Surgery open science最新文献

Use of a microvascular anastomotic coupler device for kidney transplantation in rats

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-31 DOI: 10.1016/j.sopen.2025.01.008

Henrik Lauer, Jana Ritter, Patrick Nachtnebel, Kathrin Simmendinger, Emily Lerchbaumer, Vladyslav Kavaka, Dominik Steiner, Jonas Kolbenschlag, Adrien Daigeler, Johannes C. Heinzel

Background

Allogenic kidney transplantation has been the gold standard treatment for end-stage renal disease. In the research setting, rat models are widely utilized to refine surgical techniques and enhance graft viability. One critical factor affecting transplantation outcomes is the efficiency of the venous anastomosis. This study evaluates the utility of a microvascular coupling device for venous anastomosis in a rat kidney transplantation model.

Material and methods

Experimental allogenic kidney transplantations were conducted in male Brown Norway rats (n = 10) as donors and Lewis rats as recipients (n = 17), housed according to institutional guidelines. A microvascular coupling device was used for renal venous anastomosis, and creatinine levels were measured postoperatively to assess kidney function. Procedure times, ischemia duration, and postoperative complications were recorded and analyzed.

Results

The venous anastomosis time averaged 6.6 ± 2.2 min. Total ischemia time averaged 42.4 ± 4.9 min. Early postoperative serum creatinine levels were slightly elevated about references thresholds, which normalized by postoperative day 3. Four animals died after successful transplantation due to urethral complications and postrenal failure (23.5 %). Other postoperative mortality was primarily linked to complications unrelated to thrombosis (n = 3, 17.6 %).

Conclusion

The use of a microvascular coupling device for venous anastomosis in rat kidney transplantation significantly reduces procedure time and ischemia duration, contributing to more consistent graft outcomes. The simplification of the venous anastomosis process and reduced operative time justify the use of coupling devices. This technique holds promise for advancing preclinical transplant research and improving reproducibility in microsurgical procedures.

{"title":"Use of a microvascular anastomotic coupler device for kidney transplantation in rats","authors":"Henrik Lauer, Jana Ritter, Patrick Nachtnebel, Kathrin Simmendinger, Emily Lerchbaumer, Vladyslav Kavaka, Dominik Steiner, Jonas Kolbenschlag, Adrien Daigeler, Johannes C. Heinzel","doi":"10.1016/j.sopen.2025.01.008","DOIUrl":"10.1016/j.sopen.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Allogenic kidney transplantation has been the gold standard treatment for end-stage renal disease. In the research setting, rat models are widely utilized to refine surgical techniques and enhance graft viability. One critical factor affecting transplantation outcomes is the efficiency of the venous anastomosis. This study evaluates the utility of a microvascular coupling device for venous anastomosis in a rat kidney transplantation model.</div></div><div><h3>Material and methods</h3><div>Experimental allogenic kidney transplantations were conducted in male Brown Norway rats (<em>n</em> = 10) as donors and Lewis rats as recipients (<em>n</em> = 17), housed according to institutional guidelines. A microvascular coupling device was used for renal venous anastomosis, and creatinine levels were measured postoperatively to assess kidney function. Procedure times, ischemia duration, and postoperative complications were recorded and analyzed.</div></div><div><h3>Results</h3><div>The venous anastomosis time averaged 6.6 ± 2.2 min. Total ischemia time averaged 42.4 ± 4.9 min. Early postoperative serum creatinine levels were slightly elevated about references thresholds, which normalized by postoperative day 3. Four animals died after successful transplantation due to urethral complications and postrenal failure (23.5 %). Other postoperative mortality was primarily linked to complications unrelated to thrombosis (<em>n</em> = 3, 17.6 %).</div></div><div><h3>Conclusion</h3><div>The use of a microvascular coupling device for venous anastomosis in rat kidney transplantation significantly reduces procedure time and ischemia duration, contributing to more consistent graft outcomes. The simplification of the venous anastomosis process and reduced operative time justify the use of coupling devices. This technique holds promise for advancing preclinical transplant research and improving reproducibility in microsurgical procedures.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 16-22"},"PeriodicalIF":1.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Propensity matched analysis of DPA or DPL used within the first hour for severely hypotensive blunt trauma patients

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-25 DOI: 10.1016/j.sopen.2025.01.005

Mallory Jebbia MD, Jeffry Nahmias MD MHPE, Sebastian Schubl MD, Matthew Dolich MD, Michael Lekawa MD, Allen Kong MD, Areg Grigorian MD

Background

Prior single-center reports advocate for use of diagnostic peritoneal aspiration or lavage (DPA/DPL) to identify blunt trauma patients (BTPs) with intra-abdominal hemorrhage who require emergent surgery. Despite this, concerns exist over the potential for DPA/DPL to delay transfer to the operating room (OR). We hypothesized that DPA/DPL application in severely hypotensive BTPs would lead to increased OR transfer time and in-hospital mortality.

