World Journal of Gastrointestinal Surgery最新文献

{"title":"Integrating inflammation-based scores into gastric cancer prognosis.","authors":"Lu-Yang Li, Shinichiro Kobayashi, Shunsuke Murakami, Shun Yamaguchi, Kaito Tasaki, Susumu Eguchi, Kengo Kanetaka","doi":"10.4240/wjgs.v18.i1.113363","DOIUrl":"10.4240/wjgs.v18.i1.113363","url":null,"abstract":"<p><p>The conventional tumor-node-metastasis (TNM) staging system is crucial for predicting the prognosis of gastric cancer. However, TNM staging fails to delineate tumor biology and host immune responses. Zhou <i>et al</i> have addressed this in a noteworthy study, they analyzed a cohort of 1071 patients with stage I-III gastric cancer who had undergone radical gastrectomy. The systemic inflammation response index (SIRI) and platelet-to-lymphocyte ratio (PLR) score were derived from the SIRI and PLR. Multivariate analysis identified the SIRI-PLR score as an independent predictor of survival. This was significant along with factors such as age, tumor size, and TNM stage. Importantly, they created a nomogram that integrated these variables, demonstrating superior predictive accuracy compared to the TNM staging system. The findings of this single-center cohort study require prospective multicenter validation to confirm their reproducibility and generalizability. Furthermore, inflammatory markers are dynamic and serial measurements can offer a more refined assessment of patient prognoses and guide treatment responses. These findings should be combined with genomic, immunological, and radiomics data. This approach promises precise and personalized risk stratification, thereby improving the prediction of prognosis in patients with gastric cancer.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"113363"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202935","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":"Very early recurrence in pancreatic cancer: Redefining prognostic markers and surveillance strategies.","authors":"Riya Karmakar, Pratham Gade, Hsiang-Chen Wang, Arvind Mukundan","doi":"10.4240/wjgs.v18.i1.114574","DOIUrl":"10.4240/wjgs.v18.i1.114574","url":null,"abstract":"<p><p>This editorial discusses the difficulties and challenges of managing pancreatic ductal adenocarcinoma. Approximately 50% of patients experience recurrence within one year after the curative-intent surgery as its highly lethal malignancy, the most sever outcome is very early recurrence (VER), which occurs within 12 weeks which reflects an aggressive tumor. The limitation of standards after surgery management in preventing VER, which significantly causes death in six-months (32.44% <i>vs</i> 14.77%) which highlights the urgent need of better predictive models to categorize patients. The study by Martlı <i>et al</i> which combines traditional statistical methods with machine learning to improve prediction accuracy. The findings from study highlights poorly differentiated (grade 3) tumor as the stronger predictor of VER. The research also presents an innovative association between VER and tumor present in pancreatic head. An abnormal red cell distribution width, a marker of systemic inflammation was also identified as a risk factor. The predictive accuracy has been increased by using random forest modelling which identifies nonlinear pattern in the data, reinforcing the importance of these factors. The clinical importance for these finding is significant; identifying patients with grade 3 tumors, pancreatic head tumors, or elevated red cell distribution width allows for tailored, intensive surveillance and consideration for the early initiation of adjuvant therapy. This editorial supports the combination of predictors with clinical practice to optimize treatment outcomes, and reduce the risk of VER, improve quality of life for patient population, while underscoring the need for multi-institutional validation and future molecular studies to further elucidate the mechanisms driving this aggressive disease.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114574"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202975","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":"Admission hyperphosphatemia as a predictor of severity and mortality in acute pancreatitis: A 1000-patient cohort study.","authors":"Yavuz Özden, Nuh Mehmet Buyukberber","doi":"10.4240/wjgs.v18.i1.114227","DOIUrl":"10.4240/wjgs.v18.i1.114227","url":null,"abstract":"<p><strong>Background: </strong>Although most acute pancreatitis (AP) cases are mild, up to 20% progress to severe disease, leading to substantial morbidity and mortality. Early risk stratification remains challenging because conventional scoring systems require multiple parameters and often depend on 24-48 hours of observation.