World Journal of Gastrointestinal Surgery最新文献

{"title":"Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer.","authors":"Xiao-Peng Tian, Hui-Min Bu, Hong-Yan Ma, Min Zhao","doi":"10.4240/wjgs.v16.i9.2925","DOIUrl":"10.4240/wjgs.v16.i9.2925","url":null,"abstract":"<p><strong>Background: </strong>Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy. However, due to the physiological characteristics of elderly patients, the safety of perioperative anesthesia needs special attention. As an α2-adrenergic receptor agonist, dexmedetomidine (Dex) has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure, inhibitory effect on inflammation, and sedative and analgesic effects. Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.</p><p><strong>Aim: </strong>To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.</p><p><strong>Methods: </strong>A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital, Qingdao, China were recruited and divided into two groups: A and B. In group A, Dex was administered 30 min before surgery, while group B received an equivalent amount of normal saline. The hemodynamic changes, pulmonary compliance, airway pressure, inflammatory factors, confusion assessment method scores, Ramsay Sedation-Agitation Scale scores, and cellular immune function indicators were compared between the two groups.</p><p><strong>Results: </strong>Group A showed less intraoperative hemodynamic fluctuations, better pulmonary compliance, and lower airway resistance compared with group B. Twelve hours after the surgery, the serum levels of TLR-2, TLR-4, IL-6, and TNF-α in group A were significantly lower than those of group B (<i>P</i> < 0.05). After extubation, the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients, indicating a higher level of sedation. The incidence of delirium was significantly lower in group A than in group B (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 9","pages":"2925-2933"},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355141","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":"Preoperative systemic inflammatory response index as a prognostic marker for distal cholangiocarcinoma after pancreatoduodenectomy.","authors":"Wen-Hui Zhang, Yu Zhao, Cheng-Run Zhang, Jin-Can Huang, Shao-Cheng Lyu, Ren Lang","doi":"10.4240/wjgs.v16.i9.2910","DOIUrl":"10.4240/wjgs.v16.i9.2910","url":null,"abstract":"<p><strong>Background: </strong>The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.</p><p><strong>Aim: </strong>To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma (dCCA) who underwent pancreatoduodenectomy (PD).</p><p><strong>Methods: </strong>This single-center study included 216 patients with dCCA after PD between January 1, 2011, and December 31, 2022. The individuals were categorized into two sets based on their systemic inflammatory response index (SIRI) levels: A low SIRI group (SIRI < 1.5, <i>n</i> = 123) and a high SIRI group (SIRI ≥ 1.5, <i>n</i> = 93). Inflammatory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves. Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival (OS) and recurrence-free survival (RFS).</p><p><strong>Results: </strong>The study included a total of 216 patients, with 58.3% being male and a mean age of 65.6 ± 9.6 years. 123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA. SIRI had an area under the curve value of 0.674 for diagnosing dCCA, showing better performance than other inflammatory biomarkers. Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD, leading to lower OS [hazard ratios (HR) = 1.868, <i>P</i> = 0.006] and RFS (HR = 0.949, <i>P</i> < 0.001). Additionally, survival analysis indicated a significantly better prognosis for patients in the low SIRI group (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 9","pages":"2910-2924"},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355150","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":"Meningeal cryptococcosis in a pancreas transplant recipient requiring grafectomy: A case report.","authors":"Ileana Lulic, Gorana Fingler, Dinka Lulic, Jadranka Pavicic Saric, Danko Mikulic, Tajana Filipec Kanizaj, Eleonora Goluza","doi":"10.4240/wjgs.v16.i9.3032","DOIUrl":"10.4240/wjgs.v16.i9.3032","url":null,"abstract":"<p><strong>Background: </strong>Through continuous improvement in transplantation medicine, a wider range of solid organ transplant (SOT) recipients is considered suitable for complex procedures. Despite advances in modern transplantation practice, transpiring invasive fungal infections pose a substantial threat for SOT recipients. To our knowledge, cryptococcal infection confined amidst sole pancreas SOT recipients has not been described to date. Enforcement of a multidisciplinary transplant team approach in the management of pancreas SOT recipients presenting with complex cryptococcal complications is fundamental in improving patient outcomes.