Journal of Gastrointestinal Surgery最新文献

{"title":"Perforated peptic ulcer: close or patch a century-old controversy.","authors":"Khalid Mahmoud, Mohamad K Abou Chaar, Daniel Stephens, John M Zietlow, Stephanie F Heller, David Turay, Veljko Strajina","doi":"10.1016/j.gassur.2025.101993","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101993","url":null,"abstract":"<p><strong>Background: </strong>The study aims to establish which surgical technique used for the repair of perforated peptic ulcers is associated with more favorable outcomes.</p><p><strong>Methods: </strong>A retrospective chart review of the patients who underwent surgery for perforated peptic ulcers at the Mayo Clinic Rochester campus between 2004 and 2021 was performed.</p><p><strong>Results: </strong>The final analysis included 277 patients: 182 suture closure of the perforation, 55 patch-only repairs, 15 gastrectomies with reconstruction, 14 wedge resections, and other techniques in 11 patients. There were no leaks in patients who had stapled wedge resection. Among patients with repair of the perforation (n=237), three variables associated with the leak on univariate analysis were included in a logistic regression model. All three were independently associated with a leak: lack of suture closure of the perforation (OR 7, 95% CI 2.5-19.1), immunosuppression (OR 5.5, 95% CI 1.7-17.6), and lactate levels (OR 1.4, 95% CI 1.1-1.7).</p><p><strong>Conclusion: </strong>When both sutured and patch-only closure techniques are feasible for a perforated peptic ulcer, sutured closure is associated with a lower risk of leakage. However, given our study's retrospective, single-institution nature, the findings should be interpreted cautiously.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101993"},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcified Pancreatic Cyst in a Woman Without History of Pancreatitis.","authors":"Cordelia Muir, Priya Vasan, Chirag S Desai","doi":"10.1016/j.gassur.2025.101994","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101994","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101994"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Robot-assisted Pancreaticoduodenectomy with Left Posterior Approach for Pancreas Head Cancer with Venous Invasion.","authors":"Kosuke Kobayashi, Yosuke Inoue, Yu Takahashi","doi":"10.1016/j.gassur.2025.101996","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101996","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101996"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GASTROESOPHAGEAL REFLUX DISEASE OBJECTIVE DIAGNOSIS BY ABBREVIATED pH MONITORING WITH PROVOCATIVE TESTS COMPARED TO PROLONGED CONVENTIONAL pH MONITORING.","authors":"Rogério Mariotto, Fernando A M Herbella, Rafael Melillo Laurino Neto, Francisco Schlottmann, Marco G Patti","doi":"10.1016/j.gassur.2025.101998","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101998","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101998"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THORACOSCOPIC APPROACH IN PRONE OF A MIDDLE ESOPHAGEAL DIVERTICULUM.","authors":"Eduardo Domínguez-Adame, Andrea Scammon, Elena Guarnieri","doi":"10.1016/j.gassur.2025.101995","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101995","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101995"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predicting Insufflation-Related Events in Peroral Endoscopic Myotomy (POEM) Procedures.","authors":"Feng-Pai Tsai, Chien-Chuan Chen, Min-Hsiu Liao, Hsiu-Po Wang, Ming-Shiang Wu, Jia-Feng Wu, Shou-Zen Fan, Ping-Huei Tseng","doi":"10.1016/j.gassur.2025.101988","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101988","url":null,"abstract":"<p><strong>Background or purpose: </strong>Peroral endoscopic myotomy (POEM) has revolutionized the therapeutic landscape for esophageal achalasia, offering efficacy comparable to surgery with the convenience of an endoscopic approach. With the growing popularity of POEM, insufflation-related adverse events present unique challenges that have been widely discussed in the literature. This study aimed to investigate the safety profiles and risk factors linked to insufflation-related events in patients undergoing POEM in endoscopy suites.</p><p><strong>Methods: </strong>This retrospective analysis included 100 consecutive patients with achalasia treated by POEM at our institute between March 2016 and October 2022. All procedures were conducted in an endoscopy suite and employed CO₂ insufflation and general anesthesia with endotracheal intubation and positive pressure ventilation. We documented variations in cardiopulmonary dynamics, intra-procedural adverse events, and postoperative recovery.</p><p><strong>Results: </strong>All procedures were successfully performed with an average POEM duration of 92.3minutes and an average anesthesia duration of 108.4minutes. One major adverse event involving an esophageal leak and requiring endoscopic stenting was observed, along with a 27% incidence of minor adverse events. Insufflation-related events, manifesting as capnoperitoneum, subcutaneous emphysema, or capnomediastinum, were identified in 48% of cases, but none required additional interventions or extended hospitalization. A peak airway pressure increase of 20% or more was identified as the only predictor for insufflation-related events.</p><p><strong>Conclusions: </strong>Performing POEM in an endoscopy suite can generally be considered safe from major adverse events related to insufflation. Monitoring peak airway pressure for a 20% increase may be an early indicator for other potential insufflation-related events.