Journal of Gastrointestinal Surgery最新文献

{"title":"Body mass index and survival after surgery for gastric adenocarcinoma: a population-based nationwide cohort study in Finland","authors":"Aapo Jalkanen ,&nbsp;Arto Kokkola ,&nbsp;Johanna Louhimo ,&nbsp;Olli Helminen ,&nbsp;Mika Helmiö ,&nbsp;Heikki Huhta ,&nbsp;Anna Junttila ,&nbsp;Raija Kallio ,&nbsp;Vesa Koivukangas ,&nbsp;Simo Laine ,&nbsp;Elina Lietzen ,&nbsp;Sanna Meriläinen ,&nbsp;Vesa-Matti Pohjanen ,&nbsp;Tuomo Rantanen ,&nbsp;Ari Ristimäki ,&nbsp;Jari V. Räsänen ,&nbsp;Juha Saarnio ,&nbsp;Eero Sihvo ,&nbsp;Vesa Toikkanen ,&nbsp;Tuula Tyrväinen ,&nbsp;Joonas H. Kauppila","doi":"10.1016/j.gassur.2025.102282","DOIUrl":"10.1016/j.gassur.2025.102282","url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer surgery is associated with significant morbidity. Obesity is a risk factor for short-term complications. However, previous studies on the role of body mass index (BMI) as a predictor of long-term survival have conflicting results, and contemporary population-based data in the Western population are lacking. This study aimed to compare the long-term survival after gastric cancer surgery among patients who were underweight (BMI of &lt;18.5 kg/m²), those with normal weight (BMI of 18.5–24.9 kg/m²), those who were overweight (BMI of 25.0–29.9 kg/m²), and those who were obese (BMI of &gt;30.0 kg/m²).</div></div><div><h3>Methods</h3><div>This was a population-based, retrospective, nationwide cohort study in Finland using the Finnish National Esophago-Gastric Cancer Cohort. Patients who underwent gastrectomy with available height and weight data were included. A Cox regression model was used to calculate the 95% CI for 6-month to 5-year survival and 6-month survival, which was adjusted for age, sex (assigned), year of surgery, Charlson Comorbidity Index, pathological p/yp stage, neoadjuvant therapy, type of resection, and Lauren histological type.</div></div><div><h3>Results</h3><div>Overall, 1647 patients who underwent gastrectomy for gastric cancer were identified. Of the patients, 64 (3.9%) were underweight, 735 (44.6%) had normal weight, 584 (35.5%) were overweight, and 264 (16.0%) were obese. In the first 6 months, mortality was higher in the overweight group (hazard ratio [HR], 1.663 [95% CI, 1.158–2.389]) than in the normal weight group. However, 6-month to 5-year mortality was the highest in the underweight group (HR, 1.426 [95% CI, 1.019–1.994]) and decreased with increasing BMI (HR, 0.820 [95% CI, 0.708–0.949]). Patients with obesity had the best prognosis (HR, 0.798 [95% CI, 0.655–0.971]).</div></div><div><h3>Conclusion</h3><div>In this population-based study, higher BMI was associated with better long-term survival after gastric cancer surgery, somewhat offset by higher mortality during the first postoperative months, with patients with obesity having the best overall survival.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102282"},"PeriodicalIF":2.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited commentary on “Prospective evaluation of the novel BADCAL score for predicting colorectal anastomotic leak unicorn hunt: searching for the ideal tool to predict and identify anastomotic leak”","authors":"Frank A. DiSilvio,&nbsp;Terrah Paul Olson","doi":"10.1016/j.gassur.2025.102281","DOIUrl":"10.1016/j.gassur.2025.102281","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102281"},"PeriodicalIF":2.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ciliated foregut cyst of the biliary hilum mimicking choledochal cyst","authors":"Olivia Sears,&nbsp;Samantha M. Ruff,&nbsp;Victor M. Zaydfudim","doi":"10.1016/j.gassur.2025.102278","DOIUrl":"10.1016/j.gassur.2025.102278","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102278"},"PeriodicalIF":2.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion to permanent stoma due to poor bowel function after proctectomy with coloanal anastomosis for rectal cancer","authors":"Reena S. Suresh,&nbsp;Shannon N. Radomski,&nbsp;Miloslawa Stem,&nbsp;Michael Consul,&nbsp;Angelos Papanikolaou,&nbsp;Sophia Y. Chen,&nbsp;Susan L. Gearhart,&nbsp;Alodia Gabre-Kidan","doi":"10.1016/j.gassur.2025.102277","DOIUrl":"10.1016/j.gassur.2025.102277","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102277"},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists: reshaping the surgical paradigm in obesity and gastrointestinal disease","authors":"Vipul D. Yagnik ,&nbsp;Prema Ram Choudhary","doi":"10.1016/j.gassur.2025.102276","DOIUrl":"10.1016/j.gassur.2025.102276","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102276"},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic paraganglioma resection: tactics and procedure","authors":"Fumihiro Kawano ,&nbsp;Megan A. Lim ,&nbsp;Claudius Conrad","doi":"10.1016/j.gassur.2025.102279","DOIUrl":"10.1016/j.gassur.2025.102279","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102279"},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the role of preoperative serum insulin-like growth factor 1 as a predictor of survival and recurrence for patients with resectable hepatocellular carcinoma","authors":"Joe Eid ,&nbsp;Antony Haddad ,&nbsp;Manal Hassan ,&nbsp;Hesham M. Amin ,&nbsp;Timothy E. Newhook ,&nbsp;Yun Shin Chun ,&nbsp;Ching-Wei D. Tzeng ,&nbsp;Jean-Nicolas Vauthey ,&nbsp;Hop S. Tran Cao ,&nbsp;Ahmed O. Kaseb","doi":"10.1016/j.gassur.2025.102275","DOIUrl":"10.1016/j.gassur.2025.102275","url":null,"abstract":"<div><h3>Background</h3><div>Low serum insulin-like growth factor 1 (IGF-1) level is associated with shorter overall survival (OS) in patients with advanced unresectable hepatocellular carcinoma (HCC). This study aimed to evaluate whether preoperative IGF-1 levels are associated with OS and recurrence-free survival (RFS) in patients with HCC who underwent hepatectomy.</div></div><div><h3>Methods</h3><div>Patients who underwent hepatectomy for HCC between 2001 and 2023 were identified from a prospectively maintained database at the MD Anderson Cancer Center. Patients with IGF-1 measured within 8 weeks after hepatectomy were included. The median IGF-1 level was used as a cutoff value to categorize high and low IGF-1 levels. The primary endpoint was OS, and the secondary endpoint was RFS.</div></div><div><h3>Results</h3><div>A total of 51 patients were included in this study. The median age was 66 years, and 65% of patients were males. The median IGF-1 level was 87 ng/mL. Patients with low IGF-1 levels were more likely to be ≥65 years old, with history of diabetes mellitus, hypertension, and tobacco use, and to have multinodular tumors and higher alpha-fetoprotein levels. After a median follow-up of 61 months, no difference in RFS between the high and low IGF-1 groups was found. OS was significantly longer in patients with high IGF-1 levels than in those with low IGF-1 levels (5-year OS: 80% vs 45%, respectively; <em>P</em> =.027). On multivariate analysis, a high IGF-1 level was significantly associated with better OS (hazard ratio, 0.33 [95% CI, 0.12–0.93]).</div></div><div><h3>Conclusion</h3><div>Low preoperative IGF-1 levels were a predictor of poor survival after liver resection for HCC but did not correlate with recurrence rates. This may be related to poor hepatic reserve in patients with low IGF-1 levels.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102275"},"PeriodicalIF":2.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perianal angiomyofibroblastoma: rare pathology in an elderly male patient","authors":"Jessica N. Figueredo,&nbsp;Uma R. Phatak","doi":"10.1016/j.gassur.2025.102274","DOIUrl":"10.1016/j.gassur.2025.102274","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102274"},"PeriodicalIF":2.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-space analysis of gastrointestinal cancers among the working-age individuals in Brazil, Russia, India, China, and South Africa (BRICS)-plus countries (1990–2021): a comprehensive analysis from the Global Burden of Disease Study 2021","authors":"Minxia Yang ,&nbsp;Liejiong Wang ,&nbsp;Zhaoqi Qiu ,&nbsp;Ying Lou ,&nbsp;Feng Xuan","doi":"10.1016/j.gassur.2025.102271","DOIUrl":"10.1016/j.gassur.2025.102271","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal (GI) cancers remain a major public health concern worldwide. However, limited evidence exists on the burden and trends of these cancers among the economically active population in BRICS-plus countries, including Brazil, Russia, India, China, South Africa, Egypt, Ethiopia, Iran, Saudi Arabia, and the United Arab Emirates. This study aimed to assess the long-term patterns and current status of 6 major GI cancers among working-age adults (20–64 years) across these countries between 1990 and 2021.</div></div><div><h3>Methods</h3><div>This study used data from the Global Burden of Disease Study 2021 to analyze disability-adjusted life years (DALYs) related to 6 GI cancers: colorectal, esophageal, stomach, liver, gallbladder and biliary tract, and pancreatic cancers. Trends in age-standardized DALY rates (ASDRs) were evaluated over time, and changes in DALYs were further examined using decomposition analysis to identify contributions from population growth, aging, and changes in disease prevalence and severity.