Journal of Investigative Surgery最新文献

{"title":"Comparison of Functional Outcomes Between Robotic and Laparoscopic Surgery in Rectal Cancer Patients: Systematic Review and Meta-Analysis.","authors":"Yiwei Wang, Wenjing Wang, Yu Du, Hui Li","doi":"10.1080/08941939.2026.2652787","DOIUrl":"10.1080/08941939.2026.2652787","url":null,"abstract":"<p><strong>Background: </strong>Robotic and laparoscopic approaches are widely used for rectal cancer surgery. Although robotic systems provide enhanced visualization and dexterity, it remains unclear whether these advantages improve postoperative urinary and sexual function.</p><p><strong>Methods: </strong>MEDLINE, Embase, Web of Science, and CENTRAL (2000-2025) were searched for studies comparing robotic and laparoscopic rectal cancer surgery. Outcomes included postoperative ileus, urinary retention, and urinary and sexual function. Random-effects meta-analysis was performed using RevMan. Study quality was assessed with MINORS, and certainty of evidence with GRADE. Publication bias was evaluated using funnel plots and Egger's test.</p><p><strong>Results: </strong>Forty-four observational studies (6,121 patients) were included. Robotic surgery was associated with lower urinary retention, though this may reflect publication bias. No significant difference was found in postoperative ileus. Subgroup analyses at 3, 6, and 12 months showed no significant differences in urinary or sexual function. Although pooled results slightly favored robotic surgery, these effects were inconsistent, not sustained, and clinically modest.</p><p><strong>Conclusion: </strong>Robotic surgery may reduce urinary retention but shows no consistent functional superiority over laparoscopy. Outcomes at key follow-up points are comparable. As all studies were observational, evidence certainty is low, and findings should be interpreted cautiously.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2652787"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Esketamine on Postoperative Hospital Anxiety and Depression Scale Scores in Patients Undergoing Laparoscopic Radical Resection for Colorectal Cancer.","authors":"Lindai He, Zhihua Sun, Qulian Guo, E Wang, Longyan Li, Shenxiayu Li","doi":"10.1080/08941939.2026.2712673","DOIUrl":"10.1080/08941939.2026.2712673","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of intravenous esketamine on postoperative Hospital Anxiety and Depression Scale (HADS) scores in patients undergoing laparoscopic radical resection for colorectal cancer.</p><p><strong>Methods: </strong>In this prospective, randomized, placebo-controlled study, adult patients for elective laparoscopic radical resection were randomly assigned (1:1) to a control group (group C) or an esketamine group (group PE). Group C received conventional general anesthesia and patient-controlled intravenous analgesia (PCIA). In group PE, esketamine 0.5 mg/kg was injected during induction of anesthesia, with esketamine 1 mg/kg added to PCIA. Primary outcome was HADS score on postoperative day 1. Secondary outcomes included HADS scores on postoperative days 3 and 7, sleep quality scores, postoperative level of consciousness, complication rate, length of hospital stay, 24 h inflammatory factors, and satisfaction scores.</p><p><strong>Results: </strong>Group PE showed significantly lower HADS-A and HADS-D scores on postoperative days 1 and 3 , reduced 24 h interleukin-6 (IL-6) leveland higher patient satisfaction compared with group C (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Esketamine given during induction and in PCIA reduced early-stage postoperative HADS scores and improved patient satisfaction in colorectal cancer patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2712673"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wrist-Ankle Acupuncture on Postoperative Nausea and Vomiting Prophylaxis in High-Risk Female Patients: A Pragmatic, Randomized, Single-Blind, Sham-Controlled Trial.","authors":"Liping Yu, Xiao Wang, Ling Mei, Jiangang Song, Wei Song, Hui Xue, Sicheng Wu, Jian Wang, Lili Li, Wenting Chen","doi":"10.1080/08941939.2026.2652778","DOIUrl":"10.1080/08941939.2026.2652778","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) affects up to 80% of high-risk patients, compromising Enhanced Recovery After Surgery (ERAS) outcomes and prolonging hospitalization. This randomized controlled trial evaluated wrist-ankle acupuncture (WAA) efficacy for PONV prevention in high-risk female surgical patients.