World Journal of Gastrointestinal Surgery最新文献

{"title":"Magnetic-assisted detection and extraction of dispersed metallic foreign bodies in the abdominal cavity: A case report.","authors":"Shi-Qi Liu, Yu-Feng Li, Dong-Wen Quan, Wei Liu","doi":"10.4240/wjgs.v17.i5.101414","DOIUrl":"10.4240/wjgs.v17.i5.101414","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal foreign bodies represent a significant clinical challenge in emergency and surgical settings. While accidental ingestion predominates in healthy adults, intentional ingestion is frequently observed in pediatric, psychiatric, and incarcerated populations. Metallic sewing needles, characterized by their sharp morphology and high mobility, pose particular risks of visceral injury and complications due to their penetrative potential. Although preoperative imaging facilitates initial localization, subsequent migration of multiple needles complicates therapeutic interventions, increasing procedural complexity and patient risk.</p><p><strong>Case summary: </strong>We present a novel application of magnetic-assisted localization in managing a complex case of intentional ingestion of 30 metallic sewing needles in a psychiatric patient. The widespread distribution of needles throughout the gastrointestinal tract necessitated an innovative surgical approach. Intraoperative implementation of cylindrical magnetic localization technology enabled precise identification and successful extraction of all foreign bodies while minimizing tissue trauma.</p><p><strong>Conclusion: </strong>Magnetic-assisted localization represents an effective and safe technique to manage multiple magnetic gastrointestinal foreign bodies. This approach offers significant advantages in complex cases, particularly for needle-like metallic objects, and warrants consideration as a valuable tool in gastrointestinal surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"101414"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting risk of post-hepatectomy liver failure in patients undergoing liver resection with controlled low central venous pressure.","authors":"Liang Tang, Ling-Xi Chen, Chu-Chu Luo, Yuan Zhao","doi":"10.4240/wjgs.v17.i5.102335","DOIUrl":"10.4240/wjgs.v17.i5.102335","url":null,"abstract":"<p><strong>Background: </strong>Post-hepatectomy liver failure (PHLF), represents a serious complication after liver resection, significantly impacting the long-term outcomes for patients who undergo such surgeries. There exists a strong correlation between intraoperative hemorrhage and transfusion requirements with the development of PHLF. Presently, a combination of hepatic portal occlusion techniques alongside controlled low central venous pressure (CLCVP) methodologies is extensively employed to mitigate intraoperative bleeding. Nonetheless, limited studies have analyzed the risk factors for PHLF under CLCVP.</p><p><strong>Aim: </strong>To develop and validate a nomogram that predicts the risk factors associated with the development of PHLF patients undergoing liver resection with CLCVP.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 285 patients who underwent hepatectomy for the first time and had no history of prior non-index abdominal surgeries, with hepatic inflow occlusion combined with CLCVP from January to December 2019 in Hunan Provincial People's Hospital. Univariate and multivariate regression analyses were used to identify preoperative and intraoperative risk factors for PHLF. Eligible patients were randomly divided into training and validation groups in a 7:3 ratio, and a nomogram prediction model was constructed.</p><p><strong>Results: </strong>The incidence of PHLF in these patients was 22.46%. Multiple logistic analysis showed that preoperative serum albumin level, causes of liver resection (cancer or others), and cirrhosis were independent preoperative risk factors for PHLF (<i>P</i> < 0.05) and that only post-blocking blood potassium concentration was an independent intraoperative risk factor for PHLF (<i>P</i> < 0.05). Least absolute shrinkage and selection operator regression analysis revealed that preoperative serum albumin level, direct bilirubin level (DBIL), platelet count, causes of liver resection (cancer or others), and cirrhosis were significant predictors of PHLF. The nomogram risk prediction model based on preoperative serum albumin level, DBIL, platelet count, causes of liver resection (cancer or others), cirrhosis and post-blocking blood potassium concentration can better predict the occurrence of PHLF.