Journal of Gastrointestinal Surgery最新文献

{"title":"A novel method for intracorporeal end-to-end colorectal anastomosis using a linear stapler.","authors":"Ze-Qin Wang, Han-Kun Hao, Jun Hong","doi":"10.1016/j.gassur.2025.101992","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101992","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101992"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414424","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":"Non-gain-of-function alterations in exportin-1 (XPO1) are associated with improved overall survival in colorectal cancer.","authors":"Hunter Stecko, Diamantis Tsilimigras, Sidharth Iyer, Jad Daw, Hua Zhu, Emily Huang, Matthew Kalady, Timothy M Pawlik","doi":"10.1016/j.gassur.2025.101990","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101990","url":null,"abstract":"<p><strong>Introduction: </strong>Upregulation of nuclear export protein Exportin-1 (XPO1) has been previously demonstrated in multiple cancer subtypes, contributing to pharmacotherapy resistance and increased recurrence rates. We sought to explore the impact of non-gain-of-function XPO1 alterations among patients with colorectal cancer (CRC).</p><p><strong>Methods: </strong>Patients with colon/rectal/colorectal adenocarcinoma were identified from the Memorial Sloan Kettering CHORD dataset using cBioPortal. A subpopulation with alterations in XPO1 were identified. Patients with known amplifications and gain-of-function E571K and R749Q alterations were excluded, as were patients with in-situ and Stage IV disease. Survival analysis was performed via Kaplan-Meier and Cox proportional hazards analyses, adjusted for patient age and disease stage.</p><p><strong>Results: </strong>Among 5,543 patients with CRC, 83 patients (1.5%) had alterations in the XPO1 locus while 5,460 patients (98.5%) did not. Of those with XPO1 alteration, 66 (79.5%) had non-gain-of-function alterations while 17 (21.5%) had gain-of-function point mutations or amplifications. Overall, non-gain-of-function XPO1 alteration was associated with a mortality hazard ratio of 0.601 (95CI: 0.463-0.805, p=0.011) compared to patients without XPO1 alteration. When adjusted for patient age and disease stage, XPO1 coalteration was associated with improved overall survival in patients with alterations in TP53, APC, FBXW7, SMAD4, and BRAF genes (all p<0.01).</p><p><strong>Conclusions: </strong>XPO1 alterations are associated with improved overall survival in patients with colorectal cancer. Associated survival benefits persist when coalterations are present, particularly in coalterations with intranuclear tumor suppressor proteins.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101990"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414427","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":"Development and Validation of the ALBI-Gamma-Glutamyl Transferase Score for Enhanced Prognostic Accuracy After Hepatocellular Carcinoma Resection.","authors":"Miho Akabane, Jun Kawashima, Abdullah Altaf, Selamawit Woldesenbet, François Cauchy, Federico Aucejo, Irinel Popescu, Minoru Kitago, Guillaume Martel, Francesca Ratti, Luca Aldrighetti, George A Poultsides, Yuki Imaoka, Andrea Ruzzenente, Itaru Endo, Ana Gleisner, Hugo P Marques, Vincent Lam, Tom Hugh, Nazim Bhimani, Feng Shen, Timothy M Pawlik","doi":"10.1016/j.gassur.2025.101984","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101984","url":null,"abstract":"<p><strong>Background: </strong>The albumin-bilirubin(ALBI) score, used for predicting outcomes after hepatocellular carcinoma(HCC) resection, does not directly capture liver cell damage or biliary obstruction. Gamma-glutamyl transferase(GGT), reflecting hepatic oxidative stress and inflammation, may complement the ALBI score. We sought to develop the ALBI-GGT score, a composite prognostic tool, and evaluate its performance in predicting long-term outcomes among patients undergoing HCC resection.</p><p><strong>Methods: </strong>Patients undergoing curative-intent HCC resection(2000-2023) were identified from an international, multi-institutional database. The cohort was divided into training(65%) and testing(35%) cohorts. Multivariable Cox analysis examined the association of ALBI-GGT score with overall survival(OS).