Annals of Gastroenterological Surgery最新文献

{"title":"Role of radiotherapy in surgical approaches to pancreatic cancer treatment: A narrative review","authors":"Satoshi Yasuda,&nbsp;Minako Nagai,&nbsp;Kota Nakamura,&nbsp;Yasuko Matsuo,&nbsp;Masayuki Sho","doi":"10.1002/ags3.70012","DOIUrl":"https://doi.org/10.1002/ags3.70012","url":null,"abstract":"<p>This review discusses the evolving role of radiotherapy (RT) in the surgical treatment of pancreatic ductal adenocarcinoma (PDAC). Despite advancements in multidisciplinary treatment, PDAC continues to present significant challenges in surgical treatment strategies. Neoadjuvant therapy, in combination with chemotherapy and RT, aims to improve patient outcomes by reducing tumor size, controlling local spread, and eradicating micrometastatic disease that cannot be detected at the time of diagnosis. Recent randomized trials have shown that both neoadjuvant chemoradiotherapy (NACRT) and neoadjuvant chemotherapy (NAC) improve surgical outcomes compared with upfront surgery. A network meta-analysis integrating multiple trials demonstrated that NACRT significantly improves overall survival compared to NAC (HR: 0.79, 95% CI: 0.64–0.98). NACRT has also shown advantage in local tumor control. For locally advanced PDAC, the role of RT in conversion therapy is being actively investigated. The integration of RT in treatment regimens requires careful consideration of its therapeutic benefits against potential adverse effects. Although experimental studies suggest potential immunological benefits of RT, clinical validation remains incomplete. Recent advances in radiation delivery techniques have improved the therapeutic ratio, although further clinical validation is needed. The optimal sequence and combination of these treatment modalities with surgical strategies continue to be evaluated in ongoing clinical trials. This review synthesizes evidence from recent clinical trials and previous studies to evaluate the effectiveness, challenges, and potential of RT in PDAC treatment, aiming to inform both current clinical practice and future research directions.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"418-428"},"PeriodicalIF":2.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949879","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":"Interview with the World Class Authorities Frontiers of Cancer Research: An exclusive interview with Professor Luis Diaz","authors":"Haruna Takeda,&nbsp;Koshi Mimori,&nbsp;Masanobu Oshima,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.70003","DOIUrl":"https://doi.org/10.1002/ags3.70003","url":null,"abstract":"<p>This manuscript provides an in-depth interview with Prof. Luis Diaz, Head of Oncology at Memorial Sloan Kettering Cancer Center and Editor-in-Chief of <i>Cancer Discovery</i>. A globally recognized leader in oncology, Prof. Diaz discusses the transformative impact of precision oncology, particularly the role of mismatch repair deficiency (dMMR) and microsatellite instability-high (MSI-H) biomarkers in immunotherapy. He highlights the groundbreaking success of PD-1 blockade therapies, such as dostarlimab, which have achieved unprecedented complete response rates in dMMR/MSI-H rectal cancer, emphasizing its tumor-agnostic potential. Prof. Diaz reflects on the evolution of cancer diagnostics, notably circulating tumor DNA (ctDNA) for minimal residual disease (MRD) detection, and its implications for treatment personalization and early detection. He also addresses the challenges and prospects of cancer prevention, advocating for innovative approaches such as immunoprevention and