Journal of Gastrointestinal Surgery最新文献

{"title":"Durability of esophageal acid exposure normalization after Nissen fundoplication and its association with symptoms","authors":"Inanc S. Sarici , Sven E. Eriksson , Naveed Chaudhry , Mostafa Abdelhalim , Mara Fryer , Ping Zheng , Shahin Ayazi","doi":"10.1016/j.gassur.2025.102062","DOIUrl":"10.1016/j.gassur.2025.102062","url":null,"abstract":"<div><h3>Background</h3><div>Nissen fundoplication provides durable symptomatic control over time in patients with gastroesophageal reflux disease (GERD). Studies have also demonstrated a high rate of distal esophageal acid exposure normalization up to 1 year after surgery. However, data on the durability of acid exposure normalization after surgery are limited. This study aimed to assess esophageal acid exposure over time and determine factors associated with its durability in patients with an intact Nissen fundoplication.</div></div><div><h3>Methods</h3><div>Patients who underwent primary Nissen fundoplication at our institution with an endoscopically intact fundoplication and no herniation were selected. Those who completed esophageal pH monitoring at 1 and 4 years after surgery were included. One-year pH monitoring was performed at a mean (SD) of 17.7 (10) months, and the 4-year test at 49.0 (26) months after surgery. The degree of esophageal acid exposure was compared before and at 1 and 4 years after surgery. A subgroup of patients with acid normalization at 1 year was divided into durable and waning normalization groups based on the 4-year pH-monitoring result and compared. Normalization of esophageal acid exposure was defined as a DeMeester score of <14.7.</div></div><div><h3>Results</h3><div>The final study population comprised 71 patients (78.9% females) with a mean (SD) age of 59.5 (14). At 1-year follow-up after surgery, there was improvement in the Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) score (28.9 [18] to 13.7 [9]; <em>P</em> <.0001). There was improvement in DeMeester score (35.8 [27] to 4.3 [5.1]; <em>P</em> <.0001), with a 94.4% acid exposure normalization rate. From 1 to 4 years, GERD-HRQL score improvement was comparable (13.7 [9] to 12.0 [12]; <em>P</em> =.889]. Freedom from antisecretory medications was similar (82.6%−81.8%; <em>P</em> =.911). DeMeester score was also comparable (4.3 [5.1] to 7.3 [10.5]; <em>P</em> =.234), with similar normalization rate (94.4% vs 91.5%; <em>P</em> =.724). Of the 67 patients with acid exposure-normalization at 1 year, 91% had durable normalization at 4 years. Those with durable pH-normalization were similar in age, sex, BMI, and preoperative GERD-HRQL score to those with waning normalization (<em>P</em> >.05). GERD-HRQL scores and antisecretory medication use were comparable at both 1 and 4 years between groups (<em>P</em> >.05). The remaining 9% with waning pH-normalization had higher preoperative DeMeester scores (65.9 [34] vs 32.7 [24]; <em>P</em> =.014). They were also less likely to have >80% intact peristaltic contractions (33.0% vs 73.0%; <em>P</em> =.047) and had lower percentage complete bolus clearance on preoperative high-resolution manometry (34 [43] vs 75.5 [29]; <em>P</em> =.021).</div></div><div><h3>Conclusion</h3><div>Nissen fundoplication provides durable symptomatic and objective reflux control in patients with an intact ","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102062"},"PeriodicalIF":2.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891316","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":"Surgical management of a massive trichobezoar","authors":"Sarah Benhalima, Clément Dubois, Julie Veziant","doi":"10.1016/j.gassur.2025.102057","DOIUrl":"10.1016/j.gassur.2025.102057","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102057"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882170","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":"Geographic inequities and access to colorectal cancer surgery among rural residents: one size does not fit all!","authors":"Jillian Timperley,&nbsp;Danielle Dilsaver,&nbsp;Megan McClain,&nbsp;Yanick Tade,&nbsp;Emily Brown,&nbsp;Scott Reetz,&nbsp;Paul Wolpert,&nbsp;Nicole de Rosa,&nbsp;Ryan Walters,&nbsp;Waddah B. Al-Refaie","doi":"10.1016/j.gassur.2025.102061","DOIUrl":"10.1016/j.gassur.2025.102061","url":null,"abstract":"<div><h3>Purpose</h3><div>Nearly 60 million rural Americans face disparities in cancer surgery access and outcomes within a heterogeneous geographic landscape. This United States population-based study examined regional disparities in access to colorectal cancer (CRC) surgery among rural communities.