World Journal of Gastrointestinal Surgery最新文献

{"title":"Clinical controls and model calibration as keys to complete blood count-based studies of pediatric fistula-in-ano.","authors":"Shi-Yan Zhang, Jin-Bao Shi","doi":"10.4240/wjgs.v18.i2.116133","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.116133","url":null,"abstract":"<p><p>This commentary appraises a single-center evaluation of complete blood count (CBC) markers for pediatric fistula-in-ano. We commend the pragmatic focus of this study on low-cost tests and the dual assessment of discrimination and clinical utility. To strengthen robustness and generalizability, two priorities are emphasized: First, the use of clinical controls, children with perianal symptoms but without pediatric fistula-in-ano, to avoid spectrum bias; and second rigorous calibration and validation (k-fold or temporal splits, bootstrap optimism correction, calibration intercept/slope, and Brier score), with decision curve analyses derived from validated predictions. Given rapid hematologic maturation, age should be modeled nonlinearly and CBC values should be expressed as age-specific z-scores/percentiles. Additional refinements include clear timing/indication of blood draws, appropriate correlations (Spearman or age-adjusted partials), and odds ratios per interquartile range with multicollinearity checks (variance inflation factor). These steps can translate promising CBC signals into reliable, clinically actionable evidence.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"116133"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435499","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":"Failure mode and effects analysis nursing model improves recovery and quality of life post-laparoscopic extended radical colectomy for colorectal cancer.","authors":"Qian-Qian Yang, Zhen-Kun Wu","doi":"10.4240/wjgs.v18.i2.113730","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.113730","url":null,"abstract":"<p><strong>Background: </strong>Postoperative gastrointestinal recovery is a critical factor influencing patient rehabilitation.</p><p><strong>Aim: </strong>To investigate the effects of conventional care compared with the failure mode and effects analysis (FMEA) protocol on postoperative recovery in patients undergoing surgery.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 225 patients with colorectal cancer (conventional care group: <i>n</i> = 122; FMEA group: <i>n</i> = 103) treated between June 2021 and June 2024. Outcomes included gastrointestinal recovery (time to flatus/bowel movement and diet tolerance), functional capacity (6-minute walk distance test and sit-to-stand test), complications, quality of life (General Comfort Questionnaire, Barthel index, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and satisfaction.</p><p><strong>Results: </strong>The FMEA group demonstrated significantly accelerated recovery: Shorter hospital stays (4.49 ± 0.38 days <i>vs</i> 4.66 ± 0.42 days, <i>P</i> = 0.002), earlier flatus (18.58 ± 1.86 hours <i>vs</i> 19.09 ± 1.93 hours, <i>P</i> = 0.045), and improved 6-minute walk distance at 8 weeks (526.16 ± 88.71 m <i>vs</i> 495.29 ± 94.82 m, <i>P</i> = 0.013). Complication rates decreased (nausea/vomiting: 12.62% <i>vs</i> 22.95%, <i>P</i> = 0.046; bowel obstruction: 2.91% <i>vs</i> 10.66%, <i>P</i> = 0.024). Quality of life metrics significantly favored FMEA: Total comfort score (91.66 ± 4.71 <i>vs</i> 89.27 ± 4.87, <i>P</i> < 0.001), Barthel index (67.93 ± 3.19 <i>vs</i> 66.71 ± 3.35, <i>P</i> = 0.006), and higher \"very satisfied\" rates (61.17% <i>vs</i> 47.54%, <i>P</i> = 0.041).</p><p><strong>Conclusion: </strong>FMEA-based nursing significantly enhances postoperative functional recovery, reduces complications, and improves quality of life in patients undergoing extended colectomy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"113730"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435934","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":"Integrating traditional Chinese medicine in anal fistula surgery: A step forward in holistic patient care.","authors":"Yu-Xing Liu, Chen-Ming Liu","doi":"10.4240/wjgs.v18.i2.114639","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114639","url":null,"abstract":"<p><p>This letter comments on the retrospective cohort study by Liu <i>et al</i>, which evaluates the integration of traditional Chinese medicine (TCM) with conventional seton-based surgery for complex anal fistulas. The study reports a 90.0% success rate in the TCM-integrated group <i>vs</i> 78.8% in the conventional group, with a mean healing time reduced from 28.3 days to 21.5 days and recurrence