World Journal of Gastrointestinal Surgery最新文献

{"title":"Postoperative care for patients undergoing cholecystectomy: A comprehensive nursing review.","authors":"Jing-Jia Tu, Zhu Chen, Zhi-Qin Zhou, Fang-Yan Lu","doi":"10.4240/wjgs.v17.i8.106170","DOIUrl":"10.4240/wjgs.v17.i8.106170","url":null,"abstract":"<p><p>Cholecystectomy is a commonly performed surgical procedure globally, primarily for symptomatic cholelithiasis or related gallbladder conditions. Advances in surgical techniques, such as laparoscopic and robotic approaches, have enhanced patient results and reduced hospital stays. However, postoperative care is crucial for optimizing recovery, preventing complications, and enhancing quality of life. Nurses have a critical role in achieving these objectives, starting from immediate postoperative evaluation through long-term monitoring. This review outlines essential nursing considerations and evidence-based practices for postoperative care following cholecystectomy. Key areas encompass pain control, respiratory assistance, early mobilization, wound and drain management, nutritional advice, psychosocial aid, and discharge preparation. By integrating current research and clinical guidelines, this review aims to serve as an authoritative resource to assist nurses in improving postoperative outcomes and patient satisfaction.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"106170"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065762","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":"Clinicopathological and endoscopic ultrasonography characteristics of esophageal bronchogenic cysts: A single-center study.","authors":"Guo-Dong Shan, Long-Gui Ning, Fen-Ming Zhang, Hao-Jie Du, Wen-Guo Chen, Jing-Jie Wang, Ai-Qing Li, Guo-Qiang Xu, Hong-Tan Chen","doi":"10.4240/wjgs.v17.i8.108692","DOIUrl":"10.4240/wjgs.v17.i8.108692","url":null,"abstract":"<p><strong>Background: </strong>Esophageal bronchogenic cysts (EBCs) are usually discovered incidentally during radiologic or endoscopic examinations. They are rare and prone to misdiagnosis or mistreatment. As a submucosal lesion, the endoscopic ultrasonography (EUS) characteristics of EBCs are unclear.</p><p><strong>Aim: </strong>To analyze the clinicopathological and EUS characteristics of EBCs.</p><p><strong>Methods: </strong>A total of 22 patients with a histological diagnosis of EBCs who underwent EUS examination were retrospectively included. The clinicopathological and EUS features were collected and analyzed.</p><p><strong>Results: </strong>Most of the EBCs were asymptomatic, and no malignant transformation or precancerous changes was found histologically. Most of the EBCs were located in the lower esophagus (72.7%, 16/22). A total of 90.9% (20/22) of the EBCs originated from the muscularis propria, and 9.1% (2/22) originated from the submucosa. All of the lesions had clear boundaries. In terms of echo, 77.3% (17/22) had a hypoechoic pattern, and 22.7% (5/22) had an anechoic pattern. We found floating echoes inside the lesion, which presented as a punctiform hyperecho in 45.5% (10/22) and a flocculent hypoecho in 36.4% (8/22) of the patients. A total of 45.5% (10/22) displayed posterior wall enhancement. Fourteen patients underwent color doppler, and no blood flow signal was identified. On EUS elastography, the EBCs presented a yellow-green or green pattern (100%, 6/6). When contrast-enhanced EUS was used, the EBCs showed no enhancement (100%, 5/5).</p><p><strong>Conclusion: </strong>When a submucosal lesion located at the lower esophagus originates from the intrinsic muscle layer, the possibility of EBCs should be noted, the EUS characteristics of which include a hypoecho with a clear boundary and a posterior wall enhancement, a floating echo inside and no blood flow signal, a yellow-green or green pattern on elastography, and no enhancement on contrast EUS.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108692"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065857","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":"Laparoscopic hepatectomy based on diseased bile duct tree territory guided by double landmarks for hepatolithiasis: A case report.","authors":"Yue-Hua Yang, Xiao-Ju Li, Yi-Xuan Liu, Xing-Ru Wang, Jian-Wei Li","doi":"10.4240/wjgs.v17.i8.108959","DOIUrl":"10.4240/wjgs.v17.i8.108959","url":null,"abstract":"<p><strong>Background: </strong>Complex hepatolithiasis has a high perioperative risk and recurrence rate. Currently, standardized treatment protocols and reliable anatomical landmarks remain undefined, posing considerable challenges for laparoscopic hepatectomy in these cases. Achieving complete stone clearance and addressing hilar bile duct stenosis are critical determinants of surgical efficacy in hepatolithiasis management.