Journal of Gastrointestinal Surgery最新文献

{"title":"Invited commentary on: [Post-surgical ctDNA as a prognostic biomarker for relapse of resected pancreatic ductal adenocarcinoma].","authors":"Alexander N German, Lee M Ocuin","doi":"10.1016/j.gassur.2026.102449","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102449","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102449"},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856498","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-Term Efficacy and Safety of Neoadjuvant Chemotherapy Plus Immune Checkpoint Inhibitors Versus Chemotherapy Alone in Locally Advanced Gastric Cancer: A Real-World Propensity Score-Matched Analysis.","authors":"Jiaqi Zhou, Chengwang Guo, Mingze Zhang, Yongjin Wang, Peng Nie, Xiaojun Liu","doi":"10.1016/j.gassur.2026.102450","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102450","url":null,"abstract":"<p><strong>Background: </strong>In China, locally advanced gastric cancer (LAGC) is frequently diagnosed, yet the 5-year overall survival (OS) rate following solitary surgical intervention remains unsatisfactorily low. While the integration of chemotherapy and immune checkpoint inhibitors (ICIs) has recently demonstrated substantial efficacy in treating advanced gastric cancer, data regarding the combination of neoadjuvant chemotherapy and ICIs specifically for LAGC patients are still sparse.</p><p><strong>Objective: </strong>This study aimed to evaluate the short - term efficacy and safety of neoadjuvant chemotherapy plus ICIs versus neoadjuvant chemotherapy alone in patients with locally advanced gastric cancer (LAGC) in Gansu. A bicenter retrospective analysis with propensity score matching (PSM) was used.</p><p><strong>Results: </strong>The combined treatment group had significantly higher pathological complete response (pCR) rates (29.5% vs 4.5%), major pathological response (MPR) rates (35.7% vs 10.7%), and objective response rate (ORR, 31.3% vs 9.8%) than the chemotherapy-alone group (all P<0.001). There were no significant differences in hematological complication grades, severe hematological complication rates, liver injury grades, or severe surgical complication rates between groups(P＞0.05). There were no grade 3-4 immune-related adverse events (irAEs) in the combined treatment group. The combined treatment group had shorter postoperative recovery time (P=0.003) and lower gastric tube indwelling rate (P<0.001).</p><p><strong>Conclusion: </strong>Neoadjuvant chemotherapy combined with ICIs significantly increases pCR and MPR rates, reduces postoperative recovery time, and lowers the need for nasogastric tube placement, without increasing adverse events. These findings support chemoimmunotherapy in the neoadjuvant treatment of LAGC. Future work should include multicenter, prospective, randomized trials with biomarker analyses to validate these results.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102450"},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856444","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":"Onset of Depression Among Gastrointestinal Cancer Survivors: An \"All of Us\" Research Program Study.","authors":"Rabia Bega, Charalampos M Charalampous, Areesh Mevawalla, Qaidar Alizai, Meher Angez, Rida Ejaz, Timothy M Pawlik","doi":"10.1016/j.gassur.2026.102451","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102451","url":null,"abstract":"<p><strong>Background: </strong>Depression is common among individuals with cancer and has been associated with impaired quality of life, reduced treatment adherence, and increased morbidity and mortality. We sought to characterize the timing and predictors of early- and late-onset depression among adults with gastrointestinal (GI) cancer.</p><p><strong>Methods: </strong>Adults aged ≥18 years with a diagnosis of GI cancer were identified from the \"All of Us\" Research Program V8. Incident depression was defined as new clinical diagnosis following cancer diagnosis and its onset was categorized as early (<5 years) or late (≥5 years). Multinomial logistic regression and Cox proportional hazards models were used to evaluate association with sociodemographic factors, cancer subtype, baseline anxiety, and treatment.</p><p><strong>Results: </strong>Among 4,349 individuals, 68.2% (n=2,964) patients developed incident depression with 54.3% (n=2,360) of patients classified as having early-onset depression. On multivariable analysis, younger age was associated with lower odds of both early- (aOR 0.99, 95%CI 0.98-0.99) and late-onset depression (aOR 0.97, 95%CI 0.96-0.98), whereas female sex was associated with higher odds of early- (aOR 1.20, 95%CI 1.01-1.44) and late-onset depression (aOR 1.31, 95%CI 1.01-1.70). Compared with colorectal cancer, esophageal (aOR 1.74, 95%CI 1.19-2.56), pancreatic (aOR 1.59, 95%CI 1.25-2.02) and liver/hepatic bile duct (aOR 1.51, 95%CI 1.23-1.86) cancer were associated with higher odds of early-onset depression.</p><p><strong>Discussion: </strong>Depression was common among GI cancer survivors and frequently emerged years after diagnosis. These findings underscore the importance of longitudinal, risk-stratified mental health screening throughout GI cancer survivorship, extending beyond periods of active treatment.