vaccines targeting tumor-specific pathways, like the HPV vaccine for cervical cancer. The interview underscores the importance of fundamental research in advancing cancer care and the necessity of interdisciplinary collaboration to address unresolved questions in tumor biology. By sharing his vision and pioneering achievements, Prof. Diaz inspires the next generation of clinicians and researchers to pursue bold innovations, ultimately aiming to enhance patient outcomes and revolutionize the future of oncology. This dialogue serves as a significant resource for understanding current trends and future directions in cancer research and treatment.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"401-407"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949934","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 for pneumonia after endoscopic laryngopharyngeal surgery in cases with prior esophageal cancer treatment","authors":"Atsushi Nakao,&nbsp;Hirofumi Kawakubo,&nbsp;Masashi Takeuchi,&nbsp;Satoru Matsuda,&nbsp;Kazumasa Fukuda,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12907","DOIUrl":"https://doi.org/10.1002/ags3.12907","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Study Aims</h3>\u0000 \u0000 <p>Endoscopic laryngopharyngeal surgery is an effective treatment for superficial laryngopharyngeal cancer, particularly in cases with prior esophageal cancer treatment. Despite its frequent application, reports on the risk factors for postoperative complications are limited. This study aimed to identify the risk factors for pneumonia after endoscopic laryngopharyngeal surgery and to examine the variations in pneumonia incidence among the types of prior esophageal cancer treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who had a history of esophageal cancer treatment and subsequently underwent endoscopic laryngopharyngeal surgery for superficial pharyngolaryngeal cancer were retrospectively analyzed. We examined the association between postoperative pneumonia and several factors, including number of lesions; diameter of the resected lesion; and type of previous esophageal cancer treatment, such as endoscopic submucosal dissection, chemoradiotherapy, and esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 79 patients who had a mean age of 67.4 years. Postoperative pneumonia occurred in 16.4%. Multivariate analysis showed that the pneumonia incidence significantly increased in cases with multiple lesions (OR 4.794, 95% CI 1.133–20.288, <i>p</i> = 0.033) and larger diameter of the resected lesion (OR 7.047, 95% CI 1.791–27.730, <i>p</i> = 0.005). Importantly, compared with other treatments, prior esophagectomy for esophageal cancer did not increase the pneumonia incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multiple lesions and larger lesion diameter were the significant predictors of postoperative pneumonia. Moreover, endoscopic laryngopharyngeal surgery can be safely performed even in patients who have previously undergone esophageal cancer surgery, although careful monitoring remains necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"456-463"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949872","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 body mass index as a continuous variable on short- and long-term outcomes in patients undergoing laparoscopic surgery for colon cancer","authors":"Takayuki Aiba,&nbsp;Tomonori Akagi,&nbsp;Hidefumi Shiroshita,&nbsp;Kentaro Nakajima,&nbsp;Tetsuji Ohyama,&nbsp;Tatsuya Kinjo,&nbsp;Akiyoshi Kanazawa,&nbsp;Nobuaki Suzuki,&nbsp;Takuya Tokunaga,&nbsp;Manabu Yamamoto,&nbsp;Nobuki Ichikawa,&nbsp;Shungo