</p><p><strong>Conclusion: </strong>For patients undergoing liver resection with CLCVP, serum albumin level, DBIL, platelet count, causes of liver resection (cancer or others), and cirrhosis are independent preoperative risk factors for PHLF.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"102335"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276096","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":"Proximal gastrectomy with tubular stomach reconstruction <i>vs</i> total gastrectomy for proximal gastric cancer following neoadjuvant chemotherapy: A multicenter retrospective study.","authors":"Yi-Ming Lu, Peng Jin, Hai-Kuo Wang, Xin-Xin Shao, Hai-Tao Hu, Yu-Juan Jiang, Wang-Yao Li, Yan-Tao Tian","doi":"10.4240/wjgs.v17.i5.107579","DOIUrl":"10.4240/wjgs.v17.i5.107579","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastric cancer (GC) is a major global health challenge, and the treatment of proximal GC in particular presents unique clinical and surgical complexities. Currently, there is no consensus on whether proximal gastrectomy (PG) or total gastrectomy (TG) should be used for advanced proximal GC, and the choice of postoperative gastrointestinal reconstruction method remains controversial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To compare the short-term efficacy, long-term survival, and postoperative reflux outcomes of PG with tubular stomach reconstruction &lt;i&gt;vs&lt;/i&gt; TG with Roux-en-Y reconstruction in patients with proximal GC following neoadjuvant chemotherapy (NACT) in an effort to provide valuable insights for clinical decision-making regarding the optimal surgical approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multicenter retrospective cohort study was conducted at two Chinese medical centers between December, 2012 and December, 2022. Patients with histologically confirmed proximal GC who received NACT followed by either PG with tubular stomach reconstruction or TG with Roux-en-Y reconstruction were included. Propensity score matching (PSM) was performed to balance baseline characteristics, and the primary endpoint was 5-year overall survival (OS). Secondary endpoints included recurrence-free survival (RFS), postoperative complications, and reflux severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After PSM, 244 patients (122 PG, 122 TG) were finally included and all baseline characteristics were comparable between groups. The PG group had a significantly shorter operation time compared to the TG group (189.50 &lt;i&gt;vs&lt;/i&gt; 215.00 minutes, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), with no differences in intraoperative blood loss or postoperative complications (19.68% &lt;i&gt;vs&lt;/i&gt; 14.75%, &lt;i&gt;P&lt;/i&gt; = 0.792). The 5-year OS rates were 52.7% &lt;i&gt;vs&lt;/i&gt; 45.5% (&lt;i&gt;P&lt;/i&gt; = 0.330), and 5-year RFS rates were 54.3% &lt;i&gt;vs&lt;/i&gt; 47.6% (&lt;i&gt;P&lt;/i&gt; = 0.356) for the PG and TG groups, respectively. Reflux symptoms (18.0% &lt;i&gt;vs&lt;/i&gt; 31.1%, &lt;i&gt;P&lt;/i&gt; = 0.017) and clinically significant reflux based on gastroesophageal reflux disease questionnaire scores ≥ 8 (7.4% &lt;i&gt;vs&lt;/i&gt; 21.3%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) were significantly less frequent in the PG group. Multivariate analysis identified histological differentiation (HR = 2.98, 95%CI: 2.03-4.36, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and tumor size (HR = 0.26, 95%CI: 0.17-0.41 for tumors ≤ 4 cm, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) as independent prognostic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PG with tubular stomach reconstruction is comparable to TG in terms of surgical safety and long-term oncological outcomes for proximal GC patients following NACT. Additionally, PG has the advantages of shorter operation time and lower rates of postoperative reflux, suggesting potential benefits for patient quality of life. Notably, the analysis of postoperative prognostic factors, including histological differentiation and tumor size, further informs clinical decision-making and highlights the im","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"107579"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276097","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":"Concomitant resection of Meckel diverticulum during laparoscopic appendectomy: Retrospective propensity-matched ACS-NSQIP study and a case report.","authors":"Sean Huu-Tien Nguyen, Matthew Wheelwright, Victor Vakayil, Pravin Meshram, Ryan O'Donnell, James Vail Harmon","doi":"10.4240/wjgs.v17.i5.103078","DOIUrl":"10.4240/wjgs.v17.i5.103078","url":null,"abstract":"<p><strong>Background: </strong>The surgical management of incidentally detected Meckel diverticulum (MD) during appendectomy remains controversial. We present a case report alongside an analysis of the ACS-NSQIP database to evaluate postoperative outcomes associated with concomitant Meckel diverticulectomy during laparoscopic appendectomy.