World Journal of Gastrointestinal Surgery最新文献

{"title":"Combined application of the preclosure technique and traction approach facilitates endoscopic full-thickness resection of gastric submucosal tumors.","authors":"Qing-Qing Zu, Yan You, Ai-Zhi Chen, Xiu-Rong Wang, Si-Han Zhang, Feng-Lin Chen, Miao Liu","doi":"10.4240/wjgs.v17.i3.95704","DOIUrl":"10.4240/wjgs.v17.i3.95704","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal submucosal tumors (SMTs) mostly grew in the lumen, but also some of the lesions were extraluminal, in which the stomach was the most common site. Gastrointestinal stromal tumor account for a large proportion of SMT. Due to the deep lesion location of gastric SMT, endoscopic submucosal dissection related techniques are difficult to operate, while endoscopic full-thickness resection (EFTR) has been widely used in clinical practice because it is less invasive and can preserve the physiological structure and function of the stomach. However, complete closure of the gastrectomy site after EFTR is critical. If the closure is incomplete, it may cause peritonitis, late perforation and other conditions, and even require further surgical intervention. Although there are currently a number of suture devices and techniques that can be used to promote closure, they have the problem of requiring additional equipment or being inconvenient to use. Although metal clips are widely used, their effectiveness depends on the size and tension of the defect. Therefore, an effective and convenient endoscopic closure technique is urgently needed to solve the closure problem of gastric SMTs after treatment.</p><p><strong>Aim: </strong>To investigate the effect of combined application of the preclosure technique and dental floss traction in gastric wound closure following EFTR.</p><p><strong>Methods: </strong>In this study, the data of 94 patients treated for gastric SMTs at the Gastrointestinal Endoscopy Center of the Affiliated Union Hospital of Fujian Medical University from April 2022 to May 2023 were retrospectively analyzed. The patients were divided into a preclosure group (54 patients) and a non-preclosure group (40 patients) on the basis of the timing of wound closure with titanium clips after dental floss traction-assisted EFTR. Each patient in the preclosure group had their wounds preclosed with titanium clips after subtotal lesion resection, whereas each patient in the non-preclosure group had their wounds closed with titanium clips after total lesion resection. The lesion size, wound closure time, number of titanium clips used, incidence of postoperative complications, and postoperative hospitalization time were compared between the two groups.</p><p><strong>Results: </strong>The wound closure time was significantly shorter in the preclosure group than in the non-preclosure group (6.69 ± 2.109 minutes <i>vs</i> 11.65 ± 3.786 minutes, <i>P</i> < 0.001). The number of titanium clips used was significantly lower in the preclosure group (8.93 ± 2.231) than in the non-preclosure group (12.05 ± 4.495) (<i>P</i> < 0.001). There was no significant difference between the two groups in terms of the need for an indwelling gastric tube or the length of postoperative hospital stay (6.41 ± 1.31 <i>vs</i> 6.13 ± 1.06 days). For all patients in the preclosure group and the non-preclosure group, resection was completed successful","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"95704"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754658","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":"Correlations of three scoring systems with the prognosis of patients with liver cirrhosis complicated with sepsis syndrome.","authors":"Li-Nan Liu, Yu-Fei Chang, Hui Wang","doi":"10.4240/wjgs.v17.i3.99570","DOIUrl":"10.4240/wjgs.v17.i3.99570","url":null,"abstract":"<p><strong>Background: </strong>Severe symptoms associated with sepsis syndrome (SS) are considered a severe threat, which not only increases therapeutic difficulty but also causes a prognostic mortality rate. However, at present, few related studies focused on the application of different score scales for disease and prognosis assessment in liver cirrhosis (LC) complicated with SS.</p><p><strong>Aim: </strong>To determine the correlations of the model for end-stage liver disease (MELD), sequential organ failure assessment (SOFA), and modified early warning score (MEWS) points with the prognosis of patients with LC complicated with SS.</p><p><strong>Methods: </strong>This retrospective analysis included 426 LC cases from February 2019 to April 2022. Of them, 225 cases that were complicated with SS were assigned to the LC + SS group, and 201 simple LC cases were included in the LC group. Intergroup differences in MELD, SOFA, and MEWS scores were compared, as well as their diagnostic value for LC + SS. The correlations of the three scores with the prognosis of patients with LC + SS were further analyzed, as well as the related risk factors affecting patients' outcomes, after the follow-up investigation.