Journal of Gastrointestinal Surgery最新文献

{"title":"Giant esophageal lipoma","authors":"Dan-Ni Li , Zhou Li , Zhi-Ren Wang","doi":"10.1016/j.gassur.2024.101924","DOIUrl":"10.1016/j.gassur.2024.101924","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101924"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807283","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":"Value of radiomics features extracted from baseline computed tomography images in predicting overall survival in patients with nonsurgical pancreatic ductal adenocarcinoma: incorporation of a radiomics score to a multiparametric nomogram to predict 1-year overall survival","authors":"Seyedeh Panid Madani ,&nbsp;Mohammad Mirza-Aghazadeh-Attari ,&nbsp;Alireza Mohseni ,&nbsp;Shadi Afyouni ,&nbsp;Ghazal Zandieh ,&nbsp;Haneyeh Shahbazian ,&nbsp;Ali Borhani ,&nbsp;Iman Yazdani Nia ,&nbsp;Daniel Laheru ,&nbsp;Timothy M. Pawlik ,&nbsp;Ihab R. Kamel","doi":"10.1016/j.gassur.2024.101882","DOIUrl":"10.1016/j.gassur.2024.101882","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to determine the value of radiomics features derived from baseline computed tomography (CT) scans and volumetric measurements to predict overall survival (OS) in patients with nonsurgical pancreatic ductal adenocarcinoma (PDAC) treated with a chemotherapy combination regimen of 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX).</div></div><div><h3>Methods</h3><div>In this retrospective single-institution study, 131 patients with nonsurgical PDAC who received FOLFIRINOX neoadjuvant chemotherapy between December 2012 and November 2021 were included. Pretreatment contrast-enhanced CT images were obtained for all patients before inclusion. The primary tumor was contoured by an expert radiologist with 25 years of experience. A total of 845 radiomics features, including first-, second-, and higher-order features, were extracted from the total tumor volume. A feature reduction pipeline was used to reduce the dimensionality of the data. The selected features were used to generate a radiomics score based on the Least Absolute Shrinkage and Selection Operator coefficients. A high-dimensional Cox model was generated on the basis of the radiomics score and other quantitative and semantic imaging findings.</div></div><div><h3>Results</h3><div>From the 845 radiomics features extracted, 45 were significantly different between the tertiles. The following equation was used to generate a radiomics score: radiomics score = SmallAreaEmphasis (−66.87801 + LargeDependenceEmphasis) − 0.2345916. The radiomics score was significantly different among the 3 groups of the radiomics features (<em>P</em> = .034). The overall difference in survival was significant among the 3 groups (<em>P</em> = .02). The nomogram showed good calibration and showed significant differences among the patients when they were classified as tertiles (<em>P</em> &lt; .00).</div></div><div><h3>Conclusion</h3><div>Radiomics approaches have the potential to predict OS in nonsurgical patients with PDAC, and the inclusion of semantic imaging findings and pathologic data could further enhance prognostication in patients with PDAC.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101882"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622033","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":"Metachronous gastric metastasis from clear cell renal cell carcinoma presenting with gastrointestinal bleeding","authors":"Abdeali Saif A. Kaderi,&nbsp;Amandeep Arora,&nbsp;Manish Suresh Bhandare","doi":"10.1016/j.gassur.2024.101891","DOIUrl":"10.1016/j.gassur.2024.101891","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101891"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687192","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":"GI Surgery Summit white paper: recruiting and training the next generation of surgeons","authors":"Jenny H. Chang ,&nbsp;Kelsey Romatoski ,&nbsp;Madeline B. Torres ,&nbsp;Cyrus John Sholevar ,&nbsp;Brenessa Lindeman ,&nbsp;Cameron Gaskill ,&nbsp;Callisia N. Clark ,&nbsp;Flavio Rocha ,&nbsp;Taylor S. Riall ,&nbsp;Jennifer F. Tseng ,&nbsp;Jennifer S. Davids ,&nbsp;Timothy M. Pawlik ,&nbsp;R. Matthew Walsh","doi":"10.1016/j.gassur.2024.101896","DOIUrl":"10.1016/j.gassur.2024.101896","url":null,"abstract":"<div><h3>Background</h3><div>There is an ongoing debate on surgical training and its evolution to meet the demands of a complex and changing healthcare environment.