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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>2026-06-04T23:05:36.183+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1793385</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1793385</link>
        <title><![CDATA[Development and validation of a clinical prediction model for postoperative atrial fibrillation after lung cancer surgery: a machine-learning–based study]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yi Xu</author><author>Ting Lu</author><author>Ke Xu</author><author>Xiaoyan Feng</author><author>Rongsheng Xiong</author>
        <description><![CDATA[BackgroundPostoperative atrial fibrillation (POAF) is a common complication after lung cancer surgery, associated with increased morbidity and prolonged hospitalisation. Accurate preoperative or early postoperative risk stratification remains challenging due to the multifactorial nature of POAF. This study aimed to develop and validate machine learning–based prediction models for POAF and to construct a clinically applicable nomogram for individualised risk estimation.MethodsA total of 540 patients undergoing lung cancer surgery were retrospectively included, among whom 107 (19.8%) developed POAF. Patients were randomly divided into a training cohort (n = 379) and an independent test cohort (n = 161). Least absolute shrinkage and selection operator (LASSO) regression with 10-fold cross-validation was applied in the training cohort to select the most informative predictors. Seven machine-learning models—logistic regression (LR), k-nearest neighbours (KNN), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM), and neural network (NN)—were developed using the selected features. Model performance was evaluated in both cohorts in terms of discrimination, calibration, and decision curve analysis. A nomogram was constructed based on the optimal model.ResultsLASSO regression identified six predictors of POAF: age, education level, hypertension, marital status, postoperative pain score, and surgical approach. In the training cohort, all models demonstrated good discrimination with area under the receiver operating characteristic curve (AUC) values ranging from 0.827 to 0.995. However, performance declined to varying degrees in the test cohort. LR exhibited the most stable performance, achieving the highest AUC (0.855) and accuracy (0.857), with acceptable precision (0.667), recall (0.563), and F1 score (0.610). Calibration curves indicated good agreement between predicted and observed POAF risks for the LR model, while decision curve analysis demonstrated a consistently favourable net benefit across clinically relevant threshold probabilities. Based on these findings, an LR-based nomogram incorporating the six selected predictors was developed to facilitate individualised POAF risk prediction.ConclusionsWe developed and internally validated a machine learning–assisted risk prediction framework for POAF after lung cancer surgery. Compared with more complex models, LR demonstrated superior stability, calibration, and clinical utility. The resulting nomogram provides a practical and interpretable tool for early postoperative POAF risk assessment and may support perioperative monitoring and personalised management of patients undergoing lung cancer surgery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1759202</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1759202</link>
        <title><![CDATA[Impact of preoperative lumbar paraspinal muscle quality on the prognosis of open pedicle screw fixation for thoracolumbar fractures]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hao Liu</author><author>Yan Gong</author><author>Yang Shen</author><author>Moshan Wen</author><author>Zhen Kuang</author><author>Mai Wang</author><author>Yufeng Huang</author><author>Jintao Liu</author><author>Zhensong Yao</author><author>Jianchao Cui</author>
        <description><![CDATA[ObjectiveTo investigate the association of preoperative paraspinal muscle quality (quantified by fat infiltration) on the clinical and radiographic outcomes following open pedicle screw fixation (OPSF) for thoracolumbar fractures.MethodsThis retrospective study analyzed the clinical data of 48 patients with single-segment thoracolumbar fractures who underwent OPSF surgery between January 2021 and December 2023. Patients were stratified into a low-fat group (LFG, FI < 25%, n = 26) and a high-fat group (HFG, FI ≥ 25%, n = 22) based on the preoperative fat infiltration rate (FI) of paraspinal muscles at the L4/5 level measured on MRI. General clinical data, perioperative indicators, radiographic parameters (anterior vertebral body height ratio - AVBHr, vertebral body angle - VBA, regional kyphosis angle - RKA), and clinical efficacy scores (Visual Analogue Scale - VAS, Oswestry Disability Index - ODI) were compared between groups preoperatively, at 1 month, and 1 year postoperatively.ResultsThe groups were comparable in all baseline and perioperative characteristics (P > 0.05). The LFG demonstrated significantly better paraspinal muscle parameters at multiple spinal levels (P < 0.05). Although the immediate postoperative radiographic correction achieved was similar between groups (P > 0.05), the HFG exhibited significantly greater loss of correction in both VBA and RKA at the 1-year follow-up (P < 0.05). This difference in correction loss was particularly pronounced in the subgroup of patients with more severe, unstable fractures (AO type A3/A4). No significant differences were found in VAS and ODI scores at any postoperative time point (P > 0.05). Complication rates were similar between groups (P > 0.05).ConclusionPreoperative lumbar paraspinal muscle quality is not associated with the initial surgical reduction but is significantly associated with the long-term maintenance of radiographic correction after OPSF, especially in unstable fracture patterns. Assessment of paraspinal muscle quality could serve as a valuable prognostic tool for surgical planning and patient counseling.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1805482</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1805482</link>
