Journal of Gastrointestinal Surgery最新文献

{"title":"Effects of a whole-course individualized comprehensive nursing program on anastomotic leakage incidence and patient outcomes after esophageal cancer surgery.","authors":"Li-Hua Yan, Yan Li, Min Zhang, Yu Lu, Li-Yun Ben, Yi-Ming Xu","doi":"10.1016/j.gassur.2026.102386","DOIUrl":"10.1016/j.gassur.2026.102386","url":null,"abstract":"<p><strong>Background: </strong>To explore the effect of the whole individualized comprehensive nursing program on the incidence of anastomotic leakage and prognosis of patients after esophageal cancer surgery.</p><p><strong>Methods: </strong>A total of 120 patients who planned to undergo radical resection of esophageal cancer between March 2022 and March 2025 were randomly divided into an experimental group (n = 60) and a control group (n = 60). The experimental group received whole-course individualized comprehensive nursing, including preoperative nutritional risk screening and intervention, precise management of basic diseases, psychological intervention, perioperative preparation under the concept of enhanced recovery after surgery, postoperative fistula targeted nursing, multichannel fine management, and complication prevention. The control group received routine nursing. The incidence of anastomotic leakage, healing time, hospitalization days, medical expenses, total incidence of postoperative complications, short form (SF)-36 quality of life score, and nursing satisfaction were compared between the 2 groups.</p><p><strong>Results: </strong>The incidence of anastomotic leakage in the experimental group (3.33%) was significantly lower than that in the control group (11.67%). The healing time of fistula and length of hospital stay in the experimental group were shorter than those in the control group, and the medical cost was lower than that in the control group (P <.05). The total incidence of postoperative complications in the experimental group (8.33%) was lower than that in the control group (20.00%), and the physical health general score, mental health general score, and nursing satisfaction score on the SF-36 scale at 1 month after operation were significantly higher than those in the control group (P <.05).</p><p><strong>Conclusion: </strong>The whole course individualized comprehensive nursing program can effectively reduce the incidence of anastomotic leakage after esophageal cancer surgery, reduce the risk of complications, and improve the quality of life of patients after surgery; this has important clinical application value.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102386"},"PeriodicalIF":2.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493893","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":"Clinicopathologic Characteristics, Management, and Outcomes of Different Types of Appendiceal Cancer: A National Cancer Database Study.","authors":"Ali Esparham, Jennifer Whittington, George Agriantonis, Zahra Shafaee","doi":"10.1016/j.gassur.2026.102397","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102397","url":null,"abstract":"<p><strong>Background: </strong>The incidence of appendiceal cancer has increased over the last two decades. The current study aims to investigate the overall survival and prognostic factors of appendiceal cancer using the National Cancer Data Bank (NCDB) database.</p><p><strong>Methods: </strong>We used the NCDB (2004-2020) in the current retrospective analysis to include patients with appendiceal cancer. We meticulously selected histologies that corresponded to goblet cell adenocarcinoma (GCA), neuroendocrine neoplasm (NEN), non-mucinous adenocarcinoma (NMA), and mucinous adenocarcinoma (MA).</p><p><strong>Results: </strong>The GCA, MA, NEN, and NMA groups consist of 6,111, 16,471, 19,199, and 11,065 patients, respectively. The NMA group had significantly lower overall survival (101.40 months, 95% CI (99.13-103.67)) compared to the other groups (p<0.001). The NEN group had significantly higher overall survival (170.88 months, 95% CI (168.56-173.20)) compared to the other groups (p<0.001). Importantly, NMA type of appendiceal tumor (HR: 1.37, reference: GCA), intraoperative chemotherapy (HR: 0.60, reference: neoadjuvant therapy), and laparoscopic approach surgery (HR: 0.74, reference: open approach) were independent predictors of overall survival in patients with appendiceal cancer.</p><p><strong>Conclusion: </strong>Our study revealed that NMA and NEN types had the poorest and best overall survival rates, respectively, compared to other types. In addition, intraoperative systemic therapy and laparoscopic approach surgery were independently associated with better survival in patients with appendiceal cancer.