</p><p><strong>Results: </strong>MELD, SOFA, and MEWS scores were all higher in the LC + SS group <i>vs</i> the LC group, and their combined assessment for LC + SS revealed a diagnostic sensitivity and a specificity of 89.66% and 90.84%, respectively (<i>P</i> < 0.05). The LC + SS group reported 58 deaths, with an overall mortality rate of 25.78%. Deceased patients presented higher MELD, SOFA, and MEWS points than those who survived (<i>P</i> < 0.05). MELD, SOFA, and MEWS scores were determined by COX analysis as factors independently affecting the prognosis of patients with LC + SS (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>MELD, SOFA, and MEWS effectively diagnosed LC in patients complicated with SS, and they demonstrated great significance in assessing prognosis, which provides a reliable prognosis guarantee for patients with LC + SS. However, their assessment effects remain limited, which is worthy of further investigation by more in-depth and rigorous experimental analysis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99570"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754661","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":"Clinical effect and prognosis of laparoscopic surgery on colon cancer complicated with intestinal obstruction patients.","authors":"Pei-Hua Wu, Zheng-Quan Ta","doi":"10.4240/wjgs.v17.i3.101609","DOIUrl":"10.4240/wjgs.v17.i3.101609","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colon cancer is one of the most common malignancies of the digestive tract, often complicated by intestinal obstruction, which can significantly impact patient outcomes. While traditional laparotomy is the standard treatment, it is associated with large wounds, slower recovery, and higher complication rates. Laparoscopic surgery, a minimally invasive approach, may offer better outcomes for these patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022. Patients were divided into two groups: The control group (CG), treated with traditional laparotomy, and the observation group (OG), treated with laparoscopic surgery. Clinical effects, surgical indicators, postoperative pain, inflammatory response, complication rates, quality of life, and prognosis were assessed and compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The OG showed superior clinical outcomes compared to the CG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Postoperative pain (numerical rating scale scores) and inflammatory markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)] were lower in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The incidence of complications was significantly reduced in the OG (6.00% &lt;i&gt;vs&lt;/i&gt; 22.00%, &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastasis rates, or 1- and 3-year survival rates (&lt;i&gt;P&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The OG showed superior clinical outcomes compared to the CG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Postoperative pain (NRS scores) and inflammatory markers (TNF-α, IL-6, CRP) were lower in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The incidence of complications was significantly reduced in the OG (6.00% &lt;i&gt;vs&lt;/i&gt; 22.00%, &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastas","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101609"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754566","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":"Effects of postoperative quantitative assessment strategy-based nursing in patients with colorectal cancer.","authors":"Xiao-Qin Tan, Xiao-Lu Huang","doi":"10.4240/wjgs.v17.i3.100302","DOIUrl":"10.4240/wjgs.v17.i3.100302","url":null,"abstract":"<p><strong>Background: </strong>Scientifically sound and reasonable care strategies in surgical nursing play a crucial role in facilitating postoperative recovery and preventing complications. This study focused on the application of quantitative assessment strategies to postoperative care. By quantitatively analyzing the effects of nursing interventions, we explored their feasibility and effectiveness at improving postoperative recovery quality and reducing the incidence of complications. This study provides a scientific basis for nursing practice and offers new insights into nursing management with significant clinical value.</p><p><strong>Aim: </strong>To analyze the efficacy of postoperative quantitative assessment strategy-based nursing care for patients with colorectal cancer (CRC).