</div></div><div><h3>Methods</h3><div>Hospitalization data for rural patients undergoing CRC resections were abstracted from the 2007 to 2020 National Inpatient Sample. Rural patients were identified using the National Center for Health Statistics urban-rural classifications. Four measures were assessed: (i) elective CRC surgery, (ii) elective rectal cancer surgery, (iii) in-hospital mortality after surgery, and (iv) stoma rates. Logistic regression models were estimated to evaluate between-region differences, adjusting for patient- and hospital-level factors.</div></div><div><h3>Results</h3><div>Among the 331 004 hospitalizations of rural patients who underwent CRC surgery, elective admission rates were highest in the Midwest (76%; omnibus <em>P</em> &lt;.001). Adjusted odds of elective admission were highest in the Midwest and lowest in the South. There were 61 898 rectal cancer surgery hospitalizations identified, of which hospitalizations in the South had the lowest odds of elective admission (<em>P</em> &lt;.001). Hospitalizations of rural patients in the Northeast compared with all other regions experienced 15% to 33% greater adjusted odds of in-hospital mortality after CRC surgery. Adjusted stoma rates were higher in the West (10.3%) than in the Midwest, and the Northeast had higher odds (29.7%) than the South.</div></div><div><h3>Conclusion</h3><div>Geographic disparities in CRC surgery access among rural residents highlight the heterogeneity of rural America, complicating the challenges of adopting a universal approach to address inequities. Exploring underlying factors of these regional differences, such as variations in provider distribution, hospital resources, and local economic conditions, is essential to guide clinical innovations and policy interventions.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102061"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891151","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":"Preoperative risk score for 90-day mortality after major liver resection","authors":"Sebastiaan Ceuppens ,&nbsp;Pim B. Olthof ,&nbsp;Arthur K.E. Elfrink ,&nbsp;Stijn Franssen ,&nbsp;Rutger-Jan Swijnenburg ,&nbsp;Joost M. Klaase ,&nbsp;Maarten W. Nijkamp ,&nbsp;Frederik J.H. Hoogwater ,&nbsp;Andries E. Braat ,&nbsp;Jeroen Hagendoorn ,&nbsp;Wouter J.M. Derksen ,&nbsp;Peter B. van den Boezem ,&nbsp;Paul D. Gobardhan ,&nbsp;Marcel den Dulk ,&nbsp;Maxime J.L. Dewulf ,&nbsp;Mike S.L. Liem ,&nbsp;Wouter K.G. Leclercq ,&nbsp;Eric J.T. Belt ,&nbsp;Koert F.D. Kuhlmann ,&nbsp;Niels F.M. Kok ,&nbsp;Bas Groot Koerkamp","doi":"10.1016/j.gassur.2025.102064","DOIUrl":"10.1016/j.gassur.2025.102064","url":null,"abstract":"<div><h3>Background</h3><div>Major liver resection is frequently performed for primary and secondary liver tumors. However, 90-day mortality rates can exceed 10% in high-risk patients. This study aimed to develop a preoperative risk score for postoperative mortality after major liver resection.</div></div><div><h3>Methods</h3><div>All major liver resections between 2014 and 2019 in 2 Dutch tertiary referral centers were identified. A validation cohort consisted of all consecutive patients who underwent a major liver resection in the nationwide Dutch Hepato Biliary Audit from 2014 to 2020. Multivariate logistic regression was used to identify prognostic factors and develop a mortality risk score.