        <title><![CDATA[Personalized combined reconstructive surgical protocols for spastic foot and ankle deformities in adult stroke: a retrospective case series]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zuobin Hao</author><author>Yunli Zhou</author><author>Xingjie Gao</author><author>Guanghui Gao</author><author>Jianye Li</author><author>Yeben Wang</author><author>Wende Wang</author>
        <description><![CDATA[PurposeSpastic foot and ankle deformities following stroke severely impair lower limb function in adults, with conservative treatments often yielding limited and short-lived results. Drawing on established experience from pediatric cerebral palsy orthopedics, we designed personalized combined surgical protocols tailored to different deformity presentations, applied them to adult stroke, and aimed to observe the feasibility and safety of the protocol for treating such complex deformities and report preliminary functional outcomes.MethodsThis single-center retrospective observational case series study included patients with post-stroke spastic hemiplegia manifesting as foot drop, varus deformity, and toe flexion spasm (claw toe deformity) between September 2023 and February 2025. The personalized functional reconstruction surgical protocol was performed based on the specific deformity, which included: (A) Achilles tendon lengthening to imporve foot drop deformity; (B) Anterior tibial tendon transfer to correct varus deformity; (C) Flexor hallucis longus(FHL) lengthening and flexor digitorum longus(FDL) tenotomy to alleviate claw toe deformity. Primary outcome measures included muscle tone assessed by the modified Ashworth scale(MAS), passive ankle range of motion(ROM), 10-meter walking time(10mWT), timed up-and-go test (TUGT), and Holden score for lower limb function.ResultsThe study included 24 patients (21 male, 3 female) with a mean age of 53.58 ± 10.30 years and a mean follow-up of 19.23 ± 4.10 months. At postoperative follow-up intervals of 3, 6, and 12 months, as well as at the final follow-up, muscle tone in the gastrocsoleus, FHL and FDL was significantly reduced compared to preoperative levels (P < 0.005). Lower limb function showed an improving trend, with increased ankle ROM and varying degrees of improvement in 10mWT, TUGT and Holden score (P < 0.05). Postoperative resting appearance of the foot and ankle was corrected, enhancing aesthetics. No serious complications occurred throughout the follow-up period.ConclusionFor complex spastic foot and ankle deformities in adult stroke patients, this study developed personalized combined reconstructive surgical protocols. This retrospective case series suggests that the protocol has preliminary feasibility and safety in reducing muscle tone, improving ankle mobility, and lower limb motor function.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1764671</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1764671</link>
        <title><![CDATA[Classification of iliac vessels and selection of surgical approach and window in oblique lumbar interbody fusion at L5-S1 based on magnetic resonance imaging]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zhao Liu</author><author>Kuan Lu</author><author>Fengyu Liu</author><author>Yuan Gao</author><author>Zhenfang Gu</author><author>Zhengqi Zhao</author><author>Xianze Sun</author>
        <description><![CDATA[ObjectiveTo investigate how the position of iliac vessels affects the choice of surgical approach (left or right oblique abdominal incision) and window (central or lateral) during L5-S1 oblique lumbar interbody fusion (OLIF), through imaging anatomy research.MethodsCT and axial T2-weighted MRI at L5-S1 were used to evaluate the iliac vessels’ position and classify the central vascular window (CW). Measurements were taken for the central window (CW), distance from the midline of the L5-S1 disc to the vessel's medial surface (DV), and psoas to iliac vein distances (LPV/RPV). Classification was based on the location of the common iliac vein/internal iliac artery: The intervertebral space was divided evenly from anterior to posterior into four zones—I, II, III, and IV. Based on iliac vein positions, patients were classified as follows: Type A (both veins in Zone I, left I/right I), Type B (left I/right II), Type C (left II/right I), Type D (both veins in Zone II, left II/right II), and Other Type (veins in Zone III or IV). A comparative analysis of imaging findings was performed.Results302 patients were included (124 Type A, 30 Type B, 62 Type C, 82 Type D), and the remaining 4 patients, whose iliac veins were located in Zone III or IV, were defined as Other Type. Gender differences were observed, with Type A predominantly female. Type A had the smallest CW, while Type D had the largest. Type D showed the largest DV and RDV compared to other types. LPV and RPV were statistically significant between groups, with Type A and B having greater LPV than C and D.ConclusionsClassification based on iliac vessel positioning helps determine the optimal approach for OLIF: Left ATP-OLIF is preferred for Type A and B; Right ATP-OLIF or Left O-ALIF for Type C; Left O-ALIF for Type D. The classification simplifies approach selection, minimizing vascular and nerve damage.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1835070</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1835070</link>
