Journal of Gastrointestinal Surgery最新文献

{"title":"Intraabdominal fat necrosis as a cause of abdominal pain","authors":"Belén Del Rosario Pinto , Felipe Higuera , Roy López Grove","doi":"10.1016/j.gassur.2026.102336","DOIUrl":"10.1016/j.gassur.2026.102336","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102336"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994531","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 “Body mass index and survival after surgery for gastric adenocarcinoma – a population-based nationwide cohort study in Finland” revisiting the obesity paradox in gastric cancer surgery","authors":"Mio Kitano, Alexander A. Parikh","doi":"10.1016/j.gassur.2025.102310","DOIUrl":"10.1016/j.gassur.2025.102310","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102310"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900485","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":"Perioperative fluid management in pancreaticoduodenectomy in the era of goal-directed fluid therapy: a review of the literature","authors":"Meghan Grim,&nbsp;Richard Zheng,&nbsp;Nader Hanna,&nbsp;Harish Lavu,&nbsp;Charles J. Yeo,&nbsp;Avinoam Nevler","doi":"10.1016/j.gassur.2025.102316","DOIUrl":"10.1016/j.gassur.2025.102316","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is the only curative option for localized pancreatic head and periampullary malignancies. However, PD is associated with significant perioperative morbidity. Perioperative fluid management has emerged as an important modifiable factor influencing surgical outcomes in PD.</div></div><div><h3>Methods</h3><div>In this qualitative review, PubMed/Medline searches were performed between March and August 2025 to review the terms “pancreaticoduodenectomy,” “fluid management,” “Enhanced Recovery After Surgery,” “complications,” and related terms.</div></div><div><h3>Results</h3><div>Historically, liberal fluid administration was favored to compensate for third-space losses, but contemporary evidence has linked excessive fluid volumes to complications, such as postoperative pancreatic fistula, anastomotic edema, and increased inflammatory responses. Recent studies, including those utilizing Enhanced Recovery After Surgery (ERAS) protocols, indicate the possible benefit of more restrictive fluid regimens, finding that restrictive fluids are associated with reduced overall complications, lower cardiopulmonary morbidity, and shorter post-operative hospital stays, amongst others. However, overly restrictive strategies may risk hypoperfusion, driving the necessity for a delicate balance between restrictive fluid administration and physiologic demand.</div></div><div><h3>Conclusions</h3><div>Goal-directed fluid therapy protocols offer a promising approach to PD fluid management by individualizing fluid delivery, minimizing complications, and improving perfusion metrics, resulting in a more effective restrictive fluid approach. Despite these advancements, heterogeneity in study designs, fluid management definitions, and monitoring tools limits a clear consensus. Future research should prioritize multicenter randomized controlled trials, standardized protocols, and long-term outcome assessments to refine evidence-based, patient-centered fluid management strategies in PD.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102316"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856762","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":"Hiatal hernia and anemia: a single-center experience","authors":"Andrés R. Latorre-Rodríguez ,&nbsp;Raj Shah ,&nbsp;Hailey Simmonds ,&nbsp;Jill Benavidez ,&nbsp;Arianna Vittori ,&nbsp;Ross M. Bremner ,&nbsp;Sumeet K. Mittal","doi":"10.1016/j.gassur.2026.102333","DOIUrl":"10.1016/j.gassur.2026.102333","url":null,"abstract":"<div><h3>Background</h3><div>Hiatal hernia (HH) is an often overlooked cause of chronic anemia, and the therapeutic role of surgical HH repair (HHr) in these cases remains underexplored. Thus, we assessed the prevalence of anemia and visible Cameron lesions in patients undergoing primary HHr, explored associations with hernia size, and evaluated objective postoperative improvements.</div></div><div><h3>Methods</h3><div>This retrospective, observational study used a prospectively maintained surgical database at a high-volume tertiary referral center to identify patients with anemia or upper gastrointestinal bleeding who underwent HHr between September 2016 and March 2024. Adults who underwent HHr with (i) preoperative anemia (hemoglobin &lt;13.0 g/dL for men or &lt;12.0 g/dL for women), (ii) endoscopic evidence of Cameron lesions, (iii) documented anemia in medical records, or (iv) documented history of iron deficiency anemia-related therapies were included. Patients with prior foregut procedures or other identifiable sources of blood loss were excluded. The primary endpoints were the rates of postoperative transfusion-level anemia and iron deficiency anemia-related therapies.