Annals of Surgical Treatment and Research最新文献

{"title":"Physical AI goes to the operating room: are we ready for the Surgical Data Factory?","authors":"Namkee Oh, Kyu-Hwan Jung, Gyu-Seong Choi","doi":"10.4174/astr.2026.110.3.135","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.135","url":null,"abstract":"<p><p>The operating room remains a paradox: it is one of the most sensor-rich environments in the hospital, yet it produces largely underutilized data. While surgical artificial intelligence (AI) has achieved remarkable progress in recent years, the day-to-day practice of surgery has changed little, with most systems confined to passive decision support. This narrative review traces the evolution of surgical AI from perception to cognition to early forms of action, arguing that the next paradigm shift requires \"physical AI\"-systems capable of meaningful physical interaction and autonomous execution. The clinical motivation for pursuing physical AI is clear: surgical outcomes vary substantially across surgeons, access is constrained by workforce shortages, and high-quality care remains tied to the scarcity of human expertise. If reliable autonomous systems can be developed, surgery could become more standardized, scalable, and reproducible. However, a critical bottleneck persists: the scarcity of synchronized, multimodal training data. The fundamental barrier is environmental rather than algorithmic, as most operating rooms are not configured to measure surgical practice objectively. We propose reconceptualizing the operating room as a \"Surgical Data Factory\"-a closed-loop ecosystem designed to capture multimodal signals, structure them via consensus taxonomies linked to outcomes, and utilize them for training, validation, and monitoring. Surgeons must transition from passive users to active architects of this infrastructure. Investing in systematic data governance is the prerequisite for responsibly developing, validating, and scaling physical AI in surgery.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"135-143"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hungry bone syndrome after parathyroidectomy in secondary and tertiary hyperparathyroidism: a retrospective cohort study.","authors":"Douk Kwon, Byung-Chang Kim, Yu-Mi Lee, Tae-Yon Sung, Ki-Wook Chung, Won Woong Kim","doi":"10.4174/astr.2026.110.3.149","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.149","url":null,"abstract":"<p><strong>Purpose: </strong>Hungry bone syndrome (HBS) is a common and critical postoperative complication in patients undergoing parathyroidectomy (PTX) for secondary hyperparathyroidism (SHPT) and tertiary hyperparathyroidism (THPT). We aimed to identify clinical predictors of HBS and assess its impact on bone mineral density (BMD) after PTX.</p><p><strong>Methods: </strong>We retrospectively analyzed data of patients with SHPT and THPT who underwent PTX at Asan Medical Center (2010-2022). Clinical characteristics, including biochemical markers and BMD, were investigated. HBS was defined as profound hypocalcemia of less than 8.4 mg/dL (2.1 mmol/L) or prolonged hypocalcemia for more than 4 days after PTX.</p><p><strong>Results: </strong>A total of 91 patients were included: 18 (19.8%) with SHPT and 73 (80.2%) with THPT. Subtotal PTX was performed in 80 patients (87.9%), while 11 patients (12.1%) underwent total PTX with autotransplantation (TPTX + AT). HBS occurred in 31 patients (34.1%), with a higher incidence in patients with SHPT (72.2%) and all patients who underwent TPTX + AT. Patients with HBS required more calcium supplementation and had higher ALP levels at all timepoints (P < 0.001). In the HBS group, BMD improved more significantly in the femur (P = 0.005) and showed a trend towards improvement in the spine (P = 0.059). Risk factors for HBS included younger age, SHPT, and elevated preoperative ALP and intact parathyroid hormone levels.</p><p><strong>Conclusion: </strong>HBS is characterized by severe hypocalcemia due to calcium reabsorption into bone after PTX. Identifying risk factors for HBS may promote early risk stratification and tailored perioperative management, including surgical approach, especially for high-risk patients.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"149-156"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center experience with pediatric short bowel syndrome: clinical outcomes based on etiology and anatomical type in a retrospective cohort study.","authors":"Honam Hwang, Dayoung Ko, Joong Kee Youn, Hee-Beom Yang, Hyun-Young Kim","doi":"10.4174/astr.2026.110.3.194","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.194","url":null,"abstract":"<p><strong>Purpose: </strong>Short bowel syndrome (SBS) is a critical condition in pediatric patients. It often results in dependence on parenteral nutrition (PN) and significant morbidity. This study aimed to review pediatric SBS patients from a single center and analyze clinical outcomes based on etiology and anatomical type.</p><p><strong>Methods: </strong>A total of 55 patients diagnosed with SBS at our institution from January 2004 to December 2018 were retrospectively analyzed. Clinical demographics and outcomes including growth and PN dependence were evaluated according to etiology and anatomical type.