1
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Long Y, Du H, Li J, Liu X, Chen L. Detection of small intestine duplication in a 16-year-old girl using small bowel enteroscopy without balloon assistance. Endoscopy 2025; 57:E20-E21. [PMID: 39809295 PMCID: PMC11732372 DOI: 10.1055/a-2503-6137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2025]
Affiliation(s)
- Yanqin Long
- Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Haojie Du
- Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Li
- Pathology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaosun Liu
- Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Lihua Chen
- Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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2
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Yang Y, Zhao Z, Wu S, Yao D. Structural or functional abnormality of sphincter of Oddi: an important factor for the recurrence of choledocholithiasis after endoscopic treatment. Ann Med 2025; 57:2440119. [PMID: 39673217 PMCID: PMC11648144 DOI: 10.1080/07853890.2024.2440119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/15/2024] [Accepted: 11/01/2024] [Indexed: 12/16/2024] Open
Abstract
A high recurrence rate is undesirable after treatment of common bile duct (CBD) stones. A major risk factor identified for recurrence is that invasive techniques, including surgical or endoscopic treatments, will impair the biliary tract system either by direct incision of the CBD or by cutting or dilating the ampulla of Vater. During endoscopic treatment, two main assisted methods for lithotomy, sphincterotomy and papillary balloon dilation, can result in different degrees of damage to the structure and function of the sphincter of Oddi (SO), contributing to slowing of biliary excretion, cholestasis, biliary bacterial infection, and promotion of bile duct stone recurrence. In this review, the relationship between endoscopic lithotomy and structural impairment or functional abnormality of the SO will be summarized, and their relationship with the recurrence of CBD stones will also be analyzed. Further improvement of these endoscopic methods or exploration of some novel methods, such as endoscopic endoclip papilloplasty, temporary insertion of a self-expandable metal stent, and combined application of peroral cholangioscopy, may aid in providing more appropriate treatment for patients with choledocholithiasis, repair or protect the function and structure of SO, reduce or prevent the recurrence of bile duct stones, and improve patient outcomes.
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Affiliation(s)
- Ye Yang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zeying Zhao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Dianbo Yao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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3
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Li D, Chu X, Liu W, Ma Y, Tian X, Yang Y. The regulatory roles of RNA-binding proteins in the tumour immune microenvironment of gastrointestinal malignancies. RNA Biol 2025; 22:1-14. [PMID: 39718205 DOI: 10.1080/15476286.2024.2440683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/03/2024] [Accepted: 12/04/2024] [Indexed: 12/25/2024] Open
Abstract
The crosstalk between the tumour immune microenvironment (TIME) and tumour cells promote immune evasion and resistance to immunotherapy in gastrointestinal (GI) tumours. Post-transcriptional regulation of genes is pivotal to GI tumours progression, and RNA-binding proteins (RBPs) serve as key regulators via their RNA-binding domains. RBPs may exhibit either anti-tumour or pro-tumour functions by influencing the TIME through the modulation of mRNAs and non-coding RNAs expression, as well as post-transcriptional modifications, primarily N6-methyladenosine (m6A). Aberrant regulation of RBPs, such as HuR and YBX1, typically enhances tumour immune escape and impacts prognosis of GI tumour patients. Further, while targeting RBPs offers a promising strategy for improving immunotherapy in GI cancers, the mechanisms by which RBPs regulate the TIME in these tumours remain poorly understood, and the therapeutic application is still in its early stages. This review summarizes current advances in exploring the roles of RBPs in regulating genes expression and their effect on the TIME of GI tumours, then providing theoretical insights for RBP-targeted cancer therapies.
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Affiliation(s)
- Dongqi Li
- Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China
| | - Xiangyu Chu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Weikang Liu
- Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China
| | - Yongsu Ma
- Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China
| | - Xiaodong Tian
- Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China
| | - Yinmo Yang
- Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China
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4
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Slama E, Ben Hamida S, Zaouga S, Elloumi H, Cheikh I, Dahak AG, Missaoui M, Chelibi A, Ganzoui I. Primary adenocarcinoma of duodenal bulb mimicking a pancreatic tumor: a case report. Future Sci OA 2025; 11:2456651. [PMID: 39905859 DOI: 10.1080/20565623.2025.2456651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 12/19/2024] [Indexed: 02/06/2025] Open
Abstract
Duodenal bulb adenocarcinoma is a rare malignancy of the gastrointestinal tract. This cancer often presents with an insidious onset, making it challenging to diagnose early. A noteworthy case-study involved a 56 year-old-woman complaining from epigastric transfixing pain, jaundice, and overall health decline. The initial diagnosis suspected was a pancreatic tumor. An abdominal CT scan however showed no abnormality in the pancreas but revealed on the other hand an irregular, non-stenosing, heterogeneous fibrous thickening of the lower aspect of the duodenal bulb. An EGD showed a congested infiltrated area in the post-bulbar region, and Pathological exam confirmed the diagnosis of a primary adenocarcinoma of the duodenal bulb. The purpose of this article is to present the case of a primary adenocarcinoma of duodenal bulb mimicking a pancreatic tumor: a rare presentation of a rare tumor itself and to present points differentiating these two neoplasms. Diagnosis relies on a comprehensive assessment involving clinical, radiological, endoscopic, and histologic features. Integration of advanced imaging modalities, such as CT/MRI, coupled with upper gastrointestinal endoscopy, is crucial for accurate evaluation.
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Affiliation(s)
- Eya Slama
- Departement of Gastroenterology, Habib Bougatfa Hospital, Bizerte, Tunisia
| | - S Ben Hamida
- Departement of Gastroenterology, Habib Bougatfa Hospital, Bizerte, Tunisia
| | - S Zaouga
- Departement of Gastroenterology, Habib Bougatfa Hospital, Bizerte, Tunisia
| | - H Elloumi
- Departement of Gastroenterology, Habib Bougatfa Hospital, Bizerte, Tunisia
| | - I Cheikh
- Departement of Gastroenterology, Habib Bougatfa Hospital, Bizerte, Tunisia
| | - A G Dahak
- Departement of Radiology, Habib Bougatfa Hospital, Bizerte, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - M Missaoui
- Departement of Radiology, Habib Bougatfa Hospital, Bizerte, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A Chelibi
- Departement of Radiology, Habib Bougatfa Hospital, Bizerte, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - I Ganzoui
- Departement of Radiology, Habib Bougatfa Hospital, Bizerte, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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5
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Uriot O, Deschamps C, Scanzi J, Brun M, Kerckhove N, Dualé C, Fournier E, Durif C, Denis S, Dapoigny M, Langella P, Alric M, Etienne-Mesmin L, Stéphanie BD. Gut microbial dysbiosis associated to diarrheic irritable bowel syndrome can be efficiently simulated in the Mucosal ARtificial COLon (M-ARCOL). Bioengineered 2025; 16:2458362. [PMID: 39902883 PMCID: PMC11796540 DOI: 10.1080/21655979.2025.2458362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 01/08/2025] [Accepted: 01/16/2025] [Indexed: 02/06/2025] Open
Abstract
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder, with diarrhea-predominant IBS (IBS-D) as the most frequent subtype. The implication of gut microbiota in the disease's etiology is not fully understood. In vitro gut systems can offer a great alternative to in vivo assays in preclinical studies, but no model reproducing IBS-related dysbiotic microbiota has been developed. Thanks to a large literature review, a new Mucosal ARtifical COLon (M-ARCOL) adapted to IBS-D physicochemical and nutritional conditions was set-up. To validate the model and further exploit its potential in a mechanistic study, in vitro fermentations were performed using bioreactors inoculated with stools from healthy individuals (n = 4) or IBS-D patients (n = 4), when the M-ARCOL was set-up under healthy or IBS-D conditions. Setting IBS-D parameters in M-ARCOL inoculated with IBS-D stools maintained the key microbial features associated to the disease in vivo, validating the new system. In particular, compared to the healthy control, the IBS-D model was characterized by a decreased bacterial diversity, together with a lower abundance of Rikenellaceae and Prevotellaceae, but a higher level of Proteobacteria and Akkermansiaceae. Of interest, applying IBS-D parameters to healthy stools was not sufficient to trigger IBS-D dysbiosis and applying healthy parameters to IBS-D stools was not enough to restore microbial balance. This validated IBS-D colonic model can be used as a robust in vitro platform for studies focusing on gut microbes in the absence of the host, as well as for testing food and microbiota-related interventions aimed at personalized restoration of gut microbiota eubiosis.
