Our study aims to retrospectively analyze the combined effects of closed continuous irrigation drainage technique (CCIDT) and narrative nursing on recovery, anxiety, and quality of life in ultra-low rectal cancer (ULRC) patients undergoing anus-preserving operation.
Methods
A total of 224 ULRC patients were analyzed with four groups: conventional drainage with routine care (Group A), conventional drainage with narrative nursing (Group B), irrigated drainage with routine care (Group C), and irrigated drainage with narrative nursing (Group D). The outcome assessment included the first postoperative exhaust time, drainage tube placement time, and length of stay. Anxiety levels were measured using the Generalized Anxiety Disorder-7 scale, and quality of life was assessed using the EORTC QLQ-C30 questionnaire.
Results
The CCIDT significantly shortened the first postoperative exhaust time, drainage tube placement time, and length of stay compared to conventional drainage techniques (p < 0.001 for all comparisons). However, CCIDT did not significantly affect the occurrence of anastomotic fistulas or abdominal infections. Narrative nursing significantly reduced anxiety levels (p < 0.001) and improved quality of life (p < 0.001). However, narrative nursing did not influence the incidence of anastomotic fistulas or abdominal infections. The combination of CCIDT and narrative nursing effectively enhances postoperative recovery, reduces anxiety, and improves quality of life in ULRC patients.
{"title":"Effects of Closed Continuous Irrigation and Drainage Technique Combined With Narrative Nursing in Ultra-Low Rectal Cancer Patients Who Received Anus-Preserving Operation","authors":"Yan Sun, Yun Weng, Qing Zhang, Ying Sun, Lili Liu","doi":"10.1002/jso.70172","DOIUrl":"10.1002/jso.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aims to retrospectively analyze the combined effects of closed continuous irrigation drainage technique (CCIDT) and narrative nursing on recovery, anxiety, and quality of life in ultra-low rectal cancer (ULRC) patients undergoing anus-preserving operation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 224 ULRC patients were analyzed with four groups: conventional drainage with routine care (Group A), conventional drainage with narrative nursing (Group B), irrigated drainage with routine care (Group C), and irrigated drainage with narrative nursing (Group D). The outcome assessment included the first postoperative exhaust time, drainage tube placement time, and length of stay. Anxiety levels were measured using the Generalized Anxiety Disorder-7 scale, and quality of life was assessed using the EORTC QLQ-C30 questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CCIDT significantly shortened the first postoperative exhaust time, drainage tube placement time, and length of stay compared to conventional drainage techniques (<i>p</i> < 0.001 for all comparisons). However, CCIDT did not significantly affect the occurrence of anastomotic fistulas or abdominal infections. Narrative nursing significantly reduced anxiety levels (<i>p</i> < 0.001) and improved quality of life (<i>p</i> < 0.001). However, narrative nursing did not influence the incidence of anastomotic fistulas or abdominal infections. The combination of CCIDT and narrative nursing effectively enhances postoperative recovery, reduces anxiety, and improves quality of life in ULRC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"143-152"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862950","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: Marginal Resection Is Appropriate for Radical Surgery for Solitary Fibrous Tumors of the Pelvis","authors":"Humna Minhas, Abdullah Hameed","doi":"10.1002/jso.70149","DOIUrl":"10.1002/jso.70149","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"233-234"},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856710","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}
Osteosarcoma (OS) survival rates have remained unchanged for decades, while video-assisted thoracic surgery (VATS) for lung metastasis (LM) became common. We aimed to clarify clinical outcomes of post-relapse survival (PRS) for patients with OS based on LM-free survival (LMFS) across different eras.
Methods
This single-centre retrospective study included 168 patients with OS without LM at initial diagnosis. Patients were categorised into three groups: non-LM (n = 89), synchronous LM (sLM: less than 1-year LMFS) (n = 40), and mLM (at least 1-year LMFS) (n = 39). We compared PRS in patients with sLM and mLM across periods 1 (1990–2005) and 2 (2006–2022).
