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Tailored indocyanine green fluorescence navigation for laparoscopic anatomic segment Ⅶ resection: A novel classification system based on portal pedicle anatomy(with videos) 认领 引用
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作者 Jia-Guo Wang Jing-Sheng Yuan +1 位作者 Jia-Yin Yang Jie Xu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2026年第3期340-345,共6页
Anatomic liver resection, which adheres to the principles of the tumor-bearing portal territory, is the gold standard for oncologic liver surgery, offering improved tumor clearance and reduced postoperative recurrence... Anatomic liver resection, which adheres to the principles of the tumor-bearing portal territory, is the gold standard for oncologic liver surgery, offering improved tumor clearance and reduced postoperative recurrence compared to non-anatomic resection [1, 2]. However, laparoscopic anatomic resections of posterosuperior liver segments-particularly segment Ⅶ(S7)-remain technically demanding due to deep anatomical positioning, restricted operative exposure, and variable branching patterns of the portal pedicles [3–5]. 展开更多
关键词 portal pedicles d laparoscopic anatomic segment vii resection tumor bearing portal territory tailored indocyanine green fluorescence navigation anatomic resections anatomic liver resectionwhich novel classification system portal pedicle anatomy
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Utility of liver surface-guided encirclement of hepatoduodenal ligament for the Pringle maneuver in minimally invasive repeat liver resection 认领 引用
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作者 Yoichi Kawano Takahiro Murokawa +18 位作者 Yuto Aoki Akira Hamaguchi Takashi Ono Takahiro Haruna DaigoYoshimori Toshiyuki Irie Junji Ueda Tetsuya Shimizu Akira Matsushita Mampei Kawashima Ryo Ga Hiroyasu Furuki Tomohiro Kanda Yukio Oshiro Keisuke Minamimura Masato Yoshioka Nobuhiko Taniai Yoshiharu Nakamura Hiroshi Yoshida 《World Journal of Gastroenterology》 SCIE CAS 2026年第1期126-138,共13页
BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly dev... BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection. 展开更多
关键词 Laparoscopic liver resection Repeat liver resection Pringle maneuver Postoperative adhesion Minimally invasive liver resection Hepatocellular carcinoma Cancer of colon and rectum Liver metastasis Guidelines Second and third hepatectomies
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Is salvage surgery necessary for non-R0 endoscopic resection of small rectal neuroendocrine tumors? 认领 引用
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作者 Shi-Yong Lin Ze-Hua Li +2 位作者 Guo-Liang Xu Jun Weng Kun-Hao Bai 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第6期216-222,共7页
BACKGROUND The rate of R0 endoscopic resection for small rectal neuroendocrine tumors(r-NETs)is nearly 90%.However,there is still controversy about subsequent treatment options for patients with non-R0 endoscopically ... BACKGROUND The rate of R0 endoscopic resection for small rectal neuroendocrine tumors(r-NETs)is nearly 90%.However,there is still controversy about subsequent treatment options for patients with non-R0 endoscopically resected r-NETs.AIM To investigate the necessity of salvage surgery for non-R0 endoscopic resection of small r-NETs.METHODS A single-center retrospective study.Thirty-eight patients with r-NETs who underwent non-R0 endoscopic resection at Sun Yat-sen University Cancer Centre between 2007 and 2023 were retrospectively analyzed.RESULTS Thirty patients underwent salvage surgery while 8 received follow-up only.Among those 30 patients with salvage surgery,12 cases underwent salvage endoscopic submucosal dissection,while 16 underwent salvage transanal endoscopic microsurgery,2 underwent salvage radical resection(low anterior resection).Postoperative pathology following salvage surgery indicated an absence of tumor cells in all 30 patients.Among the 8 patients who received follow-up only,3 received endoscopic biopsy of the scar during follow-up.Pathological evaluation of the biopsy specimens also showed no residual tumor cells.All 38 patients underwent regular endoscopic and imaging follow-up with an average follow-up duration of 46.4±14.8 months.No evidence of local tumor recurrence or distant metastasis was observed.CONCLUSION These findings suggest that salvage surgery may not be essential for patients with non-R0 endoscopically resected r-NETs,with regular follow-up being a safe alternative. 展开更多
关键词 Rectal neuroendocrine tumors Endoscopic resection Non-R0 resection Salvage surgery Follow-up
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Ex vivo liver resection and autotransplantation for hepatic alveolar echinococcosis with cavernous transformation of the portal vein 认领 引用 被引量：1
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作者 Yierfan Yilihaer Mao-Lin Wang +3 位作者 Hao Wen Tie-Min Jiang Ying-Mei Shao Tuerganaili Aji 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2026年第2期144-151,共8页
