Annals of Gastroenterological Surgery最新文献

{"title":"Impact of Abdominoperineal Resection on Postoperative Male Sexual Function After Minimally Invasive Rectal Cancer Surgery: A Subgroup Analysis From the LANDMARC Study","authors":"Taiki Kajiwara,&nbsp;Shinobu Ohnuma,&nbsp;Michiaki Unno,&nbsp;Masakatsu Numata,&nbsp;Tomohiro Yamaguchi,&nbsp;Koya Hida,&nbsp;Tomonori Akagi,&nbsp;Suguru Hasegawa,&nbsp;Akio Shiomi,&nbsp;Ryo Inada,&nbsp;Manabu Shiozawa,&nbsp;Keisuke Kazama,&nbsp;Masanori Hotchi,&nbsp;Masahiko Watanabe,&nbsp;Takeshi Naitoh","doi":"10.1002/ags3.70171","DOIUrl":"https://doi.org/10.1002/ags3.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Using data from the LANDMARC study, we aimed to evaluate the impacts of abdominoperineal resection (APR) on postoperative sexual function in males with rectal cancer undergoing minimally invasive surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were categorized into the APR (<i>n</i> = 44) and anal-sparing surgery (AS) groups (<i>n</i> = 329). A detailed subgroup analysis was performed in patients with tumors located &lt; 5 cm from the anal verge (APR, <i>n</i> = 39; AS, <i>n</i> = 59). Sexual function was assessed preoperatively and at 3, 6, and 12 months postoperatively using the International Index of Erectile Function-5 (IIEF-5), Erection Hardness Score (EHS), and a customized questionnaire for ejaculatory function. Propensity score–based logistic regression models and longitudinal analyses were applied to address significant baseline imbalances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the overall cohort, APR was independently associated with significantly impaired erectile function. Adjusted models showed higher predicted probabilities of erectile dysfunction (ErD) after APR at 3 months (38.7% vs. 16.8) and 12 months (34.7% vs. 13.7%). Longitudinal analyses confirmed increased odds of ErD at 3 months (OR 2.86; 95% CI 1.25–6.53) and 12 months (OR 3.05; 95% CI 1.30–7.14). Potency impairment was also significantly more frequent at 3 months. Ejaculatory dysfunction was more common after APR early postoperatively. In patients with tumors located &lt; 5 cm from the anal verge, APR remained associated with impaired erectile function, whereas ejaculatory function showed partial recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results suggest that APR is associated with a high risk of postoperative sexual dysfunction, even in minimally invasive surgery. Sexual function preservation is an important consideration when APR is considered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1051-1065"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373176","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":"Risks and Benefits of Feeding Enterostomy Creation During Minimally Invasive Esophagectomy: A Propensity-Weighted Analysis Using the Japanese National Clinical Database","authors":"Eisuke Booka,&nbsp;Shinya Hirakawa,&nbsp;Hisateru Tachimori,&nbsp;Koji Tanaka,&nbsp;Hideki Ueno,&nbsp;Yasue Kimura,&nbsp;Ken Shirabe,&nbsp;Hiroya Takeuchi","doi":"10.1002/ags3.70216","DOIUrl":"https://doi.org/10.1002/ags3.70216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Feeding enterostomy is commonly created during minimally invasive esophagectomy (MIE); however, its short-term impact remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 19 054 patients who underwent MIE for esophageal or esophagogastric junction cancer during 2019–2022. Inverse probability of treatment weighting was applied to balance baseline characteristics, and G-computation was used to estimate adjusted risks and means and their differences. A secondary analysis was performed to compare gastrostomy and jejunostomy in retrosternal cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 19 054 patients, 4599 (24.1%) received a feeding enterostomy. After adjustment, the primary outcome, postoperative bowel obstruction, did not differ significantly between enterostomy group and no-enterostomy group (+0.2%, <i>p</i> = 0.132). The enterostomy group demonstrated higher rates of reoperation (+2.5%, <i>p</i> &lt; 0.001) and respiratory complications, including pneumonia (+2.5%, <i>p</i> &lt; 0.001) and prolonged ventilation (+0.9%, <i>p</i> = 0.012), than the no-enterostomy group. Conversely, delayed gastric emptying (−0.9%, <i>p</i> &lt; 0.001) and deep vein thrombosis (−0.4%, <i>p</i> = 0.028) occurred less frequently. Among 2723 patients who underwent retrosternal reconstruction with feeding enterostomy, jejunostomy was associated with a shorter operative time (−11.2 min, <i>p</i> = 0.025), whereas gastrostomy was associated with a 2.3-day shorter hospital stay than jejunostomy (<i>p</i> = 0.022). Bowel-related events were rare, and adjusted comparisons for these outcomes were not performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Feeding enterostomy during MIE