World Journal of Gastrointestinal Surgery最新文献

{"title":"Efficacy-cost analysis of endoscopic mucosal resection and cold snare polypectomy: A propensity score matching analysis.","authors":"Shi-Yi Zhang, Ying-Chun Wang, Lei-Lei Liu, Zhi-Heng Wang, Xue-Mei Guan","doi":"10.4240/wjgs.v17.i2.99510","DOIUrl":"10.4240/wjgs.v17.i2.99510","url":null,"abstract":"<p><strong>Background: </strong>Although substantial evidence supports the advantages of cold snare polypectomy (CSP) in terms of polypectomy efficacy and reduced postoperative adverse events, few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection (EMR) for the treatment of intestinal polyps.</p><p><strong>Aim: </strong>To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.</p><p><strong>Methods: </strong>A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023. According to the treatment methods, they were divided into EMR (<i>n</i> = 46) group and CSP (<i>n</i> = 54) group. The baseline data of the two groups were balanced by 1:1 propensity score matching (PSM), and the cost-effectiveness analysis was performed on the two groups after matching. The recurrence rate of the two groups of patients was followed up for 1 year, and they were divided into recurrence group and non-recurrence group according to whether they recurred. Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.</p><p><strong>Results: </strong>Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM (<i>P</i> < 0.05). Following PSM, the number of polyps and smoking history were well balanced between the EMR and CSP groups. The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group. Concurrently, the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group (<i>P</i> < 0.05). Upon completion of the 1-year follow-up, the rate of recurrence after endoscopic intestinal polypectomy was 38.00%. Multivariate methods revealed that age ≥ 60 years, male sex, number of polyps ≥ 3, and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>CSP was more cost-effective for the treatment of intestinal polyps. An age ≥ 60 years, male sex, having a number of polyps ≥ 3, and pathological type of adenoma are independent influencing factors for recurrence.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"99510"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586942","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":"Magnamosis for rectal reconstruction in canines.","authors":"Shi-Qi Liu, Hong-Ke Zhang, Yi Lv, Xiang-Hua Xu, Yu-Feng Li, Dong-Wen Quan","doi":"10.4240/wjgs.v17.i2.97862","DOIUrl":"10.4240/wjgs.v17.i2.97862","url":null,"abstract":"<p><strong>Background: </strong>The magnamosis, a minimal invasive, suture-free procedure, has been used for digestive tract or vessel reconstruction, such as gastrointestinal anastomosis, bilioenteric anastomosis, and coronary artery bypass. Although some case reports have demonstrated the potential of magnamosis for the treatment of congenital rectal atresia (RA), they cannot provide strong evidence for its widespread application.</p><p><strong>Aim: </strong>To assess the feasibility and safety of magnamosis in treating RA in dogs as compared to suturing anastomosis. The findings of this study can be beneficial in guiding the clinical application of magnamosis.</p><p><strong>Methods: </strong>Thirty-six dogs were randomly assigned to the magnamosis group (<i>n</i> =18) and the suturing anastomosis group (<i>n</i> =18). The rectum was freed laparoscopically in all dogs. In the magnamosis group, rectal anastomosis was performed using a pair of magnetic rings, while the suturing anastomosis group underwent a straight-sighted end-to-end rectal anastomosis with 4-0 absorbable sutures. The anastomosis time was recorded, and abdominal plain film examination was performed to locate the magnets until they were expelled postoperatively. Specimens of the anastomosis were evaluated at one month, three months, and six months after surgery.</p><p><strong>Results: </strong>The mean time for rectal anastomosis was significantly shorter in the magnamosis group (12.22 ± 2.78 minutes) than the suturing anastomosis group (18.11 ± 1.68 minutes). There was one incidence of anastomotic bleeding in the suturing anastomosis group, whereas no complication was recorded in the magnamosis group. The magnets were discharged post-surgery in 7.17 ± 1.30 days in all the dogs. The histopathological examination revealed a smoother healing of anastomotic mucosa in the magnamosis group as compared to that in the suturing anastomosis group. Moreover, the fiber alignment was also more natural in the magnamosis group with minimal inflammation.