Results
PRS for mLM was longer in period 2 than in period 1 (Hazard ratio: 0.37, 95% confidence interval: 0.12–0.97, p = 0.04), whereas no difference was observed for sLM. In mLM, ratios of surgery, radiotherapy, and chemotherapy were unchanged; the rate of VATS increased in period 2 (7/18 vs. 10/12, p = 0.01). The rate of reoperation remained unchanged (7/18 vs. 7/12, p = 0.39).
Conclusions
In period 2, mLM had a better prognosis than in period 1. There was an increased use of VATS, while the rates of reoperation for LM remained unchanged. Conversely, the prognosis for sLM was not altered.
背景和目的：骨肉瘤（OS）的生存率几十年来一直保持不变，而视频辅助胸外科手术（VATS）治疗肺转移（LM）变得普遍。我们的目的是基于不同时期的无lm生存期（LMFS）来阐明OS患者复发后生存期（PRS）的临床结果。方法：本单中心回顾性研究纳入168例初诊无LM的OS患者。患者分为三组：非LM (n = 89)，同步LM (sLM：少于1年的LMFS) （n = 40）和mLM（至少1年的LMFS） （n = 39）。我们比较了第1期（1990-2005）和第2期（2006-2022）sLM和mLM患者的PRS。结果：第二阶段mLM的PRS比第一阶段长（风险比：0.37,95%可信区间：0.12-0.97,p = 0.04），而sLM无差异。在mLM中，手术、放疗和化疗的比例不变；第2期VATS发生率升高（7/18 vs 10/12, p = 0.01）。再手术率保持不变（7/18 vs. 7/12, p = 0.39）。结论：2期mLM预后优于1期。VATS的使用增加，而LM的再手术率保持不变。相反，sLM的预后没有改变。
{"title":"Clinical Outcomes and Surgical Procedures for Patients With Osteosarcoma and Metachronous Lung Metastasis: A Chronological Analysis","authors":"Kazuha Nakabachi, Hirokazu Shimizu, Masatake Matsuoka, Tamotsu Soma, Hirofumi Adachi, Yasushi Mizukami, Norimasa Iwasaki, Akira Iwata, Hiroaki Hiraga","doi":"10.1002/jso.70152","DOIUrl":"10.1002/jso.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Osteosarcoma (OS) survival rates have remained unchanged for decades, while video-assisted thoracic surgery (VATS) for lung metastasis (LM) became common. We aimed to clarify clinical outcomes of post-relapse survival (PRS) for patients with OS based on LM-free survival (LMFS) across different eras.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-centre retrospective study included 168 patients with OS without LM at initial diagnosis. Patients were categorised into three groups: non-LM (<i>n</i> = 89), synchronous LM (sLM: less than 1-year LMFS) (<i>n</i> = 40), and mLM (at least 1-year LMFS) (<i>n</i> = 39). We compared PRS in patients with sLM and mLM across periods 1 (1990–2005) and 2 (2006–2022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PRS for mLM was longer in period 2 than in period 1 (Hazard ratio: 0.37, 95% confidence interval: 0.12–0.97, <i>p</i> = 0.04), whereas no difference was observed for sLM. In mLM, ratios of surgery, radiotherapy, and chemotherapy were unchanged; the rate of VATS increased in period 2 (7/18 vs. 10/12, <i>p</i> = 0.01). The rate of reoperation remained unchanged (7/18 vs. 7/12, <i>p</i> = 0.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In period 2, mLM had a better prognosis than in period 1. There was an increased use of VATS, while the rates of reoperation for LM remained unchanged. Conversely, the prognosis for sLM was not altered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"210-216"},"PeriodicalIF":1.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827941","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}
Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC) that delays recovery and extends hospital stay. Our objective was to develop machine learning (ML) models that can predict patients at a high risk of developing POI after RC.
Methods
Data of patients who underwent RC for bladder cancer at our institution were retrospectively extracted for analysis and model creation. Data pre-processing and variable selection were applied. Several ML models were developed, evaluated, and compared using the area under the curve (AUC), F1 score, precision, sensitivity, and specificity.
