BMC Surgery最新文献

英文中文

Hidden blood loss in robot-assisted vs. conventional midline lumbar interbody fusion: a single-center propensity-score-matched cohort study. 机器人辅助与传统中线腰椎椎体间融合的隐性失血：一项单中心倾向评分匹配队列研究。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-11 DOI: 10.1186/s12893-026-03564-1

Junjie Qiao, Xinyao Lv, Yuyu Fan, Ruizhao Zhao, Xiutong Fang

引用次数: 0

Life-threatening spinal cord injury and occult intercostal artery rupture following low-energy trauma in a patient with ankylosing spondylitis: a case report. 强直性脊柱炎患者低能损伤后危及生命的脊髓损伤和隐匿肋间动脉破裂：1例报告。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-11 DOI: 10.1186/s12893-026-03594-9

Zhongshan Kang, Bin Luo, Xujia Zhou, Xianyi Yang

Background: Ankylosing spondylitis (AS) significantly increases vulnerability to severe spinal injuries from minor trauma due to rigid "bamboo spine" morphology and secondary osteoporosis. Isolated intercostal artery rupture without rib fractures is extremely rare in general trauma populations. The concurrent occurrence of multilevel spinal fractures with complete spinal cord injury and occult intercostal artery hemorrhage following low-energy blunt trauma in AS patients has rarely been documented, and the underlying pathophysiological mechanisms remain unclear.Case presentation: A 43-year-old male with previously undiagnosed AS sustained a low-velocity bicycle collision, resulting in cervical and thoracic fracture-dislocation (C6-C7 and T11 bilateral laminae fractures) with complete spinal cord injury (ASIA Grade A, complete paraplegia), massive hemothorax, and active intercostal artery bleeding without significant rib fractures. Due to the patient's hemodynamic instability and altered consciousness on admission (hemorrhagic shock with SBP 63/40 mmHg), formal assessment of the bulbocavernosus reflex was not performed initially. The ASIA Grade A classification was based on complete absence of motor function (lower limbs 0/5) and sensory function below the T3 level, including absence of sacral sparing. Computed tomography angiography revealed active contrast extravasation from the right T10-level intercostal artery. Emergency transcatheter arterial angiography and embolization using coils and gelatin sponge particles successfully controlled the hemorrhage and stabilized the patient's hemodynamics. Following stabilization, staged posterior cervical (C5-C7) and thoracolumbar (T9-T12, L3-S1) pedicle screw-rod internal fixation with anterior cervical discectomy and fusion were performed. Despite postoperative complications including hospital-acquired pneumonia, pulmonary fungal infection (Candida albicans isolated from bronchoalveolar lavage, treated with intravenous fluconazole), and deep vein thrombosis, the patient demonstrated partial neurological recovery, with ASIA grade improving from Grade A (complete paraplegia) on admission to Grade C (incomplete paraplegia) at discharge on day 59. Serial neurological examinations documented the evolution from complete to incomplete injury (Table 1). The patient was subsequently transferred to a specialized rehabilitation center for long-term functional training.Conclusions: This case illustrates the heightened and often unrecognized risk of complex, multisystem injuries in AS patients following seemingly minor trauma. Early recognition of hemothorax without rib fractures should raise high suspicion for intercostal artery injury, necessitating a lowered diagnostic threshold for computed tomography angiography. Transcatheter arterial embolization should be considered the first-line treatment for confirmed intercostal artery bleeding rather th

