Journal of Gastrointestinal Surgery最新文献

英文中文

Letter to editor regarding “Laparoscopic antireflux surgery with the RefluxStop implant for severe sufferers with complex disease: a retrospective study of the first 100 patients with 12-month follow-up at an early adopter institution” 致编辑的信关于：使用reffluxstop植入物对患有复杂疾病的严重患者进行腹腔镜抗反流手术：一项对早期采用机构的前100名患者进行12个月随访的回顾性研究。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-15 DOI: 10.1016/j.gassur.2026.102335

Lirong Zhang

引用次数: 0

Intraabdominal fat necrosis as a cause of abdominal pain. 腹腔内脂肪坏死是引起腹痛的原因。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-15 DOI: 10.1016/j.gassur.2026.102336

Belén Del Rosario Pinto, Felipe Higuera, Roy López Grove

引用次数: 0

Intrathoracic side-overlap vs circular stapled esophagogastrostomy for Siewert type I/II adenocarcinoma of the esophagogastric junction: a retrospective comparative study 胸内侧重叠与环形吻合器食管胃造口术治疗食管胃交界siwert I/II型腺癌的回顾性比较研究

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-14 DOI: 10.1016/j.gassur.2026.102332

Chuanle Cheng , Zhanpeng Tang , Yijun Ma, Lei Qi, Hui Tian, Lin Li

Background

Esophagectomy remains the primary curative treatment of esophageal cancer, and the anastomotic technique is a crucial determinant of postoperative outcomes. Although circular stapled esophagogastrostomy (CSE) is widely used, side-overlap esophagogastrostomy (SOE) has recently been adapted for intrathoracic reconstruction.

Methods

This retrospective study included 105 patients who underwent Ivor-Lewis esophagectomy. The short-term clinical outcomes were compared between the SOE group and the CSE group.

Results

No significant differences were observed between the SOE and CSE groups in operative duration (189.0 ± 49.9 vs 200.2 ± 48.3 min, respectively; P =.246), estimated blood loss (110 mL [IQR, 150–90] vs 120 mL [IQR, 150–100], respectively; P =.354), or number of lymph nodes harvested (19.0 [IQR, 23.0–16.0] vs 17.5 [IQR, 21.0–15.8], respectively; P =.285). The overall postoperative complication rate was similar (18.2% in the SOE group vs 22.0% in the CSE group; P =.625). However, patients in the SOE group reported significantly lower pain scores on postoperative days (PODs) 1 and 2 (POD1: 3.49 ± 0.79 in the SOE group vs 4.04 ± 0.95 in the CSE group; P =.002; POD2: 2.73 ± 0.65 in the SOE group vs 3.06 ± 0.62 in the CSE group, P =.009). The incidence of severe gastroesophageal reflux (Reflux Disease Questionnaire ≥ 12) was significantly lower in the SOE group than in the CSE group (14.5% vs 34.0%, respectively; P =.019). Dysphagia symptoms were less frequent in the SOE group than in the CSE group (9.1% vs 24.0%, respectively; P =.038).

Conclusion

Intrathoracic SOE is a safe and feasible alternative to CSE for patients with Siewert type I/II adenocarcinoma of the esophagogastric junction undergoing esophagectomy. SOE offers comparable operative safety while reducing postoperative pain, severe reflux, and dysphagia, suggesting functional advantages in short-term recovery.

背景：食管切除术仍然是食管癌的主要治疗方法，吻合技术是术后预后的关键决定因素。虽然环形吻合器食管胃造口术（CSE）被广泛应用，但侧重叠食管胃造口术（SOE）最近也被用于胸内重建。方法：回顾性研究纳入105例Ivor-Lewis食管切除术患者。比较SOE组与CSE组近期临床疗效。结果：SOE组与CSE组在手术时间（189.0±49.9min vs 200.2±48.3min, P = 0.246）、估计失血量（110 [150 ~ 90]mL vs 120 [150 ~ 100] mL, P = 0.354）、淋巴结清扫数（19 [23 ~ 16]vs 17.5 [21 ~ 15.8], P = 0.285）方面均无显著差异。术后总并发症发生率相似（18.2% vs 22.0%, P = 0.625）。然而，SOE组患者术后第1天和第2天（POD）疼痛评分明显降低（POD1: 3.49±0.79比4.04±0.95,P = 0.002; POD2: 2.73±0.65比3.06±0.62,P = 0.009）。严重胃食管反流发生率（RDQ≥12）在SOE组显著降低（14.5% vs. 34.0%, P = 0.019）。SOE组吞咽困难症状较少（9.1%比24.0%,P = 0.038）。结论：对于Siewert I/II型AEG行食管切除术的患者，胸腔内SOE是一种安全可行的替代CSE的方法。SOE提供了相当的手术安全性，同时减少了术后疼痛、严重的反流和吞咽困难，表明在短期恢复中的功能优势。

