Annals of Surgical Treatment and Research最新文献

{"title":"Laparoscopic <i>versus</i> open liver resection following transarterial radioembolization for hepatocellular carcinoma: a retrospective propensity score-matched study.","authors":"Yi Ping Sng, YoungRok Choi, Su Young Hong, Hyo-Cheol Kim, Jin Woo Choi, Gayoung Kim, Min Kyoung Kim, Sang Hyuk Park, Jiyoung Kim, Jae-Yoon Kim, Jeong-Moo Lee, Suk Kyun Hong, Kwang-Woong Lee","doi":"10.4174/astr.2026.111.1.24","DOIUrl":"10.4174/astr.2026.111.1.24","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to compare perioperative and oncologic outcomes between laparoscopic and open liver resection following transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC). TARE is increasingly used as a bridge therapy for HCC when immediate resection is not feasible. However, the safety and efficacy of subsequent laparoscopic liver resection compared to open surgery remain unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 65 patients who underwent liver resection after TARE for HCC between 2012 and 2023 at a single high-volume center. Propensity score matching based on age, sex, tumor size, and tumor markers (AFP, PIVKA-II) yielded 18 matched pairs for laparoscopic and open surgery.</p><p><strong>Results: </strong>The laparoscopic group demonstrated shorter time from TARE to operation (99.7 days <i>vs.</i> 166.9 days, P = 0.04) and reduced hospital stay (11.2 days <i>vs.</i> 15.6 days, P = 0.04). Operative outcomes were comparable between groups, including operative time (243.9 minutes <i>vs.</i> 210.0 minutes, P = 0.13) and blood loss (438.9 mL <i>vs.</i> 775.0 mL, P = 0.12). Major complications (Clavien-Dindo grade ≥III) occurred in 11.1% of laparoscopic <i>vs.</i> 27.8% of open cases (P = 0.40). Recurrence rates (55.6% <i>vs.</i> 44.4%, P = 0.51), overall survival (56.5 months <i>vs.</i> 44.7 months, P = 0.10), and progression-free survival (28.1 months <i>vs.</i> 32.4 months, P = 0.815) were similar between groups.</p><p><strong>Conclusion: </strong>Laparoscopic liver resection following TARE appears to be a safe and effective approach for selected HCC patients, offering comparable oncologic outcomes to open surgery while achieving shorter hospitalization. These findings support the consideration of minimally invasive approaches in appropriate candidates after TARE at experienced centers.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"24-32"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418147","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":"Is breast-conserving surgery feasible for patients with prior breast augmentation?: a single-center retrospective case series.","authors":"Mi Young Jang, Jae Bok Lee, Woo Young Kim, Yong Yeup Kim, Jai Hyun Chung, Ji Hye Kim, Ye Ryung Kim, Sang Uk Woo","doi":"10.4174/astr.2026.111.1.20","DOIUrl":"10.4174/astr.2026.111.1.20","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer has the highest incidence among Korean women. With the global rise in breast augmentation, the number of patients diagnosed with breast cancer after augmentation is increasing. Surgical management in this group remains controversial, as breast-conserving surgery (BCS) followed by radiation therapy poses challenges such as capsular contracture, poor cosmetic outcomes, and difficulty obtaining clear margins. This study aimed to assess the feasibility and clinical outcomes of BCS with radiation therapy in breast cancer patients with prior augmentation.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective case series review of 4,568 patients who underwent breast cancer surgery at Korea University Guro Hospital between 2008 and 2023. Seventeen patients had prior breast augmentation. Clinical records, imaging, pathology, and surgical data were reviewed for tumor characteristics, implant placement, treatment, and recurrence. Postoperative mammography was used to assess breast symmetry.</p><p><strong>Results: </strong>Of the 17 patients (mean age, 46 years), 16 underwent BCS and 1 underwent mastectomy due to extensive microcalcification. Tumor stages ranged from ductal carcinoma <i>in situ</i> to stage IIB. One local recurrence occurred 7 years after surgery. The mean breast volume difference between the treated and untreated breast was 104 mL. No implant rupture or removal occurred during surgery.