Journal of Gastrointestinal Surgery最新文献

{"title":"Association of symptom complexes with consequence severity in low anterior resection syndrome after intersphincteric resection for ultralow rectal cancer: An exploratory cross-sectional study.","authors":"Bin Zhang, Chen-Chen Zou, Hai-Tao Ma, Yu-Juan Zhao, Guang-Zuan Zhuo, Jian-Bin Xiang, Jian-Hua Ding","doi":"10.1016/j.gassur.2026.102421","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102421","url":null,"abstract":"<p><strong>Background: </strong>The international consensus delineates eight symptom complexes and eight consequences for defining low anterior resection syndrome (LARS). This exploratory cross-sectional study aimed to evaluate differential associations of the symptom complexes with consequence severity after intersphincteric resection (ISR) for ultralow rectal cancer.</p><p><strong>Methods: </strong>Patients were enrolled ≥12 months after diverting ileostomy reversal following ISR. The severity of the consensus-defined LARS variables was assessed using five-point Likert scales. Participants completed questionnaires on bowel function and condition-specific quality-of-life (CSQoL).</p><p><strong>Results: </strong>A total of 174 patients were included (response rate: 85.3%). Our exploratory severity scores revealed a strong symptom-consequence correlation (r_s = 0.78). All symptom complexes demonstrated significant univariable associations with LARS consequence severity, bowel function satisfaction, and CSQoL (all p < 0.001), although \"altered stool consistency\" showed uniformly weak associations. Multivariable analysis identified four symptom complexes remained independently associated with adverse consequences: \"emptying difficulties\" (B = 2.15, 95% CI [1.16, 3.14], p < 0.001), \"urgency\" (B = 1.55, 95% CI [0.62, 2.48], p = 0.001), \"variable and unpredictable bowel function\" (B = 1.46, 95% CI [0.46, 2.45], p = 0.004), and \"repeated painful stools\" (B = 1.17, 95% CI [0.45, 1.89], p = 0.002). In contrast, \"altered stool consistency\" exhibited a near-null independent association (B = -0.03, 95% CI [-0.88, 0.82], p = 0.944).</p><p><strong>Conclusion: </strong>Four specific symptom complexes, including \"emptying difficulties\", \"urgency\", \"variable bowel function\", and \"repeated painful stools\", were independently associated with adverse LARS consequences after ISR. However, \"altered stool consistency\" showed no such independent link, which warrants further investigation.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102421"},"PeriodicalIF":2.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674076","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":"Postsurgical circulating tumor DNA as a prognostic biomarker for relapse of resected pancreatic ductal adenocarcinoma","authors":"Matthew Z. Guo ,&nbsp;Apoorvaa S. Sachidanand ,&nbsp;Thanh Nguyen ,&nbsp;Sagar D. Patel ,&nbsp;William R. Burns ,&nbsp;Richard Burkhart ,&nbsp;Dung T. Le ,&nbsp;Kelly Lafaro ,&nbsp;Katherine M. Bever ,&nbsp;Michael J. Pishvaian ,&nbsp;Christopher Shubert ,&nbsp;Daniel Laheru ,&nbsp;Elizabeth Jaffee ,&nbsp;Eric S. Christenson ,&nbsp;Jin He","doi":"10.1016/j.gassur.2026.102359","DOIUrl":"10.1016/j.gassur.2026.102359","url":null,"abstract":"<div><h3>Background</h3><div>Circulating tumor DNA (ctDNA) has been used to diagnose and monitor response to therapy in the setting of advanced pancreatic ductal adenocarcinoma (PDAC), but its utility in the adjuvant setting to monitor for relapse after curative resection is less understood.</div></div><div><h3>Methods</h3><div>In this single-institution, retrospective study, we evaluated the use of ctDNA during the postoperative window (within 90 days from surgical resection and 30 days from the start of adjuvant therapy) and subsequent adjuvant/surveillance window (after the postoperative window) as prognostic biomarkers for relapse. We compared demographic and clinical characteristics among patients with radiographic disease relapse based on ctDNA positivity.</div></div><div><h3>Results</h3><div>We identified 51 patients with PDAC who underwent curative-intent surgical resection between 2013 and 2024 and completed postoperative ctDNA testing. Median follow-up was 635 days, and 28 patients (54.9%) experienced disease relapse. ctDNA during the postoperative window had a sensitivity of 35.7% and specificity of 88.9% for prognosticating disease relapse after resection, with a positive predictive value (PPV) of 79.6% and negative predictive value (NPV) of 53.2%. ctDNA during the adjuvant/surveillance window had a sensitivity of 62.5%, specificity of 95.5%, PPV of 94.4%, and NPV of 67.7%. Patients with disease relapse as liver metastases had the highest rate of ctNA positivity (n = 10 of 12; 83.3%), followed by resection bed recurrence (n = 4 of 7; 57.1%) and nonliver distant metastatic recurrence (n = 4 of 9; 44.4%).</div></div><div><h3>Conclusion</h3><div>Positive ctDNA is a strong prognostic factor for relapse after resection for PDAC; however, ctDNA testing lacks sensitivity to replace conventional surveillance testing in patients with resected PDAC.