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Perioperative outcomes and phase-specific intraoperative glycemic management in simultaneous pancreas-kidney transplantation:A single-center case series 认领 引用 被引量：1
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作者 Felix R Montes Juan Diego Gutierrez-Navarro +9 位作者 Natalia Restrepo-Patiño Laura Gutiérrez-Soriano Eduardo Becerra-Zapata Juan Carlos Kling Laura Peña-Blanco Rodrigo Martinez-Ardila Nicolas Diaz-Riaño Laura Gonzalez-Vasquez Nathaly Ramirez-Sanchez Luis Manuel Barrera-Lozano 《World Journal of Transplantation》 2026年第2期201-209,共9页
BACKGROUND Simultaneous pancreas-kidney transplantation(SPKT),an established treatment for patients with type 1 diabetes mellitus(T1DM)or type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD),provides metabo... BACKGROUND Simultaneous pancreas-kidney transplantation(SPKT),an established treatment for patients with type 1 diabetes mellitus(T1DM)or type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD),provides metabolic stabilization and improved survival.Although perioperative glycemic control is crucial for graft viability;intraoperative management remains understudied,and standardized phase-specific protocols are lacking.AIM To explore the feasibility,safety,and immediate outcomes of a six-phase intraoperative glycemic control algorithm for SPKT.METHODS This retrospective case series included 11 patients with T1DM or T2DM and ESRD who underwent SPKT at a quaternary care center between January 2024 and May 2025.All patients were managed using a six-phase institutional glycemic control algorithm that maintains intraoperative blood glucose levels within predefined targets.Data on clinical,metabolic,surgical variables;complications;and early outcomes were collected.RESULTS In most cases,intraoperative blood glucose levels were maintained within target ranges;however variations were observed[range:63-453 mg/dL(3.5-25.2 mmol/L)].No severe hypoglycemia or ketoacidosis occurred.During the first 24 postoperative hours,seven patients(63.6%)achieved euglycemia without exogenous insulin,whereas two required transient insulin therapy.Six patients(54.5%)had postoperative complications,including thrombotic(n=4),infectious(n=2),and reperfusion syndrome(n=1).One patient experienced more than one event.All events were successfully managed,without graft loss,acute rejection,or in-hospital mortality.CONCLUSION The phase-specific intraoperative glycemic protocol for SPKT is feasible and safe.However,prospective studies with larger cohorts are warranted to assess its long-term impact on graft survival and patient outcomes. 展开更多
关键词 Simultaneous pancreas-kidney transplantation Intraoperative glycemic control Perioperative management Pancreatic graft function Metabolic stability
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Pix2Pix-driven virtual pathology staining based on phase contrast microscopy:A low-cost strategy for rapid intraoperative assessment of breast cancer 认领 引用 被引量：1
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作者 Yunhong Li Jianbo Zhu +5 位作者 Huijie Wang Jing Pei Zichen Ling Sheng Ding Linwei Shang Jianhua Yin 《Journal of Innovative Optical Health Sciences》 SCIE EI CSCD 2026年第4期114-122,共9页
Intraoperative pathological assessment requires rapid,high-quality stained sections to support surgical decisions.Currently,however,this area lacks cost-effective and rapid staining methods for intraoperative procedur... Intraoperative pathological assessment requires rapid,high-quality stained sections to support surgical decisions.Currently,however,this area lacks cost-effective and rapid staining methods for intraoperative procedures.This study integrated a low-cost phase contrast microscope(PCM)imaging and Pix2Pix Generative Adversarial Network(GAN)to take the microimages and create a virtual staining framework of intraoperative sample-frozen sections for converting label-free phase contrast images(PCIs)into H&E-stained equivalents for thefirst time.PCIs and H&Estained whole-slide images were captured from sample-frozen sections of 15 registered patients with breast cancer and compared with their autofluorescence image results.Pix2Pix and CycleGAN models were trained on these images.It's found that the Pix2Pix GAN excels in PCI and generates a clear nuclear boundary and accurate tissue structure without staining artifacts.Quantitatively,Pix2Pix model provides a higher structural similarity index(SSIM?0.57)and peak signal-to-noise ratio(PSNR?21.65)in phase contrast mode than CycleGAN in the comparison study.The virtual staining results of PCM integrated with Pix2Pix are clearly superior to those of autofluorescence with Pix2Pix,as well as with CycleGAN.Additionally,the approach offers fast processing(1.5 s/mm2T and can generate a standard WSI virtual stained section in 3 min.This low-cost virtual staining approach bypasses the cumbersome H&E staining process in conventional pathology,significantly accelerating diagnostic procedures.It's very possible and of significance for this intelligent intraoperative technology to be extended to other intraoperative pathological assessment scenarios requiring rapid histological assessment. 展开更多
关键词 Breast cancer diagnosis phase contrast microscope Pix2Pix intraoperative virtual staining
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Aberrant drainage of the right anterior sectional bile duct into the neck of the gallbladder:Intraoperative fluorescence-guided identification and functional reconstruction 认领 引用
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作者 Bo-Wen Zheng Hong-Fei Wang +1 位作者 Jian-Lei Chen Hao Li 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2026年第2期221-224,共4页
