World Journal of Gastrointestinal Surgery最新文献

{"title":"Risk factors, monitoring, and treatment strategies for early recurrence after rectal cancer surgery.","authors":"Si-Jia Wu, Chu-Ying Wu, Kai Ye","doi":"10.4240/wjgs.v17.i1.100232","DOIUrl":"10.4240/wjgs.v17.i1.100232","url":null,"abstract":"<p><p>Early recurrence (ER) following surgery for rectal cancer is a significant factor impacting patient survival rates. Tsai <i>et al</i> identified age, preoperative neoadjuvant therapy, length of hospital stay, tumour location, and pathological stage as factors influencing the risk of ER. Postoperative monitoring for ER should encompass a thorough medical history review, physical examination, tumour marker testing, and imaging studies. Additionally, noninvasive circulating tumour cell DNA testing can be utilized to predict ER. Treatment strategies may involve radical surgery, radiation therapy, chemotherapy, and immunotherapy. Through a comprehensive analysis of risk factors, the optimization of monitoring methods, and the development of personalized treatment strategies, it is anticipated that both the efficacy of treatment and the quality of life for rectal cancer patients with postoperative recurrence can be significantly improved.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"100232"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053660","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":"Multimodal treatment combining neoadjuvant therapy, laparoscopic subtotal distal pancreatectomy and adjuvant therapy for pancreatic neck-body cancer: Case series.","authors":"Jia Li, Xi-Tao Wang, Yi Wang, Kang Chen, Guo-Guang Li, Yan-Fei Long, Mei-Fu Chen, Chuang Peng, Yi Liu, Wei Cheng","doi":"10.4240/wjgs.v17.i1.97897","DOIUrl":"10.4240/wjgs.v17.i1.97897","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer involving the pancreas neck and body often invades the retroperitoneal vessels, making its radical resection challenging. Multimodal treatment strategies, including neoadjuvant therapy, surgery, and postoperative adjuvant therapy, are contributing to a paradigm shift in the treatment of pancreatic cancer. This strategy is also promising in the treatment of pancreatic neck-body cancer.</p><p><strong>Aim: </strong>To evaluate the feasibility and effectiveness of a multimodal strategy for the treatment of borderline/locally advanced pancreatic neck-body cancer.</p><p><strong>Methods: </strong>From January 2019 to December 2021, we reviewed the demographic characteristics, neoadjuvant and adjuvant treatment data, intraoperative and postoperative variables, and follow-up outcomes of patients who underwent multimodal treatment for pancreatic neck-body cancer in a prospectively collected database of our hospital. This investigation was reported in line with the Preferred Reporting of Case Series in Surgery criteria.</p><p><strong>Results: </strong>A total of 11 patients with pancreatic neck-body cancer were included in this study, of whom 6 patients were borderline resectable and 5 were locally advanced. Through multidisciplinary team discussion, all patients received neoadjuvant therapy, of whom 8 (73%) patients achieved a partial response and 3 patients maintained stable disease. After multidisciplinary team reassessment, all patients underwent laparoscopic subtotal distal pancreatectomy and portal vein reconstruction and achieved R0 resection. Postoperatively, two patients (18%) developed ascites, and two patients (18%) developed pancreatic fistulae. The median length of stay of the patients was 11 days (range: 10-15 days). All patients received postoperative adjuvant therapy. During the follow-up, three patients experienced tumor recurrence, with a median disease-free survival time of 13.3 months and a median overall survival time of 20.5 months.</p><p><strong>Conclusion: </strong>A multimodal treatment strategy combining neoadjuvant therapy, laparoscopic subtotal distal pancreatectomy, and adjuvant therapy is safe and feasible in patients with pancreatic neck-body cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"97897"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053628","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 evaluation of endoscopic biliary stenting in treatment of malignant obstructive jaundice.","authors":"Wei Wang, Chao Zhang, Bing Li, Ge-Yi-Lang Yuan, Zhi-Wu Zeng","doi":"10.4240/wjgs.v17.i1.97596","DOIUrl":"10.4240/wjgs.v17.i1.97596","url":null,"abstract":"<p><strong>Background: </strong>Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.</p><p><strong>Aim: </strong>To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.