World Journal of Gastrointestinal Surgery最新文献

{"title":"Rare large sigmoid hamartomatous polyp in an elderly patient with atypical Peutz-Jeghers syndrome: A case report.","authors":"Zhe-Sen Tian, Xiao-Peng Ma, Hong-Xun Ruan, Yang Yang, Ya-Lei Zhao","doi":"10.4240/wjgs.v17.i3.102174","DOIUrl":"10.4240/wjgs.v17.i3.102174","url":null,"abstract":"<p><strong>Background: </strong>Peutz-Jeghers (PJ) syndrome (PJS) is a rare autosomal dominant genetic disease characterized by the association of intestinal polyposis, mucosal skin pigmentation, and cancer susceptibility. PJS patients have a significantly increased risk of malignant tumors in the gastrointestinal tract and extra-gastrointestinal tract, including various epithelial malignant tumors (colorectal cancer, gastric cancer, pancreatic cancer, breast cancer, and ovarian cancer, <i>etc.</i>). PJS is commonly seen in children and adolescents with multiple small intestinal polyps, often causing intussusception.</p><p><strong>Case summary: </strong>A 62-year-old male presented with intermittent left lower abdominal pain after drinking or consuming cold beverages that was accompanied by occasional hematochezia. Abdominal contrast-enhanced computed tomography indicated an isolated sigmoid colon grape-like lesion. Subsequently, the patient underwent laparoscopic surgery, and the pathological diagnosis was PJ hamartomatous polyp. PJS was not considered at the initial visit, as the patient was older, and the facial pigmentation was not obvious. However, significant pigmentation was observed in the perineum during digital rectal examination. Interestingly, we observed that the patient exhibited nodular shadows in the adrenal glands computed tomography images that may be related to pigmentation. Therefore, we performed the determination of adrenal cortical hormones, but the results were not abnormal. Combined with skin and mucosal pigmentation and laboratory examinations, the patient was diagnosed with PJS. After laparoscopic sigmoid colon resection, the patient's symptoms improved, and no discomfort symptoms were reported in the later follow-up.</p><p><strong>Conclusion: </strong>The age of onset and lesion location of this case are different from those of typical or isolated PJS patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102174"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754632","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":"Genetic and environmental factors influencing Crohn's disease.","authors":"Ye-Hui Fan, Ming-Wei Wang, Yu-Ning Gao, Wen-Mao Li, Yan Jiao","doi":"10.4240/wjgs.v17.i3.98526","DOIUrl":"10.4240/wjgs.v17.i3.98526","url":null,"abstract":"<p><p>This editorial discusses Pellegrino and Gravina's essay. Crohn's disease (CD) is a complex and multifactorial disease that is influenced by a combination of genetic and environmental factors. While genetic factors play a key role in the development of the disease, environmental factors also play a significant role in influencing the risk of developing CD. By looking at present understanding of CD pathogenesis, we emphasize the important factors involved in the development of this illness, such as nucleotide-binding oligomerization domain-2, smoking, and vitamin D. Understanding the interplay between genetic and environmental factors is crucial for developing effective strategies for preventing and treating this chronic inflammatory bowel disease.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"98526"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754677","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 influencing sphincter preservation in laparoscopic radical rectal cancer surgery.","authors":"Jia-Rui Liu, Jin Zhang, Xiang-Long Duan","doi":"10.4240/wjgs.v17.i3.101061","DOIUrl":"10.4240/wjgs.v17.i3.101061","url":null,"abstract":"<p><strong>Background: </strong>The surgical management of rectal cancer is continuously advancing, with a current emphasis on minimising the need for a permanent stoma. Understanding the risk factors influencing sphincter preservation is crucial for guiding clinical decision-making and optimising preoperative patient evaluation.</p><p><strong>Aim: </strong>To examine the risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery.</p><p><strong>Methods: </strong>A retrospective analysis of the demographics, preoperative and intraoperative data, and pathological findings of 179 patients with rectal cancer who underwent laparoscopic radical rectal cancer surgery at our hospital between January 2022 and December 2023 was conducted. These clinical data were compared between two groups: Patients with sphincter preservation and those without, categorised as the sphincter-preserved and sphincter-unpreserved groups, respectively.</p><p><strong>Results: </strong>Of the 179 patients analysed, 150 were in the sphincter-preserved group and 29 were in the sphincter-unpreserved group. Tumour height was significantly greater in the sphincter-preserved group compared to the sphincter-unpreserved group. Conversely, elevated levels of carcinoembryonic antigen, carbohydrate antigen 19-9, and plasma D-dimer were significantly higher in the sphincter-unpreserved group. Significant differences were also observed between the two groups in terms of place of residence, presence of colonic polyps, neoadjuvant chemotherapy, preoperative radiotherapy, mucinous adenocarcinoma, nerve invasion, and tumour height. No significant differences were observed for other parameters. Logistic regression analysis identified colonic polyps, mucinous adenocarcinoma, nerve invasion, and tumour height as independent risk factors for sphincter preservation.