Surgery in practice and science最新文献

{"title":"Red blood cell mass as a predictor of transfusion risk of packed red blood cells in cardiac surgery patients requiring cardiopulmonary bypass","authors":"Jennette Hansen,&nbsp;Niaman Nazir,&nbsp;George Zorn III","doi":"10.1016/j.sipas.2025.100321","DOIUrl":"10.1016/j.sipas.2025.100321","url":null,"abstract":"<div><h3>Introduction</h3><div>Red blood cell (RBC) transfusion in cardiac surgery is associated with adverse outcomes and increased costs. Traditional predictors such as hemoglobin and BMI offer limited physiologic insight. This study evaluates RBC mass, a calculated measure of total red cell volume, as a preoperative predictor of transfusion in adult cardiac surgery patients undergoing cardiopulmonary bypass (CPB).</div></div><div><h3>Materials and Methods</h3><div>This retrospective observational study included 463 adult patients undergoing elective cardiac surgery with CPB at a single academic center in 2024. Exclusion criteria included procedures with inherently high transfusion risk (e.g., redo sternotomy, LVAD implantation, circulatory arrest, and “bring-backs”). RBC mass was calculated using estimated blood volume (sex-adjusted mL/kg) and hematocrit. Patients were categorized into three RBC mass groups: 1–2 L, 2–3 L, and &gt;3 L. Multivariable logistic regression was used to assess the association between RBC mass and transfusion, adjusting for sex, age, BMI, and bypass time.</div></div><div><h3>Results</h3><div>Of the 463 patients, 102 (22 %) received RBC transfusions. Transfused patients had significantly lower RBC mass (mean 1.95 L) versus non-transfused (2.58 L, <em>p</em> &lt; 0.001). Patients in the 1–2 L group accounted for 54.9 % of transfusions despite representing only 25.5 % of the cohort. These patients had 18.7 times the odds of transfusion compared to those with &gt;3 L RBC mass. Female sex, older age, lower BMI, and longer CPB time were also associated with increased transfusion risk.</div></div><div><h3>Discussion</h3><div>RBC mass proved a more physiologically integrated and predictive metric for transfusion risk than hemoglobin or BMI alone. It may be especially useful in identifying at-risk female patients and those with normal hemoglobin but limited oxygen-carrying reserve.</div></div><div><h3>Conclusions</h3><div>Preoperative RBC mass is a strong independent predictor of transfusion in cardiac surgery. Its incorporation into preoperative planning may improve patient optimization and reduce unnecessary transfusions.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100321"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of tumor-infiltrating lymphocytes, tumor associated neutrophils and metabolic checkpoint molecules on survival of patients with metastatic pancreatic ductal adenocarcinoma","authors":"Tao Zhang ,&nbsp;Rainer C. Miksch ,&nbsp;Ughur Aghamaliyev ,&nbsp;Maximilian Weniger ,&nbsp;Michael Günther ,&nbsp;Steffen Ormanns ,&nbsp;Fatma Parsa ,&nbsp;Jan G. D’Haese ,&nbsp;Alexandr V. Bazhin ,&nbsp;Matthias Ilmer ,&nbsp;Bernhard W. Renz ,&nbsp;Jens Werner","doi":"10.1016/j.sipas.2025.100320","DOIUrl":"10.1016/j.sipas.2025.100320","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate the tumor microenvironment (TME) of metastatic PDAC, focusing on tumor-infiltrating leukocytes (TILs) and metabolic checkpoint molecules (MCMs).</div></div><div><h3>Background</h3><div>The role of TME in primary and metastatic PDAC is not well understood. Furthermore, the role of energy metabolism in metastatic PDAC is unclear. Therefore, this study aimed to explore the TME in primary tumors and metastases of PDAC, and its prognostic role.</div></div><div><h3>Materials and Methods</h3><div>We included 26 cases of metastatic PDAC in this study. We performed immunohistochemistry for TILs and MCMs (HIF-1α, GLUT1, and PDHK1) in primary and corresponding metastatic tumor tissues. We quantified stromal TILs and MCMs using a tumor immune stroma (QTiS) algorithm and correlated the data with clinical outcome.</div></div><div><h3>Results</h3><div>We found that CD3⁺, CD8⁺, and CD20⁺ TILs were increased in primary tumors compared to metastatic ones. Kaplan-Meier plots revealed that high infiltration of CD20⁺ and its combinations in primary tumors correlated with better OS in metastatic PDAC patients. We also found that high infiltration of CD8⁺ TILs in metastatic tumors correlated with better OS, as did the low density of GLUT1 in both PDAC primary and metastatic tumors. A multivariate Cox regression analysis revealed that CD8⁺ TILs in metastatic tumors and GLUT1 in PDAC primary and metastatic tumors were independent predictors of survival.