Annals of Gastroenterological Surgery最新文献

{"title":"The Japanese Hernia Society (JHS) Guidelines for Adult Groin Hernia Management 2024.","authors":"Hitoshi Idani, Gen Shimada, Katsuhito Suwa, Yoshiko Honda, Yuji Konishi, Itsuro Nagae, Kenta Saito, Takafumi Tamura, Satoshi Nagayama, Chie Tanaka, Seiko Hirono","doi":"10.1002/ags3.70295","DOIUrl":"10.1002/ags3.70295","url":null,"abstract":"<p><p>Groin hernia is a common surgical condition. The Japanese Hernia Society (JHS) Guidelines for Groin Hernia Management 2024 were developed to reflect both international evidence and the realities of clinical practice in Japan. This article is an authorized English translation of a summary of the adult section of the JHS Guidelines for Groin Hernia Management 2024, presenting key clinical questions, recommendations, and concise explanations for an international readership. It covers diagnosis, classification, surgical indications, operative approaches, mesh and fixation, anesthesia, chronic postoperative inguinal pain, recurrent and emergency hernia, training, cost-effectiveness, and registry-based outcome assessment; relevant differences from the international HerniaSurge guidelines are discussed. Laparoscopic repair is favored in selected patients when performed by experienced surgeons, particularly for pain reduction and early recovery, whereas open anterior mesh repair remains appropriate when general anesthesia or laparoscopy is unsuitable. For femoral hernia, chronic pain management, recurrent hernia, and incarcerated or strangulated hernia, evidence remains limited, leading to cautious or conditional recommendations.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13735530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149340400","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":"Reduced-Port Laparoscopic Colectomy for Colorectal Cancer: The Comparison That Matters Now Is With Reduced-Access Robotic Surgery","authors":"Mehmet Mahir Özmen,&nbsp;Cem Kaan Parsak,&nbsp;Tahsin Çolak","doi":"10.1002/ags3.70273","DOIUrl":"10.1002/ags3.70273","url":null,"abstract":"<p>We read the systematic review and meta-analysis by Shaukat et al. with interest [<span>1</span>]. It is, to our knowledge, the first meta-analysis to compare reduced-port laparoscopic colectomy (RPLC) with conventional multi-port laparoscopic colectomy (MPLC) specifically for colorectal cancer, and the methodology is sound: a PRISMA-adherent, prospectively registered protocol, and a meta-regression that correctly identifies tumor stage as the main driver of the operative-time benefit and of the between-study heterogeneity.</p><p>Our main comment concerns what the comparison leaves out. Excluding robotic-assisted procedures is defensible for internal comparability, but it sidesteps the question that is becoming more relevant every year. Single-port and reduced-port robotic platforms are already in clinical use for colorectal resection, with early series reporting acceptable oncologic and short-term outcomes [<span>2</span>]. A scoping review of that literature published earlier this year found reporting just as fragmented as the pattern the authors describe for laparoscopic RPLC: only 9 of 19 studies used a standardized complication-grading system, and follow-up interval was documented in barely a quarter of them [<span>3</span>]. For a department now deciding where to invest its training effort and capital, RPLC versus reduced-access robotic surgery is the more pressing comparison—conventional five-port laparoscopy is no longer the only alternative on the table.</p><p>A smaller point: the higher rate of Clavien–Dindo Grade 1 complications in the RPLC arm, despite fewer incisions, may reflect a genuine learning-curve effect rather than ascertainment bias alone, given that “RPLC” here pools two-port, three-port, and solo-surgeon configurations under one label.</p><p>Both issues point to the same fix: neither laparoscopic nor robotic RPLC will be comparable across studies, or against each other, until they are reported against a common minimum dataset (Table 1).</p><p>Current guidelines endorse minimally invasive resection for colorectal cancer without specifying a preferred port configuration [<span>4</span>], leaving this choice to individual surgeon and institutional experience. Registries run jointly by minimally invasive and colorectal surgical societies, built around this dataset, would let future analyses adjust for the confounders the authors already flag—and would let RPLC be tested against reduced-access robotic surgery on equal terms, not only against five-port laparoscopy.