Surgery Today最新文献_第6页

Long-term impact of diverting ileostomy after stoma closure on the renal function and risk factors for chronic kidney disease following colorectal tumor surgery. 结直肠肿瘤术后慢性肾脏疾病的危险因素及造口后转路回肠造口对肾功能的长期影响

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-06 DOI: 10.1007/s00595-026-03357-2

Emi Ota, Jun Watanabe, Hirokazu Suwa, Yusuke Suwa, Kazuya Nakagawa, Mayumi Ozawa, Itaru Endo

{"title":"Long-term impact of diverting ileostomy after stoma closure on the renal function and risk factors for chronic kidney disease following colorectal tumor surgery.","authors":"Emi Ota, Jun Watanabe, Hirokazu Suwa, Yusuke Suwa, Kazuya Nakagawa, Mayumi Ozawa, Itaru Endo","doi":"10.1007/s00595-026-03357-2","DOIUrl":"10.1007/s00595-026-03357-2","url":null,"abstract":"Purpose: Long-term renal outcomes after ileostomy closure in patients undergoing curative colorectal tumor resection and diverting ileostomy remain unclear. We investigated renal outcomes and risk factors for chronic kidney disease (CKD) in this population.Methods: Patients who underwent colorectal tumor surgery after diverting ileostomy between January 2013 and December 2020 were analyzed. The serum creatinine (sCr) level and estimated glomerular filtration rate (eGFR) were monitored for up to three years after stoma closure. CKD progression was defined as an eGFR < 60 mL/min/1.73 m2. A multivariate analysis was used to identify independent risk factors for CKD.Results: In total, 533 patients were included: 112 with preoperative CKD and 421 without CKD. Among patients without preoperative CKD, 322 were followed up for 3 years after stoma closure. sCr levels and the eGFR showed persistent worsening even after stoma closure. Based on the eGFR at three years, patients were grouped into CKD and non-CKD groups. A multivariate analysis revealed that age ≥ 70 years old, a preoperative eGFR < 90 mL/min/1.73 m2, and ileostomy-associated kidney injury were independent risk factors for CKD after stoma closure. The sCr levels and eGFR worsened up to three years after stoma closure, even without these risk factors.Conclusions: Diverting ileostomy poses a risk of a renal function decline even after stoma closure.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2266-2276"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176769","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}

引用次数: 0

Comments on "The CALLY index as a predictive biomarker for the prognosis and treatment outcomes of colorectal cancer". “CALLY指数作为预测结直肠癌预后和治疗结果的生物标志物”点评

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-10 DOI: 10.1007/s00595-026-03346-5

Qin-Jian Lu

引用次数: 0

Revisiting the lateral-to-medial approach in robotic surgery for left-sided colorectal cancer. 左侧结直肠癌机器人手术中外侧-内侧入路的再探讨。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-07-09 DOI: 10.1007/s00595-026-03390-1

Yoshiaki Fujii, Takahisa Hirokawa, Hiroki Takahashi, Masahiro Kimura, Kenji Kobayashi, Shuji Takiguchi

{"title":"Revisiting the lateral-to-medial approach in robotic surgery for left-sided colorectal cancer.","authors":"Yoshiaki Fujii, Takahisa Hirokawa, Hiroki Takahashi, Masahiro Kimura, Kenji Kobayashi, Shuji Takiguchi","doi":"10.1007/s00595-026-03390-1","DOIUrl":"10.1007/s00595-026-03390-1","url":null,"abstract":"Robotic surgery has been widely adopted for left-sided colorectal cancer; however, mesenteric mobilization is predominantly performed using the medial-to-lateral approach. This technique can be technically demanding because dissection must be performed within a narrow working space dorsal to the mesenteric vessels, requiring the identification and preservation of the ureter and gonadal vessels. In robotic surgery, arm rigidity and the lack of tactile feedback may increase the risk of inadvertent pressure on the deep retroperitoneal structures. To address these challenges, we describe a lateral-to-medial approach that is optimized for robotic surgery. By utilizing wristed instruments, high-definition three-dimensional visualization, and stable traction, this approach enables mesenteric mobilization in a wider working space. In 19 patients, the mobilization time was comparable to that in the conventional approach, with no unintended deviation of the dissection plane. These findings suggest that the robotic lateral-to-medial approach is technically feasible and may be a useful option for robotic left-sided colorectal resection.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2561-2567"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412145","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}