Methods

The 2017–2019 TQIP database was queried for adult BTPs presenting with severe hypotension (systolic blood pressure <70 mmHg) who underwent any operative intervention within two-hours. Using a 1:2 propensity-score model, patients who underwent DPA/DPL within one-hour of arrival were compared with those who did not, controlling for age, sex, comorbidities, ≥6 units of packed red cells within 4 h, and injury profile.

Results

From 5514 patients, 62 (1.1 %) underwent DPA/DPL. We matched 52 DPA/DPL patients to 104 patients not undergoing DPA/DPL. There were no differences in the matched variables between cohorts (all p > 0.05). Compared to those not undergoing DPA/DPL, patients undergoing DPA/DPL had a higher rate/risk of in-hospital complications (59.6 % vs. 39.4 %, p = 0.02) (OR 2.27, CI 1.15–4.47, p = 0.02) but statistically similar rate/risk of death (65.4 % vs. 50.0 %, p = 0.07) (OR 1.89, CI 0.95–3.76, p = 0.07). Time to OR was similar between both groups (DPA/DPL 39 min vs. non-DPA/DPL 42 min, p = 0.87).

Conclusion

DPA or DPL used within the first hour of arrival does not appear to delay time to OR and does not increase risk of death. This challenges concerns over potential DPA/DPL-associated delays and heightened mortality risks.

{"title":"Propensity matched analysis of DPA or DPL used within the first hour for severely hypotensive blunt trauma patients","authors":"Mallory Jebbia MD, Jeffry Nahmias MD MHPE, Sebastian Schubl MD, Matthew Dolich MD, Michael Lekawa MD, Allen Kong MD, Areg Grigorian MD","doi":"10.1016/j.sopen.2025.01.005","DOIUrl":"10.1016/j.sopen.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Prior single-center reports advocate for use of diagnostic peritoneal aspiration or lavage (DPA/DPL) to identify blunt trauma patients (BTPs) with intra-abdominal hemorrhage who require emergent surgery. Despite this, concerns exist over the potential for DPA/DPL to delay transfer to the operating room (OR). We hypothesized that DPA/DPL application in severely hypotensive BTPs would lead to increased OR transfer time and in-hospital mortality.</div></div><div><h3>Methods</h3><div>The 2017–2019 TQIP database was queried for adult BTPs presenting with severe hypotension (systolic blood pressure <70 mmHg) who underwent any operative intervention within two-hours. Using a 1:2 propensity-score model, patients who underwent DPA/DPL within one-hour of arrival were compared with those who did not, controlling for age, sex, comorbidities, ≥6 units of packed red cells within 4 h, and injury profile.</div></div><div><h3>Results</h3><div>From 5514 patients, 62 (1.1 %) underwent DPA/DPL. We matched 52 DPA/DPL patients to 104 patients not undergoing DPA/DPL. There were no differences in the matched variables between cohorts (all p > 0.05). Compared to those not undergoing DPA/DPL, patients undergoing DPA/DPL had a higher rate/risk of in-hospital complications (59.6 % vs. 39.4 %, p = 0.02) (OR 2.27, CI 1.15–4.47, p = 0.02) but statistically similar rate/risk of death (65.4 % vs. 50.0 %, p = 0.07) (OR 1.89, CI 0.95–3.76, p = 0.07). Time to OR was similar between both groups (DPA/DPL 39 min vs. non-DPA/DPL 42 min, p = 0.87).</div></div><div><h3>Conclusion</h3><div>DPA or DPL used within the first hour of arrival does not appear to delay time to OR and does not increase risk of death. This challenges concerns over potential DPA/DPL-associated delays and heightened mortality risks.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 1-4"},"PeriodicalIF":1.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Innovative strategies in bile duct repair: Assessing efficacy and safety across varied graft techniques - A systematic review

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-25 DOI: 10.1016/j.sopen.2025.01.006

Anung Noto Nugroho , Soetrisno Soetrisno , Ambar Mudigdo , Kristanto Yuli Yarso , Dono Indarto , Akmal Zhahir Wahyudi , Enrico Ananda Budiono , Auliya Yudia Yasyfin

