{"title":"Surgical Practice May 2025 CME for fellows","authors":"","doi":"10.1111/1744-1633.70018","DOIUrl":"https://doi.org/10.1111/1744-1633.70018","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 3","pages":"175-176"},"PeriodicalIF":0.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915229","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":"Surgical Practice August 2025 CME for Fellows","authors":"","doi":"10.1111/1744-1633.70023","DOIUrl":"https://doi.org/10.1111/1744-1633.70023","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 3","pages":"177-178"},"PeriodicalIF":0.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915230","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}
Chylous ascites is a rare but significant complication following extended pelvic lymph node dissection (ePLND) during radical prostatectomy. No universal treatment guideline currently exists. Herein, we present the case of a 74-year-old patient with prostate cancer who developed chylous ascites after radical prostatectomy with bilateral ePLND. Persistent ascites continued despite a medium-chain triglyceride diet, octreotide, and percutaneous drainage. Lymphoscintigraphy confirmed lymphatic leakage but failed to localise the source. Ultimately, intranodal lymphangiography with Lipiodol was performed, which identified and sealed the leakage site, sparing the patient from surgical intervention. Follow-up imaging showed only a small, resolving lymphocele, and the patient remained asymptomatic at 3 months. This case highlights the diagnostic and therapeutic value of intranodal lymphangiography with Lipiodol in managing post-operative chylous ascites.
{"title":"Post-prostatectomy chylous ascites treated by intranodal lymphangiography: A case report and review","authors":"Kin-Yuan Ko MBBS, Erica On-Ting Chan MBChB, Peggy Sau-Kwan Chu FRCSEd (Urol), Chi-Wai Man FRCSEd (Urol), Samson Yun-Sang Chan FRCSEd (Urol)","doi":"10.1111/1744-1633.70022","DOIUrl":"https://doi.org/10.1111/1744-1633.70022","url":null,"abstract":"<p>Chylous ascites is a rare but significant complication following extended pelvic lymph node dissection (ePLND) during radical prostatectomy. No universal treatment guideline currently exists. Herein, we present the case of a 74-year-old patient with prostate cancer who developed chylous ascites after radical prostatectomy with bilateral ePLND. Persistent ascites continued despite a medium-chain triglyceride diet, octreotide, and percutaneous drainage. Lymphoscintigraphy confirmed lymphatic leakage but failed to localise the source. Ultimately, intranodal lymphangiography with Lipiodol was performed, which identified and sealed the leakage site, sparing the patient from surgical intervention. Follow-up imaging showed only a small, resolving lymphocele, and the patient remained asymptomatic at 3 months. This case highlights the diagnostic and therapeutic value of intranodal lymphangiography with Lipiodol in managing post-operative chylous ascites.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"231-233"},"PeriodicalIF":0.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Steady minds, steady hands: Why surgeons must prioritise their own health to improve patient outcomes","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.70024","DOIUrl":"https://doi.org/10.1111/1744-1633.70024","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 3","pages":"126-127"},"PeriodicalIF":0.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914955","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}
Divyaam Satija BS, Asvin M. Ganapathi MD, Rachel E. Wolf BA, Victor Heh PhD, Scott Lilly MD, PhD, Konstantinos Dean Boudoulas MD, Nancy Matre MA, Bryan A. Whitson MD, PhD, John Bozinovski MD, Nahush A. Mokadam MD, Matthew C. Henn MD, MS
Background
Transcatheter aortic valve replacement (TAVR) has emerged as an acceptable and often preferred alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. However, the mid- and long-term efficacy of TAVR in patients with bicuspid aortic valves (BAVs) remains unclear. This study aims to compare the mid-term outcomes of patients with BAV undergoing either procedure.
Methods
We retrospectively reviewed all patients who underwent AVR at our institution between 2011 and 2022. Of 278 patients identified, 217 underwent SAVR and 61 underwent TAVR. Propensity score matching was used to create comparable groups. Outcomes were compared using Kaplan–Meier survival analyses and chi-square tests (α = 0.05). Sensitivity analyses using multiple calliper widths assessed the robustness of our findings.
Results
In both unmatched and propensity score-matched cohorts, Kaplan–Meier survival analysis demonstrated a significant survival advantage for SAVR over TAVR. TAVR patients experienced significantly higher rates of combined post-operative complications—including stroke/transient ischaemic attack, bleeding, and dialysis—and showed a trend towards increased pacemaker implantation. However, TAVR was associated with significantly shorter hospital stays. Notably, sensitivity analyses consistently favoured SAVR across all calliper widths. Similar findings were observed within the low-risk subgroup.
