Annals of Gastroenterological Surgery最新文献

{"title":"Systematic Review and Meta-Analysis on the Efficacy and Safety of Salvage Esophagectomy for T4 Esophageal Squamous Cell Carcinoma","authors":"Makoto Sakai,&nbsp;Kengo Kuriyama,&nbsp;Kazue Nagai,&nbsp;Ken Shirabe,&nbsp;Hiroshi Saeki","doi":"10.1002/ags3.70233","DOIUrl":"10.1002/ags3.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Salvage esophagectomy is associated with high morbidity and mortality rates. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of salvage esophagectomy for unresectable locally advanced (T4) esophageal squamous cell carcinoma (ESCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched the MEDLINE (PubMed) databases, the Cochrane Library databases, Ichushi-Web (the databases of the Japan Medical Abstract Society), and CiNii (the Academic Information Search Service of the National Institute of Information from Japan) for articles on salvage esophagectomy for T4 ESCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies (208 cases) were eligible for meta-analysis. The overall postoperative complications rate (Clavien–Dindo grade ≥ III) was 30% (95% CI: 23–38, <i>I</i>² = 0%); anastomotic leak rate was 18% (95% CI: 13–25, <i>I</i>² = 15%); pulmonary complication rate was 31% (95% CI: 20–42, <i>I</i>² = 63%); mortality rate was 7% (95% CI: 3–11, <i>I</i>² = 0%); and R0 resection rate was 72% (95% CI: 59–83, <i>I</i>² = 72%). A meta-analysis of survival was not performed due to heterogeneous reporting across studies. However, overall survival was reported to be higher in patients achieving R0 resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Salvage esophagectomy for cT4 ESCC is associated with significant morbidity, particularly a high anastomotic leak rate of 18%. The procedure should be reserved for carefully selected patients in whom R0 resection is highly feasible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1441-1449"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576777","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":"Extent of Lymph Node Dissection for cStage I Siewert Type I/II Cancers Based on Lymph Node Metastasis Risk Stratification","authors":"Masayoshi Terayama,&nbsp;Akihiko Okamura,&nbsp;Tomoyuki Irino,&nbsp;Naoki Takahashi,&nbsp;Jun Kanamori,&nbsp;Yu Imamura,&nbsp;Masaru Hayami,&nbsp;Motonari Ri,&nbsp;Souya Nunobe,&nbsp;Masayuki Watanabe","doi":"10.1002/ags3.70221","DOIUrl":"10.1002/ags3.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The optimal surgical strategy and extent of lymph node (LN) dissection for clinical Stage I (cStage I) adenocarcinoma of the esophagogastric junction (AEG) remain controversial. This study aimed to evaluate surgical outcomes and clarify the prevalence and distribution of LN metastasis according to tumor characteristics in cStage I Siewert type I/II AEG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 151 patients who underwent radical surgery for cStage I Siewert type I/II AEG. The prevalence and anatomical distribution of LN metastasis were analyzed in relation to tumor depth, tumor size, Siewert classification, and esophageal invasion length (EIL). Surgical outcomes were compared between esophagectomy and gastrectomy with distal esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LN metastasis was identified in 13.9% of patients, and no recurrence was observed during a median follow-up of 58.8 months. Metastases were predominantly located in abdominal LN stations (1, 2, 3, and 7), and occurred exclusively in pT1b and pT2 tumors. Cervical and mediastinal LN metastases were rare (approximately 1%) and were limited to those with tumor size ≥ 35 mm, Siewert type I classification, and an EIL of ≥ 30 mm. Gastrectomy with distal esophagectomy was associated with fewer postoperative complications (22.9% versus. 50.0%, <i>p</i> = 0.003) compared with esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In cStage I AEG, LN metastasis is largely confined to the abdominal region. Cervical and mediastinal LN metastases are potentially associated with specific tumor characteristics. For patients without these features, gastrectomy with distal esophagectomy, including D1 abdominal LN dissection, represents an oncologically adequate procedure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1478-1485"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576863","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":"Contemporary Regional Disparities in Robotic-Assisted Rectal Resection in Japan: A Nationwide Population-Based Study Using the National Database Open Data","authors":"Ryo Ohta,&nbsp;Takeshi Yamada,&nbsp;Key Uehara,&nbsp;Hiromichi Sonoda,&nbsp;Akihisa Matsuda,&nbsp;Seiichi Shinji,&nbsp;Yasuyuki Yokoyama,&nbsp;Goro Takahashi,&nbsp;Nobuhiko Taniai,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.70220","DOIUrl":"10.1002/ags3.