</p><p>Letter to the editor is prepared by M.M.Ö. and evaluated and corrected by M.M.Ö., C.K.P., and T.Ç.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p><p>The data that support the findings of this study are available from the corresponding author upon reasonable request.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1810-1811"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863206","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":"Reduced-Port Versus Multi-Port Laparoscopic Colectomy for Colorectal Cancer: A Systematic Review, Meta-Analysis, and Meta-Regression","authors":"Ayesha Shaukat,&nbsp;Saad Ashraf,&nbsp;Hamza Irfan,&nbsp;Muhammad Shahmeer Ullah Shah,&nbsp;Yumna Khabir,&nbsp;Santosh Sah,&nbsp;Um E. Abiha Batool,&nbsp;Muhammad Zain Ul Haq,&nbsp;Omer Bin Khalid Jamil,&nbsp;Aymar Akilimali","doi":"10.1002/ags3.70264","DOIUrl":"https://doi.org/10.1002/ags3.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reduced-port laparoscopic colectomy (RPLC) has emerged as an alternative to multi-port laparoscopic colectomy (MPLC) for colorectal cancer surgery, aiming to reduce operative morbidity and improve cosmetic outcomes. This systematic review and meta-analysis evaluated and compared operative, postoperative, and oncologic outcomes between RPLC and MPLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, we systematically searched PubMed, Cochrane Library, ScienceDirect, and Google Scholar from inception to June 2025. The protocol was registered on PROSPERO (CRD420251078328). Included studies were randomized controlled trials (RCTs) or cohort studies comparing RPLC and MPLC. Primary outcomes were estimated blood loss, operative time, hospital stay, lymph node yield, and postoperative recovery indicators. Secondary outcomes included conversion rates, complications, and Clavien-Dindo graded adverse events. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane RoB 2.0 tool. A random-effects meta-regression was performed to explore the impact of high-stage tumors on the outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies (<i>n</i> = 2897) were included. RPLC significantly reduced operative time (MD: −19.98 min; 95% CI: −29.73 to −10.24, <i>p</i> &lt; 0.0001) and estimated blood loss (MD: −13.70 mL; 95% CI: −25.63 to −1.77, <i>p</i> = 0.02) without compromising hospital stay, lymph node yield, or complication rates. Meta-regression revealed tumor stage significantly influenced operative time (<i>p</i> = 0.0013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RPLC appears to provide comparable postoperative outcomes to MPLC with modest intraoperative advantages. As the evidence is largely retrospective and heterogeneous, these findings indicate the feasibility of RPLC rather than its superiority over MPLC. High-quality clinical trials with longer follow-up are required to confirm these findings and optimize clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO registration ID: CRD420251078328</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1712-1721"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149311865","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":"Redefining the Role of Splenectomy in Scirrhous Gastric Cancer: Toward a Selective Multimodal Strategy","authors":"Tsutomu Hayashi,&nbsp;Takaki Yoshikawa","doi":"10.1002/ags3.70254","DOIUrl":"10.1002/ags3.70254","url":null,"abstract":"<p>Scirrhous gastric cancer, characterized by diffuse infiltration and a high propensity for peritoneal dissemination, remains one of the most aggressive subtypes of gastric cancer. Despite a relatively high incidence of splenic hilar lymph node (No. 10) metastasis, the oncologic benefit of splenectomy remains controversial, while its association with increased postoperative morbidity is well established. Recent advances in systemic therapy, including immune checkpoint inhibitors and molecular-targeted agents, have shifted the treatment paradigm toward improved systemic disease control. In parallel, minimally invasive surgical approaches, particularly spleen-preserving splenic hilar lymph node dissection, have emerged as feasible alternatives to conventional splenectomy. However, in scirrhous gastric cancer, disease-specific features such as diffuse infiltration, marked fibrosis, and difficulty in intraoperative assessment continue to pose significant challenges. Furthermore, the optimal extent of lymphadenectomy, especially following neoadjuvant therapy, remains undefined. Taken together, splenectomy should no longer be regarded as a routine component of surgical management for scirrhous gastric cancer, but rather as a selective procedure tailored to individual tumor characteristics and treatment context. Future studies integrating systemic therapy, surgical safety, and oncologic adequacy are required to establish evidence-based strategies for this challenging disease.