Surgery in practice and science最新文献

{"title":"Single-surgeon outcomes of open radical cystectomy for muscle-invasive bladder cancer: Experience from a tertiary center in Azerbaijan","authors":"Rashad Sholan ,&nbsp;Rufat Aliyev ,&nbsp;Seymur Karimov ,&nbsp;Jamal Musayev ,&nbsp;Anar Almazkhanli ,&nbsp;Rahman Ismayilov","doi":"10.1016/j.sipas.2025.100296","DOIUrl":"10.1016/j.sipas.2025.100296","url":null,"abstract":"<div><h3>Objective</h3><div>Radical cystectomy is the standard treatment for muscle-invasive bladder cancer (MIBC). This study presents the first analysis of open radical cystectomy (ORC) outcomes in Azerbaijan, where robotic surgery is unavailable.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 106 patients with non-metastatic MIBC who underwent ORC with bilateral pelvic lymph node dissection and Bricker ileal conduit reconstruction, performed by a single surgeon between 2014 and 2024. Demographic data, comorbidities, operative metrics (duration, blood loss), complications, length of stay, and follow-up data were analyzed.</div></div><div><h3>Results</h3><div>The cohort's mean age was 64.2 years (72.6 % male), with common comorbidities including hypertension (33 %), diabetes (33 %), and coronary artery disease (24.5 %). The median operative time was 300 min and blood loss was 450 mL. Postoperative complications occurred in 9.4 %, primarily urinary tract infections. No intraoperative complications or in-hospital mortalities occurred. Longer hospital stays were associated with advanced age (<em>p</em> &lt; 0.001), higher body mass index (<em>p</em> = 0.042), longer operative time (<em>p</em> &lt; 0.001), and increased blood loss (<em>p</em> = 0.008). Of all patients, 58.5 % were followed for a median of 71.3 months with no observed recurrences. There were three non-cancer related deaths.</div></div><div><h3>Conclusion</h3><div>This initial report from Azerbaijan demonstrates acceptable perioperative outcomes for ORC in MIBC, despite the absence of robotic surgery. Our findings emphasize optimizing surgical efficiency, comorbidity management, and strengthening follow-up to enhance patient outcomes in resource-limited settings.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100296"},"PeriodicalIF":0.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588485","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":"Emergency general surgery: The prevalence of non-operative consultations and importance of a registry","authors":"Nisha Narula ,&nbsp;Shanen M. Mulles ,&nbsp;Aziz M. Merchant ,&nbsp;Kenechi Onwubalili ,&nbsp;Lauren Cue ,&nbsp;Michele Fiorentino ,&nbsp;Nina Awan ,&nbsp;Joseph B. Oliver ,&nbsp;Dustin Cummings ,&nbsp;Michael E. Shapiro ,&nbsp;Anne C. Mosenthal ,&nbsp;David H. Livingston ,&nbsp;Nina E. Glass","doi":"10.1016/j.sipas.2025.100295","DOIUrl":"10.1016/j.sipas.2025.100295","url":null,"abstract":"<div><h3>Introduction</h3><div>An emergency general surgery (EGS) service is a crucial component of care in a hospital. Current reviews of EGS focus on procedural-based or diagnosis-driven reviews of administrative data. However, patients evaluated by an EGS service may or may not undergo surgery. Therefore, we sought to determine the feasibility of maintaining an EGS registry to include those who do and do not undergo surgery and determine the contribution of nonoperative care to the service.</div></div><div><h3>Methods</h3><div>Demographic and clinical data for operative and nonoperative general surgery consult patients extracted from the local medical record were entered into a registry over 12 months from 2018 to 2019. We used descriptive statistics to demonstrate differences in demographics and clinical presentation between operative and nonoperative groups.</div></div><div><h3>Results</h3><div>1065 EGS patients were captured into the registry, only 40 % of whom required an operation. Insurance status and race/ethnicity were different between operative and nonoperative groups. Reasons for consultation varied broadly with the largest group (20 %) being for hepatopancreaticobiliary disease.</div></div><div><h3>Discussion</h3><div>Providing insight into the important contribution of nonoperative care on EGS burden, we present data from an institutional EGS registry. EGS registries can provide direction for future studies to guide optimal management of EGS patients, especially in resource-limited settings.</div></div><div><h3>Conclusion</h3><div>Maintaining registries poses challenges but given its importance and the need to determine the contribution of patients who do not undergo procedures to the service load, resources are necessary to ensure they continue.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100295"},"PeriodicalIF":0.