</p><p><strong>Methods: </strong>The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed. According to the treatment method, the patients were divided into an observation group (29 patients) and a control group (30 patients). General data, liver function indices, complications, adverse effects, and 3-year survival rates after different surgical treatments were recorded for the two groups.</p><p><strong>Results: </strong>There were no significant differences in baseline information (sex, age, tumor type, or tumor diameter) between the two groups (<i>P</i> > 0.05). Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels were significantly better in both groups after surgery than before surgery (<i>P</i> < 0.05). The overall incidence of biliary bleeding, gastrointestinal bleeding, pancreatitis, and cholangitis was 6.9% in the observation group and 30% in the control group (<i>P</i> < 0.05). No significant differences in the rates of blood transfusion, intensive care unit admission, or death within 3 years were observed between the two groups at the 1-month follow-up (<i>P</i> > 0.05). The 3-year survival rates were 46.06% and 39.71% in the observation and control groups, respectively.</p><p><strong>Conclusion: </strong>Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function, with minimal complications. This technique is a promising palliative approach for patients ineligible for radical surgery. However, further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"97596"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053769","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 observation on prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation.","authors":"Yan-Mei Huang, Dong Ouyang","doi":"10.4240/wjgs.v17.i1.99464","DOIUrl":"10.4240/wjgs.v17.i1.99464","url":null,"abstract":"<p><strong>Background: </strong>A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.</p><p><strong>Aim: </strong>To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation (RPH).</p><p><strong>Methods: </strong>A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group (<i>n</i> = 50) and the treatment group (<i>n</i> = 50) by rolling the dice. The procedure for prolapse and hemorrhoids (PPH) was adopted in the control group, while polidocanol foam injection + RPH was adopted in the treatment group. The therapeutic effects, operation time, wound healing time, hospital stay, pain situation (24 hours post-operative pain score, first defecation pain score), quality of life (QOL), incidence of complications (post-operative hemorrhage, edema, infection), incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.</p><p><strong>Results: </strong>Compared with the control group, the total effective rate of treatment group was higher, and the difference was significant (<i>P</i> < 0.05). The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group (<i>P</i> < 0.05). The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group (<i>P</i> < 0.05). After surgery, the QOL scores of the two groups decreased, with the treatment group having higher scores than that of the control group (<i>P</i> < 0.05). Compared with the control group, the incidence of postoperative complications in the treatment group was lower, and the difference was significant (<i>P</i> < 0.05); However, there was no significant difference in the incidence of postoperative bleeding between the two groups (<i>P</i> > 0.05); There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>For patients with mixed hemorrhoids, the therapeutic effect achieved by using polidocanol injection combined with RPH was better. The wounds of the patients healed faster, the postoperative pain was milder, QOL improved, and the incidence of complications was lower, and the short-term and long-term prognosis was good.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"99464"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053771","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 ligamentum teres uteri preservation in laparoscopic high hernia sac ligation in children with indirect inguinal hernia.","authors":"Xiao-Qiang Lin, Hua-Fang Li, Yan-Zhu Lin, Wen-You Chen","doi":"10.4240/wjgs.v17.i1.99155","DOIUrl":"10.4240/wjgs.v17.i1.99155","url":null,"abstract":"<p><strong>Background: </strong>Routinely separating the ligamentum teres uteri (LTU) intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia (IIH).</p><p><strong>Aim: </strong>To identify the effect of LTU preservation in laparoscopic high hernia sac ligation (LHSL) in children with IIH.