Cholecystectomy is one of the most commonly performed procedures in hepatobiliary surgery,with ongoing clinical attention focused on its safety and minimizing complications.Bile duct injury(BDI)remains a serious conce... Cholecystectomy is one of the most commonly performed procedures in hepatobiliary surgery,with ongoing clinical attention focused on its safety and minimizing complications.Bile duct injury(BDI)remains a serious concern,with an incidence of approximately 0.3%-0.6%[1],primarily associated with anatomical variations[2].While standard preoperative imaging like magnetic resonance cholangiopancreatography(MRCP)offers high sensitivity,it may fail to detect rare,dynamic,or functionally significant biliary anomalies[3]. 展开更多
关键词 cholecystectomy bile duct injury magnetic resonance cholangiopancreatography mrcp offers duct injury bdi remains intraoperative fluorescence guided identification aberrant drainage functional reconstruction hepatobiliary surgerywith
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Phase-specific intraoperative glycemic control in simultaneous pancreas-kidney transplantation 认领 引用
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作者 Pranjal Kashiv Manish Ramesh Balwani +3 位作者 Priyanka Tolani Amit Pasari Khushboo Saxena Vivek B Kute 《World Journal of Transplantation》 2026年第2期25-32,共8页
In this review summarizes studies addressing a critical and long-overlooked vulnerability in simultaneous pancreas-kidney transplantation(SPKT):Perioperative metabolic instability during the transition from graft isch... In this review summarizes studies addressing a critical and long-overlooked vulnerability in simultaneous pancreas-kidney transplantation(SPKT):Perioperative metabolic instability during the transition from graft ischemia to endocrine recovery after reperfusion.Despite the central role of glycemia in pancreatic graft viability,intraoperative glucose management has remained largely empirical,reactive,and inconsistently standardized across transplant centres.The authors propose a structured,six-phase intraoperative glycemic control framework that aligns glucose targets with discrete operative stages,advancing a physiologyinformed alternative to static,threshold-based insulin administration.In their single-centre experience,phase-adapted targets were associated with early insulin-independent euglycemia and the absence of severe hypoglycemia,ketoacidosis,early graft loss,or perioperative mortality.Notably,greater intraoperative glycemic variability clustered among recipients who developed early thrombotic and infectious complications,implicating glucose instability as a potential amplifier of endothelial injury and immunothrombotic risk at a moment of maximal graft vulnerability.Although limited by small sample size,lack of a control cohort,and short follow-up,this work demonstrates that intraoperative metabolic control in SPKT can be conceptualized and implemented using phase-specific objectives rather than uniform glycemic thresholds,laying the groundwork for future prospective validation incorporating time-in-range and variability metrics. 展开更多
关键词 Simultaneous pancreas-kidney transplantation Intraoperative glycemic control Glycemic variability Immunothrombosis Ischemia-reperfusion injury Metabolic stewardship
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Navigation value of intraoperative ultrasound combined with indocyanine green fluorescence in complex hepatocellular carcinoma resection 认领 引用
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作者 Sheng Zhang Shao-Ying Li Bing Zhou 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第4期103-117,共15页
BACKGROUND Primary hepatocellular carcinoma(HCC)is a common malignancy worldwide,with surgical resection being the most effective treatment for long-term survival.For complex HCC(large diameter,central location,multip... BACKGROUND Primary hepatocellular carcinoma(HCC)is a common malignancy worldwide,with surgical resection being the most effective treatment for long-term survival.For complex HCC(large diameter,central location,multiple lesions,or proximity to major vessels),traditional surgery relying on surgeon experience and palpation has limitations including difficulty identifying deep lesions and high positive margin rates.Intraoperative ultrasound(IOUS)provides real-time hepatic structural visualization but has limited capability for isoechoic lesions,while indocyanine green(ICG)fluorescence imaging enables real-time tumor visualization but lacks deep anatomical information.Combined application may offer complementary advantages,yet systematic evaluation studies in complex HCC resection remain scarce.AIM To evaluate the clinical application value of IOUS combined with ICG fluorescence imaging technology in radical resection of complex HCC.METHODS Clinical data of 200 patients with complex HCC who underwent radical hepatectomy from January 2019 to August 2024 were retrospectively analyzed.Patients were divided into a combined navigation group(n=103)and a conventional surgery group(n=97)based on whether IOUS and ICG fluorescence imaging technology were used in combination.Intraoperative indicators,oncological indicators,postoperative recovery indicators,and long-term prognosis were compared between the two groups.Logistic regression analysis was used to analyze factors influencing postoperative complications,and Cox regression analysis was used to analyze factors influencing survival prognosis.RESULTS Baseline characteristics were balanced between the two groups.The combined navigation group