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted rectal resection has expanded in Japan since national health insurance reimbursement began in 2018; however, its population-level regional distribution remains unclear. We evaluated temporal trends and contemporary regional disparities using the National Database (NDB) Open Data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed NDB Open Data for fiscal years 2014–2023. All patients undergoing rectal resection, irrespective of disease etiology, were included. Procedures were classified as open, laparoscopic, or robotic-assisted. We assessed temporal trends and age- and sex-stratified surgical volumes. For 2023, prefecture-level surgical rates per 100 000 population and robotic proportions were calculated. Standardized claim ratios (SCRs) were computed to adjust for age and sex. Population density was used as a proxy for urbanization. Prefectures were categorized into urban and rural groups using the highest and lowest population-density quartiles (middle two quartiles excluded), and robotic proportions were compared using the Mann–Whitney <i>U</i> test as an exploratory analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotic-assisted rectal resections increased markedly after 2018, whereas open surgery declined. Substantial inter-prefectural variation was observed in surgical volume and robotic utilization, and heterogeneity persisted after age- and sex-standardization using SCRs. Urban prefectures exhibited a higher median robotic proportion than rural prefectures (29.3% vs. 19.0%), although this difference did not reach statistical significance (<i>p</i> = 0.09). Treating population density as a continuous measure, robotic proportion was positively associated with population density (Spearman <i>ρ</i> = 0.338, <i>p</i> = 0.020).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotic-assisted rectal resection expanded in Japan after reimbursement, yet marked inter-prefectural heterogeneity remained, underscoring the need for continued nationwide monitoring of geographic variation in adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1470-1477"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576878","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":"Prevalence of MSI-H/dMMR Colorectal Cancer in Japan: Data From the Clinical Study Group of the University of Osaka-Colorectal Registry","authors":"Yoshihiro Morimoto,&nbsp;Mamoru Uemura,&nbsp;Yoshinori Kagawa,&nbsp;Hidekazu Takahashi,&nbsp;Masayuki Hiraki,&nbsp;Yozo Suzuki,&nbsp;Shinichi Yoshioka,&nbsp;Mitsuyoshi Tei,&nbsp;Shu Okamura,&nbsp;Yukako Mokutani,&nbsp;Atsushi Naito,&nbsp;Shinji Tokuyama,&nbsp;Takamichi Komori,&nbsp;Akinobu Yasuyama,&nbsp;Genta Sawada,&nbsp;Yujiro Fujie,&nbsp;Shinya Yamashita,&nbsp;Naotsugu Haraguchi,&nbsp;Yusuke Matsuura,&nbsp;Chu Matsuda,&nbsp;Yoshinao Chinen,&nbsp;Tatsushi Shingai,&nbsp;Katsuki Danno,&nbsp;Nobuo Tanaka,&nbsp;Kazuya Sakata,&nbsp;Kohei Murata,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1002/ags3.70226","DOIUrl":"10.1002/ags3.70226","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer (CRC) is a distinct subtype. Although immune checkpoint inhibitors are used for advanced cases, data on its frequency and characteristics, especially in resectable Asian CRC, remain limited. This study investigated MSI-H/dMMR frequency and features in Japanese patients to support future personalized treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter observational study included 1464 patients with pathologically confirmed primary CRC enrolled from April 2024 to March 2025 at 25 institutions affiliated with Osaka University. MSI/MMR status and clinicopathological data were extracted from a prospectively maintained database. Univariate analyses were performed to evaluate factors associated with MSI-H/dMMR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1464 patients, 137 (9.4%) had MSI-H/dMMR tumors. MSI/MMR testing was conducted preoperatively in 772 patients (52.7%). MSI-H/dMMR was more frequent in patients aged ≥ 70 years, in females (OR = 1.46, <i>p</i> = 0.036), and in tumors located in the cecum, ascending, or transverse colon (<i>p</i> &lt; 0.001). It was