Annals of Gastroenterological Surgery最新文献

{"title":"A multicenter randomized controlled trial evaluating the effect of the use of an anti-adhesion barrier for diverting ileostomy on the multidimensional workload in minimally invasive surgery for rectal cancer (YCOG 2005: The ADOBARRIER study)","authors":"Emi Ota,&nbsp;Jun Watanabe,&nbsp;Yusuke Suwa,&nbsp;Masakatsu Numata,&nbsp;Hirokazu Suwa,&nbsp;Hiroki Ohya,&nbsp;Kazuya Nakagawa,&nbsp;Mayumi Ozawa,&nbsp;Itaru Endo","doi":"10.1002/ags3.70009","DOIUrl":"https://doi.org/10.1002/ags3.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to assess whether the use of spray-type anti-adhesion material during diverting ileostomy construction could reduce the surgeon's multidimensional workload, the degree of adhesion, and the operation time in ileostomy closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients diagnosed with rectal cancer, who were scheduled for laparoscopic or robotic rectal surgery followed by diverting ileostomy, were single-blindly (patient-blind), randomly assigned to either the AdSpray™ arm or the control arm. The primary endpoint was the multidimensional workload of the ileostomy closure operator (SURG-TLX value).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between January 2020 and December 2022, 126 patients were enrolled. Five patients were excluded and a total of 121 patients (control arm, <i>n</i> = 60; AdSpray™ arm, <i>n</i> = 61) were analyzed. The baseline factors were well balanced between the two arms. Regarding SURG-TLX in ileostomy closure, operators in the AdSpray™ arm required a significantly lower overall workload than those in the control arm (AdSpray™ arm, 28.1; control arm, 58.9; <i>p</i> &lt; 0.001). Mental, physical, and temporal demands, task complexity, situation stress, and distractions were significantly lower in the AdSpray™ arm (<i>p</i> &lt; 0.001). Operative time was significantly shorter in the AdSpray™ arm (AdSpray™ arm, 58 min; control arm, 65 min; <i>p</i> = 0.040). The degree of adhesion (<i>p</i> &lt; 0.001) and extent of intra-abdominal adhesions (<i>p</i> &lt; 0.001) in ileostomy closure were significantly lower in the AdSpray™ arm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of spray-type anti-adhesion material was associated with a significantly lower SURG-TLX value, lower incidence of adhesion, less severe adhesion, and shorter operative time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 5","pages":"971-979"},"PeriodicalIF":3.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012284","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 role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study","authors":"Tomohisa Yamamoto,&nbsp;Toshio Shimokawa,&nbsp;Masamichi Hayashi,&nbsp;Masamichi Mizuma,&nbsp;Katsuhisa Hirano,&nbsp;Atsushi Oba,&nbsp;Toshimichi Asano,&nbsp;Hideyo Miyato,&nbsp;Makoto Yoshida,&nbsp;Ippei Matsumoto,&nbsp;Yasunari Kawabata,&nbsp;Katsunori Sakamoto,&nbsp;Fuyuhiko Motoi,&nbsp;Shigeto Ishii,&nbsp;Yuki Homma,&nbsp;Hiromitsu Maehira,&nbsp;Yutaro Matsunaga,&nbsp;Tetsuya Ikemoto,&nbsp;Masafumi Nakamura,&nbsp;Yuko Mataki,&nbsp;Tsuyoshi Notake,&nbsp;Keiichi Akahoshi,&nbsp;Hideki Takami,&nbsp;So Yamaki,&nbsp;Daisuke Hashimoto,&nbsp;Yasutoshi Kimura,&nbsp;Satoshi Hirano,&nbsp;Yosuke Inoue,&nbsp;Tsutomu Fujii,&nbsp;Michiaki Unno,&nbsp;Yasuhiro Kodera,&nbsp;Joji Kitayama,&nbsp;Sohei Satoi,&nbsp;the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination","doi":"10.1002/ags3.70001","DOIUrl":"https://doi.org/10.1002/ags3.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effectiveness of intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) in pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal dissemination remains elusive. The aim of this study is to investigate the clinical outcome of patients treated with i.p.-PTX combined with systemic chemotherapy compared with current standard chemotherapy including gemcitabine plus nab-paclitaxel and FOLFIRINOX.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients with peritoneal dissemination was retrospectively collected and analyzed (i.p.-PTX, <i>n</i> = 83; control, <i>n</i> = 86). Inverse probability of treatment-weighted analyses (IPTW) was used to balance baseline characteristics between two groups. Survival curves were estimated using Kaplan–Meier method, and the differences were compared using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were noted in overall survival (14.9 vs. 15.5 months, <i>p</i> = 0.481) and progression free survival (9.5 vs. 9.1 months, <i>p</i> = 0.267) between i.p.-PTX and the control groups. Nevertheless, i.p.-PTX (9.9 months) significantly prolonged the median progression-free survival (PFS) time compared with the control (8.6 months), among the matched patients using IPTW (hazard ratio 0.666, <i>p</i> = 0.041). Moreover, subgroup analysis among the patients whose primary tumor were evaluated either as resectable or borderline resectable disease revealed significantly better overall survival in the i.p.