Bile duct injuries (BDI) from surgical procedures pose significant clinical challenges, requiring precise interventions for optimal outcomes. This systematic review explores the utilization of grafts in the repair of bile duct injuries, aiming to gain insights from existing literature. Graft-based techniques show promise in improving postoperative outcomes, but their efficacy varies. A systematic search was conducted across PubMed, Science Direct, and Scopus following the PRISMA 2020 Checklist, focusing on studies published until February 19, 2024. The inclusion criteria involved research using grafts to treat bile duct injuries in pig, swine, or mini-pig models. Out of 2231 studies identified, eleven met the inclusion criteria. These studies evaluated various graft techniques, including autologous tissue with biodegradable stents, decellularized grafts, patches, prosthetic grafts, bacterial cellulose film, and heterogeneous materials. Each method had distinct advantages and limitations, particularly regarding postoperative outcomes and histological findings. This review highlights the need for further research to determine the most effective graft-based strategies for BDI repair and improve patient care.

{"title":"Innovative strategies in bile duct repair: Assessing efficacy and safety across varied graft techniques - A systematic review","authors":"Anung Noto Nugroho , Soetrisno Soetrisno , Ambar Mudigdo , Kristanto Yuli Yarso , Dono Indarto , Akmal Zhahir Wahyudi , Enrico Ananda Budiono , Auliya Yudia Yasyfin","doi":"10.1016/j.sopen.2025.01.006","DOIUrl":"10.1016/j.sopen.2025.01.006","url":null,"abstract":"<div><div>Bile duct injuries (BDI) from surgical procedures pose significant clinical challenges, requiring precise interventions for optimal outcomes. This systematic review explores the utilization of grafts in the repair of bile duct injuries, aiming to gain insights from existing literature. Graft-based techniques show promise in improving postoperative outcomes, but their efficacy varies. A systematic search was conducted across PubMed, Science Direct, and Scopus following the PRISMA 2020 Checklist, focusing on studies published until February 19, 2024. The inclusion criteria involved research using grafts to treat bile duct injuries in pig, swine, or mini-pig models. Out of 2231 studies identified, eleven met the inclusion criteria. These studies evaluated various graft techniques, including autologous tissue with biodegradable stents, decellularized grafts, patches, prosthetic grafts, bacterial cellulose film, and heterogeneous materials. Each method had distinct advantages and limitations, particularly regarding postoperative outcomes and histological findings. This review highlights the need for further research to determine the most effective graft-based strategies for BDI repair and improve patient care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"24 ","pages":"Pages 5-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A retrospective study assessing RefluxStop surgery for gastroesophageal reflux disease: Clinical outcomes in 79 patients from Germany 一项评估RefluxStop手术治疗胃食管反流病的回顾性研究：来自德国的79例患者的临床结果

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.003

Thorsten Lehmann MD, Mantas Šimkus MD, Christoph Oehler MD

Background

This study reports outcomes of the RefluxStop procedure treating gastroesophageal reflux disease (GERD) in clinical practice at a high-volume regional hospital in Germany.

Methods

A retrospective analysis was conducted on 79 patients with chronic GERD that underwent the RefluxStop procedure, comprising high mediastinal dissection, loose cruroplasty, esophagogastroplication between vagal trunks, and fundus invagination of the RefluxStop implant. The primary outcome was GERD Health-Related Quality-of-Life (GERD-HRQL) score and improvement from baseline. Secondary outcomes included proton pump inhibitor (PPI) use and intra- and postoperative complications, including dysphagia, esophageal dilatation, and reoperation.

Results

Baseline characteristics (n = 79) included large hiatal hernia >3 cm (32.4 %) and previous antireflux surgery (20.3 %). At mean (SD) follow-up of 11 (4.4) months ranging from 4 to 19 months, the median (IQR) and mean (SD) improvements in GERD-HRQL score were 100 % (90.2–100 %) and 92.4 % (13.9 %) from baseline, respectively. Significant reduction in PPI use was observed from a baseline of 94.9 % to 2.5 % at follow-up. All cases of preoperative dysphagia (7.6 %) completely resolved. New-onset, mild dysphagia occurred in one subject (1.3 %) at final follow-up. One subject (1.3 %) experienced asymptomatic device migration into the stomach, likely due to surgical technique with a much too tight invagination, with subsequent conversion to Toupet fundoplication.