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588484","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":"Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study","authors":"Grace EM Kennedy ,&nbsp;Ramy Rashed ,&nbsp;Joshua Lau ,&nbsp;Maham Khan ,&nbsp;Mohammad Abdelmonem ,&nbsp;Sathya Lakpriya ,&nbsp;Bryony Ford ,&nbsp;Ahmed El-Bakoury","doi":"10.1016/j.sipas.2025.100293","DOIUrl":"10.1016/j.sipas.2025.100293","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Posterior pelvic ring disruption has been associated with high-energy trauma, and significant morbidity and mortality. We aimed to determine functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries at a major trauma centre.</div></div><div><h3>Methods</h3><div>Patients who underwent sacroiliac screw fixation at our institution, between 1^st January 2013 – 1^st April 2020 were identified from a database. Electronic systems were accessed to obtain information regarding patient demographics, injuries sustained, and interventions performed. Patients were contacted via telephone regarding clinical outcomes (EQ5D3L, EQVAS and Majeed scores). Radiographical outcomes were assessed using the Keshishyan cross-measure method.</div></div><div><h3>Results</h3><div>115 patients were identified. The mean age at injury was 51.6 years (17–84 years). Most injuries resulted from falls and road traffic collisions (83.5 %). Eighty patients (69.6 %) sustained additional non-pelvic injuries and twenty-nine (25.2 %) underwent a non-pelvic procedure, most commonly limb or clavicle fracture fixation (<em>N</em> = 19). Thirty-day and 12-month all-cause mortality rates were 0.9 % and 1.7 %, respectively. Clinical outcomes were obtained for 82/105 possible patients (78.1 %). Regarding EQ5D3L, 36/82 patients (43.9 %) reported a full health status; only six patients reported severe problems. The mean Majeed score was 70.3. 49/59 patients (86.0 %) returned to their pre-injury employment. A significant association was found between the clinical outcomes (EQ5D3L index, EQVAS, Majeed score) and the pre-operative asymmetry value and deformity index but not the post-operative asymmetry value and deformity index. One patient (0.9 %) required revision for infection, 12 patients (10.4 %) reported post-operative lower limb paraesthesia, and one patient (0.9 %) experienced a post-operative deep vein thrombus.</div></div><div><h3>Conclusions</h3><div>Most patients with pelvic ring injuries experienced high-energy trauma, often resulting in multiple injuries and operative interventions. Nevertheless, mortality rates were low, and most patients experienced either mild or no functional difficulties. The magnitude of the pelvic deformity pre-operatively correlates with post-operative clinical scores.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100293"},"PeriodicalIF":0.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605309","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":"Reversal of Hartmann’s procedure: The impact of timing – a single-tertiary-center experience","authors":"Sascha Vaghiri ,&nbsp;Maria Chara Stylianidi ,&nbsp;Laura Engelmann ,&nbsp;Eslam Elmaghraby ,&nbsp;Levent Dizdar ,&nbsp;Wolfram Trudo Knoefel ,&nbsp;Hermann Kessler ,&nbsp;Dimitrios Prassas","doi":"10.1016/j.sipas.2025.100292","DOIUrl":"10.1016/j.sipas.2025.100292","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal timing for Hartmann’s reversal remains a topic of ongoing debate. This study aimed to assess postoperative outcomes in patients undergoing early versus late Hartmann’s reversal at a tertiary academic center in Germany.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted, including all patients who underwent Hartmann’s reversal between January 2008 and July 2020. Patients were stratified into early (ER) and late (LR) reversal groups using a median cut-off value of 159 days. Operative outcomes including major morbidity and overall postoperative complications were compared between both groups. Factors associated with major postoperative morbidity were detected using uni- and multivariate regression models.</div></div><div><h3>Results</h3><div>A total of 133 patients classified into the ER (n = 67, 50.38%) and LR (n = 66, 49.62%) groups were analyzed. There were no significant differences in overall morbidity (ER 56.72% versus LR 39.39%, p = 0.057) and major morbidity rates (Clavien-Dindo ≥ IIIa) (ER 28.36% versus LR 21.21%, p = 0.423) between both groups. On multivariate analysis, smoking (p = 0.006), chronic renal disease (p = 0.003) and anastomotic configuration (p = 0.003) were identified as significant factors contributing to major morbidity after Hartmann’s reversal.