Conclusion
Despite longer hospital stays, SAVR was associated with improved mid-term survival and fewer complications compared with TAVR in patients with BAV. These differences were particularly pronounced in the low-risk cohort. Our findings support the continued consideration of SAVR for patients with BAV who are suitable surgical candidates and underscore the need for comprehensive, multicentre prospective studies.
{"title":"Transcatheter vs surgical aortic valve replacement for bicuspid aortic valve disease","authors":"Divyaam Satija BS, Asvin M. Ganapathi MD, Rachel E. Wolf BA, Victor Heh PhD, Scott Lilly MD, PhD, Konstantinos Dean Boudoulas MD, Nancy Matre MA, Bryan A. Whitson MD, PhD, John Bozinovski MD, Nahush A. Mokadam MD, Matthew C. Henn MD, MS","doi":"10.1111/1744-1633.70021","DOIUrl":"https://doi.org/10.1111/1744-1633.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) has emerged as an acceptable and often preferred alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. However, the mid- and long-term efficacy of TAVR in patients with bicuspid aortic valves (BAVs) remains unclear. This study aims to compare the mid-term outcomes of patients with BAV undergoing either procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed all patients who underwent AVR at our institution between 2011 and 2022. Of 278 patients identified, 217 underwent SAVR and 61 underwent TAVR. Propensity score matching was used to create comparable groups. Outcomes were compared using Kaplan–Meier survival analyses and chi-square tests (α = 0.05). Sensitivity analyses using multiple calliper widths assessed the robustness of our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both unmatched and propensity score-matched cohorts, Kaplan–Meier survival analysis demonstrated a significant survival advantage for SAVR over TAVR. TAVR patients experienced significantly higher rates of combined post-operative complications—including stroke/transient ischaemic attack, bleeding, and dialysis—and showed a trend towards increased pacemaker implantation. However, TAVR was associated with significantly shorter hospital stays. Notably, sensitivity analyses consistently favoured SAVR across all calliper widths. Similar findings were observed within the low-risk subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite longer hospital stays, SAVR was associated with improved mid-term survival and fewer complications compared with TAVR in patients with BAV. These differences were particularly pronounced in the low-risk cohort. Our findings support the continued consideration of SAVR for patients with BAV who are suitable surgical candidates and underscore the need for comprehensive, multicentre prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"221-228"},"PeriodicalIF":0.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinically relevant post-operative pancreatic fistula (CR-POPF) is a major complication following pancreatic resection. It is challenging to manage and may lead to significant morbidity and mortality. This study aims to evaluate the utility of drain fluid colour as an early clinical indicator of CR-POPF.
Methods
A retrospective audit was conducted of all adult patients who underwent pancreatic resection at Northern Health between 1 January 2010 and 31 December 2022. The data collected included patient demographics, as well as preoperative, operative, and post-operative variables.
Results
A total of 169 patients were identified over the 13-year study period. Soft pancreatic texture (odds ratio [OR] 4.8, 95% confidence interval [CI] 1.9–12.1; P < .001) and a pancreatic ductal diameter less than 3 mm (OR 2.3, 95% CI 1.04–5.1; P = .04) were identified as significant risk factors for CR-POPF. Abnormal drain fluid colour (ie, dark red, brown, or port wine) within the first 5 post-operative days was predictive of CR-POPF, with a sensitivity of 72.5% and specificity of 86.8%. On multivariate analysis, it remained an independent predictor with an OR of 11.7 (95% CI 4.7–29.2; P < .001).
Conclusions
Abnormal drain fluid colour provides clinical value as an early indicator of CR-POPF. Early identification may facilitate timely management and potentially prevent secondary complications.