        <title><![CDATA[Risk factors for recurrence and surgical site infection after abdominal wall hernia repair: a systematic review and meta analysis]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Ping Wei</author><author>Xin Zhao</author><author>Guangjian Tian</author>
        <description><![CDATA[BackgroundSurgical site infection (SSI) and hernia recurrence are among the most common and impactful complications following abdominal wall hernia repair. Identifying patient-related risk factors is essential for improving outcomes and guiding perioperative management.MethodsA systematic review and meta-analysis were conducted in accordance with PRISMA 2020 and AMSTAR 2 guidelines. PubMed, Embase, Scopus, CNKI,Wanfang, and VIP were searched up to September 20,2025. Eligible studies included randomized controlled trials, cohort, and case-control studies that reported associations between patient-related variables and SSI or recurrence after hernia repair. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Beyond I2, the 95% prediction interval (PI) was utilized as the primary metric to evaluate the absolute dispersion of true effects. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS).ResultsA total of 11 studies involving 97,428 patients were included. No significant associations were observed for female sex (OR: 1.05, 95% CI: 0.77–1.42, P = 0.77; 95% PI: 0.48–2.29), obesity (OR: 1.15, 95% CI: 0.78–1.68, P = 0.48; 95% PI: 0.37–3.55), COPD (OR: 0.95, 95% CI: 0.47–1.92, P = 0.88; 95% PI: 0.14–6.25), or immunosuppressive therapy (OR 0.90, 95% CI: 0.38–2.14, P = 0.81). Although diabetes mellitus reached nominal statistical significance (OR: 1.46, 95% CI: 1.01–2.11, P = 0.04), its wide 95% PI (0.55–3.90) suggested considerable inconsistency across cohorts. Similarly, higher ASA classification (>3 vs. <2; OR: 1.63, 95% CI: 0.96–2.78, P = 0.07; 95% PI: 0.47–5.69) was not a consistent predictor. Data on recurrence were fragmented and unsuitable for robust pooled analysis, although individual studies suggested that risk factors for recurrence may differ from those for SSI.ConclusionsContrary to common clinical assumptions, traditional host-related risk factors such as gender, obesity, and diabetes do not consistently predict adverse outcomes after abdominal wall hernia repair when clinical heterogeneity is rigorously accounted for. The wide 95% PIs observed for most factors underscore substantial clinical variance across surgical settings. These findings highlight the limitations of relying on isolated comorbidities for risk assessment and advocate for the development of integrated, individualized risk prediction models.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261278753, identifier CRD420261278753.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1772964</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1772964</link>
        <title><![CDATA[Effects of obesity on post-surgical recovery and functional outcomes in rotator cuff tear repair]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Wuren Hou</author><author>Anpeng Xu</author><author>Minou Xu</author><author>Jian Chen</author>
        <description><![CDATA[BackgroundRotator cuff tears (RCTs) are a common cause of shoulder pain and can severely affect patients' ability to perform daily activities. Comorbidities, such as obesity, are known to influence the outcomes of RCT repair, particularly in the context of arthroscopic surgery. However, the effect of obesity on postoperative outcomes following RCT repair has not been sufficiently explored, especially in patients undergoing minimally invasive procedures. This study aims to evaluate the impact of obesity on postoperative pain, range of motion, and functional recovery after arthroscopic rotator cuff repair.MethodsThis retrospective cohort study included 50 patients who underwent arthroscopic RCT repair between January 1, 2022, and January 1, 2025. All patients were followed for a minimum of two years postoperatively. Data collected included factors such as fatty infiltration (Goutallier grade), tendon retraction (Patte grade), obesity (BMI ≥ 30), education level, and smoking status. The primary outcomes assessed were postoperative pain (Visual Analog Scale, VAS), range of motion (active forward flexion and external rotation), UCLA Shoulder Score, and ASES Score.ResultsThe average age of the study participants was 59.9 ± 7.4 years, with 28% of patients being female. A total of 42 patients (84%) had a full-thickness rotator cuff tear. The median time from diagnosis to surgery was 22.5 months (IQR: 17.3–29.8 months), with a median follow-up duration of 30.2 months (IQR: 26.3–34.1 months). Eighteen patients (36%) were classified as obese (BMI ≥ 30). Obese patients demonstrated a trend toward higher postoperative pain (VAS: 4.8 ± 2.8 vs. 4.0 ± 3.2, p = 0.076), and showed significantly reduced active forward flexion (130.5° ± 48.4° vs. 137.6° ± 52.7°, p = 0.035) and external rotation (40.3° ± 17.4° vs. 48.4° ± 19.5°, p = 0.024) compared to non-obese patients. BMI was negatively correlated with improvements in both forward flexion and abduction following surgery.ConclusionThis study found that obesity was significantly associated with reduced active forward flexion (p = 0.035) and external rotation (p = 0.024) following arthroscopic rotator cuff repair, and demonstrated a trend toward higher postoperative pain levels (p = 0.076) that did not reach conventional statistical significance. Functional recovery, as assessed by UCLA and ASES scores, showed a consistent directional trend toward poorer outcomes in obese patients; however, these differences were not statistically significant (p = 0.196 and p = 0.322, respectively), and should be interpreted with caution given the limited sample size. These findings highlight obesity as a potential risk factor for reduced range of motion recovery following rotator cuff repair, while acknowledging that its impact on broader functional outcomes remains to be confirmed in larger prospective studies. Tailored perioperative and rehabilitation strategies targeting obese patients may help optimize postoperative recovery, though further evidence is needed to guide specific clinical recommendations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1831917</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1831917</link>