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1691-1698"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590293","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":"Correction to “Preoperative Aortic Calcification Volume Predicts Postoperative Complications in Nonpancreatic Cancer Patients Undergoing Pancreaticoduodenectomy”","authors":"","doi":"10.1002/ags3.70262","DOIUrl":"10.1002/ags3.70262","url":null,"abstract":"<p>\u0000 <span>M. Horiuchi</span>, <span>K. Miyake</span>, <span>K. Sahara</span>, et al., “ <span>Preoperative Aortic Calcification Volume Predicts Postoperative Complications in Nonpancreatic Cancer Patients Undergoing Pancreaticoduodenectomy</span>,” <i>Annals of Gastroenterological Surgery</i> <span>10</span>, no. <span>3</span> (<span>2026</span>): <span>803</span>–<span>810</span>. https://doi.org/10.1002/ags3.70132\u0000 </p><p>In the published version of this article, several rows in Table 1 were inadvertently omitted.</p><p>The correct version of Table 1 is provided below:</p><p>This correction does not affect the results, interpretation, or conclusions of the article.</p><p>We apologize for this error.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1823-1824"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705251","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":"Artificial Intelligence–Based Surgical Phase Analysis Enables Objective Assessment of Surgeon Skill in Robotic Distal Gastrectomy: A Multicenter Study","authors":"Masaru Komatsu,&nbsp;Daichi Kitaguchi,&nbsp;Yoichi Ninomiya,&nbsp;Yuya Takabe,&nbsp;Mitsumasa Yoshida,&nbsp;Masahiro Yura,&nbsp;Nobuyoshi Takeshita,&nbsp;Takahiro Kinoshita,&nbsp;Masaaki Ito","doi":"10.1002/ags3.70249","DOIUrl":"10.1002/ags3.70249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Artificial intelligence (AI)–based surgical video analysis can automate time-consuming manual assessments and enable objective characterization of surgical workflows. We aimed to construct a large, multicenter, fully annotated dataset of robotic distal gastrectomy (RDG) videos and evaluate the feasibility and performance of an AI model for surgical phase recognition. We further explored whether AI-derived phase-specific metrics could characterize phase-level performance differences according to surgeon experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed an image classification model to automatically identify surgical phases in RDG videos. Experienced gastric surgeons annotated nine predefined surgical phases on a frame-by-frame basis (1 fps). Model performance was assessed using accuracy, precision, recall, and F1-score. In an exploratory analysis, the duration of each AI-predicted surgical phase was quantified and compared according to each surgeon's robotic case volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analyzed 137 RDG videos collected from 15 institutions. The nine-phase recognition model achieved an overall accuracy of 87.0%. Among the surgical phases, the AI-predicted duration of right-sided greater curvature lymphadenectomy was shorter for surgeons with higher robotic case volume than those with lower volume (3789 vs. 2547 frames, <i>p</i> &lt; 0.01), indicating phase-specific differences in operative performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed AI model demonstrated robust performance in multicenter surgical phase recognition. AI-based surgical phase analysis enabled objective characterization of phase-specific operative profiles according to surgeon experience. These findings support the feasibility of surgical phase analysis as an exploratory framework for performance profiling and educational support in robotic gastrectomy. However, generalizability may be limited owing to institutional overlap between the training and validation datasets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1722-1731"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576754","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":"Return-To-Work and Working Status After Surgery for Gastric and Esophageal Cancer: A Prospective Observational Study","authors":"Kentaro Goto,&nbsp;Shigeo Hisamori,&nbsp;Kohei Ueno,&nbsp;Hiroyasu Abe,&nbsp;Ryosuke Okamura,&nbsp;Hisahiro Hosogi,&nbsp;Yoshito Yamashita,&nbsp;Dai Manaka,&nbsp;Hiroaki Hata,&nbsp;Tatsuto Nishigori,&nbsp;Sanae Nakajima,&nbsp;Michihiro Yamamoto,&nbsp;Koichi Kinoshita,&nbsp;Shintaro Okumura,&nbsp;Masazumi Sakaguchi,&nbsp;Shigeru Tsunoda,&nbsp;Yu Sakagami,&nbsp;Koya Hida,&nbsp;Kazutaka Obama","doi":"10.1002/ags3.70251","DOIUrl":"10.1002/ags3.