World Journal of Surgical Oncology最新文献

{"title":"Prevalence of occult endometrial carcinoma in patients with endometrial intraepithelial neoplasia who underwent hysterectomy.","authors":"Waraphon Thongsang, Sompop Kuljarusnont, Suchanan Hanamornroongruang, Irene Ruengkhachorn","doi":"10.1186/s12957-025-03677-6","DOIUrl":"10.1186/s12957-025-03677-6","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of occult endometrial carcinoma in patients with endometrial intraepithelial neoplasia (EIN) post-hysterectomy and identify pre-hysterectomy risk factors predictive of occult carcinoma.</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with EIN between 2007 and 2021 who underwent hysterectomy as primary treatment. An expert gynecologic pathologist reviewed pathological slides. Data collected from medical records included demographic and gynecologic information, sonographic findings, and surgical and pathological outcomes. The prevalence of occult endometrial carcinoma was calculated. Descriptive statistics evaluated carcinoma incidence, and logistic regression analysis identified independent risk factors.</p><p><strong>Results: </strong>A total of 113 patients were evaluated. The median time to hysterectomy was 9.1 weeks (range 5.8-12.8 weeks). Post-hysterectomy, 36 patients (31.8%) were diagnosed with endometrial carcinoma, all endometrioid type. Of these, 88.9% were stage I per the International Federation of Gynecology and Obstetrics classification system, and 11.1% were at high risk for nodal metastasis. Predictive factors for occult carcinoma included the intraoperative gross lesion size (2 cm or larger and less than 2 cm) and endometrial aspiration. Adjusted odds ratios were 6.723 (95% CI 2.338 to 19.333) for lesions 2 cm or larger, 3.381 (95% CI 1.128 to 10.132) for lesions less than 2 cm, and 2.752 (95% CI 1.092 to 6.936) for endometrial aspiration.</p><p><strong>Conclusions: </strong>Occult endometrial carcinoma was identified in 31.8% of patients with a pre-hysterectomy EIN diagnosis. The significant predictors were endometrial aspiration and the presence of a gross lesion during surgery.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"24"},"PeriodicalIF":2.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy comparison of optimal natural orifice specimen extraction for robotic middle rectal cancer resection in women: transanal or transvaginal orifice.","authors":"Yao Yao, Jiarui Ding, Houqiong Ju, Lingling Yang, Yang Liu, Yahang Liang, Yuli Yuan, Taiyuan Li, Xiong Lei","doi":"10.1186/s12957-024-03630-z","DOIUrl":"10.1186/s12957-024-03630-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the optimal natural orifice specimen extraction (NOSE) method for robotic-assisted mid-rectal cancer resection in women.</p><p><strong>Methods: </strong>This retrospective propensity score-matched (PSM) study was to analyze the clinical data prospectively collected from female rectal cancer patients who underwent either robotic-assisted transvaginal specimen extraction (RATV) or robotic-assisted transanal specimen extraction (RATA) at our center between June 2016 and December 2022. The main outcome measures were urinary, anal, and sexual function. Disease-free survival (DFS), and overall survival (OS) were also included .</p><p><strong>Results: </strong>Anal function, assessed by the Wexner score, was better in the RATV group than in the RATA group (P = 0.034). Additionally, pre-menopausal women in RATV group exhibited superior anal function over those in RATA group (P = 0.031). There was no statistically significant difference in urinary function between the groups for both pre-menopausal and peri-menopausal patients (P = 0.711, P = 0.106). No difference was observed in sexual function between the two groups (P = 0.351); however, pre-menopausal patients in RATA group had better sexual function than those in RATV group (P = 0.045). Univariate logistic regression analysis showed surgical procedure was not a significant factor for the occurrence of sexual dysfunction. There were no significant difference in DFS (P = 0.845)and OS (P = 0.642) between the two groups.</p><p><strong>Conclusion: </strong>Though the postoperative efficacy of the RATA and RATV was equivalent on urinary and sexual function, RATV is an optimal natural orifice specimen extraction for robotic middle rectal cancer resection in women based on anal function.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"22"},"PeriodicalIF":2.