Surgery open science最新文献

英文中文

Race/ethnicity on firearm & self-injuries during COVID-19 using TQIP data 使用TQIP数据的COVID-19期间枪支和自伤的种族/民族

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-10 DOI: 10.1016/j.sopen.2026.01.001

Veronica Layrisse Landaeta M.D. , Shahenda Khedr B.A. , Victoria Yuan M.D. , Eshani Pareek M.B.S. , Debra D'Angelo M.S. , Elizabeth Zhao BS , Gala Cygiel M.D. , Konstantin Khariton D.O., F.A.C.S. , Steven Y. Chao M.D., F.A.C.S.

Introduction

The COVID-19 pandemic led to increased assaults, self-inflicted injuries, and firearm-related injuries across the nation, along with increased reports of depression and anxiety worldwide. Our study examines trends in these types of injuries among diverse racial and ethnic groups in the United States during this time.

Methods

Data was extracted from the ACS-TQIP database, including patients with assaults, self-inflicted injuries and firearm-related injuries from 2018 to 2021. Pre-COVID period was defined as 2018–2019, and COVID period as 2020–2021. We performed univariable and multivariable logistic regressions to identify associations between injury rates and COVID period, sex, race, and ethnicity.

Results

We identified 417,797 assaults (9.3% of traumas), 57,853 self-inflicted injuries (1.3%) and 208,882 firearm-related injuries (4.7%). Multivariable analysis revealed significant increase in assaults (OR: 1.02, 95% CI: [1.01, 1.03]; p < 0.001) and firearm-related injuries (1.28 [1.27, 1.29]; p < 0.001) and a significant decrease in self-inflicted injuries (0.98 [0.97, 0.99]; p = 0.039) during the COVID period.

Asian American Pacific Islanders (1.06 [1.02–1.10]; p < 0.005), American Indians (3.47 [3.35–3.60]; p < 0.001), Black or African American (5.32 [5.26–5.38]; p < 0.001, other races (1.23 [1.20–1.25]; p < 0.001) and Hispanics (1.71[1.65–1.74]; p < 0.001) had higher odds of assaults during COVID.

Asian American Pacific Islanders (1.12 [1.04–1.20]; p = 0.001) and American Indians (1.23 [1.12–1.35]; p < 0.001 had higher odds of self-inflicted injuries and Hispanic patients had lower odds (0.73 [0.70–0.76]; p < 0.001) during COVID.

American Indians (1.45 [1.36–1.55]; p < 0.001), Black or African Americans (6.42 [6.33–6.52]; p < 0.001), Hispanics (1.46 [1.43–1.50]; p < 0.001) and other races (1.11 [1.08–1.15]; p < 0.001) had higher odds of firearm related injuries during COVID.

Conclusion

The COVID period saw higher odds of assaults, self-inflicted injuries, and firearm-related injuries in certain racial/ethnic minorities. These findings highlight the need for targeted interventions to address the disproportionate impact on racial/ethnic minorities.

2019冠状病毒病大流行导致全国范围内袭击、自残和枪支相关伤害的增加，同时全球范围内抑郁和焦虑的报告也在增加。我们的研究调查了这段时间美国不同种族和民族群体中这些类型伤害的趋势。方法从ACS-TQIP数据库中提取数据，包括2018年至2021年发生袭击、自伤和枪支相关伤害的患者。预冠期定义为2018-2019年，新冠期定义为2020-2021年。我们进行了单变量和多变量logistic回归，以确定受伤率与COVID期间、性别、种族和民族之间的关系。结果共发现417,797起袭击（占创伤的9.3%），57,853起自残（1.3%）和208,882起涉枪伤害（4.7%）。多变量分析显示，在疫情期间，袭击事件（OR: 1.02, 95% CI: [1.01, 1.03]; p < 0.001）和枪支相关伤害（1.28 [1.27,1.29];p < 0.001）显著增加，自我伤害（0.98 [0.97,0.99];p = 0.039）显著减少。亚裔美国太平洋岛民（1.06 [1.02-1.10];p < 0.005）、美洲印第安人（3.47 [3.35-3.60];p < 0.001）、黑人或非裔美国人（5.32 [5.26-5.38];p < 0.001）、其他种族（1.23 [1.20-1.25];p < 0.001）和西班牙裔（1.71[1.65-1.74];p < 0.001）在COVID期间遭受袭击的几率更高。亚裔美国太平洋岛民（1.12 [1.04-1.20];p = 0.001）和美洲印第安人（1.23 [1.12 - 1.35];p < 0.001）在COVID期间自我伤害的几率较高，西班牙裔患者的几率较低（0.73 [0.70-0.76];p < 0.001）。美洲印第安人（1.45 [1.36-1.55];p < 0.001）、黑人或非裔美国人（6.42 [6.33-6.52];p < 0.001）、西班牙裔美国人（1.46 [1.43-1.50];p < 0.001）和其他种族（1.11 [1.08-1.15];p < 0.001）在COVID期间枪支相关伤害的几率更高。结论新冠肺炎疫情期间，某些少数民族发生袭击、自残和涉枪伤害的几率更高。这些发现突出表明，需要采取有针对性的干预措施，以解决对种族/族裔少数群体的不成比例的影响。

