Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Application of Single Stapling Natural Orifice Specimen Extraction Surgery (ssNOSES) in Rectal Cancer.","authors":"Yanle Fang, Hongxun Ruan, Xiaoning Qin, Lin Lin","doi":"10.1097/SLE.0000000000001398","DOIUrl":"10.1097/SLE.0000000000001398","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the outcomes of single stapling natural orifice specimen extraction surgery (ssNOSES) with double stapling natural orifice specimen extraction surgery (dsNOSES) in anterior resection for rectal cancer.</p><p><strong>Methods: </strong>A total of 100 patients with rectal cancer were selected from the Colorectal Department of the Second Hospital of Hebei Medical University. These patients underwent Natural Orifice Specimen Extraction Surgery (NOSES) between July 2018 and July 2020. Fifty patients who underwent ssNOSES were compared with fifty patients who underwent dsNOSES. The comparison focused on patient demographics, surgical outcomes, and complications, with a particular emphasis on operative time, cost, and complications.</p><p><strong>Results: </strong>Four cases of anastomotic leakage were observed in the dsNOSES group, and this group also incurred higher costs. Although the surgical time for ssNOSES was longer, the procedure was associated with lower costs and no cases of anastomotic leakage.</p><p><strong>Conclusions: </strong>ssNOSES is a cost-effective and safer alternative to dsNOSES. Furthermore, the surgical time for ssNOSES can be reduced through training and experience.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754356","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":"Novel Endoscopic Clip For Effective Management of Gastrointestinal Perforations: A Feasibility Study in a Porcine Model.","authors":"Jeongho Sohn, Sunseok Yoon, Kwang Dae Hong","doi":"10.1097/SLE.0000000000001397","DOIUrl":"10.1097/SLE.0000000000001397","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) perforations typically occur as complications following endoscopic procedures or intestinal anastomosis surgery. Endoscopic closure of these perforations is desirable as it avoids the risks associated with surgery. Although several endoscopic devices have been developed to address this issue, none have yet demonstrated consistently effective clinical outcomes. This study introduces a novel endoscopic clip assembly designed to overcome these challenges.</p><p><strong>Materials and methods: </strong>The Z-shaped clip, named the kinetic utility (KU) clip, was constructed with nitinol, allowing it to operate at 45 °C. When the clip is delivered endoscopically, it can close perforations with a predeformed configuration that is triggered by temperature. Ex vivo experiments were conducted using porcine stomach tissue to compare the performance of the KU clip with through-the-scope clips (TTSCs). Maximal force and area under the curve (AUC) on the force-displacement curve were measured to assess the retention capability of the clip in tissue. The in vivo experiment involved creating iatrogenic perforations in a pig, applying the KU clip, and monitoring its healing and safety outcomes.</p><p><strong>Results: </strong>Ex vivo experiments showed a difference between the TTSC and KU groups with a P -value of 0.08 for maximal force and 0.01 for AUC. The in vivo experiment validates the effectiveness of the KU clip, as there was complete healing of the perforation site with no significant adverse reactions during the experimental period.</p><p><strong>Conclusions: </strong>The KU clip demonstrates potential as a versatile and effective tool for endoscopic management of GI perforations.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660247","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":"Endoscopic Submucosal Dissection for Gastroesophageal Reflux Disease-Related Neoplasms.","authors":"Zhukai Chen, Zhuyun Leng, Jiacheng Xu, Kang Fang, Zehua Zhang, Jingjing Lian, Haibin Zhang, Li Zhang, Tao Chen, Meidong Xu","doi":"10.1097/SLE.0000000000001389","DOIUrl":"10.1097/SLE.0000000000001389","url":null,"abstract":"<p><strong>Background and aim: </strong>Gastroesophageal reflux disease (GERD) is a widely prevalent disease that severely influences patients' quality of life and is a known risk factor for esophageal adenoma and carcinoma. Endoscopic submucosal dissection (ESD) is a tissue resection technique that involves circumferential en bloc resection of the mucosa that surrounds the tumor followed by dissection of the esophagogastric junction (EGJ) submucosa under the lesion. After mucosal resection, the mucosal healing results in scar formation, which in turn results in shrinkage and remodeling of gastric cardia flap valve, thereby theoretically reducing reflux events. This study investigated the safety and efficacy of ESD for GERD-related neoplasms.</p><p><strong>Methods: </strong>We performed a retrospective analysis of data collected from 96 patients with GERD-related neoplasms treated with ESD between December 2018 and May 2023. Clinical, endoscopic, histologic, and follow-up data were collected.