</p><p><strong>Methods: </strong>The participants were 100 female children with unilateral IIH admitted from April 2022 to January 2024 to the Pediatric Surgery Department of Zhangzhou Municipal Hospital of Fujian Province. They were categorized based on LTU retention into the control group (<i>n</i> = 45 cases), which underwent LTU ligation intraoperatively, and the experimental group (55 cases), which had the LTU preserved intraoperatively. All children underwent LHSL.</p><p><strong>Results: </strong>This study comparatively analyzed the operation time, hospitalization time, blood loss, postoperative recurrence rate, and complications (repeated pain in the inguinal region, foreign body sensation in the inguinal region, bloody exudation at the inguinal incision, and incision infection), which were all comparable between the two groups.</p><p><strong>Conclusion: </strong>The above results indicate that LTU preservation during LHSL exerts certain therapeutic benefits for children with IIH. LTU preservation does not increase hospitalization time, blood loss, postoperative recurrence rate, and complications, which is safe and feasible, compared with conventional LTU ligation. LHSL with LTU preservation should be performed if conditions permit, which is worth popularizing.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"99155"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053787","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":"Retraction note: Predictive value of machine learning models for lymph node metastasis in gastric cancer: A two-center study.","authors":"Jia-Ping Yan, Jin-Lei Wang","doi":"10.4240/wjgs.v17.i1.101330","DOIUrl":"10.4240/wjgs.v17.i1.101330","url":null,"abstract":"<p><p>[This retracts the article on p. 85 in vol. 16, PMID: 38328326.].</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"101330"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053585","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":"Microbiota in patients with cefuroxime resistance and anal fistula revealed by 16S ribosomal DNA.","authors":"Yi-Ting Ling, Fei Yao, Sen-Juan Li, Chen-Xi Cao, Zhen-Wei Chen, Min Qiu, Bu-Zhuo Li, Bi-Wen Hu, Shen-Yan Zhong, Guang-Lei Hu, Jia-Hua Li","doi":"10.4240/wjgs.v17.i1.100790","DOIUrl":"10.4240/wjgs.v17.i1.100790","url":null,"abstract":"<p><strong>Background: </strong>Anal fistula is increasingly prevalent due to modern lifestyle factors, and surgery remains the primary treatment. However, the rising incidence of antibiotic resistance, particularly to cefuroxime, complicates perioperative management. The role of gut microbiota in influencing this resistance is not well understood.</p><p><strong>Aim: </strong>To investigate the relationship between gut microbiota composition and cefuroxime resistance in anal fistula patients and to assess probiotic intervention impact.</p><p><strong>Methods: </strong>This study included 30 anal fistula patients categorized into cefuroxime-sensitive (Cefur-S) and cefuroxime-resistant (Cefur-NS) groups. Gut microbiota samples were collected during colonoscopy, and 16S ribosomal DNA sequencing was performed to analyze microbial diversity. Patients in the Cefur-NS group received a 7-day course of <i>Clostridium butyricum</i> tablets. Post-intervention, microbial composition and cefuroxime resistance were reassessed.</p><p><strong>Results: </strong>Alpha and beta diversity analyses showed no significant differences in microbial diversity between the Cefur-S and Cefur-NS groups. However, effect size analysis identified <i>Roseburia</i> and <i>Butyricicoccus</i> as dominant genera in the Cefur-S group, with higher butyrate production potentially protecting against cefuroxime resistance. Post-intervention, the Cefur-NS group showed a significant reduction in cefuroxime resistance, improved stool consistency, and reduced bowel movement frequency.</p><p><strong>Conclusion: </strong>This study suggests that specific gut microbiota, particularly <i>Butyricicoccus</i> and <i>Roseburia</i>, may mitigate cefuroxime resistance in anal fistula patients by increasing butyrate production. Probiotic intervention targeting gut microbiota composition presents a promising strategy for reducing antibiotic resistance and improving clinical outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"100790"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053386","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 serum total bilirubin-albumin ratio as a prognostic indicator in patients with hepatitis-related cirrhosis after splenectomy.","authors":"Yi-Fan Chen, Yu-Xin Lin, Miao-Miao Chi, Da-Qing Li, Lin-Tao Chen, Yu Zhang, Rong-Qian Wu, Zhao-Qing Du","doi":"10.4240/wjgs.v17.i1.96512","DOIUrl":"10.4240/wjgs.v17.i1.96512","url":null,"abstract":"<p><strong>Background: </strong>Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis. However, the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.