Pub Date : 2025-11-19DOI: 10.1016/j.gassur.2025.102288
Lisa Milena Anabela, Syifa Salsabila, Wilbert Huang, Muhammad Irfan Fathoni, Aklila Qurrota A’ini Sumardi, Cynthia Parameswari
Background
Hypoglycemia is a common adverse outcome after bariatric surgery. Preoperative factors are important to predict worse hypoglycemic incidence. This study aimed to evaluate preoperative risk factors associated with the incidence of hypoglycemia after bariatric surgery.
Methods
A systematic search was performed across 3 databases until September 2024. Hypoglycemia was defined as the presence of neuroglycopenic and/or neurogenic signs and symptoms, accompanied by a blood glucose level of <3.0 mmol/L (54 mg/dL) with resolution after glucose ingestion.
Results
A total of 11 observational and randomized controlled trial studies, which were composed of 8428 patients, were included in the study. Female sex (odds ratio [OR] 1.56, [95% CI, 1.28–1.89]; P <.00001; I2 = 0%) and body mass index (BMI; OR, 1.03 [95% CI, 1.01–1.05]; P =.002; I2 = 0%) were associated with an increased risk of developing hypoglycemia after bariatric surgery. Preoperative fasting blood glucose value was associated with increased odds of hypoglycemia (OR, 3.16 [95% CI, 1.34–7.44]; P =.008; I2 = 83%; r, −492 [range, −0.572 to −402]; P =.000). Age, hemoglobin A1C level, high-density lipoprotein cholesterol, triglycerides, and preoperative smoking status were not significantly associated with the increased odds of postbariatric hypoglycemia (PBH) or linearly correlated with the outcome (P >.05).
Conclusion
Female sex, BMI, and preoperative fasting blood glucose level were significantly associated with the incidence of PBH. A lower preoperative fasting blood glucose level increased the risk of PBH.
{"title":"Preoperative risk factors associated with hypoglycemia after bariatric surgery: a systematic review and meta-analysis","authors":"Lisa Milena Anabela, Syifa Salsabila, Wilbert Huang, Muhammad Irfan Fathoni, Aklila Qurrota A’ini Sumardi, Cynthia Parameswari","doi":"10.1016/j.gassur.2025.102288","DOIUrl":"10.1016/j.gassur.2025.102288","url":null,"abstract":"<div><h3>Background</h3><div>Hypoglycemia is a common adverse outcome after bariatric surgery. Preoperative factors are important to predict worse hypoglycemic incidence. This study aimed to evaluate preoperative risk factors associated with the incidence of hypoglycemia after bariatric surgery.</div></div><div><h3>Methods</h3><div>A systematic search was performed across 3 databases until September 2024. Hypoglycemia was defined as the presence of neuroglycopenic and/or neurogenic signs and symptoms, accompanied by a blood glucose level of <3.0 mmol/L (54 mg/dL) with resolution after glucose ingestion.</div></div><div><h3>Results</h3><div>A total of 11 observational and randomized controlled trial studies, which were composed of 8428 patients, were included in the study. Female sex (odds ratio [OR] 1.56, [95% CI, 1.28–1.89]; <em>P</em> <.00001; <em>I</em><sup><em>2</em></sup> = 0%) and body mass index (BMI; OR, 1.03 [95% CI, 1.01–1.05]; <em>P</em> =.002; <em>I</em><sup><em>2</em></sup> = 0%) were associated with an increased risk of developing hypoglycemia after bariatric surgery. Preoperative fasting blood glucose value was associated with increased odds of hypoglycemia (OR, 3.16 [95% CI, 1.34–7.44]; <em>P</em> =.008; <em>I</em><sup><em>2</em></sup> = 83%; <em>r</em>, −492 [range, −0.572 to −402]; <em>P</em> =.000). Age, hemoglobin A1C level, high-density lipoprotein cholesterol, triglycerides, and preoperative smoking status were not significantly associated with the increased odds of postbariatric hypoglycemia (PBH) or linearly correlated with the outcome (<em>P</em> >.05).</div></div><div><h3>Conclusion</h3><div>Female sex, BMI, and preoperative fasting blood glucose level were significantly associated with the incidence of PBH. A lower preoperative fasting blood glucose level increased the risk of PBH.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102288"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564159","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}
Pub Date : 2025-11-18DOI: 10.1016/j.gassur.2025.102286
Chamanthi Konidala , Cameron Dabbs , Ryan Shargo , Isaac Poonen-Honig , Pavani Peddi , Camille Thélin , Salvatore Docimo Jr , Rebecca Klam , Joseph Sujka
Background
Gastroparesis is a chronic gastrointestinal (GI) motility disorder that is defined by objectively delayed gastric emptying of solids in the absence of mechanical obstruction. Gastroparesis presents as a syndrome marked by a range of upper GI symptoms, most commonly nausea, vomiting, early satiety, bloating, belching, and upper abdominal discomfort or pain. Pylorus-targeting approaches have been a common management for gastroparesis, with gastric peroral endoscopic myotomy (G-POEM) and pyloroplasty being effective surgical options. However, comparative data on redo procedure rates and outcomes remain limited. This study aimed to compare the frequency, timing, and clinical outcomes of redo interventions after G-POEM vs pyloroplasty in patients with refractory gastroparesis, addressing the current gap in comparative data to help guide long-term procedural decision-making.