引用次数: 0

Gastrointestinal bypass surgery for non-strangulated adhesive small bowel obstruction. 非绞窄性粘连性小肠梗阻的胃肠搭桥手术。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-06 DOI: 10.1007/s00595-026-03352-7

Yuta Yamamoto, Masato Kitazawa, Satoshi Nakamura, Satoru Miyazaki, Nao Hondo, Masahiro Kataoka, Hirokazu Tanaka, Tadaaki Shimizu, Naoki Ishizaka, Naoya Yamamoto, Yuji Soejima

{"title":"Gastrointestinal bypass surgery for non-strangulated adhesive small bowel obstruction.","authors":"Yuta Yamamoto, Masato Kitazawa, Satoshi Nakamura, Satoru Miyazaki, Nao Hondo, Masahiro Kataoka, Hirokazu Tanaka, Tadaaki Shimizu, Naoki Ishizaka, Naoya Yamamoto, Yuji Soejima","doi":"10.1007/s00595-026-03352-7","DOIUrl":"10.1007/s00595-026-03352-7","url":null,"abstract":"The effectiveness of gastrointestinal bypass surgery for treating non-strangulated adhesive small bowel obstruction (ASBO) remains unclear. We aimed to compare the outcomes of gastrointestinal bypass and conventional surgery in patients with non-strangulated ASBO who were unresponsive to conservative treatment. The patients (n = 55) were divided into a bypass group (n = 15) undergoing bypass surgery and a non-bypass group (n = 40) undergoing conventional surgery, including adhesiolysis or small bowel resection. The serum albumin levels and prognostic nutritional index were comparable between the two groups at 12 months postoperatively. No patients (0%) in the bypass group and 13 (32.5%) in the non-bypass group experienced recurrent ASBO after surgery (p = 0.008). The recurrence-free survival was significantly longer in the bypass group than in the non-bypass group (p = 0.030). Gastrointestinal bypass surgery may reduce long-term recurrence and thus represents a promising alternative surgical strategy for non-strangulated ASBO.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2543-2549"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176735","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}

引用次数: 0

Clinical significance of the C-reactive protein-albumin-lymphocyte index in older patients with colorectal cancer. 老年结直肠癌患者c反应蛋白-白蛋白淋巴细胞指数的临床意义

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-20 DOI: 10.1007/s00595-026-03318-9

Daiki Matsubara, Miki Tanaka, Atsuhito Ando, Atsushi Matsumura, Satoshi Mochizuki, Koji Miyagawa, Nobuaki Fuji, Atsushi Shiozaki

{"title":"Clinical significance of the C-reactive protein-albumin-lymphocyte index in older patients with colorectal cancer.","authors":"Daiki Matsubara, Miki Tanaka, Atsuhito Ando, Atsushi Matsumura, Satoshi Mochizuki, Koji Miyagawa, Nobuaki Fuji, Atsushi Shiozaki","doi":"10.1007/s00595-026-03318-9","DOIUrl":"10.1007/s00595-026-03318-9","url":null,"abstract":"Purpose: This study aimed to investigate the association between the C-reactive protein-albumin-lymphocyte (CALLY) index and long-term prognosis and postoperative complications in older patients with colorectal cancer (CRC).Methods: Three hundred three patients with pathological stage (pStage) I-III CRC who underwent curative surgery at our institution between 2015 and 2022 were retrospectively analyzed. Patients aged ≥ 75 years were defined as older.Results: In the overall cohort, a low CALLY index was an independent prognostic factor (hazard ratio (HR) = 2.42, 95% confidence interval (CI): 1.31-4.47, p = 0.004). The age-stratified analysis revealed that a low CALLY index was associated with a worse prognosis and was an independent prognostic factor in older patients (HR = 3.46, 95% CI: 1.44-8.30, p = 0.005), whereas no independent prognostic significance was observed in non-older patients. Moreover, although the CALLY index was not associated with postoperative complications in non-older patients, a low CALLY index was an independent risk factor for postoperative complications in older patients (odds ratio = 3.93, 95% CI 1.49-10.3, p = 0.005).Conclusion: The CALLY index is a valuable predictor of both short- and long-term outcomes in patients with pStage I-III CRC, with a particularly strong impact on older patients aged ≥ 75 years.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2387-2395"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296291","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}

