- Defining the learning curve of laparoscopic adrenalectomy: a single-center experience. [Journal Article]
- CONCLUSIONS: A learning curve was observed, with operative duration improving after approximately 23 cases. A secondary multivariable model identified a later model-based breakpoint at around 33 cases. These findings should be interpreted as cohort-specific estimates and suggest that learning-curve interpretation in laparoscopic adrenalectomy should consider both accumulated experience and operative factors that influence surgical performance.
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- Comparative outcomes of central venous access via open jugular and ultrasound-guided subclavian approaches in low-weight pediatric patients: a study with secondary outcomes. [Randomized Controlled Trial]
- CONCLUSIONS: Both approaches were generally safe, with no major adverse events observed in either group. Ultrasound-guided subclavian access was associated with a shorter procedure time, whereas hematoma occurred only in the jugular group and catheterization failure and upper-limb edema were seen only in low-weight infants in the subclavian group. However, because access site and technique were evaluated together, their independent effects could not be determined. In addition, the findings in infants weighing < 2.5 kg were based on few events and should be considered hypothesis-generating rather than definitive.
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- Routine versus postoperative CRP/CT guided selective diverting ileostomy after laparoscopic low anterior resection for rectal cancer: a comparative randomized controlled trial. [Randomized Controlled Trial]
- CONCLUSIONS: A postoperative CRP/CT-guided selective ileostomy strategy reduces the need for diverting ileostomy after laparoscopic low anterior resection for rectal cancer while improving operative outcomes and quality of life; however, confirmed leakage was infrequent in both groups. This approach may serve as an alternative to routine diversion in appropriately monitored surgical units.
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- Right upper lobectomy via selective right upper lobe isolation using a left-sided double-lumen tube placed in the right bronchus intermedius: a case report. [Case Reports]
- CONCLUSIONS: Intentional placement of a left-sided DLT into the right bronchus intermedius is a feasible strategy for selective RUL isolation when standard OLV is contraindicated due to severe contralateral lung compromise. Preoperative computed tomography (CT)-based airway assessment and fiberoptic bronchoscopic guidance are recommended for safe implementation.
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- Tranexamic acid in primary total knee arthroplasty: a systematic review and meta-analysis of blood loss, transfusion, and deep vein thrombosis. [Systematic Review]
- CONCLUSIONS: The current evidence indicates that TXA in primary TKA significantly reduces blood loss and transfusion requirements with no detected increase in DVT risk in the available randomized evidence. The blood loss analysis showed substantial heterogeneity, whereas the transfusion and DVT analyses were more consistent across studies.
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- Early prediction of severe morbidity after liver resection using serum albumin and ALBI-score in a mixed patient cohort. [Journal Article]
- CONCLUSIONS: ALBI on POD1 independently predicted severe morbidity after LR and may provide a simple tool for early postoperative risk stratification based on routine laboratory data. External validation is required before routine implementation.
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- Prevalence and risk factors associated with inadvertent intraoperative hypothermia in patients undergoing trauma surgery: a single-center retrospective study. [Journal Article]
- CONCLUSIONS: This study represents the first report on the incidence rate of inadvertent intraoperative hypothermia in patients undergoing trauma surgery and identify key risk factors including lower baseline body temperature, longer duration of surgery, lower BMI, more fluid infusion and combined positions. We also contribute the multifactor model demonstrated superior predictive value for inadvertent intraoperative hypothermia.
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- Unilateral biportal endoscopic lumbar fusion versus minimally invasive transforaminal lumbar interbody fusion for single-level mild to moderate lumbar spondylolisthesis: a retrospective study. [Journal Article]
- CONCLUSIONS: The efficacy of ULIF in the treatment of single-level mild to moderate lumbar spondylolisthesis is comparable to that of MIS-TLIF. However, the ULIF group is associated with less intraoperative blood loss, less postoperative drainage, and faster postoperative recovery, albeit with a longer operative time.
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- Laparoscopic versus open emergency colonic resection for obstruction: a multicentre retrospective cohort study. [Multicenter Study]
- CONCLUSIONS: Laparoscopic emergency resection in patients with acute benign or malignant colonic obstruction was associated with lower postoperative morbidity, shorter LOS and less intensive postoperative analgesic requirements in a selected cohort. However, these findings should be interpreted cautiously given substantial differences in baseline characteristics and surgeon specialization between groups.
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- The 30-day perioperative outcomes of sigmoid volvulus surgery in resource-limited setting in Northcentral Ethiopia. [Journal Article]
- CONCLUSIONS: More than half of patients underwent emergency surgery, and two-thirds of these had intraoperative gangrenous bowel. Perioperative complication rates were high among patients undergoing emergency surgery and among those with comorbidities and higher ASA grades, despite most patients being classified as low surgical risk. Improving access to bellwether surgery, strengthening processes of care, and building surgical capacity and health-system delivery could help achieve safe, equitable surgical care for sigmoid volvulus.
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- The impact of Braun-modified single loop versus isolated Roux-en-y reconstruction on clinical outcomes following pancreaticoduodenectomy. [Journal Article]
- CONCLUSIONS: BMSL reconstruction was associated with lower DGE rates and a shorter hospital stay. No significant difference was observed between the groups' CR-POPF rates. The POPF-related findings should therefore be interpreted with care due to the low event rate and absence of any Grade C cases.
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- Delphian lymph node metastasis as a marker of extensive nodal involvement in papillary thyroid cancer. [Journal Article]
- CONCLUSIONS: DLN metastasis reflects the extent of central nodal disease in PTC, particularly paratracheal involvement, and serves as a marker of overall nodal burden. DLN status may support intraoperative decision-making and contribute to individualized surgical strategies.
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- Preoperative biliary stenting is associated with increased bacterial contamination and postoperative inflammation in pancreatic head resections. [Journal Article]
- CONCLUSIONS: Preoperative biliary stenting is associated with predominantly polymicrobial bacterial bile contamination, longer operative times, increased postoperative inflammatory response and wound-related complications, while pancreas-specific complications were not significantly increased. These findings support a selective rather than routine use of biliary drainage in patients with resectable pancreatic cancer, and suggest that the microbial spectrum, including the detection of Candida species in nearly one fifth of culture-positive patients, should be considered when planning perioperative antimicrobial strategies.
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- Outpatient Total Extraperitoneal (TEP) for inguinal hernia repair following federal German outpatient operation procedure reform: a preliminary single-center descriptive study of same-day discharge, unplanned admission, and patient-reported outcomes. [Journal Article]
- CONCLUSIONS: This preliminary single-center experience provides descriptive information on the early implementation of an outpatient TEP pathway under the German AOP framework. Although patients who successfully completed same-day discharge and responded to follow-up reported high satisfaction and perceived safety, the 29.4% unplanned inpatient admission rate, exclusion of admitted patients from the patient-reported outcome analysis, and 60.2% response rate substantially limit conclusions regarding the overall safety, acceptability, and successful implementation of the programme. Prospective multicenter studies with predefined admission criteria and systematic follow-up of all patients are required.
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