</p><p><strong>Conclusion: </strong>Rectal reconstruction using magnamosis is a feasible, safe, and effective alternative to suturing anastomosis in dogs, with the added benefit of faster and more natural healing of the anastomosis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"97862"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587241","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 C-reactive protein, procalcitonin, and total bilirubin levels for pancreatic fistula after gastrectomy for gastric cancer.","authors":"Jing-Long Yuan, Xuan Wen, Pan Xiong, Li Pei","doi":"10.4240/wjgs.v17.i2.103266","DOIUrl":"10.4240/wjgs.v17.i2.103266","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment. Advances in surgical technology have reduced the risk of complications after radical gastrectomy; however, post-surgical pancreatic fistula remain a serious issue. These fistulas can lead to abdominal infections, anastomotic leakage, increased costs, and pain; thus, early diagnosis and prevention are crucial for a better prognosis. Currently, C-reactive protein (CRP), procalcitonin (PCT), and total bilirubin (TBil) levels are used to predict post-operative infections and anastomotic leakage. However, their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear. The present study was conducted to determine their predictive value.</p><p><strong>Aim: </strong>To determine the predictive value of CRP, PCT, and TBil levels for pancreatic fistula after gastric cancer surgery.</p><p><strong>Methods: </strong>In total, 158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included. The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group. Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula. Receiver operating characteristic (ROC) curves were used to determine the predictive value of serum CRP, PCT, and TBil levels on day 1 post-surgery.</p><p><strong>Results: </strong>On day 1 post-surgery, the CRP, PCT, and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group (<i>P</i> < 0.05). A higher fistula grade was associated with higher levels of the indices. Univariate analysis revealed significant differences in the presence of diabetes, hyperlipidemia, pancreatic injury, splenectomy, and the biomarker levels (<i>P</i> < 0.05). Logistic multivariate analysis identified diabetes, hyperlipidemia, pancreatic injury, CRP level, and PCT level as independent risk factors. ROC curves yielded predictive values for CRP, PCT, and TBil levels, with the PCT level having the highest area under the curve (AUC) of 0.80 [95% confidence interval (CI): 0.72-0.90]. Combined indicators improved the predictive value, with an AUC of 0.86 (95%CI: 0.78-0.93).</p><p><strong>Conclusion: </strong>Elevated CRP, PCT, and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"103266"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587262","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":"Preliminary study on the clinical value of endoscopic stricturotomy in the treatment of stricturing Crohn's disease.","authors":"Lu Cui, Min Su, Yan-Bo Ding, Mei Wang, Ke-Wen Sun","doi":"10.4240/wjgs.v17.i2.100631","DOIUrl":"10.4240/wjgs.v17.i2.100631","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) frequently leads to intestinal strictures, which pose significant challenges due to their complexity and limited treatment options. While medications can address inflammatory strictures, they are largely ineffective for fibrotic and mixed strictures, often necessitating surgical intervention. However, surgery carries considerable risks, including bleeding, infection, anastomotic leaks, and postoperative restricture formation. Endoscopic treatment, particularly endoscopic stricturotomy, offers a minimally invasive alternative that bridges the gap between medication and surgery.</p><p><strong>Aim: </strong>To investigate the safety and efficacy of stricturotomy under single-balloon enteroscopy in stricturing CD.</p><p><strong>Methods: </strong>Patients diagnosed with stricturing CD at The First People's Hospital of Changzhou from June 2020 to April 2024 were enrolled and underwent endoscopic stricturotomy (ES). Relevant clinical data of patients were collected retrospectively. Outcomes included success rate, remission time, complications, and follow-up interventions. This observational study was followed up postoperatively to observe patient remission and recurrence rates.</p><p><strong>Results: </strong>Seventeen endoscopic strictures were created in 11 patients, achieving a 100% immediate success rate without any serious complications. During the follow-up period, stricture recurrence was observed in two patients, resulting in an endoscopic reintervention rate of 18.2%. Additionally, two patients required subsequent surgical intervention, with a surgical treatment rate of 18.2%. One patient experienced bowel obstruction 18 months post-ES and was successfully managed with conservative treatment without surgical intervention. The remission duration after the initial ES treatment was 10.1 ± 8.2 months, with a median remission time of 10 months.</p><p><strong>Conclusion: </strong>ES is a safe and effective treatment for CD-related strictures and warrants further clinical promotion and application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"100631"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587264","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":"Comprehensive influence of individualized nutrition support and nursing strategy on rehabilitation of patients with liver cancer after operation.","authors":"Xue-Li Zhang, Hai-Yan Ma","doi":"10.4240/wjgs.v17.i2.101297","DOIUrl":"10.4240/wjgs.v17.i2.101297","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms. Surgical intervention constitutes a critical therapeutic approach for this condition. Nonetheless, postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.