Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Preventing Postsurgical Lymphoceles: Efficacy of Preventing Lymphocele Ensuring Absorption Transperitoneally Technique in Robot-Assisted Laparoscopic Prostatectomy.","authors":"Bulent Onal, Mehmet Hamza Gultekin, Kadir Can Sahin, Ahmet Vural, Goktug Kalender, Emre Akkus","doi":"10.1177/10926429251381449","DOIUrl":"https://doi.org/10.1177/10926429251381449","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphocele is an important condition commonly seen in the follow-up of patients who underwent radical prostatectomy and extended pelvic lymph node dissection (ePLND) for prostate cancer. Since the formation and treatment of lymphocele may have negative consequences in terms of patient-care and health expenditure. Several techniques have been used to prevent lymphocele. In this study, we aimed to investigate the efficacy of the previously described preventing lymphocele ensuring absorption transperitoneally (P.L.E.A.T.) technique and compare the outcomes of patients who underwent this technique. <b><i>Methodology:</i></b> The data of patients who underwent robot-assisted laparoscopic radical prostatectomy with ePLND for prostate cancer between 2017 and 2023 in our institution were retrospectively analyzed. Patients were divided into two groups according to the application of the P.L.E.A.T. technique in their operations. All patients were followed up with the same protocol. Patient characteristics and postoperative follow-up data were statistically analyzed. <b><i>Results:</i></b> Data of 78 patients (26 patients in the P.L.E.A.T. group and 52 patients in control group) were evaluated retrospectively. There were no statistically significant differences between the groups in terms of demographic and clinical characteristics, including age, prostate-specific antigen levels, body mass index, American Society of Anaesthesiologists score, D'Amico risk classification, or the number of lymph nodes removed. Analysis of postoperative data revealed statistically significant differences between the two groups in total amount of drainage (<i>P</i> < .05), drain removal day (<i>P</i> < .05), and length of hospital stay (<i>P</i> < .05). <b><i>Conclusions:</i></b> Our experience with the P.L.E.A.T. technique showed potential advantages in line with the literature, with a considerable reduction in total drain amount, drain removal day, and length of stay.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Renal Pelvis Urine Attenuation Value in Forecasting Infection Risk After Mini-Percutaneous Nephrolithotomy.","authors":"Huseyin Burak Yazili, Ufuk Caglar, Ahmet Halis, Oguzhan Yildiz, Arda Meric, Resit Yusuf, Omer Sarilar, Faruk Ozgor","doi":"10.1177/10926429251381201","DOIUrl":"https://doi.org/10.1177/10926429251381201","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate whether renal pelvis urine density (RPUD), measured on preoperative computed tomography (CT), predicts infectious complications following percutaneous nephrolithotomy (PCNL). <b><i>Methods:</i></b> This retrospective study included patients who underwent PCNL between June 2019 and June 2024 at a tertiary care center. Patients with preoperative infection signs, drainage devices, or incomplete data were excluded. All included patients had sterile urine cultures preoperatively. RPUD was measured on noncontrast CT by two independent urologists, and interobserver agreement was calculated. Patients were grouped according to the presence of postoperative infectious complications (fever, sepsis, or septic shock). Demographic and perioperative variables were compared. Logistic regression was used to identify independent predictors of infection. <b><i>Results:</i></b> A total of 226 patients were analyzed. Patients with postoperative infections had significantly higher RPUD values (13.7 versus 6.0 Hounsfield units, <i>P</i> = .001) and longer operative times (70 versus 50 minutes, <i>P</i> = .001). On multivariate analysis, both RPUD (odds ratio: 1.238) and operative time (odds ratio: 1.055) were independent predictors. ROC analysis showed that an RPUD cutoff of 9.250 predicted infection with 80.0% sensitivity and 80.1% specificity (AUC: 0.875). Interobserver reliability for RPUD was excellent (intraclass correlation coefficient: 0.942). <b><i>Conclusions:</i></b> Preoperative RPUD is a reliable, noninvasive radiological marker for predicting infectious complications after PCNL. Routine measurement of RPUD may improve preoperative risk stratification and optimize perioperative management. These findings should be validated in future prospective, multicenter studies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Endoscopic