World Journal of Gastrointestinal Surgery最新文献

{"title":"Impact of enhanced recovery after surgery on postoperative pain management and functional recovery in patients with colorectal cancer.","authors":"Dan Wu, Jing Wang","doi":"10.4240/wjgs.v17.i9.107356","DOIUrl":"10.4240/wjgs.v17.i9.107356","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists regarding the role of enhanced recovery after surgery (ERAS) protocols in optimizing pain management and functional recovery after colorectal cancer (CRC) surgery.</p><p><strong>Aim: </strong>To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.</p><p><strong>Methods: </strong>A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study. They were divided into two groups: A control group (<i>n</i> = 50) receiving standard perioperative care and an observation group (<i>n</i> = 59) managed under an ERAS protocol. Clinical outcomes, including postoperative pain intensity [assessed using the Visual Analogue Scale (VAS)], functional recovery indicators (time to first ambulation, bowel sound recovery, first anal gas discharge, and first defecation), average sleep duration on postoperative day 3, sleep quality (measured using the Pittsburgh Sleep Quality Index), length of hospitalization, quality of life (evaluated using the Short Form 36 Health Survey), and incidence of postoperative complications (<i>e.g.</i>, surgical site infection, pulmonary infection, abdominal distension/pain, and intestinal obstruction), were systematically compared between the two groups.</p><p><strong>Results: </strong>The observation group exhibited significantly lower VAS scores at 72 hours postoperatively, shorter durations of maximum VAS scores, earlier recovery of functional indicators (time to first ambulation, bowel sound recovery, first anal gas discharge, and first defecation), and shorter hospitalization compared with the control group. Additionally, average sleep duration on postoperative day 3 was significantly longer in the observation group. Furthermore, the observation group demonstrated significantly improved sleep quality (lower Pittsburgh Sleep Quality Index scores) and higher quality of life (higher Short Form 36 Health Survey scores across all domains) than both the baseline and control groups. The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.</p><p><strong>Conclusion: </strong>ERAS protocols are highly effective in relieving postoperative pain, accelerating functional recovery, and improving overall clinical outcomes in patients with CRC undergoing surgery, supporting their broader clinical application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107356"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192906","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":"Mesenteric-guided approach to pyloric lymphadenectomy in laparoscopic radical gastrectomy.","authors":"Guo-Feng Pan, Wei-Hong Zhang, Zhi-Ming Cai, Jian Chen, Ji-Huang Wu, Jian-Bin Weng, Zi-Peng Zhu, Zhi-Xing Guo, Jian-Jin Lin, Zhi-Xiong Li, Yan-Chang Xu","doi":"10.4240/wjgs.v17.i9.110064","DOIUrl":"10.4240/wjgs.v17.i9.110064","url":null,"abstract":"<p><strong>Background: </strong>Lymphadenectomy of the infrapyloric region remains technically demanding in laparoscopic radical gastrectomy. Traditional vessel-guided approaches often result in incomplete dissection and higher complication rates, especially at station No. 6.</p><p><strong>Aim: </strong>To propose a mesentery-based strategy for infrapyloric lymphadenectomy and evaluate its safety, feasibility, and efficacy.</p><p><strong>Methods: </strong>By identifying key anatomical landmarks and defining the inferior mesenteric boundary of the pyloric region (right gastro-omental mesentery), this approach enables full exposure and <i>en bloc</i> resection of anterior and posterior mesenteric planes, with proximal ligation at the root of feeding vessels. A retrospective cohort study was conducted on 330 gastric cancer patients who underwent D2 lymphadenectomy (D2) from January 2020 to December 2021. Outcomes were compared between 165 patients treated with D2 plus complete mesogastric excision (D2 + CME) and 165 matched controls receiving conventional D2.</p><p><strong>Results: </strong>The D2 + CME group demonstrated significantly improved surgical outcomes, including shorter total operative time (279.19 ± 45.50 minutes <i>vs</i> 301.25 ± 52.30 minutes, <i>P</i> < 0.001), reduced infrapyloric dissection time (22.24 ± 3.80 minutes <i>vs</i> 27.58 ± 4.20 minutes, <i>P</i> < 0.001), and lower blood loss (4.71 ± 1.12 mL <i>vs</i> 24.83 ± 6.35 mL, <i>P</i> < 0.001). More lymph nodes were retrieved overall (43.80 ± 10.05 <i>vs</i> 37.25 ± 8.80, <i>P</i> < 0.001), particularly at station No. 6 (5.26 ± 0.87 <i>vs</i> 4.14 ± 0.41, <i>P</i> < 0.001). Postoperative recovery indicators and hospital stay were comparable between groups, while the complication rate was significantly lower in the D2 + CME group (20% <i>vs</i> 30.3%, <i>P</i> = 0.042).