</p><p><strong>Conclusion: </strong>Several risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery were identified. These factors could be valuable tools for guiding clinical decision-making and optimising preoperative patient evaluations.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101061"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754687","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":"Impact of a visual mobile terminal-based continuity of care model on caregiver competence of children with enterostomies.","authors":"Ying Yu, Xian-Qiang Wang, Gang Liu, Lei Li, Li-Na Chen, Li-Juan Zhang, Qiao Xia","doi":"10.4240/wjgs.v17.i3.99099","DOIUrl":"10.4240/wjgs.v17.i3.99099","url":null,"abstract":"<p><strong>Background: </strong>Children with critical acute abdominal conditions often undergo intestinal stoma surgery.</p><p><strong>Aim: </strong>To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.</p><p><strong>Methods: </strong>One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group. The control group (60 cases) received traditional telephone follow-up for continuity of care, while the study group (60 cases) used a visualization mobile terminal-based care model. The incidence of stoma-related complications, caregiver burden scale, and competence scores of children with stoma were compared between the two groups.</p><p><strong>Results: </strong>The primary caregiver burden score in the study group (37.22 ± 3.17) was significantly lower than that in the control group (80.00 ± 4.47), and the difference was statistically significant (<i>P</i> < 0.05). Additionally, the caregiving ability score of the study group (172.08 ± 3.49) was significantly higher than that of the control group (117.55 ± 4.28; <i>P</i> < 0.05). The total incidence of complications in the study group (11.7%, 7/60) was significantly lower compared to the control group (33.3%, 20/60; <i>χ</i> ² = 8.086, <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>The visual mobile terminal-based care model reduces caregiver burden, improves home care ability, lowers the incidence of complications and readmission rates, and supports successful second-stage reduction surgery for children with enterostomies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99099"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754693","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":"Advances in management strategies for enteral nutrition-related gastric retention in adult patients with nasogastric tubes.","authors":"Li-Fei Feng, Xiang-Wei Li, Xiao-Qiu Zhu, Lin-Na Jin","doi":"10.4240/wjgs.v17.i3.101751","DOIUrl":"10.4240/wjgs.v17.i3.101751","url":null,"abstract":"<p><p>Gastric retention is a common complication in individuals receiving enteral nutrition (EN) <i>via</i> a nasogastric tube, increasing the risk of aspiration pneumonia and causing unnecessary interruptions in nutritional support. Given its clinical significance, establishing effective, evidence-based, and standardized management strategies is essential for bettering patient outcomes and mitigating complications. This review systematically synthesized the diagnostic criteria, assessment methods, influencing factors, management procedures, and intervention strategies for gastric retention in EN patients. Although no universal consensus exists regarding gastric residual volume (GRV) thresholds, evidence indicates that EN can continue at high GRV levels in the absence of gastrointestinal symptoms. Bedside ultrasound emerged as a non-invasive, and precise method GRV assessment, offering potential to standardize clinical practice. Key risk factors for gastric retention include neurological disorders and EN infusion rates exceeding 100 mL/h. Effective management strategies encompass non-pharmacological interventions, pharmacological agents, and traditional Chinese medicine (TCM) therapies. This review underscored the need for integrated, multi-modal management strategies and recommended the adoption of bedside ultrasound and standardized protocols to optimize EN delivery and improve patient outcomes. Large-scale, multicenter clinical trials should be a priority for future investigation to verify the effectiveness of TCM therapies and develop personalized intervention plans for high-risk patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101751"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754214","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":"Neoadjuvant therapy: Dawn of reducing the high post-surgery recurrence rate of hepatocellular carcinoma.","authors":"Xiao-Dong Zhang, Lu-Yi Zhang, Jia-Liang Luo, Ke-Heng Yu, Ke-Lei Zhu","doi":"10.4240/wjgs.v17.i3.103740","DOIUrl":"10.4240/wjgs.v17.i3.103740","url":null,"abstract":"<p><p>The high postoperative recurrence rate remains a major challenge in the treatment of hepatocellular carcinoma (HCC) following resection. Increasing research has been delved into investigating the role of neoadjuvant therapy on the prognosis of resectable HCC. Recent trends in combination therapy with molecularly targeted agents and immune checkpoint inhibitors have significantly improved the efficacy of systemic antitumor treatments, yielding survival benefits exceeding 40%. Neoadjuvant therapy for HCC, whether based on systemic antitumor treatments, locoregional therapies, or their combination, has emerged as a promising research direction. However, there remains a matter of debate on neoadjuvant therapy. In this review, we summarize and discuss the research progress and challenges of neoadjuvant therapy for HCC over the past five years from the perspective of Chinese guidelines to provide new insights and future directions in this field.