may confer benefits (e.g., reduced delayed gastric emptying and deep vein thrombosis) but is also associated with increased postoperative complications. Routine or uniform placement of a feeding enterostomy should be avoided, and gastrostomy may be preferable in retrosternal reconstruction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1042-1050"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373366","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":"Rethinking Perioperative Corticosteroids in Esophageal Cancer Surgery: Evidence From an Integrative Meta-Analysis","authors":"Tomohiko Yasuda,&nbsp;Akihisa Matsuda,&nbsp;Nobutoshi Hagiwara,&nbsp;Yoshiharu Nakamura,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.70208","DOIUrl":"https://doi.org/10.1002/ags3.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Esophagectomy remains a highly invasive procedure associated with substantial postoperative morbidity. Pulmonary complications, anastomotic leakage, and in-hospital mortality are of particular concern. Perioperative corticosteroids are often administered to attenuate excessive inflammatory responses; however, the clinical impact in esophageal cancer surgery remains inconclusive, with studies yielding inconsistent findings and lacking integrated long-term evaluation. This meta-analysis aimed to comprehensively assess the effects of perioperative corticosteroid administration on both short-term complications and long-term survival in patients undergoing esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search identified randomized controlled trials and observational studies published to October 2025 that examined corticosteroid use during esophagectomy. Primary outcomes comprised postoperative pneumonia, anastomotic leakage, and in-hospital mortality. Secondary outcomes comprised respiratory failure, acute respiratory distress syndrome, wound infection, hepatic and renal dysfunction, cardiac complications, and overall survival. Pooled odds ratios (ORs) and hazard ratios were calculated using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen studies involving 38 316 patients were included. Perioperative corticosteroid use was associated with a significantly lower incidence of pneumonia (OR = 0.71), in-hospital mortality (OR = 0.79), and respiratory failure (OR = 0.30) compared with no corticosteroids. No increase in anastomotic leakage or wound infection rates were observed with versus without perioperative corticosteroids; long-term survival was unaffected (hazard ratio: 0.85), and no excess risk of other complications was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this is the first meta-analysis integrating both short- and long-term outcomes, suggesting that perioperative corticosteroids may reduce major postoperative complications without evidence of adverse long-term oncologic outcomes; however, these findings were largely driven by observational studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"995-1007"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373355","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":"Bona Fide Intersegmental Plane Hepatectomy Along the Glissonean Branches (BIPHG)","authors":"Go Wakabayashi,&nbsp;Taiga Wakabayashi","doi":"10.1002/ags3.70180","DOIUrl":"https://doi.org/10.1002/ags3.70180","url":null,"abstract":"<p>This review traces the author's personal journey over three decades in the evolution of liver resection techniques, culminating in the proposal of the <i>Bona Fide Intersegmental Plane Hepatectomy Along Glissonean Branches</i> (BIPHG). Beginning with pioneering experiences in laparoscopic and robotic liver surgeries, the author highlights key anatomical insights—particularly Laennec's capsule and intersegmental planes—that have advanced surgical precision. Transitioning from laparoscopy-assisted to pure laparoscopic donor hepatectomy illustrated the importance of safety, visualization, and anatomy-guided dissection. Inspired by innovations in intraoperative imaging and microanatomy, the author introduces BIPHG—an innovative tension-based technique utilizing indocyanine green (ICG) fluorescence to define natural intersegmental boundaries along Glissonean branches. This method emphasizes real-time visualization, enabling accurate, minimally invasive, and function-preserving liver resections. The review underscores the significance of standardizing definitions and assessment tools, such as the difficulty score, to facilitate broader adoption. Looking forward, ongoing technological and anatomical advances are expected to further refine these approaches, positioning BIPHG as a promising, safe, and precise strategy in minimally invasive liver surgery. This personal narrative aims to contribute to the continued evolution of anatomy-based, minimally invasive hepatic resection techniques.