LANGENBECKS ARCHIVES OF SURGERY兰根贝克外科学文献
LANGENBECKS ARCHIVES OF SURGERY(英文缩写 LANGENBECK ARCH SURG),ISSN 1435-2443,eISSN 1435-2451,中文译名:兰根贝克外科学文献 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：2025-09-27 至 2026-09-27，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 | 2.895 | Q2 |
| 2022 | 2.300 | Q2 |
| 2023 | 2.100 | Q2 |
| 2024 | 1.800 | Q2 |
| 2025 | 2.200 | Q2 |
LANGENBECKS ARCHIVES OF SURGERY 最新收录文献
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1. Preparing surgery for Generation Z - Motivation and protective factors for pursuing a surgical career among medical students and early-career physicians: a cross-sectional study.
PMID:日期:2026-09-22Surgery is facing a substantial shortage of young professionals. In particular, it has become increasingly difficult to attract medical students, especially women, to pursue a surgical career, although women currently represent the majority of medical students. The specialty is often associated with a high workload, hierarchical leadership structures, and limited compatibility between professional and private life. Against this background, the aim of this study was to identify the factors that motivate medical students, early-career physicians and board-certified surgeons to pursue a career in surgery despite these challenges. An anonymous online survey was conducted between October and December 2025. The questionnaire comprised 18 items addressing motivations as well as encouraging and discouraging factors influencing the decision to pursue a surgical career. Responses were recorded using a five-point Likert scale ranging from 1 to 5. A total of 179 individuals participated in the survey (11.7% male [n = 21], 88.3% female [n = 158]; mean age 31 ± 6.3 years), including 28.5% medical students, 48.0% residents, and 23.5% board-certified surgeons. Overall, 68.7% reported having decided on a surgical career during medical school. Notably, 87.2% of respondents stated that they had been discouraged in relation to their career choice, with discouraging feedback predominantly coming from men and from individuals working in surgical specialties. Women had 6.5-fold higher adjusted odds of reporting that they had been discouraged from pursuing a surgical career compared with men (p < 0.001). The most frequently reported motivating factors were the operative nature of the work (97.8%), working in a supportive and appreciative team environment (60.9%), and the opportunity to make a meaningful contribution to patient care (60.9%). The potential future surgical workforce is predominantly female and largely belongs to Generation Z. Overall, participants emphasize the importance of high-quality and structured training, a respectful working environment, predictable career pathways, and working conditions that allow for a sustainable balance between professional and private life. Addressing these factors should be considered a strategic priority for professional societies, training supervisors, and clinical leaders to attract and sustainably retain qualified surgical trainees.
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2. Upfront surgery vs. neoadjuvant therapy in pancreatic cancer with venous involvement: a multicenter retrospective analysis.
PMID:日期:2026-09-22The benefits of neoadjuvant therapy (NAT) for pancreatic cancer (PC) with portal venous involvement remain debated. This study aimed to compare the short- and long-term outcomes of surgery with or without NAT in patients with PC with suspected venous involvement. A multicentre retrospective cohort study compared patients who underwent upfront surgery (US) or surgery following NAT for PC with suspicion of venous involvement between 2007 and 2017. The primary endpoints were short-term morbidity and mortality, overall survival and disease-free survival. We included 361 patients who received NAT and 690 patients who underwent US at nine centres. NAT patients had greater suspicion of venous involvement (96.9% vs. 83.6%, p<0.001), but underwent fewer venous resections (53.7% vs. 79.3%, p<0.001), and had less venous infiltration (52.3% vs 65.9%, p<0.001), perineural invasion (75.2% vs. 90.1%, p<0.001), angioinvasion (59.9% vs. 76.7%, p<0.001), lymph node involvement (60.6% vs. 83.6%, p<0.001) and R1 resections (44.7% vs. 67.2%, p<0.001) than patients who underwent US. Among patients undergoing venous resection, major postoperative complications were similar between the groups. However, without venous resection, NAT patients had significantly fewer (Clavien-Dindo ≥IIIb) postoperative complications (10.8% vs. 24.4%, p=0.02), fewer reoperations (3.0% vs. 11.2%, p=0.006), and lower 90-day mortality (2.4% vs. 7.7%, p=0.03). NAT patients showed improved survival (27.3 vs. 21.2 months, p=0.003). NAT maybe beneficial for patients with PC with venous involvement, as it might allow better patient selection for surgery and is associated with fewer major postoperative complications and better overall survival.
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4. Orbitozygomatic-transsylvian approach to the insula: microsurgical anatomy and endoscopic correlation using the fiber-separation technique.