significantly less common in Stage IV disease (OR = 0.22, <i>p</i> &lt; 0.001) and <i>KRAS</i>-mutant tumors (OR = 0.22, <i>p</i> &lt; 0.001), but strongly associated with <i>BRAF V600E</i> mutation (OR = 52.41, <i>p</i> &lt; 0.001), poorly differentiated adenocarcinoma (OR = 7.17, <i>p</i> &lt; 0.001), and mucinous adenocarcinoma (OR = 3.10, <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MSI-H/dMMR CRC accounted for 9.4% of Japanese patients, including resectable cases, and exhibited distinct clinical and molecular characteristics. These findings provide a basis for future personalized treatment strategies in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1538-1545"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576632","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":"Characteristics of Anal Fistula Cancer in Patients Who Underwent Surgery: A Nationwide Observational Study Using Diagnosis Procedure Combination Data","authors":"Nobuaki Hoshino,&nbsp;Hiromitsu Kinoshita,&nbsp;Kazutaka Obama,&nbsp;Kiyohide Fushimi,&nbsp;Susumu Kunisawa,&nbsp;Yuichi Imanaka","doi":"10.1002/ags3.70228","DOIUrl":"10.1002/ags3.70228","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Anal fistula cancer is a rare disease that occurs in &lt; 1% of patients with anal fistulas. The clinical characteristics of anal fistula cancer are not fully understood. This study aimed to identify the characteristics of patients with anal fistula cancer by comparing them with those of patients with anal canal or rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a nationwide observational study using the Diagnosis Procedure Combination data. Patients who underwent abdominoperineal resection or total pelvic exenteration for anal fistula, anal canal, or rectal cancer were included in this study. Patient background, surgical outcomes, postoperative complications, and medical costs were compared among the three types of cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 206 patients with anal fistula cancer, 1207 patients with anal canal cancer, and 18 254 patients with rectal cancer. Patients with anal fistula cancer were more likely to be male, younger, or smokers. In patients with anal fistula cancer, the proportion of open surgeries was significantly higher, and the length of hospital stay was significantly longer than in those with anal canal and rectal cancer. Anal fistula cancer tended to be more locally advanced than other cancers, whereas lymph node and distant metastases were less common. The incidence of incisional wound infection and wound dehiscence was significantly higher, and medical costs were the highest in patients with anal fistula cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anal fistula cancer is characterized by aggressive local progression, resulting in a higher frequency of open surgery, a higher incidence of wound-related complications, and higher medical costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1546-1552"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576886","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":"Innovations in Gastric Cancer Surgery During Early Minimally Invasive Era and Future Perspectives","authors":"Reut El-On,&nbsp;Young-Woo Kim","doi":"10.1002/ags3.70234","DOIUrl":"10.1002/ags3.70234","url":null,"abstract":"<p>The landscape of gastric cancer surgery has undergone remarkable transformation, evolving from traditional open procedures to the modern era of live-streamed minimally invasive operations. This evolution owes much to pioneering surgeons who have continued to expand the boundaries of innovation. Over recent decades, the field has progressed from the introduction of laparoscopic techniques to the refinement of lymphadenectomy, while surgeons have simultaneously integrated insights from tumor biology, advanced instrumentation, and data analytics to improve decision-making and precision. Progress has been fueled by extensive clinical experience and collaborative multicenter trials that provide evidence-based guidance for clinical practice. With continuing revelations in tumor biology and the emergence of artificial intelligence, new horizons for surgical innovation are opening. At the center of this transformative journey stands the innovative surgeon, driven by passion, guided by data, and steadfast in the commitment to patient safety and quality of life. The surgeon of the future will lead multicenter collaborations, integrating technology and biology to optimize outcomes and continually advance the standards of gastric cancer surgery.