Journal of Gastrointestinal Surgery最新文献

{"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}

{"title":"Eosinophilic Esophagitis.","authors":"Tian-Qi Zhao, Bei Wang, Wei Liu","doi":"10.1016/j.gassur.2026.102439","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102439","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102439"},"PeriodicalIF":2.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816287","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":"Reversible Bariatric Surgery: Is Long Gastric Partition (Bariclip) Superior to Gastric Banding?","authors":"S Olmi, G Sarro, P Pizzi, M Bonaldi, C Rubicondo, V Consalvo, D Foschi","doi":"10.1016/j.gassur.2026.102438","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102438","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102438"},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773505","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":"Procedure-Dependent Cardiovascular Risk Reduction After Metabolic and Bariatric Surgery: A Large Cohort Study.","authors":"Wissam Ghusn, Annabella R Strathman, Katherine L Schleiss, Richard S Betancourt, Nour El Ghazal, Tala Abdelqader, Simon J Laplante, Todd A Kellogg, Omar M Ghanem","doi":"10.1016/j.gassur.2026.102436","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102436","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major contributor to atherosclerotic cardiovascular disease through adverse effects on blood pressure, lipid metabolism, and glucose regulation. Metabolic and bariatric surgery produces durable cardiometabolic improvement, but procedures differ in their metabolic effects. Whether these differences translate into meaningful variation in integrated cardiovascular risk reduction remains uncertain. We compared changes in estimated cardiovascular risk following sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults undergoing primary metabolic and bariatric surgery at a tertiary academic center. Patients were required to have complete clinical and laboratory data at baseline and one year after surgery. Ten-year and lifetime atherosclerotic cardiovascular disease risk estimates were calculated using pooled cohort equations. Primary outcomes were absolute changes in estimated ten-year and lifetime cardiovascular risk at one year. Secondary outcomes included percent total body weight loss and changes in blood pressure and lipid parameters.</p><p><strong>Results: </strong>The cohort included 2,642 patients (699 sleeve gastrectomy, 1,813 Roux-en-Y gastric bypass, and 130 biliopancreatic diversion with duodenal switch). At one year, mean ten-year cardiovascular risk decreased by 0.33 after sleeve gastrectomy, 0.93 after Roux-en-Y gastric bypass, and 1.58 after biliopancreatic diversion with duodenal switch (p=0.006). Mean lifetime cardiovascular risk decreased by 3.24, 7.67, and 10.49, respectively (p<0.001). Percent total body weight loss was 23.6%, 31.0%, and 36.8%, respectively (p<0.001).</p><p><strong>Conclusion: </strong>Metabolic and bariatric surgery is associated with significant cardiovascular risk reduction, with greater benefit observed after more metabolically intensive procedures.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102436"},"PeriodicalIF":2.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773488","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":"Impact of gastric ischemic preconditioning prior to esophagectomy on pathologic response.","authors":"Samantha L Savitch, David Booth, Jonathan E Williams, Andrew C Chang, Rishindra M Reddy, Kiran H Lagisetty","doi":"10.1016/j.gassur.2026.102437","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102437","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102437"},"PeriodicalIF":2.4,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773512","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":"Incidence, Risk Factors, and Outcomes of Opioid Overdose Following Major Gastrointestinal Surgery.","authors":"Charalampos M Charalampous, Qaidar Alizai, Azza Sarfraz, Meher Angez, Abdulaziz Elemosho, Timothy M Pawlik","doi":"10.1016/j.gassur.2026.102435","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102435","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative opioid overdose (OD) is a rare but serious complication, yet data on its risk factors and outcomes after gastrointestinal (GI) surgery remain limited. We aimed to define risk factors and outcomes of opioid OD following major GI surgery.</p><p><strong>Methods: </strong>Data was extracted on opioid OD from the National Inpatient Sample (2016-2019), including adults that underwent major GI surgery. Patients were grouped into opioid OD and non-OD groups and outcomes included in-hospital complications, mortality, length of stay (LOS), and hospitalization costs. Multivariable regression analyses estimated the association of opioid OD with outcomes.