临床相关的术后胰瘘（CR-POPF）是胰腺切除术后的主要并发症。它具有挑战性，并可能导致显著的发病率和死亡率。本研究旨在评估引流液颜色作为CR-POPF早期临床指标的效用。方法对2010年1月1日至2022年12月31日期间在Northern Health行胰腺切除术的所有成年患者进行回顾性审计。收集的数据包括患者人口统计数据，以及术前、手术和术后变量。结果在13年的研究期间，共发现169例患者。胰腺质地柔软（比值比[OR] 4.8, 95%可信区间[CI] 1.9-12.1; P < .001）和胰管直径小于3mm（比值比[OR] 2.3, 95% CI 1.04-5.1; P = .04）被认为是CR-POPF的重要危险因素。术后前5天内异常引流液颜色（如深红色、棕色或葡萄酒色）可预测CR-POPF，敏感性为72.5%，特异性为86.8%。在多变量分析中，它仍然是一个独立的预测因子，OR为11.7 （95% CI 4.7-29.2; P < .001）。结论引流液颜色异常作为CR-POPF的早期指标具有临床价值。早期识别有助于及时处理，并有可能预防继发性并发症。
{"title":"Early drain colour change for the detection of clinically relevant post-operative pancreatic fistula","authors":"Yuchen Luo MBBS, MS, Jurstine Daruwalla MBBS, PhD, FRACS, Mani Suleiman PhD, Russell Hodgson MBBS, PhD, FRACS, Nezor Houli MBBS, FRACS, Tuck Leong Yong MBBS, MS, FRACS","doi":"10.1111/1744-1633.70019","DOIUrl":"https://doi.org/10.1111/1744-1633.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinically relevant post-operative pancreatic fistula (CR-POPF) is a major complication following pancreatic resection. It is challenging to manage and may lead to significant morbidity and mortality. This study aims to evaluate the utility of drain fluid colour as an early clinical indicator of CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective audit was conducted of all adult patients who underwent pancreatic resection at Northern Health between 1 January 2010 and 31 December 2022. The data collected included patient demographics, as well as preoperative, operative, and post-operative variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 169 patients were identified over the 13-year study period. Soft pancreatic texture (odds ratio [OR] 4.8, 95% confidence interval [CI] 1.9–12.1; <i>P</i> < .001) and a pancreatic ductal diameter less than 3 mm (OR 2.3, 95% CI 1.04–5.1; <i>P</i> = .04) were identified as significant risk factors for CR-POPF. Abnormal drain fluid colour (ie, dark red, brown, or port wine) within the first 5 post-operative days was predictive of CR-POPF, with a sensitivity of 72.5% and specificity of 86.8%. On multivariate analysis, it remained an independent predictor with an OR of 11.7 (95% CI 4.7–29.2; <i>P</i> < .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Abnormal drain fluid colour provides clinical value as an early indicator of CR-POPF. Early identification may facilitate timely management and potentially prevent secondary complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"215-220"},"PeriodicalIF":0.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595365","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}
S. Sri Poorani MS, Cherring Tandup MS, Bikash Medhi MD, Swapnesh Kumar Sahu MS, Lileswar Kaman MS, FRCS, Satish Subbiah Nagaraj MS, MRCS, Survadeep Mitra MD, Arunanshu Behera MS
Background
Peritoneal adhesions are an important complication of abdominal surgeries, causing chronic pain, bowel obstruction, and infertility. Despite advances in surgical techniques, pharmacological prevention remains a challenge. This study aimed to evaluate the effectiveness of sirolimus, prednisolone, and their combination in preventing post-operative adhesions in a rat model.
Methods
This was a randomised, controlled experimental study. Thirty-three female Wistar rats were divided into five groups: control, vehicle carrier, sirolimus (0.1 mg/kg/day), prednisolone (1 mg/kg/day), and a sirolimus–prednisolone combination. Adhesions were induced by laparotomy and caecal abrasion. Adhesion severity was evaluated by macroscopic analysis (Nair classification) and microscopic analysis (Zühlke grading). Statistical analyses were performed using the chi-square and Mann–Whitney tests, with a significance level of 5% (P < .05).
Results
The combination group was the only one with no macroscopic or microscopic adhesions (P < .05). Both the sirolimus and prednisolone groups showed reduced adhesion severity compared with the control group. The control and vehicle carrier groups exhibited the highest incidence and severity of adhesions (P < .05).
Conclusions
The combination of sirolimus and prednisolone significantly prevents post-operative adhesions, suggesting a potential pharmacological approach to reducing adhesion-related morbidity. Further studies are needed to confirm these findings in clinical settings and to evaluate long-term outcomes. Clinical application should be approached with caution due to the potential immunosuppressive and wound-healing effects of the drugs involved.
