World Journal of Gastrointestinal Surgery最新文献

{"title":"Construction of a risk prediction model for postoperative gastrointestinal dysfunction and prevention in patients with gastrointestinal tumors.","authors":"Xiao-Hui Wang, Yi Wang, Xi Liu, Xiao-Lan Ouyang, Fen Xie, Lu Liao","doi":"10.4240/wjgs.v18.i2.114483","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114483","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of gastrointestinal tumors is continuously increasing. Surgery remains the primary treatment modality. However, postoperative gastrointestinal dysfunction remains prevalent, severely impeding patient recovery and increasing medical burden. Existing research investigating risk prediction and preventive management has some limitations.</p><p><strong>Aim: </strong>To construct a risk-prediction model for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors and explore preventive management strategies.</p><p><strong>Methods: </strong>Data from 176 patients who underwent gastrointestinal tumor surgery at the authors' hospital between November 2022 and November 2024 were included. Patients were divided into groups according to Tilburg Frailty Scale scores on postoperative day 5. Risk factors were screened using univariate and multivariate logistic regression analyses to establish a model, and the effectiveness of preventive management measures was evaluated.</p><p><strong>Results: </strong>Seven factors including age, sex, body mass index, tumor stage, operative duration, and preoperative hemoglobin and albumin levels were identified as independent risk factors. The constructed model had an area under the receiver operating characteristic curve of 0.895. The incidence of postoperative gastrointestinal dysfunction in the intervention group was significantly lower than that in the control group using preventive management measures based on the model.</p><p><strong>Conclusion: </strong>An effective risk-prediction model was constructed and independent risk factors were identified. Preventive management measures based on this model can reduce risk and provide a scientific basis for clinical practice.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114483"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435826","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 the effectiveness nursing interventions for contrast-induced adverse reactions in postoperative general surgery patients undergoing contrast-enhanced computed tomography scans.","authors":"Li An, Xin-Yue Chang","doi":"10.4240/wjgs.v18.i2.114434","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114434","url":null,"abstract":"<p><strong>Background: </strong>Contrast-enhanced computed tomography (CT) is common postoperatively; however, contrast-induced adverse reactions increase the risk of renal injury and inflammation, requiring effective nursing care.</p><p><strong>Aim: </strong>To investigate the efficacy of comprehensive precision nursing interventions in preventing and managing contrast-induced adverse reactions during abdominal contrast-enhanced CT among postoperative general surgery patients.</p><p><strong>Methods: </strong>Eighty patients undergoing elective surgery in the Department of General Surgery at the Beihua University Affiliated Hospital between January 2021 and January 2025, who required postoperative abdominal contrast-enhanced CT, were enrolled. The patients were randomly assigned to two groups using a random number table: A control group (<i>n</i> = 40) that received conventional nursing care, and an observation group (<i>n</i> = 40) that received comprehensive precision nursing interventions in addition to conventional care. Comparisons were made between the groups for the following: Heart rate variability indices, including SD of normal R-R intervals (SDNN) and root mean square of successive R-R interval differences (RMSSD); inflammatory cytokine levels, including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α); patient-reported outcomes; and procedure-related complications (<i>e.g.</i>, contrast extravasation and acute adverse reactions).