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引用次数: 0

Obesity surgery improves metabolic dysfunction-associated steatotic liver disease and type 2 diabetes – MRI and biochemical analysis of liver and pancreas 肥胖手术改善代谢功能障碍相关的脂肪变性肝病和2型糖尿病——肝脏和胰腺的MRI和生化分析

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-01 DOI: 10.1016/j.sopen.2025.12.006

Dr. med. Hannes Götz Kenngott M.Sc. , Philipp Anthony Wise , Yixin Jiang M.Med. , Dr. med. Amila Cizmic , Felix Wagner , Prof. Dr. med. Hans-Ulrich Kauczor , PD Dr. Dr. med. Adrian T. Billeter , Prof. Dr. med. Lars Fischer MBA , PD Dr. med. Johanna Nattenmüller , Prof. Dr. med. Beat Peter Müller-Stich , Dr. Med. Rainer Grotelüschen , Prof. Dr. med. Felix Nickel MME

Background

This study evaluated changes in metabolic dysfunction-associated steatotic liver disease (MASLD), type 2 diabetes mellitus, liver volume, liver/pancreas fat in patients after obesity surgery.

Methods

Magnetic Resonance Imaging (MRI) measured liver volume/fat and pancreas fat in 31 patients with laparoscopic sleeve gastrectomy (LSG, N = 20) or Roux-en-Y gastric bypass (RYGB, N = 11) preoperatively and at 3- and 12-month follow-up. Clinical data and blood values were taken concomitantly to calculate Non-alcoholic fatty liver disease (NAFLD) score.

Results

The percentage total weight lost (17.5 % ± 5.4 % at 3 months, 28.4 % ± 8.3 % at 12 months) and percentage excess weight lost (40.0 % ± 11.8 % at 3 months, 65.0 % ± 18.8 % at 12 months) were significant. Liver volume decreased from 2378.3 ± 514.5 cm³ to 1928.7 ± 333.5 cm³ at 3 months (p < 0.001) and 1685.0 ± 310.9 cm³ at 12 months (p < 0.001) after surgery. Liver fat percentage decreased from 16.7 % ± 10.3 % to 8.7 % ± 5.4 % at 3 months (p < 0.001) and 5.2 % ± 3.6 % at 12 months (p < 0.001). Pancreatic fat percentage showed a reduction from 14.8 % ± 5.5 % to 10.9 % ± 4.9 % at 3 months (p = 0.007) postoperatively. NAFLD score improved from preoperative measurements to 12 months postoperatively (−0.89 ± 1.54 vs. -1.77 ± 1.25, p < 0.019). Preoperatively, 22 of 31 (71 %) patients had advanced/intermediate scores; 12 months postoperatively only 12 (39 %) remained (p = 0.044). No significant differences between LSG and RYGB were found regarding goal parameters.

Conclusion

Obesity surgery reduced liver volume, type 2 diabetes, fat content of liver and pancreas and improved indicators of MASLD. No significant difference in outcome between operation methods could be established.

