Annali italiani di chirurgia最新文献

{"title":"Predicting Risk Factors Affecting the Efficacy of Flexible Ureteral Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy for Ureteral Calculi Based on Decision Tree Model.","authors":"Ben Wu, Li Wu, Hao He, Xiaogui Ding, Tong Bao, Rui Zhou","doi":"10.62713/aic.3702","DOIUrl":"10.62713/aic.3702","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURL) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral calculi based on decision tree model.</p><p><strong>Methods: </strong>A total of 600 patients with ureteral calculi, including 289 treated with FURL and 311 cases with ESWL in Anqing Municipal Hospital from June 2021 to August 2023, were selected as study subjects. Perioperative indicators and stone clearance rate of the two groups were compared, and the preoperative and postoperative (24 and 72 hours) changes of serum creatinine, cystatin C (Cys-C) and microalbumin were observed. The complications during and 7 days after treatment, the influence of perioperative indexes, total stone removal rate and renal function indexes were analyzed using decision tree method, and a complication risk prediction model was constructed.</p><p><strong>Results: </strong>The operation time, length of hospital stays and postoperative hematuria time in FURL group were shorter than those in ESWL group (p < 0.001), and the usage of painkillers was less frequent in FURL group than in ESWL group (p = 0.002). The total stone removal rate in the FURL group was higher than that in the ESWL group (p < 0.001). Serum creatinine, urinary microalbumin and Cys-C in both groups were lower before surgery than at 24 h and 72 h after surgery (p < 0.05). Serum creatinine, urinary microalbumin and Cys-C in FURL group were lower than those in the ESWL group at 24 and 72 h after operation (p < 0.001). The overall complication rate in the FURL group was lower than that in the ESWL group (p = 0.028). Decision tree model analysis showed that four explanatory variables, including preoperative creatinine, urinary microalbumin, Cys-C and surgical method were identified by screening. The risk statistic of the model was 0.027, and the accuracy, sensitivity and specificity of the model in predicting postoperative complications in patients with ureteral calculi were 97.33%, 97.73% and 97.30%, respectively.</p><p><strong>Conclusions: </strong>FURL has significant advantages over ESWL in the treatment of ureteral calculi, and has less impact on renal function and fewer complications. Preoperative creatinine, urinary microalbumin, Cys-C and surgical methods may adversely influence the occurrence of postoperative complications. These identified factors can be employed to build a decision tree model for predicting the occurrence of postoperative complications.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"78-85"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999049","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":"Diode Laser Surgery for the Disinclusion of Palatally Impacted Canines: A Case Report.","authors":"Martina Horodynski, Adriana Assunta De Stefano, Francesca Crocamo, Alessandra Impellizzeri, Umberto Romeo, Gabriella Galluccio","doi":"10.62713/aic.3592","DOIUrl":"10.62713/aic.3592","url":null,"abstract":"<p><strong>Aim: </strong>Mandibular third molars are the most frequently impacted teeth, followed by maxillary canines. Between one and three percent of the general population is affected by permanent maxillary canine impaction; in males, this condition is less common than in females. This case report evaluates the spontaneous eruption of palatally impacted canines following diode laser exposure.</p><p><strong>Case presentation: </strong>A 15-year-old female referred to our observation to improve her smile. At the first visit, the absence of upper left permanent canines and the persistence of upper right primary canines were detected. Meticulous surgical exposure with a diode laser was planned based on the cone beam computed tomography (CBCT). The wound was covered with a periodontal pack, and the traction of the teeth in the dental arch was achieved without the need for orthodontic devices. The canines' eruption was tracked at 1, 8 and 16 weeks following surgery, using an intraoral scanner (Medit i700, Medit Corp., Seoul, South Korea) and photos.</p><p><strong>Results: </strong>Both canines completely erupted 16 weeks after surgery, so brackets were placed on them, and self-ligating multibrackets were used to bandage the upper arch.