World Journal of Gastrointestinal Surgery最新文献

{"title":"Analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive inguinal hernia surgery.","authors":"Qian-Xing Lou, Ke-Ping Xu","doi":"10.4240/wjgs.v17.i3.99597","DOIUrl":"10.4240/wjgs.v17.i3.99597","url":null,"abstract":"<p><strong>Background: </strong>Currently, very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.</p><p><strong>Aim: </strong>To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.</p><p><strong>Methods: </strong>In this retrospective study, 94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia, admitted to Yiwu Central Hospital between May 2022 and May 2023, were divided into a control group (inhalation combined general anesthesia) and a treatment group (dexmedetomidine-assisted intravenous-inhalation combined general anesthesia). Perioperative indicators, analgesic effect, preoperative and postoperative 24-hours blood pressure (BP) and heart rate (HR), stress indicators, immune function levels, and adverse reactions were compared between the two groups.</p><p><strong>Results: </strong>Baseline data, including age, hernia location, place of residence, weight, monthly income, education level, and underlying diseases, were not significantly different between the two groups, indicating comparability (<i>P</i> > 0.05). No significant difference was found in operation time and anesthesia time between the two groups (<i>P</i> > 0.05). However, the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group (<i>P</i> < 0.05). Preoperatively, no significant differences were found in the visual analog scale (VAS) scores between the two groups (<i>P</i> > 0.05). However, at 12, 18, and 24 hours postoperatively, the treatment group had significantly lower VAS scores than the control group (<i>P</i> < 0.05). Although no significant differences in preoperative hemodynamic indicators were found between the two groups (<i>P</i> > 0.05), both groups experienced some extent of changes in postoperative HR, diastolic BP (DBP), and systolic BP (SBP). Nevertheless, the treatment group showed smaller changes in HR, DBP, and SBP than the control group (<i>P</i> < 0.05). Preoperative immune function indicators showed no significant differences between the two groups (<i>P</i> > 0.05). However, postoperatively, the treatment group demonstrated higher levels of CD3<sup>+</sup>, CD4<sup>+</sup>, and CD4+/CD8<sup>+</sup> and lower levels of CD8<sup>+</sup> than the control group (<i>P</i> < 0.05). The rates of adverse reactions were 6.38% and 23.40% in the treatment and control groups, respectively, revealing a significant difference (<i>χ</i> <sup>2</sup> = 5.371, <i>P</i> = 0.020).</p><p><strong>Conclusion: </strong>Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal ","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99597"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754230","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":"Effect of forearm and posterior wall anastomosis on gastroesophageal reflux in proximal gastrectomy patients.","authors":"Jia-Le Yang, Yi-Jie Yang, Lu Xu","doi":"10.4240/wjgs.v17.i3.100799","DOIUrl":"10.4240/wjgs.v17.i3.100799","url":null,"abstract":"<p><strong>Background: </strong>Proximal gastrectomy for gastric cancer often leads to postoperative gastroesophageal reflux (GER). This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.</p><p><strong>Aim: </strong>To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.</p><p><strong>Methods: </strong>A retrospective evaluation was conducted on 60 patients who underwent proximal gastrectomy between December 2020 and December 2023, divided equally into two groups based on the anastomosis technique used (forearm or posterior wall). GER symptoms were assessed using the GER disease questionnaire (GerdQ) preoperatively and on the first postoperative day. Biochemical markers [diamine oxidase (DAO), D-lactic acid, and endotoxin (ETX)] and nutritional indicators [serum ferritin (SF), prealbumin (PA), and albumin (ALB)] were measured to evaluate gastrointestinal barrier function and nutritional status.</p><p><strong>Results: </strong>Both groups showed significant improvements in GerdQ scores and reflux symptom scores post-treatment, with the observation group exhibiting greater reductions. Biochemical markers indicated enhanced gastrointestinal barrier function post-treatment in both groups, with notable increases in DAO, D-lactic, and ETX levels. Nutritional status indicators also demonstrated significant changes, with reductions in SF, PA, and ALB levels, suggesting an impact of treatment on inflammatory and nutritional status.