Endo,&nbsp;Yutaka Kojima,&nbsp;Takatoshi Nakamura,&nbsp;Shuji Saito,&nbsp;Yoshinori Kagawa,&nbsp;Shinobu Ohnuma,&nbsp;Seiichiro Yamamoto,&nbsp;Takeshi Naitoh,&nbsp;Masafumi Inomata","doi":"10.1002/ags3.12916","DOIUrl":"https://doi.org/10.1002/ags3.12916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short- and long-term outcomes of laparoscopic surgery for obese colon cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Obese (BMI ≥25 kg/m²) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short- and long-term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log-transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, <i>p</i> &lt; 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, <i>p</i> &lt; 0.05). There was no association between BMI continuous variables and 3-year relapse-free survival (RFS) and overall survival. However, 3-year RFS was possibly better in patients with BMI ≥28.5 kg/m² versus those with BMI &lt;28.5 kg/m² (hazard ratio: 0.682, 95% CI: 0.462–1.008, <i>p</i> = 0.055).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m²), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"392-400"},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950528","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":"Effectiveness of advanced dressings in preventing surgical site infections compared to that of standard dressings in gastrointestinal surgery: A systematic review and meta-analysis for guideline revision by the Japanese Society for Surgical Infection","authors":"Keita Kouzu,&nbsp;Hironori Tsujimoto,&nbsp;Seiichi Shinji,&nbsp;Hiroji Shinkawa,&nbsp;Koji Tamura,&nbsp;Yukio Sato,&nbsp;Koji Munakata,&nbsp;Yasunari Fukuda,&nbsp;Daisuke Koike,&nbsp;Hiromu Miyake,&nbsp;Yohei Hosoda,&nbsp;Motoi Uchino,&nbsp;Hiroki Ohge,&nbsp;Junzo Shimizu,&nbsp;Seiji Haji,&nbsp;Yasuhiko Mohri,&nbsp;Chizuru Yamashita,&nbsp;Yuichi Kitagawa,&nbsp;Motomu Kobayashi,&nbsp;Yuki Hanai,&nbsp;Hiroshi Nobuhara,&nbsp;Masahiro Yoshida,&nbsp;Toru Mizuguchi,&nbsp;Toshihiko Mayumi,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12909","DOIUrl":"https://doi.org/10.1002/ags3.12909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This is a systematic review and meta-analysis of the efficacy of wound coverage using advanced dressings specifically for the prevention of surgical site infections (SSI) in gastrointestinal surgery, as part of the update of the SSI prevention guidelines of the Japan Society for Surgical Infection (JSSI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After searching CENTRAL, PubMed, and ICHUSHI-Web in July 2024, we included randomized controlled trials (RCTs) comparing advanced dressings and standard dressings for surgical wounds in gastrointestinal surgery (PROSPERO No. CRD42024569084). Three authors independently screened the RCTs. We assessed the risk of bias and certainty of the body of evidence for the extracted data. The primary outcome was superficial SSI, and the secondary outcomes were length of postoperative hospital stay, costs, and allergy. This study was partially supported by the JSSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of seven RCTs and 927 patients were included. The use of advanced dressings significantly lowered the risk of SSI compared to that associated with standard dressings (risk ratio: 0.54, 95% confidence intervals: 0.34–0.88). The certainty of the evidence was rated as moderate. According to the subgroup analysis, advanced dressings reduced the risk of SSI in colorectal surgery. Advanced dressings did not reduce the length of postoperative hospital stay or costs compared to that of standard