Results
Three hundred and seven patients were included in the analysis, and of these, 30 patients (9.8%) developed POI. Overall, 78.2% of patients were male and 91.2% were White. Of the various ML models, logistic regression demonstrated the highest AUC (0.98), followed by random forest (0.97), Support Vector Machine (0.97), XGBoost (0.95), simple neural network (0.87), and decision tree (0.84). Furthermore, the first two models also displayed higher specificity (0.94 and 0.93) and F1 scores (0.78 and 0.75). All models except for the decision tree and neural network achieved 100% sensitivity. Features such as age, body mass index (BMI), American Society of Anaesthesiologists (ASA) class status, surgical approach, potassium level, and the placement of a nasogastric tube were identified as key predictors of the outcome.
Conclusion
Based on our data, ML models can effectively predict POI after RC, especially with logistic regression and random forest. The identification of relevant predictors may contribute meaningfully to potential applications in risk stratification and personalized care.
{"title":"Development of a Multivariable Machine Learning Model for the Prediction of Postoperative Ileus After Radical Cystectomy","authors":"Murugesan Manoharan, Mohamed Javid Raja Iyub, Yanjia Zhang, Pushan Prabhakar, Arjun Pon Avudaiappan, Mahmoud Eldefrawy, Sai Raghavendra Sridhar, Deerush Kannan Sakthivel","doi":"10.1002/jso.70161","DOIUrl":"10.1002/jso.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC) that delays recovery and extends hospital stay. Our objective was to develop machine learning (ML) models that can predict patients at a high risk of developing POI after RC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients who underwent RC for bladder cancer at our institution were retrospectively extracted for analysis and model creation. Data pre-processing and variable selection were applied. Several ML models were developed, evaluated, and compared using the area under the curve (AUC), F1 score, precision, sensitivity, and specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and seven patients were included in the analysis, and of these, 30 patients (9.8%) developed POI. Overall, 78.2% of patients were male and 91.2% were White. Of the various ML models, logistic regression demonstrated the highest AUC (0.98), followed by random forest (0.97), Support Vector Machine (0.97), XGBoost (0.95), simple neural network (0.87), and decision tree (0.84). Furthermore, the first two models also displayed higher specificity (0.94 and 0.93) and F1 scores (0.78 and 0.75). All models except for the decision tree and neural network achieved 100% sensitivity. Features such as age, body mass index (BMI), American Society of Anaesthesiologists (ASA) class status, surgical approach, potassium level, and the placement of a nasogastric tube were identified as key predictors of the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on our data, ML models can effectively predict POI after RC, especially with logistic regression and random forest. The identification of relevant predictors may contribute meaningfully to potential applications in risk stratification and personalized care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"226-232"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708267","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":"Comment on “Noncolorectal Cancer-Related Deaths in Patients With Early-Onset Colorectal Cancer: A Population-Based Study”","authors":"Jilong Feng","doi":"10.1002/jso.70160","DOIUrl":"10.1002/jso.70160","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"141-142"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708247","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}
Jackson A. Baril, Karl Y. Bilimoria, Eugene P. Ceppa, Michael G. House, Thomas K. Maatman, Alexandra M. Roch, Anthony D. Yang, C. Max Schmidt, Ryan J. Ellis
Background and Objectives
Adjuvant chemotherapy (AC) is considered for patients with stage II small bowel adenocarcinoma (SBA) with an inadequate lymphadenectomy; however, the prognostic role of additional high-risk features (T4 primary, positive resection margin, poorly differentiated tumor, or lymphovascular invasion) is unknown. The objectives were to describe utilization of AC among patients with stage II SBA with inadequate lymphadenectomy, identify factors associated with receipt of AC, and examine the association between AC and survival stratified by presence of additional high-risk features.
Methods
Patients with stage II SBA were identified using the National Cancer Database from 2004 to 2021. Inadequate lymphadenectomy was defined < 5 lymph nodes duodenal tumors and < 8 lymph nodes other sites.
Results
Of 1765 patients with stage II SBA and an inadequate lymphadenectomy, 525 (29.8%) received AC. T4 primary, poor grade tumor, and positive resection margin were associated with receiving AC. Receipt of AC was associated with improved 5-year survival in patients with additional high-risk features (49.9% vs 31.4%; HR 0.62, 95%CI 0.48–0.79) but not in patients without additional high-risk features (67.1% vs. 53.2%; HR 0.83, 95%CI 0.55–1.24).