</p><p><strong>Case summary: </strong>We present the case of a female pancreas transplant recipient, with confirmed meningeal cryptococcosis, referred to our institution for further evaluation and treatment from the Regional Center for Infectious Diseases. On admission, the patient was weaned from the protocolized immunosuppression therapy for two consecutive weeks, in addition to tapering systemic corticosteroid remedial treatment. Our novel multidisciplinary transplant team approach embodied exhaustive discussions of possible complex and diverse multiple organ system physiologic and pathologic challenges associated with distinct management strategies in pancreas transplant recipients. Owing to the potentially devastating impact of invasive cryptococcosis in terms of morbidity and mortality, a definitive surgical intervention of pancreas transplant grafectomy was reinforced, as a pathway towards secure access to early meaningful expertise care. The patient was discharged to the Regional Center for Infectious Diseases 2 mo after the admittance further advancing to a clinical improvement.</p><p><strong>Conclusion: </strong>The precision transplantation approach by tailoring complex medical interventions to individual needs proved indispensable in improving our patient's outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 9","pages":"3032-3040"},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355144","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 fluid therapy combined with a preoperative glucose load regimen on postoperative recovery in patients with rectal cancer.","authors":"Lv-Chi Xia, Ke Zhang, Chuan-Wen Wang","doi":"10.4240/wjgs.v16.i8.2662","DOIUrl":"10.4240/wjgs.v16.i8.2662","url":null,"abstract":"<p><strong>Background: </strong>Patients with rectal cancer undergoing radical resection often have poor postoperative recovery due to preoperative fasting and water deprivation and the removal of diseased tissue, and have a high risk of complications. Therefore, it is of great significance to apply appropriate rehydration regimens to patients undergoing radical resection of rectal cancer during the perioperative period to improve the postoperative outcomes of patients.</p><p><strong>Aim: </strong>To analyze the effects of goal-directed fluid therapy (GDFT) with a preoperative glucose load regimen on postoperative recovery and complications in patients undergoing radical resection for rectal cancer.</p><p><strong>Methods: </strong>Patients with rectal cancer who underwent radical resection (<i>n</i> = 184) between January 2021 and December 2023 at our hospital were randomly divided into either a control group or an observation group (<i>n</i> = 92 in each group). Both groups received a preoperative glucose load regimen, and routine fluid replacement and GDFT were additionally implements in the control and observation groups, respectively. The operative conditions, blood levels of lactic acid and inflammatory markers, postoperative recovery, cognitive status, hemodynamic indicators, brain oxygen metabolism, and complication rates were compared between the groups.</p><p><strong>Results: </strong>The colloidal fluid dosage, total infusion, and urine volume, as well as time to first exhaust, time to food intake, and postoperative length of hospital stay, were lower in the observation group (<i>P</i> < 0.05). No significant differences were observed between the two groups in terms of operation time, bleeding volume, crystalloid liquid consumption, time to tracheal extubation, complication rate, heart rate, or mean arterial pressure (<i>P</i> > 0.05). Compared with the control group, in the observation group the lactic acid level was lower immediately after the surgery (<i>P</i> < 0.05); the Mini-Mental State Examination score was higher on postoperative day 3 (<i>P</i> < 0.05); the pulse pressure variability (PPV) was lower at 30 min after pneumoperitoneum (<i>P</i> < 0.05), though the differences in the PPV of the two groups was not significant at the remaining time points (<i>P</i> > 0.05); tumor necrosis factor-α and interleukin-6 levels were lower on postoperative day 3 (<i>P</i> < 0.05); and the left and right regional cerebral oxygen saturation was higher immediately after the surgery and 30 min after pneumoperitoneum (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>GDFT combined with the preoperative glucose load regimen is a safe and effective treatment strategy for improving postoperative recovery and risk of complications in patients with rectal cancer undergoing radical resection.