Journal of Gastrointestinal Surgery最新文献

{"title":"Stapled Kono-S anastomosis as a protective strategy against postoperative endoscopic recurrence in ileocolonic Crohn’s disease: a dual-center retrospective cohort analysis","authors":"Zhouhang Dai , Ming Duan , Wei Liu , Xiaolong Ge , Lei Cao , Wei Zhou , Yi Li","doi":"10.1016/j.gassur.2025.102318","DOIUrl":"10.1016/j.gassur.2025.102318","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102318"},"PeriodicalIF":2.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889198","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":"Comparative effectiveness of exercise modalities on psychological outcomes and quality of life in digestive system cancer survivors: a systematic review and network meta-analysis","authors":"Jiaqi Li,&nbsp;Qian Zhang,&nbsp;Wei Ning,&nbsp;Zhenzi Wang","doi":"10.1016/j.gassur.2025.102313","DOIUrl":"10.1016/j.gassur.2025.102313","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of digestive system cancers frequently experience depression, anxiety, fatigue, and impaired health-related quality of life (HRQoL). Exercise has emerged as a promising adjunctive therapy. However, the optimal modality and prescription remain unclear. This study aimed to evaluate the effects of exercise on psychological outcomes and HRQoL, to rank the relative efficacy of different modalities, and to identify optimal exercise characteristics through subgroup analyses.</div></div><div><h3>Methods</h3><div>PubMed, Embase, CENTRAL, Web of Science, and Google Scholar were searched until August 31, 2025, for randomized controlled trials (RCTs) of exercise interventions in adult survivors of digestive system cancers. Eligible comparators included usual care, no intervention, or alternative exercise. The primary outcomes were HRQoL, fatigue, depression, and anxiety, which were measured using validated instruments. The standardized mean differences (SMDs) with 95% CIs were used as effect estimates. Pairwise meta-analyses were performed with random-effects models, and Bayesian network meta-analysis was used to compare exercise modalities. Subgroup analyses were used to examine moderators, including cancer type, exercise intensity, frequency, session duration, and intervention length.</div></div><div><h3>Results</h3><div>A total of 38 RCTs that involved 3255 participants were included. The exercise group significantly had improved HRQoL (SMD, 0.43 [95% CI, 0.27–0.59]) and reduced fatigue (SMD, −0.52 [95% CI, −0.72 to −0.32]), depression (SMD, −0.37 [95% CI, −0.58 to −0.15]), and anxiety (SMD, −0.33 [95% CI, −0.44 to −0.21]) compared with the control group. Network meta-analysis indicated that mind-body exercise (such as yoga or tai chi) was most effective for HRQoL (SMD, 0.68 [95% CI, 0.22–1.14]) and depression (SMD, −0.55 [95% CI, −0.95 to −0.16]), resistance training for fatigue (SMD, −0.79 [95% CI, −1.35 to −0.23]), and combined training (CT) for anxiety (SMD, −0.38 [95% CI, −0.53 to −0.23]). Subgroup analyses showed that moderate-intensity, moderate-frequency, and medium-to-long interventions produced the most consistent benefits.</div></div><div><h3>Conclusion</h3><div>Exercise interventions significantly improved HRQoL and reduced depression, anxiety, and fatigue in survivors of digestive system cancers. Mind-body exercise (eg, yoga or tai chi) demonstrated the greatest benefits for HRQoL and depression, resistance training best alleviated fatigue, and CT reduced anxiety. Moderate-intensity, sustained programs achieved the most consistent benefits, supporting individualized exercise prescriptions in survivorship care.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102313"},"PeriodicalIF":2.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878464","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":"Perioperative fluid management in pancreaticoduodenectomy in the era of goal-directed fluid therapy: a review of the literature","authors":"Meghan Grim,&nbsp;Richard Zheng,&nbsp;Nader Hanna,&nbsp;Harish Lavu,&nbsp;Charles J. Yeo,&nbsp;Avinoam Nevler","doi":"10.1016/j.gassur.2025.102316","DOIUrl":"10.1016/j.gassur.2025.102316","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is the only curative option for localized pancreatic head and periampullary malignancies. However, PD is associated with significant perioperative morbidity. Perioperative fluid management has emerged as an important modifiable factor influencing surgical outcomes in PD.