Annals of Surgical Treatment and Research最新文献

{"title":"Prediction model for hypertrophied liver volume followed by hemihepatectomy: a retrospective cohort study.","authors":"Jiwon Yu, Sunghae Park, Gyu-Seong Choi, Jongman Kim, Namkee Oh, Bogeun Kim, Jinsoo Rhu","doi":"10.4174/astr.2026.111.2.86","DOIUrl":"10.4174/astr.2026.111.2.86","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a statistical model for predicting hypertrophied future liver remnant volume (HFLRV) in patients with right hemihepatectomy (RHH).</p><p><strong>Methods: </strong>Patients who underwent RHH at Samsung Medical Center between January 2022 and March 2024 were included in this study. Liver volume was calculated from abdomen CT by using a deep learning-based volumetric tool.</p><p><strong>Results: </strong>A total of 98 patients were included. There were 58 and 40 patients whose liver regeneration index was less than 0.8 and 0.8 or more, respectively. The prediction model, which focused on identifying variables associated with HFLRV, included age at diagnosis (P = 0.14), sex (P = 0.01), both preoperative hemi-liver volumes (P < 0.001), and international normalized ratio (P < 0.05). This model demonstrated adjusted R² of 0.60, correlation coefficient (r) of 0.78, and P-value of <0.001.</p><p><strong>Conclusion: </strong>This study developed a linear prediction model for HFLRV and determined which factors can be used to predict HFLRV before RHH.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"86-92"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711292","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":"A preliminary experimental study of venoactive compounds on human lymphatic endothelial cells: cellular response and therapeutic potential.","authors":"Hyunmin Ko","doi":"10.4174/astr.2026.111.2.122","DOIUrl":"10.4174/astr.2026.111.2.122","url":null,"abstract":"<p><strong>Purpose: </strong>Lymphedema is a common complication following surgical procedures, particularly in breast cancer patients. However, no effective medical treatment has been clearly established. Venoactive compounds (venoactive drugs, VADs) are frequently used as an alternative option, despite limited supporting evidence. This study aimed to evaluate their potential therapeutic role in lymphedema.</p><p><strong>Methods: </strong>Human lymphatic endothelial cells (HLECs) were used to assess the effects of diosmin, calcium dobesilate, and <i>Vitis vinifera</i> extract. Cell viability was evaluated using the MTT assay to determine non-cytotoxic concentrations. Lymphangiogenesis was assessed using Transwell migration and Matrigel-based tube formation assays (Corning). Western blot analysis was performed to examine the activation of protein kinase B (AKT), extracellular signal-regulated kinase (ERK), and p38 mitogen-activated protein kinase (MAPK) signaling pathways.</p><p><strong>Results: </strong>Treatment with VADs showed an overall tendency to suppress cell migration compared to the control. On the other hand, there was no significant difference in the tube formation. Western blot analysis revealed that <i>Vitis vinifera</i> extract significantly inhibited the activation of AKT, ERK, and p38 MAPK pathways. Diosmin increased p38 activation without affecting AKT or ERK, while calcium dobesilate did not induce any significant changes in these signaling pathways.</p><p><strong>Conclusion: </strong>VADs did not directly promote lymphangiogenesis in HLECs. Their therapeutic effects in lymphedema may instead be mediated by microvascular stabilization through anti-inflammatory, antioxidant, and permeability-reducing mechanisms. Further experimental and clinical studies are needed to validate these findings.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"122-130"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711328","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":"Comparison of four commercially available adhesion barriers after open thyroid surgery: a prospective observational study.","authors":"Yoon Kong, Ja Kyung Lee, Sukmin Yun, Eunji Kim, Jae Bong Choi, Hyeong Won Yu, June Young Choi","doi":"10.4174/astr.2026.111.2.77","DOIUrl":"10.4174/astr.2026.111.2.77","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative cervical adhesions after thyroidectomy can lead to neck tightness, dysphagia, and cosmetic dissatisfaction, but the clinical benefits of antiadhesion agents remain unclear. This study compared the efficacy and safety of four commercially available antiadhesion agents applied after open thyroid surgery.