dressings. Allergies were reported in only one patient using silver-impregnated dressings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of advanced dressings for primary wounds in gastrointestinal surgery was associated with a significantly lower risk of SSI than that associated with standard dressings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"408-417"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950173","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":"Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy","authors":"Keisuke Toya,&nbsp;Yoshito Tomimaru,&nbsp;Shogo Kobayashi,&nbsp;Kazuki Sasaki,&nbsp;Yoshifumi Iwagami,&nbsp;Daisaku Yamada,&nbsp;Takehiro Noda,&nbsp;Hidenori Takahashi,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1002/ags3.12888","DOIUrl":"https://doi.org/10.1002/ags3.12888","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Decreasing intraoperative blood loss is one reported advantage of laparoscopic surgery compared with open surgery. However, several reports indicate that blood loss during laparoscopic surgery may be underestimated. No studies have evaluated this possibility in laparoscopic distal pancreatectomy (LDP). Here we evaluated estimated blood loss (e-BL) compared to intraoperative blood loss (i-BL) during distal pancreatectomy (DP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 114 patients undergoing DP in our institution during the study period. We examined the relationship between i-BL and e-BL. Based on these results, we further investigated the relationship with LDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The laparoscopic approach was used in a significantly higher percentage of patients in e-BL &gt; i-BL group compared to e-BL &lt; i-BL group (55.9% vs 10.9%, <i>p</i> &lt; 0.0001). Within the LDP group (<i>n</i> = 39), e-BL was significantly more than i-BL (388 ± 248 vs 127 ± 160 mL; <i>p</i> &lt; 0.0001). Within the open distal pancreatectomy (ODP) group (<i>n</i> = 75), e-BL was significantly less than i-BL (168 ± 324 vs 281 ± 209 mL; <i>p =</i> 0.0017). The e-BL &gt; i-BL trend in the LDP group was consistent, regardless of the indication for DP. In contrast, the finding of i-BL &gt; e-BL in the ODP group was limited to patients with pancreatic cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>During LDP, e-BL was significantly more than i-BL. During ODP, e-BL was significantly less than i-BL, only in patients with pancreatic cancer. These results suggested the possibility of i-BL underestimation during LDP, and overestimation during ODP in cases with pancreatic cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"569-577"},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949732","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":"Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study","authors":"Hiromasa Hoshi,&nbsp;Akira Endo,&nbsp;Koji Ito,&nbsp;Tomohiro Akutsu,&nbsp;Hikaru Odera,&nbsp;Hideto Shiraki,&nbsp;Kei Ito,&nbsp;Takeshi Yokoyama,&nbsp;Yasukazu Narita,&nbsp;Taro Masuda,&nbsp;Akira Suekane,&nbsp;Koji Morishita","doi":"10.1002/ags3.12908","DOIUrl":"https://doi.org/10.1002/ags3.12908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although perforated peptic ulcer is common in Japan, few large-scale studies have assessed its management, including surgical procedures and outcomes. This study aimed to survey the characteristics, management, and outcomes of perforated peptic ulcer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter retrospective descriptive analysis was conducted across seven centers in Japan between 2011 and 2022. Perforated peptic