</div></div><div><h3>Conclusion</h3><div>Distribution of TILs in the TMEs of primary and metastases of metastatic PDAC is different. Our results suggest that TILs (CD8⁺) and MCMs (GLUT1) in tumor stromal areas can predict OS of patients with metastatic PDAC.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100320"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of artificial intelligence in advancing urologic care: From diagnostics to therapeutics","authors":"Sina Samenezhad ,&nbsp;Dorna Rafighi","doi":"10.1016/j.sipas.2025.100322","DOIUrl":"10.1016/j.sipas.2025.100322","url":null,"abstract":"<div><div>Artificial intelligence (AI) is gradually altering urology by improving diagnostic precision, prognostic evaluation, and therapy decisions in a broad spectrum of urologic diseases. Utilizing machine learning, deep learning, and radiomics, applications of AI have exhibited promise in enhancing cancer identification, stratification, and therapy response prediction, especially in prostate, bladder, and kidney cancers. Beyond cancer therapy, AI enables individually tailored care for benign diseases like benign prostatic hyperplasia, urolithiasis, Functional Urology even in pediatrics by enhancing diagnostic ability and outcome prediction. Heterogeneity of data, model explainability, ethical issues, and lack of prospective validation constrain incorporation into everyday practice. This review summarizes current applications and discusses methodological and ethical limitation, and defines future directions toward enhancing multidisciplinary interaction, standardization across datasets, and prudent implementation. Eventually, AI provides large-scale opportunity to transform urologic care by facilitating individually tailored, expedient, and equitable patient care.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"24 ","pages":"Article 100322"},"PeriodicalIF":0.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of primary intestinal anastomosis versus stoma in necrotizing enterocolitis: A systematic review and meta-analysis","authors":"Amani N. Alansari ,&nbsp;Salma Mani ,&nbsp;Marwa Messaoud ,&nbsp;Tariq Altokhais","doi":"10.1016/j.sipas.2025.100319","DOIUrl":"10.1016/j.sipas.2025.100319","url":null,"abstract":"<div><h3>Background</h3><div>Approximately one-quarter of necrotizing enterocolitis (NEC) cases require surgical resection due to bowel perforation, necrosis, or failure to respond to conservative management. In such cases, the optimal method for restoring intestinal continuity remains debatable. Stoma is traditionally favored over primary anastomosis for its perceived safety, particularly in unstable infants, but it is associated with complications such as fluid and electrolyte imbalances, impaired growth, and the need for a second surgery. This study aims to systematically review and analyze the evidence comparing stoma versus primary anastomosis in neonates undergoing surgery for NEC.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science (WOS), the Cochrane Library, and Scopus for studies comparing the outcomes of stoma versus primary anastomosis in neonates with NEC. The primary outcomes included overall postoperative complications, intestinal perforation, stricture, mortality, wound infection, time to full enteral nutrition, time to end parenteral nutrition, and length of hospital stay. The meta-analysis was conducted using Review Manager (RevMan) version 5.4.</div></div><div><h3>Results</h3><div>Eighteen studies were included in the meta-analysis. Primary anastomosis was associated with lower mortality risk: (risk ratios (RR) = 0.61; 95 % confidence interval (CI): 0.42:0.88). No significant differences were observed between groups in overall complications, wound infection, duration of hospital stay, duration of parenteral nutrition, the need for a second operation (excluding stoma closure), strictures, and perforations.</div></div><div><h3>Conclusion</h3><div>Primary anastomosis for neonates with NEC is associated with lower mortality and comparable complication rates compared to stoma formation in selected cases.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100319"},"PeriodicalIF":0.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Laplace's law with patient-specific hemodynamics to predict rupture risk in unruptured intracranial aneurysms: A systematic review of a biophysical and computational framework","authors":"Muhammad Mohsin Khan ,&nbsp;Noman Shah ,&nbsp;Bipin Chaurasia","doi":"10.1016/j.sipas.2025.100318","DOIUrl":"10.1016/j.sipas.2025.100318","url":null,"abstract":"<div><h3>Introduction</h3><div>This systematic review aimed to synthesize the literature on integrating biophysical principles such as Laplace’s law with patient-specific hemodynamics to create a more precise and mechanistic framework for assessing rupture risk in unruptured intracranial aneurysms.