World Journal of Gastrointestinal Surgery最新文献

{"title":"Controversies and consensus surrounding laparoscopic pylorus-preserving gastrectomy for early gastric cancer.","authors":"Ying-Xuan Ye, Chu-Ying Wu, Li-Quan Chen, Si-Jia Wu, Kai Ye","doi":"10.4240/wjgs.v17.i5.105295","DOIUrl":"10.4240/wjgs.v17.i5.105295","url":null,"abstract":"<p><p>In recent years, the detection rate of early gastric cancer in China has significantly increased. Early gastric cancer is associated with a favourable prognosis; thus, enhancing the postoperative quality of life for patients has become an increasingly pressing issue in treating gastric cancer. Consequently, function-preserving gastrectomy has emerged as a viable option. This surgical approach aims to minimize the extent of resection while preserving some gastric function, all within the framework of radical tumour excision. Pylorus-preserving gastrectomy (PPG) serves as a representative example of a function-preserving technique and is particularly suitable for early-stage gastric cancer of the middle segment of the stomach. Compared with distal gastrectomy, laparoscopic PPG offers several advantages: (1) Results in less surgical trauma; and (2) Reduces the incidence of postoperative complications such as dumping syndrome, bile reflux gastritis, and gallstones while also improving nutritional status postsurgery. However, the implementation of PPG remains contentious within the medical community. In light of new Japanese guidelines for gastric cancer treatment and informed by current research trends along with relevant evidence-based medicine principles, this review examines various aspects related to laparoscopic PPG, including its definition and indications, safety profile, benefits, technical considerations, methods for digestive tract reconstruction and postoperative complications.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"105295"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275949","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":"Application effect of anticipatory care in postoperative infection and complication management in children with acute appendicitis.","authors":"Ning-Ning Xue, Xiang-Jing Li, Zhao-Ming Liu, Fei Tian, Li-Bo Wang, Jia-Huan Wang","doi":"10.4240/wjgs.v17.i5.103141","DOIUrl":"10.4240/wjgs.v17.i5.103141","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is common among pediatric patients, and postoperative infections and complications are significant factors that affect recovery. As a \"forward-looking\" nursing model, anticipatory care may reduce the incidence of postoperative wound infections and complications.</p><p><strong>Aim: </strong>To explore the effects of anticipatory care on the management of postoperative infections and complications in pediatric patients diagnosed with acute appendicitis.</p><p><strong>Methods: </strong>This prospective randomized controlled study included data from 78 pediatric patients who underwent acute appendicitis surgery at Shijiazhuang Sixth Hospital (Hebei Province, China) between February 2021 and March 2024. Patients were divided into two groups: The intervention and control groups (<i>n</i> = 39 each) were based on a random numbers table method. Both groups received routine postoperative nursing care, whereas the intervention group received additional anticipatory care. Statistical analyses were performed using independent sample <i>t</i>-tests, <i>χ</i> ² tests, analysis of variance, and rank-sum tests.</p><p><strong>Results: </strong>Postoperative pain scores and hospital length of stay were significantly lower in the intervention group than those in the control group (<i>P</i> < 0.05 and <i>P</i> < 0.001, respectively). Postoperative wound infection and overall complication rates were significantly lower in the intervention group than those in the control group (5.13% <i>vs</i> 23.08%, <i>P</i> < 0.001; 15.38% <i>vs</i> 46.15%, <i>P</i> < 0.001, respectively). Furthermore, parental satisfaction scores were significantly higher in the intervention group than those in the control group (<i>P</i> < 0.05). Logistic regression identified high C-reactive protein level as a risk factor for postoperative infections and complications, whereas proactive (<i>i.e.</i> anticipatory) nursing intervention was a protective factor.</p><p><strong>Conclusion: </strong>This study provided a scientific basis for the implementation of anticipatory care in the postoperative management of pediatric patients experiencing acute appendicitis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"103141"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275993","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":"Novel inflammatory-nutritional prognostic index for advanced gastric cancer patients undergoing gastrectomy and prophylactic hyperthermic intraperitoneal chemotherapy.","authors":"Liang Wang, Mei-Zhu Chen, Lei Liu, Zi-Nian Jiang, Si-Meng Zhang, Mao-Shen Zhang, Xian-Xiang Zhang, Rui-Qing Liu, Dong-Sheng Wang","doi":"10.4240/wjgs.v17.i5.102201","DOIUrl":"10.4240/wjgs.v17.i5.102201","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) is one of the methods to prevent peritoneal metastasis of advanced gastric cancer (AGC). However, the prognosis of gastric cancer patients who receive this treatment are different.</p><p><strong>Aim: </strong>To investigate whether inflammation and nutritional indicators affect the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC, and to develop a novel inflammatory nutritional prognostic index (INPI). Additionally, we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.</p><p><strong>Methods: </strong>Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected. Multicollinearity analysis and least absolute shrinkage and selection operator (LASSO) Cox regression were utilized to construct the INPI. Survival analyses were performed using the Kaplan-Meier method and log-rank test. Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors, and a prognostic nomogram was generated. And the model was validated using the bootstrap method.</p><p><strong>Results: </strong>Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected. Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI. Survival analyses were performed using the Kaplan-Meier method and log-rank test. Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors, and a prognostic nomogram was generated. And the model was validated using the bootstrap method.