BMC Gastroenterology最新文献

{"title":"Ustekinumab trough concentrations predict clinical remission in perianal fistulizing crohn's disease: a real-world retrospective cohort study.","authors":"Xiaoyu Liu, Yuehua Yan, Jiaqin Yi, Dongmei Luo, Jun Geng, Huixian Huang, Jingjing Wang, Yunfei Gu, Bolin Yang, Yuxia Gong, Hao Wang","doi":"10.1186/s12876-025-04323-x","DOIUrl":"10.1186/s12876-025-04323-x","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists on the long-term efficacy of ustekinumab (UST) in perianal fistulizing Crohn's disease (PFCD), and the optimal UST trough level for predicting fistula remission remains uncertain. This study aimed to assess both short- and long-term effectiveness of UST in PFCD and to identify thresholds predicting fistula clinical remission.</p><p><strong>Methods: </strong>This retrospective cohort included 89 PFCD patients treated with UST. Evaluations utilized the Harvey-Bradshaw Index (HBI), Perianal Crohn's Disease Activity Index (PDAI), and Fistula Drainage Assessment (FDA). Magnetic resonance imaging (MRI) with the Van Assche Index (VAI) was performed at 52 weeks. Receiver operating characteristic (ROC) curves identified UST trough levels predictive of clinical remission.</p><p><strong>Results: </strong>The fistula clinical remission rates were 66.3% (59/89) at 16/20 weeks and 74.2% (66/89) at 52 weeks. Biochemical markers, including CRP, ESR, and PLT, significantly decreased, while RBC and HB levels increased after treatment (p < 0.05). MRI showed fistula improvement in 54.7% (35/64) of patients and complete healing in 21.8% (14/64). Comparative analysis revealed that anti-TNF-naïve patients had significantly higher rates of fistula remission, whereas seton insertion did not affect long-term fistula healing. ROC analysis identified UST trough concentrations ≥3.95 µg/mL at 16/20 weeks as predictive of clinical fistula remission (AUC: 0.791; sensitivity: 73.8%; specificity: 78.6%).</p><p><strong>Conclusion: </strong>UST achieves 74.2% fistula clinical remission at 52 weeks in PFCD, with trough concentrations at 16/20 weeks predictive of clinical remission. These findings support the use of therapeutic drug monitoring(TDM) to optimize clinical outcomes.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"718"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and tissue-level validation of ferroptosis-related genes in small intestinal neuroendocrine neoplasms based on machine learning.","authors":"Chuang Lv, Zhiqiang Liu, Chengcheng Tong, Le Liu, Ziyue Dou, Xi Chen","doi":"10.1186/s12876-025-04326-8","DOIUrl":"10.1186/s12876-025-04326-8","url":null,"abstract":"<p><strong>Background: </strong>Small intestinal neuroendocrine neoplasms (SI-NENs), a subgroup of neuroendocrine tumors originating from neuroendocrine cells in the small intestine, present significant therapeutic challenges, and their relationship with ferroptosis-a regulated form of cell death driven by iron-dependent lipid peroxidation-remains poorly understood. This study aimed to identify the ferroptosis-related genes in SI-NENs and evaluate their clinical relevance.</p><p><strong>Methods: </strong>The RNA sequencing data of SI-NENs patients were retrieved from two public datasets (GSE65286 and GSE98894). Machine learning (LASSO regression, a regularization method for selecting key features by reducing redundant genes, and random forest, an ensemble learning algorithm that builds multiple decision trees to improve prediction accuracy) was adopted to identify the core ferroptosis-related genes in SI-NENs. An external cohort consisting of 10 health volunteers and 14 SI-NENs patients was enrolled and intestinal mucosal biopsies were obtained for validation.</p><p><strong>Results: </strong>CDCA3, CDC25A, CYP4F8, and MYB were identified as the core ferroptosis-related genes in SI-NENs patients via machine learning. In the external cohort, immunofluorescence (IF) staining confirmed a significantly decreased expression of CYP4F8 and CDCA3 in patients with SI-NENs compared with the health control. Moreover, in G2/3 patients, the expression levels of CYP4F8 and CDCA3 were significantly decreased compared with G1 patients. In contrast, no significant difference in the expression of the four core ferroptosis genes was found across the different tumor locations, the age stratifications, or the abdominal pain statuses. In addition, a statically negative correlation of the expression of CYP4F8 was further detected concerning the tumor diameter and the expression of Ki67.</p><p><strong>Conclusion: </strong>Four core ferroptosis-related genes (CDCA3, CDC25A, CYP4F8, and MYB) were identified in SI-NENs patients, which may aid in developing the diagnostic biomarkers and therapeutic targets in the clinic.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"720"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting surgical NEC in neonates: risk factors and model development.","authors":"Mingyun Tang, Xiaofei Ma, Yuan Gan, Yanxing Lv, Yunzhi Liu, Yongjiang Jiang, Xiaolan Li, Yueju Cai","doi":"10.1186/s12876-025-04340-w","DOIUrl":"10.1186/s12876-025-04340-w","url":null,"abstract":"<p><strong>Background: </strong>Neonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency associated with high morbidity and mortality in neonates. Early identification of cases requiring surgical intervention is critical to improving outcomes.