</p><p><strong>Results: </strong>Post-examination, compared with the control group, the observation group exhibited significantly lower increase in serum neutrophil gelatinase-associated lipocalin and cystatin C (<i>P</i> < 0.05), higher SDNN and RMSSD values (<i>P</i> < 0.05), and markedly reduced IL-6 and TNF-α concentrations (<i>P</i> < 0.05). Regarding patient subjective experiences, the observation group demonstrated superior scores for emotional functioning, overall health status, and discomfort when compared with the control group (<i>P</i> < 0.05). Furthermore, incidence of contrast medium extravasation and overall adverse reaction rates were lower in the observation group than those in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Implementing comprehensive, precision nursing interventions for postoperative general surgery patients helps mitigate early renal tubular damage caused by iodinated contrast agents, maintains autonomic nervous system stability, alleviates systemic inflammatory responses, and enhances patients' subjective comfort and treatment experience. Concurrently, this nursing model effectively reduces the complication risks associated with contrast agent administration, thereby improving the safety and clinical service quality of contrast-enhanced CT.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114434"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435947","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":"Optimization of nursing care for patients with acute intestinal obstruction using dedicated multidisciplinary team.","authors":"Chao Wang, Zhang-Bin Ling, Pan-Pan Sun, Ming Dong, Ting Cao, Xiang Ma, Lan-Jun Lu, Yang Li","doi":"10.4240/wjgs.v18.i2.111845","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.111845","url":null,"abstract":"<p><strong>Background: </strong>Acute intestinal obstruction is a common surgical emergency with high mortality, requiring efficient multidisciplinary collaboration to improve outcomes.</p><p><strong>Aim: </strong>To explore the optimization of nursing pathways for patients with acute intestinal obstruction using the multidisciplinary team (MDT) model.</p><p><strong>Methods: </strong>A total of 176 patients with acute intestinal obstruction admitted to the Emergency Department of our hospital between December 2023 and February 2025 were randomly divided into a control group (<i>n</i> = 88) and an intervention group (<i>n</i> = 88) using a random number table. The control group received routine emergency nursing interventions, whereas the intervention group received emergency nursing pathway interventions under the MDT model. The groups were compared in terms of emergency treatment efficiency, improvement of clinical symptoms, 36-Item Short Form Health Survey (SF-36) scores, nursing satisfaction, and early (within 72 hours) intestinal obstruction-related complications-specifically, electrolyte disturbance, strangulated obstruction, and intestinal necrosis/perforation.</p><p><strong>Results: </strong>The intervention group had significantly shorter triage, condition assessment, and emergency treatment times (all <i>P</i> < 0.001), faster relief of abdominal pain and vomiting, and earlier return of bowel function (all <i>P</i> < 0.001). The rate of early complications was lower in the intervention group (2.27% <i>vs</i> 10.23%, <i>P</i> = 0.029). Nursing satisfaction was higher (96.59% <i>vs</i> 81.82%, <i>P</i> = 0.002), and post-intervention SF-36 scores were significantly higher (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The MDT-based emergency nursing pathway improves emergency efficiency, relieves clinical symptoms, enhances quality of life and satisfaction, and reduces early intestinal obstruction-related complications in patients with acute intestinal obstruction.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"111845"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435962","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":"Neurotrophin-3 rs1805149A>G variant in Hirschsprung disease: An investigative study.","authors":"Xiao-Gang Xu, Yan-Qing Liu, Meng-Long Lan, Fei Liu, Hui-Min Xia, Ji-Xiao Zeng","doi":"10.4240/wjgs.v18.i2.114724","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114724","url":null,"abstract":"<p><strong>Background: </strong>Hirschsprung disease (HSCR) is a congenital disorder of the enteric nervous system (ENS) caused by defective migration of neural crest cells. Genetic factors, including neurotrophic genes such as neurotrophin-3 (<i>NTF3</i>), may contribute to its pathogenesis.</p><p><strong>Aim: </strong>To investigate the association between the <i>NTF3</i> rs1805149A>G variant and susceptibility to HSCR in a southern Chinese Han population. In addition, this study also aims to provide population-specific genetic data on HSCR and to explore whether this neurotrophin-related variant contributes to disease pathogenesis, potentially broadening the spectrum of candidate genes implicated in ENS development.</p><p><strong>Methods: </strong>A study was conducted involving 1470 HSCR patients and 1473 healthy controls. Genomic DNA was extracted and genotyping of the <i>NTF3</i> rs1805149 variant was performed using a TaqMan real-time PCR system. Genotype and allele frequencies were analyzed using <i>χ</i> ² tests.