Surgery open science最新文献

英文中文

The association of malnutrition with clinical and financial outcomes of traumatic injuries in older adults: A national retrospective analysis 营养不良与老年人创伤性损伤的临床和财务结果的关联：一项全国回顾性分析

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-17 DOI: 10.1016/j.sopen.2025.09.008

Troy N. Coaston MSCR , Konmal Ali BS , Amulya Vadlakonda MD , Deep J. Mehta , Sara Sakowitz MD, MPH , Dariush Yalzadeh BS , Areti Tillou MD , Peyman Benharash MD , on behalf of the Academic Trauma Research Consortium (ATRIUM)

Background

Malnutrition is an often underrecognized condition among older adults and carries significant relevance among patients hospitalized with traumatic injuries. The present study aimed to evaluate the association of malnutrition with clinical and financial outcomes among older adult patients admitted with external trauma.

Study design

This was a retrospective cohort study of the 2016–2021 National Inpatient Sample including older adults (≥65 years) hospitalized with traumatic injuries. Patients were stratified by nutritional status (Malnourished and Non-Malnourished). Risk-adjusted logistic and linear regression models were constructed to evaluate the association of malnutrition with outcomes including inpatient mortality, clinical complications, and hospitalization costs.

Results

Of 6,587,907 older adults admitted with traumatic injuries, 7.5 % had malnutrition. The prevalence of malnutrition rose from 5.8 % to 8.6 % over the study period (nptrend<0.001). Patients with malnutrition were more commonly of the lowest income quartile (25.5 vs 24.5 %), non-White (19.4 vs 16.9 %), and male (41.3 vs 39.1 %, all p < 0.001). Following risk-adjustment, malnutrition was linked with increased odds of inpatient mortality (Adjusted Odds Ratio [AOR] 1.92, 95 % Confidence Interval [CI] 1.86–1.98) and infectious complications (AOR 2.30, 95 % CI 2.25–2.35) as well as greater inpatient costs (β + $7400, 95 % CI $7100-7600).

Conclusion

Malnutrition among older adults is associated with poorer clinical outcomes and increased financial burden. Rising prevalence and significant disparities underscore the need for increased screening and culturally relevant nutritional interventions to promote quality, equity, and sustainability in trauma care.

背景：营养不良在老年人中是一种常被忽视的疾病，在创伤性损伤住院患者中具有重要的相关性。本研究旨在评估老年外伤患者营养不良与临床和财务结果的关系。这是一项2016-2021年全国住院患者样本的回顾性队列研究，包括因创伤性损伤住院的老年人（≥65岁）。根据营养状况（营养不良和非营养不良）对患者进行分层。构建风险校正logistic和线性回归模型来评估营养不良与住院死亡率、临床并发症和住院费用等结果的关系。结果6587907例老年人外伤住院患者中，营养不良占7.5%。在研究期间，营养不良发生率从5.8%上升到8.6% （nptrend<0.001）。营养不良的患者更常见于最低收入四分位数（25.5%对24.5%）、非白人（19.4%对16.9%）和男性（41.3%对39.1%，均p <； 0.001）。风险调整后，营养不良与住院死亡率增加（调整优势比[AOR] 1.92, 95%可信区间[CI] 1.86-1.98）和感染并发症（AOR 2.30, 95% CI 2.25-2.35）以及住院费用增加（β + $7400, 95% CI $7100-7600）有关。结论老年人营养不良与临床预后差、经济负担增加有关。不断上升的患病率和显著的差异强调需要增加筛查和与文化相关的营养干预措施，以促进创伤护理的质量、公平性和可持续性。