</p><p><strong>Conclusion: </strong>The forearm anastomosis technique appears to be more effective in reducing GER symptoms and preserving gastrointestinal health in patients undergoing proximal gastrectomy for gastric cancer compared to the posterior wall anastomosis technique. These preliminary findings advocate for further research to confirm the benefits and potentially standardize Forearm Anastomosis in surgical practice for gastric cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100799"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754639","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 fluorouracil combined with paclitaxel and oxaliplatin for the treatment of advanced gastric signet ring cell carcinoma.","authors":"Mi Liu, Bei Feng, Na He, Rong Yan, Jie Qin","doi":"10.4240/wjgs.v17.i3.94286","DOIUrl":"10.4240/wjgs.v17.i3.94286","url":null,"abstract":"<p><strong>Background: </strong>Gastric signet ring cell carcinoma (GSRC) is a distinctive type of gastric cancer. It is a mucus-secreting adenocarcinoma that may progress to distant metastasis at an early stage. Because of poor differentiation, aggressive invasion, rapid progression, and other high-risk characteristics, early surgical intervention should be prioritized.</p><p><strong>Aim: </strong>To explore the clinical efficacy of fluorouracil (5-FU) combined with paclitaxel and oxaliplatin for the treatment of advanced GSRC.</p><p><strong>Methods: </strong>A total of 85 patients with advanced GSRC were selected between January 2020 and June 2021 and randomly divided into a control group (<i>n</i> = 42, receiving standard chemotherapy) and a treatment group (<i>n</i> = 43, receiving monotherapy with oxaliplatin, 5-FU, and paclitaxel). Patients in the treatment group received a 135 mg/m² infusion of paclitaxel for 3 hours, a 400 mg/m² infusion of calcium folate (or 200 mg/m² of levocalcium folate) for 2 hours, and an 85 mg/m² infusion of oxaliplatin for 2 hours. This was followed by a continuous intravenous infusion of 2200-2400 mg/m² 5-FU for 46 hours using a portable pump.</p><p><strong>Results: </strong>The treatment group showed a median survival time of 11.7 months and an objective response rate (ORR) of 32.5%, significantly higher than the control group (<i>P</i> < 0.05). Serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and albumin levels were correlated with treatment effectiveness in advanced GSRC (<i>P</i> < 0.01), but total serum protein was not correlated (<i>P</i> > 0.05). Safety and survival were assessed in all patients. Short-term efficacy was evaluated in 66 patients, with a disease control rate of 89.4% and an ORR of 48.5%. Median progression-free survival was 7.0 months (95% confidence interval [CI]: 6.85-7.15), and median overall survival was 10.6 months (95%CI: 9.86-11.3). Primary grade III/IV adverse events included neutropenia (22.1%) and peripheral neurotoxicity (10.3%).</p><p><strong>Conclusion: </strong>This treatment regimen is more effective for patients with advanced GSRC. Serum levels of CEA, CA19-9, and albumin predicted chemotherapy efficacy, while total protein concentration correlated minimally and insignificantly.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"94286"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754643","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 microwave ablation <i>vs</i> laparoscopic hepatectomy for primary small liver cancer: A comparative study.","authors":"Huan-Song Li, Xuan-Feng Zhang, Jun Fu, Bo Yuan","doi":"10.4240/wjgs.v17.i3.101786","DOIUrl":"10.4240/wjgs.v17.i3.101786","url":null,"abstract":"<p><strong>Background: </strong>In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation (MWA) and laparoscopic hepatectomy (LH), which are both important treatment modalities for liver neoplasms, have been limited in patients diagnosed with primary small liver cancer (PSLC).</p><p><strong>Aim: </strong>To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.</p><p><strong>Methods: </strong>This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups. The LH group, consisting of 61 cases, received LH, and the MWA group, which included 62 cases, underwent liver tumor MWA. Basic data and various perioperative indicators were compared between the two groups, including changes in liver function indicators [alanine aminotransferase (ALT), glutamic aminotransferase (AST), and total bilirubin (TBIL)] pre- and post-treatment, and efficacy and postoperative complications were analyzed.