</p><p><strong>Conclusion: </strong>Our findings suggest that BCS with radiation therapy is a feasible treatment option for patients with prior augmentation, as adequate margins were achieved in most cases. However, postoperative breast asymmetry may occur. Given the small sample size and retrospective nature of this study, further large-scale studies are needed to confirm oncological safety and evaluate long-term cosmetic and patient-reported outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 1","pages":"20-23"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418117","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":"A minimally invasive approach to esophagojejunostomy leakage: a retrospective cohort study of the efficacy of endoscopic Histoacryl injection compared with conventional treatments.","authors":"Min Chan Kim, Sue-Yeon Kim, Sunghwa Kang, Myeongseok Koh","doi":"10.4174/astr.2026.110.6.374","DOIUrl":"10.4174/astr.2026.110.6.374","url":null,"abstract":"<p><strong>Purpose: </strong>Esophagojejunostomy leakage (EJL) continues to be a serious and potentially fatal complication following total gastrectomy for gastric cancer. This study aimed to evaluate the clinical outcomes of endoscopic Histoacryl (B. Braun) injection in comparison to alternative treatment strategies for EJL.</p><p><strong>Methods: </strong>Out of 885 patients who underwent total gastrectomy at a single institution between January 2003 and August 2023, 26 (2.9%) developed EJL. Patients were categorized into four groups according to the management received: conservative treatment (n = 5), endoscopic Histoacryl injection (n = 10), reoperation (n = 8), and combined therapy (n = 3). Outcomes assessed included postoperative hospital stay, duration to oral intake, treatment success rate, and mortality.</p><p><strong>Results: </strong>Of the 26 patients with EJL, 3 (11.5%) succumbed to sepsis: two in the reoperation group and 1 in the Histoacryl group. In the 23 successfully managed cases, the Histoacryl group achieved the shortest median postoperative hospital stay, the shortest time to resuming of oral intake, and a 90% success rate without any procedure-related complications. The reoperation group experienced increased morbidity and mortality. Stent migration was reported in one patient from the combined treatment group. Differences in recovery between the four groups reached statistical significance (P < 0.05).</p><p><strong>Conclusion: </strong>Endoscopic Histoacryl injection represents a safe, effective, and minimally invasive modality for managing EJL, providing improved recovery times and reduced complication rates. It is beneficial both as a primary intervention and as part of combination therapy.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"374-381"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262968","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":"Artificial intelligence-assisted prediction of bile duct bifurcation site in pure laparoscopic donor right hepatectomy: a retrospective feasibility study.","authors":"Jiyoung Baik, Namkee Oh, Gyu-Seong Choi, Jinsoo Rhu, Jongman Kim","doi":"10.4174/astr.2026.110.6.359","DOIUrl":"10.4174/astr.2026.110.6.359","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate identification of the bile duct bifurcation site is crucial in pure laparoscopic donor right hepatectomy (PLDRH) for living donor liver transplantation. This study aimed to develop and evaluate a deep learning model to predict the bile duct bifurcation site for surgical precision.</p><p><strong>Methods: </strong>We retrospectively analyzed 55 PLDRH procedures conducted between August 2021 and April 2022. A deep learning model combining UNet with a MiT-B3 encoder was trained on 150 manually annotated frames. We then incorporated expert-reviewed pseudo-labels from an additional 901 frames to refine the model. Performance was evaluated using 5-fold cross-validation and an independent test set.</p><p><strong>Results: </strong>Clinical evaluation showed a 97% accuracy in 5-fold cross-validation and 93.3% accuracy in the independent test set. From the initial to final model, dice similarity coefficient improved from 0.392 to 0.472, intersection over union from 0.279 to 0.339, and sensitivity from 0.487 to 0.643, while specificity remained consistent at 0.993.</p><p><strong>Conclusion: </strong>The proposed artificial intelligence (AI) model demonstrated strong clinical performance in predicting the bile duct bifurcation site during PLDRH. Despite modest quantitative scores, the high clinical accuracy highlights the potential of integrating AI for precise donor hepatectomy.