</p><p><strong>Results: </strong>Among 1,562,770 weighted population, 0.1% (n=1,434) experienced perioperative opioid OD. Patients with opioid OD were predominantly female (65.5%, n=940 vs. 51.7%, n=807,450; p<0.001) and more likely to have Medicaid insurance (16.0%, n=230 vs. 9.8%, n=152,555; p<0.001). The incidence of opioid OD declined from 0.12% in 2016 to 0.07% in 2019. On adjusted analyses, compared to colectomy, esophagectomy (AOR 3.78, 95%CI: 2.01-7.11), hepatectomy (AOR 2.08, 95%CI: 1.13-3.83), and pancreatectomy (AOR 1.90, 95%CI: 1.10-3.26), were associated with higher odds of OD, as emergency admissions (AOR 1.99, 95%CI: 1.49-2.67), and drug abuse disorder (AOR 4.51, 95%CI: 3.11-6.55). Opioid OD was associated with higher odds of renal complications (AOR 2.77, 95%CI: 2.07-3.72), longer LOS (+2.97 days, 95%CI: +1.67, +4.28) and increased costs (+$14,320, 95%CI: $9,110-$19,520).</p><p><strong>Conclusion: </strong>Opioid OD was associated with substantial morbidity, prolonged hospitalization, and increased costs. Temporal decline with persistent risk among vulnerable groups highlights the need for systematic perioperative substance screening and structured stewardship programs in major GI surgery care.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102435"},"PeriodicalIF":2.4,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773551","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":"Surgery for multiple bilobar colorectal liver metastases: from staged resections to liver transplantation. A systematic review of the outcomes of the different strategies.","authors":"Emma Zuppi, Pietro Addeo","doi":"10.1016/j.gassur.2026.102429","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102429","url":null,"abstract":"<p><strong>Background: </strong>The management of multiple bilobar colorectal liver metastases (BCRLM) continues to evolve and the optimal strategy remains debated. We systematically analyzed the outcomes of the different surgical strategies for BCRLM.</p><p><strong>Methods: </strong>A systematic literature search including MEDLINE, EMBASE, and the Cochrane Library was performed according to PRISMA guidelines and registered in PROSPERO. We included studies reporting surgery for BCRLM (January 2010-August 2025) according five strategies: two-stage hepatectomy (TSH), associated liver partitioning and portal vein ligation for staged hepatectomy (ALPPS), parenchymal sparing hepatectomy (PSH), one stage hepatectomy combined with ablation (OSHA), and liver transplantation (LT).</p><p><strong>Results: </strong>Thirty-four studies reporting outcomes of 2756 patients were included [TSH (n=20, 1813 patients), ALPPS (n=11; 272 patients), PSH (n=2; 142 patients) OSHA (n=3, 279 patients), LT (n=8, 250 patients)]. BRCLM treated has mostly synchronous presentation (82.3%). ALPSS patients showed the higher rate of extrahepatic disease while LT the lower (0%). Patients undergoing LT had the highest rate of preoperative chemotherapy (100%) and the higher median number of lesion (n=11) but were less likely female. Mutational status (KRAS, BRAF) was reported in less than 40% of patients. The overall 90 postoperative mortality rate was 4%, lower for LT (0.8%). Overall R1 resection rate was 18.9%, higher for PSH (55.7%). Median OS and DFS were similar across strategies (TSH: 41months/15months; ALPPS: 44months/11months; PSH: 45months/9months; OSH: 47months/10months; LT: 60months/19months) but LT showed higher OS and DFS.</p><p><strong>Conclusions: </strong>Outcomes of patients with BCRLM differ through surgical strategies that showed high variability across countries, centers and eras. There is a need for common definition of BCRLM and guidelines for managing patients including transplant option.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102429"},"PeriodicalIF":2.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716935","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":"Idiopathic Myointimal Hyperplasia of Mesenteric Veins.","authors":"Carola Hermoso, Juliana Napoli, Juan Pablo Campana","doi":"10.1016/j.gassur.2026.102430","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102430","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102430"},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716953","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":"Robotics on the Rise, But Not Everywhere: National Trends in Robotic Approach for Colorectal Cancer Surgery.","authors":"Andrew Hu, Benjamin Gallant, Hayley Reddington, Zachary Ballinger, Justin Maykel, Tess Aulet, Paul Sturrock, Thomas Peponis, Feiran Lou, Karim Alavi","doi":"10.1016/j.gassur.2026.102424","DOIUrl":"10.1016/j.gassur.2026.102424","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical approaches, including laparoscopic and robotic techniques, improved outcomes in colorectal cancer resection by decreasing pain, hospital length of stay, and perioperative mortality. However, broader robotic adoption faces several barriers. This study evaluated national trends in robotic colorectal surgery using the National Cancer Database (NCDB).