        <title><![CDATA[Unilateral biportal endoscopic decompression for thoracic intraspinal gout with ossified ligamentum flavum: a case report and literature review]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Fangling Zhong</author><author>Chenxing Huang</author><author>Xiaoteng Feng</author><author>Zhaojun Cheng</author><author>Wenjing Su</author><author>Weibo Yu</author><author>Hui Ren</author><author>Binwei Chen</author><author>Xiaobing Jiang</author>
        <description><![CDATA[ObjectiveIntraspinal tophaceous gout is rare but may cause severe neurological deficits when it compresses the spinal cord. Thoracic spinal stenosis due to ossification of the ligamentum flavum (OLF) is an additional, common dorsal compressive pathology. We report a patient with thoracic spinal canal stenosis due to OLF with concomitant epidural tophaceous gout, successfully treated using unilateral biportal endoscopy (UBE) combined with percutaneous pedicle screw fixation.Clinical presentation and interventionA 50-year-old man with a 4-year history of gout and multiple peripheral tophi presented with a 2-year history of back pain that worsened over 2 weeks, accompanied by bilateral lower-limb pain, numbness, and marked weakness (lower-limb strength grade 2). Preoperative imaging demonstrated severe thoracic canal stenosis at T10-T11 due to OLF and new compression fractures at T8 and T10. Laboratory tests revealed leukocytosis, elevated ESR and CRP, and hyperuricemia. The patient underwent UBE-assisted decompression with resection of the OLF at T10-T11, followed by percutaneous pedicle screw fixation at T7-T9 and T11-T12. Intraoperatively, abundant chalky-white tophaceous material was identified in the epidural space and confirmed histologically as monosodium urate deposits with granulomatous inflammation. His symptoms gradually resolved, muscle strength improved, and he achieved good functional recovery one year post-operatively.ConclusionThis case suggests that UBE may be a precise minimally invasive option for selected patients with thoracic intraspinal gout and underscores the necessity of multidisciplinary care and long-term urate-lowering therapy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1801805</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1801805</link>
        <title><![CDATA[Case Report: External fixation of airway stents for management of tracheal stenosis secondary to thyroid cancer]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Conghui Liu</author><author>Ziyang Zeng</author><author>Ziyan Wang</author><author>Xinran Li</author><author>Jingpu Hou</author><author>Aishuang Fu</author><author>Yanlei Ge</author>
        <description><![CDATA[BackgroundThyroid cancer, in the advanced stage, often invades the airway and leads to tracheal stenosis. Airway stents can be used as a palliative treatment to restore airway and relieve dyspnea. However, stent migration remains a frequent complication, especially for lesions near the glottis. Simple fixing technology suitable for environments with limited resources is rarely reported.MethodsA 79-year-old woman with advanced thyroid cancer developed upper tracheal stenosis due to tumor compression. To restore airway patency, the patient accepted placement of a self-expanding metallic stent in the upper airway, but early migration occurred. Under combined ultrasound and bronchoscopic guidance, a simplified external fixation technique using a button was performed.ResultsThe stent restored tracheal patency, and the stent position was stabilized following external fixation. During the short-term follow-up, the stent remained stable, but the tumor progression, granulation tissue formation, and secretion retention were observed.ConclusionsThe technique of external fixation with an airway stent offers a new choice for subglottic airway stenosis caused by thyroid cancer in elderly patients. This technology helps maintain the stent position in the short term in an environment with limited medical materials. However, further observation and a longer follow-up period are needed to assess its generalizability and safety.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1872423</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1872423</link>
        <title><![CDATA[Antegrade Kirschner wire fixation for small talar osteochondral fractures: a case report]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Haiqing Wang</author><author>Lufeng Yao</author><author>Feng Zhang</author><author>Lei Huang</author>
