tbuckley/cabot-search huggingface dataset:
Efficacy of Laparoscopic Parenchyma-sparing Hepatectomy Using Augmented Reality Navigation Combined With Fluorescence Imaging for Colorectal Liver Metastases: A Retrospective Cohort Study Using Inverse Probability Treatment Weighting Analysis
Authors: Xiaojun Zeng, Xinci Li, Wenjun Lin, Junfeng Wang, Chihua Fang, Mingxin Pan, Haisu Tao, Jian Yang
Journal: International Journal of Surgery (2024)

Background Laparoscopic parenchyma-sparing hepatectomy (PSH) is an effective treatment for colorectal liver metastases (CRLMs), but ensuring the safety and radicality of the procedure, particularly for deep-seated tumors, remains challenging. Surgical navigation technologies such as augmented reality navigation (ARN) and indocyanine green fluorescence imaging (ICG-FI) are increasingly utilized to guide surgery, yet their efficacy for CRLMs is unclear. This study aims to evaluate the short- and long-term outcomes of ARN combined with ICG-FI-guided (ARN-FI) laparoscopic PSH for CRLMs. Methods Between January 2020 and December 2022, eighty-nine consecutive patients who underwent laparoscopic PSH for CRLMs were included in the study. Patients were divided into ARN-FI group (n = 38) and non-ARN-FI group (n = 51) based on the use of ARN-FI. Inverse probability treatment weighting (IPTW) was used to balance baseline characteristics and minimize potential selection bias. Short-term and long-term outcomes were compared between the two groups. Cox regression analysis was conducted to identify risk factors associated with recurrence-free survival (RFS) and hepatic RFS. Results After IPTW, there were 87 patients in the ARN-FI group and 89 patients in the non-ARN-FI group. Shorter parenchymal transection time, postoperative hospital stays and wider margins were observed in the ARN-FI group. No significant difference in RFS or hepatic RFS between the groups. Mutant KRAS status was an independent risk factor for both RFS and hepatic RFS, while tumor diameter ≥ 5 cm and deep-seated location were risk factors for hepatic RFS. In the subgroup analysis of deep-seated tumors, the ARN-FI group also showed less intraoperative blood loss, a lower rate of strategy change, shorter postoperative recovery times, a higher R0 resection rate, and improved RFS and hepatic RFS. Conclusions In laparoscopic PSH for CRLMs, ARN-FI may improve surgical efficiency and accuracy. Especially for deep-seated tumors, it has the potential to reduce blood loss and attain higher R0 resection rates.
Invasive or Non-invasive Vagus Nerve Stimulation Modulation of Brain Function and Remodeling After Stroke: a Review
Authors: Jun Zhang, FengYuan Zhou, Neil Roberts, Qiang Yuan, Meihua Wang, Gang Wu, Weijian Yang, Pengfei Fu, Meiyun Wang, Jin Hu
Journal: International Journal of Surgery (2024)

Background: The main reason restricting stroke patients from reintegrating into society is neurological deficits. Of particular interest is the potential Vagus Nerve Stimulation (VNS) potentially offers for sustaining improvement in neurological deficits. The goal of the present study is to provide a summary of the findings from research that has been carried out to elucidate the mechanisms and demonstrate the efficacy and safety of the clinical application of VNS, as well as to identify research gaps in the field, in order to offer references for subsequent further research and application. Methods: A systematic search was conducted in the PubMed, Web of Science, Embase, and Ovid MEDLINE databases (1,866 publications). An initial screening of abstracts and titles was performed, followed by a thorough review and assessment of the full texts of 253 relevant papers. Results: Ultimately, 62 studies that met the eligibility criteria were included. VNS may be performed either invasively or non-invasively. The modulation of brain function that is produced by VNS may improve cerebral function by one or more of the following means, namely stimulating the pathway that regulates synaptic plasticity, inhibiting inflammatory response, promoting vascular regeneration or protecting the blood-brain barrier. Application of invasive VNS has produced promising results in the treatment of moderate/severe upper limb dyskinesia in patients with ischemic stroke and has gradually entered clinical practice. Furthermore, transcutaneous auricular VNS has also demonstrated potential therapeutic effects (SMD 1.16, 95% CI = 0.02-2.30). However, further developments are required in many aspects, including preventing indications of dysfunction, optimisation of parameters, timing and duration of stimulation and site of application. Conclusions: The VNS as a promising therapeutic approach for stroke rehabilitation. The application of VNS in the treatment of hemorrhagic stroke is still unexplored and warrants attention in future studies.
Long-term results of laparoscopic Heller-Dor for esophageal-gastric junction outflow obstruction: a prospective comparative study
Authors: Renato Salvador, Francesca Forattini, Luca Provenzano, Andrea Costantini, Arianna Vittori, Matteo Santangelo, Giovanni Capovilla, Mario Costantini, Lucia Moletta, Giulia Nezi, Loredana Nicoletti, Michele Valmasoni
Journal: International Journal of Surgery (2024)

