World Journal of Surgery (WORLD J SURG )

Publisher: International Society of Surgery, Springer Verlag

Description

World Journal of Surgery publishes original articles that offer significant contributions to knowledge in the broad fields of clinical surgery, experimental surgery and related sciences, surgical education and history, and the socioeconomic aspects of surgical care. The Journal has an international circulation and is designed to serve as a medium for rapid dissemination of new and important information about the science and art of surgery throughout the world. In the interests of a wide international readership, use of the English language is required. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.

Impact factor 2.35

  • Hide impact factor history
     
    Impact factor
  • 5-year impact
    2.75
  • Cited half-life
    6.80
  • Immediacy index
    0.48
  • Eigenfactor
    0.03
  • Article influence
    0.84
  • Website
    World Journal of Surgery website
  • Other titles
    World journal of surgery (Online), World j. surg
  • ISSN
    0364-2313
  • OCLC
    43477365
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Author's pre-print on pre-print servers such as arXiv.org
    • Author's post-print on author's personal website immediately
    • Author's post-print on any open access repository after 12 months after publication
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (see policy)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Cakir et al. [1] raise an excellent point regarding the mental health of post-operative patients. We too were surprised by the lack of statistically significant difference in mental health scores between the post-operative walking group and the control group. Because our study design focused on the effect of walking on the physical recovery profile, we did not have pre-participation mental health profiles available.We agree that the similarity in post-operative mental health scores could be a result of the walking group having a lower pre-operative mental health score than the control group, thus making the final scores a significant finding. Another possibility is that the walking intervention’s effect on mental health is greatest in the first few weeks post-operatively. We may have missed this effect in our study of patients who were 30 days status post-surgery. Lastly, our study is limited by a small sample size. We may have lacked the statistical power to elucidate a difference in ...
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Serum bilirubin levels frequently increase after esophagectomy for esophageal cancer. Several studies have reported hyperbilirubinemia in patients with postoperative complications. We aimed to perform a detailed large-scale analysis to clarify this association. Methods We compared postoperative serum bilirubin levels of 200 patients with esophageal cancer who underwent esophagectomy, with and without postoperative complications, from January 2008 to July 2013 at Keio University Hospital, Tokyo, Japan. We also analyzed other risk factors for postoperative hyperbilirubinemia by univariate and multivariate analyses in an attempt to determine the mechanism of postoperative hyperbilirubinemia. Results Hyperbilirubinemia (total bilirubin >2.0 mg/dL) occurred in 71 patients (35.5 %). The mean total bilirubin peak level was 1.5 mg/dL in patients without complications, 2.0 mg/dL in those with at least one complication, 2.1 mg/dL in those with pneumonia, and 2.3 mg/dL in those with anastomotic leakage. Bilirubin levels were significantly higher in each complication group than in the non-complication group (p Conclusions Although various factors impact postoperative hyperbilirubinemia, postoperative complications were most significantly associated with postoperative hyperbilirubinemia. Patients with postoperative hyperbilirubinemia after esophagectomy must be managed more carefully because unnoticed complications may be associated with hyperbilirubinemia.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Common bile duct injuries (CBDI) are serious complications of cholecystectomies which are often associated with vascular involvement, meaning that their management represents a major challenge to the physician. We present our experience in major hepatectomy due to CBDI, highlighting indications, postoperative complications, and long-term outcomes. Methods From August 1993 to September 2013, 287 patients with CBDI were treated in our centre. In 15 patients of this group (5 %), a major hepatectomy was performed. Eleven patients presented E4 and four presented E5 injuries of Strasberg classification. Seven patients presented vascular involvement. In 12 patients, prior treatment attempts, either biliodigestive anastomosis, endoscopic or percutaneous drainage, was performed without success. The median time delay between lesional surgery and hepatectomy was 24 months. Results Right hepatectomy was performed in 10 patients and left hepatectomy in 5. Postoperative morbidity was 60 %. The incidence of serious complications (≥grade IIIa of DC classification) was 40 %. There was no mortality in our study. The mean follow-up was 43.5 months and the overall survival was 100 %. Three patients had a single episode of ascendant cholangitis who were successfully treated with medical treatment. All other patients were asymptomatic during follow-up. No patients required further surgical procedures. Conclusion In our series, major hepatectomy due to CBDI was a successful treatment with high rates of postoperative morbidity and excellent long-term outcomes which require a multidisciplinary approach in referral centres of HPB surgery.