</p><p><strong>Case summary: </strong>We present the case of a woman with intrahepatic and extrahepatic bile duct stones and chronic cholangitis who underwent laparoscopic hepatectomy. Hepatic segments I, II, III, IV, VI, and VII of the diseased bile duct tree and bile duct cyst were resected according to the preoperative plan, plastic repair of the hilar bile duct was performed, and the repaired bile duct was anastomosed with the jejunum. The patient achieved a favorable prognosis and long-term survival.</p><p><strong>Conclusion: </strong>Based on segmental/subsegmental diseased bile duct tree territory hepatectomy and hilar stenosis relief, laparoscopic hepatectomy for complex hepatolithiasis can be safely performed guided by double landmarks (diseased bile duct/hepatic vein).</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108959"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065633","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":"Kamikawa anastomosis in proximal gastrectomy for gastric cancer: A systematic review and meta-analysis.","authors":"Cheng-Cong Liu, Jian Yang, Gang Yin, Zhen Tian, Chen Qin","doi":"10.4240/wjgs.v17.i8.107706","DOIUrl":"10.4240/wjgs.v17.i8.107706","url":null,"abstract":"<p><strong>Background: </strong>Proximal gastrectomy (PG) for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications. Although the Kamikawa anastomosis has gained attention for its theoretical anti-reflux advantages, robust clinical evidence remains limited.</p><p><strong>Aim: </strong>To comprehensively evaluate the efficacy, safety, and nutritional outcomes of the Kamikawa anastomosis in PG, thereby addressing a critical gap in surgical decision-making.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we systematically searched PubMed, Embase, and the Cochrane Library for studies on Kamikawa anastomosis after PG. Data were pooled using fixed- or random-effects models based on heterogeneity levels (<i>I</i> ² statistics). The risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions. The protocol was prospectively registered in PROSPERO.</p><p><strong>Results: </strong>Of 106 screened studies, 20 involving 2291 patients were included. Most studies (85%) originated from Japan, with a mean patient age of 54-73 years and a male predominance (68.1%). Overall pooled incidence of 30-day postoperative complications was 9.9% [95% confidence interval (95%CI): 6.8-12.9], with major complications (Clavien-Dindo grade ≥ III) occurring in 6.1% (95%CI: 4.6-7.7). Anastomosis-related complications were observed in 7.2% of cases, comprising leakage 1.8% (95%CI: 1.1-2.4), stenosis in 7.2% (95%CI: 5.8-8.5), and bleeding in 0.7% (95%CI: 0.1-1.2). Pooled incidence of reflux esophagitis was 4% (95%CI: 2.7-5.3) for all LA grades at 12-month follow-up, with 28.3% (95%CI: 14.7-41.9) of patients requiring regular proton pump inhibitor use. Operative outcomes demonstrated a pooled mean operative time of 349.5 minutes (95%CI: 331-380), estimated blood loss of 351.5 mL (95%CI: 264-495), and postoperative hospital stay of 12.3 days (95%CI: 11.5-13.1). Nutritional outcomes revealed 11.4% (95%CI: 10.6-12.2) body weight loss at one year. Comparative analyses showed equivalent safety profiles between the Kamikawa anastomosis and double-tract reconstruction but longer operative times (<i>P</i> < 0.001) compared with total gastrectomy.</p><p><strong>Conclusion: </strong>These findings underscore the clinical viability of the Kamikawa anastomosis following PG, demonstrating favorable anti-reflux efficacy, acceptable incidence of anastomotic strictures, and preservation of nutritional status.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"107706"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065642","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":"Mechanism and treatment of pancreatic duct stones.","authors":"Sheng Wu, Ye Zheng, Jiang-Wei Mou, Yan-Jun Zhang, Ke-Xiang Zhu","doi":"10.4240/wjgs.v17.i8.108312","DOIUrl":"10.4240/wjgs.v17.i8.108312","url":null,"abstract":"<p><p>Pancreatic duct stones (PDS) pose substantial therapeutic challenges owing to their tendency to induce recurrent pain and discomfort <i>via</i> mechanical irritation and ductal obstruction, resulting in a marked decline in patients' quality of life. The pathogenesis of pancreatic duct calculi remains incompletely understood due to its multifactorial and intricate nature. Advances in minimally invasive endoscopic interventions have broadened the available treatment modalities for PDS. This review summarizes current perspectives on the mechanisms driving stone formation alongside evolving therapeutic strategies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108312"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065669","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":"Outcomes of iodine-125 seed strips combined with double self-expandable metallic stent for Bismuth type III and IV malignant biliary obstruction.","authors":"Chuan-Guo Zhou, Yong Zhang, Hui Li, Ke-Yun Liu, Xiang-Yu Yang, Kun Gao","doi":"10.4240/wjgs.v17.i8.108579","DOIUrl":"10.4240/wjgs.v17.i8.108579","url":null,"abstract":"<p><strong>Background: </strong>No reports have been published on the use of iodine-125 (¹²⁵I) seed strips combined with double biliary self-expandable metallic stent (SEMS) for the treatment of type III and IV hilar malignant biliary obstruction (MBO).