</div></div><div><h3>Methods</h3><div>A GI Surgery Summit was held in January 2024 that included prominent leaders and rising talents from the Society for Surgery of the Alimentary Tract, Society of Surgical Oncology, Association for Academic Surgery, and Society of University Surgeons. This meeting was held to address the multifaceted current and future challenges of surgery.</div></div><div><h3>Results</h3><div>This paper addresses the topic of recruitment and training of the next generation of surgeons in the United States and abroad and reflects a collective focus on surgical education to ensure the delivery of high-quality care in an increasingly sophisticated medical and surgical landscape.</div></div><div><h3>Conclusion</h3><div>The discussions and recommendations from the 2024 GI Surgery Summit underscore the crucial need to support diversity, embrace innovative educational frameworks, build a robust global surgical workforce, and foster a culture of wellness and support. Focusing on these key areas ensures that the future leaders of surgery are not only skilled and knowledgeable but also resilient and compassionate, ready to meet the evolving challenges of the healthcare landscape.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101896"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695708","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":"Change and predictors of body composition after gastrectomy for gastric cancer during first postoperative year","authors":"Tomohiro Osaki ,&nbsp;Tomoyuki Matsunaga ,&nbsp;Masahiro Makinoya ,&nbsp;Shota Shimizu ,&nbsp;Yuji Shishido ,&nbsp;Kozo Miyatani ,&nbsp;Ayumi Tsuda ,&nbsp;Kanenori Endo ,&nbsp;Keigo Ashida ,&nbsp;Shigeru Tatebe ,&nbsp;Yoshiyuki Fujiwara","doi":"10.1016/j.gassur.2024.101931","DOIUrl":"10.1016/j.gassur.2024.101931","url":null,"abstract":"<div><h3>Purpose</h3><div>After gastrectomy for gastric cancer, patients often lose significant body weight because of decreased caloric intake and nutrient absorption. Body weight typically requires approximately 1 year to stabilize. This study aimed to examine the changes and predictors of body composition during the first postoperative year.</div></div><div><h3>Methods</h3><div>A total of 230 patients underwent radical gastrectomy for stage I to III gastric cancers. Body composition was measured using bioelectrical impedance analysis, and changes were analyzed over 1 year. Multiple regression analysis was used to identify predictors of body composition changes.</div></div><div><h3>Results</h3><div>Body composition changes and significant body weight and body fat mass reductions occurred primarily within the first 6 months postoperatively. Skeletal muscle mass initially decreased but improved after 6 months without significant changes related to adjuvant chemotherapy. Increased edema was observed at 6 and 12 months postoperatively in patients after total gastrectomy and adjuvant chemotherapy. Gastrectomy type and body mass index significantly affected postoperative body weight changes. In addition, gastrectomy type was associated with changes in skeletal muscle mass and bone mineral content. Adjuvant chemotherapy significantly affected the whole-body phase angle at 6 and 12 months.</div></div><div><h3>Conclusion</h3><div>Our findings emphasized the initial significant reductions postoperatively and subsequent adjustments over time and elucidated the complex interplay between surgical techniques, adjuvant treatment, and patient characteristics and midterm changes in body composition.