{"title":"The association of malnutrition with clinical and financial outcomes of traumatic injuries in older adults: A national retrospective analysis","authors":"Troy N. Coaston MSCR , Konmal Ali BS , Amulya Vadlakonda MD , Deep J. Mehta , Sara Sakowitz MD, MPH , Dariush Yalzadeh BS , Areti Tillou MD , Peyman Benharash MD , on behalf of the Academic Trauma Research Consortium (ATRIUM)","doi":"10.1016/j.sopen.2025.09.008","DOIUrl":"10.1016/j.sopen.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is an often underrecognized condition among older adults and carries significant relevance among patients hospitalized with traumatic injuries. The present study aimed to evaluate the association of malnutrition with clinical and financial outcomes among older adult patients admitted with external trauma.</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study of the 2016–2021 National Inpatient Sample including older adults (≥65 years) hospitalized with traumatic injuries. Patients were stratified by nutritional status (<em>Malnourished</em> and <em>Non-Malnourished</em>). Risk-adjusted logistic and linear regression models were constructed to evaluate the association of malnutrition with outcomes including inpatient mortality, clinical complications, and hospitalization costs.</div></div><div><h3>Results</h3><div>Of 6,587,907 older adults admitted with traumatic injuries, 7.5 % had malnutrition. The prevalence of malnutrition rose from 5.8 % to 8.6 % over the study period (nptrend<0.001). Patients with malnutrition were more commonly of the lowest income quartile (25.5 vs 24.5 %), non-White (19.4 vs 16.9 %), and male (41.3 vs 39.1 %, all <em>p</em> < 0.001). Following risk-adjustment, malnutrition was linked with increased odds of inpatient mortality (Adjusted Odds Ratio [AOR] 1.92, 95 % Confidence Interval [CI] 1.86–1.98) and infectious complications (AOR 2.30, 95 % CI 2.25–2.35) as well as greater inpatient costs (β + $7400, 95 % CI $7100-7600).</div></div><div><h3>Conclusion</h3><div>Malnutrition among older adults is associated with poorer clinical outcomes and increased financial burden. Rising prevalence and significant disparities underscore the need for increased screening and culturally relevant nutritional interventions to promote quality, equity, and sustainability in trauma care.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 13-18"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108033","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

HOW I DO IT: Breaking boundaries in surgical education by delivering expert feedback to residents anytime and anywhere. The LAPPCLINIC project. 我怎么做：通过随时随地向住院医生提供专家反馈，打破外科教育的界限。LAPPCLINIC项目。

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-12 DOI: 10.1016/j.sopen.2025.09.007

Diego Sanhueza R. MD , Cristián Jarry T. MD, MSc , Julián Varas C. MD, MSc

Objective

To describe LAPPCLINIC, an innovative web-based platform designed to enhance surgical education through remote and asynchronous feedback by video-analysis of residents' own surgical procedures.

Design

We provide a detailed description of the platform workflow, highlighting key features for enhancing surgical education.

Setting

An ongoing multicenter study involving seven surgical residency programs across Chile.

Participants

First-year surgical residents from seven different Chilean programs, with feedback provided by five surgeons, experienced in surgical education, who are beyond their learning curves in laparoscopic cholecystectomy and trained in structured quality-feedback delivery.

Conclusion

LAPPCLINIC implementation has shown strong resident acceptance and significantly higher evaluation of feedback quality compared to traditional OR-based teaching.

目的介绍一种创新的基于网络的平台LAPPCLINIC，该平台旨在通过对住院医生自身手术过程的视频分析，通过远程和异步反馈来加强外科教育。我们提供了平台工作流程的详细描述，突出了加强外科教育的关键功能。一项正在进行的多中心研究涉及智利的七个外科住院医师项目。参与者：来自智利7个不同项目的第一年外科住院医师，由5名外科医生提供反馈，他们在外科教育方面经验丰富，在腹腔镜胆囊切除术方面超出了他们的学习曲线，并接受了结构化质量反馈交付的培训。结论与传统的基于手术室的教学相比，实施lappclinic的住院医师接受度高，反馈质量评价显著提高。

引用次数: 0

Why Transanal Opening of Intersphincteric Space (TROPIS) is effective in high complex anal fistula? 为什么经肛门括约肌间隙开放术（TROPIS）治疗高度复杂肛瘘有效？

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-12 DOI: 10.1016/j.sopen.2025.09.005

Pankaj Garg

引用次数: 0

Association of operative approach with adverse events following hepatic resections 肝切除术后手术入路与不良事件的关系

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-08 DOI: 10.1016/j.sopen.2025.09.004

Arjun Chaturvedi , Esteban Aguayo , Oh. Jin Kwon , Kevin Tabibian , Barzin Badiee , Saad Mallick , Daniel Tabibian , Peyman Benharash

Background

Despite growing use of minimally invasive surgery (MIS) for hepatocellular carcinoma (HCC), contemporary national data contrasting MIS with open hepatectomy are sparse.

