Annals of Gastroenterological Surgery最新文献

{"title":"Exploratory Analysis of Factors Associated With the Recovery of Erectile Dysfunction After Rectal Cancer Surgery (Sub-Analysis of LANDMARC Trial).","authors":"Ryosuke Mizuno, Koya Hida, Masakatsu Numata, Takashi Sakamoto, Kazutaka Obama, Akio Shiomi, Ryo Inada, Manabu Shiozawa, Mayumi Ozawa, Masanori Hotchi, Daisuke Yamamoto, Suguru Hasegawa, Masashi Miguchi, Shinobu Ohnuma, Tomohiro Yamaguchi, Tomonori Akagi, Yusuke Kinugasa, Shigeki Yamaguchi, Hiroyasu Kagawa, Masahiko Watanabe, Takeshi Naitoh, Ichiro Takemasa","doi":"10.1002/ags3.70246","DOIUrl":"10.1002/ags3.70246","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ErD) is an important complication after rectal cancer surgery, however a substantial proportion of patients experience functional recovery over time. Evidence regarding which patients are more likely to recover remains limited. This study aimed to identify factors associated with the recovery of postoperative ErD in male patients undergoing minimally invasive rectal cancer surgery.</p><p><strong>Methods: </strong>This study was a sub-analysis of the LANDMARC study, a multicenter prospective trial across 49 hospitals, including male patients who underwent minimally invasive surgery for middle or lower rectal cancer. Erectile function was assessed preoperatively and up to 12 months postoperatively using the Erection Hardness Score (EHS). Analyses focused on ErD at 3 months and recovery at 12 months postoperatively. Modified Poisson regression was used to explore factors associated with recovery.</p><p><strong>Results: </strong>Among 337 patients with complete data, postoperative ErD was observed in 136 patients (40%). Of these, 67 patients (49%) showed recovery of ErD at 12 months. Factors associated with the recovery of ErD were upper tumor location (RR: 1.51; 95% CI: 1.06, 2.16), pathological T stage ≤ 2 (RR: 1.59; 95% CI: 1.07, 2.38), absence of neoadjuvant chemotherapy (RR: 2.05; 95% CI: 1.01, 4.13), and creation of a diverting stoma (RR: 1.85; 95% CI: 1.21, 2.85). Sensitivity analyses using alternative recovery definitions showed consistent results, particularly for tumor location and diverting stoma.</p><p><strong>Conclusions: </strong>ErD after rectal cancer surgery is not always irreversible. These exploratory findings may help inform future studies aimed at developing individualized penile rehabilitation strategies after rectal cancer surgery.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":"1623-1630"},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576937","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 Upfront Surgery and Preoperative Chemotherapy for CY1P0 Gastric Cancer: A Japanese Sub-Analysis of CONVO-GC-1","authors":"Kenichiro Furukawa,&nbsp;Itaru Yasufuku,&nbsp;Hironori Ishigami,&nbsp;Masahiro Yura,&nbsp;Takanobu Yamada,&nbsp;Shigeaki Baba,&nbsp;Takeshi Kubota,&nbsp;Erina Nagai,&nbsp;Seito Fujibayashi,&nbsp;Mitsumasa Yoshida,&nbsp;Takahiro Kinoshita,&nbsp;Nobuhisa Matsuhashi,&nbsp;Masanori Terashima","doi":"10.1002/ags3.70188","DOIUrl":"https://doi.org/10.1002/ags3.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radical gastrectomy, followed by adjuvant chemotherapy has been a common practice in Japan for peritoneal lavage cytology-positive (CY1) but peritoneal dissemination-negative (P0) stage IV gastric cancer. This study aimed to clarify the differences in treatment outcomes between upfront surgery and preoperative chemotherapy, followed by surgery for patients with CY1P0 gastric cancer using data from Japanese patients recruited for the CONVO-GC-1 study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used data from Japanese patients with CY1P0 gastric cancer recruited for the international retrospective observational CONVO-GC-1 study. Gastrectomy was performed between January 1, 2001, and December 31, 2014. CY1 was cytologically confirmed. The patients were divided into two groups: upfront surgery (Sx) and preoperative chemotherapy, followed by surgery (CSx). Patient background and survival outcomes were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred and thirty-three patients treated at 45 Japanese institutions were analyzed. There were 306 and 127 patients in the Sx and CSx groups, respectively. The 5-year overall survival (OS) rates were 19.2% in the Sx group and 35.9% in the CSx group, with a significant difference. When stratifying OS of the two groups by residual tumor status, the 5-year OS rates were 43.0% in the CSx-R0 group, 14.9% in the CSx-R1 group, 20.7% in the Sx-R1 group, and 0.0% in the CSx-R2 and Sx-R2 groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In CY1P0 gastric cancer, survival was better with preoperative chemotherapy, followed by surgery than with upfront surgery. Survival was particularly favorable in patients who underwent R0 resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1021-1030"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373341","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":"Association of a Multimodal Perioperative Care Program With Postoperative Complications in Elderly Patients Undergoing Gastrectomy for Gastric Cancer","authors":"Keiichi Fujiya,&nbsp;Hiroshi Fuseya,&nbsp;Yusuke Yonenaga,&nbsp;Keiko Sanada,&nbsp;Toshimi Inano,&nbsp;Yumi Oguma,&nbsp;Kazuko Nakajima,&nbsp;Chikako Ando,&nbsp;Kumiko Oka,&nbsp;Yusuke Koseki,&nbsp;Kenichiro Furukawa,&nbsp;Yutaka Tanizawa,&nbsp;Masanori Terashima,&nbsp;Etsuro Bando","doi":"10.1002/ags3.70194","DOIUrl":"https://doi.org/10.1002/ags3.