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"103740"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754721","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":"Successful management of bleeding ectopic small bowel varices secondary to portal hypertension: A retrospective study.","authors":"Nian-Jun Xiao, Jian-Guo Chu, Shou-Bin Ning, Bao-Jie Wei, Zhi-Bo Xia, Zhe-Yi Han","doi":"10.4240/wjgs.v17.i3.102589","DOIUrl":"10.4240/wjgs.v17.i3.102589","url":null,"abstract":"<p><strong>Background: </strong>Bleeding ectopic varices located in the small bowel (BEV-SB) caused by portal hypertension (PH) are rare and life-threatening clinical scenarios. The current management of BEV-SB is unsatisfactory. This retrospective study analyzed four cases of BEV-SB caused by PH and detailed the management of these cases using enteroscopic injection sclerotherapy (EIS) and subsequent interventional radiology (IR).</p><p><strong>Aim: </strong>To analyze the management of BEV-SB caused by PH and develop a treatment algorithm.</p><p><strong>Methods: </strong>This was a single tertiary care center before-after study, including four patients diagnosed with BEV-SB secondary to PH between January 2019 and December 2023 in the Air Force Medical Center. A retrospective review of the medical records was conducted. The management of these four patients involved the utilization of EIS followed by IR. The management duration of BEV-SB in each patient can be retrospectively divided into three phases based on these two approaches: Phase 1, from the initial occurrence of BEV-SB to the initial EIS; phase 2, from the initial EIS to the initial IR treatment; and phase 3, from the initial IR to December 2023. Descriptive statistics were performed to clarify the blood transfusions in each phase.</p><p><strong>Results: </strong>Four out of 519 patients diagnosed with PH were identified as having BEV-SB. The management duration of each phase was 20 person-months, 42 person-months, and 77 person-months, respectively. The four patients received a total of eight and five person-times of EIS and IR treatment, respectively. All patients exhibited recurrent gastrointestinal bleeding following the first EIS, while no further instances of gastrointestinal bleeding were observed after IR treatment. The transfusions administered during each phase were 34, 31, and 3.5 units of red blood cells, and 13 units, 14 units, and 1 unit of plasma, respectively.</p><p><strong>Conclusion: </strong>EIS may be effective in achieving hemostasis for BEV-SB, but rebleeding is common, and IR aiming to reduce portal pressure gradient may lower the rebleeding rate.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102589"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754733","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":"Perioperative neurocognitive dysfunction and role of dexmedetomidine in radical colon cancer surgery in elderly patients.","authors":"Chandra K Pandey, Abhishek Kumar","doi":"10.4240/wjgs.v17.i3.100126","DOIUrl":"10.4240/wjgs.v17.i3.100126","url":null,"abstract":"<p><p>This article explored the application of dexmedetomidine (Dex), a highly selective alpha-2 agonist, in managing postoperative cognitive dysfunction (POCD) in elderly patients undergoing radical colon cancer surgery. Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes, including POCD, which encompasses many neurocognitive disorders that manifest during the perioperative period. The aging population is at a higher risk for POCD, which can lead to prolonged hospital stays, delayed recovery, and increased healthcare costs. Dex has neuroprotective, opioid-sparing, and sympatholytic properties, which reduces the incidence and severity of POCD. Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits. Its application extends to sedation, analgesia, maintenance of anesthesia, and controlling delirium. Its neuroprotective and anti-inflammatory effects have been explored in managing POCD. This article discussed the broad range of patient and procedure-related risk factors for POCD. Early identification and intervention are crucial to prevent the progression of POCD, which can have severe physical, psychological, and economic consequences. The article underscored the importance of a multidisciplinary approach in managing POCD, involving the optimization of comorbidities, depth of anesthesia monitoring, hemodynamic stability, and cerebral oxygenation monitoring.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100126"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754627","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 delta hemoglobin and bleeding-related risk factors in pancreaticoduodenectomy.","authors":"Yi-Min Lin, Chao Yu, Guo-Zhe Xian","doi":"10.4240/wjgs.v17.i3.100999","DOIUrl":"10.4240/wjgs.v17.i3.100999","url":null,"abstract":"<p><strong>Background: </strong>Objective and accurate assessment of blood loss during pancreaticoduodenectomy (PD) is crucial for ensuring the safety and efficacy of the procedure. While the visual method remains the most common clinical metric, many scholars argue that it significantly differs from actual blood loss and is inherently subjective.