</div></div><div><h3>Results</h3><div>Among 448 patients who underwent primary HHr, 132 (29.5%) were included. The rates of anemia-related findings increased with HH size as follows: small, 7.3%; moderate, 28.7%; large, 58.4%; and intrathoracic stomach, 44.7%. Significant reductions were seen in postoperative rates of transfusion-level anemia (15.2% to 0%; <em>P</em> =.004) and anemia-related medical therapies (50.8% to 2.2%; <em>P</em> &lt;.001).</div></div><div><h3>Conclusion</h3><div>Anemia and/or visible Cameron lesions are common in patients undergoing HHr and increase with hernia size. HHr significantly reduces transfusion-level anemia and the need for anemia-related therapies. Early surgical referral should be considered, as medical treatment alone may not address the underlying causes.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102333"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989505","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":"Contemporary emergency management and 1-year outcomes of colonic diverticulitis: a population-based cohort study","authors":"Teagan Telesnicki ,&nbsp;Therese A. Stukel ,&nbsp;Andrew S. Wilton ,&nbsp;Anthony de Buck van Overstraeten ,&nbsp;Charles de Mestral ,&nbsp;David Gomez","doi":"10.1016/j.gassur.2025.102311","DOIUrl":"10.1016/j.gassur.2025.102311","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to describe contemporary outcomes on index hospitalization and 1-year outcomes from index discharge in patients with diverticulitis.</div></div><div><h3>Methods</h3><div>This population-based retrospective cohort study included adult residents of Ontario, Canada, who presented to the emergency department (ED) with diverticulitis (January 2017 to March 2022). For individuals hospitalized at the time of index ED presentation, the risks of urgent surgery, percutaneous drainage, and mortality were reported. After index presentation discharge (from the ED or hospital with an intact colon), the cumulative incidences of unplanned hospitalization, urgent surgery, and scheduled surgery were reported at 30 days and 1 year, accounting for competing risks.</div></div><div><h3>Results</h3><div>Of 24,759 patients presenting to the ED with diverticulitis, 6263 (25%) were hospitalized, and 5379 (23%) required no intervention. However, a minority of patients required surgery (555 [2.2%]) and percutaneous drainage (329 [1.3%]). After index presentation discharge, the cumulative incidences of unplanned hospitalization, urgent surgery, and scheduled surgery were 2.00% (95% CI, 2.10%–2.40%), 0.60% (95% CI, 0.50%–0.70%), and 0.06% (95% CI, 0.03%–0.09%) at 30 days and 7.00% (95% CI, 6.70%–7.30%), 1.30% (95% CI, 1.20%–1.50%), and 1.50% (95% CI, 1.30%–1.60%) at 1 year, respectively. People managed with percutaneous drainage at index presentation were at higher 1-year risk: 44% (95% CI, 29%–39%) unplanned hospitalization and 11% (95% CI, 8%–14%) urgent surgery.</div></div><div><h3>Conclusion</h3><div>For most patients, the disease course 1 year from index discharge remains benign, with only a small minority of patients requiring hospitalization or surgery. These outcome estimates can guide patient counseling, including the appropriateness of scheduled colectomy for diverticulitis.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102311"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834290","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":"Uncinate lift technique for pancreatoduodenectomy via robotic approach","authors":"Ali Ahmad ,&nbsp;Bryant Morocho ,&nbsp;Steve Kwon","doi":"10.1016/j.gassur.2026.102342","DOIUrl":"10.1016/j.gassur.2026.102342","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102342"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040849","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":"Degos disease presenting with small intestinal perforations","authors":"Rui Zhong ,&nbsp;Yufang Wang ,&nbsp;Zhihui Yi","doi":"10.1016/j.gassur.2026.102337","DOIUrl":"10.1016/j.gassur.2026.102337","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102337"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003551","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":"Exercise interventions for health-related quality of life, fatigue, depression, and anxiety in colorectal cancer survivors: a systematic review and network meta-analysis","authors":"Hu Tang ,&nbsp;Lin Zhang ,&nbsp;Yangliang Ren ,&nbsp;Yuxiang Wu ,&nbsp;Xiang Zhang ,&nbsp;Yi Dai ,&nbsp;Jian Chen","doi":"10.1016/j.gassur.2026.102320","DOIUrl":"10.1016/j.gassur.2026.102320","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer survivors frequently experience persistent fatigue, psychological distress, and reduced health-related quality of life (HRQoL) after treatment. Exercise is increasingly recognized as an effective nonpharmacologic intervention, but the comparative efficacy of different modalities remains uncertain. This study aimed to evaluate and rank the effects of exercise interventions on HRQoL, fatigue, depression, and anxiety in colorectal cancer survivors through a systematic review and network meta-analysis.