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Affiliation(s)
- Ophélie Uriot
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Charlotte Deschamps
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Julien Scanzi
- UMR INSERM 1107 NEURO-DOL, Université Clermont Auvergne, Clermont-Ferrand, Puy-de-Dôme,France
- Service de Gastroentérologie, Centre Hospitalo-Universitaire, Clermont-Ferrand, Puy-de-Dôme,France
- Service de Gastroentérologie, Centre Hospitalier de Thiers, Thiers, Puy-de-Dôme, France
| | - Morgane Brun
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Nicolas Kerckhove
- UMR INSERM 1107 NEURO-DOL, Université Clermont Auvergne, Clermont-Ferrand, Puy-de-Dôme,France
- Service de Pharmacologie médicale, Centre Hospitalo-Universitaire, Clermont-Ferrand, Puy-de-Dôme,France
| | - Christian Dualé
- CIC INSERM 1405, Centre Hospitalo-Universitaire, Clermont-Ferrand, Puy-de-Dôme,France
| | - Elora Fournier
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Claude Durif
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Sylvain Denis
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Michel Dapoigny
- UMR INSERM 1107 NEURO-DOL, Université Clermont Auvergne, Clermont-Ferrand, Puy-de-Dôme,France
- Service de Gastroentérologie, Centre Hospitalo-Universitaire, Clermont-Ferrand, Puy-de-Dôme,France
| | - Philippe Langella
- Micalis, INRAE, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, Yvelines,France
| | - Monique Alric
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Lucie Etienne-Mesmin
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
| | - Blanquet-Diot Stéphanie
- UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, Université Clermont Auvergne – INRAE, Clermont-Ferrand, Puy-de-Dôme,France
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Huang Y, Qiu M, Pan S, Zhou Y, Huang X, Jin Y, Zippi M, Fiorino S, Zimmer V, Hong W. Temporal trends in gender, etiology, severity and outcomes of acute pancreatitis in a third-tier Chinese city from 2013 to 2021. Ann Med 2025; 57:2442073. [PMID: 39699078 DOI: 10.1080/07853890.2024.2442073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 11/05/2024] [Accepted: 11/12/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND To evaluate temporal trends in gender, etiology, severity, outcomes, cost and median length of stay (MLS) in patients with acute pancreatitis (AP) in a third-tier Chinese city. METHODS Patients with AP admitted to a university hospital between January 2013 and December 2021. Relationships between etiology, prevalence of severe acute pancreatitis (SAP) and survey years were investigated by joinpoint regression analysis. RESULTS A total of 5459 (male 62.3%) patients with AP were included. Between January 2013 and December 2021, we observed: (a) the prevalence of biliary diseases-related AP was stable, while the prevalence of hypertriglyceridemia (HTG)-associated AP (Ptrend = 0.04) and alcohol-associated AP (Ptrend < 0.0001) both increased; (b) there was an increase in crude prevalence of SAP from 4.97% to 12.2% between 2013 and 2021 (Ptrend < 0.0001); (c) compared to female populations, male gender had a higher prevalence of AP; (d) there was a decrease in MLS from 11 days to 8 days (Ptrend < 0.0001) and in median cost of hospitalization (MCH) for all patients (from 20,166 to 12,845 YUAN) (Ptrend < 0.0001); (e) the overall in-hospital mortality rate was 1.28% (70/5459) for patients with AP. There was no statistically significant in the time trend of mortality during the study period (Ptrend = 0.5873). At multivariate analysis, survey year was associated with prevalence of SAP after adjustment by age and biliary diseases (OR: 1.07; 95% CI: 1.03-1.12). Based on the stratification by severity of disease, the decrease of MLS and MCH was more significant in non-SAP vs. SAP patients. CONCLUSIONS Over the observational period, the proportion of male patients with AP, prevalence of age-adjusted rate of HTG and alcohol-associated AP and SAP increased, while MLS and MCH for all patients decreased, and the time trend of mortality of AP was stable.
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Affiliation(s)
- Yining Huang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minhao Qiu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuang Pan
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yan Zhou
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Huang
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yinglu Jin
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Maddalena Zippi
- Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy
| | - Sirio Fiorino
- Medicine Department, Internal Medicine Unit, Budrio Hospital Azienda USL, Budrio, Italy
| | - Vincent Zimmer
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Wandong Hong
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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7
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Nakagawa H, Takeda T, Okamoto T, Hirai T, Mie T, Furukawa T, Kasuga A, Sasaki T, Ozaka M, Matsuda T, Igarashi Y, Sasahira N. Efficacy and safety of a novel polytetrafluoroethylene-coated self-expandable metal stent for distal malignant biliary obstruction. DEN OPEN 2025; 5:e70010. [PMID: 39228862 PMCID: PMC11369803 DOI: 10.1002/deo2.70010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/19/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
Background Stent migration and sludge formation remain significant problems associated with covered self-expandable metal stents (CSEMSs). The EGIS biliary stent fully covered flare type (EGIS biliary stent), a new type of polytetrafluoroethylene-coated self-expandable metal stent with low axial force and an anti-migration system, was developed to overcome these disadvantages. We conducted this study to evaluate the efficacy and safety of this stent in comparison with conventional CSEMS (c-CSEMS). Methods We retrospectively analyzed consecutive patients with unresectable pancreatic cancer who received initial CSEMS for distal malignant biliary obstruction. The primary outcome was time to recurrent biliary obstruction (RBO). Secondary outcomes included technical success rate, functional success rate, stent-related adverse events, causes of RBO, and re-intervention. Results A total of 40 patients were included (EGIS group: 20; c-CSEMS group: 20). The technical and functional success rates were similar between the two groups. Stent-related adverse event rates (20% vs. 15%, p > 0.99) and overall RBO rates (56% vs. 50%, p > 0.99) were not significantly different between the two groups. Stent migration was the most common cause of RBO in the EGIS group, while stent occlusion was in the c-CSEMS group. The median time to RBO (102 vs. 434 days, p = 0.10) was not significantly different between the two groups. Endoscopic transpapillary re-intervention was successful in most patients in both groups. Conclusions The EGIS biliary stent was not associated with a longer time to RBO compared to c-CSEMS. Further improvements, especially against stent migration, are needed to improve its efficacy.