背景：强直性脊柱炎（AS）由于刚性的“竹棘”形态和继发性骨质疏松症而显著增加轻微创伤对严重脊柱损伤的易感性。孤立性肋间动脉破裂而无肋骨骨折在一般外伤人群中极为罕见。AS患者低能钝性创伤后并发多节段脊柱骨折并完全性脊髓损伤和隐匿性肋间动脉出血的情况很少有文献记载，其潜在的病理生理机制尚不清楚。病例介绍：43岁男性，既往未确诊AS，持续低速自行车碰撞，导致颈椎和胸椎骨折脱位（C6-C7和T11双侧椎板骨折），完全性脊髓损伤（ASIA A级，完全性截瘫），大量血胸，活动性肋间动脉出血，无明显肋骨骨折。由于患者入院时血流动力学不稳定和意识改变（出血性休克，收缩压63/40 mmHg），最初未对球海绵体反射进行正式评估。ASIA分级为A级，基于运动功能完全缺失（下肢0/5）和感觉功能低于T3级，包括骶骨保留缺失。计算机断层血管造影显示右侧t10水平肋间动脉造影剂活跃外渗。急诊经导管动脉造影和栓塞使用线圈和明胶海绵颗粒成功地控制出血和稳定患者的血流动力学。稳定后，分阶段进行颈椎后路（C5-C7）和胸腰椎（T9-T12, L3-S1）椎弓根螺钉-棒内固定并行颈椎前路椎间盘切除术和融合术。尽管术后并发症包括医院获得性肺炎、肺部真菌感染（从支气管肺泡灌洗液中分离出白色念珠菌，经静脉氟康唑治疗）和深静脉血栓形成，但患者表现出部分神经功能恢复，入院时的ASIA等级从A级（完全截瘫）改善到出院时的C级（不完全截瘫）第59天。一系列神经学检查记录了从完全损伤到不完全损伤的演变（表1）。患者随后被转移到专门的康复中心进行长期功能训练。结论：该病例说明了AS患者在看似轻微的创伤后发生复杂、多系统损伤的风险增加，但往往未被认识到。早期发现无肋骨骨折的血胸应提高对肋间动脉损伤的高度怀疑，需要降低计算机断层血管造影的诊断门槛。经导管动脉栓塞治疗应被视为确诊的肋间动脉出血的一线治疗，而不是最后的手段。及时诊断，个性化的多学科管理，以及早期转诊到具有介入和脊柱外科能力的专业中心，对于优化这些高危患者的预后至关重要。

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引用次数: 0

Different surgical approaches for recurrent lumbar disc herniation after percutaneous endoscopic transforaminal discectomy: analysis of clinical and imaging outcomes. 不同手术入路治疗经皮内窥镜经椎间孔椎间盘切除术后复发性腰椎间盘突出症：临床和影像学结果分析。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-11 DOI: 10.1186/s12893-026-03571-2

Jingbo Ma, Tusheng Li, Qiang Jiang, Jiaheng Han, Yu Ding

Objective: We compared the clinical efficacy of different surgical approaches for recurrent lumbar disc herniation (RLDH) after percutaneous endoscopic transforaminal discectomy (PETD).

Methods: Eighty-seven patients with RLDH were included between June 2013 and June 2022, of whom 38 underwent percutaneous endoscopic interlaminar discectomy (PEID) and 49 underwent PETD again. We compared perioperative variables as well as clinical and imaging outcomes. Clinical evaluations consisted of visual analog scale for back pain (VAS-B) and leg pain (VAS-L), Japanese Orthopedic Association score (JOA), and Oswestry disability index (ODI). Imaging measurements consisted of disc height index (DHI), range of motion (ROM), and sagittal translation (ST).

Results: Compared to the PETD group, the PEID group presented shorter operative time and fewer fluoroscopy times (P < 0.05); nevertheless, intraoperative blood loss, hospital stay, incision length, and the complication rate showed no significant between-group difference (P > 0.05). Both groups showed significant clinical improvement postoperatively (P < 0.05). At 7 days after surgery, VAS-B, VAS-L, JOA, and ODI showed greater improvement in the PEID group compared with the PETD group (P < 0.05). There were no significant between-group differences in imaging data (P > 0.05). Postoperative ROM and ST remained below instability thresholds, and no lumbar instability was observed.

Conclusion: For patients with RLDH after PETD, both PEID and PETD achieve satisfactory clinical efficacy. PEID provides advantages over PETD by reducing operative time and fluoroscopy, and is effective in avoiding scar tissue formation from initial surgery. These findings suggest that PEID may be preferable in selected recurrent cases, particularly where scar tissue or anatomical barriers compromise transforaminal access.

