World Journal of Gastrointestinal Surgery最新文献

{"title":"Comparison of outcomes of laparoscopic-assisted and total laparoscopic right hemicolectomy for right-sided colon cancer.","authors":"Wen-Feng Du, Tang-Shuai Liang, Zong-Fei Guo, Jian-Jun Li, Cheng-Gang Yang","doi":"10.4240/wjgs.v17.i4.100476","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.100476","url":null,"abstract":"<p><strong>Background: </strong>Colon cancer is a significant health issue in China, with high incidence and mortality rates. Surgical resection remains the primary treatment, with the introduction of complete mesocolic excision in 2009 improving precision and outcomes. Laparoscopic techniques, including laparoscopic-assisted right hemicolectomy (LARH) and total laparoscopic right hemicolectomy (TLRH), have further advanced colon cancer treatment by reducing trauma, blood loss, and recovery time. While TLRH offers additional benefits such as faster recovery and fewer complications, its adoption has been limited by longer operative times and technical challenges.</p><p><strong>Aim: </strong>To compare the short-term outcomes of TLRH and LARH for the treatment of right -sided colon cancer and explore the advantages and feasibility of TLRH.</p><p><strong>Methods: </strong>Clinical data from 109 right-sided colon cancer patients admitted between January 2019 and May 2021 were retrospectively analyzed. Patients were divided into an observation group (TLRH, <i>n</i> = 50) and a control group (LARH, <i>n</i> = 59). Study variables were operation time, intraoperative bleeding volume, postoperative hospital stays, length of surgical specimen, number of lymph nodes dissected, and postoperative inflammatory factor levels of the two groups of patients. The postoperative complications were analyzed and compared, and survival, recurrence, and remote metastasis rates of the two groups were compared during a 2-year follow-up period.</p><p><strong>Results: </strong>The TLRH group showed the advantages of reduced intraoperative bleeding, shorter hospital stays, and quicker recovery. Lymph node dissection outcomes were comparable, and postoperative inflammatory markers were lower in the TLRH group. Complication rates were similar. Short-term follow-up (2 years) revealed no significant differences in recurrence, metastasis, or survival rates.</p><p><strong>Conclusion: </strong>Compared to LARH, TLRH offers significant advantages in terms of reducing surgical trauma, lowering postoperative inflammatory factor levels, and mitigating the impact on intestinal function. This approach contributes to a shorter hospital stay and promotes postoperative recovery in patients. The study suggests that TLRH may offer favorable outcomes for colorectal cancer patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"100476"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020994","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":"Nomogram for predicting myocardial injury in pediatric patients undergoing living donor liver transplantation for biliary atresia.","authors":"Yu-Li Wu, Yong-Le Jing, Wei-Hua Liu, Xin-Yuan Gong, Lu Che, Jing-Yi Xue, Tian-Ying Li, Lei Jiang, Xiao-Yu Huang, Wen-Li Yu, Yi-Qi Weng","doi":"10.4240/wjgs.v17.i4.103263","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.103263","url":null,"abstract":"<p><strong>Background: </strong>Myocardial injury is common during liver transplantation and is associated with poor outcomes. The development of a reliable prediction system for this type of injury is crucial for reducing the incidence of cardiac complications in children receiving living donor liver transplantation (LDLT). However, establishing a practical myocardial injury prediction system for children with biliary atresia remains a considerable challenge.</p><p><strong>Aim: </strong>To create and validate a nomogram model for predicting myocardial injury in children with biliary atresia who received LDLT.</p><p><strong>Methods: </strong>Clinical data from pediatric patients who received LDLT for biliary atresia between November, 2019 and January, 2022 were retrospectively analyzed. The complete dataset was randomly partitioned into a training set and a validation set at a ratio of 7:3. Least absolute shrinkage and selection operator regression was used to preliminarily screen out the predictors of myocardial injury. The prediction model was established <i>via</i> multivariable logistic regression and presented in the form of a nomogram.</p><p><strong>Results: </strong>This study included 321 patients, 150 (46.7%) of whom had myocardial injury. The participants were randomly allocated into two groups: A training group consisting of 225 patients and a validation group comprising 96 patients. The predictors in this nomogram included the preoperative neutrophil-to-lymphocyte ratio, high sensitivity C-reactive protein level, pediatric end-stage liver disease score and postreperfusion syndrome. The area under the curve for predicting myocardial injury was 0.865 in the training set and 0.856 in the validation set. The calibration curve revealed that the predicted values were very close to the actual values in the two sets. Decision curve analysis revealed that the prediction model offered a favorable net benefit.