World Journal of Gastrointestinal Surgery最新文献

{"title":"Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia: Surgical outcome, postoperative complications, and serum inflammation effects.","authors":"Xue-Qi Wang, Chi-Huan Kong","doi":"10.4240/wjgs.v17.i4.100617","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.100617","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery, with the advantage of less trauma, has been predominantly performed to treat pediatric inguinal hernia. However, the traditional three-port laparoscopic surgery remains extremely traumatic for children, whereas single-port laparoscopic surgery causes less damage to children than traditional laparoscopy. However, single-port laparoscopic surgery is more challenging; thus, studies on the effect of its application in pediatric inguinal hernia remain relatively limited.</p><p><strong>Aim: </strong>To analyze the association of single-incision laparoscopic herniorrhaphy needle treatment with surgical outcomes, postoperative complications, and serum inflammation in pediatric inguinal hernia.</p><p><strong>Methods: </strong>This retrospective study included 113 pediatric patients with inguinal hernia who underwent surgery at the Children's Hospital, Capital Institute of Pediatrics, from April 2022 to May 2023. Participants were categorized into the observation group (single-incision laparoscopic herniorrhaphy needle, <i>n</i> = 60) and the control group (two-port laparoscopic surgery, <i>n</i> = 53). Comparative analyses involved surgical duration, intraoperative blood loss, and length of hospital stay. C-reactive protein (CRP) and white blood cell count (WBC) levels were measured preoperatively and 24 hours postoperatively. Postoperative pain was evaluated with the face, legs, activity, cry, and Consolability scale. Further, the incidence of complications, recurrence, and reoperation rates was assessed. Logistic regression was employed to determine independent risk factors related to poor prognosis.</p><p><strong>Results: </strong>The observation group demonstrated significantly reduced intraoperative blood loss and shorter hospitalization compared to the control group (<i>P</i> < 0.05). Both groups demonstrated increased CRP and WBC levels postoperatively, but the observation group exhibited significantly lower levels (<i>P</i> < 0.05). Further, pain scores at 24 hours postoperatively were significantly lower in the observation group (<i>P</i> < 0.05). Additionally, the observation group experienced fewer adverse events, recurrence rates, and reoperations compared to the control group (<i>P</i> < 0.05). Logistic regression analysis determined increased postoperative stress markers and surgical technique as independent predictors of recurrence (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia exhibits significant efficacy, effectively reduces postoperative complications, ensures a more concealed surgical incision, and promotes faster postoperative recovery than conventional two-port laparoscopy. This approach merits wider application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"100617"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987900","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":"Adenocarcinoma originating from a colonic duplication cyst: A case report.","authors":"Jeehye Lee, Jung Wook Suh","doi":"10.4240/wjgs.v17.i4.103136","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.103136","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal duplication is a rare congenital anomaly of the digestive tract, with colonic manifestations being particularly uncommon. Malignant transformation of colonic duplication cysts is rare, with adenocarcinoma being the most frequently reported type. Herein, we report a rare case of adenocarcinoma originating from a colonic duplication cyst.</p><p><strong>Case summary: </strong>A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup. Imaging revealed a well-defined abdominal cavity cystic mass, which was initially suspected to be an ovarian teratoma. Laparoscopic surgery revealed a duplication cyst, and pathological examination confirmed adenocarcinoma arising from the cyst. The mass within the transverse mesocolon was successfully excised by a colorectal surgeon. Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria. Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy, except for an elevated cancer antigen 19-9 level. A multidisciplinary team recommended no further chemotherapy, advising routine follow-up for monitoring.</p><p><strong>Conclusion: </strong>Colonic duplications, though rare, remain a differential diagnosis of unexplained abdominal masses, with complete resection being their primary treatment approach.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"103136"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056455","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":"Effect of rapid rehabilitation surgical nursing on patients' gastrointestinal function recovery and sleep quality after laparoscopic appendectomy.","authors":"Shan-Shan Chen, Yi-Ming Gao, Xiao-Fang Yao, Qi-Qi Zhang, Kai-Long Yang, Qiao Xia, Jing Ding","doi":"10.4240/wjgs.v17.i4.102681","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.102681","url":null,"abstract":"<p><strong>Background: </strong>Appendicitis is a common acute abdominal pain disorder. Laparoscopic appendectomy, a commonly used modality, is associated with less trauma and faster recovery than traditional open appendectomy. However, postoperative recovery remains an important issue that affects rehabilitation quality and surgical results.</p><p><strong>Aim: </strong>To explore the effects of rapid rehabilitation and surgical nursing care on gastrointestinal function recovery and sleep quality among patients undergoing laparoscopic appendectomy.