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Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer:A propensity score matching analysis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 670-680页

作者： Hajime Kayano Nana Mamuro Yutaro Kamei Takashi Ogimi Hiroshi Miyakita Toshio Nakagohri Kazuo Koyanagi Masaki Mori Seiichiro Yamamoto Department of gastroenterological Surgery Tokai University School of MedicineIsehara 259-1193KanagawaJapan

BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or *** IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor ***,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been *** cavity in *** Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological *** Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two *** addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA *** IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.

关键词： Colon cancer Intracorporeal anastomosis 3-year disease-free survival Recurrence Surgical site infection Postoperative biological response

No-touch isolation technique in emergency pancreaticoduodenectomy for neoplastic hemorrhage: Two case reports and review of literature

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1910-1917页

作者： Akihiro Cho Satoshi Katagiri Masao Ota Shunsuke Onizawa Ryota Higuchi Toshiya Sugishita Yukiko Niwa Takeshi Ishita Toshihiko Mouri Akita Kato Moe Iwata Division of gastroenterological Surgery Tokyo Women’s Medical UniversityYachiyo Medical CenterChiba 276-8524Japan

BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary *** intraoperative blood loss is correlated with poor post-operative *** SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and *** operative times were 220 and 239 min,and the blood loss was 70 and 270 g,*** patients were discharged on the 14^(th) and 10^(th) postoperative day,***-two patients underwent EPD for the treatment of neoplastic *** mean operative time was 361.6 min,and the mean blood loss was 747.3 *** comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.

关键词： No-touch isolation technique Pancreaticoduodenectomy Emergency pancre-aticoduodenectomy Neoplastic bleeding Superior mesenteric artery first approach Case report

Endoscopic pancreatogastric anastomosis in the treatment of symptoms associated with inflammatory diseases of the pancreas

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 406-412页

作者： Mateusz Jagielski Eryk Bella Marek Jackowski Department of General Gastroenterological and Oncological SurgeryNicolaus Copernicus UniversityToruń87-100Poland

BACKGROUND The outflow of pancreatic juice into the duodenum is often impaired in pancreatic inflammatory *** basis of interventional treatment in these cases is anatomical transpapillary access of the main pancreatic duct during endoscopic retrograde cholangiopancreatography(ERCP),which ensures the physiological outflow of pancreatic juice into the lumen of the digestive ***,in some patients,anatomical changes prevent transpapillary drainage of the main pancreatic *** is the treatment of choice in such *** To evaluate the effectiveness and safety of endoscopic pancreaticogastrostomy under endoscopic ultrasound(EUS)*** Retrospective analysis of treatment outcomes of all patients with acute or chronic pancreatitis who underwent endoscopic pancreatogastric anastomosis under EUS guidance in 2018-2023 at the Department of General,gastroenterological and Oncological Surgery,Ludwik Rydygier Collegium Medicum in Bydgoszcz,Nicolaus Copernicus University in Toruń,*** In 9 patients[7 men,2 women;mean age 53.45(36-66)years],endoscopic pancreatogastric anastomosis under EUS guidance was performed because of the lack of transpapillary access during *** of the main pancreatic duct at the head of the pancreas was observed in 4/9 patients(44.44%).Pancreatic fragmentation(disconnected pancreatic duct syndrome)was diagnosed in 3/9 patients(33.33%).In 2/9 patients(22.22%),narrowing of the pancreatoenteric anastomosis was observed after *** success of endoscopic pancreaticogastrostomy was observed in 8/9 patients(88.89%).Endotherapeutic complications were observed in 2/9 patients(22.22%).Clinical success was achieved in 8/9 patients(88.89%).The mean follow-up period was 451(42-988)***-term success of endoscopic pancreatogastric anastomosis was achieved in 7/9 patients(77.78%).CONCLUSION Endoscopic pancreaticogastrostomy under EUS guidance is an effective and safe treatment method,espec

关键词： Pancreaticogastrostomy Chronic pancreatitis Acute pancreatitis Disconnected pancreatic duct syndrome Endotherapy

Adenylate cyclase activates the cAMP signalling pathway to enhance platelet-rich plasma-treated Achilles tendon disease,a theoretical bioinformatics-based study

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World Journal of Orthopedics 2024年第2期15卷 192-200页

作者： Jing-Yi Sun Cai Li Feng-Ying Du College of Basic Medical Science Qilu Medical UniversityZibo 255300Shandong ProvinceChina Department of gastroenterological Surgery Shandong Provincial Hospital of Shandong First Medical UniversityJinan 250021Shandong ProvinceChina

The effectiveness of platelet-rich plasma(PRP)for the treatment of Achilles tendon disorders still needs to be evaluated through a series of prospective studies,but genomic analysis can reveal the existence of complementary PRP treatment *** on the 96 platelet activation-related genes in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,we performed Gene Ontology functional enrichment analysis and KEGG enrichment analysis,pathway correlation analysis,and enrichment mapping to determine the enrichment results of the gene set enrichment analysis and found that the cAMP signalling pathway may be the key to enhancing the effectiveness of PRP *** cAMP signalling pathway interacts with the Rap1 signalling pathway and cGMPPKG signalling pathway to mediate the entire pathophy-siological process of Achilles tendon ***,ADCY1-9 may be the key to the activation of the cAMP signalling *** based on the data in the Gene Expression Omnibus database,it was found that ADCY4 and ADCY7 may be the players that play a major role,associated with the STAT4-ADCY4-LAMA5 axis and the GRbeta-ADCY7-SEMA3C axis,which is expected to be a complementary target for enhancing the efficacy of PRP in the treatment of Achilles tendon disease.