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102397"},"PeriodicalIF":2.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377716","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 Editor regarding: \"Overuse of subtotal cholecystectomy: surgeon practice patterns and outcomes in a large healthcare system\".","authors":"Farman Ali","doi":"10.1016/j.gassur.2026.102384","DOIUrl":"https://doi.org/10.1016/j.gassur.2026.102384","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102384"},"PeriodicalIF":2.4,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369549","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 “Restoring bowel continuity after extended left colectomy: a comparative study of the retroileal window and Deloyers techniques”","authors":"Vitaliy Poylin","doi":"10.1016/j.gassur.2025.102309","DOIUrl":"10.1016/j.gassur.2025.102309","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102309"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948869","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":"Disparities in presentation and outcomes after surgery for medically refractory gastroparesis: the impact of demographic and socioeconomic status","authors":"Emma Venard ,&nbsp;Sven E. Eriksson ,&nbsp;Margaret Gardner ,&nbsp;Ping Zheng ,&nbsp;Shahin Ayazi","doi":"10.1016/j.gassur.2025.102312","DOIUrl":"10.1016/j.gassur.2025.102312","url":null,"abstract":"<div><h3>Background</h3><div>Gastroparesis is a debilitating disorder, and surgical therapy can provide meaningful improvement in patients who remain symptomatic despite medical treatment. However, patients often present with variable disease severity, and the influence of demographic and socioeconomic factors on this variability and on postoperative outcomes remains poorly defined. This study aimed to evaluate the effect of demographic status and socioeconomic status (SES) on preoperative characteristics and postoperative outcomes in patients who underwent surgery for medically refractory gastroparesis.</div></div><div><h3>Methods</h3><div>All patients who underwent surgical treatment of medically refractory gastroparesis between 2012 and 2024 at a tertiary foregut center were retrospectively analyzed. Demographics, gastroparesis etiology, gastric emptying, and Gastroparesis Cardinal Symptom Index (GCSI) scores were compared across sex, race, age, and SES groups. SES classification was derived from zip code–level United States census data. Surgical procedures included pyloroplasty, gastric peroral endoscopic pyloromyotomy, and gastric electrical stimulation.</div></div><div><h3>Results</h3><div>A total of 387 patients were included (82.4% female; mean age of 51.3 ± 15.6 years). Idiopathic (62.3%) and diabetic (23.9%) etiologies predominated. Overall, GCSI total score improved significantly (median: 3.1 [IQR, 2.5–3.9] to 2.4 [IQR 1.6–3.3]; <em>P</em> &lt;.001), and gastric retention at 4 h decreased (29.0% [IQR, 17.0%–44.9%] to 8.0% [IQR, 1.0%–24.0%]; <em>P</em> &lt;.001). African American patients presented with higher baseline GCSI total score (median: 4.3 [IQR, 3.3–4.8] vs 3.1 [IQR, 2.4–3.8]; <em>P</em> =.011) and continued to report higher postoperative symptom scores (GCSI total score: 3.1 vs 2.4; <em>P</em> =.031). Similarly, patients with low SES demonstarted a trend toward more severe preoperative symptoms and higher gastric retention but achieved postoperative improvement comparable with those with higher SES. A significant correlation between preoperative gastric emptying at 4-hour retention and GCSI total score was observed only in men, both preoperatively (<em>r</em> = 0.46; <em>P</em> =.049) and postoperatively (<em>r</em> = 0.60; <em>P</em> =.025). Younger patients were less likely to have symptom resolution (<em>P</em> =.035).</div></div><div><h3>Conclusion</h3><div>Surgical treatment achieved durable improvement in medically refractory gastroparesis, with similar postoperative gains across SES groups. Persistent symptoms in African American and younger patients and sex-specific differences in symptom-motility correlation suggest multifactorial mechanisms beyond motility alone.