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"359-365"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262974","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":"Impact of expanded pediatric surgery add-on payments on claimed surgical fees: a multi-institutional data analysis.","authors":"Joonhyuk Son, Sanghoon Lee, Sungjoo Park, Wontae Kim, Jeong-Meen Seo, Chaeyoun Oh","doi":"10.4174/astr.2026.110.6.391","DOIUrl":"10.4174/astr.2026.110.6.391","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric surgery in Korea has historically been undervalued under the national fee system. Since 2021, the government has progressively expanded surgical add-on reimbursement for pediatric surgeries, yet their real-world impact remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed pediatric surgeries (<19 years) performed at 4 tertiary institutions from 2020 to 2025. Surgeries were divided into 4 periods based on major policy changes. Variables included the number of surgeries, claimed surgical fees, patient age and weight, and eligibility for add-on reimbursement. Trends over time and variations among hospitals were examined.</p><p><strong>Results: </strong>A total of 1,959 surgeries were analyzed. Surgical volume did not significantly change across periods (P = 0.342). In contrast, total claimed surgical fees increased 1.66-fold in Period 2, 3.26-fold in Period 3, and 3.42-fold in Period 4 compared with Period 1. The proportion of surgeries eligible for add-on reimbursement rose to 76.6% in Period 4. The average claimed fee per case increased from 973,446 Korean won in Period 1 to 3,463,428 in Period 4. Patients <1,500 g demonstrated the largest increase (471%). Across hospitals, the magnitude of claimed fee increases varied, but all institutions showed substantial growth in claimed surgical fees.</p><p><strong>Conclusion: </strong>Stepwise expansion of pediatric surgical add-on reimbursement substantially increased claimed surgical fees across institutions without inflating surgical volume. These reforms improved financial reimbursement and may support future improvements in workforce sustainability, training, and care equity. Continuous policy monitoring will be essential to ensure long-term effectiveness and fiscal balance.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"391-399"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262993","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 the time-to-laparotomy indicator of regional trauma center quality metrics in South Korea: a multicenter retrospective study with propensity score matching.","authors":"Youngmin Kim, Junsik Kwon, Hang Joo Cho, Gil Jae Lee","doi":"10.4174/astr.2026.110.6.382","DOIUrl":"10.4174/astr.2026.110.6.382","url":null,"abstract":"<p><strong>Purpose: </strong>Timely surgical intervention is crucial in trauma care, particularly in patients with hypotensive abdominal injuries. In South Korea, the regional trauma center system has adopted a quality metric mandating initiation of emergency surgery within 1 hour of emergency department (ED) arrival for such patients. We evaluated the impact of ED-to-surgery time on clinical outcomes in hypotensive abdominal trauma and assessed the appropriateness of the 1-hour threshold.</p><p><strong>Methods: </strong>This multicenter retrospective study included 425 trauma patients who underwent emergency abdominal surgery at 2 regional trauma centers between 2019 and 2022. Patients with an initial or lowest recorded systolic blood pressure (SBP) <90 mmHg were included. The primary outcome was in-hospital mortality; secondary outcomes included complications, intensive care unit stay, and total hospital stay. Patients were categorized into early (≤1 hour) and delayed (>1 hour) surgery groups. Statistical analyses included logistic regression, propensity score matching (PSM), receiver operating characteristic curve, and complication analysis by 30-minute intervals.</p><p><strong>Results: </strong>We found that 243 patients (57.2%) underwent surgery within 1 hour. In-hospital mortality did not differ significantly between early and delayed groups. Age, Glasgow Coma Scale, lowest SBP, 4-hour RBC transfusion volume, and abdominal Abbreviated Injury Scale were independent mortality predictors. PSM confirmed no mortality difference by surgical timing. However, complication rates increased with surgical delays.</p><p><strong>Conclusion: </strong>While surgical delay was not associated with mortality, it was linked to increased complications. Future trauma quality metrics should incorporate refined patient stratification and evaluate the entire process aimed at restoring physiological instability, rather than relying on a strict 1-hour threshold.