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        <title>Frontiers in Surgery | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/surgery</link>
        <description>RSS Feed for Frontiers in Surgery | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-07-08T19:49:27.249+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1830529</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1830529</link>
        <title><![CDATA[Case Report: Making room for radicality: balancing liver reserve and oncologic clearance in hilar cholangiocarcinoma through portal vein embolisation]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Elvin Jia Hong Lee</author><author>Zhun Shen Tan</author><author>Azlanudin Azman</author><author>Isa Azzaki Zainal</author><author>Muhammad Zahid Abdul Muien</author><author>Ian Chik</author>
        <description><![CDATA[Hilar cholangiocarcinoma frequently necessitates extended hepatectomy to achieve oncological clearance, yet the risk of post-hepatectomy liver failure (PHLF) remains a critical concern when the future liver remnant (FLR) is inadequate. Over the last decade, strategies to induce FLR hypertrophy, including Portal Vein Embolization (PVE), Liver Venous Deprivation (LVD), and Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) have redefined the boundaries of resectability in patients with limited FLR. This report discusses a successful extended right hepatectomy enabled by PVE and explores the technical and physiological considerations of modern liver hypertrophy techniques for advanced hilar cholangiocarcinoma, highlighting three key aspects of contemporary hepatobiliary surgery: the physiological role of FLR optimization, the evolving hierarchy of liver hypertrophy strategies, and the intraoperative balance between oncologic radicality and preservation of functional liver reserve. We present a case of a 61-year-old male patient with minimal symptoms who was incidentally diagnosed with Bismuth-Corlette type IIIA hilar cholangiocarcinoma following detection of elevated serum carbohydrate antigen 19-9 (CA19-9) and cholestatic liver dysfunction. Multidisciplinary evaluation identified marginal FLR of 34%, prompting right PVE. Post-PVE volumetric assessment demonstrated robust hypertrophy with FLR increasing to 60.5%. The patient subsequently underwent open extended right hepatectomy with caudate lobectomy, complete bile duct excision, regional lymphadenectomy and Roux-en-Y hepaticojejunostomy reconstruction. The hypertrophied FLR enabled safe completion of extended resection without PHLF. This underscores the importance of preoperative PVE in converting a marginal FLR into an adequate physiological reserve, thereby enabling safe completion of extended hepatectomy for hilar cholangiocarcinoma without PHLF.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1852407</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1852407</link>
        <title><![CDATA[Case Report: Sigmoidorectal intussusception mimicking rectal prolapse—a diagnostic pitfall with surgical implications]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Tudor-Alexandru Popoiu</author><author>Dan Brebu</author><author>Rares Borcean</author><author>Adrian Vaduva</author><author>Mircea Selaru</author>
        <description><![CDATA[Adult intussusception is a rare condition typically associated with a structural lead point and often requiring surgical management, particularly in colonic forms where malignancy risk is high. Sigmoidorectal intussusception represents an exceptionally uncommon subtype that may clinically mimic rectal prolapse, posing a significant diagnostic challenge. We report the case of a 57-year-old female presenting with an irreducible anorectal mass, initially suggestive of prolapse, in whom computed tomography suggested the diagnosis of sigmoidorectal intussusception, which was subsequently confirmed intraoperatively. The patient underwent emergency surgical resection with primary anastomosis, and histopathology revealed a large tubulovillous adenoma with high-grade dysplasia as the lead point. The postoperative course was uneventful. This case highlights the importance of maintaining a high index of suspicion for intussusception in atypical prolapsing anorectal lesions and underscores the critical role of cross-sectional imaging in differentiating between rectal prolapse and invagination. Timely diagnosis enables appropriate oncologic surgical management and helps avoid potentially inappropriate perineal approaches.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1882426</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1882426</link>
        <title><![CDATA[Comparison of hybrid surgeries for the treatment of three-level cervical degenerative disease: a systematic review and network meta-analysis]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Jiyuan Liao</author><author>Yuchen Duan</author><author>Yunfei Lu</author><author>Wenjie Liu</author>
