Journal of Gastrointestinal Surgery最新文献

{"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":"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}

{"title":"Right trisectionectomy with en bloc portal vein resection for perihilar cholangiocarcinomas: technique and outcomes","authors":"Pietro Addeo,&nbsp;Pierre de Mathelin,&nbsp;Philippe Bachellier","doi":"10.1016/j.gassur.2025.102054","DOIUrl":"10.1016/j.gassur.2025.102054","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102054"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864945","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":"Continuous glucose monitoring reveals the clinical impact of glycemic status on surgical stress in patients who underwent gastrectomy","authors":"Yusuke Koseki ,&nbsp;Satoshi Kamiya ,&nbsp;Masanori Terashima ,&nbsp;Kenichiro Furukawa ,&nbsp;Keiichi Fujiya ,&nbsp;Yutaka Tanizawa ,&nbsp;Etsuro Bando","doi":"10.1016/j.gassur.2025.102049","DOIUrl":"10.1016/j.gassur.2025.102049","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102049"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795512","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":"Navigating cholecystitis in an ectopic pelvic liver: a surgical challenge after omphalocele repair","authors":"Raffi Melikian,&nbsp;Navpreet Kaur,&nbsp;Mohd Raashid Sheikh","doi":"10.1016/j.gassur.2025.102047","DOIUrl":"10.1016/j.gassur.2025.102047","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102047"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788424","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 role of placental growth factor as a biomarker in patients with resectable gastric cancer","authors":"Ingmar F. Rompen ,&nbsp;Daniel Nerz ,&nbsp;Nerma Crnovrsanin ,&nbsp;Wenjun Hu ,&nbsp;Sarah Zimmer ,&nbsp;Julian Musa ,&nbsp;Georg Martin Haag ,&nbsp;Timon Fiedler ,&nbsp;Thomas Longerich ,&nbsp;Mohammed Al-Saeedi ,&nbsp;Leila Sisic ,&nbsp;Thomas Schmidt ,&nbsp;Henrik Nienhüser","doi":"10.1016/j.gassur.2025.102051","DOIUrl":"10.1016/j.gassur.2025.102051","url":null,"abstract":"<div><h3>Background</h3><div>Systemic treatment failure and an insufficient treatment response to neoadjuvant treatment underscore the urgency for better tumor-directed treatment for patients with resectable gastric cancer. The angiogenic pathway has repeatedly shown predictive and prognostic value in this cancer subtype; however, the relevance of placental growth factor (PlGF) is unclear. Therefore, we aimed to assess PlGF as a prognostic and predictive biomarker.</div></div><div><h3>Methods</h3><div>This translational study was performed in 2 phases. First, adenogastric (AGS) and Mie-Kinen-45 (MKN-45) gastric cancer cell lines were treated with recombinant angiogenic growth factors and chemotherapeutic agents. Cell count analyses and quantitative polymerase chain reaction were performed to assess proliferative and cytotoxic effects. Second, prospectively collected blood samples of patients undergoing surgical treatment for gastric cancer were assessed by enzyme-linked immunosorbent assay and correlated to clinicopathologic outcomes.</div></div><div><h3>Results</h3><div>In MKN-45 cells, treatment with PlGF led to increased cell numbers after 72 h (<em>P</em> &lt;.01), whereas proliferative effects of PlGF were less pronounced in the AGS cell line. Addition of PlGF lowered the cytotoxic effect of standard chemotherapeutic agents as evidenced by significant differences in cell growth at low concentrations of cisplatin (5 µM cisplatin vs 5 µM cisplatin plus PlGF) and high concentrations of paclitaxel (25 µM paclitaxel vs 25 µM paclitaxel plus PlGF) in both AGS and MKN-45 cell cultures after 72 h (all comparisons <em>P</em> &lt;.05). In patients with gastric cancer (n = 68), high PlGF concentrations were significantly associated with more recurrences (estimated 5-year-recurrence rate, 34% [high PlGF] vs 6% [low PlGF]; log-rank <em>P</em> =.009) but no association was found with pathologic treatment response, tumor size, nodal stage, or tumor grade.