</p><p><strong>Case summary: </strong>We report the case of a 34 year-old woman presenting with acute appendicitis and an incidentally detected MD. The patient presented to the emergency department with right lower quadrant pain. Computed tomography revealed acute appendicitis with possible contained perforation. During laparoscopic operative management of her appendicitis, an incidental MD was noted and resected <i>via</i> a stapled diverticulectomy. She was discharged on the same day as her surgery without complication. Postoperative pathology examination revealed an MD without acute pathology. To review outcomes associated with performing incidental Meckel diverticulectomy during laparoscopic appendectomy, an additional 12-year retrospective ACS-NSQIP analysis was performed. To compare between laparoscopic appendectomy alone and Meckel diverticulectomy with appendectomy (MA), propensity matching was employed. MA was associated with a significantly increased operative time and longer hospital stays. However, no significant differences in 30-day mortality or postoperative outcomes were observed between the groups.</p><p><strong>Conclusion: </strong>Resection of incidental MD can be performed during laparoscopic appendectomy without significant morbidity or mortality.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103078"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275947","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":"Effectiveness of early enteral nutrition support in patients undergoing gastrointestinal perforation repair surgery within the enhanced recovery.","authors":"Miao-Miao Hu, Ya-Li Ding, Juan Li","doi":"10.4240/wjgs.v17.i5.106384","DOIUrl":"10.4240/wjgs.v17.i5.106384","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) perforation (GP) repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage. After surgery, patients often experience a high metabolic state due to trauma, infection, and postoperative stress. In the Enhanced Recovery After Surgery (ERAS) protocol, early enteral nutrition is a key strategy for promoting postoperative recovery. Compared with parenteral nutrition, enteral nutrition more effectively meets the physiological needs of the GI system, promotes the recovery of gut function, and reduces the risk of GI infections.</p><p><strong>Aim: </strong>To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.</p><p><strong>Methods: </strong>This retrospective study analyzed 66 patients who underwent GP repair. Patients were divided into a control group (<i>n</i> = 32), managed with a traditional nutritional regimen, primarily consisting of total parenteral nutrition; and an observation group (<i>n</i> = 34), which included those who received early enteral nutrition support as part of the ERAS protocol. This study examined the time to first postoperative flatus and bowel movement, changes in nutritional and immune function, inflammatory markers on postoperative days 1 and 5, and adverse reactions.</p><p><strong>Results: </strong>The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group (<i>P</i> < 0.05). On postoperative day 5, the observation group demonstrated higher nutritional and immune function levels than the control group (<i>P</i> < 0.05), while C-reactive protein levels were significantly lower (<i>P</i> < 0.05). The overall incidence of adverse reactions in the observation group was 8.82% (3/34), which was lower than the 28.13% (9/32) observed in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Early enteral nutritional support facilitates GI recovery after GP repair. It improves nutritional status, enhances immune function, and attenuates inflammatory responses while also demonstrating a favorable safety profile.