        <description><![CDATA[BackgroundIn recent years, hybrid surgery (HS) has emerged as one of the major surgical modalities for the treatment of multisegmental cervical degenerative disease (CDD). Two types of HS have been introduced (HS1, 1-level TDR with 2-level anterior cervical discectomy and fusion, ACDF or HS2, 2-level TDR with 1-level ACDF), and the clinical and radiological results could differ.MethodsThis study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The Web of Science Core Collection, PubMed and Embase were comprehensively searched from inception to December 19, 2025.ResultsFive studies were included in this network meta-analysis. The Neck disability index (NDI) in the HS1 was significantly lower than that in the ACDF. The C2-7 range of motions (ROMs) in the HS1 and HS2 were both significantly greater than those in the ACDF. The C2-7 ROM in the HS1 was significantly lower than that in the HS2. The ROMs of the upper and lower segments in the HS1 and HS2 were both significantly lower than those in the ACDF. No significant difference was identified in the ROM of the upper or lower segment between the HS1 and the HS2.ConclusionHS1, HS2 and ACDF are all safe and effective surgical options for three-level CDD. HS1 and HS2 could better preserve the C2-7 ROM. ACDF is associated with an increased ROM of adjacent segments. Compared with HS1, HS2 could better preserve the C2-7 ROM. HS1, HS2 and ACDF presented similar incidences of ASD.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251271417, PROSPERO (CRD420251271417).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1897151</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1897151</link>
        <title><![CDATA[Recent progress in postoperative nausea and vomiting after thyroidectomy]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Qihao Zhao</author><author>Fuling Song</author><author>Meimei Cui</author><author>Haoping Jia</author><author>Rongzhan Fu</author><author>Guanghan Wu</author><author>Dongsheng Zhou</author>
        <description><![CDATA[Postoperative nausea and vomiting (PONV) is a common and distressing complication following thyroidectomy. Notably, vomiting can increase both the risk and severity of postoperative complications, including cervical hematoma formation, wound dehiscence, postoperative bleeding, increased pain, delayed recovery and, in severe cases, airway compromise. The pathophysiology of PONV is multifactorial, involving interactions among peripheral surgical stimulation, central emetic pathways, anesthetic-related mechanisms and individual patient susceptibility. The recognized risk factors include female sex, non-smoking status, a history of motion sickness or prior PONV and exposure to volatile anesthetics or opioid analgesics during surgery. Contemporary perioperative practice emphasizes evidence-based multimodal prophylactic strategies supported by current consensus guidelines and randomized controlled trials to reduce PONV, including total intravenous anesthesia (TIVA), opioid-sparing analgesic techniques and intraoperative administration of serotonin (5-HT3) receptor antagonists and corticosteroids. Comprehensive risk assessments and individualized antiemetic strategies are essential for effectively reducing the incidence of PONV and improving overall postoperative outcomes in patients undergoing thyroidectomy. This narrative review summarizes recent progress in the epidemiology, mechanisms, risk assessment, prevention and treatment of PONV following thyroidectomy, with particular emphasis on thyroidectomy-specific factors and clinically applicable perioperative strategies. A better understanding of the underlying mechanisms may facilitate individualized risk stratification and optimize patient-centered perioperative care, ultimately improving postoperative outcomes in thyroidectomy patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1825806</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1825806</link>
        <title><![CDATA[Correcting depressed distal radial malunions at distal levels via a 5 mm incision]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hao Yao</author><author>Jingqiao Li</author><author>Xu Zhang</author><author>Bin Wang</author><author>Xuewu Zhou</author><author>Xiaoliang Yang</author>
        <description><![CDATA[ObjectiveThis study aims to evaluate the efficiency of correcting depressed distal radial malunions at distal levels via a 5 mm incision.MethodsBetween May 2021 and October 2023, 46 patients (46 wrists; external fixation group) with depressed distal radial malunions at the distal levels were treated. For comparison, we reviewed another 49 patients (49 wrists; plating group) treated with conventional open reduction and internal fixation with plate and crew systems in an earlier period.ResultsIn the plating group, secondary surgery to remove the plate was performed in 32 of 49 patients. There were significant differences in off work time (152 ± 42 vs. 210 ± 72; P < 0.01) and total treatment cost and loss due to off work (US$ 32,653 ± 1,234 vs. US$ 43,653 ± 3,234; P < 0.01). There were significant between-group differences in radial height (12.1 ± 3.9 mm vs. 10.2 ± 2.7 mm; P < 0.05) and ulnar variance (0.5 ± 0.2 mm vs. 1.7 ± 1.2 mm; P < 0.05). There was no significant difference in the Mayo Wrist Scores (94.3 ± 5.7 vs. 92.8 ± 7.1; P > 0.05), including excellent (32 vs. 33), good (14 vs. 13), and fair (0 vs. 3) results. The patient aesthetics scores were 8.8 ± 1.8 vs. 8.1 ± 1.1 (P < 0.05). The patient satisfaction scores were 8.9 ± 1.6 vs. 8.1 ± 1.2 (P < 0.05) based on the Short Assessment of Patient Satisfaction questionnaire.ConclusionsDepressed distal radial malunions at the distal levels can be treated via a 5 mm incision. External fixation through this small incision may be effective in maintaining radial height, especially in patients with osteoporosis. Usually, owing to a non-necessity for secondary implant removal in some patients, this technique results in acceptable outcomes in total treatment cost, total off work time, and patient satisfaction. The technique can be an alternative in addition to plate fixation. However, more factors should be considered when selecting the treatment strategy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1835514</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1835514</link>