</p><p><strong>Methods: </strong>A total of 120 patients who underwent laparoscopic appendectomy at our hospital between January 2019 and March 2024 and for whom complete clinical data were available were selected. Patients were randomly assigned to two groups (<i>n</i> = 60 each) using the random number table method. The control group received routine nursing care, while the experimental group received rapid rehabilitation surgical nursing care; all patients continued to receive nursing care until discharge. The recovery of gastrointestinal function, length of hospital stay, complications, Pittsburgh sleep quality index, and nursing satisfaction were compared between groups.</p><p><strong>Results: </strong>Following the implementation of effective nursing measures, the times to bowel sound recovery, first exhaust, first defecation, and first feeding were notably shorter in the study <i>vs</i> control group (<i>P</i> < 0.05). Additionally, the duration of the first postoperative activity and the length of hospital stay were significantly shorter in the study <i>vs</i> control group (<i>P</i> < 0.05). Furthermore, the study group exhibited better sleep quality than the control group (<i>P</i> < 0.05). The postoperative complication rate was significantly lower and the nursing satisfaction rate significantly higher in the study <i>vs</i> control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Rapid rehabilitation surgical nursing interventions provided to patients after laparoscopic appendectomy can accelerate their postoperative recovery, reduce the occurrence of complications, and improve their sleep quality and nursing satisfaction.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"102681"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985305","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":"Brief insight regarding the use of transanal, laparoscopic, and robotic total mesorectal excision for rectal cancer.","authors":"Kevan English","doi":"10.4240/wjgs.v17.i4.102487","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.102487","url":null,"abstract":"<p><p>In this article, we provide an important commentary on the original study Lu <i>et al</i>, which offers insight into the surgical efficacy of transanal total mesorectal excision (TaTME) <i>vs</i> laparoscopic total mesorectal excision (LapTME) in the management of low-lying locally advanced rectal cancer (LARC). We focus specifically on the rate of postoperative complications between the two using existing data from the literature. We additionally introduce robotic total mesorectal excision (RTME) and look at its postoperative complications relative to the TaTME and LapTME. LARC has been conventionally approached by open surgery. However, minimally invasive techniques have emerged over the past two decades as alternatives to open total mesorectal excision, namely robotic, laparoscopic, and transanal. Each approach has its supporters, but conflicting data on resection outcomes and complications has fueled ongoing debate over the optimal minimally invasive technique for low/mid-LARC. This article aims to extend on the data regarding the use of TaTME and RTME in the treatment of low/mid-LARC and further elaborate on their comparative efficacy relative to LapTME.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"102487"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029821","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":"Association between postoperative feeding patterns and gastrointestinal function reconstruction after congenital intestinal atresia in neonates.","authors":"Hui-Ling Kang, Yue-Zhi Zhao","doi":"10.4240/wjgs.v17.i4.102980","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.102980","url":null,"abstract":"<p><strong>Background: </strong>Congenital intestinal atresia (CIA) is a common intestinal malformation in the neonatal period, and surgery is currently the main treatment method. The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.</p><p><strong>Aim: </strong>To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.</p><p><strong>Methods: </strong>Twenty-six children diagnosed with neonatal CIA, treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024, were selected for this single-center prospective randomized controlled study. They were divided into two groups using envelope randomization: Enteral nutrition (EN) group (<i>n</i> = 13) and parenteral nutrition (PN) group (<i>n</i> = 13). Baseline and clinical characteristics were collected, and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction. Differences between the groups were analyzed using <i>t</i>-test, <i>χ</i> ² test, and Fisher's exact test. Spearman's correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.</p><p><strong>Results: </strong>The time to bowel sound recovery (51.54 <i>vs</i> 65.85, <i>P</i> = 0.013) and first defecation (58.15 <i>vs</i> 76.62, <i>P</i> < 0.001) was shorter in the EN group compared to the PN group. Clinical improvements in the EN group, including discharge weight (<i>P</i> = 0.044), hospital stay (<i>P</i> = 0.027), white blood cell count (<i>P</i> = 0.023), albumin content (<i>P</i> = 0.013), and direct bilirubin content (<i>P</i> = 0.018), were also better than those in the PN group. No substantial differences in postoperative complications were found between the groups. Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation. Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation. Abdominal infection and an operation time > 2 hours may be risk factors for prolonged time to first defecation.</p><p><strong>Conclusion: </strong>EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children. Future research should explore optimal EN practices to enhance clinical application and child health.