目的：比较不同手术入路治疗经皮内镜下经椎间孔椎间盘切除术（PETD）后复发性腰椎间盘突出症的临床疗效。方法：2013年6月至2022年6月共纳入87例RLDH患者，其中38例行经皮内窥镜椎间盘切除术（PEID）， 49例再次行PETD。我们比较了围手术期变量以及临床和影像学结果。临床评估包括背部疼痛视觉模拟量表（VAS-B）和腿部疼痛视觉模拟量表（VAS-L）、日本骨科协会评分（JOA）和Oswestry残疾指数（ODI）。成像测量包括椎间盘高度指数（DHI）、活动范围（ROM）和矢状面平移（ST）。结果：与PETD组相比，PEID组手术时间短，透视次数少（P < 0.05）。两组术后临床表现均有显著改善（P < 0.05）。术后ROM和ST均低于不稳定阈值，未观察到腰椎不稳定。结论：对于经PETD治疗的RLDH患者，PEID和PETD均获得满意的临床疗效。与PETD相比，PEID的优点是减少了手术时间和透视检查，并且有效地避免了初始手术后疤痕组织的形成。这些发现表明PEID可能更适合于选择复发病例，特别是疤痕组织或解剖障碍妨碍经椎间孔通路的病例。

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引用次数: 0

Effects of combined Triflow, deep breathing and coughing exercises on postoperative pulmonary function after mitral valve replacement: a randomized controlled trial. Triflow联合深呼吸和咳嗽练习对二尖瓣置换术后肺功能的影响：一项随机对照试验。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-026-03542-7

Naile Akıncı, Esra Eren

Background: Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement.

Methods: This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone.

Results: Postoperative SpO₂ levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV₁/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group.

Conclusion: The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.

Trial registration: ClinicalTrials.gov Identifier NCT06997224 (First registered on 15 May 2025).

背景：术后肺部并发症仍然是心脏瓣膜手术后发病的主要原因。尽管激励性肺活量测定法（Triflow）在术后护理中被常规使用，但关于将Triflow与深呼吸和咳嗽练习相结合的额外益处的证据仍然有限。本研究旨在评估Triflow联合深呼吸和咳嗽练习对二尖瓣置换术后成人患者肺功能的影响。方法：这项随机对照、单盲试验于2025年5月至8月在伊斯坦布尔一家私立医院进行。采用简单随机法将60例接受二尖瓣置换术的成人患者随机分为实验组（n = 30）和对照组（n = 30）。实验组采用Triflow联合深呼吸和咳嗽练习，对照组单独使用Triflow。结果：实验组术后SpO₂水平在T1 （p = 0.009; 95% CI: 0.46-3.14）和T2 (p)时均显著升高。结论：与单用Triflow相比，联合应用Triflow、深呼吸和咳嗽运动可显著改善二尖瓣置换术患者术后肺功能、氧饱和度、疼痛减轻和早期活动。这些发现表明，一个结构化的、联合的呼吸运动方案可能在术后早期提供额外的临床益处。试验注册：ClinicalTrials.gov标识符NCT06997224（首次注册于2025年5月15日）。

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引用次数: 0

Comparison of novel double-needle puncture technique to the conventional TESSYS technique in percutaneous endoscopic lumbar discectomy: enhanced efficiency and reduced radiation exposure. 新型双针穿刺技术与传统TESSYS技术在经皮内窥镜腰椎间盘切除术中的比较：提高效率和减少辐射暴露。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-026-03584-x

Liu Bo, Li Zhicheng, Zhang Zhihai, Zhi Zhonggui

引用次数: 0

Clinical and biomechanical outcomes of single-position anterior fixation in anterior lumbar interbody fusion. 腰椎前路椎间融合术单位前固定的临床和生物力学结果。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-026-03566-z

Mingquan Liu, Dapeng Feng, Xiaobing Yan, Mingdong Zhang, Zhengwei Li

Background: Anterior lumbar interbody fusion (ALIF) is an effective treatment for lumbar degenerative diseases, but it usually requires combined posterior fixation. Currently, Currently, there is no high-strength fixation technique for single-position anterior approach. This study aimed to introduce L5 vertebral body screws combined with S1 vertebral body-pedicle screw fixation (BPSF) as a novel single-position anterior fixation technique for ALIF, and to evaluate its clinical and biomechanical outcomes.

