Journal of Surgical Research最新文献

{"title":"Comparison Between Billroth II and Billroth II + Braun Anastomosis in Gastrectomy for Gastric Cancer","authors":"Yu Wang MM, Yuan Xu MM, Fu-Ji Meng MM, Xian-Lei Cai MD, Wei-Ming Yu MD, Miao-Zun Zhang MD","doi":"10.1016/j.jss.2024.09.044","DOIUrl":"10.1016/j.jss.2024.09.044","url":null,"abstract":"<div><h3>Introduction</h3><div>Distal gastrectomy remains the predominant therapeutic approach for gastric cancer, with digestive tract reconstruction as an integral procedure. The implementation of Braun anastomosis following Billroth II anastomosis is common in distal gastrectomy. This retrospective cohort study evaluated the clinical utility of Braun anastomosis by comparing the outcomes and quality of life between Billroth II (B-II) and Billroth II with Braun (B-IIB) anastomosis in the treatment of gastric cancer.</div></div><div><h3>Methods</h3><div>A retrospective cohort study examined clinical and pathological data from 377 patients who underwent distal gastrectomy for gastric cancer treatment at The Affiliated Lihuili Hospital, Ningbo University, from October 2016 to October 2021.185 patients received B-II anastomosis, while the other 192 received B-IIB anastomosis, forming the B-II and B-IIB groups, respectively. Baseline characteristics, perioperative variables, short-term and long-term complications, and nutritional indicators at 1 mo and 1 y postsurgery were compared across both groups. Additionally, gastric endoscopy results at 6 mo and 1 y postsurgery were evaluated. Quality of life at 1 y postsurgery was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30.</div></div><div><h3>Results</h3><div>Baseline characteristics between the two groups revealed no statistically significant differences (all <em>P ></em> 0.05), confirming their equivalence. All 377 patients successfully underwent curative distal gastrectomy for gastric cancer without intraoperative procedural modifications. No intraoperative complications or perioperative mortality occurred. Notable differences included extended operative time (222.1 ± 41.0 vs. 199.4 ± 24.9 min, <em>P</em> < 0.001), reduced postoperative nasogastric tube removal time (1.8 ± 0.9 vs. 2.2 ± 1.1 d, <em>P</em> < 0.001), decreased average gastric drainage volume (100.7 ± 35.2 vs. 112.2 ± 32.0 mL, <em>P</em> = 0.001), and increased incidence of internal hernia and ileus (4.7% vs. 1.1% and 8.3% vs. 3.2%, <em>P</em> = 0.038 and <em>P</em> = 0.035) in the B-IIB group compared to the B-II group. No significant differences were observed in estimated blood loss, lymph node dissection, postoperative flatus time, transition to a semiliquid diet, length of hospital stay, or short-term and long-term complications (all <em>P</em> > 0.05). Nutritional assessments conducted 1 mo and 1 y postsurgery indicated no statistically significant differences in body mass index, total protein, and serum albumin levels between the two groups (all <em>P</em> > 0.05). Gastric endoscopy evaluations at 6 mo and 1 y postsurgery, including food residue grade, gastritis severity, extent of gastritis, and bile reflux, demonstrated no significant discrepancies between the groups (all <em>P</em> > 0.05). At the 1-y follow-up, neither group exhibited tumor r","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 670-678"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing Trends of Traumatic Brain Injury Despite a Surge in Anticoagulant Use in the Elderly","authors":"Aryan Rafieezadeh MD,&nbsp;Bardiya Zangbar MD,&nbsp;Gabriel Rodriguez PhD,&nbsp;Jordan Kirsch DO,&nbsp;David Samson MS,&nbsp;Ilya Shnaydman MD,&nbsp;Anna Jose MD,&nbsp;Kartik Prabhakaran MD","doi":"10.1016/j.jss.2024.09.078","DOIUrl":"10.1016/j.jss.2024.09.078","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, with the introduction of new anticoagulants there has been a rise in their usage among elderly population who are at risk for traumatic brain injury (TBI) at the same time. We assessed the change in use of anticoagulant in elderly trauma patients and its association with TBI outcomes.