</p><p><strong>Conclusion: </strong>The mesentery-based approach enables safe pyloric lymphadenectomy. Systematic mesogastric excision improves operative efficiency and lymph node yield, especially at station No. 6, offering potential oncological benefits in gastric cancer surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"110064"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193026","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":"Inferior mesenteric arteriovenous fistula: Two case reports.","authors":"Yea-Jin Moon, Seung-Hun Lee","doi":"10.4240/wjgs.v17.i9.107139","DOIUrl":"10.4240/wjgs.v17.i9.107139","url":null,"abstract":"<p><strong>Background: </strong>Inferior mesenteric arteriovenous fistula (IMAVF) is an uncommon circulatory malformation with few reported instances. It entails a direct arteriovenous communication within the inferior mesenteric vascular system, producing abnormal hemodynamic flow that may result in gastrointestinal hypoperfusion, elevated portal venous pressure, and secondary cardiac dysfunction. Diagnosis often experiences delays because of nonspecific symptoms. Imaging modalities, such as multi-detector computed tomography (MDCT) and angiography, prove essential for accurate diagnosis and treatment planning.</p><p><strong>Case summary: </strong>Over a 10-year period, only two cases of IMAVF were encountered. The initial case involved a 56-year-old male without notable prior medical conditions who experienced intermittent lower abdominal discomfort, diarrhea, and hematochezia over several months. Ischemic colitis with an IMAVF was revealed through colonoscopy and MDCT angiography. Due to the size of the IMAVF, Hartmann's procedure was performed instead of an endovascular intervention. Recovery proceeded uneventfully, and the colostomy was reversed one year later, with no recurrence observed on follow-up imaging. The subsequent case involved a 76-year-old female with repeated left-sided pyelonephritis and colonic diverticular disease, who manifested with abdominal discomfort and hematochezia. In contrast to previous computed tomography scans, MDCT and angiography revealed a newly developed IMAVF. Given her unstable vital signs, emergency laparoscopic total colectomy with ileorectal anastomosis and temporary ileostomy was conducted. Recovery occurred without complications, and the ileostomy was successfully reversed 2 months later, with no recurrence noted.</p><p><strong>Conclusion: </strong>These cases emphasize the need to evaluate for vascular abnormalities in individuals presenting with ischemic colitis and unexplained gastrointestinal bleeding. The second case demonstrates that recurrent intra-abdominal inflammation may contribute to the development of IMAVF.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107139"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193078","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":"Misdiagnosis of Crohn's disease as appendicitis: A case report.","authors":"Wen-Qian Wang, Jin-Peng Yang, Jia-Wen Dong, Ya-Bo Chen","doi":"10.4240/wjgs.v17.i9.108348","DOIUrl":"10.4240/wjgs.v17.i9.108348","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is a chronic inflammatory disease of the intestinal tract that can alternate between disease phases and remission. Currently, endoscopy is the gold standard for diagnosis of CD and evaluation of its activity and complications. However, gastrointestinal ultrasound (GIUS) is a valuable technique in the management of CD because it is noninvasive, convenient, and highly accurate, sensitive, and specific.</p><p><strong>Case summary: </strong>A 15-year-old female presented with recurrent right lower quadrant abdominal pain that had persisted for 2 weeks. Initial GIUS and computed tomography revealed significant edema of the appendix and ascending colon wall, thickening, and multiple lymphadenopathies of the mesentery. Clinicians suspected appendicitis involving the adjacent bowel, and laparoscopic appendectomy was performed. The pathological diagnosis was acute simple appendicitis. However, the patient's symptoms persisted and aggravated with the occurrence of hematochezia. Follow-up GIUS revealed persistent edema of the ascending and transverse colon walls, intestinal polyps, and local luminal stenosis. CD was suspected and confirmed by endoscopy.</p><p><strong>Conclusion: </strong>CD should be suspected with persistent right lower quadrant abdominal pain. GIUS is essential for initial evaluation, before the confirmatory endoscopy, to assess CD-typical signs like bowel edema and thickening.