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-grade mucinous neoplasm originating from intestinal duplication: a case report and review of the literature.","authors":"Huihui Yin, Jie Yu, Yunzhao Chen","doi":"10.1186/s12957-025-03682-9","DOIUrl":"10.1186/s12957-025-03682-9","url":null,"abstract":"<p><strong>Background: </strong>Low-grade mucinous neoplasms typically originate from the appendix and are characterized by a lining of low-grade mucus-secreting columnar epithelial cells and smooth muscle. However, atypical origins can occur, as demonstrated in this case report.</p><p><strong>Case presentation: </strong>We present a case involving a 33-year-old male who, upon physical examination, was found to have an abdominal mass. A computed tomography (CT) scan revealed a cystic mass located between the pancreatic tail and the adjacent bowel duct, with significant enhancement of the cyst wall observed on contrast-enhanced imaging. The patient subsequently underwent laparoscopic surgical resection of the mass, and the resected specimen was sent for pathological evaluation. The pathology results were consistent with the histological morphology and immunohistochemical characteristics of low-grade mucinous tumors arising from intestinal duplication. Three and a half years post-resection, the patient returned for a follow-up examination, during which abdominal CT and blood tumor markers indicated no signs of tumor recurrence.</p><p><strong>Conclusions: </strong>While low-grade mucinous tumors predominantly originate from the appendix, this case illustrates an unusual occurrence of such neoplasms arising from intestinal duplication. This report aims to enhance clinical awareness of low-grade mucinous tumors originating from intestinal duplication, thereby improving the rates of preoperative diagnosis and reducing instances of misdiagnosis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"20"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy analysis of drug-eluting beads transcatheter arterial chemoembolization combining systemic chemotherapy and immune checkpoint inhibitors in unresectable intrahepatic cholangiocarcinoma: a multicenter retrospective cohort study based on propensity score matching.","authors":"Liu Song, Wang Qingdong, Yin Shunhang, Li Long, Zhao Guangsheng, Yu Guangji, Wang Dong","doi":"10.1186/s12957-025-03679-4","DOIUrl":"10.1186/s12957-025-03679-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE) combined with systemic chemotherapy and immune checkpoint inhibitors in the treatment of unresectable intrahepatic cholangiocarcinoma.</p><p><strong>Methods: </strong>This study used retrospective cohort analysis to collect the clinical data of 209 patients with unresectable intrahepatic cholangiocarcinoma treated in Linyi Cancer Hospital, Affiliated Zhongshan Hospital of Dalian University, Affiliated Central Hospital of Dalian University of Technology from January 2020 to January 2024. The patients were divided into observation group and control group based on their treatment plans. The observation group was treated with DEB-TACE combined with systemic chemotherapy and immune checkpoint inhibitor, and the control group was treated with simple systemic chemotherapy and immune checkpoint inhibitor. Based on propensity score matching analysis, the clinical treatment efficacy, survival prognosis, and incidence of adverse reactions of two groups of patients were evaluated.</p><p><strong>Results: </strong>82 patients in the observation group received DEB-TACE combined with systemic chemotherapy and immune checkpoint inhibitors, The control group of 127 patients were treated with systemic chemotherapy and immune checkpoint inhibitors. After a propensity score matching analysis to control for the consistency of patient age, sex, tumor size, tumor number, Child grade, ECOG score, and tumor stage. Propensity score matching analysis created 71 pairs of patients in 2 groups. The objective response rate (ORR, 76.06%) and disease control rate (DCR, 97.18%) in the observed group were significantly higher than that in the control group (52.11%, 85.92%), Progression-free survival (PFS, 10 months) and overall survival (OS, 17 months) were higher than the control group (8 months, 11 months). The Cox proportional hazards model analysis revealed that, Child grade and treatment modality were independent predictors of PFS and OS in patients. The adverse effects during treatment were similar in the two groups, with no statistical difference.