World Journal of Gastrointestinal Surgery最新文献

{"title":"Application of enhanced recovery after surgery techniques in gastrointestinal surgery patients.","authors":"Xiao-Jun Fu, Jia-Xin Ren, Ling-Ling Yuan, Ying Hong","doi":"10.4240/wjgs.v17.i9.107605","DOIUrl":"10.4240/wjgs.v17.i9.107605","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal surgery has disadvantages such as long operation time, extended hospitalization time, and slow postoperative recovery. However, the promotion and clinical application of the enhanced recovery after surgery (ERAS) concept have considerably shortened the hospitalization time of gastrointestinal surgery patients and reduced reactions to surgical stress and the risk of medical complications and readmission. ERAS breaks the conventional operating mode in the field of surgery but introduces great challenges in practice.</p><p><strong>Aim: </strong>To explore the application of ERAS in perioperative patients within the field of gastrointestinal surgery, with a particular focus on investigating the awareness of ERAS among healthcare professionals and the barriers to its implementation.</p><p><strong>Methods: </strong>A retrospective study of medical records of perioperative patients in the gastrointestinal surgery ward of Ningbo No. 2 Hospital from March 2020 to March 2022 was conducted. According to the different nursing modes adopted by patients during the perioperative period, patients were divided into the ERAS group and the control group. The postoperative outcomes of these groups such as the time to first ambulation, the time to first intake of food, and nursing satisfaction were compared. A self-developed questionnaire was used to assess the awareness of ERAS among healthcare professionals, along with a survey identifying barriers to its implementation.</p><p><strong>Results: </strong>Compared with the control group, the ERAS group demonstrated superior scores across various metrics, with the exception of the readmission rate due to complications within 1 month post-discharge (<i>P</i> < 0.05). Statistically significant differences were observed between the two groups in terms of educational background, years of service, and prior training in ERAS (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>ERAS significantly reduces the time to first ambulation and first food intake for patients undergoing gastrointestinal surgery. Furthermore, the awareness of ERAS among healthcare professionals correlates with their educational background, years of experience, and prior training. ERAS plays a crucial role in expediting patient recovery, improving nursing satisfaction, and optimizing healthcare resources.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107605"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193068","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 application value of narrative nursing model in patients undergoing laparoscopic radical gastrectomy for gastric cancer.","authors":"Li-Na Shi, Liang Wang, Yu-Bo Gao, Dong-Hua Ma, Yu-Ling Mao, Ya-Qin Wang, Yue Wang, Qi-Xian Guo, Rui-Min He, Jia-Ming Chen","doi":"10.4240/wjgs.v17.i9.106514","DOIUrl":"10.4240/wjgs.v17.i9.106514","url":null,"abstract":"<p><strong>Background: </strong>Narrative nursing uses narrative methods to establish an interaction between nursing staff and patients, in which the experience of the patient's illness is understood and comprehended. By listening, the patient's understanding, comprehension, and acceptance of their own disease symptoms, quality of life, and living conditions are understood, thereby providing a basis for formulating corresponding nursing plans for the patient, further promoting the psychological and physical rehabilitation of the patient.</p><p><strong>Aim: </strong>To explore the impact of the new narrative nursing model on postoperative recovery, psychological status, and satisfaction of patients.</p><p><strong>Methods: </strong>A total of 108 patients with resectable gastric cancer who were treated from January 2024 to December 2024 were selected as the study subjects. They were divided into a routine nursing group and a narrative nursing group using a random number table method. Postoperative recovery indicators were compared between the two groups, and questionnaires and position and postoperative nausea and vomiting were conducted on the day of discharge.</p><p><strong>Results: </strong>There were statistically significant differences in visual analogue scale pain scores at 12-96 hours postoperatively, the time of first ambulation postoperatively, and the length of postoperative hospital stay between the two groups (<i>P</i> < 0.05). There were statistically significant differences in postoperative self-rating anxiety scale, self-rating depression scale, and satisfaction scores between the two groups (<i>P</i> < 0.05). Further analysis using a binary logistic regression model found that the new narrative nursing model adopted postoperatively could improve patients' satisfaction with the work of nursing staff during their hospitalization.