        <title><![CDATA[Case Report: Bilateral congenital fourth metacarpal shortening in a competitive softball athlete with preserved function]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Sui-Ling Perez</author><author>Rakesh R. Nair</author><author>Noah S. Llaneras</author><author>Emily Garateix</author><author>Lidia Sabater</author><author>Roberto A. Miki</author>
        <description><![CDATA[BackgroundCongenital shortening of the fourth metacarpal (brachydactyly type E) is an uncommon anatomical variant that may occur in isolation or with syndromic conditions. Prior case reports have documented this finding in adults, but none have assessed functional outcomes in the context of high-level athletic participation.Case presentationA 67-year-old woman presented to the emergency department on two separate occasions after falling on her left and right wrists. Radiography and computed tomography revealed a non-displaced triquetral fracture (left) and a non-displaced scaphoid fracture (right), with incidental bilateral symmetric shortening of the fourth metacarpals. Radiographic archives spanning more than a decade have confirmed stable morphology, thereby supporting a congenital etiology. The patient reported no history of hand dysfunction and had competed in softball at the high school level and internationally as part of her national team. Following conservative management, the patient regained a full, pain-free range of motion bilaterally.DiscussionThis case is the first report of bilateral congenital shortening of the fourth metacarpal in a lifelong competitive athlete, demonstrating that this variant is compatible with high-level athletic participation without self-reported functional limitations. Radiographic stability for more than a decade and preserved function into late adulthood extend the evidence base for the long-term benignity of this condition. Formal grip dynamometry and validated functional scores were not available, which is acknowledged as a limitation of this study.ConclusionConservative management with reassurance is appropriate for asymptomatic patients. Recognition of this radiographic appearance can prevent misinterpretation as traumatic shortening or growth plate injury.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1852643</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1852643</link>
        <title><![CDATA[Arthroscopic capsular release combined with Latarjet procedure for chronic locked anterior shoulder dislocation secondary to epilepsy: a case report with one-year follow-up]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Zeyan Chen</author><author>Jiancong Chen</author><author>Guoliang Wang</author><author>Zhenfeng Zhang</author>
        <description><![CDATA[BackgroundChronic anterior shoulder dislocation is rare and poses significant therapeutic challenges due to associated structural injuries. This case report details the management of a chronic dislocation with complex pathologies.Case presentationA 28-year-old female patient presented with persistent left shoulder deformity and restricted motion 1 year after an anterior dislocation. Imaging revealed a locked anterior dislocation, Bankart lesion, Hill-Sachs lesion, pseudoglenoid formation, and rotator cuff atrophy. Preoperative functional scores were poor.InterventionArthroscopic posterior capsular release and glenoid osteoplasty were performed, followed by open Latarjet procedure with coracoid transfer and screw fixation. Temporary Kirschner wire stabilization was maintained for 2 weeks.OutcomesAt 1-year follow-up, shoulder mobility significantly improved and functional scores markedly increased with no recurrence. The patient reported high satisfaction.ConclusionThe Latarjet procedure combined with arthroscopic release effectively restored stability and function in chronic anterior shoulder dislocation caused by epileptic seizure. Early postoperative rehabilitation is critical for optimal recovery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1813508</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1813508</link>
        <title><![CDATA[Reframing diagnostic reasoning: the Bayesian imperative in shoulder examination]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Eugene Rezk</author>
        <description><![CDATA[Despite the widespread use of clinical shoulder tests such as the Jobe or Neer test, diagnostic reasoning often remains binary and insufficiently quantitative. Moreover, reported diagnostic accuracy varies substantially across studies, with sensitivity, specificity, and likelihood ratios typically presented as ranges that do not adequately reflect study weighting or uncertainty. In this Perspective, we apply a Bayesian framework to formalize diagnostic reasoning by integrating pre-test probability with pooled likelihood ratios, using published data from Hegedus et al. (2012). This approach allows for the calculation of post-test probability in a transparent and reproducible manner. Using a clinical example, a pre-test probability of 30% increased to approximately 51% following a positive Drop Arm Test, illustrating that even tests with comparatively higher pooled likelihood ratios produce only moderate shifts in diagnostic probability. However, when multiple tests are applied sequentially, the combined effect results in a substantial increase in post-test probability (up to approximately 63%). Importantly, while the final post-test probability remains invariant to the order of test application due to the multiplicative nature of likelihood ratios, the intermediate diagnostic trajectory differs depending on the sequence, with implications for clinical decision-making and efficiency. These findings highlight the limited standalone diagnostic value of individual clinical tests and emphasize the importance of structured, sequential test application. Rather than relying on heterogeneous range-based summaries, Bayesian modeling provides a coherent and evidence-based framework for clinical reasoning that explicitly accounts for diagnostic uncertainty. As such, it offers a more robust approach for interpreting clinical test results in musculoskeletal care.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1859811</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1859811</link>