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Affiliation(s)
- Hiroki Nakagawa
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
- Department of Internal MedicineOmori Medical CenterDivision of Gastroenterology and HepatologyToho UniversityTokyoJapan
| | - Tsuyoshi Takeda
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Okamoto
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Tatsuki Hirai
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takafumi Mie
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takaaki Furukawa
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Akiyoshi Kasuga
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takashi Sasaki
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Masato Ozaka
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Takahisa Matsuda
- Department of Internal MedicineOmori Medical CenterDivision of Gastroenterology and HepatologyToho UniversityTokyoJapan
| | - Yoshinori Igarashi
- Department of Internal MedicineOmori Medical CenterDivision of Gastroenterology and HepatologyToho UniversityTokyoJapan
| | - Naoki Sasahira
- Department of Hepato‐Biliary‐Pancreatic MedicineCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
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Le XY, Feng JB, Guo Y, Zhou YQ, Li CM. Predicting preoperative lymph node metastasis in esophageal cancer: Advancement and challenges. World J Clin Oncol 2025; 16:102863. [DOI: 10.5306/wjco.v16.i3.102863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 12/18/2024] [Accepted: 01/07/2025] [Indexed: 01/21/2025] Open
Abstract
Accurate preoperative prediction of lymph node metastasis is crucial for developing clinical management strategies for patients with esophageal cancer. In this letter, we present our insights and opinions on a new nomogram proposed by Xu et al. Although this research has great potential, there are still concerns regarding the small sample size, limited consideration of biological complexity, subjective image segmentation, incomplete image feature extraction and statistical analyses. Furthermore, we discuss how to achieve more robust and accurate predictive performance in future research.
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Affiliation(s)
- Xing-Yan Le
- Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
| | - Jun-Bang Feng
- Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
| | - Yi Guo
- Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
| | - Yue-Qin Zhou
- Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
| | - Chuan-Ming Li
- Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
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9
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Gadour E. Lesson learnt from 60 years of liver transplantation: Advancements, challenges, and future directions. World J Transplant 2025; 15:93253. [DOI: 10.5500/wjt.v15.i1.93253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 09/06/2024] [Accepted: 09/14/2024] [Indexed: 11/26/2024] Open
Abstract
Over the past six decades, liver transplantation (LT) has evolved from an experimental procedure into a standardized and life-saving intervention, reshaping the landscape of organ transplantation. Driven by pioneering breakthroughs, technological advancements, and a deepened understanding of immunology, LT has seen remarkable progress. Some of the most notable breakthroughs in the field include advances in immunosuppression, a revised model for end-stage liver disease, and artificial intelligence (AI)-integrated imaging modalities serving diagnostic and therapeutic roles in LT, paired with ever-evolving technological advances. Additionally, the refinement of transplantation procedures, resulting in the introduction of alternative transplantation methods, such as living donor LT, split LT, and the use of marginal grafts, has addressed the challenge of organ shortage. Moreover, precision medicine, guiding personalized immunosuppressive strategies, has significantly improved patient and graft survival rates while addressing emergent issues, such as short-term complications and early allograft dysfunction, leading to a more refined strategy and enhanced post-operative recovery. Looking ahead, ongoing research explores regenerative medicine, diagnostic tools, and AI to optimize organ allocation and post-transplantation car. In summary, the past six decades have marked a transformative journey in LT with a commitment to advancing science, medicine, and patient-centered care, offering hope and extending life to individuals worldwide.
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Affiliation(s)
- Eyad Gadour
- Department of Gastroenterology and Hepatology, King Abdulaziz National Guard Hospital, Ahsa 36428, Saudi Arabia
- Internal Medicine, Zamzam University College, Khartoum 11113, Sudan
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10
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Chen B, Wang T, Gao J, Chen Y, Chang H, Shu Y, Zhang Y, Li J, Weng W. Acupuncture relieves postoperative pain of mixed hemorrhoids through the P2X7/ERK axis in dorsal root ganglion. Physiol Behav 2025; 291:114806. [PMID: 39814121 DOI: 10.1016/j.physbeh.2025.114806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 12/15/2024] [Accepted: 01/06/2025] [Indexed: 01/18/2025]
Abstract
Haemorrhoids are a common anorectal disease primarily treated through surgery, often leading to complications such as pain. The efficacy of acupuncture in relieving postoperative pain in mixed haemorrhoids has not been well-documented. This study included 90 patients undergoing haemorrhoid surgery and their Visual Analogue Score (VAS), inflammatory factor levels, Hamilton Depression Rating Scale (HAMD), and analgesic drug use were accessed. A rat incisional pain model was also constructed to monitor behavioral responses, with assessments including Sucrose Preference Test (SPT) and Open Field Test (OFT). The levels of ATP and proinflammatory cytokines in the dorsal root ganglion (DRG) were measured using luciferase assay and ELISA. We also examined P2×7 and ERK1/2 levels in DRG tissues of anal incisional pain rat model. In a Chronic Constriction Injury (CCI) rat model treated with BzATP, a potent agonist for P2×7 receptors, followed by acupuncture for 15 days, postoperative pain and behavioral responses were observed and assessed, alongside mechanistic studies of ATP and inflammatory factors in DRG tissues. Patients receiving acupuncture had significantly lower VAS scores, reduced levels of inflammatory factors, improved depression scores, and decreased analgesic drug use. In the animal model, acupuncture increased pain thresholds, improved behavioral responses, reduced ATP content and inflammatory factors, and modulated the P2×7/ERK axis. In the CCI model, BzATP increased P2×7 and ERK1/2 levels, pain sensitivity, and anxiety, which were mitigated by acupuncture. Our data suggest that acupuncture significantly alleviates postoperative pain following haemorrhoid surgery and modulates the pain response through the P2×7/ERK axis.
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Affiliation(s)
- Bin Chen
- Department of Anorectal Surgery, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Tian Wang
- Department of Anesthesiology, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Jie Gao
- Department of Acupuncture, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Yan Chen
- Department of Anorectal Surgery, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Haijing Chang
- Department of Anorectal Surgery, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Yi Shu
- Department of Anorectal Surgery, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Yaling Zhang
- Department of Acupuncture, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Jiahuan Li
- Department of Acupuncture, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China
| | - Weiqun Weng
- Department of Nursing, Nantong First People's Hospital, Nantong, Jiangsu, 226001, China.