rates of 5.0% <i>vs</i> 15.0%. These outcomes highlight the potential of TCM modalities - such as herbal decoctions and fumigation - to complement surgical management by addressing inflammation, pain, and tissue regeneration. While the retrospective design and single-center setting warrant cautious interpretation, this work provides a valuable foundation for future randomized trials and underscores the importance of personalized, integrative approaches in colorectal surgery. Further research should focus on standardizing TCM protocols and elucidating the underlying mechanisms of its efficacy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114639"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435912","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":"Enhanced recovery after surgery pathways and postoperative gastrointestinal function in colorectal cancer: A prospective cohort study.","authors":"Bai-Hui Zhao, Chun-Xiao Bao","doi":"10.4240/wjgs.v18.i2.115050","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.115050","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) pathways, integrated with systematic rehabilitation interventions, are essential for promoting recovery of gastrointestinal function and improving quality of life (QoL) after colorectal cancer surgery.</p><p><strong>Aim: </strong>To explore how ERAS pathways with rehabilitation affect postoperative recovery of gastrointestinal function and QoL in patients with colorectal cancer.</p><p><strong>Methods: </strong>In this prospective cohort study, 122 patients undergoing colorectal cancer surgery between January 2022 and June 2024 were randomly divided into experimental (ERAS + rehabilitation, <i>n</i> = 61) and control (routine nursing, <i>n</i> = 61) groups. The experimental group received a comprehensive ERAS pathway, preoperative carbohydrate loading, targeted fluid management, multimodal analgesia, early feeding, and structured rehabilitation training. The control group received traditional perioperative management. Gastrointestinal function recovery indicators, pain scores, complication rates, and QoL were compared between the groups.</p><p><strong>Results: </strong>The ERAS group showed significantly shorter recovery time for gastrointestinal peristalsis, earlier first exhaust and defecation times, lower pain scores, and fewer complications (all <i>P</i> < 0.05). Rehabilitation training compliance was 91.8%. The ERAS group also had significantly better QoL scores in the physical, psychological, and gastrointestinal domains (<i>P</i> < 0.05). Multivariate logistic regression analysis confirmed that ERAS was an independent protective factor against delayed gastrointestinal recovery (odds ratio = 0.32, 95% confidence interval: 0.12-0.85). Subgroup analysis confirmed its effectiveness in improving inflammation and barrier indicators.</p><p><strong>Conclusion: </strong>ERAS pathways with rehabilitation training can enhance postoperative gastrointestinal recovery, alleviate pain, reduce complications, and improve the QoL in patients with colorectal cancer, showing significant clinical and rehabilitative value.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"115050"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435926","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":"Emergency surgery for malignant large bowel obstruction: Assessing management options and outcomes.","authors":"Terence N Moyana","doi":"10.4240/wjgs.v18.i2.113867","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.113867","url":null,"abstract":"<p><p>Malignant large bowel obstruction accounts for a disproportionately high percentage of colorectal cancer emergencies. Traditionally, it was treated by emergency surgery, which, depending on the circumstances, could involve primary resection or staged procedures. However, this was associated with considerable morbidity and mortality. Qiu <i>et al</i> sought to improve this by creating a nomogram that can be used as a benchmark in the management of such patients. Although the nomogram is meant to be a predictive model for recurrence, it is only based on a snapshot of parameters at 2 years. To be of maximum benefit to patients consenting for surgery and their caregivers, the performance of the model should be assessed over both the short- and long-term intervals (<i>e.g.,</i> 30, 60, and 90 days as well as 1, 2, and 5 years or longer). Moreover, the heterogeneity of colorectal cancer (<i>e.g.,</i> right-sided <i>vs</i> left-sided cancers <i>vs</i> rectal cancers) limits the nomogram's applicability in certain situations, as it was constructed using a one-size-fits-all approach. It is also noteworthy that the increasing acceptance of self-expanding metal stents as an option to emergency surgery provides significant benefits for patients with malignant large bowel obstruction. Lastly, it is important to distinguish residual disease from recurrence, as conflating the two may confound parameters and study endpoints. This distinction has gained renewed interest with recent advances in liquid biopsies and genomics and how they can better define minimal residual disease.