</div></div><div><h3>Results</h3><div>Major liver resection was performed in 513 patients, of whom 238 (46.4%) had a primary liver cancer, and in 148 patients (28.8%), a hepaticojejunostomy was performed; 90-day mortality occurred in 56 patients (10.8%). Mortality was independently predicted by 5 risk factors: age ≥ 65 years, diabetes mellitus type 2, diagnosis of primary liver cancer, American Society of Anesthesiologists ≥ 3, and extended hemihepatectomy. A risk score with 1 point assigned to each risk factor showed good discrimination (area under the curve [AUC], 0.77; 95% CI, 0.71–0.83). The predicted 90-day mortality was 3.5% for low-risk (0 or 1 points; 53.8% of all patients), 11.1% for intermediate-risk (2 points; 25.3%), and 29.7% for high-risk patients (3–5 points; 20.9%). External validation in the nationwide cohort with 1617 patients showed similar concordance (AUC, 0.69; 95% CI, 0.64–0.75).</div></div><div><h3>Conclusion</h3><div>The proposed and validated risk score can aid in shared decision making.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102064"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904064","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":"Rex saphenous shunt in patients with massive patent umbilical veins: an alternative temporary portocaval shunt during liver transplantation","authors":"Pietro Addeo,&nbsp;Ivan Marchitelli","doi":"10.1016/j.gassur.2025.102059","DOIUrl":"10.1016/j.gassur.2025.102059","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102059"},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882171","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":"New navigation for laparoscopic and robotic cholecystectomy using artificial intelligence","authors":"Yutaka Nakano ,&nbsp;Keita Sonoda ,&nbsp;Yuta Abe,&nbsp;Masashi Takeuchi,&nbsp;Minoru Kitago,&nbsp;Hirofumi Kawakubo,&nbsp;Yuko Kitagawa","doi":"10.1016/j.gassur.2025.102063","DOIUrl":"10.1016/j.gassur.2025.102063","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102063"},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898948","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":"Long-term outcomes of additional surgery vs. observation after noncurative endoscopic submucosal dissection for early gastric cancer and application value of the eCura scoring system: a propensity score–matched study","authors":"Shangtao Mao ,&nbsp;Wenjun Li ,&nbsp;Yinya Pan ,&nbsp;Hai Wu ,&nbsp;Ying Xiang ,&nbsp;Miao Liu ,&nbsp;Tao Zhao ,&nbsp;Hongji Tao ,&nbsp;Lei Wang ,&nbsp;Guifang Xu","doi":"10.1016/j.gassur.2025.102030","DOIUrl":"10.1016/j.gassur.2025.102030","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic submucosal dissection (ESD) is increasingly used for treating early gastric cancer (EGC). Noncurative ESD often necessitates additional surgical intervention because of the high risk of lymph node metastasis (LNM), but the optimal post-ESD management remains controversial.</div></div><div><h3>Methods</h3><div>This study collected data from patients with EGC who underwent noncurative ESD at Nanjing Drum Tower Hospital between January 2014 and December 2021. Patients were divided into surgical and observation groups and stratified by eCura scores into low (0–1), intermediate (2–4), and high-risk (5–7) categories. A 1:1 propensity score–matched analysis was performed between the 2 groups. Receiver operating characteristic analysis was used to assess the eCura score’s ability to predict LNM. Survival outcomes, including overall survival (OS) and disease-specific survival (DSS), were compared between groups.</div></div><div><h3>Results</h3><div>Among the 260 patients, 91 were included in each group. No significant differences in OS or DSS were observed between the groups overall or among low-risk and intermediate-risk patients. However, high-risk patients in the surgical group had significantly better 5-year OS rates than those in the observation group, whereas the difference in DSS was not statistically significant. The eCura score exhibited strong predictive accuracy for LNM (area under the curve, 0.835; sensitivity, 70%; specificity, 92%). The subgroup analysis suggested that postchemoradiotherapy and total gastrectomy might be associated with better prognosis, although the differences were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The eCura scoring system seems to be a valuable tool for guiding post-ESD management. Treatment decisions should be based on the individual characteristics and clinical factors of each patient. For carefully selected patients who are not suitable candidates for surgery, ESD may be a viable alternative treatment option.