Background: The aim of this prospective, controlled study was to assess the 5-year follow-up of Laparoscopic Heller-Dor (LHD) in patients with esophago-gastric junction outflow obstruction (EGJOO), compared with achalasia patients (ACH). The management of EGJOO reflects the experience gained with esophageal achalasia, for which LHD has been proven to be an effective long-term treatment. Prospective long-term results of LHD in EGJOO patients are still lacking. Materials and methods: Patients with diagnosis of idiopathic EGJOO referred for dysphagia or food-regurgitation, treated with LHD, were enrolled and then followed prospectively for 5 years. During the follow-up, patients were evaluated with Eckard score (ES), Barium-swallow X-ray, High Resolution Manometry (HRM), 24-hour pH-monitoring and endoscopy. Primary outcome was therapeutic success (ES ≤ 3 or no additional treatment). Results: The study involved 150 patients: 25 in the EGJOO group and 125 in the ACH group. After 5 years, there was no significant difference in success rate: 90.5% in the EGJOO group, 87.5% in ACH stage I-pattern I, 91.6% in ACH stage I-pattern II and pattern III (p = 0.94). The ES and all the HRM parameters were similar in all groups. Moreover, the screening endoscopy and the 24-hours pH-monitoring showed a similar postoperative acid exposure in all groups. Conclusion: This is the first study based on prospective data to assess the long-term outcome of LHD in patients with EGJOO. After at least 5 years of follow-up, LHD has a comparable success rate in both EGJOO and achalasia patients and can be proposed as a safe and effective treatment for EGJOO patients.
Postoperative complications and surgical outcomes of robotic versus laparoscopic Pancreaticoduodenectomy: A meta-analysis of propensity-score-matched studies
Authors: Gang Tang, Jie Zhang, Linyu Zhang, Lingying Xia, Rui Chen, Rongxing Zhou
Journal: International Journal of Surgery (2024)

Background: Robotic pancreaticoduodenectomy (RPD) is used more commonly, but high-level evidence is still scarce. This meta-analysis aimed to compare the short-term outcomes between RPD and laparoscopic pancreaticoduodenectomy (LPD) using data collected from propensity score-matched (PSM) studies. Materials and methods: We searched PubMed, Cochrane Library, Embase, and Web of Science databases for PSM studies comparing RPD and LPD. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: Ten PSM studies were included, encompassing 8106 patients (RPD group: 3695 patients; LPD group: 4411 patients). Compared with LPD, RPD was associated with a lower conversion (RR, 0.56) and blood transfusion rates (RR, 0.49), and a higher number of harvested lymph nodes (MD, 2.15). There were no significant differences observed in 30-day readmission (RR, 1.02), 90-day mortality (RR, 1.01), overall morbidity (RR, 0.94), major complications (RR, 1.06), operative time (MD, − 8.00 mins), blood loss (MD, − 19.37 mL), reoperation (RR, 0.95), bile leak (RR, 0.93), chylous leak (RR, 1.40), postoperative pancreatic fistula (RR, 1.06), delayed gastric emptying (RR, 0.92), wound infection (RR, 1.12), length of stay (MD, − 0.32 days), and R0 resection (RR, 0.98) between the groups. Conclusions: Although LPD and RPD had similar surgical outcomes, RPD had the perioperative advantage over LPD in decreasing conversion rates and blood transfusion rates and increasing the number of lymph nodes harvested. Further randomized controlled trials evaluating the potential advantages of RPD over LPD are warranted.
Alterations of Oscillatory Activity and Cognitive Function After Aneurysmal Subarachnoid Hemorrhage
Authors: Peng Liu, Chuanliang Han, Tongyu Zhang, Yueqiao Xu, Kun Yang, Yuxia Li, Zhennan Ye, Changming Wang, Hongqi Zhang
Journal: International Journal of Surgery (2024)