        <title><![CDATA[Case Report: Successful laparoscopic approach for the management of a voluminous left paratubal cyst: two cases and a literature review]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Asma Sghaier</author><author>Sabri Youssef</author>
        <description><![CDATA[IntroductionParatubal or adnexal cysts develop in the broad ligament of the uterus. They are regarded as giant when the 150 mm threshold is reached. Clinical features and presenting symptoms include either the effects of compression of the adjacent organs or complications. Surgical resection of these cystic masses is required for diagnosis and treatment.Case presentationWe report the cases of two young women who complained of pelvic pain and progressive abdominal distension. Investigations indicated that paratubal cysts were compressing their adjacent structures. The medical staff's decision was to operate on these patients using a laparoscopic approach to provide histological confirmation and treat their symptoms. This decision was taken on the basis of the lack of morphological signs of benignity. Thus, the patients were managed via a laparoscopic approach to provide histological confirmation and symptom relief. The procedure was performed under a pneumoperitoneum of 12 mmHg with a specific strategy to prevent spillage.DiscussionA laparoscopic approach in the management of large paratubal cysts appears to be safe and feasible. However, expertise is required for the successful removal of the mass. The first challenge is to avoid spilling the cyst’s contents, as there is no evidence of benignity, and the second is to preserve the ovaries and adnexa for fertility.ConclusionCystic paratubal masses require comprehensive investigations to determine their nature and origin. However, only surgical resection can confirm the diagnosis, as it offers the possibility of histological confirmation. Moreover, a laparoscopic approach is also useful for treating the patient’s symptoms. It is important to note, however, that the size of the cyst could limit the use of this approach; therefore, expertise is required.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1761954</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1761954</link>
        <title><![CDATA[Clinical effect evaluation of postoperative complications of papillary thyroid carcinoma based on individualized intervention and prognostic analysis of precision nursing intervention]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yu Sun</author><author>Gang Pu</author>
        <description><![CDATA[ObjectiveThis study aims to explore the preventive effects of individualized interventions on postoperative complications in patients with papillary thyroid carcinoma and their impact on patient prognosis.MethodsA retrospective analysis was conducted, including 1,595 patients with papillary thyroid carcinoma who underwent radical thyroidectomy. Based on the systemic reform of nursing protocols implemented at the end of 2022, the patients were divided into a study group (SG, n = 798) and a control group (CG, n = 797) according to differences in nursing measures. The CG received routine care, while the SG received individualized interventions in a multidisciplinary perioperative nursing protocol based on routine care, including preoperative thyroid function assessment, intraoperative nerve monitoring and parathyroid protection, and postoperative continuous calcium monitoring.ResultsThe overall incidence of postoperative complications in the SG was significantly lower than that in the CG (P < 0.001). The incidence of transient recurrent laryngeal nerve injury (P = 0.010) and transient hypocalcemia (P = 0.007) in the SG were significantly lower than those in the CG. Patients in the SG had lower VAS pain scores at 24 and 72 h postoperatively, and achieved earlier ambulation, feeding, and extubation (P < 0.05). The SG had shorter voice recovery time and hospital stay, and higher swallowing function scores (P < 0.05). At the 6-month follow-up, patients in the SG had significantly higher scores than those in the CG in terms of thyroid symptoms, mental health, social life, and overall quality of life (P < 0.05). The results of the 1-year follow-up showed that the SG had a higher rate of complete voice recovery (P = 0.011) and normal calcium metabolism (P = 0.016), as well as a lower rate of readmission related to complications (P = 0.012).ConclusionsThe implementation of a multidisciplinary perioperative nursing protocol is associated with a reduced incidence of postoperative complications in patients with papillary thyroid carcinoma. It helps alleviate pain intensity and rehabilitation indicators, promotes physiological function recovery, and improves quality of life.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807406</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807406</link>
        <title><![CDATA[Adult degenerative scoliosis: challenges in diagnosis, pain management, and surgical decision-making]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Shuiwang Zhao</author><author>Jiaxin Liu</author><author>Bei Li</author><author>HaoLi Zhang</author><author>Rong Tian</author><author>Shenqiao Yang</author><author>Li Zhu</author>
