World Journal of Gastrointestinal Surgery最新文献

{"title":"Clinical benefits and controversies of jejunostomy feeding in patients undergoing gastrectomy for gastric cancer.","authors":"Martino Munini, Margot Fodor, Alessio Corradi, Antonio Frena","doi":"10.4240/wjgs.v17.i3.100384","DOIUrl":"10.4240/wjgs.v17.i3.100384","url":null,"abstract":"<p><p>Globally, gastric cancer ranks as the fifth most common malignancy and the third leading cause of cancer-related mortality. Gastrectomy combined with perioperative chemotherapy is currently the standard of care in locally advanced stages, but the completion rate of multimodal approach is influenced also by patient related factors. Malnutrition is a well-known risk factor associated with poor oncological outcomes. Its perioperative supplementation could lead to an improvement of the nutritional status. This article reviews and comments the retrospective study conducted by Jaquet <i>et al,</i> which evaluates the impact of enteral nutrition by jejunostomy feeding in patients undergoing gastrectomy for cancer. The authors included 172 patients, 35% of whom received jejunostomy. Patients with optimized biological nutritional parameters (body mass index, albumin, prealbumin) showed reduced major complications (> III), according to the Dindo-Clavien classification, 0 (0%) <i>vs</i> 8 (4.7%) (<i>P</i> = 0.05). In the era of multimodal treatment, optimization of nutritional and performance status is integral part of the therapeutic strategy.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100384"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754628","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":"Nonsurgical treatment of postoperative intestinal obstruction caused by heterotopic ossification of the mesentery: A case report.","authors":"Jing-Tian Chen, Yao-Ping Li, Shang-Qi Guo, Jin-Sheng Huang, Yong-Gang Wang","doi":"10.4240/wjgs.v17.i3.99015","DOIUrl":"10.4240/wjgs.v17.i3.99015","url":null,"abstract":"<p><strong>Background: </strong>Among all forms of heterotopic ossification, heterotopic mesenteric ossification (HMO) is rare, with fewer than 100 reported cases to date. Postoperative early small bowel obstruction caused by HMO is even rarer, presenting extremely high surgical risks, the potential for multiple surgeries, and a poor prognosis. There have been no reported cases of conservative treatment for resolving such early postoperative obstruction.</p><p><strong>Case summary: </strong>A 57-year-old male presented with severe postoperative small bowel obstruction shortly after undergoing open radical resection for transverse colon cancer. Laparotomy revealed extensive adhesions in the proximal jejunum and mesentery, making it too difficult to relieve without injuring the small bowel. Additionally, multiple fixed nodules were found in the mesentery during the operation. Pathology confirmed the presence of heterotopic ossification. The patient was treated with methylprednisolone on postoperative day 1, which gradually relieved his symptoms.</p><p><strong>Conclusion: </strong>Hormone therapy may have a potential role in treating small bowel obstruction caused by early HMO after operative intervention.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99015"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754722","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":"Retrospective analysis of preoperative tumor marker levels in rectal cancer patients: Implications for diagnosis.","authors":"Ming Li, Da-Hao Yuan, Zhi Yang, Teng-Xiang Lu, Lei Zhang","doi":"10.4240/wjgs.v17.i3.100820","DOIUrl":"10.4240/wjgs.v17.i3.100820","url":null,"abstract":"<p><strong>Background: </strong>Early detection of rectal cancer poses significant challenges. Current diagnostic methods, including colonoscopy, imaging techniques, and fecal tests, have limitations such as invasiveness, cost, and varying sensitivity. This study evaluated the diagnostic value of preoperative serum tumor markers in rectal cancer patients.</p><p><strong>Aim: </strong>To investigate the value of a multi-marker approach for the preoperative diagnosis of rectal cancer.