</div></div><div><h3>Conclusion</h3><div>The association of elevated PlGF expression with disease-specific survival despite no correlation with other tumor-specific prognostic factors may indicate that PlGF could be used as an independent prognostic biomarker in gastric cancer. The ability to predict resistance to neoadjuvant treatment, as demonstrated in cell experiments, requires further investigation in a clinical setting.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102051"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788452","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":"National trends in perioperative opioid prescription fills for inguinal hernia repair (2010-2021): a cohort study","authors":"Patrick C.M. Brown ,&nbsp;Sherin Ismail ,&nbsp;Chris B. Agala ,&nbsp;Arielle J. Perez","doi":"10.1016/j.gassur.2025.102052","DOIUrl":"10.1016/j.gassur.2025.102052","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative opioid prescriptions are a crucial source of new opioid exposure. The effectiveness of legislative efforts to limit opioid prescribing remains unknown, especially after general surgery procedures.</div></div><div><h3>Methods</h3><div>This was a cohort study that used the MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases. The study included adult beneficiaries without opioid use in the previous year who underwent ambulatory inguinal hernia repair between January 2010 and December 2021. This study examined trends in frequency and average morphine milligram equivalents (MMEs) of preoperative and postoperative opioid prescription fills among patients who underwent minimally invasive hernia repair and open hernia repair and the incidence of new persistent opioid use (NPOU). In addition, this study used the inverse probability of treatment weighting to control for confounding and weighted generalized models to assess the trends of opioid prescription fills between the 2 surgical approaches and incidence of NPOU.</div></div><div><h3>Results</h3><div>The study included 188,377 patients, with a median age of 52 years. Of note, 92.9% of the included patients were male. Preoperative opioid prescription fills decreased from 7.9% in 2010 to 5.4% in 2021 (<em>P</em> &lt;.0001), whereas postoperative opioid prescription fills decreased from 75.7% to 72.3% (<em>P</em> =.14). The median MMEs per prescription fill increased over the study period (<em>P</em> &lt;.0001). The incidence of NPOU was 1.0%.</div></div><div><h3>Conclusion</h3><div>Despite reductions in the frequency of preoperative opioid prescription fills, the average size of perioperative opioid prescription fills increased. Our findings underscore the need for enhanced opioid stewardship programs and educational initiatives to minimize opioid prescribing after inguinal hernia repair.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102052"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788399","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":"Perineal wound complications after proctectomy for Crohn’s disease: the impact of the omental pedicle flap and predictors of return to the operating room","authors":"Ian S. Reynolds ,&nbsp;Lauren Gleason ,&nbsp;Roy Hajjar ,&nbsp;Sidrah Khan ,&nbsp;Emilio Sanchez ,&nbsp;Katherine A. Bews ,&nbsp;Jorys Martinez-Jorge ,&nbsp;William R. Perry ,&nbsp;Kellie L. Mathis ,&nbsp;Nicholas P. McKenna","doi":"10.1016/j.gassur.2025.102048","DOIUrl":"10.1016/j.gassur.2025.102048","url":null,"abstract":"<div><h3>Background</h3><div>The role of omental pedicle flaps (OPFs) in reducing the risk of perineal wound complications and postoperative pelvic abscesses in patients with Crohn’s disease remains unclear. This study aimed to determine whether OPFs had any effect on the incidence of perineal wound complications requiring a return to the operating room (OR) or the requirement for radiologic-guided drainage of pelvic abscesses in patients with Crohn’s disease who underwent proctectomy.</div></div><div><h3>Methods</h3><div>This was a retrospective, single-center study. The study included patients who underwent proctectomy for Crohn’s disease with primary perineal closure, with or without an OPF. The primary outcome measures were return to the OR for perineal wound complications or the requirement for radiologically guided drainage of pelvic abscesses.