</div></div><div><h3>Conclusion</h3><div>Hartmann’s reversal is still associated with an increased risk of postoperative complications. However, timing of Hartmann’s reversal does not seem to influence postoperative morbidity. Of note, patient-related modifiable factors as well as the anastomotic configuration are important determinants of major complication occurrence.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100292"},"PeriodicalIF":0.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321728","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 surgical care for low- and middle-income countries: Challenges, opportunities, and the path forward","authors":"William Nkenguye","doi":"10.1016/j.sipas.2025.100290","DOIUrl":"10.1016/j.sipas.2025.100290","url":null,"abstract":"<div><div>The application of Artificial Intelligence (AI) and Machine Learning (ML) in surgical care has significantly advanced healthcare delivery in high-income countries (HICs), yet remains underutilized in lower- and middle-income countries (LMICs). With a growing burden of surgical diseases, limited surgical expertise, and constrained healthcare resources, AI and ML offer transformative potential in optimizing surgical workflows, improving patient outcomes, and expanding access to specialized care. This manuscript explores the current status, challenges, and future prospects of AI and ML in surgical care for LMICs, emphasizing the critical need for investment, capacity building, and policy development to bridge the healthcare gap.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100290"},"PeriodicalIF":0.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291439","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":"Synchronous adenocarcinoma of the transverse colon and gastroesophageal junction: a case report","authors":"Adam Avas ,&nbsp;Astrid Schümatschek ,&nbsp;Julia Mühlhäusser ,&nbsp;Martin Bolli ,&nbsp;Markus Gass ,&nbsp;Francesco Mongelli","doi":"10.1016/j.sipas.2025.100289","DOIUrl":"10.1016/j.sipas.2025.100289","url":null,"abstract":"<div><h3>Introduction</h3><div>Esophageal cancer is a malignancy with a rapidly increasing incidence in recent decades. The presence of a second synchronous tumor poses challenges when a curative approach is offered.</div></div><div><h3>Case presentation</h3><div>We report a case of a 68-year-old Caucasian male diagnosed with synchronous adenocarcinomas of the transverse colon and the gastroesophageal junction (GEJ), Siewert Type II. The diagnosis followed the presentation of dysphagia and was confirmed through esophagogastroduodenoscopy and colonoscopy. The patient underwent a staging work-up. This has revealed no distant metastases, leading to a decision for curative treatment with multimodal therapy. Neoadjuvant chemotherapy with the FLOT regimen was administered, followed by thoracoabdominal esophagectomy and extended right hemicolectomy. Histopathological and molecular profiling analyses revealed that the tumor of the colon was a metastasis of the GEJ tumor.</div></div><div><h3>Clinical discussion</h3><div>This case demonstrates the diagnostic and therapeutic challenges posed by rare metastatic pattern of the GEJ. Despite thorough preoperative staging, the metastatic nature of the colonic lesion was only revealed postoperatively in our case. This emphasizes the need for molecular profiling in selected cases to enhance diagnostic accuracy and guide treatment decisions more effectively.</div></div><div><h3>Conclusion</h3><div>Colonic metastases from esophageal cancer are exceedingly rare, with only a few cases reported. In this case, according to the postoperative staging (M1) a palliative chemotherapy might have been more appropriate. This case highlights the importance of comprehensive diagnostic workups and the need for molecular profiling of synchronous lesions. Molecular diagnostic may be considered as a part of decision-making, as it can significantly impact treatment strategies and outcomes.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100289"},"PeriodicalIF":0.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263537","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":"Esophageal cancer surgery in Ethiopia: postoperative mortality and long-term survival","authors":"Mintesinot Birhanu Senbeta ,&nbsp;Sileshi Abiy ,&nbsp;Hirbo Samuel ,&nbsp;Nigist Birhanu","doi":"10.1016/j.sipas.2025.100288","DOIUrl":"10.1016/j.sipas.2025.100288","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer remains the leading cause of death worldwide, with esophageal cancer being the sixth leading cause of cancer-related deaths. For individuals with esophageal cancer, esophagectomy is the most effective treatment option available and has a high risk of both death and morbidity. Moreover, despite advances in preoperative optimization, surgery, and anesthesia techniques as well as the introduction of neoadjuvant therapy, the mortality and morbidity associated with esophagectomy remain high.