</p><p><strong>Methods: </strong>A retrospective analysis of 250 patients diagnosed with rectal cancer between July 2022 and July 2024 was conducted. Preoperative alpha-fetoprotein levels, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), CA19-9, CA15-3, and CA72-4 were analyzed. All blood samples were collected under standardized conditions, including fasting status and proper storage methods, within two weeks before surgery. Diagnostic performance was assessed using receiver operating characteristic curve analysis. Correlations among clinicopathological features were also evaluated.</p><p><strong>Results: </strong>CEA demonstrated the highest diagnostic performance among individual tumor markers with an area under the curve (AUC) of 0.78 [95% confidence interval (CI): 0.73-0.83]. However, a combination of CEA, CA19-9, and CA72-4 showed superior performance, achieving an AUC of 0.87 (95%CI: 0.83-0.91). Significant correlations were observed between CEA levels and several clinicopathological features, including tumor stage (<i>P</i> < 0.001), lymph node involvement (<i>P</i> = 0.002), and distant metastasis (<i>P</i> < 0.001). Furthermore, in a subgroup analysis of patients diagnosed after July 2022, the integration of fecal occult blood testing with the tumor marker panel (CEA + CA19-9 + CA72-4) significantly improved diagnostic accuracy, increasing the AUC to 0.91 (95%CI: 0.86-0.96).</p><p><strong>Conclusion: </strong>A multimarker approach combining CEA, CA19-9, and CA72-4 with fecal occult blood testing enhances the preoperative assessment of patients with rectal cancer. These findings suggest potential improvements in risk stratification and management of patients with rectal cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100820"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754667","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 outcomes of interlocking main pancreatic duct-jejunal internal bridge drainage in middle pancreatectomy: A comparative study.","authors":"Xin-Yan Lu, Xiao-Dong Tan","doi":"10.4240/wjgs.v17.i3.102428","DOIUrl":"10.4240/wjgs.v17.i3.102428","url":null,"abstract":"<p><strong>Background: </strong>Middle pancreatectomy (MP) is a surgical procedure that removes non-invasive lesions in the pancreatic neck and body, allowing for the preservation of pancreatic function. However, MP is associated with a higher risk of postoperative complications, and there's no clear consensus on which anastomotic method is preferable. In recent years, our team has developed a new method called interlocking main pancreatic duct-jejunal (IMPD-J) internal bridge drainage to MP.</p><p><strong>Aim: </strong>To compare perioperative and postoperative outcomes in patients who underwent IMPD-J bridge drainage and those underwent traditional duct-to-mucosa pancreatojejunostomy.</p><p><strong>Methods: </strong>Patients who underwent MP in our hospital between October 1, 2011 and July 31, 2023 were enrolled in this study. Patients were divided into two groups based on their pancreatojejunostomy technique: IMPD-J bridge drainage group and duct-to-mucosa pancreatojejunostomy group. Demographic data (age, gender, body mass index, hypertension, diabetes, <i>etc.</i>) and perioperative indicators [operation time, intraoperative bleeding, clinically relevant postoperative pancreatic fistula (CR-POPF), delayed gastric emptying, <i>etc.</i>] were recorded and analyzed statistically.</p><p><strong>Results: </strong>A total of 53 patients were enrolled in this study, including 23 in the IMPD-J Bridge Drainage group and 30 in the traditional duct-to-mucosa pancreatojejunostomy group. There were no significant differences in demographic or preoperative characteristics between the groups. Compared to traditional duct-to-mucosa pancreaticojejunostomy, IMPD-J bridge drainage had a significant shorter operation time (4.3 ± 1.3 hours <i>vs</i> 5.8 ± 1.8 hours, <i>P</i> = 0.002), nasogastric tube retention days (5.3 ± 1.7 days <i>vs</i> 6.5 ± 2.0 days, <i>P</i> = 0.031), lower incidence of delayed gastric emptying (8.7% <i>vs</i> 36.7%, <i>P</i> = 0.019), and lower incidence of CR-POPF (39.1% <i>vs</i> 70.0%, <i>P</i> = 0.025). Multivariate logistic regression analysis showed that pancreaticojejunostomy type (odds ratio = 4.219, 95% confidence interval = 1.238-14.379, <i>P</i> = 0.021) and plasma prealbumin (odds ratio = 1.132, 95% confidence interval = 1.001-1.281, <i>P</i> = 0.049) were independent risk factor for CR-POPF. In IMPD-J bridge drainage group, only one patient experienced recurrent pancreatitis due to the large diameter of the silicone tube and had it removed six months after surgery.