World Journal of Gastrointestinal Surgery最新文献

{"title":"Risk factors and clinical prediction models for short-term recurrence after endoscopic surgery in patients with colorectal polyps.","authors":"Meng Zhang, Rui Yin, Jie Ying, Guan-Qi Liu, Ping Wang, Jian-Xin Ge","doi":"10.4240/wjgs.v17.i8.109057","DOIUrl":"10.4240/wjgs.v17.i8.109057","url":null,"abstract":"<p><strong>Background: </strong>Colorectal polyps (CPs) are important precursor lesions of colorectal cancer, and endoscopic surgery remains the primary treatment option. However, the short-term recurrence rate post-surgery is high, and the risk factors for recurrence remain unknown.</p><p><strong>Aim: </strong>To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.</p><p><strong>Methods: </strong>Overall, 362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included. We screened basic demographic data, clinical and polyp characteristics, surgery-related information, and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses. The multivariate analysis results were used to construct a nomogram prediction model, internally validated using Bootstrapping, with performance evaluated using area under the curve (AUC), calibration curve, and decision curve analysis.</p><p><strong>Results: </strong>CP re-occurred in 166 (45.86%) of the 362 patients within 1 year post-surgery. Multivariate logistic regression analysis showed that age (OR = 1.04, <i>P</i> = 0.002), alcohol consumption (OR = 2.07, <i>P</i> = 0.012), <i>Helicobacter pylori</i> infection (OR = 2.34, <i>P</i> < 0.001), polyp number > 2 (OR = 1.98, <i>P</i> = 0.005), sessile polyps (OR = 2.10, <i>P</i> = 0.006), and adenomatous pathological type (OR = 3.02, <i>P</i> < 0.001) were independent risk factors for post-surgery recurrence. The nomogram prediction model showed good discriminatory (AUC = 0.73) and calibrating power, and decision curve analysis showed that the model had good clinical benefit at risk probabilities > 20%.</p><p><strong>Conclusion: </strong>We identified multiple independent risk factors for short-term recurrence after endoscopic surgery. The nomogram prediction model showed a certain degree of differentiation, calibration, and potential clinical applicability.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"109057"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065228","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":"Morphomics in esophageal cancer: Validation and association with muscular and cardiorespiratory fitness.","authors":"Watson Hua-Sheng Tseng, Shu-Chun Huang, Stewart C Wang, Jules Lin, Peng Zhang, Yu-Chen Liu, Yin-Kai Chao, Chien-Hung Chiu","doi":"10.4240/wjgs.v17.i8.108600","DOIUrl":"10.4240/wjgs.v17.i8.108600","url":null,"abstract":"<p><strong>Background: </strong>Morphomics, a computed tomography-based body composition assessment, helps predicting esophageal cancer outcomes, but its link to bioelectrical impedance analysis (BIA) and functional assessments such as hand grip strength (HGS) and cardiopulmonary exercise testing (CPET) remains unclear.</p><p><strong>Aim: </strong>To investigate correlations between morphomics and BIA, HGS, CPET, and assess its ability to predict low cardiorespiratory fitness (CRF).</p><p><strong>Methods: </strong>Fifty esophageal cancer patients underwent multi-level morphomics, BIA, HGS, and CPET. Correlations were analyzed using heatmaps and scatter plots, and logistic regression assessed morphomic predictive value for low CRF.</p><p><strong>Results: </strong>T11 is the only level with complete morphomic data, making it the most applicable. To ensure reliability, T11 and its adjacent levels, T10-12, were included in the subsequent analysis. Dorsal muscle group volume from T10-12 morphomics all correlated positively with BIA muscle components (<i>r</i> = 0.56-0.68, all <i>P</i> < 0.001), HGS (<i>r</i> = 0.4-0.48, all <i>P</i> < 0.001), and CPET variables (<i>r</i> = 0.43-0.51, all <i>P</i> < 0.001). Subcutaneous fat area and visceral fat area from morphomics correlated with body fat percentage (<i>r</i> = 0.58-0.67, all <i>P</i> < 0.001) and negatively with CPET parameters (<i>r</i> = -0.33 to -0.52, all <i>P</i> < 0.05). Morphomics also showed potential in identifying low CRF, with an area under the receiver operating characteristic curve of 0.778.</p><p><strong>Conclusion: </strong>T11 morphomics shows strong correlation with BIA, HGS, and CPET, and may serve as a practical tool for preoperative risk assessment in esophageal cancer patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108600"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065600","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 anticoagulation reduces the incidence of venous thromboembolism in patients undergoing gastrointestinal surgery.","authors":"Ying Jiang, Jia-Fei Wang","doi":"10.4240/wjgs.v17.i8.107967","DOIUrl":"10.4240/wjgs.v17.i8.107967","url":null,"abstract":"<p><strong>Background: </strong>The risk and mortality rate of venous thromboembolism (VTE) following gastrointestinal surgery remain high, and the symptoms are atypical. Therefore, it is necessary to identify the risk factors associated with the occurrence of VTE following gastrointestinal surgery and to implement appropriate prevention and treatment measures.