</p><p><strong>Results: </strong>The distribution of genotypes (AA, AG, GG) and allelic frequencies (A and G) showed no statistically significant differences between HSCR patients and controls. No association was found between the rs1805149 variant and specific clinical subtypes of HSCR.</p><p><strong>Conclusion: </strong>The <i>NTF3</i> rs1805149A>G variant does not appear to be associated with HSCR susceptibility in the studied southern Chinese cohort. Further studies with larger sample sizes and multi-gene analysis are warranted to better understand the genetic basis of HSCR.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114724"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436035","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":"Colitis cystica profunda diagnosed by laparoscopic excision: A case report and review of literature.","authors":"Tong Zhao, Xian-Ru Jia, Kai-Jiang Li, Wen-Feng Zheng, Xue-Jin Liu","doi":"10.4240/wjgs.v18.i2.114137","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114137","url":null,"abstract":"<p><strong>Background: </strong>Colitis cystica profunda (CCP) is a rare condition with multiple cystic lesions in the mucosal/submucosal layers, predominantly involving the rectum and sigmoid colon. Its etiology remains unclear, with mucinous neoplasms and polyps as major differential diagnoses. Nonspecific imaging and clinical manifestations make preoperative diagnosis challenging (most confirmed postoperatively). This report summarizes reported cases, adds a new one, and compares it with 106 prior cases to enhance understanding of its features, diagnosis and management.</p><p><strong>Case summary: </strong>Herein, we report a 32-year-old man with a history of colonoscopy detection of two submucosal colonic elevations (20 cm and 18 cm from the anal verge) 2 weeks ago, without any disturbing symptoms. Endorectal ultrasound showed two cystic masses in the sigmoid's intrinsic muscular and submucosal layers. Computed tomography showed rectosigmoid thickening. We performed a laparoscopic operation to remove the lump. Final pathology was diagnosed with CCP. The patient was discharged five days later and had follow-up visits with no signs of relapse for a period of 3 months.</p><p><strong>Conclusion: </strong>CCP is rare and the clinical symptoms are not typical, and pre-operative diagnosis is difficult. Histopathology is required for definitive diagnosis. Surgical excision is widely reported as the surgical treatment of choice for CCP.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114137"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435465","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":"From inflammation to precision medicine in colon cancer: Methodological considerations and future directions.","authors":"Arunkumar Krishnan","doi":"10.4240/wjgs.v18.i2.114796","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114796","url":null,"abstract":"<p><p>A recent study by Zhu SS <i>et al</i> evaluated the prognostic value of the systemic immune-inflammation index and serum lactoferrin in older patients with colon cancer. While this work highlights the potential role of inflammation-based biomarkers in predicting survival, several methodological and analytical concerns limitations constrain its clinical applicability. These include a small sample size, a single-center observational design, a short follow-up duration, incomplete adjustment for confounding variables, and reliance on cut-off thresholds derived from receiver operating characteristic analyses, which increases the risk of overfitting. Moreover, the reported predictive accuracy was moderate, yet the findings were presented as clinically decisive, warranting caution in interpretation. Future studies should aim for multicenter, prospective cohorts with larger sample sizes, longer follow-up periods, and the integration of established prognostic indices and molecular biomarkers. Incorporating rigorous statistical validation and exploring biomarker dynamics over time would strengthen external validity. Addressing these issues could advance the development of reliable, inflammation-based prognostic tools and support individualized treatment strategies for elderly colon cancer patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114796"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435919","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":"Post-chemotherapy C-reactive protein/albumin ratio predicts prognosis in stage II-III colorectal cancer.","authors":"Fei-Fei Kong, Xuan Geng, Ru-Ming Liu, Wen-Tao Zhang, Bin Quan, Yong Zhong, You-Long Zhu","doi":"10.4240/wjgs.v18.i2.112924","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.112924","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. The C-reactive protein/albumin ratio (CAR) has emerged as a potential prognostic marker in various cancers. Nonetheless, if the post-surgical drug therapy CAR is a beneficial predictive component in individuals with CRC remains unclear.