World Journal of Gastrointestinal Surgery最新文献

{"title":"Risk and management of adverse events in minimally invasive esophagectomy.","authors":"Li-Qun Li, Yan Jiao","doi":"10.4240/wjgs.v17.i3.103941","DOIUrl":"10.4240/wjgs.v17.i3.103941","url":null,"abstract":"<p><p>Minimally invasive esophagectomy (MIE) has transformed esophageal surgery by reducing morbidity, accelerating recovery, and improving postoperative outcomes compared to traditional open esophagectomy. By utilizing techniques such as laparoscopic, thoracoscopic, and robotic-assisted approaches, MIE minimizes surgical trauma while maintaining oncological thoroughness. However, it also presents unique challenges, including risks of complications such as anastomotic leakage, pulmonary complications, and atrial fibrillation. Zhong <i>et al</i> developed and validated a risk stratification model for predicting surgical adverse events after MIE, enhancing preoperative assessment and patient management. This editorial further examines the advantages of MIE, its comparable oncological and long-term outcomes, as well as the incidence and contributing factors of postoperative complications. Emerging technologies, including machine learning models, intraoperative nerve monitoring, and robotic-assisted surgery, are highlighted as innovative solutions for risk prediction and prevention. Strategies such as enhanced recovery after surgery protocols and multidisciplinary collaboration are emphasized for their critical roles in minimizing complications and optimizing patient outcomes. By addressing these aspects, this editorial provides guidance to surgical teams in maximizing the benefits of MIE while effectively managing its associated risks.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"103941"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754681","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 on Lou Bei Er Chen decoction and acupuncture in gastroesophageal reflux disease post-gastric cancer surgery.","authors":"Jing-Hua Shi, Hui Yang, Shi-Tao Wang, Wen-Jun Wang, Ye Shi, Shan-Shan Huang, Su Jiang","doi":"10.4240/wjgs.v17.i3.99626","DOIUrl":"10.4240/wjgs.v17.i3.99626","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastric cancer is a growing clinical challenge, particularly due to the increased risk of postoperative gastroesophageal reflux disease (GERD) following surgical treatment. traditional Chinese medicine (TCM), including acupuncture and herbal medicine, has been proposed as an adjunctive therapy to promote gastrointestinal recovery and alleviate GERD symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To retrospectively study the clinical efficacy of modified Lou Bei Er Chen decoction combined with acupuncture in treating patients with GERD after radical gastrectomy due to gastric cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted, including patients with gastric cancer or malignant tumors of the stomach from January 2019 to December 2023 in the Affiliated Taizhou People's Hospital of Nanjing Medical University. Patients with a TCM diagnosis of qi depression and phlegm obstruction (&lt;i&gt;n&lt;/i&gt; = 128) were selected on the basis of prescription and treatment principles. They were then divided into a control group (&lt;i&gt;n&lt;/i&gt; = 61) and an observation group (&lt;i&gt;n&lt;/i&gt; = 67). The control group received treatment with Western medicine domperidone. The observation group were treated with Lou Bei Er Chen decoction orally, with acupuncture at specific acupoints (bilateral Hegu, bilateral Neiguan, and bilateral Zusanli), in addition to the treatment as in the control group, for a continuous treatment period of 8 weeks. The improvement time of postoperative gastrointestinal function indicators, gastrointestinal dysfunction scores, GERD-Q scores, and TCM syndrome scores were further observed for both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The observation group showed significantly shorter times for first flatus, defecation, bowel sound recovery, and initiation of nasogastric enteral nutrition than the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Upon treatment, the two groups demonstrated a significant reduction in gastrointestinal dysfunction scores, with a more significant reduction in the observation group (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The GERD-Q scores significantly decreased after 8 weeks of treatment in the two groups (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), with a significant reduction in the observation group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), compared with baseline. The TCM syndrome scores significantly decreased after 4 and 8 weeks of treatment in the two groups (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), with a significant reduction in the observation group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The effective rate of the observation group after 8 weeks of treatment was significantly higher than that after 4 weeks (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 13.648, &lt;i&gt;P&lt;/i&gt; = 0.003), and it was significantly higher than that of control group (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 13.879, &lt;i&gt;P&lt;/i&gt; = 0.003).