        <description><![CDATA[BackgroundAdult Degenerative Scoliosis (ADS) is an age-related, progressive, three-dimensional spinal deformity driven by asymmetric degeneration of the intervertebral discs, facet joints, and supporting soft tissues. With population aging, ADS is increasingly recognized as a major contributor to pain, disability, loss of independence, and healthcare utilization.ObjectiveThis narrative review synthesizes evidence around three core challenges in the clinical management of ADS: (1) diagnostic difficulty due to heterogeneous etiology and symptom overlap with other degenerative conditions, (2) multidimensional chronic pain requiring multimodal, longitudinal strategies, and (3) high-stakes surgical decision-making that must balance deformity correction against complication risk and patient expectations.Methods and key contentWe integrate contemporary concepts from adult spinal deformity classification and alignment targets, clinical and imaging assessment, and both nonoperative and operative treatment pathways. Particular emphasis is placed on standing full-spine radiographs and spinopelvic parameters, the mixed mechanical and neurogenic pain phenotypes that typify ADS, and stratified surgical strategies ranging from decompression alone to long-segment fusion with osteotomy. We also summarize major complications (e.g., proximal junctional kyphosis, pseudarthrosis, implant failure, infection) and their implications for counseling and risk mitigation.ConclusionADS care benefits from a patient-centered, individualized, and multidisciplinary strategy. Future work should prioritize accurate prognostic models, minimally invasive and alignment-restoring techniques with lower morbidity, and durable approaches for long-term pain control and function preservation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1868881</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1868881</link>
        <title><![CDATA[Integrated polyetheretherketone patient-specific implants for multi-subunit midface concavity: a retrospective case series]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xin Wang</author><author>Sihan Wu</author><author>Menghao Wang</author><author>Tianhang Wu</author><author>Xiangyu Zheng</author><author>Fei Li</author><author>Xiaowei Wang</author><author>Zhihan Hu</author><author>Xinyi Chen</author><author>Qiming Zhao</author><author>Xiaoping Chen</author><author>Yue Chen</author>
        <description><![CDATA[BackgroundCorrection of multi-subunit midface concavity in patients without malocclusion remains challenging when multiple prefabricated implants are used, because implant transitions may be irregular and dissection around the infraorbital foramen is technically demanding. This study evaluated the feasibility, safety, and short-term aesthetic outcomes of integrated polyetheretherketone patient-specific implants designed using computer-aided design and manufacturing technology.MethodsThis retrospective case series screened consecutive adults treated with bilateral integrated PEEK patient-specific implants for multi-subunit midface concavity. Eligible patients had normal or essentially normal occlusion, clinical and CT-based moderate-to-severe concavity involving at least two adjacent subunits, adequate soft-tissue coverage, and completed postoperative follow-up. Demographic, implant-planning, satisfaction, and adverse-event data were reviewed. The primary outcome was late postoperative patient-reported aesthetic satisfaction assessed using a modified GAIS-derived 5-point scale. Early (10–30 days) and late (>90 days) satisfaction scores were compared using the Wilcoxon signed-rank test.ResultsSixty-two implants were placed in 31 patients. The mean follow-up was 8.3 ± 2.1 months. Implant placement was successful in all cases, and no intraoperative reshaping was required. Late postoperative satisfaction scores were significantly higher than early postoperative scores (P < 0.01). At late follow-up, 28 patients (90.3%) were satisfied or very satisfied. Transient postoperative edema occurred in all patients, and transient upper-lip or infraorbital-region hypoesthesia occurred in 12 patients (38.7%), resolving spontaneously within 3 months. No infection, implant exposure, migration, extrusion, chronic inflammation, sinus tract formation, or permanent infraorbital nerve injury was observed.ConclusionIntegrated polyetheretherketone patient-specific implants appear to be a feasible option for selected patients with multi-subunit midface concavity and normal or essentially normal occlusion. The integrated patient-specific design may support customized skeletal augmentation across adjacent midfacial subunits and individualized aesthetic planning. Further studies with longer follow-up, comparative controls, and objective three-dimensional outcome assessment are warranted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1814872</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1814872</link>
        <title><![CDATA[Use of a combined sublay–onlay “sandwich” technique for abdominal incisional hernia repair: a case report]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Xing-Kai Kang</author><author>Bin Wu</author><author>Jing Wang</author><author>Yi-Zhou Shao</author><author>Tao Wang</author>
        <description><![CDATA[An abdominal incisional hernia is one of the most common complications of abdominal surgery. Giant incisional hernias often make it difficult to choose an optimal treatment plan because of the large abdominal defects. This article reports the case of a large incisional hernia with an abdominal wall defect width of approximately 12 cm. We implemented a double-layer polypropylene patch repair technique combining sublay and onlay placement—a “sandwich” technique. The patient recovered smoothly postoperatively, and the 6-month follow-up showed good results for abdominal wall repair without recurrence. The “sandwich” technique was demonstrated to be a reliable strategy, and this case provides feasible ideas for doctors to treat such patients. This approach provides a solution for giant incisional hernias by overcoming the mechanical limitations associated with traditional single-layer mesh repairs, thereby ensuring better abdominal wall stability.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1750514</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1750514</link>