</p><p><strong>Conclusion: </strong>Compared to traditional duct-to-mucosa pancreatojejunostomy, IMPD-J bridge drainage has the advantages of simplicity and fewer perioperative complications, with favorable long-term outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102428"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754655","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 water infusion combined with defoamers in colonoscopy.","authors":"Jian Li, Jun-Ping Chen, Chun-Han Lai, Lian Fu, Yong Ji","doi":"10.4240/wjgs.v17.i3.99784","DOIUrl":"10.4240/wjgs.v17.i3.99784","url":null,"abstract":"<p><strong>Background: </strong>Currently, colonoscopy still needs continuous optimization and exploration of novel alternative approaches to enhance the experience of patients during colonoscopy.</p><p><strong>Aim: </strong>To analyze the efficacy of water infusion combined with defoamers in colonoscopy.</p><p><strong>Methods: </strong>This study included 97 patients undergoing colonoscopy from January 2024 to June 2024. The participants were categorized into two groups, namely, the control group (<i>n</i> = 47), who underwent conventional colonoscopy, and the experimental group (<i>n</i> = 50), who received colonoscopy using water injection combined with defoamers. A comparative analysis was then conducted on the disease detection rate (colonic polyps, colonorrhagia, colonic ulcers, colonic mucosal lesions, and others), colonoscopy duration, abdominal pain [visual analog scale (VAS)], Boston bowel preparation scale (BBPS), self-rating anxiety scale (SAS), bowel preparation comfort, complications (intestinal perforation, bleeding, nausea and vomiting, abdominal pain, and abdominal distension), and patient satisfaction.</p><p><strong>Results: </strong>The experimental group demonstrated a significantly higher total disease detection rate, BBPS scores, and patient satisfaction compared with the control group. Further, the research group exhibited shorter colonoscopy duration, lower VAS and SAS scores and total complication rate, and better patient comfort and satisfaction.</p><p><strong>Conclusion: </strong>These results indicate that the combination of water injection and defoamers exhibited an overall better therapeutic effect than conventional colonoscopy, mainly reflected in higher disease detection rate, faster examination efficiency, lower abdominal pain, anxiety, and complication incidences, and significantly better bowel preparation, comfort, and patient satisfaction.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99784"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754663","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":"Follow-up of elderly gastric cancer post-radical surgery: Trauma, complications, and prognosis.","authors":"Li-Ling Zhu, Rui-Zhi Shen","doi":"10.4240/wjgs.v17.i3.100143","DOIUrl":"10.4240/wjgs.v17.i3.100143","url":null,"abstract":"<p><strong>Background: </strong>The incidence of gastric cancer in the elderly is increasing; however, standardized surgical approaches are lacking.</p><p><strong>Aim: </strong>To investigate the effects of radical surgery on the trauma response, postoperative complications, and long-term prognosis in elderly patients with gastric cancer.</p><p><strong>Methods: </strong>Between January 2020 and December 2023, 110 gastric cancer patients admitted to the Department of Oncology Jiangnan University Medical Center were categorized into a control group (40 cases) and an observation group (70 cases) based on surgical method differences. The control and observation group received palliative surgery and radical surgery, respectively, and were further divided into open (25 cases) and laparoscopic (45 cases) surgery. Surgical outcomes, trauma indicators, complication rates, and long-term survival at 6 months, 1-, and 2-years were compared.