Methods

Adults (≥18 y) undergoing hepatectomy for HCC in the American College of Surgeons National Surgical Quality Improvement Program (2015–2022) were studied. MIS (laparoscopic or robotic) resections were compared with open operations. Entropy balancing harmonized covariates, and multivariable logistic or linear models produced adjusted odds ratios (AOR) for major adverse events (MAE; composite of mortality and serious complications), liver-specific complications, and 30-day readmission.

Results

Among 5832 hepatectomies, 27.0 % were MIS, rising from 18.8 % in 2015 to 36.1 % in 2022 (p < 0.001). After adjustment, MIS was associated with markedly lower odds of MAE (AOR 0.36, 95 % CI 0.29–0.46), postoperative liver failure (AOR 0.34, 0.20–0.58), bile leak (AOR 0.49, 0.28–0.89), need for invasive intervention (AOR 0.29, 0.18–0.47), and 30-day readmission (AOR 0.61, 0.44–0.86). In the subset undergoing major resections, MIS retained protective associations for MAE (AOR 0.26, 0.15–0.46) and readmission (AOR 0.28, 0.11–0.80).

Conclusions

In a large, contemporary U.S. cohort, MIS hepatectomy was independently associated with fewer perioperative complications, liver-specific adverse events, and readmissions compared with open surgery—even for major resections. These findings support continued expansion of minimally invasive hepatectomy and targeted training to extend its benefits to appropriately selected patients with resectable HCC.

背景：尽管微创手术（MIS）在肝细胞癌（HCC）治疗中的应用越来越多，但目前国内对比微创手术与开放肝切除术的数据很少。方法研究美国外科医师学会国家手术质量改进计划（2015-2022）中接受HCC肝切除术的成人（≥18岁）。MIS（腹腔镜或机器人）切除与开放手术比较。熵平衡协调协变量，多变量逻辑或线性模型产生了主要不良事件（MAE；死亡率和严重并发症的组合）、肝脏特异性并发症和30天再入院的调整优势比（AOR）。结果5832例肝切除术中，MIS占27.0%，由2015年的18.8%上升至2022年的36.1% （p < 0.001）。调整后，MIS与MAE （AOR 0.36, 95% CI 0.29 - 0.46）、术后肝衰竭（AOR 0.34, 0.20-0.58）、胆漏（AOR 0.49, 0.28-0.89）、需要侵入性干预（AOR 0.29, 0.18-0.47）和30天再入院（AOR 0.61, 0.44-0.86）的发生率显著降低相关。在接受主要切除术的亚组中，MIS保留了MAE （AOR 0.26, 0.15-0.46）和再住院（AOR 0.28, 0.11-0.80）的保护性关联。结论：在一项大型的美国当代队列研究中，与开放式手术相比，MIS肝切除术的围手术期并发症、肝脏特异性不良事件和再入院率均较低，即使是大切除手术。这些发现支持继续扩大微创肝切除术和有针对性的培训，以扩大其对适当选择的可切除HCC患者的益处。