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102359"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125280","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":"Robotic-assisted resection of a retroperitoneal arteriovenous malformation","authors":"Melody Pi Yin Tu,&nbsp;Hoe Yan Hor,&nbsp;Nabil Wasif","doi":"10.1016/j.gassur.2026.102371","DOIUrl":"10.1016/j.gassur.2026.102371","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102371"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201965","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":"Quain’s internal hernia: a case report","authors":"Ricardo Soto Gómez","doi":"10.1016/j.gassur.2026.102324","DOIUrl":"10.1016/j.gassur.2026.102324","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102324"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994517","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 “Oral microbiome signatures as potential biomarkers for gastric cancer risk assessment”","authors":"Kanishka Harariya ,&nbsp;Thakur Rohit Singh ,&nbsp;Ankita Kalra ,&nbsp;Swarupanjali Padhi ,&nbsp;Fayaz Ahamed","doi":"10.1016/j.gassur.2026.102339","DOIUrl":"10.1016/j.gassur.2026.102339","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102339"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003513","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":"Operative strategies for the acute difficult gallbladder: a Society for Surgery of the Alimentary Tract state-of-the-art systematic review and meta-analysis of subtotal cholecystectomy outcomes","authors":"Muhammad Ahmad Nadeem ,&nbsp;Abdul Rafeh Awan ,&nbsp;Chase J. Wehrle ,&nbsp;Ayaka Tsutsumi ,&nbsp;Fabrizio Darby ,&nbsp;Shaan Bhandarkar ,&nbsp;David Bentrem ,&nbsp;Casey Allen ,&nbsp;Kaitlyn Kelly ,&nbsp;Clancy Clark ,&nbsp;Toms Augustin ,&nbsp;Vanita Ahuja ,&nbsp;Samer Naffouje","doi":"10.1016/j.gassur.2026.102345","DOIUrl":"10.1016/j.gassur.2026.102345","url":null,"abstract":"<div><h3>Background</h3><div>The “difficult gallbladder” in acute cholecystitis can preclude safe achievement of the critical view of safety, prompting subtotal cholecystectomy (STC) as a guideline-supported bailout. We performed a contemporary synthesis to clarify STC’s safety effectiveness trade-offs vs total cholecystectomy (TC) and delineate technique-specific outcomes and patient factors that may influence risk.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies from 2010 to June 2025. Three comparisons were evaluated: (i) single-arm outcomes after STC, (ii) STC vs TC, and (iii) fenestrating STC (f-STC) vs reconstituting STC (r-STC). Random-effects models were applied, with prespecified subgroup analyses, leave-one-out sensitivity analyses, and exploratory meta-regression.</div></div><div><h3>Results</h3><div>In single-arm analysis, bile duct injury (BDI) occurred in 0.3%, bile leak in 13.5%, retained stones in 6.1%, and overall complications in 24.7% of patients. Readmission and reoperation occurred in 17.8% and 6.3%, whereas mortality was 0.8%. Postprocedural endoscopic retrograde cholangiopancreatography (ERCP) occurred in 16.2%, and percutaneous drainage in 5.7%. Compared with TC, STC had significantly higher bile leak, retained stones, overall complications, readmission, reoperation, and ERCP, with no significant difference in mortality, intensive care unit admission, or length of stay (LOS). Meta-regression linked diabetes with higher leak, complications, and ERCP, and male sex with higher surgical site infection. f-STC had significantly higher bile leak and longer LOS than r-STC, with ERCP trending higher.</div></div><div><h3>Conclusion</h3><div>STC carries a very low BDI rate, but higher postoperative morbidity and secondary interventions than TC. r-STC demonstrated superior outcomes to f-STC. Diabetes and male sex were important risk modifiers. STC remains a rational bailout when the critical view cannot be achieved.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102345"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125356","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":"Neoadjuvant stereotactic body vs conventionally fractionated radiation therapy for borderline resectable and locally advanced pancreatic cancer: a propensity score–matched analysis","authors":"Takayuki Shimizu ,&nbsp;Serena Zheng ,&nbsp;Shimpei Maeda ,&nbsp;Jason Link ,&nbsp;Aletta Deranteriassian ,&nbsp;Alykhan Premji ,&nbsp;Johathan King ,&nbsp;Mark Girgis ,&nbsp;Oscar Joe Hines ,&nbsp;Zev Wainberg ,&nbsp;Ann Raldow ,&nbsp;Jin He ,&nbsp;William Burns ,&nbsp;Amol Narang ,&nbsp;Motaz Qadan ,&nbsp;Carlos Fernandez-Del Castillo ,&nbsp;Keith D. Lillemoe ,&nbsp;Jennifer Wo ,&nbsp;Theodore Hong ,&nbsp;Timothy R. Donahue","doi":"10.1016/j.gassur.2026.102358","DOIUrl":"10.1016/j.gassur.2026.102358","url":null,"abstract":"<div><h3>Background</h3><div>Stereotactic body radiation therapy (SBRT) is increasingly used in neoadjuvant chemoradiotherapy (NCRT) for borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PC), but head-to-head data on SBRT vs conventionally fractionated radiation therapy (CFRT) remain limited. We compared clinical and pathological outcomes of SBRT vs CFRT in BR/LA PC.