</p><p><strong>Methods: </strong>Patients with stage I-III colon and rectal adenocarcinoma undergoing resection (2010 - 2021) were identified. Trends in surgical approach (open, laparoscopic, robotic) were analyzed. Multivariable logistic regression identified factors associated with robotic adoption.</p><p><strong>Results: </strong>A total of 537,627 colon and 116,763 rectal resections were included. Robotics were utilized in 61,640 (11.5%) colon and 30,569 (26.1%) rectal cases. For colon cancer, robotic adoption increased +2.4% annually, nearly equalling open surgery by 2021 (26.7% vs. 27.2%). For rectal cancer, adoption rose +4.28% annually, surpassing both laparoscopic and open approaches by 2018. Robotic surgery was predominately performed in metropolitan centers (87.2%) versus rural areas (1.5%). Regionally, adoption was highest in the West North Central (+5.0%/year) and West South Central (+3.3%/year) regions and lowest in New England (+1.3%/year). Compared with New England, all regions were more likely to utilize robotics, with the West North Central region demonstrating the highest odds (OR 2.15; 95% CI: 1.95-2.38).</p><p><strong>Conclusions: </strong>Robotic colorectal cancer surgery has expanded substantially over the past decade, with marked regional and institutional disparities. Understanding these patterns may inform targeted educational initiatives and promote nationwide equitable adoption of robotic surgery.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102424"},"PeriodicalIF":2.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698963","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":"Evidence Rising, Integration Lagging: The Bottleneck of Circulating Free and Tumor DNA Application in Liver Transplantation for Hepatocellular Carcinoma.","authors":"Sami Shoucair, Ahmed Sayed Ahmed, Valberto Sanha, Geofia Crasta, Wei Kelly Wu, Dylan Isaacson, Woo Jin Choi, Ramsey Ugarte, Mariam Ismail, Jibran Khan, Chase Wehrle, Suneel Kamath, Shilpa Junna, Jamak Modaresi-Esfeh, Alejandro Pita, Koji Hashimoto, Mazhar Khalil, Jaekeun Kim, David C H Kwon, Federico Aucejo","doi":"10.1016/j.gassur.2026.102426","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102426","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a leading indication for liver transplantation (LT), yet post-transplant recurrence remains a major challenge. Liquid biopsy biomarkers including circulating cell-free DNA (cfDNA) and circulating tumor DNA (ctDNA) have emerged as promising tools for dynamic risk stratification, molecular residual disease (MRD) detection, and personalized surveillance. Despite increasing evidence supporting their prognostic value, integration of cfDNA and ctDNA into transplant algorithms remains limited.</p><p><strong>Methods: </strong>We performed a targeted literature review synthesizing data from studies evaluating cfDNA and ctDNA in patients undergoing curative-intent hepatectomy or LT for HCC. We examined their roles in pre-transplant biological risk assessment, perioperative monitoring, and post-transplant MRD detection. We additionally evaluated logistical, methodological, operational, and ethical barriers to widespread adoption, including assay performance variability, workflow constraints, and infrastructure limitations.</p><p><strong>Results: </strong>Elevated preoperative cfDNA levels and postoperative ctDNA positivity consistently predicted aggressive tumor biology, early recurrence, and reduced survival. Tumor-informed, tumor-naïve, and methylation-based ctDNA assays demonstrated high sensitivity for detecting recurrence, often 3-8 months before radiographic progression, and provided prognostic discrimination beyond AFP and traditional morphologic criteria. However, translation into clinical practice is hindered by heterogeneity in testing platforms (ddPCR, NGS, methylation assays), differences in detection thresholds (0.01%-1% VAF), lack of standardized protocols for sampling and analysis, limited reimbursement pathways, 7-14-day turnaround times, and poor integration with electronic medical records.</p><p><strong>Conclusion: </strong>cfDNA and ctDNA offer transformative opportunities to enhance biologically informed LT selection, enable early recurrence detection, and support precision-guided postoperative management. Standardized protocols and large-scale prospective validation are essential to achieving routine clinical integration and realizing the full potential of liquid biopsy in transplant oncology.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102426"},"PeriodicalIF":2.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699040","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}