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"108348"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193270","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 vitamin D in the management of chronic pain after gastrointestinal surgery.","authors":"Can-Can Cheng, Lang Yu, Ning Zheng, Fan Zhang, Qin Liao","doi":"10.4240/wjgs.v17.i9.107796","DOIUrl":"10.4240/wjgs.v17.i9.107796","url":null,"abstract":"<p><p>Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is a common issue that poses significant challenges to patients' recovery and quality of life. Given the importance of vitamin D in inflammation reduction, nerve repair, bone health, and immune regulation, its potential role in pain management has gained increasing attention. Preliminary evidence suggests that many patients who undergo GI surgery have lower perioperative vitamin D levels. Patients with vitamin D deficiency have increased opioid use and heightened pain sensitivity after colorectal cancer surgery. Patients with lower vitamin D levels experience greater pain three months after arthroscopic rotator cuff repair or video-assisted thoracoscopic surgery. However, research on the relationship between vitamin D and CPSP after GI surgery is limited. Larger, well-designed clinical trials are needed to determine the causal relationship between low vitamin D levels and CPSP, determine the optimal perioperative vitamin D levels, and provide more reliable evidence for clinical application. Moreover, vitamin D has positive effects on various systemic diseases and postoperative recovery, including immune regulation, infection prevention, wound healing, tissue regeneration, nutritional status, and metabolic health. These findings indicate that vitamin D has broad clinical application potential. We hope to provide a new insight into postoperative recovery and pain management strategies for GI surgeries.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107796"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193284","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":"Survival benefit of primary tumor resection in pancreatic neuroendocrine tumors with unresectable liver metastases: A meta-analysis.","authors":"Jie Gong, Ben-Jian Gao, Ze-Hua Lei","doi":"10.4240/wjgs.v17.i9.107966","DOIUrl":"10.4240/wjgs.v17.i9.107966","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic neuroendocrine tumors (PNETs) are rare malignancies frequently associated with liver metastases (LM). The benefit of primary tumor resection (PTR) in patients with unresectable LM remains controversial. This study evaluates the impact of PTR on overall survival (OS) and tumor grading by integrating evidence from a systematic review, meta-analysis, and Surveillance, Epidemiology, and End Results (SEER) database analysis.</p><p><strong>Aim: </strong>To evaluate the survival benefits of PTR in patients with PNETs and LM.</p><p><strong>Methods: </strong>This study was conducted in accordance with the PRISMA guidelines. A systematic literature search and meta-analysis were performed using five databases: PubMed, Web of Science, EMBASE, Cochrane Library, and CNKI, with records included up to February 2025. A total of 16 studies (<i>n</i> = 8761; including 1 prospective and 15 retrospective studies) were included. A random-effects model was applied to pool hazard ratios for OS and odds ratios for tumor grading, with heterogeneity assessed by the <i>I</i> ² statistic. Risk of bias was evaluated using the ROBINS-I tool. In addition, an independent analysis based on the SEER database (<i>n</i> = 791) was conducted using Kaplan-Meier survival curves and log-rank tests.</p><p><strong>Results: </strong>Meta-analysis results revealed that PTR significantly improved OS in patients with PNETs and LM (hazard ratio = -1.10, 95% confidence interval: -1.43 to -0.71, <i>P</i> < 0.0001). Subgroup analyses showed that neither study design (prospective vs. retrospective) nor sample size (< 400 <i>vs</i> ≥ 400) significantly influenced the survival benefit. In terms of tumor grading, no statistically significant difference was observed between the surgical and non-surgical groups (odds ratio = 1.60, 95% confidence interval: 0.70-3.63, <i>P</i> = 0.26). Independent analysis of the SEER database (<i>n</i> = 791) further confirmed the survival advantage of PTR across different tumor differentiation levels, with significant differences in OS between surgical and non-surgical groups (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>PTR significantly improves OS in PNET patients with LM. However, its effect on tumor grading remains unclear, warranting further prospective studies to refine surgical strategies for this population.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107966"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193337","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":"Evaluating Glasgow-Blatchford score for fast-track emergency management of patients with acute upper gastrointestinal bleeding.","authors":"Dong-Qing Zhang, Qin Zhou, Yun-Feng Li, Xin-Yu Jia, Xue Li, Shu Chen, Ke Lin","doi":"10.4240/wjgs.v17.i9.104997","DOIUrl":"10.4240/wjgs.v17.i9.104997","url":null,"abstract":"<p><strong>Background: </strong>Acute upper gastrointestinal bleeding (AUGIB) is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration. As a resuscitation mode, the fast track for emergency treatment increases the success rate and improves patient outcomes. However, misuse will consume resources. The Glasgow-Blatchford score (GBS) is considered to predict the clinical intervention needs for AUGIB patients, guiding diagnosis and treatment. Therefore, clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.