Asian Journal of Surgery最新文献

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Risk prediction models for venous thromboembolism after radical colorectal cancer surgery: A systematic review and meta-analysis 大肠癌根治性手术后静脉血栓栓塞的风险预测模型：系统回顾和荟萃分析

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.06.125

Fang Liu, Yali Hu, Zhuoyun Li, Xiaoying Wang

引用次数: 0

Extended arch repair with aortic-femoral/iliac bypass if necessary for treating lower extremity malperfusion secondary to acute type A aortic dissection 如有必要，应用主动脉-股动脉/髂动脉旁路术治疗急性A型主动脉夹层继发的下肢灌注不良

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.05.254

QiYi Chen , YuLin Wang , KeJie Shao , Hao Lai , ChunSheng Wang , Qiang Ji

Objective

In patients with acute type A aortic dissection (ATAAD) complicated by lower extremity (LE) malperfusion (MP), the optimal surgical approach and its outcomes remain a topic of debate. This study aimed to assess both in-hospital and midterm outcomes of our strategy, which involves extended arch repair with additional aortic-femoral or iliac bypass when required, for managing ATAAD with LE-MP.

Methods

The study included 92 patients with ATAAD and LE-MP and 588 without MP who underwent surgical repair at our center over a 7-year period. From this cohort, 90 matched pairs (1:1) were selected. In-hospital and midterm outcomes were compared between groups in both unmatched and matched cohorts. Additional outcomes, including rates of lower-limb ischemia resolution after central repair alone, limb loss, and bypass patency, were documented.

Results

In total, 81 (88.0 %) LE-MP patients achieved resolution of lower-limb ischemia following extended arch repair alone, while 11 required additional aortic-femoral or iliac bypass procedures during the initial repair. Postoperatively, four (4.3 %) LE-MP patients underwent re-intervention due to persistent limb ischemia, with one (1.1 %) eventually requiring a minor amputation. In-hospital mortality for ATAAD patients with LE-MP was 15.2 %, significantly higher than that observed in ATAAD patients without MP (p < 0.001). LE-MP was associated with elevated operative mortality and morbidity in both multivariable and propensity score analyses, and a high cumulative mortality in Cox regression (HR 3.6, 95 % CI 2.2–5.7, p < 0.001). Patent aortic-femoral or aortic-iliac bypass was observed in six (85.7 %) patients during a median follow-up period of 26.1 months.

Conclusion

Preoperative LE-MP in ATAAD patients is linked to poorer outcomes. Extended arch repair with selective aortic-femoral or iliac bypass may represent an effective strategy for treating ATAAD with LE-MP.

目的急性A型主动脉夹层（ATAAD）合并下肢（LE）灌注不良（MP）患者的最佳手术入路及预后仍是一个有争议的话题。本研究旨在评估我们的策略的住院和中期结果，该策略包括延长弓修复术，必要时附加主动脉-股动脉或髂旁路，用于治疗LE-MP治疗ATAAD。方法本研究纳入92例ATAAD合并LE-MP患者和588例无MP患者，这些患者在我中心接受了7年的手术修复。从该队列中，选择了90对配对（1:1）。对未匹配组和匹配组的住院和中期结果进行比较。其他结果，包括单独中央修复后下肢缺血消退率、肢体丧失和旁路通畅，均被记录在案。结果共有81例（88.0%）LE-MP患者仅通过延长弓修复即可解决下肢缺血，而11例患者在初始修复时需要额外的主动脉-股动脉或髂动脉旁路手术。术后，4例（4.3%）LE-MP患者由于持续肢体缺血而再次进行干预，其中1例（1.1%）最终需要轻微截肢。伴有LE-MP的ATAAD患者的住院死亡率为15.2%，显著高于无MP的ATAAD患者（p < 0.001）。在多变量分析和倾向评分分析中，LE-MP与手术死亡率和发病率升高有关，在Cox回归分析中，LE-MP与高累积死亡率相关（HR 3.6, 95% CI 2.2-5.7, p < 0.001）。在26.1个月的中位随访期间，6例（85.7%）患者观察到主动脉-股动脉或主动脉-髂动脉旁路通畅。结论ATAAD患者术前LE-MP与预后较差有关。选择性主动脉-股动脉或髂动脉旁路延长弓修复可能是治疗LE-MP合并ATAAD的有效策略。

