Journal of Gastrointestinal Surgery最新文献

{"title":"Efficacy evaluation of postoperative adjuvant TACE in preventing HCC recurrence within Milan criteria: A multi-center propensity score matching analysis based on pathological indicators.","authors":"Kun He, Yongqiang Xiao, Shuju Tu, Yourao Li, Zhao Wu, Liping Liu, Wei Shen, Shiyun Bao, Yongzhu He","doi":"10.1016/j.gassur.2025.101978","DOIUrl":"https://doi.org/10.1016/j.gassur.2025.101978","url":null,"abstract":"<p><strong>Objective: </strong>Malignant biological behaviors such as microvascular invasion (MVI), satellite nodule formation and poor differentiation can appear in the postoperative pathology of early hepatocellular carcinoma (HCC), which often indicates that it has entered the stage of malignant evolution earlier. This study aimed to evaluate tumor recurrence in HCC patients meeting the Milan criteria who underwent postoperative adjuvant transarterial chemoembolization (PA-TACE) based on postoperative pathological indices.</p><p><strong>Methods: </strong>A retrospective study was conducted on 790 HCC patients within the Milan criteria who underwent hepatectomy across four medical centers, comprising 366 patients treated with PA-TACE and 424 patients without PA-TACE. To reduce selection bias, propensity score matching (PSM) at a 1:1 ratio was applied, achieving balanced clinical characteristics between the two groups.</p><p><strong>Results: </strong>Patients receiving PA-TACE did not experience more severe adverse events or toxicity-related deaths. After PSM of each subgroup, it was found that patients with MVI (Median time: 37 months vs 17 months, p = 0.010), satellite nodules (Median time: NA vs 14 months, p = 0.018), and Edmondson-Steiner grade III-IV (Median time: NA vs 13 months, p = 0.004) who received PA-TACE had higher recurrence-free survival (RFS). However, patients who were MVI-negative, satellite nodule-negative, and Edmondson-Steiner grade I-II did not benefit from PA-TACE in terms of RFS (All p > 0.05). Patients who received PA-TACE were more likely to undergo liver transplantation, re-hepatectomy, and local ablation after tumor recurrence, whereas patients who did not receive PA-TACE were more likely to receive TACE, chemoradiotherapy, and immunotargeted therapy after tumor recurrence (All p < 0.05).</p><p><strong>Conclusion: </strong>Postoperative pathological indicators can guide the selection of PA-TACE for patients with HCC within the Milan criteria. Patients with MVI, satellite nodules, and Edmondson-Steiner grade III-IV are more suitable for receiving PA-TACE to improve RFS. PA-TACE may alter the recurrence pattern of tumors, rendering them more localized.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"101978"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122999","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":"Endoluminal approaches for colorectal neoplasia in inflammatory bowel disease: a viable alternative for colectomy?","authors":"Ali Alipouriani,&nbsp;Stefan D. Holubar,&nbsp;Kamil Erozkan,&nbsp;Lukas Schabl,&nbsp;Joshua Sommovilla,&nbsp;Michael Valente,&nbsp;Scott R. Steele,&nbsp;Emre Gorgun","doi":"10.1016/j.gassur.2024.101876","DOIUrl":"10.1016/j.gassur.2024.101876","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic resection of visible dysplastic lesions in patients with inflammatory bowel disease (IBD) is an alternative to colectomy. The endoscopic techniques that can be used include endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and ESD combined with EMR. These endoscopic approaches may allow organ preservation in patients with IBD. This study aimed to evaluate the outcomes of endoscopic resection, including EMR, ESD, and ESD combined with EMR, for the treatment of colorectal dysplasia in patients with IBD.</div></div><div><h3>Methods</h3><div>This was a retrospective review of patients with IBD who underwent endoscopic resection for colorectal dysplasia at our tertiary care center between 2014 and 2023. Patients were identified via a search of our endoscopy database. Medical records were reviewed to collect data on patient demographics, IBD history, details of endoscopic technique, procedural factors, final pathology results, and outcomes, including recurrence of dysplasia.