Clinical Research Directory

Ostene in Thoracolumbar Decompression and Fusion Evaluated With VIBE

In spine surgery, it is important to try to minimize bleeding. In particular, spine surgery often involves inserting hardware into bone, and/or removing bone in the spine. Because the bone in the spine contains blood vessels, there can often be bleeding from the bone itself that is difficult to stop completely. One way to stop bone bleeding is through the use of wax-like materials, which plug the bleeding bone and act as a physical barrier to stop bleeding. One example is Ostene bone hemostasis material, which has the advantage of being "water soluble", meaning it will dissolve naturally over time. The purpose of this study is to evaluate how well Ostene does at decreasing bleeding, by using a recognized scale called the validated intraoperative bleeding severity scale, abbreviated as "VIBe". In this study, the investigators will record the bleeding severity throughout multiple time points in surgery using this scale, and then the investigators will compare the measurements to patients in the past who did not receive Ostene. Overall, this research will help measure how well Ostene decreases bleeding.

Video-Based Grading of Intraoperative Adverse Events in Pediatric Laparoscopic Appendectomy

Acute appendicitis is the most common surgical emergency in children, and laparoscopic appendectomy is its standard treatment. Although intraoperative adverse events (iAEs) are recognized as an important determinant of surgical safety and outcome, no validated tool exists for grading them in children. ClassIntra, an internationally validated five-level severity classification of intraoperative adverse events, has been validated in adults. Its use in children is limited to two single-centre cohorts - one in pediatric neurosurgery and one in a mixed pediatric robotic surgery programme - in which it was applied prospectively by the operating teams. Its inter-rater reliability has never been assessed in a pediatric population, it has not been applied to video-recorded pediatric procedures, and no study has focused on pediatric appendectomy. Likewise, the association between intraoperatively graded event severity and postoperative complication severity graded with the pediatric-specific Clavien-Madadi classification has not been examined in children. This prospective, single-center, single-surgeon, video-based pilot study (IDEAL Framework Stage 2a) evaluates whether ClassIntra can be feasibly applied to the laparoscopic phase of pediatric appendectomy. Eighty children aged 5 to under 18 years undergoing laparoscopic appendectomy for non-complicated acute appendicitis will be enrolled. Operative videos will be recorded, de-identified, assigned a case code, and independently assessed in randomized order by two pediatric surgeons from outside the operating institution, who remain blinded to all postoperative clinical data. Each observed event is characterized on three levels: event type (E1-E7), mechanism (GERT categories M1-M4), and severity (ClassIntra Grade I-V). Postoperative complications within 30 days are graded separately with the Clavien-Madadi classification by the principal investigator, independently of the video assessment. The primary outcome is the feasibility of ClassIntra in this setting, evaluated as a progression-criteria profile rather than a composite rule, using three pre-specified criteria: inter-rater reliability (Gwet's AC1 \>= 0.60, the key indicator), applicable coverage (proportion of non-assessable cases \< 5%), and discriminative capacity (at least three of the five ClassIntra grades represented in the cohort). Secondary outcomes are descriptive: iAE incidence with Wilson score confidence intervals and the distribution of event types, mechanisms and severity grades. Exploratory hypotheses examine the association of intraoperative event severity with adherence to the institutional Enhanced Recovery After Surgery (ERAS) protocol, with time to medical readiness for discharge, and with Clavien-Madadi-graded postoperative complication severity. The study involves no additional intervention, investigational product, or extra procedure for the participating children; care follows institutional standards throughout. Its purpose is to provide feasibility evidence and calibration parameters for subsequent multicenter validation studies, not to establish the validity of the classification system itself.

Major Vascular Injuries in Elective Thoracic Surgery: A 10-Year Single-Center Experience

This study retrospectively examines major vascular injuries that occurred during elective thoracic surgeries over a 10-year period at a single tertiary care center. Although these injuries are rare, they can lead to life-threatening complications. The study aims to determine how often these injuries happen, what causes them, and how they are managed during surgery. It also evaluates the role of preoperative imaging and planning, including cardiovascular surgery team involvement, in preventing or managing these events. The findings are intended to help improve surgical safety and guide future preventive strategies.