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Kumar A, Aravind N, Gillani T, Kumar D. Artificial intelligence breakthrough in diagnosis, treatment, and prevention of colorectal cancer – A comprehensive review. Biomed Signal Process Control 2025; 101:107205. [DOI: 10.1016/j.bspc.2024.107205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2024]
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12
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Xuan W, Zhang X, Fang Y, Zhang Y, Xiang Z, Yu Y, Wu Q, Zhang X. Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis. Oncol Lett 2025; 29:122. [PMID: 39807096 PMCID: PMC11726279 DOI: 10.3892/ol.2025.14868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2024] [Accepted: 12/05/2024] [Indexed: 01/16/2025] Open
Abstract
Hepatocellular carcinoma (HCC) with coexisting portal vein tumor thrombus (PVTT) is associated with poor patient outcomes. The efficacy and safety of neoadjuvant therapy in patients with HCC with PVTT remain a subject of debate. In the present study, a comprehensive search of electronic databases, including PubMed, Web of Science, Embase and the Cochrane Library, was conducted to identify studies evaluating the outcomes of neoadjuvant therapy in patients with HCC and PVTT. The primary outcomes assessed were overall survival (OS) and relapse-free survival (RFS), with complication rates as a secondary outcome. A total of six studies comprising 750 patients were included in the present meta-analysis. The neoadjuvant therapy group exhibited significantly superior OS [hazard ratio (HR), 0.39; P<0.001] and RFS (HR, 0.31; P<0.001) compared with the primary hepatectomy control group. Compared with the control group, neoadjuvant radiotherapy improved OS (HR, 0.34; P<0.001) and RFS (HR, 0.24; P=0.004). While the neoadjuvant intervention subgroup exhibited an improved OS compared with controls (HR, 0.37; P=0.001), no significant difference in RFS was observed (HR, 0.11; P=0.095). Geographical analysis revealed that the Chinese subgroup demonstrated a significantly improved OS and RFS (HR, 0.41 for both; P<0.001), compared with the control group. However, the Japanese and Korean subgroups showed no improvement in OS (HR, 0.25; P=0.057) compared with the control group, and the results did not reach statistical significance. There were no significant differences between the groups in terms of blood transfusion, blood loss, operation time, bile leakage, ascites, peritoneal infection, postoperative bleeding, complications or mortality (all P>0.05). Overall, neoadjuvant therapy significantly improved survival outcomes in patients with HCC and PVTT without increasing complication rates, supporting its efficacy and manageable safety profile.
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Affiliation(s)
- Wangyi Xuan
- Department of Gastroenterology, Ningbo Zhenhai Hospital of Traditional Chinese Medicine, Ningbo, Zhejiang 315299, P.R. China
| | - Xiaoming Zhang
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Yingying Fang
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Yueming Zhang
- Intensive Care Unit, Hospital of Zhejiang People's Armed Police, Hangzhou, Zhejiang 310051, P.R. China
| | - Zhiyi Xiang
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Yifei Yu
- School of Stomatology, Zhejiang University of Chinese Medicine, Hangzhou, Zhejiang 310053, P.R. China
| | - Qingping Wu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China
| | - Xingfen Zhang
- Department of Liver Disease, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, P.R. China
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13
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Ulkucu A, Erkaya M, Erozkan K, Catalano B, Liska D, Allende D, Steele SR, Sommovilla J, Gorgun E. Should endoscopic submucosal dissection be offered to patients with early colorectal cancer? Surgery 2025; 179:109030. [PMID: 39732557 DOI: 10.1016/j.surg.2024.109030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 11/25/2024] [Accepted: 12/05/2024] [Indexed: 12/30/2024]
Abstract
BACKGROUND Endoscopic submucosal dissection is increasingly used to treat early-stage colorectal cancer. This study evaluated the feasibility of endoscopic submucosal dissection in this setting and the determinants of lymph node metastasis. METHODS We reviewed patients who underwent colorectal endoscopic submucosal dissection for early-stage colorectal cancer at a tertiary center between 2011 and 2023. The primary outcome was the identification of high-risk pathologic features predictive of lymph node metastasis in patients undergoing oncologic colon resection following endoscopic submucosal dissection. RESULTS We reviewed 1,398 patients who underwent endoscopic submucosal dissection, and 83 (6%) had colorectal cancer. Twenty-four patients (29%) were closely monitored after endoscopic submucosal dissection, and 59 (71%) underwent oncologic colon resection because of high-risk pathologies of the endoscopic submucosal dissection specimen. In the oncologic colon resection group, the mean age was 62.7 years (±10.2), with 56% male predominance, and 14% showed positive lymph nodes in the final pathology. Analysis comparing patients with and without lymph node metastasis showed significant differences in sex, lesion size, submucosal invasion depth, and budding scores. Multivariate analysis showed that lesions with a submucosal invasion depth ≥2.00 mm of the endoscopic submucosal dissection resection specimen had higher odds of lymph node metastasis (odds ratio 18.7, P = .028), whereas lesions with a diameter >20 mm were associated with a lower likelihood of lymph node metastasis (odds ratio 0.07, P = .036). CONCLUSION The study highlights the oncologic safety of early-stage endoscopic submucosal dissection as a viable treatment option for carefully selected patients with colorectal cancer. After tissue resection with endoscopic submucosal dissection, if the lesion size is less than 20 mm, depth of invasion up to 2 mm may be considered safe in the absence of other high-risk pathologic factors.
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Affiliation(s)
- Attila Ulkucu
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH. https://twitter.com/AttilaUlkucu
| | - Metincan Erkaya
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH. https://twitter.com/MetinErkayaMD
| | - Kamil Erozkan
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - Brogan Catalano
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - David Liska
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH. https://twitter.com/DavidLiskaMD
| | - Daniela Allende
- Department of Pathology, Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Scott R Steele
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH. https://twitter.com/ScottRSteeleMD
| | - Joshua Sommovilla
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - Emre Gorgun
- Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.
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14
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Antel R, Whitelaw S, Gore G, Ingelmo P. Moving towards the use of artificial intelligence in pain management. Eur J Pain 2025; 29:e4748. [PMID: 39523657 PMCID: PMC11755729 DOI: 10.1002/ejp.4748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 09/15/2024] [Accepted: 10/14/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND AND OBJECTIVE While the development of artificial intelligence (AI) technologies in medicine has been significant, their application to acute and chronic pain management has not been well characterized. This systematic review aims to provide an overview of the current state of AI in acute and chronic pain management. DATABASES AND DATA TREATMENT This review was registered with PROSPERO (ID# CRD42022307017), the international registry for systematic reviews. The search strategy was prepared by a librarian and run in four electronic databases (Embase, Medline, Central, and Web of Science). Collected articles were screened by two reviewers. Included studies described the use of AI for acute and chronic pain management. RESULTS From the 17,601 records identified in the initial search, 197 were included in this review. Identified applications of AI were described for treatment planning as well as treatment delivery. Described uses include prediction of pain, forecasting of individualized responses to treatment, treatment regimen tailoring, image-guidance for procedural interventions and self-management tools. Multiple domains of AI were used including machine learning, computer vision, fuzzy logic, natural language processing and expert systems. CONCLUSION There is growing literature regarding applications of AI for pain management, and their clinical use holds potential for improving patient outcomes. However, multiple barriers to their clinical integration remain including lack validation of such applications in diverse patient populations, missing infrastructure to support these tools and limited provider understanding of AI. SIGNIFICANCE This review characterizes current applications of AI for pain management and discusses barriers to their clinical integration. Our findings support continuing efforts directed towards establishing comprehensive systems that integrate AI throughout the patient care continuum.