</p><p><strong>Aim: </strong>To assess the efficacy of perioperative anticoagulation for the prevention of postoperative VTE.</p><p><strong>Methods: </strong>This retrospective study enrolled 205 patients who underwent gastrointestinal surgery. In the observation group (<i>n</i> = 101), prophylactic anticoagulation was administered <i>via</i> hypodermic injection of low-molecular-weight heparin during the perioperative period, whereas the control group (<i>n</i> = 104) only received low-molecular-weight heparin treatment postoperatively. Blood coagulation parameters and the incidence of VTE of the bilateral lower limbs pre- and post-surgery were compared between groups. Postoperative VTE was transformed into a dichotomous variable, and influencing factors were explored using multivariate logistic regression analyses.</p><p><strong>Results: </strong>On the 7^th day postoperatively, the incidence of VTE of the bilateral lower limbs was significantly lower in the observation group than in the control group, as were the D-dimer levels (<i>P</i> < 0.05). At 1 month postoperatively, the incidence of VTE was significantly lower in the observation group than in the control group (<i>P</i> < 0.05). An age ≥ 65 years, a body mass index ≥ 24 kg/m², and malignant diseases of the digestive system were identified as risk factors for the occurrence of postoperative VTE in patients undergoing gastrointestinal surgery.</p><p><strong>Conclusion: </strong>The incidence of VTE in patients who underwent gastrointestinal surgery peaked within 1 week postoperatively. The findings confirmed perioperative anticoagulation can safely and effectively reduce the incidence of postoperative VTE.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"107967"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065711","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":"Current debate in gastric cancer surgery: Omentectomy?","authors":"Enver Ilhan, Mehmet Yildirim","doi":"10.4240/wjgs.v17.i8.108110","DOIUrl":"10.4240/wjgs.v17.i8.108110","url":null,"abstract":"<p><p>Despite the advancement of technology and neoadjuvant/adjuvant chemotherapy, molecular targeted agents, gastrectomy, and D2 lymph node dissection are the only curative treatment option for advanced gastric cancer (GC). The most common sites of recurrence in patients with GC are the peritoneum and omentum. The omentum contains areas rich in lymphatic tissue (the milky area) that form the connection between the peritoneum and the lymphatic system. Tumor cells are often found in these areas. Therefore, omentectomy is added to radical gastric resection and modified D2 lymph node dissection in the treatment of GC. Total omentectomy is recommended by Western countries for GC diagnosed at T3-4 stage, while Japanese research suggests partial omentectomy at T1-2 stage and total omentectomy at T3-4 stage due to early diagnosis of GC. In addition to the differences in tumor biology, the fact that patients in Western countries are more likely to receive perioperative chemotherapy and the 5% incidence of omental metastasis in advanced disease has led to the belief that partial omentectomy is an adequate surgical procedure compared with total omentectomy. There are studies recommending total omentectomy for the removal of possible tumor foci, and there are some studies reporting that partial omentectomy is sufficient even in advanced GC. The aim of this review was to investigate whether total or partial omentectomy should be performed in patients with GC.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108110"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064782","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 and safety of combining intestinal stenting with laparoscopic surgery in colorectal cancer patients with acute intestinal obstruction.","authors":"Yi-Na He, Tian-Tian Zhao","doi":"10.4240/wjgs.v17.i8.106499","DOIUrl":"10.4240/wjgs.v17.i8.106499","url":null,"abstract":"<p><strong>Background: </strong>Recently, intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction. However, its safety and efficacy have not yet been established.</p><p><strong>Aim: </strong>To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.</p><p><strong>Methods: </strong>Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction, who were admitted to the emergency department of the authors' hospital between October 2023 and November 2024, were collected and analyzed. Patients were divided into two groups based on the surgical intervention: A control group (emergency open surgery, <i>n</i> = 37) and a study group (intestinal stent implantation combined with laparoscopic surgery, <i>n</i> = 37). Observation indicators included stent placement rate, obstruction relief rate, and stent-related complications.