Background:Ex vivo liver resection and autotransplantation(ELRA)offers new therapeutic perspectives and possibilities for R0 resection in patients with hepatic alveolar echinococcosis(AE)combined with cavernous transf... Background:Ex vivo liver resection and autotransplantation(ELRA)offers new therapeutic perspectives and possibilities for R0 resection in patients with hepatic alveolar echinococcosis(AE)combined with cavernous transformation of the portal vein(CTPV).Methods:We analyzed 49 hepatic AE patients with CTPV treated at our center from January 2010 to June 2023.We compared the different outcomes with different treatments for the 49 patients:ELRA for 12 and conservative for 9 patients.After propensity score matching,we compared the ELRA treatment outcomes for 12 patients with CTPV and 24 patients without CTPV.Kaplan-Meier analysis was used to compare overall survival,and Cox regression to identify factors influencing postoperative survival.Results:In the ELRA cohort,both CTPV and non-CTPV patients had no intraoperative mortality;90-day mortality rate for both groups was 16.7%(2/12 in CTPV patients and 4/24 in non-CTPV patients).Pleural effusion was the most common postoperative complication.CTPV patients required significantly longer operative time and more intraoperative blood transfusions(P0.05).In the CTPV cohort,patients who underwent ELRA had significantly better long-term survival compared to those who did not receive surgery(72.9%vs.29.6%,P<0.05).Extrahepatic AE disease,rather than CTPV,was identified as an independent risk factor for postoperative survival(P<0.05).Conclusions:ELRA is a safe and effective approach for hepatic AE patients with CTPV,significantly improving long-term survival.CTPV itself does not negatively impact postoperative survival,further emphasizing the benefits of this procedure in this particular population. 展开更多
关键词 Hepatic alveolar echinococcosis Hepatic resection Liver transplantation Ex vivo resection Portal vein cavernoma
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Chinese expert consensus on additional surgery following endoscopic resection for early colorectal cancer(2025 edition) 认领 引用
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作者 Zhipeng Qi Fuqiang Zhao +11 位作者 Xuhua Hu Yunshi Zhong Qian Liu Zhongtao Zhang Guiying Wang Digestive Tract Polyp and Precancerous Lesion Professional Committee China Anti-Cancer Association Colorectal Surgery Group, Society of Surgery Chinese Medical Association Colorectal Group Society of Digestive Endoscopy Chinese Medical Association Surgical Group Colorectal Tumor Committee Chinese Medical Doctor Association 《Cancer Biology & Medicine》 SCIE CAS CSCD 2026年第6期796-809,共14页
Early colorectal cancer is often treated through endoscopic procedures to remove tumors.However,when initial removal is incomplete or shows high-risk features,further major surgery is required to ensure no cancer rema... Early colorectal cancer is often treated through endoscopic procedures to remove tumors.However,when initial removal is incomplete or shows high-risk features,further major surgery is required to ensure no cancer remains.This consensus provides a standard for surgeons to decide when and how to perform this additional surgery.A multidisciplinary group of Chinese medical experts reviewed global research and clinical evidence published between 2010 and 2024.The medical experts formulated key clinical recommendations,which were then discussed and finalized through expert voting to ensure high agreement.The consensus identifies specific high-risk factors necessitating additional surgery.The consensus recommends that these follow-up surgeries should ideally take place approximately 4 weeks after the first procedure.Furthermore,the consensus provides detailed protocols for marking the tumor location and selecting the best surgical approach.These consensuses offer a practical framework to improve the safety and effectiveness of treating early colorectal cancer.By standardizing surgical decisions,the consensus aims to help patients achieve better long-term recovery and quality of life. 展开更多
关键词 Early colorectal cancer endoscopic resection additional surgery risk factors Chinese expert consensus
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Traction-preclosure-assisted vs conventional endoscopic fullthickness resection for gastric subepithelial tumors:Safety,efficacy in a retrospective cohort(with video) 认领 引用
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作者 Xin Li Ren-Yi Zhang +2 位作者 Xu-Dong Wen Xue-Qin Li Wei-Hui Liu 《World Journal of Gastroenterology》 SCIE CAS 2026年第19期12-25,共14页
BACKGROUND Gastric subepithelial tumors(SETs),commonly encountered in gastrointestinal practice,require precise and complete resection to prevent recurrence and malignant transformation.AIM To compare efficacy,safety,... BACKGROUND Gastric subepithelial tumors(SETs),commonly encountered in gastrointestinal practice,require precise and complete resection to prevent recurrence and malignant transformation.AIM To compare efficacy,safety,and clinical outcomes between traction-preclosure(TPC)-assisted endoscopic full-thickness resection(EFTR)and conventional EFTR for gastric SETs.METHODS We retrospectively analyzed 214 patients who underwent EFTR for gastric SETs,assigning them to the conventional EFTR(n=129)or TPC-EFTR(n=85)group.Primary outcomes were complete and en bloc resection rates.Secondary outcomes included procedural efficiency(operation time,closure time,time to resumption of diet and defecation),safety(adverse events,blood parameters,pneumoperitoneum),and clinical efficacy(pain scores,EuroQol visual analogue scale,health utility values,recurrence rate).Recurrence-free survival was assessed by KaplanMeier analysis.RESULTS Compared to the conventional EFTR group,the TPC-EFTR group had a higher complete resection rate(95.3%vs 86.8%,P=0.041),shorter operation time[60.0(40.0)minutes vs 70.0(39.5)minutes,P=0.047],shorter closure time(13.0±4.5 minutes vs 14.3±4.5 minutes,P=0.044),and lower pneumoperitoneum incidence(4.7%vs 14.0%,P=0.033).The TPC-EFTR group showed higher postoperative EuroQol visual analogue scale scores[79.9(7.6)vs 79.3(2.0),P=0.001]and health utility values[95.0(4.0)×10-2 vs 92.0(14.0)×10-2,P=0.002].Kaplan-Meier curves showed comparable median recurrence-free survival between the two groups[not reached(95%confidence interval:26.0-not reached)months vs 75.0(95%confidence interval:60.0-75.0)months,P=0.770].CONCLUSION TPC-EFTR is safe and effective strategy gastric SETs,enhancing procedural efficiency and postoperative quality of life while potentially achieving comparable or superior long-term oncological outcomes vs conventional EFTR. 展开更多