</div></div><div><h3>Results</h3><div>In 2021, China had the highest ASDRs of GI cancers among BRICS-plus countries, contributing more than 17 million DALYs. Of note, 4 cancers (colorectal, esophageal, stomach, and liver) together accounted for more than 70% of the total GI cancer burden between 1990 and 2021. Although the overall number of DALYs increased in most countries, largely due to population growth, the ASDRs decreased in most BRICS-plus countries, except Egypt. Reductions were most pronounced in patients with esophageal and stomach cancers. Men had a higher burden for most GI cancers than women, except for gallbladder and biliary tract cancers, in which women were more affected. The highest burden was observed in individuals aged 60 to 64 years.</div></div><div><h3>Conclusion</h3><div>GI cancers place a substantial and growing burden on the working-age population in BRICS-plus countries. Substantial disparities in cancer burden were observed across time, age, sex, and country, highlighting the urgent need for tailored public health strategies.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102271"},"PeriodicalIF":2.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of same-day discharge after robotic hiatal hernia repair: a comparative study","authors":"Niloufar Salehi,&nbsp;Sophia Luo,&nbsp;Teagan Marshall,&nbsp;Hala Al Asadi,&nbsp;Anjani Turaga,&nbsp;Maria Alqamish,&nbsp;Sayani Saha,&nbsp;Jacques Greenberg,&nbsp;Brendan M. Finnerty,&nbsp;Thomas J. Fahey III,&nbsp;Rasa Zarnegar","doi":"10.1016/j.gassur.2025.102270","DOIUrl":"10.1016/j.gassur.2025.102270","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;With the increasing use of minimally invasive techniques and recovery protocols, hiatal hernia repair is increasingly performed with a same-day discharge (SDD) approach. This study aimed to identify factors affecting patient selection for SDD at a tertiary center and compare the outcomes of SDD with extended observation stay (EOS) after robotic hiatal hernia repair.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a retrospective review of patients who underwent robotic hiatal hernia repair from January 2012 to April 2024. Patients who had SDD were those managed in ambulatory care and discharged within 12 h of admission. This study compared perioperative characteristics and postoperative outcomes, including emergency department (ED) returns and readmissions. Multivariate logistic regression identified risk factors for ED returns and 30-day readmission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 740 included patients, 464 had EOS, and 276 had SDD. There was a growing trend toward SDD. Patients who had EOS were generally older (&lt;em&gt;P&lt;/em&gt; &lt;.001); had higher comorbidity rates (diabetes mellitus [&lt;em&gt;P&lt;/em&gt; =.006], hypertension [&lt;em&gt;P&lt;/em&gt; =.034], and pulmonary disease [&lt;em&gt;P&lt;/em&gt; =.013]); had more paraesophageal hernias (&lt;em&gt;P&lt;/em&gt; =.002); and presented with more severe dysphagia (&lt;em&gt;P&lt;/em&gt; =.019) and elevated American Society of Anesthesiologists (ASA) scores (&lt;em&gt;P&lt;/em&gt; &lt;.001). In addition, patients who had EOS underwent more revisional surgical procedures (&lt;em&gt;P&lt;/em&gt; &lt;.001), Collis procedures (&lt;em&gt;P&lt;/em&gt; &lt;.001), relaxing incisions (&lt;em&gt;P&lt;/em&gt; &lt;.001), and Nissen fundoplications (&lt;em&gt;P&lt;/em&gt; =.028), whereas patients who had SDD more frequently received magnetic sphincter augmentation (MSA; &lt;em&gt;P&lt;/em&gt; =.007). Most patients who had EOS had longer operative duration (&lt;em&gt;P&lt;/em&gt; =.001) and were evening/night cases (&lt;em&gt;P&lt;/em&gt; =.002), with an average hospital stay of 26.8 h (IQR, 20.8–32.0) compared with 9.0 h (IQR, 8.0–10.0) for patients who had SDD (&lt;em&gt;P&lt;/em&gt; &lt;.001). However, postoperative outcomes, including ED returns, readmissions, gastroesophageal reflux disease symptoms, and dysphagia, were comparable. Multivariate analysis revealed that a higher ASA score (odds ratio [OR], 1.8 [95% CI, 1.1–3.0]; &lt;em&gt;P&lt;/em&gt; =.037) and paraesophageal hernia (OR, 2.2 [95% CI, 1.2–4.1]; &lt;em&gt;P&lt;/em&gt; =.011) were associated with a higher ED returns and that MSA was associated with a lower ED return rate than Toupet fundoplication (OR, 0.2 [95% CI, 0.1–0.9]; &lt;em&gt;P&lt;/em&gt; =.021). Diabetes mellitus (OR, 3.1 [95% CI, 1.5–6.0]; &lt;em&gt;P&lt;/em&gt; =.002) and paraesophageal hernia (OR, 2.2 [95% CI, 1.2–4.4]; &lt;em&gt;P&lt;/em&gt; =.016) increased the odds of 30-day readmission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;SDD after robotic hiatal hernia repair is safe and feasible, with outcomes similar to those of EOS when patients are appropriately selected. Higher ASA score, diabetes mellitus, paraesophageal hernia, and Toupet fundoplication are associate","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102270"},"PeriodicalIF":2.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}