</div></div><div><h3>Material and Methods</h3><div>We performed a 5-y retrospective analysis of Trauma Quality Improvement Program (2017-2021) of trauma patients ≥65 y. Patient who had TBI were identified. We queried the preexisting comorbid conditions for anticoagulant use. The primary outcome was mortality, and the secondary outcome was TBI admissions during study period. We conducted a linear regression analysis to assess for trends in data. We also utilized a propensity score matching in 1:1 ratio to compare patients on prehospital anticoagulant versus nonreceivers.</div></div><div><h3>Results</h3><div>A total of 1,688,157 patients were included. The trend of TBI admission over the study period has been decreasing significantly (<em>P</em> &lt; 0.001). Prehospital anticoagulant use has been increasing over the study period with the slope of 0.078 (<em>P</em> = 0.043). After propensity score matching, patients with TBI who used anticoagulants before hospitalization had a higher mortality rate compared to nonreceivers (9.1% <em>versus</em> 6.8%, <em>P</em> &lt; 0.001). The mortality rate in patients with anticoagulant use decreased from 2017 to 2019 and increased from 2019 to 2021. However this change was not significant in a linear fashion.</div></div><div><h3>Conclusions</h3><div>Despite increasing trends of anticoagulant usage, which is associated with a higher mortality risk after TBI in elderly, the rate of TBI admissions has been decreasing over the years. Meanwhile, the trend of mortality in patients with anticoagulant use appears to remain unchanged.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 663-669"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Therapeutic Hypothermia Depths in Acute Type A Aortic Dissection Repair","authors":"Andrei M. Belyaev PhD ,&nbsp;Sergey Y. Boldyrev PhD ,&nbsp;Pavel A. Myalyuk PhD ,&nbsp;Kirill O. Barbukhatty MD ,&nbsp;Alexey A. Petrishchev MD ,&nbsp;Vladimir A. Porkhanov MD ,&nbsp;Oksana S. Bezdenezhnykh MD ,&nbsp;Andrei V. Marchenko MD ,&nbsp;Nikolay A. Trofimov PhD ,&nbsp;Vadim E. Babokin PhD ,&nbsp;Daria V. Smirnova MD","doi":"10.1016/j.jss.2024.09.023","DOIUrl":"10.1016/j.jss.2024.09.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Existing evidence regarding the impact of hypothermic circulatory arrest (HCA) depth in acute type A aortic dissection (ATAAD) repair lacks robustness concerning blood loss and mortality. We aimed to assess whether using mild and moderate HCA (MMHCA) <em>versus</em> deep and profound HCA (DPHCA) in ATAAD repair is associated with reduced bleeding risk, lower in-hospital mortality, and improved long-term survival.</div></div><div><h3>Methods</h3><div>This retrospective cohort study spanned from 2003 to 2023. ATAAD repair patients were identified from hospital records, with exclusion criteria applied to those who died before surgery, those with symptoms lasting longer than 14 d, and those who operated on without HCA. Patients in the DPHCA group underwent surgery with HCA (<em>T</em> ≤ 20°C), while those in the MMHCA group had temperatures ranging from 34°C to 20.1°C.</div></div><div><h3>Results</h3><div>Out of 549 eligible ATAAD patients, the MMHCA group exhibited a reduced rate of chest re-exploration for bleeding (39% <em>versus</em> 14%, <em>P</em> &lt; 0.005), decreased blood loss after surgery (1637 mL <em>versus</em> 1045 mL, <em>P</em> &lt; 0.005), and lower volumes for red blood cell transfusions (1375 mL <em>versus</em> 903 mL, <em>P</em> &lt; 0.005) compared with the DPHCA group. Additionally, the MMHCA group had lower crude and age- and sex-adjusted in-hospital mortality rates, with a mortality rate ratio of 0.65 (<em>P</em> = 0.003). Cox regression analysis revealed a 25% reduction in long-term mortality for the MMHCA group compared with the DPHCA group (hazard ratio = 0.75; <em>P</em> = 0.045).</div></div><div><h3>Conclusions</h3><div>ATAAD repair using MMHCA and antegrade cerebral perfusion is associated with lower blood loss and improved immediate and long-term survival.