Methods: Sixty-three patients with L5/S1 degenerative disease undergoing ALIF were divided into BPSF (n = 22) and posterior pedicle screw fixation (PPSF, n = 41) groups. Clinical outcomes, radiographic parameters, and complications were collected and compared between groups. Biomechanically, an adult lumbar spine model was used to simulate two ALIF fixation configurations under normal and osteoporotic conditions. Each construct was loaded with 500N compression and 10N·m torque to simulate flexion/extension, lateral bending, and axial rotation. Kinematic analyses included ROM, interbody cage stress, and fixation device strain.

Results: The BPSF group showed significantly shorter operative duration (152.5 min (127.5, 173.1) vs. 165.0 min (140.0, 262.5), less intraoperative blood loss (115.0 ± 56.9 ml vs. 160.0 ml (110.0, 222.5) mL), and lower postoperative low back pain scores (1.6 ± 0.8 vs. 2.2 ± 0.7) compared to the PPSF group. And there were no statistically significant differences between the two groups in JOA improvement rate (49.9 ± 14.2% vs. 54.7 ± 18.1%), lumbar lordosis correction (6.9 ± 7.3° vs. 7.6 ± 7.1°), fusion rate (90.9% vs. 92.7%), or complication rate (27.3% vs. 19.5%). Biomechanically, BPSF reduced ROM during flexion (12% reduction) and axial rotation (63% reduction) compared to PPSF, with higher interbody cage stress but lower posterior fixation device stress under most loading conditions.

Conclusion: BPSF provides safe anterior fixation for ALIF, reducing operative time and early postoperative pain. Its biomechanical stability, especially in rotational resistance, supports it as an alternative to PPSF for L5/S1 fusion.

背景：腰椎前路椎体间融合术（ALIF）是治疗腰椎退行性疾病的有效方法，但通常需要联合后路固定。目前，尚无用于单体位前路入路的高强度固定技术。本研究旨在介绍L5椎体螺钉联合S1椎体椎弓根螺钉固定（BPSF）作为ALIF单位前路固定新技术，并评价其临床和生物力学效果。方法：63例L5/S1退行性疾病行ALIF的患者分为BPSF组（22例）和后路椎弓根螺钉固定组（41例）。收集两组临床结果、影像学参数和并发症并进行比较。生物力学方面，采用成人腰椎模型模拟正常和骨质疏松情况下的两种ALIF固定配置。每个构建体加载500N压缩和10N·m扭矩，模拟屈伸、侧向弯曲和轴向旋转。运动学分析包括ROM、椎间笼应力和固定装置应变。结果：与PPSF组相比，BPSF组手术时间明显缩短(152.5 min (127.5, 173.1) vs. 165.0 min(140.0, 262.5)，术中出血量明显减少（115.0±56.9 ml vs. 160.0 ml (110.0, 222.5) ml），术后腰痛评分明显降低（1.6±0.8 vs. 2.2±0.7）。两组患者JOA改良率（49.9±14.2%比54.7±18.1%）、腰椎前凸矫正率（6.9±7.3°比7.6±7.1°）、融合率（90.9%比92.7%）、并发症发生率（27.3%比19.5%）差异无统计学意义。生物力学方面，与PPSF相比，BPSF在屈曲（减少12%）和轴向旋转（减少63%）时减少了ROM，在大多数负载条件下，BPSF具有较高的体间笼应力但较低的后路固定装置应力。结论：BPSF为ALIF提供了安全的前路固定，减少了手术时间和术后早期疼痛。它的生物力学稳定性，特别是在旋转阻力方面，支持它作为L5/S1融合的替代方案。