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This retrospective study aimed to assess the clinical effectiveness of a multimodal perioperative care program in reducing postoperative complications in elderly patients undergoing gastrectomy for gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 1285 patients aged ≥ 75 years who underwent curative gastrectomy were classified into pre-program (2008–2018, <i>n</i> = 965) and post-program (2020–2024, <i>n</i> = 320) groups. The program consisted of preoperative nutritional counseling, oral care, swallowing and physical function screening, and targeted rehabilitation. The clinical characteristics and surgical outcomes of the two groups were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the post-program group, 314 patients underwent swallowing screening, with 108 receiving targeted speech–language therapy and 49 being prescribed a dysphagia diet. Physical function screening was conducted on 281 patients, with 204 receiving perioperative exercise therapy. Program implementation was significantly associated with a lower incidence of overall complications (21% vs. 40%), surgical (13% vs. 21%) and non-surgical complications (7% vs. 17%), pneumonia (4% vs. 9%), and delirium (3% vs. 7%). Multivariate analysis revealed that the program was independently associated with a significantly decreased incidence of overall complications (odds ratio [OR]: 0.431, <i>p</i> &lt; 0.001) and non-surgical complications (OR: 0.309, <i>p</i> &lt; 0.001). Meanwhile, the reduction in the incidence of surgical complications was not statistically significant (OR: 0.696, <i>p</i> = 0.094).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multimodal perioperative care program may effectively reduce postoperative complications, particularly non-surgical complications such as pneumonia, in elderly patients with gastric cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1031-1041"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373360","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":"Annual Report of the 2022 National Clinical Database: Decade-Long Trends and Current Status of Gastroenterological Surgery in Japan","authors":"Koshi Kumagai,&nbsp;Arata Takahashi,&nbsp;Hideki Ueno,&nbsp;Naoki Hiki,&nbsp;Yoshiki Kajiwara,&nbsp;Tomoki Ebata,&nbsp;Takao Otsuka,&nbsp;Taro Oshikiri,&nbsp;Yoshihiro Kakeji,&nbsp;Takanori Goi,&nbsp;Akio Saiura,&nbsp;Hiroshi Saeki,&nbsp;Chie Tanaka,&nbsp;Masanori Tokunaga,&nbsp;Tsutomu Fujii,&nbsp;Satoru Matsuda,&nbsp;Tsunekazu Mizushima,&nbsp;Hiroyuki Yamamoto,&nbsp;Yuko Kitagawa,&nbsp;Ken Shirabe","doi":"10.1002/ags3.70172","DOIUrl":"https://doi.org/10.1002/ags3.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The National Clinical Database (NCD) of Japan is the largest nationwide registry, covering over 95% of surgeries in the country. This 2022 annual report summarizes the short-term outcomes of gastroenterological surgeries and discusses trends and insights over the past decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the NCD data for gastroenterological surgeries performed between 2013 and 2022. The number of surgeries, patient demographics, surgical approaches, postoperative outcomes, and the involvement of board-certified surgeons and anesthesiologists were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 591 221 surgeries were recorded in 2022. Compared to 2021, the overall surgical volume remained stable, with a continued increase in minimally invasive procedures. Patient aging continued across all organ categories, with a rise in the proportion of patients aged ≥ 80 years. Board-certified surgeon participation remained high in complex procedures, while emergency surgeries were associated with higher morbidity and mortality. Operative mortality continued to decrease, particularly in pancreatic and hepatic surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 2022 NCD data provide a comprehensive overview of the current status and evolving trends in gastroenterological surgery in Japan. Continued efforts toward data-driven quality improvement and surgical education remain essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"928-959"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373175","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":"Surgical Outcomes and Recurrence Management in Borderline Resectable Hepatocellular Carcinoma: Implications for Multidisciplinary Strategies","authors":"Koichiro Haruki,&nbsp;Kenei Furukawa,&nbsp;Munetoshi Akaoka,&nbsp;Yuto Yamahata,&nbsp;Shinji Onda,&nbsp;Yoshihiro Shirai,&nbsp;Masashi Tsunematsu,&nbsp;Tomohiko Taniai,&nbsp;Michinori Matsumoto,&nbsp;Toru Ikegami","doi":"10.1002/ags3.70177","DOIUrl":"https://doi.org/10.1002/ags3.