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"975-983"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373299","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 of Minimally Invasive Colectomy Between Intra- Versus Extra-Corporeal Anastomosis Technique (COMMIT Study): Mid-Term Analysis","authors":"Takuya Takami,&nbsp;Takehito Yamamoto,&nbsp;Yoshiro Itatani,&nbsp;Ryosuke Mizuno,&nbsp;Shinya Hamasu,&nbsp;Keita Hanada,&nbsp;Kenji Kawada,&nbsp;Teppei Murakami,&nbsp;Satoshi Nagayama,&nbsp;Kazutaka Obama","doi":"10.1002/ags3.70184","DOIUrl":"https://doi.org/10.1002/ags3.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The adoption of intracorporeal anastomosis (IA) in minimally invasive colectomy for colon cancer has increased; however, its mid-term oncological outcomes compared with those of extracorporeal anastomosis (EA) remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective cohort study analyzed patients who underwent minimally invasive curative colectomy for colon cancer between 2018 and 2022 from the Kyoto Colorectal Surgery Group database. Propensity score matching (1:4) was applied to balance patient, tumor, and surgical characteristics between IA and EA groups. Primary outcome was 2-year recurrence-free survival (RFS). Secondary outcomes included 2-year cumulative incidence of peritoneal, anastomotic, and distant recurrence, and postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1904 eligible patients (IA, <i>n</i> = 253; EA, <i>n</i> = 1651), matching yielded 224 IA and 862 EA cases with well-balanced baseline covariates. After matching, the 2-year RFS tended to be better in the IA group (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.41–1.06), though not statistically significant. The incidences of peritoneal and anastomotic recurrence were similar between the groups (risk difference [RD], 0.13%; 95% CI, −0.76% to 1.02%; and RD, −0.25%; 95% CI, −0.61% to 0.10%, respectively), whereas distant recurrence was lower in the IA group (RD, −4.79%; 95% CI, −6.75% to −2.83%). Subgroup analyses suggested a greater reduction in distant recurrence in patients with advanced tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IA demonstrated a comparable risk of peritoneal and anastomotic recurrence and suggested a potential reduction in distant recurrence without an associated deterioration in 2-year RFS. These findings support IA as an oncologically reasonable option, even for advanced-stage tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1077-1086"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373626","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":"Extralevator Abdominoperineal Excision Improves Overall Survival Compared to Standard Abdominoperineal Excision: A Systematic Review and Meta-Analysis","authors":"Sarolta Beáta Kávási,&nbsp;Diana-Elena Floria,&nbsp;Anett Rancz,&nbsp;Dániel Sándor Veres,&nbsp;Nándor Faluhelyi,&nbsp;Pál Miheller,&nbsp;Péter Hegyi,&nbsp;Szabolcs Ábrahám","doi":"10.1002/ags3.70182","DOIUrl":"https://doi.org/10.1002/ags3.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In advanced low rectal cancer, the surgical technique chosen can affect long-term oncological outcomes. Extralevator abdominoperineal excision (ELAPE) was developed to improve radicality compared with standard abdominoperineal excision (APE). Although earlier analyses suggested reduced local recurrence and mortality with ELAPE, its survival benefit remains debated, and concerns about wound complications persist. This meta-analysis compared ELAPE and APE, focusing on oncological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The protocol was registered on PROSPERO (CRD42023412308). A systematic search of PubMed, Embase, and CENTRAL was performed (April 14, 2023). Comparative studies of ELAPE versus APE were included. Data were synthesized using random-effects models. For overall survival (OS), disease-free survival (DFS), and local recurrence-free survival (LRFS), hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, with individual patient data extracted from Kaplan–Meier curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight studies, including over 5000 patients, were analyzed. ELAPE reduced mortality by 46% (HR 0.54, 95% CI 0.40–0.73) and achieved a 5-year OS of 83% (CI 0.53–0.95) versus 69% (CI 0.40–0.88) for APE. ELAPE improved DFS (HR 0.74, 95% CI 0.55–0.99), with a 5-year DFS of 87% (CI 0.50–0.98) compared with 65% (CI 0.24–0.92) for APE. LRFS favored ELAPE but was not significant (HR 0.67, 95% CI 0.45–1.00). Rates of perineal wound complications did not differ (OR 1.39, 95% CI 0.81–2.40).