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"106384"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276060","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 laparoscopic radical resection of colorectal cancer in older patients and its effects on inflammatory factors.","authors":"Zhen-Yu Min, Jie Zhou, Zhong-Wei Zhu, Zhen-Zhong Fa","doi":"10.4240/wjgs.v17.i5.103065","DOIUrl":"10.4240/wjgs.v17.i5.103065","url":null,"abstract":"<p><strong>Background: </strong>Currently, open surgery for colorectal cancer (CRC) exhibits certain therapeutic efficacy; however, it may also hinder postoperative recovery in patients. Therefore, more advanced surgical methods are required to ensure smoother postoperative recovery.</p><p><strong>Aim: </strong>To analyze the efficacy of laparoscopic radical resection of CRC (LRRCC) in treating older patients with CRC and the effect of this procedure on inflammatory factors.</p><p><strong>Methods: </strong>The study included 104 older patients with CRC admitted from August 2022 to August 2024. Participants undergoing open radical resection of CRC were categorized as the control group (50 patients), whereas those receiving LRRCC were classified as the research group (54 patients). Subsequently, comparative analyses involved data on efficacy, postoperative complications (ileus, incision infection, anastomotic fistula, and pulmonary infection), surgery-related parameters (operation duration and intraoperative bleeding volume), postoperative recovery-related indicators (time to first postoperative passage of flatus and defecation and length of hospital stay), and inflammatory factors (tumor necrosis factor-α, high-sensitivity C-reactive protein, and interleukin-6).</p><p><strong>Results: </strong>Data revealed markedly superior therapeutic efficacy and a lower overall postoperative complication rate in the research group compared to the control group. The research group demonstrated substantially less intraoperative bleeding, less time to first postoperative passage of flatus and defecation, and a shorter length of hospital stay despite a notably longer operation duration compared to the control group. Further, tumor necrosis factor-α, high-sensitivity C-reactive protein, and interleukin-6 levels in the research group were significantly reduced 3 days postoperatively compared to both the preoperative and control group values.</p><p><strong>Conclusion: </strong>LRRCC for older patients with CRC exhibited superior therapeutic efficacy compared to open radical resection and significantly suppressed postoperative stress-related inflammatory responses, which merits clinical application and promotion.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103065"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276061","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 reinforcing sutures in preventing anastomotic leakage after surgery for rectal cancer: A systematic review and metaanalysis.","authors":"Zi-Xuan Zhuang, Yang Zhang, Xu-Yang Yang, Zi-Qiang Wang, Xiang-Bing Deng, Ming-Ming Zhang","doi":"10.4240/wjgs.v17.i5.103758","DOIUrl":"10.4240/wjgs.v17.i5.103758","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) is a challenging complication following rectal cancer surgery, often leading to increased morbidity and healthcare costs. The use of reinforcement sutures is expected to reduce the rate of AL, their preventive effects are controversial.</p><p><strong>Aim: </strong>To determine the efficacy of reinforcing sutures in preventing AL in rectal cancer.</p><p><strong>Methods: </strong>A systematic search of major medical databases was conducted to identify studies up to June 2024. Intraoperative and postoperative outcomes were assessed; the primary outcome assessed was the incidence of AL. Pooled odds ratios (ORs) and mean differences (MDs) with a 95% confidence interval (CI) were calculated using fixed-effect or random-effect models under heterogeneity.</p><p><strong>Results: </strong>This meta-analysis incorporated 20 studies involving 3726 patients. Pooled results demonstrated a statistically significant reduction AL incidence in the reinforced suture group (OR: 0.26, 95%CI: 0.19-0.35, <i>P</i> < 0.001) than the unreinforced suture group. The reinforced suture group also exhibited a shorter hospital stay (MD: -1.17, 95%CI: -1.78 to -0.57, <i>P</i> < 0.001), earlier anal exhaust (MD: -0.13, 95%CI: -0.22 to -0.05, <i>P</i> = 0.002), longer operative time (MD: 15.25, 95%CI: 10.71-19.80, <i>P</i> < 0.001), lower infection rate (OR: 0.54, 95%CI: 0.29-1.00, <i>P</i> = 0.05) and lower reoperation rate (OR: 0.19, 95%CI: 0.08-0.45, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The results substantiate the clinical value of anastomotic reinforcement sutures in reducing AL incidence post-rectal cancer surgery. Nevertheless, these conclusions warrant verification through additional high-quality randomized controlled trials.