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Affiliation(s)
- Ryan Antel
- Department of AnesthesiaMcGill UniversityMontrealQuebecCanada
- Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Sera Whitelaw
- Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and EngineeringMcGill UniversityMontrealQuebecCanada
| | - Pablo Ingelmo
- Department of AnesthesiaMcGill UniversityMontrealQuebecCanada
- Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children's HospitalMcGill University Health CenterMontrealQuebecCanada
- Alan Edwards Center for Research in PainMontrealQuebecCanada
- Research InstituteMcGill University Health CenterMontrealQuebecCanada
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15
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Gross A, Hong H, Hossain MS, Chang JH, Wehrle CJ, Sahai S, Quick J, Izda A, Said S, Naffouje S, Walsh RM, Augustin T. Clinical and patient-reported outcomes following subtotal cholecystectomy: 10-year single-institution experience. Surgery 2025; 179:108805. [PMID: 39358120 DOI: 10.1016/j.surg.2024.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/30/2024] [Accepted: 07/30/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVE Subtotal cholecystectomy provides a safe, bail-out alternative for difficult gallbladders. However, long-term outcomes comparing fenestrating and reconstituting subtotal cholecystectomy subtypes remain underexplored. METHODS This retrospective cohort included patients who underwent subtotal cholecystectomy between 2010 and 2020 within a single hospital system. Subtotal cholecystectomy was identified by parsing operative notes for keywords. Demographic and clinical variables were collected by manual review. Patient-reported outcomes were collected via phone using an abbreviated Gastrointestinal Quality-of-Life Index. RESULTS We identified 218 subtotal cholecystectomies, with 113 (51.8%) fenestrating subtotal cholecystectomy and 105 (48.2%) reconstituting subtotal cholecystectomy and a median follow-up of 63 months (interquartile range 27-106). Rates of bile duct injury (0.9% vs 1.0%; P > .99), bile leak (10.6% vs 9.5%; P > .99), and 30-day readmission (7.6% vs 8.0%; P > .99) did not differ between fenestrating and reconstituting subtotal cholecystectomy. For fenestrating subtotal cholecystectomy, the postoperative bile leak rate decreased fourfold when cystic duct closure was achieved (6.0% vs 24.1%; P = .012). Subtotal cholecystectomies completed laparoscopically had fewer postoperative bile leaks (2.9% vs 16.8%; P = .001), fewer wound complications (4.8% vs 13.3%; P = .035), and decreased length of stay (7.00 ± 9.07 vs 10.15 ± 13.50 days; P < .001) compared with open operations. The survey response rate was 38.9% (n = 51/131); 47 patients (92.2%) did not report recurrent biliary pain or postprandial nausea or vomiting, but 19 patients (37.2%) reported dietary restriction. Long-term completion cholecystectomy rate was 0.9%. CONCLUSION Given no notable difference in postoperative or quality of life outcomes between subtotal cholecystectomy subtypes, consideration of technique depends on intraoperative conditions. Cystic duct closure during fenestrating subtotal cholecystectomy and laparoscopic completion of subtotal cholecystectomy are associated with improved postoperative outcomes.
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Affiliation(s)
- Abby Gross
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH. https://twitter.com/AbbyRGrossMD
| | - Hanna Hong
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH
| | - Mir Shanaz Hossain
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Jenny H Chang
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Chase J Wehrle
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH. https://twitter.com/ChaseWehrle
| | | | - Joseph Quick
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Aleksander Izda
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Sayf Said
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Samer Naffouje
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - R Matthew Walsh
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH
| | - Toms Augustin
- Department of General Surgery/Hepato-Pancreato-Biliary Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH.
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16
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Ayeldeen G, Badr BM, Shaker OG, Diab K, Ahmed TI, Hassan EA, Nagaty RA, Galal S, Hasona NA. Integrated analysis of non‑coding RNAs (HOTAIR and miR‑130a) and their cross‑talk with TGF‑β1, SIRT1 and E‑cadherin as potential biomarkers in colorectal cancer. Oncol Lett 2025; 29:116. [PMID: 39807105 PMCID: PMC11726295 DOI: 10.3892/ol.2025.14863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 11/15/2024] [Indexed: 01/16/2025] Open
Abstract
Molecular changes have a substantial impact on the onset of colorectal cancer (CRC). Complexes of HOTAIR and miRNAs disrupt several cellular functions during carcinogenesis, primarily by disrupting several carcinogenic signaling pathways. In the present study, the relationships between the serum levels of transforming growth factor-β1 (TGF-β1), sirtuin-1 (SIRT1) and E-cadherin and those of HOX transcript antisense intergenic RNA (HOTAIR) and microRNA-130a (miR-130a) in individuals with CRC were analyzed, including their correlations and diagnostic potential. Patients with colon cancer and healthy volunteers were enrolled in the study. Blood samples were collected from 70 patients with CRC and 30 age-matched healthy control volunteers and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to determine the serum levels of HOTAIR and miR-130a. In addition, the levels of TGF-β1, SIRT1 and E-cadherin were determined utilizing enzyme-linked immunosorbent assays. Patients with CRC were found to have significantly higher TGF-β1, SIRT1, HOTAIR and miR-130a serum levels than those of healthy participants. In addition, patients with high-grade CRC had significantly higher levels of TGF-β1, SIRT1, HOTAIR and miR-130a compared with those of patients with low-grade CRC. A significant reduction in the serum levels of E-cadherin was observed in participants with CRC compared with healthy participants, but no significant difference was detected according to the grade of CRC. Positive correlations were found between HOTAIR and miR-130a, as well as TGF-β1 and SIRT1. By contrast, negative correlations were noted between E-cadherin and HOTAIR, miR-130a, TGF-β1 and SIRT1. Therefore, it may be concluded that the miR-130a/HOTAIR and TGF-β1/SIRT1/E-cadherin axes may serve as novel biomarkers for the early diagnosis of CRC.
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Affiliation(s)
- Ghada Ayeldeen
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza 12613, Egypt
| | - Bahaa Mohammed Badr
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Al-Azhar University (Assiut branch), Assiut 71524, Egypt
| | - Olfat G. Shaker
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza 12613, Egypt
| | - Khaled Diab
- Department of General Surgery, Faculty of Medicine, Fayoum University, Fayoum 63514, Egypt
| | - Tarek I. Ahmed
- Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum 63514, Egypt
| | - Essam A. Hassan
- Department of Tropical Medicine, Faculty of Medicine, Fayoum University, Fayoum 63514, Egypt
| | - Raghda A. Nagaty
- Clinical and Chemical Pathology Research Institute of Ophthalmology, Ministry of Higher Education and Scientific Research, Cairo 11694, Egypt
| | - Shaymaa Galal
- Department of Biochemistry, Modern University for Technology and Information, Cairo 11792, Egypt
| | - Nabil A. Hasona
- Department of Biochemistry, Faculty of Science, Beni-Suef University, Beni-Suef 62511, Egypt
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17
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Afghani E, Lennon AM. What Is the Latest in Pancreatic Cysts? Gastroenterol Clin North Am 2025; 54:189-203. [PMID: 39880527 DOI: 10.1016/j.gtc.2024.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2025]
Abstract
Pancreatic cysts are common incidental findings. The understanding of pancreatic cysts has evolved tremendously over the past few decades. Molecular diagnostic and endoscopic techniques have led to more precise characterization of cyst types and interventions to improve patient outcomes. This article outlines these recent innovations in pancreatic cyst diagnosis and management.