</p><p><strong>Conclusions: </strong>Laser surgery for impacted canines is an excellent conservative option for their exposure; compared to standard surgery, it offers several advantages, including faster eruption, no need for sutures, and no bleeding during or after the operation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 2","pages":"143-151"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432357","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":"Efficacy of Open Reduction and Internal Fixation Assisted by Handheld Ultrasound Combined with 3D Printing Technology in Treating Multiple Rib Fractures.","authors":"Jieshi Li, Qianshun Chen, Xunyu Xu, Yimeng Zhuo, Minhui Zhang, Dong Zhou, Zhong Li","doi":"10.62713/aic.3612","DOIUrl":"10.62713/aic.3612","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the efficacy of open reduction and internal fixation assisted by handheld ultrasound combined with three-dimensional (3D) printing technology in treating multiple rib fractures.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data from 84 patients affected with multiple rib fractures admitted to our hospital between August 2022 and April 2024. After excluding four cases, 80 cases were included in this study. Based on the method of preoperative rib fracture localization, patients were divided into three groups: group A (n = 30), group B (n = 26), and group C (n = 24). Group A received 3D reconstruction of ribs on chest Computed Tomography (CT), group B adopted the examination of handheld ultrasound and 3D reconstruction of ribs on chest CT, and group C received handheld ultrasound, 3D reconstruction of ribs on chest CT, and 3D printing technology. The operation-related indicators (such as incision length, exposure time of surgical field, intraoperative blood loss), pulmonary function [total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in one second/forced vital capacity (FEV1/FVC), residual volume (RV)], quality of life, degree of pain, and incidence of complications were compared among the three groups.</p><p><strong>Results: </strong>Before surgery, there were no significant differences in pulmonary function, quality of life, and degree of pain among the three groups (p > 0.05). However, after surgery, significant differences in the pairwise comparison of TLC, FVC, FEV1/FVC and RV were observed among the three groups (p < 0.001), with group C indicating the highest levels of observational indicators and group A exhibiting the lowest levels. Furthermore, a significant difference was observed in the pairwise comparison of incision length, exposure time of surgical field, and intraoperative blood loss among the three groups (p < 0.001). Group C had the shortest incision length, the lowest exposure time in the surgical field, and the least intraoperative blood loss, while those in group A were the opposite. After surgery, a significant difference was found in the pairwise comparison of the quality of life and degree of pain among the three groups (p < 0.001). Group C had the highest quality of life and the lowest degree of pain, while Group A had the opposite results. Additionally, there was no significant difference in the incidence of complications among the three groups (p > 0.05).</p><p><strong>Conclusions: </strong>The open reduction and internal fixation assisted by handheld ultrasound combined with 3D printing technology revealed effective curative outcomes in treating multiple rib fractures. This method promotes the formulation of an accurate and personalized surgical plan and seems to have high clinical significance.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"98-107"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999022","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 Study on Thromboembolic Events in Prostate Cancer Patients Receiving Radiation Therapy With or Without Androgen Deprivation Therapy.","authors":"Xuejun Huangfu, Jia Zheng, Zhiqiang Fan","doi":"10.62713/aic.3946","DOIUrl":"https://doi.org/10.62713/aic.3946","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the incidence of thromboembolic events (TEs) in prostate cancer (PCa) patients receiving radiation therapy with or without androgen deprivation therapy (ADT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 125 PCa patients admitted to the Henan Provincial People's Hospital from February 2020 to February 2022. Patients were divided into control and observation groups after baseline matching, with the former consisting of 31 patients receiving radiation therapy alone and the latter constituting 31 patients receiving radiation therapy combined with ADT. The incidence rates of TEs, coagulation function indicators (fibrinogen [FIB], D-dimer [D-D], activated partial thromboplastin time [APTT], prothrombin time [PT]), and thrombotic molecular markers (plasminogen-α2-antiplasmin complex [PIC], thrombomodulin [TM], thrombin-antithrombin [TAT] complex, tissue-type plasminogen activator-inhibitor complex [t-PAIC]) were compared between the two groups.