tbuckley/cabot-search huggingface dataset:
Suitability of the MP1000 system for robot-assisted partial nephrectomy: A multicenter randomized controlled noninferiority trial
Authors: Yu Gao, Yang Yang, Shaoxi Niu, Wang He, Jin Tao, Shengjie Guo, Hongzhao Li, Xin Ma, Jian Huang, Xing Ai, Fangjian Zhou, Xuepei Zhang, Xu Zhang
Journal: International Journal of Surgery (2024)

Purpose: This study aimed to compare the safety and effectiveness of the MP1000 surgical system with the da Vinci ® Si robot system in robot-assisted partial nephrectomy (RAPN) through a prospective, single-blinded, randomized control trial. Materials and Methods: A total of 62 patients who were scheduled to undergo RAPN were randomly assigned to either the da Vinci® Si robot or MP1000 group. A noninferiority test was conducted with a non-inferior intermediate value of 10%. The study compared installation and operation times, estimated blood loss, warm ischemia time, postoperative surgical margin, rate of conversion to open surgery, eGFR level, complications, and other safety indicators between the two groups. Results: All procedures were successfully completed without the need for conversion to open or laparoscopic surgery, and no major complications were observed during the process. The test of noninferiority was achieved. There were no significant differences in median installation time, operation time, complication rate at 3 months, rate of positive surgical margin, and eGFR level at 3 months between the groups. Additionally, no evidence of recurrence was found on imaging in both groups. No difference in National Aeronautics and Space Administration task load index results for ergonomic considerations. A limitation of this study was its small sample size. Conclusions: The MP1000 system is a suitable platform for RAPN with safety and effectiveness comparable with da Vinci ® Si system.
Right gastroepiploic artery length determined anastomotic leakage after minimally invasive esophagectomy for esophageal cancer- a prospective cohort study
Authors: KunKun Li, YingJian Wang, TaiMing Zhang, Liang Zhang, ShuLin Zhao, Liang Chen, Tao Bao, XiaoLong Zhao, XianFeng Xie, Wei Guo
Journal: International Journal of Surgery (2024)

Background: This prospective cohort study, conducted at a high-volume esophageal cancer center from July 2019 to July 2022, aimed to investigate the link between the right gastroepiploic artery (RGEA) length and anastomotic leakage (AL) rates following minimally invasive esophagectomy (MIE). Real-world data on stomach blood supply in the Chinese population were examined. Materials and Methods: A total of 516 cases were enrolled, categorized into two groups based on the Youden index-determined optimal cut-off value for the relative length of RGEA (length of RGEA/length of gastric conduit, 64.69%) through ROC analysis: Group SR (short RGEA) and Group LR (long RGEA). The primary observation parameter was the relationship between AL incidence and the ratio of direct blood supply from RGEA. Secondary parameters included the mean length of the right gastroepiploic artery, greater curvature, and the connection type between right and left gastroepiploic vessels. Patient data were prospectively recorded in electronic case report forms. Results: The study revealed median lengths of 43.60 cm for greater curvature, 43.16 cm for the gastric conduit, and 26.75 cm for RGEA. AL, the most common postoperative complication, showed a significant difference between groups (16.88% vs. 8.84%, P =0.01). Multivariable binary logistic regression identified Group SR and LR (Odds ratio: 2.651, 95% CI: 1.124–6.250, P =0.03) and Neoadjuvant therapy (Odds ratio: 2.479, 95% CI: 1.374–4.473, P =0.00) as independent predictors of AL. Conclusions: The study emphasizes the crucial role of RGEA length in determining AL incidence in MIE for esophageal cancer. Preserving RGEA and fostering capillary arches between RGEA and LGEA are recommended strategies to mitigate AL risk.
Optimal duration of oxaliplatin-based adjuvant chemotherapy in patients with different risk factors for stage II-III colon cancer: a meta-analysis
Authors: Ziyu Kuang, Jiaxi Wang, Kexin Liu, Jingyuan Wu, Jie Li
Journal: International Journal of Surgery (2024)