本研究评估了肥胖手术后患者代谢功能障碍相关脂肪变性肝病（MASLD）、2型糖尿病、肝体积、肝/胰腺脂肪的变化。方法采用磁共振成像（MRI）对31例腹腔镜袖胃切除术（LSG, N = 20）或Roux-en-Y胃旁路术（RYGB, N = 11）患者术前及随访3个月和12个月时的肝脏体积/脂肪和胰腺脂肪进行测量。同时采集临床资料和血液值，计算非酒精性脂肪性肝病（NAFLD）评分。结果总减重百分比（3个月时为17.5%±5.4%，12个月时为28.4%±8.3%）和超重减重百分比（3个月时为40.0%±11.8%，12个月时为65.0%±18.8%）均有显著性差异。术后3个月肝体积由2378.3±514.5 cm3降至1928.7±333.5 cm3 (p < 0.001)， 12个月肝体积由1685.0±310.9 cm3降至1685.0±310.9 cm3 （p < 0.001）。肝脏脂肪百分比从16.7%±10.3%下降到8.7%±5.4%,3个月(p & lt; 0.001)和5.2%±3.6%,12个月(p & lt; 0.001)。术后3个月胰脂率由14.8%±5.5%降至10.9%±4.9% （p = 0.007）。NAFLD评分从术前到术后12个月均有改善（- 0.89±1.54比-1.77±1.25,p < 0.019）。术前，31例患者中有22例（71%）有高级/中级评分；术后12个月仅存活12例（39%）（p = 0.044）。LSG和RYGB在目标参数方面无显著差异。结论肥胖手术减少了肝脏体积，降低了2型糖尿病，降低了肝脏和胰腺脂肪含量，改善了MASLD指标。两种手术方式的预后无明显差异。

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引用次数: 0

Trends, challenges and ethical considerations in pediatric robotic surgery 儿童机器人手术的趋势、挑战和伦理考虑

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-01 DOI: 10.1016/j.sopen.2025.12.002

Anoush Sardesai Sadat , Suhaib J.S. Ahmad , Sjaak Pouwels

Robotic surgery is revolutionizing healthcare by offering unparalleled precision and control in minimally invasive procedures. With the da Vinci system leading this transformation, surgeons can perform complex operations with enhanced accuracy, reduced recovery times, and fewer complications. In this narrative review, we expanding role of robotic surgery in pediatric cases, highlighting its advantages over conventional techniques, such as improved visualization, reduced tremor, and shorter learning curves. However, challenges like high costs, limited instrument availability, and ethical concerns about access and equity persist. We also examine emerging trends, including telesurgery and augmented reality, which promise to further innovate the field. As pediatric robotic surgery continues to evolve, balancing technological advancements with ethical considerations is crucial to ensuring all children benefit from these cutting-edge surgical solutions. Understanding these dynamics will help guide future applications, making robotic surgery not just a tool for select cases but a standard of care that is accessible, efficient, and equitable.

机器人手术通过在微创手术中提供无与伦比的精度和控制，正在彻底改变医疗保健。在达芬奇系统的引领下，外科医生可以以更高的准确性、更短的恢复时间和更少的并发症来进行复杂的手术。在这篇叙述性的综述中，我们扩大了机器人手术在儿科病例中的作用，强调了它比传统技术的优势，如改善可视化、减少震颤和缩短学习曲线。然而，诸如高成本、有限的仪器可用性以及对获取和公平的道德关切等挑战仍然存在。我们还研究了新兴趋势，包括远程手术和增强现实，它们有望进一步创新该领域。随着儿科机器人手术的不断发展，平衡技术进步和道德考虑对于确保所有儿童都能从这些尖端的手术解决方案中受益至关重要。了解这些动态将有助于指导未来的应用，使机器人手术不仅仅是选择病例的工具，而是一种可获得、高效和公平的标准护理。

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引用次数: 0

Appraisal on the indications, subtypes, and complications of surgically treated thyroid diseases for thyroidologists: A systematic review and meta-analysis in thyroidology 甲状腺医生手术治疗甲状腺疾病的适应症、亚型和并发症评价：甲状腺学的系统回顾和荟萃分析

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-01 DOI: 10.1016/j.sopen.2025.12.005

Ilker Sengul MD, Professor , Demet Sengul MD, Professor

引用次数: 0

Assessing the impact of comorbidities on surgical outcomes in laparoscopic gastrectomy 评估合并症对腹腔镜胃切除术手术结果的影响