{"title":"Pharmacological prevention of peritoneal adhesions: Synergistic effects of sirolimus and prednisolone","authors":"S. Sri Poorani MS, Cherring Tandup MS, Bikash Medhi MD, Swapnesh Kumar Sahu MS, Lileswar Kaman MS, FRCS, Satish Subbiah Nagaraj MS, MRCS, Survadeep Mitra MD, Arunanshu Behera MS","doi":"10.1111/1744-1633.70016","DOIUrl":"https://doi.org/10.1111/1744-1633.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peritoneal adhesions are an important complication of abdominal surgeries, causing chronic pain, bowel obstruction, and infertility. Despite advances in surgical techniques, pharmacological prevention remains a challenge. This study aimed to evaluate the effectiveness of sirolimus, prednisolone, and their combination in preventing post-operative adhesions in a rat model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a randomised, controlled experimental study. Thirty-three female Wistar rats were divided into five groups: control, vehicle carrier, sirolimus (0.1 mg/kg/day), prednisolone (1 mg/kg/day), and a sirolimus–prednisolone combination. Adhesions were induced by laparotomy and caecal abrasion. Adhesion severity was evaluated by macroscopic analysis (Nair classification) and microscopic analysis (Zühlke grading). Statistical analyses were performed using the chi-square and Mann–Whitney tests, with a significance level of 5% (<i>P</i> < .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The combination group was the only one with no macroscopic or microscopic adhesions (<i>P</i> < .05). Both the sirolimus and prednisolone groups showed reduced adhesion severity compared with the control group. The control and vehicle carrier groups exhibited the highest incidence and severity of adhesions (<i>P</i> < .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of sirolimus and prednisolone significantly prevents post-operative adhesions, suggesting a potential pharmacological approach to reducing adhesion-related morbidity. Further studies are needed to confirm these findings in clinical settings and to evaluate long-term outcomes. Clinical application should be approached with caution due to the potential immunosuppressive and wound-healing effects of the drugs involved.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"203-208"},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595286","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}
Simon O. Belozerov MD, Tatiana I. Ionova DSc, Tatiana P. Nikitina MD, PhD, Roman A. Chernikov MD, PhD, Arseny A. Semenov MD, PhD, Natalia A. Gorskaya MD, Milostiva Mladenovic MD, Ilya V. Sleptsov MD, PhD
Background
We aimed to develop a Russian version of the Patient and Observer Scar Assessment Scale (POSAS 3.0; POSAS-R), evaluate its psychometric properties, and test its applicability in patients undergoing thyroid surgery.
Methods
POSAS-R was developed in accordance with international guidelines. Its feasibility, reliability, validity, and sensitivity to change were then evaluated.
Results
The POSAS-R was tested in a group of 115 patients (mean age 39.2 years) who underwent thyroid surgery. Both subscales, the Russian version of the Patient Scar Assessment Scale and the Russian version of the Observer Scar Assessment Scale, demonstrated acceptable internal consistency (Cronbach α = 0.82–0.86), reproducibility (intraclass correlation coefficient = 0.97 and 0.88; P < .001), and strong correlations with the Visual Analog Scale (Spearman r = −0.807 and −0.712; P < .001). Sensitivity to change was moderate (effect size = 0.50 and 0.52).
Conclusion
The developed Russian version of the POSAS is a valid and reliable tool for evaluating post-operative scars after thyroid surgery. The sensitivity and applicability of the POSAS-R to monitor scar changes in patients following thyroid surgery were demonstrated.