Conclusion

Analysis of this cohort that underwent RefluxStop surgery indicates excellent safety and effectiveness over this short-term follow-up. Significant improvements in quality of life and PPI use were observed in a population where half had either large hiatal hernia >3 cm or reoperation for previously failed antireflux surgery, a demographic with usually much higher complication rates.

背景：本研究报告了在德国一家大容量地区医院应用RefluxStop治疗胃食管反流病（GERD）的临床实践结果。方法：回顾性分析79例接受了reffluxstop手术的慢性胃食管反流病患者，包括高纵隔分离、松散胃成形术、迷走干之间的食管胃折叠和reffluxstop植入物的眼底内陷。主要终点是GERD健康相关生活质量（GERD- hrql）评分和较基线的改善。次要结果包括质子泵抑制剂（PPI）的使用和术中及术后并发症，包括吞咽困难、食管扩张和再手术。结果：基线特征（n = 79）包括大裂孔疝（3cm）（32.4%）和既往抗反流手术（20.3%）。平均（SD）随访11（4.4）个月，从4到19个月，与基线相比，GERD-HRQL评分的中位（IQR）和平均（SD）改善分别为100%（90.2- 100%）和92.4%（13.9%）。随访时观察到PPI的使用从基线的94.9%显著降低到2.5%。所有术前吞咽困难病例（7.6%）完全缓解。在最后的随访中，有一名受试者（1.3%）出现了新发的轻度吞咽困难。1名受试者（1.3%）无症状地将器械移至胃内，可能是由于手术技术过于紧致内陷，随后转换为Toupet底吻合。结论：对该队列进行了reffluxstop手术的分析表明，该短期随访具有良好的安全性和有效性。生活质量和PPI的使用均有显著改善，其中一半的患者患有大裂孔疝（30cm）或因先前失败的抗反流手术而再次手术，这一人群的并发症发生率通常更高。

{"title":"A retrospective study assessing RefluxStop surgery for gastroesophageal reflux disease: Clinical outcomes in 79 patients from Germany","authors":"Thorsten Lehmann MD, Mantas Šimkus MD, Christoph Oehler MD","doi":"10.1016/j.sopen.2024.12.003","DOIUrl":"10.1016/j.sopen.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>This study reports outcomes of the RefluxStop procedure treating gastroesophageal reflux disease (GERD) in clinical practice at a high-volume regional hospital in Germany.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 79 patients with chronic GERD that underwent the RefluxStop procedure, comprising high mediastinal dissection, loose cruroplasty, esophagogastroplication between vagal trunks, and fundus invagination of the RefluxStop implant. The primary outcome was GERD Health-Related Quality-of-Life (GERD-HRQL) score and improvement from baseline. Secondary outcomes included proton pump inhibitor (PPI) use and intra- and postoperative complications, including dysphagia, esophageal dilatation, and reoperation.</div></div><div><h3>Results</h3><div>Baseline characteristics (<em>n</em> = 79) included large hiatal hernia >3 cm (32.4 %) and previous antireflux surgery (20.3 %). At mean (SD) follow-up of 11 (4.4) months ranging from 4 to 19 months, the median (IQR) and mean (SD) improvements in GERD-HRQL score were 100 % (90.2–100 %) and 92.4 % (13.9 %) from baseline, respectively. Significant reduction in PPI use was observed from a baseline of 94.9 % to 2.5 % at follow-up. All cases of preoperative dysphagia (7.6 %) completely resolved. New-onset, mild dysphagia occurred in one subject (1.3 %) at final follow-up. One subject (1.3 %) experienced asymptomatic device migration into the stomach, likely due to surgical technique with a much too tight invagination, with subsequent conversion to Toupet fundoplication.</div></div><div><h3>Conclusion</h3><div>Analysis of this cohort that underwent RefluxStop surgery indicates excellent safety and effectiveness over this short-term follow-up. Significant improvements in quality of life and PPI use were observed in a population where half had either large hiatal hernia >3 cm or reoperation for previously failed antireflux surgery, a demographic with usually much higher complication rates.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 9-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical procedures and techniques in robot-assisted retrograde para-aortic lymphadenectomy

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.008

Xinyou Wang, Jing Na, Ya Li, Shichao Han, Jun Wang

Background

To study the robotic-assisted abdominal aorta lymphadenectomy at the level of the left renal vein, aimed at standardizing and optimizing the surgical procedure.

Methods

All surgical procedures are guided by the theory of membrane anatomy, operating within the intermembrane spaces of embryonic compartments.