</p><p><strong>Results: </strong>The incidence of deep vein thrombosis (DVT) in the observation group was significantly higher than in the control group (p < 0.05). No cases of pulmonary embolism (PE) or arterial embolism (AE) were reported in either group. After treatment, the observation group showed significantly lower PT and APTT levels and significantly higher levels of FIB, D-D, and all thrombotic molecular markers (TAT, PIC, TM, and t-PAIC) compared to the control group (p < 0.05).</p><p><strong>Conclusions: </strong>Although ADT provides substantial benefits in controlling PCa progression, it significantly increases the risk of TEs, particularly DVT. Physicians should carefully evaluate the thromboembolic risk before initiating ADT in PCa patients and consider prophylactic anticoagulation strategies for risk mitigation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"533-542"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953065","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":"Predicting Success: The Crucial Role of Preoperative Data in Refractive Surgery Outcomes.","authors":"Federico Visalli, Caterina Gagliano, Fabiana D'Esposito, Mutali Musa, Daniele Tognetto, Marco Zeppieri","doi":"10.62713/aic.3778","DOIUrl":"10.62713/aic.3778","url":null,"abstract":"<p><p>Refractive surgery, which includes techniques such as Laser-Assisted In Situ Keratomileusis (LASIK), Photorefractive Keratectomy (PRK) and Small Incision Lenticule Extraction (SMILE), has revolutionized ophthalmology by offering advanced solutions for vision correction. However, the choice of the technique to be used in the individual patient is highly dependent on a thorough preoperative evaluation. This retrospective study aims to investigate how preoperative parameters, including corneal thickness, topography, and refraction, affect long-term post-operative clinical outcomes. Through a systematic review of the literature published between 2000 and 2023, we identify the main predictors of success for each surgical technique. This study emphasizes the importance of personalized surgical strategies based on meticulous preoperative analysis.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"19-28"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999050","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 Efficacy of Automatic Ruiyun Procedure for Hemorrhoids and Procedure for Prolapse and Hemorrhoids in the Treatment of Mixed Hemorrhoids: A Comparative Study.","authors":"Hao Xu, Xinyong Yan, Dongpeng Hao, Jieliang Hu, Yan Wang","doi":"10.62713/aic.3746","DOIUrl":"10.62713/aic.3746","url":null,"abstract":"<p><strong>Aim: </strong>The occurrence of mixed hemorrhoids becomes increasingly more frequent with age, posing psychological pressure and distress to affected patients. This retrospective study aims to compare the clinical efficacy of automatic Ruiyun procedure for hemorrhoids and procedure for prolapse and hemorrhoids in the treatment of mixed hemorrhoids.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with mixed hemorrhoids who visited the Third Affiliated Hospital of Gansu University of Chinese Medicine (The 1st People's Hospital of Baiyin) from January 2019 to December 2023 was conducted using propensity score matching (PSM) with a ratio of 1:1 for nearest neighbor matching grouping. In this study, 60 cases were grouped under the Ruiyun procedure for hemorrhoids (RPH) group, and the other 60 cases were categorized in the procedure for prolapse and hemorrhoids (PPH) group. The postoperative medical humanistic evaluation, clinical efficacy evaluation, subjective evaluation of patients, the occurrence of complications and the rate of unplanned readmission were compared between the two groups.</p><p><strong>Results: </strong>Surgical time, intraoperative blood loss, duration of postoperative pain, length of hospital stay and hospitalization expenses between the two groups presented statistically significant differences (p < 0.001). There were statistically significant intra-group and between-group differences between RPH group and PPH group in the visual analogue scale (VAS) scores on the 4th and 6th postoperative days (p < 0.001). The European Quality of Life-5 Dimensions, 5-Level Version (EQ-5D-5L) score in the RPH group was lower than that in the PPH group at the 12th week of follow-up (p < 0.001), signifying an improved level of quality of life. There was no difference in Vaizey's Fecal Incontinence Rating Scale score between the RPH group and the PPH group at the 12th week of follow-up (p > 0.05). The rate of unplanned postoperative readmission was higher in the PPH group than in the RPH group, although the difference was not of statistical significance (p > 0.05).