</p><p><strong>Results: </strong>Among 759 patients, median ALBI score was -2.78[-3.02,-2.48], and median GGT was 55.0[31.0,93.0]U/L. On multivariable analysis, ALBI score(HR:1.473[1.112-1.950];p=0.007) and GGT(HR:1.007[1.004-1.010];p<0.001) were predictors of overall mortality, alongside Tumor Burden Score(HR:1.051[1.015-1.090];p=0.006) and ASA class>2(HR:1.473[1.005-2.161];p=0.047). There was near-linear correlation between increasing ALBI scores and GGT and higher hazards of death. The ALBI-GGT score demonstrated the highest predictive accuracy in the testing set(C-index:0.68[0.58-0.72]), outperforming the ALBI score(0.62[0.56-0.69]) and GGT(0.65[0.58-0.72]). It achieved the lowest Akaike and Bayesian information criterion. Time-dependent AUC analysis showed consistent superiority over 0-60 months. At 1, 3, and 5 years, the ALBI-GGT score had AUCs of 0.782, 0.725, and 0.688, respectively, outperforming ALBI score and GGT. ALBI-GGT score was able to stratify patients into distinct prognostic groups(5-year OS:low ALBI-GGT,85.0% vs. intermediate ALBI-GGT,65.8% vs. high ALBI-GGT,56.8%;p<0.001).</p><p><strong>Conclusion: </strong>ALBI score alone may be insufficient to prognostically stratify HCC patients. Combining ALBI score with GGT provided a superior tool for stratifying patients relative to long-term survival.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101984"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373528","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":"LAPAROSCOPIC SIDE-TO-SIDE DUODENODUODENOSTOMY FOR INCOMPLETE ANNULAR PANCREAS CAUSING GASTRIC OUTLET OBSTRUCTION IN A 21-YEAR-OLD PATIENT.","authors":"Antonio Mazzeo, Valentino Fiscon, Giuseppe Portale","doi":"10.1016/j.gassur.2025.101983","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101983","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101983"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365069","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":"Laparoscopic fundoplication improves esophageal motility in patients with gastroesophageal reflux disease: a high-volume single-center controlled study in the era of high-resolution manometry and 24-hour pH impedance","authors":"Arianna Vittori ,&nbsp;Giovanni Capovilla ,&nbsp;Renato Salvador ,&nbsp;Matteo Santangelo ,&nbsp;Luca Provenzano ,&nbsp;Loredana Nicoletti ,&nbsp;Andrea Costantini ,&nbsp;Francesca Forattini ,&nbsp;Matteo Pittacolo ,&nbsp;Lucia Moletta ,&nbsp;Edoardo V. Savarino ,&nbsp;Michele Valmasoni","doi":"10.1016/j.gassur.2024.101888","DOIUrl":"10.1016/j.gassur.2024.101888","url":null,"abstract":"<div><h3>Background</h3><div>Most existing literature studies reported that laparoscopic fundoplication (LF) is safe in the setting of ineffective or weak peristalsis. However, the effect of the wrap on esophageal motility is still debated. This study aimed to assess how a functioning and effective fundoplication could affect esophageal motility in patients with gastroesophageal reflux disease (GERD).</div></div><div><h3>Methods</h3><div>This study analyzed prospectively collected data on patients who underwent laparoscopic Nissen (LN) fundoplication or laparoscopic Toupet (LT) fundoplication for GERD at our department between 2010 and 2022. Demographic and clinical characteristics were recorded. Patients were evaluated using the Gastroesophageal Reflux Disease Questionnaire (GerdQ), barium swallow, endoscopy, high-resolution manometry (HRM), and 24-hour pH impedance (multichannel intraluminal impedance and pH monitoring [MII-pH]) before and after surgery. HRM was reviewed by 2 experts, following the criteria of the Chicago Classification (version 4.0). LF failure was objectively defined in case of abnormal postoperative MII-pH according to the Lyon 2.0 criteria with/without an abnormal GerdQ.