</p><p><strong>Aim: </strong>To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.</p><p><strong>Methods: </strong>A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS ≥ 6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023. Based on GBS risk stratification, patients were divided into moderate-risk (12 > GBS ≥ 6) and high-risk (GBS ≥ 12) groups. Furthermore, depending on whether a fast track was established after the patients arrived in the emergency department, the patients were categorized into control and fast-track groups. The changes in various indicators, such as length of time in the emergency resuscitation room, door-to-endoscopy time, total blood transfusion volume, hospitalization duration, and hospitalization costs, were compared between the control and fast-track groups under each risk stratification level.</p><p><strong>Results: </strong>In the comparison of the aforementioned indicators, the moderate-risk fast-track group did not show any significant differences from the control group (<i>P</i> > 0.05). However, in the high-risk fast-track group, the door-to-endoscopy time, total blood transfusion volume, and hospitalization costs were significantly lower than those in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time, decreasing total blood transfusion volume, and lowering hospitalization costs in patients with AUGIB. GBS ≥ 12 is recommended as the threshold for implementing the fast track for emergency treatment, and its clinical promotion is advised.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"104997"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193357","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":"Application value of abdominal ultrasonography in the diagnosis of pediatric patients aged 3-12 years with acute appendicitis.","authors":"Min Dai, Fu-Wang Zhang, Wei Jiang","doi":"10.4240/wjgs.v17.i9.105779","DOIUrl":"10.4240/wjgs.v17.i9.105779","url":null,"abstract":"<p><strong>Background: </strong>Early detection of acute appendicitis (AA) in pediatric cases, critical to avoiding life-threatening complications such as perforation or abscess, remains challenging.</p><p><strong>Aim: </strong>To evaluate the utility of abdominal ultrasonography (AUS) in diagnosing pediatric AA.</p><p><strong>Methods: </strong>Overall, 102 pediatric patients (aged 3-12 years) suspected of having AA were enrolled and divided into the AA (<i>n</i> = 78) and non-AA (<i>n</i> = 24) groups. All children underwent AUS and computed tomography (CT). Comparative analyses regarding general patient characteristics and appendix-specific parameters were conducted. The diagnostic performance of AUS and CT in pediatric AA was evaluated.</p><p><strong>Results: </strong>All appendix-related parameters were greater in the AA group than in the non-AA group. The areas under the receiver-operating characteristic curves for pediatric AA diagnosis using AUS, CT, and AUS + CT were 0.870, 0.824, and 0.931 (all <i>P</i> < 0.001), respectively (AUS: 94.87% sensitivity, 79.17% specificity; CT: 89.74% sensitivity, 75.00% specificity; combined: 98.72% sensitivity, 87.50% specificity). The positive predictive value (PPV), negative predictive value (NPV), accuracy rate, positive detection rate, and misdiagnosis rate of AUS were 93.67%, 82.61%, 91.18%, 72.55%, and 20.83%, respectively. CT had a slightly lower PPV (92.11%) and NPV (69.23%), along with accuracy, positive detection, and misdiagnosis rates of 86.27%, 68.63%, and 25%, respectively. Their combination improved performance, yielding 96.25% PPV, 95.45% NPV, 96.08% accuracy, 75.49% positive detection rate, and 12.50% misdiagnosis rate.</p><p><strong>Conclusion: </strong>AUS demonstrates certain diagnostic potential in AA diagnosis in pediatric patients, and its combination with CT further improves diagnostic efficacy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"105779"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193174","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":"Optimizing postoperative infection control strategies in gastrointestinal surgery <i>via</i> integrated disinfection, isolation measures, and risk prediction models.","authors":"Qin-Zhi Liu, Lei Zeng, Nian-Zhe Sun","doi":"10.4240/wjgs.v17.i9.108136","DOIUrl":"10.4240/wjgs.v17.i9.108136","url":null,"abstract":"<p><p>This editorial critically evaluated the recent study by Wang <i>et al</i>, which systematically investigated the efficacy of perioperative disinfection and isolation measures (including preoperative povidone-iodine disinfection, intraoperative sterile barrier techniques, and postoperative intensive care) in reducing infection rates. The study further incorporated the surgical site infection risk prediction model (constructed <i>via</i> the least absolute shrinkage and selection operator algorithm, integrating patients' baseline characteristics, surgical indicators, and