Methods
A retrospective chart review was conducted on patients who underwent G-POEM or pyloroplasty from 2019 to 2024. Data included redo rates, time to reintervention, and postintervention outcomes. Statistical analyses were performed using appropriate tests for categorical and continuous variables.
Results
Among 173 patients (85 who underwent G-POEM and 88 who underwent pyloroplasty), those who underwent pyloroplasty were more likely to have preoperative patient-reported esophageal reflux (P <.001) and concurrent procedures (P <.001). Of note, 42 patients (24%) required redo procedures (G-POEM: 52.4%; pyloroplasty: 47.6%). The mean time to redo was 383.18 days (P =.156). Although the reintervention rates were similar (P =.770), patients who underwent G-POEM more often underwent secondary pyloroplasty, whereas those who underwent pyloroplasty more frequently received gastric neurostimulators (P =.012). Symptom improvement was comparable (P =.870), with 51% reporting relief and 21% achieving resolution.
Conclusion
G-POEM and pyloroplasty have similar redo rates but differ in terms of the types of secondary intervention, highlighting the need for individualized treatment planning.
{"title":"Redo rates and outcomes of gastric peroral endoscopic myotomy vs pyloroplasty for gastroparesis: a retrospective analysis","authors":"Chamanthi Konidala , Cameron Dabbs , Ryan Shargo , Isaac Poonen-Honig , Pavani Peddi , Camille Thélin , Salvatore Docimo Jr , Rebecca Klam , Joseph Sujka","doi":"10.1016/j.gassur.2025.102286","DOIUrl":"10.1016/j.gassur.2025.102286","url":null,"abstract":"<div><h3>Background</h3><div>Gastroparesis is a chronic gastrointestinal (GI) motility disorder that is defined by objectively delayed gastric emptying of solids in the absence of mechanical obstruction. Gastroparesis presents as a syndrome marked by a range of upper GI symptoms, most commonly nausea, vomiting, early satiety, bloating, belching, and upper abdominal discomfort or pain. Pylorus-targeting approaches have been a common management for gastroparesis, with gastric peroral endoscopic myotomy (G-POEM) and pyloroplasty being effective surgical options. However, comparative data on redo procedure rates and outcomes remain limited. This study aimed to compare the frequency, timing, and clinical outcomes of redo interventions after G-POEM vs pyloroplasty in patients with refractory gastroparesis, addressing the current gap in comparative data to help guide long-term procedural decision-making.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on patients who underwent G-POEM or pyloroplasty from 2019 to 2024. Data included redo rates, time to reintervention, and postintervention outcomes. Statistical analyses were performed using appropriate tests for categorical and continuous variables.</div></div><div><h3>Results</h3><div>Among 173 patients (85 who underwent G-POEM and 88 who underwent pyloroplasty), those who underwent pyloroplasty were more likely to have preoperative patient-reported esophageal reflux (<em>P</em> <.001) and concurrent procedures (<em>P</em> <.001). Of note, 42 patients (24%) required redo procedures (G-POEM: 52.4%; pyloroplasty: 47.6%). The mean time to redo was 383.18 days (<em>P</em> =.156). Although the reintervention rates were similar (<em>P</em> =.770), patients who underwent G-POEM more often underwent secondary pyloroplasty, whereas those who underwent pyloroplasty more frequently received gastric neurostimulators (<em>P</em> =.012). Symptom improvement was comparable (<em>P</em> =.870), with 51% reporting relief and 21% achieving resolution.</div></div><div><h3>Conclusion</h3><div>G-POEM and pyloroplasty have similar redo rates but differ in terms of the types of secondary intervention, highlighting the need for individualized treatment planning.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102286"},"PeriodicalIF":2.4,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564114","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}
Pub Date : 2025-11-17DOI: 10.1016/j.gassur.2025.102284
Lukas Schabl , Lucas F. Sobrado , Imran Khan , Kamil Erozkan , Tarkan Jäger , Scott R. Steele , Tracy L. Hull
Background
Establishing an anastomosis after an extended left hemicolectomy can be challenging due to insufficient colonic reach. Surgical options include the Deloyers technique (DT) and the retroileal window technique (RIWT). The primary objective was to compare the safety and functional outcomes of these restorative techniques.