Results

Using robotic assistance in an inverted position to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein enables safe and reliable lymph node removal, combined with the concept of membrane anatomy, not only minimizes surgical bleeding but also helps reduce complications, such as vascular and intestinal injuries.

Conclusion

Utilizing robotics to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein can achieve a more meticulous and refined surgical outcome. Precise surgical techniques contribute to standardizing and optimizing surgical procedures, thereby facilitating the learning process.

Trial registration

No trial involve.

{"title":"Surgical procedures and techniques in robot-assisted retrograde para-aortic lymphadenectomy","authors":"Xinyou Wang, Jing Na, Ya Li, Shichao Han, Jun Wang","doi":"10.1016/j.sopen.2024.12.008","DOIUrl":"10.1016/j.sopen.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>To study the robotic-assisted abdominal aorta lymphadenectomy at the level of the left renal vein, aimed at standardizing and optimizing the surgical procedure.</div></div><div><h3>Methods</h3><div>All surgical procedures are guided by the theory of membrane anatomy, operating within the intermembrane spaces of embryonic compartments.</div></div><div><h3>Results</h3><div>Using robotic assistance in an inverted position to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein enables safe and reliable lymph node removal, combined with the concept of membrane anatomy, not only minimizes surgical bleeding but also helps reduce complications, such as vascular and intestinal injuries.</div></div><div><h3>Conclusion</h3><div>Utilizing robotics to perform lymphadenectomy of the abdominal aorta at the level of the left renal vein can achieve a more meticulous and refined surgical outcome. Precise surgical techniques contribute to standardizing and optimizing surgical procedures, thereby facilitating the learning process.</div></div><div><h3>Trial registration</h3><div>No trial involve.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 35-41"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The succession of One Day Surgery with Breast Cancer Home Recovery Program by the National Cancer Institute (ODS BHR NCI) during the COVID-19 pandemic in Thailand 泰国国家癌症研究所（ODS BHR NCI）在2019冠状病毒病（COVID-19）大流行期间连续实施“乳腺癌家庭康复一天手术”计划。

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.001

Chayanoot Rattadilok , Napaphat Poprom , Vipavee Niyomnaitham , Oradee Phadhana-anake , Jirawadee Ruamjaroenchai , Napat Saigosoom , Wimonporn Papathe , Suttida Thuranutch , Araya Chanwet

Background

Breast cancer is the most common cancer among women. In response to the need to hospital stays and minimize waiting time for surgery, particularly during the COVID-19 pandemic, the National Cancer Institute developed the One Day Surgery with Breast cancer Home Recovery program (ODS BHR NCI). The aim of study is to assess the success rate of breast cancer surgeries conducted through this program and to evaluate the incidence of complications.

Method

The cohort study includes all breast cancer patients who underwent surgery through the ODS BHR NCI program between August 2021 to November 2023. Eligible participants were under 70 years of age. The patients received comprehensive care and education from a multidisciplinary team, adhering to the program's guidelines. Their postoperative outcomes were monitored on the 1^st, 3^rd, and 5^th days following discharge.

Result

A total of 206 patients participated in the ODS BHR NCI program during the COVID-19 pandemic in Thailand. The mean age and BMI were 54.21 ± 9.74 years and 24.18 ± 4.02, respectively. The success rate was 99.02 %, with only one case involving a serious complication. Minor complications were reported in 20 cases, including anesthesia-related issues and minor surgical complications. Notably, no patients were diagnosed with COVID-19 following their surgery.

Conclusion

Breast cancer surgeries performed under the ODS BHR NCI program achieved a high success rate. The development of pre-, intra-, and post-operative care protocols, alongside comprehensive patient education, has potential to reduce complications and provide an effective model for extending systemic care to a wider range of patients.

背景：乳腺癌是女性中最常见的癌症。为了满足住院时间的需求并最大限度地减少手术等待时间，特别是在2019冠状病毒病大流行期间，美国国家癌症研究所制定了“乳腺癌家庭康复一天手术计划”（ODS BHR NCI）。研究的目的是评估通过该方案进行的乳腺癌手术的成功率和评估并发症的发生率。方法：队列研究包括所有在2021年8月至2023年11月期间通过ODS BHR NCI项目接受手术的乳腺癌患者。符合条件的参与者年龄在70岁以下。患者接受了多学科团队的全面护理和教育，并遵守了该计划的指导方针。在出院后第1天、第3天和第5天监测患者的术后情况。结果：泰国2019冠状病毒病大流行期间，共有206名患者参加了ODS BHR NCI项目。平均年龄为54.21±9.74岁，BMI为24.18±4.02岁。手术成功率为99.02%，仅有1例发生严重并发症。报告了20例轻微并发症，包括麻醉相关问题和轻微手术并发症。值得注意的是，没有患者在手术后被诊断为COVID-19。结论：ODS BHR NCI方案下的乳腺癌手术成功率高。术前、术中和术后护理方案的制定，以及全面的患者教育，有可能减少并发症，并为更广泛的患者提供系统护理的有效模式。