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Lou Bei Er Chen decoction combined with acupuncture treatment can effectively alleviate clinical symptoms in patients GERD after gastric cancer surgery and improve their life quality. It is worthy of further pro","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99626"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754675","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":"Endoscopic full-thickness resection <i>vs</i> surgical resection for gastric stromal tumors: Efficacy and safety using propensity score matching.","authors":"Si-Qiao Zhao, Si-Yao Wang, Nan Ge, Jin-Tao Guo, Xiang Liu, Guo-Xin Wang, Lei Su, Si-Yu Sun, Sheng Wang","doi":"10.4240/wjgs.v17.i3.101002","DOIUrl":"10.4240/wjgs.v17.i3.101002","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic full-thickness resection (EFTR) is increasingly used for treating gastrointestinal stromal tumors (GISTs) in the stomach.</p><p><strong>Aim: </strong>To compare the efficacy, tolerability, and clinical outcomes of EFTR <i>vs</i> surgical resection (SR) for gastric GISTs.</p><p><strong>Methods: </strong>We collected clinical data from patients diagnosed with GISTs who underwent either EFTR or SR at our hospital from October 2011 to July 2024. Patients were matched in a 1:1 ratio based on baseline characteristics and tumor clinical-pathological features using propensity score matching. We analyzed perioperative outcomes and follow-up data. The primary outcome measure was progression-free survival (PFS).</p><p><strong>Results: </strong>Out of 912 patients, 573 met the inclusion criteria. After matching, each group included 95 patients. The EFTR group demonstrated statistically significant advantages over the SR group in average operative time (<i>P</i> < 0.001), length of hospital stay (<i>P</i> < 0.001), time to resume liquid diet (<i>P</i> < 0.001), incidence of adverse events (<i>P</i> = 0.031), and hospitalization costs (<i>P</i> < 0.001). The <i>en bloc</i> resection rate was significantly different, with SR group at 100% and EFTR group at 93.7% (<i>P</i> = 0.038). The median follow-up was 2451.50 days. Recurrence occurred in 3 patients in the EFTR group and 4 patients in the SR group, with no statistically significant difference (<i>P</i> = 1.000). Factors associated with PFS included age, tumor size, high-risk category in the modified National Institutes of Health (NIH) risk score, and resection status. Resection status was identified as an independent prognostic factor for PFS (<i>P</i> = 0.0173, hazard ratios = 0.0179, 95%CI: 0.000655-0.491). Notably, there was no statistically significant difference in PFS between the two groups.</p><p><strong>Conclusion: </strong>This study is a non-inferiority design. The EFTR group significantly outperformed the SR group in terms of operative time, length of hospital stay, time to resume a liquid diet, incidence of adverse events, and hospitalization costs, demonstrating its higher economic efficiency and better tolerability. Additionally, although the <i>en bloc</i> resection rate was lower in the EFTR group compared to the SR group, there were no significant differences in tumor recurrence rates and progression-free survival between the two groups. This study found no statistical difference in the primary endpoint of postoperative recurrence rates between the two groups. However, due to sample size limitations, this result requires further validation in larger-scale studies. The current results should be viewed as exploratory evidence.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101002"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754666","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":"Role of two-dimensional shear wave elastography in predicting post-hepatectomy liver failure: A step forwards in hepatic surgery.","authors":"Hua-Zhen Deng, Yu-Feng Liu, Han-Wen Zhang","doi":"10.4240/wjgs.v17.i3.98454","DOIUrl":"10.4240/wjgs.v17.i3.98454","url":null,"abstract":"<p><p>This study explores the significance of using two-dimensional shear wave elastography (2D-SWE) to assess liver stiffness (LS) and spleen area (SPA) for predicting post-hepatectomy liver failure (PHLF). By providing a non-invasive method to measure LS, which correlates with the degree of liver fibrosis, and SPA, an indicator of portal hypertension, 2D-SWE offers a comprehensive evaluation of a patient's hepatic status. These advancements are particularly crucial in hepatic surgery, where accurate preoperative assessments are essential for optimizing surgical outcomes and minimizing complications. This letter highlights the practical implications of integrating 2D-SWE into clinical practice, emphasizing its potential to improve patient safety and surgical precision by enhancing the ability to predict PHLF and tailor surgical approaches accordingly.