Background: Aneurysmal subarachnoid hemorrhage (aSAH) can lead to cognitive impairment, but underlying neural mechanisms remain to be elucidated. Materials and methods: To predict long-term cognitive impairment after aSAH, resting electroencephalography (EEG) was measured in 112 patients hospitalized with a diagnosis of aSAH (n = 66) or unruptured intracranial aneurysms (UIA; controls) (n = 46). A neuropsychological battery was administered 8 to 24 months after discharge. Results: Power spectrum analysis in the parietal-occipital lobe showed significantly higher power theta vs. alpha oscillations in patients with cognitive impairment after aSAH. The power of theta and alpha oscillations were significantly correlated with multiple cognitive scale scores on the neuropsychological battery. A neural model was established, which showed that connectivity between inhibitory and excitatory neurons in neural circuits contributed to changes in theta and alpha oscillations and cognitive impairment in aSAH. Conclusion: The data collection, analysis, and computational model established in this study can serve as a new paradigm for other clinical studies investigating cognitive impairment.
Trends, age shifts, and potential delayed peaks post-pandemic of early-onset brain and central nervous system cancers in individuals aged 20-49: a cross-sectional study
Authors: Haibo Teng, Ouying Yan, Chaoxin Xiao, Xin Wang, Zhiyong Liu, Jianguo Xu
Journal: International Journal of Surgery (2024)

Central nervous system (CNS) cancers are highly lethal and increasingly affect younger populations aged 20-49, posing significant challenges to global healthcare systems. Current research on early-onset CNS cancer trends is limited and outdated, with uncertain impacts from the COVID-19 pandemic. This study explores the epidemiology of early-onset CNS cancer and the pandemic's effects. We analyzed incidence, mortality, and Disability-Adjusted Life Years (DALYs) rates for early-onset CNS cancer (ages 20-49) from 2019 to 2021 using GBD 2021 data. The global data were categorized into five regions based on the Socio-Demographic Index (SDI), reflecting income, education, and fertility rates. Trends over the past 30 years were examined using Estimated Annual Percentage Change (EAPC), Average Annual Percentage Change (AAPC), and Joinpoint analysis, with a focus on 2019-2021. The Bayesian Age-Period-Cohort (BAPC) model predicted post-pandemic impacts on CNS cancer metrics. In 2021, global cases of early-onset CNS cancer rose to 50,201.7 (95% UI, 42,864.1-58,187.5), with deaths increasing to 25,023.1 (95% UI, 20,973.8-29,670.8) and DALYs reaching 1,483,019.4 (95% UI, 1,240,923.4-1,756,043.3). The incidence rate increased to 2.1 (95% UI, 1.8-2.5), while mortality rates remained stable at 1.1 (95% UI, 0.9-1.2), and DALY rates decreased to 62.6 (95% UI, 52.4-74.1). Over the past two decades, the incidence of early-onset CNS cancer has steadily increased, particularly in regions with a high SDI and in emerging economies. Although there was a decline in early-onset CNS cancer-related metrics during the pandemic, it is anticipated that global incidence rates will peak between 2035 and 2040. This study provides a comprehensive overview of early-onset CNS cancer trends. Despite stable mortality rates, the increasing incidence suggests a growing global burden, with a delayed peak expected due to the pandemic. These findings highlight the need for preventive and control policies targeting early-onset CNS cancer.
Probiotics prevent pegylated liposomal doxorubicin-associated hand-foot syndrome and oral mucositis of breast cancer patients following surgery and chemotherapy:a randomized placebo-controlled trial
Authors: Zhang Juan, Jie Chen, Boni Ding, Liang Yongping, Haifeng Cai, Hui Chen, Ling Wang, Yuan Le, Jingcheng Shi, Yuhui Wu, Daqing Ma, Wen Ouyang, Yong Cheng, Jianbin Tong
Journal: International Journal of Surgery (2024)