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-01 DOI: 10.1016/j.sopen.2025.12.003

Saleha Khan , Aleena Zobairi , Ibrahim Kutbi , Nuran Alsobyani , Hamad Aldobashi , Zulaihat Galadima , Ameena Manzoor , Sjaak Pouwels

引用次数: 0

Inflammation and fibrosis at pancreatic resection margin and their role in post-operative pancreatic fistula development after pancreaticoduodenectomy: a pilot study from a single institution 胰腺切除术边缘的炎症和纤维化及其在胰十二指肠切除术后胰瘘发展中的作用：来自单一机构的一项初步研究

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2026-01-01 DOI: 10.1016/j.sopen.2025.12.004

Roberto Cammarata MD , Vincenzo La Vaccara MD, PhD , Alberto Catamerò MD , Chiara Taffon MD , Gianluca Costa MD, PhD , Laura Olivieri MD , Roberto Coppola MD , Damiano Caputo MD

Background/objectives

Postoperative pancreatic fistula (POPF) is a major complication after pancreaticoduodenectomy (PD), with significant impact on outcomes. While the absence of pancreatic fibrosis is a known risk factor, its intraoperative assessment is often subjective. Moreover, the potential protective role of chronic inflammation at the pancreatic resection margin (PRM) has not been fully explored. This study aimed to evaluate the histological presence of fibrosis and chronic lymphomononuclear inflammatory infiltrate (CLII) at the PRM as predictors of POPF and clinically relevant POPF (CR-POPF), and to assess their intraoperative feasibility via frozen sections.

Materials and methods

A retrospective analysis was performed on 141 patients who underwent PD (2014–2022). Intraoperative frozen sections of the PRM were reviewed for fibrosis and CLII using standardized semi-quantitative grading. Univariate and multivariate analyses identified predictors of POPF and CR-POPF.

Results

POPF and CR-POPF occurred in 42.5 % and 22.7 % of patients, respectively. Absence of fibrosis and CLII were independently associated with increased risk of POPF (OR 7.51 and 4.30; p < 0.0001) and CR-POPF (OR 4.43 and 3.40; p = 0.0003 and p = 0.0099). Combined absence of both further elevated risk (OR 5.20 for POPF; OR 4.83 for CR-POPF). In multivariate analysis, absence of fibrosis and CLII and main pancreatic duct <3 mm remained independent predictors.

Conclusion

The absence of fibrosis and CLII at the PRM strongly predicts POPF and CR-POPF. Their intraoperative evaluation via frozen sections is feasible and may support tailored surgical strategies, especially in minimally invasive PD.

背景/目的术后胰瘘（POPF）是胰十二指肠切除术（PD）后的主要并发症，对预后有重要影响。虽然没有胰腺纤维化是一个已知的危险因素，但其术中评估往往是主观的。此外，慢性炎症在胰腺切除边缘（PRM）的潜在保护作用尚未得到充分探讨。本研究旨在评估PRM的组织学纤维化和慢性淋巴单核细胞炎症浸润（CLII）作为POPF和临床相关POPF （CR-POPF）的预测因子，并通过冷冻切片评估其术中可行性。材料与方法对2014-2022年141例PD患者进行回顾性分析。采用标准化的半定量分级对术中PRM冷冻切片进行纤维化和CLII检查。单因素和多因素分析确定了POPF和CR-POPF的预测因子。结果spopf和CR-POPF发生率分别为42.5%和22.7%。无纤维化和CLII与POPF （OR为7.51和4.30;p < 0.0001）和CR-POPF （OR为4.43和3.40;p = 0.0003和p = 0.0099）风险增加独立相关。两者的联合缺失进一步增加了风险（POPF的OR为5.20；CR-POPF的OR为4.83）。在多变量分析中，无纤维化、CLII和主胰管<； 3mm仍然是独立的预测因素。结论PRM无纤维化和CLII可预测POPF和CR-POPF。术中通过冷冻切片进行评估是可行的，可以支持量身定制的手术策略，特别是在微创PD中。