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102312"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957634","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":"Light amplification by stimulated emission of radiation in fistula-in-ano: innovation or impetuosity? Current position","authors":"Vipul D. Yagnik ,&nbsp;Prema Ram Choudhary ,&nbsp;Pankaj Garg","doi":"10.1016/j.gassur.2026.102328","DOIUrl":"10.1016/j.gassur.2026.102328","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102328"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989572","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":"Comparative effectiveness of exercise modalities on psychological outcomes and quality of life in digestive system cancer survivors: a systematic review and network meta-analysis","authors":"Jiaqi Li,&nbsp;Qian Zhang,&nbsp;Wei Ning,&nbsp;Zhenzi Wang","doi":"10.1016/j.gassur.2025.102313","DOIUrl":"10.1016/j.gassur.2025.102313","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of digestive system cancers frequently experience depression, anxiety, fatigue, and impaired health-related quality of life (HRQoL). Exercise has emerged as a promising adjunctive therapy. However, the optimal modality and prescription remain unclear. This study aimed to evaluate the effects of exercise on psychological outcomes and HRQoL, to rank the relative efficacy of different modalities, and to identify optimal exercise characteristics through subgroup analyses.</div></div><div><h3>Methods</h3><div>PubMed, Embase, CENTRAL, Web of Science, and Google Scholar were searched until August 31, 2025, for randomized controlled trials (RCTs) of exercise interventions in adult survivors of digestive system cancers. Eligible comparators included usual care, no intervention, or alternative exercise. The primary outcomes were HRQoL, fatigue, depression, and anxiety, which were measured using validated instruments. The standardized mean differences (SMDs) with 95% CIs were used as effect estimates. Pairwise meta-analyses were performed with random-effects models, and Bayesian network meta-analysis was used to compare exercise modalities. Subgroup analyses were used to examine moderators, including cancer type, exercise intensity, frequency, session duration, and intervention length.</div></div><div><h3>Results</h3><div>A total of 38 RCTs that involved 3255 participants were included. The exercise group significantly had improved HRQoL (SMD, 0.43 [95% CI, 0.27–0.59]) and reduced fatigue (SMD, −0.52 [95% CI, −0.72 to −0.32]), depression (SMD, −0.37 [95% CI, −0.58 to −0.15]), and anxiety (SMD, −0.33 [95% CI, −0.44 to −0.21]) compared with the control group. Network meta-analysis indicated that mind-body exercise (such as yoga or tai chi) was most effective for HRQoL (SMD, 0.68 [95% CI, 0.22–1.14]) and depression (SMD, −0.55 [95% CI, −0.95 to −0.16]), resistance training for fatigue (SMD, −0.79 [95% CI, −1.35 to −0.23]), and combined training (CT) for anxiety (SMD, −0.38 [95% CI, −0.53 to −0.23]). Subgroup analyses showed that moderate-intensity, moderate-frequency, and medium-to-long interventions produced the most consistent benefits.</div></div><div><h3>Conclusion</h3><div>Exercise interventions significantly improved HRQoL and reduced depression, anxiety, and fatigue in survivors of digestive system cancers. Mind-body exercise (eg, yoga or tai chi) demonstrated the greatest benefits for HRQoL and depression, resistance training best alleviated fatigue, and CT reduced anxiety. Moderate-intensity, sustained programs achieved the most consistent benefits, supporting individualized exercise prescriptions in survivorship care.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102313"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878464","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 parenchymal-sparing right posterior hepatectomy for large hepatic adenoma: practical technique of parenchymal transection using the SynchroSeal ultrasonic device","authors":"Shivanshu Kumar,&nbsp;Maria Christodoulou,&nbsp;Iswanto Sucandy","doi":"10.1016/j.gassur.2026.102341","DOIUrl":"10.1016/j.gassur.2026.102341","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102341"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040812","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":"The efficacy of immunotherapy in the treatment of tyrosine kinase inhibitor-refractory gastrointestinal stromal tumors: a systematic review and meta-analysis","authors":"YuLong Zhang ,&nbsp;XianHao Xiao ,&nbsp;JiaYing Tan,&nbsp;Liang Shan,&nbsp;He Song","doi":"10.1016/j.gassur.2025.102307","DOIUrl":"10.1016/j.gassur.2025.102307","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. The advent of tyrosine kinase inhibitors (TKIs), such as imatinib, has significantly improved clinical outcomes in patients with GISTs by delaying metastasis and prolonging survival. However, most patients eventually develop resistance to TKIs, limiting long-term disease control. Immunotherapy has demonstrated durable responses in various solid tumors and has emerged as a potential treatment strategy for TKI-refractory GISTs. This study aimed to systematically evaluate the efficacy and safety of immunotherapy in patients with advanced or recurrent GIST, particularly those who have failed previous TKI therapy, to inform future clinical decision-making and research directions.