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Oncological resectability classification for hepatocellular carcinoma (HCC) emphasizes the need to reassess treatment strategies for borderline resectable (BR) cases. This study evaluated surgical outcomes and prognostic factors in BR-HCC and reconsidered multidisciplinary approaches for recurrence management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study comprised 433 patients who underwent primary hepatic resection for HCC between 2000 and 2023. Patients were classified as R, BR1, and BR2 according to the Expert Consensus Statement 2023. Multivariate Cox proportional hazard models were conducted to identify prognostic factors for disease-free and overall survival in BR (BR1 + BR2) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 70 patients with BR-HCC (BR1: <i>n</i> = 37, BR2: <i>n</i> = 33), 5-year overall survival was 53% in BR1 versus 22% in BR2 patients (<i>p</i> = 0.06). In multivariate analysis, up-to-7 out (<i>p</i> &lt; 0.001) and lymph node metastasis (<i>p</i> &lt; 0.001) were independent predictors of cancer recurrence, whereas anatomical resection was associated with improved disease-free survival (<i>p</i> = 0.02). Independent predictors of overall survival included older age (<i>p</i> = 0.01), Child-Pugh B (<i>p</i> &lt; 0.001), up-to-7 out (<i>p</i> = 0.01), macrovascular invasion (<i>p</i> = 0.01), and lymph node metastasis (<i>p</i> &lt; 0.001). Recurrence occurred in 89% of BR-HCC patients, with BR2 showing more frequent early recurrence within 1 year (<i>p</i> = 0.006) and recurrence beyond Milan criteria (<i>p</i> = 0.02) compared to BR1. Patients receiving surgical resection or radiofrequency ablation for recurrence demonstrated better survival compared with other treatments (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BR1 and BR2-HCC represent biologically aggressive subsets with high recurrence rates and poor prognosis, particularly in tumors with up-to-7 out status, lymph node metastasis, and macrovascular invasion. Active salvage treatment for recurrence may improve survival, highlighting the importance of multidisciplinary approaches in BR-HCC management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1143-1154"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373205","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":"Preoperative Computed Tomography Colonography-Angiography for Vascular Mapping to Guide and Standardize D3 Lymphadenectomy in Right-Sided and Transverse Colon Cancer","authors":"Takeharu Kato,&nbsp;Yukihide Kanemitsu,&nbsp;Mototaka Miyake,&nbsp;Gen Tomizawa,&nbsp;Kohei Takura,&nbsp;Hiroshi Nagata,&nbsp;Yasuyuki Takamizawa,&nbsp;Konosuke Moritani,&nbsp;Shunsuke Tsukamoto","doi":"10.1002/ags3.70215","DOIUrl":"https://doi.org/10.1002/ags3.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In right hemicolectomy (RHC) and left-sided transverse colectomy (TC), D3 lymph node dissection is oncologically significant but technically demanding because of marked vascular variability. Standardization requires reliable preoperative anatomical assessment. We evaluated colic vascular anatomy and quantified D3 dissection distance using computed tomography colonography-angiography (CTC-A).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 591 patients with primary right or transverse colon cancer who underwent preoperative CTC-A during 2014–2023. Arterial origins, venous drainage, and positional relationships around the superior mesenteric artery (SMA) and vein (SMV) were classified. After excluding aberrant cases, branching patterns relevant to D3 dissection were categorized and D3 distances measured along the SMA centerline using curved planar reformation images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An accessory middle colic artery (aMCA) was present in 38.1% of patients (SMA-derived, 76.4%). The MCA originated as a common trunk in 77.8% and as independent branches in 19.0%. The right colic artery (RCA) was observed in 41.8%. Four reproducible vascular patterns each were identified for RHC and TC. In RHC (<i>n</i> = 490), independent-origin MCA was consistently associated with shorter D3 distances (RCA-present, 22.5 vs. 27.5 mm, <i>p</i> = 0.012; RCA-absent, 16.5 vs. 20.5 mm, <i>p</i> &lt; 0.001). In TC (<i>n</i> = 524), the aMCA originated dorsal to the pancreas in ~23%, and D3 distance was shorter in aMCAs with an independent-origin MCA (18.0 vs. 25.0 mm, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High-resolution CTC-A yielded a single-modality, operation-oriented mapping integrating tumor location with mesenteric arteriovenous anatomy. Pattern-based classification and objective D3 distance estimation may support preoperative planning and help establish standardized, safer D3 lymphadenectomy for right-sided and transverse colon cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1120-1132"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373303","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":"Robotic Versus Laparoscopic Anatomic Liver Resection: Comparison of Perioperative Outcomes—A Systematic Review and Meta-Analysis","authors":"Yutaro Kato,&nbsp;Atsushi Sugioka,&nbsp;Hiroyuki Kato,&nbsp;Akihiko Horiguchi","doi":"10.1002/ags3.70183","DOIUrl":"https://doi.org/10.1002/ags3.