had shorter tumor localization time(P<0.001),less intraoperative blood loss(P=0.004),lower intraoperative transfusion rate(P=0.021),higher detection rate of occult lesions(23.3%vs 6.2%,P<0.001),and higher anatomical resection rate(P=0.040).The combined navigation group had lower positive margin rate(2.9%vs 13.4%,P=0.006),higher R0 resection rate(97.1%vs 86.6%,P=0.006),and greater margin distance(P<0.001).The combined navigation group had lower overall postoperative complication rate(18.4%vs 28.9%,P=0.042)and severe complication rate(5.8%vs 12.4%,P=0.042),and shorter postoperative hospital stay(P=0.003).With a median follow-up of 28.6 months,the combined navigation group had higher 2-year overall survival rate(76.8%vs 65.2%,P=0.033)and 2-year diseasefree survival rate(58.4%vs 45.7%,P=0.022),and lower postoperative recurrence rate(36.9%vs 50.5%,P=0.048).Multivariate analysis showed that application of combined navigation technology was an independent protective factor for postoperative complications(odds ratio=0.498,P=0.027),and was also an independent protective factor for overall survival(hazard ratio=0.584,P=0.028)and disease-free survival(hazard ratio=0.631,P=0.025).CONCLUSION IOUS combined with ICG fluorescence imaging technology can improve tumor localization accuracy in complex HCC surgery,improve margin control,reduce intraoperative blood loss,decrease the incidence of postoperative complications,and improve long-term survival prognosis in patients,demonstrating important clinical application value. 展开更多
关键词 Hepatocellular carcinoma Complex hepatocellular carcinoma Intraoperative ultrasound Indocyanine green fluorescence imaging Surgical navigation Precision hepatectomy
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Observation on the Application Effect of Precision Intraoperative Nursing Cooperation in Laparoscopic Uterine Myomectomy 认领 引用
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作者 WANG Song 《外文科技期刊数据库（文摘版）医药卫生》 2026年第4期123-127,共5页
Objective: To evaluate the efficacy of refined intraoperative nursing care in laparoscopic myomectomy. Methods: A total of 66 patients undergoing laparoscopic myomectomy at our hospital (from August 2024 to October 20... Objective: To evaluate the efficacy of refined intraoperative nursing care in laparoscopic myomectomy. Methods: A total of 66 patients undergoing laparoscopic myomectomy at our hospital (from August 2024 to October 2025) were randomly assigned to either an observation group receiving refined intraoperative nursing care (n=33) or a control group receiving conventional nursing care (n=33). Postoperative recovery time, complication incidence, patient comfort levels, and quality of life were assessed. Results: Compared with the control group, the observation group exhibited shorter postoperative recovery time, lower complication incidence, higher comfort scores, and better quality of life scores (P<0.05). Conclusion: The application of refined intraoperative nursing care in laparoscopic myomectomy promotes patient recovery, reduces complication rates, enhances comfort and quality of life, and is worthy of clinical adoption. 展开更多
关键词 refined intraoperative nursing coordination laparoscopy myomectomy
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GenAI synthesis of histopathological images from Raman imaging for intraoperative tongue squamous cell carcinoma assessment 认领 引用 被引量：3
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作者 Bing Yan Zhining Wen +5 位作者 Lili Xue Tianyi Wang Zhichao Liu Wulin Long Yi Li Runyu Jing 《International Journal of Oral Science》 SCIE CAS CSCD 2025年第2期244-254,共11页
The presence of a positive deep surgical margin in tongue squamous cell carcinoma(TSCC)significantly elevates the risk of local recurrence.Therefore,a prompt and precise intraoperative assessment of margin status is i... The presence of a positive deep surgical margin in tongue squamous cell carcinoma(TSCC)significantly elevates the risk of local recurrence.Therefore,a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection.In this study,we integrate Raman imaging technology with an artificial intelligence(AI)generative model,proposing an innovative approach for intraoperative margin status diagnosis.This method utilizes Raman imaging to swiftly and non-invasively capture tissue Raman images,which are then transformed into hematoxylin-eosin(H&E)-stained histopathological images using an AI generative model for histopathological diagnosis.The generated H&E-stained images clearly illustrate the tissue’s pathological conditions.Independently reviewed by three pathologists,the overall diagnostic accuracy for distinguishing between tumor tissue and normal muscle tissue reaches 86.7%.Notably,it outperforms current clinical practices,especially in TSCC with positive lymph node metastasis or moderately differentiated grades.This advancement highlights the potential of AI-enhanced Raman imaging to significantly improve intraoperative assessments and surgical margin evaluations,promising a versatile diagnostic tool beyond TSCC. 展开更多
关键词 Surgical margin Intraoperative assessment Local recurrence Tongue squamous cell carcinoma raman imaging tongue squamous cell carcinoma tscc significantly Raman imaging Histopathological diagnosis
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Current use of intraoperative ultrasound in modern liver surgery 认领 引用 被引量：2
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作者 Kai-Jian Chu Yoshikuni Kawaguchi Kiyoshi Hasegawa 《Oncology and Translational Medicine》 CAS 2023年第4期168-175,共8页