关键词 Gastric subepithelial tumors Endoscopic full-thickness resection Traction method Pre-closure technique Recurrence-free survival
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Predictors of one-year adverse outcomes after laparoscopic resection for hepatocellular carcinoma:Development and validation of an early-warning model 认领 引用
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作者 Wei Feng Qing-Wang Ye +3 位作者 Qi-Le Wang Si-Ying Chen Yao Ma Fan-Lai Meng 《World Journal of Gastroenterology》 SCIE CAS 2026年第6期41-56,共16页
BACKGROUND The global burden of primary liver cancer(PLC)continues to rise.Although minimally invasive,especially laparoscopic,resection is increasingly performed for early-stage disease,1-year adverse outcomes(recurr... BACKGROUND The global burden of primary liver cancer(PLC)continues to rise.Although minimally invasive,especially laparoscopic,resection is increasingly performed for early-stage disease,1-year adverse outcomes(recurrence,metastasis,or mortality)remain common.Widely used scores,such as the albumin-bilirubin grade,primarily assess hepatic reserve and may not fully reflect tumor biology or systemic inflammation for individualized early prognostic warning.This study aimed to develop and validate a least absolute shrinkage and selection operator(LASSO)-based model to predict 1-year adverse outcomes after minimally invasive PLC resection.AIM To identify predictors of short-term(1-year)adverse outcomes following minimally invasive PLC resection and construct an individualized postoperative prognostic model using LASSO regression.METHODS This retrospective study included patients with PLC who underwent minimally invasive resection at The Affiliated Suqian Hospital of Xuzhou Medical University between January 2019 and January 2023.Prognostic predictors were identified using LASSO regression and incorporated into a logistic regression model.Model performance and clinical utility were evaluated using receiver operating characteristic curves,calibration plots,and decision curve analysis.The dataset was randomly divided into training(n=277)and internal validation(n=144)cohorts.An external validation cohort of 138 patients with PLC(February 2023 to June 2024)was used to assess generalizability.RESULTS Receiver operating characteristic analysis indicated good performance of the logistic regression model based on six predictors,white blood cell count,tumor diameter,vascular invasion,portal vein infiltration,cirrhosis,and alphafetoprotein,with area under the curve(AUC)values of 0.756[95%confidence interval(CI):0.687-0.824]and 0.750(95%CI:0.659-0.841)in the training and internal validation cohorts,respectively.The model exhibited strong calibration(training,P=0.6951;external validation,P=0.5223)and clear net clinical benefit across risk thresholds.External validation further supported its generalizability(n=138;AUC=0.735,95%CI:0.640-0.830).Compared with albumin-bilirubin,the LASSO-based risk score showed higher though non-significant AUCs in the training(0.756 vs 0.691;DeLong P=0.206)and external(0.735 vs 0.717;P=0.803)cohorts and comparable performance in the internal validation cohort(0.750 vs 0.753;P=0.968).CONCLUSION LASSO regression was used to identify six independent predictors of adverse 1-year outcomes after minimally invasive PLC resection.The resulting risk score model demonstrates reliable discrimination,calibration,and clinical utility for individualized prognostic assessment. 展开更多
关键词 Primary liver cancer Minimally invasive resection Outcomes Predictors Least absolute shrinkage and selection operator regression Prognostic model
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Long-term disease-free survival following preoperative diagnosis and laparoscopic radical resection for Meckel’s diverticulum adenocarcinoma:A case report 认领 引用
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作者 Ze-Hao Yu Chun-Run Ling +2 位作者 Jun-Ying Yu Qiu-Huan Zhang Shan-Shan Wei 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期403-410,共8页
BACKGROUND Meckel’s diverticulum(MD)is most commonly encountered during emergency interventions for complications or as an incidental finding during an unrelated procedure.Definitive pre-operative diagnosis of MD-ass... BACKGROUND Meckel’s diverticulum(MD)is most commonly encountered during emergency interventions for complications or as an incidental finding during an unrelated procedure.Definitive pre-operative diagnosis of MD-associated adenocarcinoma,permitting radical resection,is very rare in clinical practice.CASE SUMMARY A 36-year-old male presented with recurrent dark-red hematochezia.Initial gastroscopy,colonoscopy,computed tomography,and tumor marker assessments were unremarkable.A technetium-99m pertechnetate Meckel scan(Meckel scan)revealed ectopic gastric mucosa,suggesting an MD.Double-balloon enteroscopy revealed an ulcerative stricture in the ileum,and biopsy confirmed a moderately differentiated adenocarcinoma.The patient underwent laparoscopic radical small bowel resection.Histopathology confirmed pT3N0M0,stage ⅡA(the American Joint Committee on Cancer 8th edition)moderately differentiated adenocarcinoma with lymphovascular invasion.Adjuvant chemotherapy was administered postoperatively.No recurrence or metastasis was observed during a 36-month followup.CONCLUSIONFor recurrent obscure gastrointestinal hemorrhage, combined Meckel scan and double-balloon enteroscopy iscritical for diagnosing MD-associated, enabling curative resection. 展开更多
关键词 Meckel’s-diverticulum-associated adenocarcinoma Pre-operative diagnosis Technetium-99m pertechnetate Meckel scan Double-balloon enteroscopy Radical resection Case report
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Letter to the Editor:Gut microbiota–bile acid crosstalk-Prevotellaceae NK3B31 and 7-ketolithocholic acid drive metabolic benefits of distal bowel resection with preservation of terminal ileum 认领 引用