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"98454"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754714","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":"Therapeutic effectiveness and influencing factors of laparoscopic appendectomy with mesoappendix dissection in the treatment of acute appendicitis.","authors":"Jiang Yuan, Qiang Liu, Bo-Yu Wu","doi":"10.4240/wjgs.v17.i3.103516","DOIUrl":"10.4240/wjgs.v17.i3.103516","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis (AP) is a frequently encountered surgical emergency, and appendectomy is conventionally regarded as the predominant treatment modality. Nevertheless, the therapeutic efficacy of this surgical approach remains to be improved. Thus, the exploration and implementation of surgical refinements are necessary.</p><p><strong>Aim: </strong>To elucidate the therapeutic effectiveness and influencing factors of laparoscopic appendectomy (LA) with mesoappendix dissection in the treatment of AP.</p><p><strong>Methods: </strong>First, 150 patients with AP who visited Shangrao Municipal Hospital between January 2022 and June 2024 were enrolled in this study. Among them, 72 patients were assigned to the control group to receive conventional LA, whereas 78 cases were included in the observation group for LA with mesoappendix dissection. Subsequently, indicators such as therapeutic effectiveness, surgical indices (operation time, intraoperative blood loss, and hospital stay), postoperative recovery indices (time to ambulation, gastrointestinal function recovery time, and time to food intake), incidence of adverse events (postoperative bleeding, pelvic infection, puncture site infection, and ileus), and serum inflammatory factors [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and C-reactive protein (CRP)] were collected and comparatively analyzed, and the influencing factors of therapeutic effectiveness in patients with AP were analyzed.</p><p><strong>Results: </strong>Compared with the control group, the observation group had higher clinical therapeutic effectiveness, less operation time, intraoperative blood loss, and hospital stay; shorter time to ambulation, gastrointestinal function recovery, and food intake; and a lower total incidence of adverse events, and this difference is statistically significant. In addition, the expression levels of various serum inflammatory factors in the observation group were significantly reduced postoperatively, which were markedly lower than those in the control group. Moreover, sex, age, body mass index, time from acute onset to admission, family medical history, preoperative TNF-α, preoperative IL-6, preoperative CRP, and treatment modality were identified to be not independent factors affecting the therapeutic effectiveness of LA with mesoappendix dissection in patients with AP.</p><p><strong>Conclusion: </strong>Overall, LA with mesoappendix dissection has a remarkable curative effect in treating patients with AP, which is worthy of clinical promotion.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"103516"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754778","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":"Initial experience with ultrafine choledochoscopy combined with low-dose atropine for the treatment of Oddi intersphincter stones.","authors":"Xiao-Si Hu, Yong Wang, Hong-Tao Pan, Chao Zhu, Shuai Zhou, Shi-Lei Chen, Hui-Chun Liu, Qing Pang, Hao Jin","doi":"10.4240/wjgs.v17.i3.102998","DOIUrl":"10.4240/wjgs.v17.i3.102998","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the use of ultrafine choledochoscopy has gradually increased in the treatment of cholelithiasis. However, stone incarceration and residual spasm of the sphincter of Oddi may be inevitable when an ultrafine choledochoscope is used alone.</p><p><strong>Aim: </strong>To investigate the safety and feasibility of ultrafine choledochoscopy combined with low-dose atropine in the treatment of Oddi intersphincter stones.</p><p><strong>Methods: </strong>Seventeen patients with Oddi intersphincter stones were retrospectively analyzed. The perioperative clinical data and follow-up information were collected.</p><p><strong>Results: </strong>Among the 17 patients, 3 were male and 14 were female. The mean age was 40.6 ± 13.9 years, and the mean diameter of the common bile duct was 7.8 ± 1.3 mm. All patients successfully underwent Oddi intersphincter stone removal using a combination of ultrafine choledochoscopy and low-dose atropine. No serious complications, such as postoperative hemorrhage, pancreatitis or bile leakage occurred in the 17 patients. During the one-year follow-up, none of the patients experienced stone recurrence.</p><p><strong>Conclusion: </strong>Ultrafine choledochoscopy combined with low-dose atropine is safe and feasible for the treatment of Oddi intersphincter stones.