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102451"},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856459","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 \"Employment Disruption and Missed Workdays following Neoadjuvant Therapy Receipt for High-risk GI cancer\".","authors":"Jessica Hu, Zhi Ven Fong","doi":"10.1016/j.gassur.2026.102440","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102440","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102440"},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856478","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: Endoscopic resection of gastric submucosal tumors: a single-center retrospective study.","authors":"Daniela D Vera-Camargo, Juan S Barajas-Gamboa","doi":"10.1016/j.gassur.2026.102445","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102445","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102445"},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816254","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 associated with fecal diversion prior to rectovaginal fistula repair.","authors":"Megan Obi, Arielle Kanters, Anna R Spivak, Stefan D Holubar, Scott R Steele, David Liska, Tracy Hull, Olga Lavryk","doi":"10.1016/j.gassur.2026.102442","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102442","url":null,"abstract":"<p><strong>Background: </strong>Temporary fecal diversion (FD) is selectively performed in patients with rectovaginal fistulas (RVF). We aimed to identify the factors associated with FD in treatment of RVF and hypothesized that FD is associated with increased recurrence free survival METHODS: A retrospective review of females who underwent repair of a RVF was performed. Patients were divided into 2 groups based on the utilization of FD. Recurrence was defined as evidence of RVF on clinical exam or imaging after at least 2 prior follow ups noting healing.</p><p><strong>Results: </strong>158 patients underwent 424 surgical procedures of which 100 (63.3%) patients underwent FD, while 58 (36.7%) did not. Patients were comparable in terms of age, BMI, diabetes, smoking history, IBD history, and fistula etiology. Patients in FD group required a median of 3 (IQR 1-5) repairs (p<0.005). Interposition flaps were more common in FD group than non-FD: gracilis [13 (13%) vs 2 (3%); p=0.05] and Martius [17 (17%) vs 2 (3%); p=0.01]. There were no significant differences in healing or recurrence rates. Multivariate analysis revealed an increased number of prior attempted repairs was associated with the use of FD (p<0.001). The cumulative 5-yr Kaplan-Meier cure rate was 72.7% (61 - 87) in FD group and 64.3% (48 - 86) (p=0.38) in non-FD group.</p><p><strong>Conclusion: </strong>Multiple prior RVF repairs and interposition flap repairs are associated with the utilization of FD. Selecting high risk patients for FD before re-repair may allow the recurrence rate to be similar to lower risk non-diverted patients.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102442"},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816239","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":"Neoadjuvant Treatment Response and Oncologic Outcomes After Pelvic Exenteration for Locally Advanced Rectal Cancer.","authors":"Alexander Troester, Julia Frebault, Sarah L Mott, Lauren Weaver, Cyrus Jahansouz, Wolfgang Gaertner, Imran Hassan, Paolo Goffredo","doi":"10.1016/j.gassur.2026.102441","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102441","url":null,"abstract":"<p><strong>Background: </strong>Lack of response to neoadjuvant chemoradiotherapy (nCRT) has been described as a surrogate of aggressive tumor biology leading to poor oncologic outcomes in locally advanced rectal cancer (LARC). However, there is a paucity of data on this association for LARC patients undergoing pelvic exenteration (PE).</p><p><strong>Methods: </strong>The National Cancer Database was queried for adults with cT4 rectal adenocarcinoma between 2006-2021. Three groups were identified: upfront PE, nCRT with neoadjuvant rectal (NAR) score <8 followed by PE, and nCRT with NAR≥8 followed by PE. The NAR score is a validated endpoint that incorporates cT, pT, and pN to calculate treatment efficacy.</p><p><strong>Results: </strong>Of 942 patients, 73% were <65 years old, 57% female, 84% white with a median follow-up of 40 (0-201) months; 5% underwent upfront PE, 82% nCRT with NAR≥8, and 13% nCRT with NAR<8. Overall, 15% had positive margins. On univariable analysis, compared to NAR<8, upfront PE and NAR≥8 were significantly associated with increased odds of a positive surgical margin. Five-year OS was 84% for NAR<8, 55% for NAR≥8, and 28% for upfront PE. After adjustment, upfront PE (HR 5.10, 95% CI 2.69-9.65) and NAR≥8 (HR 2.23, 95% CI 1.31-3.79) cohorts experienced worse overall survival (OS).</p><p><strong>Conclusions: </strong>In this US-based cohort of LARC undergoing PE, tumor regression after nCRT was strongly associated with lower rates of positive margins and better overall survival, confirming its significant relevance in the selection and management of these patients.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102441"},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816274","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":"Outcomes Following Repair of Enterocutaneous Fistulae at a Specialized Center.","authors":"Beatrix Choi, Amirbahador Abbasi, Usama Ahmed Ali, Yuanyuan Ge, Thomas Imahiyerobo, Erin Testerman, Vanessa Marra, Kenneth Autencio, Osama Jabi, Dilara Khoshknabi, Marco Bertucci Zoccali, Debbie Bakes, Le-Chu Su, Bo Shen, James Church, Ravi P Kiran","doi":"10.1016/j.gassur.2026.102446","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102446","url":null,"abstract":"<p><strong>Background: </strong>Enterocutaneous fistula (ECF) is a serious condition that can be challenging to treat with high recurrence and mortality rate. This study reports the characteristics and outcomes of a large series of patients with ECF, aiming at evaluating the rate and factors associated with successful surgical management.