</p><p><strong>Results: </strong>Intestinal stent placement was 100% successful in the study group, all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group, as well as less intraoperative blood loss, shorter time to flatus, and shorter hospital stay. The complication rate was 5.41% (2/37; bleeding and re-obstruction), with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality. The overall complication rates were 5.41% (2/37) and 21.62% (8/37) in the intervention and control groups, respectively. Tumor recurrence and overall survival rates were 2.70% and 97.30% in the study group and 13.51% and 91.89% in the control group, respectively.</p><p><strong>Conclusion: </strong>Intestinal stenting relieved acute obstructions, reduced the number of emergency surgeries, and supported laparoscopic procedures while improving primary anastomosis rates, minimizing ostomy occurrence, surgical trauma, and complications, and accelerating recovery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"106499"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065483","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: Three case reports.","authors":"Si-Bin Mei, Jing Liu, Yu Wang, Peng Hu, Qian Cao","doi":"10.4240/wjgs.v17.i8.108656","DOIUrl":"10.4240/wjgs.v17.i8.108656","url":null,"abstract":"<p><strong>Background: </strong>Inferior mesenteric arteriovenous fistula (IMAVF) is an extremely rare condition characterized by abnormal communication between the inferior mesenteric artery and vein. IMAVF often mimics ischemic bowel disease and ulcerative colitis (UC), leading to diagnostic challenges and treatment failures.</p><p><strong>Case summary: </strong>Three consecutive cases presented with non-specific symptoms including perianal pain and bloody diarrhea were reported. Initial diagnosis included acute severe UC and ischemic colitis. Pathology suggested ischemic changes, and with further contrast-enhanced computed tomography together with digital subtraction angiography which confirmed the diagnosis of IMAVF. All three cases were treated by vascular embolization, and symptoms improved rapidly following treatment.</p><p><strong>Conclusion: </strong>We presented the largest single center IMAVF series with detailed clinical characteristics, facilitating early diagnosis for similar cases in the future.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108656"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065635","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":"Preoperative interleukin-17a as a predictor of acute pancreatitis after pancreaticoduodenectomy.","authors":"Jie Zheng, Wei-Kang Ye, Jin Wang, Yi-Nong Zhou, Ting-Ting Yu","doi":"10.4240/wjgs.v17.i8.105112","DOIUrl":"10.4240/wjgs.v17.i8.105112","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a potentially life-threatening complication of pancreaticoduodenectomy that increases morbidity and mortality in patients. Interleukin-17A (IL-17a) the potential preoperative marker for predicting postoperative outcomes. The purpose of this study is to retrospectively assess the prognostic value of preoperative IL-17a level in prediction of AP and related postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy.</p><p><strong>Aim: </strong>To retrospectively assess the prognostic value of preoperative IL-17a levels in predicting AP and related POPF following pancreaticoduodenectomy.</p><p><strong>Methods: </strong>Retrospective analysis of pancreaticoduodenectomies performed on patients 150 patients between 2017 and 2023. Clinical data including pre-operative IL-17a levels were collected. The primary composite outcomes were postoperative AP and postoperative pancreatic (PP), and the predictive performances of IL-17a levels and fluid load status for postoperative complications were evaluated by statistical analysis.</p><p><strong>Results: </strong>A total of 150 patients were included, and 26 patients (17.3%) developed postoperative AP and 34 patients (22.7%) developed PP. Preoperative IL-17a was a risk factor for postoperative AP (<i>P</i> = 0.03). Furthermore, excessive intraoperative fluid load was a significantly associated (<i>P</i> = 0.01) with PP. The model (IL-17a levels + fluid load status) was highly accurate.</p><p><strong>Conclusion: </strong>Preoperative IL-17a levels and intravascular volume status may serve as useful predictors of AP and subsequent PP following PD. These parameters provide means to evaluate preoperative risk and may guide clinical decision making to enhance postoperative recovery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"105112"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065686","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":"Predicting early recurrence in resectable rectal cancer.","authors":"Manuel Carmo Silva, Tiago Correia de Sá, Kayla P Pereira, Joana M Pisco","doi":"10.4240/wjgs.v17.i8.101227","DOIUrl":"10.4240/wjgs.v17.i8.101227","url":null,"abstract":"<p><p>We provide an editorial of recent findings on early recurrence (ER) in rectal cancer (RC), focusing on the study on ER of resectable RC by Tsai <i>et al</i>. The study established