Submucosal Dissection Truly Comparable to Transanal Endoscopic Microsurgery for Early Rectal Epithelial and Subepithelial Tumors? A Meta-Analysis.","authors":"Hind El Naamani, Joseph A Sujka, Raja Hamsa Chitturi, Damanpartap Singh Sandhu, Madhu Babu Adusmilli, Salvatore Docimo, Christopher G DuCoin, Abdul-Rahman F Diab","doi":"10.1177/10926429251381920","DOIUrl":"https://doi.org/10.1177/10926429251381920","url":null,"abstract":"<p><p><b><i>Background:</i></b> Early rectal tumors can be effectively managed using transanal endoscopic microsurgery (TEM) and endoscopic submucosal dissection (ESD). This study aimed to compare ESD and TEM in the resection of early rectal tumors concerning <i>en bloc</i> resection rates, R0 resection rates, mean procedural times, perforation rates, bleeding rates, adverse events/complication rates, and mean length of stay (LOS). <b><i>Methods:</i></b> We conducted a systematic literature review in accordance with PRISMA guidelines to identify studies directly comparing ESD and TEM for the resection of early rectal tumors. A pairwise meta-analysis was performed using a random-effects model, reporting odds ratios and mean differences. <b><i>Results:</i></b> The R0 resection rate was lower in the ESD group. Subgroup analysis indicated that the reduced R0 resection rate in ESD remained significant in the subepithelial subgroup but not in the epithelial subgroup, with the subgroup difference reaching statistical significance (<i>P</i> = .05) but didn't meet conventional statistical significance (<i>P</i> < .05). The number needed to treat with ESD to result in one additional missed R0 resection (harmful event) compared to TEM was 10 (95% CI 4-162). The ESD group demonstrated significantly shorter mean procedural times and LOS, with no significant subgroup differences between epithelial and subepithelial tumors. <b><i>Conclusions:</i></b> This study suggests that ESD is associated with a lower R0 resection rate compared to TEM, but offers a shorter mean LOS and procedural time. To date, no randomized controlled trials (RCTs) have been published. Large-scale RCTs that also involve operators who have achieved technical mastery in ESD and TEM are necessary to reach more definitive conclusions. Until such RCTs are published, strong recommendations cannot be made. Additionally, further studies are required to assess whether tumor origin (epithelial versus subepithelial) impacts the R0 resection rate in ESD.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prediction of Difficult Laparoscopic Cholecystectomy for Acute Cholecystitis from Preoperative Clinical Factors and Radiological Findings.","authors":"Hung-Yu Chung, Shang-Yu Wang, Yu-Liang Hung, Ker-En Lee, Huan-Wu Chen, Chun-Yi Tsai, Jun-Te Hsu, Ta-Sen Yeh, Chun-Nan Yeh, Yi-Yin Jan","doi":"10.1177/10926429251379864","DOIUrl":"https://doi.org/10.1177/10926429251379864","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aimed to identify predictive clinical factors and computed tomography (CT) findings for difficult laparoscopic cholecystectomy (LC) in patients with acute cholecystitis (AC). <b><i>Methods:</i></b> We retrospectively reviewed 549 patients with AC who underwent LC following preoperative CT scans from January 2011 to August 2020. Difficult LC was defined as requiring conversion to laparotomy or subtotal cholecystectomy, blood loss >500 mL, operative time significantly exceeding average, or bile duct injury. Clinical characteristics and specific CT findings were analyzed using univariate and multivariate logistic regression. <b><i>Results:</i></b> Twenty-seven patients (4.9%) experienced difficult LC. Multivariate analysis identified body mass index (BMI) >30 kg/m² (odds ratio [OR] = 4.70, 95% confidence interval [CI]: 1.86-11.92; <i>P</i> = .004) and C-reactive protein (CRP) ≥60 mg/L (OR = 3.12, 95% CI: 1.31-7.44; <i>P</i> = .01) as independent predictors. Radiological findings from CT, such as peri-gallbladder fluid and fat stranding, demonstrated no significance statistically. <b><i>Conclusions:</i></b> High BMI and elevated CRP levels were significant independent predictors for difficult LC in patients with AC. Preoperative CT findings alone did not predict surgical difficulty, suggesting clinical factors should remain the primary consideration in preoperative assessment.