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Affiliation(s)
- Elham Afghani
- Department of Medicine, Johns Hopkins University, 1830 East Monument Street, Room 436, Baltimore, MD 21287, USA
| | - Anne Marie Lennon
- Department of Medicine, University of Pittsburgh, 3550 Terrace Street, 1218 Scaife Hall, Pittsburgh, PA 15261, USA.
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18
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Lorenz WR, Holland AM, Kerr SW, Ayuso SA, Polcz ME, Scarola GT, Kercher KW, Heniford BT, Augenstein VA. Outcomes of synthetic and biologic mesh in abdominal wall reconstruction: A propensity-matched analysis in Centers for Disease Control and Prevention class 1 and 2 wounds. Surgery 2025; 179:108795. [PMID: 39304440 DOI: 10.1016/j.surg.2024.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION The choice of biologic compared with synthetic mesh in abdominal wall reconstruction remains controversial, especially in Centers for Disease Control and Prevention class 1 and 2 wounds. This study evaluated wound complications and hernia recurrence with a 2:1 propensity-matched sample and extended follow-up. METHODS AND PROCEDURES A prospectively maintained abdominal wall reconstruction database was queried for patients undergoing open abdominal wall reconstruction using biologic or synthetic mesh in Centers for Disease Control and Prevention class 1 and 2 wounds. Patients receiving synthetic or biologic mesh were propensity score matched in a 2:1 fashion. Univariate, bivariate, and inferential analyses were conducted. Unless stated, data are reported as biologic compared with synthetic. RESULTS In total, 519 patients were compared, 173 with biologic and 346 with synthetic mesh. Defect size (215.2 ± 153.6 cm2 vs 251.5 ± 284.3 cm2), body mass index (33.6 ± 9 kg/m2 vs 34 ±17.7 kg/m2), and comorbidities were well matched (all P > .05). Although Centers for Disease Control and Prevention wound class was used in the match, it was significantly different between groups (Centers for Disease Control and Prevention 1:43.4% vs 81.2%, Centers for Disease Control and Prevention 2:56.6% vs 18.8%; P < .001). The rate of component separation (40.1% vs 44.2%; P = .397), fascial closure (97.7% vs 98.3%; P = .738), and panniculectomy (33.5% vs 29.2%; P = .315) were similar. Mesh size was also similar (816.4 ± 555.5 vs 892.2 ± 487.8 cm2; P = .112). Wound complications were equal, including wound breakdown (10.5% vs 7.5%; P = .315), wound cellulitis (5.2% vs 5.8%; P = .843), wound infection (7.5% vs 4.6%; P = .223), seroma requiring intervention (6.4% vs 7.8%; P = .597), and mesh infection (1.2% vs 0.9%; P > .999). The biologic group had an increased length of stay (6.8 ± 5.5 days vs 5.4 ± 2.3 days; P < .001) and greater hospital charges ($82,181 ± 50,356 vs $62,221 ± 26,817 USD; P < .001). Mean follow-up after biologic repair was longer (33.9 ± 36.6 months vs 23.3 ± 32.3 months; P < .001). Hernia recurrence between the biologic and synthetic groups was not significantly different (2.9% vs 1.4%; P = .313). On multivariable regression, wound complications were predictive of recurrence, and panniculectomy was predictive of wound complications. CONCLUSION In a 2:1 matched analysis of Centers for Disease Control and Prevention 1 and 2 wounds with nearly 3-years of follow-up, biologic and synthetic mesh had similar rates of wound complications and recurrence in abdominal wall reconstruction.
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Affiliation(s)
- William R Lorenz
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Alexis M Holland
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Samantha W Kerr
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Sully A Ayuso
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Monica E Polcz
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Gregory T Scarola
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Kent W Kercher
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - B Todd Heniford
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC
| | - Vedra A Augenstein
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC.
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Zhou K, Li ZW, Wu Y, Wang ZJ, Wang LQ, Zhou LX, Jia L, Ji K, Yang XS, Zhang J, Wu XJ, Wang AQ, Bu ZD. Lymph node metastatic patterns of gastric carcinoma with a combination of adenocarcinoma and neuroendocrine carcinoma components. World J Gastroenterol 2025; 31:102347. [DOI: 10.3748/wjg.v31.i8.102347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 12/14/2024] [Accepted: 01/07/2025] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma (G-MANEC) is a subtype of gastric cancer. Building upon prior research findings, we propose that tumours containing both neuroendocrine carcinoma (NEC) and adenocarcinoma (AC) components, with each component ranging from 1% to 99% of the tumour, be classified as a distinct entity. We hereby term this adenoneuroendocrine mixed gastric cancer (G-ANEC). Research on lymph node (LN) involvement in G-MANEC has focused mainly on metastasis status, with limited studies on metastatic composition.
AIM To investigate the LN metastasis patterns of G-ANEC, the clinicopathological features associated with these metastasis patterns, and to explore adjuvant chemotherapy regimens for G-ANEC.
METHODS We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022. Utilizing χ2 tests in IBM statistical product and service solutions statistics and R software.
RESULTS We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion, tumour invasion depth, Lauren classification, and tumour location (P values: 0.008, 0.015, 0.01, and 0.004, respectively). When the SOX/XELOX regimen was applied for adjuvant chemotherapy, patients with LN metastasis comprising only AC exhibited better overall survival (OS) (94.25 ± 11.07 months vs 54.36 ± 11.36 months) than did those with NEC. When LN metastasis components contained NEC, there was a trend towards improved OS (64 ± 10.77 months vs 54.35 ± 11.36 months) and disease-free survival (71.28 ± 9.92 months vs 66.28 ± 11.93 months) in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.
CONCLUSION We found a significant correlation between the NEC percentage, tumour invasion depth, Lauren classification, and tumour location and LN metastasis patterns in G-ANEC. For G-ANEC, a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs. Different adjuvant chemotherapy regimens should be administered on the basis of the varying components of LN metastasis in patients with G-ANEC.
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Affiliation(s)
- Kai Zhou
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Zhong-Wu Li
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yan Wu
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Zhi-Jie Wang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ling-Qian Wang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Li-Xin Zhou
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ling Jia
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ke Ji
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xue-Song Yang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ji Zhang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xiao-Jiang Wu
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - An-Qiang Wang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Zhao-De Bu
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
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20
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Ye Y, Xin XY, Huo ZJ, Zhu YT, Fan RW, Zhang HL, Gao Y, Shen HB, Li D. Acupuncture for postoperative ileus: Advancement and underlying mechanisms. World J Gastrointest Surg 2025; 17:99160. [DOI: 10.4240/wjgs.v17.i2.99160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 11/25/2024] [Accepted: 12/18/2024] [Indexed: 01/22/2025] Open
Abstract
Postoperative ileus (POI) remains a prevalent and significant challenge following abdominal surgeries, precipitating patient distress, prolonged hospital stays, and escalated medical expenditures. Conventionally addressed via pharmacological interventions, POI is increasingly being explored through adjunctive therapeutic strategies, with acupuncture gaining recognition as a promising option. Acupuncture has demonstrated encouraging potential in promoting gastrointestinal motility in patients with POI. Moreover, recent research has shed light on the therapeutic mechanisms underlying its efficacy. This article aims to present a comprehensive overview of acupuncture as a treatment for POI, highlighting advancements in clinical research and recent elucidations of its mechanistic underpinnings. It aspires to contribute a pivotal reference point for scholars and enthusiasts keen on garnering a deeper understanding of acupuncture’s role in managing POI.