</p><p><strong>Results: </strong>Laparoscopic surgery showed superior surgical outcomes compared to the open surgery and control groups (<i>P</i> < 0.05). Trauma indicators were lowest in the laparoscopic group and highest in the control group (<i>P</i> < 0.05). No significant difference was observed in the complication rates between the open and laparoscopic groups (<i>P</i> > 0.05), but both were higher than those in the control group (<i>P</i> < 0.05). No significant differences were found in survival rates at different follow-up periods between the laparoscopic and open groups (<i>P</i> > 0.05); however, both groups showed higher survival rates than the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Radical surgery in elderly patients with gastric cancer reduces surgical trauma response, facilitates postoperative recovery, and improves long-term survival rates, albeit with an increased risk of complications. Laparoscopic radical surgery further minimizes postoperative trauma, with no significant difference in complication rates and survival prognosis compared with open radical surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100143"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754674","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":"High cellular prion protein expression in cholangiocarcinoma: A marker for early postoperative recurrence and unfavorable prognosis.","authors":"Dong Woo Shin, Yoon Ah Cho, Sung-Hoon Moon, Tae Hyung Kim, Ji-Won Park, Jung-Woo Lee, Ji-Young Choe, Min-Jeong Kim, Sung-Eun Kim","doi":"10.4240/wjgs.v17.i3.101940","DOIUrl":"10.4240/wjgs.v17.i3.101940","url":null,"abstract":"<p><strong>Background: </strong>The cellular prion protein (PrP^C), traditionally associated with neurodegenerative disorders, plays an important role in cancer progression and metastasis by inhibiting apoptosis.</p><p><strong>Aim: </strong>To investigate the influence of PrP^C expression in cholangiocarcinoma (CCA) on patient outcomes following surgical resection.</p><p><strong>Methods: </strong>Patients who underwent curative surgical resection for either intrahepatic or hilar CCA were enrolled in this retrospective study. Based on the immunohistochemical staining results of the surgical specimens, patients were categorized into two groups: The low PrP^C group (negative or 1+) and the high PrP^C group (2+ or 3+). Survival analyses, including overall survival and recurrence-free survival, were conducted using the Kaplan-Meier method and compared using the log-rank test.</p><p><strong>Results: </strong>In total, seventy-six patients diagnosed with CCA (39 with intrahepatic and 37 with hilar CCA) underwent curative hepatectomy from January 2011 to November 2021. Among these patients, 38 (50%) demonstrated high PrP^C expression, whereas the remaining 38 (50%) showed low expression of PrP^C. During a median follow-up period of 31.2 months (range: 1 to 137 months), the high PrP^C group had a significantly shorter median overall survival than the low PrP^C group (40.4 months <i>vs</i> 137.9 months, respectively; <i>P</i> = 0.041). Moreover, the high PrP^C group had a significantly shorter median recurrence-free survival than the low PrP^C group (13.3 months <i>vs</i> 23.8 months, respectively; <i>P</i> = 0.026).</p><p><strong>Conclusion: </strong>PrP^C expression is significantly associated with early recurrence and decreased survival period in CCA patients following surgical resection. Thus, PrP^C may be used as a prognostic factor in treatment planning.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101940"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754680","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":"Predictive value of serum calcium ion level in patients with colorectal cancer: A retrospective cohort study.","authors":"Yin Shu, Ke-Jin Li, Subinur Sulayman, Zi-Yi Zhang, Saibihutula Ababaike, Kuan Wang, Xiang-Yue Zeng, Yi Chen, Ze-Liang Zhao","doi":"10.4240/wjgs.v17.i3.102638","DOIUrl":"10.4240/wjgs.v17.i3.102638","url":null,"abstract":"<p><strong>Background: </strong>Serum calcium ion (Ca²⁺) is an economical and readily available indicator as a routine screening test for hospitalized patients. There are no studies related to serum Ca²⁺ level and digestive tract malignancy.</p><p><strong>Aim: </strong>To evaluate the effectiveness of serum Ca²⁺ level in predicting the prognosis of patients with colorectal cancer (CRC).</p><p><strong>Methods: </strong>We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University. By analyzing the clinicopathological features, differences between serum Ca²⁺ concentrations on the first day after surgery were determined. We used the receiver operating characteristic curve to assess the predictive ability of serum Ca²⁺ for survival. Survival analyses were performed using the Kaplan-Meier method, and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca²⁺ levels and CRC survival outcomes.