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作者 Xu Cui Long-Yao Xu +3 位作者 Bing-Qian Yin Liu Chen Zheng Liang Chao-Ming Zhou 《World Journal of Hepatology》 2026年第5期313-317,共5页
This letter commends on the study published in World Journal of Gastroenterology by Xu et al,which elucidated the mechanism by which distal bowel resection with terminal ileum preservation(DBRPI)improves hepatic gluco... This letter commends on the study published in World Journal of Gastroenterology by Xu et al,which elucidated the mechanism by which distal bowel resection with terminal ileum preservation(DBRPI)improves hepatic gluconeogenesis via the Prevotellaceae NK3B31_group/7-ketolithocholic acid(7-KLCA)/farnesoid X receptor(FXR)axis.Using multiomics and functional assays,Xu et al identified this microbial–bile acid(BA)axis as central to the metabolic benefits of DBRPI,linking microbial enrichment(e.g.,Prevotellaceae NK3B31_group)to increased 7-KLCA levels and FXR activation,thereby suppressing gluconeogenic gene expression.We highlight the novelty of this work in its focus on taxon-specific microbial and BA dynamics,which advances the understanding of postoperative glucose regulation.Additionally,we note its translational potential—targeting this axis via probiotics or 7-KLCA analogs—and raise several open questions,including causal validation of the microbial taxon,serum 7-KLCA dynamics,and glucagon-likepeptide-1/FXR interplay.Overall,this study bridges gut microbiota and BA crosstalk,offering actionable insights for the treatment of metabolic disease. 展开更多
关键词 Distal bowel resection with terminal ileum preservation Gut microbiota Bile acid metabolism Prevotellaceae NK3B31_group 7-ketolithocholic acid Glucose homeostasis
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Current status of endoscopic resection for small rectal neuroendocrine tumors 认领 引用 被引量：3
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作者 Jian-Ning Liu Hui Chen Nian Fang 《World Journal of Gastroenterology》 SCIE CAS 2025年第19期10-27,共18页
Rectal neuroendocrine tumor(rNET)is an indolent malignancy often detected during colonoscopy screening.The incidence of rNET has increased approximately 10-fold over the past 30 years.Most rNETs detected during screen... Rectal neuroendocrine tumor(rNET)is an indolent malignancy often detected during colonoscopy screening.The incidence of rNET has increased approximately 10-fold over the past 30 years.Most rNETs detected during screening endoscopy are small,measuring<10 mm.Current guidelines recommend endoscopic resection for small,well-differentiated rNET using modified endoscopic submucosal resection(mEMR)or endoscopic submucosal dissection.However,the optimal endoscopic treatment method remains uncertain.This paper summarizes the evidence on mEMR with submucosal stretching,mEMR without submucosal stretching,endoscopic submucosal dissection and endoscopic full-thickness resection.Given that rNETs often exhibit submucosal invasion,achieving adequate resection depth is crucial to ensure histological complete resection.mEMR with submucosal stretching appears favorable due to its high rate of histological complete resection,safety and convenience.Risk factors associated with lymph node and distant metastases are also discussed.A treatment algorithm is proposed to facilitate clinical decision-making. 展开更多
关键词 Rectal neuroendocrine tumor Endoscopic resection Endoscopic submucosal dissection Modified endoscopic mucosal resection Histological complete resection Resection depth Risk factor Treatment algorithm
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Ex-vivo liver resection and autotransplantation for large tumors in the caudate lobe 认领 引用
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作者 Xuan Tong Hong-Qiang Zhao +3 位作者 Guang-Dong Wu Yu-Cheng Hou Qian Lu Rui Tang 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2026年第2期234-236,共3页
To the Editor:We paid attention to the recent article by Xiao et al.[1].They reviewed a new strategy for expanding the allograft pool,which involves using otherwise-wasted resected liver lobes from patients with large... To the Editor:We paid attention to the recent article by Xiao et al.[1].They reviewed a new strategy for expanding the allograft pool,which involves using otherwise-wasted resected liver lobes from patients with large,symptomatic benign liver tumors as liver transplant donors.Liver transplantation is the ultimate curative treatment for patients with acute or chronic end-stage liver diseases,or malignant liver tumors,but it is restricted due to the limited availability of donor organs. 展开更多
关键词 large tumors ex vivo liver resection expanding allograft poolwhich donor organs malignant liver tumorsbut autotransplantation caudate lobe allograft pool
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Vasopressin and fluid retention after liver resection:Comparison with the renin-angiotensin-aldosterone system by surgical extent and liver function 认领 引用
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作者 Yuto Aoki Youichi Kawano +4 位作者 Ryo Ga Kazuhiko Endo Junji Ueda Tetsuya Shimizu Hiroshi Yoshida 《World Journal of Gastroenterology》 SCIE CAS 2026年第10期82-93,共12页
