Journal of Gastrointestinal Surgery最新文献

{"title":"Intraabdominal fat necrosis as a cause of abdominal pain","authors":"Belén Del Rosario Pinto , Felipe Higuera , Roy López Grove","doi":"10.1016/j.gassur.2026.102336","DOIUrl":"10.1016/j.gassur.2026.102336","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102336"},"PeriodicalIF":2.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994531","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":"Intrathoracic side-overlap vs circular stapled esophagogastrostomy for Siewert type I/II adenocarcinoma of the esophagogastric junction: a retrospective comparative study","authors":"Chuanle Cheng ,&nbsp;Zhanpeng Tang ,&nbsp;Yijun Ma,&nbsp;Lei Qi,&nbsp;Hui Tian,&nbsp;Lin Li","doi":"10.1016/j.gassur.2026.102332","DOIUrl":"10.1016/j.gassur.2026.102332","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> =.246), estimated blood loss (110 mL [IQR, 150–90] vs 120 mL [IQR, 150–100], respectively; <em>P</em> =.354), or number of lymph nodes harvested (19.0 [IQR, 23.0–16.0] vs 17.5 [IQR, 21.0–15.8], respectively; <em>P</em> =.285). The overall postoperative complication rate was similar (18.2% in the SOE group vs 22.0% in the CSE group; <em>P</em> =.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; <em>P</em> =.002; POD2: 2.73 ± 0.65 in the SOE group vs 3.06 ± 0.62 in the CSE group, <em>P</em> =.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; <em>P</em> =.019). Dysphagia symptoms were less frequent in the SOE group than in the CSE group (9.1% vs 24.0%, respectively; <em>P</em> =.038).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102332"},"PeriodicalIF":2.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989575","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 “Beyond short-term outcomes: mechanistic and equity considerations for minimally invasive surgery in small bowel neuroendocrine tumors”","authors":"Ye Tian,&nbsp;Ce Zhang,&nbsp;Muhu Chen","doi":"10.1016/j.gassur.2026.102334","DOIUrl":"10.1016/j.gassur.2026.102334","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102334"},"PeriodicalIF":2.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989551","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":"Hiatal hernia and anemia: a single-center experience","authors":"Andrés R. Latorre-Rodríguez ,&nbsp;Raj Shah ,&nbsp;Hailey Simmonds ,&nbsp;Jill Benavidez ,&nbsp;Arianna Vittori ,&nbsp;Ross M. Bremner ,&nbsp;Sumeet K. Mittal","doi":"10.1016/j.gassur.2026.102333","DOIUrl":"10.1016/j.gassur.2026.102333","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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 &lt;13.0 g/dL for men or &lt;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.</div></div><div><h3>Results</h3><div>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%; <em>P</em> =.004) and anemia-related medical therapies (50.8% to 2.2%; <em>P</em> &lt;.001).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102333"},"PeriodicalIF":2.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989505","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":"Disparities in presentation and outcomes after surgery for medically refractory gastroparesis: the impact of demographic and socioeconomic status","authors":"Emma Venard ,&nbsp;Sven E. Eriksson ,&nbsp;Margaret Gardner ,&nbsp;Ping Zheng ,&nbsp;Shahin Ayazi","doi":"10.1016/j.gassur.2025.102312","DOIUrl":"10.1016/j.gassur.2025.102312","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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]; <em>P</em> &lt;.001), and gastric retention at 4 h decreased (29.0% [IQR, 17.0%–44.9%] to 8.0% [IQR, 1.0%–24.0%]; <em>P</em> &lt;.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]; <em>P</em> =.011) and continued to report higher postoperative symptom scores (GCSI total score: 3.1 vs 2.4; <em>P</em> =.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 (<em>r</em> = 0.46; <em>P</em> =.049) and postoperatively (<em>r</em> = 0.60; <em>P</em> =.025). Younger patients were less likely to have symptom resolution (<em>P</em> =.035).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102312"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957634","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":"Light amplification by stimulated emission of radiation in fistula-in-ano: innovation or impetuosity? Current position","authors":"Vipul D. Yagnik ,&nbsp;Prema Ram Choudhary ,&nbsp;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}