</div></div><div><h3>Results</h3><div>During the study period, 124 patients with GERD (89 males and 35 females) were recruited. Of note, 58 patients underwent LN fundoplication, and 66 patients underwent LT fundoplication. All procedures were completed laparoscopically, and the 90-day postoperative mortality was nil. At the postoperative MII-pH, good outcome was recorded in 103 patients, and failure was recorded in 21 patients. There was a significant association between a successful LF and the normalization of esophageal motility (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>Our data confirmed that LF is an effective treatment in patients with GERD, regardless of esophageal motility status. Moreover, our results indicate that LF could determine a normalization of motility abnormalities in patients with GERD.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101888"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622012","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":"Prediction of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy based on multifrequency magnetic resonance elastography","authors":"Yu-Qing Zhong ,&nbsp;Xiao-Xu Zhu ,&nbsp;Xi-Tai Huang ,&nbsp;Yan-Ji Luo ,&nbsp;Chen-song Huang ,&nbsp;Qiong-cong Xu ,&nbsp;Xiao-Yu Yin","doi":"10.1016/j.gassur.2024.101886","DOIUrl":"10.1016/j.gassur.2024.101886","url":null,"abstract":"<div><h3>Background</h3><div>Clinically relevant postoperative pancreatic fistula (CR-POPF) is the major complication of pancreatoduodenectomy, and the pancreatic texture is one of the potential affecting factors. Multifrequency magnetic resonance elastography (MRE) is a novel technique for measuring tissue stiffness, but its value in predicting CR-POPF preoperatively has not been well documented.</div></div><div><h3>Methods</h3><div>A total of 70 patients who underwent multifrequency MRE before pancreatoduodenectomy between July 2021 and April 2024 were retrospectively recruited into the study. The parameters of MRE, shear wave speed (<em>c</em>) and phase angle (<em>φ</em>), and clinical data were collected. Logistic regression and the receiver operating characteristic curve analyses were used to assess the performance of multifrequency MRE in predicting CR-POPF.</div></div><div><h3>Results</h3><div>CR-POPF was developed in 14 of 70 patients (20%), all categorized as grade B. The CR-POPF group had significantly lower <em>c</em> (1.339 ± 0.210 m/s) and longer hospital stays (21 [IQR, 15.50−37.75] days) than the no-CR-POPF group. The MRE parameters, <em>c</em> and <em>φ</em>, were moderately correlated with pancreas stiffness (eta² for <em>φ</em> = 0.189 and eta² for <em>c</em> = 0.106). Dilated major pancreatic duct (MPD ≥ 3 mm) and higher <em>c</em> were independently associated with a lower risk of CR-POPF in univariant and multivariant analyses (odds ratio [OR] for <em>c</em>, 0.041 [95% CI, 0.002–0.879]; OR for dilated MPD, 0.129 [95% CI, 0.022–0.768]). The area under the curve (AUC) of the predictive model based on <em>c</em> and MPD diameter was 0.786, which was better than the fistula risk score (FRS) (AUC = 0.587) and alternative FRS (AUC = 0.556) in our center, with the DeLong test <em>P</em> = .028 and <em>P</em> = .002, respectively.</div></div><div><h3>Conclusion</h3><div>The MRE parameters were associated with pancreatic stiffness, and <em>c</em> was an independent predictor of CR-POPF after pancreatoduodenectomy.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101886"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639089","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":"Resectable gastric cancer: should we apply a tailored surgical strategy according to microsatellite status?","authors":"Edoardo Maria Muttillo ,&nbsp;Leonardo Di Cicco ,&nbsp;Alice La Franca ,&nbsp;Alessio Lucarini ,&nbsp;Giulia Arrivi ,&nbsp;Francesco Saverio Li Causi ,&nbsp;Giorgio Castagnola ,&nbsp;Andrea Scarinci ,&nbsp;Emanuela Pilozzi ,&nbsp;Federica Mazzuca ,&nbsp;Genoveffa Balducci ,&nbsp;Roberto Luca Meniconi ,&nbsp;Giuseppe Maria Ettorre ,&nbsp;Paolo Mercantini","doi":"10.1016/j.gassur.2024.101890","DOIUrl":"10.1016/j.gassur.2024.101890","url":null,"abstract":"<div><h3>Background</h3><div>High microsatellite instability (MSI) represents a small subgroup of gastric cancer (GC) with favorable prognostic and predictive significance. This study aimed to investigate locoregional lymph node (LN) involvement, overall survival (OS), disease-free survival (DFS), and the interplay between molecular subtypes and histologic profiles regarding survival outcomes in MSI GC vs microsatellite stability (MSS) GC.