Annals of Gastroenterological Surgery最新文献

{"title":"A severity-based tumor-superior mesenteric/portal vein interface grading criteria as a predictor of survival outcomes in pancreatic head ductal adenocarcinoma patients undergoing pancreaticoduodenectomy following neoadjuvant chemoradiotherapy","authors":"Benson Kaluba,&nbsp;Naohisa Kuriyama,&nbsp;Motonori Nagata,&nbsp;Takahiro Ito,&nbsp;Aoi Hayasaki,&nbsp;Takehiro Fujii,&nbsp;Yasuhiro Murata,&nbsp;Akihiro Tanemura,&nbsp;Masashi Kishiwada,&nbsp;Shugo Mizuno","doi":"10.1002/ags3.70002","DOIUrl":"https://doi.org/10.1002/ags3.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the ability of a new severity-based tumor-superior mesenteric/portal vein interface criteria to predict survival outcomes in pancreatic ductal adenocarcinoma patients undergoing pancreaticoduodenectomy after neoadjuvant chemoradiotherapy (CRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two hundred and twenty-six post-CRT patients were enrolled and 22 had no tumor-SMV/PV contact, while the remaining 204 had. Based on correlation with overall survival (OS), circumferential (210 degrees) and contact length (25 mm) interface cut-off values were identified, then used to formulate no tumor-SMV/PV contact, non-severe, and severe interface criteria. Significant predictors of disease-free (DFS) and OS were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The severe group had significantly more UR-LA, cStage 3 cases, longer operation times, more intra-operative blood loss, R1 resection, and pPV invasion cases than the no tumor-contact and non-severe interface groups (<i>p</i> &lt; 0.001). Median DFS were 37.7 (no tumor-contact), 17.0 (non-severe), and 5.2 (severe) months and OS was 56.7, 29.9, and 12.0. Among tumor-contact patients, the interface criteria (84.7%) had a better specificity in predicting pPV invasion than tumor-contact length (76.9%) and tumor-circumferential interface (73.8%). Those with pPV invasion had shorter DFS (16.7 vs. 5.7) and OS (28.3 vs. 13.6) than those without pPV invasion. Significant independent predictors of both DFS and OS were the interface criteria, resection margins, and pPV invasion. Clinical and pathological lymph node involvement also influenced DFS, while circumferential interface and pathological tumor stage also impacted OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients can be stratified as no tumor-contact, non-severe, or severe interface cases and the criteria might be useful in preoperatively predicting not only survival but also intra-operative outcomes and pPV invasion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"842-860"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520004","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":"Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan","authors":"Atsushi Hamabe,&nbsp;Arata Takahashi,&nbsp;Hiraku Kumamaru,&nbsp;Hiroshi Hasegawa,&nbsp;Koki Otsuka,&nbsp;Yoshihiro Kakeji,&nbsp;Ken Shirabe,&nbsp;Masafumi Inomata,&nbsp;Yuko Kitagawa,&nbsp;Ichiro Takemasa","doi":"10.1002/ags3.70007","DOIUrl":"https://doi.org/10.1002/ags3.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 123 771 right hemicolectomy and 126 965 low anterior resection cases performed between 2013 and 2019 were selected from the National Clinical Database for analysis. Patients were stratified by regional and economic variables, and open and minimally invasive surgical outcomes were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In secondary medical regions characterized by urban settings and numerous designated cancer care hospitals, the observed 30-day mortality of low anterior resections was lower only in the minimally invasive surgery group. For right hemicolectomies in regions with many designated cancer care hospitals, the observed incidence of postoperative complications was also lower in the minimally invasive group. Residents of high-income areas undergoing low anterior resection had a lower frequency of 30-day reoperation regardless of the type of surgery and a lower 30-day mortality in the minimally invasive group. For both right hemicolectomy and low anterior resection, patients with longer travel distances had fewer postoperative complications and lower 30-day reoperation rates in the minimally invasive group than in the open surgery group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found regional and patient characteristic disparities in minimally invasive surgical outcomes; national policies should be implemented to address these inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"769-784"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519823","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":"Does surgical intervention contribute to survival for patients with para-aortic lymph node metastasis from colorectal cancer?","authors":"Akira Ouchi,&nbsp;Koji Komori,&nbsp;Sono Ito,&nbsp;Yusuke Kinugasa,&nbsp;Soichiro Ishihara,&nbsp;Akio Shiomi,&nbsp;Yukihide Kanemitsu,&nbsp;Takeshi Suto,&nbsp;Hiroki Takahashi,&nbsp;Yoichi Ajioka,&nbsp;the study group for PALNM projected by JSCCR","doi":"10.1002/ags3.70019","DOIUrl":"https://doi.org/10.1002/ags3.