</div></div><div><h3>Methods</h3><div>In this qualitative review, PubMed/Medline searches were performed between March and August 2025 to review the terms “pancreaticoduodenectomy,” “fluid management,” “Enhanced Recovery After Surgery,” “complications,” and related terms.</div></div><div><h3>Results</h3><div>Historically, liberal fluid administration was favored to compensate for third-space losses, but contemporary evidence has linked excessive fluid volumes to complications, such as postoperative pancreatic fistula, anastomotic edema, and increased inflammatory responses. Recent studies, including those utilizing Enhanced Recovery After Surgery (ERAS) protocols, indicate the possible benefit of more restrictive fluid regimens, finding that restrictive fluids are associated with reduced overall complications, lower cardiopulmonary morbidity, and shorter post-operative hospital stays, amongst others. However, overly restrictive strategies may risk hypoperfusion, driving the necessity for a delicate balance between restrictive fluid administration and physiologic demand.</div></div><div><h3>Conclusions</h3><div>Goal-directed fluid therapy protocols offer a promising approach to PD fluid management by individualizing fluid delivery, minimizing complications, and improving perfusion metrics, resulting in a more effective restrictive fluid approach. Despite these advancements, heterogeneity in study designs, fluid management definitions, and monitoring tools limits a clear consensus. Future research should prioritize multicenter randomized controlled trials, standardized protocols, and long-term outcome assessments to refine evidence-based, patient-centered fluid management strategies in PD.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102316"},"PeriodicalIF":2.4,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856762","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":"Biological, mechanical, and immune changes in an abdominal rectus fascia transplant model in rats","authors":"Jeremias Elias Moreira ,&nbsp;Ivana Ivanoff ,&nbsp;Marco Santillán Pazmiño ,&nbsp;Pedro Martín ,&nbsp;Verónica Milesi ,&nbsp;Pablo Stringa ,&nbsp;Anastasios D. Giannou ,&nbsp;Lucrecia Cúneo ,&nbsp;Fernando Ogresta ,&nbsp;Araceli Castro ,&nbsp;Augusto Pellegrino Damelio ,&nbsp;Martín Eleta ,&nbsp;María Virginia Gentilini ,&nbsp;Martín Rumbo ,&nbsp;Gabriel Eduardo Gondolesi","doi":"10.1016/j.gassur.2025.102306","DOIUrl":"10.1016/j.gassur.2025.102306","url":null,"abstract":"<div><h3>Background</h3><div>Primary abdominal wall closure after intestinal and multivisceral transplants remains a challenge. Avascular transplant of the abdominal rectus fascia (TxARF) has emerged as an alternative to reduce postoperative morbidity and mortality. This study aimed to evaluate tissue and immunological responses to TxARF in a rat model without immunosuppression.</div></div><div><h3>Methods</h3><div>A total of 34 TxARFs were performed in rats (17 isogenic [ISO] and 17 allogeneic [ALLO]), with recipients sacrificed at 30 and 120 days after surgery. Serum and graft samples were analyzed for donor-specific antibodies (DSAs), elasticity, cellular analysis by flow cytometry, histopathology, and immunohistochemistry for CD3+ cells.</div></div><div><h3>Results</h3><div>Muscle fiber loss was observed at 30 days, with collagen content significantly higher in ALLO (55.97 ± 3.68) and ISO (33.13 ± 3.85) groups than controls (3.78 ± 0.47) (<em>P</em> &lt;.0001). The lateral portions of the grafts showed more large blood vessels, whereas the medial areas had small vessels. The ALLO group exhibited increased resistance to stretching and elasticity loss. Despite the lack of immunosuppression, CD3+ levels in all groups were similar to controls, with only 1 animal showing a positive DSA response.</div></div><div><h3>Conclusion</h3><div>Long-term changes include muscle fiber replacement with fibrosis and loss of elasticity, especially in the alloreactive group. No significant immune response occurred, confirming the fascia’s low immunogenicity.