</p><p><strong>Methods: </strong>This randomized controlled trial evaluated the ability of nursing interventions using a quantitative assessment strategy to prevent postoperative complications and enhance patient recovery. Patients with CRC were randomly divided into routine nursing (RN) and quantitative assessment strategy nursing (QASN) groups. The RN group received standard care, while the QASN group also underwent screenings for visual analog scale for pain, Barthel Index for functional recovery, and self-rating anxiety scale and self-rating depression scale for psychological status. Follow-ups were conducted on postoperative days 1, 7, 14, 28, and 56.</p><p><strong>Results: </strong>The participants' baseline characteristics did not significantly differ between study groups, thereby ensuring the reliability of the results. The QASN <i>vs</i> RN group showed significant improvements in pain management (visual analog scale scores) and psychological status (self-rating anxiety scale and self-rating depression scale scores) and a reduced incidence of postoperative complications (<i>P</i> < 0.05). The follow-up evaluations at specified intervals confirmed these findings, indicating that quantitative assessment strategies significantly enhanced patients' postoperative pain management and psychological well-being.</p><p><strong>Conclusion: </strong>Nursing interventions using structured quantitative assessments demonstrated significantly improved postoperative recovery and quality of life in patients with CRC, supporting their integration into standard postoperative care protocols.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100302"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754640","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":"Efficacy of combined psychological and physical nursing in preventing peripherally inserted central catheter-related thrombosis in gastric cancer patients.","authors":"Wei-Jing Ni, Yu-Xiu Xi, Yong-Chao Zhou","doi":"10.4240/wjgs.v17.i3.100430","DOIUrl":"10.4240/wjgs.v17.i3.100430","url":null,"abstract":"<p><strong>Background: </strong>Long-term chemotherapy for patients with gastric cancer (GC), facilitated by peripherally inserted central catheter (PICC) catheterization, reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications. A combination of group psychological nursing and physical movement care significantly mitigates the risk of venous thrombosis and improves psychological well-being, and enhances motor function, underscoring its clinical importance.</p><p><strong>Aim: </strong>To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.</p><p><strong>Methods: </strong>Sixty-five GC patients with PICC, admitted from January 2022 to January 2023, were randomly divided into two groups using the lottery method: A control group (<i>n</i> = 35, routine nursing) and an observation group (<i>n</i> = 30, routine nursing plus psychological nursing and physical movement nursing). Both groups received continuous care for 2 weeks. Pre-nursing and post-nursing data on psychological state, physical function, chemotherapy-related thrombosis incidence, and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.</p><p><strong>Results: </strong>After nursing, both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores, with the observation group performing better (<i>P</i> < 0.05). The Functional Comprehensive Assessment score for the observation group after nursing was (65.42 ± 2.35) points, lower than the control group's (62.19 ± 4.33) points (<i>P</i> < 0.05). Although no significant difference was observed in the incidence of venous thrombosis between the two groups (<i>χ</i> ² = 0.815, <i>P</i> = 0.367), the observation group had lower incidence. Both groups showed decreased Revised Piper Fatigue Scale scores, with the observation group scoring lower (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk, improves psychological well-being, cancer-related fatigue, and physical function, making it highly promotable.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100430"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754642","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":"Optimal timing of endoscopic biliary drainage for bile duct leaks: A multicenter, retrospective, clinical study.","authors":"De-Xin Chen, Kai-Xuan Fang, Sheng-Xin Chen, Sen-Lin Hou, Gui-Hai Wen, Hai-Kun Yang, Da-Peng Shi, Qing-Xin Lu, Ya-Qi Zhai, Ming-Yang Li","doi":"10.4240/wjgs.v17.i3.99425","DOIUrl":"10.4240/wjgs.v17.i3.99425","url":null,"abstract":"<p><strong>Background: </strong>Bile duct leaks (BDLs) are serious postsurgical adverse events. Typically, conservative management with abdominal drainage is the initial treatment option. However, prolonged abdominal drainage without improvement can lead to biliary stricture and delay the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Aim: </strong>To identify the optimal timing for ERCP and the period during which clinical observation with conservative management is acceptable, balancing ERCP success and the risk of biliary strictures.