SURGERY外科
SURGERY(英文缩写 SURGERY),ISSN 0039-6060,eISSN 1532-7361,中文译名:外科 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 4.348 | Q1 |
| 2022 | 3.800 | Q1 |
| 2023 | 3.200 | Q1 |
| 2024 | 2.700 | Q1 |
| 2025 | 3.200 | Q1 |
SURGERY 最新收录文献
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4. Computer vision scoring of laparoscopic right hemicolectomy performance: A multicenter proof-of-concept study.
4. 腹腔镜右半结肠切除术表现的计算机视觉评分：一项多中心概念验证研究PMID:日期:2026-09-10该文献暂无摘要。
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5. Outcomes following left-sided pancreatectomy management with and without splenectomy for major pancreatic injury.
5. 左侧胰腺切除术治疗严重胰腺损伤伴或不伴脾切除术后的结局PMID:日期:2026-09-09Traumatic pancreatic injuries carry significant mortality and often involve splenectomy because of the anatomic proximity of the spleen. However, current trauma guidelines provide no evidence-based recommendation for or against routine splenectomy at the time of left-sided pancreatectomy, instead advocating an individualized approach. Contemporary data comparing left-sided pancreatectomy management with splenectomy and without splenectomy (nonsplenectomy) remain limited. We evaluated perioperative outcomes following splenectomy versus nonsplenectomy left-sided pancreatectomy in a national trauma cohort. The 2018-2021 Trauma Quality Improvement Program was queried for patients ≥16 years with pancreatic injury undergoing left-sided pancreatectomy. Those with concomitant splenic injury were excluded, and records were stratified by whether splenectomy was performed. The primary end point was in-hospital mortality. Secondary outcomes included major adverse events, individual complications, intensive care unit admission, and intensive care unit length of stay. Multivariable regression models assessed the independent association between splenectomy and left-sided pancreatectomy and outcomes. Of 758 patients, 393 (51.8%) underwent splenectomy, and 365 (48.2%) underwent nonsplenectomy. Splenectomy patients had lower Traumatic Injury Machine Learning-based scores (0.05 vs 0.07; P < .001) and shorter time to operation (64 vs 519 minutes; P < .001). Following risk adjustment, splenectomy was not associated with differences in in-hospital mortality (adjusted odds ratio, 0.81; 95% confidence interval, 0.47-1.38) or major adverse events (adjusted odds ratio, 0.97; 95% confidence interval, 0.68-1.39). Rates of cardiac, respiratory, thromboembolic, infectious, and renal complications were comparable between cohorts, as were intensive care unit admission and length of stay. Utilization remained stable throughout the study period (nptrend, 0.18). Left-sided pancreatectomy with splenectomy was not associated with differences in postoperative mortality or major complications compared with nonsplenectomy left-sided pancreatectomy. These findings support individualized operative decision-making, whereas long-term septic complications and follow-up warrant further investigation.
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6. Factors associated with successful nonoperative management of colonic fistulas from necrotizing pancreatitis.
6. 坏死性胰腺炎所致结肠瘘非手术治疗成功的相关因素PMID:日期:2026-09-07Necrotizing pancreatitis can result in colonic fistulas from inflammatory sequelae or drain erosion. We sought to define the optimal operative management or nonoperative management of colonic fistulas secondary to necrotizing pancreatitis. A retrospective analysis was performed of adult patients in an institutional necrotizing pancreatitis registry who developed colonic fistulas between 2015 and 2025. Patient cohorts were established by nonoperative management or operative management status, and exploratory univariate analysis was used to compare risk factors for operative management. Among 1,092 necrotizing pancreatitis patients, 47 developed colonic fistulas. The median interval from initial acute pancreatitis diagnosis to colonic fistula was 58 (29-103) days. Nonoperative management was utilized in 20 (43%) patients with initial intervention, including 11 (55%) percutaneous or 4 (20%) endoscopic. Operative management was used in 27 (57%); initial interventions were 10 (37%) percutaneous and 17 (63%) upfront operative management. Twenty-three patients had drain-related colonic fistulas: 10 (50%) nonoperative management and 13 (48%) operative management. Nonoperatively managemed patients had significantly lower Bedside Index for Severity in Acute Pancreatitis (BISAP) scores on presentation to our institution (1.0 [1.0-2.0] vs 3.0 [1.0-3.0]; P = .04) with a BISAP score (≥3) associated with operative management (odds ratio, 6.10; 95% confidence interval, 1.59-30.68; P = .007). Nonoperatively managemed patients also had a shorter length of stay (10 [0-30] vs 39 [24-55] days; P < .01) and less frequent intensive care unit admission (7 [35%] vs 21 [78%]; P < .01). There was no significant difference in overall survival in nonoperative management versus operative management (P = .07). While colonic fistulas are important to identify in patients with necrotizing pancreatitis, they do not mandate operative intervention. Our data suggest that low-risk patients, based on critically ill status and BISAP score, may undergo successful nonoperative management.