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 2","pages":"Article 102306"},"PeriodicalIF":2.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843759","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 “Sixteen years of microwave ablation: a homogeneous dataset or a mirror of technical evolution?”","authors":"Xiaoming Zhang ,&nbsp;Zhenbo Shu","doi":"10.1016/j.gassur.2025.102317","DOIUrl":"10.1016/j.gassur.2025.102317","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102317"},"PeriodicalIF":2.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843747","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 modified gastric tube reconstruction after laparoscopic proximal gastrectomy for early adenocarcinoma in the upper third stomach and esophagogastric junction: short-term surgical outcomes","authors":"Yi Liao ,&nbsp;Wengcheong Tam ,&nbsp;Hao Chen ,&nbsp;Jintuan Huang ,&nbsp;Jun Xiang ,&nbsp;Chunyu Chen ,&nbsp;Zuli Yang","doi":"10.1016/j.gassur.2025.102315","DOIUrl":"10.1016/j.gassur.2025.102315","url":null,"abstract":"<div><h3>Background</h3><div>Proximal gastrectomy with conventional esophagogastrostomy is frequently associated with postoperative complications, including significant reflux esophagitis. This study aimed to evaluate a modified reconstruction technique that combines gastric tube (GT) formation with overlap anastomosis and partial fundoplication.</div></div><div><h3>Methods</h3><div>Between January 2021 and January 2024, 29 consecutive patients diagnosed with early-stage proximal gastric cancer underwent laparoscopic proximal gastrectomy using our novel reconstruction method. The surgical protocol included the creation of a GT conduit, overlap esophagogastric anastomosis, and partial fundoplication procedure. Perioperative outcomes and postoperative follow-up data were prospectively collected.</div></div><div><h3>Results</h3><div>The cohort demonstrated a mean operative time of 239 ± (SD) 50 min and a median estimated blood loss of 50 mL (IQR, 20–150). Lymph node dissection yielded a median count of 25 nodes (IQR, 9–66). Postoperative complications included 1 case (3.4%) of anastomotic leakage requiring conservative management. Mild reflux symptoms (heartburn) were transiently observed in 2 patients (6.9%), both resolving with short-term proton pump inhibitor therapy. Endoscopic evaluation at the 3-month follow-up revealed grade A or B reflux esophagitis (Los Angeles classification) in 2 patients (6.9%). Nutritional parameters (serum albumin and total protein levels) showed expected postoperative declines during the initial 3-month period, followed by progressive recovery to preoperative baseline values by 6 months postoperatively (<em>P</em> &lt;.05 for longitudinal comparison).</div></div><div><h3>Conclusion</h3><div>Our preliminary findings suggest that GT reconstruction with overlap anastomosis and partial fundoplication is a technically feasible and safe approach for proximal gastrectomy, demonstrating acceptable short-term functional outcomes with mitigated reflux complications.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102315"},"PeriodicalIF":2.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843773","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":"Contemporary emergency management and 1-year outcomes of colonic diverticulitis: a population-based cohort study","authors":"Teagan Telesnicki ,&nbsp;Therese A. Stukel ,&nbsp;Andrew S. Wilton ,&nbsp;Anthony de Buck van Overstraeten ,&nbsp;Charles de Mestral ,&nbsp;David Gomez","doi":"10.1016/j.gassur.2025.102311","DOIUrl":"10.1016/j.gassur.2025.102311","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to describe contemporary outcomes on index hospitalization and 1-year outcomes from index discharge in patients with diverticulitis.</div></div><div><h3>Methods</h3><div>This population-based retrospective cohort study included adult residents of Ontario, Canada, who presented to the emergency department (ED) with diverticulitis (January 2017 to March 2022). For individuals hospitalized at the time of index ED presentation, the risks of urgent surgery, percutaneous drainage, and mortality were reported. After index presentation discharge (from the ED or hospital with an intact colon), the cumulative incidences of unplanned hospitalization, urgent surgery, and scheduled surgery were reported at 30 days and 1 year, accounting for competing risks.