</p><p><strong>Aim: </strong>To investigate the prognostic value of post-adjuvant chemotherapy CAR in comparison with preoperative CAR and other inflammatory markers in patients with stage II-III CRC.</p><p><strong>Methods: </strong>This retrospective study included 445 patients with CRC that experienced anti-cancer therapy subsequent to definitive excision. Pre-surgical and post-adjuvant therapeutic regimen CAR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated to assess the inflammatory state of the patients. First, patients were divided into two groups based on the CAR, NLR, PLR, and SII values. Furthermore, patients were partitioned into four clusters for every parameter based on the long-term variations in measures from before surgery to after chemotherapy: Low, normalized, high, and elevated groups. Multiple studies concerning overall survival (OS) were executed to compensate for well-documented clinicopathological factors. Kaplan-Meier method and Cox regression approaches were applied to evaluate distinct predictive factor.</p><p><strong>Results: </strong>Post-adjuvant chemotherapy CAR demonstrated the highest area under the curve value (0.8175) among all inflammatory markers for predicting OS. Post-adjuvant chemotherapy inflammatory markers (CAR, NLR, PLR, and SII) showed significantly higher area under the curve values than their preoperative counterparts. Longitudinal analysis revealed that a reduced inflammatory cohort exhibited markedly superior OS than an elevated inflammatory cohort regarding every indicator (all <i>P</i> < 0.0001). The normalized group (high preoperatively but low post-chemotherapy) exhibited notably inferior outlook than the consistently reduced population for CAR (<i>P</i> = 0.0002) and SII (<i>P</i> = 0.0002).</p><p><strong>Conclusion: </strong>These results indicate that post-adjuvant chemotherapy CAR is superior to preoperative measurements and other systemic inflammation-based prognostic scores in predicting outcomes for patients with stage II-III CRC. Longitudinal monitoring of inflammatory markers, particularly CAR, provides valuable prognostic information and may guide clinical decision-making in the post-treatment surveillance period.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"112924"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435981","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":"Psoas muscle variables and adjuvant chemotherapy-related and survival outcomes following pancreaticoduodenectomy for periampullary malignancy.","authors":"Shahin Hajibandeh, Shahab Hajibandeh, Hamish Mckittrick, Usman Imrani, Abin Varghese, Ravivarma Balasubramaniam, Damien Durkin, Tejinderjit S Athwal","doi":"10.4240/wjgs.v18.i2.114743","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114743","url":null,"abstract":"<p><strong>Background: </strong>Early skeletal muscle wasting has been demonstrated to be associated with chemotherapy-related toxicity in patients with cancer. Hounsfield unit average calculation (HUAC) or psoas muscle index (PMI) can be used to diagnose skeletal muscle wasting radiologically by calculations involving psoas muscle area.</p><p><strong>Aim: </strong>To evaluate ability of HUAC and PMI in predicting adjuvant chemotherapy (AC)-related and survival outcomes following pancreaticoduodenectomy for periampullary malignancy.</p><p><strong>Methods: </strong>A retrospective study of patients who underwent pancreaticoduodenectomy for periampullary malignancy was conducted. HUAC and PMI were determined from preoperative computed tomography scans. Time to AC, completion of AC, survival, failure to initiate AC, mortality during AC, AC-related toxicity, cancer progression during AC and non-chemotherapy-related complications were the outcome measures.</p><p><strong>Results: </strong>A total of 148 patients were included of whom 62.2% completed AC. The AC was terminated due to toxicity in 33.9%, cancer progression in 25.0%, non-chemotherapy-related complications in 16.1%, or poor performance status in 3.5% of the patients. The 1-,3-,5-years survival rates were 85.1%, 29.7% and 19.9%, respectively. The overall median survival was 22.6 (76.8) months. HUAC was an independent predictor of time to AC (<i>P</i> = 0.0005), AC-related toxicity (<i>P</i> = 0.0431), and completion of AC (<i>P</i> = 0.0486). However, HUAC did not predict 1-year (<i>P</i> = 0.8616), 3-years (<i>P</i> = 0.5941) or overall (<i>P</i> = 0.9206) survival. Being an octogenarian (<i>P</i> = 0.0009), Clavien-Dindo > III (<i>P</i> = 0.0184), and length of hospital stay (<i>P</i> = 0.0103) were independent predictors of failure to initiate AC. Moreover, being an octogenarian was an independent predictor of 3-years (<i>P</i> = 0.0201) and overall (<i>P</i> = 0.0433) survival. PMI did not predict any of the outcome measures.