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引用次数: 0

Letter to editor regarding “Beyond short-term outcomes: mechanistic and equity considerations for minimally invasive surgery in small bowel neuroendocrine tumors” 致编辑关于：超越短期结果：微创手术治疗小肠神经内分泌肿瘤的机制和公平性考虑。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-14 DOI: 10.1016/j.gassur.2026.102334

Ye Tian, Ce Zhang, Muhu Chen

引用次数: 0

Hiatal hernia and anemia: a single-center experience. 裂孔疝和贫血：单中心体验。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-14 DOI: 10.1016/j.gassur.2026.102333

Andrés R Latorre-Rodríguez, Raj Shah, Hailey Simmonds, Jill Benavidez, Arianna Vittori, Ross M Bremner, Sumeet K Mittal

Background: Hiatal hernia (HH) is an often overlooked cause of chronic anemia, and the therapeutic role of surgical HH repair (HHr) in these cases remains underexplored. Thus, we assessed the prevalence of anemia and visible Cameron lesions in patients undergoing primary HHr, explored associations with hernia size, and evaluated objective postoperative improvements.

Methods: This retrospective, observational study used a prospectively maintained surgical database at a high-volume tertiary referral center to identify patients with anemia or upper gastrointestinal bleeding who underwent HHr between September 2016 and March 2024. Adults who underwent HHr with (i) preoperative anemia (hemoglobin <13.0 g/dL for men or <12.0 g/dL for women), (ii) endoscopic evidence of Cameron lesions, (iii) documented anemia in medical records, or (iv) documented history of iron deficiency anemia-related therapies were included. Patients with prior foregut procedures or other identifiable sources of blood loss were excluded. The primary endpoints were the rates of postoperative transfusion-level anemia and iron deficiency anemia-related therapies.

Results: Among 448 patients who underwent primary HHr, 132 (29.5%) were included. The rates of anemia-related findings increased with HH size as follows: small, 7.3%; moderate, 28.7%; large, 58.4%; and intrathoracic stomach, 44.7%. Significant reductions were seen in postoperative rates of transfusion-level anemia (15.2% to 0%; P =.004) and anemia-related medical therapies (50.8% to 2.2%; P <.001).

Conclusion: Anemia and/or visible Cameron lesions are common in patients undergoing HHr and increase with hernia size. HHr significantly reduces transfusion-level anemia and the need for anemia-related therapies. Early surgical referral should be considered, as medical treatment alone may not address the underlying causes.

背景：裂孔疝（HH）通常是慢性贫血的一个被忽视的原因，手术HH修复（HHr）在这些病例中的治疗作用仍未得到充分探讨。因此，我们评估了原发性HHr患者贫血和可见卡梅伦病变的患病率，探讨了与疝大小的关系，并评估了客观的术后改善。方法：这项回顾性观察性研究使用了一个大容量三级转诊中心前瞻性维护的外科数据库，以确定2016年9月至2024年3月期间接受HHr治疗的贫血或上消化道出血患者。结果：在448例原发性HHr患者中，包括132例（29.5%）。贫血相关症状的发生率随着HH大小的增加而增加：小，7.3%；温和,28.7%;大,58.4%;胸内胃44.7%。术后输血水平贫血发生率（15.2%至0%，p=0.004）和贫血相关药物治疗发生率（50.8%至2.2%）显著降低。结论：贫血和/或可见卡梅伦病变在HHr患者中很常见，并随着疝大小的增加而增加。HHr显著降低输血水平贫血和对贫血相关治疗的需求。应考虑早期手术转诊，因为单靠药物治疗可能无法解决根本原因。