</div></div><div><h3>Results</h3><div>Of 24,759 patients presenting to the ED with diverticulitis, 6263 (25%) were hospitalized, and 5379 (23%) required no intervention. However, a minority of patients required surgery (555 [2.2%]) and percutaneous drainage (329 [1.3%]). After index presentation discharge, the cumulative incidences of unplanned hospitalization, urgent surgery, and scheduled surgery were 2.00% (95% CI, 2.10%–2.40%), 0.60% (95% CI, 0.50%–0.70%), and 0.06% (95% CI, 0.03%–0.09%) at 30 days and 7.00% (95% CI, 6.70%–7.30%), 1.30% (95% CI, 1.20%–1.50%), and 1.50% (95% CI, 1.30%–1.60%) at 1 year, respectively. People managed with percutaneous drainage at index presentation were at higher 1-year risk: 44% (95% CI, 29%–39%) unplanned hospitalization and 11% (95% CI, 8%–14%) urgent surgery.</div></div><div><h3>Conclusion</h3><div>For most patients, the disease course 1 year from index discharge remains benign, with only a small minority of patients requiring hospitalization or surgery. These outcome estimates can guide patient counseling, including the appropriateness of scheduled colectomy for diverticulitis.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102311"},"PeriodicalIF":2.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834290","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 single-center retrospective study of conversion surgery in stage IV gastric cancer: association with immune checkpoint inhibitor-based chemotherapy","authors":"Yuki Ushimaru,&nbsp;Takeshi Omori,&nbsp;Kazuyoshi Yamamoto,&nbsp;Kei Yamamoto,&nbsp;Yasunori Masuike,&nbsp;Yoshitomo Yanagimoto,&nbsp;Norihiro Matsuura,&nbsp;Takahito Sugase,&nbsp;Takashi Kanemura,&nbsp;Ryota Mori,&nbsp;Masatoshi Kitakaze,&nbsp;Masahiko Kubo,&nbsp;Yasunari Fukuda,&nbsp;Hisateru Komatsu,&nbsp;Masaaki Miyo,&nbsp;Toshinori Sueda,&nbsp;Yoshinori Kagawa,&nbsp;Kunihito Gotoh,&nbsp;Shogo Kobayashi,&nbsp;Hiroshi Miyata","doi":"10.1016/j.gassur.2025.102301","DOIUrl":"10.1016/j.gassur.2025.102301","url":null,"abstract":"<div><h3>Background</h3><div>Stage IV gastric cancer remains challenging to treat despite recent advances in systemic therapy. Among patients with favorable responses to chemotherapy, conversion surgery aiming for R0 resection has shown promise in improving survival. Immune checkpoint inhibitors (ICIs) have become a key component of systemic treatment, but their prognostic impact in the setting of conversion surgery remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective single-center study included 98 patients with gastric cancer who received platinum-based doublet chemotherapy followed by minimally invasive surgery. Patients were stratified into ICI (n = 41) and non-ICI groups (n = 57). Perioperative outcomes, progression-free survival (PFS), and overall survival (OS) were evaluated using Kaplan–Meier analysis and Cox regression models.</div></div><div><h3>Results</h3><div>The median operative time was 345 min, and the median blood loss was 5 mL. R0 resection was achieved in 79.6% of cases, and the median hospital stay was 7 days. Clavien–Dindo grade ≥ II complications occurred in 12.2% of patients. ICI-treated patients had significantly longer PFS (hazard ratio [HR], 0.418; <em>P</em> =.0008) and OS (HR, 0.437; <em>P</em> =.024). R0 resection was independently associated with improved PFS (HR, 0.179; <em>P</em> &lt;.0001) and OS (HR, 0.231; <em>P</em> &lt;.0001). Multivariate analysis identified pathological N status, R0 resection, and ICI use as independent predictors of PFS.</div></div><div><h3>Conclusion</h3><div>Among patients who underwent conversion surgery in this real-world cohort, those treated with ICI-based chemotherapy demonstrated more favorable long-term outcomes than those treated with chemotherapy alone. Although our findings do not demonstrate a causal relationship of ICI therapy on resectability, they suggest that ICI-based chemotherapy may be associated with improved survival in appropriately selected patients with human epidermal growth factor receptor 2–negative stage IV gastric cancer. Prospective studies are warranted to clarify optimal indications and perioperative strategies for integrating ICI-based regimens into conversion treatment.