Ejso最新文献

{"title":"Comments on “Open versus laparoscopic radical cholecystectomy for incidental and non-incidental gallbladder cancer”","authors":"Mesut Tez","doi":"10.1016/j.ejso.2025.110254","DOIUrl":"10.1016/j.ejso.2025.110254","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110254"},"PeriodicalIF":3.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a deep learning-based surgical-skill assessment model focused on instrument handling in laparoscopic colorectal surgery","authors":"Kei Nakajima ,&nbsp;Shin Takenaka ,&nbsp;Daichi Kitaguchi ,&nbsp;Atsuki Tanaka ,&nbsp;Kyoko Ryu ,&nbsp;Nobuyoshi Takeshita ,&nbsp;Yusuke Kinugasa ,&nbsp;Masaaki Ito","doi":"10.1016/j.ejso.2025.110260","DOIUrl":"10.1016/j.ejso.2025.110260","url":null,"abstract":"<div><h3>Introduction</h3><div>Poor instrument handling, such as \"repeatedly makes tentative or awkward moves\" and \"grasper (frequently) slip,\" is associated with poor surgical skills. We constructed and applied an automated recognition model of tissue grasping during laparoscopic surgery using computer vision technology to clarify whether automated surgical-skill assessment using the number of tissue grasps could be feasible.</div></div><div><h3>Methods</h3><div>The number of tissue grasps and classification of success/failure were manually and automatically counted. Intraoperative videos of three groups with obviously different surgical levels (the high-, intermediate-, and low-skill groups) were prepared; an automated distinction between these groups was attempted using the models.</div></div><div><h3>Results</h3><div>The number of manually counted tissue grasps was significantly higher in the low-skill group than in the other groups, while the number of failed tissue grasps was significantly lower in the high-skill group than in the other groups. The number of automatically counted tissue grasps showed strong correlations with the manually counted ones, whereas the other parameters showed only moderate correlations. The number of automatically counted tissue grasps was significantly higher in the low-skill group than in the other groups, similar to that noted with manual counting. The other automatic parameters showed no results similar to the manual ones.</div></div><div><h3>Conclusion</h3><div>We successfully constructed automated recognition models of tissue grasping during laparoscopic surgery and found that automated surgical-skill assessment based on the number of tissue grasps could be feasible. However, the results were insufficient for automatically distinguishing between successful/failed tissue grasps. Further improvements in recognition accuracy are required for this model.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110260"},"PeriodicalIF":3.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal aortic balloon occluding in the pelvic and sacral tumor resection: An expert-based Delphi consensus","authors":"Zhiqing Zhao ,&nbsp;Wei Wang ,&nbsp;Bing Wang,&nbsp;Yunfei Lin,&nbsp;Taiqiang Yan","doi":"10.1016/j.ejso.2025.110251","DOIUrl":"10.1016/j.ejso.2025.110251","url":null,"abstract":"<div><h3>Background</h3><div>Massive bleeding remains a critical challenge during pelvic and sacral tumor resection. Over recent decades, abdominal aortic balloon occluding (AABO) has been increasingly utilized to control intraoperative bleeding. However, standardized protocols for its application in pelvic and sacral tumor resection remain lacking. This Delphi consensus aims to establish guidelines for AABO in this field based on the existing evidence and expertise.</div></div><div><h3>Methods</h3><div>A three-round Delphi process was conduct following a comprehensive literature review. Consensus was predefined as ≥85 % agreement among respondents. Forty-three experts from 19 regions of Chinese participated, including orthopedic surgeons, vascular surgeons, and anesthesiologists.</div></div><div><h3>Results</h3><div>Consensus was achieved on eleven key variables: indications/contraindications, safety in elderly patients, preoperative preparation, balloon placement position, procedures of AABO, occlusion duration, measures to reduce complications related to AABO, acute femoral thrombosis management, intraoperative anesthesia monitoring indicators, and postoperative monitoring.