Ultrasound plays an important role not only in preoperative diagnosis but also in intraoperative guidance for liver surgery.Intraoperative ultrasound(IOUS)has become an indispensable tool for modern liver surgeons,esp... Ultrasound plays an important role not only in preoperative diagnosis but also in intraoperative guidance for liver surgery.Intraoperative ultrasound(IOUS)has become an indispensable tool for modern liver surgeons,especially for minimally invasive surgeries,partially substituting for the surgeon’s hands.In fundamental mode,Doppler mode,contrast enhancement,elastography,and real-time virtual sonography,IOUS can provide additional real-time information regarding the intrahepatic anatomy,tumor site and characteristics,macrovascular invasion,resection margin,transection plane,perfusion and outflow of the remnant liver,and local ablation efficacy for both open and minimally invasive liver resections.Identification and localization of intrahepatic lesions and surrounding structures are crucial for performing liver resection,preserving the adjacent vital vascular and bile ducts,and sparing the functional liver parenchyma.Intraoperative ultrasound can provide critical information for intraoperative decision-making and navigation.Therefore,all liver surgeons must master IOUS techniques,and IOUS should be included in the training of modern liver surgeons.Further investigation of the potential benefits and advances in these techniques will increase the use of IOUS in modern liver surgeries worldwide.This study comprehensively reviews the current use of IOUS in modern liver surgeries. 展开更多
关键词 Intraoperative ultrasound(IOUS) Contrast-enhanced intraoperative ultrasound(CE-IOUS) Intraoperative ultrasound cholangiography(IOUSC) Doppler intraoperative ultrasound(Doppler IOUS) Real-time tissue elastography(RTE) Real-time virtual sonography(RVS)
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Intraoperative endoscopy:A controversial tool or a necessity in modern esophagogastric surgery? 认领 引用
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作者 Dionysios Dellaportas Ioannis Margaris +7 位作者 Charalampos M Charalampous Zoi Gkiafi Anastasia Pikouli Despoina Myoteri Nikolaos Pararas Panagis M Lykoudis Constantinos Nastos Emmanuel Pikoulis 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第12期34-42,共9页
Upper gastrointestinal(UGI)endoscopy has become increasingly popular with the recent advancements in technology and the increase of minimally invasive techniques.UGI endoscopy is indicated for diagnostic,staging,and t... Upper gastrointestinal(UGI)endoscopy has become increasingly popular with the recent advancements in technology and the increase of minimally invasive techniques.UGI endoscopy is indicated for diagnostic,staging,and therapeutic purposes and significantly influences the management of patients with a spectrum of foregut diseases,including esophageal and gastric malignancies,achalasia,and gastroesophageal reflux disease.There is growing evidence that intraoperative UGI endoscopy can be a useful adjunct and a powerful tool to enhance tumor localization,offering a direct evaluation of the surgical reconstruction and identifying potential sources of postoperative complications.However,its widespread utilization has been limited by concerns over cost,accessibility,and sufficient training and expertise.The aim of the current study was to review and elaborate on the available literature while presenting our experience in an academic institution specializing in esophagogastric surgery with intraoperative UGI endoscopy.We focused on the indications,added benefits,and related complications. 展开更多
关键词 Upper gastrointestinal surgery Esophagogastroduodenoscopy Foregut surgery Esophagogastric surgery Intraoperative endoscopy
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Navigating anatomical complexity in laparoscopic sigmoid cancer surgery:A three-dimension reconstruction protocol for intraoperative safety and efficiency 认领 引用
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作者 Zong-Xian Zhao Run-Dong Yao +3 位作者 Zong-Ju Hu Chao-Qian Chen Shu Zhu Yuan Yao 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第8期350-361,共12页
BACKGROUND Sigmoid colon cancer faces challenges due to anatomical diversity,including variable inferior mesenteric artery(IMA)branching and tumor localization complexities,which increase intraoperative risks.AIM To c... BACKGROUND Sigmoid colon cancer faces challenges due to anatomical diversity,including variable inferior mesenteric artery(IMA)branching and tumor localization complexities,which increase intraoperative risks.AIM To comprehensively evaluate the impact of three-dimensional(3D)visualization technology on enhancing surgical precision and safety,as well as optimizing perioperative outcomes in laparoscopic sigmoid cancer resection.METHODS A prospective cohort of 106 patients(January 2023 to December 2024)undergoing laparoscopic sigmoid cancer resection was divided into the 3D(n=55)group and the control(n=51)group.The 3D group underwent preoperative enhanced computed tomography reconstruction(3D Slicer 5.2.2&Mimics 19.0).3D reconstruction visualization navigation intraoperatively guided the following key steps:Tumor location,Toldt’s space dissection,IMA ligation level selection,regional lymph node dissection,and marginal artery preservation.Outcomes included operative parameters,lymph node yield,and recovery metrics.RESULTS The 3D group demonstrated a significantly shorter operative time(172.91±20.69 minutes vs 190.29±32.29 minutes;P=0.002),reduced blood loss(31.5±11.8 mL vs 44.1±23.4 mL,P=0.001),earlier postoperative flatus(2.23±0.54 days vs 2.53±0.61 days;P=0.013),shorter hospital length of stay(13.47±1.74 days vs 16.20±7.71 days;P=0.013),shorter postoperative length of stay(8.6±2.6 days vs 10.5±4.9 days;P=0.014),and earlier postoperative exhaust time(2.23±0.54 days vs 2.53±0.61 days;P=0.013).Furthermore,the 3D group exhibited a higher mean number of lymph nodes harvested(16.91±5.74 vs 14.45±5.66;P=0.030).CONCLUSION The 3D visualization technology effectively addresses sigmoid colon anatomical complexity through surgical navigation,improving procedural safety and efficiency. 展开更多