{"title":"The succession of One Day Surgery with Breast Cancer Home Recovery Program by the National Cancer Institute (ODS BHR NCI) during the COVID-19 pandemic in Thailand","authors":"Chayanoot Rattadilok , Napaphat Poprom , Vipavee Niyomnaitham , Oradee Phadhana-anake , Jirawadee Ruamjaroenchai , Napat Saigosoom , Wimonporn Papathe , Suttida Thuranutch , Araya Chanwet","doi":"10.1016/j.sopen.2024.12.001","DOIUrl":"10.1016/j.sopen.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most common cancer among women. In response to the need to hospital stays and minimize waiting time for surgery, particularly during the COVID-19 pandemic, the National Cancer Institute developed the One Day Surgery with Breast cancer Home Recovery program (ODS BHR NCI). The aim of study is to assess the success rate of breast cancer surgeries conducted through this program and to evaluate the incidence of complications.</div></div><div><h3>Method</h3><div>The cohort study includes all breast cancer patients who underwent surgery through the ODS BHR NCI program between August 2021 to November 2023. Eligible participants were under 70 years of age. The patients received comprehensive care and education from a multidisciplinary team, adhering to the program's guidelines. Their postoperative outcomes were monitored on the 1<sup>st</sup>, 3<sup>rd</sup>, and 5<sup>th</sup> days following discharge.</div></div><div><h3>Result</h3><div>A total of 206 patients participated in the ODS BHR NCI program during the COVID-19 pandemic in Thailand. The mean age and BMI were 54.21 ± 9.74 years and 24.18 ± 4.02, respectively. The success rate was 99.02 %, with only one case involving a serious complication. Minor complications were reported in 20 cases, including anesthesia-related issues and minor surgical complications. Notably, no patients were diagnosed with COVID-19 following their surgery.</div></div><div><h3>Conclusion</h3><div>Breast cancer surgeries performed under the ODS BHR NCI program achieved a high success rate. The development of pre-, intra-, and post-operative care protocols, alongside comprehensive patient education, has potential to reduce complications and provide an effective model for extending systemic care to a wider range of patients.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 1-8"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Board Page

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/S2589-8450(25)00007-7

引用次数: 0

NIH funding for the pediatric surgeon-scientist: An analysis of current trends

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.005

Colton D. Wayne MD , Zachary Dumbauld BS , Ethan Mills BS , Diana L. Farmer MD , Gail E. Besner MD

Background/purpose

Previous studies highlighted the success of pediatric surgeons in obtaining NIH funding. Given increasing clinical demands, we sought to analyze the current state of NIH funding for pediatric surgeon-scientists.

Methods

APSA membership in August 2023 was filtered for Regular/Associate members and referenced through NIH RePORTER. Data included history of prior/active NIH funding, award type/institute, and funding pathways. Demographics collected included level of professorship, post-graduate degrees, and gender. Academic productivity was assessed by PubMed publications. In addition, a survey was distributed to Regular/Associate APSA members.

Results

1079 APSA Regular/Associate members were identified. Total (previous/current) funding: 149 (13.8 %) surgeons had previous/current NIH funding, 145 with complete funding information. There were 371 previous/current grants totaling $387,148,625. 31.7 % of funded surgeons held Chair/Chief positions, 77.9 % were male, and 84.1 % had M.D. degree only. 282 (76.0 %) grants were independent, and 42 (11.3 %) were mentored. 100 (69.0 %) funded surgeons obtained independent investigator awards, 33 (22.8 %) with and 67 (46.2 %) without prior training/mentored grants. Current funding: 52 (4.8 %) surgeons had current NIH funding, with 80 grants totaling $44,232,644. 73 (91.25 %) were independent while 7 (8.75 %) were mentored awards. Academic productivity: Assessment revealed 7197 total publications (range = 0–207, mean = 49.6). Survey: results highlighted perceived challenges and suggested improvements.