</p><p><strong>Aim: </strong>To evaluate effectiveness and safety of ¹²⁵I seed trips combined with double SEMS in treating Bismuth type III and IV hilar MBO.</p><p><strong>Methods: </strong>This was a retrospective, observational study conducted from April 2017 to December 2022. Patients with Bismuth-Corlette type III and IV hilar MBO who underwent ¹²⁵I seed strip implantation combined with double SEMS placement were analyzed. Patient demographics, clinical characteristics, SEMS implantation methods, procedural and clinical outcomes, overall survival, stent patency duration, and complications were evaluated.</p><p><strong>Results: </strong>Four types of stent implantation were utilized: (1) Type X; (2) Type T; (3) Type Y; and (4) Tandem type. The technical success rate was 94.1% (16/17), and the clinical success rate was 100% (17/17). The median overall survival time was 189.00 days ± 47.27 days (95%CI: 96.35-281.66). The median stent fluency time was 154.00 days ± 12.19 days (95%CI: 130.11-177.89). No serious complications were observed.</p><p><strong>Conclusion: </strong>This retrospective, observational study suggests that the combination of ¹²⁵I seed strips with double SEMS may be a safe and potentially effective approach for managing type III and IV hilar MBO patients.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108579"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical observation of combined transarterial chemoembolization and targeted therapy in postoperative recurrent colorectal cancer with liver metastasis.","authors":"Jian-Yu Liu, Zhi-Hui Liang, Jing-Lei Liu, Liang Li, Bao Cui, Tie-Gang Li","doi":"10.4240/wjgs.v17.i8.104568","DOIUrl":"10.4240/wjgs.v17.i8.104568","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) with liver metastasis remains a significant therapeutic challenge, particularly in cases of postoperative recurrence. While transarterial chemoembolization (TACE) and targeted therapies have shown promise individually, the efficacy combining these for treating postoperative recurrent CRC with liver metastasis requires further investigation.</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of TACE combined with targeted therapies for postoperative recurrent CRC with liver metastasis.</p><p><strong>Methods: </strong>This observational study enrolled 75 patients with postoperative recurrent CRC accompanied by liver metastasis between January 2020 and December 2023. All patients received combined treatment with TACE and targeted therapy: Bevacizumab (40 patients, 53.3%), cetuximab (25 patients, 33.3%), or panitumumab (10 patients, 13.3%). Treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 criteria, with overall survival (OS) and progression-free survival as the primary endpoints. Quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire at baseline and after six months of treatment.</p><p><strong>Results: </strong>The median OS was 28 months (95% confidence interval: 24-32 months), and the median progression-free survival was 12 months (95% confidence interval: 10-14 months). Patients treated with bevacizumab showed significantly better survival outcomes than those treated with cetuximab/panitumumab (median OS, 30 <i>vs</i> 24 months, <i>P</i> = 0.015). The overall response rate was 58.7%, with a disease control rate of 86.7%. Quality of life scores improved significantly across all domains, with greater improvements observed in the bevacizumab group. Treatment-related adverse events were manageable, with grade 3-4 events occurring in 13.3% of the patients and no treatment-related mortality.</p><p><strong>Conclusion: </strong>The combination of TACE with targeted therapy, particularly bevacizumab, has demonstrated promising efficacy and acceptable safety for the treatment of postoperative recurrent CRC with liver metastasis. This multimodal approach not only improved survival outcomes but also enhanced the patients' quality of life, suggesting its potential as a valuable treatment strategy for this challenging condition.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"104568"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065793","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":"Clinicopathologic features of allied disorders of Hirschsprung disease and status update.","authors":"Miao Lu","doi":"10.4240/wjgs.v17.i8.104954","DOIUrl":"10.4240/wjgs.v17.i8.104954","url":null,"abstract":"<p><p>Allied disorders of Hirschsprung diseases (ADHDs) have abnormal enteric ganglia and symptoms that are similar to congenital megacolon. The classification of ADHDs includes neuronal dysplasia, enteric gangliocytomatosis, isolated ganglion dysfunction, immature ganglion, and internal anal sphincter achalasia. The diagnosis, treatment and prognosis of ADHDs are distinct from congenital megacolon. This review summarizes the classification, epidemiology, pathogenesis, gene basis, pathology, diagnosis, treatment, and prognosis of ADHDs based on existing diagnostic criteria.