</div></div><div><h3>Results</h3><div>A total of 50 patients with IBD who underwent endoscopic resection were included in the study, with 38 ESD cases, 11 ESD combined with EMR cases, and 1 EMR case. The median age was 62 years, (IQR, 54–68), and 34 patients (68%) were male. The median body mass index was 27.6 kg/m² (IQR, 24.8–31.7). The underlying diagnoses were ulcerative colitis in 33 patients (66%) and Crohn’s disease in 17 patients (33%). The median disease duration was 27.5 years (IQR, 8–30). Polyp locations were distributed as follows: right colon, rectum, left colon, transverse colon, and cecum, with 9 polyps (18%) in each area. The median procedure time was 47.5 min (IQR, 31.2–73.7). En bloc resection was performed in 34 patients (68%), and piecemeal resection was performed in 16 patients (32%). On pathology, the median lesion size was 23.5 mm (IQR, 20.2–40.0). High-grade dysplasia was found in 7 patients (14%), whereas low-grade dysplasia was found in 15 patients (30%). During a median follow-up period of 3 years, 18% of patients experienced recurrence. No significant difference in recurrence rates was observed between the ESD and ESD combined with EMR groups.</div></div><div><h3>Conclusion</h3><div>Endoscopic resection, including EMR, ESD, and ESD combined with EMR, is an effective treatment of visible dysplastic lesions and is a safe alternative to colectomy in patients with IBD. In this cohort, favorable short-term outcomes were observed after endoscopic resection.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101876"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621983","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":"Effects of gut microbiota and metabolites on pancreatitis: a 2-sample Mendelian randomization study","authors":"Zhirong Zhao ,&nbsp;Li Han ,&nbsp;Baobaonai Tuerxunbieke ,&nbsp;Lan Ming ,&nbsp;Jiamin Ji ,&nbsp;Yuan Chen ,&nbsp;Ran Sun ,&nbsp;Weiliang Tian ,&nbsp;Fan Yang ,&nbsp;Qian Huang","doi":"10.1016/j.gassur.2024.101885","DOIUrl":"10.1016/j.gassur.2024.101885","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) and chronic pancreatitis (CP) have high incidences and poor prognoses. The early screening of at-risk populations still awaits further study. The limitation was mainly based on observational studies, with limited sample size and the presence of confounding factors. This study used a 2-sample Mendelian randomization (MR) analysis based on publicly available data from genome-wide association studies to reveal the causal effect of gut microbiota and metabolites on pancreatitis.</div></div><div><h3>Methods</h3><div>This study collected summary statistics on gut microbiota, metabolites, AP, and CP. A 2-sample MR analysis was performed using MR-Egger, inverse variance-weighted, MR Pleiotropy RESidual Sum and Outlier, maximum likelihood, and weighted median.</div></div><div><h3>Results</h3><div>The 2-sample MR showed that only <em>Eubacterium coprostanoligenes</em> was an independent protective factor for AP among all gut microbiota, and the other microbiota were not significant for pancreatitis. Unsaturated fatty acids in metabolites are protective factors for both AP (odds ratio [OR], 0.730; 95% CI, 0.593–0.899; <em>P</em> = .003) and CP (OR, 0.660; 95% CI, 0.457–0.916; <em>P</em> = .013). Furthermore, carnitine was a protective factor CP, and glucose was an independent risk factor for CP.</div></div><div><h3>Conclusion</h3><div>This study provides potential evidence of the causal role of gut microbiota and metabolites on pancreatitis, which may be conducive for designing microbiome and metabolite interventions on AP or CP in the future.