</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies published between January 2010 and December 2024 were identified from databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The Joanna Briggs Institute checklist and Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool were used to assess study quality and bias.</div></div><div><h3>Results</h3><div>These studies showed increasing integration of Laplace's law with patient-specific flow simulations and vessel wall modeling. Hemodynamic models frequently revealed that areas with low wall shear stress or high oscillatory shear index overlapped with regions of high mechanical stress. Thin walled blebs small outpouchings on aneurysms were particularly prone to rupture and were often associated with abnormal flow patterns and higher wall tension. The synthesized evidence supports the conceptual validity of an integrative model that spatially correlates high wall tension with adverse hemodynamic patterns.</div></div><div><h3>Conclusion</h3><div>This review demonstrates that the proposed integration of Laplace’s law with advanced hemodynamic modeling, as evidenced by the literature, holds promise for improving rupture risk prediction. Future research should focus on implementing this combined approach in a clinical cohort to compare its predictive ability against existing models like the PHASES score.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100318"},"PeriodicalIF":0.8,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in thoracic surgery: Perspectives and challenges","authors":"Wenwei Liao ,&nbsp;Bin Peng ,&nbsp;Guanggui Ding ,&nbsp;Zhikai Li ,&nbsp;Guangsuo Wang","doi":"10.1016/j.sipas.2025.100317","DOIUrl":"10.1016/j.sipas.2025.100317","url":null,"abstract":"<div><div>With the advances of artificial intelligence (AI) in the medical field, particularly the widespread utilization of large language models (LLMs) such as ChatGPT, Claude, Gemini, Llama, and Deepseek, clinical practice is undergoing an unprecedented technological revolution. These cutting-edge technologies facilitate efficient processing and analysis of vast datasets, providing medical professionals with auxiliary diagnoses and treatment suggestions, while markedly enhancing the quality and efficiency of medical services. Over the past decade, the field of thoracic surgery has achieved transformative progress, primarily driven by AI innovations. Consequently, thoracic surgeons must possess a foundational understanding of AI in order to grasp its implications on their daily practice and explore potential ways of integrating this technology into their work. This article reviews the fundamental elements of AI and the relationships between AI-based techniques. It further summarizes the application of AI in thoracic surgery, aiming to enhance thoracic surgeons' comprehensive understanding of the latest developments in this area. Additionally, this article explores the challenges and limitations faced by AI, including data security and privacy concerns, issues of bias and discrimination, challenges in verification and interpretability, ethical and legal considerations, technical obstacles, as well as training and educational requirements. Finally, it explores emerging AI architectures and their paradigm-shifting impacts on medical ecosystems.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100317"},"PeriodicalIF":0.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide survey of Indian cardiac surgeons on the management of acute type A aortic dissection","authors":"Mohammed Idhrees ,&nbsp;Nimrat Grewal ,&nbsp;Mohammed Ayyub ,&nbsp;Jasima Nilofer ,&nbsp;Bashi Velayudhan","doi":"10.1016/j.sipas.2025.100316","DOIUrl":"10.1016/j.sipas.2025.100316","url":null,"abstract":"<div><h3>Objective</h3><div>Acute Type A aortic dissection (ATAAD) is associated with high morbidity and mortality, and management strategies vary widely among surgeons. This study aimes to evaluate practice patterns and decision-making among Indian cardiac surgeons regarding ATAAD, with focus on differences related to surgical experience and institutional case volume.</div></div><div><h3>Methods</h3><div>A 23-item electronic questionnaire covering preoperative, intraoperative and postoperative management of ATAAD was distributed to all members of the Indian Association of Cardiovascular-Thoracic Surgeons. Ninety-three responses were analyzed and compared according to surgeon experience (&lt;10, 10–20, &gt;20 years) and institutional aortic surgery volume (high vs low).</div></div><div><h3>Results</h3><div>Over one-quarter of surgeons (26.9 %) declined to operate on patients &gt;70 years old, a practice more frequent among surgeons with &lt;20 years of experience (32% vs 5.56 % p=0.011). Active cardiopulmonary resuscitation (56 %), and preoperative stroke (52.7%) were the most common reasons to withhold surgery, whereas senior surgeons (&gt;20 years) were more likely to operate despite malperfusion or CPR (38.8 % vs 13.3 %, p=0.005).