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and Objective The effectiveness of antimicrobial prophylaxis (AMP) in the prevention of surgical site infection (SSI) following thyroid and parathyroid surgery remains uncertain. The objective of this prospective randomized controlled trial (Ito-RCT1) was to assess the effectiveness of AMP in clean neck surgery performed to treat thyroid and parathyroid disease. Methods Participants comprised patients scheduled for clean neck surgery for thyroid and parathyroid disease at Ito Hospital. Patients whose surgery included sternotomy or resection of the trachea, larynx, pharynx, or esophagus were excluded. AMP consisted of 2 g of piperacillin (PIPC) (group A, n = 541) or 1 g of cefazolin (CEZ) (group B, n = 541) administered intravenously immediately after endotracheal intubation. Patients in the control group (Group C, n = 1,082) did not receive AMP. Results Statistical analysis was performed to compare the AMP group (Group A + Group B) with the control group (Group C). Drug-induced acute reactions correlated to PIPC or CEZ did not occur in the AMP group. No significant differences in the postoperative incidence of liver or renal dysfunction were seen between the AMP and control groups. Postoperative incidence of urinary tract infection was significantly higher in the control group (p = 0.002). The incidence of SSI events was very low, with only 1 event (0.09 %) in the AMP group and 3 events (0.28 %) in the control group, and this difference between groups was not significant (p = 0.371). Conclusions AMP is not necessary to prevent SSI after clean thyroid or parathyroid surgery.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The objective of this study is to assess oncological outcome after changing operative strategy from abdominoperineal resection (APR) to sphincter preservation (SP) in T3 low rectal carcinomas downstaged by neoadjuvant chemoradiation (nCRT). Patients and Methods This was a prospective observational study performed at academic medical centers. Patients with T3 rectal carcinoma, ( Results LAR with colorectal or coloanal anastomosis were done in 9 and 36 patients, respectively. After a mean follow-up of 57 months (range 48–70), local recurrences was reported in 4 patients (8.8 %), one of them had also distant metastasis while 2 patients (4.4 %) had only distant metastasis. Disease-free and overall survival rates were 87 and 89 %, respectively. Three of 4 patients with local recurrence (the fourth had liver metastasis) underwent salvage APR with free safety margins. Follow-up after salvage surgery for 31, 33, and 37 months revealed no recurrences. Wexner continence score ≤4 was noted in 39 patients; while major incontinence (Wexner score >12) was noted in 2 patients. Conclusions For selected patients of T3 low rectal cancer, changing operative strategy from APR to SP after downstaging by nCRT can be done in motivated patients with good sphincter function. Disease-free survival rates and continence are comparable to patients had APR and to previous publications with decision made before nCRT. With strict follow-up, early diagnosis of recurrence and salvage surgery with free resection margins can be achieved.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Standardised measurement of remnant liver volume (RLV), where total liver volume (TLV) is calculated from patients’ body surface area (RLV-sTLV), has been advocated. Extrapolating the model of living donor liver transplantation, we showed in a pilot study that the simplified RLV/body weight ratio (RLVBWR) was accurate in assessing the functional limit of hepatectomy. The aim of the study was to compare in a prospective series of extended right hepatectomy the predictive value of the RLVBWR and the RLV-sTLV at a cut-off of 0.5% (RLVBWR0.5%) and 20% (RLV-sTLV20%), respectively. Methods We studied the impact of RLVBWR0.5% and of RLV-sTLV20% on three months morbidity and mortality in 74 non-cirrhotic patients operated on for malignant tumours. Of these, 47 patients who were not included in the initial pilot study were enrolled in a prospective validation cohort to reappraise the predictive value of each method. Results RLVBWR and RLV-sTLV were highly correlated (Pearson correlation coefficient, 0.966). Three months overall and severe morbidity (grade 3b–5) and mortality were significantly increased in groups RLVBWR ≤ 0.5% and RLV-sTLVs ≤ 20% compared to groups >0.5% and >20%, respectively. The sensitivity and specificity in predicting death from liver failure were 100 and 84.1% for RLVBWR0.5% and 60 and 94.2% for RLV-sTLV20%, respectively. Similar results were observed in the validation cohort for the RLVBWR0.5% (lack of statistical power for RLV-sTLV as only 2 patients showed a RLV-sTLV ≤ 20%). Conclusions The RLVBWR0.5% is a method of assessing the remnant liver that is simple and as reliable as the standardised RLV-sTLV20%.