{"title":"Association of operative approach with adverse events following hepatic resections","authors":"Arjun Chaturvedi , Esteban Aguayo , Oh. Jin Kwon , Kevin Tabibian , Barzin Badiee , Saad Mallick , Daniel Tabibian , Peyman Benharash","doi":"10.1016/j.sopen.2025.09.004","DOIUrl":"10.1016/j.sopen.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite growing use of minimally invasive surgery (MIS) for hepatocellular carcinoma (HCC), contemporary national data contrasting MIS with open hepatectomy are sparse.</div></div><div><h3>Methods</h3><div>Adults (≥18 y) undergoing hepatectomy for HCC in the American College of Surgeons National Surgical Quality Improvement Program (2015–2022) were studied. MIS (laparoscopic or robotic) resections were compared with open operations. Entropy balancing harmonized covariates, and multivariable logistic or linear models produced adjusted odds ratios (AOR) for major adverse events (MAE; composite of mortality and serious complications), liver-specific complications, and 30-day readmission.</div></div><div><h3>Results</h3><div>Among 5832 hepatectomies, 27.0 % were MIS, rising from 18.8 % in 2015 to 36.1 % in 2022 (<em>p</em> < 0.001). After adjustment, MIS was associated with markedly lower odds of MAE (AOR 0.36, 95 % CI 0.29–0.46), postoperative liver failure (AOR 0.34, 0.20–0.58), bile leak (AOR 0.49, 0.28–0.89), need for invasive intervention (AOR 0.29, 0.18–0.47), and 30-day readmission (AOR 0.61, 0.44–0.86). In the subset undergoing major resections, MIS retained protective associations for MAE (AOR 0.26, 0.15–0.46) and readmission (AOR 0.28, 0.11–0.80).</div></div><div><h3>Conclusions</h3><div>In a large, contemporary U.S. cohort, MIS hepatectomy was independently associated with fewer perioperative complications, liver-specific adverse events, and readmissions compared with open surgery—even for major resections. These findings support continued expansion of minimally invasive hepatectomy and targeted training to extend its benefits to appropriately selected patients with resectable HCC.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"28 ","pages":"Pages 1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050534","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

A 9 year retrospective review of motorcycle accidents at a level 1 trauma center in Riyadh 对利雅得一级创伤中心摩托车事故的9年回顾性审查

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/j.sopen.2025.09.006

Hussam Alhathlol , Khalid Alsikhan , Turki Alharbi , Ibrahim Alsamaani , Ali Alhathloul , Rifan Alyami

Introduction

Motorcycle accidents are a significant cause of morbidity and mortality worldwide, with an increasing trend observed in Saudi Arabia. These accidents often result in severe injuries, leading to long-term disability or death, highlighting the need for better understanding and management in trauma centers. These findings highlight the vulnerability of motorcyclists on the roads and underscore the critical need to address motorcycle safety in order to reduce the burden of road traffic accidents.

Methods

This retrospective study assessed the rate, injury patterns, and outcomes of motorcycle accidents at King Abdulaziz Medical City (KAMC) in Riyadh, a level 1 trauma center, from January 2016 to December 2024. A total of 415 adult patients were included, with data on demographics, injury types, and treatment outcomes collected from hospital records. Multivariable logistic regression was performed to identify predictors of intensive care unit (ICU) admission, intubation, and surgical intervention.

Results

The cohort consisted predominantly of young males (84.1 %), with the highest incidence observed in the 18–35 age group. Common injuries included fractures (86.7 %), brain injuries/bleeding (38.1 %), and cut/open wounds (27.5 %). Although the incidence peaked in 2023, no statistically significant trend was observed over the study period. Moreover, a surgical intervention was required in 69.9 % of the cases, with 28.2 % experiencing long-term disability, which was defined based on discharge disposition and documented rehabilitation needs Factors significantly associated with ICU admission and intubation included head injuries, chest injuries, and facial trauma.

Conclusion

Motorcycle accidents continue to pose a significant public health challenge in Saudi Arabia, with young male motorcyclists being the most vulnerable group. The high incidence of fractures and brain injuries emphasizes the importance of improving safety measures to reduce the severity of injuries.

摩托车事故是世界范围内发病率和死亡率的重要原因，在沙特阿拉伯观察到增加的趋势。这些事故往往造成严重伤害，导致长期残疾或死亡，突出表明创伤中心需要更好地了解和管理这一问题。这些调查结果突出了摩托车手在道路上的脆弱性，并强调迫切需要解决摩托车安全问题，以减轻道路交通事故的负担。方法本回顾性研究评估2016年1月至2024年12月在利雅得一级创伤中心阿卜杜勒阿齐兹国王医疗城（KAMC）摩托车事故的发生率、伤害模式和结局。总共纳入了415名成年患者，从医院记录中收集了人口统计学、损伤类型和治疗结果的数据。采用多变量logistic回归来确定重症监护病房（ICU）入院、插管和手术干预的预测因素。结果该队列以年轻男性为主（84.1%），18-35岁年龄组发病率最高。常见的损伤包括骨折（86.7%）、脑损伤/出血（38.1%）和割伤/开放性伤口（27.5%）。虽然发病率在2023年达到顶峰，但在研究期间没有观察到统计学上显著的趋势。此外，69.9%的病例需要手术干预，28.2%的病例经历了长期残疾，这是根据出院处置和记录的康复需求来定义的，与ICU入院和插管显著相关的因素包括头部损伤、胸部损伤和面部创伤。结论摩托车事故继续对沙特阿拉伯的公共卫生构成重大挑战，年轻男性摩托车手是最脆弱的群体。骨折和脑损伤的高发生率强调了改善安全措施以降低损伤严重程度的重要性。