</p><p><strong>Conclusions: </strong>Compared with systemic therapy alone (systemic chemotherapy + immune checkpoint inhibitor), combined DEB-TACE improves the tumor control rate of patients with unresectable intrahepatic cholangiocarcinoma, extends the survival time and without increasing treatment-related adverse effects, which is a safe and feasible treatment modality.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"21"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Down syndrome with cryptorchidism and retroperitoneal mixed germ cell tumour in an adult patient: a case report and literature review.","authors":"Qiang Wang, Hai-Bin Zhou, Li Ao, Yi Jiang, Xiao-Cong Zhou","doi":"10.1186/s12957-024-03589-x","DOIUrl":"10.1186/s12957-024-03589-x","url":null,"abstract":"<p><strong>Background: </strong>An association between testicular cancer and Down syndrome has been reported by several studies. Down syndrome with cryptorchidism and retroperitoneal mixed germ cell tumours is rare, and yolk sac tumours are often considered secondary components of mixed germ cell tumours. Herein, we present a rare case of retroperitoneal mixed germ cell tumour with cryptorchidism accompanied by yolk sac tumour and seminoma in a patient with Down syndrome, along with its imaging features.</p><p><strong>Case presentation: </strong>A 42-year-old man was admitted to the hospital for 6 months due to a worsening abdominal pain that was followed by syncope for 8 h. There was a significant increase in AFP and β-HCG levels. An enhanced computed tomography (CT) scan of the entire abdomen showed a mixed cystic solid mass in the retroperitoneal space. Fluorine-2-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron emission tomography/CT examination showed an abnormal increase in the FDG uptake in the parenchymal part of the mass, with a maximum standardised uptake value of approximately 10.5. The pathological diagnosis was retroperitoneal mixed germ cell tumour (yolk sac tumour + seminoma). One and a half months postoperatively, the tumour recurred. Consequently, the patient underwent chemotherapy, and after one course of treatment, the patient developed bone marrow suppression. Finally, he died due to complications.</p><p><strong>Conclusions: </strong>Yolk sac tumours, the main components of mixed germ cell tumours, are rare in adults and exhibit rapid growth, heightened malignancy, and poor prognoses. CT features play a crucial role in diagnosis. Down syndrome is a high-risk factor for malignant testicular germ cell tumours. Therefore, comprehensive examinations for gonadal and germ cell tumours in patients with Down syndrome are imperative and should be prioritised by clinicians.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"19"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-stage versus two-stage thoracoscopic surgery for synchronous bilateral pulmonary nodules: a propensity score-matched analysis.","authors":"Yu Han, Fei Xiao, Qianli Ma, Zhenrong Zhang, Zaiyong Wang, Chaoyang Liang, Deruo Liu","doi":"10.1186/s12957-025-03660-1","DOIUrl":"10.1186/s12957-025-03660-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to compare the surgical efficacy of one-stage and two-stage video-assisted thoracoscopic surgery (VATS) for bilateral multiple pulmonary nodules (BMPNs).</p><p><strong>Methods: </strong>A retrospective analysis was made of 156 patients, 84 who underwent one-stage and 72 who underwent two-stage VATS for BMPNs at our department between January 2019 and December 2022. Perioperative and long-term outcomes were compared between the two groups using propensity score-matched (PSM) analysis.</p><p><strong>Results: </strong>There were 48 patients in each group after PSM. No significant difference was observed in operation time, blood loss, rates of overall complications, and 3-year overall survival (p>0.05) between one-stage and two-stage groups. The one-stage procedure was associated with shorter length of stay (5 days [IQR 4-5.75 days] vs. 9 days [IQR 7-10 days]; p<0.001), as well as lower total cost (14626.3 ± 4149.4 vs. 18975.9 ± 3720.8 USD, p<0.001) compared to the two-stage procedure. The one-stage group was associated with better 3-year RFS compared with the two-stage group (90.7% vs. 75.3%, p = 0.039).</p><p><strong>Conclusion: </strong>One-stage and two-stage VATS for BMPNs are both safe and feasible in selected patients. One-stage procedure possess potential advantages in reducing hospital stay and cost, as well as preventing tumor progression.