</p><p><strong>Results: </strong>No statistically significant difference was observed between the two groups in terms of age, gender, tumor diameter, liver function Child-Pugh classification and number of tumors, body mass index, and educational status (<i>P</i> > 0.05). The overall effective rate was higher in the MWA group than in the LH group (98.39% <i>vs</i> 88.52%) (<i>χ</i> ² = 4.918, <i>P</i> = 0.027). The MWA group exhibited less operation time, intraoperative bleeding, defecation time, and hospital stay than the LH group (<i>P</i> < 0.05). No difference was found in liver function indicators between the two groups pre-treatment (<i>P</i> > 0.05), and ALT, AST, and TBIL levels decreased in both groups post-treatment, with the MWA group demonstrating lower levels (<i>P</i> < 0.05). The MWA and LH groups exhibited postoperative complication rates of 4.84% and 19.67%, respectively, with statistically significant differences between the two groups (<i>P</i> = 0.012, <i>χ</i> ² = 6.318).</p><p><strong>Conclusion: </strong>MWA is more effective in treating PSLC, and it promotes faster postoperative recovery for patients, and more security improves liver function and reduces postoperative complications compared to LH.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101786"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754662","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":"Early and accurate diagnosis and selection of appropriate treatment plans are crucial for patients with gastrointestinal hemangiomas.","authors":"Zhou Chen, Liang Wang, Peng-Jie Yu","doi":"10.4240/wjgs.v17.i2.99432","DOIUrl":"10.4240/wjgs.v17.i2.99432","url":null,"abstract":"<p><p>Gastrointestinal hemangioma (GIH) is clinically rare, accounting for 7%-10% of benign gastrointestinal tumors and 0.5% of systemic hemangiomas. GIH can occur as either solitary or multiple lesions, with gastrointestinal bleeding as a significant clinical manifestation. Understanding the clinical and endoscopic features of GIH is essential for improving diagnostic accuracy, particularly through endoscopy and selective arteriography, which are highly effective in diagnosing GIH and preventing misdiagnosis and inappropriate treatment. Upon confirmed diagnosis, it is essential to thoroughly evaluate the patient's condition to determine the most suitable treatment modality-whether surgical, endoscopic, or minimally invasive intervention. The minimally invasive interventional partial embolization therapy using polyvinyl alcohol particles, proposed and implemented by Pospisilova <i>et al</i>, has achieved excellent clinical outcomes. This approach reduces surgical trauma and the inherent risks of traditional surgical treatments.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"99432"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586918","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":"Value of brief hematological characteristics in differentiating carcinoembryonic-antigen-negative colorectal cancer from benign colorectal diseases.","authors":"Li-Ling Yi, Xian-Jun Lao, Liu-Yi Lu, Chun-Ling Zhu, Dong-Yi Zhou, Si-Ting Li, Meng-Li Fan, Qi-Liu Peng","doi":"10.4240/wjgs.v17.i2.101403","DOIUrl":"10.4240/wjgs.v17.i2.101403","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains one of the most common malignancies worldwide, with a significant subset of patients exhibiting absence of carcinoembryonic-antigen (CEA) expression. The lack of effective diagnostic method for CEA-negative CRC prevents its early treatment.</p><p><strong>Aim: </strong>To identify potentially valuable biomarkers for identifying CEA-negative CRC, the hematological characteristics of patients with CEA-negative CRC was investigated.</p><p><strong>Methods: </strong>In this retrospective analysis, 74 patients were included who had been pathologically confirmed to have CEA-negative CRC, along with 79 individuals diagnosed with benign colorectal conditions. The utility of various biomarkers was evaluated using analysis of the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Compared with patients with benign colorectal diseases, those with CEA-negative CRC had lower hemoglobin-to-red blood cell distribution width ratio (HRR) and lymphocyte-to-red blood cell distribution width ratio (LRR), and higher platelet-to-lymphocyte ratio (PLR) (<i>P</i> < 0.05). Correlation analysis showed that HRR was negatively correlated with T stage (<i>r</i> = -0.237), LRR was negatively correlated with T stage (<i>r</i> = -0.265) and distant metastasis (<i>r</i> = -0.321), and PLR was positively correlated with T stage (<i>r</i> = 0.251) (all <i>P</i> < 0.05). ROC analysis indicated that HRR outperformed LRR and PLR in identifying CEA-negative CRC. Combining HRR and PLR provided the highest area under the curve (area under the curve = 0.808; sensitivity = 82.43%; specificity = 68.35%) for distinguishing CEA-negative CRC from benign colorectal diseases.