</p><p><strong>Results: </strong>The predominant cause of SBS was necrotizing enterocolitis (NEC). At the last follow-up, the mean weight-for-age (z-score) was -2.00 ± 2.07 and 52.7% of patients were weaned off PN. Catheter-related bloodstream infection and PN-associated liver disease occurred in 36.4% and 20.0% of cases, respectively. Patients with motility disorders exhibited lower weight-for-age and longer durations of PN than those with NEC or intestinal atresia. Additionally, outcomes varied significantly by anatomical type, with type I patients showing higher PN dependence and lower rates of successful weaning off PN than type III patients.</p><p><strong>Conclusion: </strong>The study suggests that clinical outcomes in pediatric SBS patients can vary depending on underlying etiology and anatomical type, indicating that tailored interventions might enhance patient outcomes. Further research is needed to identify independent prognostic factors for SBS and improve the quality of life of SBS children.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"194-201"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical response and prognosis of estrogen receptor-positive and human epidermal growth factor receptor-negative breast cancer patients after neoadjuvant chemotherapy: a retrospective cohort study.","authors":"Jin Ah Lee, Dooreh Kim, Young Joo Lee, Chang Ik Yoon, Woo-Chan Park, Soo Youn Bae","doi":"10.4174/astr.2026.110.3.157","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.157","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant chemotherapy (NAC) significantly revolutionized the management of locally advanced breast cancer, especially in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes. However, its effectiveness is limited in estrogen receptor (ER)-positive, HER2-negative breast cancer. This study investigates the clinical response and prognosis of ER-positive, HER2-negative breast cancer after NAC.</p><p><strong>Methods: </strong>The clinicopathological characteristics and treatment responses of 149 patients with ER-positive, HER2-negative breast cancer treated with NAC and surgery at The Catholic University of Korea, Seoul St. Mary's Hospital between 2018 and 2023 were retrospectively analyzed. Pathologic complete response (pCR) was defined as the absence of invasive tumors (ypT0/is, ypN0). Disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier methods, stratified by age (≤50 years <i>vs.</i> >50 years).</p><p><strong>Results: </strong>Among 149 patients, 13 (8.7%) achieved pCR, 87 (58.4%) attained partial responses, 40 (26.8%) had stable disease, and 9 (6.0%) experienced progressive disease. RECIST responses differed significantly by age (P = 0.003). DFS (P = 0.011) and OS (P = 0.005) were significantly associated with clinical response in patients aged ≤50 years. Post-NAC Ki-67 was associated with DFS (P = 0.013) but not OS (P = 0.083) in patients aged ≤50 years. Clinical responses and post-NAC Ki-67 were not associated with DFS (P = 0.544) or OS (P = 0.569) in patients aged >50 years.</p><p><strong>Conclusion: </strong>In ER-positive, HER2-negative breast cancer, clinical responses and post-NAC Ki-67 were significant prognostic factors in patients aged ≤50 years but not in older patients. These findings highlight the need for tailored therapeutic approaches that consider age-specific prognostic differences.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"157-169"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted <i>versus</i> laparoscopic cholecystectomy: a matched study in pediatric cases at a single center.","authors":"Suhyeon Ha, Hyunhee Kwon, Jung-Man Namgoong, Dae Yeon Kim","doi":"10.4174/astr.2026.110.3.188","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.188","url":null,"abstract":"<p><strong>Purpose: </strong>In the past decade, advancements in robotic surgery have significantly expanded its application into diverse fields, including urological, gastrointestinal, hepatobiliary, and gynecological procedures. However, comparative outcome data between robotic and laparoscopic cholecystectomy (LC) in pediatric patients are scarce. Therefore, this study aims to evaluate the clinical utility of robotic cholecystectomy (RC) by comparing its outcomes with those of LC.</p><p><strong>Methods: </strong>A retrospective study was conducted using patient records from a single institution involving individuals who underwent RC or LC. Patients who had undergone open cholecystectomy or previous open abdominal surgeries were excluded. Matching criteria included operative age, body mass index, and total bilirubin levels. Baseline and outcome variables were compared using appropriate statistical tests to assess significance.</p><p><strong>Results: </strong>Groups were well-matched for demographic variables. Regression-adjusted analysis showed no significant difference in operative time between RC and LC and hospital stay length (P > 0.05). Complication rates were higher in the RC group (25.0% <i>vs.</i> 3.4%, P = 0.040) and analgesic use was significantly higher in the RC group (adjusted odds ratio, ∞; P < 0.001), as all RC patients received postoperative analgesics.</p><p><strong>Conclusion: </strong>The baseline characteristics between the 2 groups were well-matched. While most outcomes showed no statistically significant differences, the RC group had significantly higher postoperative analgesic use and complication rates. These findings highlight the need for careful patient selection and further studies to evaluate the safety profile of RC in pediatric patients.