</p><p><strong>Conclusion: </strong>Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC. The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"102201"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276093","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":"Nutritional and inflammatory indicators differ among patients with colorectal cancer with distinct microsatellite stability statuses.","authors":"Hao Zuo, Zheng Yuan, Meng-Hui Gu, Wei Xu, Jia-Hui Zhou, Yan Zhang, Xin-Hua Gu","doi":"10.4240/wjgs.v17.i5.104394","DOIUrl":"10.4240/wjgs.v17.i5.104394","url":null,"abstract":"<p><strong>Background: </strong>Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer, which are factors closely associated with the diagnosis and treatment of colorectal cancer (CRC).</p><p><strong>Aim: </strong>To explore the relationship between nutritional and inflammatory indicators and microsatellite stability (MSS) status in CRC.</p><p><strong>Methods: </strong>The clinical data of 56 patients who underwent surgical treatment for CRC were collected. Furthermore, the expressions of nutritional (levels of serum albumin, triglycerides, serum cholesterol, and body mass index) and inflammatory response indicators (absolute neutrophil count, absolute lymphocyte count, absolute monocyte count, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) as well as their correlation with microsatellite instability (MSI) status were investigated in patients with CRC.</p><p><strong>Results: </strong>Compared to the patients with MSS tumors, those with MSI tumors demonstrated significantly lower levels of two nutritional indicators, namely serum albumin and body mass index (<i>P</i> < 0.05). Moreover, patients in the MSI group demonstrated significantly lower absolute lymphocyte counts and higher neutrophil-to-lymphocyte ratio than those in the MSS group (<i>P</i> < 0.05), indicating pronounced differences in inflammatory responses and immune states between the two groups.</p><p><strong>Conclusion: </strong>Certain nutritional and inflammatory indicators exhibit significant differences among patients with MSI and MSS CRC, highlighting their potential role in the clinical treatment and health management of this specific population.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"104394"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276094","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":"Parenteral nutrition with n-3 polyunsaturated fatty acids on nutrition inflammatory and immune status of gastrointestinal cancer patients: Meta-analysis.","authors":"Qin-Hu Gan, Shu-Qun Li, Xin-Li Gan, Zhi-Qing Jiang, Zhi-Yuan Jian","doi":"10.4240/wjgs.v17.i5.105743","DOIUrl":"10.4240/wjgs.v17.i5.105743","url":null,"abstract":"<p><strong>Background: </strong>The incidence of malignant tumors in the digestive system is increasing and is a threat to human health. However, the long duration from tumor detection to radical resection, stress responses due to surgical trauma, and insufficient nutritional intake increases the risk of malnutrition, immune function reduction, postoperative complications, and intestinal dysfunction among patients.</p><p><strong>Aim: </strong>To systematically investigate the association of parenteral nutrition enriched with n-3 polyunsaturated fatty acids (PUFAs) with the nutritional status of patients after gastrointestinal treatment.</p><p><strong>Methods: </strong>Randomized controlled trials associated with PUFA-enriched parenteral nutrition administration in patients with digestive system malignancies were retrieved from online databases such as PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network, China VIP, Wanfang, and China Biomedical Literature Database, with the retrieval time from database inception to present. Two researchers independently extracted data. Each article's bias risk was assessed by referring to the Cochrane Handbook version 5.3 criteria and RevMan5.4 was used for data analysis.</p><p><strong>Results: </strong>This meta-analysis involved six randomized controlled trials involving a total of 505 cases. Random-effects model analysis indicated remarkably better improvements in various inflammatory factors in the study group (<i>P</i> < 0.05). Meta-analysis of nutritional indicators revealed that the study group had higher total protein, albumin, and prealbumin levels, as well as lower transferrin levels compared to the control group (<i>P</i> < 0.05). Meanwhile, meta-analysis of T-cell subsets revealed no remarkable inter-group difference in post-treatment CD8⁺ cells (<i>P</i> > 0.05). Moreover, the meta-analysis identified a notably lower incidence of adverse reactions in the study group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Administration of PUFAs helps improve the nutritional status of patients with digestive malignancies in the perioperative period. It promotes immune function recovery, reduces the inflammatory response, and decreases the risk of adverse effects. These beneficial effects make it worth investigating and promoting their use in appropriate patient populations. However, further validation <i>via</i> high-quality studies with long intervention time and extended follow-up periods is required.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"105743"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276095","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":"Ultrasound-guided endoscopic drainage for the management of pancreatic pseudocysts: A case report.","authors":"Ying-Ling Liu, Jie Liu, Wen-Jun Jiang, Kai-Guang Zhang, Ye-Tao Wang","doi":"10.4240/wjgs.v17.i5.106784","DOIUrl":"10.4240/wjgs.v17.i5.106784","url":null,"abstract":"<p><strong>Background: </strong>The treatment strategy for pancreatic pseudocysts (PPC) is comprehensive and warrants multidisciplinary participation. However, at present, the treatment concepts for PPC are inconsistent. Moreover, the timing of interventional therapy is unclear, and complication management is insufficient. Therefore, the development of a multidisciplinary expert consensus on PPC is warranted. At present, endoscopic treatment is recommended for managing PPC in American Society for Gastrointestinal Endoscopy guideline and Chinese Consensus guidelines.</p><p><strong>Case summary: </strong>In this study, we present a rare case of PPC identified by endoscopy and imaging examination, and successfully managed by endoscopic and percutaneous drainage. In detail, an obese patient with a history of recurrent pancreatitis presents an irregular, elliptical cystic low-density shadow in the pancreatic region. Endoscopic ultrasound combined with double knife incision technique was used to endoscopic drainage, resulting in a favorable prognosis.</p><p><strong>Conclusion: </strong>Ultrasound-guided endoscopic drainage for the management of PPC may provide additional insights to current clinical guidelines.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 5","pages":"106784"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276053","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":"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}