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引用次数: 0

Disparities in presentation and outcomes after surgery for medically refractory gastroparesis: the impact of demographic and socioeconomic status 难治性胃轻瘫手术后表现和结果的差异：人口统计学和社会经济地位的影响

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-13 DOI: 10.1016/j.gassur.2025.102312

Emma Venard , Sven E. Eriksson , Margaret Gardner , Ping Zheng , Shahin Ayazi

Background

Gastroparesis is a debilitating disorder, and surgical therapy can provide meaningful improvement in patients who remain symptomatic despite medical treatment. However, patients often present with variable disease severity, and the influence of demographic and socioeconomic factors on this variability and on postoperative outcomes remains poorly defined. This study aimed to evaluate the effect of demographic status and socioeconomic status (SES) on preoperative characteristics and postoperative outcomes in patients who underwent surgery for medically refractory gastroparesis.

Methods

All patients who underwent surgical treatment of medically refractory gastroparesis between 2012 and 2024 at a tertiary foregut center were retrospectively analyzed. Demographics, gastroparesis etiology, gastric emptying, and Gastroparesis Cardinal Symptom Index (GCSI) scores were compared across sex, race, age, and SES groups. SES classification was derived from zip code–level United States census data. Surgical procedures included pyloroplasty, gastric peroral endoscopic pyloromyotomy, and gastric electrical stimulation.

Results

A total of 387 patients were included (82.4% female; mean age of 51.3 ± 15.6 years). Idiopathic (62.3%) and diabetic (23.9%) etiologies predominated. Overall, GCSI total score improved significantly (median: 3.1 [IQR, 2.5–3.9] to 2.4 [IQR 1.6–3.3]; P <.001), and gastric retention at 4 h decreased (29.0% [IQR, 17.0%–44.9%] to 8.0% [IQR, 1.0%–24.0%]; P <.001). African American patients presented with higher baseline GCSI total score (median: 4.3 [IQR, 3.3–4.8] vs 3.1 [IQR, 2.4–3.8]; P =.011) and continued to report higher postoperative symptom scores (GCSI total score: 3.1 vs 2.4; P =.031). Similarly, patients with low SES demonstarted a trend toward more severe preoperative symptoms and higher gastric retention but achieved postoperative improvement comparable with those with higher SES. A significant correlation between preoperative gastric emptying at 4-hour retention and GCSI total score was observed only in men, both preoperatively (r = 0.46; P =.049) and postoperatively (r = 0.60; P =.025). Younger patients were less likely to have symptom resolution (P =.035).

Conclusion

Surgical treatment achieved durable improvement in medically refractory gastroparesis, with similar postoperative gains across SES groups. Persistent symptoms in African American and younger patients and sex-specific differences in symptom-motility correlation suggest multifactorial mechanisms beyond motility alone.

背景：脑轻瘫是一种使人衰弱的疾病，手术治疗可以对药物治疗后仍有症状的患者提供有意义的改善。然而，患者往往表现出不同的疾病严重程度，人口统计学和社会经济因素对这种变异性和术后结果的影响仍不明确。本研究旨在评估人口统计状况和社会经济状况（SES）对难治性胃轻瘫手术患者术前特征和术后结局的影响。方法回顾性分析2012 ~ 2024年在第三前肠中心接受手术治疗的难治性胃轻瘫患者。人口统计学、胃轻瘫病因学、胃排空和胃轻瘫主要症状指数（GCSI）评分在性别、种族、年龄和社会经济地位组之间进行比较。SES分类来源于邮政编码级别的美国人口普查数据。手术包括幽门成形术、经口胃镜幽门肌切开术和胃电刺激。结果共纳入387例患者，其中女性82.4%，平均年龄51.3±15.6岁。特发性（62.3%）和糖尿病（23.9%）病因为主。总体而言，GCSI总分显著提高（中位数：3.1 [IQR, 2.5-3.9]至2.4 [IQR 1.6-3.3]; P < 0.001）， 4 h胃潴留下降（29.0% [IQR, 17.0%-44.9%]至8.0% [IQR, 1.0%-24.0%]; P < 0.001）。非裔美国患者的基线GCSI总分较高（中位数：4.3 [IQR, 3.3-4.8] vs 3.1 [IQR, 2.4 - 3.8]; P = 0.011），术后症状评分继续较高（GCSI总分：3.1 vs 2.4; P = 0.031）。同样，低SES患者术前症状更严重，胃潴留更严重，但术后改善程度与高SES患者相当。术前4小时胃排空与GCSI总分之间的相关性仅在男性中观察到，术前（r = 0.46; P = 0.049）和术后（r = 0.60; P = 0.025）均有统计学意义。年轻患者症状缓解的可能性较小（P = 0.035）。结论手术治疗可使难治性胃轻瘫获得持久改善，SES组术后获益相似。非裔美国人和年轻患者的持续症状以及症状-运动性相关性的性别特异性差异表明，多因素机制不仅仅是运动性。