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"113867"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435804","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":"Safety and efficacy of endoscopic papillectomy for duodenal papillary adenomas: A single-center retrospective study.","authors":"Lei Xu, Si-Jia Chen, Pin Wang, Liang Mao, Xiao-Ping Zou, Lei Wang, Yi Wang","doi":"10.4240/wjgs.v18.i2.113698","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.113698","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is currently the preferred surgical procedure to remove duodenal papillary adenoma. It offers a low recurrence rate, but a high rate of postoperative complications.</p><p><strong>Aim: </strong>To determine the efficacy and safety of endoscopic papillectomy (EP) for duodenal papillary adenoma.</p><p><strong>Methods: </strong>This retrospective case-control study included 102 patients who received treatment at Nanjing Drum Tower Hospital between January 2010 and December 2024. Clinicopathological features, adverse events, and outcomes were compared between the two groups.</p><p><strong>Results: </strong>After propensity score matching for sex, year, and tumor size, 37 patients each were assigned to the PD and EP groups. All patients underwent successful removal of the diseased tissues. The pathological analysis revealed no significant differences between the two groups (<i>P</i> > 0.05). The PD group exhibited a significantly higher incidence of pancreatic fistula and intra-abdominal infection after surgery. Two patients in the PD group died from surgery-related complications, whereas no mortality was observed in the EP group (<i>P</i> = 0.152).</p><p><strong>Conclusion: </strong>EP may be effective and safe for the removal of duodenal papillary adenoma in a minimally invasive manner, and can offer superior long-term survival compared with conventional PD.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"113698"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436140","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":"Risk factor analysis and nomogram model construction for mortality in patients following colonic perforation surgery.","authors":"Xiu-Juan Xu, Hou-Dao Zhang, Chu-Ji Cheng, Ya-Ming Zhang, Qi Zhang","doi":"10.4240/wjgs.v18.i2.115427","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.115427","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colonic perforation is a surgical emergency with high mortality due to rapid progression to septic shock. Early identification of high-risk patients is critical for improving outcomes, yet existing predictive tools are often complex and lack clinical practicality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To identify the risk factors for postoperative mortality in patients with colonic perforation and develop and validate a predictive model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on patients who underwent surgery for colonic perforation at the Department of Critical Medicine and General Surgery, Anqing Municipal Hospital, between January 2020 and July 2025. Patients were selected on the basis of inclusion and exclusion criteria and were classified into two groups according to postoperative outcomes: Death and survival. General demographics, laboratory results, and imaging data were collected and compared between the two groups. Univariate analysis was performed initially, followed by multivariate logistic regression analysis for variables with significant differences in the univariate analysis. A predictive model for postoperative mortality was constructed on the basis of the multivariate results. Internal validation was conducted using the bootstrap resampling method. The clinical optimal threshold was identified through decision curve analysis (DCA), and the operability of the dual cut-off strategy was demonstrated using a full-sample confusion matrix and a funnel-type pathway diagram. A nomogram was developed as a personalized prediction tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 134 patients were included in the study, with 21 patients in the postoperative death group and 113 in the survival