</p><p><strong>Conclusion: </strong>HRR, LRR, and PLR alone or in combination could be used to distinguish CEA-negative CRC from benign colorectal diseases.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"101403"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587275","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":"Healthcare professionals' knowledge, attitude and practice towards ischemic bowel disease.","authors":"Mei Ying, Yan-Ju Li, Yan Chen, Ming-Yan Fu, Ge Zhang","doi":"10.4240/wjgs.v17.i2.96493","DOIUrl":"10.4240/wjgs.v17.i2.96493","url":null,"abstract":"<p><strong>Background: </strong>Ischemic bowel disease (IBD) is a critical condition caused by reduced blood flow to the intestines, leading to tissue damage and potentially severe complications. Early recognition and timely management are essential for improving patient outcomes and reducing morbidity and mortality associated with IBD.</p><p><strong>Aim: </strong>To evaluate the knowledge, attitude and practice (KAP) of healthcare professionals regarding IBD.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among healthcare professionals in China from November 2023 to December 2023 using a self-designed questionnaire.</p><p><strong>Results: </strong>A total of 315 valid questionnaires were analyzed, with 215 participants (68.25%) being female. The mean KAP scores were 17.55 ± 5.35 (range: 0-24), 27.65 ± 2.77 (range: 8-40), and 18.88 ± 4.23 (range: 6-30), respectively. Multivariate linear regression analysis revealed the following factors to be independently associated with knowledge: Age 26-35 years (<i>β</i> = 2.80, 95%CI: 0.31-5.30, <i>P</i> = 0.028), professional title (<i>β</i> = 2.66, 95%CI: 0.91-4.41, <i>P</i> = 0.003), position (<i>β</i> = -3.78, 95%CI: -5.45 to -2.11, <i>P</i> < 0.001), participation in IBD-related training (<i>β</i> = 3.45, 95%CI: 2.39-4.51, <i>P</i> < 0.001), and admission of more than five IBD cases in the past month (<i>β</i> = 3.25, 95%CI: 1.58-4.92, <i>P</i> < 0.001). Attitude was independently associated with knowledge (<i>β</i> = 0.20, 95%CI: 0.15-0.26, <i>P</i> < 0.001) and being a nurse or nursing supervisor (<i>β</i> = -1.30, 95%CI: -2.16 to -0.40, <i>P</i> = 0.003). Practice was independently associated with knowledge (<i>β</i> = 0.20, 95%CI: 0.10-0.30, <i>P</i> < 0.001) and attitude (<i>β</i> = 0.24, 95%CI: 0.06-0.42, <i>P</i> = 0.007). Structural equation modeling demonstrated direct effects of knowledge on attitude (<i>β</i> = 0.24, <i>P</i> < 0.001) and practice (<i>β</i> = 0.26, <i>P</i> < 0.001), as well as of attitude on practice (<i>β</i> = 0.22, <i>P</i> = 0.012).</p><p><strong>Conclusion: </strong>Healthcare professionals demonstrated adequate knowledge but moderate attitude and inactive practice regarding IBD. Addressing the gaps in attitude and practice through targeted training programs and interventions is essential for improving patient care and outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"96493"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587235","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":"Long-term survival outcomes of duodenal adenocarcinoma: A cohort study with 15-year single-center experience.","authors":"Qing-Feng Xie, Lian-Sheng Long, Yang-Yang Luo, Meng-Ting Lu, Wai-Kit Ming, Li-Ying Zhao, Hao Liu","doi":"10.4240/wjgs.v17.i2.101365","DOIUrl":"10.4240/wjgs.v17.i2.101365","url":null,"abstract":"<p><strong>Background: </strong>Duodenal adenocarcinoma (DA), a rare gastrointestinal malignancy, lacks clear natural history and management strategies. This study aimed to investigate the long-term outcomes of patients with DA, focusing on long-term survival and the impact of tumor characteristics, surgery, and adjuvant therapy.</p><p><strong>Aim: </strong>To bridge this knowledge gap, we conducted a hospital-based cohort study in our 15-year experience with DA aimed at investigating the long-term outcomes of the patients with DA, along with analyzing the impact of the tumor characteristics, operations and adjuvant therapy on survival outcomes.</p><p><strong>Methods: </strong>A retrospective analysis of 208 patients diagnosed with non-ampullary DA at a single institution between 2009 and 2023 was performed. This study used SPSS 26.0 software to make a comprehensive statistical analysis of demographic characteristics, clinical presentation, treatment modalities, and survival outcomes. The effectiveness of surgical resection and adjuvant therapy in 5-year oval survival (OS) and disease-free survival was evaluated using Kaplan-Meier survival curves, the Cox proportional hazards model, and statistical comparisons of survival distributions.