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 2","pages":"Article 102301"},"PeriodicalIF":2.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804680","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 efficacy of immunotherapy in the treatment of tyrosine kinase inhibitor-refractory gastrointestinal stromal tumors: a systematic review and meta-analysis","authors":"YuLong Zhang ,&nbsp;XianHao Xiao ,&nbsp;JiaYing Tan,&nbsp;Liang Shan,&nbsp;He Song","doi":"10.1016/j.gassur.2025.102307","DOIUrl":"10.1016/j.gassur.2025.102307","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. The advent of tyrosine kinase inhibitors (TKIs), such as imatinib, has significantly improved clinical outcomes in patients with GISTs by delaying metastasis and prolonging survival. However, most patients eventually develop resistance to TKIs, limiting long-term disease control. Immunotherapy has demonstrated durable responses in various solid tumors and has emerged as a potential treatment strategy for TKI-refractory GISTs. This study aimed to systematically evaluate the efficacy and safety of immunotherapy in patients with advanced or recurrent GIST, particularly those who have failed previous TKI therapy, to inform future clinical decision-making and research directions.</div></div><div><h3>Methods</h3><div>A systematic literature search of PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov was conducted for studies published before June 23, 2025. The inclusion criteria focused on immunotherapy interventions in patients with histologically confirmed GIST. Study selection, data extraction, and risk of bias assessments were performed independently by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Joanna Briggs Institute checklist was used for quality appraisal. Random-effects models were used to pool estimates of clinical benefit rate (CBR), objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Generalized linear mixed models (GLMM) were used to account for cohorts with extreme values. This review protocol was registered with the International Registry of Systematic Reviews (registration number: CRD42024496866).</div></div><div><h3>Results</h3><div>A total of 9 studies involving 169 patients were included. The pooled CBR was 41.69% (95% CI, 26.99%–58.03%), and the ORR was 16.49% (95% CI, 6.25%–36.91%), both with moderate to high heterogeneity. GLMM adjustments, which incorporated additional extreme value cohorts, yielded a corrected CBR of 46.39% (95% CI, 28.85%–64.88%) and ORR of 13.23% (95% CI, 4.21%–34.56%). The pooled median PFS across 7 cohorts was 6.11 months (95% CI, 2.63–9.59), and the OS, which was calculated using 2 models, ranged from 15.53 to 17.01 months, depending on the data imputation strategy.</div></div><div><h3>Conclusion</h3><div>This meta-analysis suggests that immunotherapy provides modest yet clinically meaningful efficacy in patients with advanced or treatment-refractory GIST. Despite considerable heterogeneity among studies, the observed trends in response and survival outcomes support immunotherapy as a viable treatment option. Further large-scale, biomarker-driven clinical trials are warranted to validate these findings and guide personalized therapeutic strategies.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 3","pages":"Article 102307"},"PeriodicalIF":2.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800569","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":"Dysphagia megalatriensis as differential diagnosis of recurrence in a long-term survivor of gastric cancer: an uncommon cause of dysphagia beyond the alimentary tract","authors":"Enrique Biel ,&nbsp;Juan Sánchez-Parrilla ,&nbsp;Manuel Pera","doi":"10.1016/j.gassur.2025.102305","DOIUrl":"10.1016/j.gassur.2025.102305","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 2","pages":"Article 102305"},"PeriodicalIF":2.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781039","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}