Conclusions
Receipt of AC was associated with improved survival in patients with inadequate lymphadenectomy and any additional high-risk feature. Multiple variables may be considered in decisions regarding AC.
背景和目的：考虑辅助化疗（AC）用于淋巴结切除术不充分的II期小肠腺癌（SBA）患者；然而，其他高危特征（T4原发、切除边缘阳性、低分化肿瘤或淋巴血管侵袭）的预后作用尚不清楚。目的是描述淋巴结切除术不充分的II期SBA患者AC的使用情况，确定与AC接受相关的因素，并通过存在额外的高风险特征来检查AC与生存率之间的关系。方法：从2004年到2021年，使用国家癌症数据库确定II期SBA患者。结果：在1765例II期SBA和不充分的淋巴结切除术患者中，525例（29.8%）接受了AC。T4原发、恶性肿瘤和阳性切除缘与接受AC相关。接受AC与具有额外高风险特征的患者的5年生存率相关（49.9% vs 31.4%; HR 0.62, 95%CI 0.48-0.79），但与没有额外高风险特征的患者无关（67.1% vs 53.2%; HR 0.83, 95%CI 0.55-1.24）。结论：接受AC与淋巴结切除术不充分和任何其他高风险特征的患者的生存率提高相关。在有关AC的决策中可能要考虑多个变量。
{"title":"Treatment and Outcomes for Patients With Inadequate Lymphadenectomy After Resection of Stage II Small Bowel Adenocarcinoma","authors":"Jackson A. Baril, Karl Y. Bilimoria, Eugene P. Ceppa, Michael G. House, Thomas K. Maatman, Alexandra M. Roch, Anthony D. Yang, C. Max Schmidt, Ryan J. Ellis","doi":"10.1002/jso.70151","DOIUrl":"10.1002/jso.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Adjuvant chemotherapy (AC) is considered for patients with stage II small bowel adenocarcinoma (SBA) with an inadequate lymphadenectomy; however, the prognostic role of additional high-risk features (T4 primary, positive resection margin, poorly differentiated tumor, or lymphovascular invasion) is unknown. The objectives were to describe utilization of AC among patients with stage II SBA with inadequate lymphadenectomy, identify factors associated with receipt of AC, and examine the association between AC and survival stratified by presence of additional high-risk features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with stage II SBA were identified using the National Cancer Database from 2004 to 2021. Inadequate lymphadenectomy was defined < 5 lymph nodes duodenal tumors and < 8 lymph nodes other sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1765 patients with stage II SBA and an inadequate lymphadenectomy, 525 (29.8%) received AC. T4 primary, poor grade tumor, and positive resection margin were associated with receiving AC. Receipt of AC was associated with improved 5-year survival in patients with additional high-risk features (49.9% vs 31.4%; HR 0.62, 95%CI 0.48–0.79) but not in patients without additional high-risk features (67.1% vs. 53.2%; HR 0.83, 95%CI 0.55–1.24).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Receipt of AC was associated with improved survival in patients with inadequate lymphadenectomy and any additional high-risk feature. Multiple variables may be considered in decisions regarding AC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"186-195"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Severe Complications in Remnant Gastric Cancer: An Epiphenomenon of Tumor Biology and Surgical Complexity?","authors":"Yong Zhang","doi":"10.1002/jso.70165","DOIUrl":"10.1002/jso.70165","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"196-197"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708245","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":"Comment on “A SEER-Based Analysis of Survival Predictors in Stage I Colorectal Cancer”","authors":"Ahmet Necati Sanli, Deniz Esin Tekcan Sanli","doi":"10.1002/jso.70156","DOIUrl":"10.1002/jso.70156","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701284","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":"Comment on: Predictive Factors for Failed Sentinel Lymph Node Mapping in Endometrial Cancer: A Retrospective Multicenter Study—Missing Data on Indocyanine Green Injection Timing Relative to Adhesiolysis Warrants Retrospective Subgroup Extraction","authors":"Shuang Xiao","doi":"10.1002/jso.70157","DOIUrl":"10.1002/jso.70157","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 1","pages":"6-7"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701221","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}
Postoperative pancreatic fistula (POPF) is a serious complication following Pancreatoduodenectomy (PD). Accurate prediction of clinically relevant POPF (CR-POPF) is essential to reduce morbidity. Identifying objective, easily measurable preoperative risk factors may improve patient outcomes. Therefore, we aimed to identify significant predictive risk factors for CR-POPF.
