Journal of Gastrointestinal Surgery最新文献

{"title":"Light amplification by stimulated emission of radiation in fistula-in-ano: innovation or impetuosity? Current position","authors":"Vipul D. Yagnik , Prema Ram Choudhary , Pankaj Garg","doi":"10.1016/j.gassur.2026.102328","DOIUrl":"10.1016/j.gassur.2026.102328","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102328"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989572","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":"Per oral endoscopic myotomy and laparoscopic Heller myotomy show similar outcomes in type III achalasia","authors":"Archana K. Jeeji,&nbsp;Peter T. White,&nbsp;Adam J. Bograd,&nbsp;Alexander S. Farivar,&nbsp;Emily M. Mackay,&nbsp;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}

{"title":"Early Recurrence of Esophagogastric junction adenoCarcinoma after Surgery: a multicentre analysis of risk factors (ERECS Trial)","authors":"Stefano de Pascale ,&nbsp;Riccardo Rosati ,&nbsp;Vincenzo Bagnardi ,&nbsp;Andrea Cossu ,&nbsp;Giovanni Ferrari ,&nbsp;Samuele Frassoni ,&nbsp;Simone Giacopuzzi ,&nbsp;Monica Gualtierotti ,&nbsp;Lucia Moletta ,&nbsp;Mario Morino ,&nbsp;Giovanni Pallabazzer ,&nbsp;Marco Realis Luc ,&nbsp;Fabrizio Rebecchi ,&nbsp;Stefano Santi ,&nbsp;Michele Valmasoni ,&nbsp;Jacopo Weindelmayer ,&nbsp;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> &lt;.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}