PMID:日期:2026-09-18Insular surgery remains technically demanding because of the region's deep location and intimate relationships with the middle cerebral artery complex and surrounding white matter pathways. Safe resection requires precise understanding of vascular landmarks and subcortical functional boundaries. Eight formalin-fixed adult cadaveric heads (16 hemispheres) underwent bilateral two-piece orbitozygomatic (OZ) transsylvian (TS) dissections. Endoscopic assistance (0° and 30°) was used selectively to enhance visualization of deep and anatomically concealed regions. Following cortical exposure, approach-oriented subinsular fiber separation and dedicated hemispheric Klingler fiber dissections were performed to define operative surgical boundaries and characterize the three-dimensional organization of the peri-insular white matter. The OZ-TS corridor provided wide anterior and anteroinferior exposure of the insula, allowing early identification of the M2 trunks, M3 opercular branches, and lenticulostriate arteries, thereby clarifying the medial vascular limit. Endoscopic assistance provided complementary visualization of the limen insulae, anterior perforated substance, and deep perforators while maintaining the established operative corridor. Layered subinsular dissection consistently revealed the extreme capsule, claustrum, external capsule with its uncinate fasciculus and inferior fronto-occipital fasciculus (IFOF), followed by the putamen and internal capsule. The IFOF formed a critical medial boundary in anterior resections, whereas the posterior limb of the internal capsule and optic radiation defined posteromedial and posterior functional limits. Endoscope-assisted OZ-TS exposure combined with a structured fiber-separation strategy provides an integrated anatomical perspective of the insular region. Early identification of vascular landmarks and systematic progression along intrinsic white matter planes facilitate anatomical definition of subcortical surgical boundaries.
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5. Concordance between GPT-4 and a multidisciplinary tumor board in pancreatic cancer: A prospective pilot study.
5. GPT-4与多学科肿瘤委员会在胰腺癌中的一致性：一项前瞻性初步研究PMID:日期:2026-09-17Large language models (LLMs) such as GPT-4 are being evaluated for their use as supportive tools in oncological treatment planning. However, in pancreatic cancer, current studies are confined to predefined question-answer formats, while studies specifically investigating real-world scenarios that benchmark LLM performance against multidisciplinary tumor board (MDT) decisions are lacking. This prospective comparative analysis evaluated treatment and diagnostic recommendations for patients with newly diagnosed or suspected pancreatic cancer between an MDT and GPT-4. Using MDT referrals, clinical data were entered into a clinical data matrix and submitted to GPT-4 for therapeutic and diagnostic recommendations. Outputs were assessed before and after additional prompting with 41 high-ranking abstracts relevant to pancreatic cancer care. The primary endpoint was the concordance of recommendations between the MDT and GPT-4 before and after literature-based prompting. Between September 1, 2024 and March 31, 2025, 45 patients were enrolled. The overall concordance rate between the MDT and GPT-4 was 73.3% (κ = 0.64, p < 0.0001) and did not improve following literature prompting. Discordance most often occurred in complex clinical scenarios. Concordance was highest in cases of metastatic disease (90.0%) and in neoadjuvant settings (90.0%) while it was lowest in patients requiring additional diagnostic workup (50.0%). GPT-4 demonstrated substantial agreement with MDT recommendations in patients with newly diagnosed or suspected pancreatic cancer. However, specific abstract prompting did not enhance the rate of concordance and GPT-4's limitations in individualized or complex contexts underscore the need for a cautious future integration into oncologic workflows.
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7. Early postoperative serum IL-6 may contribute to risk stratification for pancreas-specific complications after pancreatic resection.
PMID:日期:2026-09-14IL-6 level in serum has been shown to have predictive value for postoperative infectious complications and prognostic value in acute pancreatitis. Evidence on its role after pancreatic resection is limited. The aim of the study was to analyse the predictive role of early postoperative serum IL-6 regarding complications after pancreatic resection. A retrospective analysis of patients with pancreatic resection at a tertiary German centre was performed. All IL-6 values per patient within 48 h after resection were delineated. Values at fixed postoperative time points were interpolated between each patient's measurements and, beyond them, predicted from a linear mixed-effects model. Receiver operating characteristic curve analysis was performed, and optimal time and cut-off points for prediction of postoperative pancreatic fistula (POPF), postpancreatectomy acute pancreatitis (PPAP) and overall complications were set out. Out of 316 patients, 157 patients with more than one IL-6 value were included. IL-6 at 36 h after resection showed the best diagnostic performance for all three endpoints. For PPAP B/C, the AUC was 0.800 (95% CI 0.685-0.916) at a cut-off of 296 pg/ml (sensitivity 62%, specificity 80%, PPV 26%, NPV 95%), and for POPF B/C 0.715 (0.632-0.798) at 192 pg/ml (sensitivity 70%, specificity 59%, PPV 52%, NPV 76%). Discrimination for major complications (Clavien-Dindo ≥ 3b) was weaker, with an AUC of 0.636 (0.539-0.733) at 208 pg/ml (sensitivity 55%, specificity 62%, PPV 44%, NPV 73%). Serum IL-6 within 48 h after pancreatic resection could be useful in risk assessment for pancreas-specific complications.