regional antibiotic-resistant bacterial data), and proposed a dynamic prevention and control system termed \"disinfection protocols-predictive models-real-time monitoring\". The article highlighted that preoperative risk stratification, intraoperative personalized antibiotic selection, and postoperative multidimensional monitoring (encompassing inflammatory biomarkers, imaging, and microbiological testing) enabled the precise identification of high-risk patients and optimized intervention thresholds. Future research is deemed necessary to validate the synergistic effects of disinfection protocols and predictive models through large-scale multicenter studies, combined with advanced intraoperative rapid microbial detection technologies. This approach aims to establish standardized infection control protocols tailored for precision medicine and regional adaptability. Future research should prioritize validating the synergistic effects of disinfection protocols and predictive models <i>via</i> multi-center studies, while incorporating advanced rapid intraoperative microbial detection technologies to develop standardized infection prevention and control procedures. Such efforts will enhance the implementation of precise and regionally adaptive infection control strategies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"108136"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193182","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":"Application effect of linaclotide capsules combined with compound polyethylene glycol in colonoscopy bowel preparation.","authors":"Li-Wei Xue, Yi-Qian Zhang, Wei-Lai Yu, Zai-Bo Wen","doi":"10.4240/wjgs.v17.i9.105983","DOIUrl":"10.4240/wjgs.v17.i9.105983","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the field of clinical intestinal preparation, compound polyethylene glycol electrolyte solution (SF-PEG) is a commonly used intestinal cleaner. However, practice has shown that using only a single polyethylene glycol formulation often fails to achieve the desired intestinal preparation effect. Linalotide has a unique mechanism of action, which can effectively enhance the secretion of small intestinal fluid and promote intestinal peristalsis. The combination of linaclotide and SF-PEG may provide a better solution for intestinal preparation and improve the quality of intestinal cleaning. Therefore, exploring the application value and clinical efficacy of linaclotide capsules combined with SF-PEG in intestinal preparation is of great clinical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore the effects of the combination of linaclotide capsules and SF-PEG, including its efficacy in intestinal preparation and patient tolerance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To investigate the differences in the effectiveness of different bowel preparation plans in colonoscopy, this article conducted a comprehensive and detailed retrospective analysis of the medical records of patients who underwent colonoscopy from January 2023 to December 2023. In this study, 116 patients were accurately divided into three groups based on the different intestinal preparation drugs used before colonoscopy. Among them, group A consisted of 29 patients who underwent intestinal preparation using 3 liters of SF-PEG combined with linaclotide; group B consists of 50 patients who underwent intestinal preparation using 3 liters of SF-PEG; group C consisted of 37 patients who underwent intestinal preparation using a combination of 2-liter SF-PEC and linaclotide. Subsequently, this article evaluated the quality of intestinal preparation in these three groups of patients, using the Boston bowel preparation scale (BBPS) as a quantitative indicator, while comparing multiple indicators such as intestinal preparation completion rate and detection of positive lesions, providing a strong basis for optimizing clinical intestinal preparation plans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No statistically significant differences were found in BBPS scores (7.75 ± 1.23, 7.69 ± 1.14, and 7.66 ± 1.31; &lt;i&gt;P&lt;/i&gt; = 0.240), bowel preparation completion rates (96.55%, 90.00%, and 97.30%; &lt;i&gt;P&lt;/i&gt; = 0.293), adenoma detection rates (20.69%, 38.00%, and 32.43%; &lt;i&gt;P&lt;/i&gt; = 0.281), polyp detection rates (34.48%, 50.00%, 37.84%; &lt;i&gt;P&lt;/i&gt; = 0.326), insertion time (6.03 ± 4.34, 6.12 ± 3.60, and 5.33 ± 2.42; &lt;i&gt;P&lt;/i&gt; = 0.584), and patient satisfaction rates (89.66%, 84.00%, and 97.30%; &lt;i&gt;P&lt;/i&gt; = 0.398) among the three groups. However, statistically significant differences were observed in withdrawal time (7.45 ± 2.91, 9.02 ± 3.54, and 6.86 ± 2.66; &lt;i&gt;P&lt;/i&gt; = 0.027) and adverse reaction rates (6.90%, 20.00%, and 2.70%; &lt;i&gt;P&lt;/i&gt; = 0.029) among the three groups. Multiple comparisons showed ","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"105983"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193031","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}