-PTX group compared with the control group (21.3 vs. 14.7 months, hazard ratio; 0.532, <i>p</i> = 0.033). Conversion surgery was more frequently performed in the i.p.-PTX group than the control group (24% vs. 4%, <i>p</i> = 0.006).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The i.p. PTX regimen prolonged PFS but not overall survival, and subgroup analysis suggested the possibility of survival benefit in patients with occult peritoneal dissemination whose primary tumor was classified as resectable/borderline resectable disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"830-841"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520050","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":"Prognostic impact of postoperative fixed-point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study","authors":"Ryota Matsui,&nbsp;Manabu Ohashi,&nbsp;Motonari Ri,&nbsp;Rie Makuuchi,&nbsp;Tomoyuki Irino,&nbsp;Masaru Hayami,&nbsp;Takeshi Sano,&nbsp;Souya Nunobe","doi":"10.1002/ags3.70006","DOIUrl":"https://doi.org/10.1002/ags3.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to determine the cutoff values of C-reactive protein (CRP) on postoperative day 3 to predict poor overall survival (OS) in men and women with gastric cancer after radical gastrectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStages I–III gastric cancer between May 2006 and March 2017. The patients were randomly divided 6:4 into a training set, which examined the cutoff values for CRP, and a validation set, which validated the cutoff values. Patients with a CRP level higher than the cutoff value were defined as the high-CRP group, and those with a CRP level lower than the cutoff value were defined as the low-CRP group. We compared the OS of the high and low CRP groups using the log-rank test and identified prognostic factors using Cox proportional hazards regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We examined the cutoff values of CRP, which were 19.1 mg/dL for men and 8.1 mg/dL for women. The median follow-up duration was 66 months. The high-CRP group had poorer OS than the low-CRP group (<i>p</i> &lt; 0.001). Multivariate analyses showed that a high CRP level was an independent poor prognostic factor for OS in all patients (hazard ratio, 1.356; 95% confidence interval, 1.168–1.576; <i>p</i> &lt; 0.001), not only in patients without postoperative complications (<i>p</i> = 0.001) but also in patients with postoperative complications (<i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that a high postoperative CRP was an independent poor prognostic factor for OS in patients with gastric cancer after radical gastrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"698-710"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520051","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":"Institutional learning curve and factors of prolonged operation time of robotic distal pancreatectomy: An analysis of an initial 117 cases","authors":"Yuki Hirata,&nbsp;Laura Prakash,&nbsp;Jess Maxwell,&nbsp;Rebecca Snyder,&nbsp;Michael Kim,&nbsp;Hop Tran Cao,&nbsp;Ching-Wei D. Tzeng,&nbsp;Jefferey E. Lee,&nbsp;Matthew H. G. Katz,&nbsp;Naruhiko Ikoma","doi":"10.1002/ags3.70005","DOIUrl":"https://doi.org/10.1002/ags3.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The granular methods by which centers can safely implement and effectively expand robotic distal pancreatectomy (RDP), including those related to appropriate patient selection during the learning curve period, remain unclear. This study aimed to verify that our strategic robotic surgical oncology program effectively implemented RDP as standard practice and to identify factors associated with prolonged operation time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We performed a detailed analysis of the intraoperative and short-term outcomes of consecutive patients (October 2018–September 2023) undergoing RDP at our center, beginning with the first patient in our program. Operation time was analyzed using a cumulative sum chart (CUSUM), and factors associated with prolonged operation time were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Throughout the study period, five surgeons performed RDP for 117 patients. The CUSUM analysis indicated our center required 18 cases to overcome the initial learning phase and 43 additional cases to become proficient. In contrast, when comparing short-term outcomes across the three observation periods, there were no significant changes in the incidence of ACCORDION grade ≥3 pancreatic fistulas (<i>p</i> = 0.684), or readmission rates (<i>p</i> = 0.457). A multivariable analysis revealed BMI ≥30 in male, the presence of pancreatitis or fibrosis, and the performance of concomitant procedures were associated with extended operation times, while BMI ≥30 in female was not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although an institutional learning curve was observed, our program enabled the safe implementation of RDP and successfully expanded the number of primary operating surgeons while maintaining stable short-term outcomes. The absence of an impact of high BMI on operation time in female patients suggests a notable advantage of robotic approach for these individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"861-869"},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520244","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":"Light-emitting diode irradiation targets aerobic glycolysis in cancer-associated fibroblasts to inhibit metabolic coupling with colon cancer cells","authors":"Masaaki Nishi,&nbsp;Chiharu Nakasu,&nbsp;Toshiaki Yoshimoto,&nbsp;Takuya Tokunaga,&nbsp;T. Hideya Kashihara,&nbsp;Chie Takasu,&nbsp;Daichi Ishikawa,&nbsp;Yuma Wada,&nbsp;Mitsuo Shimada","doi":"10.1002/ags3.70004","DOIUrl":"https://doi.org/10.1002/ags3.