</p><p><strong>Objective: </strong>To identify independent risk factors associated with surgical treatment in neonates with NEC and to develop a predictive model that supports timely surgical decision-making and enhances prognosis.</p><p><strong>Methods: </strong>This retrospective study included 188 neonates diagnosed with NEC (Bell stage II or higher) at Liuzhou Hospital, Guangzhou Women and Children's Medical Center between December 2018 and December 2024. Patients were categorized into a surgical treatment group (n = 70) and a conservative treatment group (n = 118). Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were used to identify independent risk factors. A nomogram was developed based on these factors. Model performance was assessed using receiver operating characteristic (ROC) curve analysis, calibration curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among the 188 neonates, 70 (37.2%) underwent surgery. The mortality rate was significantly higher in the surgical group compared to the conservative group (17.1% vs. 1.1%). Multivariable analysis identified C-reactive protein (CRP), serum lactate, portal venous gas, reduced intestinal motility, white blood cell count, and absolute lymphocyte count as independent predictors of surgical intervention. The nomogram model demonstrated excellent discrimination (AUC = 0.946, 95% CI: 0.911-0.981), with a sensitivity of 0.914 and specificity of 0.890. Calibration and DCA confirmed strong clinical utility.</p><p><strong>Conclusion: </strong>This study established a nomogram-based predictive model for surgical treatment in NEC, utilizing six indicators: CRP, serum lactate, portal venous gas, reduced intestinal motility, white blood cell count, and absolute lymphocyte count. The model shows high accuracy and clinical utility. It can assist clinicians in predicting the need for surgery at the early stages of NEC, optimizing treatment decisions, reducing mortality, and improving the prognosis of affected neonates.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"719"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of 200 mg versus 1200 mg of simethicone with 3 L polyethylene glycol electrolyte solution for afternoon colonoscopy: a randomized controlled trial.","authors":"Xiaoyu Cai, Peng Xue, Yinpeng Li, Yinhua Rao, Xianrong Du, Lin Zhong, Ling Chen, Shuangyan Liu, Qian Yue, Dingguo Zhang","doi":"10.1186/s12876-025-04215-0","DOIUrl":"10.1186/s12876-025-04215-0","url":null,"abstract":"<p><strong>Background: </strong>Simethicone (SIM) can enhance bowel preparation efficiency, but the optimal dose for patients undergoing afternoon colonoscopy is still unclear. This study compares bowel preparation efficiency and adenoma detection rate (ADR) between patients receiving 3 L of polyethylene glycol electrolyte solution (PEG-ELS) with 200 mg SIM or 1200 mg SIM for afternoon colonoscopy.</p><p><strong>Method: </strong>This prospective, randomized, and observer-blinded trial included consecutive patients undergoing colonoscopy. It compared the effects of two SIM dosages (200 mg and 1200 mg) added to a 3 L PEG-ELS regimen. The primary outcome of our study was the rate of adequate bowel preparation, as defined by all 3 segments 2 or 3 on the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included the Bubble Scale (BS) score and ADR. Adverse effects related to bowel preparation were systematically administered by a trained nurse using standardized patient questionnaire.</p><p><strong>Results: </strong>A total of 668 participants were randomly assigned to either the 200 mg group (n = 332) or 1200 mg SIM group (n = 336). There were no significant differences in baseline characteristics between the two groups. Additionally, no significant differences were observed in adequate bowel preparation rate (95.8% vs. 97.6%, P = 0.276) and ADR (22.3% vs. 25.6%, P = 0.561). Both regimens were well tolerated and accepted by participants, as assessed through a standardized patient questionnaire.</p><p><strong>Conclusion: </strong>200 mg versus 1200 mg of SIM in 3 L PEG-ELS for afternoon colonoscopy demonstrated no statistically significant difference in bowel cleansing quality, ADR and bowel preparation-related adverse events. This evidence supports the clinical feasibility of 200 mg simethicone as an effective alternative for optimizing colonic preparation while maintaining procedural standards.</p><p><strong>Trial registration: </strong>This clinical trial was retrospectively registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR2400089196) on 3 September 2024.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"722"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Tc-99 m scintigraphic method and radiological method for colon transmit assessment in patients with functional constipation.","authors":"Yuan Tian, Yan Li, Ting Yi, Qiyue Wang, Xuan Jiang, Zuo-Xiang He","doi":"10.1186/s12876-025-04299-8","DOIUrl":"10.1186/s12876-025-04299-8","url":null,"abstract":"<p><strong>Background: </strong>The methods for assessing colonic transit in patients with functional constipation include the radiological method and Tc-99m scintigraphic method. This study aims to validate the practicality and accuracy of the Tc-99m scintigraphic method in evaluating colon transit, while also exploring the significance of the geometric center (GC).