{"title":"Inflammation and fibrosis at pancreatic resection margin and their role in post-operative pancreatic fistula development after pancreaticoduodenectomy: a pilot study from a single institution","authors":"Roberto Cammarata MD , Vincenzo La Vaccara MD, PhD , Alberto Catamerò MD , Chiara Taffon MD , Gianluca Costa MD, PhD , Laura Olivieri MD , Roberto Coppola MD , Damiano Caputo MD","doi":"10.1016/j.sopen.2025.12.004","DOIUrl":"10.1016/j.sopen.2025.12.004","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Postoperative pancreatic fistula (POPF) is a major complication after pancreaticoduodenectomy (PD), with significant impact on outcomes. While the absence of pancreatic fibrosis is a known risk factor, its intraoperative assessment is often subjective. Moreover, the potential protective role of chronic inflammation at the pancreatic resection margin (PRM) has not been fully explored. This study aimed to evaluate the histological presence of fibrosis and chronic lymphomononuclear inflammatory infiltrate (CLII) at the PRM as predictors of POPF and clinically relevant POPF (CR-POPF), and to assess their intraoperative feasibility via frozen sections.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis was performed on 141 patients who underwent PD (2014–2022). Intraoperative frozen sections of the PRM were reviewed for fibrosis and CLII using standardized semi-quantitative grading. Univariate and multivariate analyses identified predictors of POPF and CR-POPF.</div></div><div><h3>Results</h3><div>POPF and CR-POPF occurred in 42.5 % and 22.7 % of patients, respectively. Absence of fibrosis and CLII were independently associated with increased risk of POPF (OR 7.51 and 4.30; <em>p</em> < 0.0001) and CR-POPF (OR 4.43 and 3.40; <em>p</em> = 0.0003 and <em>p</em> = 0.0099). Combined absence of both further elevated risk (OR 5.20 for POPF; OR 4.83 for CR-POPF). In multivariate analysis, absence of fibrosis and CLII and main pancreatic duct <3 mm remained independent predictors.</div></div><div><h3>Conclusion</h3><div>The absence of fibrosis and CLII at the PRM strongly predicts POPF and CR-POPF. Their intraoperative evaluation via frozen sections is feasible and may support tailored surgical strategies, especially in minimally invasive PD.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"29 ","pages":"Pages 36-42"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978543","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}

引用次数: 0

Association of psychiatric illness with acute outcomes following emergency general surgery 精神疾病与急诊普通外科手术后急性预后的关系

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-12-08 DOI: 10.1016/j.sopen.2025.12.001

Giselle Porter BS , Sara Sakowitz MD MBA MPH , Syed Shaheer Ali , Troy Coaston MSCR , Konmal Ali , Amulya Vadlakonda MD , Zihan Gao MHSc , Peyman Benharash MD

Introduction

Prior work has linked severe psychiatric illness (SPI) with greater postoperative mortality and complications following several elective operations. However, this relationship has not been defined in the setting of emergency general surgery (EGS).

Methods

The 2016–2021 United States Nationwide Readmissions Database was used to identify all non-elective adult EGS hospitalizations performed within 48 h of admission. SPI was defined using ICD-10 codes for bipolar disorder and schizophrenia. Patients with severe psychiatric illness comprised the SPI cohort (others: Non-SPI). Multivariable linear and logistic regression models were developed to evaluate the independent association of severe psychiatric illness with in-hospital mortality, perioperative complications, and costs.

Results

Of 2,124,284 EGS patients, 52,130 (2.5 %) were categorized as SPI. On adjusted analysis, SPI was associated with greater odds of in-hospital mortality (Adjusted Odds Ratio [AOR] 1.21; 95 % Confidence Interval [CI]:1.11–1.31), hospitalization costs (+$2304; 95 %CI: +1950, +2658), as well as a 3-fold increase in relative risk of non-home discharge (AOR 3.18, 95 % CI: 3.05–3.31).

Conclusions

Among EGS patients, severe psychiatric illness was linked with inferior clinical and financial outcomes. Improved psychiatric screening and care may allow for early intervention and targeted postoperative care, potentially mitigating complications and costs for these vulnerable patients.