{"title":"A rare type of gastric malignancy: primary gastric Burkitt lymphoma","authors":"Shaoping Xiong,&nbsp;Wenju Chen","doi":"10.1016/j.gassur.2026.102326","DOIUrl":"10.1016/j.gassur.2026.102326","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102326"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984955","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":"Early vs delayed oral feeding after esophagectomy for esophageal cancer: a systematic review and meta-analysis of randomized controlled trials assessing safety, clinical recovery, and quality of life outcomes","authors":"Nirmal Paudel ,&nbsp;Anurag Jha ,&nbsp;Amina Basharat ,&nbsp;Muhammad Huzaifa Khalil ,&nbsp;Ramsha Ali ,&nbsp;Shaista Qadir ,&nbsp;Syed Hassan Akhlaq ,&nbsp;Muhammad Anas ,&nbsp;Muhammad Abbas ,&nbsp;Awais Ayub ,&nbsp;Muhammad Nabeel Saddique ,&nbsp;Nukhbat Ullah Awan","doi":"10.1016/j.gassur.2026.102322","DOIUrl":"10.1016/j.gassur.2026.102322","url":null,"abstract":"<div><h3>Background</h3><div>Esophagectomy traditionally involves delayed oral feeding (DOF) due to anastomotic leakage concerns. Enhanced Recovery After Surgery protocols favor early feeding, but its safety remains controversial. This study compared early oral feeding (EOF) and DOF after esophagectomy.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Scopus were systematically searched from inception of the study to October 2025 for randomized controlled trials comparing EOF (0–3 days) and DOF (≥5 days) after esophagectomy. The primary outcomes were anastomotic leakage and pneumonia. The secondary outcomes included complications, hospital outcomes, gastrointestinal (GI) recovery, and quality of life (QOL). Effect sizes were calculated as mean differences (MDs) or standardized MDs (SMDs) for continuous variables and risk ratios (RRs) for dichotomous variables, with 95% CIs, using Review Manager (version 5.4; Cochrane Collaboration).</div></div><div><h3>Results</h3><div>A total of 13 trials involving 1468 patients were included in the study. Early feeding showed no increase in anastomotic leakage (RR, 0.89 [95% CI, 0.55–1.45]; <em>I</em>² = 0%), with consistent safety across anastomotic locations and surgical approaches. Early feeding significantly reduced pneumonia (RR, 0.66 [95% CI, 0.47–0.92]; <em>P</em> =.01) and accelerated GI recovery: time to first bowel movement (MD, −0.50 days [95% CI, −0.55 to −0.46]; <em>P</em> &lt;.00001) and first flatus (MD, −0.61 days [95% CI, −0.95 to −0.26]; <em>P</em> =.0006). Hospital stay was reduced by 1.89 days (95% CI, −3.06 to −0.72; <em>P</em> =.002) with lower medical expenses (SMD, −1.19 [95% CI, −2.07 to −0.30]; <em>P</em> =.009). QOL improved: global health status (MD, 9.08 [95% CI, 3.88–14.29]; <em>P</em> =.0006), dysphagia (MD, −6.15 [95% CI, −9.97 to −2.34]; <em>P</em> =.002), pain (MD, −3.60 [95% CI, −5.32 to −1.89]; <em>P</em> &lt;.00001), and swallowing difficulties (MD, −1.39 [95% CI, −1.53 to −1.26]; <em>P</em> &lt;.00001).</div></div><div><h3>Conclusion</h3><div>EOF after esophagectomy seems safe and effective, reducing complications while accelerating recovery. However, further high-quality multicenter trials are needed to validate these findings.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102322"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984983","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":"The association of preoperative nutritional status and physical fitness with postoperative outcomes in esophageal cancer: results from the PReoperative intervention to Improve Outcomes in esophageal cancer patients after Resection study.","authors":"Elja A E Reijneveld, Jaap J Dronkers, Iris B Mekenkamp, Joran J Kauw, Ewout A Kouwenhoven, Jan Willem Haveman, Edwin J van Adrichem, Miranda J Velthuis, Sandra Beijer, Jelle P Ruurda, Cindy Veenhof","doi":"10.1016/j.gassur.2026.102327","DOIUrl":"10.1016/j.gassur.2026.102327","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate whether preoperative nutritional status and physical fitness after prehabilitation are associated with surgical outcomes, functional capacity, fatigue, and quality of life after esophagectomy.</p><p><strong>Methods: </strong>This multicenter, observational cohort study included patients with esophageal cancer who underwent curative treatment and multimodal prehabilitation as part of standard care. Preoperative assessments included body mass index (BMI), risk of malnutrition, exercise capacity, handgrip strength (HGS), upper leg muscle function, physical activity level, and fatigue, after finishing prehabilitation. Differences in preoperative parameters between patients with and without postoperative overall or pulmonary complications were analyzed using independent samples t-tests. Associations between preoperative parameters and length of hospital stay, postoperative functional capacity, fatigue, and quality of life were examined using multivariable linear regression models.</p><p><strong>Results: </strong>A total of 168 patients were included in the study, with a mean age of 65.9 ± 8.6 years and 78.0% of the patients being male. A higher preoperative BMI was associated with more overall complications (P =.029). Better preoperative exercise capacity and upper leg muscle function were associated with less pulmonary complications (P <.045) and better postoperative functional capacity (P <.032). Less preoperative fatigue was associated with better postoperative functional capacity, quality of life, and less fatigue (P ≤.001). Risk of malnutrition, HGS, and physical activity level were not significantly associated with postoperative outcomes.</p><p><strong>Conclusion: </strong>BMI, exercise capacity, upper leg muscle function, and fatigue seem to be important factors in the preoperative assessment before esophagectomy in terms of postoperative complications, postoperative functional capacity, fatigue, and quality of life. During prehabilitation, specific attention is needed for patients with a high BMI, low fitness level, and high fatigue.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102327"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985001","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 “Restoring bowel continuity after extended left colectomy: a comparative study of the retroileal window and Deloyers techniques”","authors":"Vitaliy Poylin","doi":"10.1016/j.gassur.2025.102309","DOIUrl":"10.1016/j.gassur.2025.102309","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102309"},"PeriodicalIF":2.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948869","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":"Overuse of subtotal cholecystectomy: surgeon practice patterns and outcomes in a large healthcare system","authors":"Ramsey Michael Dallal ,&nbsp;Samantha Ekanayake ,&nbsp;Alec C. Beekley ,&nbsp;Sultan Mahmoud Abdelhamid ,&nbsp;Radi F. Zaki ,&nbsp;Noah Streitfeld ,&nbsp;Charles J. Yeo","doi":"10.1016/j.gassur.2026.102325","DOIUrl":"10.1016/j.gassur.2026.102325","url":null,"abstract":"<div><h3>Background</h3><div>Subtotal cholecystectomy (SC) is a possible bailout procedure to prevent bile duct injuries (BDIs) when a critical view of safety cannot be obtained during cholecystectomy (CC).</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 17,299 CCs performed by 111 surgeons across 12 hospitals within 1 large healthcare system using multilevel propensity-weighted logistic regression to model the risk of SC and reinterventions, accounting for patient-, surgeon-, and hospital-level factors.</div></div><div><h3>Results</h3><div>Among 157 SC cases, 94 (60%) were performed by just 8 surgeons, who collectively accounted for only 13% of all CCs. In addition, 136 cases (87%) of SC were concentrated in 3 hospitals, accounting for 31% of all CCs. Surgeons with increasing experience performing SC were significantly more likely to perform the procedure (odds ratio [OR], 1.13; <em>P</em> =.004). Conversely, the more CCs a surgeon performed, the lower the likelihood of performing an SC (OR, 0.998; <em>P</em> &lt;.001). Fellowship training and years of experience were not significant independent predictors. The 30-day disease-specific reintervention rate after SC was 22.3%. There was no detectable increase in reinterventions among surgeons or hospitals who had never or rarely performed SC. In addition, 6 major BDIs requiring reconstruction were identified after CC (BDI rate of 0.03%). Surgeon-level variability, not hospital-level variability, explained the residual clustering of SC use, accounting for 16% of the adjusted residual.</div></div><div><h3>Conclusion</h3><div>SC use was primarily surgeon driven, even after accounting for patient factors that were independently associated with SC. These findings challenge SC’s role as a universal bailout and call for curbing its discretionary overuse.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102325"},"PeriodicalIF":2.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948955","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 “Contemporary emergency management and 1-year outcomes of colonic diverticulitis: a population-based cohort study”","authors":"Sean J. Langenfeld","doi":"10.1016/j.gassur.2026.102323","DOIUrl":"10.1016/j.gassur.2026.102323","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102323"},"PeriodicalIF":2.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944556","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-assisted decompression of the celiac trunk via the common hepatic artery approach for median arcuate ligament syndrome","authors":"Michela Orsi,&nbsp;Lorenza Beomonte Zobel,&nbsp;Giuseppe S. Sica","doi":"10.1016/j.gassur.2026.102321","DOIUrl":"10.1016/j.gassur.2026.102321","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102321"},"PeriodicalIF":2.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933630","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}