Surgery open science最新文献

英文中文

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.

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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。

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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

Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2025.01.001

Dietrich Doll , Susanne Haas , Ida Kaad Faurschou , Theo Hackmann , Henrike Heitmann , Myriam Braun-Münker , Christina Oetzmann von Sochaczewski

Background

Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.

Methods

Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.

Results

Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; p < 0.0001). The subgroup of individuals aged 16–18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.

Conclusions

Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.

{"title":"Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults","authors":"Dietrich Doll , Susanne Haas , Ida Kaad Faurschou , Theo Hackmann , Henrike Heitmann , Myriam Braun-Münker , Christina Oetzmann von Sochaczewski","doi":"10.1016/j.sopen.2025.01.001","DOIUrl":"10.1016/j.sopen.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.</div></div><div><h3>Methods</h3><div>Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.</div></div><div><h3>Results</h3><div>Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; <em>p</em> < 0.0001). The subgroup of individuals aged 16–18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.</div></div><div><h3>Conclusions</h3><div>Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 50-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100638","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 usefulness of presepsin in the early detection of anastomotic leakage after esophagectomy

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2025.01.003

Yoshiro Imai, Ryo Tanaka, Kentaro Matsuo, Hidero Yoshimoto, Mitsuhiro Asakuma, Hideki Tomiyama, Sang-Woong Lee

Background

Anastomotic leakage is a severe complication of esophagectomy, therefore early detection is crucial. Presepsin is a biomarker for early diagnosis of infectious complications. This study assessed presepsin as a biomarker for anastomotic leakage after esophagectomy, compared to C-reactive protein (CRP), white blood cells (WBCs), and neutrophils (Neuts).

Materials and methods

This study enrolled 27 patients between October 2019 and December 2020. Levels of presepsin, CRP, WBCs, and Neuts were measured preoperatively and on postoperative days (PODs) 1, 3, 5, and 7.

Results

Five patients had anastomotic leakage. Their presepsin levels on POD 7 were significantly higher and tended to be higher on POD 5 (p = 0.04 and p = 0.06, respectively) compared to those without leakage. The area under the curve values for presepsin were highest on PODs 5 and 7 (0.89 and 0.83). Optimal cut-off values for presepsin were 400 pg/mL (sensitivity 100 %; specificity 81.9 %) on POD 5 and similar on POD 7.

Conclusions

Presepsin levels on PODs 5 and 7 effectively detect anastomotic leakage after esophagectomy, making it a valuable, simple, non-invasive early detection test.

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引用次数: 0

Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients 儿科创伤患者非计划入住重症监护病房的结局和预测因素。

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.002

Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE

Background

Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.

Methods

The 2017–2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.

Results

From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).

Conclusion

UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.

背景：非计划重症监护病房（ICU）入住（UIA）与成人创伤患者的发病率增加有关，然而，在儿科创伤患者（PTPs）中尚未得到很好的研究。我们试图确定UIA的预测因素，假设ptp与UIA的死亡率增加。方法：查询2017-2019年创伤质量改善计划（TQIP）数据库，收集≤16岁入住非icu护理级别的ptp患者。将有UIA的患者与没有UIA的患者进行比较。采用多变量logistic回归分析确定UIA的预测因素。结果：在142160名ptp患者中，233名患者有UIA(结论：ptp患者的UIA很少见，但与并发症和死亡增加有关。UIA的重要预测因素包括输尿管、食管和脑损伤。

{"title":"Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients","authors":"Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE","doi":"10.1016/j.sopen.2024.12.002","DOIUrl":"10.1016/j.sopen.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.</div></div><div><h3>Methods</h3><div>The 2017–2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.</div></div><div><h3>Results</h3><div>From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).</div></div><div><h3>Conclusion</h3><div>UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 30-34"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017996","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

Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study 复发性肝细胞癌再切除术的疗效和预后指标：来自回顾性研究的见解。

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.004

Qi Fan MM , Pengcheng Wei MM , Delin Ma MD , Qian Cheng MD , Jie Gao MD , Jiye Zhu MD , Zhao Li MD

Aims

To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance.

Methods

A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses.

Results

Baseline characteristics were comparable between groups (P > 0.05). DFS was similar between groups (30.8 vs. 32.2 months, P = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, P = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (P = 0.044), time to recurrence (P = 0.002), tumor differentiation (P = 0.044), and satellite nodules (P = 0.019). Factors influencing OS included Child-Pugh classification (P = 0.040), time to recurrence (P = 0.002), and tumor differentiation (P = 0.032).

