vs 3.3%; 6.0% vs 0.7%, both P < 0.01), with TT as independent risk factor. At median 36.2 months, RFS favored TT (adjusted HR = 0.37, P = 0.012); however, given only 21 recurrence events, this finding is exploratory. Among LT patients, 34.7% (52/150) ultimately required completion thyroidectomy due to pathologic upgrade. Independent predictors were tumor size (OR = 3.19/cm), multifocality (OR = 4.81), and positive lymph node count (OR = 2.61/node) (all P < 0.01). While tumor size is preoperatively assessable, multifocality and nodal burden are predominantly postoperative findings guiding risk stratification.ConclusionsThe oncologic safety of lobectomy for low-risk PTC is well-established. The key tradeoff is clear: lobectomy markedly reduces permanent hypoparathyroidism (0.7% vs 6.0%) but carries a one-in-three reoperation risk, predicted by tumor size, multifocality, and nodal burden. Although TT showed an exploratory RFS benefit, this finding requires confirmation. These tradeoffs must be explicitly discussed during preoperative counseling to enable informed, preference-sensitive decision-making.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261494195"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0