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Incision Laparoscopic Ileocecectomy in Pediatric Crohn's Disease: A 15-Year Experience.","authors":"Seth Saylors, Cory Nonnemacher, Shawn St Peter","doi":"10.1177/10926429251379867","DOIUrl":"https://doi.org/10.1177/10926429251379867","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> In refractory Crohn's disease, the terminal ileum is a common site requiring excision. Laparoscopic ileocecectomy is the procedure of choice and we use a single-incision laparoscopic technique (SILS). We have previously reported our experience with SILS ileocecectomy with a sizeable cohort compared to other series. This project aims to expand on our single-institutional experience and evaluate the impact of operative experience. <b><i>Methods:</i></b> We completed a single-institution retrospective review of patients who underwent SILS ileocecectomy for Crohn's disease from January 1, 2009 to March 31, 2024. Operative and inpatient characteristics were collected to determine complication rates. Subgroup analysis was completed comparing previously studied patients (January 1, 2009 to February 1, 2013) to our updated cohort. <b><i>Results:</i></b> Seventy-eight patients underwent SILS ileocecectomy for Crohn's disease and had a median age of 16.5 years (interquartile range: 15.0, 17.8). The median length of stay (LOS) was 96 hours (72, 186). The overall complication rate was 17%. On subgroup analysis, patients operated on after 2013 were older (<i>P</i> = .012), had a longer disease length before operating room (OR) (<i>P</i> = .051) and were more likely to be on anti-tumor necrosis factor therapy (<i>P</i> = .014). Mean operative time was significantly lower in the newer cohort (70 mins versus 85 mins, <i>P</i> = .007). The patients in the newer cohort had a shorter median LOS (72 hours compared to 108 hours, <i>P</i> = .149) and had a lower complication (13% versus 23%, <i>P</i> = .283) and re-operation rate (4% versus 15%, <i>P</i> = .159). <b><i>Conclusions:</i></b> SILS ileocecectomy is effective and safe in pediatric patients with Crohn's disease. As operative experience increases, we have observed a clinically significant decrease in operative time and complication rates. <b><i>Level of Evidence:</i></b> III, Retrospective study.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Trainee Performance and Surgical Safety: A Comparison of Supine and Left Lateral Positioning in Pediatric Laparoscopic Appendectomy.","authors":"Vaibhav Pandey, Shashi Prakash Mishra, Indra Singh Choudhary, Bhanumurthy Marripati Kaushik, Amit Gupta, Ruchira Nandan","doi":"10.1177/10926429251378093","DOIUrl":"https://doi.org/10.1177/10926429251378093","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic appendectomy is the preferred treatment for acute appendicitis, offering reduced morbidity and quicker recovery compared with open surgery. The positioning of the patient during surgery can significantly impact both the ergonomics for the surgeon and the operational outcomes. This study compares the conventional supine positioning with an innovative left lateral decubitus approach for surgical efficiency and recovery outcomes. <b><i>Methods:</i></b> This prospective, comparative study included 30 pediatric patients undergoing interval appendectomy at the Department of Pediatric Surgery, from October 2023 to March 2024. Patients were randomly assigned to undergo appendectomy either in the traditional supine position (Group A) or a modified left lateral position (Group B). The study measured operative times, complication rates, and surgical outcomes using the modified Objective Structured Assessment of Technical Skills (OSATS). <b><i>Results:</i></b> The study consisted of 15 patients in each group, with comparable demographics and baseline characteristics. Group B showed a significant reduction in mean operating time (55.25 ± 3.62 minutes) compared with Group A (62.45 ± 4.15 minutes) (<i>P</i> < .001). There were fewer complications in Group B, with no serosal tears reported compared with a 15.3% incidence in Group A. The modified OSATS scores were higher in Group B, indicating better flow of operation and overall performance. <b><i>Conclusion:</i></b> The left lateral positioning in pediatric laparoscopic appendectomy demonstrated a potential to enhance surgical efficiency, reduce operative time, and minimize complications compared with the traditional supine approach. These findings suggest that the left lateral position could be considered a preferable alternative in pediatric appendectomy, particularly beneficial for surgical trainees due to improved ergonomics.