</div></div><div><h3>Results</h3><div>A total of 219 patients (71 with flap and 148 without flap) underwent proctectomy during the study period. No differences were observed in the rate of unplanned return to the OR (11.27% in the OPF group vs 9.46% in the non-OPF group; <em>P</em> =.81) or the number of patients requiring radiologically guided drainage of pelvic abscesses (11.27% in the OPF group vs 6.76% in the non-OPF group, respectively; <em>P</em> =.30) between the cohorts. Patients in the flap cohort were more likely to have a history of tobacco use (<em>P</em> =.02), fistulizing perianal disease (<em>P</em> =.01), undergo extrasphincteric dissection (<em>P</em> =.03), and use incisional wound vacuum assisted closure (VAC) at the time of surgery (<em>P</em> =.02).</div></div><div><h3>Conclusion</h3><div>Careful patient selection for the OPF might play a role in reducing wound complications to a level similar to that observed in patients with lower-risk perineal wounds.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102048"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788428","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":"Short- and midterm outcomes of prehabilitation in abdominal wall surgery: a retrospective cohort study","authors":"Gaëtan-Romain Joliat ,&nbsp;Sonia Krouk ,&nbsp;Eddy Cotte ,&nbsp;Guillaume Passot","doi":"10.1016/j.gassur.2025.102045","DOIUrl":"10.1016/j.gassur.2025.102045","url":null,"abstract":"<div><h3>Background</h3><div>Data concerning prehabilitation in abdominal wall surgery (AWS) remain scarce and controversial. This study aimed to compare the postoperative short- and midterm outcomes between patients with prehabilitation and those without prehabilitation before AWS.</div></div><div><h3>Methods</h3><div>All consecutive patients who underwent surgery for primary/incisional, midline/lateral, and parastomal hernias between October 2021 and October 2024 were retrospectively included. Patients who underwent prehabilitation (including nutritional support, psychological support, and physical preparation) were compared with those who did not undergo prehabilitation. The primary outcome was 30-day morbidity.</div></div><div><h3>Results</h3><div>A total of 315 patients were included: 114 with prehabilitation and 201 without prehabilitation. Preoperative and intraoperative characteristics were similar in both groups, except for the higher botulinum toxin injection (BTI) rate (71/114 in the prehabilitation group vs 18/201 in the no-prehabilitation group; <em>P</em> &lt;.001) and larger median hernia size (10 cm in the prehabilitation group vs 6 cm in the no-prehabilitation group; <em>P</em> &lt;.001). There were no differences between both groups in complication rates (35/114 in the prehabilitation group vs 61/201 in the no-prehabilitation group; <em>P</em> =.948), major complications (15/114 in the prehabilitation group vs 28/201 in the no-prehabilitation group; <em>P</em> =.848), surgical site occurrences (23/114 in the prehabilitation group vs 40/201 in the no-prehabilitation group; <em>P</em> =.953), and median length of stay (3 days in the prehabilitation group vs 2 days in the no-prehabilitation group; <em>P</em> =.707). In contrast, the recurrence rate was lower in patients in the prehabilitation group than in those in the no-prehabilitation group (2/114 vs 14/201, respectively; <em>P</em> =.043; median follow-up: 16 months [95% CI, 15–17]). Among patients who received BTI, patients in the prehabilitation group had a lower complication rate than those in the no-prehabilitation group (20/71 vs 10/18, respectively; <em>P</em> =.028). Prehabilitation was independently associated with a decreased morbidity rate among patients who received BTI (odds ratio, 0.3 [95% CI, 0.1–0.9]; <em>P</em> =.027).</div></div><div><h3>Conclusion</h3><div>Prehabilitation did not decrease postoperative morbidity in the overall cohort but was associated with a lower midterm recurrence rate. In the BTI subgroup, patients in the prehabilitation group had less complications, suggesting a potential benefit of coupling BTI with a prehabilitation pathway.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 6","pages":"Article 102045"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788448","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}