</p><p><strong>Conclusion: </strong>The nomogram developed in this study effectively predicts myocardial injury in pediatric LDLT patients, showing good accuracy and potential for clinical application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"103263"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062484","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":"Association of <i>Clostridium difficile</i> infection with clinical outcomes of patients with inflammatory bowel disease: A meta-analysis.","authors":"Hai-Xin Qi, Qi Wang, Gui-Qun Zhou","doi":"10.4240/wjgs.v17.i4.100555","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.100555","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridium difficile</i> infection (CDI) is common in patients with inflammatory bowel disease (IBD).</p><p><strong>Aim: </strong>To assess the association of CDI with clinical outcomes of IBD.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science, and the Cochrane Library databases were searched from inception to March 2024. Eligible articles included observational studies that reported on outcomes such as mortality, colectomy, hospitalization, intensive care unit (ICU) admission, complication rates, and length of hospital stay in IBD patients with and without CDI. Data were extracted, and a random-effects model was used to calculate pooled odds ratios (ORs) and mean differences (MDs).</p><p><strong>Results: </strong>As shown in the data from 21 studies with 1249158 participants, CDI significantly increased the risk of mortality in IBD patients [pooled OR = 4.569, 95% confidence intervals (95%CI): 2.584 to 8.079]. Although the pooled OR for colectomy was 1.409 (95%CI: 0.922 to 2.155), it was not statistically significant. Similarly, CDI did not impact hospitalization (pooled OR = 1.056, 95%CI: 0.512 to 2.179) and ICU admission outcomes (pooled OR = 1.970, 95%CI: 0.420 to 9.246) of patients with IBD. The rate of complications was comparable in the two groups (pooled OR = 0.658, 95%CI: 0.378 to 1.147). However, CDI was associated with a significantly more extended hospital stay (pooled MD = 0.349 days, 95%CI: 0.002 to 0.696).</p><p><strong>Conclusion: </strong>CDI is linked to increased mortality and prolonged hospitalization in IBD patients. These results emphasize the need for early detection and appropriate management. Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"100555"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985304","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":"Important issues on the prevention of surgical site infections and the management of prophylactic antibiotics.","authors":"Xue-Lu Yu, Jian-Hui Peng, Qing Chang, Jing-Wen Chen, Ji-Shun Yang, Ming-Ke Wang","doi":"10.4240/wjgs.v17.i4.102144","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.102144","url":null,"abstract":"<p><p>In this article, we have addressed the recent published article by Wang <i>et al</i> which examines risk factors associated with surgical site infections (SSIs) and evaluates the effectiveness of prophylactic antibiotics in their prevention. Wang <i>et al</i> identified several significant risk factors of SSIs, including age ≥ 60 years, diabetes mellitus, and surgical complications such as insufficient cystic duct stump closure, gallbladder perforation, empyema, and postoperative hematoma. Their findings suggest that prophylactic antibiotics can serve as a protective factor against SSIs. However, other reported risk factors and preventive strategies warrant consideration to further reduce the incidence of SSIs, lower healthcare costs, and enhance patient outcomes. Additionally, the judicious use of prophylactic antibiotics is crucial in light of the growing global challenge of antibiotic resistance caused by the misuse and overuse of antibiotics. Effective management strategies for prophylactic antibiotic use should be prioritized to balance infection control with the need to combat antimicrobial resistance.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"102144"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018438","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":"Control observation of different digestive tract reconstruction methods in total gastrectomy for gastric cancer.","authors":"Ming Wei, Hai-Bo Jiang, Yuan-Yuan Wang, Ya-Hong Shi, Zhe Han, Ying-Chao Gao","doi":"10.4240/wjgs.v17.i4.101599","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.101599","url":null,"abstract":"<p><strong>Background: </strong>For patients with advanced gastric cancer, surgical resection remains the main treatment option. Total gastrectomy combined with radical resection of gastric cancer lesions and sentinel lymph nodes can significantly prolong the survival of patients. Digestive tract reconstruction after total gastrectomy is essential to maintain gastrointestinal function and optimize postoperative recovery. Therefore, it is very important to choose a suitable reconstruction method to improve the quality of life of total gastrectomy patients.</p><p><strong>Aim: </strong>To evaluate the effects of different digestive tract reconstruction methods in gastric cancer patients undergoing total gastrectomy.