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"382-390"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262937","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":"Gray zone possibility in repeat Bethesda III cytology: a retrospective cohort study of malignancy and multifocality in thyroid nodules.","authors":"Nevin Sakoglu, Ferhat Ozden","doi":"10.4174/astr.2026.110.6.405","DOIUrl":"10.4174/astr.2026.110.6.405","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid cancer is the most common endocrine cancer, developing in an average of 5%-7% of all nodules. In this study, we aimed to estimate the true risk, including multifocality and microcarcinomas, in patients who underwent total thyroidectomy after repeat Bethesda III cytology and in the other Bethesda groups.</p><p><strong>Methods: </strong>Three hundred patients participated in the study. Eighty-three (27.7%) of the patients were male and 217 (72.3%) were female. In the study, the diagnostic performances of the R-TIRADS (Revised Thyroid Imaging Reporting and Data System) classification used in the diagnosis of malignancy in thyroid nodules were compared with the Bethesda cytological classification. In order to compare the malignancy prediction powers, receiver operating characteristic curves were created for each system and area under the curve values were calculated. In all statistical analyses, a P-value below 0.05 was interpreted as statistically significant. A total of 150 cases (50.0%) with atypia of unknown significance (AUS) or follicular lesions of unknown significance (FLUS) were retrospectively evaluated.</p><p><strong>Results: </strong>Histopathology results were consistent with malignancy in 103 patients. Of these patients, 27 had multifocality (26.2%), 26 had microcarcinomas (25.2%), and 22 had both multifocality and microcarcinoma (21.3%). The majority of the carcinomas (46.6%) were seen to arise in AUS with cellular and nuclear atypias.</p><p><strong>Conclusion: </strong>Prevalence of Bethesda category III cytologies is significantly higher than reported. A high rate of multifocality and incidental microcarcinomas in the definitive histopathology reports shows that the Bethesda classification falls short in the accuracy of risk in AUS/FLUS.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"405-415"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262944","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":"Anatomical risk stratification for major portal vein complications in dual portal vein living donor liver transplantation: a retrospective cohort study.","authors":"Hyun Hwa Choi, Jae-Yoon Kim, Jiyoung Kim, Jaewon Lee, Su Young Hong, YoungRok Choi, Kwang-Woong Lee, Suk Kyun Hong","doi":"10.4174/astr.2026.110.6.366","DOIUrl":"10.4174/astr.2026.110.6.366","url":null,"abstract":"<p><strong>Purpose: </strong>Right lobe living donor liver transplantation (LDLT) with dual portal veins (PVs) remains technically challenging. This study aimed to identify independent risk factors for PV complications.</p><p><strong>Methods: </strong>We retrospectively analyzed 111 recipients of dual PV LDLT between 2011 and 2020. Recipient characteristics, anatomical geometry, and surgical factors were evaluated. Outcomes were overall PV complications and major PV complications (Clavien-Dindo grade ≥III). Logistic regression was performed.</p><p><strong>Results: </strong>PV complications developed in 41 patients (36.9%), including 16 major events (14.4%). Univariate analysis revealed associations with right posterior PV (RPPV) diameter, axial angle, and coronal angle. On multivariate analysis, larger RPPV diameter (odds ratio [OR], 1.79; P = 0.041) and wider axial angle (OR, 1.08; P = 0.015) were independent predictors of major PV complications. Reconstruction method was not significant. Patients with overall major Clavien-Dindo grade ≥III complications had inferior 100-month survival (80% <i>vs.</i> 100%; P = 0.014, log-rank test).</p><p><strong>Conclusion: </strong>In dual PV LDLT, anatomical geometry-specifically RPPV diameter and axial angle-independently predicts major PV complications, whereas surgical technique does not. Preoperative 3-dimensional imaging and anatomical risk stratification should inform donor selection and surgical planning.