Background: The duration of oxaliplatin–based chemotherapy in high–risk stage II, low–risk stage III, and high–risk stage III colon cancer patients is controversial. To reduce the risk of adverse events (AEs) without compromising efficacy while improving chemotherapy compliance is crucial. Methods: We searched Cochrane, Embase, Pubmed, and Web of Science databases for articles from inception to 2023.8.8, the main outcomes were disease–free survival, overall survival, chemotherapy completion rates, and AE frequency. Results: Six randomized controlled trials involving 10,332 patients were included. Disease–free survival analysis revealed that only the high–risk stage III colon cancer patients experienced better results with the six–month FOLFOX regimen when compared with the 3–month regimen (Hazard ratio [HR]: 1.32, 95% CI: 1.15–1.51, P &lt;0.0001). Overall survival analysis revealed that extending the use of FOLFOX and CAPEOX regimens did not provide survival benefits for stage III colon cancer patients (HR: 1.16, 95% CI: 0.9–1.49, and HR: 0.89, 95% CI: 0.67–1.18, P =0.40). The completion rate of the three–month oxaliplatin–based adjuvant chemotherapy regimen was significantly higher than that of the six–month regimen (Relative risk [RR]: 1.16, 95% CI: 1.06–1.27, P =0.002). Moreover, the three–month regimen had significantly lower AE rates than the six–month regimen (RR: 0.62, 95% CI: 0.57–0.68, P &lt;0.00001), with differences mainly concentrated in grade 3/4 neutropenia (RR: 0.70, 95% CI: 0.59–0.85, P =0.0002), peripheral sensory neuropathy at≥grade 2 (RR: 0.45, 95% CI: 0.38–0.53, P &lt;0.00001), and hand–foot syndrome at≥grade 2 (RR: 0.36, 95% CI: 0.17–0.77, P =0.009). Conclusions: The six–month FOLFOX regimen should only be recommended for high–risk stage III colon cancer, while the three–month regimen can be recommended for other stages. A three–month CAPEOX regimen can be recommended for stage II–III colon cancer.
Advancements and current trends in tumor treating fields: a scientometric analysis
Authors: Yang Xing, Feroza Yasinjan, Jiayue Cui, Yizhao Peng, Minghua He, Wenhui Liu, Xinyu Hong
Journal: International Journal of Surgery (2024)

Tumor treating fields (TTFields) therapy is a novel and effective noninvasive cancer therapy, and it has been approved by FDA in the treatment of recurrent and newly diagnosed glioblastoma, and malignant pleural mesothelioma. Moreover, TTFields therapy has been widely studied in both clinical trials and preclinical studies in recent years. Based on its high efficacy, research on TTFields therapy has been a hot topic. Thus, the authors made this scientometric analysis of TTfields to reveal the scientometric distributions such as annual publications and citations, countries and institutions, authors, journals, references, and more importantly, research status and hot topics of the field. In recent years, publication numbers have been stable at high values, and citation numbers have been increasing greatly. The United States and Israel were the top two countries with the highest publication numbers, followed by Germany and Switzerland. Scientometric analyses of keywords indicated that clinical applications and antitumor mechanisms are probably the two main parts of current research on TTfields. Most clinical trials of TTfields focus on the treatment of glioblastoma. And a variety of other cancers such as lung cancer especially nonsmall cell lung cancer, hepatic cancer, other brain tumors, etc. have also been studied in both clinical trials and preclinical studies.
Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study
Authors: Yu-Hang Gao, Yu-Meng Qi, Pei-Hong Huang, Xing-Yu Zhao, Xin Qi
Journal: International Journal of Surgery (2024)

Background: Few studies have reported the coronal constitutional alignment of the lower limbs in mainland China. This study aimed to analyse the distribution of the coronal plane alignment of the knee (CPAK) classification in the osteoarthritic and healthy Chinese populations. Materials and Methods: The CPAK distributions of 246 patients (477 knees) with osteoarthritis (OA) and 107 healthy individuals (214 knees) were retrospectively examined using long-leg radiographs. Radiological measurements and CPAK classification of different Kellgren–Lawrence grades in patients with unilateral total knee arthroplasty (TKA) were compared. The clinical outcomes of patients with CPAK type I who underwent mechanical alignment or restricted kinematic alignment during TKA were examined. Results: The most common distributions in the OA and healthy groups were type I and type II, respectively. In patients who underwent unilateral TKA, the most common distribution of knees graded as Kellgren–Lawrence 3–4 was type I. However, the most common distributions of contralateral knees graded as Grade 0–2 were type I and II. For patients with CPAK type I, the mechanical alignment and restricted kinematic alignment groups did not differ significantly concerning postoperative clinical outcomes at three months. Conclusion: The most common distributions in Chinese osteoarthritic and healthy populations were types I and II, respectively. In addition, OA progression may lead to changes in the CPAK classification.
A commentary on “Risk factors for delayed recovery in postanesthesia care unit after surgery: a large and retrospective cohort study”
Authors: Chao Yang, Qifei Deng, Chi Zhang, Yongsheng Cao, Junting Li, Changkun Mao
Journal: International Journal of Surgery (2024)

