Journal of Gastrointestinal Surgery最新文献

{"title":"Switching Biologic Drug Class After Resection for Crohn's Disease is Associated with Increased Risk of Re-intervention.","authors":"Olivia Ziegler, Alicia C Greene, Eric W Schaefer, Michael J Deutsch, Jeffrey S Scow, Matthew D Coates, Audrey S Kulaylat","doi":"10.1016/j.gassur.2025.102033","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102033","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102033"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730331","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":"Endoscopic therapy with fully covered metal stents for management of post- colorectal surgery anastomotic stenoses: a retrospective study.","authors":"Rahul Karna, Cyrus Jahansouz, Paolo Goffredo, Nabeel Azeem, Stuart K Amateau","doi":"10.1016/j.gassur.2025.102032","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102032","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102032"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730326","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":"Gastric Per Oral Pyloromyotomy (GPOP) is Effective Management of All Types of Gastroparesis.","authors":"Ashley E Williams, Eldrin Bhanat, Venkata N Seerapu, John Salvemini, Grace Howell, Mary Michael Evans, Jacob R Moremen","doi":"10.1016/j.gassur.2025.102031","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.102031","url":null,"abstract":"<p><strong>Background: </strong>Gastric peroral pyloromyotomy (G-POP) is a minimally invasive endoscopic technique for the treatment of refractory gastroparesis. Functional luminal imaging probe (FLIP) is an endoscopic tool that measures physiologic parameters of GI sphincters. In this study, FLIP was employed to investigate the association between physiologic measurements of the pylorus with clinical outcomes following G-POP using the Gastroparesis Cardinal Symptom Index (GCSI) to monitor clinical response.</p><p><strong>Methods: </strong>This is a single-center prospective study of forty-eight gastroparetic patients who underwent G-POP for management of refractory gastroparesis. Cross-sectional area (CSA), pressure, and the distensibility index (DI) of the pylorus were evaluated with FLIP at 40mL and 50mL balloon fill volumes pre- and post-procedurally. GCSI scores were used to monitor clinical symptoms both pre-procedurally and at 6-weeks post-G-POP.</p><p><strong>Results: </strong>Technical success was achieved in 100% of patients. GCSI scores (0-5) decreased by an average of 0.95 +/- 1.45 points at 6 weeks post-op, with the Nausea/Vomiting and Bloating subscales showing the greatest improvement. The change in DI at 50-mL balloon fill volumes was a statistically significant predictor of symptomatic improvement following the procedure, with ∆DI @ 50mL > 1.5mmHg/mm2 strongly correlated with larger improvements in GCSI (Pearson coefficient 0.544, p = 0.036).</p><p><strong>Conclusions: </strong>EndoFLIP was not found to be a reliable predictor of clinical success prior to G-POP, however measuring changes pre- and post-procedurally can be used to guide management. Additional investigations are needed to elucidate the relationship between physiologic pyloric sphincter measurements and clinical response to G-POP.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102031"},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692280","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":"Application of machine learning models to identify predictors of good outcome after laparoscopic fundoplication","authors":"Rippan N. Shukla ,&nbsp;Richard Woodman ,&nbsp;Jennifer C. Myers ,&nbsp;David I. Watson ,&nbsp;Tim Bright ,&nbsp;Sarah K. Thompson","doi":"10.1016/j.gassur.2025.102029","DOIUrl":"10.1016/j.gassur.2025.102029","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic fundoplication remains the gold standard treatment for gastroesophageal reflux disease. However, 10% to 20% of patients experience new, persistent, or recurrent symptoms warranting further treatment. Potential predictors for the best outcome after laparoscopic fundoplication were tested using a mature prospectively maintained database.</div></div><div><h3>Methods</h3><div>Data from 894 consecutive patients who underwent primary laparoscopic fundoplication from 1998 to 2015 were examined using regression and machine learning (ML) models. Preoperative factors were assessed for influence on postoperative outcomes: heartburn, dysphagia, and satisfaction scores at a median follow-up of 5 years.</div></div><div><h3>Results</h3><div>The accuracy in predicting heartburn score (range, 0–10) assessed using the root mean squared error (RMSE) was similar to a negative binomial regression model (RMSE = 2.39) and the least absolute shrinkage support operator ML model (RMSE = 2.34). The multivariate analysis using only patients with complete data (n = 221) generated a lower error than using mean imputation for patients with missing values. The most predictive variables were male sex for heartburn (β = −1.48 [95% CI, −2.37 to −0.6; <em>P</em> =.001) and dysphagia (β = −4.70 [95% CI, −8.02 to −1.39; <em>P</em> =.006) and percentage of esophageal peristalsis for satisfaction (β = 0.63 [95% CI, 0.16–1.10]; <em>P</em> =.009) and dysphagia (β = −1.85 [95% CI, −3.43 to −0.27]; <em>P</em> =.02).