先前的研究已经将严重精神疾病（SPI）与一些选择性手术后更高的术后死亡率和并发症联系起来。然而，在急诊普通外科（EGS）中，这种关系尚未明确。方法使用2016-2021年美国全国再入院数据库来识别入院后48小时内进行的所有非选择性成人EGS住院。SPI使用双相情感障碍和精神分裂症的ICD-10代码进行定义。重度精神疾病患者组成SPI队列（其他：非SPI）。建立了多变量线性和逻辑回归模型来评估严重精神疾病与住院死亡率、围手术期并发症和费用的独立关联。结果2124284例EGS患者中，52130例（2.5%）为SPI。经校正分析，SPI与住院死亡率（校正优势比[AOR] 1.21； 95%可信区间[CI]: 1.11-1.31）、住院费用（+ 2304美元；95% CI: +1950, +2658）以及非家庭出院相对风险增加3倍相关（AOR 3.18, 95% CI: 3.05-3.31）。结论在EGS患者中，严重的精神疾病与较差的临床和财务结果有关。改进的精神病学筛查和护理可能允许早期干预和有针对性的术后护理，潜在地减轻这些弱势患者的并发症和费用。

{"title":"Association of psychiatric illness with acute outcomes following emergency general surgery","authors":"Giselle Porter BS , Sara Sakowitz MD MBA MPH , Syed Shaheer Ali , Troy Coaston MSCR , Konmal Ali , Amulya Vadlakonda MD , Zihan Gao MHSc , Peyman Benharash MD","doi":"10.1016/j.sopen.2025.12.001","DOIUrl":"10.1016/j.sopen.2025.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Prior work has linked severe psychiatric illness (SPI) with greater postoperative mortality and complications following several elective operations. However, this relationship has not been defined in the setting of emergency general surgery (EGS).</div></div><div><h3>Methods</h3><div>The 2016–2021 United States Nationwide Readmissions Database was used to identify all non-elective adult EGS hospitalizations performed within 48 h of admission. SPI was defined using ICD-10 codes for bipolar disorder and schizophrenia. Patients with severe psychiatric illness comprised the SPI cohort (others: Non-SPI). Multivariable linear and logistic regression models were developed to evaluate the independent association of severe psychiatric illness with in-hospital mortality, perioperative complications, and costs.</div></div><div><h3>Results</h3><div>Of 2,124,284 EGS patients, 52,130 (2.5 %) were categorized as SPI. On adjusted analysis, SPI was associated with greater odds of in-hospital mortality (Adjusted Odds Ratio [AOR] 1.21; 95 % Confidence Interval [CI]:1.11–1.31), hospitalization costs (+$2304; 95 %CI: +1950, +2658), as well as a 3-fold increase in relative risk of non-home discharge (AOR 3.18, 95 % CI: 3.05–3.31).</div></div><div><h3>Conclusions</h3><div>Among EGS patients, severe psychiatric illness was linked with inferior clinical and financial outcomes. Improved psychiatric screening and care may allow for early intervention and targeted postoperative care, potentially mitigating complications and costs for these vulnerable patients.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"29 ","pages":"Pages 1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753683","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}

引用次数: 0

Isolated right hepatic duct dilation – Type VI of Mirizzi syndrome? 孤立性右肝管扩张- Mirizzi综合征的VI型？

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-12-01 DOI: 10.1016/j.sopen.2025.11.006

Longchang Chen , Yan Sun , Quanda Liu

引用次数: 0

Mesenteric inclusion in Crohn's disease surgery: Promising breakthrough or tempest in a teapot? An updated meta-analysis 克罗恩病手术中的肠系膜包涵术：有希望的突破还是茶壶里的风暴？更新后的元分析

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-12-01 DOI: 10.1016/j.sopen.2025.10.010

Mohamed Maatouk MD, MS , Mohamed Ben Khalifa MD , Nada Essid MD , Aymen Mabrouk MD , Mariem Nouira MD , Moez Boudokhane MD , Mounir Ben Moussa MD, PhD

Background

Recently, renewed concern has been centered on the role of the mesentery in the development of Crohn's disease (CD). However, there are minimal data supporting the extended mesenteric excision (EME), which may lead to reticence in the adoption of this surgical option. This systematic review and meta-analysis aimed to compare the post-operative outcomes in patients undergoing EME vs limited mesenteric excision (LME) for CD.

