World Journal of Surgery (WORLD J SURG)

Publisher: International Society of Surgery, Springer Verlag

Journal 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.

Current impact factor: 2.64

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.642
2013 Impact Factor 2.348
2012 Impact Factor 2.228
2011 Impact Factor 2.362
2010 Impact Factor 2.693
2009 Impact Factor 2.696
2008 Impact Factor 2.641
2007 Impact Factor 1.778
2006 Impact Factor 1.765
2005 Impact Factor 1.601
2004 Impact Factor 1.952
2003 Impact Factor 1.909
2002 Impact Factor 1.777
2001 Impact Factor 1.644
2000 Impact Factor 2.02
1999 Impact Factor 2.025
1998 Impact Factor 2.271
1997 Impact Factor 2.077
1996 Impact Factor 1.809
1995 Impact Factor 1.262
1994 Impact Factor 1.507
1993 Impact Factor 1.171
1992 Impact Factor 1.364

Impact factor over time

Impact factor

Additional details

5-year impact 2.84
Cited half-life 7.10
Immediacy index 0.54
Eigenfactor 0.03
Article influence 0.89
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
    • 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

Publications in this journal

  • John A. Stauffer · Alessandro Coppola · Kabir Mody · Horacio J. Asbun

    No preview · Article · Feb 2016 · World Journal of Surgery

  • No preview · Article · Feb 2016 · World Journal of Surgery
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    ABSTRACT: Introduction The purpose of this study was to identify independent unfavorable prognostic factors for patients who underwent video-assisted thoracoscopic surgery for resection of pulmonary metastases from colorectal cancer (CRC). Methods Between January 2004 and December 2013, 131 patients with pulmonary metastases from CRC underwent the aforementioned procedure for the first time at our institution. Kaplan–Meier survival curves and log-rank tests were used to analyze the survival rates. Multivariate analyses were performed using the Cox proportional hazards regression model. Results The 5-year disease-free survival (DFS) rate of these 131 patients was 34 %. Multivariate analyses showed two variables to be independent significant unfavorable prognostic factors for DFS: preoperative high serum carcinoembryonic antigen (CEA) level and a greater number of pulmonary metastases. According to subgroup analyses that combined these two risk factors, the 5-year DFS rates were 58, 25, and 12 % for patients with 0, 1, or 2 risk factors, respectively. Conclusion In patients who underwent video-assisted thoracoscopic surgery for pulmonary metastases from CRC, we identified two independent unfavorable prognostic factors for DFS: a high CEA level before metastasectomy and a greater number of pulmonary metastases. These factors can be used to identify higher- and lower-risk subgroups, which may help with selecting patients who would benefit the most from video-assisted thoracoscopic pulmonary metastasectomy.
    No preview · Article · Feb 2016 · World Journal of Surgery
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    ABSTRACT: Background: Minimally invasive pancreaticoduodenectomy (MIPD), which includes laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), is a complex procedure that needs to be performed by experienced surgeons. However, the safety and oncologic performance have not yet been conclusively determined. Methods: A systematic literature search was performed using the Embase, Medline, and PubMed databases to identify all studies published up to March 2015. Articles written in English containing the keywords: "pancreaticoduodenectomy" or "Whipple operation" combined with "laparoscopy," "laparoscopic," "robotic," "da vinci," or "minimally invasive surgery" were selected. Furthermore, to increase the power of evidence, articles describing more than ten MIPDs were selected for this review. Results: Twenty-six articles matched the review criteria. A total of 780 LPDs and 248 RPDs were included in the current review. The overall conversion rate to open surgery was 9.1 %. The weighted average operative time was 422.6 min, and the weighted average blood loss was 321.1 mL. The weighted average number of harvested lymph nodes was 17.1, and the rate of microscopically positive tumor margins was 8.4 %. The cumulative morbidity was 35.9 %, and a pancreatic fistula was reported in 17.0 % of cases. The average length of hospital stay was 12.4 days, and the mortality rate was 2.2 %. Conclusions: In conclusion, after reviewing one-thousand cases in the current literature, we conclude that MIPD offers a good perioperative, postoperative, and oncologic outcome. MIPD is feasible and safe in well-selected patients.