Methods
This retrospective cohort analysis used prospectively collected data on postoperative quality of life (QoL) and bowel function. Adult patients who underwent either RIWT or DT at a tertiary center between 1995 and 2023 were included in the study. The primary outcomes were complications, patient-reported bowel function, and QoL, which were assessed using validated questionnaires.
Results
RIWT was performed in 87 patients, and DT was performed in 97 patients. Cancer was the most common indication in both groups. RIWT occurred more during index operation (64.4% in the RIWT group vs 33.0% in the DT group; P <.001), whereas DT had higher rates of low anastomosis (57.7% in the DT group vs 27.6% in the RIWT group; P <.001) and protective stomas (69.1% in the DT group vs 19.5% in the RIWT group; P <.001). RIWT had higher odds of postoperative ileus (odds ratio, 7.2 [95% CI, 1.7–30.2]; P =.007). Other postoperative complications, including Clavien-Dindo grade > II events, were comparable. DT showed more dietary and social restrictions and bowel movements at night and per 24 h on univariate analysis, although not significant on multivariate analysis. The Wexner continence scores and QoL were similar between the groups.
Conclusion
RIWT and DT are safe and effective techniques for achieving tension-free anastomosis after extended left colectomy. Given the comparable complication rates and functional outcomes, the choice of surgical technique should be based on intraoperative findings and surgeon expertise.
{"title":"Restoring bowel continuity after extended left colectomy: a comparative study of the retroileal window and Deloyers techniques","authors":"Lukas Schabl , Lucas F. Sobrado , Imran Khan , Kamil Erozkan , Tarkan Jäger , Scott R. Steele , Tracy L. Hull","doi":"10.1016/j.gassur.2025.102284","DOIUrl":"10.1016/j.gassur.2025.102284","url":null,"abstract":"<div><h3>Background</h3><div>Establishing an anastomosis after an extended left hemicolectomy can be challenging due to insufficient colonic reach. Surgical options include the Deloyers technique (DT) and the retroileal window technique (RIWT). The primary objective was to compare the safety and functional outcomes of these restorative techniques.</div></div><div><h3>Methods</h3><div>This retrospective cohort analysis used prospectively collected data on postoperative quality of life (QoL) and bowel function. Adult patients who underwent either RIWT or DT at a tertiary center between 1995 and 2023 were included in the study. The primary outcomes were complications, patient-reported bowel function, and QoL, which were assessed using validated questionnaires.</div></div><div><h3>Results</h3><div>RIWT was performed in 87 patients, and DT was performed in 97 patients. Cancer was the most common indication in both groups. RIWT occurred more during index operation (64.4% in the RIWT group vs 33.0% in the DT group; <em>P</em> <.001), whereas DT had higher rates of low anastomosis (57.7% in the DT group vs 27.6% in the RIWT group; <em>P</em> <.001) and protective stomas (69.1% in the DT group vs 19.5% in the RIWT group; <em>P</em> <.001). RIWT had higher odds of postoperative ileus (odds ratio, 7.2 [95% CI, 1.7–30.2]; <em>P</em> =.007). Other postoperative complications, including Clavien-Dindo grade > II events, were comparable. DT showed more dietary and social restrictions and bowel movements at night and per 24 h on univariate analysis, although not significant on multivariate analysis. The Wexner continence scores and QoL were similar between the groups.</div></div><div><h3>Conclusion</h3><div>RIWT and DT are safe and effective techniques for achieving tension-free anastomosis after extended left colectomy. Given the comparable complication rates and functional outcomes, the choice of surgical technique should be based on intraoperative findings and surgeon expertise.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102284"},"PeriodicalIF":2.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556946","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}
Precise resection margins are crucial in gastric cancer surgery to optimize oncological outcomes and reduce postoperative functional disorders. Fluorescent marking clips (ZEOCLIP FS; Zeon Medical Co, Ltd) have demonstrated potential in improving resection line accuracy during laparoscopic gastrectomy. However, the original ZEOCLIP FS contained insufficient fluorescent dye, limiting its visibility with the Firefly mode of the da Vinci Surgical System. To address this limitation, a new version with increased dye concentration, the ZEOCLIP FS Marker, was developed. This study aimed to evaluate the utility and safety of the enhanced ZEOCLIP FS Marker in robot-assisted gastric cancer surgery.