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Minimally invasive anatomic liver resection (AR) is technically demanding, and the efficacy of robotic surgery in AR remains unestablished. This systematic review aims through a meta-analysis to compare surgical outcomes between robotic (RAR) and conventional laparoscopic (LAR) AR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search of relevant studies published between 2001 and 2024 in PubMed/MEDLINE, Embase and Cochrane Library was carried out, and 15 studies were selected. Meta-analysis was performed to compare perioperative outcomes between RAR and LAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4171 patients comprising 2042 RAR and 2129 LAR patients who underwent major hepatectomy or liver parenchyma-sparing AR (PSAR) were included. All included studies were retrospective comparative studies, including eight using propensity score-matched analysis. Meta-analysis demonstrated that as primary outcomes, the 30-day and 90-day mortalities and postoperative overall morbidity were comparable between RAR and LAR, while RAR had significantly less morbidity≥Clavien-Dindo grade II and a lower rate of open conversion. As secondary outcomes, compared to LAR, RAR showed significantly less blood loss and shorter postoperative hospital stay, while RAR had a higher rate of postoperative 30-day readmission. Operative time, blood transfusion, Pringle maneuver, R0 resection, and reoperation were comparable. Subgroup meta-analyses showed a lower rate of blood transfusion in robotic PSAR and a lower rate of open conversion in RAR in the right cranial regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This large-scale meta-analysis of minimally invasive AR suggests that RAR can confer comparable or partly better perioperative outcomes as compared to LAR, indicating potential advantages of the robotic approach to AR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"960-974"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373541","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":"Rising Pancreatic Cancer Incidence in Young Japanese Women and Increasing Distal Pancreatectomy in Older Adults: A Nationwide Claims-Based Analysis From 2016 to 2023","authors":"Masamitsu Kido,&nbsp;Ryo Morimura,&nbsp;Yusuke Yamamoto,&nbsp;Tomohiro Arita,&nbsp;Shingo Nakashima,&nbsp;Katsutoshi Shoda,&nbsp;Taisuke Imamura,&nbsp;Hidemasa Kubo,&nbsp;Kengo Yoshii,&nbsp;Iichiroh Onishi,&nbsp;Atsushi Shiozaki","doi":"10.1002/ags3.70178","DOIUrl":"https://doi.org/10.1002/ags3.70178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This nationwide observational study investigated recent trends in pancreatic cancer (PC) incidence and surgical management in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Annual data on PC incidence (2016–2021) and surgical procedures (2016–2023) were obtained from the Cancer Information Database and the National Database of Health Insurance Claims and Specific Health Checkups (NDB), respectively. Surgical procedures were categorized by type (distal pancreatectomy (DP, 2016–2023)/pancreatoduodenectomy (PD, 2020–2023)) and approach (open/laparoscopic). Crude and age-adjusted rates per 100 000 person-years were calculated. Temporal trends were evaluated using linear and Poisson regression to estimate annual risk ratios (RRs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the study period, the annual average PC incidence was 43 015, and the average number of PC surgery was 13 899. Age-adjusted PC incidence rates rose significantly among males, females, and both sexes (RR = 1.007, 1.016 and 1.011, respectively; <i>p</i> &lt; 0.0001). A particularly notable rise was observed among females aged 10–29 years (RR range: 1.347–1.449; all <i>p</i> &lt; 0.0009). DP rates increased significantly among males, females, and both sexes (RR = 1.033, 1.032, and 1.033, respectively; <i>p</i> &lt; 0.0001), with marked increases among individuals aged 65–89 years for both sexes (RR range: 1.018–1.114; all <i>p</i> &lt; 0.0012). PD volumes also rose during 2020–2023, although the limited analytic window precluded formal rate-based trend evaluation. In 2023, PD comprised 65.6% of PC surgeries (9444/14397), while DP comprised 34.4% (4953/14397).