</p><p><strong>Methods: </strong>This singlecenter prospective observational study at a tertiary care hospital included included patients aged 20-70 years undergoing their first open thyroid surgery with intraoperative application of 1 of 4 agents: MegaShield (MS; L&C Bio Co., Ltd.), MegaDerm (MD; L&C Bio Co., Ltd.), CollaBarrier (CB; Dalim Tissen Co., Ltd.), or ACE COL (AC; Korea BNC Co., Ltd. and IreBio Co., Ltd.). Two units were applied at the tracheal bed and subcutaneous layer at the end of surgery. A 7item adhesion questionnaire and the Vancouver Scar Scale (VSS) were assessed at 2 and 12 weeks postoperatively by an independent evaluator. Adverse events were recorded at each visit. Group differences were analyzed using nonparametric tests.</p><p><strong>Results: </strong>Of 200 enrolled patients, 180 completed followup (MS, 46; MD, 45; CB, 47; and AC, 42). Baseline characteristics were comparable. Adhesion scores increased at 2 weeks and improved by 12 weeks in all groups, with no significant betweengroup differences at any time point. VSS total scores showed a similar pattern, with only a transiently higher pigmentation score at 2 weeks in the MS group; no differences persisted at 12 weeks. Complication rates were low and similar across groups.</p><p><strong>Conclusion: </strong>Four different antiadhesion agents demonstrated comparable shortterm efficacy for adhesionrelated symptoms and scar quality after open thyroid surgery, with no clinically meaningful superiority of any single agent. All products were well tolerated.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"77-85"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711325","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":"Effect of endoscopic submucosal dissection on short-term surgical outcome after radical gastrectomy: a multicenter retrospective study based on the Korean Gastric Cancer Association nationwide survey.","authors":"Jinjoo Kim, Ki Bum Park, Han Hong Lee","doi":"10.4174/astr.2026.111.2.101","DOIUrl":"10.4174/astr.2026.111.2.101","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. However, 17%-21% of patients require additional curative gastrectomy (ACG) due to non-curative factors. Although ESD may induce fibrosis or adhesions that could complicate subsequent surgery, its impact on surgical outcomes after ACG remains unclear. This study aimed to evaluate the impact of prior ESD on postoperative outcomes following ACG.</p><p><strong>Methods: </strong>We retrospectively analyzed national data from the Korean Gastric Cancer Association, including 11,594 patients with EGC who underwent gastrectomy between January 2019 and December 2019. Of these, 913 patients underwent ACG after non-curative ESD, while 10,681 underwent primary gastrectomy. Outcomes were compared between the ACG and surgery-only groups using 1:1 propensity score matching.</p><p><strong>Results: </strong>A total of 1,826 matched patients were analyzed, with 913 patients in each group. There was no significant difference in severe complication rates (Clavien-Dindo grade ≥III) between the post-ESD group and the surgery-only group (4.4% <i>vs.</i> 5.3%, P = 0.986). Operative time, blood loss, and 30-day mortality were also comparable between groups. Higher body mass index (odds ratio [OR], 1.069; P = 0.043) and total gastrectomy (OR, 2.088; P = 0.006) were associated with an increased risk of severe complications.</p><p><strong>Conclusion: </strong>This study is the first to use national data to evaluate surgical outcomes after ACG following non-curative ESD. The results suggest that prior ESD does not adversely affect postoperative outcomes, providing evidence to guide surgical decision-making in patients with EGC requiring ACG.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"101-110"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711287","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":"Comparison of postoperative survival after neoadjuvant treatment <i>versus</i> upfront surgery in resected pancreatic ductal adenocarcinoma: a propensity score matching analysis.","authors":"Wonjun Jang, Hye-Sol Jung, Youngmin Han, Yoonsoo Chae, Younsoo Seo, Inhyuck Lee, Young Jae Cho, Go-Won Choi, Joon Seong Park, Jin-Young Jang, Wooil Kwon","doi":"10.4174/astr.2026.111.2.93","DOIUrl":"10.4174/astr.2026.111.2.93","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence regarding long-term prognosis after surgery by pathological stage in pancreatic ductal adenocarcinoma (PDAC) patients following neoadjuvant treatment (NAT) remains limited.