关键词 Three-dimension reconstruction Sigmoid colon cancer Visualization Inferior mesenteric artery Anatomical complexity Intraoperative safety
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Safety and efficacy of intraoperative radiation therapy using a low-energy X-ray source for resectable pancreatic cancer:an interim evaluation of an ongoing prospective phaseⅡstudy 认领 引用
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作者 Xingyun Chen Shuo Li +5 位作者 Chuntao Gao Wei Wang Haorui Li Yuxiao Liu Rui Liu Jihui Hao 《Cancer Biology & Medicine》 SCIE CAS CSCD 2025年第1期67-76,共10页
Objective:The role of intraoperative radiation therapy(IORT)in the management of resectable pancreatic cancer(RPC)remains unclear.To date,the application of IORT using a low-energy X-ray source has not been extensivel... Objective:The role of intraoperative radiation therapy(IORT)in the management of resectable pancreatic cancer(RPC)remains unclear.To date,the application of IORT using a low-energy X-ray source has not been extensively investigated.Therefore,this study was conducted to evaluate the safety and efficacy of IORT using a 50 kV X-ray source in treating RPC.Methods:Patients with RPC who underwent radical pancreatectomy and IORT were enrolled.The primary endpoint was time to treatment failure(TTF)survival,whereas the secondary endpoints were safety and overall survival(OS).Results:By November 2023,35 patients with RPC were treated according to the study protocol.The median TTF was 11.67 months,whereas the median OS for the cohort was 22.2 months.The local recurrence rate was 20%.The most common postoperative complication was pancreatic fistula.The incidence of delayed gastric emptying was 20%.Within 30 days after surgery,one patient experienced abdominal pain,another experienced vomiting,and one died because of abdominal infection and a grade C pancreatic fistula.Carcinoembryonic antigen(CEA)and D-dimer levels significantly correlated with TTF and OS in multivariate analyses.The carbohydrate antigen 19-9(CA19-9)level was another prognostic factor significantly associated with OS.Patients with low D-dimer and normal CA19-9 levels showed prolonged OS with an IORT dose≤15 Gy.Conclusions:This study supports use of IORT with a 50 kV X-ray source in treating RPC.IORT using a low-energy X-ray source was well-tolerated and feasible.Additionally,D-dimer,CEA,and CA19-9 levels may help identify patient profiles potentially benefitting from IORT. 展开更多
关键词 Resectable pancreatic cancer intraoperative radiation survival complications benefit group
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Deep learning-based differentiation of benign and malignant thyroid follicular neoplasms on multiscale intraoperative frozen pathological images:A multicenter diagnostic study 认领 引用
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作者 Jiahui Liu Chuanguang Xiao +10 位作者 Haicheng Zhang Pengyi Yu Qi Wang Ziru Peng Guohua Yu Ping Yang Yakui Mou Chuanliang Jia Hongxia Cheng Ning Mao Xicheng Song 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2025年第3期303-315,共13页
Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pat... Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pathological images.Methods:A total of 1,213 patients were divided into training and validation sets,an internal test set,a pooled external test set,and a pooled prospective test set at three centers.DMILS was constructed using a deep learningbased weakly supervised method based on multiscale WSIs at 10×,20×,and 40×magnifications.The performance of the DMILS was compared with that of a single magnification and validated in two pathologist-unidentified subsets.Results:The DMILS yielded good performance,with areas under the receiver operating characteristic curves(AUCs)of 0.848,0.857,0.810,and 0.787 in the training and validation sets,internal test set,pooled external test set,and pooled prospective test set,respectively.The AUC of the DMILS was higher than that of a single magnification,with 0.788 of 10×,0.824 of 20×,and 0.775 of 40×in the internal test set.Moreover,DMILS yielded satisfactory performance on the two pathologist-unidentified subsets.Furthermore,the most indicative region predicted by DMILS is the follicular epithelium.Conclusions:DMILS has good performance in differentiating thyroid follicular neoplasms on multiscale WSIs of intraoperative frozen pathological images. 展开更多
关键词 Deep learning intraoperative frozen pathological image pathological diagnosis thyroid follicular neoplasm
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Intraoperative imaging adequacy and its impact on unplanned return-to-theatre rates in pedicle screw instrumentation 认领 引用
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作者 Ramy Sherif Ella Clifford Spence +1 位作者 Jessica Smith Michael John Haydon McCarthy 《World Journal of Orthopedics》 2025年第3期49-55,共7页
BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the ... BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the use of both anteroposterior(AP)and lateral views—on surgical outcomes remains insufficiently studied.Evaluating whether the adequacy of these imaging modalities affects the risk of unplanned returns to theatre(URTT)within 90 days due to screw malplacement is essential for refining surgical practices and improving patient care.AIM To evaluate how intraoperative imaging adequacy influences unplanned returnto-theatre rates,focusing on AP and lateral fluoroscopic views.METHODS This retrospective cohort study analyzed 1335 patients who underwent thoracolumbar and sacral pedicle screw instrumentation between January 2013 and December 2022.Data on intraoperative imaging adequacy,screw placement,and URTT events were collected and statistically analyzed using IBM SPSS v23.Imaging adequacy was assessed based on the presence of both AP and lateral views,and outcomes were compared between imaging groups.RESULTS A total of 9016 pedicle screws were inserted,with 82 screws identified as malplaced in 52 patients.Of these,46 patients required URTT due to screw malplacement,with 37 returning within 90 days(URTT90).Patients with both AP and lateral imaging saved intraoperatively had significantly lower URTT90 rates compared to those with only lateral imaging saved,demonstrating the critical role of imaging adequacy in improving surgical outcomes.CONCLUSION This study underscores that comprehensive intraoperative imaging with both AP and lateral views reduces unplanned returns,improves outcomes,enhances precision,and offers a cost-effective approach for better spinal surgery results. 展开更多
关键词 Pedicle screw placement Intraoperative imaging Surgical outcomes Fluoroscopy standards Return-to-theatre Unplanned returns to theatre Imaging adequacy Surgical precision Screw malplacement
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Current roles of colonoscopy in minimally invasive colorectal surgery:Preoperative guidance,intraoperative colonoscopy,and combined endoscopic-laparoscopic surgery 认领 引用
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作者 Yuuri Hatsuzawa Shingo Tsujinaka +6 位作者 Tomoya Miura Yoh Kitamura Atsushi Mitamura Kentaro Sawada Makoto Hikage Toru Nakano Chikashi Shibata 《World Journal of Gastrointestinal Endoscopy》 2025年第11期23-31,共9页
Colonoscopy is a cornerstone in the detection and diagnosis of colorectal tumors,playing a critical role in both screening and clinical evaluation. More recently, itsutility has expanded to therapeutic guidance, parti... Colonoscopy is a cornerstone in the detection and diagnosis of colorectal tumors,playing a critical role in both screening and clinical evaluation. More recently, itsutility has expanded to therapeutic guidance, particularly with the advent ofminimally invasive surgical techniques. Preoperative tattoo marking is commonlyused for tumor localization;however, it poses challenges such as intraperitonealink scattering and difficulty in defining dissection planes in the lower rectum. Toaddress these limitations, a new technology utilizing a near-infrared fluorescenceclip placed preoperatively enables accurate intraoperative tumor localization.Intraoperative colonoscopy offers additional advantages, including real-timetumor localization, colonic irrigation, visualization of the proximal colon inobstructive cases, and assessment of anastomosis following colorectal resection.Notably, intraoperative colonoscopy allows for the immediate detection andmanagement of complications, such as anastomotic bleeding and leakage, potentiallyimproving postoperative outcomes. Furthermore, advances in endoscopicresections, including endoscopic mucosal resection, endoscopic submucosal dissection,hybrid endoscopic submucosal dissection, and combined endoscopiclaparoscopic surgery, have broadened the indications for endoscopic and endoscopy-guided full-thickness resection of colorectal tumors. These approaches areincreasingly applicable beyond conventional colorectal neoplasms and showpromise in managing appendiceal tumors as well. 展开更多
关键词 Intraoperative colonoscopy Tumor localization Anastomotic integrity Synchronous lesion Endoscopic mucosal resection Endoscopic submucosal dissection Combined endoscopic laparoscopic surgery Laparoscopy and endoscopy cooperative
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Application of laparoscopic intraoperative ultrasound in laparoscopic hepatic resection for liver tumor 认领 引用
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作者 Ji-Xing Wu Yan-Yang Fu Chang-Jun Jia 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第7期53-62,共10页
Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery.However,the lack of haptic feedback results in a certain amount of risk.The use of laparoscopic ultrasound(LUS)enables the operato... Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery.However,the lack of haptic feedback results in a certain amount of risk.The use of laparoscopic ultrasound(LUS)enables the operator to observe internal structures of the liver in real time to easily avoid the main blood vessels.It also allows for the detection of tumor boundaries and the extent of tumor thrombi,considerably improving the success rate of the operation.Besides its advantages in detecting small lesions that are not detectable through preoperative imaging,thus assisting diagnosis and staging,the LUS can also be used to monitor ablation therapy,portal vein puncture staining,and lesion blood perfusion.Recent advances in technology like contrast-enhanced intraoperative ultrasound and realtime virtual sonography can help surgeons better perform laparoscopic surgery.For liver surgeons,LUS is an essential technique for safely performing laparoscopic surgery,making their proficiency in the use of LUS vital.This article reviews the application of LUS in laparoscopic hepatic resection of liver tumors and the new technology of LUS to help liver surgeons understand the current application status of LUS and the future research directions. 展开更多