</p><p><strong>Aim: </strong>To evaluate whether serum phosphate levels measured upon hospital admission can predict disease severity and short-term clinical outcomes in patients with AP.</p><p><strong>Methods: </strong>We retrospectively analyzed 1000 consecutive patients hospitalized for AP between November 2023 and June 2025. Admission phosphate was categorized as hypophosphatemia (< 2.5 mg/dL), normophosphatemia (2.5-4.5 mg/dL), or hyperphosphatemia (> 4.5 mg/dL). Clinical outcomes included severe AP (SAP), pancreatic necrosis, intensive care unit (ICU) admission, and 30-day all-cause mortality. Multivariable logistic regression was performed to evaluate the independent association between phosphate levels and clinical outcomes, with additional models adjusted for creatinine levels and acute kidney injury (AKI).</p><p><strong>Results: </strong>SAP occurred in 60% of patients with hyperphosphatemia and in 20% of those with normophosphatemia (<i>P</i> < 0.001). Pancreatic necrosis (50% <i>vs</i> 10%) and ICU admission (70% <i>vs</i> 15%) were also significantly more frequent in the hyperphosphatemia group. Thirty-day mortality was 25% in the hyperphosphatemia group and 3% in the normophosphatemia group. Hyperphosphatemia independently predicted 30-day mortality (adjusted OR 5.8; 95%CI: 2.9-11.5; <i>P</i> < 0.001), and this association remained significant after adjustment for creatinine and AKI (adjusted OR 4.7; 95%CI: 2.1-10.3; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Admission hyperphosphatemia independently predicts severe disease, pancreatic necrosis, ICU admission, and early mortality, highlighting a simple and inexpensive biomarker to support rapid risk stratification in AP.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114227"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202343","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 clinical and laboratory factors associated with early complications after low anterior resection: Exploratory analysis of the eosinophil/lymphocyte ratio.","authors":"Ali Kemal Taşkin, Mustafa Akar, Mustafa Suphi Turgut, Burak Bilir, Enes Karademir","doi":"10.4240/wjgs.v18.i1.114570","DOIUrl":"10.4240/wjgs.v18.i1.114570","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer is of particular importance among colorectal malignancies due to technical difficulties in surgical treatment and serious complications that can occur postoperatively.</p><p><strong>Aim: </strong>To determine the probable factors affecting early postoperative complications in patients undergoing low anterior resection (LAR) for rectal cancer.</p><p><strong>Methods: </strong>This retrospective study included adult patients who underwent LAR for rectal cancer between January 1, 2018 and December 31, 2024. The patients were divided into two groups, those with and those without early postoperative complications. Complications developing within the first 30 days after LAR were considered early and complications developing after 30 days were considered late. The level of statistical significance in all statistical evaluations was set as <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 105 patients underwent LAR for rectal cancer, comprising 66 (62.9%) males and 39 (37.1%) females with a mean age of 66 ± 12 years (28-85 years). Protective loop ileostomy was performed in 23 (21.9%) patients. The LAR was performed as open surgery in 63 (60%) patients and laparoscopically in 42 (40%) patients. The mean follow-up period was 46.44 ± 25 months (1-85 months) and the mean disease-free survival duration was 42.49 ± 24 months (1-85 months). Early postoperative complications were observed in 29 (27.6%) patients and late complications were observed in 14 (13.3%) patients. The most frequently seen early postoperative complication was anastomosis leakage in 10 (9.5%) patients. Advanced age, the presence of diabetes mellitus, advanced stage disease, increased preoperative eosinophil/lymphocyte ratio (ELR), and low preoperative albumin and hemoglobin levels were found to be significantly associated with early postoperative complications (<i>P</i> < 0.05). Patients who underwent open LAR surgery were observed to require longer hospitalization and developed more early complications than patients who underwent laparoscopic surgery.</p><p><strong>Conclusion: </strong>Elevated preoperative ELR in patients undergoing LAR for rectal cancer may predict the development of early postoperative complications. Therefore, further studies are required to be able to establish the importance of the preoperative ELR.