</p><p><strong>Results: </strong>The overall rates of en bloc resection, complete resection, curative resection, and major complications were 100%, 99.0%, 95.8%, and 8.4%, respectively. During the follow-up period, all patients remained free from local recurrence and metastasis. The proportion of patients who remained alleviation of GERD symptom was 69.6% after 6 months. The proportion of the resected lumen circumference was the factor that affected the alleviation of GERD symptoms.</p><p><strong>Conclusions: </strong>ESD is safe and effective for GERD-related neoplasms and is efficacious for the high probability of alleviation of GERD symptoms.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tattoo Trap: A Cautionary Note on Lesion Localization in Laparoscopic Bowel Resection.","authors":"Khalid Hureibi","doi":"10.1097/SLE.0000000000001396","DOIUrl":"10.1097/SLE.0000000000001396","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-2"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601625","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":"Efficacy and Safety of Endoscopic Pancreatic Stenting for Traumatic Pancreatic Fistula.","authors":"Juanjuan Zhang, Xiaoli Qian, Binlin Da, Lin Zhu, Gefei Wang, Zhiming Wang","doi":"10.1097/SLE.0000000000001395","DOIUrl":"10.1097/SLE.0000000000001395","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic pancreatic fistula is challenging and complicated to manage. Our aim was to assess the efficacy of endoscopic pancreatic duct stenting in the treatment of traumatic pancreatic fistula.</p><p><strong>Methods: </strong>Patients with pancreatic trauma treated by endoscopic pancreatic duct stenting at Jinling Hospital from May 2016 to October 2022 were enrolled. We recorded clinical data, the cause of pancreatic trauma, the location of injuries, pancreatic injury grade, the timing and duration of stent placement and removal, and long-term outcomes.</p><p><strong>Results: </strong>Twenty-six patients with traumatic pancreatic fistula who underwent 33 endoscopic pancreatic duct stenting procedures were enrolled. Most patients (20/26, 76.9%) were grade IV. The median time interval from injury to endoscopic stenting was 48 (range: 1 to 959) days. The main pancreatic duct (MPD) was visualized in all patients, and the average diameter of the MPD was 1.73±0.45 mm. Serum amylase levels, drain amylase levels, and drainage volume were significantly decreased after stent placement. One patient had a pancreatic duct stricture at the neck, 1 patient had poor drainage after stenting, and there were no other complications. The technical success rate was 93.9% (31/33), and the clinical efficacy rate was 76.9% (20/26). Univariate analysis revealed that the interval from injury to stenting (HR: 10.500, 95% CI: 1.115-98.914, P =0.040) was associated with stent success.</p><p><strong>Conclusion: </strong>Pancreatic duct stenting is a safe and effective treatment modality and should be an optional treatment for the management of traumatic pancreatic fistula. Before stent placement, the duration of pancreatic fistula should be assessed since it is related to fistula healing.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601624","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":"Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy.","authors":"Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco","doi":"10.1097/SLE.0000000000001394","DOIUrl":"10.1097/SLE.0000000000001394","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery is recognized as the gold standard for cholecystectomy, with various approaches having been implemented over time. Since 2018, the da Vinci Single-Port (DVSP) robotic system (Intuitive) has been used in experimental surgical contexts, revitalizing interest in single-site surgical techniques. The authors' aim is to describe the learning curve associated with single-port robotic cholecystectomy (SPRC).</p><p><strong>Methods: </strong>A prospective series of 266 consecutive off-label SPRC performed by a single surgeon experienced in laparoscopy, single-site surgery, and multiport robotic surgery was analyzed. These procedures were conducted under an Institutional Review Board-approved protocol. Preoperative, intraoperative, and postoperative data were collected and organized. Indications for SPRC included symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, porcelain gallbladder, gallbladder polyps, choledocholithiasis, and gallstone pancreatitis. A learning curve was generated using the cumulative sum analysis (CUSUM) to assess changes in overall operation time, docking time, pre-console time, and surgeon console time.</p><p><strong>Results: </strong>Our analysis demonstrated a statistically significant reduction in docking time and pre-console time ( P <0.001) in the 3 phases identified by the CUSUM analysis. The CUSUM analysis identified only 1 phase regarding the console time with a mean time of 20 (7 to 113) minutes. The average overall time was 59 (19 to 175) minutes. CUSUM analysis identified 3 phases for overall time, with reduction from 59 to 46 minutes ( P <0.001). The general characteristics of the groups identified for OT were homogeneous. Analysis of early surgical outcomes did not differ between the groups.