关键词 Laparoscopic hepatectomy Laparoscopic ultrasound Laparoscopic ablation Portal vein puncture Contrast-enhanced intraoperative ultrasound
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Intraoperative blood perfusion factors in free anterolateral thigh flap repair for diabetic foot ulcers:A retrospective analysis 认领 引用 被引量：1
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作者 Hong-Liang Wu Huan Huang +2 位作者 Bin-Qi Chen Jian Xia Li-Bing Jiang 《World Journal of Diabetes》 SCIE 2025年第8期38-51,共14页
BACKGROUND Diabetic foot ulcers(DFUs)in patients with type 2 diabetes(T2D)are associated with heightened risks of infection and amputation and thus require effective surgical interventions to enhance outcomes.Free ant... BACKGROUND Diabetic foot ulcers(DFUs)in patients with type 2 diabetes(T2D)are associated with heightened risks of infection and amputation and thus require effective surgical interventions to enhance outcomes.Free anterolateral thigh(ALT)perforator flap is a promising reconstructive method;however,diabetic vasculopathy challenges optimal perfusion.This study analyzes factors influencing intraoperative blood perfusion in ALT flap repair for DFUs.AIM To identify key factors affecting intraoperative blood perfusion during free ALT perforator flap repair in patients with T2D and DFUs,thereby providing insights to improve surgical outcomes.METHODS This retrospective case-control study included 100 patients with T2D who underwent ALT flap repair at our institution between June 2016 and June 2024.Patients were categorized into normal(n=50)and abnormal(n=50)blood perfusion groups based on intraoperative perfusion assessments.Data on demographics,clinical characteristics,vascular status,metabolic control,and preoperative laboratory parameters were collected.Statistical analyses,including univariate and multivariate logistic regression,were conducted to identify significant predictive factors for perfusion outcomes.RESULTS Old age,high body mass index,long diabetes duration,and presence of diabetic peripheral neuropathy were associated with impaired perfusion.Abnormal perfusion was correlated with poor ankle-brachial index and elevated glycated hemoglobin(HbA1c),creatinine,triglycerides,and partial pressure of carbon dioxide.Conversely,high hemoglobin,albumin,and prealbumin levels and partial pressure of oxygen(PaO2)were protective.Multivariate analysis identified diabetes duration,HbA1c,PaCO2,PaO2,and albumin as independent predictors of perfusion,underscoring the roles of metabolic control and vascular health.CONCLUSION Optimizing metabolic control,vascular health,and nutritional status was crucial to enhance intraoperative blood perfusion in diabetic patients undergoing ALT perforator flap repair for DFUs. 展开更多
关键词 Diabetic foot ulcers Intraoperative blood perfusion Anterolateral thigh perforator flap Type 2 diabetes Surgical outcomes Vascular health
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Application of Intraoperative Contrast-Enhanced Ultrasound in the Resection of Brain Tumors 认领 引用 被引量：4
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作者 An-yu TAO Xu CHEN +4 位作者 Ling-yun ZHANG Yong CHEN Dan CAO Zheng-qian GUO Jian CHEN 《Current Medical Science》 SCIE CAS 2022年第1期169-176,共8页
Objective:To investigate the value of routine intraoperative ultrasound(IU)and intraoperative contrast-enhanced ultrasound(ICEUS)in the surgical treatment of brain tumors,and to explore the utilization of ICEUS for th... Objective:To investigate the value of routine intraoperative ultrasound(IU)and intraoperative contrast-enhanced ultrasound(ICEUS)in the surgical treatment of brain tumors,and to explore the utilization of ICEUS for the removal of the remnants surrounding the resection cavity.Methods:In total,51 patients who underwent operations from 2012 to 2018 due to different tumors in the brain were included in this study.The clinical data were evaluated retrospectively.IU was performed in all patients,among which 28 patients underwent ICEUS.The effects of IU and ICEUS on tumor resection and recurrence were evaluated. 展开更多
关键词 intraoperative ultrasound intraoperative contrast-enhanced ultrasound brain tumor hypervascular glioma
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The Effect of Operating Room Nursing Intervention on the Incidence of Intraoperative Hypothermia in Patients Undergoing Thoracoscopic Surgery 认领 引用
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作者 Jingjing Liu Bo Sheng 《Science International Innovative Medicine》 2025年第6期28-32,共5页
Objective:To explore the effect of targeted temperature intervention in the operating room on the incidence of intraoperative hypothermia in patients undergoing thoracoscopic surgery.Methods:A randomized controlled de... Objective:To explore the effect of targeted temperature intervention in the operating room on the incidence of intraoperative hypothermia in patients undergoing thoracoscopic surgery.Methods:A randomized controlled design was adopted,enrolling 80 patients who underwent thoracoscopic surgery from January to December 2025.They were divided into an observation group and a control group(40 cases each)using a random number table method.The control group received routine operating room nursing,while the observation group received additional comprehensive intervention measures on the basis of routine care,including preoperative environmental temperature control,heated clothing,constant temperature infusion of fluids and irrigation solutions,continuous core temperature monitoring,and dynamic heat preservation.Results:The core body temperature of the observation group during and at the end of surgery was significantly higher than that of the control group(P<0.001).The incidence of hypothermia in the observation group decreased to 20.00%,which was significantly lower than 55.00%in the control group(χ²=10.286,P<0.05).The severity of hypothermia was mainly mild,with no moderate or severe cases.The total incidence of shivering and complications also decreased significantly(P<0.05).Conclusion:Systematic temperature intervention can effectively maintain intraoperative temperature homeostasis,reduce the risk of hypothermia and related stress responses,and improve perioperative safety and nursing quality. 展开更多