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"102998"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754699","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":"Analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive inguinal hernia surgery.","authors":"Qian-Xing Lou, Ke-Ping Xu","doi":"10.4240/wjgs.v17.i3.99597","DOIUrl":"10.4240/wjgs.v17.i3.99597","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Currently, very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective study, 94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia, admitted to Yiwu Central Hospital between May 2022 and May 2023, were divided into a control group (inhalation combined general anesthesia) and a treatment group (dexmedetomidine-assisted intravenous-inhalation combined general anesthesia). Perioperative indicators, analgesic effect, preoperative and postoperative 24-hours blood pressure (BP) and heart rate (HR), stress indicators, immune function levels, and adverse reactions were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline data, including age, hernia location, place of residence, weight, monthly income, education level, and underlying diseases, were not significantly different between the two groups, indicating comparability (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). No significant difference was found in operation time and anesthesia time between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). However, the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Preoperatively, no significant differences were found in the visual analog scale (VAS) scores between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). However, at 12, 18, and 24 hours postoperatively, the treatment group had significantly lower VAS scores than the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Although no significant differences in preoperative hemodynamic indicators were found between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05), both groups experienced some extent of changes in postoperative HR, diastolic BP (DBP), and systolic BP (SBP). Nevertheless, the treatment group showed smaller changes in HR, DBP, and SBP than the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Preoperative immune function indicators showed no significant differences between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). However, postoperatively, the treatment group demonstrated higher levels of CD3&lt;sup&gt;+&lt;/sup&gt;, CD4&lt;sup&gt;+&lt;/sup&gt;, and CD4+/CD8&lt;sup&gt;+&lt;/sup&gt; and lower levels of CD8&lt;sup&gt;+&lt;/sup&gt; than the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The rates of adverse reactions were 6.38% and 23.40% in the treatment and control groups, respectively, revealing a significant difference (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 5.371, &lt;i&gt;P&lt;/i&gt; = 0.020).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal ","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"99597"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754230","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 forearm and posterior wall anastomosis on gastroesophageal reflux in proximal gastrectomy patients.","authors":"Jia-Le Yang, Yi-Jie Yang, Lu Xu","doi":"10.4240/wjgs.v17.i3.100799","DOIUrl":"10.4240/wjgs.v17.i3.100799","url":null,"abstract":"<p><strong>Background: </strong>Proximal gastrectomy for gastric cancer often leads to postoperative gastroesophageal reflux (GER). This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.</p><p><strong>Aim: </strong>To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.</p><p><strong>Methods: </strong>A retrospective evaluation was conducted on 60 patients who underwent proximal gastrectomy between December 2020 and December 2023, divided equally into two groups based on the anastomosis technique used (forearm or posterior wall). GER symptoms were assessed using the GER disease questionnaire (GerdQ) preoperatively and on the first postoperative day. Biochemical markers [diamine oxidase (DAO), D-lactic acid, and endotoxin (ETX)] and nutritional indicators [serum ferritin (SF), prealbumin (PA), and albumin (ALB)] were measured to evaluate gastrointestinal barrier function and nutritional status.</p><p><strong>Results: </strong>Both groups showed significant improvements in GerdQ scores and reflux symptom scores post-treatment, with the observation group exhibiting greater reductions. Biochemical markers indicated enhanced gastrointestinal barrier function post-treatment in both groups, with notable increases in DAO, D-lactic, and ETX levels. Nutritional status indicators also demonstrated significant changes, with reductions in SF, PA, and ALB levels, suggesting an impact of treatment on inflammatory and nutritional status.</p><p><strong>Conclusion: </strong>The forearm anastomosis technique appears to be more effective in reducing GER symptoms and preserving gastrointestinal health in patients undergoing proximal gastrectomy for gastric cancer compared to the posterior wall anastomosis technique. These preliminary findings advocate for further research to confirm the benefits and potentially standardize Forearm Anastomosis in surgical practice for gastric cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100799"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754639","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 fluorouracil combined with paclitaxel and oxaliplatin for the treatment of advanced gastric signet ring cell carcinoma.","authors":"Mi Liu, Bei Feng, Na He, Rong Yan, Jie Qin","doi":"10.4240/wjgs.v17.i3.94286","DOIUrl":"10.4240/wjgs.v17.i3.94286","url":null,"abstract":"<p><strong>Background: </strong>Gastric signet ring cell carcinoma (GSRC) is a distinctive type of gastric cancer. It is a mucus-secreting adenocarcinoma that may progress to distant metastasis at an early stage. Because of poor differentiation, aggressive invasion, rapid progression, and other high-risk characteristics, early surgical intervention should be prioritized.