Annals of Surgical Treatment and Research最新文献

{"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":"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":2.0,"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":"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":2.0,"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}

{"title":"Development of an artificial intelligence-based prediction platform for early recurrence of resectable pancreatic cancer after curative surgery-toward future use as an indication for neoadjuvant treatment: a retrospective multicenter cohort study.","authors":"So Jeong Yoon, Sung Hyun Kim, Hongbeom Kim, Sang Hyun Shin, Jin Seok Heo, Seung Soo Hong, Chang Moo Kang, Kyung Sik Kim, Ho Kyoung Hwang, In Woong Han","doi":"10.4174/astr.2026.110.2.76","DOIUrl":"10.4174/astr.2026.110.2.76","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant treatment (NAT) is now the standard for borderline resectable pancreatic cancer (RPC) and is being considered for RPC. Early recurrence after curative surgery in RPC is often seen as a treatment failure, prompting considerations for NAT. Our goal was to develop an artificial intelligence (AI)-based predictive model utilizing preoperatively available factors to forecast early recurrences of resected RPC.</p><p><strong>Methods: </strong>This study included 469 patients who underwent surgery for RPC between 2011 and 2019. Clinicopathologic and oncologic data were retrospectively reviewed. Preoperative variables, including laboratory data and imaging findings, were collected. Early recurrence was defined as recurrence occurring within a year after surgery. Deep neural networks were then used to select variables by assessing their importance. A new model predicting early recurrence of RPC was subsequently developed.</p><p><strong>Results: </strong>Of the patients evaluated, 199 (42.4%) experienced early recurrence. The predictive model included 14 preoperative variables: CA 19-9, preoperative pancreatitis, serum albumin, platelet count, lymphocyte count, the American Society of Anesthesiologists physical status classification, tumor size, monocyte count, age, body mass index, CRP, hemoglobin, WBC count, and CEA. The area under the curve for the model was 0.786 in the training set and 0.734 in the test set.</p><p><strong>Conclusion: </strong>We developed an AI-based model to predict the early recurrence of RPC using preoperative parameters. By identifying patients at risk of early recurrence, optimal individualized treatments such as NAT can be considered. Future prospective studies are crucial to establish clear indications for NAT in RPC.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"76-83"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177593","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":"Progesterone receptor expression and its prognostic role in hormone receptor-positive/human epidermal growth factor receptor 2-positive breast cancer: a retrospective cohort study.","authors":"Ji Hye Kim, Yeryung Kim, Jai Hyun Chung, Yong Yeup Kim, Woo Young Kim, Jae Bok Lee, Sang Uk Woo","doi":"10.4174/astr.2026.110.2.112","DOIUrl":"10.4174/astr.2026.110.2.112","url":null,"abstract":"<p><strong>Purpose: </strong>While progesterone receptor (PR) negativity in luminal-type breast cancer is generally associated with worse oncologic outcomes, its prognostic role in estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains underexplored. This study aimed to evaluate the prognostic significance of PR expression in ER-positive, HER2-positive breast cancer.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with ER-positive, HER2-positive breast cancer who underwent primary surgery at Korea University Guro Hospital between January 2009 and December 2019. Patients were grouped by PR expression as negative/low (Allred score, 0-6) or strongly positive (Allred score,7 or 8). Prognostic outcomes, including disease-free survival (DFS), distant recurrence-free survival (DRFS), and breast cancer-specific survival (BCSS) were analyzed.</p><p><strong>Results: </strong>A total of 223 patients were included. Patients in the negative/low PR group were older compared to the strongly positive PR group. The negative/low PR group showed significantly worse DFS (P = 0.005) and DRFS (P = 0.014) but showed no significant difference in BCSS (P = 0.153). On multivariate analysis, negative or low PR expressions were linked to inferior DFS (hazard ratio [HR], 3.10; 95% confidence interval [CI], 1.34-7.16; P = 0.008) and DRFS (HR, 9.55; 95% CI, 1.22-74.77; P = 0.032).