Journal of Gastrointestinal Surgery最新文献

{"title":"Decision regret and satisfaction with shared decision-making in pancreatic surgery","authors":"Nicholas Galouzis ,&nbsp;Maria Khawam ,&nbsp;Evelyn V. Alexander ,&nbsp;Michael D. Yallourakis ,&nbsp;Lusine Mesropyan ,&nbsp;Carrie Luu ,&nbsp;Mohammad R. Khreiss ,&nbsp;Taylor S. Riall","doi":"10.1016/j.gassur.2024.10.025","DOIUrl":"10.1016/j.gassur.2024.10.025","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic surgery often does not provide long-term survival in patients with cancer or consistently improve symptoms in benign disease. This study aimed to assess decision regret and satisfaction with the decision-making process among patients who underwent pancreatectomy.</div></div><div><h3>Methods</h3><div>This study administered the Brehaut Decision Regret Scale (DRS), 9-Item Shared Decision-Making Questionnaire (SDM-Q-9), and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) to all patients who underwent elective pancreatectomies from 2021 to 2023. Decision regret was defined as a DRS of &gt;25. In addition, this study evaluated SDM-Q-9 responses in patients with and without regret.</div></div><div><h3>Results</h3><div>A total of 143 patients were included in this study, of whom 71 patients (49.6%) completed the distributed surveys. Demographics, pathology, and major complication rates were similar between responders and nonresponders. The indications for surgery were malignancy (67.6%) and benign disease (32.4%). Decision regret after pancreatic surgery was reported in 18.3% of patients. Patients who experienced regret were younger (50.8 ± 18.7 years [younger group] vs 62.0 ± 14.9 years [older group]; <em>P</em> = .03), more likely to have benign disease (39.1% [benign disease] vs 8.3% [malignant disease]; <em>P</em> &lt; .01), underwent a distal pancreatectomy (34.5% [distal pancreatectomy] vs 7.7% [pancreaticoduodenectomy]; <em>P</em> = .02), or experienced a major complication (36.8% [major complication] vs 11.5% [no major complication]; <em>P</em> = .03). Patients with regret had lower global health (57.1 ± 20.1 [patients with regret] vs 76.2 ± 22.2 [patients without regret]; <em>P</em> &lt; .01) and social function scores (61.5 ± 31.5 [patients with regret] vs 77.6 ± 22.0 [patients without regret]; <em>P</em> = .03) on the EORTC QLQ-C30. Patients with regret were less satisfied with the shared decision-making process.</div></div><div><h3>Conclusion</h3><div>Strong decision regret was reported in 18% of patients who underwent pancreatectomy. Younger age, distal pancreatectomy, benign indications, and major postoperative complications were associated with regret. Data from the SDM-9 highlight areas for potential improvement to help patients make decisions aligned with their goals of care.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101870"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622023","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":"Gastrointestinal Stromal Tumor (GIST) Quiz: Test your knowledge","authors":"Sadie Munter ,&nbsp;Ashwyn Sharma ,&nbsp;Mark Antkowiak ,&nbsp;Tannaz Ranjbarian ,&nbsp;Mojgan Hosseini ,&nbsp;Jason K. Sicklick","doi":"10.1016/j.gassur.2024.10.014","DOIUrl":"10.1016/j.gassur.2024.10.014","url":null,"abstract":"<div><div>Having a strong understanding of the epidemiology, pathophysiology, and clinical management of gastrointestinal stromal tumors (GISTs) is crucial for clinicians who may encounter this cancer. The quiz below is designed for medical students, residents, fellows, and practicing physicians to test their knowledge and review key concepts for understanding GIST.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101859"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501931","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":"Pyloric impedance planimetry during endoscopic per-oral pyloromyotomy guides myotomy extent","authors":"Hee Kyung (Jenny) Kim ,&nbsp;Jamie DeCicco ,&nbsp;Rachna Prasad ,&nbsp;Hemasat Alkhatib ,&nbsp;Kevin El-Hayek","doi":"10.1016/j.gassur.2024.10.011","DOIUrl":"10.1016/j.gassur.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Per-oral pyloromyotomy (POP), also known as gastric per-oral endoscopic myotomy, is the first-line endoscopic intervention for medically refractory gastroparesis. This study aimed to assess the value of pyloric impedance planimetry using a functional lumen imaging probe (FLIP) during POP.</div></div><div><h3>Methods</h3><div>Patients who underwent POP between October 2019 and February 2024 were retrospectively reviewed. FLIP measurements, symptoms measured using the Gastroparesis Cardinal Symptom Index (GCSI), and gastric emptying scintigraphy (GES) were evaluated before and after POP.