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Introduction: While total vascular exclusion (TVE) with veno-venous bypass and hypothermia may be undertaken to increase liver tolerance for complex liver resection, these procedures are still associated with elevated rates of postoperative complications and mortality. In particular, one of the main issues of this strategy is the management of bleeding after declamping, which is enhanced by both hypothermic state and acidosis. To overcome this high risk of morbidity, several technical refinements might be undertaken and here described (with video). Methods: All patients, requiring TVE >60 min and liver cooling during hepatectomy, were retrospectively included in this study. Technical key points as (a) patient selection, (b) anesthetic management, (c) two-surgeon's technique, (d) preparation for clamping, (e) veno-venous bypass, (f) cooling of the liver, and (g) parenchymal transection, rewarming, and declamping are described and detailed. Results: From 2011 to 2013, we included 8 cases of liver resection with TVE, veno-venous bypass, and hypothermia for malignant disease. Due to the technical refinements, median observed overall blood loss of 550 ml (300-900) including 200 ml (50-300) at declamping and transfusion of packed red blood cell (PRBC) units was required in 5 patients with a mean of 1.25 PRBC/patient. Conclusion: The association of TVE, veno-venous bypass, and liver cooling can reduce the time of transection, and blue dye injection and liver rewarming before declamping can reduce blood loss and coagulopathy. Altogether, limited blood loss can be achieved for these complex procedures and may allow to decreasing morbidity.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Neuroendocrine Neoplasms of the small intestine have been noticed more frequently over the past 35 years. They constitute about 25 % of all NENs and 29 % of all tumors of the small intestine. Due to the predominantly indolent nature and overall good prognosis, the benefit of surgical treatment is still debated. Methods In a retrospective study, data of 83 surgically treated patients with neuroendocrine neoplasms of the small intestine, 48 males and 35 females with a median age of 62 years (range 25–86 years) were analyzed. Patient data were documented in the MaDoc database for neuroendocrine tumors of the University Medical Center of Mainz. IBM SPSS Statistics 20 was used for statistical analysis. Kaplan–Meier survival curves and Log-Rank tests, censoring patients at the time of last follow-up, were used to compare the overall survival depending on potential prognostic factors (stage, grade, surgical treatment). Results At the time of diagnoses, the most common clinical symptoms were abdominal pain (n = 31, 37.3 %), bowel obstruction (n = 11, 13.3 %), bowel perforation and peritonitis (n = 3, 3.6 %), gastrointestinal bleeding (n = 9, 10.8 %), weight loss (n = 11, 13.3 %), and carcinoid syndrome (n = 27, 32.5 %). 65 patients (78.3 %) had lymph node metastasis and in 58 patients (69.9 %) distant metastasis were present. Segmental bowel resection (44) was the most common surgical procedure, followed by right hemi-colectomy (32) and explorative laparotomy (7). In most patients (78.9 %), lymphadenectomy (systematic/selective) was performed. The 5-year survival of patients who underwent a systematic or a selective lymphadenectomy differed significantly (82.2 vs. 40.0 %). The overall 3-, 5-, and 10-year survival rates were 88.2, 80.3, and 71.0 %, respectively. Conclusion Mesenteric lymph node metastases are almost invariably present and have significant impact on patients’ prognosis. Systematic lymphadenectomy prevents complications and improves the survival. Early surgical treatment should be the goal in order to prevent complications.