引用次数: 0

Self-reported harassment during Japanese surgical residency: secondary analysis of a nationwide survey of newly board-certified surgeons. 日本外科住院医师自我报告的骚扰：对全国范围内新获得委员会认证的外科医生调查的二次分析。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI: 10.1007/s00595-026-03391-0

Masayuki Fukumoto, Saseem Poudel, Takahiro Korai, Daisuke Koike, Yoshiyuki Kiyasu, Jun Watanabe, Yoshiko Yamaoka-Fujikawa, Atsushi Tanikawa, Takashi Kohmura, Sonoko Ishida, Chiaki Suda, Mitsue Saito, Norihiko Ikeda, Akinobu Taketomi

{"title":"Self-reported harassment during Japanese surgical residency: secondary analysis of a nationwide survey of newly board-certified surgeons.","authors":"Masayuki Fukumoto, Saseem Poudel, Takahiro Korai, Daisuke Koike, Yoshiyuki Kiyasu, Jun Watanabe, Yoshiko Yamaoka-Fujikawa, Atsushi Tanikawa, Takashi Kohmura, Sonoko Ishida, Chiaki Suda, Mitsue Saito, Norihiko Ikeda, Akinobu Taketomi","doi":"10.1007/s00595-026-03391-0","DOIUrl":"10.1007/s00595-026-03391-0","url":null,"abstract":"Purpose: To assess the prevalence of self-reported harassment during surgical residency in Japan, identify independent risk factors, and examine its impact on early career intentions among newly board-certified surgeons.Methods: We conducted a prespecified secondary analysis of a 2023 nationwide survey of surgeons certified between 2021 and 2022 (N = 1410). Respondents answering \"Yes\" to the perceived harassment item were assigned to the harassment group, while those answering \"No\" constituted the control; respondents selecting \"Prefer not to answer\" were excluded from this prespecified secondary analysis to avoid interpretive ambiguity. Complete‑case multivariable logistic regression produced adjusted odds ratios (aORs) for trainee, program, and workload level correlates.Results: Among the respondents, 304 (41.5%) reported harassment by instructors. In the multivariable model, low instructor teaching ability (adjusted odds ratio [aOR] 2.75; 95% CI] 1.72-4.41) and overtime > 80 h/month (aOR 2.28; 95% CI 1.57-3.30) were the primary factors independently associated with self-reported harassment. Furthermore, experiencing harassment was significantly associated with overall program dissatisfaction, lack of intention to return to the training institution, and a higher likelihood of dropping out (p < 0.001).Conclusions: Self-reported harassment experiences are associated with an excessive workload and unsatisfactory surgical instruction, threatening trainee retention. Duty hour limits, instructor education, and confidential reporting systems should therefore be prioritized.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2486-2493"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377004","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}

引用次数: 0

Clinical significance of lower admission amylase levels as an indicator of medical management in pancreatic trauma with AAST grade I injury. 入院时较低淀粉酶水平作为胰腺创伤合并AAST一级损伤医疗管理指标的临床意义

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI: 10.1007/s00595-026-03380-3

Kyohei Matsumoto, Atsushi Shimizu, Akihiro Takeuchi, Hideki Motobayashi, Masatoshi Sato, Tomohiro Yoshimura, Shinya Hayami, Atsushi Miyamoto, Kensuke Nakamura, Manabu Kawai