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1382-1387"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576917","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":"Potential Survival Benefit of Neoadjuvant Docetaxel, Cisplatin and 5-Fluorouracil Therapy in Patients With Esophageal Squamous Cell Carcinoma With Multiple Lymph Node Metastases: A Single-Institute Propensity Score Analysis","authors":"Eiji Higaki,&nbsp;Tetsuya Abe,&nbsp;Hironori Fujieda,&nbsp;Shigenori Kadowaki,&nbsp;Tsutomu Tanaka,&nbsp;Masahiro Tajika,&nbsp;Koji Komori,&nbsp;Seiji Ito,&nbsp;Isao Oze,&nbsp;Kei Muro","doi":"10.1002/ags3.70224","DOIUrl":"10.1002/ags3.70224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neoadjuvant chemotherapy with fluorouracil, cisplatin, and docetaxel (NAC-DCF) followed by surgery is the current standard of care for resectable advanced esophageal squamous cell cancer (ESCC) in Japan based on the JCOG1109 trial. Although NAC-DCF improves survival, it also increases the risk of febrile neutropenia. Therefore, it is essential to identify tumor factors that predict the greatest benefit from NAC-DCF over conventional fluorouracil and cisplatin chemotherapy (NAC-CF) to optimize patient selection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed patients with resectable advanced ESCC who received either NAC-CF or NAC-DCF at our institution between 2006 and 2019. Propensity score-based inverse probability weighting (IPW) and multivariable adjusted analyses were used to consider baseline differences and compare overall survival (OS) stratified by cTNM factors between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 408 patients received NAC-CF, while 218 received NAC-DCF. NAC-DCF was applied to more advanced patients, with 86% having cT3-4a and 52% having cN2-3 (both <i>p</i> &lt; 0.001). After IPW, the hazard ratio (HR) for OS in the NAC-DCF group was 0.74 [95% confidence interval (CI), 0.55–0.98]. Subgroup analysis showed that patients with cN2-3 had a significant survival benefit with NAC-DCF (HR 0.51; 95% CI, 0.34–0.76) in the IPW analysis, whereas no clear association was observed in those with cN0–1 (HR 0.93; 95% CI, 0.62–1.34), with a nominally significant interaction by clinical N stage (<i>p</i> = 0.039).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neoadjuvant chemotherapy with fluorouracil, cisplatin, and docetaxel (NAC-DCF) was associated with improved survival, with a potential benefit in patients with advanced nodal involvement; however, these findings should be interpreted as hypothesis-generating given the retrospective design.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1496-1506"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576458","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":"Sex-Based Body Composition Changes in Patients With Rectal Cancer Undergoing Preoperative Chemoradiotherapy: A Prospective Observational Study","authors":"Shinya Abe,&nbsp;Hiroaki Nozawa,&nbsp;Kentaro Abe,&nbsp;Yumi Yokota,&nbsp;Shunsuke Hori,&nbsp;Yusuke Taguchi,&nbsp;Mitsutaka Yakabe,&nbsp;Kazuhito Sasaki,&nbsp;Sumito Ogawa,&nbsp;Soichiro Ishihara","doi":"10.1002/ags3.70231","DOIUrl":"10.1002/ags3.70231","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preoperative chemoradiotherapy (CRT) for rectal cancer may have an attritional impact on body composition and functional status, affecting postoperative outcomes. This prospective study characterized changes in body composition, muscle strength, and physical performance in patients with rectal cancer receiving CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Body composition measures by a bioelectrical impedance analysis, hand grip strength (HGS), gait speed, and the nutritional status by the Mini-Nutritional Assessment (MNA) were assessed at Weeks 0 (pre-CRT), 2, 4, 6, and 10 (post-CRT). The pre-sarcopenic status was defined as low muscle mass alone and the sarcopenic status as low muscle mass and low muscle strength or function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of 38 enrolled patients (25 men) was 59 years. The mean body fat mass, phase angle, and non-dominant HGS significantly decreased by 1.3 kg, 0.3°, and 0.7 kg, respectively, after CRT. Skeletal muscle mass and the MNA slightly decreased, while gait speed did not change. Significant reductions were observed in body fat mass (2.3 kg, <i>p</i> = 0.04) and non-dominant HGS (1.3 kg, <i>p</i> &lt; 0.01) in women, while slight decreases were noted in