{"title":"The use of the Patient and Observer Scar Assessment Scale (POSAS) scale to assess neck scar quality: Development of the Russian version of the POSAS and its testing in patients undergoing thyroid surgery","authors":"Simon O. Belozerov MD, Tatiana I. Ionova DSc, Tatiana P. Nikitina MD, PhD, Roman A. Chernikov MD, PhD, Arseny A. Semenov MD, PhD, Natalia A. Gorskaya MD, Milostiva Mladenovic MD, Ilya V. Sleptsov MD, PhD","doi":"10.1111/1744-1633.70015","DOIUrl":"https://doi.org/10.1111/1744-1633.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to develop a Russian version of the Patient and Observer Scar Assessment Scale (POSAS 3.0; POSAS-R), evaluate its psychometric properties, and test its applicability in patients undergoing thyroid surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>POSAS-R was developed in accordance with international guidelines. Its feasibility, reliability, validity, and sensitivity to change were then evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The POSAS-R was tested in a group of 115 patients (mean age 39.2 years) who underwent thyroid surgery. Both subscales, the Russian version of the Patient Scar Assessment Scale and the Russian version of the Observer Scar Assessment Scale, demonstrated acceptable internal consistency (Cronbach α = 0.82–0.86), reproducibility (intraclass correlation coefficient = 0.97 and 0.88; <i>P</i> < .001), and strong correlations with the Visual Analog Scale (Spearman <i>r</i> = −0.807 and −0.712; <i>P</i> < .001). Sensitivity to change was moderate (effect size = 0.50 and 0.52).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The developed Russian version of the POSAS is a valid and reliable tool for evaluating post-operative scars after thyroid surgery. The sensitivity and applicability of the POSAS-R to monitor scar changes in patients following thyroid surgery were demonstrated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"192-202"},"PeriodicalIF":0.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595284","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}
Kelvin K. C. Ng MBBS, MS, PhD, FRCSEd (Gen), Charing C. N. Chong MBChB, FRCSEd (Gen), Chun-Kwok Wong BSc (Hons), MPhil, PhD, FRSB (UK), Nathalie Wong BSc. (London), DPhil (Oxon)
Background
Thermal ablation is effective for early-stage hepatocellular carcinoma (HCC). It can induce a host immune response through dynamic changes in serum cytokines. It is unknown whether this host immune response correlates with tumour recurrence. This prospective study aims to investigate the dynamic changes of serum cytokines after thermal ablation of HCC and its clinical significance.
Methods
Sixty patients with HCC treated by thermal ablation were recruited. The dynamic changes of 39 serum cytokines were measured. The primary outcome was 2-year disease-free survival. Univariate and multivariate analyses were performed to identify the prognostic factors for disease-free survival.
Results
Six cytokines [interleukin (IL)-1, IL-6, IL-10, epidermal growth factor (EGF), eotaxin, transforming growth factor (TGF)-α] demonstrated significant dynamic changes after thermal ablation. The overall tumour recurrence rate was positively correlated with the dynamic changes in serum IL-6 and IL-10 levels. The 2-year disease-free survival was 49.7%. Serum bilirubin (≥25 μmol/L) and dynamic change of serum IL-10 (≥22 IU/mL) levels were the significant independent prognostic factors for disease-free survival.
Conclusion
There are significant dynamic changes in serum cytokines after thermal ablation. High serum bilirubin and upregulation of serum IL-10 levels are independent poor prognostic factors for tumour recurrence after thermal ablation.
{"title":"Dynamic changes of serum cytokines and their prognostic values in patients with hepatocellular carcinoma treated by thermal ablation","authors":"Kelvin K. C. Ng MBBS, MS, PhD, FRCSEd (Gen), Charing C. N. Chong MBChB, FRCSEd (Gen), Chun-Kwok Wong BSc (Hons), MPhil, PhD, FRSB (UK), Nathalie Wong BSc. (London), DPhil (Oxon)","doi":"10.1111/1744-1633.70013","DOIUrl":"https://doi.org/10.1111/1744-1633.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thermal ablation is effective for early-stage hepatocellular carcinoma (HCC). It can induce a host immune response through dynamic changes in serum cytokines. It is unknown whether this host immune response correlates with tumour recurrence. This prospective study aims to investigate the dynamic changes of serum cytokines after thermal ablation of HCC and its clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty patients with HCC treated by thermal ablation were recruited. The dynamic changes of 39 serum cytokines were measured. The primary outcome was 2-year disease-free survival. Univariate and multivariate analyses were performed to identify the prognostic factors for disease-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six cytokines [interleukin (IL)-1, IL-6, IL-10, epidermal growth factor (EGF), eotaxin, transforming growth factor (TGF)-α] demonstrated significant dynamic changes after thermal ablation. The overall tumour recurrence rate was positively correlated with the dynamic changes in serum IL-6 and IL-10 levels. The 2-year disease-free survival was 49.7%. Serum bilirubin (≥25 μmol/L) and dynamic change of serum IL-10 (≥22 IU/mL) levels were the significant independent prognostic factors for disease-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are significant dynamic changes in serum cytokines after thermal ablation. High serum bilirubin and upregulation of serum IL-10 levels are independent poor prognostic factors for tumour recurrence after thermal ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 3","pages":"154-162"},"PeriodicalIF":0.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Practice February 2025 CME for Fellows","authors":"","doi":"10.1111/1744-1633.70008","DOIUrl":"https://doi.org/10.1111/1744-1633.70008","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"119-120"},"PeriodicalIF":0.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309038","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}
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