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101885"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644075","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":"Long-term follow-up of sacrococcygeal pilonidal sinus disease after previous abscess drainage: a retrospective cohort study","authors":"Jochem de Kort ,&nbsp;Anne Akke Pronk ,&nbsp;Menno R. Vriens ,&nbsp;Niels Smakman ,&nbsp;Edgar J.B. Furnee","doi":"10.1016/j.gassur.2024.101892","DOIUrl":"10.1016/j.gassur.2024.101892","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101892"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687262","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":"Postoperative skeletal muscle loss as a prognostic indicator of clinical outcomes in patients with gastric cancer: a systematic review and meta-analysis","authors":"Chenyang Zhan ,&nbsp;Jun Bu ,&nbsp;Sheng Li ,&nbsp;Xiujin Huang ,&nbsp;Zongjie Quan","doi":"10.1016/j.gassur.2024.101898","DOIUrl":"10.1016/j.gassur.2024.101898","url":null,"abstract":"<div><h3>Background</h3><div>A decrease in skeletal muscle mass is frequently observed during the perioperative period in patients with gastric cancer (GC) and is strongly associated with postoperative complications and poor long-term survival outcomes. Relevant research indicates that a certain proportion of patients with GC experience skeletal muscle mass loss after surgery. Therefore, a systematic review and meta-analysis was conducted to assess postoperative skeletal muscle loss as a prognostic marker for clinical outcomes in patients with GC.</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, and Embase were used to systematically screen and retrieve relevant studies according to strictly established inclusion and exclusion criteria. Further analysis of the effect of postoperative skeletal muscle loss on long-term survival metrics (including overall survival [OS], recurrence-free survival [RFS], disease-free survival [DFS], and disease-specific survival [DSS]) in patients with GC was performed.</div></div><div><h3>Results’</h3><div>From 10 studies and 11 related publications, more than 3764 patients with GC were identified. Severe postoperative skeletal muscle loss occurred in 25.7% of patients with GC and was significantly correlated with poorer OS (hazard ratio [HR], 2.27; 95% CI, 1.58–3.25; <em>P</em> &lt;.00001), RFS (HR, 2.96; 95% CI, 1.47–5.97; <em>P</em> =.002), DFS (HR, 2.41; 95% CI, 1.17–4.97; <em>P</em> =.02), and DSS (HR, 4.12; 95% CI, 2.44–6.94; <em>P</em> &lt;.00001). When postoperative skeletal muscle loss advanced to sarcopenia, patients had worse OS as well (HR, 2.22; 95% CI, 1.49–3.30; <em>P</em> &lt;.0001).</div></div><div><h3>Conclusion</h3><div>Patients who undergo radical surgery for GC often experience skeletal muscle mass loss, and significant skeletal muscle mass loss is associated with poorer survival outcomes. Identifying patients with significant skeletal muscle mass loss during follow-up and promptly providing tailored interventions, such as nutritional and exercise support, are essential.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101898"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750974","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":"Analyzing the interaction between time to surgery and tumor burden score in hepatocellular carcinoma","authors":"Miho Akabane ,&nbsp;Jun Kawashima ,&nbsp;Selamawit Woldesenbet ,&nbsp;Abdullah Altaf ,&nbsp;François Cauchy ,&nbsp;Federico Aucejo ,&nbsp;Irinel Popescu ,&nbsp;Minoru Kitago ,&nbsp;Guillaume Martel ,&nbsp;Francesca Ratti ,&nbsp;Luca Aldrighetti ,&nbsp;George A. Poultsides ,&nbsp;Yuki Imaoka ,&nbsp;Andrea Ruzzenente ,&nbsp;Itaru Endo ,&nbsp;Ana Gleisner ,&nbsp;Hugo P. Marques ,&nbsp;Vincent Lam ,&nbsp;Tom Hugh ,&nbsp;Nazim Bhimani ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.gassur.2024.101903","DOIUrl":"10.1016/j.gassur.2024.101903","url":null,"abstract":"<div><h3>Background</h3><div>The effect of “time to surgery (TTS)” on outcomes for curative-intent hepatectomy of hepatocellular carcinoma (HCC) remains debated. The interaction between tumor burden score (TBS) and TTS remains unclear. We sought to evaluate the effects of TBS and TTS on long-term HCC outcomes.