BACKGROUND Early postoperative edema and ascites after liver resection are common;however,the endocrine drivers of water retention are not fully defined.Arginine vasopressin(AVP)promotes antidiuresis via V2-mediated a... BACKGROUND Early postoperative edema and ascites after liver resection are common;however,the endocrine drivers of water retention are not fully defined.Arginine vasopressin(AVP)promotes antidiuresis via V2-mediated aquaporin trafficking,whereas the renin-angiotensin-aldosterone system primarily modulates sodium handling.Differences in postoperative trajectories and their relationship to early fluid retention have not been clarified in patients undergoing liver resection.AIM To examine postoperative changes in plasma AVP and plasma aldosterone concentration(PAC)after liver resection,and association with fluid retention.METHODS We conducted a prospective cohort study of adults undergoing elective liver resection at a tertiary center.Blood samples were collected preoperatively,immediately post-resection,and on postoperative days(POD)1,2,3,and 5.The primary objective was characterizing postoperative dynamics of AVP and PAC.Secondary objectives evaluated their temporal alignment with early fluid retention(body weight,urine output during POD 1-3)and compared hormonal profiles between major and minor resections.Analyses used trajectory and timebased comparisons by resection extent.RESULTS AVP increased sharply immediately after resection and remained above the preoperative baseline through POD 3,showing the most pronounced and sustained elevation after major liver resection.In contrast,PAC showed a transient postoperative increase that returned to near-baseline levels by POD 2.The period of elevated AVP closely matched the time frame during which early postoperative fluid retention was most evident,as indicated by greater short-term weight gain and reduced urine output.These patterns were consistent across sensitivity analyses and showed similar directional trends in subgroup comparisons based on resection extent.CONCLUSION AVP remains elevated longer than aldosterone and coincides with early fluid retention,particularly after major resection.Vasopressin-driven antidiuresis may be important in postoperative water retention. 展开更多
关键词 Hepatectomy Liver resection Vasopressin Aldosterone Fluid management Water retention Liver surgery
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Computed Tomography Scans in the Prediction of Margin-Negative Resection in Pancreatic Cancer Following Neoadjuvant Treatment:An Updated Systematic Review and Meta-Analysis 认领 引用
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作者 Ehsan Emami Dina Seyedi +12 位作者 Alireza Hassanpour Faizan Bashir Elina Attaran Maryam Mostofi Mohammadjavad Abbaspour Farzin Tahmasbi Arashlow Pariya Zibaei Alaleh Alizadeh Neda Tizro Arash Saberian Komeil Aghazadeh-Habashi Masoud Noroozi Niloofar Deravi 《iRADIOLOGY》 CSCD 2026年第2期147-156,共10页
Pancreatic cancer is a highly lethal malignancy with a rising incidence.An early diagnosis of pancreatic cancer is challenging,and although computed tomography(CT)scans are the primary imaging modality for assessing r... Pancreatic cancer is a highly lethal malignancy with a rising incidence.An early diagnosis of pancreatic cancer is challenging,and although computed tomography(CT)scans are the primary imaging modality for assessing resectability after neoadjuvant treatment,their accuracy in predicting margin-negative(R0)resection remains a concern.This systematic review and metaanalysis evaluated the role of CT scans in predicting R0 resection in patients with pancreatic cancer post-neoadjuvant therapy.A search of PubMed,Scopus,and Google Scholar was conducted up to October 4,2025,with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Study selection,data extraction,and quality assessment were performed independently by two reviewers.Pooled sensitivity,specificity,and the area under the curve were assessed using the bivariate random-effects model.Nine unique articles providing 10 study estimates met the inclusion criteria.A meta-analysis showed significant heterogeneity for specificity(I2=87%)and sensitivity(I2=90%).Pooled sensitivity was 0.50(95%confidence interval[CI]:0.34–0.66)and pooled specificity was 0.75(95%CI:0.61–0.85).The area under the curve for overall diagnostic performance was 0.69(95%CI:0.65–0.73).The pooled diagnostic odds ratio was 3.00(95%CI:1.85–4.86).Deeks'funnel plot analysis showed no significant publication bias.Although CT scans play a crucial role in pancreatic cancer staging,their ability to predict R0 resection after neoadjuvant therapy is limited by low sensitivity and moderate specificity,as shown by the low area under the curve.These findings indicate the requirement for multimodal preoperative assessment strategies incorporating advanced imaging techniques and other diagnostic modalities to improve surgical planning and patients'outcomes. 展开更多
关键词 computed tomography margin-negative resection neoadjuvant therapy pancreatic cancer sensitivity specificity
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Laparoscopic liver resection is superior to open liver resection for hepatocellular carcinoma patients with BCLC stage 0-A hepatocellular carcinoma and portal hypertension 认领 引用
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作者 Wu-Gui Yang Bin Liang +5 位作者 Yu-Fu Peng Yu-Bo Yang Ya-Ni Liu Bo Li Yong-Gang Wei Fei Liu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2026年第1期32-41,共10页
Background:According to the 2022 update of the BCLC strategy,laparoscopic liver resection(LLR)is considered feasible for BCLC stage 0-A hepatocellular carcinoma(HCC)patients with clinically significant portal hyperten... Background:According to the 2022 update of the BCLC strategy,laparoscopic liver resection(LLR)is considered feasible for BCLC stage 0-A hepatocellular carcinoma(HCC)patients with clinically significant portal hypertension(CSPH).However,there is still no research to explore the outcomes of laparoscopic versus open liver resection(OLR)in the specific patients with BCLC stage 0-A HCC and CSPH.Methods:Patients diagnosed with BCLC stage 0-A HCC and CSPH who underwent liver resection at West China Hospital of Sichuan University from February 2018 to December 2022 were analyzed.Demographic characteristics,pathological findings and postoperative outcomes were compared using propensity score matching(PSM).Long-term outcomes after surgery were analyzed using Kaplan-Meier analysis both before and after PSM.Results:A total of 409 patients,including 261 LLRs and 148 OLRs,were enrolled in this study.There were imbalances between the groups in baseline information.After 1:1 PSM,118 patients were included in each group with comparable baseline characteristics.Patients in the LLR group had significantly less intraoperative blood loss compared to those in the OLR group(median 223 vs.318 mL,P75×109/L.Conclusions:Compared with OLR,LLR had less intraoperative blood loss,fewer postoperative complications and comparable oncological outcomes for patients with BCLC stage 0/A HCC and CSPH. 展开更多