</p><p><strong>Conclusion: </strong>The new narrative nursing model not only eliminated the negative emotions of patients, but also further promoted their postoperative recovery, and gained patients' trust and satisfaction with the nursing staff.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"106514"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193108","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":"Gallstone and bile microbiota: A case-control study based on 16S rRNA gene sequencing.","authors":"Zhong-Xiao Lu, Yan-Qi Jiang, Dang-Shou Wang, Yu-Ting Song, Xiao-Ming Jiang, Fu-Jian Xu, Jie Tang, Bing Li, Wen-Hai Huang","doi":"10.4240/wjgs.v17.i9.109521","DOIUrl":"10.4240/wjgs.v17.i9.109521","url":null,"abstract":"<p><strong>Background: </strong>Gallstone (GS), a prevalent biliary disorder, is associated with bile stasis, infection, and cholesterol metabolism. Recent research highlights the potential role of bile microbiota in GS pathogenesis. This is a case control study conducted at Jinshan Hospital between 2022 and 2023.</p><p><strong>Aim: </strong>To investigate the relationship between bile microbiota dysbiosis and GS formation, and analyze bile microbiota composition in GS patients.</p><p><strong>Methods: </strong>This is a retrospective analysis conducted at Jinshan Hospital between 2022 and 2023. A total of 40 patients were analyzed, including 25 with GS and 15 with GS-free (GSF). Bile samples from 27 patients were analyzed using 16S rRNA gene sequencing to assess microbial composition.</p><p><strong>Results: </strong>Significant differences were found in bile acid profiles between GS and GSF groups, with lower microbial diversity in GS patients, indicated by reduced Shannon, Chao, Ace, and Sobs indices, and a higher Simpson index. At the phylum level, the most abundant taxa in GS patients were <i>Proteobacteria</i> (91.59%), <i>Firmicutes</i> (2.90%), and <i>Actinobacteria</i> (1.70%), while <i>Proteobacteria</i> (79.81%), <i>Firmicutes</i> (9.67%), and <i>Bacteroidota</i> (3.80%) were predominated in the GSF group. Notably, <i>Achromobacter</i> was more abundant in GS patients, while <i>Acinetobacter</i>, <i>Lactobacillus</i>, and <i>Prevotella</i> were enriched in the GSF group, suggesting their potential protective role against GS formation.</p><p><strong>Conclusion: </strong>Dysbiosis, particularly overgrowth of <i>Proteobacteria</i>, may contribute to gallstone formation, while <i>Lactobacillus</i> could play a protective role. Further research is needed to validate these findings.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109521"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193338","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":"Prediction of parastomal hernia in patients undergoing preventive ostomy after rectal cancer resection using machine learning.","authors":"Wang-Shuo Yang, Yang Su, Yan-Qi Li, Jun-Bo Hu, Meng-Die Liu, Lu Liu","doi":"10.4240/wjgs.v17.i9.107977","DOIUrl":"10.4240/wjgs.v17.i9.107977","url":null,"abstract":"<p><strong>Background: </strong>Parastomal hernia (PSH) is a common and challenging complication following preventive ostomy in rectal cancer patients, lacking accurate tools for early risk prediction.</p><p><strong>Aim: </strong>To explore the application of machine learning algorithms in predicting the occurrence of PSH in patients undergoing preventive ostomy after rectal cancer resection, providing valuable support for clinical decision-making.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 579 patients who underwent rectal cancer resection with preventive ostomy at Tongji Hospital, Huazhong University of Science and Technology, between January 2015 and June 2023. Various machine learning models were constructed and trained using preoperative and intraoperative clinical variables to assess their predictive performance for PSH risk. SHapley Additive exPlanations (SHAP) were used to analyze the importance of features in the models.</p><p><strong>Results: </strong>A total of 579 patients were included, with 31 (5.3%) developing PSH. Among the machine learning models, the random forest (RF) model showed the best performance. In the test set, the RF model achieved an area under the curve of 0.900, sensitivity of 0.900, and specificity of 0.725. SHAP analysis revealed that tumor distance from the anal verge, body mass index, and preoperative hypertension were the key factors influencing the occurrence of PSH.</p><p><strong>Conclusion: </strong>Machine learning, particularly the RF model, demonstrates high accuracy and reliability in predicting PSH after preventive ostomy in rectal cancer patients. This technology supports personalized risk assessment and postoperative management, showing significant potential for clinical application. An online predictive platform based on the RF model (https://yangsu2023.shinyapps.io/parastomal_hernia/) has been developed to assist in early screening and intervention for high-risk patients, further enhancing postoperative management and improving patients' quality of life.