</p><p><strong>Methods: </strong>Our study is a single-center, retrospective analysis. We examined the medical records of 47 patients, who underwent colonic transit by the Tc-99m scintigraphic method and the radiological method for investigation of chronic constipation. Geometric center (GC) and transmit index (TI) were calculated respectively in these two methods. The patients were divided into four types of constipation: normal transit constipation (NTC), slow transit constipation (STC), defecatory disorders (DD) and STC combined with DD.</p><p><strong>Results: </strong>The results of the Tc-99m scintigraphic method and radiological method were consistent in the diagnosis of slow colon transmission (Kappa value = 0.718, P < 0.001). TI and 48-h GC were positively correlated (r = 0.657, p = 0.001). Patients with DD exhibited higher 24-h GC and 48-h GC values compared to those with STC.</p><p><strong>Conclusion: </strong>Tc-99m scintigraphic method can be used to evaluate colonic transit in patients with constipation, and GC values may be used to distinguish the types of constipation.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"721"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of inflammatory bowel disease in five East Asian countries an analysis based on the global burden of disease study 1990-2021.","authors":"Ya-Lin Liu, Hai-Rui Shang, Liang-Bi Xu, Xiao-Wen Xu, Yuan-Xue Ji, Yi-Yang He, Ye Wang, Pai-Lan Peng","doi":"10.1186/s12876-025-04311-1","DOIUrl":"10.1186/s12876-025-04311-1","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic and relapsing gastrointestinal disorder whose global disease burden continues to rise, making it a significant public health issue. In recent years, rapid socioeconomic development in East Asia has led to notable changes in lifestyle and dietary patterns, accompanied by dynamic shifts in the epidemiological characteristics of IBD. However, there remains a lack of systematic comparison and analysis of the long-term disease burden and evolutionary trends of IBD across five East Asian countries and regions: China, Japan, South Korea, North Korea, and Mongolia. Based on data from The Global Burden of Disease Study 2021 (GBD 2021), this study aims to comprehensively describe the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD in The region from 1990 to 2021, thereby providing a basis for differentiated prevention and control strategies.</p><p><strong>Methods: </strong>Descriptive analysis, Joinpoint regression, and age-period-cohort (APC) modeling were employed to examine epidemiological patterns and trends.</p><p><strong>Results: </strong>Significant variations in IBD burden were observed across the region. China and South Korea experienced the most rapid increases in incidence and prevalence, exhibiting a profile of \"high morbidity and low disability.\" Japan demonstrated a stabilizing disease burden alongside a continuing decline in standardized mortality rates, reflecting its advanced healthcare system. North Korea and Mongolia currently have a relatively low overall burden; however, a notable rise in incidence among young Mongolians suggests an emerging risk of early-onset IBD. APC analysis further indicated complex influences from environmental factors, healthcare resource allocation, and lifestyle changes such as Westernized diets. The study proposes tailored prevention strategies: high-SDI countries should optimize geriatric care systems, medium-SDI countries should enhance preventive interventions for adolescents, and low-SDI countries should prioritize the establishment of primary screening networks.</p><p><strong>Conclusion: </strong>These findings provide a scientific basis for differentiated IBD prevention and control in East Asia and contribute to a deeper understanding of the epidemiological transition of chronic diseases.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"714"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elucidating the role of IgA plasma cells and PECAM1-CD38 interaction in intestinal fibrosis: a single-cell RNA sequencing analysis in Crohn's disease.","authors":"Shuyang Sun, Jiheng Wang, Kai Li, Hua Jin, Shuwen Du, Jingyan Feng, Limin Zhang, Lei Li, Yuqi He","doi":"10.1186/s12876-025-04312-0","DOIUrl":"10.1186/s12876-025-04312-0","url":null,"abstract":"<p><strong>Background: </strong>Intestinal fibrosis-associated stricture is a frequent complication of inflammatory bowel disease (IBD), often necessitating endoscopic or surgical interventions. This study aims to investigate the pathogenesis of fibrosis in Crohn's disease (CD), a type of IBD, by analyzing single-cell RNA sequencing (scRNA-Seq) data from colon biopsies of both CD and ulcerative colitis (UC) patients.</p><p><strong>Results: </strong>The analysis revealed significant cellular heterogeneity, altered cell-cell interactions, and key molecular pathways in both CD and UC. CD showed a marked increase in IgA plasma cells. Ligand-receptor analysis indicated that IgA plasma cells strongly interacted with inflammation-associated fibroblasts (IAFs) in CD, predominantly through the PECAM1-CD38 axis, whereas these interactions were less pronounced in UC. Our study indicated that IL-1β was upregulated in Th17 cells in CD. MAPK signaling pathway were upregulated in Th17 cells.