group, yielding a mortality rate of 15.6%. Moreover, no significant differences were found between the two groups concerning sex, history of hypertension, diabetes, cerebrovascular sequelae, cardiac history, haemoglobin level, albumin concentration, intraperitoneal free gas presence, intraperitoneal free fluid presence, perforation site, cause of perforation, operation time, or intraoperative blood loss volume. However, significant differences in age; American Society of Anaesthesiologists classification; Acute Physiology and Chronic Health Evaluation II (APACHE II) score; preoperative peripheral blood white blood cell (WBC) count; platelet count; serum total bilirubin level; serum creatinine level; lactate level; C-reactive protein level; procalcitonin level; the presence of portal venous gas (PVG); and time from onset to surgery (whether &gt; 24 hours) were detected (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Multivariate logistic regression analysis revealed that the APACHE II score [odds ratio (OR) = 1.24, 95% confidence interval (CI): 1.03-1.48], lactate level (OR = 2.40, 95%CI: 1.34-4.31), and presence of PVG (OR = 20.32, 95%CI: 1.89-218.45) were risk factors for postoperative mortality, whereas an elevated WBC count ","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"115427"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436148","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":"Synchronous <i>vs</i> sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma: Efficacy and prognosis.","authors":"Yi Yu, Wei Yuan, Jin Lei, Chun-Bo Zhao, Cheng-Gang Tao, Sheng-Hui Liu, Bai-Lin Wang","doi":"10.4240/wjgs.v18.i2.114378","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114378","url":null,"abstract":"<p><strong>Background: </strong>Despite therapeutic advances, outcomes in hepatocellular carcinoma (HCC) remain suboptimal, underscoring the need to explore more effective treatment strategies.</p><p><strong>Aim: </strong>To compare efficacy and prognosis in HCC patients treated with synchronous <i>vs</i> sequential transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA).</p><p><strong>Methods: </strong>A total of 106 patients with HCC admitted between March 2022 and March 2024 were included. Patients receiving concurrent TACE and MWA constituted the synchronous group (<i>n</i> = 56), while those treated with TACE followed by MWA formed the sequential group (<i>n</i> = 50). Intergroup comparisons encompassed curative efficacy, ablation-related parameters (number of needle insertions, ablation duration, and power), prognostic indicators (progression-free survival and overall survival), tumor biomarkers [alpha-fetoprotein (AFP), AFP-L3], hepatic function indices [total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], and post-procedural complications (pyrexia, abdominal pain, and gastrointestinal reactions).</p><p><strong>Results: </strong>No significant intergroup differences were observed in curative efficacy, ablation power, prognosis, or overall complication rates (<i>P</i> > 0.05). However, the synchronous group required fewer ablation needles and shorter ablation durations than the sequential group (<i>P</i> < 0.05), AFP, AFP-L3, TBIL, ALT, and AST levels significantly decreased after treatment in both groups (<i>P</i> < 0.05), with no significant differences between groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Synchronous TACE combined with MWA is non-inferior to the sequential approach regarding therapeutic efficacy, survival outcomes, safety, and tumor control in HCC. Notably, the synchronous strategy offers procedural advantages by reducing ablation attempts and shortening treatment duration.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114378"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435459","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":"Two-port <i>vs</i> four-port laparoscopic resection for colorectal cancer: Efficacy and outcomes.","authors":"Hong-Xing Xia, Su Peng","doi":"10.4240/wjgs.v18.i2.113103","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.113103","url":null,"abstract":"<p><strong>Background: </strong>In the current laparoscopic surgery practice of colorectal cancer (CRC), the four-port technique is more traumatic, whereas the single-port surgery is associated with technical difficulty and a limited field of view. Thus, the two-port technique, which is less traumatic and more feasible, becomes increasingly significant in clinical practice.</p><p><strong>Aim: </strong>To compare the clinical effects of two-port and four-port laparoscopic techniques for CRC treatment.