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"366-373"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262922","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 inguinal hernia repair outcomes between open and laparoscopic approaches in a pediatric population: a retrospective cohort study.","authors":"Wahyudhy Adriansyah, Aditya Rifqi Fauzi, Verrell Christopher Amadeus, Tiara Putri Leksono, Qisthinadia Hazhiyah Setiadi, Andi Dwihantoro, Akhmad Makhmudi, Gunadi","doi":"10.4174/astr.2026.110.6.400","DOIUrl":"10.4174/astr.2026.110.6.400","url":null,"abstract":"<p><strong>Purpose: </strong>Many studies compared the outcomes of hernia repair in children between open and laparoscopic techniques. However, the results still need to be clarified. Moreover, the reports from developing countries are also limited.</p><p><strong>Methods: </strong>We compared the outcomes of hernia repair between the open and laparoscopic techniques in children and associated them with risk factors.</p><p><strong>Results: </strong>We involved 92 children, consisting of laparoscopy (36 males and 10 females) and open (42 males and 4 females) methods. There was a significant difference between 2 groups regarding the gestational age and age at surgery (both P < 0.001). Laparoscopy had a shorter length of stay (LOS) than the open group (1.09 ± 0.28 days <i>vs.</i> 1.37 ± 0.57 days, P = 0.004), while the duration of surgery was similar in both groups (P = 0.801). Multivariate analysis revealed no significant association between the recurrence of hernia and risk factors, including the surgical procedure, sex, age at surgery, and prematurity (P > 0.05).</p><p><strong>Conclusion: </strong>Laparoscopic surgery might have a beneficial effect on shorter LOS compared with open hernia repair. None of the risk factors is significantly associated with hernia recurrence after repair. A further prospective multicenter study with a larger sample size is necessary to clarify our findings.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 6","pages":"400-404"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262929","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":"A unified framework for postoperative complications after gastrectomy for gastric cancer: insights from the Korean Quality Improvement Platform in Surgery program.","authors":"Jeong Ho Song, Chang Seok Ko, Han Hong Lee, Hong Man Yoon, Hyoung-Il Kim, In Gyu Kwon, Ji Yeon Park, Ji Yeong An, Jong Won Kim, Mi Ran Jung, Sang-Il Lee, Seong Ho Kong, Sun-Hwi Hwang, Yun-Suhk Suh, Sang-Yong Son, Sang-Uk Han","doi":"10.4174/astr.2026.110.5.290","DOIUrl":"10.4174/astr.2026.110.5.290","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative complications following gastric cancer surgery significantly impact patient outcomes, yet standardized definitions for these events have not been consistently applied across institutions in Korea. This study aimed to develop a consensus-based, standardized complication classification system specific to gastrectomy for gastric cancer as part of the Korean Quality Improvement Platform in Surgery (K-QIPS) initiative.</p><p><strong>Methods: </strong>As part of K-QIPS, a dedicated task force team (TFT) was formed with surgical experts from fourteen high-volume hospitals across Korea. The TFT conducted ten formal meetings to review existing literature and international guidelines, and incorporated findings from randomized controlled trials. The final complication list was developed through expert consensus and structured into a standardized framework. A Data Entry Manual was created to support consistent data collection by surgical clinical reviewers.</p><p><strong>Results: </strong>The TFT defined specific postoperative complications following gastrectomy for gastric cancer, including anastomotic leakage, duodenal stump leakage, pancreatic fistula, intra-abdominal and luminal bleeding, delayed gastric emptying, and internal hernia. Notably, internal hernia was described in standardized form for the first time. General complications were developed first and overlapped in part with the gastric cancer-specific list. The task force also produced a Data Entry Manual that provides practical instructions to ensure consistency and accuracy in complication reporting.</p><p><strong>Conclusion: </strong>This nationwide consensus initiative established the first standardized complication classification system for gastric cancer surgery in Korea. The proposed definitions and data entry system are expected to improve complication reporting, enable multicenter research, support surgical quality benchmarking, and ultimately enhance patient outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"110 5","pages":"290-298"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925891","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}