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101931"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824225","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":"Gastric metastasis from Merkel cell carcinoma","authors":"Juliana Maria Napoli,&nbsp;Felipe Higuera,&nbsp;Fernando Gabriel Wright","doi":"10.1016/j.gassur.2024.101925","DOIUrl":"10.1016/j.gassur.2024.101925","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101925"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829106","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":"A national perspective on palliative interventions for malignant gastric outlet obstruction","authors":"Ayesha P. Ng,&nbsp;Joseph E. Hadaya,&nbsp;Yas Sanaiha,&nbsp;Nikhil L. Chervu,&nbsp;Mark D. Girgis,&nbsp;Peyman Benharash","doi":"10.1016/j.gassur.2024.101884","DOIUrl":"10.1016/j.gassur.2024.101884","url":null,"abstract":"<div><h3>Background</h3><div>Of note, 15% to 20% of patients with duodenal or periampullary malignancies develop gastric outlet obstruction (GOO). Although small randomized trials have reported more rapid recovery and shorter hospital stay with endoscopic stenting (ES), limited studies have evaluated outcomes at a national level. The current study characterized short-term clinical and financial outcomes associated with gastrojejunostomy (GJ) vs ES in malignant GOO.</div></div><div><h3>Methods</h3><div>Adults with malignant GOO treated with ES or GJ were identified in the 2016–2020 Nationwide Readmissions Database. Entropy balancing was used to balance covariates between groups, and multivariate regression was used to evaluate the association between GJ or ES and in-hospital mortality, total parenteral nutrition (TPN) use, complications, length of stay (LOS), costs, and 90-day readmission.</div></div><div><h3>Results</h3><div>Of 8186 patients with GOO, 5603 (68.4%) underwent ES, and 2583 (31.6%) underwent GJ. The cohorts were similar in age, female/male sex, and comorbidities. However, patients who underwent GJ were more commonly frail. After risk adjustment, mortality, composite complications, and 90-day readmission were comparable between patients who underwent GJ and those who underwent ES. GJ was associated with greater odds of blood transfusion (adjusted odds ratio [AOR], 1.74; 95% CI, 1.37–2.21) and postoperative TPN use (AOR, 3.76; 95% CI, 2.64–5.35). Furthermore, patients who underwent GJ experienced a significant increment of &gt;$15,800 in costs and &gt;6.9 days in LOS. In subgroup analysis of patients with metastatic disease, mortality, complications, and readmission remained comparable among palliation strategies.</div></div><div><h3>Conclusion</h3><div>ES seems to yield comparable short-term morbidity and mortality relative to GJ with significant cost reduction. Increasing access to endoscopic technology and regionalizing care to high-volume centers may help improve outcomes for patients with malignant GOO.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101884"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639045","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":"Association between sex-specific criteria for visceral obesity and surgical site infection after gastrectomy","authors":"Shinichiro Shiomi ,&nbsp;Wataru Gonoi ,&nbsp;Kotaro Sugawara ,&nbsp;Satoru Taguchi ,&nbsp;Shouhei Hanaoka ,&nbsp;Mariko Kurokawa ,&nbsp;Nobuhiko Akamatsu ,&nbsp;Shohei Inui ,&nbsp;Koichi Yagi ,&nbsp;Haruki Kume ,&nbsp;Osamu Abe ,&nbsp;Yasuyuki Seto","doi":"10.1016/j.gassur.2024.101919","DOIUrl":"10.1016/j.gassur.2024.101919","url":null,"abstract":"<div><h3>Background</h3><div>High visceral fat area (VFA), estimated by computed tomography (CT), is reportedly associated with surgical site infection (SSI) in patients who undergo gastrectomy for gastric cancer (GC). Given that fat distributions vary markedly according to sex, sex-specific definitions of visceral obesity should be applied. This study investigated the optimal sex-specific thresholds for VFA at the L3 level to assess the risk of SSI after gastrectomy.</div></div><div><h3>Methods</h3><div>This study included 828 patients (564 males and 264 females) who underwent curative gastrectomy. Intra-abdominal or incisional infectious complications with Clavien-Dindo scores ≥ 2 were defined as SSIs. Receiver operating characteristic (ROC) analyses were used to determine the optimal sex-specific VFA cutoffs to extract patients with obesity who are at risk of developing SSI. In addition, logistic regression analyses were performed, and the corrected Akaike information criterion (AICc) was calculated to compare the capability to evaluate the possibility of SSI of our sex-specific VFA-based criteria vs the conventional VFA-based or body mass index (BMI)-based criterion.