</div></div><div><h3>Methods</h3><div>Five databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar) were searched from inception to October 30, 2025. Eligible randomized controlled trials included adult colorectal cancer survivors receiving structured exercise interventions—such as aerobic exercise (AE), resistance training (RT), combined AE plus RT (AE + RT), yoga, qigong, tai chi, or multicomponent programs—compared with usual care or alternative exercise modalities. Primary outcomes were HRQoL, fatigue, depression, and anxiety assessed after the intervention. Standardized mean differences (SMDs) and 95% CIs were pooled using random-effects models, and comparative rankings were estimated using the surface under the cumulative ranking curve (SUCRA).</div></div><div><h3>Results</h3><div>A total of 22 trials (n = 1676) met the inclusion criteria. Overall, exercise significantly improved HRQoL (SMD, 0.48; 95% CI, 0.28–0.67) and reduced fatigue (SMD, −0.44; 95% CI, −0.70 to −0.19), depression (SMD, −0.29; 95% CI, −0.48 to −0.10), and anxiety (SMD, −0.29; 95% CI, −0.42 to −0.15). Subgroup analyses indicated greater effects with supervised or tele-supervised, moderate-intensity programs (3–5.9 metabolic equivalents of task) in 30- to 60-min sessions, 3 to 4 times weekly for 9 to 23 weeks. Network meta-analysis ranked RT highest for improving HRQoL (SUCRA, 91.8%), and AE + RT most effective for reducing fatigue, depression, and anxiety (SUCRA, 81.7%–82.4%).</div></div><div><h3>Conclusion</h3><div>Exercise significantly enhances HRQoL and psychological well-being in colorectal cancer survivors, with optimal benefits observed from moderate-intensity, supervised, or tele-supervised programs. AE + RT seems the most effective for symptom relief, whereas RT provides the greatest gains in global quality of life.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102320"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906082","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":"Stapled Kono-S anastomosis as a protective strategy against postoperative endoscopic recurrence in ileocolonic Crohn’s disease: a dual-center retrospective cohort analysis","authors":"Zhouhang Dai ,&nbsp;Ming Duan ,&nbsp;Wei Liu ,&nbsp;Xiaolong Ge ,&nbsp;Lei Cao ,&nbsp;Wei Zhou ,&nbsp;Yi Li","doi":"10.1016/j.gassur.2025.102318","DOIUrl":"10.1016/j.gassur.2025.102318","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102318"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889198","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":"Early Recurrence of Esophagogastric junction adenoCarcinoma after Surgery: a multicentre analysis of risk factors (ERECS Trial)","authors":"Stefano de Pascale ,&nbsp;Riccardo Rosati ,&nbsp;Vincenzo Bagnardi ,&nbsp;Andrea Cossu ,&nbsp;Giovanni Ferrari ,&nbsp;Samuele Frassoni ,&nbsp;Simone Giacopuzzi ,&nbsp;Monica Gualtierotti ,&nbsp;Lucia Moletta ,&nbsp;Mario Morino ,&nbsp;Giovanni Pallabazzer ,&nbsp;Marco Realis Luc ,&nbsp;Fabrizio Rebecchi ,&nbsp;Stefano Santi ,&nbsp;Michele Valmasoni ,&nbsp;Jacopo Weindelmayer ,&nbsp;Uberto Fumagalli Romario","doi":"10.1016/j.gassur.2026.102329","DOIUrl":"10.1016/j.gassur.2026.102329","url":null,"abstract":"<div><h3>Background</h3><div>Esophagogastric junction adenocarcinoma (EGJA) is characterized by a high recurrence rate after esophagectomy, which significantly affects patient survival. This study aimed to identify the risk factors contributing to early recurrence (ER) within 12 months after Ivor Lewis esophagectomy (ILE) in patients with EGJA.</div></div><div><h3>Methods</h3><div>A retrospective multicenter analysis was conducted across 7 high-volume Italian centers that included 594 patients with Siewert type I and II EGJAs who underwent ILE between January 2018 and December 2022. The clinicopathologic characteristics and postoperative outcomes were analyzed. ER was defined as cancer recurrence within 12 months after surgery. Univariate and multivariate analyses were performed to identify the independent risk factors for ER.</div></div><div><h3>Results</h3><div>The overall recurrence rate was 41.2% (245/594), with ER occurring in 24.4% (145/594) of patients. The 1-year overall survival rate was 87.7%, and the 1-year recurrence-free survival (RFS) rate was 70.6%. The median RFS was 32.1 months. Multivariate Cox regression analysis identified lower body mass index (hazard ratio [HR], 0.95; <em>P</em> =.009), poor or absent response to neoadjuvant treatment based on the Mandard classification (HR, 2.26; <em>P</em> =.013), and advanced stage (HR, 2.24; <em>P</em> &lt;.001) as independent significant risk factors for ER in EGJA.</div></div><div><h3>Conclusion</h3><div>Identifying prognostic factors associated with ER allows for the stratification of a subgroup of patients with poor oncological outcomes who require a personalized treatment approach, distinct from the standard multimodal treatment.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102329"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989488","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}