</p><p><strong>Methods: </strong>This single-center, randomized, patient- and assessor-blinded, sham-controlled trial enrolled female patients (aged 18-60 years, ASA I-II) scheduled for elective surgery under general anesthesia with documented motion sickness or previous PONV. Participants received either WAA (sterile needles at four standardized acupoints, 30-minute retention) or sham acupuncture postoperatively. The primary outcome was 24-h PONV incidence using the Rhodes Index of Nausea, Vomiting, and Retching (R-INVR).</p><p><strong>Results: </strong>Among 132 patients (median age 41 years), WAA significantly reduced 24-h PONV incidence versus sham (42.4% vs. 71.2%; RR 0.60, 95% CI 0.42-0.82; <i>p</i> = 0.002). Median R-INVR scores were lower with WAA [0 (0-5) vs. 8 (0-11); <i>p</i> < 0.001]. WAA patients reported significantly reduced nausea/vomiting at 30 min, 6 h, and 24 h (all <i>p</i> ≤ 0.006) and higher satisfaction scores (<i>p</i> < 0.001). Antiemetic use was comparable (9.1% vs. 16.7%; <i>p</i> = 0.299). No adverse events occurred.</p><p><strong>Conclusions: </strong>WAA significantly reduced PONV incidence and severity with sustained effects and improved satisfaction, offering a promising non-pharmacological prevention strategy.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2652778"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Cytological, and Virological Factors Associated with Histological Severity and Recurrence in Vaginal Intraepithelial Neoplasia: A Retrospective Observational Study.","authors":"Luigi Della Corte, Mario Palumbo, Virginia Foreste, Dominga Boccia, Giuseppe Bifulco, Giada Lavitola","doi":"10.1080/08941939.2026.2719254","DOIUrl":"10.1080/08941939.2026.2719254","url":null,"abstract":"<p><strong>Background: </strong>Vaginal intraepithelial neoplasia (VAIN) is a rare HPV-related condition with heterogeneous behavior and a relevant recurrence risk. Factors associated with severity and recurrence remain incompletely defined.</p><p><strong>Objective: </strong>To explore clinical, cytological, virological, and colposcopic features associated with high-grade VAIN and recurrence.</p><p><strong>Methods: </strong>This retrospective study included 42 women with histologically confirmed VAIN at a tertiary center between January 2020 and January 2026. All underwent vaginal cytology, high-risk HPV (HR-HPV) genotyping, colposcopy, and biopsy. Histology was classified as VAIN1 or VAIN2-3. Recurrence was defined as a histologically confirmed lesion after treatment and documented disease-free assessment. Associations were assessed using bivariate and exact analyses.</p><p><strong>Results: </strong>VAIN2-3 was diagnosed in 31 women (73.8%). Among HR-HPV-positive women, HPV16-related infection was more frequent in VAIN2-3 than VAIN1 (65.4% vs 18.2%; OR 8.50, 95% CI 1.27-91.56; <i>p</i> = 0.013). Cytology was associated with histological grade (<i>p</i> = 0.024); all women with HSIL/ASC-H had VAIN2-3, although sensitivity was limited. Over a median follow-up of 24 months, eight women (19.0%) recurred after a median of 11.5 months. HPV16-related infection was more frequent with recurrence (75.0% vs 38.2%; OR 4.85, 95% CI 0.70-54.01; <i>p</i> = 0.112), but the evidence was not definitive. HPV16-only infection showed borderline evidence of association (<i>p</i> = 0.050), while no clear outcome pattern emerged for multiple-genotype infection. No other significant associations with recurrence were observed.</p><p><strong>Conclusion: </strong>HPV16-related infection was associated with high-grade histology among HR-HPV-positive women, while its prognostic relevance for recurrence remains uncertain. The limited sensitivity of cytology underscores the value of multimodal assessment. These exploratory signals warrant prospective validation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2719254"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Age, Treatment Modality and Survival in Atypical Meningioma: Analysis of the SEER Database, 2000-2021.","authors":"Hao-Chien Yang","doi":"10.1080/08941939.2026.2687182","DOIUrl":"https://doi.org/10.1080/08941939.2026.2687182","url":null,"abstract":"<p><strong>Purpose: </strong>Atypical meningiomas have higher recurrence and mortality than benign variants, and age may influence treatment decisions and outcomes. We evaluated associations between age, treatment modality, and survival in patients with atypical meningioma.</p><p><strong>Methods: </strong>Adults with histologically confirmed intracranial atypical meningioma were identified from the 2000-2021 Surveillance, Epidemiology, and End Results database. Multivariable Cox regression assessed overall survival (OS) and cancer-specific survival (CSS), and logistic regression evaluated predictors of gross total resection (GTR) versus subtotal resection (STR).