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Biliary Drainage: Jaundice and Symptomatic Relief in a Public National Hospital.","authors":"Magdalena Bozzetti, Benjamin Romei, Patricio Reilly, Guillermo Rossini, Mariano Palermo","doi":"10.1177/10926429251380315","DOIUrl":"https://doi.org/10.1177/10926429251380315","url":null,"abstract":"<p><p><b><i>Background:</i></b> Obstructive jaundice is a common condition in daily clinical practice. Given the severity of its potential complications, prompt management and resolution are essential. Percutaneous biliary drainage is a viable therapeutic option. The aim is to evaluate the effectiveness of percutaneous biliary drainage in reducing bilirubin levels and providing symptomatic relief in patients with obstructive jaundice treated at Hospital Nacional Posadas between 2019 and 2024. <b><i>Methods:</i></b> A retrospective review was conducted using the database of Hospital Nacional Prof. A. Posadas. All patients diagnosed with obstructive jaundice (total bilirubin ≥2 mg/dL) who underwent percutaneous biliary drainage between June 2019 and May 2024 were included (<i>n</i> = 118). Data collected included age, sex, comorbidities, procedures, underlying cause, complications, laboratory results, and symptomatic improvement. <b><i>Results:</i></b> A total of 118 patients underwent percutaneous biliary drainage. Of these, 58 (49.1%) were female and 60 (50.8%) were male. The mean age was 60.43 years. The average baseline total bilirubin level was 15.44 mg/dL. Clinical presentation included jaundice (86.44%), fever (20.33%), and pain (55.08%). At 72 hours postprocedure, 59.32% of patients experienced a 50% reduction in bilirubin levels, and 70.33% reported symptomatic relief. The average total bilirubin at discharge was 8.6 mg/dL. Procedure-related complications occurred in 5.08% of patients, the most common being hemorrhage (2.54%). A second drainage procedure or catheter replacement was necessary in 31.34% of cases, and 15.25% required an additional intervention (endoscopic retrograde cholangiopancreatography or surgery) to achieve adequate bilirubin reduction. <b><i>Conclusion:</i></b> In our series, percutaneous biliary drainage proved to be an effective and safe method for reducing bilirubin levels and providing symptomatic relief, with an acceptably low complication rate.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Preoperative JJ Stent Diameter on Retrograde Intrarenal Surgery: A RIRSearch Group Study.","authors":"Mehmet Fatih Şahin, Oktay Özman, Kerem Teke, Muhammet Fatih Şimşekoğlu, Murat Akgül, Cem Başataç, Önder Çınar, Hakan Çakır, Duygu Sıddıkoğlu, Cenk Murat Yazıcı, Eyüp Burak Sancak, Barbaros Başeskioğlu, Haluk Akpınar, Bülent Önal","doi":"10.1177/10926429251377021","DOIUrl":"https://doi.org/10.1177/10926429251377021","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> A JJ stent placed before retrograde intrarenal surgery (RIRS) may passively dilate the ureter and facilitate ureteral access sheath (UAS) implantation. No studies have examined the significance of preoperative JJ stent diameter, even though numerous studies have shown that UAS insertion is simpler in patients with them. Our study examines the relationship between preoperative ureteral stent caliber and UAS placement and RIRS results. <b><i>Materials and Methods:</i></b> A total of 655 patients with known preoperative double-J stent size before RIRS were analyzed. The patients were categorized into two groups based on their preoperative stent diameter (Group 1: 4.8 Fr and Group 2: 6 Fr). Demographic and clinical data of the patients, stone characteristics, surgical data, perioperative and postoperative complications, duration of hospitalization, and stone-free rates (SFRs) were analyzed for comparison. <b><i>Results:</i></b> The groups contained 323 and 332 patients. The demographic data of the two groups were similar. There was no statistically significant difference between SFR, UAS insertion rate, hospitalization time, and complications. The success rate of placing a UAS with a higher caliber was statistically significantly higher in those with a 6 Fr JJ stent than in those with a 4.8 Fr stent (<i>P</i> = <b>.001</b>). The operation time was also shorter in the group with a thicker stent (<i>P</i> = <b>.003</b>). <b><i>Conclusions:</i></b> Our data suggest that while the preoperative JJ stent diameter does not significantly affect overall UAS insertion success, complication rates, or postoperative stone-free status, using a 6 Fr stent facilitates the placement of larger UAS calibers and may decrease operation time. Consequently, although both stent diameters are efficacious, selecting a 6 Fr stent may provide procedural benefits without jeopardizing safety or results.