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"102980"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041564","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":"Central vascular ligation and complete mesocolon excision <i>vs</i> D3 lymphadenectomy: Standardization of surgical technique.","authors":"Sung Uk Bae","doi":"10.4240/wjgs.v17.i4.103704","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.103704","url":null,"abstract":"<p><p>Surgical advancements have transformed colorectal cancer treatment, with complete mesocolic excision (CME) becoming a crucial method to guarantee oncological safety and effectiveness. The article by Yadav emphasized the significance of CME in attaining optimal resection margins, thorough lymph node dissection, and enhanced long-term survival rates. The adjunctive function of D3 lymphadenectomy, emphasizing the clearance of lymphatic drainage along the supplying vessels, was also addressed. CME with central vascular ligation, based on the principles of total mesorectal excision for rectal cancer, entails <i>en bloc</i> tumor resection and precise dissection along the embryological planes, thus diminishing recurrence and improving survival rates. The viability and safety of minimally invasive techniques, such as laparoscopic CME, have been confirmed; however, technical difficulties remain owing to the intricate vascular anatomy. Robotic-assisted surgery presents potential benefits, including accurate lymphatic dissection and intracorporeal anastomosis. However, evidence demonstrating its superiority over laparoscopic techniques is scarce owing to high costs and prolonged duration. This study promotes the global standardization of CME as an essential element of modern colorectal cancer surgery. CME epitomizes contemporary oncological practices, requiring widespread adoption to achieve superiority in colon cancer management.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"103704"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel multimodal analgesic regimen for perioperative pain management after hepatic artery infusion chemotherapy in patients with advanced hepatocellular carcinoma.","authors":"Jing Yan, Rui An, Jing-Jing Wang, Min Wang, Qi Zhao, Shen Zhao, Jian Xu","doi":"10.4240/wjgs.v17.i4.101439","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.101439","url":null,"abstract":"<p><strong>Background: </strong>Hepatic artery infusion chemotherapy (HAIC) is a widely used local therapeutic approach for intermediate to advanced-stage hepatocellular carcinoma (HCC), exhibiting considerable efficacy. However, the prevalence of postoperative pain highlights the importance of pain management. Owing to the limitations inherent in existing pain management strategies, this study investigates and assesses the analgesic effectiveness of a multimodal treatment protocol in mitigating pain after HAIC procedures.</p><p><strong>Aim: </strong>To provide patients with a more comprehensive and effective pain management strategy.</p><p><strong>Methods: </strong>A total of 100 patients with primary HCC who underwent HAIC were randomly assigned to a control group (<i>n</i> = 50) and a multimodal group (<i>n</i> = 50). Baseline characteristics and perioperative data were collected. Upon enrollment, patients in the multimodal group received parecoxib (40 mg) 30 minutes before HAIC, followed by 48 hours of patient-controlled analgesia with sufentanil. In contrast, the control group underwent standard preoperative preparation (psychological support) and received dezocine (5 mg) intraoperatively, with intravenous flurbiprofen (100 mg) administered every 12 hours for 48 hours postoperatively.</p><p><strong>Results: </strong>Compared to the control group, the multimodal analgesia group exhibited significantly lower resting and movement visual analog scale pain scores at postoperative 0, 2, 4, 6, and 12 hours (<i>P</i> < 0.05). Furthermore, the multimodal group experienced a reduced incidence of postoperative nausea and vomiting, as well as a lower overall frequency of adverse events, compared to the control group (<i>P</i> < 0.05). Patient satisfaction was also significantly higher in the multimodal group than in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Our study demonstrates that multimodal analgesia is effective in reducing postoperative pain, minimizing adverse reactions, and improving patient satisfaction in HCC patients undergoing HAIC. This approach provides valuable clinical strategies for optimizing pain management in this patient population.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"101439"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039157","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 <i>Bifidobacterium</i> triple viable bacteria-assisted mirtazapine in managing depression in patients after radical surgery for gastric cancer.","authors":"Heng Lu, Wei-Dong Wu, Li Ji, Xiao-Yan Xu","doi":"10.4240/wjgs.v17.i4.100821","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.100821","url":null,"abstract":"<p><strong>Background: </strong>Patients with gastric cancer may have a risk of depression after radical surgery, which affects recovery and requires intensive intervention.</p><p><strong>Aim: </strong>To explore the role of <i>Bifidobacterium</i> triple viable bacteria-assisted mirtazapine in patients with depression after radical surgery for gastric cancer.</p><p><strong>Methods: </strong>This study included 80 patients with gastric cancer who experienced depression after undergoing radical surgery from January 2022 to December 2023 at Jiangnan University Hospital in Wuxi city in Jiangsu province. The patients were categorized into the control group (<i>n</i> = 40) treated with mirtazapine and observation group (<i>n</i> = 40) treated with combined <i>Bifidobacterium</i> triple viable bacteria-assisted mirtazapine. Neuroendocrine index, intestinal flora level, nutrition status, and patient quality of life were analyzed.