</div></div><div><h3>Conclusions</h3><div>This expert-based Delphi consensus provides a framework for standardizing AABO application, enhancing surgical safety, and guiding future research.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110251"},"PeriodicalIF":3.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online risk scores for pre- and postoperative prediction of early recurrence in hepatocellular carcinoma patients undergoing conversion liver resection after tyrosine kinase inhibitors and immune checkpoint inhibitors therapy","authors":"Kong-Ying Lin ,&nbsp;Hong-Zhi Liu ,&nbsp;Jian-Wei Liu ,&nbsp;Xiao-Dong Zhu ,&nbsp;Yang-Xun Pan ,&nbsp;Shun-Li Shen ,&nbsp;Wei Zhang ,&nbsp;Ren-An Jin ,&nbsp;Chuang-Ye Han ,&nbsp;Jie Chen ,&nbsp;Xiao-Yun Zhang ,&nbsp;Bin-Yong Liang ,&nbsp;Yao-Dong Zhang ,&nbsp;Jian Ma ,&nbsp;Nan-Ya Wang ,&nbsp;Dong-Xiao Li ,&nbsp;Rui Xiong ,&nbsp;Zhong-Chao Li ,&nbsp;Jing-Dong Li ,&nbsp;Zhi-Bo Zhang ,&nbsp;Yong-Yi Zeng","doi":"10.1016/j.ejso.2025.110220","DOIUrl":"10.1016/j.ejso.2025.110220","url":null,"abstract":"<div><h3>Background</h3><div>Conversion therapy with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) offers the potential for curative resection in unresectable hepatocellular carcinoma (HCC). However, early recurrence (≤2 years) after conversion liver resection remains a major concern. This study aimed to develop and validate online preoperative and postoperative risk scores to predict early recurrence in patients undergoing conversion liver resection.</div></div><div><h3>Methods</h3><div>A total of 203 patients with initially unresectable HCC who underwent conversion liver resection following TKI and ICI therapy across 28 academic centers were analyzed. Independent predictors of early recurrence were identified using Cox proportional hazards analyses, and risk scores were developed and validated using the C-index, time-dependent AUC (tdAUC), and calibration curves.</div></div><div><h3>Results</h3><div>Preoperative risk score model included the neutrophil-to-lymphocyte ratio (NLR) ≥ 1.39, multiple tumors, absence of radiographic response, and no alpha-fetoprotein (AFP) response. Postoperative risk score model included NLR ≥1.39, multiple tumors, no AFP response, active macrovascular invasion, and incomplete pathological response. The preoperative risk score had a C-index of 0.699 (training) and 0.681 (validation), while the postoperative risk score had a C-index of 0.739 (training) and 0.706 (validation). Both models demonstrated good predictive accuracy through tdAUC and calibration curves. Decision tree analysis stratified patients into distinct risk categories with significant differences in 2-year recurrence rates. All risk score models are available online for clinical use.</div></div><div><h3>Conclusion</h3><div>Online preoperative and postoperative risk scores provide valuable tools for predicting early recurrence in HCC patients after conversion liver resection, aiding in surgical decision-making and postoperative management.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110220"},"PeriodicalIF":3.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of preoperative TACE in hepatocellular carcinoma beyond Milan criteria: A propensity score matching analysis","authors":"Runhu Lan ,&nbsp;Zhengwei He ,&nbsp;Chengxian Wu ,&nbsp;Xiaoyin Yuan ,&nbsp;Awang Danzeng ,&nbsp;Pingcuo Ciren ,&nbsp;Binhao Zhang","doi":"10.1016/j.ejso.2025.110248","DOIUrl":"10.1016/j.ejso.2025.110248","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the impact of preoperative transarterial chemoembolization (TACE) on patients diagnosed with hepatocellular carcinoma (HCC) beyond the Milan criteria, and investigate the prognostic factors associated with long-term outcomes.