        <title><![CDATA[Effect of perioperative intervention based on the theory of planned behavior on preventing deep vein thrombosis after laparoscopic cholecystectomy: a retrospective study]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Bo Wang</author><author>Xiaojun Deng</author><author>Xinguo Sun</author><author>Zhang Hu</author><author>Huiping Li</author><author>Qiong Yan</author>
        <description><![CDATA[ObjectiveTo assess the efficacy of a perioperative intervention based on the Theory of Planned Behavior (TPB) in preventing lower extremity deep vein thrombosis (LEDVT) and improving postoperative outcomes in patients undergoing laparoscopic cholecystectomy (LC).MethodsThis retrospective study enrolled 136 gallstone patients who underwent LC at Nanhua University Affiliated Nanhua Hospital between January 2023 and January 2025. 60 patients (January 2023–December 2023) received conventional perioperative care (control group), while 76 patients (January 2024–January 2025) received TPB-based intervention (intervention group). The intervention targeted attitudes, subjective norms, and perceived behavioral control through preoperative health belief reinforcement, simulation training, intraoperative emotion regulation, and postoperative goal-setting. Outcomes included clinical recovery indicators, complication rates, coagulation function (fibrinogen, prothrombin time, activated partial thromboplastin time, D-dimer, platelet count), emotional status (Hospital Anxiety and Depression Scale), and health behaviors (Self-Rated Abilities for Health Practices).ResultsBaseline characteristics were comparable between groups (all P > 0.05). The intervention group showed significantly shorter times to first flatus, defecation, bowel sound recovery, first ambulation, and reduced hospital stay (all P < 0.001). Complication rates, including LEDVT and pulmonary infection (2.63% vs. 8.33%) were lower in the intervention group (all P<0.05). The intervention group also exhibited improved coagulation profiles, lower HADS anxiety/depression scores, and higher health behavior scores (allP<0.001).ConclusionTPB-based perioperative intervention accelerates recovery, reduces LEDVT and complications, optimizes coagulation, alleviates negative emotions, and enhances health behaviors, supporting its integration into standard perioperative care for LC patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1811255</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1811255</link>
        <title><![CDATA[Single-port robotic segmentectomy using the da Vinci SP system for non-small cell lung cancer]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jun Hee Lee</author><author>Hyeong Hun Song</author><author>Byung Mo Gu</author><author>Soon Young Hwang</author><author>Kook Nam Han</author><author>Hyun Koo Kim</author>
        <description><![CDATA[ObjectivesRobot-assisted thoracic surgery using the single-port robotic system is a novel minimally invasive approach; however, clinical data on its use for anatomical segmentectomy remain limited. Therefore, this single-center retrospective cohort study aimed to investigate the safety and feasibility of this technique for segmentectomy by comparing its perioperative outcomes with those of multi-port robot-assisted thoracic surgery and video-assisted thoracoscopic surgery.MethodsData from patients with non-small cell lung cancer who underwent anatomical segmentectomy from April 2014 to April 2025 were analyzed. Patients were categorized into single-port and multi-port robot-assisted thoracic surgery groups and video-assisted thoracoscopic surgery group according to the surgical approach. Perioperative outcomes were analyzed after propensity score matching.ResultsA total of 345 patients were included in the analysis: single-port robot-assisted thoracic surgery (SP-RATS, n = 50), multi-port robot-assisted thoracic surgery (MP-RATS, n = 75), and video-assisted thoracoscopic surgery (VATS, n = 220). Following matching, 47 patients were included in each group. All patients in the single-port robot-assisted thoracic surgery group underwent complete resection (R0) without conversion to open thoracotomy. In the matched cohort, the SP-RATS group demonstrated a significantly shorter total operative time than that of the MP-RATS group (p < 0.001), whereas no significant difference was observed between the SP-RATS and the VATS groups. In addition, the SP-RATS group had a significantly shorter duration of chest tube drainage than those of the MP-RATS and VATS groups (p = 0.015 and p = 0.039, respectively). No significant differences were observed between groups in terms of postoperative complications, postoperative pain, or pathological outcomes, including the number of harvested lymph nodes.ConclusionsRobotic segmentectomy using the da Vinci SP system appears safe and feasible, with favorable short-term perioperative outcomes. Large-scale, well-designed prospective trials with long-term follow-up are remained warranted to validate its clinical efficacy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1841068</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1841068</link>
        <title><![CDATA[Biomechanics of chest wall injury: implications for surgical stabilization and failure prevention]]></title>