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引用次数: 0

Retained metallic spinal introducer needle: Implications for day-case surgery practice 保留金属脊柱引入针：对日常手术实践的影响

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.06.037

Ileana Lulic , Jadranka Pavicic Saric , Ivan Gornik , Dinka Lulic

引用次数: 0

Knee replacement in a syphilitic patient with pigmented choroidal nodular synovitis and synovial chondromatosis 患有色素脉络膜结节性滑膜炎和滑膜软骨瘤病的梅毒患者的膝关节置换术

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.04.022

Cong Wang , Guorong Zhang , Dongsheng Niu , Yuqi Liang

引用次数: 0

Mechanical perfusion at physiological temperature for 24h effectively preserved amputated sheep limbs 生理温度下机械灌注24h，可有效保存绵羊断肢

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.06.131

Yang-hui Dong, Xiang-yu Song, Wen-jing Xu, Jiang Peng

引用次数: 0

SMARCA4-deficient non-small cell lung cancer: Clinicopathological features of five cases 缺乏smarca4的非小细胞肺癌5例临床病理特征分析

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.04.034

Hairen Chen, Jinping Chen, Rong Ge

引用次数: 0

Plasmacytoma of the distal tibia: A case report 胫骨远端浆细胞瘤1例

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.04.050

Long Ma , Zhangui Gu , Zongqiang Yang , Jiandang Shi

引用次数: 0

PYCR1 promotes ovarian cancer progression through HIF-1α signaling PYCR1通过HIF-1α信号传导促进卵巢癌进展

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.03.065

Jiaqi Zong, Xia'nan Yang, Dandan Zhao, Dongmei Fan

引用次数: 0

Comparisons of clinical features between pediatric and adult patients with surgically resected abdominal lymphatic malformations: An observational study of a large cohort 手术切除腹部淋巴畸形的儿童和成人患者的临床特征比较：一项大型队列的观察性研究

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.06.038

Min Yang , Cong-xia Yang , Yu-jia Zhang , Jiang-yuan Zhou, Tong Qiu, Zi-xin Zhang, Yi Ji

Introduction

Abdominal lymphatic malformations (ALMs) are a rare subgroup of lymphatic anomalies that may manifest differently between paediatric and adult patients. We aimed to systematically compare the clinical features of ALMs in terms of patient sex and clinical presentation, cyst content and location, preoperative complications and surgical treatment regimens between paediatric and adult patients.

Methods

Data from patients who were surgically treated and pathologically diagnosed as ALMs were retrospectively compared between paediatric (≤18 years) and adult (>18 years) patients.

Results

We ultimately enrolled 320 patients with ALMs, including 162 paediatrics and 158 adults. There were significantly more female patients in the adult group (P = 0.001). Acute abdominal disease occurred more frequently in paediatric patients (P < 0.001), but ALMs were more often detected by incidental health checkups in adults (P < 0.001). Furthermore, ALMs were more often detected in the small intestinal mesentery (P < 0.001), large intestinal mesentery (P = 0.034) and greater omentum (P < 0.001) in paediatric patients, while ALMs in adults were more frequently located in the retroperitoneum (P < 0.001) and spleen (P < 0.001). Simultaneous resection of ALMs and the intestine was performed more frequently in paediatric patients (P < 0.001). Acute abdomen (P < 0.001) was an independent risk factor for preoperative complications in paediatric patients with ALMs, while incidental detection (P = 0.003) and retroperitoneum (P = 0.046) were found to be independent protective factors against preoperative complications in adult patients with ALMs.

Conclusion

ALMs in children and adults are rare vascular anomalies with different clinical features and risk factors for preoperative complications. Our study provides a deep understanding of ALMs for clinicians.