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>As survival after gastric and esophageal cancer continues to improve, sustained work participation has become an important survivorship outcome. We aimed to evaluate return-to-work (RTW) rates 18 months after curative-intent surgery for gastric and esophageal cancers and to identify clinical and socioeconomic factors associated with delayed or failed RTW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter, longitudinal, prospective cohort study evaluated working-age Japanese patients undergoing curative-intent surgery for gastric or esophageal cancer. Working status was assessed preoperatively and at 6, 12, and 18 months postoperatively. The primary outcome was working status at 18 months. Secondary outcomes included time to first RTW, and factors associated with non-working and delayed RTW. Exploratory analyses evaluated 6-month patient-reported outcomes (QLQ-C30) and postoperative weight loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 158 eligible patients, 124 (78.5%) were working at 18 months. Older age (≥ 65 years) and pathological stage≥ III were associated with non-working at 18 months, whereas sedentary work and self-employment were associated with a lower risk of non-working. Postoperative appetite loss, financial difficulties (QLQ-C30), and ≥ 10% body weight loss at 6 months were associated with non-working status. Median time to first RTW was 30 and 70 days for gastric and esophageal cancers, respectively. Esophageal cancer and advanced stage were consistently associated with delayed RTW, with weaker evidence for associations with female sex and preoperative retirement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Approximately 80% of patients were working at 18 months after surgery. Postoperative nutritional impairment and symptom burden were associated with long-term work participation and may help identify patients at risk of not working after surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1732-1742"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598044","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":"Prediction of Long-Term Prognosis in Patients With Hepatocellular Carcinoma Using the National Clinical Database Risk Calculator","authors":"Mariko Tsukagoshi,&nbsp;Kenichiro Araki,&nbsp;Norio Kubo,&nbsp;Takamichi Igarashi,&nbsp;Shunsuke Kawai,&nbsp;Kei Hagiwara,&nbsp;Kouki Hoshino,&nbsp;Ryo Muranushi,&nbsp;Ken Shirabe","doi":"10.1002/ags3.70256","DOIUrl":"10.1002/ags3.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the value of the National Clinical Database (NCD) risk calculator for predicting surgical outcomes and long-term prognosis in patients undergoing resection for hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 210 patients with HCC who underwent initial hepatic resection between January 2016 and December 2022. We calculated predicted incidence of surgery-related mortality (predicted mortality rate) using the NCD risk calculator. We assessed the relationship between predicted mortality rate and clinicopathological factors, including their relationship with long-term prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A predicted mortality rate of ≥ 3% significantly correlated with worse recurrence-free survival and overall survival (OS), with a high-risk group showing increased blood loss, longer hospital stays, and higher severe complication rates. Multivariate analysis identified predicted mortality rate of ≥ 3% as an independent prognostic indicator for poor OS, alongside male sex and microvascular invasion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NCD risk calculator showed potential to predict not only short-term outcomes but also long-term prognosis in patients with HCC undergoing resection. The NCD risk calculator may be a valuable complementary tool for decision-making about liver resection in patients with HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1780-1787"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598066","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":"More Liver Volume Is Necessary for High Risk Living Donor Liver Transplantation Candidates","authors":"Haruka Kobayashi,&nbsp;Takashi Aida,&nbsp;Kenei Furukawa,&nbsp;Toru Ikegami","doi":"10.1002/ags3.70276","DOIUrl":"10.1002/ags3.70276","url":null,"abstract":"<p>We enjoyed the recent excellent article presented by Yugawa et al. [<span>1</span>], describing small-for-size graft syndrome (SFSS) grade B/C in living donor liver transplantation (LDLT) still occurred in one in five patients even though who underwent splenectomy (Spx) for inflow modulation. LDLT. They concluded that patients with high recipient neutrocyte lymphocyte ratio (NLR), high model for end-stage liver disease (MELD) score over 30, or older donor age over 50 years have increased risk of SFSS despite performing Spx.