{"title":"A 9 year retrospective review of motorcycle accidents at a level 1 trauma center in Riyadh","authors":"Hussam Alhathlol , Khalid Alsikhan , Turki Alharbi , Ibrahim Alsamaani , Ali Alhathloul , Rifan Alyami","doi":"10.1016/j.sopen.2025.09.006","DOIUrl":"10.1016/j.sopen.2025.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Motorcycle accidents are a significant cause of morbidity and mortality worldwide, with an increasing trend observed in Saudi Arabia. These accidents often result in severe injuries, leading to long-term disability or death, highlighting the need for better understanding and management in trauma centers. These findings highlight the vulnerability of motorcyclists on the roads and underscore the critical need to address motorcycle safety in order to reduce the burden of road traffic accidents.</div></div><div><h3>Methods</h3><div>This retrospective study assessed the rate, injury patterns, and outcomes of motorcycle accidents at King Abdulaziz Medical City (KAMC) in Riyadh, a level 1 trauma center, from January 2016 to December 2024. A total of 415 adult patients were included, with data on demographics, injury types, and treatment outcomes collected from hospital records. Multivariable logistic regression was performed to identify predictors of intensive care unit (ICU) admission, intubation, and surgical intervention.</div></div><div><h3>Results</h3><div>The cohort consisted predominantly of young males (84.1 %), with the highest incidence observed in the 18–35 age group. Common injuries included fractures (86.7 %), brain injuries/bleeding (38.1 %), and cut/open wounds (27.5 %). Although the incidence peaked in 2023, no statistically significant trend was observed over the study period. Moreover, a surgical intervention was required in 69.9 % of the cases, with 28.2 % experiencing long-term disability, which was defined based on discharge disposition and documented rehabilitation needs Factors significantly associated with ICU admission and intubation included head injuries, chest injuries, and facial trauma.</div></div><div><h3>Conclusion</h3><div>Motorcycle accidents continue to pose a significant public health challenge in Saudi Arabia, with young male motorcyclists being the most vulnerable group. The high incidence of fractures and brain injuries emphasizes the importance of improving safety measures to reduce the severity of injuries.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 144-150"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049331","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

Predictive value of ultrasound BIRADS in conjunction with cytological and histopathological outcomes in breast disease management 超声BIRADS结合细胞学和组织病理学结果在乳腺疾病管理中的预测价值

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/j.sopen.2025.08.005

Hussein Hadi Jaber , Qutaiba Abd El-Razaq Muner

Background

Breast cancer represents the leading cause of cancer-related mortality among Iraqi women (19.5 % of female cancers). Ultrasound BI-RADS classification integrated with tissue sampling requires population-specific validation for optimal diagnostic accuracy.

Objective

To evaluate the diagnostic accuracy of ultrasound BI-RADS classification when correlated with cytological and histopathological findings in predicting malignancy risk among Iraqi women.

Methods

A prospective cross-sectional analytical study was conducted from February 2024 to February 2025 at two tertiary care teaching hospitals with specialized breast units in Baghdad, Iraq. One hundred sixty women aged ≥18 years with breast lesions classified as BI-RADS 3–5 underwent ultrasound evaluation, fine needle aspiration cytology (FNAC), and core needle biopsy (CNB) or surgical excision when indicated. Both participating radiologists completed formal BI-RADS training workshops by the Iraqi Radiological Society in 2023. Diagnostic performance metrics were calculated using histopathological confirmation as the reference standard.

