Annali italiani di chirurgia最新文献

{"title":"Risk Factors for Hypothermia during Laparoscopic or Open Surgery of Colorectal Cancer under General Anesthesia.","authors":"Yi-Hui Tu, Di Zhang","doi":"10.62713/aic.3548","DOIUrl":"10.62713/aic.3548","url":null,"abstract":"<p><strong>Aim: </strong>Colorectal cancer (CRC) is one of the most prevalent malignancies, which is commonly treated with curative surgical resection, often leading to intraoperative hypothermia. Therefore, this study aimed to compare and analyze the risk factors for intraoperative hypothermia associated with laparoscopic and open CRC resections under general anesthesia.</p><p><strong>Methods: </strong>This study included 120 CRC patients admitted between January 2023 and January 2024. Data from these patients were analyzed using logistic regression analysis to investigate the risk factors for hypothermia during CRC surgery. Additionally, surgical indicators such as, intraoperative bleeding volume, number of lymph nodes dissected, and operation time, and serum inflammatory markers like Interleukin-6 (IL-6) and Interleukin-8 (IL-8) were assessed and compared between the two surgical groups.</p><p><strong>Results: </strong>The study group comprised 41 men and 79 women, with a mean age of 52.53 ± 8.90 years and an average body mass index (BMI) of 23.13 ± 3.32 kg/m2. The American Society of Anesthesiologists (ASA) score was measured as 1 for 62 (51.67%) patients and 2 for 58 (48.33%). Among them, 50 patients underwent open surgery, whereas 70 patients were treated with laparoscopic surgery. Gender, laparoscopic surgery, intraoperative fluid infusion volume, prolonged anesthesia, and intraoperative blood transfusion were determined as the independent risk factors for intraoperative hypothermia during CRC surgery under general anesthesia (p < 0.05). The intraoperative bleeding volume was significantly reduced (p < 0.01), with significantly longer operation time (p < 0.05) in patients treated with laparoscopic surgery compared to those with open surgery. However, the two groups had a similar number of lymph nodes dissected. Additionally, the levels of IL-6 and IL-8 in both laparoscopic and open surgery of patients increased significantly after surgery, but the extent of increase in the patients of laparoscopic surgery was significantly lower than that in the patients of open surgery (p < 0.05).</p><p><strong>Conclusions: </strong>In conclusion, gender, surgical approach, intraoperative fluid infusion volume, prolonged anesthesia, and intraoperative blood transfusion are the potential risk factors for hypothermia during laparoscopic radical CRC surgery under general anesthesia.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"108-115"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999052","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}

{"title":"Evaluation of the Performance of an Innovative Model for the Organisation of Specialised Hospital Activities throughout Italy: The \"Diffuse Hospital\".","authors":"Mattia Morri, Cristiana Forni, Anselmo Campagna, Annella Mingazzini, Viola Damen, Manuela De Clerico, Elisa Carretta, Guglielmo Celli, Matteo Buccioli, Marika Tomasello, Gerardina Protupapa, Erik Boetto","doi":"10.62713/aic.3565","DOIUrl":"10.62713/aic.3565","url":null,"abstract":"<p><strong>Aim: </strong>The objective of the study is to evaluate the performance of an innovative model of hospital activity known \"Diffuse Hospital\" (DH) that involved 3 hospital wards/departments (A, B and C) located throughout Italy and the Reference Hospital (RH) that organised the construction of this model.</p><p><strong>Methods: </strong>An organisational retrospective observational study was conducted on the orthopaedic ward of each hospital from March 2022 to March 2023. Hospitals A, B and C had organisational differences in relation to the working relationship of healthcare professionals, the care pathways implemented, the presence or absence of an emergency department and the management of operating theatres. The primary indicator was the number of Diagnosis-Related Groups (DRGs) provided by the individual facilities. Additionally, a series of indicators were collected, and to enable comparison, these indicators were calculated in relation to the available resources.