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>There is a lack of compelling evidence supporting the benefit of surgical resection for para-aortic lymph node metastasis (PALNM) from colorectal cancer (CRC). We aimed to investigate the true impact of surgical resection on survival for patients with PALNM from CRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients diagnosed with PALNM from CRC at the Japanese Society for Cancer of the Colon and Rectum institutions between January 2011 and December 2015 were analyzed. Those who had received surgical resection and those who did not were matched one-on-one by the propensity score (PS)-matching method. A total of 77 PS-matched pairs extracted from 347 patients at 36 institutions were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-one (40.3%) patients each in the surgical resection and chemotherapy groups had distant metastasis other than PALNM, and the most dominant organ was the liver in 18 (23.4%) patients in both groups. In the surgical resection group, 56 (72.7%) patients achieved curative resection of all disease lesions, of which 49 (63.6%) were R0 resection. Three- and 5-year relapse-free survival of patients who achieved curative resection were 24.4% and 24.4%, respectively. Three- and 5-year overall survival (OS) of patients in the surgical resection were 68.4% and 40.2%, which were significantly better than that in the chemotherapy groups (40.9% and 27.7%), respectively (Log-rank <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The OS of patients with surgical resection for PALNM was significantly better than those without surgical resection. These results highlight the benefit of surgical intervention to survival for patients with resectable PALNM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"997-1007"},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012348","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 hospital costs for robotic and open pancreatectomy incurred during the implementation of a robotic pancreatectomy program at a cancer center","authors":"Heather G. Lyu,&nbsp;Yuki Hirata,&nbsp;Pamela W. Lu,&nbsp;Jess E. Maxwell,&nbsp;Rebecca A. Snyder,&nbsp;Michael P. Kim,&nbsp;Hop Tran Cao,&nbsp;Ching-Wei D. Tzeng,&nbsp;Matthew H. G. Katz,&nbsp;Naruhiko Ikoma","doi":"10.1002/ags3.70017","DOIUrl":"https://doi.org/10.1002/ags3.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Costs associated with robotic pancreatectomy compared to those of open pancreatectomy are assumed to be high but are not well known, particularly during the initial implementation of the robot.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Patients who underwent pancreatectomy for any diagnosis from January 2017 to August 2021 were identified retrospectively. Total hospital cost was calculated using intraoperative, inpatient, and outpatient costs within 30 days of surgery. The ratio of the total cost of each pancreatectomy to the average cost of all operations at our center was used to represent cost without sharing proprietary financial data. Propensity score matching was performed to account for significant differences between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 679 patients who underwent pancreatectomies, 88 of which were robotic. After propensity score matching, the open cohort had 176 patients, and the robotic cohort remained at 88 patients. The median hospital length of stay was 2 days shorter for robotic than for open pancreatectomy (<i>p</i> &lt; 0.001). The total hospital cost was markedly lower in the robotic pancreatectomy cohort. The inpatient and outpatient costs for robotic pancreatectomy were considerably lower than those for open pancreatectomy despite substantially higher intraoperative costs for the former procedure. A scatter plot of total costs after the initial adoption of the robot showed a trend of decreasing costs over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, total hospital costs associated with robotic pancreatectomy were lower than those for open surgery, mainly driven by shorter length of stay. Our findings suggest that costs of robotic pancreatectomy may decrease further with increased surgeon experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"1066-1074"},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012351","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":"Short-term and long-term outcomes of self-expandable metallic stent placement versus creation of a diverting stoma for obstructive colorectal cancer: A systematic review and meta-analysis","authors":"Thanakorn Yingruxpund,&nbsp;Akihisa Matsuda,&nbsp;Takeshi Yamada,&nbsp;Chaiya Chansai,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.70011","DOIUrl":"https://doi.org/10.1002/ags3.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A diverting stoma (DS) is often used as a bridge to surgery in patients with obstructive colorectal cancer (OCRC). However, the self-expandable metallic stent (SEMS) has emerged as a less invasive option. This systematic review and meta-analysis compared the efficacy and safety of the SEMS with that of a DS for OCRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic literature search through to May 2024 was performed to identify studies that compared the SEMS and DS as a bridge to surgery in patients with OCRC. The primary outcomes were postoperative complications and mortality. Secondary outcomes included clinical success of decompression, surgical site infection, anastomotic leakage, bleeding, permanent stoma creation, locoregional recurrence, and 3-year overall survival. The data were pooled using a random-effects