</div><div>Dual arterial cannulation was preferred by 62.4% of surgeons, with a shift toward single site cannulation with increasing experience (p=0.008). The distal anastomosis was performed using on-clamp technique by 26.8 % of respondents, more frequently among low-volume aortic surgeons (35.1 % vs 13.8%, p=0.012).</div></div><div><h3>Conclusion</h3><div>Management of ATAAD in India shows substantial variation, strongly influenced by surgeon experience and aortic surgery volume. Differences are particularly evident in patients selection, cannulation strategy and distal repair techniques. These findings highlight the need for structured referral systems and the potential benefit of developing high-volume ‘aortic centres’ in India.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100316"},"PeriodicalIF":0.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling the disparities in surgical site infections and related antimicrobial resistance in low- and middle-income countries","authors":"Rana Farsakoury ,&nbsp;Massimo Sartelli ,&nbsp;Susu M Zughaier","doi":"10.1016/j.sipas.2025.100315","DOIUrl":"10.1016/j.sipas.2025.100315","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The financial burden, morbidity, and mortality of surgical site infection (SSI) is a global issue. Incidence rates of SSI are high in low- and middle-income countries (LMICs), with evidence of surge in antimicrobial resistance (AMR) in these regions. This mini review aimed to collect and analyze existing data on SSI incidence and the associated AMR in LMICs to address some concerns about causes and control strategies.</div></div><div><h3>Methods</h3><div>MEDLINE, Embase, the Cochrane Library, Scopus, AMED, Biosis, and CINAHL were all searched for this study until June 8, 2025. We included all studies comparing disparities in surgical site infections and related antimicrobial resistance in low- and middle-income countries.</div></div><div><h3>Results</h3><div>The overall SSI incidence in LMICs is higher than in high-income countries . The intertwined relationship between SSI and the rising AMR burden further complicates the issue. The emergence of AMR is driven by inappropriate antibiotic use, poor regulatory oversight and stewardship, inadequate healthcare infrastructure, economic limitations that result in incomplete or informal treatments, weak surveillance systems, and environmental contamination from hospitals, agriculture, and wastewater. Vaccination, sanitation and hygiene, infection control, education, alternative therapies consideration of, antimicrobial stewardship, and prevention, are strategies to prevent and reduce the development of AMR.</div></div><div><h3>Conclusion</h3><div>AMR is a dire global problem that requires immediate action to combat its spread. Effective AMR surveillance from a \"One Health\" viewpoint is needed in LMICs to map and track the spread of resistance. Environmental resistome sample is required to detect the factors influencing resistance. Searching for solution to colistin resistance, a last resort antibiotic, is critical.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100315"},"PeriodicalIF":0.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing outcomes of one-way Heimlich valve with conventional chest tube drainage for primary spontaneous pneumothorax: a randomized clinical trial","authors":"Mohammad Hadi Bahri ,&nbsp;Seyed Mohammad Naghibalghora ,&nbsp;Mojtaba Ahmadinejad ,&nbsp;Kourosh Kabir ,&nbsp;Nazanin Khezri","doi":"10.1016/j.sipas.2025.100314","DOIUrl":"10.1016/j.sipas.2025.100314","url":null,"abstract":"<div><h3>Background</h3><div>Primary spontaneous pneumothorax (PSP) is the accumulation of air in the pleural space without underlying lung disease. Standard management often involves chest tube insertion connected to an underwater seal drainage system (bottle), but alternatives like the Heimlich one-way valve exist. This study aimed to compare the clinical outcomes of using a Heimlich valve versus standard chest tube drainage for PSP.</div></div><div><h3>Methods</h3><div>This was a single-center, open-label, parallel-group randomized controlled trial conducted at Shahid Madani Hospital, Karaj, Iran, from March 2023 to March 2024. Forty patients aged 18–40 years with symptomatic PSP (&gt;15% collapse) were randomized (1:1 ratio) using block randomization. The intervention group received a 28 Fr chest tube connected to a Heimlich valve. The control group received a 28 Fr chest tube attached to an underwater sealed bottle. Primary outcomes included length of hospital stay, time to return to normal activities other outcomes included pain scores (Visual Analog Scale - VAS), dyspnea score (0–10), ease of getting out of bed (0–10), need for ketorolac analgesia, treatment failure (requiring VATS within 7 days), 30-day rehospitalization, and complications.