Results

Mean participant age was 48.2 ± 9.7 years. BI-RADS distribution included: category 3 (25.0 %), 4A (18.8 %), 4B (12.5 %), 4C (12.5 %), and 5 (31.2 %). Overall malignancy rate was 40.0 %, varying by BI-RADS category: 2.5 % (category 3), 10.0 % (4A), 25.0 % (4B), 55.0 % (4C), and 88.0 % (category 5). ROC analysis demonstrated good discriminative ability (AUC = 0.85, 95 % CI: 0.79–0.91). At the optimal threshold (BI-RADS ≥4A), sensitivity was 98.4 % and specificity 40.6 %. Inter-modality agreement showed substantial concordance between FNAC and histopathology (κ = 0.76) and almost perfect agreement between CNB and histopathology (κ = 0.92). The integration of BI-RADS with tissue sampling demonstrated a 35–40 % reduction in unnecessary biopsies.

Conclusions

Ultrasound BI-RADS classification demonstrates good diagnostic performance in the Iraqi population, with increasing malignancy rates corresponding to higher BI-RADS categories. The integration of BI-RADS with tissue sampling techniques provides reliable diagnostic accuracy for breast disease management in resource-limited settings.

背景乳腺癌是伊拉克妇女癌症相关死亡的主要原因（占女性癌症的19.5%）。超声BI-RADS分类与组织采样集成需要人群特异性验证，以获得最佳诊断准确性。目的评价超声BI-RADS分型与细胞学和组织病理学结果在预测伊拉克妇女恶性肿瘤风险中的诊断准确性。方法于2024年2月至2025年2月在伊拉克巴格达两所设有乳腺专科的三级护理教学医院进行前瞻性横断面分析研究。160名年龄≥18岁、乳腺病变分类为BI-RADS 3-5的女性接受了超声评估、细针穿刺细胞学（FNAC）和核心针活检（CNB）或手术切除。两位参与的放射科医生于2023年完成了由伊拉克放射学会举办的正式BI-RADS培训讲习班。以组织病理学确认为参考标准计算诊断性能指标。结果患者平均年龄为48.2±9.7岁。BI-RADS分布包括：第3类（25.0%）、第4A类（18.8%）、第4B类（12.5%）、第4C类（12.5%）和第5类（31.2%）。总体恶性肿瘤发生率为40.0%，根据BI-RADS分类不同：2.5%（3类）、10.0% （4A类）、25.0% （4B类）、55.0% （4C类）和88.0%（5类）。ROC分析显示有良好的判别能力（AUC = 0.85, 95% CI: 0.79 ~ 0.91）。在最佳阈值（BI-RADS≥4A）下，敏感性为98.4%，特异性为40.6%。FNAC与组织病理学基本一致（κ = 0.76）， CNB与组织病理学基本一致（κ = 0.92）。BI-RADS与组织取样的结合表明，不必要的活组织检查减少了35 - 40%。结论超声BI-RADS分型在伊拉克人群中具有较好的诊断效果，BI-RADS分型越高，恶性肿瘤发生率越高。BI-RADS与组织采样技术的整合为资源有限的乳腺疾病管理提供了可靠的诊断准确性。