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and Genetic Polymorphisms of CXCR5 Are Associated with Postoperative Incisional Pain in Patients Undergoing Laparoscopic Cholecystectomy.","authors":"Lan Zhao, Yue Sun, Zengzhen Zhang, Huiqing Li, Xiaobo Fu","doi":"10.1177/10926429251376386","DOIUrl":"https://doi.org/10.1177/10926429251376386","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to identify the biomarkers that was associated with the postoperative incisional pain in patients with acute cholecystitis undergoing laparoscopic cholecystectomy surgery (ACC-LC). <b><i>Methods:</i></b> Sixty ACC-LC patients were enrolled and divided into mild pain (MP) and moderate-to-severe pain (MSP) groups based on their visual analog scale (VAS) scores 24 hours postoperatively. RNA sequencing was used to screen the potential pain associated markers, and ELISA were used to analyze the expression of one identified marker, CXCR5 in peripheral blood mononuclear cells (PBMCs). Single nucleotide polymorphism genotyping for CXCR5 rs3922 was performed, and its correlation with pain levels, inflammatory markers, and perioperative clinical features were assessed. <b><i>Results:</i></b> CXCR5 expression was significantly upregulated in the MSP group compared to the MP group. Higher CXCR5 levels correlated with increased VAS scores and were predictive of pain severity. The CXCR5 rs3922 G allele was associated with elevated CXCR5-associated pain levels, together with the increased Interleukin-6 (IL-6) levels, and decreased Transforming Growth Factor-beta (tgf-β) levels. Patients carrying the GG genotype also exhibited higher Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) levels, indicating greater liver damage, and experienced a longer time to anal exhaust and more postoperative complications. <b><i>Conclusion:</i></b> CXCR5 expression and the rs3922 polymorphism were associated with incisional pain and inflammatory damage in ACC-LC patients. These findings suggest that CXCR5 may serve as a biomarker for pain prediction and personalized pain management strategies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Liver Pathology Following a Sleeve Gastrectomy.","authors":"Lila Brody, James Alex Randall, Fatima Khambaty, Rob Young, Parini Shah, R Natalie Reed","doi":"10.1177/10926429251377372","DOIUrl":"https://doi.org/10.1177/10926429251377372","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The rising prevalence of obesity in the United States is paralleled by an increase in type II diabetes (T2D) and metabolic-associated steatotic liver disease. While lifestyle changes often do not afford sustainable weight loss, bariatric surgery, particularly sleeve gastrectomy (SG), offers a durable solution. This study investigates long-term outcomes in Veterans who underwent SG with concurrent liver biopsy. <b><i>Methods:</i></b> All patients undergoing SG with a liver biopsy from January 2018 to March 2021 were included. Baseline demographics and comorbidities included age, gender, race, preoperative BMI, hemoglobin A1c (HgbA1c), T2D, hypertension (HTN), gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), and presence of steatosis and fibrosis. Patients were followed postoperatively at 1, 3, and 5 years. Patient demographics and comorbidities were stratified by liver scores and compared pre- and postoperatively. A paired <i>t</i>-test compared variables. Multivariate linear regression assessed associations between liver pathology and BMI. Multivariate logistic regression analyzed associations between comorbidities and liver pathology. A <i>P</i> < .05 was significant. <b><i>Results:</i></b> A total of 95 patients underwent a laparoscopic SG with a liver biopsy. There was a level of steatosis (81%) or fibrosis (76.8%) in the majority of biopsies. For the entire cohort, there was a significant BMI reduction from baseline (40.6 ± 3.0 kg/m²) at 1, 3, and 5 years (33.9 ± 4.2, 35.0 ± 4.6, 34.7 ± 4.9 kg/m²; <i>P</i> < .001). At 5 years, % total weight loss (TWL) for no, low, and high liver scores was 18.3 ± 7.5, 13.5 ± 1.6, and 13.7 ± 2.5(<i>P</i> = .82). At 5 years postoperatively, there were significant reductions in mean HgbA1c level (6.2 versus 5.7, <i>P</i> < .001), T2D (47.4% versus 36.8%, <i>P</i> < .001), HTN (56.8% versus 39.0%, <i>P</i> < .001), GERD (49.5% versus 31.6%, <i>P</i> < .001), and OSA (66.3% versus 42.1%, <i>P</i> < .001). There was no significant difference in any postoperative comorbidity, BMI, or %TWL based on pathological liver scores (<i>P</i> > .05). <b><i>Conclusion:</i></b> This study underscores the long-term efficacy of SG in a predominantly African American Veteran cohort, irrespective of liver pathology. These results advocate for bariatric surgery to treat obese patients with liver disease, and even those with advanced hepatic conditions can achieve substantial health benefits.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}