Diagnostic Efficacy of CNN in Predicting Intraoperative Complications and Postoperative Outcomes in SMILE

To evaluate the diagnostic efficiency of the neural network in predicting complications of Small Incision Lenticule Extraction in a multi-center cross-sectional study.

Prospective Cohort Study of Pheochromocytoma/Paraganglioma

The study will enroll patients scheduled for PPGL removal surgery at Peking Union Medical College Hospital. Before surgery, researchers will use a 6-variable model to predict the patient's risk of experiencing severe blood pressure swings during the operation. During surgery, a real-time early warning tool will be tested for its ability to accurately predict blood pressure changes 60 seconds in advance. The study will also explore the value of continuous glucose monitoring (CGM) in understanding blood pressure fluctuations and evaluate the performance of an artificial intelligence (AI) agent for preoperative anesthesia assessment, comparing its accuracy, consistency, and efficiency against that of human anesthesiologists. Participation involves no changes to the patient's standard surgical or medical care. It includes collecting clinical data, wearing a CGM sensor from the day before to the day after surgery, and having the preoperative assessment performed by both the AI agent and anesthesiologists.

GLS in Difficult CPB Weaning

The goal of this observational study is to learn whether global longitudinal strain (GLS), measured by echocardiography, can predict difficulty separating from cardiopulmonary bypass (CPB) in adults undergoing elective cardiac surgery. The main questions it aims to answer are: * Can preoperative GLS measurement predict difficult separation from CPB? * Are GLS values associated with outcomes such as intensive care unit (ICU) stay, hospital stay, cardiac biomarkers, or 30-day mortality? Participants will: * Undergo standard cardiac surgery requiring CPB * Have echocardiographic assessments (TTE before and after surgery) * Have their recovery and outcomes monitored, including ICU and hospital stay, postoperative labs, and survival within 30 days

Clinical Trial of VISOR vs fURS for Upper Urinary Tract Stone

This prospective randomized controlled clinical study aims to evaluate the safety and efficacy of a novel Vortex Intelligence Stone Optimized Removal (VISOR,The experimental group) system compared to a single-use ureterorenoscope (the control) for treating upper urinary tract stones. A total of 100 patients with upper urinary tract stones (cumulative stone diameter ≤3 cm) will be enrolled and randomly assigned in a 1:1 ratio to either the experimental group (n=50) or the control group (n=50). The experimental group will undergo surgery using the innovative system, which integrates irrigation-suction, pressure monitoring-regulation, and lithotripsy-evacuation functions. The control group will be treated with a conventional single-use ureterorenoscope. The primary outcome measure is the immediate stone-free rate (SFR), defined as the proportion of patients with residual fragments \<4 mm on renal non-contrast computed tomography (NCCT) performed within 24 hours postoperatively. Key secondary endpoints include the SFR at 3 months, operative and lithotripsy times, total laser energy used, intraoperative ureteral injury (Traxer grading), postoperative pain scores, incidence of fever (\>38.0°C), and overall complication rates (Clavien-Dindo classification). Patient follow-up assessments will be conducted at 24 hours, 21±7 days, and 90±14 days post-surgery to monitor stone clearance, complications, and recovery. This study seeks to determine if the novel system offers superior stone clearance while maintaining a safe renal pelvic pressure profile, potentially improving outcomes for patients with larger renal stones treated ureteroscopically.

Appropriate Dosage of Vasopressor in Neonates and Infants

In this study, the investigators will evaluate cerebral blood flow before and after drug infusion using ultrasound to suggest blood pressure criteria and dosage of ephedrine, a vasopressor, to maintain adequate cerebral blood flow in neonates and infants undergoing surgery and anesthesia.