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 636-644"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Pediatric Firearm Injuries: When and Where are Children at Risk?","authors":"Kylie Callier MD ,&nbsp;Michael J. Littau MD ,&nbsp;Justin M. Cirone MD ,&nbsp;Marion C. Henry MD, MPh ,&nbsp;David Hampton MD, Meng ,&nbsp;Ashley Wolf MD, MS","doi":"10.1016/j.jss.2024.09.031","DOIUrl":"10.1016/j.jss.2024.09.031","url":null,"abstract":"<div><h3>Objective</h3><div>In 2022, firearms injured or killed more than 6000 American children. Significant disparities exist in injury risk. We hypothesized that analyzing an injury's time, date, and location could help identify additional risk and protective factors in the pediatric population.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of the 2003-2020 National Violent Death Reporting System. The National Violent Death Reporting System currently collects data from all 50 states, the District of Columbia, and Puerto Rico. Demographic (age, sex, race/ethnicity) and incident (date, time, location) data were abstracted. Inclusion criteria were pediatric victims (age≤18) of fatal firearm injuries. Records with missing values were excluded. Chi-squared tests were used to test the association between victim demographics and time, date, or location. Significance was <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Nine thousand fifty-eight children (male: 83.5% [<em>n</em> = 7559]), age: 17 yrs old (interquartile range: 15-18 years old), Black: 64.1% [<em>n</em> = 5810]) were eligible. 6161 (68.1%) of children had not completed high school. 3308 (36.5%) fatal injuries occurred after school or at night (1601-2359 h). 3678 (40.6%) injuries occurred at home. Black children were significantly more likely to be injured during the summer months (June – August, <em>P</em> &lt; 0.01), after school or at night (<em>P</em> &lt; 0.001), and along a street (<em>P</em> &lt; 0.001). Hispanic children were more likely to be killed after school or at night (<em>P</em> &lt; 0.001) and along a street (<em>P</em> &lt; 0.001). There was no seasonal variation in this demographic. Compared to other times of the day, there was a significant increase in weekend (Friday-Sunday) morning (0000- 0800) injuries. (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Firearm violence disproportionately impacts Black children. There are significant associations with the time and season. Interventions during those times such as extended academic engagement or after school programs beyond the traditional school day and school year may afford opportunities which could mitigate exposure to firearm violence.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 645-651"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability and Quality Evaluation of Thyroidectomy Websites: A Systematic Review","authors":"Maria P. Cote MD ,&nbsp;Jorge L. Gomez-Mayorga MD ,&nbsp;Natalia Chaves MD, MPH ,&nbsp;Jordan M. Broekhuis MD, MPH ,&nbsp;Megan C. Mcnichol MLS, AHIP ,&nbsp;Q. Lina Hu MD, MS ,&nbsp;Benjamin C. James MD, MS","doi":"10.1016/j.jss.2024.09.052","DOIUrl":"10.1016/j.jss.2024.09.052","url":null,"abstract":"<div><h3>Introduction</h3><div>Online websites are a major source of educational material for patients undergoing thyroidectomy. We hypothesize that thyroidectomy websites have low quality and are written above the 6^th grade readability recommendation.</div></div><div><h3>Methods</h3><div>A systematic literature review of studies evaluating readability and/or quality of thyroidectomy-informing, English-written websites was performed in November 2023 in three major online databases (Embase, PubMed, and Web of Science).</div></div><div><h3>Results</h3><div>Ten out of 2017 initially screened studies met the inclusion criteria. All studies found websites’ readability above the recommended 6th grade level. Quality was heterogeneously defined and evaluated by seven of the included studies. Nonetheless, all studies deemed most thyroidectomy websites quality as poor to fair.