</p><p><strong>Methods: </strong>Data were obtained from a prospectively maintained database at an academic institution. All patients who underwent repair of an enterocutaneous fistula between 2013-2025 were included. Clinical characteristics, operative details, and postoperative outcomes were evaluated. Primary outcomes were fistula recurrence and mortality. Secondary outcomes were intra- and postoperative complications. Regression analysis was used to identify independent risk factors for the primary outcomes.</p><p><strong>Results: </strong>A total of 93 patients (52% female) underwent surgery with median age of 58 years (IQR 44.2-66.6) and body mass index (BMI) of 23.4kg/m2 (IQR 20.4-27.8). Proximate cause of fistula formation was spontaneous in 12 patients (13%), while the remainder were postoperative; 16 patients (17%) had underlying Crohn's disease. Twenty-two patients (24%) had a recurrence, hence 76% had a successful repair. Median time to fistula recurrence was 85 days (IQR 53-372). Mortality occurred in 5 patients (5%). The most common postoperative complications were intra-abdominal or pelvic abscess (19%) and transfusion (28%). Patients with fistula recurrence, when compared to patients with no recurrence, had similar age, BMI, etiology (IBD vs non-IBD), ASA class, gender, race, and comorbidities. A significantly longer length of stay was observed in the recurrence group (18.5 vs 8 days, P < 0.01). Postoperative complications were similar except for anastomotic leak, which was higher in the recurrence group (22.7% vs 7.0%, P=0.053). In the multivariable logistic regression analysis, recurrence was independently associated with high-output fistula (OR 6.62, 95% CI 1.38-31.80, P=0.018), preoperative stoma use (OR 4.36, 95% CI 1.17-16.27, P=0.029), wound class overall (P=0.015), primary repair (OR 4.55, 95% CI 1.10-18.85, P=0.037), and intraoperative transfusion (OR 7.72, 95% CI 1.46-40.74, P=0.016).</p><p><strong>Conclusion: </strong>Surgery for ECF can be accomplished with good rates of healing in experienced centers. Recurrence appears to be associated with fistula severity, operative complexity, and intraoperative burden, underscoring the importance of careful patient optimization and meticulous operative management.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102446"},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816222","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 Impact of Lymph Node Harvest on Recurrence in Rectal Cancer Following Neoadjuvant Chemoradiotherapy.","authors":"Min Hyeong Jo, Duck-Woo Kim, Ji Ae Lee, Mi Jeong Choi, Hye-Rim Shin, Tae-Gyun Lee, Hong-Min Ahn, Heung-Kwon Oh, Sung-Bum Kang, Min Jung Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park","doi":"10.1016/j.gassur.2026.102447","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102447","url":null,"abstract":"<p><strong>Background: </strong>While current guidelines recommend harvesting ≥ 12 lymph nodes (LNs) for rectal cancer staging, its appropriateness after neoadjuvant chemoradiotherapy (nCRT) remains debated. This study evaluated the prognostic value of harvested lymph nodes (HLNs) following nCRT.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,596 patients who underwent radical surgery for rectal cancer following nCRT at two tertiary hospitals between April 2004 and December 2021. Patients were categorized by the number of HLNs (≥ 12 vs. <12). Clinicopathologic outcomes and recurrence were compared, and multivariable analyses were performed to identify factors associated with recurrence and survival.</p><p><strong>Results: </strong>HLNs < 12 were found in 321 patients (20.1%), and ≥ 12 in 1,275 (79.9%). No significant differences were observed in age, sex, tumor height, resection margins, or circumferential resection margin involvement. The HLNs ≥ 12 group showed more advanced ypT, ypN, and overall stage, with higher rates of venous and perineural invasion. Completeness of postoperative chemotherapy was comparable. However, the HLNs < 12 group demonstrated a higher recurrence rate (24.6% vs. 18.8%, p = 0.026). In multivariate analysis, HLNs < 12 were identified as independent risk factors for overall survival (HR = 1.624, p = 0.002) and disease-free survival (HR = 1.297, p = 0.047). Kaplan-Meier analysis showed 5-year overall survival was significantly lower in the HLNs <12 group than the HLNs ≥12 group (83.1% vs. 86.1%, p = 0.003).</p><p><strong>Conclusion: </strong>Harvesting fewer than 12 LNs was significantly associated with worse overall survival and remains an independent prognostic factor of rectal cancer following nCRT.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102447"},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816220","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: Assessment of stapled versus hand-sewn anastomoses in video-assisted thoracoscopic and laparoscopic McKeown esophagectomy for esophageal cancer.","authors":"Theodore Lin, Sumeet K Mittal","doi":"10.1016/j.gassur.2026.102444","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102444","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102444"},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816282","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}