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Affiliation(s)
- Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Xi-Yan Xin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Ze-Jun Huo
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Yu-Tian Zhu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Rui-Wen Fan
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Hao-Lin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Yu Gao
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Hong-Bo Shen
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing 100191, China
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21
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Romic I, Separovic I, Grgic D, Petrovic I, Mavrek J, Silovski H. Reducing invasiveness in liver surgery-where is the limit? World J Gastrointest Surg 2025; 17:101852. [DOI: 10.4240/wjgs.v17.i2.101852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Revised: 11/29/2024] [Accepted: 12/31/2024] [Indexed: 01/22/2025] Open
Abstract
In this article, we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology Surgery. Most prominent advancements in liver surgery in the last two decades are related to refinements in surgical technique (extraglissonean approach) and advancements in surgical technology (laparoscopy and robotics). In this article, authors present both these aspects: Laparoscopic segmentectomy using extraglissonean approach. Furthermore, they describe segmental resections of all 8 segments which is the main novelty that can be observed in the article. By now, extraglissonean approach was thoroughly described mainly in hepatectomies or lateral sectionectomies. Various “hilar gates” are defined which allows safe liver resection by ligating Glissonean pedicles first which is then followed by parenchymal resection. We here focus on past, present and future perspectives of extraglissonean approach and laparoscopic liver resections and comment the value of the presented article.
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Affiliation(s)
- Ivan Romic
- Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia
| | - Ivan Separovic
- Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia
| | - Dora Grgic
- Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb 10000, Croatia
| | - Igor Petrovic
- Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia
| | - Josip Mavrek
- Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia
| | - Hrvoje Silovski
- Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia
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22
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Chen Z, Wang L, Yu PJ. Early and accurate diagnosis and selection of appropriate treatment plans are crucial for patients with gastrointestinal hemangiomas. World J Gastrointest Surg 2025; 17:99432. [DOI: 10.4240/wjgs.v17.i2.99432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 11/15/2024] [Accepted: 12/03/2024] [Indexed: 01/22/2025] Open
Abstract
Gastrointestinal hemangioma (GIH) is clinically rare, accounting for 7%-10% of benign gastrointestinal tumors and 0.5% of systemic hemangiomas. GIH can occur as either solitary or multiple lesions, with gastrointestinal bleeding as a significant clinical manifestation. Understanding the clinical and endoscopic features of GIH is essential for improving diagnostic accuracy, particularly through endoscopy and selective arteriography, which are highly effective in diagnosing GIH and preventing misdiagnosis and inappropriate treatment. Upon confirmed diagnosis, it is essential to thoroughly evaluate the patient's condition to determine the most suitable treatment modality—whether surgical, endoscopic, or minimally invasive intervention. The minimally invasive interventional partial embolization therapy using polyvinyl alcohol particles, proposed and implemented by Pospisilova et al, has achieved excellent clinical outcomes. This approach reduces surgical trauma and the inherent risks of traditional surgical treatments.
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Affiliation(s)
- Zhou Chen
- Department of Emergency Medicine, The Second Affiliated Hospital of Guangdong University, Zhanjiang 524000, Guangdong Province, China
| | - Liang Wang
- Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
| | - Peng-Jie Yu
- Department of Anorectal Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
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23
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Mayer NR, Ehrenpreis ED. Modeling post-operative survival in patients with gallbladder cancer resections: The road to improved patient care? World J Gastrointest Surg 2025; 17:101553. [DOI: 10.4240/wjgs.v17.i2.101553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 11/26/2024] [Accepted: 12/12/2024] [Indexed: 01/22/2025] Open
Abstract
In this letter, we discuss the article by Li et al published in the World Journal of Gastrointestinal Surgery. Gallbladder cancer is a rare but fatal cancer that is often detected unexpectedly and at an advanced stage following routine cholecystectomy. Although the prognosis is poor, curative resections often combined with postoperative chemotherapy and/or radiation therapy can improve survival. However, targeted patient selection for the appropriate therapeutic approach is critical to minimize unnecessary morbidity. Using advanced statistical techniques, the authors developed a nomogram with the potential to predict survival after gallbladder cancer resection, identifying factors associated with long- and short-term survival. This tool could improve patient selection for surgery and post-operative treatment. In this letter, we provide background on survival nomograms including an in-depth discussion of statistical methods employed in this study, the use of nomograms in other forms of cancer, limitations to the model, and directions for future research.
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Affiliation(s)
- Nancy R Mayer
- Department of Internal Medicine, Riverside Medical Center, Kankakee, IL 60901, United States
| | - Eli Daniel Ehrenpreis
- Department of Internal Medicine, Lutheran General Hospital, Park Ridge, IL 60068, United States
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24
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Bao CY, Ding XK, Qi QF, Ye P, Fang ZJ. Effect of comprehensive perioperative nursing on pain intensity, complication rates, and comfort levels in patients undergoing gallstone surgery. World J Gastrointest Surg 2025; 17:99826. [DOI: 10.4240/wjgs.v17.i2.99826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 11/04/2024] [Accepted: 12/06/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Surgery is the gold standard for gallstone treatment. Nevertheless, the complications associated with the surgical procedure can exert diverse and adverse impacts on patients’ health and quality of life to varying extents. Hence, it is essential to offer perioperative care to patients undergoing gallstone surgery.
AIM To examine the impact of perioperative comprehensive nursing on pain intensity, complication rates, and patient comfort in individuals undergoing gallstone surgery.
METHODS From February 2022 to February 2024, 195 patients who underwent gallstone surgery at Sanmen People’s Hospital were selected and divided into two groups: A control group receiving routine nursing care (95 patients) and a research group receiving perioperative comprehensive nursing (100 patients). Key postoperative recovery indicators, including time to first postoperative anal exhaust, oral food intake, and ambulation, were observed, along with pain intensity (measured by the numeric rating scale), complication rate (bleeding, incision infection, recurrence), patient comfort (assessed using the visual analogue scale), and quality of life (measured by the World Health Organization Quality of Life-BREF).
RESULTS The research group showed significantly shorter times to first postoperative anal exhaust, oral intake, and ambulation. Moreover, numeric rating scale pain scores in the research group were markedly lower post-nursing, and the total complication rate was significantly reduced compared to the control group. Furthermore, comfort levels improved considerably in the research group, and World Health Organization Quality of Life-BREF scores across the physical, psychological, social, and environmental domains were significantly higher compared to the control group following nursing care.
CONCLUSION Perioperative comprehensive nursing effectively enhances postoperative recovery in patients undergoing gallstone surgery, reducing pain, lowering complications, and improving patient comfort and quality of life, which deserves clinical application.