ulcer was defined as gastric or duodenal ulcer perforation, excluding malignant or iatrogenic perforation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 703 patients with perforated peptic ulcer. The overall in-hospital mortality rate was 35/703 (5.0%). Conservative treatment was performed as an initial treatment in 217/703 (30.9%) patients, among whom 52 (24.0%) eventually underwent surgery. The median age (interquartile range) of patients who successfully completed the conservative treatment was 60 (46–71) years. A total of 538/703 (76.5%) patients underwent surgery. The gastrectomy percentage increased with the perforation diameter. The anastomotic leakage rate for gastrectomy was high in 10/66 (15.2%) patients. Laparoscopy was performed in 115/538 (21.4%) patients, among whom 23 (20.0%) were converted to open surgery. Patients who underwent laparoscopy had a perforation diameter ≤ 20 mm. The use of laparoscopy varied among facilities, ranging from 1.8% to 61.2%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The in-hospital mortality rate for perforated peptic ulcer in this study was 5.0%, and conservative treatment was safely performed even in elderly patients. As the perforation diameter increased, the rate of gastrectomy tended to rise, and the rate of anastomotic leakage in those patients was high. UMIN Clinical Trials Registry; UMIN000054391.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"464-475"},"PeriodicalIF":2.9,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12908","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950014","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 impact of low fornix perfusion on devascularized whole stomach as a risk factor for anastomotic leakage after esophagectomy","authors":"Keita Takahashi,&nbsp;Masami Yuda,&nbsp;Yoshitaka Ishikawa,&nbsp;Takahiro Masuda,&nbsp;Takanori Kurogochi,&nbsp;Naoko Fukushima,&nbsp;Akira Matsumoto,&nbsp;Kazuto Tsuboi,&nbsp;Katsunori Nishikawa,&nbsp;Fumiaki Yano,&nbsp;Ken Eto","doi":"10.1002/ags3.12905","DOIUrl":"https://doi.org/10.1002/ags3.12905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>We previously reported poor vascularity of narrow gastric tube evaluated by thermography was associated with anastomotic leakage (AL) after esophagectomy. Meanwhile, the association between the fornix low perfusion on devascularized whole stomach (DWS) and the incidence of AL remains unclear. Therefore, this study aimed to clarify the impact of the fornix low perfusion on DWS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 238 patients who underwent Mckeown esophagectomy with gastric tube reconstruction between 2008 and 2021 were analyzed. Patients were divided into non-AL and AL groups and their clinical outcomes including vascular factors of DWS and gastric tube were compared. Additionally, the logistic regression analysis was conducted to detect the risk factors of AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AL occurred in 31 patients (13.0%). Regarding vascular factors, avascular area temperature retain rate (Av-TRr) on DWS, right gastroepiploic artery length rate and anastomotic viability index (AVI) on gastric tube were significantly smaller in the AL group than in the non-AL group. In logistic regression model for AL, multivariate analysis showed that diabetes (Odds ratio [OR], 3.90; 95% confidence interval [CI], 1.32–11.60), hand-sewn anastomosis (OR, 4.42;95% CI, 1.05–18.60), Av-TRr on DWS&lt;0.91 (OR, 4.67; 95% CI, 2.00–10.90), and AVI&lt;0.64 (OR, 2.68; 95% CI, 1.12–6.39) were significant risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fornix