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 312 patients with BR/LA PC who received NCRT followed by margin-negative (R0)/margin-positive surgery at 3 high-volume academic centers (2011–2021). To reduce selection bias, 1:1 propensity score matching (PSM) was applied based on baseline clinical variables. The primary outcome was overall survival (OS), and the secondary outcome was clinical and pathological response to NCRT.</div></div><div><h3>Results</h3><div>Of 312 patients, 177 (56.7%) received SBRT and 135 (43.3%) received CFRT. Before PSM, significant differences were observed in patient age, neoadjuvant chemotherapy regimen, and duration of the preoperative interval. After PSM, 180 patients were matched, with no significant differences in pretreatment variables between groups. Clinical and pathological outcomes were similar between the matched cohorts, including complete/near-complete pathological response rates (36.7% vs 45.6%; <em>P</em> =.56), node-positive disease (32.2% vs 36.7%; <em>P</em> =.53), and R0 resection rates (80.0% vs 82.2%; <em>P</em> =.70). The median OS was not significantly different (27.2 vs 40.6 months; <em>P</em> =.70). Patients in the SBRT cohort were more likely to receive adjuvant therapy than those in the CFRT cohort (60.0% vs 38.9%; <em>P</em> =.007). In subgroup analyses restricted to patients treated with neoadjuvant FOLFIRINOX (FFX), SBRT was associated with a significantly longer OS among those presenting with markedly elevated pretreatment carbohydrate antigen 19-9 (CA19-9) levels (≥1500 U/mL) (29.8 vs 12.1 months; <em>P</em> =.02).</div></div><div><h3>Conclusion</h3><div>Neoadjuvant SBRT achieves oncologic outcomes comparable with CFRT in BR/LA PC and is associated with greater adjuvant therapy use. A potential survival signal for SBRT in patients receiving FFX with CA19-9 of ≥1500 U/mL is hypothesis generating and warrants validation and formal interaction testing.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102358"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125343","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":"Robotic ventral mesh rectopexy: standard technique and difficult scenarios","authors":"Marco Bertucci Zoccali,&nbsp;Taylor Kavanagh,&nbsp;Yuhamy Curbelo","doi":"10.1016/j.gassur.2026.102362","DOIUrl":"10.1016/j.gassur.2026.102362","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102362"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132027","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":"Distant esophageal metastasis from colorectal adenocarcinoma","authors":"Tian-Qi Zhao ,&nbsp;Kai-Rong Hou ,&nbsp;Wei Liu","doi":"10.1016/j.gassur.2026.102370","DOIUrl":"10.1016/j.gassur.2026.102370","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102370"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197733","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":"Age-related differences in postoperative outcomes following colectomy for diverticular disease: a National Surgical Quality Improvement Program study","authors":"Spyridon Papadimatos,&nbsp;Itzel Elizabeth Vidal Sanchez,&nbsp;Alexander A. Xu,&nbsp;Kristen T. Crowell,&nbsp;Evangelos Messaris","doi":"10.1016/j.gassur.2026.102340","DOIUrl":"10.1016/j.gassur.2026.102340","url":null,"abstract":"<div><h3>Purpose</h3><div>The incidence of diverticular disease in younger adults has been on the rise over the past decades. This study aimed to evaluate the association between age and postoperative outcomes for patients undergoing colectomy for diverticular disease.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files between 2016 and 2020. Adults aged ≥18 years who underwent colectomy for diverticular disease were included. Demographic, perioperative, and postoperative variables were analyzed between patients aged &lt;50 and ≥50 years. A multivariable logistic regression was used to identify independent predictors of major intra-abdominal complications, defined as positive when either anastomotic leak or organ/space surgical site infections were present.</div></div><div><h3>Results</h3><div>A total of 39,729 patients met the inclusion criteria. Younger individuals comprised 23% of the cohort, were less often female (36% vs 61%; <em>P</em> &lt;.001), had a higher mean body mass index (32 vs 29; <em>P</em> &lt;.001), and were more likely to be smokers (28% vs 18%; <em>P</em> &lt;.001). Readmissions were more frequent in older patients (8.5% vs 7.5%; <em>P</em> =.002); however, the median time to first readmission occurred earlier in younger patients (12 vs 15 days; <em>P</em> &lt;.001). In multivariable analysis, among other factors, age younger than 50 years independently increased the risk of major intra-abdominal complications (odds ratio, 1.14; 95% CI, 1.02–1.27).</div></div><div><h3>Conclusion</h3><div>Despite their overall healthier profile, younger patients experience comparable postoperative risk rates with older patients and are at an increased risk of severe intra-abdominal complications. These findings provide insights that add to patient–physician shared decision making.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 4","pages":"Article 102340"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040817","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}