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114570"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202696","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":"Risk factors and prediction model for acute respiratory distress syndrome in patients with digestive tumor after surgery.","authors":"Jie Zhen, Wei Chen, Yi-Fei Xu, Ying-Min Ma","doi":"10.4240/wjgs.v18.i1.112103","DOIUrl":"10.4240/wjgs.v18.i1.112103","url":null,"abstract":"<p><strong>Background: </strong>Postoperative acute respiratory distress syndrome (ARDS) after digestive tumors is a serious complication that severely affects patients' prognosis; however, systematic studies assessing its risk factors are lacking, and effective prediction models are urgently required.</p><p><strong>Aim: </strong>To investigate the risk factors for postoperative ARDS in patients with digestive tumors and construct a prediction model.</p><p><strong>Methods: </strong>Overall, 42 of the 176 patients developed ARDS, with an incidence rate of 23.86%. Multifactorial logistic regression analysis identified advanced age [odds ratio (OR) = 1.24, <i>P</i> < 0.001], smoking history (OR = 3.17, <i>P</i> = 0.012), preoperative lung infection (OR = 3.07, <i>P</i> = 0.015), low preoperative albumin level (OR = 0.71, <i>P</i> = 0.003), preoperative percentage of forced expiratory volume in 1 second, (OR = 0.96, <i>P</i> = 0.006), preoperative percentage of forced vital capacity (OR = 0.94, <i>P</i> = 0.012), and postoperative anastomotic fistula (OR = 4.55, <i>P</i> = 0.022) as independent risk factors for postoperative ARDS. The nomogram prediction model showed good discriminatory power [area under the curve (AUC) = 0.86] and goodness of fit (Hosmer-Lemeshow, <i>P</i> = 0.729). The internal validation demonstrated an AUC of 0.86 and a good calibration curve fit (Hosmer-Lemeshow, <i>P</i> = 0.914). Prospective clinical validation confirmed the reliability and clinical value of the model (AUC = 0.91, accuracy = 82.35%).</p><p><strong>Results: </strong>Overall, 42 of the 176 patients developed ARDS, with an incidence rate of 23.86%. Multifactorial logistic regression analysis identified advanced age (OR = 1.24, <i>P</i> < 0.001), smoking history (OR = 3.17, <i>P</i> = 0.012), preoperative lung infection (OR = 3.07, <i>P</i> = 0.015), low preoperative albumin level (OR = 0.71, <i>P</i> = 0.003), preoperative percentage of forced expiratory volume in 1 second, (OR = 0.96, <i>P</i> = 0.006), preoperative percentage of forced vital capacity (OR = 0.94, <i>P</i> = 0.012), and postoperative anastomotic fistula (OR = 4.55, <i>P</i> = 0.022) as independent risk factors for postoperative ARDS. The nomogram prediction model showed good discriminatory power (AUC = 0.86) and goodness of fit (Hosmer-Lemeshow, <i>P</i> = 0.729). The internal validation demonstrated an AUC of 0.86 and a good calibration curve fit (Hosmer-Lemeshow, <i>P</i> = 0.914). Prospective clinical validation confirmed the reliability and clinical value of the model (AUC = 0.91, accuracy = 82.35%).</p><p><strong>Conclusion: </strong>The nomogram prediction model based on independent risk factors for postoperative ARDS in patients with digestive tumors demonstrated good differentiation, calibration, and clinical utility and helped identify high-risk patients early.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"112103"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202748","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":"Knockdown of 5-methylcytosine RNA methyltransferase NOP2/sun RNA methyltransferase 5 in hepatocellular carcinoma cells affects their biological functions.","authors":"Na Liu, Jin Liu, Yin-Ling Wang, Li Zhu, Chuan-Wu Zhu","doi":"10.4240/wjgs.v18.i1.112243","DOIUrl":"10.4240/wjgs.v18.i1.112243","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is among the most prevalent cancers worldwide. Recent studies have indicated that 5-methylcytosine (m5c) RNA modifications play crucial roles in various biological processes through interactions with specific regulatory factors, including their involvement in the malignant progression of multiple tumors.</p><p><strong>Aim: </strong>To examine the impact of NOP2/sun RNA methyltransferase 5 (NSUN5), an m5c methyltransferase, on the functional behavior of HCC cells.</p><p><strong>Methods: </strong><i>NSUN5</i> expression in HCC and normal liver tissues was analyzed using the Gene Expression Profiling Interactive Analysis bioinformatics tool. Human normal hepatocytes (LO2) and HCC cells were examined. The m5c levels in cellular extracts and culture supernatants were quantified using enzyme-linked immunosorbent assay, while NSUN5 levels were quantified using quantitative reverse transcription polymerase chain reaction (for mRNA levels) and Western blotting (for protein levels). Changes in NSUN5 expression following silencing of NSUN5 using transfection with short hairpin RNA were determined. Functional assays were used to evaluate HCC cell growth (Cell Counting Kit-8 and Colony Formation Assays), migration and invasion (Transwell and Wound-Healing Assays), and cell cycle and apoptosis (flow cytometry).