</p><p><strong>Aim: </strong>To explore the clinical efficacy of fluorouracil (5-FU) combined with paclitaxel and oxaliplatin for the treatment of advanced GSRC.</p><p><strong>Methods: </strong>A total of 85 patients with advanced GSRC were selected between January 2020 and June 2021 and randomly divided into a control group (<i>n</i> = 42, receiving standard chemotherapy) and a treatment group (<i>n</i> = 43, receiving monotherapy with oxaliplatin, 5-FU, and paclitaxel). Patients in the treatment group received a 135 mg/m² infusion of paclitaxel for 3 hours, a 400 mg/m² infusion of calcium folate (or 200 mg/m² of levocalcium folate) for 2 hours, and an 85 mg/m² infusion of oxaliplatin for 2 hours. This was followed by a continuous intravenous infusion of 2200-2400 mg/m² 5-FU for 46 hours using a portable pump.</p><p><strong>Results: </strong>The treatment group showed a median survival time of 11.7 months and an objective response rate (ORR) of 32.5%, significantly higher than the control group (<i>P</i> < 0.05). Serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and albumin levels were correlated with treatment effectiveness in advanced GSRC (<i>P</i> < 0.01), but total serum protein was not correlated (<i>P</i> > 0.05). Safety and survival were assessed in all patients. Short-term efficacy was evaluated in 66 patients, with a disease control rate of 89.4% and an ORR of 48.5%. Median progression-free survival was 7.0 months (95% confidence interval [CI]: 6.85-7.15), and median overall survival was 10.6 months (95%CI: 9.86-11.3). Primary grade III/IV adverse events included neutropenia (22.1%) and peripheral neurotoxicity (10.3%).</p><p><strong>Conclusion: </strong>This treatment regimen is more effective for patients with advanced GSRC. Serum levels of CEA, CA19-9, and albumin predicted chemotherapy efficacy, while total protein concentration correlated minimally and insignificantly.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"94286"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754643","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 microwave ablation <i>vs</i> laparoscopic hepatectomy for primary small liver cancer: A comparative study.","authors":"Huan-Song Li, Xuan-Feng Zhang, Jun Fu, Bo Yuan","doi":"10.4240/wjgs.v17.i3.101786","DOIUrl":"10.4240/wjgs.v17.i3.101786","url":null,"abstract":"<p><strong>Background: </strong>In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation (MWA) and laparoscopic hepatectomy (LH), which are both important treatment modalities for liver neoplasms, have been limited in patients diagnosed with primary small liver cancer (PSLC).</p><p><strong>Aim: </strong>To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.</p><p><strong>Methods: </strong>This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups. The LH group, consisting of 61 cases, received LH, and the MWA group, which included 62 cases, underwent liver tumor MWA. Basic data and various perioperative indicators were compared between the two groups, including changes in liver function indicators [alanine aminotransferase (ALT), glutamic aminotransferase (AST), and total bilirubin (TBIL)] pre- and post-treatment, and efficacy and postoperative complications were analyzed.</p><p><strong>Results: </strong>No statistically significant difference was observed between the two groups in terms of age, gender, tumor diameter, liver function Child-Pugh classification and number of tumors, body mass index, and educational status (<i>P</i> > 0.05). The overall effective rate was higher in the MWA group than in the LH group (98.39% <i>vs</i> 88.52%) (<i>χ</i> ² = 4.918, <i>P</i> = 0.027). The MWA group exhibited less operation time, intraoperative bleeding, defecation time, and hospital stay than the LH group (<i>P</i> < 0.05). No difference was found in liver function indicators between the two groups pre-treatment (<i>P</i> > 0.05), and ALT, AST, and TBIL levels decreased in both groups post-treatment, with the MWA group demonstrating lower levels (<i>P</i> < 0.05). The MWA and LH groups exhibited postoperative complication rates of 4.84% and 19.67%, respectively, with statistically significant differences between the two groups (<i>P</i> = 0.012, <i>χ</i> ² = 6.318).</p><p><strong>Conclusion: </strong>MWA is more effective in treating PSLC, and it promotes faster postoperative recovery for patients, and more security improves liver function and reduces postoperative complications compared to LH.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101786"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754662","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}