        <description><![CDATA[Small acute osteochondral fractures (OCFs) of the talus are rare and often undiagnosed. Inaccurate diagnosis or improper management of these injuries can lead to defects in the talar cartilage, increasing the risk of long-term ankle arthritis. The ideal treatment approach for these fractures continues to be a topic of discussion. This report presents a case of antegrade Kirschner wire fixation for an acute small osteochondral fracture on the medial talus, combined with an undisplaced medial malleolus fracture (MMF). The MMF was surgically opened to achieve optimal exposure of the osteochondral fracture. After anatomical reduction of the osteochondral fragment, two 1.0-mm Kirschner wires were inserted antegrade and passed through the opposite skin. They were then removed retrogradely to ensure that the wire tails were flush with the articular surface. Two months postoperatively, radiological imaging confirmed the healing of both the MMF and the osteochondral fragment. The Kirschner wire was then removed percutaneously. At the final follow-up, imaging showed successful osteochondral healing of the talus, with favorable clinical and radiological outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1871267</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1871267</link>
        <title><![CDATA[Application of a self-developed femoral artery compression hemostasis device in proximal femoral nail anti-rotation surgery for intertrochanteric fractures: a case report]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Limin He</author><author>Tietao Di</author><author>Dandan Wang</author><author>Qihong Wu</author><author>Bin Zhao</author><author>Po Yang</author>
        <description><![CDATA[BackgroundIntertrochanteric fractures of the femur are a prevalent type of hip fracture among the elderly. While surgical treatment is the preferred approach for managing these fractures, conventional tourniquets cannot be applied in hip surgery due to anatomical constraints. As a result, effectively controlling intraoperative and perioperative blood loss has long posed a significant clinical challenge.Case presentationA 70-year-old male patient with a comminuted fracture in the left intertrochanteric region of the femur underwent closed reduction and internal fixation using a proximal femoral nail anti-rotation (PFNA). During the procedure, a proprietary compression-type femoral artery hemostasis device was used to effectively control regional blood flow. The femoral artery pulsation was palpated inferior to the inguinal ligament and superior to the pubic ramus. A compression device was then applied to achieve precise compression of the femoral artery. Effective compression was indicated by the absence of the dorsalis pedis artery pulse, which helped maintain collateral circulation. The procedure lasted 45 min, with an estimated intraoperative visible blood loss of 50 mL. Quantitative analysis using the Gross formula, based on the patient's hematocrit decline from 0.394 preoperatively to 0.358 on postoperative day 2, revealed a calculated total perioperative blood loss of 433 mL, with hidden blood loss accounting for 383 mL. There were no postoperative complications, including limb ischemia, nerve injury, or deep vein thrombosis. The patient was discharged in good condition 6 days after surgery. A follow-up examination at 6 weeks postoperatively revealed satisfactory callus formation at the fracture site and stable internal fixation.ConclusionIn this single case, application of the self-developed femoral artery compression hemostatic device was associated with reduced intraoperative blood loss and a favorable safety profile during PFNA fixation of an intertrochanteric fracture. The device may offer a novel, non-invasive hemostatic strategy for selected hip fracture surgeries; however, further studies are required to confirm its efficacy and safety.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1741838</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1741838</link>
        <title><![CDATA[Risk factors for surgical site infection following posterior internal fixation of thoracolumbar fractures]]></title>
        <pubdate>2026-06-03T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Pengxi He</author><author>Lei Ren</author><author>Shenshen Hao</author><author>Chengjin Zhao</author><author>Zhibin Liu</author><author>Changhong Li</author><author>Yangyang Feng</author><author>Yong Feng</author><author>Yuhu Zhou</author><author>Nannan Li</author>
        <description><![CDATA[BackgroundSurgical site infection (SSI) following posterior internal fixation of thoracolumbar fractures constitutes a severe complication that adversely impacts patient recovery. Despite its clinical significance, there remains a paucity of research investigating the risk factors associated with SSI. Therefore, this study aimed to explore these risk factors and propose potential therapeutic strategies.MethodsA retrospective analysis was conducted on 157 patients who underwent posterior internal fixation for thoracolumbar fractures at the Department of Orthopedics, Affiliated Hospital of Yan’an University, between February 2017 and October 2021. Patients were stratified into an infection group (n = 12) and a non-infection group (n = 145). Preoperative baseline data included age, gender, body mass index, total protein (TP), albumin (ALB), hemoglobin (HB), red blood cell count (RBC), white blood cell count (WBC), total lymphocyte count (TLC), platelet count (PLT), and the presence of diabetes or hypertension. Operative data encompassed preoperative preparation time, length of the surgical incision, number of internal fixation segments, operation duration (≥3 h vs. <3 h), occurrence of allogeneic blood transfusion, intraoperative blood loss (≥400 mL vs. <400 mL), and type of drainage tube (negative-pressure vs. normal). Postoperative management-related data included dressing changes at the surgical incision within 24 h following the operation, indwelling time of the drainage tube (≥3 days vs. <3 days), drainage volume upon removal of the drainage tube (≥50 mL vs. <50 mL), reoperation requirement, and postoperative levels of TP, ALB, HB, RBC, WBC, TLC, and