Yang, Chao MB; Deng, Qifei MM; Zhang, Chi MB; Cao, Yongsheng MB; Li, Junting MB; Mao, Changkun MM Author Information
Post-transplant HBV reactivation impacts the prognosis of patients with hepatitis B-related hepatocellular carcinoma: a dual-center retrospective cohort study in China
Authors: Huigang Li, Di Lu, Jingyan Chen, Junchi Zhang, Jianyong Zhuo, Zuyuan Lin, Chenghao Cao, Wei Shen, Chiyu He, Hao Chen, Zhihang Hu, Yiyang Sun, Xuyong Wei, Li Zhuang, Shusen Zheng, Xiao Xu
Journal: International Journal of Surgery (2024)

Background: Highly active hepatitis B virus (HBV) is known to be associated with poor outcomes in patients with hepatocellular carcinoma (HCC). This study aims to investigate the relationship between HBV status and HCC recurrence after liver transplantation. Methods: The study retrospectively analyzed HCC patients undergoing liver transplantation in two centers between January 2015 and December 2020. We reviewed post-transplant HBV status and its association with outcomes. Results: The prognosis of recipients with hepatitis B surface antigen (HBsAg) reappearance (n=58) was poorer than those with HBsAg persistent negative (n=351) and positive (n=53). In HBsAg persistent positive group, recipients with HBV DNA reappearance or &gt; 10-fold increase above baseline had worse outcomes than those without ( P &lt;0.01). HBV reactivation was defined as (a) HBsAg reappearance or (b) HBV DNA reappearance or &gt; 10-fold increase above baseline. After propensity score matching, the 5-year overall survival rate and recurrence-free survival rate after liver transplantation in recipients with HBV reactivation were significantly lower than those without (32.0% vs 62.3%; P &lt;0.01, and 16.4% vs 63.1%; P &lt;0.01, respectively). Moreover, HBV reactivation was significantly related to post-transplant HCC recurrence, especially lung metastasis. Cox regression analysis revealed that beyond Milan criteria, microvascular invasion and HBsAg positive graft were independent risk factors for post-transplant HBV reactivation, and a novel nomogram was established accordingly with a good predictive efficacy (AUROC=0.78, C-index =0.73). Conclusions: Recipients with HBV reactivation had worse outcomes and higher tumor recurrence rates than those without. The nomogram could be used to evaluate the risk of post-transplant HBV reactivation effectively.
Impact of varied immunosuppressive agents and posttransplant diabetes mellitus on prognosis among diverse transplant recipients (Experimental studies)
Authors: Yuan Liu, Jinxin Zheng, Qining He, Haijiao Zhang, Peizhen Wen, Peihao Wen, Jifu Ge, Yang Yang, Tao Zhang, Rangrang Wang
Journal: International Journal of Surgery (2024)

The success of solid organ transplantation (SOT) and the use of immunosuppressive agents offer hope to patients with end-stage diseases. However, the impact of posttransplant diabetes mellitus (PTDM) on SOT patients has become increasingly evident. In our study, we utilized the Scientific Registry of Transplant Recipients (SRTR) database to investigate the association between PTDM and patient survival in various types of organ transplantations, including liver, kidney, intestinal, heart, lung, and combined heart-lung transplantations (all P &lt;0.001). Our findings revealed a negative effect of PTDM on the survival of these patients. Furthermore, we examined the effects of both generic and innovator immunosuppressive agents on the development of PTDM and the overall survival of different SOT populations. Interestingly, the results were inconsistent, indicating that the impact of these agents may vary depending on the specific type of transplantation and patient population. Overall, our study provides a comprehensive and systematic assessment of the effects of different immunosuppressive agents on prognosis, as well as the impact of PTDM on the survival of patients undergoing various types of SOT. These findings emphasize the need for further research and highlight the importance of optimizing immunosuppressive regimens and managing PTDM in SOT patients to improve their long-term outcomes.
Preoperative duration of type 2 diabetes mellitus and remission after Roux-en-Y gastric bypass: A single center long-term cohort study
Authors: Karl Hage, Kamal Abi Mosleh, Jack W. Sample, Robert A. Vierkant, Manpreet S. Mundi, Konstantinos Spaniolas, Barham K. Abu Dayyeh, Omar M. Ghanem
Journal: International Journal of Surgery (2024)