</div></div><div><h3>Conclusions</h3><div>Websites addressing thyroidectomy do not meet the recommended readability level for patient educational material. The heterogeneity of scoring and reporting of quality limits comparability. This study highlights the necessity of revising and modifying existing websites to adequately aid patient decision-making.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 652-662"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Gastrostomy Techniques in Stroke Patients With Dysphagia: An Entropy-Balanced Analysis","authors":"Armaun D. Rouhi BA ,&nbsp;Sebastian Leon MD ,&nbsp;Jeffrey L. Roberson MD, MBA ,&nbsp;Lauren A. Shreve MD, MBA ,&nbsp;Gregory J. Nadolski MD ,&nbsp;Noel N. Williams MD ,&nbsp;Kristoffel R. Dumon MD","doi":"10.1016/j.jss.2024.09.064","DOIUrl":"10.1016/j.jss.2024.09.064","url":null,"abstract":"<div><h3>Introduction</h3><div>Enteral nutrition is commonly placed via percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) techniques. This study compared perioperative outcomes of PEG and RIG in adults with dysphagia caused by cerebral infarction.</div></div><div><h3>Methods</h3><div>Adult stroke patients who underwent either PEG or RIG between 2018 and 2020 at a tertiary care center were reviewed retrospectively. Differences in baseline characteristics between PEG and RIG patients were adjusted using entropy-balanced weights. Multivariable weighted logistic and linear regressions were subsequently developed to evaluate the independent association between RIG and outcomes of interest.</div></div><div><h3>Results</h3><div>217 stroke patients met inclusion criteria, of whom 37 (17.0%) received PEG and 180 (83.0%) received RIG. Compared to PEG, patients with RIG were more commonly Medicare beneficiaries and had a higher burden of comorbidities as measured by the Charlson comorbidity index. Time to achieve goal feeds was comparable between PEG and RIG (3 d [interquartile range 2-5] vs 4 d [interquartile range 3-5], respectively, <em>P</em> = 0.059). After multivariate adjustment, RIG was associated with significantly lower odds of reoperation (adjusted odds ratio [AOR] 0.10, 95% CI 0.02-0.50, <em>P</em> = 0.005), cerebrovascular accident (AOR 0.24, 95% CI 0.00-0.74, <em>P</em> = 0.030), and intensive care unit admission (AOR 0.14, 95% CI 0.03-0.70, <em>P</em> = 0.017). Risk factors for in-hospital mortality among RIG included arrhythmia (AOR 6.54, 95% CI 1.67-15.48, <em>P</em> = 0.009), myocardial infarction (AOR 4.78, 95% CI 2.25-10.23, <em>P</em> = 0.009), and obesity (AOR 4.48, 95% CI 1.03-9.61, <em>P</em> = 0.047).</div></div><div><h3>Conclusions</h3><div>While both techniques are effective methods of enteral feeding in stroke patients, RIG may confer lower perioperative morbidity. Local referral patterns and individual patient comorbidities could influence outcomes following PEG or RIG, necessitating careful patient selection.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 579-586"},"PeriodicalIF":1.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex Utero Intrapartum Treatment for Prenatally Diagnosed Cervicofacial Lymphatic Malformations","authors":"Srinithya R. Gillipelli BA ,&nbsp;Sarah E. Peiffer MD, MPH ,&nbsp;Shannon M. Larabee MD ,&nbsp;Pamela Ketwaroo MD ,&nbsp;Kristy L. Rialon MD ,&nbsp;Joshua Bedwell MD ,&nbsp;Deepak Mehta MD ,&nbsp;Timothy C. Lee MD ,&nbsp;Sundeep G. Keswani MD ,&nbsp;Alice King MD","doi":"10.1016/j.jss.2024.08.026","DOIUrl":"10.1016/j.jss.2024.08.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervicofacial lymphatic malformations (cf-LM) may be identified on prenatal ultrasound, prompting consideration of ex utero intrapartum treatment (EXIT) to secure the fetal airway. Furthermore, the recent shift in postnatal management of cf-LM from resection alone toward a multimodal approach including sirolimus and sclerotherapy may impact the neonatal outcomes of cf-LM. This study aims to characterize the neonatal outcomes of patients with prenatally diagnosed cf-LM who underwent EXIT-to-airway.