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background SMAD3, which is accumulated in the nucleus, transcriptionally regulates TGF-β target genes, playing a significant role in mediating the activities of TGF-β. In this study, we assessed the roles of TGF-β1, SMAD3, and phosphorylated SMAD3 expressions in patients with locally advanced rectal cancer following preoperative fluoropyrimidine-based chemoradiotherapy. Methods Using immunohistochemistry, we examined TGF-β1, SMAD3, and phosphorylated SMAD3 expressions in pre-chemoradiotherapy cancer tissues from 86 locally advanced rectal cancer patients. After chemoradiotherapy, 64 of 86 (74.4 %) locally advanced rectal cancer patients were classified as responders (pathological tumor regression grades of 2–4). Results A multivariate analysis showed that phosphorylated SMAD3 overexpression correlated to poor preoperative chemoradiotherapy responses (P = 0.015; OR 7.218; 95 % CI 1.479–35.229). Furthermore, a poor response (pathological tumor regression grades of 0–1) was an independent predictor of postoperative relapse (P = 0.021; OR 5.452; 95 % CI 1.286–23.113). Additionally, patients with phosphorylated SMAD3 overexpression were found to have a worse disease-free survival (P = 0.023). Conclusions Our data suggested that analyzing pre-chemoradiotherapy tumors for phosphorylated SMAD3 overexpression would assist physicians in identifying locally advanced rectal cancer patients who may have a poor response risk to preoperative fluoropyrimidine-based chemoradiotherapy.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background The clinicopathologic significance of mucin production in patients with papillary cholangiocarcinoma (PCC) is still controversial. We aimed at clarifying the similarities and differences between PCC cases with and without mucin secretion with regard to biological behavior and clinical course. Methods Among 644 patients with surgically resected cholangiocarcinoma (1998–2011), 184 (28 %) patients were considered to have PCC and were enrolled in the study. Those patients were divided into two groups based on whether their PCC was mucin-producing (PCC-M, n = 89) or not (PCC-NM, n = 95). The presence of mucin secretion was determined by the cut surface of the specimens and by pathologic examination. Results The clinicopathological features of PCC-M and PCC-NM largely overlapped. No significant between-group differences in malignant potential characteristics, including the depth of invasion, pathological T classification, and regional/periaortic lymph node metastasis, were observed (P = 0.193, 0.181, 0.083, and 0.674, respectively). However, a few clinicopathological differences existed between the two PCC types, i.e., the predominant histological type and epithelial subtype (P P = 0.016, respectively). Immunohistochemically, MUC2, MUC5AC, MUC6, and HGM were more frequently expressed in PCC-M than PCC-NM (P P = 0.097). Conclusion PCC-M and PCC-NM were similar in morphology and prognosis. Although a few clinicopathological differences exist between them, their overlapping features and identical survival curves appear to justify the lack of a specific treatment modality for either type.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Dear EditorI read with great interest the recently published article by Rehem et al. in which the authors investigated the relation between serum levels of leptin and well-differentiated thyroid carcinoma (WDTC) and evaluated its correlation with patient and tumor characteristics [1]. In conclusion, higher leptin levels were found to be associated with a diagnosis of WDTC with a significant drop in the leptin levels following surgery. However, I think that there are some points that should be emphasized about this study.First, according to literature, although obesity has been positively associated with several cancers through a family of metabolically active adipocytokines, its connection with thyroid cancer has not been firmly established yet [2]. In obesity, a mild inflammatory condition, deregulated secretion of proinflammatory cytokines and adipokines, such as IL-1, IL-6, TNF-α and leptin from adipose tissue, inflammatory and cancer cells could contribute to the onset and progress ...