model. The results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five non-randomized studies that included 977 patients (SEMS, <i>n</i> = 427; DS, <i>n</i> = 550) were included. Postoperative complications (OR 0.78, 95% CI 0.60–1.01, <i>p</i> = 0.06) and mortality (OR 1.15, 95% CI 0.61–2.16, <i>p</i> = 0.67) were comparable between the groups. SEMS placement had a significantly lower clinical success of decompression but reduced the risk of surgical site infection (OR 0.45, 95% CI 0.27–0.77, <i>p</i> = 0.003). There was no significant between-group difference in frequency of anastomotic leakage (<i>p</i> = 0.68), bleeding (<i>p</i> = 0.94), permanent stoma formation (<i>p</i> = 0.95), locoregional recurrence (<i>p</i> = 0.31), or 3-year overall survival (<i>p</i> = 0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although clinical success was inferior to DS, SEMS contributed to comparable outcomes including postoperative complications, mortality, and long-term outcomes, but significantly reduced SSI. These findings support the broader adoption of SEMS in clinical practice, particularly requiring minimized invasiveness and improving patient quality of life are prioritized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"632-642"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519902","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":"Comparison between olanexidine gluconate and conventional antiseptics for surgical site infection in gastroenterological surgery: A meta-analysis","authors":"Akihisa Matsuda,&nbsp;Takeshi Yamada,&nbsp;Kay Uehara,&nbsp;Aya Yamagishi,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.70014","DOIUrl":"https://doi.org/10.1002/ags3.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the preventative effect of the new antiseptic olanexidine gluconate (OLG) with conventional antiseptics on surgical site infections (SSIs) in gastroenterological surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive electronic literature search was conducted through November 2024 to identify studies comparing the occurrence of SSIs between OLG and conventional antiseptics (Conv), including povidone-iodine (PI) or chlorhexidine gluconate (CHG), for incisional site disinfection. The primary outcomes were the occurrence of overall SSI and incisional SSI (including superficial and deep incisional SSI). A meta-analysis was performed using random-effects models to calculate odds ratios (ORs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies involving 7807 patients (OLG, <i>n</i> = 3491; Conv, <i>n</i> = 4316) were included. The overall SSI rates were 7.8% in the OLG group and 11.1% in the Conv group. OLG significantly reduced overall SSIs (OR: 0.65, 95% CI: 0.53–0.81, <i>p</i> &lt; 0.001) without statistical heterogeneity. OLG also significantly reduced incisional SSIs (4.3% vs. 6.6%) (OR: 0.63, 95% CI: 0.49–0.81, <i>p</i> &lt; 0.001) without statistical heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this is the first meta-analysis with a sufficient sample size to investigate the effect of OLG compared with other antiseptics, demonstrating that OLG significantly reduces overall SSIs and incisional SSIs in gastroenterological surgery without increasing adverse skin reactions. These findings may enhance SSI management for patients undergoing various types of surgeries by introducing new preventative strategies and potentially lowering SSI-related healthcare costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"883-893"},"PeriodicalIF":3.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013104","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":"Reoperative pouch surgery for suspected Crohn's-related complications aided by biologic coverage: Early experience from an inflammatory bowel disease center","authors":"Mehmet Gulmez,&nbsp;Daniel J. Wong,&nbsp;Ariela K. Holmer,&nbsp;Eren Esen,&nbsp;Shannon Chang,&nbsp;Arman Erkan,&nbsp;David Hudesman,&nbsp;Andre da Luz Moreira,&nbsp;Feza H. Remzi","doi":"10.1002/ags3.70016","DOIUrl":"https://doi.org/10.1002/ags3.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In patients with failing ileo-anal pouches there is often diagnostic uncertainty. In this setting, we may offer revisional pouch surgery with biologic “coverage” for presumed Crohn's disease (CD) which enables an alternative to pouch excision and end ileostomy to highly motivated patients. The aim of this study is to assess postoperative outcomes in patients who underwent revisional/redo ileal pouch anal anastomosis (IPAA) for failing pouches with biologic coverage for possible CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cross-sectional study based on data from a tertiary inflammatory bowel disease center. Patients who underwent revisional/redo IPAA surgery between September 2016 and December 2022 were included. The primary outcome measure was the rate of functioning pouch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 213 patients who underwent revisional/redo IPAA surgery, 17 underwent redo IPAA surgery with biologic coverage due to concern for CD. An additional seven patients were started on biologics between the two operative stages of redo IPAA surgery. At a median follow-up of 17 months, the functioning pouch rate was 75%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Revisional IPAA surgery for suspected CD-related complications leading to pouch