Methods

We conducted a systematic search from January 2018 to January 2025 for studies reporting outcomes in patients undergoing EME compared with LME for CD. A pooled meta-analysis was performed. The risk of bias was examined using the ROBINS-I v2 and RoB2 tool.

Results

Nine studies were included in final analysis, comprising two randomized controlled trials, enrolling a total of 4823 patients. Definitions of EME differ, with some studies preserving the ileocolic trunk and others resecting the mesentery with proximal ligation. No significant difference in surgical or endoscopic recurrence was observed between EME and LME. Concerning secondary outcomes, including overall morbidity, intra-abdominal abscess, anastomotic leak and hospital stay, the two groups showed no significant differences.

Conclusions

EME appears as safe as the LME in terms of morbidity, but does not significantly reduce surgical or endoscopic recurrence. Due to the absence of a precise definition of the EME procedure in CD and the need of further high-quality research, the approach of EME still lacks sufficient validation and cannot be broadly recommended for routine clinical practice.

最近，人们重新关注肠系膜在克罗恩病（CD）发展中的作用。然而，支持扩展肠系膜切除（EME）的数据很少，这可能导致对采用这种手术选择的保留。本系统综述和荟萃分析旨在比较EME与有限肠系膜切除（LME）治疗CD患者的术后结果。方法我们从2018年1月至2025年1月对报道EME与LME治疗CD患者结果的研究进行了系统检索。使用ROBINS-I v2和RoB2工具检查偏倚风险。结果纳入9项研究，包括2项随机对照试验，共纳入4823例患者。EME的定义不同，一些研究保留回肠结肠干，而另一些研究切除肠系膜并近端结扎。EME和LME在手术或内镜下复发方面无显著差异。在总体发病率、腹内脓肿、吻合口漏、住院时间等次要结局方面，两组无显著差异。结论在发病率方面，seme与LME一样安全，但没有显著减少手术或内镜下复发。由于缺乏对CD中EME程序的精确定义和进一步高质量研究的需要，EME方法仍然缺乏足够的验证，不能广泛推荐用于常规临床实践。

{"title":"Mesenteric inclusion in Crohn's disease surgery: Promising breakthrough or tempest in a teapot? An updated meta-analysis","authors":"Mohamed Maatouk MD, MS , Mohamed Ben Khalifa MD , Nada Essid MD , Aymen Mabrouk MD , Mariem Nouira MD , Moez Boudokhane MD , Mounir Ben Moussa MD, PhD","doi":"10.1016/j.sopen.2025.10.010","DOIUrl":"10.1016/j.sopen.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Recently, renewed concern has been centered on the role of the mesentery in the development of Crohn's disease (CD). However, there are minimal data supporting the extended mesenteric excision (EME), which may lead to reticence in the adoption of this surgical option. This systematic review and meta-analysis aimed to compare the post-operative outcomes in patients undergoing EME vs limited mesenteric excision (LME) for CD.</div></div><div><h3>Methods</h3><div>We conducted a systematic search from January 2018 to January 2025 for studies reporting outcomes in patients undergoing EME compared with LME for CD. A pooled meta-analysis was performed. The risk of bias was examined using the ROBINS-I v2 and RoB2 tool.</div></div><div><h3>Results</h3><div>Nine studies were included in final analysis, comprising two randomized controlled trials, enrolling a total of 4823 patients. Definitions of EME differ, with some studies preserving the ileocolic trunk and others resecting the mesentery with proximal ligation. No significant difference in surgical or endoscopic recurrence was observed between EME and LME. Concerning secondary outcomes, including overall morbidity, intra-abdominal abscess, anastomotic leak and hospital stay, the two groups showed no significant differences.</div></div><div><h3>Conclusions</h3><div>EME appears as safe as the LME in terms of morbidity, but does not significantly reduce surgical or endoscopic recurrence. Due to the absence of a precise definition of the EME procedure in CD and the need of further high-quality research, the approach of EME still lacks sufficient validation and cannot be broadly recommended for routine clinical practice.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 89-97"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623886","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}

引用次数: 0

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IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-12-01 DOI: 10.1016/S2589-8450(25)00103-4

引用次数: 0

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