</p><p><strong>Methods: </strong>757 patients who underwent PDAC resection between 2017 and 2021 were analyzed retrospectively. Among them, 262 received NAT followed by surgery (NAT group) and 415 underwent upfront surgery (UFS group). Propensity score matching (PSM) was performed for balanced comparison using the following variables: age, sex, American Society of Anesthesiologists physical status class, and adjuvant treatment.</p><p><strong>Results: </strong>After PSM, the UFS group showed higher postoperative CA 19-9, larger tumors, less advanced initial clinical stage, but more advanced pathological stage and fewer positive lymph nodes compared with the NAT group. Median overall survival (OS) was similar between groups (NAT <i>vs.</i> UFS: 35 <i>vs.</i> 34 months, P = 0.88). In stage IA, UFS patients had longer OS compared to NAT (not reached <i>vs.</i> 42 months, P = 0.037). No significant OS differences were observed at stages IB, IIA, IIB, and III.</p><p><strong>Conclusion: </strong>Postoperative survival did not differ between NAT and UFS groups when stratified by pathological stage, except for stage IA where UFS showed better outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"93-100"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711299","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":"Comparison of mesh and non-mesh repair in adolescent inguinal hernia surgery using the Korean National Health Insurance Service database: a nationwide retrospective cohort study.","authors":"Min Seung Kim, So Ra Yoon, Ho Jong Jeon","doi":"10.4174/astr.2026.111.1.47","DOIUrl":"10.4174/astr.2026.111.1.47","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to analyze the long-term outcomes of inguinal hernia repair in adolescent patients and assess the effectiveness of using mesh with data from the National Health Insurance Service (NHIS) database.</p><p><strong>Methods: </strong>Using the NHIS claims data between 2005 and 2023, 15,808 adolescents aged 10-19 years who underwent inguinal hernia surgery were identified. Patients were categorized by mesh use, and postoperative outcomes were analyzed using statistical and Cox regression models.</p><p><strong>Results: </strong>Among 15,808 patients, 810 (5.1%) underwent mesh repair, whereas 14,998 (94.9%) did not. Mesh use increased significantly with age and was more frequent in males. There were no significant differences in readmission or reoperation rates after 1 year. However, mesh repair showed higher readmission (4.32% <i>vs.</i> 3.01%, P = 0.03) and reoperation (3.95% <i>vs.</i> 2.69%, P = 0.03) rates after 5 years. Older age was an independent risk factor for both outcomes. Recurrence analysis revealed no significant differences between the 2 techniques.</p><p><strong>Conclusion: </strong>NHIS data showed no clear long-term recurrence benefit of mesh repair for adolescent inguinal hernia. Given data limitations and potential selection bias, routine mesh use is not recommended, and individualized decision-making is advised. Further prospective studies are needed, particularly for older adolescents.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"47-55"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418161","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":"Prevalence, causes, management strategies, and outcomes of secondary interventions during long-term follow-up after endovascular aneurysm repair: a retrospective cohort study.","authors":"Hyo Jun Kim, Hyung Sub Park, Jinsol Jung, Ji Young Lee, Myung Yup Hyun, Jonghyuk Park, Taeseung Lee","doi":"10.4174/astr.2026.111.1.1","DOIUrl":"10.4174/astr.2026.111.1.1","url":null,"abstract":"<p><strong>Purpose: </strong>This study was conducted to evaluate the prevalence, causes, management strategies, and outcomes of secondary interventions after endovascular aneurysm repair (EVAR) in a Korean cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed 242 patients who underwent standard EVAR for infrarenal abdominal aortic aneurysm at Seoul National University Bundang Hospital between 2008 and 2023. Clinical and anatomical parameters were analyzed. Secondary intervention indications, management, and outcomes were documented. Kaplan-Meier analysis estimated freedom from intervention and survival, and Cox regression identified predictors of mortality.