</div></div><div><h3>Methods</h3><div>Patients with HCC who underwent curative-intent hepatectomy (2000–2022) were analyzed from a multi-institutional database and categorized by TTS (≤60 or &gt;60 days). Overall survival (OS) and cancer-specific survival were assessed.</div></div><div><h3>Results</h3><div>Among 910 patients, median TTS estimates were 22 days in the short TTS group (n = 485) and 120 days in the long TTS group (n = 425). Patients with long TTS were older and were more likely to have American Society of Anesthesiologists class &gt;2, diabetes mellitus, and cirrhosis. There was no difference in median TBS among patients who had short versus long TTS (4.61 vs 5.00, respectively). In addition, there was no difference in 5-year OS (70.0% vs 63.1%, respectively; <em>P</em> =.05). On multivariate analysis TBS (hazard ratio [HR], 1.07; 95% CI, 1.03–1.11; <em>P</em> &lt;.001), log alpha-fetoprotein (HR, 1.08; 95% CI, 1.01–1.14; <em>P</em> =.02), and albumin-bilirubin score (HR, 2.52; 95% CI, 1.66–3.82; <em>P</em> &lt;.001) were associated with OS. In contrast, TTS was not associated with OS (HR, 1.18; 95% CI, 0.78–1.77; <em>P</em> =.43). Interaction analysis demonstrated that TBS was asssociated with OS among patients with short TTS (HR, 1.12; 95% CI, 1.07–1.17; <em>P</em> &lt;.001), but not among patients with long TTS (HR, 0.98; 95% CI, 0.91–1.05; <em>P</em> =.56). Among patients with low TBS (≤5), higher mortality was observed with long TTS versus short TTS (5-year OS: 82.4% vs 63.0%, respectively; <em>P</em> =.001); however, TTS was not associated with OS among patients with high TBS (5-year OS: 57.9% vs 63.3%, respectively; <em>P</em> =.92). Multivariate analysis demonstrated that long TTS was a risk factor for OS among patients with low TBS (HR, 3.12; 95% CI, 1.60–6.01; <em>P</em> &lt;.001), but not among individuals with high TBS (HR, 0.57; 95% CI, 0.30–1.07; <em>P</em> =.08). Similar trends were observed relative to cancer-specific survival.</div></div><div><h3>Conclusion</h3><div>TTS needs to be considered in light of patient and tumor-specific factors. Expediting TTS may be particularly important among patients with HCC and a low TBS.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101903"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755024","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":"Letter to editor regarding: “Impact of splenectomy on long-term outcomes after gastrectomy for gastric cancer: a population-based study”","authors":"Liqiu Kou ,&nbsp;Jixuan Wu ,&nbsp;Zili Zhang ,&nbsp;Lei Zhang","doi":"10.1016/j.gassur.2024.101921","DOIUrl":"10.1016/j.gassur.2024.101921","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101921"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769517","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":"Endoscopic “step-up” myotomy: a salvage technique for full-thickness tunnel entry in end-stage achalasia","authors":"Jeong Hoon Kim,&nbsp;Qais Dawod,&nbsp;Kartik Sampath","doi":"10.1016/j.gassur.2024.101895","DOIUrl":"10.1016/j.gassur.2024.101895","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101895"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693046","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":"Letter to the editor regarding “Graft choice in pancreatectomy with vascular resection: equivalent safety in selected patients”","authors":"Uday Singh Dadhwal","doi":"10.1016/j.gassur.2024.101922","DOIUrl":"10.1016/j.gassur.2024.101922","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101922"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785715","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 exploring rural-urban differences in the receipt of nonelective cancer-specific gastrointestinal surgery using a multilevel mixed-effects approach","authors":"Lena Egbert,&nbsp;Zhi Ven Fong","doi":"10.1016/j.gassur.2024.101902","DOIUrl":"10.1016/j.gassur.2024.101902","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 2","pages":"Article 101902"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769584","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}