Roux-en-Y gastric bypass (RYGB) has demonstrated excellent glycemic control and type 2 diabetes mellitus (T2DM) remission for patients with obesity and T2DM. Duration of T2DM is a consistent negative predictor of remission after RYGB. However, the exact timing to offer surgical intervention during the course of the disease is not well elucidated.
Strategy of lymph node dissection in uniportal thoracoscopic surgery for lung cancer
Authors: Yaodong Zhou
Journal: International Journal of Surgery (2024)

Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China Case Series Editorials Running head: Strategy for lymph node dissection in uniportal VATS Please contact the corresponding author if necessary. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article *Corresponding Author. Address: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai 200032, People's Republic of China, Tel +86 21 6417 5590, Fax +86 21 6268 6511. E-mail address: [email protected](Yaodong Zhou). Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, www.lww.com/international-journal-of-surgery. Published online ■ ■ This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
A novel technique of reverse-sequence endoscopic nipple-sparing mastectomy with direct-to-implant breast reconstruction: medium-term oncological safety outcomes and feasibility of 24-hour discharge for breast cancer patients
Authors: Zhou Jiao, Yanyan Xie, Faqing Liang, Yu Feng, Huanzuo Yang, Mengxue Qiu, Qing Zhang, Kawun Chung, Hui Dai, Yang Liu, Peng Liang, Zhenggui Du
Journal: International Journal of Surgery (2024)

Background: Due to the short operation time and no need for special instruments, reverse-sequence endoscopic nipple-sparing mastectomy (R-E-NSM) with direct-to-implant breast reconstruction (DIBR) has been rapidly becoming popular in the last three years. However, there has yet to be an evaluation of its oncologic safety or the feasibility of discharging patients within 24 hours. Materials and Methods: In this single-center retrospective cohort study, individuals diagnosed with stage 0–III breast cancer between May 2020 and April 2022 who underwent traditional open mastectomy or R-E-NSM with DIBR were included. Follow-up started on the date of surgery and ended in December 2023. Data, including demographics, tumor characteristics, medium-term oncological outcomes, and postoperative complications, were collected and analyzed. Propensity score matching (PSM) was performed to minimize selection bias. Results: This study included 1679 patients (median [IQR] age, 50 [44-57] years). Of these, 344 patients underwent R-E-NSM with DIBR (RE-R group), and 1335 patients underwent traditional open mastectomy (TOM group). The median [IQR] follow-up time was 30 [24-36] months (29 [23-33] months in the RE-R group and 30 [24-36] months in the TOM group). Regarding before or after PSM, the P value of local recurrence-free survival (LRFS, 0.910 and 0.450), regional recurrence-free survival (RRFS, 0.780 and 0.620), distant metastasis-free survival (DMFS, 0.061 and 0.130), overall survival (OS, 0.260 and 0.620), disease-free survival (DFS, 0.120 and 0.330) were not significantly different between the RE-R group and the TOM group. The 3y-LRFS and 3y-DFS rates were 99.0% and 97.1% for the RE-R group and 99.5% and 95.3% for the TOM group, respectively. The rates of any complications and major complications were not significantly different between the RE-R patients who were discharged within 24 hours and the RE-R patients who were not discharged within 24 hours ( P =0.290, P =0.665, respectively) or the TOM patients who were discharged within 24 hours ( P =0.133, P =0.136, respectively). Conclusions: R-E-NSM with DIBR is an innovative oncologic surgical procedure that not only improves cosmetic outcomes but also ensures reliable oncologic safety and fewer complications, enabling patients to be safely discharged within 24 hours. A long-term prospective multicenter assessment will be supporting.
Global burden of all cause-specific injuries among children and adolescents from 1990 to 2019 : a prospective cohort study
Authors: Cong Li, Jinghua Jiao, Guangyao Hua, Gantugs Yundendorj, Shunming Liu, Honghua Yu, Lijun Zhang, Xiaohong Yang, Lei Liu
Journal: International Journal of Surgery (2024)