腹腔淋巴畸形（ALMs）是一种罕见的淋巴异常亚群，在儿科和成人患者中可能表现不同。我们的目的是系统地比较小儿和成人患者在患者性别和临床表现、囊肿内容和位置、术前并发症和手术治疗方案方面的临床特征。方法回顾性比较手术治疗和病理诊断为ALMs的儿童（≤18岁）和成人（≤18岁）患者的资料。结果我们最终招募了320例ALMs患者，包括162名儿科和158名成人。成年组女性患者明显多于女性（P = 0.001）。急性腹部疾病在儿科患者中更常见（P < 0.001），但在成人中，ALMs更常通过偶然的健康检查发现（P < 0.001）。此外，在儿童患者中，ALMs多见于小肠肠系膜（P < 0.001）、大肠肠系膜（P = 0.034）和大网膜（P < 0.001），而成人患者中ALMs多见于腹膜后（P < 0.001）和脾脏（P < 0.001）。同时切除ALMs和肠道在儿科患者中更为常见（P < 0.001）。急腹症（P < 0.001）是小儿急性腹痛患者术前并发症的独立危险因素，而意外发现（P = 0.003）和腹膜后（P = 0.046）是成人急性腹痛患者术前并发症的独立保护因素。结论儿童与成人alms是一种罕见的血管异常，其临床特征和术前并发症的危险因素各不相同。我们的研究为临床医生提供了对alm的深刻理解。

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引用次数: 0

Robot-assisted cortical bone trajectory versus traditional pedicle screws in the treatment of lumbar spinal stenosis with osteoporosis: A retrospective cohort study 机器人辅助皮质骨轨迹与传统椎弓根螺钉治疗腰椎管狭窄伴骨质疏松症：一项回顾性队列研究

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.asjsur.2025.06.215

Ruizhao Zhao, Yuyu Fan, Junjie Qiao, Lixiang Ding, Wei Qu, Xiutong Fang

Purpose

The aging population has led to a rise in the incidence of lumbar degenerative diseases, especially lumbar spinal stenosis (LSS). When conservative treatment fails, surgical intervention has become the preferred approach. The emerging cortical bone trajectory (CBT) screw technique and the traditional pedicle screw technique remain subjects of debate. A retrospective cohort study was conducted to compare the early efficacy of robot-assisted CBT and traditional pedicle screw (TPS) in the treatment of LSS in patients with Osteoporosis.

Methods

A total of 110 patients underwent robot-assisted posterior lumbar interbody fusion (PLIF) between September 2018 to June 2021. They were divided into two groups, the CBT group (N = 55) and the TPS group (N = 55). The general information, surgical related data, postoperative related indicators and functional scores for the two groups were analyzed to evaluate the differences between the two screw placement methods.

Results

The CBT group demonstrated significantly lower the intraoperative blood loss, length of surgical incision and visual analogue scale (VAS) scores at 6 months after operation compared with TPS group (P < 0.05). The difference of blood glucose at 1 week after operation was statistically significant (P < 0.05). The rate of screw loosening, adjacent facet joint invasion and the degree of paraspinal muscle fat infiltration in the CBT group were significantly lower than those in the TPS group as at the last follow-up (P < 0.05).

Conclusions

Compared to TPS instrumentation, PLIF with robot-assisted CBT screw provides better short-term symptom relief, a lower rate of screw loosening, and reduced adjacent facet joint invasion and paraspinal muscle fat infiltration.

目的人口老龄化导致腰椎退行性疾病的发病率上升，尤其是腰椎管狭窄症（LSS）。当保守治疗失败时，手术干预已成为首选方法。新出现的皮质骨轨迹（CBT）螺钉技术和传统的椎弓根螺钉技术仍然是争论的主题。一项回顾性队列研究比较了机器人辅助CBT与传统椎弓根螺钉（TPS）治疗骨质疏松患者LSS的早期疗效。方法2018年9月至2021年6月，共有110例患者接受了机器人辅助的后路腰椎椎间融合术（PLIF）。将患者分为CBT组（N = 55）和TPS组（N = 55）。分析两组患者的一般资料、手术相关资料、术后相关指标及功能评分，评价两种螺钉置入方式的差异。结果CBT组术后6个月术中出血量、手术切口长度及视觉模拟评分（VAS）均低于TPS组（P < 0.05）。术后1周血糖差异有统计学意义（P < 0.05）。截至末次随访，CBT组螺钉松动率、临近小关节侵犯率、棘旁肌脂肪浸润程度均显著低于TPS组（P < 0.05）。结论与TPS内固定相比，PLIF配合机器人辅助CBT螺钉可更好地缓解短期症状，降低螺钉松动率，减少相邻小关节侵犯和棘旁肌脂肪浸润。

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引用次数: 0

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