</div></div><div><h3>Methods</h3><div>This study included 72 patients with GC who underwent surgery with or without chemotherapy from 2017 to 2023. Clinicopathologic characteristics, OS, and DFS were compared between LN-positive and LN-negative patients stratified by microsatellite status, treatments, molecular profiles, and tumor cell types.</div></div><div><h3>Results</h3><div>MSI GC was more common in older patients (79.0 vs 70.2 years; <em>P</em> &lt;.001), more common in females (73.68% vs 43.32%; <em>P</em> =.023), and associated with intestinal-type histology (94.5% vs 49.0%; <em>P</em> =.002). Positive LN involvement and lymphovascular invasion (LVI) were lower in the MSI group than in the MSS group (positive LN: 2.73 vs 4.15, respectively; <em>P</em> =.366; LVI: 36.8% vs 64.5%, respectively; <em>P</em> =.039). Patients with MSI showed slightly better OS and DFS than those with MSS (OS: 84.20% vs 66.00%, respectively; <em>P</em> =.108; DFS: 84.62% vs 63.89%, respectively; <em>P</em> =.120). In addition, compared with patients with MSS GC, those with MSI GC had improved OS and DFS in the LN-positive group (OS: 72.7% vs 61.3%, respectively; <em>P</em> =.255; DFS: 75.0% vs 50.0%, respectively; <em>P</em> =.148) and LN-negative group (OS: 100.0% vs 85.7%, respectively; <em>P</em> =.149; DFS: 100.0% vs 85.7%, respectively; <em>P</em> =.376). In patients not receiving chemotherapy, the MSI/intestinal-type group had the highest OS and DFS (77.0% and 87.5%, respectively; <em>P</em> =.024), whereas the MSS/mixed-type group had the lowest OS and DFS (25.0% and 100.0%, respectively; <em>P</em> =.290). In patients receiving chemotherapy, the MSI/intestinal-type group had the highest OS and DFS (100.0% and 100.0%, respectively; <em>P</em> =.741), whereas the MSS/mixed-type group had the lowest OS and DFS (66.7% and 50.0%, respectively; <em>P</em> =.397).</div></div><div><h3>Conclusion</h3><div>First, patients with MSI GC have a significantly lower risk of locoregional LN involvement and better OS and DFS than those with MSS GC. Second, treatment responses differ based on MSI status: patients with MSI tumors benefit more from upfront surgical interventions, whereas those with MSS, particularly mixed histotypes, demonstrate improved outcomes with preoperative chemotherapy. These results advocate for a tailored therapeutic approach that considers microsatellite status, Lauren classification, and patient clinical conditions.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101890"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687275","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":"Castleman disease masquerading as a retroperitoneal mass with dense calcification","authors":"Abdeali Saif Arif Kaderi ,&nbsp;Gauri Deshpande ,&nbsp;Shraddha Patkar","doi":"10.1016/j.gassur.2024.101901","DOIUrl":"10.1016/j.gassur.2024.101901","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101901"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755027","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 thrombosis and anticoagulation after portal vein resection during pancreatic surgery: a systematic review","authors":"Epameinondas Dogeas,&nbsp;Michael A. Choti","doi":"10.1016/j.gassur.2024.101900","DOIUrl":"10.1016/j.gassur.2024.101900","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101900"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755028","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":"Anomalous origin of the posterior superior pancreaticoduodenal artery: critical vascular variations in the field of hepato-pancreato-biliary surgery","authors":"Yuki Okazoe,&nbsp;Hiroaki Yanagimoto,&nbsp;Daisuke Tsugawa,&nbsp;Masayuki Akita,&nbsp;Hirochika Toyama,&nbsp;Masahiro Kido,&nbsp;Takumi Fukumoto","doi":"10.1016/j.gassur.2024.101926","DOIUrl":"10.1016/j.gassur.2024.101926","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101926"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818376","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}