</p><p><strong>Methods: </strong>This retrospective study included 172 patients who underwent total gastrectomy for gastric cancer at The First Hospital of Hebei Medical University for analysis. The patients were categorized into two groups: Group A, consisting of 90 patients who underwent modified Roux-en-Y gastrojejunostomy, and group B, consisting of 82 patients who underwent uncut Roux-en-Y gastrojejunostomy. The general patient characteristics, perioperative indicators, postoperative gastrointestinal mucosal barrier function, nutritional status, immunological markers, and occurrence of complications were compared between the two groups.</p><p><strong>Results: </strong>Group A showed shorter digestive tract reconstruction time than group B (<i>P</i> < 0.05). On the first postoperative day, group A showed lower serum levels of D-lactate, diamine oxidase, and endotoxin than group B (<i>P</i> < 0.05). One month postoperatively, group A showed higher prognostic nutritional index, serum albumin, total protein, and body weight than group B (<i>P</i> < 0.05). One month postoperatively, the levels of cluster of differentiation (CD) 3 +, CD4 +, and CD8 + cells were not significantly different between two groups (<i>P</i> > 0.05). The complication rates were 10.00% in group A and 24.39% in group B; group A had a significantly lower complication rate than group B (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Using modified Roux-en-Y gastrojejunostomy during total gastrectomy shortens the time required for gastrointestinal anastomosis, reduces surgery-induced gastrointestinal mucosal damage, and mitigates postoperative declines in nutritional status.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"101599"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056235","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":"Modified single-port laparoscopic appendectomy using needle-type grasping forceps <i>vs</i> conventional three-port laparoscopic appendectomy for acute uncomplicated appendicitis.","authors":"Yang Chen, Shi-Gang Guo, Xin-Ao Fu, Zong-Qi Fan, Jie-Qing Yuan, Xiao-Xin Zhang, Huan Liu, Zhu Liu, Yong-Shuai Huang, Lei Song","doi":"10.4240/wjgs.v17.i4.102607","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.102607","url":null,"abstract":"<p><strong>Background: </strong>Single-port laparoscopic appendectomy is an advanced minimally invasive surgery that involves the use of upgraded instruments and equipment. We previously modified single-port laparoscopic appendectomy with needle-type grasping forceps (mSLAN) for patients with simple appendicitis, but the feasibility and safety of our modified procedure need further evaluation in a high-quality clinical study.</p><p><strong>Aim: </strong>To compare the short-term clinical outcomes of mSLAN with those of conventional three-port laparoscopic appendectomy (CLA) for patients with acute uncomplicated appendicitis.</p><p><strong>Methods: </strong>This single-center, single-blind, prospective, randomized controlled trial included patients who underwent emergency laparoscopic appendectomy for acute uncomplicated appendicitis at our center between April 2024 and August 2024. Patients were randomly divided into the mSLAN group or the CLA group <i>via</i> computer-generated randomization. The primary endpoint was the 24-hour postoperative visual analog scale (VAS) score, and the secondary endpoints included the operative time, 24-hour postoperative inflammatory response biomarkers (including white blood cells, the neutrophil ratio, interleukin-6, and C-reactive protein), time to first postoperative exhaust, time to first out-of-bed activity, postoperative length of hospital stay, cost of hospitalization, and incidence of postoperative complications.</p><p><strong>Results: </strong>A total of 72 patients were enrolled and randomly divided into 2 groups: The mSLAN group (<i>n</i> = 36) and the CLA group (<i>n</i> = 36). The 24-hour VAS scores, 24-hour postoperative inflammatory response marker levels, first postoperative exhaust times, first out-of-bed activity times, postoperative lengths of hospital stay, operative times, or hospitalization costs did not significantly differ between the two groups. No postoperative complications, including incision infection or hernia, abdominal abscess or intestinal obstruction, were observed during the 1-month postoperative follow-up in either group.</p><p><strong>Conclusion: </strong>Compared with the CLA protocol, the mSLAN protocol for acute uncomplicated appendicitis yielded comparable short-term clinical outcomes, with a similar operative time and better cosmetic outcomes, indicating its potential for clinical application and superiority for patients with high cosmetic requirements. Further research is needed to evaluate the long-term outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"102607"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030479","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":"Perioperative risk factors for prognosis in patients undergoing radical esophagectomy: A retrospective study.","authors":"Shu-Gang Liu, Xin-Jian Xu, Ming He, Ji-Dong Zhao, Lin Pei","doi":"10.4240/wjgs.v17.i4.103483","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.103483","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes. While surgical resection remains the cornerstone of curative intervention, optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy. However, substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.