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"18"},"PeriodicalIF":2.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest wall perforator flap reconstruction in breast conserving surgery: quality of life and limited complications in outpatient treatment.","authors":"L J van Zeelst, R Straten, R R J P van Eekeren, D J P van Uden, J H W de Wilt, L J A Strobbe","doi":"10.1186/s12957-024-03638-5","DOIUrl":"10.1186/s12957-024-03638-5","url":null,"abstract":"<p><strong>Background: </strong>Breast conserving surgery (BCS) with partial breast reconstruction (PBR) results in less morbidity, better cosmetic outcomes, and improved patient satisfaction compared to mastectomy. Perforator flap reconstruction can attenuate defects prone to breast deformity after BCS. Usually, postoperative drains and inpatient admission are part of this treatment. The main objective of this study is to report on postoperative complications and patient satisfaction after drainless perforator flap reconstruction by a dedicated breast surgeon.</p><p><strong>Methods: </strong>In a retrospective case series, 42 patients were included. All patients underwent BCS with drainless perforator flap reconstruction, planned and performed by a single breast surgeon. Outcomes were complication incidence and patient satisfaction reported in the Breast-Q Breast Conserving Therapy (BCT) module.</p><p><strong>Results: </strong>In the study cohort, the median age was 59.5 (49.8-71.3) years. Tumour types were ductal carcinoma in situ (DCIS, four patients, 9.5%), invasive no special type (NST, 22 patients, 52.4%), invasive lobular (12 patients, 28.6%), and other invasive cancers (4 patients, 9.5%). Complication incidence was seven of 42 patients (16.7%), including hematoma, seroma, wound dehiscence, fat necrosis, and lymphedema, all Clavien Dindo grade 0-1, without readmission or reoperation. Reported Breast-Q scores (median of 17 months after surgery) were 87/100 for psychosocial well-being, 82/100 for breast satisfaction, and 71/100 for physical well-being. Outpatient treatment was successful in 38 patients (90.5%), and 13 patients (31.0%) had an unplanned visit to the outpatient clinic.</p><p><strong>Conclusion: </strong>Drainless perforator flap reconstruction performed by the breast surgeon results in high patient satisfaction and limited complications, both in number and severity. The use of drains and hospital stays after perforator flap reconstruction must be discouraged.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"17"},"PeriodicalIF":2.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene mutation, clinical characteristics and pathology in resectable lung adenocarcinoma.","authors":"Ji'an Zou, Wei Han, Yan Hu, Chao Zeng, Jina Li, Weixuan Lei, Jieming Cao, Quanming Fei, Mengqi Shao, Junqi Yi, Zeyu Cheng, Li Wang, Fang Wu, Wenliang Liu","doi":"10.1186/s12957-025-03680-x","DOIUrl":"10.1186/s12957-025-03680-x","url":null,"abstract":"<p><strong>Objective: </strong>With the wide use of CT scan in clinical practice, more lung cancer was diagnosed in resectable stage. Pathological examination and genetic testing have become a routine procedure for lung adenocarcinoma following radical resection. This study analyzed special pathological components and gene mutations to explore their relationship with clinical characteristics and overall survival.</p><p><strong>Methods: </strong>Clinical, pathological, and gene mutation data from 1,118 patients were collected. All patients underwent surgery at the Department of Thoracic Surgery, the Second Xiangya Hospital of Central South University. Patients were grouped based on pathological components and gene mutations. Differences in clinical features and overall survival were analyzed as well.</p><p><strong>Results: </strong>Patients with mucinous, neuroendocrine, and poor-differentiated components were presented with more prognostic risk factors, including pleural invasion, carcinothrombosis, STAS, and advanced stages, along with varying frequencies of gene mutations. These factors significantly shortened overall survival. ALK and KRAS mutations were also associated with risk factors such as solid nodules, pleural invasion, STAS, and later stages. However, a significant reduction in overall survival was observed only in patients with the KRAS mutation. Relationship between gene mutations and pathological components still requires further investigation.