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"188-193"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year outcomes of a prospective, multicenter study of rotational atherectomy with antirestenotic therapy for infrainguinal arterial disease.","authors":"Sungsin Cho, Hyung-Kee Kim, Woo-Sung Yun, Ui Jun Park, Sang Su Lee, Jaehoon Lee, Hong-Pil Hwang, Jin Hyun Joh","doi":"10.4174/astr.2026.110.3.180","DOIUrl":"https://doi.org/10.4174/astr.2026.110.3.180","url":null,"abstract":"<p><strong>Purpose: </strong>Atherosclerotic plaques in peripheral arterial disease (PAD) include fatty, mixed, and calcified types. Plaque burden is significantly associated with restenosis, reintervention, and amputation-free survival. Rotational and aspirational atherectomy (RAA) may effectively remove such plaques. This study aimed to evaluate long-term outcomes of RAA for infrainguinal PAD.</p><p><strong>Methods: </strong>Patients with infrainguinal lesions underwent revascularization using the Jetstream Atherectomy System (Boston Scientific). This 60-month extension assessed primary patency rate (PPR) and clinically driven target lesion revascularization (CD-TLR). Kaplan-Meier curves were used for survival analysis; P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 150 patients (mean age, 70.9 years; male, 86.0%; 65.4% with diabetes) were enrolled. The mean lesion length was 15.8 cm, with 74.0% occlusions and 47.3% severe calcification. Lesions were sclerotic (72.4%), thrombosclerotic (13.4%), thrombotic (9.4%), or in-stent (4.7%). A drug-coated balloon (DCB) was used in 85.5% of cases. PPR at 1, 3, and 5 years was 84.1%, 68.1%, and 58.5%, respectively. CD-TLR rates were 93.0%, 81.5%, and 67.4%, respectively. The benefit of DCB was sustained through 3 years but attenuated thereafter, highlighting the need for extended follow-up in infrainguinal interventions.</p><p><strong>Conclusion: </strong>RAA demonstrated durable 5-year patency and safety outcomes. Device type, DCB use, lesion morphology, and calcium grade did not significantly influence long-term results. Lesion complexity remains the primary predictor of clinical outcome. Despite the complexity of infrainguinal lesions, the use of RAA demonstrated sustained patency through 3 years, with lesion complexity (particularly TASC classification) emerging as the most critical predictor of long-term success.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 3","pages":"180-187"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phyllodes tumors of the breast: a comprehensive review.","authors":"Eun-Shin Lee, Hyunyou Kim, Harim Oh, You-Na Sung, Seungpil Jung","doi":"10.4174/astr.2026.110.2.65","DOIUrl":"10.4174/astr.2026.110.2.65","url":null,"abstract":"<p><p>Phyllodes tumors are rare biphasic fibroepithelial breast neoplasms classified as benign, borderline, or malignant. Despite their rarity, malignant variants carry higher risks of recurrence and metastasis. This review synthesizes current evidence on their clinical, histopathological, and molecular characteristics, including treatment strategies and prognostic factors, emphasizing tailored management. We performed a comprehensive literature review to summarize knowledge on clinical presentation, imaging, histopathological features, surgical treatment, adjuvant therapy, and outcomes. Recent genomic and molecular research was also evaluated to identify future directions. Persistent challenges include a lack of consensus on optimal surgical margins, adjuvant radiotherapy, and follow-up protocols, highlighting the need for larger, high-quality studies. Advances in molecular profiling suggest potential for targeted therapies, especially in aggressive or metastatic cases. Due to clinical heterogeneity and the limited accuracy of core biopsies, definitive grading based on surgical histopathology remains essential for treatment planning. This review offers an updated perspective on phyllodes tumor management, identifies critical gaps, and suggests priorities for future research.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"65-75"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146176892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based classification of superficial femoral arterial lesions: a pilot study.","authors":"Yo Sep Lee, Choongmin Kim, Youngje Woo, Jang Yong Kim","doi":"10.4174/astr.2026.110.2.92","DOIUrl":"10.4174/astr.2026.110.2.92","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the feasibility of detecting peripheral arterial lesions in plane-reconstructed lower extremity CT angiograms using object detection algorithms.</p><p><strong>Methods: </strong>We retrospectively collected 1,241 contrast-enhanced lower extremity CT images from patients with peripheral arterial disease. One-stage (YOLOv5: v5s, v5m, v5l, v5x) and 2-stage (Faster R-CNN) detectors were used to classify stent, stenosis, and occlusion. A one-by-one comparison between manual test image annotations and algorithmic detection results was conducted to evaluate model performance and errors. Performance was evaluated by mean average precision (mAP@.5) and precision-recall curves.