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study involving 448 patients with BDLs between November 2002 and November 2022. The patients were divided into four groups based on the timing of ERCP: 3 days, 7 days, 14 days, and 21 days. The primary outcome was clinical success, defined as the resolution of BDL and related symptoms within 6 months without additional percutaneous drainage, surgery, or death. The secondary outcome was incidence of biliary strictures. Univariate and multivariate logistic regression analyses were performed to identify factors associated with ERCP success and biliary stricture occurrence.</p><p><strong>Results: </strong>In a cohort of 448 consecutive patients diagnosed with BDLs, 354 were excluded, leaving 94 patients who underwent ERCP. Clinical success was achieved in 84% of cases (79/94), with a median ERCP timing of 20 days (9.5-35.3 days). Biliary strictures were identified in 29 (30.9%) patients. Performing ERCP within 3 weeks, compared to after 3 weeks, was associated with higher success rates [92.0% (46/50) <i>vs</i> 75.0% (33/44), <i>P</i> = 0.032] and a lower incidence of biliary stricture incidence [18.0% (9/50) <i>vs</i> 45.5% (20/44), <i>P</i> = 0.005]. Subsequent multivariate analysis confirmed the association with higher success rates (odds ratio = 4.168, <i>P</i> = 0.045) and lower biliary stricture rates (odds ratio = 0.256, <i>P</i> = 0.007).</p><p><strong>Conclusion: </strong>Performing ERCP for BDLs within 3 weeks may be associated with a higher success rate and a lower biliary stricture rate. If patients with BDLs do not respond to conservative treatment, ERCP is suggested to be performed within 3 weeks.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99425"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753833","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":"Analysis of risk factors for bile leakage after laparoscopic exploration and primary suture of common bile duct.","authors":"Qing-Song Yang, Meng Zhang, Chang-Song Ma, Da Teng, Ao Li, Ji-Dong Dong, Xi-Fei Wang, Fu-Bao Liu","doi":"10.4240/wjgs.v17.i3.102190","DOIUrl":"10.4240/wjgs.v17.i3.102190","url":null,"abstract":"<p><strong>Background: </strong>Bile leakage is a common complication following laparoscopic common bile duct exploration (LCBDE) with primary duct closure (PDC). Identifying and analyzing the risk factors associated with bile leakage is crucial for improving surgical outcomes.</p><p><strong>Aim: </strong>To explore the value analysis of common risk factors for bile leakage after LCBDE and PDC, with a focus on strict adherence to indications.</p><p><strong>Methods: </strong>Clinical data of 106 cases undergoing LCBDE + PDC in the Hepatobiliary and Pancreatic Surgery Department (Division 1) of Chuzhou First People's Hospital from April 2019 to March 2024 were collected. Retrospective and multiple factor regression analysis were conducted on common risk factors for bile leakage. The change in surgical time was analyzed using the cumulative summation (CUSUM) method, and the minimum number of cases required to complete the learning curve for PDC was obtained based on the proposed fitting curve by identifying the CUSUM maximum value.</p><p><strong>Results: </strong>Multifactor logistic regression analysis showed that fibrinous inflammation and direct bilirubin/indirect bilirubin were significant independent high-risk factors for postoperative bile leakage (<i>P</i> < 0.05). The time to drain removal and length of hospital stay in cases without bile leakage were significantly shorter than in cases with bile leakage (<i>P</i> < 0.05), with statistical significance. The CUSUM method indicated that a minimum of 51 cases were required for the surgeon to complete the learning curve (<i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>With a good assessment of duodenal papilla sphincter function, unobstructed bile-pancreatic duct convergence, exact stone clearance, and sufficient surgical experience to complete the learning curve, PDC remains the preferred method for bile duct closure and is worthy of clinical promotion.