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引用次数: 0

Light amplification by stimulated emission of radiation in fistula-in-ano: innovation or impetuosity? Current position 激光治疗肛瘘：创新还是冲动？流式的位置。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-13 DOI: 10.1016/j.gassur.2026.102328

Vipul D. Yagnik , Prema Ram Choudhary , Pankaj Garg

引用次数: 0

Per oral endoscopic myotomy and laparoscopic Heller myotomy show similar outcomes in type III achalasia 经口内窥镜肌切开术和腹腔镜heller肌切开术治疗III型贲门失弛缓症的结果相似。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-13 DOI: 10.1016/j.gassur.2026.102331

Archana K. Jeeji, Peter T. White, Adam J. Bograd, Alexander S. Farivar, Emily M. Mackay, Brian E. Louie

Background

Achalasia is classified into 3 manometric subtypes with variable treatment response. Guidelines recommend per oral endoscopic myotomy (POEM) over laparoscopic Heller myotomy (LHM) for the treatment of achalasia type III. However, there is limited evidence directly comparing these operations. We aimed to compare the treatment response to POEM vs LHM in type III achalasia.

Methods

We conducted a retrospective, case-control review of patients undergoing primary myotomy for type III achalasia or achalasia variants with type III features. The primary outcome was symptomatic response assessed using the Eckardt score (ES) with a score of ≤3 classified as success. The secondary outcome was the need for reintervention(s) within 3 years.

Results

There were 46 patients, of whom 16 underwent POEM, and 30 underwent LHM. The groups were similar in demographics, preoperative ESs, and rates of preoperative endoscopic interventions. Both groups had median myotomy lengths of 6 cm (4 cm esophageal and 2 cm gastric). After myotomy, both groups had similar rates of success (14/16 POEM vs 26/30 LHM, P =.94). The primary persisting symptom was dysphagia in both groups. Reinterventions occurred in 4/16 (25%) of POEM patients who underwent 9 reinterventions compared with 5/30 (16.7%) LHM patients who underwent 6 reinterventions (P =.49). Most patients in both groups had symptomatic improvement after their last reintervention.

Conclusion

Patients with type III achalasia had similar improvements after undergoing POEM or LHM. There was no difference in reintervention rates between the groups. Patients undergoing reintervention after POEM were more likely to undergo multiple reinterventions.

背景：失弛缓症可分为三种压力测量亚型，治疗反应各不相同。指南推荐口服内窥镜肌切开术（POEM）而不是腹腔镜Heller肌切开术（LHM）治疗III型贲门失弛缓症。然而，直接比较这些操作的证据有限。我们的目的是比较POEM和LHM治疗III型失弛缓症的疗效。方法：我们对因III型失弛缓症或III型失弛缓症变异而接受原发性肌切开术的患者进行了回顾性、病例对照研究。主要结局是使用Eckardt评分（ES）评估症状反应，评分≤3分为成功。次要指标为3年内是否需要再干预。结果：46例患者中16例行POEM， 30例行LHM。两组在人口统计学、术前Eckardt评分和术前内镜干预率方面相似。两组中位切肌长度均为6cm（食管4cm，胃2cm）。在肌切开术后，两组的成功率相似（14/16 POEM vs 26/30 LHM, p=0.94）。两组患者的主要持续症状均为吞咽困难。在接受9次再干预的POEM患者中，有4/16（25%）发生了再干预，而接受6次再干预的LHM患者中有5/30（16.7%）发生了再干预（p=0.49）。两组患者均在最后一次再干预后症状改善。结论：III型贲门失弛缓症患者接受POEM或LHM治疗有相似的改善。两组之间的再干预率没有差异。POEM后再干预的患者更有可能进行多次再干预。