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background According to the Swedish Hernia Register (SHR), the reoperation rate is more than doubled after recurrent groin hernia repair compared with primary repair. The aim was to study the impact of type of mesh repair used in recurrent groin hernia surgery on a 2nd recurrence in a population-based cohort derived from the SHR. Material and method All 1st recurrent hernia repairs in the south-west region of Sweden, registered in SHR between 1998 up to 2007 were included. A questionnaire was sent in 2009. Patients stating a new lump or persisting problems were examined. A 2nd recurrence was identified as a 2nd reoperation or at physical examination. The incidence was analysed comparing anterior mesh repair (AMR) and posterior mesh repairs (PMR) (endoscopic and open). Results Eight hundred and fifteen recurrent operations in 767 patents were analysed, 401 AMRs and 414 PMRs. PMR had a lower 2nd recurrence rate compared with AMR (5.6 vs. 11.0 %) (p = 0.025). An increased risk [3.21 (CI 1.33–7.44) (p = 0.009)] of a subsequent 2nd recurrence was seen after anterior index repair followed by AMR and a decreased risk [0.08 (CI 0.01–0.94) (p = 0.045)] after posterior index repair followed by AMR. Conclusion PMR in recurrent groin hernia surgery was associated with a lower 2nd recurrence rate compared to anterior. A posterior approach for 1st recurrent operation is recommended after an anterior index repair and an anterior approach after a posterior index operation.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients with penetrating wounds to the neck present with overt symptoms and/or signs or are asymptomatic or modestly/moderately symptomatic. With overt symptoms and/or signs, immediate resuscitation and an emergency operation are appropriate. Asymptomatic patients or those with modest or moderate symptoms and/or signs undergo observation or a diagnostic evaluation to avoid the 45 % “negative” exploration rate documented in the past (denominator = all patients). Asymptomatic patients with penetration of the platysma muscle, but no signs of a visceral or vascular injury, should undergo serial physical examinations every 6–8 for 24–36 h before discharge. Noncontrast CT does not add to the accuracy of serial physical examinations. In stable patients with a variety of modest/moderate symptoms or signs possibly related to an injury to the carotid artery, CT-arteriography has become the diagnostic modality of choice. Patients with possible injuries to the cervical esophagus are often still evaluated with a Gastrografin swallow and, if needed, a “thin” barium swallow prior to fiberoptic esophagoscopy. CT-esophagograms are likely to replace these time-honored studies in the near future. Over 85 % of patients with injuries to the trachea present with overt symptoms or signs, while the remainder have historically been evaluated with laryngoscopy and fiberoptic bronchoscopy. Again, cervical multislice CT is likely to replace these studies. Operative repair of the carotid artery with 6–0 polypropylene sutures requires heparinization and shunting on rare occasions. Both the trachea and esophagus are repaired with 3–0 absorbable sutures, and tracheostomy and esophageal diversion are used in only large and/or complex injuries. Sternal head or sternocleiodomastoid interposition flaps are used when combined visceral and vascular injuries are present.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background The clamshell incision (CI) offers a better exposure than the left anterolateral thoracotomy (LAT) as a resuscitative thoracotomy. Most surgeons will have to manage a heart wound only once or twice in their career. The patient’s survival depends on how fast the surgeon can control the heart wound; however, it is unclear which of the two incisions allows for faster control in the hands of inexperienced surgeons. The aim of this study was to compare the time needed to access and control a standardized stab wound to the right ventricle, by inexperienced surgical trainees, by LAT or CI; we hypothesized that the CI does not take longer than the LAT. Methods Sixteen residents were shown a video on how to perform both procedures. They were randomly assigned to control a standardized stab wound of the right ventricle on perfused human cadavers by LAT (n = 8) or CI (n = 8). Access time (skin to maximal exposure), control time (maximal exposure until control of the heart wound) and total time (the sum of access and control times) were recorded. Results Total time was 6.62 min [3.20–8.14] (median [interquartile range]) for LAT and 4.63 min [3.17–6.73] for CI (p = 0.46). Access time was 2.39 min [1.21–2.76] for LAT and 2.33 min [1.58–4.86] for CI (p = 0.34). Control time was 4.16 min [2.32–5.49] for LAT and 1.85 min [1.38–2.23] for CI (p = 0.018). Conclusions The time needed from skin incision until cardiac wound control via CI was not longer than via LAT and the easier control of the cardiac wound when using CI was confirmed.