</p><p><strong>Results: </strong>Before drug index level, no statistically significant difference was observed between the two groups <i>P</i> > 0.05). After drug administration, both groups experienced a decline in depression scores, cortisol, <i>Escherichia coli</i>, <i>Enterococcus faecalis</i> levels, and quality of life scores, whereas dopamine, serotonin, <i>Lactobacillus</i>, <i>Bifidobacteria</i>, hemoglobin, serum albumin and prealbumin levels increased. The observation group demonstrated significantly greater improvements across these indicators, with significant differences within groups and between groups (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong><i>Bifidobacterium</i> has a relieving effect on depression in patients after radical surgery for gastric cancer, improves neuroendocrine status, regulates intestinal flora, and improves nutritional status and quality of life.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"100821"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037267","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":"Machine learning-based prediction of postoperative mortality risk after abdominal surgery.","authors":"Ji-Hong Yuan, Yong-Mei Jin, Jing-Ye Xiang, Shuang-Shuang Li, Ying-Xi Zhong, Shu-Liu Zhang, Bin Zhao","doi":"10.4240/wjgs.v17.i4.103696","DOIUrl":"https://doi.org/10.4240/wjgs.v17.i4.103696","url":null,"abstract":"<p><strong>Background: </strong>Preoperative risk assessments are vital for identifying patients at high risk of postoperative mortality. However, traditional scoring systems can be time consuming. We hypothesized that the use of machine learning models would enable rapid and accurate risk assessments to be performed.</p><p><strong>Aim: </strong>To assess the potential of machine learning algorithms to develop predictive models of mortality risk after abdominal surgery.</p><p><strong>Methods: </strong>This retrospective study included 230 individuals who underwent abdominal surgery at the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine between January 2023 and December 2023. Demographic and surgery-related data were collected and used to develop nomogram, decision-tree, random-forest, gradient-boosting, support vector machine, and naïve Bayesian models to predict 30-day mortality risk after abdominal surgery. Models were assessed using receiver operating characteristic curves and compared using the DeLong test.</p><p><strong>Results: </strong>Of the 230 included patients, 52 died and 178 survived. Models were developed using the training cohort (<i>n</i> = 161) and assessed using the validation cohort (<i>n</i> = 68). The areas under the receiver operating characteristic curves for the nomogram, decision-tree, random-forest, gradient-boosting tree, support vector machine, and naïve Bayesian models were 0.908 [95% confidence interval (CI): 0.824-0.992], 0.874 (95%CI: 0.785-0.963), 0.928 (95%CI: 0.869-0.987), 0.907 (95%CI: 0.837-0.976), 0.983 (95%CI: 0.959-1.000), and 0.807 (95%CI: 0.702-0.911), respectively.</p><p><strong>Conclusion: </strong>Nomogram, random-forest, gradient-boosting tree, and support vector machine models all demonstrate strong performances for the prediction of postoperative mortality and can be selected based on the clinical circumstances.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 4","pages":"103696"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064931","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 effect and prognosis of laparoscopic surgery on colon cancer complicated with intestinal obstruction patients.","authors":"Pei-Hua Wu, Zheng-Quan Ta","doi":"10.4240/wjgs.v17.i3.101609","DOIUrl":"10.4240/wjgs.v17.i3.101609","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colon cancer is one of the most common malignancies of the digestive tract, often complicated by intestinal obstruction, which can significantly impact patient outcomes. While traditional laparotomy is the standard treatment, it is associated with large wounds, slower recovery, and higher complication rates. Laparoscopic surgery, a minimally invasive approach, may offer better outcomes for these patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022. Patients were divided into two groups: The control group (CG), treated with traditional laparotomy, and the observation group (OG), treated with laparoscopic surgery. Clinical effects, surgical indicators, postoperative pain, inflammatory response, complication rates, quality of life, and prognosis were assessed and compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The OG showed superior clinical outcomes compared to the CG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Postoperative pain (numerical rating scale scores) and inflammatory markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)] were lower in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The incidence of complications was significantly reduced in the OG (6.00% &lt;i&gt;vs&lt;/i&gt; 22.00%, &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastasis rates, or 1- and 3-year survival rates (&lt;i&gt;P&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The OG showed superior clinical outcomes compared to the CG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Postoperative pain (NRS scores) and inflammatory markers (TNF-α, IL-6, CRP) were lower in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The incidence of complications was significantly reduced in the OG (6.00% &lt;i&gt;vs&lt;/i&gt; 22.00%, &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastas","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"101609"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754566","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}