{"title":"Per oral endoscopic myotomy and laparoscopic Heller myotomy show similar outcomes in type III achalasia","authors":"Archana K. Jeeji, Peter T. White, Adam J. Bograd, Alexander S. Farivar, Emily M. Mackay, Brian E. Louie","doi":"10.1016/j.gassur.2026.102331","DOIUrl":"10.1016/j.gassur.2026.102331","url":null,"abstract":"<div><h3>Background</h3><div>Achalasia is classified into 3 manometric subtypes with variable treatment response. Guidelines recommend per oral endoscopic myotomy (POEM) over laparoscopic Heller myotomy (LHM) for the treatment of achalasia type III. However, there is limited evidence directly comparing these operations. We aimed to compare the treatment response to POEM vs LHM in type III achalasia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, case-control review of patients undergoing primary myotomy for type III achalasia or achalasia variants with type III features. The primary outcome was symptomatic response assessed using the Eckardt score (ES) with a score of ≤3 classified as success. The secondary outcome was the need for reintervention(s) within 3 years.</div></div><div><h3>Results</h3><div>There were 46 patients, of whom 16 underwent POEM, and 30 underwent LHM. The groups were similar in demographics, preoperative ESs, and rates of preoperative endoscopic interventions. Both groups had median myotomy lengths of 6 cm (4 cm esophageal and 2 cm gastric). After myotomy, both groups had similar rates of success (14/16 POEM vs 26/30 LHM, <em>P</em> =.94). The primary persisting symptom was dysphagia in both groups. Reinterventions occurred in 4/16 (25%) of POEM patients who underwent 9 reinterventions compared with 5/30 (16.7%) LHM patients who underwent 6 reinterventions (<em>P</em> =.49). Most patients in both groups had symptomatic improvement after their last reintervention.</div></div><div><h3>Conclusion</h3><div>Patients with type III achalasia had similar improvements after undergoing POEM or LHM. There was no difference in reintervention rates between the groups. Patients undergoing reintervention after POEM were more likely to undergo multiple reinterventions.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102331"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989569","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}

引用次数: 0

Early Recurrence of Esophagogastric junction adenoCarcinoma after Surgery: a multicentre analysis of risk factors (ERECS Trial) 食管胃交界腺癌术后早期复发：一项多中心危险因素分析（ERECS试验）

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-13 DOI: 10.1016/j.gassur.2026.102329

Stefano de Pascale , Riccardo Rosati , Vincenzo Bagnardi , Andrea Cossu , Giovanni Ferrari , Samuele Frassoni , Simone Giacopuzzi , Monica Gualtierotti , Lucia Moletta , Mario Morino , Giovanni Pallabazzer , Marco Realis Luc , Fabrizio Rebecchi , Stefano Santi , Michele Valmasoni , Jacopo Weindelmayer , Uberto Fumagalli Romario

Background

Esophagogastric junction adenocarcinoma (EGJA) is characterized by a high recurrence rate after esophagectomy, which significantly affects patient survival. This study aimed to identify the risk factors contributing to early recurrence (ER) within 12 months after Ivor Lewis esophagectomy (ILE) in patients with EGJA.

Methods

A retrospective multicenter analysis was conducted across 7 high-volume Italian centers that included 594 patients with Siewert type I and II EGJAs who underwent ILE between January 2018 and December 2022. The clinicopathologic characteristics and postoperative outcomes were analyzed. ER was defined as cancer recurrence within 12 months after surgery. Univariate and multivariate analyses were performed to identify the independent risk factors for ER.

Results

The overall recurrence rate was 41.2% (245/594), with ER occurring in 24.4% (145/594) of patients. The 1-year overall survival rate was 87.7%, and the 1-year recurrence-free survival (RFS) rate was 70.6%. The median RFS was 32.1 months. Multivariate Cox regression analysis identified lower body mass index (hazard ratio [HR], 0.95; P =.009), poor or absent response to neoadjuvant treatment based on the Mandard classification (HR, 2.26; P =.013), and advanced stage (HR, 2.24; P <.001) as independent significant risk factors for ER in EGJA.