</p><p><strong>Results: </strong>During a mean follow-up of 61.4 ± 45.8 months, 54 patients (22.3%) underwent 70 secondary interventions. The most common indications were Type II endoleaks with sac growth (24.1%), graft limb occlusion/stenosis (20.4%), Type IB endoleaks (11.1%), and Type III endoleaks (9.3%). Type II endoleaks were primarily treated with transarterial embolization, but many required repeated interventions or open conversion. Type I and III endoleaks were managed with stent graft extensions, endoanchors, or revision EVAR. Freedom from secondary intervention was 73.3% at 5 years and 57.5% at 10 years. Aneurysm-related survival was high (95.3% at 10 years), but overall survival declined to 42.5%, mainly due to comorbidities like malignancy, pneumonia, and cardiovascular disease. Multivariate analysis identified age, chronic obstructive pulmonary disease, hospital stay, and aneurysm diameter as independent mortality predictors, with dyslipidemia being protective.</p><p><strong>Conclusion: </strong>Secondary interventions after EVAR were required in over 20% of patients, primarily for Type II endoleaks. While aneurysm-related survival remained high, overall survival was limited by comorbidities. Lifelong imaging surveillance and management of comorbidities are essential for optimizing EVAR outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418114","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":"Safety and efficacy of HLBLS-200 (BleeFix) as a novel hemostatic agent in hepatic surgery: a multicenter, randomized, active-controlled clinical trial.","authors":"Junsun Lee, Hee-Hoon Yoon, Sang-Eun Cho, Yun Kyung Jung, Kyeong Sik Kim, Kyeong Geun Lee, Han Joon Kim, Hwon Kyum Park, Gyu-Seong Choi, Dongho Choi","doi":"10.4174/astr.2026.111.1.33","DOIUrl":"10.4174/astr.2026.111.1.33","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the safety and efficacy of HLBLS-200 (BleeFix, HLB Cell Co., Ltd.) in patients requiring hemostasis for exudative bleeding following primary hemostasis during hepatic resection.</p><p><strong>Methods: </strong>This prospective, randomized controlled clinical trial was conducted at three hospitals in South Korea, with Arista AH (Becton Dickinson) serving as the active comparator. A total of 156 patients who underwent elective liver resection with exudative bleeding were randomized. The primary endpoint was the hemostasis success rate within 5 minutes of application. Secondary endpoint included hemostatic success rates at 3, 4, 7, and 10 minutes. Safety was assessed by monitoring adverse events over a 12-week follow-up period.</p><p><strong>Results: </strong>The hemostatic success rate within 5 minutes was 98.5% (66/67) in the BleeFix group and 97.0% (65/67) in the control group. The between-group difference was 1.49% (95% confidence interval [CI], -5.72% to 9.07%). The lower bound of the CI (-5.72%) exceeded the predefined non-inferiority margin of -15.00%, confirming the non-inferiority of BleeFix. Treatment-emergent adverse events (TEAEs) were more frequent in the BleeFix group (97.44% <i>vs.</i> 87.18%, P = 0.016), with most events classified as mild (grade 1). This difference may be partially attributed to a statistically significant variation in sex distribution between groups. Serious TEAEs occurred in four participants, with no statistically significant differences between groups.</p><p><strong>Conclusion: </strong>BleeFix demonstrated non-inferior hemostatic efficacy compared with Arista AH during hepatectomy. These findings support the clinical use of BleeFix as a safe and effective hemostatic agent for managing exudative bleeding during hepatic resection.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"33-46"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418187","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":"Rethinking routine technical choices in minor surgery: a retrospective cohort study of implantable venous port catheter placement.","authors":"Omer Yavuz, Mehlika Iscan, Eren Erdogdu, Muhammet Kertmen, Ali Yeginsu","doi":"10.4174/astr.2026.111.1.56","DOIUrl":"10.4174/astr.2026.111.1.56","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether two commonly overlooked technical choices, preoperative skin marking and electrocautery use, independently affect procedural success and long-term outcomes, using implantable venous port catheter placement as a model procedure within minor surgery.