</div></div><div><h3>Methods</h3><div>Retrospective, single-center review of all patients who underwent EXIT-to-airway for cf-LM (2011-2020) was performed. Demographics, prenatal imaging, intraoperative details, and outcomes were analyzed using descriptive statistics (median [interquartile range]).</div></div><div><h3>Results</h3><div>Six patients with prenatally diagnosed cf-LM underwent EXIT-to-airway at a median gestational age of 36 (33.8-36.9) wk. The median volume on fetal magnetic resonance imaging was 187.5 mL (142.3-237.8) and median tracheoesophageal displacement index was 11 mL (9.25-15). All were successfully intubated on placental support with a median duration of 25 (15.25-91) d. There was one fatality at day of life 10 due to necrotizing enterocolitis totalis. Among survivors, 2 of 5 underwent tracheostomy placement, 4 of 5 underwent gastrostomy tubes placement, and all 5 received sirolimus at day of life of 9 [8-10] d. Four patients underwent debulking or excision of their cf-LM during the initial hospitalization. Patients had a median length of stay of 68 (45-129) d. One patient experi enced a pneumothorax with evidence of barotrauma following EXIT-to-airway requiring chest tube placement (duration 8 d).</div></div><div><h3>Conclusions</h3><div>EXIT-to-airway procedure remains a feasible strategy for mitigating neonatal hypoxia in cases of prenatally diagnosed cervicofacial lymphatic malformations. However, postnatal outcomes are variable with potential long-term aerodigestive sequelae.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 628-635"},"PeriodicalIF":1.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Cotransporter-2 Inhibition Normalizes Metabolic Derangements in the Ischemic Myocardium","authors":"Christopher Stone MD,&nbsp;Dwight D. Harris MD,&nbsp;Mark Broadwin MD,&nbsp;Sharif A. Sabe MD,&nbsp;Krishna Bellam BS,&nbsp;Meghamsh Kanuparthy MD,&nbsp;M. Ruhul Abid MD, PhD,&nbsp;Frank W. Sellke MD","doi":"10.1016/j.jss.2024.09.065","DOIUrl":"10.1016/j.jss.2024.09.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown efficacy in the context of heart failure but have not been well-studied in ischemic heart disease. We employed a large animal model of chronic coronary artery disease and metabolic syndrome (MS) to investigate the hemodynamic and metabolic consequences of SGLT2i administration.</div></div><div><h3>Methods</h3><div>Thirty-eight Yorkshire swine were divided into two groups, with half (<em>n</em> = 21) receiving a high fat diet to induce MS, and the other half fed a standard diet (<em>n</em> = 17). All animals underwent thoracotomy for ameroid constrictor placement over the left circumflex coronary artery. Treatment with SGLT2i was then initiated, generating four groups: regular diet placebo (CON, <em>n</em> = 9), regular diet canagliflozin (<em>n</em> = 8), high-fat control (<em>n</em> = 11), and high-fat canagliflozin (<em>n</em> = 10). After 5 wks, all animals underwent terminal myocardial harvest with pressure-volume loop acquisition, perfusion studies, and tissue resection for molecular analysis.</div></div><div><h3>Results</h3><div>SGLT2i improved multiple measures of myocardial performance, including a nearly 1.5-fold increase in both cardiac output and ejection fraction; these changes were associated with augmented capillary density and a twofold increase perfusion to the ischemic myocardium. These augmentations were blunted; however, in the presence of MS, and associated with modulated myocardial expression of multiple major metabolic enzymes.</div></div><div><h3>Conclusions</h3><div>SGLT2i significantly improved cardiac function in our large animal model of coronary artery disease, with metabolic modulation of the myocardial tissue serving as a candidate account of these changes. The blunting seen with MS underscores the dependence of clinical translatability on faithful representation of the biochemical environment of human disease.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 600-612"},"PeriodicalIF":1.