</p><p><strong>Results: </strong>The median OS time for the cohort was 39 months, with 3- and 5-year OS rates of 51.2% and 43.6%, respectively. Radical resection was performed in 82.6% of cases, and was significantly associated with an improved 5-year OS, with a rate of 57.8%. Adjuvant therapy showed a survival benefit in the specific patient subsets, particularly in tumor stage II or III tumors, with an improved OS. Adjuvant therapy (hazard ratio= 2.71, 95% confidence interval: 1.30-5.62, <i>P</i> = 0.008), pancreatic invasion and advanced tumor stage were identified as significant predictors of OS in multivariate analyses.</p><p><strong>Conclusion: </strong>Radical operation for DA is associated with a remarkable improvement in the 5-year OS. Importantly, postoperative adjuvant therapy can significantly prolong the OS time in patients with radical operation, especially in patients with stage III. It highlights the necessity for early diagnosis, tailored surgical approaches, and a nuanced understanding of the role of adjuvant therapy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"101365"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587240","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":"Overview of endoscopic biliary stenting in malignant obstructive jaundice.","authors":"Hui Wang, Yan Jiao, Qiang Ma, Ya-Hui Liu","doi":"10.4240/wjgs.v17.i2.103378","DOIUrl":"10.4240/wjgs.v17.i2.103378","url":null,"abstract":"<p><p>This article discusses Wang <i>et al</i>'s essay. Endoscopic biliary stenting, a less invasive alternative to surgery, is effective for malignant obstructive jaundice. This article summarizes the pathophysiology of biliary obstruction, the technical aspects of stenting, and the clinical outcomes. By comparison of endoscopic stenting with percutaneous biliary drainage, improvements and complications are focused on. Additionally, patient selection for stenting and future advancements in stent technology are important. Overall, endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice, especially those ineligibles for surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"103378"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587257","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":"Gamma-glutamyl transferase-to-lymphocyte ratio as a prognostic marker in patients with hepatocellular carcinoma undergoing hepatectomy.","authors":"Peng-Cheng Zhou, Rui Huang, Hai-Tao Wang, Jun Yang, Jian-Dong Peng, Zi-Xuan Fu, Wen-Jun Liao, Hai-Qiang Ma, Lin-Quan Wu, En-Liang Li","doi":"10.4240/wjgs.v17.i2.98578","DOIUrl":"10.4240/wjgs.v17.i2.98578","url":null,"abstract":"<p><strong>Background: </strong>We investigated the utility of gamma-glutamyl transferase-to-lymphocyte ratio (GLR) as a predictive indicator for postoperative survival in patients with hepatocellular carcinoma (HCC) across different time periods and developed a predictive model based on this.</p><p><strong>Aim: </strong>To evaluate the prognostic accuracy of GLR for overall survival (OS) in patients with HCC and its impact over time.</p><p><strong>Methods: </strong>This study enrolled 301 patients with HCC treated with curative hepatectomy. Exclusion criteria included non-HCC hepatic malignancies, inadequate records, and prior cancer treatments. Baseline demographics, clinical features, and hematological parameters were recorded. Time-dependent receiver operating characteristic curve analysis was used to determine the optimal GLR threshold for survival prediction at 13 months. Statistical analyses included the Kaplan-Meier method, multivariate Cox regression, and the creation of a prognostic nomogram.</p><p><strong>Results: </strong>Out of 301 patients, 293 were eligible for analysis, with a male predominance (84.6%). High preoperative GLR correlated with several adverse clinical features. Optimal cutoff values for GLR were significantly associated with stratification of 13-month OS. Multivariate analysis identified age, liver enzymes, postoperative transarterial chemoembolization, Child-Pugh grade, and inflammatory markers as independent predictors of OS. Notably, GLR had a significant impact on long-term postoperative OS, with its influence becoming more pronounced over time.</p><p><strong>Conclusion: </strong>GLR can serve as a potent prognostic tool for postoperative HCC management, particularly in predicting long-term outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"98578"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587191","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}