Journal of Gastrointestinal Surgery最新文献

{"title":"Robotic parenchymal-sparing right posterior hepatectomy for large hepatic adenoma: practical technique of parenchymal transection using the SynchroSeal ultrasonic device","authors":"Shivanshu Kumar, Maria Christodoulou, 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}

{"title":"A rare type of gastric malignancy: primary gastric Burkitt lymphoma","authors":"Shaoping Xiong,&nbsp;Wenju Chen","doi":"10.1016/j.gassur.2026.102326","DOIUrl":"10.1016/j.gassur.2026.102326","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102326"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984955","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":"Per oral endoscopic myotomy and laparoscopic Heller myotomy show similar outcomes in type III achalasia","authors":"Archana K. Jeeji,&nbsp;Peter T. White,&nbsp;Adam J. Bograd,&nbsp;Alexander S. Farivar,&nbsp;Emily M. Mackay,&nbsp;Brian E. Louie","doi":"10.1016/j.gassur.2026.102331","DOIUrl":"10.1016/j.gassur.2026.102331","url":null,"abstract":"<div><h3>Background</h3><div>Achalasia is classified into 3 manometric subtypes with variable treatment response. Guidelines recommend per oral endoscopic myotomy (POEM) over laparoscopic Heller myotomy (LHM) for the treatment of achalasia type III. However, there is limited evidence directly comparing these operations. We aimed to compare the treatment response to POEM vs LHM in type III achalasia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, case-control review of patients undergoing primary myotomy for type III achalasia or achalasia variants with type III features. The primary outcome was symptomatic response assessed using the Eckardt score (ES) with a score of ≤3 classified as success. The secondary outcome was the need for reintervention(s) within 3 years.</div></div><div><h3>Results</h3><div>There were 46 patients, of whom 16 underwent POEM, and 30 underwent LHM. The groups were similar in demographics, preoperative ESs, and rates of preoperative endoscopic interventions. Both groups had median myotomy lengths of 6 cm (4 cm esophageal and 2 cm gastric). After myotomy, both groups had similar rates of success (14/16 POEM vs 26/30 LHM, <em>P</em> =.94). The primary persisting symptom was dysphagia in both groups. Reinterventions occurred in 4/16 (25%) of POEM patients who underwent 9 reinterventions compared with 5/30 (16.7%) LHM patients who underwent 6 reinterventions (<em>P</em> =.49). Most patients in both groups had symptomatic improvement after their last reintervention.</div></div><div><h3>Conclusion</h3><div>Patients with type III achalasia had similar improvements after undergoing POEM or LHM. There was no difference in reintervention rates between the groups. Patients undergoing reintervention after POEM were more likely to undergo multiple reinterventions.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102331"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989569","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 “Beyond short-term outcomes: mechanistic and equity considerations for minimally invasive surgery in small bowel neuroendocrine tumors”","authors":"Ye Tian,&nbsp;Ce Zhang,&nbsp;Muhu Chen","doi":"10.1016/j.gassur.2026.102334","DOIUrl":"10.1016/j.gassur.2026.102334","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102334"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989551","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":"Reassessing Medicaid expansion analyses in the National Cancer Database: the perils of misclassified state expansion status","authors":"Rohin Gawdi ,&nbsp;Julien T. Hohenleitner ,&nbsp;Matthew J. Weiss","doi":"10.1016/j.gassur.2026.102343","DOIUrl":"10.1016/j.gassur.2026.102343","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102343"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044057","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 decompression of the celiac trunk via the common hepatic artery approach for median arcuate ligament syndrome","authors":"Michela Orsi,&nbsp;Lorenza Beomonte Zobel,&nbsp;Giuseppe S. Sica","doi":"10.1016/j.gassur.2026.102321","DOIUrl":"10.1016/j.gassur.2026.102321","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102321"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933630","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 “Laparoscopic antireflux surgery with the RefluxStop implant for severe sufferers with complex disease: a retrospective study of the first 100 patients with 12-month follow-up at an early adopter institution”","authors":"Lirong Zhang","doi":"10.1016/j.gassur.2026.102335","DOIUrl":"10.1016/j.gassur.2026.102335","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102335"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994515","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":"Early vs delayed oral feeding after esophagectomy for esophageal cancer: a systematic review and meta-analysis of randomized controlled trials assessing safety, clinical recovery, and quality of life outcomes","authors":"Nirmal Paudel ,&nbsp;Anurag Jha ,&nbsp;Amina Basharat ,&nbsp;Muhammad Huzaifa Khalil ,&nbsp;Ramsha Ali ,&nbsp;Shaista Qadir ,&nbsp;Syed Hassan Akhlaq ,&nbsp;Muhammad Anas ,&nbsp;Muhammad Abbas ,&nbsp;Awais Ayub ,&nbsp;Muhammad Nabeel Saddique ,&nbsp;Nukhbat Ullah Awan","doi":"10.1016/j.gassur.2026.102322","DOIUrl":"10.1016/j.gassur.2026.102322","url":null,"abstract":"<div><h3>Background</h3><div>Esophagectomy traditionally involves delayed oral feeding (DOF) due to anastomotic leakage concerns. Enhanced Recovery After Surgery protocols favor early feeding, but its safety remains controversial. This study compared early oral feeding (EOF) and DOF after esophagectomy.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Scopus were systematically searched from inception of the study to October 2025 for randomized controlled trials comparing EOF (0–3 days) and DOF (≥5 days) after esophagectomy. The primary outcomes were anastomotic leakage and pneumonia. The secondary outcomes included complications, hospital outcomes, gastrointestinal (GI) recovery, and quality of life (QOL). Effect sizes were calculated as mean differences (MDs) or standardized MDs (SMDs) for continuous variables and risk ratios (RRs) for dichotomous variables, with 95% CIs, using Review Manager (version 5.4; Cochrane Collaboration).</div></div><div><h3>Results</h3><div>A total of 13 trials involving 1468 patients were included in the study. Early feeding showed no increase in anastomotic leakage (RR, 0.89 [95% CI, 0.55–1.45]; <em>I</em>² = 0%), with consistent safety across anastomotic locations and surgical approaches. Early feeding significantly reduced pneumonia (RR, 0.66 [95% CI, 0.47–0.92]; <em>P</em> =.01) and accelerated GI recovery: time to first bowel movement (MD, −0.50 days [95% CI, −0.55 to −0.46]; <em>P</em> &lt;.00001) and first flatus (MD, −0.61 days [95% CI, −0.95 to −0.26]; <em>P</em> =.0006). Hospital stay was reduced by 1.89 days (95% CI, −3.06 to −0.72; <em>P</em> =.002) with lower medical expenses (SMD, −1.19 [95% CI, −2.07 to −0.30]; <em>P</em> =.009). QOL improved: global health status (MD, 9.08 [95% CI, 3.88–14.29]; <em>P</em> =.0006), dysphagia (MD, −6.15 [95% CI, −9.97 to −2.34]; <em>P</em> =.002), pain (MD, −3.60 [95% CI, −5.32 to −1.89]; <em>P</em> &lt;.00001), and swallowing difficulties (MD, −1.39 [95% CI, −1.53 to −1.26]; <em>P</em> &lt;.00001).</div></div><div><h3>Conclusion</h3><div>EOF after esophagectomy seems safe and effective, reducing complications while accelerating recovery. However, further high-quality multicenter trials are needed to validate these findings.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102322"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984983","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}