</p><p><strong>Results: </strong>The total number of DRGs provided by the DH was 3904, broken down into 1187 at Hospital A, 1851 at Hospital B and 866 at Hospital C. The RH comparison standard recorded 1603 DRGs. Hospital B showed higher DRG indicators of 39.7, 2.5 and 30.9 percentage points, respectively, than the RH. In relation to theatre activities and healthcare staff, Hospitals A and C revealed lower scores than the standard.</p><p><strong>Conclusions: </strong>The DH model may become a useful tool in healthcare policy strategies to enable national RHs to deliver treatments with high standards of care at a territorial level. The facilities involved in the DH organisational model produced different outcomes in terms of both efficiency and clinical outcomes. Where there is no direct management by the RH of healthcare staff, care pathways and operating theatres, replication of the standard is more difficult and outcomes are poorer. In the hospital where there is no need for emergency surgical activity and scheduling is concentrated within the week, better efficiency levels can be achieved.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 2","pages":"221-227"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432359","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}

{"title":"Desmoid-type Fibromatosis of the Breast: A Case Report.","authors":"Wen-Yong Ren, Hao Su, Wei Guo, Xiao-Min Fu, Yanhong Dou, Jian-Ling Jia, Ai-Ping Shi, Di Wu","doi":"10.62713/aic.3581","DOIUrl":"10.62713/aic.3581","url":null,"abstract":"<p><p>Desmoid-type fibromatosis (DTF) is a rare and locally aggressive benign tumor affecting the breasts. It is characterized by infiltrative growth and local recurrence, though it cannot metastasize. We present the case of a woman in her early 20s diagnosed with a palpable mass within her right breast. Imaging evidence was classified as Breast Imaging Reporting and Data System (BI-RADS) category 4 and above. We performed ultrasound-guided core needle biopsy, and pathological examination revealed hyperplasia of ductal epithelium and lobular tissue. Imaging results suggested a greater likelihood of the mass being malignant; however, pathological outcomes indicated that it was benign, resulting in the decision to perform an extended mastectomy. Postoperative pathological results suggested DTF. However, no further treatment was performed after surgery, and the patient's breast color Doppler ultrasound evaluation 12 months after surgery showed no recurrence or metastasis.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"315-321"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639413","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}

{"title":"Surgery of the Primary Tumor in de novo Metastatic Breast Cancer: A Palliative Approach or a Potential Survival Game-Changer?","authors":"Gianluca Franceschini","doi":"10.62713/aic.3928","DOIUrl":"10.62713/aic.3928","url":null,"abstract":"<p><p>Approximately 5-10% of primary breast cancer cases present as de novo stage IV disease, characterized by distant metastases at diagnosis. Traditionally, systemic therapies such as chemotherapy, endocrine therapy and targeted treatments have formed the cornerstone of treatment for metastatic breast cancer (MBC), focusing on disease control, symptom palliation and quality of life improvement. While systemic therapies remain crucial, the role of local treatments, particularly surgery for the primary tumor, is increasingly debated. Historically viewed as a palliative intervention, surgery for the primary tumor aimed to address symptoms such as bleeding, ulceration and pain. However, emerging evidence suggests that surgical resection could offer survival benefits in specific patient subgroups, such as those with limited metastatic burden or bone-only metastases. Retrospective studies and meta-analyses indicate potential survival advantages but randomized trials have produced mixed results. These discrepancies highlight the complexity of surgery's role in MBC management influenced by factors such as cancer subtype, metastatic pattern and systemic treatment response. Personalized treatment strategies are mandatory for optimizing outcomes in de novo MBC. Surgery of the primary tumor should not be universally applied but considered for select patients based on clinical and molecular factors. Collaboration within multidisciplinary teams is essential to integrating surgery into comprehensive care plans. Future research, including nuanced and appropriate clinical trials, is needed to define the role of surgery in prolonging survival and enhancing quality of life for patients with de novo MBC.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"277-281"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639420","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}