</p><p><strong>Aim: </strong>To identify perioperative factors affecting prognosis after radical esophagectomy, aiming to improve patient outcomes through targeted interventions.</p><p><strong>Methods: </strong>A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy (McKeown, Sweet, or Ivor-Lewis procedures) from January 2022 through December 2023. All operations were performed by experienced surgeons following standardized perioperative protocols. The investigation gathered data on patient demographics, surgical parameters, tumor pathology (using the 8^th edition American Joint Committee on Cancer staging system), and survival outcomes. Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling, with adjustment for confounding variables.</p><p><strong>Results: </strong>Multivariate Cox proportional hazards analysis identified three independent predictors of survival: Tumor-node-metastasis staging [Hazard ratio (HR) = 2.31, 95% confidence interval (CI): 1.72-3.10, <i>P</i> < 0.001], tumor differentiation (moderate: HR = 1.46, 95%CI: 1.02-2.09, <i>P</i> = 0.038; poor: HR = 2.15, 95%CI: 1.47-3.14, <i>P</i> < 0.001), and extended postoperative analgesic use (> 5 days) (HR = 1.43, 95%CI: 1.08-1.89, <i>P</i> = 0.012). Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for > 5 days compared to ≤ 5 days (<i>P</i> = 0.003), with consistent patterns observed for both opioid (<i>P</i> = 0.019) and nonsteroidal anti-inflammatory drug use (<i>P</i> = 0.028). The extended analgesic group exhibited a higher proportion of elderly patients (48.47% <i>vs</i> 35.57%, <i>P</i> = 0.015), while other baseline characteristics and tumor features remained comparable between groups.</p><p><strong>Conclusion: </strong>Tumor-node-metastasis staging, tumor differentiation, and duration of postoperative analgesic use independently predict survival following radical esophagectomy, underscoring the significance of optimal pain management protocols.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"103483"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039881","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":"Comparison of the efficacy of carbapenems and cephalosporins for postoperative treatment of perforated appendicitis in children.","authors":"Tian Hang, Qiao-Lin Chen, Ya-Hong Li, Shi-Wen Wang, Xiao-Hong Jiang, Wei-Chao Zhu","doi":"10.4240/wjgs.v17.i4.104712","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.104712","url":null,"abstract":"<p><strong>Background: </strong>Pediatric perforated appendicitis (PPA) is a severe acute condition requiring surgical intervention and postoperative antibiotic therapy. Antibiotic selection differs significantly among pediatric centers, and an ideal postoperative anti-infective approach for PPA management has yet to be established.</p><p><strong>Aim: </strong>To examine the spectrum of pathogenic bacteria in pediatric PPA and to summarize the postoperative experience with carbapenem (CBP) and cephalosporin (CPS) antibiotics.</p><p><strong>Methods: </strong>We retrospectively analyzed medical records of 65 children (43 boys, 22 girls; mean age 6.92 ± 3.41 years) with PPA who underwent surgery at our hospital between December 2019 and August 2022. Data were collected in September 2023. Based on postoperative antibiotic selection, patients were divided into CBP (32 cases) and CPS (33 cases) groups. Chi-square and T-tests compared recovery outcomes, while univariate and multivariate regression models identified independent factors affecting postoperative recovery.</p><p><strong>Results: </strong>There were no significant differences between the two groups in gender, age, weight, height, body mass index, baseline ear temperature, or heart rate (<i>P</i> > 0.05). <i>Escherichia coli</i> (40.00%) and <i>Pseudomonas aeruginosa</i> (24.62%) were the most common pathogens in PPA. Postoperative analysis showed significantly shorter C-reactive protein (CRP) recovery times in the CPS group than in the CBP group [(6.18 ± 1.84) <i>vs</i> (8.12 ± 3.48) days, <i>P</i> = 0.009]. Univariate logistic regression indicated CPS selection (OR = 0.32, 95%CI: 0.10-0.97, <i>P</i> = 0.044) was significantly associated with a higher CRP recovery rate within 7 days. Multivariate analysis confirmed CPS selection (OR = 3.49, 95%CI: 1.19-10.24, <i>P</i> = 0.023) as an independent factor affecting CRP recovery within 7 days postoperatively.