Methods
We retrospectively analyzed data from 143 patients who underwent PD. Preoperative computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) was used to measure the main pancreatic duct (MPD) diameter, the distance from the peritoneum to the anterior surface of the pancreas (PTP), and the abdominal wall thickness (AWT). The PTP/AWT ratio was calculated as a surrogate marker for the visceral-to-subcutaneous fat ratio (V/S ratio). The liver-to-pancreas mean CT attenuation ratio (late/early phase; L/E ratio) was also assessed. Univariate and multivariable analyses were performed to identify risk factors for CR-POPF.
Results
CR-POPF occurred in 33 (23.1%) patients. Multivariable analysis identified V/S ratio ≥ 3.5 (OR: 3.55, p = 0.041), and L/E ratio < 1.2 (OR: 6.07, p = 0.004) as independent risk predictors of CR-POPF.
Conclusions
Simple, objective parameters from preoperative CT or MRCP images may help predict CR-POPF. Accurate risk assessment and early intervention may reduce complications and improve postoperative outcomes.
背景与目的：胰瘘（POPF）是胰十二指肠切除术（PD）后的严重并发症。准确预测临床相关POPF （CR-POPF）对于降低发病率至关重要。确定客观的、容易测量的术前危险因素可以改善患者的预后。因此，我们旨在确定CR-POPF的重要预测危险因素。方法：我们回顾性分析143例PD患者的资料。术前采用计算机断层扫描（CT）或磁共振胰胆管造影（MRCP）测量主胰管（MPD）直径、腹膜到胰腺前表面的距离（PTP）和腹壁厚度（AWT）。计算PTP/AWT比率作为内脏与皮下脂肪比率（V/S比率）的替代指标。同时评估肝脏与胰腺的平均CT衰减比（晚期/早期；L/E比）。进行单变量和多变量分析以确定CR-POPF的危险因素。结果：发生CR-POPF 33例（23.1%）。多变量分析确定V/S比≥3.5 (OR: 3.55, p = 0.041)， L/E比。结论：术前CT或MRCP图像中简单、客观的参数可能有助于预测CR-POPF。准确的风险评估和早期干预可以减少并发症，改善术后预后。
{"title":"Risk Prediction of Postoperative Pancreatic Fistula After Open Pancreatoduodenectomy Using Objective Indicators Obtained From Preoperative Images","authors":"Shota Kuwabara, Yuta Ishizuka, Hiroyasu Tojima, Yuma Aoki, Kazuyuki Yamamoto, Yasuhito Shoji, Akira Fukunaga, Tatsunosuke Ichimura, Hiroto Manase, Satoshi Hirano","doi":"10.1002/jso.70155","DOIUrl":"10.1002/jso.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Postoperative pancreatic fistula (POPF) is a serious complication following Pancreatoduodenectomy (PD). Accurate prediction of clinically relevant POPF (CR-POPF) is essential to reduce morbidity. Identifying objective, easily measurable preoperative risk factors may improve patient outcomes. Therefore, we aimed to identify significant predictive risk factors for CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 143 patients who underwent PD. Preoperative computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) was used to measure the main pancreatic duct (MPD) diameter, the distance from the peritoneum to the anterior surface of the pancreas (PTP), and the abdominal wall thickness (AWT). The PTP/AWT ratio was calculated as a surrogate marker for the visceral-to-subcutaneous fat ratio (V/S ratio). The liver-to-pancreas mean CT attenuation ratio (late/early phase; L/E ratio) was also assessed. Univariate and multivariable analyses were performed to identify risk factors for CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CR-POPF occurred in 33 (23.1%) patients. Multivariable analysis identified V/S ratio ≥ 3.5 (OR: 3.55, <i>p</i> = 0.041), and L/E ratio < 1.2 (OR: 6.07, <i>p</i> = 0.004) as independent risk predictors of CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simple, objective parameters from preoperative CT or MRCP images may help predict CR-POPF. Accurate risk assessment and early intervention may reduce complications and improve postoperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"170-176"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701281","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}
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