Background: Hand-foot syndrome (HFS) and oral mucositis (OM) are common adverse events during cancer chemotherapy and can significantly decrease patients’ quality of life and chemotherapy adaptation, however, prevention strategies of these complications yet to be established. Methods: Patients with stage I-III breast cancer, who had surgery and needed pegylated liposomal doxorubicin (PLD)-based adjuvant chemotherapy were screened, recruited and randomly assigned to receive either probiotics or placebo (three capsules, twice/day) treatment during the course of chemotherapy from Nov. 2019 to Aug. 2020. The incidence and severity of PLD related HFS and OM, and patients’ quality of life were assessed. Their plasma biomarkers, metabolites and faecal microbiota compositions were measured. And the results were further verified in animal experiments. Results: Probiotics supplement during PLD treatment significantly decreased the incidence and the severity of HFS and OM ( P &lt; 0.001), improved patients’ life quality ( P &lt; 0.001), increased the relative abundance of intestinal Enterococcus ( P = 0.025) and mitigated the changes of seven plasma metabolites. Among these metabolites, the changes of p-Mentha-1,8-dien-7-ol (MDO) ( B = − 0.441, P = 0.02) and L-Arginine ( B = − 0.586, P = 0.002) were negatively correlated with the occurrence of severe HFS and OM. MDO can partly reproduce the preventive effects of probiotics on PLD-related skin cell proliferating inhibition, DNA damage, and local inflammation in rats. Conclusion: Probiotics supplement during PLD-based chemotherapy prevents the incidence and severity of HFS and OM, which may be associated with modulating plasma metabolites including the MDO. Trial registration:
Cold scissors ploughing technique versus electrosurgical excision for hysteroscopic adhesiolysis: a multicenter randomized controlled trial
Authors: Yichun Liu, Xiaoshi Xie, Pingping Xue, Fang Yuan, Yinghua Qi, Hui Wang, Ping Wang, Guanjun Lv, Kejuan Song, Zongzhi Yang, Ya-Nan Zhang, Lei Yan
Journal: International Journal of Surgery (2024)

Intrauterine adhesions (IUA) may lead to abnormal menstruation, infertility, and pregnancy-related complications. Hysteroscopic separation is the gold standard treatment for IUA and can be performed using a variety of instruments and methods, including cold scissors and electrotomy. However, it is unclear which method is more effective for relieving IUA, restoring uterine anatomy, and improving the pregnancy rate in women of childbearing age. This multicenter prospective randomized clinical trial included 218 women aged 20–40 years who were treated for IUA between 1 March 2021 and 30 June 2022 and followed for 1.5 years. The women were randomly assigned to a cold scissors group (n = 109) or electrosurgical excision group (n = 109). Second-look hysteroscopy was performed in all patients within 3–10 days after the end of the first postoperative menstrual period. The primary outcome was the change in American Fertility Society score. Secondary outcomes included postoperative menstrual blood loss, the recurrence rate, and the reproductive outcome. There was no significant difference in the curative effect of hysteroscopic adhesiolysis between the cold scissors group and the electrosurgical excision group (5 [interquartile range, 4-6] vs 5 [interquartile range, 4-6], P = 0.729) or in the postoperative recurrence rate (27.5% vs. 30.6%, relative risk 0.901, 95% confidence interval 0.594–1.366, P = 0.623) or pregnancy outcomes between the two groups. Postoperative menstrual blood loss was significantly greater in the cold scissors group than in the electrosurgical excision group (65.1% vs. 48.1%, P = 0.029). The treatment cost was significantly lower in the cold scissors group (P &lt; 0.001). In conclusion, hysteroscopic adhesiolysis using cold scissors does not differ significantly from electrosurgery in terms of treatment efficacy, recurrence rate, pregnancy rate, or pregnancy-related complications in patients with IUA who have normal ovarian reserve and an endometrial thickness of ≥ 6 mm before ovulation. The cold scissors ploughing technique can increase menstrual blood loss and is a cost-effective procedure.
A Comprehensive Study of Efficacy Evaluation for Kinesio Taping in the Treatment of Lateral Humeral Epicondylitis
Authors: Yuanchun Zhu, Yuying Yang, Yuhang Zhang, Mingnan Shi, Runlin Shi, Lixia Chen
Journal: International Journal of Surgery (2024)

Zhu, Yuanchun MSc; Yang, Yuying MSc; Zhang, Yuhang PhD; Shi, Mingnan BSc; Shi, Runlin BSc; Chen, Lixia MM Author Information
Predicting early recurrence in locally advanced gastric cancer after gastrectomy Using CT-based deep learning model: a multicenter study
Authors: Xinyu Guo, Mingzhen Chen, Lingling Zhou, Lingyi Zhu, Shuang Liu, Liyun Zheng, Yongjun Chen, Qiang Li, Shuiwei Xia, Chenying Lu, Minjiang Chen, Feng Chen, Jiansong Ji
Journal: International Journal of Surgery (2024)