{"title":"Predictive value of ultrasound BIRADS in conjunction with cytological and histopathological outcomes in breast disease management","authors":"Hussein Hadi Jaber , Qutaiba Abd El-Razaq Muner","doi":"10.1016/j.sopen.2025.08.005","DOIUrl":"10.1016/j.sopen.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer represents the leading cause of cancer-related mortality among Iraqi women (19.5 % of female cancers). Ultrasound BI-RADS classification integrated with tissue sampling requires population-specific validation for optimal diagnostic accuracy.</div></div><div><h3>Objective</h3><div>To evaluate the diagnostic accuracy of ultrasound BI-RADS classification when correlated with cytological and histopathological findings in predicting malignancy risk among Iraqi women.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional analytical study was conducted from February 2024 to February 2025 at two tertiary care teaching hospitals with specialized breast units in Baghdad, Iraq. One hundred sixty women aged ≥18 years with breast lesions classified as BI-RADS 3–5 underwent ultrasound evaluation, fine needle aspiration cytology (FNAC), and core needle biopsy (CNB) or surgical excision when indicated. Both participating radiologists completed formal BI-RADS training workshops by the Iraqi Radiological Society in 2023. Diagnostic performance metrics were calculated using histopathological confirmation as the reference standard.</div></div><div><h3>Results</h3><div>Mean participant age was 48.2 ± 9.7 years. BI-RADS distribution included: category 3 (25.0 %), 4A (18.8 %), 4B (12.5 %), 4C (12.5 %), and 5 (31.2 %). Overall malignancy rate was 40.0 %, varying by BI-RADS category: 2.5 % (category 3), 10.0 % (4A), 25.0 % (4B), 55.0 % (4C), and 88.0 % (category 5). ROC analysis demonstrated good discriminative ability (AUC = 0.85, 95 % CI: 0.79–0.91). At the optimal threshold (BI-RADS ≥4A), sensitivity was 98.4 % and specificity 40.6 %. Inter-modality agreement showed substantial concordance between FNAC and histopathology (κ = 0.76) and almost perfect agreement between CNB and histopathology (κ = 0.92). The integration of BI-RADS with tissue sampling demonstrated a 35–40 % reduction in unnecessary biopsies.</div></div><div><h3>Conclusions</h3><div>Ultrasound BI-RADS classification demonstrates good diagnostic performance in the Iraqi population, with increasing malignancy rates corresponding to higher BI-RADS categories. The integration of BI-RADS with tissue sampling techniques provides reliable diagnostic accuracy for breast disease management in resource-limited settings.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 171-178"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048746","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

Editorial Board Page 编委会页面

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/S2589-8450(25)00084-3

引用次数: 0

Removal notice to “Surgical procedures and techniques in robot-assisted retrograde para-aortic lymphadenectomy” [Surg Open Sci 23 (2025) 35–41′] 关于“机器人辅助逆行主动脉旁淋巴结切除术的手术程序和技术”的删除通知[外科开放科学23 (2025)35-41]

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/j.sopen.2025.07.002

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

引用次数: 0

Association of hospital profit status with operative rates for acute appendicitis 医院盈利状况与急性阑尾炎手术率的关系

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/j.sopen.2025.09.003

Konmal Ali BS , Sona Mahrokhi MD , Amulya Vadlakonda MD , Troy Coaston MS , Melissa Justo MD , Deep Mehta , Edward Livingston MD , Peyman Benharash MD

Background

Although appendicitis can now be treated nonoperatively, the uptake of nonoperative management of appendicitis (NOM) has been slow. We explored patient and hospital factors that might explain variation in appendectomy and NOM rates.

Methods

All adult hospitalizations for appendicitis were tabulated from the 2019–2022 Nationwide Readmissions Database. Initial, exploratory analyses revealed that appendectomy rates were lower in not-for-profit (NFP) relative to for-profit (FP) hospitals. Bayesian logistic regression and Fairlie decomposition were employed to explain the bases for these differences.

Results

There were 4394 NFP and 818 FP hospitals. When compared with FP facilities, NFP hospitals had a smaller proportion of appendicitis cases treated by appendectomy (82.9 ± 11.8 v. 89.7 ± 8.0) (mean ± SD) (Cohen's d: −0.70) and less than one-half the amount of charges $44,713 [30,217, 65,442] vs. $93,078 [64,171, 129,301] (median ± IQR) (Cohen's d > −0.7, medium effect size). When estimated from regression equations, the gap between NFP and FP hospital appendectomy rates was 7.5 %. Total charges explained almost all of the gap between NFP and FP hospital appendectomy rates (0.068/0.090 = 75 %) of the gap. The presence of complicated appendicitis and EGS volume reduced the gap by −0.013 (−0.013/0.090 = 14 %).

Conclusion

Appendectomy rates for the treatment of appendicitis were greater in FP hospitals with almost all the difference in the rates explained by much higher charges observed in FP hospitals. The potential for greater profit from appendectomy as compared with NOM of appendicitis may explain why appendectomy is more common in FP hospitals.