Conclusions

Compared to a 2013 study by King et al., the percent of funded APSA members has trended downward; however, the number of funded pediatric surgeon-scientists and dollar amount of active NIH funds has increased. Concentrated efforts are needed to support surgical trainees and junior faculty, particularly females, to pursue research and academic pediatric surgery.

{"title":"NIH funding for the pediatric surgeon-scientist: An analysis of current trends","authors":"Colton D. Wayne MD , Zachary Dumbauld BS , Ethan Mills BS , Diana L. Farmer MD , Gail E. Besner MD","doi":"10.1016/j.sopen.2024.12.005","DOIUrl":"10.1016/j.sopen.2024.12.005","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Previous studies highlighted the success of pediatric surgeons in obtaining NIH funding. Given increasing clinical demands, we sought to analyze the current state of NIH funding for pediatric surgeon-scientists.</div></div><div><h3>Methods</h3><div>APSA membership in August 2023 was filtered for Regular/Associate members and referenced through NIH RePORTER. Data included history of prior/active NIH funding, award type/institute, and funding pathways. Demographics collected included level of professorship, post-graduate degrees, and gender. Academic productivity was assessed by PubMed publications. In addition, a survey was distributed to Regular/Associate APSA members.</div></div><div><h3>Results</h3><div>1079 APSA Regular/Associate members were identified. <u>Total (previous/current) funding</u>: 149 (13.8 %) surgeons had previous/current NIH funding, 145 with complete funding information. There were 371 previous/current grants totaling $387,148,625. 31.7 % of funded surgeons held Chair/Chief positions, 77.9 % were male, and 84.1 % had M.D. degree only. 282 (76.0 %) grants were independent, and 42 (11.3 %) were mentored. 100 (69.0 %) funded surgeons obtained independent investigator awards, 33 (22.8 %) with and 67 (46.2 %) without prior training/mentored grants. <u>Current funding</u>: 52 (4.8 %) surgeons had current NIH funding, with 80 grants totaling $44,232,644. 73 (91.25 %) were independent while 7 (8.75 %) were mentored awards. <u>Academic productivity</u>: Assessment revealed 7197 total publications (range = 0–207, mean = 49.6). <u>Survey:</u> results highlighted perceived challenges and suggested improvements.</div></div><div><h3>Conclusions</h3><div>Compared to a 2013 study by King et al., the percent of funded APSA members has trended downward; however, the number of funded pediatric surgeon-scientists and dollar amount of active NIH funds has increased. Concentrated efforts are needed to support surgical trainees and junior faculty, particularly females, to pursue research and academic pediatric surgery.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 42-49"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age-stratified trends and outcomes of inpatient cholecystectomy for acute cholecystitis in the United States 美国急性胆囊炎住院胆囊切除术的年龄分层趋势和结果

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.006

Ayesha P. Ng, Joseph E. Hadaya, Sara Sakowitz, Zihan Gao, James Wu, Peyman Benharash

Background

The elderly population in the United States is rapidly expanding. Older patients over age 65 with acute cholecystitis may face greater perioperative risk compared to younger patients undergoing urgent laparoscopic cholecystectomy. We aimed to characterize trends in utilization and outcomes of inpatient cholecystectomy across the United States stratified by age.

Methods

All adults undergoing nonelective, laparoscopic cholecystectomy for acute cholecystitis in the 2012–2021 National Inpatient Sample were identified. Patients were stratified into 4 age groups: 18–49, 50–64, 65–79, and 80+ years. Major adverse events included in-hospital mortality and complications. Multivariable mixed regression was used to evaluate the association of age group with outcomes. Interaction terms were used to analyze differences in risk-adjusted outcomes over time.

Results

Of 2,015,699 patients, 41.7 % were aged 18–49, 24.7 % were 50–64, 23.5 % were 65–79, and 10.2 % were 80+ years. Patients aged 65–79 and 80+ had major adverse event rates of 25 % and 34 %, respectively, compared to 5–14 % among younger patients (p < 0.001). After adjustment, patients over age 65 demonstrated nearly 2-fold greater odds of major adverse events (including repair of bile duct injury) and conversion to an open operation compared to younger patients. Patients aged 65–79 comprised an increasing proportion of cholecystectomy cases over time, from 20.0 % in 2012 to 27.5 % in 2021 (p < 0.001).

Conclusions

Outcomes following cholecystectomy for acute cholecystitis among older patients remained significantly worse compared to younger patients over the past decade, with complication rates of 25–34 %. Preoperative counseling about the increased risk of complications following cholecystectomy for older patients is warranted.