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Limited data exist on surgical providers and their scope of practice in low-income countries (LICs). The aim of this study was to assess the distribution and productivity of all surgical providers in an LIC, and to evaluate correlations between the surgical workforce availability, productivity, rates, and volume of surgery at the district and hospital levels. Methods Data on surgeries and surgical providers from 56 (93.3 %) out of 60 healthcare facilities providing surgery in Sierra Leone in 2012 were retrieved between January and May 2013 from operation theater logbooks and through interviews with key informants. Results The Sierra Leonean surgical workforce consisted of 164 full-time positions, equal to 2.7 surgical providers/100,000 inhabitants. Non-specialists performed 52.8 % of all surgeries. In rural areas, the densities of specialists and physicians were 26.8 and 6.3 times lower, respectively, compared with urban areas. The average individual productivity was 2.8 surgeries per week, and varied considerably between the cadres of surgical providers and locations. When excluding four centers that only performed ophthalmic surgery, there was a positive correlation between a facility’s volume of surgery and the productivity of its surgical providers (r s = 0.642, p < 0.001). Conclusions Less than half of all of the surgery in Sierra Leone is performed by specialists. Surgical providers were significantly more productive in healthcare facilities with higher volumes of surgery. If all surgical providers were as productive as specialists in the private non-profit sector (5.1 procedures/week), the national volume of surgery would increase by 85 %.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Complications following esophagectomy are a significant source of morbidity. The aim of this study was to investigate the utility of the neutrophil:lymphocyte ratio (NLR) in the early identification of complications following esophagectomy, as compared to other routinely available parameters. Methods We performed a retrospective cohort study of patients undergoing Ivor-Lewis esophagectomy at a single centre. Baseline characteristics and complications occurring within the first 30 days of surgery were recorded. White blood cell counts and C-reactive protein (CRP) levels immediately following surgery (day 0) and over the subsequent three postoperative days were analysed. Results Sixty-five patients were included, of whom 29 (45 %) developed complications. The median NLR was similar among patients with and without a complicated recovery on day 0 (12.7 vs 13.6, p = 0.70) and day 1 (10.0 vs 9.3, p = 0.29). Patients who subsequently developed complications had a higher NLR on day 2 (11.8 vs 7.5, p < 0.001) and day 3 (9.0 vs 6.5, p = 0.001) compared to those whose recovery was uncomplicated. Receiver-operating-characteristic plots for the diagnostic performance of the NLR, neutrophil count, lymphocyte count and CRP level at each time point demonstrated that the NLR on day 2 had the greatest discriminatory ability in predicting complications, with an area under the curve of 0.83 (95 % CI 0.73–0.94). An NLR of >8.3 on day 2 had a sensitivity of 93 % and a specificity of 72 % for predicting complications. Conclusion The NLR is a simple and routinely available parameter which has a high sensitivity in the early detection of complications following esophagectomy.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Objective The purpose of this article is to systematically analyse the randomized, controlled trials (RCTs) comparing Ferguson or closed haemorrhoidectomy (CH) versus open haemorrhoidectomy (OH) or Milligan–Morgan haemorrhoidectomy in the management of haemorrhoidal disease (HD). Methods RCTs on the effectiveness of CH and OH in the management of HD were analysed systematically using RevMan®, and combined outcome was expressed as odds ratio (OR) and standardized mean difference. Results Eleven CRTs encompassing 1326 patients were analysed systematically. There was significant heterogeneity among included trials. Therefore, in the random effects model, CH was associated with a reduced post-operative pain (SMD, −0.36; 95 % CI, −0.64, −0.07; z = 2.45; p = 0.01), faster wound healing (OR, 0.08; 95 % CI, 0.02, 0.24; z = 4.33; p < 0.0001), lesser risk of post-operative bleeding (OR, 0.50; 95 % CI, 0.27, 0.91; z = 2.27; p < 0.02) and prolonged duration of operation (SMD, 6.10; 95 % CI, 3.21, 8.98; z = 4.13; p < 0.0001). But the variables such as pain on defecation (SMD, −0.33; 95 % CI, −0.68, 0.03; z = 1.82; p = 0.07), length of hospital stay, post-operative complications, HD recurrence and risk of surgical site infection were similar in both groups. Conclusion CH has clinically measurable advantages over OH in terms of reduced post-operative pain, lower risk of post-operative bleeding and faster wound healing.
    No preview · Article · Jan 2016 · World Journal of Surgery