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8. Postoperative outcomes after inguinal hernia repair in octogenarians in Germany: an exploratory analysis of a retrospective single-centre cohort.
PMID:日期:2026-09-11As the population ages, the number of elderly patients undergoing inguinal hernia repair is increasing. Advanced age is associated with higher rates of comorbidity and frailty, which may potentially affect postoperative outcomes. This study evaluated postoperative morbidity in different age groups with a focus on octogenarians. This exploratory retrospective single-centre study included 388 patients undergoing elective inguinal hernia repair between 2014 and 2020. The patients were stratified into three groups according to age < 65 years (n = 240), 65-79 years (n = 117), and ≥ 80 years (n = 31). Open (Lichtenstein) and transabdominal preperitoneal laparoscopic techniques were analysed. The primary outcome was postoperative morbidity according to the Clavien-Dindo classification. Logistic regression analyses were performed to identify risk factors. Octogenarians more frequently underwent open repair, whereas younger patients more often received laparoscopic treatment (p < 0.001). No significant differences were observed between age groups in regard to intraoperative or overall postoperative complications, including complication severity. In the multivariable analysis, age was not associated with postoperative complications (p = 0.974). Laparoscopic repair was associated with lower odds of postoperative complications (odds ratio (OR) 0.544; p = 0.031), while longer operative time was associated with increased risk of complications (OR 1.009; p = 0.022). Octogenarians did not show increased postoperative morbidity. Surgical decision-making should not rely on chronological age alone. Not applicable.
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9. Outcome after renal transplantation utilizing octogenarian donors- retrospective single-center analysis within the Eurotransplant region.
PMID:日期:2026-09-11A severe shortage of donors and organs remains the primary challenge in modern transplantation medicine. For kidney transplantation, prolonged time on the waiting list increases morbidity and mortality, particularly among elderly patients. Dedicated allocation initiatives, such as the Eurotransplant Senior Program (ESP), were established to shorten waiting times, and previous age limits for organ acceptance were raised to expand the donor pool for this specific patient population. This retrospective study evaluated all patients who received a kidney graft from an octogenarian donor between January 2006 and September 2023. Key outcomes assessed included patient survival, graft survival, and graft function. A total of 71 kidney transplantations were included. Primary non-function occurred in five patients, and nine patients experienced delayed graft function. The 5-year recipient survival rate was 68.8%, and the 5-year death-censored graft survival rate was 65.3%. Graft function, assessed via median serum creatinine levels, remained stable throughout the follow-up period, although median creatinine values did not return to the normal range. Following meticulous donor selection, allocating kidney grafts from donors aged 80 years or older represents a viable strategy to expand the donor pool for ESP patients.
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10. Does age matter? Acute appendicitis in octogenarians vs. younger patients - results of a German multicenter analysis.
PMID:日期:2026-09-08Acute appendicitis is a common indication for emergency abdominal surgery. Octogenarians (≥ 80 years) are considered high risk due to comorbidities and reduced physiological reserve. This study examined age-related differences in symptoms, surgical management, and outcomes in patients undergoing surgery for acute appendicitis. This multicenter retrospective cohort study includes 1,582 surgically treated patients from 41 German hospitals, comprising 1,533 non-octogenarians (18-79 years) and 49 octogenarians (≥ 80 years). Octogenarians had higher comorbidity burden and ASA classification (both p < 0.001). Clinical presentation was largely comparable; however, octogenarians experienced lower pain intensity (p = 0.05) and had higher CRP levels (p < 0.001). Complicated appendicitis was more prevalent in octogenarians (63.3% vs. 28.1%; p < 0.001), with higher rates of perforation, peritonitis, and abscess formation (all p < 0.001). Consequently, extended resections (p = 0.01), open or converted surgery (p < 0.001), drainage (p < 0.001), and stoma formation (p = 0.01) were more common. Postoperative complications (p < 0.001), mortality (p = 0.002), ICU admission (p < 0.001), duration of antimicrobial therapy (p < 0.001), and hospital stay (p < 0.001) were all increased. Following propensity score matching, outcomes were largely comparable between octogenarians and younger patients, indicating the comorbidity spectrum of the elderly, rather than chronological age alone, as key determinants. Despite a similar initial presentation, octogenarians present with more advanced appendicitis and significantly worse postoperative outcomes. This emphasizes the need for age- and comorbidity-adapted diagnostic and perioperative strategies.