</p><p><strong>Results: </strong>Among 3,882 patients, advanced age was associated with worse OS and CSS. Compared with patients aged <40 years, those aged ≥60 years had higher overall mortality (aHR 5.29, 95% CI 3.78-7.39) and cancer-specific mortality (aHR 3.15, 95% CI 1.99-4.99; both <i>p </i>< 0.001). Patients aged 40-59 years showed intermediate OS risk but no significant difference in CSS. Older patients received radiotherapy less often, whereas age was not an independent predictor of GTR. STR, male sex, unmarried status, tumor ≥5 cm, and Black race were associated with poorer survival.</p><p><strong>Conclusion: </strong>Advanced age independently predicted inferior OS and CSS but not a lower likelihood of GTR, supporting individualized, age-sensitive management.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2687182"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Transumbilical Single‑Port and Multi‑Port Laparoscopic Myomectomy in Patients with Uterine Fibroids: Effects on Stress Response, Immune Function, and Incision Cosmetic Outcomes.","authors":"Xila Wang, Chunjie Ye, Yuanxia Zou, Xiaoqian Tong, Lixia Feng","doi":"10.1080/08941939.2026.2658323","DOIUrl":"10.1080/08941939.2026.2658323","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the effects of transumbilical single‑port laparoscopic myomectomy (SPLM) and multi‑port laparoscopic myomectomy (MPLM) on stress response, immune function, and incision cosmetic outcomes in patients with uterine fibroids (UFs).</p><p><strong>Methods: </strong>A total of 146 UF patients were randomized to receive SPLM (<i>n</i> = 73) or MPLM (<i>n</i> = 73). Outcome measures included perioperative indicators, stress markers, immune parameters, ovarian function, incision cosmetic outcomes, postoperative complication rate, menstrual normalization, and recurrence.</p><p><strong>Results: </strong>The SPLM group had longer operative time and shorter postoperative exhaustion and hospitalization than the MPLM group (<i>P</i> < 0.05). At 3 days postoperatively, the SPLM group showed higher SOD, CD3⁺, and CD4⁺/CD8⁺ levels and lower MDA and ROS levels than the MPLM group (<i>P</i> < 0.05). At 3 months postoperatively, no significant differences were observed in AMH, LH, or FSH levels between the two groups (<i>P</i> > 0.05). The SPLM group showed higher CS scores and lower BIS scores compared with the MPLM group (<i>P</i> < 0.05). The rates of complications, menstrual recovery, and recurrence were comparable (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Compared with MPLM, SPLM showed better effects in reducing oxidative stress, maintaining immune function, and improving incision cosmetic outcomes for patients with UFs.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2658323"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteome-Wide Mendelian Randomization Reveals Biomarkers for Abdominal Aortic Aneurysm.","authors":"Su Yan, Yuhui Zhang, Chaomin Shen","doi":"10.1080/08941939.2025.2560332","DOIUrl":"10.1080/08941939.2025.2560332","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) is a progressive vascular disorder that enlarges irreversibly and may ultimately rupture. Mendelian randomization (MR) provides a powerful approach to uncover biomarkers. We aimed to identify plasma proteins linked to AAA and evaluate their diagnostic potential.</p><p><strong>Methods: </strong>We performed a proteome-wide MR analysis using genetic instruments for 2,940 plasma proteins from the UK Biobank Pharma Proteomics Project (UKB-PPP). Summary statistics for AAA were obtained from the Finnish R9 GWAS, comprising 4,083 cases and 420,324 controls.</p><p><strong>Results: </strong>Eleven proteins showed significant causal associations with AAA risk (FDR < 0.05): seven positively and four negatively associated, highlighting their potential as diagnostic markers.</p><p><strong>Conclusion: </strong>This study provides the first proteome-wide MR evidence linking plasma proteins to AAA, offering candidate biomarkers for diagnosis. As a hypothesis-generating work, further experimental and clinical validation is warranted.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2560332"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Surgeon Subspecialty in Laparoscopic Cholecystectomy: A Population-Based Study.","authors":"Arvid Gustafsson, My Blohm, Bobby Tingstedt, Greger Olsson","doi":"10.1080/08941939.2026.2621464","DOIUrl":"10.1080/08941939.2026.2621464","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is performed by surgeons from various specialties and remains central to minimally invasive surgical training. This study assessed whether surgeon subspecialty affects patient outcomes and explored aspects of LC education.