</p><p><strong>Aim: </strong>To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.</p><p><strong>Methods: </strong>In this study, a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients. The subjects were selected as subjects and divided into two groups based on differing nursing interventions, with each group comprising 30 patients. The control group received standard nutritional support and care, whereas the experimental group received individualized nutritional support and nursing strategies. The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices, nutritional status, quality of life (QoL), and complication rates between the two groups.</p><p><strong>Results: </strong>The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery, and the average liver function recovery index of the experimental group was 85. significantly higher than that of the control group (73.67 ± 7.19). In terms of nutritional status, the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group, which were 42.33 ± 2.4 g/L and 93.3%, respectively, compared with 36.01 ± 3.85 g/L and 76.7% of the control group. In addition, the average QoL score of the experimental group was 84.66 ± 3.7 points, which was significantly higher than that of the control group (70.92 ± 4.28 points). At the psychological level, the average anxiety score of the experimental group was 1.17 ± 0.29, and the average depression score was 1.47 ± 0.4, which were significantly lower than the 2.26 ± 0.42 and 2.57 ± 0.45 of the control group. This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy. More importantly, the complication rate in the experimental group was only 10%, much lower than the 33.3% in the control group.</p><p><strong>Conclusion: </strong>Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients. Consequently, it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"101297"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586747","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":"Personalized nutritional care for immune function recovery in postoperative gastrointestinal surgery patients: An observational study.","authors":"Fang-Hong Zhong","doi":"10.4240/wjgs.v17.i2.99893","DOIUrl":"10.4240/wjgs.v17.i2.99893","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) surgery can significantly affect the nutritional status and immune function of patients. This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.</p><p><strong>Aim: </strong>To study examines personalized nutritional care's impact on immune function recovery, nutritional status, and clinical outcomes after GI surgery.</p><p><strong>Methods: </strong>This observational study included 80 patients who underwent GI surgery between 2021 and 2023. Patients received personalized nutritional care based on their individual needs and surgical outcomes. Immune function markers including lymphocyte subsets, immunoglobulins, and cytokines were measured preoperatively and at regular intervals postoperatively. Nutritional status, clinical outcomes, and quality of life were assessed.</p><p><strong>Results: </strong>Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline. At 4 weeks postoperatively, CD4+ T-cell counts increased by 25% (<i>P</i> < 0.001), while interleukin-6 levels decreased by 40% (<i>P</i> < 0.001). Nutritional status, as measured by prealbumin and transferrin levels, improved by 30% (<i>P</i> < 0.01). Postoperative complications reduced by 35% compared to historical controls. The quality-of-life scores improved by 40% at 3 months postoperatively.</p><p><strong>Conclusion: </strong>Personalized nutritional care enhances immune function recovery, improves nutritional status, and reduces complications in patients undergoing postoperative GI surgery, highlighting its crucial role in optimizing patient outcomes following such procedures.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"99893"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587259","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 magnetic resonance imaging parameters combined with tumor markers for rectal cancer recurrence risk after surgery.","authors":"Lei Wu, Jing-Jie Zhu, Xiao-Han Liang, He Tong, Yan Song","doi":"10.4240/wjgs.v17.i2.101897","DOIUrl":"10.4240/wjgs.v17.i2.101897","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;An increasing number of studies to date have found preoperative magnetic resonance imaging (MRI) features valuable in predicting the prognosis of rectal cancer (RC). However, research is still lacking on the correlation between preoperative MRI features and the risk of recurrence after radical resection of RC, urgently necessitating further in-depth exploration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the correlation between preoperative MRI parameters and the risk of recurrence after radical resection of RC to provide an effective tool for predicting postoperative recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The