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The concepts examined in tumor metabolism research have been moving away from cancer cells themselves and the tumor microenvironment has become a focus of investigation. Epigenetic changes affecting glucose metabolism in cancer-associated fibroblasts (CAFs) in the tumor microenvironment regulate the malignancy of cancer cells. Light-emitting diode (LED) have several functional effects, including anti-tumor effects, through a variety of mechanisms. We previously reported that blue LED irradiation had an anti-tumor effect via Opsin 3 that suppress CAF function in vivo and in vitro. However, the detailed mechanism by which LED affect CAF regulation remained unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CAFs were induced from human intestinal fibroblasts co-cultured with colon cancer cells. Using lactate assays and reverse transcription-quantitative PCR, the effects of LED irradiation on glycolysis in CAFs were investigated. The effects of LED irradiation for metabolic coupling were evaluated in vitro.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reverse transcription-quantitative PCR showed higher expression of CAF marker genes in induced CAFs. Blue LED irradiation of induced CAFs suppressed their ability to promote characteristics of tumor malignancy of colon cancer cell line. LED treatment decreased expression of glycolysis markers, including phosphofructokinase and monocarboxylate transporter 4, indicating inhibition of glycolytic activity in CAFs. Extracellular secretion of lactate from CAFs was decreased by LED irradiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Blue LED irradiation targeted metabolic coupling between CAFs and colon cancer cells, thereby reducing the promotion of tumor progression by CAFs. Blue LED targeting glucose metabolism in CAFs is a promising anti-cancer treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"761-768"},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520289","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":"Perioperative outcomes of esophagectomy after doublet versus docetaxel-based triplet neoadjuvant chemotherapy in older patients: A nationwide inpatient database study in Japan","authors":"Yuki Hirano,&nbsp;Takaaki Konishi,&nbsp;Hidehiro Kaneko,&nbsp;Satoru Matsuda,&nbsp;Hirofumi Kawakubo,&nbsp;Yuya Kimura,&nbsp;Hiroki Matsui,&nbsp;Kiyohide Fushimi,&nbsp;Hiroyuki Daiko,&nbsp;Osamu Itano,&nbsp;Hideo Yasunaga,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.70000","DOIUrl":"https://doi.org/10.1002/ags3.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although docetaxel-based triplet neoadjuvant chemotherapy has yielded promising results for locally advanced esophageal cancer, there are concerns that the triplet regimen can increase perioperative adverse events in older patients. This retrospective study assessed the perioperative outcomes following doublet or docetaxel-based triplet chemotherapy and esophagectomy in older patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients aged 70–79 years who received cisplatin and 5-fluorouracil (CF) or docetaxel, cisplatin, and 5-fluorouracil (DCF) before esophagectomy were extracted from a nationwide Japanese inpatient database (April 2012–March 2022). The primary outcomes were major and respiratory complications. The secondary outcomes included anastomotic leakage, 30-day unplanned readmission, and 30- and 90-day mortality. Analyses were conducted using overlap propensity score weighting, propensity score matching, and instrumental variable methods to adjust for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 5229 eligible patients, 3457 (66%) and 1772 (34%) patients received neoadjuvant CF and DCF, respectively. Major and respiratory complications occurred in 5229 (40%) and 1388 (27%) patients, respectively. After overlap weighting, DCF was not associated with a higher frequency of major (odds ratio 0.99 [95% confidence interval 0.87–1.12]) and respiratory complications (odds ratio 1.04 [0.90–1.19]) compared with CF. The frequencies of anastomotic leakage, 30-day unplanned readmission, and 30- and 90-day mortality did not differ between the groups. Propensity score matching and instrumental variable analyses yielded similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neoadjuvant