</p><p><strong>Methods: </strong>This population-based study included 46,700 LCs performed between 2020 and 2023, using data from the Swedish Registry for Gallstone Surgery (GallRiks). Surgeons were categorized as resident surgeons (RS), attending surgeons (AS), upper gastrointestinal/hepatopancreatobiliary surgeons (UGIS), acute care surgeons (ACS), or alternate subspecialty surgeons (ASS). Primary outcomes were 30-day adverse events (AE), bile duct injuries (BDI), and operative time (OT). Educational activity and subgroup analyses for elective and acute cholecystitis cases were evaluated.</p><p><strong>Results: </strong>AE rates were higher for ACS (9.6%; OR 1.22, 95% CI 1.07-1.40) and AS (7.9%; OR 1.17, 95% CI 1.06-1.19) compared to UGIS (6.9%) but without increased BDI rates. RS demonstrated similar AE rates (6.1%) but lower BDI rates in elective cases (0.08%). OT was 24-33 min shorter for UGIS than for other surgeon types. Educational activity prolonged OT by 12 min (OR 1.06; 95% CI 1.05-1.08).</p><p><strong>Discussion: </strong>Higher AE rates among ACS and AS likely reflect more complex cases. LC performed by RS appears equally safe and efficient, provided appropriate supervision is available.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2621464"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Retrospective Study of UBE-ULBD Versus Open Surgery for Severe Thoracic Spinal Stenosis Caused by Ossification of Ligamentum Flavum.","authors":"Zhi-Wei Wang, Yan-Ping Chen, Chong Zhao, Dong-Zhe Zhang, Dao-Kuo Liu","doi":"10.1080/08941939.2026.2626245","DOIUrl":"10.1080/08941939.2026.2626245","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the safety and efficacy of UBE-ULBD for severe thoracic stenosis caused by high-occupancy TOLF.</p><p><strong>Methods: </strong>This was a retrospective comparative cohort study. 57 patients were divided into Group A and Group B. Perioperative variables, imaging findings, and clinical outcomes were compared.</p><p><strong>Results: </strong>Group A showed better early (1-week/1-month) back pain VAS scores (<i>p</i> < 0.05), but not at 3 months. Statistically significant differences (<i>p</i> < 0.05) were observed between groups in the following parameters: wound length (MD: -7.6, 95% CI: -7.88 to -7.32, <i>p</i> < 0.001); number of intraoperative fluoroscopies (MD: 2.2, 95% CI: 1.82 to 2.58, <i>p</i> < 0.001); time to ambulation (MD: -4.1, 95% CI: -4.34 to -3.86, <i>p</i> < 0.001); length of hospital stay (MD: -3.4, 95% CI: -3.97 to -2.83, <i>p</i> < 0.001); time to full weight-bearing (MD: -19.5, 95% CI: -20.86 to -18.14, <i>p</i> < 0.001); posterior bone loss rate (MD: -34.6, 95% CI: -35.78 to -32.51, <i>p</i> < 0.001); and incidence of cerebrospinal fluid leakage (RD: -19.6%, 95% CI: -36.9% to -2.3%, <i>p</i> = 0.033). No other significant differences were found.</p><p><strong>Conclusions: </strong>In this retrospective cohort, UBE-ULBD provided similar neurological recovery to open surgery with earlier recovery and fewer complications in patients with high-occupancy TOLF.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2626245"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors, Cancer Types and Prognostic Significance of Second Primary Cancer After Early-, Intermediate- and Late-Onset Colorectal Cancer: A Retrospective Study in a Chinese High-Volume Cancer Center.","authors":"Fan Chen, Jiayu Chen, Dakui Luo, Yufei Yang, Qingguo Li, Xinxiang Li","doi":"10.1080/08941939.2026.2676514","DOIUrl":"10.1080/08941939.2026.2676514","url":null,"abstract":"<p><p>The incidence of early-onset colorectal cancer (EOCRC) is increasing worldwide, and CRC survivors may have an elevated risk of second primary cancer (SPC). This retrospective study analyzed 13,302 CRC patients diagnosed between 2008 and 2018 at a Chinese high-volume cancer center, including 635 (4.77%) who developed SPC after CRC. Patients were stratified by age at CRC diagnosis (<50, 50-69, and ≥70 years) to identify risk factors, cancer types, and prognostic significance of SPC. Multivariable Cox analysis showed that older age, neoadjuvant therapy, tumor location, T stage, N stage, M stage, and radiotherapy were independently associated with SPC in the overall cohort. Age-stratified analyses revealed heterogeneous associated factors, with radiotherapy being the only independent factor in the ≥70-year group. Five-year overall survival was comparable between the <50- and 50-69-year groups and was significantly better than in the ≥70-year group among all CRC patients and those with SPC. Early-stage patients with SPC had better overall survival than those without SPC, whereas advanced-stage patients without SPC had better survival. These findings suggest age-specific heterogeneity in SPC development and support tailored surveillance strategies after CRC.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2676514"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}