</p><p><strong>Conclusion: </strong>In ER-positive, HER2-positive breast cancer, negative or weak PR expression was associated with inferior DFS and DRFS compared to strong PR expression. These findings highlight the potential prognostic value of PR status in this group, underscoring its relevance in guiding treatment and follow-up strategies for more individualized patient care.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"112-118"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146176871","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":"Comparative outcomes of dialysis vascular access in kidney transplant patients: a propensity score-matched retrospective cohort study.","authors":"Minyu Kang, Hwa-Hee Koh, Young Jin Yoo, Seon-Hee Heo, Soo Jin Kim","doi":"10.4174/astr.2026.110.2.104","DOIUrl":"10.4174/astr.2026.110.2.104","url":null,"abstract":"<p><strong>Purpose: </strong>A proportion of patients who undergo kidney transplantation (KT) eventually experience graft failure and require dialysis. However, the characteristics of posttransplant patients differ from non-KT patients considering the long-term use of immunosuppressants, steroids, and associated complications. These differences may influence the outcomes of vascular access (VA). This study aims to compare the VA outcomes and infection rates between KT with allograft failures and non-KT patients.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent VA creation between January 2018 and November 2023. A propensity score-matched cohort was created based on age and sex, comparing 61 patients who received their first VA creation after KT to 222 patients who had never undergone KT before VA creation.</p><p><strong>Results: </strong>The median VA patency was 841 days. VA abandonment within 3 months occurred in 3.2% in the non-KT group and 1.6% in the KT with failed allograft group (P = 0.845). Infection rates were also similar (4.1% <i>vs.</i> 3.3%, P = 0.226). Cox regression indicated that KT was not a significant risk factor for VA patency, whereas low body mass index and diabetes mellitus were significant risk factors for long-term patency. In the KT group, steroid and mammalian target of rapamycin (mTOR) inhibitor use before VA formation were identified as risk factors for primary patency.</p><p><strong>Conclusion: </strong>VA outcomes in KT patients with allograft failure were comparable to those of non-KT patients. While KT status itself does not adversely affect VA patency or infection rates, patients with low body mass index, diabetes mellitus, or who are receiving steroid or mTOR inhibitors should be carefully managed.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"104-111"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177584","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":"Laparoscopic management of duodenal atresia: a decade of single surgeon's perspective.","authors":"Eunyoung Jung, Nak-Hoon Son","doi":"10.4174/astr.2026.110.2.127","DOIUrl":"10.4174/astr.2026.110.2.127","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the outcomes and learning curve of laparoscopic duodenal atresia repair performed by a single pediatric surgeon over 10 years and compare it with traditional open repair.</p><p><strong>Methods: </strong>This retrospective study included 28 neonates who underwent surgical repair for congenital duodenal atresia between 2010 and 2024 at a tertiary center. In total, 20 patients underwent laparoscopic repair by a single surgeon between 2013 and 2024, whereas 8 underwent open repair between 2010 and 2014. Clinical characteristics, operative times, feeding milestones, and complications were compared. To assess the effect of surgical experience, the laparoscopic cohort was divided into early and late phases.</p><p><strong>Results: </strong>The median operative time was longer in the laparoscopic group than in the open group (124 minutes <i>vs.</i> 80 minutes, P < 0.05). However, laparoscopic patients achieved earlier oral intake (5 days <i>vs.</i> 9 days, P = 0.021) and full enteral feeding (8 days <i>vs.</i> 13 days, P = 0.028). No significant differences were observed in complication rates. The operative time improved significantly throughout the laparoscopic series, decreasing from 155 minutes in early cases to 110 minutes in later cases (P = 0.039). No conversions or anastomotic leaks were observed in the late laparoscopic group.</p><p><strong>Conclusion: </strong>Laparoscopic duodenal atresia repair performed by a single surgeon is safe and effective, allowing for faster postoperative recovery than open repair. With accumulated experience, operative efficiency improves significantly, supporting its broader adoption in neonatal surgery.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 2","pages":"127-134"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177595","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}