</div></div><div><h3>Results</h3><div>Forty patients (mean age 31.1±7.0 years; 80% male) were randomized to separate groups (20 per group). Baseline characteristics were similar between groups. The mean time to return to normal activities was significantly shorter in the Heimlich group (7.1±5.4 days vs. 10.2±8.0 days, P=0.014). Mean length of hospital stay was 5.6±3.0 days (Heimlich) vs. 7.3±4.6 days (Bottle), (P=0.081). Pain scores were significantly lower in the Heimlich group on days 1–4 (P&lt;0.01). Ketorolac use (frequency and total dose) was significantly lower in the Heimlich group (P&lt;0.001). Ease of getting out of bed was significantly greater in the Heimlich group throughout the assessment period. Pneumothorax resolution trended faster in the Heimlich group (P=0.077 on day 4). Dyspnea trended lower in the Heimlich group on day 4 (P=0.078). Treatment failure (requiring VATS) occurred in 1 (5%) of the Heimlich patients versus 3 (15%) of the Bottle patients (P = 0.29). Rehospitalization occurred in one patient per group (5%, P = 1.00).</div></div><div><h3>Conclusion</h3><div>In patients with PSP, management with a Heimlich valve resulted in a significantly faster return to normal activities, lower pain scores, reduced analgesic requirements, and greater ease of mobilization than standard chest tube drainage. While not statistically significant, trends suggested faster pneumothorax resolution and potentially shorter hospital stays. The Heimlich valve appears to be a safe and effective alternative, offering potential patient comfort and recovery benefits.</div></div><div><h3>Trial registration</h3><div>Iranian Registry of Clinical Trials (IRCT): IRCT20230208057359N1.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100314"},"PeriodicalIF":0.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes and mortality in older patients with breast cancer at a single tertiary center","authors":"Nora Trabulsi ,&nbsp;Nada AbuBakr Alkhateeb ,&nbsp;Feryal Omar Attiah ,&nbsp;Rozan Altaifi ,&nbsp;Bana Fakeeh ,&nbsp;Alaa Shabkah ,&nbsp;Ali Farsi ,&nbsp;Somayah Saeed Bawazeer ,&nbsp;Salma Sait ,&nbsp;Marwan Al-Hajeili","doi":"10.1016/j.sipas.2025.100313","DOIUrl":"10.1016/j.sipas.2025.100313","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) affect women worldwide, and with a rising global incidence, it represents a burden on health systems. In Saudi Arabia, the number of cases of BC and its age distribution have notably increased. Despite this increase, data on BC characteristics, management, and outcomes in this demographic are limited.</div></div><div><h3>Methods</h3><div>We performed this retrospective descriptive study at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, spanning 2008 to 2020. It included older women (60 years or older) diagnosed with primary BC. Data from hospital records included patient demographics, comorbidities, treatments, and short-term outcomes within 30 days of treatment. We aimed to determine the significant associations of patient, disease and treatment factors with length of stay, short-term outcomes, and mortality.</div></div><div><h3>Results</h3><div>The study included 115 older female patients with BC, with a mean age of 67 years. Comorbidities such as diabetes (39.1 %) and hypertension (40.9 %) were prevalent. Most patients were diagnosed with stage T2 (49 %) and N1 (42 %) nonmetastatic invasive ductal carcinoma (88.7 %). The recurrence rate was 21 %, while the crude all-cause mortality rate was 20 %. Short-term outcomes showed a 4.35 % readmission rate and a 2.6 % reoperation rate, with an average hospital stay of 3.61 days. Positive surgical margins, type of surgery, and the presence of metastasis significantly predicted extended hospital stays. Smoking was significantly linked to overall morbidities within 30 days.</div></div><div><h3>Conclusion</h3><div>This study highlights the unique characteristics and treatment outcomes of older women with BC. Comorbidities, tumor stage, and receptor status are crucial for its management and outcomes. The findings emphasize the need for tailored treatment strategies, in consideration of older patients' distinct profiles. Future research should include comparative analyses with younger cohorts to establish age-specific recommendations and optimize treatment approaches for older women.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"23 ","pages":"Article 100313"},"PeriodicalIF":0.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}