</p><p><strong>Conclusions: </strong>SPRC is a safe and feasible procedure, the docking time, pre-console time, and overall time were improving over time, meanwhile the console time was stable throughout the case series demonstrating a significant ability transfer between other mininvasive approaches and DVSP Platform.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650609","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":"Life-Threatening Cardiac Tamponade After Hiatal Hernia Surgery: A Review of Diagnostic Pitfalls and Therapeutic Interventions.","authors":"Guobiao Chen, Zhenhong Wang, Botao Qian, Ruiqi Wang, Jiaming Liao, Mi Tang, Jiani Hu, Yunhong Tian","doi":"10.1097/SLE.0000000000001408","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001408","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported deaths due to undiagnosed cardiac tamponade following hiatal hernia surgery, with an alarmingly high associated mortality rate. This review aims to raise awareness and improve the diagnostic accuracy of cardiac tamponade among surgeons who perform hiatal hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on cases of cardiac tamponade following hiatal hernia repair. Data collected included patient age, surgical approach, mesh fixation method, timing of cardiac tamponade diagnosis, and treatment strategies.</p><p><strong>Results: </strong>A total of 23 eligible articles reporting on 30 patients with cardiac tamponade after hiatal hernia repair were included in this review. The age of patients ranged from 40 to 84 years, with a median age of 66 years. Tacker was used in 20 patients (66.7%) for mesh fixation. In half of the cases (50.0%), cardiac tamponade was diagnosed within 48 hours after surgery. Treatment mainly included pericardiocentesis and open drainage. Seven (23.3%) patients died postoperatively. Cardiac tamponade was undiagnosed in 4 patients (13.3%), all of whom died. Mortality rates were 100.0% in the undiagnosed group and 4.3% in the diagnosed group.</p><p><strong>Conclusions: </strong>Accurate diagnosis and prompt management are crucial for rescuing patients from life-threatening cardiac tamponade following hiatal hernia surgery.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150895","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":"Robotic-Assisted Retromuscular Umbilical Prosthetic Hernia Repair (r-TARUP) With Hugo-RAS System: Case Series and Technique.","authors":"Richard Sassun, Pietro Achilli, Lorenzo Morini, Francesco Brucchi, Vincenzo Nicastro, Giuseppe di Donna, Riccardo Magarini, Bruno Domenico Alampi, Giovanni Ferrari","doi":"10.1097/SLE.0000000000001409","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001409","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive approaches have transformed ventral hernia management, with robotic platforms enhancing challenging techniques like the robotic Transabdominal Retromuscular Umbilical Prosthesis (r-TARUP). While traditionally performed using the da Vinci system, the introduction of the Medtronic Hugo RAS system offers a valuable alternative. We present our first case series with standardized surgical technique for r-TARUP using the Hugo RAS system, detailing operative setup, technical considerations, and initial outcomes.</p><p><strong>Methods: </strong>Between September 2024 and February 2025, we performed 30 r-TARUP procedures using the Hugo RAS system. Preoperative evaluation included imaging and risk factor optimization. The technique involved a lateral retromuscular approach, ipsilateral posterior rectus sheath (PRS) closure, and mesh placement. Patients were discharged the following day, with follow-ups assessing complications and recurrences.</p><p><strong>Results: </strong>The mean hernia dimensions were 3.1±1.0 cm in width and 2.6±0.8 cm in length. Rectus diastasis repair was performed in 57% of cases. Mean operating and docking times were 190.6±61.6 and 15±5.3 minutes, respectively. Two cases required conversion to laparoscopic surgery during peritoneal closure. No complications or recurrences were observed after a mean follow-up of 3.6 (1.7 to 5.3) months.</p><p><strong>Conclusions: </strong>Despite the short follow-up, our experience demonstrates the feasibility and safety of r-TARUP with the Hugo RAS system. Comparable outcomes to other robotic platforms suggest that the Hugo RAS system is a viable alternative for ventral hernia repair, offering technical flexibility and promising short-term results.