failure, in conjunction with concurrent medical therapy, provides a stoma-free alternative to patients otherwise facing pouch excision and end ileostomy. Despite the limited number of patients and varying follow-up times, this approach shows promise for maintaining pouch function in a challenging patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"980-986"},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013260","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":"Indirect assessment of hemorrhoid incidence using invasive treatment data in Japan: A 5-year study based on nationwide health insurance claims","authors":"Masamitsu Kido,&nbsp;Tomohiro Arita,&nbsp;Katsutoshi Shoda,&nbsp;Ken Inoue,&nbsp;Hiroyuki Okimura,&nbsp;Hiroki Shimizu,&nbsp;Jun Kiuchi,&nbsp;Kenji Nanishi,&nbsp;Atsushi Shiozaki","doi":"10.1002/ags3.70018","DOIUrl":"https://doi.org/10.1002/ags3.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The epidemiology of hemorrhoids is challenging because of variability in sampling methodologies and diagnostic criteria across different studies. This study indirectly clarified the epidemiology of hemorrhoids by investigating the number of invasive treatments for hemorrhoids (ITH) using a nationwide healthcare claims database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The annual number and rate of ITH procedures per 100 000 people during 2018–2022 were examined. ITH covered by the Japanese healthcare insurance includes sclerotherapy, rubber band ligation, infrared coagulation, thrombectomy, hemorrhoidectomy, and stapled hemorrhoidopexy. The demographic peak patterns in the sex- and age-stratified data were analyzed. Annual trends were evaluated using the Jonckheere–Terpstra trend test or Poisson regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 5-year period, the total number of ITH was 697 838, with a rate of 110.5 per 100 000 person-years. The male-to-female ratio was 1.2:1, indicating slight male predominance. Demographic peak analysis revealed bimodal peaks in males aged 40–44 and 75–79 years, and in females aged 35–39 and 75–79 years. No significant changes were observed in all ITH procedures. The age-adjusted number across all age groups per 100 000 person-years demonstrated annual decreasing trends for males but increasing trends for females (<i>p</i> &lt; 0.0167). Subgroup analysis indicated a decrease among older cohorts in both males and females, in contrast to an increase among young and middle-aged females (<i>p</i> &lt; 0.00088).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Distinct bimodal ITH peaks were observed in males and females in their 30s–40s and 70s. These findings provide valuable insights into the epidemiology of hemorrhoids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"987-996"},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013237","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":"Current status, trends, and controversies in the selection of gastrectomy procedures: Insights from two nationwide questionnaire surveys conducted over a 7-year interval in Japan","authors":"Koji Nakada,&nbsp;Hideyuki Kashiwagi,&nbsp;Shinichi Kinami,&nbsp;Hiroharu Yamashita,&nbsp;Nobuyoshi Hanyu,&nbsp;Atsushi Oshio,&nbsp;Michio Kaminishi,&nbsp;Yasuyuki Seto","doi":"10.1002/ags3.70015","DOIUrl":"https://doi.org/10.1002/ags3.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study explores the evolving landscape of gastrectomy procedures in Japan, based on nationwide surveys conducted in 2014 and 2021. It highlights changes in surgical approaches, including a growing focus on minimally invasive and function-preserving procedures, as well as the increasing consideration of postoperative quality of life (QOL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two nationwide questionnaire surveys were conducted in 2014 and 2021, targeting members of the Japanese Society for Gastro-surgical Pathophysiology. The surveys covered institutional characteristics, surgical case volumes, procedure preferences for early gastric cancer by tumor location, and emerging topics such as robot-assisted surgery and sentinel node navigation surgery. Statistical analysis included Fisher's exact test and residual analysis for changes in procedure selection over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicate a marked shift toward laparoscopic and robot-assisted gastrectomy, alongside a rise in function-preserving procedures, particularly proximal gastrectomy and small remnant distal gastrectomy. However, procedures like pylorus-preserving gastrectomy and vagus nerve preservation, and total gastrectomy with jejunal pouch reconstruction remain underutilized due to concerns regarding unclear benefits, technical complexity, and oncological safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores advancements in minimally invasive and function-preserving gastrectomy procedures in Japan but emphasizes the need for more robust clinical evidence to support the broader adoption of certain procedures. Future research, guided by emerging evaluation tools, is crucial for optimizing surgical outcomes and enhancing QOL for gastric cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"903-919"},"PeriodicalIF":3.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013068","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":"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}