</div></div><div><h3>Results</h3><div>Of 35 patients who underwent POP, 29 (82.9%) were female, the median age was 51.3 years (IQR, 38.4–60.9), and the median body mass index was 29.26 kg/m² (IQR, 25.46–32.56). In addition, 23 patients had pre- and post-POP FLIP measurements. The median pyloric diameter increased from 14.4 (IQR, 12.0–16.0) to 16.0 (IQR, 14.8–18.0) mm (S = 116.5; <em>P</em> &lt; .0001). The median distensibility index increased from 4.85 (IQR, 3.38–6.00) to 8.45 (IQR, 5.25–11.00) mm²/mm Hg (S = 112; <em>P</em> &lt; .0001). The management changed based on FLIP values for 5 patients (21.7%), prompting additional myotomy. At 18.0 days (IQR, 12.8–47.8) after the procedure, the median GCSI score decreased from 3.33 (IQR, 2.56–4.12) preoperatively to 2.00 (IQR, 1.00–2.89) postoperatively (S = −193; <em>P</em> &lt; .001). At a median follow-up of 136 days (IQR, 114–277), improvement in GCSI score persisted, with a median score of 2.44 (IQR, 1.44–3.67) (S = −61; <em>P</em> = .021). The median retention at 4 hours on GES decreased from 29.0% (IQR, 16.5–52.0%) to 19.5% (IQR, 5.75–35.30%) at 97 days (IQR, 88–130) after the procedure (S = −108; <em>P</em> = .0038). There was a 75% improvement and a 40% normalization in objective gastric emptying (n = 26). A greater increase in diameter after pyloromyotomy was associated with a greater decrease in 4-hour gastric retention (<em>r</em> = −0.4886; <em>P</em> = .021).</div></div><div><h3>Conclusion</h3><div>POP with FLIP resulted in clinical and radiographic improvements in patients with gastroparesis. FLIP measurements guided myotomy extent, changing the management in 21.7% of patients, and were associated with gastric emptying, demonstrating its distinct utility in the treatment of gastroparesis.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101856"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467396","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":"Intraperitoneal infiltration of Exparel, post-operative pain and the need for opioids after laparoscopic hiatal hernia repair with fundopexy","authors":"Anthony Basta ,&nbsp;Joshua Haag ,&nbsp;Karsten Fields ,&nbsp;Neel Aligave ,&nbsp;Connor Fritz ,&nbsp;Andre Miller ,&nbsp;Farzaneh Banki","doi":"10.1016/j.gassur.2024.10.021","DOIUrl":"10.1016/j.gassur.2024.10.021","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101866"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501932","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":"Optimal treatment strategies for borderline resectable liver metastases from colorectal cancer","authors":"Gurudutt P. Varty,&nbsp;Shraddha Patkar,&nbsp;Kaival Gundavda,&nbsp;Niket Shah,&nbsp;Mahesh Goel","doi":"10.1016/j.gassur.2024.10.023","DOIUrl":"10.1016/j.gassur.2024.10.023","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, colorectal liver metastases (CRLMs) are divided into “initially resectable” and “initially unresectable.” The terminology “borderline resectable” continues to be elusive without any common consensus or definition. This narrative review aims to decode the conundrum of “borderline resectable CRLM (BR-CRLM)” and to discuss optimal treatment strategies.</div></div><div><h3>Methods</h3><div>A comprehensive review was performed using Medline/PubMed and Web of Science databases with a search period ending on January 1, 2024. Using PubMed, the terms “CRLM,” “BR-CRLM,” and “management of BR-CRLM” were searched.</div></div><div><h3>Results</h3><div>The 2016 European Society for Medical Oncology guidelines defined the term “resectability” in CRLM using the “technical (surgical) criteria” and the “oncologically criteria.” These 2 criteria form the basis of defining BR-CRLM. Thus, BR-CRLM can be either technically easy but with unfavorable oncologically criteria or technically difficult with favorable oncologically criteria. Although defining BR-CRLM by incorporating both these criteria seems to be the most logical way forward, there is currently a lot of heterogeneity in the literature. It is generally agreed upon that some form of chemotherapy needs to be administered in BR-CRLM before embarking on surgery. Conversion chemotherapy is used in patients with BR-CRLM in which there is a possibility of resection after effective downsizing. Along with improved effective chemotherapy, great strides have been made in pushing the limits of surgery to achieve resectability in this subset of patients.