</div></div><div><h3>Objective</h3><div>To assess the survival status and predictors of postoperative survival in patients who underwent esophageal surgery for esophageal malignancies at selected hospitals from to 2018–2023 in Ethiopia, Addis Ababa.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study. After acquiring data from the chart review, the data were analyzed using R version 4.3.3. Descriptive statistics for categorical variables were reported as frequencies and percentages. Kaplan-Meier curves and log-rank tests were used to estimate the survival curve and the difference in survival among groups within each covariate. After esophageal surgery, the impact of each covariate on time to death was assessed using the Cox proportional hazard model.</div></div><div><h3>Results</h3><div>One hundred eighty-three patients who underwent esophageal surgeries for esophageal malignancy at four governmental hospitals in Addis Ababa over 5 years were included. The mean age was 53.8 years. 120 (65.6 %) had a tumor size &lt;3.3 cm, and squamous cell carcinoma accounted for 154 (84.2 %) cases. Epidural analgesia was the most commonly used analgesic technique, 40 (21.9 %). The 30-day mortality was 10.9 %. The overall 1-, 2-, 3-, 4-, and 5-year survival rates were 53 %, 30.6 %, 19.5 %, 19.5 %, and 13 %, respectively. The median survival was 17 months. ASA score of &gt; III (AHR = 2.14, 95 % CI: 1.12–4.12), cervical anastomotic leak (AHR = 3.29, 95 % CI: 1.44–7.52), and sepsis (AHR = 3.70, 95 % CI: 1.46–9.38) were identified as predictors of postoperative mortality in the multivariate Cox regression model.</div></div><div><h3>Conclusion</h3><div>In Ethiopia, patients who underwent surgery for esophageal cancer had low 5-year survival rates.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100288"},"PeriodicalIF":0.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253685","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":"Effects of verapamil on intestinal injury in a rat model of acute mesenteric ischemia","authors":"Silvana N Wilken ,&nbsp;Diego V Santos Rodrigues ,&nbsp;Colin Price ,&nbsp;Julia Jacobs ,&nbsp;Jack Nelson ,&nbsp;Patrick F Walker ,&nbsp;Jonathan J Morrison","doi":"10.1016/j.sipas.2025.100286","DOIUrl":"10.1016/j.sipas.2025.100286","url":null,"abstract":"<div><h3>Background</h3><div>Acute mesenteric ischemia (AMI) is a surgical emergency requiring prompt revascularization with resection of unsalvageable bowel. Despite successful revascularization, ongoing organ damage can persist from ischemia-reperfusion injury (IRI) and there is a need for adjunct therapies to ameliorate this ongoing insult.</div></div><div><h3>Materials and methods</h3><div>Sprague-Dawley rats (<em>n</em> = 36) were divided into five groups: control, heparin (HEP), HEP + verapamil (VER), HEP + valproic acid (VPA), HEP+VER+VPA. The animals were subjected to 45 min of superior mesenteric artery occlusion followed by 4 h of reperfusion. Upon reperfusion, therapies were administered. Plasma samples were collected before occlusion and at end-of-study for intestinal fatty acid binding protein (I-FABP) and pro-inflammatory cytokines. The full length of the small intestine was collected, stained with H&amp;E and scored according to the Park/Chiu score for intestinal ischemia damage.</div></div><div><h3>Results</h3><div>Twenty-three of 36 rats survived 4 h of reperfusion and there was no difference in survival between the groups. I-FABP levels was significantly lower in HEP+VER vs. control (3.8 ± 1.5 vs. 6.18 ± 1.0ng/ml; <em>p</em> = 0.0040). IL-1beta, IL-6 and TNF-alpha showed the lowest mean values in the HEP+VER group compared to all groups. The histological analysis revealed the lowest score of intestinal damage in the HEP+VER group, however, the difference to control was not significant.</div></div><div><h3>Conclusion</h3><div>Administering heparin and verapamil at the time of revascularization may mitigate intestinal IRI without causing detrimental systemic effects. Further studies in large animal models and in the setting of local administration are needed to investigate the potential of this approach.