Background: Early recurrence in patients with locally advanced gastric cancer (LAGC) portends aggressive biological characteristics and a dismal prognosis. Prediction of early recurrence may help determine treatment strategies for LAGC. To develop a deep learning model for early recurrence prediction (DLER) based on preoperative multiphase computed tomography (CT) images and further explore the underlying biological basis of the proposed model. Materials and methods: In this retrospective study, 620 LAGC patients from January 2015 to March 2023 were included in three medical centres and The Cancer Image Archive (TCIA). The DLER model was developed using DenseNet169 and multiphase 2.5D CT images, and then crucial clinical factors of early recurrence were integrated into the multilayer perceptron classifier (MLP) model (DLER MLP ). The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity were applied to measure the performance of different models. The log-rank test was used to analyze survival outcomes. The genetic analysis was performed using RNA-sequencing data from TCIA. Results: Using the MLP classifier combined with clinical factors, DLR MLP showed higher performance than DLER and clinical models in predicting early recurrence in internal validation set (AUC: 0.891 vs 0.797, 0.752), two external test set1 (0.814 vs. 0.666, 0.808) and external test2 (0.834 vs. 0.756, 0.766). Early recurrence-free survival, disease-free survival, and overall survival can be stratified using the DLER MLP (all P &lt; .001). High DLER MLP score is associated with upregulated tumour proliferation pathways (WNT, MYC, and KRAS signalling) and immune cell infiltration in the tumour microenvironment. Conclusion: The DLER MLP based on CT images was able to predict early recurrence of patients with LAGC and served as a useful tool for optimizing treatment strategies and monitoring.
The timing of surgical interventions following the implantation of coronary drug-eluting stents in patients undergoing gastrointestinal cancer surgery: a multicenter retrospective cohort study
Authors: Ziyao Xu, Yingying Lai, Yan Zhou, Lipeng Qin, Xinyu Hao, Tian Li, Lei Gao, Xinxin Wang
Journal: International Journal of Surgery (2024)

Abstract We aim to investigate the optimal timing for surgical interventions to maximize patient benefit. Background: The guidelines recommending a minimum deferral of six months for non-cardiac surgeries following drug-eluting stent percutaneous coronary intervention (DES-PCI) do not adequately address the requirements for individuals undergoing gastrointestinal cancer surgery (GCS). Methods: The study encompassed 2,501 patients treated from January 2017 to December 2021, all of whom underwent GCS within one year after DES-PCI. We conducted an analysis by comparing the occurrence of Major Adverse Cardiovascular Events (MACEs) within 30 days post-surgery at different time points. Results: This study enrolled a total of 2501 participants with meticulously recorded data who underwent DES-PCI and subsequently underwent GCS within one year post-implantation. The incidence rate of MACEs is 14.2%, including MI (5.1%), HF (5.8%), IS (3.2%), Cardiac death (0.2%) across all patients in this study. The threshold probability was determined using the Youden Index, resulting in a value of 0.320, corresponding to a “Time-to-surgery value” of 87. Significant statistical differences were observed in the occurrence rates of MACEs for adjacent time intervals at 30 days (p &lt; 0.001), 90 days (p &lt; 0.009), and 180 days (p &lt; 0.001). Conclusions: The timing of surgical intervention following DES-PCI significantly influences the occurrence of MACEs at 1 month, 3 months, and 6 months. GCS may be appropriately advanced within the 6-month timeframe, but with the exception of emergency, efforts should be made to defer them beyond the initial month.
Associations of osteoarthritis with risk of future fracture events: prospective study in UK biobank
Authors: Ping Wang, Zijun Tang, Xiaoyu Lin, Wenkai Shao, Bo Wang, Zilin Li, Xiao Lv, Gang Liu, Yong Feng
Journal: International Journal of Surgery (2024)

Background: Researchers have long been interested in the potential relationship between osteoarthritis (OA), falls, and fractures; however, the evidence supporting this relationship has been conflicting. This study aimed to investigate the association between osteoarthritis and future fracture events. Materials and Methods: This study was designed as a prospective cohort study. We recruited a total of 440,476 individuals from the UK Biobank to investigate the impact of OA on the incidence of fracture. Among the total population, there were 54,581 participants diagnosed with OA. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Results: A total of 26,083 fracture events were documented over a median follow-up period of 13.5 years. After multivariable adjustment, participants with osteoarthritis had an HR (95% CI) of 1.11 (1.08, 1.15) for future fracture events compared to participants without osteoarthritis ( P &lt; 0.0001). Falls explained 16.34% of the association between osteoarthritis and fracture events and 14.15% of the association between knee osteoarthritis and fracture events. The association was not substantially altered across the series of sensitivity analyses. Conclusion: Osteoarthritis was associated with a greater risk of future fracture events. This finding highlights the importance of preventing future fracture events in people with osteoarthritis.