</p><p><strong>Conclusions: </strong>RPH outperforms PPH in the treatment of mixed hemorrhoids with a shortened surgical time.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 2","pages":"205-212"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432352","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":"Assessing the Effect of Neuroendoscopic Surgery on Cerebral Hemodynamics and Functional Recovery in Patients With Brain Hemorrhage.","authors":"Yuanbao Kang, Quanming Zhou","doi":"10.62713/aic.3907","DOIUrl":"10.62713/aic.3907","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to investigate the impact of neuroendoscopic surgery on cerebral hemodynamics and functional recovery in patients with different brain hemorrhage severities.</p><p><strong>Methods: </strong>This study included 161 patients with brain hemorrhage who were admitted to the Affiliated Hospital of Putian University, China, between January 2021 and January 2022. Patients were divided into a neuroendoscopy group and a minimally invasive drilling group based on the surgical techniques. Furthermore, patients in the neuroendoscopy group were further stratified into mild, moderate, and severe subgroups based on their Glasgow Coma Scale (GCS) scores. Surgical outcomes, including hemorrhage volume, hematoma clearance rate, surgical duration, and postoperative hemorrhage volume, were compared between the two groups. Additionally, cerebral hemodynamic parameters, such as critical pressure (CP), mean blood flow quantity (Qmean), peripheral resistance (Rv), mean blood flow velocity (Vm), and pulsatility index (PI), were recorded before surgery and 7 days postoperatively. Functional recovery was assessed using the National Institutes of Health Stroke Scale (NIHSS), the Fugl-Meyer Assessment (FMA), and the Coma Recovery Scale-Revised (CRS-R).</p><p><strong>Results: </strong>Compared to the minimally invasive drilling group, the neuroendoscopy group exhibited greater intraoperative hemorrhage volume (p < 0.001), higher hematoma clearance rate at 24 hours post-surgery (p < 0.001), longer surgical duration (p < 0.001), and lower postoperative hemorrhage volume (p < 0.001). However, 7 days postsurgery, the neuroendoscopy group demonstrated significantly higher Qmean (p < 0.001) and Vm (p < 0.001) and lower CP (p < 0.001), Rv (p < 0.001), and PI (p < 0.001) compared to the minimally invasive drilling group. Within the neuroendoscopy group, patients in the severe subgroup had higher PI values 7 days after surgery than those in the mild and moderate subgroups. Assessment of functional recovery outcomes indicated that the neuroendoscopy group had greater improvements, with significantly lower NIHSS scores (p < 0.01) and higher FMA (p < 0.01) and CRS-R scores (p < 0.01) compared to the minimally invasive drilling group. Furthermore, mild and moderate subgroups showed greater reductions in NIHSS scores (p < 0.05) and increases in FMA (p < 0.05) and CRS-R scores (p < 0.05) than the severe subgroup.</p><p><strong>Conclusions: </strong>Neuroendoscopic treatment may effectively improve cerebral hemodynamics and promote functional recovery in patients with brain hemorrhage, with the impacts being more pronounced in patients with mild or moderate hemorrhage compared to those with severe conditions.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"371-379"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639392","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":"Small Bowel Volvulus Caused by Meckel's Diverticulum.","authors":"Roberto Cammarata, Vincenzo La Vaccara, Silvia Angeletti, Lucrezia Bani, Roberto Coppola, Damiano Caputo","doi":"10.62713/aic.3883","DOIUrl":"10.62713/aic.3883","url":null,"abstract":"<p><p>No abstract present.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"282-285"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639417","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":"Complex Post-Traumatic Reconstruction of the Lower Limb: A Case Report on Managing Soft Tissue Defects and Deltoid Ligament Damage Using an ALT Flap With Fascia Lata Extension and Fascia Lata Graft.","authors":"Federico Ziani, Corrado Rubino, Anna Manconi, Giovanni Arrica, Claudia Trignano, Ilaria Ginatempo, Matilde Tettamanzi, Emilio Trignano","doi":"10.62713/aic.3691","DOIUrl":"https://doi.org/10.62713/aic.3691","url":null,"abstract":"<p><strong>Aim: </strong>High-energy ankle traumas often lead to extensive soft tissue loss and ligament damage, making reconstruction both challenging and crucial for restoring stability and function. This study evaluated the effectiveness of using a free anterolateral thigh (ALT) flap with a fascia lata extension for addressing complex soft tissue defects and repairing the deltoid ligament in complex post-traumatic ankle injuries.