Methods
A prospective observational study was conducted in 20 patients diagnosed with gastric cancer (cT1-T4aNanyM0). Fluorescent clips were preoperatively placed along the intended resection margins, and the Firefly mode was used intraoperatively to detect the clips. The primary endpoint was the detection rate, defined as the proportion of cases in which all preoperatively placed clips were identified under fluorescence. The secondary endpoints included detection time, thread-to-clip distance, and complications.
Results
The detection rate of the clips under fluorescence was 75.0% (90% CI, 54.4%–89.6%). At least 1 fluorescent clip was detected in all patients (20/20), facilitating approximate tumor localization. Of the 51 clips placed, 45 (88.2%) were identified under fluorescence. The median thread-to-clip distance was 3 mm (range, 0–13). Clip-related complications were minimal, with 1 case of postoperative anastomotic leakage and 2 unrelated complications.
Conclusion
The enhanced ZEOCLIP FS Marker seems effective and safe for marking gastric transection lines in robot-assisted surgery. Further prospective interventional studies are warranted to confirm whether the use of fluorescent clips can reduce the reliance on intraoperative endoscopy.
{"title":"Utility and safety of near-infrared fluorescent marking clips for tumor localization in robot-assisted laparoscopic gastric cancer surgery","authors":"Koshi Kumagai , Masashi Yoshida , Hiroki Ishida , Naoki Ishizuka , Manabu Ohashi , Rie Makuuchi , Masaru Hayami , Satoshi Ida , Yohei Ikenoyama , Ken Namikawa , Yoshitaka Tokai , Shoichi Yoshimizu , Yusuke Horiuchi , Akiyoshi Ishiyama , Toshiyuki Yoshio , Toshiaki Hirasawa , Junko Fujisaki , Souya Nunobe","doi":"10.1016/j.gassur.2025.102280","DOIUrl":"10.1016/j.gassur.2025.102280","url":null,"abstract":"<div><h3>Purpose</h3><div>Precise resection margins are crucial in gastric cancer surgery to optimize oncological outcomes and reduce postoperative functional disorders. Fluorescent marking clips (ZEOCLIP FS; Zeon Medical Co, Ltd) have demonstrated potential in improving resection line accuracy during laparoscopic gastrectomy. However, the original ZEOCLIP FS contained insufficient fluorescent dye, limiting its visibility with the Firefly mode of the da Vinci Surgical System. To address this limitation, a new version with increased dye concentration, the ZEOCLIP FS Marker, was developed. This study aimed to evaluate the utility and safety of the enhanced ZEOCLIP FS Marker in robot-assisted gastric cancer surgery.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in 20 patients diagnosed with gastric cancer (cT1-T4aNanyM0). Fluorescent clips were preoperatively placed along the intended resection margins, and the Firefly mode was used intraoperatively to detect the clips. The primary endpoint was the detection rate, defined as the proportion of cases in which all preoperatively placed clips were identified under fluorescence. The secondary endpoints included detection time, thread-to-clip distance, and complications.