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7. Extended venous thromboembolism chemoprophylaxis after pancreas surgery for cancer: Does the subcutaneous needle move the needle?
7. 胰腺癌手术后延长静脉血栓栓塞症药物预防：皮下注射针头能否改变现状？PMID:日期:2026-09-04Twenty-eight days of extended chemoprophylaxis is recommended for patients undergoing pancreatectomy for malignancy. We hypothesized that the current strategy of extended venous thrombotic event chemoprophylaxis is ineffective in reducing postoperative venous thrombotic events. This was a single-institution retrospective review of pancreatectomy patients with cancer. Symptomatic postoperative venous thrombotic event (pulmonary embolism, deep vein thrombosis, and mesenteric vein thrombosis) rates at 90 days were evaluated. Perioperative variables were in accordance with National Surgical Quality Improvement Program and International Study Group for Pancreatic Surgery definitions. Univariable and multivariable analyses were performed. Institutional practice for extended venous thrombotic event prophylaxis is 28 days of once-daily subcutaneous enoxaparin. Between 2013 and 2024, 1,667 patients underwent pancreatectomy. The mean age was 67 ± 10.7 years, with a mean body mass index of 27 ± 5.8. Most operations were pancreatic head resections (1,303 [78%]). The incidence of postoperative thrombotic events was 115 (6.9%), deep vein thrombosis or pulmonary embolism was 63 (3.8%), and mesenteric vein thrombosis (portal vein/superior mesenteric vein/splenic vein) was 58 (3.5%). Sixty-nine (60%) were diagnosed with venous thrombotic event after discharge. Excluding inpatient venous thrombotic events, comparing venous thrombotic event rates between patients with and without chemoprophylaxis, there was no difference in rates of any thrombus, deep vein thrombosis/pulmonary embolism, mesenteric vein thrombosis, or clinically significant bleeding events. Among patients discharged with extended venous thrombotic event prophylaxis, multivariable logistic regression found increasing body mass index as a significant risk factor for venous thrombotic event after hospital discharge (odds ratio, 1.10; 95% confidence interval, 1.05-1.15; P ≤ .001). Routine chemoprophylaxis after pancreatectomy for cancer did not reduce rates of deep vein thrombosis, pulmonary embolism, or mesenteric vein thrombosis. Among patients discharged on extended prophylaxis, a higher body mass index was associated with an increased venous thrombotic event risk. This suggests that current prophylaxis strategies may be inadequate, and future strategies may utilize weight-based dosing for prophylaxis regimens.
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8. Limited impact of sentinel lymph node biopsy in older women with cT2N0 hormone-positive human epidermal growth factor receptor 2-negative breast cancer.
8. 前哨淋巴结活检在患有cT2N0激素阳性人表皮生长因子受体2阴性乳腺癌的老年女性中影响有限PMID:日期:2026-09-03Consensus guidelines support selective omission of sentinel lymph node biopsy for axillary staging in older women with early stage, biologically favorable breast cancer; however, applicability to clinical T2 disease remains unclear. We evaluated the impact of sentinel lymph node biopsy on adjuvant treatment decisions in women ≥65 years with cT2N0 hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. A single-institution retrospective review included consecutive patients treated from 2019 to 2023. Clinicopathologic features, adjuvant therapy decisions, and outcomes were analyzed. Among 113 patients, 35 (31%) had pN1 disease, and 2 (1.8%) had pN2-3 disease. Final pathologic tumor size was pT1 in 25 patients (22.1%), 2.1-3.0 cm in 48 (42.5%), 3.1-4.0 cm in 27 (23.9%), and >4.0 cm in 13 (11.5%). Nodal positivity was lower among patients with pT1 compared with pT2 tumors (8% vs 31%, P = .035) but did not differ across pT2 subgroups (P = .864). Twelve patients (10.6%) received chemotherapy, with nodal status determining treatment in only 2 cases. Regional nodal irradiation was administered to 15 of 37 patients with pathologically node-positive disease and omitted in the remainder. At the median follow-up of 3.1 years, 9 patients (8%) experienced recurrence; all pathologically node-positive patients with recurrence (n = 4) demonstrated endocrine therapy noncompliance. In women ≥65 years with cT2N0 hormone receptor-positive/human epidermal growth factor receptor-negative breast cancer, sentinel lymph node biopsy infrequently influenced adjuvant management. Chemotherapy was guided by genomic assays, and most patients with pathologically node-positive disease did not receive regional nodal irradiation, supporting a selective, individualized approach to axillary staging.
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9. Ventriculoperitoneal shunt management strategies during emergency abdominal surgery: A retrospective cohort analysis.