{"title":"The Early Effects of Nuss Surgery on Cardiopulmonary Function in Patients With Pectus Excavatum.","authors":"Turkan Dubus, Gokce Cangel, Cagri Duzyol","doi":"10.62713/aic.3948","DOIUrl":"https://doi.org/10.62713/aic.3948","url":null,"abstract":"<p><strong>Aim: </strong>Pectus excavatum (PE) is a common congenital chest wall deformity that can impair cardiopulmonary function. While minimally invasive Nuss surgery is widely recognized for its cosmetic benefits, its early effects on cardiopulmonary performance are still unclear. This study aimed to investigate the changes in restrictive breathing patterns and cardiac parameters in the early postoperative period.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 97 patients (26 females, 71 males) treated for pectus excavatum with a Haller index (HI) ≥3.25 at the Department of Thoracic Surgery between October 2008 and July 2020. Spirometric measurements were performed to assess lung function, including forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Cardiac parameters such as left ventricular ejection fraction (EF) and right ventricular diameter (RVD) were determined using transthoracic echocardiography. The examinations were performed preoperatively and six months postoperatively.</p><p><strong>Results: </strong>Significant improvements were observed in FVC (68.3% to 75.4%, p = 0.01) and EF (55.2% to 62.8%, p = 0.02) after the Nuss surgery, while the changes in FEV1 (p = 0.07) and RVD (p = 0.09) were not statistically significant. A subgroup analysis by HI severity showed that patients with moderate HI (3.25-4.0) had significantly higher preoperative (p = 0.0001) and postoperative (p = 0.0007) FVC, as well as preoperative (p = 0.004) and postoperative (p = 0.002) EF compared to those with severe HI (>4.0). Differences in ∆FVC (p = 0.15) and ∆EF (p = 0.20) between the groups were not statistically significant. Notably, FEV1 showed greater improvement in the moderate group (p = 0.035). An age-based analysis showed that patients under 18 years had significantly higher preoperative (p = 0.003) and postoperative (p = 0.002) FVC and postoperative EF (p = 0.008), though ∆FVC (p = 0.33) and ∆EF (p = 0.25) did not differ between age groups. Although FEV1 increased more in younger patients, this difference was not significant (p = 0.06). Gender-based analysis demonstrated that female patients had significantly higher preoperative (p = 0.02) and postoperative (p = 0.05) FVC, as well as postoperative EF (p = 0.03), compared to male patients. Although some parameters did not reach significance, the trends suggest potential long-term cardiopulmonary benefits.</p><p><strong>Conclusions: </strong>Nuss surgery leads to a significant improvement in FVC and EF, especially in younger patients and those with moderate HI deformities. Although some changes were not statistically significant, the overall trends suggest potential long-term cardiopulmonary benefits. Further studies are needed to confirm these results and evaluate long-term outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"523-532"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961363","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}

{"title":"Effect of Serum Magnesium Level on Arteriovenous Fistula Dysfunction in Patients on Maintenance Hemodialysis.","authors":"Wu-Bin Yao, Yan Shen, Liang-Lan Shen, Xiao-Hua Wang, Hong-Li Yang, Jia-Jia Chen, Lu-Lu Ma, Hua-Xing Huang","doi":"10.62713/aic.3869","DOIUrl":"https://doi.org/10.62713/aic.3869","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effect of magnesium level on the arteriovenous fistula (AVF) dysfunction in patients on maintenance hemodialysis (MHD).</p><p><strong>Methods: </strong>We selected patients who underwent AVF surgery at The Second Affiliated Hospital of Nantong University from May 2011 to May 2022 and received MHD regularly for over 3 months. Patients were divided into dysfunction and non-dysfunction groups based on their AVF function, with follow-up until 30 November 2022. Retrospective data collection included pre-dialysis general data and clinical laboratory indicators. The magnesium cut-off for AVF dysfunction prediction was determined using the receiver operating characteristic (ROC) curve, and patients were categorized into high and low magnesium groups. AVF survival rates were compared using Kaplan-Meier methods, and the risk of AVF dysfunction and independent risk factors were analyzed with logistic and Cox regressions.