</p><p><strong>Conclusion: </strong>Unlike PMI, preoperative HUAC, determined from psoas muscle area and density, may predict time to AC, AC-related toxicity and completion of AC following pancreaticoduodenectomy for periampullary cancers. However, its ability to predict survival should be evaluated by future research.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114743"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436130","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":"Surgery-assisted transmesenteric transjugular intrahepatic portosystemic shunt for esophagogastric bleeding in patients with cavernous transformation of the portal vein.","authors":"Si-Ze Wu, Guang-Qing Liu","doi":"10.4240/wjgs.v18.i2.114633","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.114633","url":null,"abstract":"<p><p>This editorial provides commentary on the study by Wu <i>et al</i>, which investigates a novel intervention for a challenging clinical scenario: Transjugular intrahepatic portosystemic shunt (TIPS) placement with the assistance of surgery in patients with cavernous transformation of the portal vein. The authors compared surgically assisted TIPS (SATIPS) in 54 patients to endoscopic sclerotherapy in 53 patients. While 3-month survival rates were similar (94.4% <i>vs</i> 92.5%), a significant difference emerged at 6 months, with survival rates of 94.4% for SATIPS <i>vs</i> 73.6% for endoscope sclerotherapy. The SATIPS group also demonstrated significantly lower incidences of liver failure, esophagogastric bleeding, and hepatic encephalopathy at 6 months. However, the SATIPS procedure was not without risk, as four patients experienced major complications, including intraoperative hemorrhage. The study concludes that SATIPS is an effective alternative for cavernous transformation of the portal vein patients with esophagogastric bleeding, but its findings must be interpreted in light of its limitations. This research represents a significant contribution to the field.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"114633"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436257","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":"Beyond stapled transanal rectal resection <i>vs</i> ventral rectopexy dichotomy: Toward a phenotype-guided surgical paradigm for obstructed defecation syndrome.","authors":"Michele Schiano di Visconte, Sonia Sarnari","doi":"10.4240/wjgs.v18.i2.116100","DOIUrl":"https://doi.org/10.4240/wjgs.v18.i2.116100","url":null,"abstract":"<p><p>Obstructed defecation syndrome (ODS) is a heterogeneous pelvic floor disorder in which a persistent focus on \"stapled transanal rectal resection (STARR) <i>vs</i> ventral rectopexy (VR)\" has encouraged procedure-driven rather than phenotype-guided care. This opinion review synthesizes contemporary evidence on STARR and VR and proposes a phenotype-guided algorithm for surgical decision-making in ODS. We first summarize comparative outcome data, highlighting higher rates of late recurrence and urgency after STARR in contrast to more durable functional relief but greater invasiveness and mesh-related concerns after VR. We then outline a structured preoperative workup that integrates symptom scores, fluoroscopic or magnetic resonance defecography, and high-resolution anorectal manometry to discriminate between isolated structural disease, complex multilevel prolapse, functional defecatory disorders, mixed phenotypes, and ODS with impaired continence or excessive perineal descent. For each phenotype, we discuss the optimal role of STARR, VR, perineal resections, pelvic organ prolapse suspension, neuromodulation, and transverse perineal support within staged, multimodal pathways. Finally, we identified research priorities, including stratified randomized trials and phenotype-indexed multicenter registries, to validate this algorithm and refine the indications. Reframing ODS management around phenotyping, rather than procedural dichotomies, may improve patient selection, reduce functional failure, and align pelvic floor surgery with a broader movement toward precision medicine.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 2","pages":"116100"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435522","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}