</p><p>The risk factors they presented for advanced grade SFSS are very reasonable and acceptable. However, we imagine LDLT usually has given us enough time for evaluating and deliberate donor and recipient matching for having higher survival rate after LDLT, although it may not feasible in emergent cases like acute on chronic liver setting. In their cohort, graft recipient weight ratio resulting in Graft B//C SFSS was 0.72 (0.63–0.87) and the graft size is overall regular size of right lobe graft. If LDLT is the only choice for high MELD and aged donor, LDLT might be limited for cases with GRWR &gt; 1 or waiting whole liver transplantation [<span>2, 3</span>], which the authors already do so.</p><p>The positive impact of splenectomy for portal decompression and increasing graft survival rate in LDLT using propensity matching analysis has been already published by Yoshizumi et al. [<span>4</span>] It revealed 10% dramatic increase in graft survival after LDLT by routine splenectomy. However, determining indicating effective splenectomy has very complex issues, including spleen size and collateral vessels around spleen. If spleen size is small, the impact of splenectomy on portal decompression should be small. If huge collateral vessels are present, splenectomy jeopardizes collateral vessels resulting in increase in portal pressure. In such cases, maybe only the solution is using larger right lobe graft or whole liver diseased graft.</p><p>Thus, we would friendly like to ask whether he authors LDLT grafts with GRWR of 0.72 (0.63–0.87) were used, and how to determine the portal decompression procedures in cases with small spleen and peri-splenic huge collaterals, and how do you think is the best way to have better outcomes in high risk cases described in your article.</p><p>Haruka Kobayashi drafted the manuscript; Takashi Aida and Kenei Furukawa critically revised the manuscript; Toru Ikegami finally approved the manuscript.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p><p>The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":"1812-1813"},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073248","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":"Correction to “Intratumoral Fusobacterium nucleatum Drives Cancer-Associated Fibroblasts Enrichment and Immune Exclusion in Esophageal Squamous Cell Carcinoma”","authors":"","doi":"10.1002/ags3.70253","DOIUrl":"10.1002/ags3.70253","url":null,"abstract":"<p>\u0000 <span>T. Ofuchi</span>, <span>K. Shinjo</span>, <span>Q. Hu</span>, et al., “ <span>Intratumoral <i>Fusobacterium nucleatum</i> Drives Cancer-Associated Fibroblasts Enrichment and Immune Exclusion in Esophageal Squamous Cell Carcinoma</span>,” <i>Annals of Gastroenterological Surgery</i> <span>10</span>, no. <span>2</span> (<span>2025</span>): <span>611</span>–<span>620</span>. https://doi.org/10.1002/ags3.70116\u0000 </p><p>The author list for the above article was incorrect. Dr. Yutaka Kondo and Dr. Keiko Shinjo should be added as co-authors. The final author list is as follows:</p><p>Takashi Ofuchi^1,2, Keiko Shinjo³, Qingjiang Hu¹, Kazuki Omachi^1,2, Kosuke Kanemitsu², Hajime Otsu¹, Yusuke Yonemura¹, Taro Tobo⁴, Yoshifumi Baba⁵, Masaaki Iwatsuki², Yutaka Kondo³, and Koshi Mimori¹.</p><p>¹Department of Surgery Beppu Hospital, Kyushu University, Oita Japan</p><p>²Department of Gastroenterological Surgery Graduate School of Medical Sciences, Kumamoto University, Kumamoto Japan</p><p>³Division of Cancer Biology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan</p><p>⁴Department of Pathology Beppu Hospital, Kyushu University Oita Japan</p><p>⁵Department of Gastrointestinal Surgery Graduate School of Medicine, The University of Tokyo, Tokyo Japan</p><p>The online article has been corrected.</p><p>We apologize for this error.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576896","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}