men. Although no significant changes were detected in the pre- and post-CRT sarcopenic status in men (4 pre-sarcopenic patients), the numbers of pre-sarcopenic and sarcopenic female patients increased from pre-CRT (1 and 0) to post-CRT (1 and 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Muscle strength and body fat decreased in patients receiving CRT, particularly women. These exploratory data provide a foundation for future investigations into the clinical utility of sex-sensitive therapeutic approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1553-1562"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576758","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":"Long-Term Outcomes After Stoma Creation in Crohn's Disease: A Retrospective Cohort Study of 422 Patients","authors":"Kentaro Nagano,&nbsp;Ryuichi Kuwahara,&nbsp;Yusuke Tomoo,&nbsp;Kurando Kusunoki,&nbsp;Yuki Horio,&nbsp;Kei Kimura,&nbsp;Kozo Kataoka,&nbsp;Masataka Ikeda,&nbsp;Motoi Uchino,&nbsp;Hiroki Ikeuchi","doi":"10.1002/ags3.70219","DOIUrl":"10.1002/ags3.70219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Stoma creation is often required in Crohn's disease (CD), most commonly because of progressive anorectal disease. As stoma closure strongly influences long-term quality of life and surgical decision-making, this study evaluated the indications and long-term outcomes of stoma creation in patients with CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospectively maintained database of CD patients who underwent surgery at Hyogo Medical University between 1974 and 2017 was retrospectively reviewed. Among 1440 surgically treated patients, 422 adults who required stoma creation for CD-related indications were included. A permanent stoma was defined as resulting from abdominoperineal resection or remaining unclosed for more than 24 months. Permanent stoma-free survival was estimated using the Kaplan–Meier method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 422 patients, 107 (25%) had a permanent stoma at initial creation, whereas 315 (75%) received a temporary stoma. Among temporary stomas, 98 (31%) were closed, 133 (42%) remained unclosed, and 84 (27%) became permanent; 13 patients (13%) required re-stoma creation after stoma closure. Anorectal disease was the most common indication (224 patients, 71%), followed by poor bowel condition (75 patients, 24%) and anastomotic leakage (14 patients, 4%). Closure rates were 13% for anorectal disease and 56% for poor bowel condition. Permanent stoma-free survival was 94.8% at 10 years and 82.7% at 20 years; in patients treated after 2005, these rates improved to 95.9% and 86.5%, respectively (<i>p</i> = 0.032).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among stomas created for Crohn's disease–related anorectal lesions, only 13% were successfully closed. These findings highlight the importance of achieving adequate disease control, including anorectal involvement, to avoid stoma creation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1463-1469"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576940","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":"Multidisciplinary Treatment for Esophagogastric Junction Cancer From a Dutch Perspective","authors":"Hidde C. G. Overtoom,&nbsp;Suzanne S. Gisbertz","doi":"10.1002/ags3.70247","DOIUrl":"10.1002/ags3.70247","url":null,"abstract":"<p>Esophagogastric junction (EGJ) cancer is an increasing health burden worldwide. Over the past decade, significant advancements in centralization, multimodal treatment strategies, as well as the widespread adoption of minimally invasive surgical techniques, have led to marked improvements in perioperative outcomes and overall survival of EGJ cancer in the Netherlands. Perioperative treatment strategies have evolved toward intensified systemic therapy, with perioperative chemotherapy, particularly the FLOT regimen. The preferred approach for surgical treatment of EGJ cancer remains debated, however, minimally invasive transthoracic techniques are increasingly adopted and have led to superior radicality and decreased morbidity. Centralization of care with specialized multidisciplinary teams has been consistently associated with improved surgical quality and survival in the Netherlands, as confirmed by the registry-based nationwide quality control.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 5","pages":"1404-1418"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576311","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}