</p><p><strong>Case presentation: </strong>A 38-year-old man was examined at the Plastic Surgery Unit three months after a motorcycle crash for reconstruction of a soft tissue defect and deltoid ligament repair. Clinical examination revealed a 3 × 5 cm soft tissue defect with bone exposure and ankle instability. Reconstruction was planned and performed using a free ALT flap with an extension of the fascia lata and a fascia lata graft for deltoid ligament repair. No complications of the flap and no clinical signs of local infection were observed. During the follow-up period of 12 months, the ankle stability and the gait were improved with a reduction in pain.</p><p><strong>Results: </strong>No complications related to the flap or clinical signs of infection were observed postoperatively. During the 12-month follow-up period, the patient exhibited improved ankle stability, reduced pain, and enhanced gait. At the one-year follow-up, the patient achieved a satisfactory functional outcome with an American Orthopedic Foot and Ankle Society (AOFAS) score of 79 points. The reconstructed tissue demonstrated adequate coverage, and the deltoid ligament repair provided joint stability. While flap bulkiness necessitated minor debulking surgery, the aesthetic and functional outcomes were satisfactory, with the patient expressing high satisfaction at 15 months post-surgery.</p><p><strong>Conclusions: </strong>The ALT flap combined with fascia lata graft is a viable option for soft tissue loss and deltoid ligament injury in clinical cases. While the ALT flap offers numerous advantages, including ease of harvest, pedicle length, and versatility, its bulkiness may necessitate revision surgery. However, despite this drawback, the combination of ALT flap and fascia lata demonstrated positive outcomes in our patient, highlighting its effectiveness in providing adequate tissue coverage and repairing the deltoid ligament.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"579-588"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075351","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":"Predictive Value of Bedside Ultrasound Evaluation of Venous Excess Ultrasound Grading System for Acute Kidney Injury in Children Undergoing Cardiac Surgery.","authors":"Weite Cao, Ruqian Wang, Ling Wang, Hong Luo","doi":"10.62713/aic.3966","DOIUrl":"https://doi.org/10.62713/aic.3966","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to investigate the predictive value of bedside ultrasound evaluation of venous excess ultrasound grading system (VExUS) for acute kidney injury (AKI) in children after cardiac surgery.</p><p><strong>Methods: </strong>This retrospective study included 122 pediatric patients who underwent cardiac surgery at the West China Second University Hospital of Sichuan University between January 2024 and November 2024. Based on the occurrence of AKI, patients were divided into the AKI (n = 42) and non-AKI (n = 80) groups. Univariate and binary logistics regression analyses were performed to identify factors influencing AKI. The predictive value of the VExUS grading system for AKI in children after pediatric cardiac surgery was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>There were no statistically significant differences (p > 0.05) between the two groups regarding age, gender, Body Mass Index (BMI), length of hospital stay, intraoperative blood loss, postoperative hypotension, 24-hour postoperative urine output, aortic cross-clamp time, preoperative left ventricular ejection fraction, postoperative inadequate circulating blood volume, and preoperative use of positive inotropic drugs, operation time, plasma input, congenital heart disease, radical operation, and emergency surgery. However, statistically significant differences were found in postoperative blood glucose levels, VExUS scores, cardiopulmonary bypass duration, and cyanosis (p < 0.05). Binary logistics regression analysis revealed that blood glucose levels, VExUS, and cyanosis were significant factors influencing AKI after pediatric cardiac surgery (p < 0.05). ROC analysis showed that the area under the curve (AUC) of 0.803 for VExUS, with a standard error of 0.043 (95% confidence interval (CI): 0.719-0.887), a Youden index of 0.48, sensitivity of 76.25%, and specificity of 71.43%.</p><p><strong>Conclusions: </strong>The VExUS grading system demonstrates significant clinical utility in predicting AKI in children undergoing cardiac surgery.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"673-680"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075580","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}