low perfusion on DWS was a risk factor of AL as well as low AVI on gastric conduit. Additionally, fornix low perfusion on DWS was correlated with low AVI on gastric conduit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"226-234"},"PeriodicalIF":2.9,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535843","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":"Acknowledgments","authors":"","doi":"10.1002/ags3.12899","DOIUrl":"10.1002/ags3.12899","url":null,"abstract":"&lt;p&gt;The publication of invaluable papers in &lt;i&gt;Annals of Gastroenterological Surgery&lt;/i&gt; depends on the prompt, careful review of submitted manuscripts. We would like to thank the following experts for reviewing manuscripts submitted between December 1, 2023 and November 30, 2024.&lt;/p&gt;&lt;p&gt;Reviewer Full Name&lt;/p&gt;&lt;p&gt;Abe, Tatsuya&lt;/p&gt;&lt;p&gt;Abe, Yuta&lt;/p&gt;&lt;p&gt;Aizawa, Masaki&lt;/p&gt;&lt;p&gt;Ajiki, Tetsuo&lt;/p&gt;&lt;p&gt;Akahoshi, Keiichi&lt;/p&gt;&lt;p&gt;Akamatsu, Nobuhisa&lt;/p&gt;&lt;p&gt;Akita, Hirofumi&lt;/p&gt;&lt;p&gt;Akiyoshi, Takashi&lt;/p&gt;&lt;p&gt;Aoki, Takeshi&lt;/p&gt;&lt;p&gt;Aoki, Taku&lt;/p&gt;&lt;p&gt;Aoyama, Toru&lt;/p&gt;&lt;p&gt;Araki, Kenichiro&lt;/p&gt;&lt;p&gt;Arigami, Takaaki&lt;/p&gt;&lt;p&gt;Arita, Junichi&lt;/p&gt;&lt;p&gt;Baba, Kenji&lt;/p&gt;&lt;p&gt;Ban, Daisuke&lt;/p&gt;&lt;p&gt;Bekki, Yuki&lt;/p&gt;&lt;p&gt;Booka, Eisuke&lt;/p&gt;&lt;p&gt;Daiko, Hiroyuki&lt;/p&gt;&lt;p&gt;Ebata, Tomoki&lt;/p&gt;&lt;p&gt;Ebihara, Yuma&lt;/p&gt;&lt;p&gt;Eguchi, Hidetoshi&lt;/p&gt;&lt;p&gt;Etoh, Tsuyoshi&lt;/p&gt;&lt;p&gt;Fujimura, Takashi&lt;/p&gt;&lt;p&gt;Fujita, Fumihiko&lt;/p&gt;&lt;p&gt;Fujita, Takeo&lt;/p&gt;&lt;p&gt;Fukagawa, Takeo&lt;/p&gt;&lt;p&gt;Fukami, Yasuyuki&lt;/p&gt;&lt;p&gt;Fukushima, Ryoji&lt;/p&gt;&lt;p&gt;Ganeko, Riki&lt;/p&gt;&lt;p&gt;Hagi, Takaomi&lt;/p&gt;&lt;p&gt;Hamabe, Atsushi&lt;/p&gt;&lt;p&gt;Hanaoka, Marie&lt;/p&gt;&lt;p&gt;Harada, Kazuto&lt;/p&gt;&lt;p&gt;Harimoto, Norifumi&lt;/p&gt;&lt;p&gt;Haruki, Koichiro&lt;/p&gt;&lt;p&gt;Hasegawa, Kiyoshi&lt;/p&gt;&lt;p&gt;Hasegawa, Yasushi&lt;/p&gt;&lt;p&gt;Hashimoto, Daisuke&lt;/p&gt;&lt;p&gt;Hashimoto, Masashi&lt;/p&gt;&lt;p&gt;Hatano, Etsuro&lt;/p&gt;&lt;p&gt;Hayami, Shinya&lt;/p&gt;&lt;p&gt;Hayashi, Hiromitsu&lt;/p&gt;&lt;p&gt;Hibi, Taizo&lt;/p&gt;&lt;p&gt;Hida, Koya&lt;/p&gt;&lt;p&gt;Hidaka, Masaaki&lt;/p&gt;&lt;p&gt;Hijioka, Susumu&lt;/p&gt;&lt;p&gt;Hirano, Satoshi&lt;/p&gt;&lt;p&gt;Hirano, Yasumitsu&lt;/p&gt;&lt;p&gt;Hirashita, Teijiro&lt;/p&gt;&lt;p&gt;Hiyoshi, Yukiharu&lt;/p&gt;&lt;p&gt;Honda, Goro&lt;/p&gt;&lt;p&gt;Hosoda, Kei&lt;/p&gt;&lt;p&gt;Ichikawa, Nobuki&lt;/p&gt;&lt;p&gt;Iguchi, Tomohiro&lt;/p&gt;&lt;p&gt;Ikeda, Masataka&lt;/p&gt;&lt;p&gt;Ikeda, Satoshi&lt;/p&gt;&lt;p&gt;Ikeuchi, Hiroki&lt;/p&gt;&lt;p&gt;Ikoma, Hisashi&lt;/p&gt;&lt;p&gt;Imamura, Yu&lt;/p&gt;&lt;p&gt;Inaki, Noriyuki&lt;/p&gt;&lt;p&gt;Inoue, Mikihiro&lt;/p&gt;&lt;p&gt;Iseda, Norifumi&lt;/p&gt;&lt;p&gt;Ishido, Keinosuke&lt;/p&gt;&lt;p&gt;Ishihara, Soichiro&lt;/p&gt;&lt;p&gt;Ishizawa, Takeaki&lt;/p&gt;&lt;p&gt;Ishizuka, Mitsuru&lt;/p&gt;&lt;p&gt;Itatani, Yoshiro&lt;/p&gt;&lt;p&gt;Ito, Takashi&lt;/p&gt;&lt;p&gt;Itoh, Shinji&lt;/p&gt;&lt;p&gt;Iwatsuki, Masaaki&lt;/p&gt;&lt;p&gt;Jiang, Xingming&lt;/p&gt;&lt;p&gt;Kagawa, Hiroyasu&lt;/p&gt;&lt;p&gt;Kagawa, Yoshinori&lt;/p&gt;&lt;p&gt;Kaibori, Masaki&lt;/p&gt;&lt;p&gt;Kaido, Toshimi&lt;/p&gt;&lt;p&gt;Kajiwara, Yoshiki&lt;/p&gt;&lt;p&gt;Kanda, Mitsuro&lt;/p&gt;&lt;p&gt;Kanemitsu, Yukihide&lt;/p&gt;&lt;p&gt;Kasai, Shunsuke&lt;/p&gt;&lt;p&gt;Kato, Atsushi&lt;/p&gt;&lt;p&gt;Kato, Motohiko&lt;/p&gt;&lt;p&gt;Kato, Yutaro&lt;/p&gt;&lt;p&gt;Kawachi, Shigeyuki&lt;/p&gt;&lt;p&gt;Kawada, Kenji&lt;/p&gt;&lt;p&gt;Kawai, Kazushige&lt;/p&gt;&lt;p&gt;Kawai, Manabu&lt;/p&gt;&lt;p&gt;Kawamura, Junichiro&lt;/p&gt;&lt;p&gt;Kawazoe, Tetsuro&lt;/p&gt;&lt;p&gt;Kim, Dong-Sik&lt;/p&gt;&lt;p&gt;Kimura, Yasutoshi&lt;/p&gt;&lt;p&gt;Kimura, Yutaka&lt;/p&gt;&lt;p&gt;Kinami, Shinichi&lt;/p&gt;&lt;p&gt;Kinoshita, Takahiro&lt;/p&gt;&lt;p&gt;Kitagawa, Akihiro&lt;/p&gt;&lt;p&gt;Kitago, Minoru&lt;/p&gt;&lt;p&gt;Kitai, Toshiyuki&lt;/p&gt;&lt;p&gt;Kitayama, Joji&lt;/p&gt;&lt;p&gt;Kiyomatsu, Tomomichi&lt;/p&gt;&lt;p&gt;Kobayashi, Hirotoshi&lt;/p&gt;&lt;p&gt;Kobayashi, Minako&lt;/p&gt;&lt;p&gt;Kobayashi, Shogo&lt;/p&gt;&lt;p&gt;Kobayashi, Toshimichi&lt;/p&gt;&lt;p&gt;Koda, Keiji&lt;/p&gt;&lt;p&gt;Koike, Yuhki&lt;/p&gt;&lt;p&gt;Komatsu, Shuhei&lt;/p&gt;&lt;p&gt;Konishi, Hirotaka&lt;/p&gt;&lt;p&gt;Kosuga, Toshiyuki&lt;/p&gt;&lt;p&gt;Kosumi, Keisuke&lt;/p&gt;&lt;p&gt;Koyama, Fumikazu&lt;/p&gt;&lt;p&gt;Koyanagi, Kazuo&lt;/p&gt;&lt;p&gt;Kubo, Shoji&lt;/p&gt;&lt;p&gt;Kubota, Takeshi&lt;/p&gt;&lt;p&gt;Kumagai, Koshi&lt;/p&gt;&lt;p&gt;Kumagai, Youichi&lt;/p&gt;&lt;p&gt;Kunisaki, Chikara&lt;/p&gt;&lt;p&gt;Kuroda, Shinji&lt;/p&gt;&lt;p&gt;Lee, Sang-Woong&lt;/p&gt;&lt;p&gt;Makino, Isamu&lt;/p&gt;&lt;p&gt;Manabe, Tatsuya&lt;/p&gt;&lt;p&gt;Marubashi, Shigeru&lt;/p&gt;&lt;p&gt;Maruyama, Suguru&lt;/p&gt;&lt;p&gt;Mats","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"211-213"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930483","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":"Palliative management for malignant biliary obstruction and gastric outlet obstruction from pancreatic cancer","authors":"Pengfei Wu,&nbsp;Kai Chen,&nbsp;Jin He","doi":"10.1002/ags3.12902","DOIUrl":"https://doi.org/10.1002/ags3.12902","url":null,"abstract":"<p>Pancreatic cancer is among the leading causes of gastrointestinal cancer-related death, with a dismal prognosis. Over 80% of pancreatic cancer patients present with advanced disease, making curative resection unfeasible. These patients are often presented with malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO). In these cases, palliative management is aimed to alleviate symptoms, enhance quality of life, and facilitate subsequent chemotherapy. Currently, neoadjuvant chemotherapy is frequently used in both borderline resectable and resectable pancreatic cancer, necessitating effective biliary and gastrointestinal drainage in a growing number of patients. Traditionally, surgical bypass was the gold standard, performed via either a minimally invasive or open approach. However, notable progress has emerged in developing endoscopic techniques, such as endoscopic retrograde cholangiopancreatography (ERCP) stenting for MBO and endoscopic enteral stenting for GOO. While these procedures provide rapid symptom relief, they are associated with higher stent dysfunction rates and more frequent re-intervention needs. When ERCP fails, percutaneous transhepatic biliary drainage is a widely accepted alternative for MBO. Endoscopic ultrasound (EUS)-guided techniques, including EUS-guided biliary drainage and EUS-guided gastroenterostomy, have recently gained prominence. Emerging clinical data suggest that these methods may be superior, potentially becoming the preferred first-line palliative treatment for unresectable pancreatic cancer. This review will summarize the current evidence on managing MBO and GOO in patients with pancreatic cancer.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"218-225"},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533373","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}