</p><p><strong>Methods: </strong>In the review of the medical records of patients with CRC from March 2022 to March 2025, 80 cases of two-port laparoscopic radical resection (two-port group) and 70 cases of four-port laparoscopic resection (four-port group) were identified for direct surgical comparison. These groups were evaluated and compared for surgical indicators (surgical duration, total intraoperative hemorrhage, and total length of incision), postoperative recovery (time to first flatus/ambulation, and total hospitalization duration), postoperative complications (ileus, anastomotic fistula, surgical site infection, bleeding, uroschesis, and intraperitoneal abscess), gastrointestinal function (gastrin and motilin), oncological indices (carcinoembryonic antigen, cytokeratin 19 fragment antigen 21-1, and carbohydrate antigen 125), and humoral immunity [immunoglobulin (Ig) A/G/M].</p><p><strong>Results: </strong>The two-port and four-port groups were comparable in terms of operation time and total intraoperative bleeding. However, the two-port group showed lower values with respect to the total incision length, time to flatus/ambulation, hospitalization time, and overall complications. Gastrin and motilin levels were reduced from baseline in the two-port group but were still higher than those in the four-port group. Carcinoembryonic antigen, cytokeratin 19 fragment antigen 21-1, and carbohydrate antigen 125 levels were lower, whereas IgA, IgG, and IgM values were higher postoperatively in the two-port group than those in the four-port group.</p><p><strong>Conclusion: </strong>Compared with patients with CRC who underwent four-port laparoscopic surgery, those who underwent two-port laparoscopic resection recovered faster and were fairly safe. In addition, the gastrointestinal hormone disturbance was relatively mild, the serum tumor markers were significantly reduced, and the humoral immune response was enhanced.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"113103"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435510","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 between type 2 diabetes mellitus and colorectal adenoma: A retrospective study with insights into Wnt/β-Catenin/TCF7L2 pathway activation.","authors":"Shu-Yan Gui, Ruo-Xi Tang, Xing Huang, Guo-Qiang Yang, Jing Yang","doi":"10.4240/wjgs.v18.i2.113476","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.113476","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have confirmed the association of type 2 diabetes mellitus with the occurrence of colorectal polyps and adenomas. However, the current research results concerning the extent and specific effect of type 2 diabetes mellitus on the occurrence and development of colorectal adenomas remain inconsistent.</p><p><strong>Aim: </strong>To identify and investigate the association between type 2 diabetes mellitus and colorectal adenoma pathogenesis.</p><p><strong>Methods: </strong>This retrospective case-control study reviewed all colonoscopies and definite pathology diagnoses performed in patients admitted to the Department of Gastroenterology, Nanshan People's Hospital, from January 2015 to December 2017. Colorectal epithelium samples from colorectal adenomas were categorized into two groups: Patients with diabetes mellitus (A + D group; <i>n</i> = 20) and those with no diabetes mellitus (A + ND group; <i>n</i> = 20). The control group (NA + ND) comprised samples from patients without colorectal adenomas or hyperglycemia (<i>n</i> = 10). Carcinoembryonic antigen and insulin-like growth factor-1 levels were analyzed in each group. The expression of transcription factor 7 like 2 (TCF7L2), β-catenin, and Ki67 was detected using immunohistochemistry.</p><p><strong>Results: </strong>Type 2 diabetes mellitus was significantly associated with colorectal adenomas (odds ratio = 2.263, 95% confidence interval = 1.252-4.09, <i>P</i> = 0.007). Compared with the A + ND or NA + ND group, carcinoembryonic antigen and insulin-like growth factor-1 levels and TCF7L2, β-catenin, and Ki67 expressions were significantly higher in the A + D group (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The results of this small-scale retrospective cohort study indicate a significant association between type 2 diabetes mellitus and colorectal adenomas. The clinical sample experimental evidence in this study indicates that the increased activity and expression of Wnt/β-catenin/TCF7L2 is one of the mechanisms of type 2 diabetes mellitus and colorectal adenomas.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"113476"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435520","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}