Journal of Gastrointestinal Surgery最新文献

{"title":"Adjuvant chemotherapy in older patients with stage II and III colon cancers: Is less more?","authors":"Julia Frebault ,&nbsp;Alexander Troester ,&nbsp;Michael Horsey ,&nbsp;Sarah L. Mott ,&nbsp;Schelomo Marmor ,&nbsp;Arjun Gupta ,&nbsp;Imran Hassan ,&nbsp;Pridvi Kandagatla ,&nbsp;Paolo Goffredo","doi":"10.1016/j.gassur.2025.102149","DOIUrl":"10.1016/j.gassur.2025.102149","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend adjuvant chemotherapy (AC) for patients with high-risk stage II and III colon cancers. However, the use of multi-agent chemotherapy (MAC) in older patients remains controversial. This study aimed to assess whether the survival benefit of single-agent chemotherapy (SAC) and MAC in stage II and III colon cancers diminishes with age.</div></div><div><h3>Methods</h3><div>The National Cancer Database was queried for adults who underwent surgical resection for colon adenocarcinoma from 2010 to 2020. Analysis was divided into 3 groups: low- and high-risk stage II and stage III. Multivariable Cox regression with an interaction term was used to estimate the effect of AC on overall survival (OS) by age (18–69, 70–79, and &gt;80 years).</div></div><div><h3>Results</h3><div>Of 61 961 patients (30% low-risk stage II, 17% high-risk stage II%, and 52% stage III), most patients with stage II were treated without chemotherapy, whereas &gt;65% of patients with stage III received MAC. In multivariable analysis, chemotherapy’s effect on OS did not significantly differ by age. In low-risk stage II, SAC showed a marginal survival benefit (hazard ratio [HR], 0.72; 95% CI, 0.58–0.89), and in high-risk stage II, AC was beneficial, with single agent providing improved benefit over multiagent (HR, 0.70; 95% CI, 0.56–0.87). In stage III, MAC offered improved survival benefit (HR, 0.42; 95% CI, 0.39–0.45).</div></div><div><h3>Conclusion</h3><div>In this national cohort, age did not significantly affect the survival effect of AC. Although SAC was beneficial in stage II disease, MAC improved survival in stage III. These findings support current guidelines and underscore the importance of individual decision making based on functional status for this population.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 9","pages":"Article 102149"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749748","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 application of robotic intragastric laparoscopic surgery in the resection of submucosal tumors adjacent to the esophagogastric junction(with video).","authors":"You Hu, Xin Chen, Xiaojun Zhou","doi":"10.1016/j.gassur.2025.102171","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102171","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102171"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760298","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":"Asthma is a risk factor for postoperative pulmonary complications and intra-abdominal infectious complications after gastrectomy.","authors":"Takahisa Yamaguchi, Shinichi Kadoya, Kenichi Ishibayashi, Tetsuya Asakawa, Katsuya Gunjigake, Yoshinao Ohbatake, Shiro Terai, Hirotaka Kitamura, Hiroyuki Bando, Noriyuki Inaki","doi":"10.1016/j.gassur.2025.102172","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102172","url":null,"abstract":"<p><strong>Background: </strong>Asthma is caused by airway hyperresponsiveness and reversible obstruction. No studies have evaluated the relationships between asthma and postoperative complications after gastrectomy for gastric cancer. In this study, we aimed to clarify the associations between asthma and postoperative complications in patients who underwent gastrectomy for gastric cancer.</p><p><strong>Methods: </strong>The clinical data of 1,001 patients who underwent gastrectomy for gastric cancer from April 2010 to December 2022 at Ishikawa Prefectural Central Hospital were retrospectively analyzed. Risk factors for postoperative complications were identified by univariate and multivariate analyses. The frequency and types of complication were evaluated in patients with and without asthma.</p><p><strong>Results: </strong>Asthma, hypertension, male sex, and higher body mass index were risk factors for postoperative complications in the univariate analysis. On multivariate analysis, the hazard ratio for the presence of asthma had the highest value, of 3.08 (95% confidence interval 1.610-5.870, p < 0.001). Patients with asthma had higher rates of anastomotic leakage (8.2% vs. 2.4%, p = 0.008), bleeding (4.8% vs. 0.3%, p < 0.001), pancreatic fistula (9.5% vs. 2.3%, p = 0.001), abdominal abscess (22.2% vs. 4.6%, p < 0.001), and pneumonia (8.9% vs. 1.2%, p < 0.001). Additionally, asthma with decreased FEV₁% was a risk factor for postoperative complications.