{"title":"Clinical and biomechanical outcomes of single-position anterior fixation in anterior lumbar interbody fusion.","authors":"Mingquan Liu, Dapeng Feng, Xiaobing Yan, Mingdong Zhang, Zhengwei Li","doi":"10.1186/s12893-026-03566-z","DOIUrl":"https://doi.org/10.1186/s12893-026-03566-z","url":null,"abstract":"Background: Anterior lumbar interbody fusion (ALIF) is an effective treatment for lumbar degenerative diseases, but it usually requires combined posterior fixation. Currently, Currently, there is no high-strength fixation technique for single-position anterior approach. This study aimed to introduce L5 vertebral body screws combined with S1 vertebral body-pedicle screw fixation (BPSF) as a novel single-position anterior fixation technique for ALIF, and to evaluate its clinical and biomechanical outcomes.Methods: Sixty-three patients with L5/S1 degenerative disease undergoing ALIF were divided into BPSF (n = 22) and posterior pedicle screw fixation (PPSF, n = 41) groups. Clinical outcomes, radiographic parameters, and complications were collected and compared between groups. Biomechanically, an adult lumbar spine model was used to simulate two ALIF fixation configurations under normal and osteoporotic conditions. Each construct was loaded with 500N compression and 10N·m torque to simulate flexion/extension, lateral bending, and axial rotation. Kinematic analyses included ROM, interbody cage stress, and fixation device strain.Results: The BPSF group showed significantly shorter operative duration (152.5 min (127.5, 173.1) vs. 165.0 min (140.0, 262.5), less intraoperative blood loss (115.0 ± 56.9 ml vs. 160.0 ml (110.0, 222.5) mL), and lower postoperative low back pain scores (1.6 ± 0.8 vs. 2.2 ± 0.7) compared to the PPSF group. And there were no statistically significant differences between the two groups in JOA improvement rate (49.9 ± 14.2% vs. 54.7 ± 18.1%), lumbar lordosis correction (6.9 ± 7.3° vs. 7.6 ± 7.1°), fusion rate (90.9% vs. 92.7%), or complication rate (27.3% vs. 19.5%). Biomechanically, BPSF reduced ROM during flexion (12% reduction) and axial rotation (63% reduction) compared to PPSF, with higher interbody cage stress but lower posterior fixation device stress under most loading conditions.Conclusion: BPSF provides safe anterior fixation for ALIF, reducing operative time and early postoperative pain. Its biomechanical stability, especially in rotational resistance, supports it as an alternative to PPSF for L5/S1 fusion.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151098","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}

引用次数: 0

Analysis of biliary pathogens and clinical characteristics in patients with biliary tract infections based on a history of biliary-enteric bypass: a single-center retrospective study. 基于胆道-肠旁路术的胆道感染患者的胆道病原体及临床特征分析：一项单中心回顾性研究

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-026-03582-z

Dongxue Geng, Jingjing Tao, Wenjie Gao, Yi Miao

引用次数: 0

Laparoscopic approach to proximal gastric cancer using wristed ArtiSential™ instruments: a comparative study of 145 laparoscopic gastrectomies. 腹腔镜下应用腕式器械治疗胃癌近端：145例腹腔镜胃切除术的比较研究。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-026-03575-y

Tomaz Jagric

Background: We compared the short- and long-term results of ArtiSential™-operated patients with a historic group of laparoscopic-operated patients.

Methods: A total of 145 patients were included (37 patients in the ArtiSential group and 108 patients in the Laparoscopic group).

Results: There were significantly more conversions in the Laparoscopic group compared to ArtiSential™ group (15.7% vs. 2.7%; p = 0.043). The procedure duration was significantly shorter in the ArtiSential™ group (240 ± 49 min vs. 277 ± 58 min; p = 0.001). There were no significant differences in postoperative morbidity and mortality between groups (19.4% in the Lap group vs. 10.8% in the ArtiSential™ group). Multivariate analysis identified intraoperative blood loss (Beta 0.335; 95%CI: 21.774-58.616; p < 0.0001), tumor location (Beta - 0.518; 95%CI: -49 - -25.939; p < 0.0001) and the reconstruction with wristed instruments (Beta - 0.312; 95%CI: -52.261- -16.613; p < 0.0001) as significant predictors for duration of the surgery, while wristed instruments (Beta 0.247; 95%CI: 3.296-13.599; p = 0.001) and the UICC stage (Beta 0.375; 95%CI: 3.205-7.517; p < 0.0001) were significant predictors for the number of extracted lymph nodes. Perioperative chemotherapy (OR 3.521; 95%CI: 1.572-7.883; p = 0.002) and the use of wristed instruments (OR 4.018; 95%CI: 1.441-11.205; p = 0.008) were significant predictors for a complete number 10 lymph node station dissection.