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102190"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754622","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":"Hyperthermia combined with opioid therapy: Enhancing cancer pain management and reducing surgical stress in gastrointestinal cancer patients.","authors":"Yue Wang, Xin Xun, Wen-Yu Luan, Zheng Zhang, Zhen-Xi Xu, Si-Xiang Lin, Yan-Dong Miao","doi":"10.4240/wjgs.v17.i3.101060","DOIUrl":"10.4240/wjgs.v17.i3.101060","url":null,"abstract":"<p><p>In this article, we evaluate the findings of the study by Qian <i>et al</i>, which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage gastrointestinal tumors. The study undertakes a retrospective analysis comparing traditional opioid therapy to an integrated approach of hyperthermia and opioids across 70 patients, highlighting significant benefits in pain control, reduction of opioid dosage, and minimization of adverse reactions. In our article, we not only discuss these findings but also emphasize the broader implications for clinical practice, particularly in enhancing patient outcomes through innovative pain management strategies. We advocate for further research to establish more robust data supporting this approach and to explore the mechanistic insights that enable these benefits. This discussion reflects on the potential paradigm shift in managing debilitating cancer-related pain, urging a reevaluation of current practices to incorporate these findings effectively.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101060"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754683","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":"Impact of diabetes on recovery after radical gastrectomy for gastric cancer: A retrospective cohort study.","authors":"Lei Zhao, Lan Wei, Xiao-Lu Fei","doi":"10.4240/wjgs.v17.i3.100763","DOIUrl":"10.4240/wjgs.v17.i3.100763","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a significant global health concern. Radical gastrectomy is the primary curative treatment. Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer, including radical gastrectomy. Previous studies have suggested that diabetes can negatively affect postoperative outcomes, such as wound healing, infection rates, and overall recovery. However, the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood. evaluate the influence of diabetes on postoperative recovery, including hospital stay duration, complications, and readmission rates, in patients undergoing gastrectomy for gastric cancer. Understanding these effects could help optimize perioperative management and improve patient outcomes.</p><p><strong>Aim: </strong>To investigate the impact of diabetes on recovery after radical gastrectomy for gastric cancer and associated postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital, Capital Medical University, Beijing, China. We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020. The patients were divided into the diabetes and non-diabetes groups. The main outcomes included length of hospital stay, postoperative complications, and 30-day readmission rate. Secondary outcomes included quality of life indicators. Propensity score matching was used to adjust for potential confounding factors.</p><p><strong>Results: </strong>A total of 1210 patients were included in the study, with 302 diabetic patients and 908 non-diabetic patients. After propensity score matching, 280 patients were included in each group. Diabetic patients demonstrated significantly longer hospital stays (mean difference 2.3 days, 95%CI: 1.7-2.9, <i>P</i> < 0.001) and higher rates of postoperative complications (OR 1.68, 95%CI: 1.32-2.14, <i>P</i> < 0.001). The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group (12.5% <i>vs</i> 7.8%, <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay, increased postoperative complications, and higher readmission rates, thus requiring optimized perioperative management strategies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100763"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754698","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":"Laparoscopic microwave ablation for giant cavernous hemangioma coexistent with diffuse hepatic hemangiomatosis: Two case reports.","authors":"Fei Xu, Jian Kong, Shu-Ying Dong, Li Xu, Shao-Hong Wang, Wen-Bing Sun, Jun Gao","doi":"10.4240/wjgs.v17.i3.101697","DOIUrl":"10.4240/wjgs.v17.i3.101697","url":null,"abstract":"<p><strong>Background: </strong>Hepatic hemangioma represents the most common benign primary hepatic neoplasm. Although most such tumors are small and asymptomatic, giant cavernous hemangioma (GCH) is frequently symptomatic, and needs intervention. Moreover, diffuse hepatic hemangiomatosis (DHH) is not rare in the liver parenchyma adjacent to a GCH. The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.</p><p><strong>Case summary: </strong>Herein, we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation. The two GCHs were ablated completely and the ablated zone atrophied obviously in imaging follow-ups after ablation. Surprisingly, there was a trend toward gradual reduction and diminishment of DHH.</p><p><strong>Conclusion: </strong>Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101697"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754702","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}