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107977"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193200","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":"Prognostic significance of advanced lung cancer inflammation index in resectable pancreatic cancer: A retrospective study.","authors":"Ze-Lin Wen, Hu Ren, He Fei, Peng-Hui Niu, Ze-Feng Li, Ying-Tai Chen, Chun-Guang Guo, Dong-Bing Zhao","doi":"10.4240/wjgs.v17.i9.108551","DOIUrl":"10.4240/wjgs.v17.i9.108551","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer (PC), ranking among the most aggressive solid malignancies, currently lacks validated prognostic biomarkers to guide survival stratification. With a 5-year survival rate under 10%, this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.</p><p><strong>Aim: </strong>To analyze whether the advanced lung cancer inflammation index (ALI) is a prognostic indicator for PC.</p><p><strong>Methods: </strong>Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China. The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile. Overall survival (OS) and surgical outcomes were calculated between the two groups. Follow-up was conducted through telephone interview. Kaplan-Meier analysis was performed to estimate OS, while the log-rank test was utilized to compare OS among different tumor stages. Cox regression was used to identify independent risk factors for OS.</p><p><strong>Results: </strong>This study included 611 patients who underwent radical PC surgery. Using an ALI cutoff of 34.0, the patients were categorized into a high ALI group (<i>n</i> = 378) and a low ALI group (<i>n</i> = 233). The low ALI group had significantly lower body mass index, serum albumin, lymphocyte count, and ALI (<i>P</i> < 0.01), but higher neutrophil count, a higher proportion of head and neck PC, and longer operation time (<i>P</i> < 0.01). As for prognosis, the low ALI group had worse OS in stage I patients (<i>P</i> < 0.01), and low ALI (<i>P</i> = 0.018, hazard ratio = 0.784, 95% confidence interval: 0.641-0.960) independently conferred an increased risk for mortality.</p><p><strong>Conclusion: </strong>Lower ALI is associated with worse OS for PC patients who underwent radical surgery. Patients demonstrating low ALI preoperatively require special attention from surgeons.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"108551"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193266","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 warm acupuncture and acupoint massage on postoperative gastrointestinal function in gastric cancer surgery patients: A meta-analysis.","authors":"Hai-Chun Ji, Ling-Juan Nie, Jia-Xi Wu, Xiao Liu, Xiao Zheng","doi":"10.4240/wjgs.v17.i9.106654","DOIUrl":"10.4240/wjgs.v17.i9.106654","url":null,"abstract":"<p><strong>Background: </strong>This study seeks to systematically assess the effects of warm acupuncture combined with acupoint massage on the recovery of gastrointestinal function following gastric cancer surgery.</p><p><strong>Aim: </strong>To evaluate the impact of warm acupuncture combined with acupoint massage on postoperative gastrointestinal function recovery after gastric cancer surgery, based on a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang, and VIP, for relevant studies published up to January 2025. Meta-analyses were carried out using RevMan 5.4, with results presented as standardized mean difference (SMD) or odds ratio with 95% confidence interval (CI). Study heterogeneity was evaluated using the <i>I</i> ² statistic, and sensitivity analyses were performed to assess the stability of the findings.</p><p><strong>Results: </strong>A total of 8 randomized controlled trials involving 694 patients were included. The meta-analysis showed that warm acupuncture combined with acupoint massage significantly improved postoperative gastrointestinal function by reducing the time to first flatus (SMD = -2.14, 95%CI: -3.14 to -1.14, <i>P</i> < 0.0001), time to first bowel movement (SMD = -2.43, 95%CI: -3.52 to -1.34, <i>P</i> < 0.0001), time to bowel sounds recovery (SMD = -3.15, 95%CI: -4.50 to -1.80, <i>P</i> < 0.00001), and time to initiate nasogastric or jejunal feeding (SMD = -1.31, 95%CI: -2.44 to -0.18, <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>The combination of warm acupuncture and acupoint massage markedly enhances gastrointestinal recovery following surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"106654"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193278","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":"Treatment of human umbilical cord-derived mesenchymal stem cells for hepatitis B virus-associated decompensated liver cirrhosis: A clinical trial.","authors":"Xian Qin, Jing Chen, Hua-Ni Zhang, Li Du, Yan Ma, Yi Li, Yu Lu, Ya-Ting Wang, Liu-Fang Wu, Zi-Hui Yu, Meng-Jing Hu, Li-Jun Li, Bo Liao, Zhen Li, Zhi-Yong Yang, Kun Li, Yu-Feng Yuan","doi":"10.4240/wjgs.v17.i9.109980","DOIUrl":"10.4240/wjgs.v17.i9.109980","url":null,"abstract":"<p><strong>Background: </strong>Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus (HBV). Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) can possibly cure decompensated liver cirrhosis because of their self-renewal and multidirectional differentiation potential.</p><p><strong>Aim: </strong>To explore the safety and effect of treating liver cirrhosis with HBV by hUC-MSCs.