Conclusion: Our findings suggest that ArtiSential™ wristed instruments offer key benefits in the challenging proximal anastomosis, allowing safe operations on patients with proximal tumors without increasing morbidity or mortality risk.

背景：我们比较了ArtiSential™手术患者与历史上一组腹腔镜手术患者的短期和长期结果。方法：共纳入145例患者，其中手工组37例，腹腔镜组108例。结果：腹腔镜组的转换率明显高于ArtiSential组（15.7% vs. 2.7%; p = 0.043）。artiential™组的手术时间明显更短（240±49分钟vs 277±58分钟，p = 0.001）。两组术后发病率和死亡率无显著差异（Lap组19.4% vs. ArtiSential™组10.8%）。多因素分析发现术中出血（Beta 0.335; 95%CI: 21.774-58.616; p）结论：我们的研究结果表明，ArtiSential™腕式器械在具有挑战性的近端吻合中提供了关键优势，允许近端肿瘤患者安全手术，而不会增加发病率或死亡率风险。

{"title":"Laparoscopic approach to proximal gastric cancer using wristed ArtiSential™ instruments: a comparative study of 145 laparoscopic gastrectomies.","authors":"Tomaz Jagric","doi":"10.1186/s12893-026-03575-y","DOIUrl":"https://doi.org/10.1186/s12893-026-03575-y","url":null,"abstract":"Background: We compared the short- and long-term results of ArtiSential™-operated patients with a historic group of laparoscopic-operated patients.Methods: A total of 145 patients were included (37 patients in the ArtiSential group and 108 patients in the Laparoscopic group).Results: There were significantly more conversions in the Laparoscopic group compared to ArtiSential™ group (15.7% vs. 2.7%; p = 0.043). The procedure duration was significantly shorter in the ArtiSential™ group (240 ± 49 min vs. 277 ± 58 min; p = 0.001). There were no significant differences in postoperative morbidity and mortality between groups (19.4% in the Lap group vs. 10.8% in the ArtiSential™ group). Multivariate analysis identified intraoperative blood loss (Beta 0.335; 95%CI: 21.774-58.616; p < 0.0001), tumor location (Beta - 0.518; 95%CI: -49 - -25.939; p < 0.0001) and the reconstruction with wristed instruments (Beta - 0.312; 95%CI: -52.261- -16.613; p < 0.0001) as significant predictors for duration of the surgery, while wristed instruments (Beta 0.247; 95%CI: 3.296-13.599; p = 0.001) and the UICC stage (Beta 0.375; 95%CI: 3.205-7.517; p < 0.0001) were significant predictors for the number of extracted lymph nodes. Perioperative chemotherapy (OR 3.521; 95%CI: 1.572-7.883; p = 0.002) and the use of wristed instruments (OR 4.018; 95%CI: 1.441-11.205; p = 0.008) were significant predictors for a complete number 10 lymph node station dissection.Conclusion: Our findings suggest that ArtiSential™ wristed instruments offer key benefits in the challenging proximal anastomosis, allowing safe operations on patients with proximal tumors without increasing morbidity or mortality risk.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158988","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}

引用次数: 0

Analysis of risk factors for postoperative lower extremity deep vein thrombosis in liver transplant patients. 肝移植术后下肢深静脉血栓形成的危险因素分析。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-10 DOI: 10.1186/s12893-025-03378-7

Xiaoqing Zhang, Ruisi Ma, Jinghui Yan, Jiaxing Zhu, Jie Wei, Yanmin Shi, Yingying Wang

引用次数: 0

Analysis of risk factors for recurrence in septated chronic subdural hematoma. 分离性慢性硬膜下血肿复发危险因素分析。

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery

Pub Date : 2026-02-09 DOI: 10.1186/s12893-026-03576-x

Xiaoliang Wang, Hongru Feng, Botao Ma, Si Qi, Hailong Du, Chao Zhang, Lei Zhao, Xiaosong Liu, Xiaomeng Liu, Gengshen Zhang, Jianliang Wu, Yaqing An, Yang Wu

引用次数: 0

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