PLT. Eligible data were subjected to univariate analysis, followed by multivariate logistic regression for variables with significant univariate associations.ResultsUnivariate analysis revealed significant differences between groups in intraoperative blood loss (≥400 mL), preoperative ALB (<30 g/L), preoperative RBC, postoperative HB, postoperative RBC, surgical incision length, and number of internal fixation segments between groups (all P < 0.05). Multivariate logistic regression analysis identified preoperative hypoalbuminemia (<30 g/L) [odds ratio (OR) = 0.851, P = 0.028] and intraoperative blood loss (≥400 mL) (OR=7.477, P = 0.005) as independent risk factors for SSI.ConclusionPreoperative hypoalbuminemia (<30 g/L) and intraoperative blood loss (≥400 mL) are associated with an elevated risk of SSI following posterior internal fixation of thoracolumbar fractures. Implementing effective perioperative management strategies is crucial to mitigate the incidence of SSI.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1800808</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1800808</link>
        <title><![CDATA[Ommaya reservoir converted to permanent cerebrospinal fluid shunt in neonatal posthemorrhagic hydrocephalus: a risk factors analysis]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Cao Xuehui</author><author>Feng Feng</author><author>Li Xin</author>
        <description><![CDATA[ObjectiveTo identify factors influencing the transition to a permanent ventriculoperitoneal (VP) shunt in neonates with severe intraventricular hemorrhage (IVH) initially managed with an Ommaya reservoir.MethodsThis retrospective study involved 26 neonates diagnosed with IVH in Hebei Children's Hospital from January 2020 to January 2025. These patients were diagnosed with Papile grade III or IV IVH and treated with an Ommaya reservoir. They were categorized into two groups: a permanent shunt group (n = 10) and a non-permanent shunt group (n = 16). These two groups were compared based on demographic, clinical, and cerebrospinal fluid (CSF) variables.ResultsOf all study subjects, 10 patients (38.5%) received a permanent VP shunt placement. The 5-minute Apgar score was significantly higher in the permanent shunt group (9.40 ± 1.08) compared to that of the control group (7.25 ± 2.50, p = 0.021). Also, the CSF protein levels were notably increased in the permanent shunt group (2.80 ± 1.43 g/L vs. 1.81 ± 0.79 g/L, p = 0.028). And, ROC curve analysis revealed that a 5-minute Apgar score exceeding 8.5 was predictive of the requirement for permanent cerebrospinal fluid shunting, with corresponding sensitivity and specificity values of 80.0% and 68.7%, respectively. Moreover, multivariate analysis indicated that a 5-minute Apgar score greater than 8.5 remained an independent predictor of permanent shunt placement (adjusted OR 12.24, 95% CI 1.11–134.75, p = 0.041). In contrast, CSF protein ≥2.04 g/L (adjusted OR 4.82, 95% CI 0.61–38.41, p = 0.138) and sex did not show statistical significance.ConclusionIn this retrospective study, a higher 5-minute Apgar score (>8.5) was identified as an independent predictor for the requirement of a permanent VP shunt after Ommaya reservoir placement in neonates with severe IVH. This seemingly counterintuitive result may be explained by the impact of a more robust neonatal circulation on the initial hemorrhage volume. Although elevated CSF protein was associated with shunt dependency, it was not an independent predictor. These findings underscore the intricate pathophysiological mechanisms of posthemorrhagic hydrocephalus.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807255</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807255</link>
        <title><![CDATA[Zenker's peroral endoscopic myotomy for treating zenker's diverticulum in an elderly patient: a case report and literature review]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Xiao Fan</author><author>Jianhua Pang</author><author>Junmin Wang</author><author>Xinying Zhu</author><author>Li Jiao</author><author>Huan Ma</author><author>Xia Meng</author>
        <description><![CDATA[BackgroundZenker's diverticulum (ZD) is a rare esophageal disorder, and traditional surgical interventions are associated with significant trauma and poor tolerance in elderly patients.Case summaryAn 85-year-old female presented with a one-year history of progressive dysphagia, accompanied by regurgitation, coughing, and a 5 kg weight loss. Diagnostic evaluations, including barium esophagography, chest computed tomography (CT), and endoscopy, confirmed an upper esophageal ZD (3 cm in diameter).TreatmentThe patient underwent submucosal tunneling endoscopic septum division (STESD), which is widely standardized in current literature as Zenker's peroral endoscopic myotomy (Z-POEM). Key procedural steps included mucosal incision, submucosal tunneling, complete septum myotomy, and mucosal closure using titanium clips. Postoperative recovery was uneventful, with no complications such as bleeding or perforation.ConclusionZ-POEM demonstrates minimally invasive advantages, safety, and efficacy in treating ZD, particularly for elderly patients with high surgical risks. This technique represents a promising therapeutic option in this population.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1764840</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1764840</link>
        <title><![CDATA[Duodenal ulcer perforation presenting as acute appendicitis in a child: a case report and literature review]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Zhihui Jin</author><author>Xusheng Yang</author><author>Yuntian Liu</author><author>Bihui Yao</author><author>Xuewen Chen</author><author>Lu Liang</author>