关键词 Laparoscopic liver resection Hepatocellular carcinoma Clinically significant portal hypertension BCLC stage
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Presentation and endoscopic resection technique of neonatal esophageal choristoma:A case report 认领 引用
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作者 Neriya Giz Julia Epshtein +2 位作者 Boris Savin Karen Meir Mordechai Slae 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第3期262-269,共8页
BACKGROUND Esophageal choristoma is an exceptionally rare congenital non-malignant mass which may present with a range of symptoms and severity according to size,growth and location.CASE SUMMARY In this article,we des... BACKGROUND Esophageal choristoma is an exceptionally rare congenital non-malignant mass which may present with a range of symptoms and severity according to size,growth and location.CASE SUMMARY In this article,we describe the case of a 12-day-old patient with an esophageal choristoma.The patient presented to the hospital with intermittent episodes of protrusion of unidentified tissue through the mouth,along with apneic episodes and failure to thrive.The mass was subsequently identified as originating from the upper esophagus.Given the mass size and the severity of symptoms,a decision was made to perform a complete endoscopic mucosal resection,the first procedure of its kind.The intervention was successful,with no complications,and the infant achieved full recovery.The endoscopic approach chosen for this case is presented in detail along with the existing literature on the presentation and treatment of similar cases.CONCLUSION Endoscopic mucosal resection is feasible and curative in neonatal esophageal symptomatic masses. 展开更多
关键词 Esophagus Choristoma Endoscopic mucosal resection Neonate Apnea Case report
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Longitudinal evolution of low anterior resection syndrome in ultralow rectal cancer:A trend analysis of a propensity-matched cohort 认领 引用
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作者 Han-Shuo Wang Yu-Xin Lin +3 位作者 Si-Rui Xu Li-Ya Wang Xiao-Dong Wang Ming-Jun Huang 《World Journal of Gastroenterology》 SCIE CAS 2026年第16期74-89,共16页
BACKGROUND Low anterior resection syndrome(LARS)severely compromises patients’quality of life after sphincter-preserving surgery for rectal cancer.Although the etiology of LARS is multifactorial,the tumor location is... BACKGROUND Low anterior resection syndrome(LARS)severely compromises patients’quality of life after sphincter-preserving surgery for rectal cancer.Although the etiology of LARS is multifactorial,the tumor location is considered a primary determinant,as it directly governs the height of the surgical anastomosis.However,it remains unclear whether the initial functional deficit and the subsequent long-term recovery trajectory differ according to the tumor height.The longitudinal evolution of LARS in patients with ultra-low rectal cancer is not well characterized.Clarifying these distinct recovery patterns is essential for developing personalized postoperative rehabilitation and functional training protocols for patients with different tumor locations.AIM To compare the postoperative features and longitudinal recovery trajectories of LARS between patients with ultra-low and non-ultra-low rectal cancer.METHODS In this single-center prospective cohort study(June 2018 to January 2024),patients undergoing sphincterpreserving surgery were stratified into ultra-low(≤3 cm from the dentate line)and non-ultra-low(>3 cm)tumor groups.LARS scores were systematically collected via follow-up at 1-,3-,6-,9-,and 12-month postoperatively.After propensity score matching,A generalized estimating equation(GEE)model was used to model the longitudinal LARS data,assessing the effects of group,time,and their interaction while accounting for repeated measures.RESULTS The final analysis included a matched cohort of 220 patients(110 per group).At all postoperative follow-up points,the ultra-low group demonstrated a significantly higher incidence of LARS(e.g.,1 month,75.5%vs 51.8%;12 months,30.0%vs 14.5%;all P<0.05).Longitudinal GEE modeling confirmed that an ultra-low tumor location was associated with a persistently higher overall odds of LARS throughout the first year(OR=2.858,95%CI=1.611-5.070;P<0.001).A significant time effect(P<0.001)signaled functional improvement in both cohorts.Critically,the non-significant group-by-time interaction(P=0.900)revealed that the groups followed parallel recovery trajectories.CONCLUSION All patients exhibited improved gastrointestinal function over the first year,but those with ultra-low tumors had significantly worse baseline function and persistently higher LARS risk,underscoring the need for tailored management. 展开更多
关键词 Rectal cancer Low anterior resection syndrome Tumor location Propensity score matching Longitudinal studies
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Exposed endoscopic full-thickness resection vs thoracoscopic surgery for complex esophageal subepithelial lesions arising from the muscularis propria 认领 引用
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作者 Xiao-Xiao Li Qing-Fen Zheng +4 位作者 Antonio Marin Garcia Zi-Yu Shi Miao Shi Mohammad Serajul Islam Dan Liu 《World Journal of Gastroenterology》 SCIE CAS 2026年第18期29-38,共10页