</p><p><strong>Conclusion: </strong>Asthma was a risk factor for postoperative complications, including pneumonia and intra-abdominal infectious complications, after gastrectomy.</p><p><strong>Data availability: </strong>The datasets used during the current study are available from the corresponding author on reasonable request.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102172"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760297","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 Morbidity of Simultaneous Pancreatic and Liver Resection for Metastatic Pancreatic Neuroendocrine Tumors.","authors":"Lyonell B Kone, Paul Wong, Michael J Jacobs, Ajay V Maker","doi":"10.1016/j.gassur.2025.102163","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102163","url":null,"abstract":"<p><strong>Background: </strong>Between 40-80% of pancreatic neuroendocrine tumors (PNETs) present with liver metastases. Liver resection or debulking of metastatic PNET has been shown to improve long-term survival. However, limited data exist on the morbidity associated with simultaneous versus staged resection for PNETs, posing a challenge for clinical decision-making.</p><p><strong>Methods: </strong>Clinical variables were collected from the 2014-2020 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) databases for patients undergoing major and minor hepatectomy and pancreatectomy. Thirty-day morbidity and secondary perioperative outcomes were compared between combined and isolated surgery cohorts utilizing multivariate regression analysis (MVA) and propensity score matching (PSM).</p><p><strong>Results: </strong>Among more than 7,000 NET patients, 1,917 underwent resection of neuroendocrine liver metastases. Of these, 1,246 had isolated liver resections, 177 had isolated pancreatic resections, and 494 underwent simultaneous liver and pancreatic PNET resections. Both MVA and PSM revealed no significant differences in morbidity (49% vs. 46%, p=0.35) or other perioperative outcomes between simultaneous and isolated pancreatic resection. However, compared to isolated liver resection, simultaneous resection was associated with increased morbidity, longer operative time, higher blood transfusion requirements, and a greater incidence of infections. Importantly, obesity was an independent predictor of increased morbidity with simultaneous resection (56%vs.43%, p=0.005), but not with isolated pancreatic (45%vs.47%, p=0.84) or isolated hepatic (29%vs.29%, p=0.94) resections.</p><p><strong>Conclusion: </strong>Simultaneous resection of neuroendocrine liver metastases and pancreatic primary tumors has a morbidity profile comparable to isolated pancreatic resection. However, compared to isolated liver resection, simultaneous resection carries increased perioperative morbidity and a greater risk of infections, underscoring the importance of careful patient selection and perioperative management to optimize outcomes. Notably, morbidity for simultaneous resection, unlike isolated resection, is significantly higher in obese patients.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102163"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753456","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":"Transforming Obesity Care: The 12-Month Impact of Endoscopic Sleeve Gastroplasty on Weight Loss and Metabolic Health.","authors":"Manoel Galvão Neto, Jonathan Jerez, David Cabrera Vásconez, Román Turró Arau, Luiz Gustavo de Quadros, Andre Teixeira, Kirsten Falcon, Martha Fors","doi":"10.1016/j.gassur.2025.102166","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102166","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure designed to reshape the stomach into a sleeve-like form.</p><p><strong>Objectives: </strong>To examine ESG's role in obesity treatment, reporting outcomes related to weight reduction in Ecuadorean subjects.</p><p><strong>Setting: </strong>The study was permed in the Clinica de Sobrepeso, Obesidad y Metabolismo (SOM) located in Quito, Ecuador.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated patients undergoing ESG at a specialized obesity center with follow-ups at 3, 6, and 12 months. Key outcomes included weight loss metrics (Body Mass Index (BMI), Excess Weight Loss(%EWL), Total Weight Loss(%TWL)) and laboratory changes (blood glucose, cholesterol, hemoglobin, vitamin D, vitamin B12 and iron levels). Blood pressure and heart rate were also assessed to analyze weight loss efficacy and comorbidity improvements.