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103758"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276062","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":"Enhanced recovery after surgery continuity nursing in elderly gastric cancer patients.","authors":"Cai-Ping Lu, Ying Gao, Zhi-Hong Zhang","doi":"10.4240/wjgs.v17.i5.103340","DOIUrl":"10.4240/wjgs.v17.i5.103340","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastric cancer predominantly affects the elderly, who face significant challenges due to high postoperative complications and stress. These challenges include comorbidities, reduced physiological reserves, and increased risks of infections and delayed healing. Traditional postoperative care often falls short in addressing these issues effectively. Enhanced recovery after surgery (ERAS) principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach. ERAS emphasizes preoperative optimization, intraoperative care, and postoperative rehabilitation tailored to patient needs. Despite its recognized benefits, the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored. This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly patients undergoing gastric cancer resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly gastric cancer patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort analysis was conducted on 322 elderly patients who underwent gastric cancer resection between January 2020 and January 2022. Patients were assigned to a routine care group (&lt;i&gt;n&lt;/i&gt; = 156) or an ERAS-control (ERAS-C) group (&lt;i&gt;n&lt;/i&gt; = 166). Data collected included demographic information, inflammatory and stress markers, satisfaction scores using the patient satisfaction questionnaire-18, and quality of life measured using the European Organization for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group (12.97 ± 4.02 pg/mL &lt;i&gt;vs&lt;/i&gt; 14.37 ± 3.86 pg/mL; &lt;i&gt;P&lt;/i&gt; = 0.002). This finding indicates that the ERAS-C group experienced reduced inflammation. The ERAS-C group also had a higher cluster of differentiation (CD) 4:CD8 ratio than the routine care group (2.34 ± 0.35 &lt;i&gt;vs&lt;/i&gt; 2.13 ± 0.61; &lt;i&gt;P&lt;/i&gt; &lt; 0.001), suggesting the former's enhanced immune response. Postoperative stress markers, including norepinephrine, cortisol, and aldosterone, were significantly lower in the ERAS-C group than in the routine care group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05 for all). Compared with the routine care group, the ERAS-C group showed increased nursing satisfaction scores (80.36 ± 7.24 &lt;i&gt;vs&lt;/i&gt; 75.23 ± 7.03; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and improved quality of life indicators, such as reduced dysphagia and pain, (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The ERAS-C group also experienced fewer complications than the routine care group (5.42% &lt;i&gt;vs&lt;/i&gt; 11.54%, &lt;i&gt;P&lt;/i&gt; = 0.048).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Continuity nursing care within the ERAS framework significantly enha","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103340"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276064","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":"Methyltransferase-like factor 14 pathway and its relationship with pathological stages in patients undergoing surgery for colorectal cancer.","authors":"Qun Dai, Peng-Fei Ma, Jing Tian, Zhan Zhang, Qin Fang, Zi-Yu Lin, Li-Li Wu, Xue-Min Li","doi":"10.4240/wjgs.v17.i5.101674","DOIUrl":"10.4240/wjgs.v17.i5.101674","url":null,"abstract":"<p><strong>Background: </strong>Epigenetic involvement of methyltransferase-like factor 14 (METTL14) in tumor development has not been clearly defined.</p><p><strong>Aim: </strong>To investigate METTL14 expression and its relationship with pathological stage in patients undergoing radical surgery for colorectal cancer (CRC).