        <pubdate>2026-07-07T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Vladislav Muldiiarov</author><author>Zachary M. Bauman</author>
        <description><![CDATA[Chest wall injury impairs ventilation not only through pain, but also through loss of thoracic cage stability and disruption of regional mechanics. As surgical stabilization of rib fractures continues to expand, variability in operative technique and construct design remains, while recurring complication patterns suggest that mismatch between fixation constructs and physiologic loading may represent an underrecognized and potentially preventable cause of failure. Drawing on clinical guidelines, experimental biomechanics, advanced imaging, and contemporary finite-element modeling, this review synthesizes the mechanical behavior of the thoracic cage across the ribs, costochondral junctions, and sternum, and translates these principles into surgical planning. We propose a mechanics-based framework that links specific instability patterns to functional impairment and informs construct selection, including operative approach, plate and screw strategy, bone quality considerations, and management of sternal and costal cartilage involvement. In addition, we summarize common modes of fixation failure and discuss practical strategies to reduce their occurrence.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1883256</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1883256</link>
        <title><![CDATA[Sigmoid volvulus and incidental enterobiasis in a young adult: a case report]]></title>
        <pubdate>2026-07-06T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Majed Yahya M. Alshahrani</author><author>Fares Rayzah</author><author>Ibrahim M. ALmanjahi</author><author>Abdullah A. Alquzi</author><author>Hisham Sabry Abdelhafiz</author><author>Yahya Shabi</author>
        <description><![CDATA[BackgroundSigmoid volvulus is a disease that typically occurs in elderly patients with chronic constipation and an elongated sigmoid mesentery. Its occurrence in previously healthy young adults is uncommon, often with delayed diagnosis, and may coexist with under-recognized predisposing factors. In this case, family clustering of vague gastrointestinal symptoms and a coexisting parasitic infestation are most likely incidental rather than causative.Case presentationA previously healthy young Saudi woman presented with 2 weeks of intermittent colicky abdominal pain, low-volume diarrhea, and a final acute episode of severe pain with progressive abdominal distension. Her 15-year-old sister had recently been diagnosed with enterobiasis with a similar symptom pattern. Vital signs were stable; abdominal examination showed mild distension without peritonism. Plain radiography demonstrated dilated colonic loops, and contrast-enhanced computed tomography revealed a markedly dilated sigmoid colon (up to 85 mm), an abrupt collapse point, and the whirl sign, consistent with sigmoid volvulus. Endoscopic detorsion was achieved successfully with placement of a rectal decompression tube; during colonoscopy, a single adult gravid Enterobius vermicularis was retrieved and confirmed parasitologically (characteristic ova demonstrated within the gravid female), prompting consultation with an infectious diseases team and a course of mebendazole. Following clinical stabilization, the patient underwent laparoscopic sigmoidectomy with extracorporeal stapled colorectal anastomosis. Operative findings confirmed a redundant sigmoid colon without ischemia, perforation, or contamination. Histopathology revealed ischemic-type changes (mucosal atrophy, submucosal edema, congested vessels, and hypertrophied muscularis propria) with viable resection margins. At the 4-week follow-up, she was asymptomatic and repeat parasitological testing (stool microscopy and adhesive tape examination) showed no E. vermicularis ova.ConclusionSigmoid volvulus should be considered in young adults presenting with acute colonic obstruction, particularly when imaging features are characteristic. A two-stage strategy of colonoscopic detorsion followed by definitive laparoscopic sigmoidectomy is feasible and effective in hemodynamically stable patients without ischemia. The clinical relevance of the coexisting enterobiasis remains hypothesis-generating and should not be overstated.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1859732</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1859732</link>
        <title><![CDATA[AI-driven perioperative risk stratification and complication management in craniomaxillofacial surgery: current progress and future directions]]></title>
        <pubdate>2026-07-06T00:00:00Z</pubdate>
        <category>Review</category>
        <author>HaiLian Chen</author><author>Shuang Zou</author><author>Linlin Zheng</author>
        <description><![CDATA[Craniomaxillofacial surgery is characterized by complex anatomy, high surgical risks, and diverse perioperative complications. Conventional perioperative management relies heavily on surgeons’ subjective experience and lacks standardized, quantifiable risk stratification tools. Artificial intelligence provides a promising strategy for precise and intelligent perioperative care in craniomaxillofacial surgery. This review summarizes recent advances in AI applications for perioperative risk stratification and complication management, focusing on three core domains: preoperative risk assessment and optimization, intraoperative decision support and safety monitoring, and postoperative risk stratification and outcome quantification. Key challenges are discussed regarding data quality and generalizability, model interpretability and clinical trust, and clinical translation and implementation. Future directions are proposed for multimodal AI, explainable AI, and generative AI to establish personalized perioperative management systems. This review aims to provide a structured reference for the intelligent development of perioperative care in craniomaxillofacial surgery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1864578</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1864578</link>