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101988"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Revisional Pancreato-Jejunal Anastomosis.","authors":"Raphael L C Araujo, John B Martinie","doi":"10.1016/j.gassur.2025.101999","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101999","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101999"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The time to non-curative recurrence following liver resection as an appropriate surrogate measure for overall survival in patients with hepatocellular carcinoma.","authors":"Yoshinori Takeda, Hiroshi Imamura, Katsuhiro Sano, Hirofumi Ichida, Ryuji Yoshioka, Yoshihiro Mise, Yutaka Matsuyama, Akio Saiura","doi":"10.1016/j.gassur.2025.101989","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101989","url":null,"abstract":"<p><strong>Background: </strong>Patients with recurrent hepatocellular carcinoma (HCC) following liver resection can often receive curative treatment, including repeat hepatic resection and local ablative therapy; however, recurrence typically becomes increasingly aggressive during the clinical course characterized by cycles of recurrence and repeated treatment, ultimately resulting in non-curative patterns.</p><p><strong>Methods: </strong>We defined non-curative recurrences as those involving ≥ 4 liver nodules, macroscopic vascular invasion, and extrahepatic lesions. We first investigated the incidence of non-curative recurrences and survival after non-curative recurrence. We subsequently examined the survival following the initial recurrence separately in patients with curative and non-curative recurrences and compared them. Finally, we investigated whether the time to non-curative recurrences serves as a surrogate for overall survival (OS) in 266 patients undergoing initial curative hepatectomy.</p><p><strong>Results: </strong>The 3-year cumulative incidences of non-curative recurrences were 15.6%, 6.0%, and 11.0% for ≥ 4 liver nodules, macroscopic vascular invasion, and extrahepatic lesions, respectively. Median post-recurrence survivals following these non-curative recurrences were 21, 17, and 8 months, respectively (P =.006). When analyzed exclusively in patient developing initial recurrence, the 3-year post-recurrence survivals were 68.3% and 27.8% for patients with curative and non-curative recurrences, respectively (P =.003). The 3-year survival rate without non-curative recurrences was 71.9%, compared to recurrence-free survival (RFS) and OS of 49.2% and 87.9%, respectively. The concordance index with OS was higher for time to non-curative recurrences (0.88) than RFS (0.67).</p><p><strong>Conclusions: </strong>These findings suggest that time to non-curative recurrences is a more suitable surrogate for OS than RFS.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101989"},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential changes in conditional survival of patients undergoing curative gastrectomy for gastric cancer.","authors":"Hiromitsu Imataki, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Junichi Takamizawa, Norihiro Yuasa","doi":"10.1016/j.gassur.2025.101987","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101987","url":null,"abstract":"<p><strong>Background: </strong>Long-term data on the prognosis of patients who survive >5 years following gastrectomy for gastric cancer (GC) remain scarce. This study aimed to investigate sequential changes in conditional survival (CS) in these patients.</p><p><strong>Methods: </strong>Of 1,129 patients with stage I-III GC who underwent R0 gastrectomy, the causes of death were assessed, and sequential changes in conditional overall survival (cOS), disease-specific survival (cDSS), and non-disease-specific survival (cNDSS) were calculated and compared. In a subgroup of 709 patients who survived >5 years, the associations between cOS, cDSS, cNDSS, and clinicopathological factors were analyzed.</p><p><strong>Results: </strong>Over a median follow-up of 63 months, 203 (18.0%) patients died from GC, and 131 (11.6%) died from non-GC causes. The 5-year cDSS consistently increased over the 10 years following gastrectomy in stages II and III. For stage II, cDSS and cNDSS intersected at 7 years post-gastrectomy, whereas for stage III, these measures crossed at 8 years. In the 709 5-year survivors, multivariate analysis identified disease stage as significantly associated with cOS and cDSS. Moreover, age ≥75, male sex, and preoperative comorbidities were associated with lower cNDSS.</p><p><strong>Conclusion: </strong>Surveillance for GC relapse was critical during the first 7 and 8 years post-gastrectomy for stages II and III, respectively. Conversely, surveillance for second primary cancers and benign diseases became relatively more important after 0, 7, and 8 years post-gastrectomy for stages I, II, and III, respectively. In 5-year survivors, age ≥75, male sex, and preoperative comorbidities were associated with mortality unrelated to GC.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101987"},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal SMARCA4-deficient tumor.","authors":"Yanan Xu, Junjie Yin, Yang Cai","doi":"10.1016/j.gassur.2025.101986","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101986","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101986"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}