Conclusion

Identifying prognostic factors associated with ER allows for the stratification of a subgroup of patients with poor oncological outcomes who require a personalized treatment approach, distinct from the standard multimodal treatment.

背景：食管胃交界腺癌（EGJA）的特点是食管切除术后复发率高，严重影响患者的生存。本研究旨在确定EGJA患者Ivor Lewis食管切除术（ILE）后12个月内早期复发（ER）的危险因素。方法：对意大利7个大容量中心进行回顾性多中心分析，包括2018年1月至2022年12月期间接受ILE治疗的594例siwert I型和II型EGJA患者。分析两组患者的临床病理特征及术后结果。ER定义为术后12个月内肿瘤复发。进行单变量和多变量分析以确定ER的独立危险因素。结果：总复发率为41.2%(245/594)，其中ER发生率为24.4%（145/594）。1年总生存率（OS）为87.7%，1年无复发生存率（RFS）为70.6%。中位RFS为32.1个月。多变量Cox回归分析发现，较低的BMI （HR = 0.95, P = 0.009）、基于标准分类的新辅助治疗反应差或无反应（HR = 2.26, P = 0.013）和晚期（HR = 2.24, P < 0.001）是EGJA患者ER的独立显著危险因素。结论：确定与ER相关的预后因素允许对需要个性化治疗方法的患者亚组进行分层，不同于标准的多模式治疗，因为肿瘤预后较差。

{"title":"Early Recurrence of Esophagogastric junction adenoCarcinoma after Surgery: a multicentre analysis of risk factors (ERECS Trial)","authors":"Stefano de Pascale , Riccardo Rosati , Vincenzo Bagnardi , Andrea Cossu , Giovanni Ferrari , Samuele Frassoni , Simone Giacopuzzi , Monica Gualtierotti , Lucia Moletta , Mario Morino , Giovanni Pallabazzer , Marco Realis Luc , Fabrizio Rebecchi , Stefano Santi , Michele Valmasoni , Jacopo Weindelmayer , Uberto Fumagalli Romario","doi":"10.1016/j.gassur.2026.102329","DOIUrl":"10.1016/j.gassur.2026.102329","url":null,"abstract":"<div><h3>Background</h3><div>Esophagogastric junction adenocarcinoma (EGJA) is characterized by a high recurrence rate after esophagectomy, which significantly affects patient survival. This study aimed to identify the risk factors contributing to early recurrence (ER) within 12 months after Ivor Lewis esophagectomy (ILE) in patients with EGJA.</div></div><div><h3>Methods</h3><div>A retrospective multicenter analysis was conducted across 7 high-volume Italian centers that included 594 patients with Siewert type I and II EGJAs who underwent ILE between January 2018 and December 2022. The clinicopathologic characteristics and postoperative outcomes were analyzed. ER was defined as cancer recurrence within 12 months after surgery. Univariate and multivariate analyses were performed to identify the independent risk factors for ER.</div></div><div><h3>Results</h3><div>The overall recurrence rate was 41.2% (245/594), with ER occurring in 24.4% (145/594) of patients. The 1-year overall survival rate was 87.7%, and the 1-year recurrence-free survival (RFS) rate was 70.6%. The median RFS was 32.1 months. Multivariate Cox regression analysis identified lower body mass index (hazard ratio [HR], 0.95; <em>P</em> =.009), poor or absent response to neoadjuvant treatment based on the Mandard classification (HR, 2.26; <em>P</em> =.013), and advanced stage (HR, 2.24; <em>P</em> <.001) as independent significant risk factors for ER in EGJA.</div></div><div><h3>Conclusion</h3><div>Identifying prognostic factors associated with ER allows for the stratification of a subgroup of patients with poor oncological outcomes who require a personalized treatment approach, distinct from the standard multimodal treatment.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102329"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989488","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}

引用次数: 0

A rare type of gastric malignancy: primary gastric Burkitt lymphoma 一种罕见的胃恶性肿瘤：原发性胃伯基特淋巴瘤。

IF 2.4 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastrointestinal Surgery

Pub Date : 2026-01-12 DOI: 10.1016/j.gassur.2026.102326

Shaoping Xiong, Wenju Chen

引用次数: 0

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