</p><p><strong>Results: </strong>In a study of 263 hemodialysis patients with a median age of 61 years, including 164 males (62.4%), 95 developed AVF dysfunction over a median follow-up of 32 months. Two groups of MHD patients were classified based on their AVF function: 95 in the dysfunction group and 168 in the non-dysfunction group. The subjects in the dysfunction group were older than those in the non-dysfunction group. Compared with the non-dysfunction group, the dysfunction group suffered significant reduction in magnesium and creatinine levels (p < 0.05), and significant increase in calcium and hemoglobin levels (p < 0.05). The ROC curve results showed that magnesium = 0.88 mmol/L was the best critical point for predicting AVF dysfunction in MHD patients, with a sensitivity of 68.42% and a specificity of 77.38%. The results of Kaplan-Meier survival analysis showed that the AVF dysfunction in the low magnesium group was significantly higher than that in the high magnesium group (log-rank χ2 = 68.678, p < 0.001). Logistic analysis showed that the low magnesium group was 9.223 times more likely to experience AVF dysfunction than the high magnesium group after adjusting for multiple confounding factors (odds ratio [OR] = 9.223, 95% confidence interval [CI], 4.876-17.445; p < 0.001). After adjusting for multiple confounding factors, multivariate Cox regression analysis suggested that advanced age, low serum magnesium, high serum calcium and high hemoglobin were independent risk factors for AVF failure in MHD patients. The risk in the low serum magnesium group was 4.534 times higher than that in the high serum magnesium group (hazard ratio [HR] = 4.534, 95% CI, 2.633-7.808; p < 0.001).</p><p><strong>Conclusions: </strong>Low serum magnesium is an independent risk factor for AVF dysfunction and can be used as a predictor of AVF dysfunction.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"478-487"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953071","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}

{"title":"Disseminated Peritoneal Leiomyomatosis: Description of a Case, Radiologic Semiotics and Differential Diagnosis.","authors":"Riccardo Bisi, Aldo Carnevale, Giacomo Feliciani, Melchiore Giganti, Anna Chiara Palo","doi":"10.62713/aic.3751","DOIUrl":"https://doi.org/10.62713/aic.3751","url":null,"abstract":"<p><strong>Aim: </strong>Leiomyomatosis peritonealis disseminata or disseminated peritoneal leiomyomatosis (DPL), is a rare nosological entity characterized by multiple leiomyomas growing within the abdominal region. It is one of the uncommon manifestations of extra-uterine leiomyomas and an eventuality that can lead to diagnostic difficulties, especially in neoplastic patients. This pictorial review aims to illustrate the multimodal characteristics of DPL, providing at the same time relevant information regarding pathogenesis, clinical presentation, and treatment. Furthermore, as DPL may enter in differential diagnosis with other atypical smooth muscle tumour localization or abdominal malignancies, such as retroperitoneal leiomyosarcoma or peritoneal carcinomatosis, the review provides a concise description of each condition: the main epidemiological and pathogenetic aspects are summarized, along with essential information on clinical presentation and radiological imaging, closing with some notes on possible treatment options.</p><p><strong>Case presentation: </strong>A case of incidental detection of DPL in a patient undergoing staging of breast cancer is employed as an example to illustrate the diagnostic difficulties that may be encountered in such scenarios: the finding of multiple vascularized nodules in the abdomen aroused the suspicion of carcinomatous localizations, and the patient underwent in-depth investigations with multiple imaging techniques by ultrasound, computed tomography and magnetic resonance.</p><p><strong>Results: </strong>Using imaging methods with better contrast resolution in the definition of soft tissues made it possible to orient the diagnostic suspicion over DPL, subsequently confirmed by histological evaluation after laparoscopic excision of bigger nodules. Once the possibility of peritoneal localization of breast cancer was excluded, the patient was treated with neoadjuvant therapy, surgery and adjuvant therapy. Follow-up imaging showed no signs of breast cancer recurrence nor significant changes in the remaining DPL nodules.</p><p><strong>Conclusions: </strong>Knowledge of the atypical presentation patterns of leiomyomas, the related imaging characteristics and the differential diagnosis allows both the clinician and the radiologist to formulate more accurate diagnostic hypotheses, thus ensuring better patient management from the view of the subsequent possible invasive diagnostic and therapeutic options.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"451-464"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970393","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}