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102030"},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874629","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":"Infection rate in patients after Enterra device placement with concurrent pyloroplasty","authors":"Tejasvi Paturu ,&nbsp;Katherine Englander ,&nbsp;Samer Ganam ,&nbsp;Vic Velanovich ,&nbsp;Joseph Sujka","doi":"10.1016/j.gassur.2025.102056","DOIUrl":"10.1016/j.gassur.2025.102056","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102056"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847566","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":"A population-based analysis of gender differences in survival outcomes for gastric gastrointestinal stromal tumors","authors":"Xia Ren ,&nbsp;Ganhong Wang ,&nbsp;Jian Chen ,&nbsp;Luojie Liu","doi":"10.1016/j.gassur.2025.102055","DOIUrl":"10.1016/j.gassur.2025.102055","url":null,"abstract":"<div><h3>Background</h3><div>Although gender-based differences have been demonstrated to affect the prognosis of multiple tumors, their specific influence on the survival of gastric gastrointestinal stromal tumors (gGISTs) at the population level is still uncertain. Consequently, we aimed to investigate gender disparities in the prognosis of gGISTs using the Surveillance, Epidemiology, and End Results (SEER) database.</div></div><div><h3>Methods</h3><div>Patients with gGISTs from the years 2000 to 2019 were retrieved from the SEER database. To minimize selection bias, propensity score matching (PSM) was used. Kaplan-Meier analyses and Cox proportional hazard models were used to assess the influence of clinical characteristics on overall survival (OS) and cancer-specific survival (CSS).</div></div><div><h3>Results</h3><div>A total of 3006 patients with gGISTs were analyzed, including 1459 males and 1547 females. Compared with female patients, male patients exhibited a higher proportion of Whites, more advanced T stage, larger tumor sizes, and elevated mitotic index. Before PSM, male patients experienced significantly worse OS (hazard ratio [HR], 1.55; 95% CI, 1.33–1.81; <em>P</em> &lt;.001) and CSS outcomes (HR, 1.61; 95% CI, 1.28–2.02; <em>P</em> &lt;.001) than female patients. Furthermore, they had lower mean OS and CSS rates at the 1-, 3-, and 5-year follow-up intervals (<em>P</em> &lt;.05). Even after <em>P</em>SM, male patients continued to show poorer OS (HR, 1.30; 95% CI, 1.10–1.54; <em>P</em> =.002) and CSS outcomes (HR, 1.34; 95% CI, 1.05–1.70; <em>P</em> =.016) than female patients, with persistently lower mean OS and CSS rates across the 1-, 3-, and 5-year follow-up intervals (<em>P</em> &lt;.05). For males without distant metastasis, 5-year OS was 78.8% and CSS was 90.0%, both lower than females’ 85.5% and 93.7% (<em>P</em> &lt;.05). For males with distant metastasis, 5-year OS was 48.7% and CSS was 58.8%, similar to females’ 55.4% and 65.3% (<em>P</em> &gt;.05). Multivariate Cox regression analysis identified age, race, gender, M stage, surgical intervention, tumor size, and mitotic index as independent risk factors for both OS and CSS.</div></div><div><h3>Conclusion</h3><div>Patients with gGISTs exhibit distinct clinical characteristics between males and females, with female patients showing a tendency toward improved OS and CSS. Surgical treatment has the potential to enhance the prognosis of patients with gGISTs.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102055"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878369","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":"Operative decision making for repair of emergent primary and recurrent ventral hernia","authors":"Jamila K. Picart ,&nbsp;Alexander Hallway ,&nbsp;Leah J. Schoel ,&nbsp;Jenny M. Shao ,&nbsp;Sean M. O’Neill ,&nbsp;Annie P. Ehlers ,&nbsp;Dana A. Telem","doi":"10.1016/j.gassur.2025.102053","DOIUrl":"10.1016/j.gassur.2025.102053","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102053"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874630","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}