</p><p><strong>Results: </strong><i>NSUN5</i> mRNA was significantly upregulated in HCC compared with normal liver tissues, with expression levels varying across different HCC stages (<i>P</i> < 0.05). HCC cells - HepG2, HEP3B, Huh-7, SMMC7721, and SK-HEP-1 - showed significantly higher <i>NSUN5</i> mRNA expression levels than the normal human hepatocyte line LO2 (<i>P</i> < 0.05). Following short hairpin RNA-mediated NSUN5 silencing, HepG2 and SMMC7721 cells exhibited reduced proliferation and growth, decreased migration and invasion, and enhanced apoptotic levels (<i>P</i> < 0.05); however, they showed no significant changes in cell cycles (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Both HCC tissues and cell models consistently demonstrated elevated <i>NSNU5</i> mRNA and protein expression. Genetic inhibition of the m5c methyltransferase NSUN5 suppresses HCC cell growth, reduces invasiveness and migration, and induces apoptosis.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"112243"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202937","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":"Anesthesiologist's perspective on endoscopic submucosal dissection: Bridging minimally invasive surgery and enhanced recovery after surgery management.","authors":"Fan Bu, Sheng-Yu Zhang, Zi-Jia Liu","doi":"10.4240/wjgs.v18.i1.114299","DOIUrl":"10.4240/wjgs.v18.i1.114299","url":null,"abstract":"<p><p>In this article, we comment on the recent article by Fang <i>et al</i>. The study highlights that endoscopic submucosal dissection (ESD) offers advantages such as minimal incisions, shorter operative time, reduced bleeding, and faster patient recovery, demonstrating its strong alignment with the principles of enhanced recovery after surgery (ERAS). From an anesthesiologic perspective, ESD contributes to decreased intraoperative stress, thereby reducing opioid requirements. Simultaneously, the shorter procedure duration and minimal tissue trauma mitigate the adverse effects of deep anesthesia on circulatory and respiratory functions, leading to a more stable emergence from anesthesia and smoother endotracheal extubation. Ultimately, the minimally invasive nature of ESD is crucial for minimizing postoperative nausea and vomiting and preventing postoperative delirium. Historically, ERAS protocols have primarily focused on open and laparoscopic surgeries, with a lack of systematic ERAS guidelines for endoscopic treatments. Therefore, anesthesiology departments should take a more proactive role in the perioperative care of patients undergoing endoscopic procedures, spearheading the development of a standardized \"ESD-ERAS\" pathway.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114299"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202784","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":"Impact of \"four-step\" death education on life quality and negative emotions in advanced esophageal cancer patients and families.","authors":"Li-Li Wen, Jian-Yu Li, Shu-Ying Zhang","doi":"10.4240/wjgs.v18.i1.112238","DOIUrl":"10.4240/wjgs.v18.i1.112238","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced esophageal cancer and their families often experience reduced quality of life (QoL) and heightened negative emotions. Death education may offer benefits, but evidence in this context is limited.</p><p><strong>Aim: </strong>To investigate the impact of a systematic \"four-step death education\" intervention on the QoL and negative emotions of postoperative patients with advanced esophageal cancer and their primary caregivers.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 235 patients with advanced esophageal cancer who underwent surgery at The Fourth Hospital of Hebei Medical University from June 2021 to June 2024. The participants were assigned to either the standard care group (SCG, <i>n</i> = 127) or the \"four-step death education\" group (FDEG, <i>n</i> = 108) on the basis of the received intervention. SCG received standard care and basic psychological support, and FDEG additionally received a four-stage death education program encompassing information provision, emotional support, life review and meaning exploration, and end-of-life care preparation. QoL and negative emotion levels were measured using validated instruments: The European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 for patient QoL, the Family QoL Survey, the Zarit Burden Interview for caregiver burden, the Pittsburgh Sleep Quality Index, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the Attitudes Toward Life and Death Scale. Assessments were conducted at baseline and 3 months post-intervention.