{"title":"A Study on Endometrial Polyps Recurrence Post-Hysteroscopic Resection: Identification of Influencing Factors and Development of a Predictive Model.","authors":"Zhuomin Wang, Tao Sun, Jian Xu","doi":"10.62713/aic.3622","DOIUrl":"10.62713/aic.3622","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore influencing factors and develop a predictive model of endometrial polyps (EP) recurrence after hysteroscopic resection.</p><p><strong>Methods: </strong>This retrospective study included 180 patients who underwent hysteroscopic resection for EP between January 2021 to December 2023. The patients were divided into a modeling group (n = 135) and a validation group (n = 45) in a 3:1 ratio. The patients in the modeling group were further divided into a recurrence group (n = 35) and a non-recurrence group (n = 100) based on whether their polyps recurred. General information on patients was compared between the two groups. Univariate and multiple logistic regression analyses were conducted to identify factors influencing EP recurrence post-hysteroscopic resection. A predictive model was developed, and the receiver operating characteristic (ROC) curve analysis was performed to determine the clinical utility of the model.</p><p><strong>Results: </strong>Comparison of baseline characteristics between the modeling and validation groups showed no statistically significant differences (p > 0.05). However, 35 patients in the modeling group had recurrence, while 12 patients experienced recurrence in the validation group. Binary logistics regression analysis revealed matrix metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinase-1 (TIMP-1), hypoxia-inducible factor-1α (HIF-1α) and platelet-derived growth factor (PDGF) as independent predictors for polyp recurrence (p < 0.05). Furthermore, a model formula, p = eZ/1 + eZ, was developed. The slope of the calibration curve of this model in both groups were straight lines close to 1, indicating that the model's predicted recurrence risk strongly agreed with the actual risk. ROC analysis demonstrated that the area under the curve in the modeling group was 0.902, with standard error of 0.028 (95% confidence interval (CI): 0.885-0.954). The model yielded the Youden value of 0.79, with a sensitivity of 82.96% and a specificity of 95.66%. Moreover, the area under the curve in the validation group was 0.871, with a standard error of 0.040 (95% CI: 0.859-0.920). However, the model showed the Youden value of 0.59, with a sensitivity of 79.29% and a specificity of 79.96%. The Decision Curve Analysis (DCA) demonstrated significant clinical advantages of the model.</p><p><strong>Conclusions: </strong>This study identified the influencing factors of EP recurrence and successfully constructed a predictive model based on these factors. After validation, the model demonstrates significant clinical utility.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"40-46"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999044","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}

{"title":"Clinical Outcomes and Complications of Total Knee Arthroplasty with Posterior-Stabilized and Cruciate-Retaining Prostheses in Osteoarthritis Patients with Valgus Deformity.","authors":"Lijun Xue, Xin Wen, Yawen Song, Shenglin Qiang, Shurui Li","doi":"10.62713/aic.3914","DOIUrl":"10.62713/aic.3914","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the short- and long-term outcomes and complications of total knee arthroplasty (TKA) using posterior-stabilized (PS) and cruciate-retaining (CR) prosthesis in patients with osteoarthritis (OA) and valgus knee deformity.