</div></div><div><h3>Conclusion</h3><div>Advanced surgical techniques and locoregional liver-directed therapies coupled with perioperative chemotherapy with or without targeted therapy have made long-term survival benefit, a reality in patients with BR-CRLM. Thus, the time has come to recognize “BR-CRLM” as a distinct entity.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101868"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501935","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 body composition changes and their clinical implications in patients with gastric cancer undergoing radical gastric cancer surgery: a prospective cohort study","authors":"Haimei Zhao ,&nbsp;Qiantong Dong ,&nbsp;Chenbin Chen ,&nbsp;Luofeng Pan ,&nbsp;Shu Liu ,&nbsp;Jun Cheng ,&nbsp;Xian Shen ,&nbsp;Sulin Wang","doi":"10.1016/j.gassur.2024.101877","DOIUrl":"10.1016/j.gassur.2024.101877","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate perioperative body composition changes and their clinical implications in patients undergoing radical gastric cancer surgery.</div></div><div><h3>Methods</h3><div>Patient data are prospectively collected. Computed tomography scans were conducted within 30 days preoperatively and on the seventh postoperative day to assess skeletal muscle mass index (SMI), skeletal muscle density (SMD), and subcutaneous adipose tissue (SAT). Changes in these parameters between the 2 scans were quantified. Logistic regression analysis was used to determine factors influencing body composition loss and clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 335 patients were included, showing varying degrees of decline in SMI, SMD, and SAT during the perioperative period. Multivariate analysis identified age ≥65 and low handgrip strength as independent risk factors for excessive SMI loss, whereas laparoscopic surgery served as a protective factor. For excessive SMD loss, independent risk factors included preoperative low SMD, Nutritional Risk Screening 2002 score ≥3, and hypoalbuminemia. Moreover, age ≥65 was identified as an independent risk factor for excessive SAT loss, whereas laparoscopic surgery remained protective. Excessive SMI and SMD loss are correlated with increased postoperative complications, prolonged hospital stays, and higher costs. Both excessive losses in SMI and SMD are independently associated with the incidence of postoperative complications. Further analysis revealed that excessive SMD loss (odds ratio, 3.164; 95% CI, 1.214–8.243) independently contributed to readmission risk.</div></div><div><h3>Conclusion</h3><div>Excessive SMI and SMD loss are associated with adverse clinical outcomes. It is essential to address and improve preoperative modifiable risk factors to reduce perioperative muscle loss and enhance prognosis.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101877"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604876","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":"Solid conclusions and wild inferences about pancreatic cancer and the immune system","authors":"Clifford S. Cho","doi":"10.1016/j.gassur.2024.10.020","DOIUrl":"10.1016/j.gassur.2024.10.020","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101865"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501934","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":"Gum chewing as an effective treatment regimen in postoperative ileus","authors":"Vimal Thomas ,&nbsp;Tarun Kumar Suvvari ,&nbsp;Ujval Sai Margan Venugopal ,&nbsp;Banasree Roy Urmi ,&nbsp;Ridmi Tharushi","doi":"10.1016/j.gassur.2024.101880","DOIUrl":"10.1016/j.gassur.2024.101880","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101880"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604874","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":"Current evidence on the diagnosis and management of spilled gallstones postlaparoscopic cholecystectomy","authors":"Alberto R. Ferreres","doi":"10.1016/j.gassur.2024.10.030","DOIUrl":"10.1016/j.gassur.2024.10.030","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101875"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568853","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":"Mutations in codon 13 of KRAS influence local recurrences in stage III rectal cancer","authors":"Richard Sassun ,&nbsp;Annaclara Sileo ,&nbsp;Giulio Mari ,&nbsp;Kellie L. Mathis ,&nbsp;Eric J. Dozois ,&nbsp;David W. Larson","doi":"10.1016/j.gassur.2024.10.029","DOIUrl":"10.1016/j.gassur.2024.10.029","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101874"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558040","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}