</div></div><div><h3>Materials &amp; methods</h3><div>From January 2013 to March 2018, 675 patients diagnosed with HCC beyond the Milan criteria, which were classified as Barcelona Clinic Liver Cancer (BCLC) stage A or B, were enrolled. Patients were assigned to two groups as follows: the surgery-alone group and the TACE + surgery group, to compare perioperative outcomes, overall survival (OS), and recurrence-free survival (RFS) following propensity score matching (PSM), a statistical method used to reduce selection bias. Univariable and multivariable Cox regression analyses were performed to identify the factors associated with OS and RFS.</div></div><div><h3>Results</h3><div>After PSM, 118 pairs of matched patients were selected. The postoperative 30-day morbidity (29.7 % vs. 27.1 %, <em>p</em> = 0.67) and length of hospital stay (12.0 days vs. 12.0 days, <em>p</em> = 0.90) were comparable between the two groups of patients. Patients in the TACE + surgery group demonstrated significantly improved median overall survival (median OS: 46.0 months vs. 29.5 months, <em>p</em> &lt; 0.001) and median recurrence-free survival (median RFS: 24.0 months vs. 12.5 months, <em>p</em> &lt; 0.001) compared with patients in the surgery-alone group. Multivariate Cox regression analysis revealed that preoperative TACE was an independent predictor of better overall survival (risk ratio [HR] 0.62, 95 % confidence interval [CI]: 0.47–0.82, <em>p</em> &lt; 0.001) and recurrence-free survival (HR 0.47, 95 % CI: 0.36–0.61, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study suggests that preoperative TACE is a safe procedure associated with improved OS and RFS for patients with HCC beyond the Milan criteria classified as BCLC stage A or B.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110248"},"PeriodicalIF":3.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on predictors of recurrence in early-stage cervical cancer without adjuvant treatment after radical surgery","authors":"Chunjun Xia,&nbsp;Xiangyue Jin,&nbsp;Xi Huang","doi":"10.1016/j.ejso.2025.110244","DOIUrl":"10.1016/j.ejso.2025.110244","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110244"},"PeriodicalIF":3.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological and prognosis analysis of intraductal papillary neoplasm of the bile duct: A dual-center retrospective study","authors":"Xiaorui Huang ,&nbsp;Zhen Zhang ,&nbsp;Dengsheng Zhu ,&nbsp;Chaobo Li ,&nbsp;Zhiqiang Gao ,&nbsp;Zhiwei Zhang ,&nbsp;Xinyi Guo ,&nbsp;Jingzhao Zhang ,&nbsp;Guangrui Lu ,&nbsp;Tong Guo ,&nbsp;Yahong Yu","doi":"10.1016/j.ejso.2025.110212","DOIUrl":"10.1016/j.ejso.2025.110212","url":null,"abstract":"<div><h3>Background</h3><div>The precise clinical features and prognosis of IPNB remain challenging to define. More research is needed to enhance understanding of the disease.</div></div><div><h3>Methods</h3><div>The study retrospectively analyzes the clinical data of 123 patients with IPNB from two medical centers during January 2013 and May 2024. The clinicopathological characteristics of IPNB were compared across subgroups. Risk factors for invasive IPNB and survival predictors of IPNB were identified by regression analysis. The prognosis of patients with IPNB was evaluated through survival and recurrence analysis.</div></div><div><h3>Result</h3><div>The majority of tumors (51.2 %) were located in the extrahepatic bile ducts, 42.3 % were in the intrahepatic bile ducts, and 6.5 % exhibited diffuse distribution. 23 patients (18.7 %) were diagnosed with low-grade dysplasia, 41 patients (33.3 %) were diagnosed with high-grade dysplasia, and the remaining 59 patients (48.0 %) were diagnosed with invasive carcinomas. Mucin secretion was observed in 33.3 % of cases. Focal bile duct wall thickening and pancreaticobiliary maljunction were identified as independent risk factors for invasive IPNB. The 1-year, 3-year, and 5-year overall survival rates were 97.4 %, 77.2 %, and 70.1 %, respectively. For all IPNB patients, the extrahepatic type and presence of invasive carcinoma were independent predictors of survival. In invasive IPNB, the extrahepatic type, local invasion, and vascular invasion were associated with worse survival.