        <description><![CDATA[IntroductionDuodenal ulcer perforation (DUP) is exceedingly rare in the pediatric population. Its clinical presentation frequently mimics acute appendicitis (AA), leading to a high risk of preoperative misdiagnosis and posing substantial diagnostic and therapeutic challenges.Case presentationWe describe a 12-year-old boy who presented with signs and symptoms suggestive of acute appendicitis. Emergency diagnostic laparoscopy revealed a 0.6-cm perforation on the anterior wall of the duodenal bulb. The perforation was successfully repaired laparoscopically. The patient had an uneventful postoperative recovery, and follow-up endoscopy confirmed complete mucosal healing.DiscussionThis case highlights that pneumoperitoneum in pediatric patients presenting with AA-like symptoms should prompt consideration of DUP in the differential diagnosis. Diagnostic laparoscopy is instrumental in establishing an accurate diagnosis and enabling timely, minimally invasive treatment.ConclusionIn children with atypical acute abdominal pain, heightened clinical suspicion for DUP, particularly when imaging reveals pneumoperitoneum, combined with proactive use of laparoscopy, can reduce misdiagnosis and improve patient outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1870176</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1870176</link>
        <title><![CDATA[Correction: Autologous fat grafting for cosmetic temporal augmentation: a systematic review]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Sahra Nasim</author><author>Henna Nasim</author><author>Martin Kauke</author><author>Ali-Farid Safi</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1880410</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1880410</link>
        <title><![CDATA[Correction: Coeliac trunk origin of bilateral inferior phrenic arteries]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Raghad Abdulaziz Almansour</author><author>Sumar Chan</author><author>Jun Mun Teoh</author><author>Rasyidah Rehir</author><author>Abeer Saleh Alshaya</author><author>Abduelmenem Alashkham</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1804208</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1804208</link>
        <title><![CDATA[Three-dimensional correction of cubitus varus deformity using patient-specific 3D-printed osteotomy guides]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Methods</category>
        <author>Mei-Ren Zhang</author><author>Xiao Zeng</author><author>Jiang-Long Guo</author><author>Kui Zhao</author><author>Jian-Hui Hu</author><author>Jian-Hao Guan</author>
        <description><![CDATA[BackgroundVarious three-dimensional (3D) corrective osteotomy techniques have been reported for the treatment of cubitus varus deformity. However, achieving accurate correction through a limited lateral incision remains technically challenging. This study introduces a method for accurate 3D osteotomy of cubitus varus deformity using a limited lateral incision.MethodsFive patients (2 males and 3 females) with cubitus varus deformity following supracondylar fracture underwent 3D corrective osteotomy using 3D-printed, patient-specific osteotomy templates, along with custom location and reduction guides, between August 2022 and January 2025. These cases were evaluated retrospectively. Clinical outcomes assessed included pre- and postoperative carrying angles, operative time, elbow joint function, intraoperative blood loss, degree of osteotomy, time to bone union, and postoperative complications.ResultsThe mean carrying angle on the affected side improved significantly from −15.74° ± 6.58° (varus) preoperatively to 7.77° ± 3.94° (valgus) postoperatively. The mean tilting angle improved from 54.8° ± 7.40° to 51.4° ± 2.33°. Elbow range of motion normalized in all patients, with a mean increase in flexion angle of 24° ± 8° (range: 15°–35°). Hyperextension of the elbow and internal rotation of the shoulder were also corrected. Bone union was achieved at a mean of 2.6 ± 0.49 months (range: 2–3 months). The average operative time was 139.6 ± 22.26 min (range: 116–175 min), and mean intraoperative blood loss was 42 ± 31.87 mL (range: 10–100 mL). The mean correction angle achieved through osteotomy was 23.51° ± 8.79° (range: 12.43°–33.43°). According to the Mayo Elbow Performance Index (MEPI), all five patients achieved excellent outcomes at the final follow-up (mean: 21.6 ± 4.8 months), with no reports of poor results, recurrence of varus deformity, or wound-related complications. One patient exhibited transient ulnar nerve symptoms postoperatively. No patients reported prominence of the lateral humerus.ConclusionThe use of a 3D-printed, patient-specific osteotomy guide combined with custom location and reduction templates enables safe, accurate, and reproducible 3D correction of cubitus varus deformity through a small lateral incision. This surgical technique, grounded in 3D computer simulation, reduces variability between surgeons and may represent a viable therapeutic option for the correction of cubitus varus deformity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1845706</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1845706</link>
        <title><![CDATA[Case Report: Intramedullary solitary fibrous tumor at the C7-T1 level diagnosed by STAT6 and treated with maximal safe resection]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Changli Han</author><author>Zixiao Li</author><author>Zhang Xiong</author><author>Mengwei Ma</author><author>Weicheng Wang</author><author>Yuqing Wang</author><author>Guangfu Di</author><author>Xiaochun Jiang</author>