BACKGROUND Tumor enucleation via thoracoscopic surgery(TS)and submucosal tunneling endoscopic resection are both effective and widely used therapies for resecting most esophageal subepithelial lesions(SELs)originating... BACKGROUND Tumor enucleation via thoracoscopic surgery(TS)and submucosal tunneling endoscopic resection are both effective and widely used therapies for resecting most esophageal subepithelial lesions(SELs)originating from the muscularis propria(MP).However,when a lesion exceeds 35 mm in diameter and/or is located in the cervical esophagus,it is classified as a complex esophageal tumor.In such cases,submucosal tunneling endoscopic resection is not feasible due to insufficient tunnel space and the inability to successfully extract the lesion from the tunnel.Exposed endoscopic full-thickness resection(EFTR),which does not require tunnel creation,is a potential alternative treatment for complex esophageal SELs-MP.However,data on esophageally exposed EFTR remain limited.AIM To compare the feasibility and safety of esophageal exposed EFTR with TS for the resection of complex esophageal SELs.METHODS Between November 2016 and October 2023,the clinical records of patients with esophageal SELs-MP who underwent resection at the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed.Patients with lesions larger than 35 mm in diameter and/or located in the cervical esophagus were included in the study.Clinicopathological characteristics,perioperative outcomes,complications,and follow-up data were collected and compared between the EFTR and TS groups.RESULTS A total of 60 patients with complex esophageal SELs-MP were included,with 15 patients in the EFTR group and 45 in the TS group.The EFTR and TS groups demonstrated comparable technical success rates(100%vs 97.8%,P=0.574)and en bloc resection rates(86.7%vs 75.6%,P=0.423).Compared to the TS group,the EFTR group had a significantly longer median procedure time(240.0 minutes vs 120.0 minutes,P<0.001)but a shorter postoperative nasogastric decompression period(5.6±4.9 days vs 10.7±13.2 days,P=0.016).In the EFTR group,complete defect closure was achieved in 3 patients(20.0%),incomplete closure in 8 patients(53.3%),and non-closure in 4 patients(26.7%).Postoperative adverse events occurred in 3 patients in the EFTR group and 4 patients in the TS group.Both groups experienced cases of esophageal stricture and fistula.Notably,chylothorax was observed exclusively in the TS group.CONCLUSION Esophageal-exposed EFTR demonstrated clinical outcomes comparable to those of TS,suggesting that it is a safe and feasible option for the treatment of complex esophageal SEL-MP.Further studies are warranted to validate these findings. 展开更多
关键词 Esophageal subepithelial lesion Exposed endoscopic full-thickness resection Thoracoscopic surgery Defect closure Cervical esophagus
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Patterns and risk factors of early recurrence after radical resection for intrahepatic cholangiocarcinoma 认领 引用
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作者 Chen-Yang Zhou Jing-Yuan Chen +2 位作者 Dan Wang Shu Zhu Hong-Chang Luo 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期185-195,共11页
BACKGROUND Intrahepatic cholangiocarcinoma(ICC)represents the second-most prevalent primary hepatic malignancy,demonstrating increasing worldwide occurrence.Although surgical methods have progressed,outcomes following... BACKGROUND Intrahepatic cholangiocarcinoma(ICC)represents the second-most prevalent primary hepatic malignancy,demonstrating increasing worldwide occurrence.Although surgical methods have progressed,outcomes following curative resection remain suboptimal due to substantial recurrence frequencies.Recurrence occurring early,usually during the initial postoperative year,indicates aggressive tumor characteristics and predicts inferior outcomes compared with delayed recurrence.Comprehending patterns and predictive indicators of early relapse is essential for refining postoperative monitoring approaches and directing adjuvant treatment choices.The present investigation concentrated on determining risk indicators and recurrence characteristics to enhance personalized patient management strategies for ICC.AIM To determine the characteristics and predictive indicators of early disease recurrence following curative surgical resection of ICC.METHODS We conducted a retrospective evaluation of 386 consecutive individuals who received curative surgical resection for ICC at our institution during the period spanning January 2017 through December 2021.Early disease recurrence was operationally defined as tumor relapse occurring within the first 12 postoperative months.Predictive indicators were examined through univariate and multivariate Cox proportional hazards regression analyses.RESULTS Within our cohort of 386 individuals,237 patients(61.4%)demonstrated disease recurrence throughout the observation period,with 178 cases(75.1%)manifesting early recurrence.The predominant anatomical locations of recurrent disease included hepatic tissue(66.7%),regional lymph nodes(18.1%),and peritoneal surfaces(8.0%).Independent predictive indicators of early recurrence encompassed:Neoplasm diameter exceeding 5 cm[hazard ratio(HR)=2.14,95%confidence interval(CI):1.52-3.01,P<0.001],presence of multiple tumor foci(HR=1.89,95%CI:1.34-2.67,P<0.001),metastatic lymph node involvement(HR=2.43,95%CI:1.71-3.45,P<0.001),microscopic vascular invasion(HR=1.76,95%CI:1.25-2.48,P=0.001),carbohydrate antigen 19-9 concentrations surpassing 200 U/mL(HR=1.92,95%CI:1.37-2.69,P<0.001),and incomplete surgical margins(HR=2.01,95%CI:1.38-2.93,P<0.001).Individuals experiencing early recurrence demonstrated markedly reduced overall survival relative to those with delayed recurrence(median:18.5 months vs 42.3 months,P<0.001).CONCLUSION Early disease recurrence following ICC resection occurs frequently and correlates with unfavorable clinical outcomes.Several neoplasm-associated and treatment-associated characteristics predict early relapse.These indicators can facilitate identification of patients at elevated risk who might benefit from intensive monitoring protocols or adjuvant therapeutic interventions. 展开更多