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed 1,122 consecutive port catheter placements, used as a model minor surgical procedure, performed by a single surgeon between June 2022 and September 2025. Preoperative skin marking and electrocautery use were recorded as primary technical variables. The primary outcome was port catheter revision requiring surgical intervention. Learning curve effects were assessed using cumulative sum (CUSUM) analysis. Multivariable logistic regression and Kaplan-Meier analyses were performed to identify independent predictors.</p><p><strong>Results: </strong>Omission of preoperative skin marking was the sole independent predictor of procedural failure in port catheter placement, increasing failure risk 6.07-fold (odds ratio [OR], 6.07; 95% confidence interval [CI], 2.63-14.01; P < 0.001). Port catheter revision occurred in 4.2% of patients. Electrocautery use was a strong independent predictor of revision (OR, 8.89; 95% CI, 1.77-44.70; P = 0.008) and was associated with significantly lower revision-free survival (hazard ratio, 3.52; P = 0.002). CUSUM analysis demonstrated that the reduction in port catheter revisions after electrocautery discontinuation occurred independently of the overall learning curve.</p><p><strong>Conclusion: </strong>Preoperative skin marking improves procedural accuracy, while avoidance of electrocautery markedly reduces revision risk, independent of surgical experience, highlighting the critical impact of routine technical decisions in port catheter placement as a model of minor surgical procedures.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"56-68"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418195","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":"Long-term patency of aortoiliac stenting with or without simultaneous infrainguinal revascularization: a propensity score-matched 10-year retrospective cohort study.","authors":"Sungsin Cho, Jin Hyun Joh","doi":"10.4174/astr.2026.111.1.12","DOIUrl":"10.4174/astr.2026.111.1.12","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the long-term impact of simultaneous infrainguinal revascularization on the primary patency rate (PPR) of aortoiliac artery stenting (AIS) for aortoiliac occlusive disease.</p><p><strong>Methods: </strong>A retrospective analysis of 334 consecutive AIS patients (2009-2024) was conducted. Patients were categorized into 2 groups: AIS with simultaneous infrainguinal treatment (Tx (+), n = 114) and AIS alone (Tx (-), n = 220). Baseline and lesion characteristics were compared. The primary outcome was 10-year PPR, analyzed using the Kaplan-Meier methods and log-rank tests, both before and after 1:1 propensity score matching for clinical and anatomical risk factors.</p><p><strong>Results: </strong>The Tx (+) group demonstrated a higher disease burden, including older age, lower body mass index, adverse lab findings, more severe calcification (P = 0.013), and greater external iliac artery involvement (P < 0.001). The overall PPR was excellent, stabilizing at 85.3% over 7 to 10 years. Before propensity matching, the Tx (-) group showed significantly superior patency (P = 0.004). However, after 1:1 propensity score matching, the difference in PPR between the Tx (+) and Tx (-) groups was no longer statistically significant (P = 0.093). Stent type did not significantly affect PPR (P = 0.220).</p><p><strong>Conclusion: </strong>Aortoiliac stenting offers durable long-term primary patency over 10 years. Although patients requiring combined infrainguinal revascularization have higher clinical and anatomical risks, simultaneous infrainguinal treatment does not independently compromise the long-term patency of the upstream aortoiliac stent. These findings support comprehensive revascularization to optimize limb perfusion without negatively impacting the iliac stent's long-term performance.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"12-19"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418184","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}