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"21 ","pages":"Article 100286"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230178","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":"A retrospective analysis of Gastric Cancer Lymph Nodes Based on Groups, Regions, and Stages","authors":"Si-kai Song ,&nbsp;Jiang Zhu ,&nbsp;Hai-min Feng ,&nbsp;An-she Ma ,&nbsp;Chao-gang Yang","doi":"10.1016/j.sipas.2025.100287","DOIUrl":"10.1016/j.sipas.2025.100287","url":null,"abstract":"<div><h3>Objective</h3><div>The consistency between clinical and pathological staging of lymph nodes (LNs) in gastric cancer (GC) remains suboptimal, and there is currently no standardized imaging criterion for diagnosing lymph node metastasis (LNM). This study aimed to elucidate the differences in LNs among various groups, regions, and stages, utilizing imaging and histopathology as the foundational basis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the clinical data of 100 GC patients who underwent surgical treatment at Zhongnan Hospital of Wuhan University between January 2022 and May 2023. Patient characteristics, along with pathological and radiological data of LNs, were collected and compared across different groups, regions, and stages.</div></div><div><h3>Results</h3><div>Pathologically, 3566 LNs were collected, with a median of 35 (range: 17–72). Radiologically, 2233 LNs were collected, with a median of 22 (range: 3–47). Significant differences were observed in the long-axis diameter (LAD), short-axis diameter (SAD), ratios of long to short axis (RLSA), and product of long and short axis (PLSA) between negative and positive LNs. However, only within group 3 did the RLSA show statistical significance upon grouping analysis. The areas under the curve (AUC) for LAD, SAD, PLSA, and their combination index (CI) in diagnosing LNM were 0.817, 0.817, 0.828, and 0.827, respectively. Diverse groups, regions, and stages exerted a more pronounced influence on LN groups 1–6, while having a comparatively lesser impact on LN groups 7–16.</div></div><div><h3>Conclusion</h3><div>LAD, SAD, and PLSA exhibited significant diagnostic value for LNM and could serve as diagnostic criteria; however, RLSA demonstrated limited diagnostic utility. The formulation of diagnostic criteria should consider the impact of groups, regions, and stages to enhance sensitivity and specificity.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"21 ","pages":"Article 100287"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204838","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":"Ventral hernia repair with T-line hernia mesh: A multi-institutional experience","authors":"Emmanuel O. Emovon III ,&nbsp;Anna Malysz Oyola ,&nbsp;Luis Arias-Espinosa ,&nbsp;Hani I. Naga ,&nbsp;Angela S. Volk ,&nbsp;William Hope ,&nbsp;Flavio Malcher ,&nbsp;Jamie P. Levine ,&nbsp;Hobart W. Harris ,&nbsp;Jin Yoo ,&nbsp;Ash Patel","doi":"10.1016/j.sipas.2025.100285","DOIUrl":"10.1016/j.sipas.2025.100285","url":null,"abstract":"<div><h3>Introduction</h3><div>Ventral hernia repair (VHR) is a common procedure complicated by high hernia recurrence rates exceeding 30 % over ten years. The T-Line® Hernia Mesh is a synthetic, polypropylene mesh featuring mesh extensions designed to prevent anchor point failure by evenly distributing tension to reduce ventral hernia recurrences. This study evaluates the outcomes of the T-Line® mesh in VHR with 1–3 year follow-up.</div></div><div><h3>Methods</h3><div>This study is a multi-institutional retrospective cohort study on patients who underwent VHR with T-Line® mesh between October 2020 and December 2022. Patient demographics, surgical details, and postoperative outcomes were collected. Patient-reported outcomes were assessed using HerQLes and ACHQC surveys.</div></div><div><h3>Results</h3><div>Fifty-seven patients underwent VHR with the T-Line® mesh with a median age of sixty years and BMI of 30.8 kg/m². The median follow-up was 454 days with a range of 365 to 1192 days. The median defect area was 97.0 cm² and mesh area was 300 cm². Seventeen patients (29.8 %) underwent hernia repair with panniculectomy. Postoperatively, seven patients (12.3 %) presented to the emergency department within 30 days, with five patients (8.8 %) requiring readmission. Eight patients (14.0 %) experienced complications within thirty days, with the majority being surgical site infections (<em>n</em> = 7, 12.3 %). Of the five patients that reported feeling a slight bulge at their previous hernia site, upon clinical evaluation two patients had a recurrence (one recurrence was caused by the suture tearing through the underlying laparotomy repair while the mesh remained anchored intact above the repair, and the second recurrence was caused by inadequate mesh fixation at the caudal border of the mesh), while no patients reported using pain medication for abdominal wall discomfort.</div></div><div><h3>Conclusions</h3><div>The T-Line® Hernia Mesh demonstrated safety and effectiveness in ventral hernia repair, with low recurrences and postoperative complications rates over a 1–3-year period, suggesting it is a valuable tool for complex hernia repairs.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"21 ","pages":"Article 100285"},"PeriodicalIF":0.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115332","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}