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. At 3 months, FDEG demonstrated significantly improved symptom and functional domain QoL scores in several areas, including fatigue, nausea, insomnia, loss of appetite, and physical and emotional functioning. FDEG reported increased family QoL and reduced caregiver burden. The patients and caregivers in FDEG showed superior improvements in sleep quality and greater reductions in anxiety and depression scores than those in SCG. Post-intervention, FDEG exhibited more positive attitudes toward death.</p><p><strong>Conclusion: </strong>The postoperative \"four-step death education\" intervention enhances QoL, relieves caregiver burden, and reduces negative emotions among patients with advanced esophageal cancer and their caregivers, supporting broadened implementation of structured death education programs in palliative care settings.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"112238"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202907","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":"Perception of rectal prolapse symptoms in patients with psychiatric disorders.","authors":"Nouf Akeel, Charlotte Mary Rajasingh, Michelle Earley, Sydni Au Hoy, Leila Neshatian, Ekene Enemchukwu, Kavita Mishra, Brooke Gurland","doi":"10.4240/wjgs.v18.i1.114452","DOIUrl":"10.4240/wjgs.v18.i1.114452","url":null,"abstract":"<p><strong>Background: </strong>The perception of symptoms in individuals with rectal prolapse (RP) can be influenced by psychiatric disorders (PD). It was hypothesized that women with a history of PD would experience higher levels of bother from RP symptoms.</p><p><strong>Aim: </strong>To examine the relationship between PD and symptom severity in women with RP.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on female patients with RP from an approved registry. Demographic data, medical history, and prolapse-associated symptoms were collected. Validated questionnaires were used to measure the severity of symptoms and degree of associated bother. Patients with and without psychiatric history were compared.</p><p><strong>Results: </strong>Among the 200 patients included in the study, 83 (42%) had a PD, with depression (<i>n</i> = 46) and anxiety (<i>n</i> = 38) being the most prevalent. Patients with psychiatric history were younger (mean age: 58 ± 16) compared to those without PD (mean age: 66 ± 15; <i>P</i> < 0.001). The patients with PD reported higher scores on the Pelvic Floor Distress Inventory Questionnaire-20 [median (interquartile range): 137.5 (77.08, 180.21) <i>vs</i> 101.04 (67.71, 150)] and Pelvic Floor Impact Questionnaire-7 [median (interquartile range): 100 (59.52, 171.43) <i>vs</i> 80.95 (38.10, 142.86)]. The bowel symptoms were the primary contributors to the distress experienced by these patients.</p><p><strong>Conclusion: </strong>Women with RP have a higher prevalence of PD and perceive bowel symptoms as more severe. Routine screening for PD is recommended and may improve patients' outcomes.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114452"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203048","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":"\"Problem of pain\": Further questions for the utility of vitamin D for chronic pain after gastrointestinal surgery.","authors":"Thomas C Varkey","doi":"10.4240/wjgs.v18.i1.114909","DOIUrl":"10.4240/wjgs.v18.i1.114909","url":null,"abstract":"<p><p>This letter to the editor provides a short review on the number of different disease states that have been linked with at least a factorial relation with deficiency in vitamin D (defined at less than 50 nmol/L or 20 ng/mL serum levels) and tries to raise some question in regards to the recent publication within the journal. This letter also highlights some of the recent work within the neurology literature which demonstrates that supratherapeutic levels of vitamin D might provide benefit for patients suffering with different disease states, with the D-Lay MS randomized clinical trial utilizing 100000 international units every 2 weeks and some of the migraine literature supporting a higher target between 50 ng/mL to 100 ng/mL which might provide benefit for patients suffering from migraines. The letter concludes with a key question for further research asking about whether in gastrointestinal surgery should a normal vitamin D level, defined as 50 nmol/L (20 ng/mL) or greater, be targeted or if there might be a role for supratherapeutic dosing within gastrointestinal surgery.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"18 1","pages":"114909"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202353","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}