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Affiliation(s)
- Chen-Yan Bao
- Department of General Surgery, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
| | - Xiao-Kun Ding
- Department of General Surgery, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
| | - Qiao-Fei Qi
- Department of General Surgery, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
| | - Peng Ye
- Department of General Surgery, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
| | - Ze-Jun Fang
- Central Laboratory, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
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25
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Yi XM, Cai HQ, Jiao Y. Programmed cell death receptor 1 inhibitor Pembrolizumab in the treatment of advanced gastric cancer. World J Gastrointest Surg 2025; 17:100257. [DOI: 10.4240/wjgs.v17.i2.100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 12/18/2024] [Accepted: 12/25/2024] [Indexed: 01/22/2025] Open
Abstract
This editorial discusses Christodoulidis et al's article, which appeared in the most recent edition. The clinical trials have demonstrated the programmed cell death receptor 1 (PD-1) inhibitor Pembrolizumab involved combination therapy can improve the efficacy of advanced gastric cancer (AGC). Pembrolizumab combined with chemotherapy can enhance its sensitivity, and further eliminate tumor cells that develop resistance to chemotherapy. The combination of Pembrolizumab and Trastuzumab targeting human epidermal growth factor receptor 2 showed improved prognosis. The overall toxic effects of Pembrolizumab are significantly lower than traditional chemotherapy, and the safety is controllable. PD-1 inhibitor Pembrolizumab sheds a light on the treatment of AGC and brings new hope to the clinical practice.
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Affiliation(s)
- Xue-Mei Yi
- Department of Second Operation Room, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Hong-Qiao Cai
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yan Jiao
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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26
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Huang YZ, Lin YY, Xie JP, Deng G, Tang D. Clip-stone and T clip-sinus post laparoscopic biliary surgery: Two case reports and review of the literature. World J Gastrointest Surg 2025; 17:99423. [DOI: 10.4240/wjgs.v17.i2.99423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 11/29/2024] [Accepted: 12/23/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) are widely used in gallbladder and biliary tract diseases. During these procedures, vessels or tissues are commonly ligated using clips. However, postoperative migration of clips to the common bile duct (CBD) or T-tube sinus tract is an overlooked complication of laparoscopic biliary surgery. Previously, most reported cases of postoperative clip migration involved metal clips, with only a few cases involving Hem-o-lok clips and review of the literature.
CASE SUMMARY This report describes two cases in which Hem-o-lok clips migrated into the CBD and the T-tube sinus tract following laparoscopic surgery. Case 1 is a 68-year-old female admitted due to abdominal discomfort, and two Hem-o-lok clips were found to have migrated into the CBD 17 months after LC and LCBDE with T-tube drainage, and were removed using a stone extraction balloon. The patient was discharged smoothly after recovery. Case 2 is a 74-year-old male who underwent LC and LCBDE with T-tube drainage and laparoscopic biliary tract basket stone extraction. Nine weeks postoperatively, following T-tube removal, a Hem-o-lok clip was found in the sinus tract, and was extracted from the T-tube sinus tract. The patient recovered smoothly postoperatively. This study also reviews the literature from 2013 to July 2024 on using Hem-o-lok clips in LC and/or LCBDE treatment of gallbladder and biliary diseases and the postoperative migration of these clips into the CBD, T-tube sinus tract, or duodenum.
CONCLUSION In patients with a history of LC and/or LCBDE, clip migration should be considered as a differential diagnosis.
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Affiliation(s)
- Ying-Zi Huang
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Yuan-Yu Lin
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Ju-Ping Xie
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Gang Deng
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Di Tang
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
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27
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Xie QF, Long LS, Luo YY, Lu MT, Ming WK, Zhao LY, Liu H. Long-term survival outcomes of duodenal adenocarcinoma: A cohort study with 15-year single-center experience. World J Gastrointest Surg 2025; 17:101365. [DOI: 10.4240/wjgs.v17.i2.101365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/25/2024] [Accepted: 11/25/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Duodenal adenocarcinoma (DA), a rare gastrointestinal malignancy, lacks clear natural history and management strategies. This study aimed to investigate the long-term outcomes of patients with DA, focusing on long-term survival and the impact of tumor characteristics, surgery, and adjuvant therapy.
AIM To bridge this knowledge gap, we conducted a hospital-based cohort study in our 15-year experience with DA aimed at investigating the long-term outcomes of the patients with DA, along with analyzing the impact of the tumor characteristics, operations and adjuvant therapy on survival outcomes.
METHODS A retrospective analysis of 208 patients diagnosed with non-ampullary DA at a single institution between 2009 and 2023 was performed. This study used SPSS 26.0 software to make a comprehensive statistical analysis of demographic characteristics, clinical presentation, treatment modalities, and survival outcomes. The effectiveness of surgical resection and adjuvant therapy in 5-year oval survival (OS) and disease-free survival was evaluated using Kaplan-Meier survival curves, the Cox proportional hazards model, and statistical comparisons of survival distributions.
RESULTS The median OS time for the cohort was 39 months, with 3- and 5-year OS rates of 51.2% and 43.6%, respectively. Radical resection was performed in 82.6% of cases, and was significantly associated with an improved 5-year OS, with a rate of 57.8%. Adjuvant therapy showed a survival benefit in the specific patient subsets, particularly in tumor stage II or III tumors, with an improved OS. Adjuvant therapy (hazard ratio= 2.71, 95% confidence interval: 1.30-5.62, P = 0.008), pancreatic invasion and advanced tumor stage were identified as significant predictors of OS in multivariate analyses.
CONCLUSION Radical operation for DA is associated with a remarkable improvement in the 5-year OS. Importantly, postoperative adjuvant therapy can significantly prolong the OS time in patients with radical operation, especially in patients with stage III. It highlights the necessity for early diagnosis, tailored surgical approaches, and a nuanced understanding of the role of adjuvant therapy.
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Affiliation(s)
- Qing-Feng Xie
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Lian-Sheng Long
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
- Department of General Surgery, General Hospital of Southern Theater Command, Guangzhou 510515, Guangdong Province, China
| | - Yang-Yang Luo
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Meng-Ting Lu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong 999077, China
| | - Li-Ying Zhao
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Hao Liu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
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28
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Zhang JW. Navigating the challenges of laparoscopic anatomical SVIII resection: A step forward in hepatobiliary surgery. World J Gastrointest Surg 2025; 17:100847. [DOI: 10.4240/wjgs.v17.i2.100847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 12/22/2024] [Accepted: 12/30/2024] [Indexed: 01/22/2025] Open
Abstract
This article comments on the study by Peng et al, published in the World Journal of Gastrointestinal Surgery, representing a notable advancement in hepatobiliary surgery. This article examines laparoscopic anatomical segment VIII resection, a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions. Peng and colleagues’ experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach. Their study’s strengths lie in technique standardization and comprehensive analysis, although its limitations highlight the need for further research. As minimally invasive liver surgery progresses, larger, prospective trials and integration of advanced technologies are essential for establishing best practices.
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Affiliation(s)
- Jin-Wei Zhang
- State Key Laboratory of Chemical Biology, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China
- Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, University of Exeter, Hatherly Laboratories, Streatham Campus, Exeter EX4 4PS, United Kingdom
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29
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Wang H, Jiao Y, Ma Q, Liu YH. Overview of endoscopic biliary stenting in malignant obstructive jaundice. World J Gastrointest Surg 2025; 17:103378. [DOI: 10.4240/wjgs.v17.i2.103378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information |