背景：美国的老年人口正在迅速扩大。65岁以上的老年急性胆囊炎患者与接受紧急腹腔镜胆囊切除术的年轻患者相比，可能面临更大的围手术期风险。我们的目的是描述全美国按年龄分层的住院胆囊切除术的使用趋势和结果。方法：选取2012-2021年全国住院患者样本中所有接受非选择性腹腔镜胆囊切除术治疗急性胆囊炎的成年人。患者分为4个年龄组：18-49岁、50-64岁、65-79岁和80+岁。主要不良事件包括住院死亡率和并发症。采用多变量混合回归评价年龄组与预后的关系。相互作用项用于分析随时间变化的风险调整结果的差异。结果：2015699例患者中，18-49岁占41.7%，50-64岁占24.7%，65-79岁占23.5%，80岁以上占10.2%。65-79岁和80岁以上患者的严重不良事件发生率分别为25%和34%，而年轻患者的严重不良事件发生率为5- 14% (p p结论：在过去十年中，老年患者急性胆囊炎胆囊切除术后的预后仍明显差于年轻患者，并发症发生率为25- 34%。术前咨询关于老年患者胆囊切除术后并发症风险增加是必要的。

{"title":"Age-stratified trends and outcomes of inpatient cholecystectomy for acute cholecystitis in the United States","authors":"Ayesha P. Ng, Joseph E. Hadaya, Sara Sakowitz, Zihan Gao, James Wu, Peyman Benharash","doi":"10.1016/j.sopen.2024.12.006","DOIUrl":"10.1016/j.sopen.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The elderly population in the United States is rapidly expanding. Older patients over age 65 with acute cholecystitis may face greater perioperative risk compared to younger patients undergoing urgent laparoscopic cholecystectomy. We aimed to characterize trends in utilization and outcomes of inpatient cholecystectomy across the United States stratified by age.</div></div><div><h3>Methods</h3><div>All adults undergoing nonelective, laparoscopic cholecystectomy for acute cholecystitis in the 2012–2021 National Inpatient Sample were identified. Patients were stratified into 4 age groups: 18–49, 50–64, 65–79, and 80+ years. Major adverse events included in-hospital mortality and complications. Multivariable mixed regression was used to evaluate the association of age group with outcomes. Interaction terms were used to analyze differences in risk-adjusted outcomes over time.</div></div><div><h3>Results</h3><div>Of 2,015,699 patients, 41.7 % were aged 18–49, 24.7 % were 50–64, 23.5 % were 65–79, and 10.2 % were 80+ years. Patients aged 65–79 and 80+ had major adverse event rates of 25 % and 34 %, respectively, compared to 5–14 % among younger patients (<em>p</em> < 0.001). After adjustment, patients over age 65 demonstrated nearly 2-fold greater odds of major adverse events (including repair of bile duct injury) and conversion to an open operation compared to younger patients. Patients aged 65–79 comprised an increasing proportion of cholecystectomy cases over time, from 20.0 % in 2012 to 27.5 % in 2021 (<em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Outcomes following cholecystectomy for acute cholecystitis among older patients remained significantly worse compared to younger patients over the past decade, with complication rates of 25–34 %. Preoperative counseling about the increased risk of complications following cholecystectomy for older patients is warranted.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 24-29"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2025.01.002

Brian Williams MD , Aubrey Swinford MD , Jordan Martucci MD , Johnny Wang MD , Jordan R. Wlodarczyk MD , Abhinav Gupta MD , Kyle G. Cologne MD , Sarah E. Koller MD , Christine Hsieh MD , Marjun P. Duldulao MD , Joongho Shin MD

Background

The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods.

Methods

This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported.

Results

Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days.

Conclusion

Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.

{"title":"Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal","authors":"Brian Williams MD , Aubrey Swinford MD , Jordan Martucci MD , Johnny Wang MD , Jordan R. Wlodarczyk MD , Abhinav Gupta MD , Kyle G. Cologne MD , Sarah E. Koller MD , Christine Hsieh MD , Marjun P. Duldulao MD , Joongho Shin MD","doi":"10.1016/j.sopen.2025.01.002","DOIUrl":"10.1016/j.sopen.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods.</div></div><div><h3>Methods</h3><div>This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported.</div></div><div><h3>Results</h3><div>Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days.</div></div><div><h3>Conclusion</h3><div>Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 69-74"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0