9. 急诊腹部手术中脑室腹腔分流管管理策略：一项回顾性队列分析PMID:日期:2026-09-03Emergency general surgery interventions may risk infection of previously implanted ventriculoperitoneal shunts, yet evidence guiding intraoperative shunt management in adults is limited. We evaluated postoperative shunt-related infections among adults with ventriculoperitoneal shunts undergoing emergency general surgery. We performed a single-institution 25-year (2000-2025) retrospective cohort study of adults (≥18 years) with ventriculoperitoneal shunts undergoing emergency general surgery. The primary outcome was ventriculoperitoneal shunt infection within 30 days, stratified by Centers for Disease Control and Prevention surgical wound class. Forty-five patients with ventriculoperitoneal shunts undergoing emergency general surgery were included. Median age was 63 years (interquartile range, 39-73), and 62.2% were male. The most common emergency general surgery diagnoses were classified as biliary (35.6%), small bowel (20%), and appendiceal (17.8%). Minimally invasive approaches were used in 42.2% of cases. The most common wound class was II (44.4%), followed by III (28.9%) and IV (17.8%). Among 44 patients with available shunt-management data, ventriculoperitoneal shunt was maintained at the time of emergency general surgery in 37 (84.1%). Valve types were programmable in 46.7%. Antibiotic-impregnated catheters were present in 64.4% of patients. The 30-day ventriculoperitoneal shunt-related infection rate was 4.4%. The first occurred following a laparoscopic appendectomy (wound class III, day 2); the ventriculoperitoneal shunt was removed on postoperative day 2, followed by eventual replacement after completing antibiotic therapy. The second infection was following percutaneous endoscopic gastrostomy placement (wound class II, day 4); ventriculoperitoneal shunt was removed, and temporary ventricular drainage was established. This patient suffered an unrelated mortality prior to reimplantation. Our study suggests that, in selected adults with ventriculoperitoneal shunts undergoing emergency general surgery, shunt preservation is associated with a low rate of shunt-related infection, with no observed adverse consequences among patients who subsequently required shunt explantation.
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10. Recurrent laryngeal nerve monitoring and postoperative airway complications following thyroid surgery: A multivariable national surgical quality improvement program analysis.
10. 甲状腺手术后喉返神经监测与术后气道并发症：国家外科质量改进计划的多变量分析PMID:日期:2026-09-03Recurrent laryngeal nerve injury during thyroid surgery can result in clinically significant airway compromise, particularly in patients with limited pulmonary reserve. Although intraoperative nerve monitoring is widely used to reduce nerve injury, its association with postoperative airway complications has not been well characterized. This study evaluates trends in intraoperative nerve monitoring and its relationship with postoperative airway compromise after thyroidectomy. We performed a retrospective cohort study of adult patients who underwent thyroid surgery between 2018 and 2022 using the National Surgical Quality Improvement Program database. Patients were stratified by use of intraoperative nerve monitoring. The primary outcome was postoperative airway compromise, defined as prolonged ventilation (>48 hours postoperatively) and unplanned postoperative reintubation. Secondary outcomes included recurrent laryngeal nerve injury, neck hematoma, and pneumonia. Univariate and multivariate analyses were performed to identify factors independently associated with airway complications. A total of 33,211 patients were included; 23,757 (71.5%) underwent surgery with intraoperative nerve monitoring. On univariate analysis, patients undergoing intraoperative nerve monitoring had lower rates of postoperative airway compromise compared with those without monitoring (0.4% vs 0.6%, P = .048). Although individual airway events were infrequent and did not differ significantly between groups, intraoperative nerve monitoring was associated with a lower rate of recurrent laryngeal nerve injury (5.7% vs 6.5%, P < .001). On multivariable analysis, preoperative dyspnea, American Society of Anesthesiologists class III or higher, advanced tumor stage (T3-4), chronic obstructive pulmonary disease, older age, and longer operative time were independently associated with increased odds of postoperative airway compromise. After adjustment for patient, tumor, and operative factors, intraoperative nerve monitoring remained independently associated with decreased odds of postoperative airway compromise (odds ratio, 0.64; P = .04). In subgroup analysis of patients with American Society of Anesthesiologists class III or higher, recurrent laryngeal nerve monitoring was associated with lower adjusted odds of postoperative airway compromise (adjusted odds ratio, 0.68), consistent with findings in the overall cohort, though estimates were limited by low event rates. In this large national cohort, intraoperative recurrent laryngeal monitoring was independently associated with reduced postoperative airway complications after thyroidectomy. Airway risk was driven primarily by patient comorbidity, physiologic reserve, disease severity, and operative complexity. These findings suggest that recurrent laryngeal nerve monitoring may be of greatest benefit in high-risk surgical patients.