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 200 patients with OA and valgus knee deformity who underwent TKA between February 2021 and November 2023. The cohort was divided into the PS group (n = 108) and the CR group (n = 92). Clinical outcomes, including Range of Motion (ROM), Hospital for Special Surgery (HSS) knee score, and Visual Analog Scale (VAS) score, were assessed at 1 week, 1 month, 3 months, 6 months, and 1 year postoperatively. Pre- and postoperative valgus angles were measured, and the incidence of complications was recorded.</p><p><strong>Results: </strong>Both groups exhibited significant postoperative improvements in ROM, HSS scores, and VAS scores compared to preoperative (p < 0.001). The CR group demonstrated superior early postoperative outcomes, with higher HSS scores, greater ROM, and lower VAS scores at 1 week, 1 month, and 3 months (p < 0.001). However, no significant differences were observed between the groups at 6 months and 1 year (p > 0.05). Radiographic analysis indicated effective correction of valgus angles in both groups postoperatively (p < 0.001), with no significant intergroup differences (p > 0.05). The complication rate was significantly lower in the CR group compared to the PS group (p < 0.05).</p><p><strong>Conclusions: </strong>CR and PS prostheses effectively correct valgus deformity, alleviate pain, and improve knee function. However, the CR prosthesis offers advantages in reducing early postoperative pain, swelling, and complications, facilitating faster functional recovery. The selection of the appropriate prosthesis based on patient-specific characteristics is critical to optimizing TKA outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"352-361"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639407","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}

{"title":"Impact of Combining Ultrasound Parameter and the Caprini Score on Predicting Lower Extremity Deep Venous Thrombosis After Orthopedic Surgery.","authors":"Xi Chen, Yungwei Chi, Shengjun Ta, Li An, Fen Gu, Feng Tian, Ming Yan, Liwen Liu","doi":"10.62713/aic.3861","DOIUrl":"10.62713/aic.3861","url":null,"abstract":"<p><strong>Aims: </strong>This study combined a new ultrasound venous filling degree (VFD) parameter with the Caprini score to assess the clinical value of the Caprini score in predicting deep venous thrombosis (DVT) of the lower extremities.</p><p><strong>Methods: </strong>This retrospective study included 150 inpatients undergoing orthopedic lower extremity surgery at the First Affiliated Hospital of the Air Force Medical University between June 2023 and June 2024. They included 41 (27.3%) cases of knee arthroplasty, 32 (21.3%) hip arthroplasty, 30 (20%) knee arthroscopy, 28 (18.7%) lower limb fractures, 12 (8%) bone tumor, and 7 (4.7%) cases of other surgery types. The data collected involved preoperative vein diameter, flow velocity, blood flow, venous lumen cross-sectional perimeter (C), lumen cross-sectional area (A), C2/A ratio (VFD) of the common femoral vein (CFV), femoral vein (FV), and popliteal vein (POV). The postoperative sonographic parameters and clinical data were compared between the DVT and non-DVT groups. Receiver operating characteristic (ROC) curve of parameters was evaluated as predictive values for DVT. Additionally, the C2/A ratio was combined with the Caprini score to assess their combined impact on DVT prediction.</p><p><strong>Results: </strong>There were significant differences in ultrasound parameters of CFV inner diameter, CFV blood flow, CFV-C, CFV-A, CFV-C2/A, FV blood flow, FV-C, FV-C2/A, POV blood flow, POV-C, POV-A, and POV-C2/A between the DVT group (24.7%, 37/150) and the non-DVT group (75.3%, 113/150) (all p < 0 .05). Area under curve (AUC) for the C2/A (CFV, FV, and POV) were 0.939 (95% confidence interval (CI): 0.888-0.972, p < 0.001), 0.937 (95% CI: 0.886-0.970, p < 0.001), and 0.917 (95% CI: 0.861-0.956, p < 0.001), respectively. When the Caprini score >2, an AUC for predicting DVT was 0.844 (95% CI: 0.776-0.899, p < 0.001). The AUC of the Caprini score >2 combined with C2/A (CFV, FV, and POV) were 0.953 (95% CI: 0.905-0.981, p < 0.001), 0.965 (95% CI: 0.922-0.988, p < 0.001), and 0.948 (95% CI: 0.900-0.978, p < 0.001), respectively.</p><p><strong>Conclusions: </strong>The ultrasound parameter of VFD-C2/A shows a high predictive value for DVT in patients undergoing orthopedic surgery. Combined with the Caprini score, the predictive value of DVT may be further enhanced compared to using the Caprini score alone.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"380-390"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639428","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}