</p><p><strong>Aim: </strong>To assess the potential of preoperative total bilirubin-albumin (B/A) ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.</p><p><strong>Methods: </strong>A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study. Normality test, <i>t</i>-test, Wilcoxon test, <i>χ</i> ² test, or Fisher's exact test was employed to analyze the intraoperative and postoperative conditions of the patients. Receiver operating characteristic (ROC) curve analysis was utilized to depict the 10-year overall survival rate.</p><p><strong>Results: </strong>During the follow-up period, 85.99% of the patients survived, with a median survival time of 64.6 months. Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival (<i>P</i> = 0.037). ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value. Consequently, the patients were categorized into two groups: High B/A group (<i>n</i> = 64) and low B/A group (<i>n</i> = 193). The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months, respectively (<i>P</i> = 0.045). Notably, the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group (<i>P</i> < 0.001). Patients with hepatocellular carcinoma (HCC) had lower overall survival rates. Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not, early Child-Pugh grade, low albumin-bilirubin grade, and model for end-stage liver disease score ≥ 10 (log-rank test, <i>P</i> < 0.001 for all).</p><p><strong>Conclusion: </strong>The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virus-related cirrhosis following splenectomy, and a higher B/A ratio may suggest a poorer prognosis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"96512"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053577","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":"Selective embolization can effectively alleviate bleeding symptoms in patients with anorectal hemangioma.","authors":"Ping-Hua Wen, Bing Hu","doi":"10.4240/wjgs.v17.i1.100108","DOIUrl":"10.4240/wjgs.v17.i1.100108","url":null,"abstract":"<p><p>In this manuscript, I comment on the article by Pospisilova <i>et al</i> published in the recent issue of the journal, in which selective embolization was used to treat anorectal hemangioma, a rare disease causing lower gastrointestinal bleeding. Anorectal hemangioma can easily be mistaken; for example, the patient in this case was previously misdiagnosed with ulcerative colitis. Choosing the appropriate tests and understanding the typical manifestations of anorectal hemangioma under colonoscopy, computerized tomography, magnetic resonance imaging and other tests are beneficial for diagnosis. The patient presented with intermittent rectal bleeding despite treatment with azathioprine and mesalazine and required blood transfusions since the degree of rectal bleeding worsened. Selective embolization successfully alleviated the patient's bleeding symptoms and avoided the need for repeated blood transfusions. Tranexamic acid may be useful, considering that the patient still has bleeding symptoms and requires parenteral iron supplementation.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"100108"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053640","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":"Improving predictive accuracy of early recurrence in pancreatic ductal adenocarcinoma: Role of postoperative serum tumor markers.","authors":"Arunkumar Krishnan, Declan Walsh","doi":"10.4240/wjgs.v17.i1.101549","DOIUrl":"10.4240/wjgs.v17.i1.101549","url":null,"abstract":"<p><p>In a recent study by He <i>et al</i>, the nomogram integrates postoperative serum tumor markers such as carbohydrate antigen 19-9 and carcinoembryonic antigen, thereby improving the accuracy of identifying high-risk patients compared to relying solely on preoperative markers, which has significant implications for customizing adjuvant therapy and potentially improving outcomes for this aggressive form of cancer. However, the study's single-center design and short follow-up period may limit the generalizability of its findings and potentially introduce reporting bias. Future studies could consider additional confounding factors, such as adjuvant chemotherapy and variations in surgical techniques, to improve the model's accuracy. Furthermore, it would be valuable to validate the nomogram in broader, prospective cohorts and explore the inclusion of additional markers like circulating tumor DNA to refine further its predictive power and applicability across diverse patient populations.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 1","pages":"101549"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053210","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}