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Blood transfusion adversely affects the outcome of coronary artery bypass grafting (CABG), yet blood transfusion after CABG is still common. Total arterial revascularisation (TAR) is increasingly used in current practice but its impact on postoperative blood transfusion is not known. Methods We reviewed the cardiothoracic and blood bank databases and collected data for isolated primary CABG patients from July 2007 to June 2012, excluding patients who had a single graft (n = 148). Perioperative variables of TAR patients (n = 745) were compared with patients who had one or more venous grafts (SVG, n = 1,761) for first-time isolated CABG. The conduits used in TAR patients were predominantly left internal thoracic and radial arteries. Matched group comparison of TAR and SVG patients was performed. The association of TAR with blood transfusion was investigated using multivariate and matched analysis. Results Of 2,506 patients, the 745 (29.7 %) that had TAR were generally younger, with less complex coronary artery disease and less often diabetic. After correcting for these by 1:1 matching, the mean chest tube drainage and rates of blood transfusion remained significantly lower (p CABG [odds ratio (OR) 0.67, 95 % confidence interval (CI) 0.47–0.97, p = .03]. Conclusions TAR achieved predominantly with left internal thoracic and radial arteries substantially reduced blood transfusion rates after primary CABG. Further studies are warranted.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Obesity has been associated with worse postoperative outcomes than those for normal weight. Data on the short-term results of laparoscopic liver resection (LLR) in patients with obesity are scarce. Furthermore, the long-term outcomes of LLR versus open liver resection (OLR) have not been adequately assessed. The aims of this study were to analyze the outcomes of obese patients undergoing LLR and to compare these to the outcomes of obese patients undergoing OLR. Methods Data regarding the short-term results from 13 obese patients who underwent laparoscopic non-anatomical liver resection were retrospectively compared with the data from 69 obese patients who underwent open non-anatomical liver resection between 2002 and 2012. The long-term results of patients with hepatocellular carcinoma were also compared. Results A total of 82 patients who underwent non-anatomical liver resection in our institution were included. There were no differences between the two groups in terms of preoperative patient characteristics. The intraoperative blood loss in the laparoscopic group was significantly less than that in the open group. There were no significant differences in the postoperative complications or postoperative mortality. The postoperative hospital stay of the laparoscopic group was significantly shorter than that of the open group. Conclusions LLR in obese patients results in decreased intraoperative blood loss and shorter postoperative hospital stays compared with OLR. When performed in selected patients, LLR may be a safe and feasible option for obese patients.
    World Journal of Surgery 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Adrenocortical cancer (ACC) is a rare malignancy. In the absence of metastatic disease, the suspicion of ACC is based on size and radiological appearance. The aim of this study was to analyse the long-term outcome of patients with large adrenal cortical tumours (>8 cm). Methods A prospective database recorded clinical, biochemical, operative and histological data on patients operated for cortical adrenal tumours between January 2000 and February 2013. Out of 130 patients operated for cortical adrenal tumours, analysis was restricted to 37 cortical tumours >8 cm. Results There were 31 (84 %) ACCs and 6 (16 %) benign adenomas (p p = 0.08, stage II vs. stage III–IV, respectively). No mortality was observed in patients with benign tumours during a median follow-up of 70 months (range 36–99 months). Mortality in the ACC group occurred in 17/31 (55 %) patients. Mitotane was administered in 12 (71 %) patients with stage III–IV ACCs with a 5-year survival rate 25 % compared to 20 % in patients who did not receive Mitotane. In stage II ACC, eight (57 %) patients received Mitotane with a 50 % mortality at 5 years. Conclusions The high incidence of ACC in cortical tumours >8 cm underlines the need for adequate surgical resection via open surgery aiming to avoid local recurrence. Beyond surgery, the impact of other therapies is not fully characterised and the efficacy of adjuvant Mitotane treatment is yet to be proven.
    World Journal of Surgery 12/2014;
  • World Journal of Surgery 12/2014;
  • World Journal of Surgery 12/2014;