</p><p><strong>Methods: </strong>This retrospective study included 80 patients with CRC who were admitted to the Third Hospital of Hefei and the Western District of the First Affiliated Hospital of Anhui Medical University between June 2021 and June 2024. These patients were selected for treatment. Lesions and adjacent tissues were collected from these patients, and METTL14 expression was assessed using immunohistochemistry. Expression levels of METTL14 were compared across different tissue samples. Additionally, we evaluated METTL14 expression in patients with varying pathological characteristics using statistical methods such as <i>χ</i> ² tests and analysis of variance to identify significant differences.</p><p><strong>Results: </strong>The positivity rate of METTL14 in tumor tissues was significantly lower than that in adjacent tissues (30% <i>vs</i> 60%, <i>P</i> < 0.05). Conversely, the negative expression rate of METTL14 was higher in tumor tissues compared to adjacent tissues (<i>P</i> < 0.05). The positive expression of METTL14 mRNA did not differ by age, sex, tumor tissue classification, tumor diameter, or tumor location (<i>P</i> > 0.05). However, the positive expression rate of METTL14 was significantly lower in patients with lymph node metastasis, invasion depth T3 + T4, and tumor, node, and metastasis (TNM) stage III/IV compared to those without lymph node metastasis, invasion depth T1 + T2, and TNM stage I (<i>P</i> < 0.05). Specifically, METTL14 mRNA expression was significantly lower in patients with lymph node metastasis (0.51 ± 0.12 <i>vs</i> 1.23 ± 0.25, <i>P</i> < 0.001), invasion depth T3 + T4 (0.48 ± 0.15 <i>vs</i> 1.18 ± 0.21, <i>P</i> < 0.001), and TNM stage III/IV (0.45 ± 0.13 <i>vs</i> 1.20 ± 0.22, <i>P</i> < 0.001) compared to those with no lymph node metastasis, invasion depth T1 + T2, and TNM stage I, respectively.</p><p><strong>Conclusion: </strong>In CRC, low positive METTL14 expression is closely correlated with lymph node metastasis, invasion depth T3 + T4, and TNM stage, indicating the malignant biological behavior of rectal cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"101674"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276088","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":"National Cancer Database analysis of gallbladder cancer: Evaluating survival benefit of chemotherapy in early-stage gallbladder cancer.","authors":"Minha Kim, Keerthivasan Vengatesan, Krist Aploks, Kyle Thompson, Xiang Dong, Ramanathan Seshadri","doi":"10.4240/wjgs.v17.i5.103653","DOIUrl":"10.4240/wjgs.v17.i5.103653","url":null,"abstract":"<p><strong>Background: </strong>For locally advanced gallbladder cancer, previous clinical studies have demonstrated that chemotherapy results in significant survival benefits when compared to surgery alone. However, data demonstrating a similar survival benefit with early-stage gallbladder cancer is limited. This study seeks to evaluate the impact chemotherapy has on survival in patients with early-stage gallbladder cancer using a large, multi-institution database.</p><p><strong>Aim: </strong>To investigate the survival benefit of chemotherapy in patients with stage II gallbladder cancer.</p><p><strong>Methods: </strong>We performed a retrospective multivariable analysis of the National Cancer Database from 2010 to 2017 to evaluate the effect that chemotherapy has on the survival of patients with stage II gallbladder cancer. Our objective was to determine if there were any statistically significant survival differences between those who received surgery and chemotherapy <i>vs</i> those who only underwent surgery.</p><p><strong>Results: </strong>Of the 899 patients with stage II gallbladder cancer, 328 patients had undergone chemotherapy and surgery. The average overall survival for those who had surgery and chemotherapy <i>vs</i> only surgery was 52.6 months and 51.1 months, respectively. This difference was not statistically significant (<i>P</i> = 0.2). In the secondary analysis, the surgical group who had a liver resection had better overall survival (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Practitioners should carefully consider chemotherapy for early-stage gallbladder cancer, as risks may outweigh survival benefits, and surgeons should also consider liver resections as part of their surgical management.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103653"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276091","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}