{"title":"Clinical significance of lower admission amylase levels as an indicator of medical management in pancreatic trauma with AAST grade I injury.","authors":"Kyohei Matsumoto, Atsushi Shimizu, Akihiro Takeuchi, Hideki Motobayashi, Masatoshi Sato, Tomohiro Yoshimura, Shinya Hayami, Atsushi Miyamoto, Kensuke Nakamura, Manabu Kawai","doi":"10.1007/s00595-026-03380-3","DOIUrl":"10.1007/s00595-026-03380-3","url":null,"abstract":"Purpose: We aimed to explore whether the admission serum amylase levels may help inform the selection of medical management in patients with AAST Grade I pancreatic injuries.Methods: We retrospectively reviewed the records of 20 patients treated for pancreatic trauma between 2010 and 2024. They were categorized into medical management or intervention groups according to the initial treatment strategy. We used a receiver operating characteristic (ROC) analysis to evaluate the predictive value of the admission serum amylase levels for successful medical management.Results: Eight patients were treated with strict medical management, whereas 12 required additional interventions. All patients in the medical management group had AAST Grade I injuries, and none required conversion to interventional treatment. The admission serum amylase levels were significantly lower in the medical management group (median 106 vs. 350 IU/L; p = 0.0228), whereas there were no significant intergroup differences in inflammatory markers. The ROC analysis yielded an area under the curve of 0.83 (95% CI, 0.59- 1.00). The cutoff value was 158 IU/L, with a sensitivity of 87.5% and a negative predictive value of 90.9%.Conclusion: Lower admission serum amylase levels in patients with AAST Grade I pancreatic injury may be associated with suitability for strict medical management; however, these findings are exploratory and require validation in larger multicenter studies.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2501-2512"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377015","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}

引用次数: 0

Anchor-shaped cutaneous flap for volume replacement in oncoplastic breast-conserving surgery for a lower non-ptotic breast. 锚形皮瓣在癌性保乳手术中的体积置换术。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI: 10.1007/s00595-026-03385-y

Yuko Kijima, Munetsugu Hirata, Yumika Nakazawa, Naoki Hayashi, Yuki Nohara, Ryunosuke Kijima

{"title":"Anchor-shaped cutaneous flap for volume replacement in oncoplastic breast-conserving surgery for a lower non-ptotic breast.","authors":"Yuko Kijima, Munetsugu Hirata, Yumika Nakazawa, Naoki Hayashi, Yuki Nohara, Ryunosuke Kijima","doi":"10.1007/s00595-026-03385-y","DOIUrl":"10.1007/s00595-026-03385-y","url":null,"abstract":"Breast-conserving surgery (BCS) is widely accepted as a standard treatment for early breast cancer, providing local control with favorable cosmetic outcomes. However, the resection of tumors in the lower pole of the breast often results in unsatisfactory deformities, particularly in women with small, non-ptotic breasts. We describe a simple oncoplastic technique using an anchor-shaped cutaneous flap that combines volume displacement of breast tissue with volume replacement using adjacent extra-breast tissue as a new oncoplastic breast-conserving surgery (OPBCS) technique. Three Japanese patients with early breast cancer involving the lower breast underwent this procedure. After complete tumor resection with adequate margins, an anchor-shaped cutaneous flap was designed along the inframammary fold. The de-epithelialized flap was elevated, rolled cranially, and sutured to fill the defect while simultaneously recreating the inframammary line. Both patients showed excellent breast symmetry, and there were no postoperative complications. This anchor-shaped flap is a practical option for patients with small, non-ptotic breasts who are not suitable candidates for reduction mammoplasty. It minimizes the volume deficit by removing redundant skin and effectively utilizes both intra- and extra-mammary tissue.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2556-2560"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376961","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}

引用次数: 0

Prognostic stratification of unresectable locally advanced pancreatic cancer using a combination of inflammatory and nutritional indices: a retrospective cohort study. 结合炎症和营养指标对不能切除的局部晚期胰腺癌进行预后分层：一项回顾性队列研究。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-03 DOI: 10.1007/s00595-026-03344-7

Michinori Matsumoto, Masashi Tsunematsu, Kenei Furukawa, Koichiro Haruki, Yoshihiro Shirai, Tadashi Uwagawa, Takeshi Gocho, Shinji Onda, Mitsuru Yanagaki, Toru Ikegami