  • No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Despite significant progress in surgery, controversy persists about timing of appendectomy. Objective of this prospective observational study was to determine associations between time interval from onset of symptoms in appendicitis to appendectomy and postoperative complications. Methods After institutional review board approval, all adult consecutive patients subjected to emergency appendectomy between 1/9/2013 and 1/12/2014 were prospectively enrolled. Data collection included demographics, open vs. laparoscopic appendectomy, comprehensive complication index (CCI), and 30-day follow-up. To determine time-dependent associations between delay of surgery and complications all patients were stratified into subgroups based on 12-h time intervals from onset of abdominal pain to surgery. Primary outcome was complications per CCI in correlation to delay from symptoms to appendectomy. Secondary outcomes included duration of surgery, hospital length of stay (HLOS), and incidence of complication within 30-day follow-up. Results A total of 266 patients with a mean age of 35.4 ± 14.8 years met inclusion criteria. Overall, 83.1 % of patients were subjected to laparoscopic appendectomy. Delay to surgery in 12-h increments showed stepwise-adjusted increase in complications per CCI (adj. P = 0.037). Also, delay to appendectomy increased significantly duration of surgery and HLOS, respectively (adj. P < 0.001 and adj. P < 0.001). Overall, 5.7 % of patients developed a surgical site infection after hospital discharge. Conclusion Extended time interval from the onset of initial symptoms to appendectomy is associated with increased complications per CCI, duration of surgery, and HLOS in acute appendicitis. Prompt appendectomy in acute appendicitis is warranted.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Hiatal hernias (HH) are more common among elderly patients, with an increase in incidence with advancing age. Elderly patients frequently suffer from comorbidity, causing them to have an increased risk of perioperative mortality and morbidity. The aim of this study is to assess the safety of this procedure within elderly patients. Methods We performed a retrospective analysis of all patients with HH operated between July 2009 and May 2015 at two hospitals in the Netherlands specialized in antireflux surgery and HH repair. Mortality rates and short- and long-term morbidity rates were compared between patients aged under 70 years and aged over 70 years. Results A total of 204 consecutive patients underwent laparoscopic HH repair at our institutions, of whom 121 were aged under 70 years and 83 were aged over 70 years. There was no mortality intraoperatively, nor during 30-days follow-up. Intraoperative complications occurred in 7 patients aged 70 years and over, with no significant differences compared to the patients aged under 70. The 30-day morbidity rate did not significantly differ between the age groups, with an overall postoperative complication rate of 9.3 %. Only length of stay (LOS) was significantly longer in the elderly patients. Performing univariate analysis, only the occurrence of intraoperative complications was associated with 30-day morbidity. Conclusion In the present study, age was not associated with increased 30-day morbidity or mortality following HH repair. Therefore, in carefully selected patients, age should not be used as an argument to withhold laparoscopic HH repair.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Pancreaticoduodenectomy (PD) is the only potential treatment for pancreatic head adenocarcinomas, which are sometimes located close to or invade the portal-superior mesenteric vein (PSMV). Surgeons often attempt to obtain a negative resectional margin after resection of the PSMV. This attempt requires PSMV reconstruction through graft replacements or end-to-end anastomosis; however, possible complications should be concerned including anastomosis stenosis, damage to some of the PSMV branches, prosthetic graft infection, and that associated with autologous graft harvesting. The first jejunal artery and vein are often resected in PD with the intent of lymphadenectomy. In this study, jejunal vein flap was used for PSMV reconstruction without causing damage to any of the PSMV branches in two patients. Here, we describe the new methods of PSMV reconstruction using first jejunal vein flap in PD.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Objective This study aimed to compare the characteristics of the tumors, the management strategy, and oncologic outcomes of patients with rectal cancer surgery in these two periods: period 1 (1993–2001) and period 2 (2002–2011). Methods All patients who underwent radical resection of rectal cancer from 1993 to 2011 were included. Comparisons of the patients’ demographics, characteristics, operating results, and oncologic outcome between the two periods were undertaken. Results Radical resection for rectal cancer was performed in 1611 patients (993 men). Patients were significantly older and more had comorbid medical diseases in period 2. More laparoscopic resections were performed and more patients had preoperative chemoradiation in period 2. The postoperative mortality was significantly lower and the hospital stay was significantly shorter in period 2. In those with non-metastatic cancer, the 5-year local recurrences of patients in period 1 and period 2 were 11.9 and 5.9 %, respectively. (p = 0.002) The patients in period 2 had significantly better 5-year overall (68.1 vs. 60.2 %, p = 0.003) and 5-year cancer-specific survival (76.1 vs. 69.4 %, p < 0.001) when compared with those treated in period 1. The improvement occurred mainly in patients with abdominoperineal resection and those with stage III diseases. In the multivariate analysis, among the other histological factors, operations performed in period 2 and laparoscopic surgery were independent factors associated with better overall survival. Conclusions Significant improvement in the surgical outcomes in terms of a lower recurrence rate and better survival was achieved in the recent years with the increase in neoadjuvant therapy and the application of laparoscopic surgery.
    No preview · Article · Jan 2016 · World Journal of Surgery
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    ABSTRACT: Background Recently, a simple and easy complication prediction system, the Surgical Apgar Sore (SAS) calculated by three intraoperative parameters (estimated blood loss, lowest mean arterial pressure, and lowest heart rate), has been proposed for general surgery. This study aimed to determine if the SAS could accurately predict perioperative morbidity in patients undergoing esophagectomy for esophageal cancer. Methods We investigated 399 patients who underwent esophagectomy at the Kumamoto University Hospital between April 2007 and March 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Patients had postoperative morbidities classified as Clavien–Dindo grade III or more. Univariate and multivariate analyses were performed to elucidate factors that affected the development of complications. Results The mean age of the study population was 65.7 years, 357 patients (89.5 %) were male. The frequency of any morbidity was 32.3 %. Univariate analyses showed that the SAS as well as preoperative chemotherapy, volume of bleeding, and reconstruction of organs were associated with morbidities. Multivariate analysis showed that a SAS < 5 was found to be an independent risk factor for morbidities. Conclusion The SAS is considered to be useful for predicting the development of postoperative morbidities after esophagectomy for esophageal cancer.
    No preview · Article · Jan 2016 · World Journal of Surgery