</div></div><div><h3>Results</h3><div>SSI developed in 59 males and 16 females. Optimal VFA thresholds were 119.3 cm² for males and 57.2 cm² for females. Multivariate analyses revealed visceral obesity, as defined by the sex-specific criteria, to be an independent risk factor for SSI (odds ratio, 2.74; 95% CI, 1.62–4.66; <em>P</em> &lt;.01). The logistic regression model with our sex-specific criteria yielded a better AICc (456.4) than the conventional (461.8) or BMI-based (467.0) criterion for obesity.</div></div><div><h3>Conclusion</h3><div>Sex-specific criteria can enhance the capability of VFA to assess the risk of SSI after gastrectomy, compared with the non–sex-specific criterion.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101919"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769554","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":"Laparoscopic surgery for gastric gastrointestinal stromal tumor in the age of Enhanced Recovery After Surgery","authors":"Mohammad S. Farooq ,&nbsp;Valentina Mattfeld ,&nbsp;Neha Shafique ,&nbsp;Gracia M. Vargas ,&nbsp;John T. Miura ,&nbsp;Giorgos C. Karakousis","doi":"10.1016/j.gassur.2024.101920","DOIUrl":"10.1016/j.gassur.2024.101920","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101920"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780342","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":"Delta-integrated relaxation pressures as a new high-resolution manometry metric to predict the positive outcome of laparoscopic Heller-Dor in patients with achalasia","authors":"Andrea Costantini ,&nbsp;Matteo Pittacolo ,&nbsp;Giulia Nezi ,&nbsp;Giovanni Capovilla ,&nbsp;Mario Costantini ,&nbsp;Arianna Vittori ,&nbsp;Matteo Santangelo ,&nbsp;Luca Provenzano ,&nbsp;Loredana Nicoletti ,&nbsp;Francesca Forattini ,&nbsp;Lucia Moletta ,&nbsp;Michele Valmasoni ,&nbsp;Edoardo V. Savarino ,&nbsp;Renato Salvador","doi":"10.1016/j.gassur.2024.101928","DOIUrl":"10.1016/j.gassur.2024.101928","url":null,"abstract":"<div><h3>Background</h3><div>There is no consensus on the definition of failure after treatment in patients with achalasia. The Eckardt score is used to define clinical outcomes. However, objective metrics are lacking. This study aimed to identify whether any high-resolution manometry (HRM) parameters may be useful in predicting a positive outcome after laparoscopic Heller-Dor (LHD).</div></div><div><h3>Methods</h3><div>Patients who underwent LHD between 2012 and 2022 were enrolled. The patients were divided according to the outcome: the success group (SG) and the failure group (FG). In addition to the common HRM parameters, we measured the difference between pre- and postoperative integrated relaxation pressures (∆-IRPs). A receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of each HRM parameter.</div></div><div><h3>Results</h3><div>Of note, 336 patients (92.3%) were classified in the SG, and 28 patients (7.7%) were classified in the FG. No difference was found in terms of manometric types, symptom duration, and history of previous treatments. Preoperative lower esophageal sphincter (LES) pressure and IRP were higher in the SG than in the FG (41 vs 35 mm Hg [<em>P</em> =.03] and 33 vs 26 mm Hg [<em>P</em> =.002], respectively). The postoperative LES metrics were similar between the 2 groups, except for the ∆-IRP that was higher in the SG (23 mm Hg [IQR, 15–31]) than in the FG (14 mm Hg [IQR, 9–17]) (<em>P</em> =.0002). In the univariate analysis, age, LES preoperative pressure, IRP, and ∆-IRP were factors able to predict a positive clinical outcome. In the multivariate analysis, the ∆-IRP was the only parameter independently related to clinical success (odds ratio, 0.94; 5%–95% CI, 0.89–0.99). The ROC curve for the ∆-IRP showed an area under the curve of 0.71, with a threshold value set at 16.5 mm Hg (sensibility of 71% and specificity of 70%).</div></div><div><h3>Conclusion</h3><div>Our data showed that the ∆-IRP with a threshold of 16.5 mm Hg could represent a new objective tool for predicting the long-term positive outcome of LHD in patients with esophageal achalasia.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101928"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824228","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}