</div></div><div><h3>Conclusion</h3><div>Although male sex and degree of intact peristalsis are significant predictors for outcomes after laparoscopic fundoplication, prediction of individual patient outcome was relatively poor, and ML prediction models provided only marginal improvement in accuracy. Clinical acumen and a discussion with patients to set realistic postoperative expectations cannot be replaced by regression models or standard ML prediction algorithms at the present time.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102029"},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Accountable Care Organizations impact on gastrointestinal cancer care: are they falling short on health outcomes?","authors":"Eshetu Worku ,&nbsp;Mujtaba Khalil ,&nbsp;Amanda B. Macedo ,&nbsp;Selamawit Woldesenbet ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.gassur.2025.102028","DOIUrl":"10.1016/j.gassur.2025.102028","url":null,"abstract":"<div><h3>Background</h3><div>Accountable Care Organizations (ACOs) have emerged as a value-based care model. However, the effect on gastrointestinal (GI) cancer care remains poorly defined. Therefore, the current study aimed to investigate the effect of hospital ACO participation on surgical and financial outcomes.</div></div><div><h3>Methods</h3><div>Patients who underwent GI cancer surgery between 2016 and 2020 were identified from the Medicare Standard Analytic Files. Difference-in-differences (DID) analysis was performed to examine the effect of hospital ACO participation on surgical outcomes and healthcare expenditures.</div></div><div><h3>Results</h3><div>A total of 23,357 beneficiaries underwent GI cancer surgery at 2180 hospitals (ACO participating: 57 [2.7%]). The median patient age was 75 years (IQR, 71–81). Moreover, most patients were female (12,207 [52.3%]) and had a Charlson Comorbidity Index score of &gt;2 (14,067 [54.3%]). On DID analysis, after adjusting for patient and hospital baseline characteristics, ACO participation was not associated with a reduced risk of complications during the index hospitalization (RRR [relative risk ratio], 1.03 [95% CI, 0.90–1.18]; <em>P</em> =.71), extended length of stay (RRR, 1.04 [95% CI, 0.92–1.67]; <em>P</em> =.52), 30-day complication (RRR, 1.96 [95% CI, 0.72–1.27]; <em>P</em> =.77), 30-day readmission (RRR, 1.07 [95% CI, 0.92–1.25]; <em>P</em> =.96), or 30-day mortality (RRR, 0.96 [95% CI, 0.77–1.21]; <em>P</em> =.74). Moreover, ACO participation was not associated with reduced healthcare costs.</div></div><div><h3>Conclusion</h3><div>Hospital participation in ACOs was not associated with improved surgical outcomes or reduced healthcare costs. There is a need for nuanced, targeted interventions within the ACO framework that address the unique needs of complex surgical patients.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102028"},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of in-hospital delay of appendectomy – a propensity score–matched analysis of 4900 consecutive patients undergoing surgery for suspected appendicitis","authors":"Liqiu Kou ,&nbsp;Zongyu Yang ,&nbsp;Yuanfu Lu ,&nbsp;Songjie Liao","doi":"10.1016/j.gassur.2025.102024","DOIUrl":"10.1016/j.gassur.2025.102024","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102024"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692276","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":"Hydatid or not? A large splenic cyst that challenged the initial diagnosis","authors":"Andres Fontaine-Nicola ,&nbsp;Jorge R. Nefa ,&nbsp;Fernanda A. Magaña","doi":"10.1016/j.gassur.2025.102026","DOIUrl":"10.1016/j.gassur.2025.102026","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102026"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692281","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":"Letter to the editor regarding “Quality of life and social health in patients after pancreatic surgery”","authors":"Xun Feng","doi":"10.1016/j.gassur.2025.102025","DOIUrl":"10.1016/j.gassur.2025.102025","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102025"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692282","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":"Comparison of perioperative outcomes and quality of life between gastric resection and bypass for acid-induced gastric strictures: a pilot study","authors":"Bijit Saha,&nbsp;Utpal Anand,&nbsp;Kunal Parasar,&nbsp;Basant Narayan Singh,&nbsp;Kislay Kant,&nbsp;Abhishek Arora,&nbsp;Rohith Kodali","doi":"10.1016/j.gassur.2025.102027","DOIUrl":"10.1016/j.gassur.2025.102027","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102027"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692278","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":"Giant massive fecaloma as a cause of bowel obstruction and extrinsic coronary artery compression","authors":"Julia Bernal-Tirapo ,&nbsp;Daniel Pastor-Altaba ,&nbsp;María Victoria Vieiro-Medina","doi":"10.1016/j.gassur.2025.102022","DOIUrl":"10.1016/j.gassur.2025.102022","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 5","pages":"Article 102022"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674067","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}