</div></div><div><h3>Methods</h3><div>A systematic literature search of PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov was conducted for studies published before June 23, 2025. The inclusion criteria focused on immunotherapy interventions in patients with histologically confirmed GIST. Study selection, data extraction, and risk of bias assessments were performed independently by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Joanna Briggs Institute checklist was used for quality appraisal. Random-effects models were used to pool estimates of clinical benefit rate (CBR), objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Generalized linear mixed models (GLMM) were used to account for cohorts with extreme values. This review protocol was registered with the International Registry of Systematic Reviews (registration number: CRD42024496866).</div></div><div><h3>Results</h3><div>A total of 9 studies involving 169 patients were included. The pooled CBR was 41.69% (95% CI, 26.99%–58.03%), and the ORR was 16.49% (95% CI, 6.25%–36.91%), both with moderate to high heterogeneity. GLMM adjustments, which incorporated additional extreme value cohorts, yielded a corrected CBR of 46.39% (95% CI, 28.85%–64.88%) and ORR of 13.23% (95% CI, 4.21%–34.56%). The pooled median PFS across 7 cohorts was 6.11 months (95% CI, 2.63–9.59), and the OS, which was calculated using 2 models, ranged from 15.53 to 17.01 months, depending on the data imputation strategy.</div></div><div><h3>Conclusion</h3><div>This meta-analysis suggests that immunotherapy provides modest yet clinically meaningful efficacy in patients with advanced or treatment-refractory GIST. Despite considerable heterogeneity among studies, the observed trends in response and survival outcomes support immunotherapy as a viable treatment option. Further large-scale, biomarker-driven clinical trials are warranted to validate these findings and guide personalized therapeutic strategies.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102307"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800569","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":"Intrathoracic side-overlap vs circular stapled esophagogastrostomy for Siewert type I/II adenocarcinoma of the esophagogastric junction: a retrospective comparative study","authors":"Chuanle Cheng ,&nbsp;Zhanpeng Tang ,&nbsp;Yijun Ma,&nbsp;Lei Qi,&nbsp;Hui Tian,&nbsp;Lin Li","doi":"10.1016/j.gassur.2026.102332","DOIUrl":"10.1016/j.gassur.2026.102332","url":null,"abstract":"<div><h3>Background</h3><div>Esophagectomy remains the primary curative treatment of esophageal cancer, and the anastomotic technique is a crucial determinant of postoperative outcomes. Although circular stapled esophagogastrostomy (CSE) is widely used, side-overlap esophagogastrostomy (SOE) has recently been adapted for intrathoracic reconstruction.</div></div><div><h3>Methods</h3><div>This retrospective study included 105 patients who underwent Ivor-Lewis esophagectomy. The short-term clinical outcomes were compared between the SOE group and the CSE group.</div></div><div><h3>Results</h3><div>No significant differences were observed between the SOE and CSE groups in operative duration (189.0 ± 49.9 vs 200.2 ± 48.3 min, respectively; <em>P</em> =.246), estimated blood loss (110 mL [IQR, 150–90] vs 120 mL [IQR, 150–100], respectively; <em>P</em> =.354), or number of lymph nodes harvested (19.0 [IQR, 23.0–16.0] vs 17.5 [IQR, 21.0–15.8], respectively; <em>P</em> =.285). The overall postoperative complication rate was similar (18.2% in the SOE group vs 22.0% in the CSE group; <em>P</em> =.625). However, patients in the SOE group reported significantly lower pain scores on postoperative days (PODs) 1 and 2 (POD1: 3.49 ± 0.79 in the SOE group vs 4.04 ± 0.95 in the CSE group; <em>P</em> =.002; POD2: 2.73 ± 0.65 in the SOE group vs 3.06 ± 0.62 in the CSE group, <em>P</em> =.009). The incidence of severe gastroesophageal reflux (Reflux Disease Questionnaire ≥ 12) was significantly lower in the SOE group than in the CSE group (14.5% vs 34.0%, respectively; <em>P</em> =.019). Dysphagia symptoms were less frequent in the SOE group than in the CSE group (9.1% vs 24.0%, respectively; <em>P</em> =.038).</div></div><div><h3>Conclusion</h3><div>Intrathoracic SOE is a safe and feasible alternative to CSE for patients with Siewert type I/II adenocarcinoma of the esophagogastric junction undergoing esophagectomy. SOE offers comparable operative safety while reducing postoperative pain, severe reflux, and dysphagia, suggesting functional advantages in short-term recovery.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102332"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989575","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}