</p><p><strong>Results: </strong>By receiver operating characteristic curve analysis, the ideal threshold value for Ca²⁺ the first postoperative day and delta serum calcium (δCa²⁺) value were 1.975 and 0.245, respectively. Overall survival (OS) and progression-free survival (PFS) were better in both the high Ca²⁺ group and high δCa²⁺ group on the first postoperative day. The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differentiation (<i>P</i> = 0.047), T stage (<i>P</i> = 0.019), N stage (<i>P</i> < 0.001), nerve vascular invasion (<i>P</i> = 0.037), carcinoembryonic antigen (<i>P</i> = 0.039), baseline serum Ca²⁺ level (<i>P</i> = 0.011), and serum Ca²⁺ level on the first day (<i>P</i> = 0.006) were independent predictors of prognosis for patients undergoing feasible radical CRC surgery. Using the findings from the multifactorial analysis, we developed a nomogram and the calibration showed a good predictive ability.</p><p><strong>Conclusion: </strong>Low serum Ca²⁺ level on the first postoperative day is an independent risk factor for OS and PFS in CRC.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102638"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754630","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":"Current opinions on the use of prophylactic antibiotics in patients undergoing laparoscopic cholecystectomy.","authors":"Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis","doi":"10.4240/wjgs.v17.i3.101938","DOIUrl":"10.4240/wjgs.v17.i3.101938","url":null,"abstract":"<p><p>Inappropriate use of antibiotics leads to microbial resistance. Single-dose antibiotic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting aspects. High-risk patients are those who are older than 70 years, have diabetes mellitus, whose operation time exceeded 120 minutes, have acute cholecystitis, experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage, suffered from obstructive jaundice, or were deemed immunocompromised. For gallbladder perforation, one dose of antibiotic prophylaxis is sufficient. Therefore, guidelines are needed and must be strictly followed. Prophylactic treatment is not needed for patients at low risk of developing sepsis following elective laparoscopic cholecystectomy, although the opposite is supported. Similarly, superficial surgical infections are related to low morbidity. Patients without risk factors have a very low risk of infection. Thus, the routine use of antibiotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101938"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754636","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-based evidence-based care plus ice stimulation for thirst management in convalescent patients following digestive surgery under general anesthesia.","authors":"Li Chen, Bi-Xi Li, Qiu-Zhi Gan, Rui-Ge Guo, Xing Chen, Xi Shen, Yan Chen","doi":"10.4240/wjgs.v17.i3.100185","DOIUrl":"10.4240/wjgs.v17.i3.100185","url":null,"abstract":"<p><strong>Background: </strong>Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention. A simple, practical, and safe method can effectively relieve thirst symptoms in such patients.</p><p><strong>Aim: </strong>To evaluate the enhanced recovery after surgery (ERAS)-based evidence-based care (EBC) plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.</p><p><strong>Methods: </strong>A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected. In total, 89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy, respectively. The following data were comparatively analyzed: (1) Thirst degree (thirst intensity numerical rating scale) and thirst distress (TD) degree (TD scale); (2) Oral mucosal wetness; (3) Unstimulated whole salivary flow rate (UWSFR); (4) Adverse reactions (palpitation, fatigue, chapped lips, and nausea and vomiting); and (5) Nursing satisfaction.</p><p><strong>Results: </strong>After nursing, thirst degree and distress were statistically lower in the research group than in the control group. Additionally, compared with the control group, the research group exhibited a lower degree of oral mucosal wetness, higher UWSFR, fewer adverse reactions, and more total nursing satisfaction.</p><p><strong>Conclusion: </strong>ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia. It can alleviate xerostomia symptoms, reduce adverse reactions, and improve patient comfort.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100185"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754668","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}