Conclusions

Re-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.

目的：评价再切除治疗复发性肝细胞癌（rHCC）的疗效，探讨影响预后的因素，为临床提供指导。方法：回顾性分析2014-2022年北京大学人民医院再次行肝癌切除术的130例rHCC患者和首次行肝切除术的60例原发性HCC患者。比较无病生存期（DFS）和总生存期（OS）。采用单因素和多因素COX回归分析确定预后因素。结果：两组间基线特征具有可比性（P < 0.05）。两组间DFS相似（30.8个月vs. 32.2个月，P = 0.612）。再切除组的1年、2年和3年DFS分别为88.5%、64.9%和56.7%，而首次切除组的DFS分别为88.3%、65.0%和53.3%。再切除组的OS较低（36.1个月vs. 47.2个月，P = 0.041）， 1年、2年和3年的OS率分别为90.8%、73.1%和60.0%，而首次切除组的OS率分别为95.0%、80.0%和68.3%。影响DFS的显著因素为Child-Pugh分型（P = 0.044）、复发时间（P = 0.002）、肿瘤分化（P = 0.044）、卫星结节（P = 0.019）。影响OS的因素包括Child-Pugh分型（P = 0.040）、复发时间（P = 0.002）和肿瘤分化（P = 0.032）。结论：再切除是rHCC的有效治疗选择，通过DFS和OS来衡量具有良好的结果，尽管OS比初始肝切除术低。关键预后因素包括Child-Pugh分类、复发时间、肿瘤分化和伴发结节。

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引用次数: 0

A quantitative amplitude of vagus nerve obtained by intraoperative neuromonitoring predicts postoperative vocal cord paralysis among patients in thyroid/parathyroid surgery as a second option

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.009

Hiroshi Katoh MD, FACS , Riku Okamoto MD , Kanako Naito MD , Tomoya Mitsuma MD , Mariko Kikuchi MD , Takaaki Tokito MD , Takeshi Naitoh MD, FACS , Naoki Hiki MD , Yusuke Kumamoto MD , Takafumi Sangai MD

Background

The advantage of intraoperative neuromonitoring (IONM) has been widely accepted in thyroid/parathyroid surgery. However, there are discrepancies of amplitudes on recurrent laryngeal nerve (RLN) palsy and vocal cord paralysis (VCP) because of amplitude variations among individuals. Accordingly, the universal usefulness of quantitative amplitude value per se among patients were assessed.

Study design

IONM using a 4-step method (Vagus nerve (V1)-RLN (R1)-R2-V2) was applied to 777 RLNs (510 patients). Forty-nine RLNs were excluded because of either loss of signal without preoperative VCP or combined RLN resection. The remaining 728 RLNs were evaluated. The optimal cut-offs of amplitudes or ratios of amplitude decrease on VCP were determined and evaluated. An independent recent cohort (177 RLNs) was analyzed for validation.

Results

Quantitative amplitudes of V2 or R2, and V2/V1 or R2/R1 ratio predicted VCP. The V2 of 117–216 μV predicted VCP with high (>80 %) sensitivity and specificity. Interestingly, the AUC of ROC curve of V2 was the highest, and a cut-off 124 μV of V2 most excellently predicted VCP with the highest sensitivity, specificity, and both positive and negative predictive values. In dissociative analyses, a V2 cut-off 124 μV still excellently predicted VCP in all ranges of initial V1 ≥ 100 μV. In a validation cohort, the V2 of 126–205 μV (cut-off 197 μV) predicted VCP with both high (>80 %) sensitivity and specificity.

Conclusions

A quantitative V2 amplitude can predict postoperative VCP among individuals as a simple and a second option, that may be especially useful in some circumstances with unavoidable insufficient initial exposure of vagus nerve.

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引用次数: 0

How to review a manuscript for journal publication: A primer for surgery residents

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-01-01 DOI: 10.1016/j.sopen.2024.12.007

Nicholas J. Zyromski MD , David Stewart MD

引用次数: 0

Acknoledgement of Reviewers

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2024-12-01 DOI: 10.1016/S2589-8450(24)00136-2

引用次数: 0

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