</p><p><strong>Conclusion: </strong>The choice of CBP or CPS independently affects CRP recovery within 7 days. CBP offers no advantage over CPS in treating PPA, with CPS also demonstrating favorable clinical outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"104712"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048495","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":"Pan-immune-inflammation in colon cancer: A prognostic biomarker and the role of tumor location in personalized care.","authors":"Gaya Spolverato, Giulia Capelli, Floriane Noel, Michele Steindler, Andrew Alexander Gumbs","doi":"10.4240/wjgs.v17.i4.101066","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.101066","url":null,"abstract":"<p><p>Despite advances in surgery, chemotherapy, and radiotherapy, the treatment of colorectal cancer (CRC) requires more personalized approaches based on tumor biology and molecular profiling. While some relevant mutations have been associated with differential response to immunotherapy, such as <i>RAS</i> and <i>BRAF</i> mutations limiting response to anti-epithelial growth factor receptor drugs or microsatellite instability predisposing susceptibility to immune checkpoint inhibitors, the role of inflammation in dictating tumor progression and treatment response is still under investigation. Several inflammatory biomarkers have been identified to guide patient prognosis. These include the neutrophil-lymphocyte ratio, Glasgow prognostic score (GPS) and its modified version, lymphocyte-C-reactive protein ratio, and platelet-lymphocyte ratio. However, these markers are not yet included in the standard clinical management of patients with CRC, and further research is needed to evaluate their efficacy in different patient populations. A recent study by Wang <i>et al</i>, published in the <i>World Journal of Gastroenterology</i>, sheds light on the prognostic significance of pan-immune-inflammation value (PIV) in CRC, particularly concerning primary tumor location. Specifically, the authors found that a high PIV was strongly correlated with worse disease-free survival in patients with left-sided colon cancer, whereas no such association was observed in patients with right-sided colon cancer. Integrating tumor location into the prognostic assessment of CRC may improve our ability to more accurately identify high-risk patients and develop personalized treatment plans that are more likely to improve patient outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"101066"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050735","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":"Role of pelvimetry in predicting surgical outcomes and morbidity in rectal cancer surgery: A retrospective analysis.","authors":"Oguzhan Fatih Ay, Deniz Firat, Bülent Özçetin, Gokhan Ocakoglu, Seray Gizem Gur Ozcan, Şule Bakır, Birol Ocak, Ali Kemal Taşkin","doi":"10.4240/wjgs.v17.i4.104726","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.104726","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer has increased in incidence, and surgery remains the cornerstone of multimodal treatment. Pelvic anatomy, particularly a narrow pelvis, poses challenges in rectal cancer surgery, potentially affecting oncological outcomes and postoperative complications.</p><p><strong>Aim: </strong>To investigate the relationship between radiologically assessed pelvic anatomy and surgical outcomes as well as the impact on local recurrence following rectal cancer surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed 107 patients with rectal adenocarcinoma treated with elective rectal surgery between January 1, 2017, and September 1, 2022. Pelvimetric measurements were performed using computed tomography (CT)-based two-dimensional methods (<i>n</i> = 77) by assessing the pelvic inlet area in mm², and magnetic resonance imaging (MRI)-based three-dimensional techniques (<i>n</i> = 52) using the pelvic cavity index (PCI). Patient demographic, clinical, radiological, surgical, and pathological characteristics were collected and analyzed in relation to their pelvimetric data.</p><p><strong>Results: </strong>When patients were categorized based on CT measurements into narrow and normal/wide pelvis groups, a significant association was observed with male sex, and a lower BMI was more common in the narrow pelvis group (<i>P</i> = 0.002 for both). A significant association was found between a narrow pelvic structure, indicated by low PCI, and increased surgical morbidity (<i>P</i> = 0.049). Advanced age (<i>P</i> = 0.003) and male sex (<i>P</i> = 0.020) were significantly correlated with higher surgical morbidity. Logistic regression analysis identified four parameters that were significantly correlated with local recurrence: older age, early perioperative readmission, longer operation time, and a lower number of dissected lymph nodes (<i>P</i> < 0.05). However, there were no significant differences between the narrow and normal/wide pelvis groups in terms of the operation time, estimated blood loss, or overall local recurrence rate (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>MRI-based pelvimetry may be valuable in predicting surgical difficulty and morbidity in rectal cancer surgery, as indicated by the PCI. The observed correlation between low PCI and increased surgical morbidity suggests the potential importance of a preoperative MRI-based pelvimetric evaluation. In contrast, CT-based pelvimetry did not show significant differences in predicting surgical outcomes or cancer recurrence, indicating that the utility of pelvimetry alone may be limited in these respects.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"104726"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002260","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}