</p><p><strong>Results: </strong>Among YOLOv5 models, v5l showed the highest overall accuracy (77% mAP@.5). While stent classification was excellent (≥ 96.9% mAP@.5 in YOLOv5 and 99.8% in Faster R-CNN), classification accuracies for stenosis (53.8%-58.7% in YOLOv5 vs. 37.2% in Faster R-CNN) and occlusion (69%-80.9% in YOLOv5 vs. 67.7% in Faster R-CNN) were moderate. Stenosis was frequently missed, resulting in high false-negative rates. Occlusions at arterial bifurcations were often not detected, and stent edges were misclassified as occlusions. Overfitting emerged in some YOLOv5 models beyond 75 epochs.</p><p><strong>Conclusion: </strong>This pilot study supports the feasibility of applying object detection algorithms as a preliminary step toward developing clinical decision support tools for peripheral arterial disease. Further refinements, including additional training data and more granular lesion annotation, are essential for improved classification of stenosis and occlusion.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"92-103"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of osteoporosis among thyroid cancer survivors: the influence of postoperative levothyroxine therapy in a nationwide cohort study.","authors":"Young Bin Cho, Kyoung Sik Park","doi":"10.4174/astr.2026.110.2.84","DOIUrl":"10.4174/astr.2026.110.2.84","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to assess whether individuals diagnosed with thyroid cancer face an elevated risk of osteoporosis compared to control subjects in a large-scale study. Additionally, we intended to identify potential risk factors associated with osteoporosis in patients with thyroid cancer.</p><p><strong>Methods: </strong>We used the National Health Insurance Service-National Sample Cohort of South Korea. We included 1,313 patients diagnosed with thyroid cancer and 3,939 control subjects without cancer. Following propensity score matching at a 1:3 ratio, Cox proportional hazards regression and stratification analyses were used to estimate the risk of osteoporosis in patients with thyroid cancer, incorporating multivariate adjustments. A restricted cubic spline model was employed to evaluate dose-response relationships.</p><p><strong>Results: </strong>Thyroid cancer patients exhibited a higher likelihood of developing osteoporosis than the control group (hazard ratio [HR], 6.59; P < 0.001). In the stratification analyses, younger thyroid cancer patients, females, and those who did not have dyslipidemia were more susceptible to osteoporosis than their counterparts in the control group. Furthermore, the administration of levothyroxine has been linked to an elevated risk of osteoporosis (HR, 2.33; P = 0.044). A restricted cubic spline analysis demonstrated a significant overall association between exposure and outcome (P for total = 0.007, P for nonlinear = 0.573), indicating an essentially linear relationship.</p><p><strong>Conclusion: </strong>Thyroid cancer patients showed a higher risk of osteoporosis compared to matched controls. Stratified analyses suggested that levothyroxine therapy may be a risk factor for osteoporosis. These findings highlight the importance of individualized treatment approaches.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"84-91"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes and prognostic factors in patients with retroperitoneal tumors: a single-center retrospective cohort study (2015-2024).","authors":"Mee Rae Kim, Yubin Lee, Yeojin Boo, Jeong Ho Song, Sang-Yong Son, Hoon Hur, Sang-Uk Han","doi":"10.4174/astr.2026.110.2.119","DOIUrl":"10.4174/astr.2026.110.2.119","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate surgical outcomes, identify complications, and analyze recurrence in patients undergoing surgery for primary retroperitoneal tumors (RPTs), which pose significant therapeutic challenges.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 59 patients who underwent surgery for primary RPTs at Ajou University Hospital between January 2015 and December 2024. Patients were divided into a multivisceral resection (MVR) group (n = 25) and a non-MVR group (n = 34) to compare demographics, clinical characteristics, pathological findings, and postoperative outcomes.</p><p><strong>Results: </strong>Compared to the non-MVR group, the MVR group had a significantly higher rate of open surgery (96.0% <i>vs.</i> 73.5%, P = 0.034), longer operative times (237.6 minutes <i>vs.</i> 188.8 minutes, P = 0.032), more frequent R2 resections (32.0% <i>vs.</i> 8.8%, P = 0.018), and longer hospital stays (13.1 days <i>vs.</i> 7.0 days, P = 0.007). Malignant tumors comprised 67.7% of cases, with sarcoma being the most common. Recurrence rates were highest in well-differentiated liposarcoma (50.0%) and dedifferentiated liposarcoma (22.2%). While univariate analysis showed MVR was associated with severe morbidity (Clavien-Dindo grade ≥III; odds ratio, 6.200; P = 0.029), this was not sustained as an independent predictor in multivariable analysis.</p><p><strong>Conclusion: </strong>Although MVR was associated with severe complications in univariate analysis, it was not an independent predictor in multivariable analysis. This suggests the increased risk reflects overall surgical complexity. Therefore, MVR should be pursued when oncologically necessary, as it presents an acceptable morbidity profile.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"119-126"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}