</p><p><strong>Methods: </strong>Twenty-four participants were recruited, divided into 3 groups, and injected with different amounts of hUC-MSCs <i>via</i> the peripheral vein. Therapy was administered 3 times. A 24-week follow-up examination of each patient's liver function, coagulation function, general condition, and immune system was performed. Adverse events were also recorded. A 2-year survival assessment was subsequently performed.</p><p><strong>Results: </strong>Infusion therapy rapidly improved liver function. Serum albumin transiently increased on days 57 and 85 but returned to baseline by day 169, while prothrombin time activity demonstrated sustained improvement from day 29 through day 169. Interleukin-8 levels decreased persistently throughout treatment. All dosage groups achieved 100% 6-month survival; 2-year survival rates were 66.7% (low-dose), 100% (medium-dose), and 87.5% (high-dose). The interaction between dosage and efficacy was weak. Notably, the improvement in liver function was statistically significant and sustained for almost 3 months, suggesting clinically meaningful therapeutic durability.</p><p><strong>Conclusion: </strong>hUC-MSCs can be considered a safe treatment for patients with decompensated liver cirrhosis associated with HBV. However, larger-scale randomized controlled trials are needed to prove its therapeutic effect.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109980"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193305","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":"Risk factors for inadequate bowel preparation before colonoscopy: A retrospective cohort study.","authors":"Tong Jin, Hao-Xuan Cheng, Jian-Yu Hao, Chao Li","doi":"10.4240/wjgs.v17.i9.109540","DOIUrl":"10.4240/wjgs.v17.i9.109540","url":null,"abstract":"<p><strong>Background: </strong>Bowel preparation is a critical step in colonoscopy and endoscopic surgery. Adequate and effective bowel cleansing significantly improves lesion detection rates while reducing operative risks and complications.</p><p><strong>Aim: </strong>To investigate the current state of inadequate bowel preparation in patients undergoing colonoscopy, identify the contributing factors, and develop interventions.</p><p><strong>Methods: </strong>This study was designed as a retrospective cohort study. A convenience sampling method was used to select 484 patients who underwent colonoscopy at Beijing Chao-Yang Hospital, Capital Medical University, from October 2023 to October 2024. General patient data, disease-related variables, and the Boston bowel preparation scale were collected. Logistic regression analysis was conducted to identify the factors associated with inadequate bowel preparation.</p><p><strong>Results: </strong>Among the 484 patients, the rate of inadequate bowel preparation was 25.8% (125/484). Influential factors for poor bowel preparation included history of colorectal surgery [odds ratio (OR) = 5.814], low-residue diet 1 day prior (OR = 0.145), time interval from last dose to start of examination (OR = 1.447), total exercise time after medication (OR = 0.992), and total number of bowel movements after medication (OR = 0.900) (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study highlights several modifiable and non-modifiable factors influencing bowel preparation, such as surgical history and behavioral adherence. The findings support implementing dietary adjustments, optimized laxative timing, physical activity guidance, and tailored strategies for high-risk patients to improve bowel cleansing and enhance the diagnostic accuracy of colonoscopy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"109540"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193181","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":"Safety and efficacy of three-dimensional reconstruction technology-assisted percutaneous transhepatic biliary drainage: A meta-analysis.","authors":"Ze-Hui Chen, Li-Juan Zhang, Zhi-Xin Lin, Shu-Xiang Lin, Zheng-Fu Song, Ze-Jian Wu, Wei Lin","doi":"10.4240/wjgs.v17.i9.105134","DOIUrl":"10.4240/wjgs.v17.i9.105134","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous transhepatic biliary drainage (PTBD) is one of the primary clinical treatment options for patients with obstructive jaundice. In recent years, PTBD assisted by three-dimensional (3D) reconstruction technology has been widely implemented, but its advantages over traditional methods remains inconclusive. Thus, a discussion is warranted.</p><p><strong>Aim: </strong>To explore the safety and efficacy of 3D reconstruction technology-assisted PTBD.</p><p><strong>Methods: </strong>We systematically searched the databases including the Cochrane Library, PubMed, EMBASE, Web of Science and China National Knowledge Infrastructure. The search period extended from the establishment of each database to November, 2024. We screened the literature according to predefined inclusion and exclusion criteria, assessed the quality of the studies, and extracted data. Meta-analysis was performed using Revman 5.4.1 software.