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2662-2670"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112661","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":"Energy spectrum computed tomography multi-parameter imaging in preoperative assessment of vascular and neuroinvasive status in gastric cancer.","authors":"Jing Wang, Jian-Cheng Liang, Fa-Te Lin, Jun Ma","doi":"10.4240/wjgs.v16.i8.2511","DOIUrl":"10.4240/wjgs.v16.i8.2511","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer (GC), but traditional imaging methods have some limitations in preoperative evaluation. In recent years, energy spectrum computed tomography (CT) multiparameter imaging technology has been gradually applied in clinical practice because of its advantages in tissue contrast and lesion detail display.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore and analyze the value of multiparameter energy spectrum CT imaging in the preoperative assessment of vascular invasion (LVI) and nerve invasion (PNI) in GC patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 62 patients with GC confirmed by pathology and accompanied by energy spectrum CT scanning at our hospital between September 2022 and September 2023, including 46 males and 16 females aged 36-71 (57.5 ± 9.1) years, were retrospectively collected. The patients were divided into a positive group (42 patients) and a negative group (20 patients) according to the presence of LVI/PNI. The CT values (CT40 keV, CT70 keV), iodine concentration (IC), and normalized IC (NIC) of lesions in the upper energy spectrum CT images of the arterial phase, venous phase, and delayed phase 40 and 70 keV were measured, and the slopes of the energy spectrum curves [K (40-70)] from 40 to 70 keV were calculated. Arterial phase combined parameter, venous phase combined parameters (VP-ALLs), and delayed phase association parameters were calculated for patients with late-stage disease. The differences in the energy spectrum parameters between the positive and negative groups were compared, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC), sensitivity, specificity, and optimal threshold were calculated to measure the diagnostic efficiency of each parameter.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the delayed phase, the CT40 keV, CT70 keV, K (40-70), IC, NIC, and CT70 keV and the NIC in the upper arterial and venous phases of energy spectrum CT were greater in the LVI/PNI-positive group than in the LVI-negative group. The representative parameters for the arterial phase NIC were 0.14 ± 0.04 in the positive group and 0.12 ± 0.04 in the negative group. The venous phase NIC was 0.5 (0.5, 0.6) in the positive group and 0.4 (0.4, 0.5) in the negative group. Last, for the delayed phase NIC, it was 0.6 ± 0.1 in the positive group and 0.5 ± 0.1 in the negative group (all &lt;i&gt;P&lt;/i&gt; values are less than 0.05). ROC curve analysis demonstrated that the diagnostic efficacy of each parameter during the venous stage was superior to that during the arterial and delayed stages. Furthermore, the diagnostic efficacy of the combined parameter throughout all three stages was superior to that of any single parameter. The AUC, sensitivity, and specificity of the optimal parameter, VP-ALL, were 0.931 (95% confidence interval: 0.872-0.990), 80.95%, and 95.00%, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2511-2520"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112673","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":"Relationship between postoperative rehabilitation style, gastrointestinal function, and inflammatory factor levels in children with intussusception.","authors":"Xue-Yan Wei, Hong-Chang Huo, Xin Li, Su-Li Sun, Jun Zhang","doi":"10.4240/wjgs.v16.i8.2640","DOIUrl":"10.4240/wjgs.v16.i8.2640","url":null,"abstract":"<p><strong>Background: </strong>Intussusception occurs in children and progresses rapidly. If not treated in time, it may lead to secondary complications such as intestinal perforation, which affect the quality of life and health of children. Surgery is the most common clinical treatment and has a good effect. However, the postoperative prognosis of children with intussusception has a correlation with the postoperative rehabilitation method. Therefore, in this study, we explored the relationship between postoperative rehabilitation, gastrointestinal function, and the expression of inflammatory factors in children with intussusception.</p><p><strong>Aim: </strong>To explore the relationship between postoperative rehabilitation, gastrointestinal function, and inflammatory factor levels in children with intussusception.