</div></div><div><h3>Results</h3><div>The detection rate of the clips under fluorescence was 75.0% (90% CI, 54.4%–89.6%). At least 1 fluorescent clip was detected in all patients (20/20), facilitating approximate tumor localization. Of the 51 clips placed, 45 (88.2%) were identified under fluorescence. The median thread-to-clip distance was 3 mm (range, 0–13). Clip-related complications were minimal, with 1 case of postoperative anastomotic leakage and 2 unrelated complications.</div></div><div><h3>Conclusion</h3><div>The enhanced ZEOCLIP FS Marker seems effective and safe for marking gastric transection lines in robot-assisted surgery. Further prospective interventional studies are warranted to confirm whether the use of fluorescent clips can reduce the reliance on intraoperative endoscopy.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102280"},"PeriodicalIF":2.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523444","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}
Pub Date : 2025-11-12DOI: 10.1016/j.gassur.2025.102282
Aapo Jalkanen , Arto Kokkola , Johanna Louhimo , Olli Helminen , Mika Helmiö , Heikki Huhta , Anna Junttila , Raija Kallio , Vesa Koivukangas , Simo Laine , Elina Lietzen , Sanna Meriläinen , Vesa-Matti Pohjanen , Tuomo Rantanen , Ari Ristimäki , Jari V. Räsänen , Juha Saarnio , Eero Sihvo , Vesa Toikkanen , Tuula Tyrväinen , Joonas H. Kauppila
Background
Gastric cancer surgery is associated with significant morbidity. Obesity is a risk factor for short-term complications. However, previous studies on the role of body mass index (BMI) as a predictor of long-term survival have conflicting results, and contemporary population-based data in the Western population are lacking. This study aimed to compare the long-term survival after gastric cancer surgery among patients who were underweight (BMI of <18.5 kg/m2), those with normal weight (BMI of 18.5–24.9 kg/m2), those who were overweight (BMI of 25.0–29.9 kg/m2), and those who were obese (BMI of >30.0 kg/m2).
Methods
This was a population-based, retrospective, nationwide cohort study in Finland using the Finnish National Esophago-Gastric Cancer Cohort. Patients who underwent gastrectomy with available height and weight data were included. A Cox regression model was used to calculate the 95% CI for 6-month to 5-year survival and 6-month survival, which was adjusted for age, sex (assigned), year of surgery, Charlson Comorbidity Index, pathological p/yp stage, neoadjuvant therapy, type of resection, and Lauren histological type.
Results
Overall, 1647 patients who underwent gastrectomy for gastric cancer were identified. Of the patients, 64 (3.9%) were underweight, 735 (44.6%) had normal weight, 584 (35.5%) were overweight, and 264 (16.0%) were obese. In the first 6 months, mortality was higher in the overweight group (hazard ratio [HR], 1.663 [95% CI, 1.158–2.389]) than in the normal weight group. However, 6-month to 5-year mortality was the highest in the underweight group (HR, 1.426 [95% CI, 1.019–1.994]) and decreased with increasing BMI (HR, 0.820 [95% CI, 0.708–0.949]). Patients with obesity had the best prognosis (HR, 0.798 [95% CI, 0.655–0.971]).
Conclusion
In this population-based study, higher BMI was associated with better long-term survival after gastric cancer surgery, somewhat offset by higher mortality during the first postoperative months, with patients with obesity having the best overall survival.