Background: To assess the burden and change in incidence, death, and disability-adjusted life years (DALYs) for all-cause-specific injuries among children and adolescents in 204 countries and territories between 1990 and 2019. Materials and Methods: Data were extracted from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019). Global, regional, and country-level age-standardized rate (per 100,000) of incidence (ASRI), mortality (ASRM), and DALYs (ASRD) with 95% uncertainty interval (95% UI) of injuries were estimated by age, sex, socio-demographic index (SDI), and all-cause specific injuries from 1990 to 2019. Results: Overall, the ASRI, ASRM, and ASRD of injury were 9006.18 (95%UI: 7459.74 to 10918.04), 23.04 (20.00 to 26.50), and 2020.19 (1759.47 to 2318.64) among children and adolescents worldwide in 2019, respectively. All the above indicators showed a downward trend from 1990 to 2019. In level 2 cause of injury, both the global transport injury and unintentional injury declined during the study years, while self-harm and interpersonal violence-related injury showed an increasing trend. High SDI regions had higher ASRI of injuries, but low SDI regions had higher ASRM and ASRD of injuries globally in 2019. Males had a higher burden of injuries than those in females. The ASRI of injuries is higher in adolescents aged 15-19 years, whereas the mortality and DALYs rate are higher among children under 5 years old. Moreover, adolescents aged 15-19 years and individuals living in Central Asia, Middle East, and Africa had higher ASRI, ASRM, and ASRD of injuries owing to self-harm and interpersonal violence. Generally, falls and road traffic injuries are the leading cause of injury among the population aged 0-19 years worldwide, but self-harm, interpersonal violence, and conflict and terrorism are also leading types of injuries in some regions, particularly in Low- and Middle-Income Countries. Conclusions: Injury remains a major global public health problem among children and adolescents, although its burden at the worldwide level showed a decreasing trend from 1990 to 2019. Of concern, the burden of injuries caused by transport injuries, and unintentional injuries has shown a downward trend in most countries, while the burden caused by self-harm and interpersonal violence has shown an upward trend in most countries. These findings suggest that more targeted and specific strategies to prevent the burden of injuries should be reoriented, and our study provides important findings for decision-makers and healthcare providers to reduce injury burden among children and adolescents.
Metagenomic next-generation sequencing, instead of procalcitonin, could guide antibiotic usage in patients with febrile acute necrotizing pancreatitis: a multicenter, prospective cohort study
Authors: Chiayen Lin, Jiarong Li, Baiqi Liu, Xiaoyue Hong, Tao Luo, Jinsong Ye, Yi Yu, Xinran Peng, Shanmiao Gou, Huayong Tang, Tongli Yuan, Jianguan Luo, Ming Yang, Bin Feng, Zhijian Zhao, Caihong Ning, Zefang Sun, Shuai Zhu, Lu Chen, Dingcheng Shen, Gengwen Huang
Journal: International Journal of Surgery (2024)

Backgrounds: The effectiveness of procalcitonin-based algorithms in guiding antibiotic usage for febrile acute necrotizing pancreatitis (ANP) remains controversial. Metagenomic next-generation sequencing (mNGS) has been applied to diagnose infectious diseases. We aimed to evaluate the effectiveness of blood mNGS in guiding antibiotic stewardship for febrile ANP. Materials and Methods: The prospective multicenter clinical trial was conducted at seven hospitals in China. Blood samples were collected during fever (T ≥38.5°C) from ANP patients. The effectiveness of blood mNGS, procalcitonin, and blood culture in diagnosing pancreatic infection was evaluated and compared. Additionally, the real-world utilization of antibiotics and the potential mNGS-guided antimicrobial strategy in febrile ANP were also analyzed. Results: From May 2023 to October 2023, a total of 78 patients with febrile ANP were enrolled and 30 patients (38.5%) were confirmed infected pancreatic necrosis (IPN). Compared with procalcitonin and blood culture, mNGS showed a significantly higher sensitivity rate (86.7% vs. 56.7% vs. 26.7%, P &lt;0.001). Moreover, mNGS outperformed procalcitonin (89.5% vs. 61.4%, P &lt;0.01) and blood culture (89.5% vs. 69.0%, P &lt;0.01) in terms of negative predictive value. Blood mNGS exhibited the highest accuracy (85.7%) in diagnosing IPN and sterile pancreatic necrosis (SPN), significantly superior to both procalcitonin (65.7%) and blood culture (61.4%). In the multivariate analysis, positive blood mNGS (OR=60.2, P &lt;0.001) and lower fibrinogen level (OR=2.0, P &lt;0.05) were identified as independent predictors associated with IPN, whereas procalcitonin was not associated with IPN, but with increased mortality (OR=11.7, P =0.006). Overall, the rate of correct use of antibiotics in the cohort was only 18.6% (13/70) and would be improved to 81.4% (57/70) if adjusted according to the mNGS results. Conclusion: Blood mNGS represents important progress in the early diagnosis of IPN, with particular importance in guiding antibiotic usage for patients with febrile ANP.