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131826","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":"Procedure-Specific Early Complications Following Bariatric Surgery: A High-Volume Single-Institution Analysis.","authors":"Kamal Abi Mosleh, Noura Jawhar, Yara Salameh, Wissam Ghusn, Nour El Ghazal, Todd A Kellogg, Omar M Ghanem","doi":"10.1097/SLE.0000000000001406","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001406","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) is an established treatment for severe obesity and its related comorbidities. While long-term outcomes are often emphasized, early postoperative complications remain a critical metric of safety and resource utilization. Large database studies have reported national trends in MBS outcomes but are limited by lack of granularity, inconsistent definitions, and inclusion of heterogeneous surgical experience. This study aimed to provide a detailed analysis of 30-day postoperative complications following sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) over a 17-year period at a single high-volume quaternary academic center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study of adult patients who underwent primary laparoscopic SG, RYGB, or DS between 2008 and 2024. All procedures were performed by fellowship-trained, minimally invasive bariatric surgeons. Complications occurring within 30 days postoperatively were identified through comprehensive chart review and classified using the Clavien-Dindo grading system. Primary outcomes included incidence, severity, and type of complications, as well as rates of readmission, reoperation, and reintervention. Multivariable logistic regression was used to identify predictors of overall and major complications.</p><p><strong>Results: </strong>Of 2190 patients included, 413 (18.9%) experienced at least 1 early complication, totaling 467 discrete events. DS had the highest complication rate (29.3%), followed by RYGB (18.4%) and SG (17.5%). RYGB was associated with a high burden of major complications, including anastomotic strictures, GI bleeding, and reoperations for obstruction or leak. The 30-day rates of readmission (2.0%) and reoperation (1.3%) were low across all groups. Independent predictors of major complications included venous stasis (aOR=3.22), renal insufficiency (aOR=2.65), and type 2 diabetes (aOR=1.96); both RYGB (aOR=2.25) and DS (aOR=2.77) carried higher risk than SG.</p><p><strong>Conclusion: </strong>This study provides a granular, procedure-specific profile of early complications after SG, RYGB, and DS. While all 3 procedures demonstrated acceptable safety profiles, DS had the highest overall complication rate, and RYGB carried the greatest burden of major complications. These findings underscore the variability in early postoperative outcomes by procedure type and reflect the value of institutional experience in characterizing complication profiles.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114194","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":"Anastomotic Leakage and Gastroparesis Syndrome Following Laparoscopic Radical Gastrectomy: A Retrospective Cohort Study Involving 3779 Patients.","authors":"Rui Li, Zhiyuan Yu, Xu Sun, Qixuan Xu, Jingwang Gao, Zhen Yuan, Bo Cao, Sixin Zhou, Wenquan Liang, Peiyu Li, Xudong Zhao","doi":"10.1097/SLE.0000000000001405","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001405","url":null,"abstract":"<p><strong>Background and objectives: </strong>The occurrence of anastomotic leakage (AL) and gastroparesis syndrome (GS), common and severe complications after laparoscopic radical gastrectomy, significantly impacts the prognosis of patients. The objective of this study was to investigate the risk factors associated with AL after laparoscopic radical gastrectomy and GS after laparoscopic distal gastrectomy.</p><p><strong>Methods: </strong>In this retrospective cohort study, 3779 patients who underwent laparoscopic radical gastrectomy and met the inclusion criteria were included. Of the 3779 patients, 85 (2.2%) were diagnosed with AL. The diagnosis of GS was made in 35 (2.4%) patients who underwent laparoscopic distal gastrectomy. Subsequently, univariate and multivariate logistic regression analyses were performed to determine the risk factors associated with AL and GS.</p><p><strong>Results: </strong>The presence of hypoalbuminemia [odds ratio (OR)=2.437, 95% CI: 1.416-4.196, P=0.001] and intraoperative blood loss >150 ml (OR=1.712, 95% CI: 1.073-2.731, P=0.024) could be used as independent risk factors for AL. Total gastrectomy (OR=0.461, 95% CI: 0.264-0.805, P=0.006) and distal gastrectomy (OR=0.488, 95% CI: 0.276-0.863, P=0.014) were identified as the protective factors for AL. The presence of smoking history (OR=2.022, 95% CI: 1.022-4.001, P=0.043), pyloric obstruction (OR=3.748, 95% CI: 1.476-9.518, P=0.005), and Roux-en-Y anastomosis (OR=4.432, 95% CI: 1.292-15.206, P=0.018) were proved to be independently associated with GS for patients who underwent laparoscopic distal gastrectomy.</p><p><strong>Conclusions: </strong>This study delineates distinct risk factors for AL and GS after laparoscopic gastrectomy. Contrary to preservation paradigms, total gastrectomy reduced AL risk versus proximal gastrectomy, challenging current proximal tumor management strategies.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993267","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}