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"104954"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065860","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":"Effects of motivational and early warning nursing on wound healing and socio-psychological adaptability in hepatobiliary surgical patients.","authors":"Ya-Juan Shan, Ding-Feng Yu, Wei-Ying Xu, Su-Qin Tu, Yue-Ping Ge","doi":"10.4240/wjgs.v17.i8.105306","DOIUrl":"10.4240/wjgs.v17.i8.105306","url":null,"abstract":"<p><strong>Background: </strong>Enhancing postoperative recovery is a critical goal in clinical practice and the application of innovative nursing models can significantly contribute to this objective.</p><p><strong>Aim: </strong>To investigate the effects of motivational and early warning nursing interventions on wound healing and sociopsychological adaptability in patients undergoing hepatobiliary surgery.</p><p><strong>Methods: </strong>A total of 160 patients who underwent surgical treatment in the hepatobiliary department of our hospital from January 2022 to June 2024 were selected and randomly divided into a control group and an observation group, with 80 patients in each group. The control group received routine nursing care, while the observation group received a combination of motivational and early warning nursing interventions. The wound healing status (class A, B, and C wound healing and healing time), social psychological adaptability, complications, postoperative recovery, and quality of life were compared between the two groups.</p><p><strong>Results: </strong>The wound healing rate in the observation group was higher than that in the control group, while the wound healing time was shorter (<i>P</i> < 0.05). The social adaptability scores in the observation group were higher than those in the control group (<i>P</i> < 0.05). The incidence of complications was lower in the observation group than in the control group (<i>P</i> < 0.05). Postoperative recovery and quality of life were better in the observation group than in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Motivational and early warning nursing interventions are beneficial for promoting wound healing in patients undergoing hepatobiliary surgery, reducing the incidence of complications and improving socio-psychological adaptability and postoperative quality of life. These interventions should be promoted in clinical nursing practice.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"105306"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065451","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":"Anal adenocarcinoma with perianal Paget's disease: A case report.","authors":"Sheng-Wei Wu, Yao Rong, Gui-Jin Chen, Xu-Song Cao, Zheng-Yong Xie, Bei Wu, Hao-Chun Huang, Zhi-Wei Wang, Xiao-Xiang Wu","doi":"10.4240/wjgs.v17.i8.108963","DOIUrl":"10.4240/wjgs.v17.i8.108963","url":null,"abstract":"<p><strong>Background: </strong>Anal canal adenocarcinoma with secondary perianal Paget's disease (PPD) is clinically rare and exhibits atypical symptoms, often misdiagnosed as benign conditions such as hemorrhoids or perianal eczema, leading to delayed treatment. Further summarization of diagnostic and therapeutic key points, as well as reasons for misdiagnosis, is necessary to enhance clinical awareness.</p><p><strong>Case summary: </strong>A retrospective analysis was conducted on a 72-year-old female patient with a 2-year history of perianal moisture, pruritus, and hematochezia, who was repeatedly misdiagnosed with mixed hemorrhoids. The diagnosis of anal canal adenocarcinoma with secondary PPD was confirmed through colonoscopy, perianal skin biopsy, and immunohistochemical staining (CK7, CK20, <i>etc.</i>). The patient underwent 3D laparoscopic-assisted abdominoperineal resection (APR) with extended perianal skin excision, achieving negative margins and primary wound healing. No recurrence or metastasis was observed during the 12-month follow-up.</p><p><strong>Conclusion: </strong>Secondary PPD has a high misdiagnosis rate. Clinicians should maintain a high index of suspicion for elderly patients with prolonged perianal symptoms (<i>e.g.</i>, pruritus, hematochezia > 6 months) and promptly perform colonoscopy and immunohistochemical testing for definitive diagnosis. APR combined with extended perianal resection is an effective treatment, and standardized long-term follow-up is crucial for prognosis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108963"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065726","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}