DCF was not associated with a higher frequency of perioperative adverse events compared with CF after esophagectomy in patients aged 70–79 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"687-697"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519927","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":"Nutritional benefits of pancreas-sparing total duodenectomy for severe duodenal polyposis in patients with familial adenomatous polyposis","authors":"Ibuki Fujinuma,&nbsp;Toshiro Ogura,&nbsp;Ayano Takahashi,&nbsp;Satoshi Nomura,&nbsp;Kei Kitamura,&nbsp;Amane Takahashi,&nbsp;Takehiro Shiraishi,&nbsp;Yoshiko Mori,&nbsp;Toru Ishiguro,&nbsp;Takatoshi Matsuyama,&nbsp;Youichi Kumagai,&nbsp;Hideyuki Ishida","doi":"10.1002/ags3.12919","DOIUrl":"https://doi.org/10.1002/ags3.12919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Severe duodenal polyposis associated with familial adenomatous polyposis considerably increases the risk of duodenal cancer. Pancreas-sparing total duodenectomy is an alternative surgical approach for managing severe duodenal polyposis. This study evaluated the postoperative nutritional outcomes following pancreas-sparing total duodenectomy in patients with severe duodenal polyposis associated with familial adenomatous polyposis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis compared 28 patients who underwent pancreas-sparing total duodenectomy for Spigelman stage IV duodenal polyposis with 29 patients who underwent pancreatoduodenectomy for low-malignancy duodenal neoplasms. Patient demographics, postoperative complications, and nutritional parameters were analyzed at 3, 6, 9, and 12 months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with patients in the pancreatoduodenectomy group, those in the pancreas-sparing total duodenectomy group were younger and had a higher incidence of previous abdominal surgeries (<i>p</i> &lt; 0.01). Postoperatively, the pancreas-sparing total duodenectomy group showed significantly better preservation of total protein, albumin, and total cholesterol levels, body mass index, body weight, and psoas major muscle area compared to the pancreatoduodenectomy group (<i>p</i> &lt; 0.05). Additionally, glucose tolerance was better maintained in the pancreas-sparing total duodenectomy group than in the pancreatoduodenectomy group (<i>p</i> &lt; 0.01), with no patients requiring the initiation of insulin therapy or experiencing the exacerbation of diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pancreas-sparing total duodenectomy effectively preserves the postoperative nutritional status in patients with duodenal polyposis associated with familial adenomatous polyposis. This surgical option maintains postoperative nutritional integrity and improves long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"822-829"},"PeriodicalIF":2.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520259","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":"Advantages of subtotal gastrectomy for upper third gastric cancer: A systematic review and meta-analysis","authors":"Yuichiro Miki,&nbsp;Tsubasa Bito,&nbsp;Yasufumi Koterazawa,&nbsp;Shingo Kanaji,&nbsp;Hisashi Shinohara","doi":"10.1002/ags3.12913","DOIUrl":"https://doi.org/10.1002/ags3.12913","url":null,"abstract":"<p>Distal gastrectomy with very small remnant stomach (subtotal gastrectomy, STG) is sometimes performed for upper third gastric cancer, instead of total gastrectomy (TG). However, the advantages of STG over TG remain fully unknown, in terms of survival outcomes, complication rates, nutritional status, and quality of life. Therefore, a systematic review was performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement for reporting systematic reviews. Meta-analyses were performed regarding operation time, complication rates, body weight changes, and reflux esophagitis by using R software. Operation time was significantly shorter in STG than in TG (Mean difference: −20.79 [95% CI: −35.59 to −5.99]). We cannot conclude whether STG is better than TG in terms of survival because of inconsistency among reports. The total complication rates (≧ grade2 and 3) are significantly lower in STG than TG. Reflux esophagitis was lower in STG than in TG (0% vs. 7.7%), although the difference was not significant probably because of small sample size. Body weight change compared with preoperative value was significantly lower after STG than TG both at 6 and 12 months after the operation (6 months: mean difference −5.31% [95% CI: −6.95 to −3.67], 12 months: mean difference −6.13 [95% CI: −8.20 to −4.06]). We revealed that STG has its advantage on shorter operation time, less complication rates, and lower body weight loss by meta-analysis. Although there are some controversies, STG can be an ideal option for patients with gastric cancer of upper third stomach.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"650-657"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520246","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}