</p><p><strong>Results: </strong>A total of 15 studies were included, involving 1434 patients. The results of the meta-analysis showed that compared with the traditional group, the overall post-operative complications rate in the 3D reconstruction technology group was significantly lower [odds ratio = 0.25; 95% confidence interval (CI): 0.17-0.36, <i>P</i> < 0.00001]. The overall puncture success rate in the 3D reconstruction group was better than those in the traditional group (odds ratio = 3.61; 95%CI: 1.98-6.55, <i>P</i> < 0.0001). However, there was no significant difference between the two groups in the reduction levels of postoperative total bilirubin (mean difference = -1.38; 95%CI: -3.29 to 0.53, <i>P</i> = 0.16). Subgroup analysis were conducted on the surgery time according to guidance stages of the 3D reconstruction, 3D reconstruction imaging modalities, and types of studies. The results were stable, with no significant changes observed.</p><p><strong>Conclusion: </strong>3D reconstruction technology significantly improves the puncture success rate and safety of PTBD. However, it has no significant advantage in bile drainage effectiveness. Continued research is warranted to further explore its clinical value and optimize its application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"105134"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193343","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":"Diagnostic significance of fluorine-18-fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating Edmondson grade II and III hepatocellular carcinoma.","authors":"Xiao-Bo Niu, Yan-Peng Li, Fang-Fang Chao, Xiao-Li Mei, Xing-Min Han, Rui-Hua Wang","doi":"10.4240/wjgs.v17.i9.107301","DOIUrl":"10.4240/wjgs.v17.i9.107301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Preoperative prognosis assessment of hepatocellular carcinoma (HCC) is crucial, and pathologic grading is a key prognostic determinant that affects patient prognosis. Therefore, accurate determination of pathological grading before surgical intervention is crucial for optimizing treatment strategies and improving prognostic outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the distinguishing capability of fluorine-18-fluorodeoxyglucose-positron emission tomography/computed tomography (&lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT)-derived metabolic parameters between Edmondson grade II and III HCC and to assess their correlation with Ki67 expression levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively assessed the &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT imaging datasets from 32 patients with solitary HCC, all of whom had pathological confirmation of their diagnosis. Patients were categorized into Edmondson grade II and III groups according to pathological grading criteria. Comparative analyses were conducted on metabolic parameters, including maximum standardized uptake value (SUV&lt;sub&gt;max&lt;/sub&gt;), mean standardized uptake value (SUV&lt;sub&gt;mean&lt;/sub&gt;), metabolic tumor volume (MTV), total lesion glycolysis (TLG), tumor-to-normal background ratio (TNR), and tumor-to-blood pool ratio (TBR), between the groups. Further, correlations between these parameters and Ki67 expression were investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant differences were observed in SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt;, TLG, TNR, and TBR between Edmondson grade II and III HCC groups (&lt;i&gt;P &lt;&lt;/i&gt; 0.05), whereas MTV was not significantly different (&lt;i&gt;P =&lt;/i&gt; 0.052). The maximum tumor diameter and Ki67 expression percentage significantly varied between the two groups (&lt;i&gt;P &lt;&lt;/i&gt; 0.05). SUV&lt;sub&gt;max&lt;/sub&gt; yielded the largest area under the receiver operating characteristic curve, measuring 0.853 (95% confidence interval: 0.709-0.997, &lt;i&gt;P&lt;/i&gt; = 0.001). Using an optimal SUV&lt;sub&gt;max&lt;/sub&gt; cut-off of 10.95, the sensitivity and specificity for identifying Edmondson grade III HCC were 66.7% and 100%, respectively. Notably, significant positive correlations were identified in terms of SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt;, TNR, TBR, and the percentage of Ki67 expression (&lt;i&gt;P &lt;&lt;/i&gt; 0.01). Conversely, MTV, TLG, and maximum tumor diameter exhibited no significant association with Ki67 expression (&lt;i&gt;P&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;&lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT-derived metabolic parameters, particularly SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt;, TNR, TBR, and TLG, are valuable in differentiating Edmondson grade II and III HCC, with SUV&lt;sub&gt;max&lt;/sub&gt; showing the optimal differential diagnostic efficacy. TLG is a three-dimensional volumetric parameter that holds some differential diagnostic potential, but it fails to display a distinct advantage. Moreover, increased &lt;sup&gt;18&lt;/sup&gt;F-FDG uptake and Ki67 expression in tumor tissue correlate with poorer HCC prognoses, emph","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 9","pages":"107301"},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193142","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}