        <description><![CDATA[Intramedullary solitary fibrous tumor is an exceptionally rare spindle-cell neoplasm of the central nervous system and is rarely diagnosed before surgery because the clinical presentation and imaging findings are non-specific. We report a man in his early 60s with more than 7 years of progressive bilateral lower-extremity numbness that worsened during the month before admission without an identifiable precipitating event. Magnetic resonance imaging demonstrated an enhancing intramedullary lesion at the C7-T1 level. The patient underwent microscopic tumor resection through a posterior C7-T2 laminectomy under intraoperative ultrasound guidance and multimodal intraoperative neurophysiological monitoring, including somatosensory evoked potentials, transcranial motor evoked potentials, D-wave monitoring, and free-running electromyography. Gross total resection was achieved without new neurological deficit. Histology showed spindle cells in fascicular and storiform arrangements with branching staghorn-like vessels. Immunohistochemistry demonstrated nuclear STAT6 positivity with co-expression of CD34, CD99, and Bcl-2. Mitotic activity was low, with only 2–3 mitoses per 10 high-power fields, and no definite tumor necrosis was identified, supporting the diagnosis of a CNS WHO grade 1 solitary fibrous tumor. Sensory symptoms improved after surgery, and no recurrence was detected on magnetic resonance imaging at 18-month follow-up. This short-term outcome is encouraging, but long-term radiological surveillance remains necessary.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785029</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785029</link>
        <title><![CDATA[Diagnosis and treatment of multiple postoperative fistulas following resection of a giant abdominal mesenteric fibromatosis: a case report and literature review]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Weihua Zheng</author><author>Junjie Lu</author><author>Shuai Jiang</author><author>Fan Zhang</author><author>Long Xia</author><author>Junjing Zhang</author>
        <description><![CDATA[Mesenteric fibromatosis (MF) is a rare, locally aggressive, borderline tumor with no metastatic potential, characterized by a high postoperative recurrence rate. This paper reports a complex case of aggressive MF. Despite receiving targeted therapy that was combined with immunotherapy, the tumor in our case progressed rapidly and symptoms of intestinal obstruction developed. Following a challenging radical resection, delayed and complex multiple complications ensued, including duodenal fistula, vaginal fistula, and ureterorectal fistula. Through personalized management under multidisciplinary team (MDT) collaboration—including adequate drainage to control infection, stepwise nutritional support (i.e., transitioning from total parenteral nutrition to enteral nutrition), and targeted management of a high-output enterostomy—the patient ultimately recuperated with drainage tubes in place, and she was able to tolerate oral feeding. This case suggests that for giant mesenteric fibromatosis that continues to progress despite medical therapy, close imaging surveillance (particularly vigilance for signs of "tension cystic change") should be employed to warn of serious complications, and a decisive, surgery-centered multidisciplinary comprehensive treatment strategy should be adopted. Postoperatively, reliance on a multidisciplinary team is essential for long-term vigilance against delayed complex fistulae triggered by factors such as infection. The diagnostic and therapeutic experience from this case provides an important reference for managing this highly challenging disease.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1809885</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1809885</link>
        <title><![CDATA[Multimodal biomarker panel for early prediction of anastomotic leak after colorectal surgery: from inflammation to ischemia]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yuji Li</author>
        <description><![CDATA[Anastomotic leakage is one of the most serious complications following colorectal surgery, with an incidence ranging from 2% to 19%, and is closely associated with increased perioperative mortality, prolonged hospital stay, and poor oncological outcomes. Traditional clinical diagnosis relies on signs, symptoms, and imaging studies, which exhibit significant time delays. In recent years, researchers have explored early warning biomarkers from multiple perspectives including inflammatory response, tissue ischemia, microbial changes, and extracellular matrix remodeling, accumulating abundant research data. This article systematically reviews the current application status of serum inflammatory markers, peritoneal drain fluid cytokines, ischemic metabolites, microbiome markers, and tissue repair-related molecules in predicting anastomotic leakage, with emphasis on analyzing the diagnostic performance, optimal detection time windows, and clinical operability of various biomarker categories. Based on this foundation, we propose a multimodal prediction framework integrating four dimensions of “inflammation-ischemia-microbiome-tissue repair” and discuss the challenges in translating this framework into clinical decision-making tools. Machine learning algorithms demonstrate application potential in integrating multi-source heterogeneous data, but insufficient external validation remains the primary bottleneck constraining clinical implementation. Future research directions should focus on large-scale multicenter prospective cohort validation, establishment of standardized detection protocols, and development of implantable real-time monitoring technologies.]]></description>
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