</p><p><strong>Conclusions: </strong>These findings may provide new insights into the mechanisms underlying early intestinal fibrosis in CD by identifying critical cell types and molecular players. Nonetheless, these observations are exploratory and will require validation in future experiments.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"712"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatments and prognosis of COVID-19 (Omicron) and hemorrhagic colitis: a case series study.","authors":"Jie Li, Chao Xu, Kebing Chen, Qing Zhang","doi":"10.1186/s12876-025-04254-7","DOIUrl":"10.1186/s12876-025-04254-7","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"711"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the direct cost of chronic viral hepatitis B in patients monitored at the hepato-gastroenterology department of the Yalgado OUEDRAOGO University Hospital.","authors":"Karim Ouedraogo, Amadou Oury Toure, Fadima Yaya Bocoum, Djenabou Diallo, Alexandre Delamou, Seni Kouanda","doi":"10.1186/s12876-025-04320-0","DOIUrl":"10.1186/s12876-025-04320-0","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic viral hepatitis B constitutes a public health problem due to its morbidity, mortality and economic consequences. To date, the direct costs incurred by patients for the treatment of this condition are not well documented. Our study aims to provide evidence on this cost in order to help facilitate patient care and optimize national hepatitis control policies.</p><p><strong>Methodology: </strong>This is a cross-sectional study with analytical aims lasting one month. The study population consisted of patients followed in outpatient consultation in the hepato-gastroenterology department of the Yalgado OUEDRAOGO University Hospital Center (CHU-YO). We conducted a census of patients seen in consultation and meeting the inclusion criteria. Data were collected following direct interviews with patients and review of medical records. The determinants of the direct cost of chronic viral hepatitis B management were identified using linear regression.</p><p><strong>Results: </strong>The mean direct cost incurred by patients on tenofovir treatment during the first three years of follow-up was 538,293 XOF with a 95% CI [466,005-610,581] and a standard deviation of 35,739 XOF. The mean direct cost incurred by patients without tenofovir treatment during the first three years of follow-up was 359,664 XOF (≈ 611.4 USD) with a 95% CI [331,276-388,052] XOF and a standard deviation of 14,323 XOF . The mean non-medical direct cost during the first three years of follow-up was 30,037 XOF (≈ 52.14 USD) with a 95% CI [22,498-37,575] XOF and a standard deviation of 3,815 XOF.</p><p><strong>Conclusion: </strong>The cost of chronic viral hepatitis B treatment at CHU-YO is very high compared to patients' income. Laboratory and imaging tests constitute the bulk of patient care expenses. To facilitate patient monitoring in order to avoid or delay the occurrence of complications, it is necessary to implement financial protection mechanisms in health.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"717"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early oral feeding after laparoscopic total gastrectomy in gastric cancer patients: a meta-analysis of randomized controlled trials and cohort studies.","authors":"Leila Mohajeri, Reza Daghayeghi, Navid Rostami, Yasamin Moeinipour, Reza Hossein Zadeh, Raoul Hossein Zadeh, Reza Shah Hosseini, Mohsen Jabbari, Komeil Aghazadeh Habashi, Niloofar Deravi","doi":"10.1186/s12876-025-04283-2","DOIUrl":"10.1186/s12876-025-04283-2","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a leading cause of cancer-related morbidity and mortality worldwide, with surgery being central to treatment. However, postoperative malnutrition is common and significantly impairs recovery. Early oral feeding (EOF) has been proposed as a strategy to promote gastrointestinal recovery and reduce complications, but its clinical effectiveness following gastrectomy remains uncertain.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines. Studies comparing EOF with delayed oral feeding (TOF) in gastric cancer patients were included. Outcomes assessed were hospital stay, time to first anal exhaust, postoperative complications, feeding tolerance, and serum albumin and prealbumin levels. Data were pooled using random-effects models, and evidence certainty was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Fifteen studies (1,847 patients) were included. EOF significantly reduced hospital stay (-1.82 days) and time to first anal exhaust (-0.85 days), and improved albumin and prealbumin levels. No significant differences were found in postoperative complications or feeding intolerance. Subgroup analyses demonstrated consistent findings across surgical techniques, extent of gastrectomy, ERAS protocol implementation, and study design. Overall, the certainty of evidence was rated as very low due to concerns regarding risk of bias, heterogeneity, and imprecision.</p><p><strong>Conclusion: </strong>EOF is a safe and effective approach after gastrectomy, promoting faster recovery without increasing complications. Further trials are needed to confirm its benefits and guide standardized protocols.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"709"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}