</p><p><strong>Results: </strong>A total of 160 patients underwent ESG, with an initial average BMI of 35.9kg/m² and mean age of 45 years. Participants lost an average of 16.1kg by the end of the study, with significant reductions in musculoskeletal mass and fat percentage. %TWL and EWL improved progressively from 11.74% and 58.34% at three months to 18.39% and 41.56% at twelve months. Notably, blood glucose and total cholesterol showed significant reductions at all follow-up points (p<0.001).</p><p><strong>Conclusions: </strong>ESG effectively promotes significant weight loss and metabolic improvements within 12 months. It reduces visceral fat, fat mass percentage, musculoskeletal mass, blood glucose, and total cholesterol, confirming its success as a minimally invasive obesity treatment.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102166"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731658","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":"Recurrence in Crohn's Disease: The Impact of Surgical Technique on Medium and Long-Term Outcomes.","authors":"Daniel Aryeh Metzger, Alessandro Fichera","doi":"10.1016/j.gassur.2025.102162","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102162","url":null,"abstract":"<p><strong>Background: </strong>Although medical management has improved significantly, surgery plays an important role in the treatment of Crohn's disease. However, it is not curative, and recurrence-often occurring at or near the site of previous anastomosis-is common. To reduce postoperative recurrence, two surgical strategies have garnered increasing attention: the Kono-S anastomosis, which modifies anastomotic configuration, and extended mesenteric excision, which targets the diseased mesentery thought to contribute to recurrence.</p><p><strong>Methods: </strong>This study discusses the theoretical basis and rationale of these two techniques and provides a critical review of the current literature evaluating their efficacy. Data are drawn from retrospective series, prospective cohort studies, and randomized controlled trials, with attention to the current state of evidence.</p><p><strong>Results: </strong>Early studies of the Kono-S anastomosis demonstrated impressively low rates of surgical recurrence. Data on its impact on endoscopic recurrence have varied but randomized data on surgical recurrence are pending. Similarly, retrospective analyses of extended mesenteric excision suggested a reduced risk of recurrence, though results across recent studies have varied-potentially due to differences in operative technique or definitions of mesenteric excision.</p><p><strong>Conclusion: </strong>High-quality data from several ongoing randomized controlled trials will help define the roles of the Kono-S anastomosis and extended mesenteric excision in reducing recurrence rates for patients with Crohn's disease.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102162"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731657","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":"Inverted pyloric gland adenoma.","authors":"Qi Gong, Jixin Chen, Zhi Wei","doi":"10.1016/j.gassur.2025.102168","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102168","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102168"},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718011","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":"Invited Commentary on: Impact of systematic enteral nutrition on postoperative complications and oncological outcome in a curative multimodal strategy for oesophageal cancer.","authors":"Sofia Bertona, Francisco Schlottmann","doi":"10.1016/j.gassur.2025.102164","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102164","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102164"},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718013","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":"Invited Commentary on \"Postoperative Outcomes of Anti-Reflux Surgery in Lung Transplant Recipients\".","authors":"Andrés R Latorre-Rodríguez, Sumeet K Mittal","doi":"10.1016/j.gassur.2025.102165","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102165","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102165"},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718012","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":"Posterior Excision of Benign Presacral Cysts: Does Coccygectomy Reduce Recurrence?","authors":"Awwab F Hammad, Stefan D Holubar, Imran Khan, Olga Lavryk, Michael Valente, David Liska, Scott R Steele","doi":"10.1016/j.gassur.2025.102170","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102170","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102170"},"PeriodicalIF":2.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718014","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}