</p><p><strong>Aim: </strong>To assess blood loss in PD <i>via</i> delta hemoglobin (ΔHb) and compare it with the visual method to predict bleeding-related risk factors.</p><p><strong>Methods: </strong>In this retrospective analysis, 1722 patients who underwent PD from 2017 to 2022 at Shandong Provincial Hospital were divided into three groups: Open PD (OPD), laparoscopic PD (LPD), and conversion to OPD (CTOPD). Intraoperative ΔHb (IΔHb) was calculated <i>via</i> preoperative and 72-hour-postoperative hemoglobin concentrations, and its association with visually obtained estimated blood loss (EBL) was analyzed. Perioperative ΔHb (PΔHb) was calculated <i>via</i> preoperative and predischarge hemoglobin concentrations. We compared the differences in IΔHb and PΔHb among the three groups, and performed univariate and multivariate regression analyses of IΔHb and PΔHb.</p><p><strong>Results: </strong>The preoperative general information of patients showed no statistically significant difference among the three groups (<i>P</i> > 0.05). The IΔHb in the OPD, LPD, and CTOPD groups were 22.00 (12.00, 36.00), 21.00 (10.00, 33.00), and 33.00 (18.12, 52.24) g/L, respectively; And the PΔHb in the OPD, LPD, and CTOPD groups were 25.87 (13.51, 42.00), 25.00 (14.00, 45.00), and 37.48 (21.64, 59.65) g/L, respectively, values significantly differed (<i>P</i> < 0.05). IΔHb and EBL were significantly correlated (<i>r</i> = 0.337, <i>P</i> < 0.001). The results of univariate and multivariate regression analyses indicated that American Society of Anesthesiologists (ASA) classification IV [95% confidence interval (CI): 2.330-37.811, <i>P</i> = 0.049] and preoperative total bilirubin > 200 μmol/L (95%CI: 2.805-8.673, <i>P</i> < 0.001) were independent risk factors for IΔHb (<i>P</i> < 0.05), and ASA classification IV (95%CI: 45.934-105.485, <i>P</i> < 0.001), body mass index > 24 kg/m² (95%CI: 1.285-9.890, <i>P</i> = 0.011), and preoperative total bilirubin > 200 μmol/L (95%CI: 6.948-16.797, <i>P</i> < 0.001) were independent risk factors for PΔHb (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>There is a correlation between IΔHb and EBL in PD, so we can assess the patients' intraoperative blood loss by the ΔHb method. ASA classification IV, body mass index > 24 kg/m², and preoperative total bilirubin > 200 μmol/L increased perioperative bleeding risk.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100999"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754635","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":"Comparative analysis of Ferguson hemorrhoidectomy combined with doppler-guided hemorrhoidal artery ligation and Ferguson hemorrhoidectomy in hemorrhoidal disease treatment.","authors":"Ismail Cem Eray, Ugur Topal, Serdar Gumus, Kubilay Isiker, Burak Yavuz, Ishak Aydin","doi":"10.4240/wjgs.v17.i3.103953","DOIUrl":"10.4240/wjgs.v17.i3.103953","url":null,"abstract":"<p><strong>Background: </strong>In hemorrhoidal disease, despite the existence of numerous treatment options to alleviate symptoms, surgical intervention continues to be the gold standard. The advantages and disadvantages of many methods have been shown in numerous studies However, only a few studies have compared the effectiveness of combined methods.</p><p><strong>Aim: </strong>To compare the results of a coloproctology clinic that switched to the Doppler-guided hemorrhoidal artery ligation (DG-HAL) + Ferguson hemorrhoidectomy (FH) technique from the FH in the treatment of hemorrhoidal disease.</p><p><strong>Methods: </strong>In this retrospective cohort, data from a total of 45 patients who underwent DG-HAL + FH (<i>n</i> = 24) and FH (<i>n</i> = 21) for grade III hemorrhoidal disease between 2020 and 2022 were analyzed. Demographic and clinical data, surgical duration, intraoperative blood loss, hospital stay, postoperative analgesic consumption, pain scores using the Visual Analog Scale (VAS), complications, time to return to normal activities, and the recurrence rate were compared in both groups.</p><p><strong>Results: </strong>The study included 45 patients, with 75.6% (<i>n</i> = 34) male and 24.4% (<i>n</i> = 11) female. The rate of intraoperative blood loss was higher in the FH group (<i>P</i> < 0.05). The VAS scores and postoperative complication rates were similar in both groups. The need for postoperative analgesics was lower in the DG-HAL + FH group (2 <i>vs</i> 4 days, <i>P</i> < 0.05), while the FH group showed a shorter time to return to normal activities (9.5 <i>vs</i> 6.0 days, <i>P</i> = 0.02). The recurrence rate (16.7% <i>vs</i> 0%) and Clavien-Dindo Score-1 complications (20.8% <i>vs</i> 9.5%, <i>P</i> = 0.29) were higher in the DG-HAL + FH group but were insignificant.</p><p><strong>Conclusion: </strong>Our study revealed that the addition of the DG-HAL to classical hemorrhoidectomy caused less intraoperative bleeding and a lower postoperative analgesia requirement.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"103953"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754660","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}