关键词 Intrahepatic cholangiocarcinoma Early recurrence Radical resection Risk factors Prognosis Survival
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Hepatic epithelioid angiomyolipoma treated with laparoscopic resection and transcatheter arterial embolization first time:A case report and review of literature 认领 引用
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作者 Fei Wang Zhong-Xing Shi +4 位作者 Xin-Yu He Xue-Jing Han Jia-Hui Wang Jia-Yi Yang Li-Ming Cui 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期422-430,共9页
BACKGROUND Hepatic epithelioid angiomyolipoma(HEAML)is rare subtype of perivascular epithelioid cell tumor that is typically benign but has malignant potential.Misdiagnosis is common due to imaging similarities with o... BACKGROUND Hepatic epithelioid angiomyolipoma(HEAML)is rare subtype of perivascular epithelioid cell tumor that is typically benign but has malignant potential.Misdiagnosis is common due to imaging similarities with other hypervascular hepatic neoplasms,such as hepatic hemangioma and hepatocellular carcinoma.An early biopsy should be considered when radiological findings raise suspicion of HEAML.A definitive diagnosis requires a histopathological assessment and immunohistochemical profile that confirm positivity for human melanoma black and smooth muscle actin and negativity for S-100.CASE SUMMARY This article presents a case of multifocal HEAML in a 37-year-old woman.Five years prior,abdominal ultrasound incidentally detected two hyperechoic lesions in the liver,which were initially diagnosed as hemangiomas and managed with routine imaging surveillance.At a recent follow-up,the progressive enlargement of both lesions was noted,and contrast-enhanced computed tomography raised the possibility of AML.The patient had a laparoscopic procedure to remove the tumor in the left liver lobe after the lesion progressed.Postoperative histopathological analysis confirmed the diagnosis of HEAML.Transarterial embolization was chosen as an alternative to surgical resection because of the high operative risk associated with the proximity of the right lobe lesion to the hepatic hilum.The patient had an uneventful recovery,and no recurrence was detected at follow-up.CONCLUSION Surgical resection combined with interventional embolization has proven effective for managing multifocal HEAML,a rare tumor with a high risk of misdiagnosis. 展开更多
关键词 Hepatic epithelioid angiomyolipoma Perivascular epithelioid cell tumor Laparoscopic hepatectomy Transarterial embolization Surgical resection and interventional embolization Hypervascular hepatic tumor Case report
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Preoperative clinical and laboratory factors associated with early complications after low anterior resection:Exploratory analysis of the eosinophil/lymphocyte ratio 认领 引用
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作者 Ali Kemal Taşkin Mustafa Akar +2 位作者 Mustafa Suphi Turgut Burak Bilir Enes Karademir 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期253-265,共13页
BACKGROUND Rectal cancer is of particular importance among colorectal malignancies due to technical difficulties in surgical treatment and serious complications that can occur postoperatively.AIM To determine the prob... BACKGROUND Rectal cancer is of particular importance among colorectal malignancies due to technical difficulties in surgical treatment and serious complications that can occur postoperatively.AIM To determine the probable factors affecting early postoperative complications in patients undergoing low anterior resection(LAR)for rectal cancer.METHODS This retrospective study included adult patients who underwent LAR for rectal cancer between January 1,2018 and December 31,2024.The patients were divided into two groups,those with and those without early postoperative complications.Complications developing within the first 30 days after LAR were considered early and complications developing after 30 days were considered late.The level of statistical significance in all statistical evaluations was set as P<0.05.RESULTS A total of 105 patients underwent LAR for rectal cancer,comprising 66(62.9%)males and 39(37.1%)females with a mean age of 66±12 years(28-85 years).Protective loop ileostomy was performed in 23(21.9%)patients.The LAR was performed as open surgery in 63(60%)patients and laparoscopically in 42(40%)patients.The mean follow-up period was 46.44±25 months(1-85 months)and the mean disease-free survival duration was 42.49±24 months(1-85 months).Early postoperative complications were observed in 29 (27.6%) patients and late complications were observed in 14(13.3%) patients. The most frequently seen early postoperative complication was anastomosis leakage in 10 (9.5%)patients. Advanced age, the presence of diabetes mellitus, advanced stage disease, increased preoperativeeosinophil/lymphocyte ratio (ELR), and low preoperative albumin and hemoglobin levels were found to besignificantly associated with early postoperative complications (P < 0.05). Patients who underwent open LARsurgery were observed to require longer hospitalization and developed more early complications than patientswho underwent laparoscopic surgery.CONCLUSIONElevated preoperative ELR in patients undergoing LAR for rectal cancer may predict the development of earlypostoperative complications. Therefore, further studies are required to be able to establish the importance of thepreoperative ELR. 展开更多
关键词 Rectal cancer Postoperative complication Early postoperative complication Low anterior resection Eosinophil/lymphocyte ratio
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