        <title><![CDATA[A cost-effective 3D-printed cement spacer reconstruction in a rare case of calcaneal Ewing sarcoma: a case report and surgical technique]]></title>
        <pubdate>2026-07-06T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Abdulrahman Alaseem</author><author>Fahad Alshayhan</author><author>Mansor Aldaijy</author><author>Ziyad Alsuwailem</author><author>Rayan Alfayez</author><author>Waleed Albishi</author><author>Hisham Alsanawi</author><author>Ibrahim Alshaygy</author>
        <description><![CDATA[BackgroundEwing sarcoma (ES) accounts for 15% of primary bone tumors and is the second most common type seen in children and young adults between ages 5 and 20, with a male-to-female ratio of 1.5 to 1. Around one-third of patients have metastatic disease at diagnosis, while involvement of the foot is rare, accounting for only 5% of cases. For patients without metastases, treatment typically includes neoadjuvant chemotherapy, limb salvage surgery when possible, and adjuvant chemotherapy. Recent advances in 3D printing enable customized, patient-specific reconstruction in complex anatomical sites, such as the calcaneus.Case presentationA 19-year-old female, previously healthy, presented with progressive left heel pain for 1 year without constitutional symptoms or trauma. Clinical observation revealed a swollen heel with intact overlying skin, no deformity, and no limitation of range of motion or neurovascular deficits. Radiologic local and systemic staging showed a nonmetastatic, aggressive, lytic, ill-defined lesion in the left calcaneus on x-ray, with MRI demonstrating a heterogeneously enhancing calcaneal tumor with soft-tissue extension into the heel fat pad and sinus tarsi. Histopathology of the image-guided true-cut biopsy specimen confirmed the diagnosis of Ewing sarcoma and primitive neuroectodermal tumor with EWSR1-FLI1 translocation. After multidisciplinary tumor board discussion, the patient received neoadjuvant chemotherapy with alternating vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide, resulting in tumor regression and good response on restaging. She then underwent limb salvage total calcanectomy. Reconstruction involved a custom-made, 3D-printed mold to fabricate an antibiotic-impregnated polymethylmethacrylate (PMMA) cement spacer, secured with two cannulated screws to the talus and Achilles tendon reattachment. After initial closure, the patient developed wound dehiscence, requiring a free radial forearm flap. She resumed adjuvant chemotherapy. At 1-year follow-up, the patient ambulated with a cane and a Toronto Extremity Salvage Score of 62.5%. By 2.5 years, she developed a deep surgical site infection (Enterococcus faecalis), managed by multiple irrigations, debridement, and implant removal. The infection resolved, the wound healed, and there were no signs of recurrence or metastasis.ConclusionsThis case underscores the feasibility of limb salvage surgery in calcaneal primary malignant neoplasm, using versatile reconstructive options including custom 3D-printed prosthetic implants, cement spacers, and total calcanectomy without reconstruction.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1886182</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1886182</link>
        <title><![CDATA[Diagnosis and treatment of congenital anterior urethral Valves: a retrospective analysis of 8 cases]]></title>
        <pubdate>2026-07-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Linling Gui</author><author>Hui Ma</author><author>Tao Zhu</author><author>Runwu Sun</author><author>Yuan Cai</author><author>Ting Gao</author><author>Haitao Chen</author><author>Xufei Duan</author>
        <description><![CDATA[BackgroundThis study aims to elucidate the clinical characteristics, management, and prognosis of anterior urethral valves (AUV) in children.MethodsA retrospective analysis was performed on 8 pediatric AUV patients (2015–2025), examining their clinical presentation, imaging and renal function data, surgical management, and reoperation rates. Prognosis was evaluated during follow-up.ResultsAmong the eight patients, four were diagnosed with AUV (one including posterior urethral valves (PUV)), and four had AUV combined with diverticula (one also associated with PUV). All diagnoses were confirmed by retrograde cystography and/or cystoscopy. Associated findings included bladder trabeculation in four cases and vesicoureteral reflux in four. Three patients had renal impairment. Treatment included cystoscopic electrocoagulation of the urethral valves, or a combination of valve resection, diverticulectomy, and urethral reconstruction. Postoperatively, five patients recovered completely, while one experienced occasional urinary tract infections (UTI). Two patients required reoperation; they continue to exhibit vesicoureteral reflux and renal impairment, and remain under close observation.ConclusionAUV can be definitively diagnosed via cystoscopy or voiding cystourethrogram (VCUG). Surgical intervention, including endoscopic valve ablation or open urethroplasty, yields favorable outcomes. However, the prognosis for patients with pre-existing renal impairment remains poor. Consequently, close monitoring and long-term follow-up are imperative.]]></description>
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