</div></div><div><h3>Conclusion</h3><div>The clinicopathological features of IPNB exhibited significant heterogeneity across subgroups. Early diagnosis and timely surgical intervention are critical for optimizing patients’ long-term outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110212"},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implications of signet ring cell proportion in gastric cancer: Insights from a novel nomogram and biomarker analysis","authors":"Maryam Imran Sheikh,&nbsp;Umer Bin Shahzad,&nbsp;Muhammad Ahmed","doi":"10.1016/j.ejso.2025.110245","DOIUrl":"10.1016/j.ejso.2025.110245","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110245"},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dilemma of ypN3 esophageal cancer","authors":"Pim B. Olthof ,&nbsp;Bo J. Noordman ,&nbsp;Sofie P.G. Henckens ,&nbsp;Marianne C. Kalff ,&nbsp;Bas P.L. Wijnhoven ,&nbsp;Mark I. van Berge Henegouwen ,&nbsp;Sjoerd Lagarde ,&nbsp;Suzanne S. Gisbertz ,&nbsp;Pieter van der Sluis","doi":"10.1016/j.ejso.2025.110224","DOIUrl":"10.1016/j.ejso.2025.110224","url":null,"abstract":"<div><div>In this study 3901 patients underwent esophagectomy after neoadjuvant treatment and 244 of these patients (6 %) had ypN3 disease. Median overall- and disease-free survival was 10.0 and 6.0 months respectively for ypN3 disease. The R1 margin rate was higher amongst ypN3 patients: 21 % compared to 4 %. Out of the 244 patients with ypN3 disease, 12 (5 %) were preoperatively staged cN3. Conversely, 11 % of the total 108 patients staged cN3 before neoadjuvant therapy, had ypN3 disease. Current staging is insufficiently accurate to preoperatively identify patients with ypN3 disease for which better imagine modalities are needed. The outcomes of patients with ypN3 disease are dismal, the survival rates in this study question the benefit of surgery in these patients. Improvement in neo-adjuvant therapy and staging might help to select patients with advanced nodal disease who will benefit from surgery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110224"},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer","authors":"Jessica Ericson ,&nbsp;Fredrik Klevebro ,&nbsp;Berit Sunde ,&nbsp;Eva Szabo ,&nbsp;Ingvar Halldestam ,&nbsp;Ulrika Smedh ,&nbsp;Bengt Wallner ,&nbsp;Jan Johansson ,&nbsp;Gjermund Johnsen ,&nbsp;Eirik Kjus Aahlin ,&nbsp;Hans-Olaf Johannessen ,&nbsp;Geir-Olav Hjortland ,&nbsp;Sissi Stove Lorentzen ,&nbsp;Malene Slott ,&nbsp;Wolfgang Schröder ,&nbsp;Ioannis Rouvelas ,&nbsp;Magnus Nilsson","doi":"10.1016/j.ejso.2025.110228","DOIUrl":"10.1016/j.ejso.2025.110228","url":null,"abstract":"<div><h3>Background</h3><div>Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients' nutritional status to recover better, possibly improving outcomes with fewer complications and better overall survival (OS) after oesophagectomy.</div></div><div><h3>Methods</h3><div>This is a substudy within a multicentre randomised controlled trial comparing outcomes in patients with oesophageal cancer after standard TTS of 4–6 weeks to prolonged TTS of 10–12 weeks after nCRT. Patients were categorised as malnourished or non-malnourished at baseline and compared regarding weight, dysphagia, postoperative complications, and OS.</div></div><div><h3>Results</h3><div>The mean weight from baseline to time of surgery decreased significantly in patients allocated to standard TTS (p &lt; 0.001) while patients with prolonged TTS recovered during the extended time to similar weight as at baseline (p = 0.131). The mean dysphagia score at the time of surgery improved significantly in both groups (p &lt; 0.001). There were no significant differences between patients allocated to standard versus prolonged TTS regarding postoperative complications, regardless of malnourishment status at baseline. No significant differences in OS after prolonged TTS compared to standard TTS, was observed in neither malnourished patients (hazard ratio, HR 1.72 (95 %, CI: 0.82–3.59, p = 0.147) nor non-malnourished patients (HR 1.26 (95 % CI:0.82–1.94, p = 0.291).</div></div><div><h3>Conclusions</h3><div>Prolonged TTS was associated with better weight recovery at the time of surgery compared to standard TTS. Patients malnourished at baseline did not benefit in terms of less postoperative complications after prolonged TTS.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110228"},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}