</p><p><strong>Methods: </strong>The medical records of 18 children who were admitted to our hospital for intussusception surgery between October 2022 and May 2024 were retrospectively reviewed. The patients were divided into the routine nursing group (<i>n</i> = 6) and rehabilitation training group (<i>n</i> = 12) according to the postoperative rehabilitation method. The general data, gastrointestinal function, and inflammatory factor levels of the two groups were statistically analyzed. Pearson correlation analysis of gastrointestinal function, inflammatory factors, and postoperative rehabilitation was performed.</p><p><strong>Results: </strong>We found no significant intergroup differences in sex, age, or disease course (<i>P</i> > 0.05). The times to first defecation, bowel sound recovery, and anal exhaust were shorter and inflammatory factor levels were lower in the rehabilitation training group than in the routine nursing group (<i>P</i> < 0.05). Pearson correlation analysis showed that gastrin and motilin levels were positively correlated with postoperative rehabilitation (<i>P</i> < 0.05). Interleukin (IL)-2, IL-4, IL-6, IL-10, high-sensitivity C-reactive protein, and tumor necrosis factor-α levels were negatively correlated with postoperative rehabilitation (<i>P</i> < 0.05). Gastrointestinal function was positively correlated (<i>P</i> < 0.05), and levels of inflammatory factors were negatively correlated with postoperative recovery time (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>We found a positive correlation between gastrointestinal function and postoperative rehabilitation training, and a negative correlation between inflammatory factor levels and rehabilitation training in children with intussusception.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2640-2648"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112692","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":"Anorectal hemangioma, a rare cause of lower gastrointestinal bleeding, treated with selective embolization: A case report.","authors":"Barbora Pospisilova, Jaromir Frydrych, Antonin Krajina, Julius Örhalmi, Ivana M Kajzrlikova, Petr Vitek","doi":"10.4240/wjgs.v16.i8.2735","DOIUrl":"10.4240/wjgs.v16.i8.2735","url":null,"abstract":"<p><strong>Background: </strong>Anorectal hemangioma is a rare and frequently misdiagnosed cause of lower gastrointestinal (GI) bleeding. Here, we present a minimally invasive therapy with selective embolization.</p><p><strong>Case summary: </strong>A 21-year-old male patient experienced painless rectal bleeding since childhood and was treated for ulcerative colitis. Diagnostic studies later revealed specific characteristics for vascular lesions-anorectal hemangiomas. The severity of rectal bleeding caused symptomatic anemia and possible surgical treatment was associated with a high risk of fecal incontinence. Here, we present selective embolization, a minimally invasive therapeutic approach that is proven as an alternative therapeutic method of choice. The patient significantly improved temporarily and had a small ischemic ulcer, which healed with a control colonoscopy and developed no stenosis.</p><p><strong>Conclusion: </strong>Awareness of the clinical and radiological features of GI hemangiomas may help improve diagnostics and avoid inappropriate therapeutic procedures.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2735-2741"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117099","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":"Assessment of perianal fistulizing Crohn's disease activity with endoanal ultrasound: A retrospective cohort study.","authors":"Na Hong, Wei-Yong Liu, Jin-Long Zhang, Kai Qian, Jie Liu, Xian-Jun Ye, Fei-Yan Zeng, Yue Yu, Kai-Guang Zhang","doi":"10.4240/wjgs.v16.i8.2494","DOIUrl":"10.4240/wjgs.v16.i8.2494","url":null,"abstract":"<p><strong>Background: </strong>Perianal fistulas pose dual challenges to Crohn's disease (CD) patients. Low patient compliance due to the complexity of existing examination methods plagues the treatment and follow-up management of perianal CD.</p><p><strong>Aim: </strong>To determine the accuracy of endoanal ultrasound (EUS) and shear wave elastography (SWE) for evaluating perianal fistulizing CD (PFCD) activity.</p><p><strong>Methods: </strong>This was a retrospective cohort study. A total of 67 patients from August 2022 to December 2023 diagnosed with CD were divided into three groups: Non-anal fistula group (<i>n</i> = 23), low-activity perianal fistulas [<i>n</i> = 19, perianal disease activity index (PDAI) ≤ 4], high-activity perianal fistulas (<i>n</i> = 25, PDAI > 4) based on the PDAI. All patients underwent assessments including EUS + SWE, pelvic magnetic resonance [pelvic magnetic resonance imaging (MRI)], C-reactive protein, fecal calprotectin, CD activity index, PDAI.