an 8-month recurrence-free survival cut-off for differentiating ER from late recurrence, with implications for postrecurrence survival and overall survival. This offers not only a valuable timeframe for enhancing surveillance strategies in patients at higher risk, especially those who have undergone neoadjuvant chemoradiotherapy (CRT), but also raises questions about its applicability across different populations. Furthermore, the article suggests that while CRT is very effective in reducing locoregional recurrence, this treatment alone may not fully address the overall risk of ER. The authors advocate for personalized risk assessment and intensive surveillance during the postoperative period to improve outcomes, particularly in the first year. Future research should focus on larger, multicenter studies and incorporate advanced diagnostic techniques with genetic and molecular biomarkers to enhance prediction and management of ER. The ultimate goal is to refine treatment and surveillance strategies to improve survival and quality of life for patients with RC.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"101227"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065703","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":"Changes in liver and spleen stiffness after transjugular intrahepatic portosystemic shunt and their relationship with prognosis.","authors":"Xiao-Fang Liu, Xiao-Chun Huang, Qian-Jun Ye, Li-Jing Yuan, Gui-Fang Gao, Jin-Yu Li, Dui-Ping Feng","doi":"10.4240/wjgs.v17.i8.109884","DOIUrl":"10.4240/wjgs.v17.i8.109884","url":null,"abstract":"<p><strong>Background: </strong>The impact of transjugular intrahepatic portosystemic shunt (TIPS) on liver and spleen stiffness remains unclear, as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.</p><p><strong>Aim: </strong>To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.</p><p><strong>Methods: </strong>A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included. Liver and spleen stiffness was assessed using the sound touch quantify (STQ) value, determined <i>via</i> point shear wave elastography in ultrasound imaging. Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.</p><p><strong>Results: </strong>The liver STQ value demonstrated a marginally decreasing trend over time (<i>P</i> = 0.052), while the spleen STQ value showed a significantly decreasing trend (<i>P</i> = 0.025). Spleen STQ was positively correlated with portal pressure gradient (PPG) levels (r_s = 0.327, <i>P</i> = 0.025). Cox regression analysis indicated that older age [hazard ratio (HR) = 1.063, 95%CI: 0.997-1.133, <i>P</i> = 0.060] and a higher liver STQ value (HR = 1.051, 95%CI: 1.009-1.095, <i>P</i> = 0.018) were associated with an increased mortality risk after TIPS. No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS. The liver STQ value [area under the receiver operating characteristic curve (AUC) = 0.724 (95%CI: 0.563-0.884)] showed superior predictive performance compared to the Child-Pugh score [AUC = 0.699 (95%CI: 0.529-0.870)] and was comparable to the model for end-stage liver disease score [AUC = 0.746 (95%CI: 0.591-0.902)].</p><p><strong>Conclusion: </strong>Following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"109884"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065805","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":"Surgical treatment of colorectal cancer: A multidimensional review.","authors":"Jing-Xian Mao, Ran Gao, Ying Wang, Xue-Bing Yan, Hui-Hui Wang","doi":"10.4240/wjgs.v17.i8.107785","DOIUrl":"10.4240/wjgs.v17.i8.107785","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is the third most prevalent malignancy worldwide and the second leading cause of cancer-related mortality. Its global incidence increases annually, with most patients diagnosed at advanced stages. Despite substantial advancements in chemotherapy, radiotherapy, immune therapy, and targeted therapy, surgical treatment remains the mainstay for CRC management. Particularly, surgery is most effective for managing early-stage and locally advanced cancers. CRC surgery has evolved from conventional subtractive surgery to modern minimally invasive and precision-based techniques. Additionally, CRC treatment strategies have expanded from a single surgical therapy to a multi-modal integrated system encompassing endoscopic therapy, perioperative therapy, molecular targeted therapy, and immunotherapy. This review elucidates the evolution of CRC surgical treatment, describing its transition from early palliative surgery to radical surgery, and, finally, to functional surgery, minimally invasive surgical techniques, and personalized treatment. It reflects the transformation in CRC treatment from simplistic to complex, from generalized to precise, and from singular to comprehensive techniques, providing a holistic perspective on advancements in CRC surgical treatment.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"107785"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065400","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}