虽然阑尾炎现在可以非手术治疗，但非手术治疗阑尾炎（NOM）的普及速度很慢。我们探讨了患者和医院因素可能解释阑尾切除术和NOM率的变化。方法从2019-2022年全国再入院数据库中列出所有因阑尾炎住院的成年人。初步的探索性分析显示，非营利性（NFP）医院的阑尾切除术率低于营利性（FP）医院。采用贝叶斯逻辑回归和费尔利分解来解释这些差异的基础。结果全国共有计划生育医院4394家，计划生育医院818家。与计划生育医院相比，非计划生育医院阑尾炎患者行阑尾切除术的比例较小（82.9±11.8 vs 89.7±8.0）（平均±SD）（Cohen’SD: - 0.70），费用为44,713美元[30,217美元，65,442美元]和93,078美元[64,171美元，129,301美元]（中位数±IQR）的一半以下（Cohen’SD > - 0.7，中等效应大小）。从回归方程估计，NFP和FP医院阑尾切除术率之间的差距为7.5%。总收费几乎解释了NFP和FP医院阑尾切除术率之间的所有差距（0.068/0.090 = 75%）。复杂性阑尾炎和EGS体积的存在使间隙减小了- 0.013（- 0.013/0.090 = 14%）。结论计划生育医院治疗阑尾炎的阑尾切除术率较高，其主要原因是计划生育医院的费用较高。阑尾切除术与非手术治疗阑尾炎相比有更大的潜在利润，这可能解释了为什么阑尾切除术在计划生育医院更常见。

{"title":"Association of hospital profit status with operative rates for acute appendicitis","authors":"Konmal Ali BS , Sona Mahrokhi MD , Amulya Vadlakonda MD , Troy Coaston MS , Melissa Justo MD , Deep Mehta , Edward Livingston MD , Peyman Benharash MD","doi":"10.1016/j.sopen.2025.09.003","DOIUrl":"10.1016/j.sopen.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Although appendicitis can now be treated nonoperatively, the uptake of nonoperative management of appendicitis (NOM) has been slow. We explored patient and hospital factors that might explain variation in appendectomy and NOM rates.</div></div><div><h3>Methods</h3><div>All adult hospitalizations for appendicitis were tabulated from the 2019–2022 Nationwide Readmissions Database. Initial, exploratory analyses revealed that appendectomy rates were lower in not-for-profit (NFP) relative to for-profit (FP) hospitals. Bayesian logistic regression and Fairlie decomposition were employed to explain the bases for these differences.</div></div><div><h3>Results</h3><div>There were 4394 NFP and 818 FP hospitals. When compared with FP facilities, NFP hospitals had a smaller proportion of appendicitis cases treated by appendectomy (82.9 ± 11.8 v. 89.7 ± 8.0) (mean ± SD) (Cohen's d: −0.70) and less than one-half the amount of charges $44,713 [30,217, 65,442] vs. $93,078 [64,171, 129,301] (median ± IQR) (Cohen's d > −0.7, medium effect size). When estimated from regression equations, the gap between NFP and FP hospital appendectomy rates was 7.5 %. Total charges explained almost all of the gap between NFP and FP hospital appendectomy rates (0.068/0.090 = 75 %) of the gap. The presence of complicated appendicitis and EGS volume reduced the gap by −0.013 (−0.013/0.090 = 14 %).</div></div><div><h3>Conclusion</h3><div>Appendectomy rates for the treatment of appendicitis were greater in FP hospitals with almost all the difference in the rates explained by much higher charges observed in FP hospitals. The potential for greater profit from appendectomy as compared with NOM of appendicitis may explain why appendectomy is more common in FP hospitals.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"27 ","pages":"Pages 151-158"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048743","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

Corrigendum to “Video-based learning for basic surgical skills - A randomized trial” [Surg Open Sci, volume 26, June 2025, pages 94–106] “基于视频的基本外科技能学习——随机试验”的勘误表[外科开放科学，26卷，2025年6月，94-106页]

IF 1.7 Q3 SURGERY

Surgery open science

Pub Date : 2025-09-01 DOI: 10.1016/j.sopen.2025.05.007

I. Dantas , I. Jorge , A. Nicolau , M. Vales , C. Coutinho , S. Rodrigues , P. Febra , V.N. Lopes

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Surgery open science

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