关键词 Thoracoscopic Surgery Intraoperative Hypothermia Temperature Intervention Operating Room Nursing Perioperative Management
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Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation 认领 引用 被引量：22
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作者 Wu, Hong Lu, Qiang +2 位作者 Luo, Yan He, Xian-Lu Zeng, Yong 《World Journal of Gastroenterology》 SCIE CAS 2010年第4期508-512,共5页
AIM:To evaluate the detection and differentiation ability of contrast-enhanced intraoperative ultrasonography(CE-IOUS) in hepatocellular carcinoma(HCC) operations.METHODS:Clinical data of 50 HCC patients were retrospe... AIM:To evaluate the detection and differentiation ability of contrast-enhanced intraoperative ultrasonography(CE-IOUS) in hepatocellular carcinoma(HCC) operations.METHODS:Clinical data of 50 HCC patients were retrospective analyzed.The sensitivity,specificity,false negative and false positive rates of contrast enhanced magnetic resonance imaging(CE-MRI),IOUS and CEIOUS were calculated and compared.Surgical strategy changes due to CE-IOUS were analyzed.RESULTS:Lesions detected by CE-MRI,IOUS and CEIOUS were 60,97 and 85 respectively.The sensitivity,specificity,false negative rate,false positive rate of CEMRI were 98.2%,98.6%,98.6%,60.0%,respectively;for IOUS were 50.0%,90.9%,1.8%,1.4%,respectively;and for CE-IOUS were 1.4%,40.0%,50.0%,9.1%,respectively.The operation strategy of 9(9/50,18.0%) cases was changed according to the results of CE-IOUS.CONCLUSION:Compared with CE-MRI,CE-IOUS performs better in detection and differentiation of small metastasis and regenerative nodules.It plays an important role in the decision-making of HCC operation. 展开更多
关键词 Hepatocellular carcinoma Liver resection Contrast enhanced magnetic resonance imaging Intraoperative ultrasonography Contrast-enhanced intraoperative ultrasonography
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Impact of intraoperative blood loss on survival after curative resection for gastric cancer 认领 引用 被引量：18
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作者 Yue-Xiang Liang Han-Han Guo +5 位作者 Jing-Yu Deng Bao-Gui Wang Xue-Wei Ding Xiao-Na Wang Li Zhang Han Liang 《World Journal of Gastroenterology》 SCIE CAS 2013年第33期5542-5550,共9页
AIM:To elucidate the potential impact of intraoperative blood loss(IBL)on long-term survival of gastric cancer patients after curative surgery.METHODS:A total of 845 stageⅠ-Ⅲgastric cancer patients who underwent cur... AIM:To elucidate the potential impact of intraoperative blood loss(IBL)on long-term survival of gastric cancer patients after curative surgery.METHODS:A total of 845 stageⅠ-Ⅲgastric cancer patients who underwent curative gastrectomy between January 2003 and December 2007 in our center were enrolled in this study.Patients were divided into 3groups according to the amount of IBL:group 1(400 mL).Clinicopathological features were compared among the three groups and potential prognostic factors were analyzed.The Log-rank test was used to assess statistical differences between the groups.Independent prognostic factors were identified by the Cox proportional hazards regression model.Stratified analysis was used to investigate the impact of IBL on survival in each stage.Cancer-specific survival was also compared among the three groups by excluding deaths due to reasons other than gastric cancer.Finally,we explored the possible factors associated with IBL and identified the independent risk factors for IBL≥200 mL.RESULTS:Overall survival was significantly influenced by the amount of IBL.The 5-year overall survival rates were 51.2%,39.4%and 23.4%for IBL less than 200mL,200 to 400 mL and more than 400 mL,respectively(400 mL,P=0.003).Age,tumor size,Borrmann type,extranodal metastasis,tumour-node-metastasis(TNM)stage,chemotherapy,extent of lymphadenectomy,IBL and postoperative complications were found to be independent prognostic factors in multivariable analysis.Following stratified analysis,patients staged TNMⅠ-Ⅱand those with IBL less than 200 mL tended to have better survival than those with IBL not less than 200mL,while patients staged TNMⅢ,whose IBL was less than 400 mL had better survival.Tumor location,tumor size,TNM stage,type of gastrectomy,combined organ resection,extent of lymphadenectomy and year of surgery were found to be factors associated with the amount of IBL,while tumor location,type of gastrectomy,combined organ resection and year of surgery were independently associated with IBL≥200 mL.CONCLUSION:IBL is an independent prognostic factor for gastric cancer after curative resection.Reducing IBL can improve the long-term outcome of gastric cancer patients following curative gastrectomy. 展开更多
关键词 Gastric carcinoma Intraoperative blood loss Blood transfusion Postoperative complication Prognosis
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