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ablative Treatments and Surgery for Early-Stage Hepatocellular Carcinoma: A Network Meta-Analysis","authors":"Yiyang Min MS ,&nbsp;Kuinan Tong MS ,&nbsp;Huajun Lin PhD ,&nbsp;Dong Wang PhD ,&nbsp;Wei Guo PhD ,&nbsp;Shun Li PhD ,&nbsp;Zhongtao Zhang PhD","doi":"10.1016/j.jss.2024.09.046","DOIUrl":"10.1016/j.jss.2024.09.046","url":null,"abstract":"<div><h3>Background</h3><div>We compared overall survival (OS) and disease-free survival (DFS) for hepatocellular carcinoma (HCC) following radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation, and liver resection (LR), with the aim of evaluating treatment plans for early-stage HCC.</div></div><div><h3>Methods</h3><div>Studies in PubMed, Web of Science, and Cochrane databases from April 1, 2004, to April 1, 2024, were searched. Articles were evaluated for quality using the randomized controlled trials tool. Two tool and the Newcastle–Ottawa Scale. Data obtained from the literature were netted using Stata 15.0 and <em>r</em> 4.2.3. The assessed primary outcomes were OS and DFS at 1 and 3 y.</div></div><div><h3>Results</h3><div>A total of 25 publications with 4548 patients were included, including 13 studies in mainland China and 12 in other regions. For 1-y DFS, the hazard ratio (HR) was 0.54 (95% credible interval (CrI): 0.38–0.76) for LR compared with RFA and 0.57 (95% CrI: 0.3–-0.82) for LR compared with MWA. For 3-y DFS, the HR was 0.52 (95% CrI: 0.38-0.72) for LR compared with RFA and 0.53 (95% CrI: 0.37–0.76). In the Chinese mainland, LR may have a better 1- and 3-y DFS than MWA, but similar survival to RFA. In the other regions, LR had a better DFS than MWA and RFA patients. The rest of the comparisons were not statistically significant.</div></div><div><h3>Conclusions</h3><div>For early-stage HCC, LR may be more effective in reducing tumor recurrence than ablative treatments. Cryoablation may be a potential treatment for HCC. The differences in treatment effectiveness in different regions are worth further study.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 587-599"},"PeriodicalIF":1.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal Fatty Acid–Binding Protein as a Marker of Necrotizing Enterocolitis Incidence and Severity: A Scoping Review","authors":"Lourenço Sbragia MD, PhD ,&nbsp;Igor José Nogueira Gualberto MD ,&nbsp;Jason Xia MD ,&nbsp;Rahul Gadde MD ,&nbsp;Angela Saulsbery MA ,&nbsp;Sophia Hameedi MD ,&nbsp;Ana Laura Ferreira Mársico Dalto MD, PhD ,&nbsp;Oluyinka O. Olutoye MD, PhD","doi":"10.1016/j.jss.2024.09.059","DOIUrl":"10.1016/j.jss.2024.09.059","url":null,"abstract":"<div><h3>Introduction</h3><div>Necrotizing enterocolitis (NEC) is a severe inflammatory disease of the gastrointestinal tract and one of the most common life-threatening emergencies affecting newborns. Intestinal fatty acid–binding protein (I-FABP) has been used as a possible marker of intestinal damage in NEC. We aimed to carry out a scoping review of all publications that explore the role of I-FABP in NEC to inspire new research into the potential utility of I-FABP as a marker of NEC.</div></div><div><h3>Methods</h3><div>We searched for relevant publications using the keywords “necrotizing enterocolitis,” “intestinal fatty acid binding protein,” “NEC,” and “I-FABP” in the National Library of Medicine (PubMed/MEDLINE), Embase, SCOPUS, and Web of Science. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used for reporting findings.</div></div><div><h3>Results</h3><div>We identified 61 relevant articles, which we divided into clinical (<em>n</em> = 47) and experimental (<em>n</em> = 14) groups.</div></div><div><h3>Conclusions</h3><div>I-FABP is a promising marker of NEC, especially for NEC stage 2 and 3. Urinary I-FABP follows the same patterns as serum and plasma I-FABP. The definitive roles of I-FABP in early diagnosis of NEC, differential diagnosis in breast feeding, alimentary intolerance, and screening of surgical NEC need clarification and remain a challenge to investigators.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"303 ","pages":"Pages 613-627"},"PeriodicalIF":1.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}