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ELAPE improves OS and DFS compared with APE without increasing wound complications. These findings support the broader application of ELAPE in rectal cancer treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1066-1076"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373485","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":"Primary Tumor Resection in Patients With Unresectable Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis","authors":"Junpei Takashima,&nbsp;Hirotoshi Kobayashi,&nbsp;Daisuke Fujimoto,&nbsp;Fumihiko Miura","doi":"10.1002/ags3.70174","DOIUrl":"https://doi.org/10.1002/ags3.70174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The benefit of primary tumor resection (PTR) in patients with asymptomatic, unresectable metastatic colorectal cancer (mCRC) remains uncertain. Previous systematic reviews often included symptomatic cases or cohorts with imbalanced chemotherapy use, weakening comparisons between upfront PTR followed by chemotherapy and chemotherapy alone. This analysis focused exclusively on studies involving asymptomatic patients with adequate chemotherapy administration in both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies explicitly excluded symptomatic cases and reported modern chemotherapy regimens. Overall survival (OS) was the primary outcome. Secondary outcomes included progression-free survival (PFS), perioperative complications, 30-day mortality, and tumor-related emergency interventions in the non-resection (NR) group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies involving 9317 patients met inclusion criteria: 5581 underwent PTR (PR group), and 3736 did not (NR group). A pooled analysis of 16 studies showed no significant OS benefit with PTR (hazard ratio [HR] = 1.10, 95% confidence interval [CI]: 0.84–1.44). No improvement in PFS was observed (HR = 0.89, 95% CI: 0.68–1.16). Postoperative morbidity and 30-day mortality in the PR group were 19.8% and 2.0%, respectively. Emergency surgery was required in 6.4% of NR group patients, with a 30-day mortality rate of 5.3%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Upfront PTR did not improve survival outcomes in asymptomatic patients with unresectable mCRC and introduced substantial perioperative risks. Routine PTR is not advisable in this population. Clinical decision-making should be individualized based on patient risk factors and tumor behavior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO: CRD420251065487</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1008-1020"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Robot-Assisted Versus Laparoscopic Colectomy for Colon Cancer: A Propensity Score-Matched Analysis","authors":"Akira Inoue,&nbsp;Yujiro Nishizawa,&nbsp;Yoshinori Kagawa,&nbsp;Masahiro Hashimoto,&nbsp;Shinya Kato,&nbsp;Yoshihiro Morimoto,&nbsp;Taishi Hata,&nbsp;Makoto Fujii,&nbsp;Masaaki Motoori,&nbsp;Kazumasa Fujitani","doi":"10.1002/ags3.70196","DOIUrl":"https://doi.org/10.1002/ags3.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Clinical benefits of robot-assisted colectomy over laparoscopic colectomy for colon cancer remain uncertain, and real-world data are limited. We evaluated the short-term outcomes of robot-assisted colectomy versus laparoscopic colectomy in patients with colon cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective cohort study evaluated patients who underwent minimally invasive colectomies for colon cancer at Osaka General Medical Center from January 2014 to November 2024. Short-term outcomes were compared after 1:1 propensity score matching to minimize confounding by indication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 480 patients underwent laparoscopic colectomies and 282 underwent robot-assisted colectomies, with 218 matched pairs. Baseline characteristics were well-balanced. Surgical procedure distribution was similar between the groups (<i>P</i> = 0.897). Mean operative times were significantly longer (212 vs. 200 min, <i>P</i> = 0.040), mean intraoperative blood loss was significantly lower (22.8 vs. 37.5 mL, <i>P</i> &lt; 0.001), rates of conversion to open surgery were significantly lower (0.0% vs. 2.3%, <i>P</i> = 0.026), and mean hospital stays were significantly shorter (7.0 vs. 11.3 d, <i>P</i> &lt; 0.001) in the robot-assisted colectomy group. The number of lymph node dissections (<i>P</i> = 0.27) and local R0 resection rates (<i>P</i> = 0.34) were comparable. Overall complication rates were significantly lower in the robot-assisted colectomies (11.0% vs. 17.9%, <i>P</i> = 0.007), whereas clinically meaningful complication rates (Clavien–Dindo grades ≥ II) were comparable (<i>P</i> = 0.150).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide real-world data supporting the feasibility of robot-assisted colectomy for colon cancer treatment. Further research should evaluate the long-term oncologic outcomes and cost-effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1087-1096"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373612","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 Resection for Colorectal Liver Metastasis in Elderly Patients Aged ≥ 80: A Retrospective Nationwide Cohort Survey in Japan With Propensity Score Matching","authors":"Kiichi Sugimoto,&nbsp;Akio Saiura,&nbsp;Shuko Nojiri,&nbsp;Hirotoshi Kobayashi,&nbsp;Goro Honda,&nbsp;Kazushige Kawai,&nbsp;Kiyoshi Hasegawa,&nbsp;Keiichi Takahashi","doi":"10.1002/ags3.70213","DOIUrl":"https://doi.org/10.1002/ags3.