{"title":"Prognostic stratification of unresectable locally advanced pancreatic cancer using a combination of inflammatory and nutritional indices: a retrospective cohort study.","authors":"Michinori Matsumoto, Masashi Tsunematsu, Kenei Furukawa, Koichiro Haruki, Yoshihiro Shirai, Tadashi Uwagawa, Takeshi Gocho, Shinji Onda, Mitsuru Yanagaki, Toru Ikegami","doi":"10.1007/s00595-026-03344-7","DOIUrl":"10.1007/s00595-026-03344-7","url":null,"abstract":"Purpose: Resectability in pancreatic cancer (PC) is determined by anatomical, biological, and conditional (ABC) criteria. However, the pretreatment prognostic markers for unresectable locally advanced (UR-LA) PC are insufficient. This study aimed to identify the baseline predictors of survival and establish an inflammation-nutrition-based prognostic score.Methods: Thirty-nine patients with UR-LA PC who received chemotherapy or chemoradiotherapy were retrospectively evaluated. Pretreatment biomarkers, including systemic immune-inflammation index (SIII) and body mass index (BMI), were analyzed using Cox proportional hazards models.Results: Multivariable analysis identified BMI < 18.5 kg/m² (PFS: HR 3.79, p = 0.003; OS: HR 2.88, p = 0.03) and SIII > 900/µL (PFS: HR 3.71, p = 0.002; OS: HR 4.25, p = 0.02) as independent predictors of worse outcomes. High SIII was correlated with elevated neutrophil-to-lymphocyte ratio and lower prognostic nutritional index, whereas low BMI was associated with sarcopenia and reduced feasibility of conversion surgery. A pretreatment SIII/BMI score (0-2 points) effectively stratified survival: median PFS was 16.4, 7.3, and 4.3 months, and median OS was 31.1, 18.0, and 7.1 months for scores 0, 1, and 2, respectively.Conclusions: Pretreatment SIII and BMI are strong independent prognostic markers for UR-LA PC. The SIII/BMI score is a practical pretreatment tool aligned with the ABC framework to support individualized treatment planning.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2158-2169"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151061","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}

引用次数: 0

Efficacy and safety of postoperative chewing gum for gastrointestinal recovery in children undergoing surgery: an updated systematic review and meta-analysis. 术后嚼口香糖对手术儿童胃肠道恢复的疗效和安全性：一项最新的系统综述和荟萃分析。

IF 2.3 4区医学

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-04 DOI: 10.1007/s00595-026-03351-8

Akiko Eto-Kimura, Shuri Nakao, Tomoo Sato, Yuki Nakashima, Yohei Sanmoto, Yudai Goto, Jun Watanabe

{"title":"Efficacy and safety of postoperative chewing gum for gastrointestinal recovery in children undergoing surgery: an updated systematic review and meta-analysis.","authors":"Akiko Eto-Kimura, Shuri Nakao, Tomoo Sato, Yuki Nakashima, Yohei Sanmoto, Yudai Goto, Jun Watanabe","doi":"10.1007/s00595-026-03351-8","DOIUrl":"10.1007/s00595-026-03351-8","url":null,"abstract":"Chewing gum may stimulate gut motility through a \"sham feeding\" mechanism, but evidence in children is limited. We performed an updated systematic review and meta-analysis of randomized controlled trials comparing chewing gum plus usual care versus usual care alone in patients younger than 18 years undergoing any surgery. We searched five databases through June 2025. Primary outcomes were the time to first flatus, time to first defecation, and postoperative length of stay (LOS). Certainty was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Ten studies (n = 649) were included: abdominal surgery (5), spinal fusion (3), and tonsillectomy (2). Chewing gum may result in little to no difference in the time to first flatus (MD - 3.58 h, 95% CI - 8.08 to 0.91) or first defecation (MD - 3.23 h, 95% CI - 6.63 to 0.18), both with low certainty. LOS evidence was very uncertain (MD - 0.18 days, 95% CI - 0.70 to 0.33). Subgroup analyses suggested shorter LOS after abdominal surgery (MD - 0.60 days, 95% CI - 1.99 to 0.79) but not after spinal fusion (MD 0.10 days, 95% CI - 0.29 to 0.50; p for interaction = 0.0362). The benefits of postoperative chewing gum in children remain uncertain, with potential surgery-specific differences in LOS warranting investigation.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"2118-2130"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158174","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}

引用次数: 0