data of 90 patients who were diagnosed with RC by surgical pathology and underwent radical surgical resection at the Second Affiliated Hospital of Bengbu Medical University between May 2020 and December 2023 were collected through retrospective analysis. General demographic data, MRI data, and tumor markers levels were collected. According to the reviewed data of patients six months after surgery, the clinicians comprehensively assessed the recurrence risk and divided the patients into high recurrence risk (37 cases) and low recurrence risk (53 cases) groups. Independent sample &lt;i&gt;t&lt;/i&gt;-test and &lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; test were used to analyze differences between the two groups. A logistic regression model was used to explore the risk factors of the high recurrence risk group, and a clinical prediction model was constructed. The clinical prediction model is presented in the form of a nomogram. The receiver operating characteristic curve, Hosmer-Lemeshow goodness of fit test, calibration curve, and decision curve analysis were used to evaluate the efficacy of the clinical prediction model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The detection of positive extramural vascular invasion through preoperative MRI [odds ratio (OR) = 4.29, &lt;i&gt;P&lt;/i&gt; = 0.045], along with elevated carcinoembryonic antigen (OR = 1.08, &lt;i&gt;P&lt;/i&gt; = 0.041), carbohydrate antigen 125 (OR = 1.19, &lt;i&gt;P&lt;/i&gt; = 0.034), and carbohydrate antigen 199 (OR = 1.27, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) levels, are independent risk factors for increased postoperative recurrence risk in patients with RC. Furthermore, there was a correlation between magnetic resonance based T staging, magnetic resonance based N staging, and circumferential resection margin results determined by MRI and the postoperative recurrence risk. Additionally, when extramural vascular invasion was integrated with tumor markers, the resulting clinical prediction model more effectively identified patients at high risk for postoperative recurrence, thereby providing robust support for clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of this study indicate that preoperative MRI detection is of great importance for predicting the risk of postoperative recurrence in patients with RC. Monitoring these markers helps clinicians identify patients at high risk, allowing for more aggressive treat","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"101897"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587263","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 small intestinal bypass outperforms Roux-en-Y and jejunoileal bypass in glucose regulation in streptozotocin induced diabetic rats.","authors":"Chi-Ying Xu, Cai Tan, Xin Luo, Kun Yang, Ren-Ran Wu, Lei Lin, Guan-Lei Liu, Jin-Yuan Duan","doi":"10.4240/wjgs.v17.i2.98585","DOIUrl":"10.4240/wjgs.v17.i2.98585","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of various bariatric surgeries varies in reducing blood glucose levels. Given the distinct mechanisms and anatomical alterations associated with each procedure, it is crucial to compare their glycemic control outcomes. We hypothesize that proximal small intestinal bypass (PSIB) is superior in blood glucose reduction over Roux-en-Y gastric bypass (RYGB) and jejunoileal bypass (JIB).</p><p><strong>Aim: </strong>To compare the effectiveness of PSIB, RYGB, and JIB in lowering blood glucose.</p><p><strong>Methods: </strong>Rats with streptozotocin-induced diabetes were randomly divided into PSIB, RYGB, JIB, and sham-operated groups. Body weight, food intake, fasting blood glucose level, oral glucose tolerance test, insulin tolerance test, liver enzymes, and blood lipids were measured.</p><p><strong>Results: </strong>Postoperatively, only the JIB group had a lower body weight compared to the sham group. The food intake of the rats in all three surgical groups was significantly less than that in the sham group. Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups. Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group, but the improvement appeared earliest in the PSIB group. At six weeks post-surgery, the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.</p><p><strong>Conclusion: </strong>PSIB demonstrated excellent hypoglycemic effects in the early postoperative period, and had better efficacy than RYGB and JIB.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"98585"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587270","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 comparative study of different surgical methods for gastric ulcer perforation: Efficacy and postoperative complications.","authors":"Yu-Fan Pang, Liang Shu, Cheng-Wei Xia","doi":"10.4240/wjgs.v17.i2.101896","DOIUrl":"10.4240/wjgs.v17.i2.101896","url":null,"abstract":"<p><strong>Background: </strong>Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed. It is often the result of chronic peptic ulcer disease, which is characterized by a breach in the gastric wall due to ulceration. Surgical intervention is essential for managing this life-threatening complication. However, the optimal surgical technique remains debatable among clinicians. Various methods have been employed, including simple closure, omental patch repair, and partial gastrectomy, each with distinct advantages and disadvantages. Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making. This study addresses the need for a comprehensive analysis in this area.</p><p><strong>Aim: </strong>To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023. The patients were divided into three groups based on the surgical method: Simple closure, omental patch repair, and partial gastrectomy. The primary outcomes were the operative success rate and incidence of postoperative complications. Secondary outcomes included the length of hospital stay, recovery time, and long-term quality of life.</p><p><strong>Results: </strong>The operative success rates for simple closure, omental patch repair, and partial gastrectomy were 92.5%, 95%, and 97.5%, respectively. Postoperative complications occurred in 20%, 15%, and 17.5% of patients in each group, respectively. The partial gastrectomy group showed a significantly longer operative time (<i>P</i> < 0.001) but the lowest rate of ulcer recurrence (2.5%, <i>P</i> < 0.05). The omental patch repair group demonstrated the shortest hospital stay (mean 7.2 days, <i>P</i> < 0.05) and fastest recovery time.</p><p><strong>Conclusion: </strong>While all three surgical methods showed high success rates, omental patch repair demonstrated the best overall outcomes, with a balance of high efficacy, low complication rates, and shorter recovery time. However, the choice of the surgical method should be tailored to individual patient factors and the surgeon's expertise.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"101896"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587272","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":"Humanistic and graded psychological nursing care for patients undergoing endoscopic submucosal dissection of gastrointestinal tumors.","authors":"Ying Jiang, Bao-Lian Bu, Wei Yang, Yuan Zhi, Hong-Yan Ye","doi":"10.4240/wjgs.v17.i2.100322","DOIUrl":"10.4240/wjgs.v17.i2.100322","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) has become a widely accepted, minimally invasive treatment for gastrointestinal submucosal tumors. It has been reported that humanistic nursing care with graded psychological interventions can effectively enhance patients' physical activity in patients, reduce postoperative complications, and improve their postoperative quality of life.</p><p><strong>Aim: </strong>To investigate the effects of combining humanistic care with graded psychological support on nursing satisfaction and quality of life in patients undergoing ESD for gastrointestinal submucosal tumors.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 180 patients who underwent ESD surgery for gastrointestinal submucosal tumors at our hospital between March 2021 and February 2023. Patients were allocated into groups based on the nursing care they received: The control group, which received routine care (<i>n</i> = 90), and the observation group, which was subjected to humanistic nursing care in combination with graded psychological support (<i>n</i> = 90). Patient anxiety and depression were assessed using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Quality of life was evaluated using the short-form 36 health survey, and additional indications such as time to first food intake, surgery duration, length of hospital stay, nursing satisfaction, and adverse reactions were also recorded. Data was analyzed using SPSS22.0, with <i>t</i>-tests employed for continuous variables and <i>χ</i> ² tests for categorical data.</p><p><strong>Results: </strong>Patients in the observation group experienced significantly shorter times to first postoperative meal, surgery, and hospital stay compared to the control group. After the intervention, the SAS score of the observation group was 43.17 ± 5.68, and the SDS score was 41.57 ± 6.52, both significantly lower than those of the control group, with SAS score of 52.38 ± 5.21 and SDS score of 51.23 ± 8.25. In addition, the observation group scored significantly higher in daily living, physical function, psychological well-being, and social functioning (80.01 ± 6.39, 83.59 ± 6.89, 81.69 ± 5.34, and 85.23 ± 6.05, respectively). Moreover, the observation group also exhibited higher satisfaction and self-efficacy scores and a lower incidence of adverse reactions compared to the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>For patients undergoing ESD for gastrointestinal submucosal tumors, humanistic nursing care in combination with graded psychological nursing care significantly shorten the times to first postoperative meal, surgery, and hospital stay, effectively alleviates anxiety and depression, improves quality of life and nursing satisfaction, and mitigate the incidence of adverse reactions.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 2","pages":"100322"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587237","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}