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As the aging of the global population increases, the number of elderly patients with colorectal liver metastasis (CRLM) is expected to increase. The aim of this study was to clarify the long-term oncological outcomes and treatment of CRLM in elderly patients aged ≥ 80.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with CRLM were identified from the Japanese database of Liver Metastases Survey of Colorectal Cancer, collected from 145 centers. Two thousand four hundred nine patients with liver resection were eligible for analysis. This cohort was divided into two groups aged &lt; 80 (group Y (younger); <i>n</i> = 2194) and ≥ 80 (group E (elderly); <i>n</i> = 215). We compared the long-term outcomes after liver resection of patients with CRLM aged ≥ 80 and &lt; 80 years after adjustment using propensity score matching (PSM), and we identified the reasons for differences in these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, group E showed a comparable recurrence-free survival to that in group Y (hazard ratio (HR): 1.20, <i>p</i> = 0.16). However, group E had significantly worse cancer-specific survival (CSS) (HR: 1.77, <i>p</i> = 0.002) and overall survival (OS) (HR: 1.80, <i>p</i> = 0.0004). Treatment for recurrence was given at a significantly lower rate in group E (80/130 (61.5%) vs. 1148/1329 (86.4%), <i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgical resection seems to be as effective in elderly patients aged ≥ 80 as in nonelderly patients. The significantly worse CSS and OS may have resulted from a lower rate of treatment for recurrence in elderly patients aged ≥ 80. Physicians should keep this finding in mind with regard to limitations of treatments for recurrence after initial liver resection in elderly patients aged ≥ 80 with CRLM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"10 4","pages":"1107-1119"},"PeriodicalIF":3.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373317","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":"Trends, Demographic Characteristics and Seasonal Patterns of Rectal Prolapse Surgery in Japan: A Nationwide Claims-Based Analysis From 2014 to 2023.","authors":"Masamitsu Kido, Tomohiro Arita, Hiroki Shimizu, Jun Kiuchi, Kenji Nanishi, Katsutoshi Shoda, Hiroyuki Okimura, Atsuko Fujihara, Kengo Yoshii, Atsushi Shiozaki","doi":"10.1002/ags3.70242","DOIUrl":"10.1002/ags3.70242","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated nationwide trends, demographic characteristics, and seasonal patterns of rectal prolapse surgery in Japan, using healthcare claims databases.</p><p><strong>Methods: </strong>Surgical data were extracted from the National Database of Health Insurance Claims (NDB) from 2014 to 2023. Procedures were classified by surgical approach as conventional or laparoscopic. Crude and age-adjusted rates per 100 000 person-years were calculated. Temporal trends were assessed using linear and Poisson regression. Seasonal variations (April 2019-March 2024) were evaluated using one-way analysis of variance with post hoc comparisons, and correlations with meteorological variables were examined using Pearson's correlation coefficients.</p><p><strong>Results: </strong>Over the decade, a total of 62 407 overall surgeries were performed, with an average annual rate of 4.7 per 100 000 person-years and an overall female-to-male ratio of 6.9:1. Overall surgery rates peaked at ages 85-89 in males (5.5 per 100 000 person-years) and females (59.1). While age-adjusted overall and conventional surgeries declined significantly, laparoscopic surgeries significantly increased (all <i>p</i> < 0.01). Age-adjusted overall surgery rates declined significantly in both sexes (RR = 0.960 for males, 0.983 for females, and 0.979 overall; each <i>p</i> < 0.0001), particularly among younger women aged 30-39 years (<i>p</i> < 0.0024). The mean seasonal overall surgeries exhibited distinct seasonal variation: 578.0 (SD 99.2) in spring, 440.0 (SD 85.9) in summer, 432.4 (SD 50.8) in autumn, and 544.4 (SD 71.8) in winter, and showed moderate negative correlations with temperature.</p><p><strong>Conclusion: </strong>This study provides contemporary epidemiological insights into surgical management of rectal prolapse in Japan.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":"1612-1622"},"PeriodicalIF":3.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576806","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}