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These nationwide findings highlight age- and sex-specific signals—notably an apparent rise among young women and increased DP use among older adults—that warrant further validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1155-1164"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373048","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":"Relationship Between the Product of Pre-Treatment Neutrophil and Monocyte Counts and Clinical Outcomes in Rectal Cancer With Suspected Lateral Lymph Node Metastasis","authors":"Takayoshi Sasaki,&nbsp;Shinya Abe,&nbsp;Hiroaki Nozawa,&nbsp;Kazuhito Sasaki,&nbsp;Koji Murono,&nbsp;Shigenobu Emoto,&nbsp;Yuichiro Yokoyama,&nbsp;Yuzo Nagai,&nbsp;Yuzo Harada,&nbsp;Soichiro Ishihara","doi":"10.1002/ags3.70212","DOIUrl":"https://doi.org/10.1002/ags3.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A novel systemic inflammatory response marker, the neutrophil × monocyte value (NM value), has been identified as a negative predictive factor for responses to chemoradiotherapy in rectal cancer. However, the clinical implications of the NM value remain unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study reviewed 352 patients with rectal cancer who received preoperative chemoradiotherapy between 2003 and 2023. The cut-off value for the pre-treatment NM value was established at the median. A pre-treatment size of lateral lymph node (LLN) ≥ 8 mm was defined as clinical LLN metastasis. The prognostic significance of the NM value was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cut-off NM value was 1 100 000; 179 patients had an NM value ≥ 1 100 000. Ninety-nine patients had LLN ≥ 8 mm. Disease-free survival (DFS) was significantly shorter in patients with an NM value ≥ 1 100 000 than in those with an NM value &lt; 1 100 000. DFS and overall survival (OS) were shorter in patients with LLN ≥ 8 mm than in those with LLN &lt; 8 mm. The LLN size and NM value were identified as independent prognostic factors for DFS (LLN size—hazard ratio (HR): 1.51, <i>p</i> = 0.04, NM value—HR: 1.53, <i>p</i> = 0.04). Patients with LLN ≥ 8 mm and an NM value ≥ 1 100 000 had the poorest prognosis among the populations compared by the combination of LLN size and NM value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The pre-treatment NM value is an independent prognostic factor associated with DFS. In patients with LLN ≥ 8 mm, a high NM value may be a significant indicator of a poor prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1097-1106"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373304","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":"Advances in Gastric Cancer Research: Insights Into Carcinogenesis, the Tumor Microenvironment, Metastasis, and Factors Influencing Prognosis","authors":"Hideo Baba,&nbsp;Takatsugu Ishimoto,&nbsp;Yoshifumi Baba,&nbsp;Hiromitsu Hayashi,&nbsp;Masaaki Iwatsuki","doi":"10.1002/ags3.70195","DOIUrl":"https://doi.org/10.1002/ags3.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Department of Gastroenterological Surgery at Kumamoto University has maintained a commitment to integrating cutting-edge clinical practice with fundamental research, particularly concerning malignant diseases of the digestive tract. This comprehensive review aimed to synthesize and consolidate the key clinical and translational research achievements published by our department, primarily focusing on gastric cancer (GC) and the pathophysiological mechanisms that drive its progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically reviewed the most impactful English-language original research papers from our institution, since 2005. The identified studies span critical areas including molecular carcinogenesis, tumor microenvironment (TME) components, and mechanisms of systemic metastasis and drug resistance, and so on.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our accumulated research has yielded significant insights into the molecular basis of GC. A core area of contribution includes the genetic and epigenetic changes during carcinogenesis of gastric cancer or Gastric Adenocarcinoma and Proximal Polyposis of the Stomach (GAPPS), the tumor microenvironment (TME) especially focusing on Cancer-Associated Fibroblasts (CAFs), a factor promoting peritoneal dissemination of ECM-related genes and gut microbiota. Furthermore, our translational work has explored mechanisms of resistance to chemotherapeutic agents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The collective research from our department represents a crucial contribution to the global understanding of gastric cancer pathogenesis, progression, and clinical management. These findings underscore our commitment to translating basic scientific discoveries into actionable strategies that advance individualized therapy, ultimately improving the long-term prognosis for patients with digestive malignancies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"984-994"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373530","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}