{"title":"Body mass index and survival after surgery for gastric adenocarcinoma: a population-based nationwide cohort study in Finland","authors":"Aapo Jalkanen , Arto Kokkola , Johanna Louhimo , Olli Helminen , Mika Helmiö , Heikki Huhta , Anna Junttila , Raija Kallio , Vesa Koivukangas , Simo Laine , Elina Lietzen , Sanna Meriläinen , Vesa-Matti Pohjanen , Tuomo Rantanen , Ari Ristimäki , Jari V. Räsänen , Juha Saarnio , Eero Sihvo , Vesa Toikkanen , Tuula Tyrväinen , Joonas H. Kauppila","doi":"10.1016/j.gassur.2025.102282","DOIUrl":"10.1016/j.gassur.2025.102282","url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer surgery is associated with significant morbidity. Obesity is a risk factor for short-term complications. However, previous studies on the role of body mass index (BMI) as a predictor of long-term survival have conflicting results, and contemporary population-based data in the Western population are lacking. This study aimed to compare the long-term survival after gastric cancer surgery among patients who were underweight (BMI of <18.5 kg/m<sup>2</sup>), those with normal weight (BMI of 18.5–24.9 kg/m<sup>2</sup>), those who were overweight (BMI of 25.0–29.9 kg/m<sup>2</sup>), and those who were obese (BMI of >30.0 kg/m<sup>2</sup>).</div></div><div><h3>Methods</h3><div>This was a population-based, retrospective, nationwide cohort study in Finland using the Finnish National Esophago-Gastric Cancer Cohort. Patients who underwent gastrectomy with available height and weight data were included. A Cox regression model was used to calculate the 95% CI for 6-month to 5-year survival and 6-month survival, which was adjusted for age, sex (assigned), year of surgery, Charlson Comorbidity Index, pathological p/yp stage, neoadjuvant therapy, type of resection, and Lauren histological type.</div></div><div><h3>Results</h3><div>Overall, 1647 patients who underwent gastrectomy for gastric cancer were identified. Of the patients, 64 (3.9%) were underweight, 735 (44.6%) had normal weight, 584 (35.5%) were overweight, and 264 (16.0%) were obese. In the first 6 months, mortality was higher in the overweight group (hazard ratio [HR], 1.663 [95% CI, 1.158–2.389]) than in the normal weight group. However, 6-month to 5-year mortality was the highest in the underweight group (HR, 1.426 [95% CI, 1.019–1.994]) and decreased with increasing BMI (HR, 0.820 [95% CI, 0.708–0.949]). Patients with obesity had the best prognosis (HR, 0.798 [95% CI, 0.655–0.971]).</div></div><div><h3>Conclusion</h3><div>In this population-based study, higher BMI was associated with better long-term survival after gastric cancer surgery, somewhat offset by higher mortality during the first postoperative months, with patients with obesity having the best overall survival.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102282"},"PeriodicalIF":2.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523438","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}
Pub Date : 2025-11-11DOI: 10.1016/j.gassur.2025.102281
Frank A. DiSilvio, Terrah Paul Olson
{"title":"Invited commentary on “Prospective evaluation of the novel BADCAL score for predicting colorectal anastomotic leak unicorn hunt: searching for the ideal tool to predict and identify anastomotic leak”","authors":"Frank A. DiSilvio, Terrah Paul Olson","doi":"10.1016/j.gassur.2025.102281","DOIUrl":"10.1016/j.gassur.2025.102281","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102281"},"PeriodicalIF":2.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504909","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}
Pub Date : 2025-11-07DOI: 10.1016/j.gassur.2025.102278
Olivia Sears, Samantha M. Ruff, Victor M. Zaydfudim
{"title":"Ciliated foregut cyst of the biliary hilum mimicking choledochal cyst","authors":"Olivia Sears, Samantha M. Ruff, Victor M. Zaydfudim","doi":"10.1016/j.gassur.2025.102278","DOIUrl":"10.1016/j.gassur.2025.102278","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102278"},"PeriodicalIF":2.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482228","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}
Pub Date : 2025-11-05DOI: 10.1016/j.gassur.2025.102277
Reena S. Suresh, Shannon N. Radomski, Miloslawa Stem, Michael Consul, Angelos Papanikolaou, Sophia Y. Chen, Susan L. Gearhart, Alodia Gabre-Kidan
{"title":"Conversion to permanent stoma due to poor bowel function after proctectomy with coloanal anastomosis for rectal cancer","authors":"Reena S. Suresh, Shannon N. Radomski, Miloslawa Stem, Michael Consul, Angelos Papanikolaou, Sophia Y. Chen, Susan L. Gearhart, Alodia Gabre-Kidan","doi":"10.1016/j.gassur.2025.102277","DOIUrl":"10.1016/j.gassur.2025.102277","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"30 1","pages":"Article 102277"},"PeriodicalIF":2.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470920","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}
Pub Date : 2025-11-05DOI: 10.1016/j.gassur.2025.102276
Vipul D. Yagnik , Prema Ram Choudhary
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