</p><p><strong>Results: </strong>The percentage of fistulas indicated by pelvic MRI and EUS was consistent at 82%, and there was good consistency in the classification of perianal fistulas (Kappa = 0.752, <i>P</i> < 0.001). Significant differences were observed in the blood flow Limberg score (<i>χ</i> ² = 8.903, <i>P</i> < 0.05) and shear wave velocity (<i>t</i> = 2.467, <i>P</i> < 0.05) between group 2 and 3. Shear wave velocity showed a strong negative correlation with magnetic resonance novel index for fistula imaging in CD (Magnifi-CD) score (<i>r</i> = -0.676, <i>P</i> < 0.001), a weak negative correlation with the PDAI score (<i>r</i> = -0.386, <i>P</i> < 0.05), and a weak correlation between the Limberg score and the PDAI score (<i>r</i> = 0.368, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>EUS combined with SWE offers a superior method for detecting and quantitating the activity of perianal fistulas in CD patients. It may be the ideal tool to assess PFCD activity objectively for management strategies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2494-2502"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112654","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":"Global research landscape of Peutz-Jeghers syndrome and successful endoscopic management of intestinal intussusception in patients with recurrent laparotomies.","authors":"Qi Sun, Xiao-Ying Wang, Guang-Jin Guo, Lei Wang, Li-Min Meng, Yun-Fei Guo, Tao Sun, Shou-Bin Ning","doi":"10.4240/wjgs.v16.i8.2702","DOIUrl":"10.4240/wjgs.v16.i8.2702","url":null,"abstract":"<p><strong>Background: </strong>Peutz-Jeghers syndrome (PJS) has brought significant physical, psychological and economic burdens on the patients and their families due to its early onset, diagnostic and therapeutic challenges and increased recurrence risk.</p><p><strong>Aim: </strong>To explore the current research status and emerging hotspots of PJS.</p><p><strong>Methods: </strong>Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection. Additionally, a case of PJS-induced intestinal intussusception, successfully treated with endoscopic methods despite three laparotomies, was highlighted. Comprehensive bibliometric and visual analysis were conducted with VOSviewer, R and CiteSpace.</p><p><strong>Results: </strong>Altogether 1760 studies were identified, indicating a steady increase in the publication number. The United States had the highest influence, whereas the University of Helsinki emerged as the leading institution, and Aaltonen LA from the University of Helsinki was the most prolific author. Cancer Research, Oncogene and Endoscopy were the top three journals based on H-index. Keyword burst direction analysis revealed that \"cancer risk\", \"management\", \"surveillance\" and \"familial pancreatic cancer\" were the potential hotspots for investigation. Additionally, \"early detection\", \"capsule endoscopy\", \"clinical management\", \"double-balloon endoscopy\", \"familial pancreatic cancer\" and \"molecular genetic basis\" were identified as the key clusters of co-cited references. Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.</p><p><strong>Conclusion: </strong>In the last three decades, global publications related to PJS show a steadily increasing trend in number. Endoscopic management is currently a research hotspot.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2702-2718"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112675","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":"Hepatic recompensation according to the Baveno VII criteria <i>via</i> a transjugular intrahepatic portosystemic shunt: Is this true?","authors":"Jin-Shan Zhang","doi":"10.4240/wjgs.v16.i8.2742","DOIUrl":"10.4240/wjgs.v16.i8.2742","url":null,"abstract":"<p><p>Hepatic recompensation is firstly described in the Baveno VII criteria, which requires the fulfillment of strict criteria. First, a primary cause of cirrhosis must be addressed, suppressed, or cured. Second, complications of liver cirrhosis, including ascites, encephalopathy, and variceal hemorrhage, must disappear without any intervention. Finally, liver function indicators must be improved. Moreover, without addressing/suppressing/curing cirrhosis and improvement in liver synthetic function, complications, including ascites and variceal hemorrhage can be improved by a transjugular intrahepatic portosystemic shunt (TIPS), which is not evidence of hepatic recompensation. Therefore, on the basis of the definition of hepatic recompensation, TIPS does not achieve hepatic recompensation.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 8","pages":"2742-2744"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112676","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}