</p><p><strong>Conclusion: </strong>Special pathological components (mucinous, neuroendocrine, and poor-differentiated) and gene mutations had an influence on biological behavior of tumors, resulting in different clinical characteristics and prognosis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"16"},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior mediastinal tracheostomy - a salvage procedure for tracheal necrosis after thyroidectomy for medullary thyroid cancer: a case-report.","authors":"Hanan Hemead, Akshay J Patel, Hannah Jesani, Sajith Kumar, Irfan Ahmed, Sat Parmar, Robert Warner, Neil Sharma, Maninder S Kalkat","doi":"10.1186/s12957-025-03653-0","DOIUrl":"https://doi.org/10.1186/s12957-025-03653-0","url":null,"abstract":"<p><p>A 34-year-old male patient with recently diagnosed with medullary thyroid carcinoma underwent total thyroidectomy and radical neck dissection, requiring sharp dissection to separate the tumour from the trachea. He required post operative intubation due to bilateral vocal cord paralysis. He developed ischaemic necrosis of the upper two thirds of the trachea presenting with marked surgical emphysema and an infective wound. The wound was opened, drained and an endotracheal tube was negotiated through the sloughed trachea into the distal intrathoracic trachea with the cuff inflated just above the carina. This complication was managed with total pharyngo-laryngectomy, anterior deep mediastinal tracheostomy and construction of a neo-cervical oesophagus with a free lateral thigh fascio-cutaneous flap. This case highlights the potential complications of a procedure, perseverance, collaboration amongst various disciplines and teamwork for treating a rare and complex condition. The patient was discharged and has had an excellent recovery with good quality of life over two years of follow up.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"14"},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the boundaries of anastomotic leak: experience in a high-volume center.","authors":"Carolina Riscanevo Bobadilla, Gloria Flórez Dussan, Jorge Vargas, Liliana Suarez, German Jimenez, Carlos Gonzalez, Andrea Carolina Córdoba, Wilmar Martín, Diego Olivera, Raúl Guevara","doi":"10.1186/s12957-024-03622-z","DOIUrl":"10.1186/s12957-024-03622-z","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a major global health challenge, ranking fourth in cancer-related deaths. Total gastrectomy with lymphadenectomy is the standard treatment, with advancements in surgery shifting towards minimally invasive techniques to reduce surgical trauma and metabolic response. Esophagojejunal anastomotic leak is a frequent complication of gastrectomy, significantly increasing morbidity and mortality rates by up to 64%.</p><p><strong>Materials and methods: </strong>A retrospective cohort study reviewed adults undergoing total gastrectomy for gastric cancer who developed esophagojejunal anastomotic leaks. The study described patient characteristics, diagnostic methods, and management at Clinica Universitaria Colombia from 2013 to 2023.</p><p><strong>Results: </strong>Among 500 patients who had total gastrectomy, 54 developed esophagojejunal leaks. The cohort was 64.8% male, average age 55.2 years (± 14.87), and average BMI 24.5 kg/m². Notably, 18.5% smoked, 11.1% had lung disease, and 9.3% had heart disease or diabetes. Chest tomography was used in 60% of cases, followed by endoscopy in 35.2%. Endoscopic management with fully covered stents was the main strategy, used in 84% of cases. Average hospitalization was 18 days, with 33% needing intensive care, and overall hospital stay was 23.31 ± 16.33 days. Patients undergoing neoadjuvant and elective laparoscopic surgeries had a significant 30-day mortality risk.</p><p><strong>Conclusions: </strong>Despite advances in surgical techniques and perioperative management, esophagojejunal anastomotic leaks continue to represent a serious complication, increasing morbidity and mortality. Therefore, early postoperative detection, based on the patient's clinical signs that allow confirmatory studies to be performed, is crucial. This facilitates the implementation of timely treatments, whether conservative, through the use of endoscopic or percutaneous strategies, or surgical procedures. The next step for the scientific community will be to conduct studies with long-term follow-ups to ensure consistency of the high-quality results reported so far.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"15"},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}