关键词： Platelet-rich plasma Achilles tendon disease cAMP Adenylate cyclase Complementary target

Distal margin distance in radical resection of locally advanced rectal cancer after neoadjuvant therapy

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Chinese Journal of Cancer Research 2024年第2期36卷 226-232页

作者： Jun Luo Mingxuan Zhu Long Zhao Meiwen He Bei Li Yifan Liu Yuhan Sun Guoqing Lyu Zhanlong Shen Department of Gastrointestinal Surgery Peking University Shenzhen HospitalShenzhen 518036China Department of gastroenterological Surgery Laboratory of Surgical OncologyBeijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment ResearchPeking University People's HospitalBeijing 100044China School of Medicine the Chinese University of Hong KongShenzhen 518172China

Colorectal cancer has a high incidence and mortality rate in China, with the majority of cases being middle and low rectal cancer. Surgical intervention is currently the main treatment modality for locally advanced rectal cancer, with the common goal of improving oncological outcomes while preserving function. The controversy regarding the circumferential resection margin distance in rectal cancer surgery has been resolved. With the promotion of neoadjuvant therapy concepts and advancements in technology, treatment strategies have become more *** tumor downstaging, there is an increasing trend towards extending the safe distance of distal rectal margin. This provides more opportunities for patients with low rectal cancer to preserve their anal ***, there is currently no consensus on the specific distance of distal resection margin.

关键词： Colorectal cancer distal resection margin neoadjuvant therapy

A computed tomography-based radiomic model for the prediction of strangulation risk in patients with acute intestinal obstruction

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Intelligent Medicine 2024年第1期4卷 33-42页

作者： Zhibo Wang Ruiqing Liu Shunli Liu Baoying Sun Wentao Xie Dongsheng Wang Yun Lu Department of gastroenterological Surgery The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266003China Department of Radiology The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266003China Neurology Department Central Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250000China Lingshui People’s Hospital LingshuiHainan 572400China

Background We created and validated a computed tomography(CT)-based radiomic model using both clinical factors and the radiomic signature for assessing the strangulation risk of acute intestinal *** would assist surgeons in accurately predicting intestinal ischemia and strangulation in patients with intestinal *** We recruited 289 patients with acute intestinal obstruction admitted in the Affiliated Hospital of Qingdao University from January 2019 to February *** patients were allocated to a training(n=226)and validation cohort(n=63).Radiomic features were collected from CT images,and the radiomic signature was extracted and used to calculate a radiomic score(Rad-score).A nomogram was constructed using the clinical features and the Rad-score,and the performance of the clinical,radiomics,and nomogram models was assessed in the two *** Six robust features were used to construct the radiomic *** nomogram incorporating hemoglobin levels,C-reactive protein levels,American Society of Anesthesiologists score,time of obstruction,CT image of mesenteric fluid(P<0.05),and the signature demonstrated good predictive ability for intestinal ischemia in patients with acute intestinal obstruction,with areas under the curve of 0.892(95%confidence interval,0.837–0.947)and 0.781(95%confidence interval,0.619–0.944)for the training and validation sets,*** decision curve analysis showed that this model outperformed the clinical and radiomic signature *** The radiomic nomogram may effectively predict intestinal ischemia in patients with acute intestinal disease and may assist clinical decision-making。

关键词： Acute intestinal obstruction Radiomics Intestinal ischemia Intestinal strangulation

Goblet cell carcinoid of the appendix:Six case reports

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World Journal of Clinical Cases 2024年第22期12卷 5217-5224页

作者： Toshiaki Toshima Ryo Inada Shinya Sakamoto Eri Takeda Takahiro Yoshioka Kento Kumon Naoki Mimura Nobuo Takata Motoyasu Tabuchi Kazuyuki Oishi Takuji Sato Kenta Sui Takehiro Okabayashi Kazuhide Ozaki Toshio Nakamura Yuichi Shibuya Manabu Matsumoto Jun Iwata Department of gastroenterological Surgery Kochi Health Sciences CenterKochi 781-8555Japan Department of Diagnostic Pathology Kochi Health Sciences CenterKochi 781-8555Japan

BACKGROUND Goblet cell carcinoid(GCC)of the appendix is a rare tumor characterized by neuroendocrine and adenocarcinoma *** preoperative diagnosis is very difficult,with most patients complaining mainly of abdominal *** tomography shows swelling of the appendix,so diagnosis is usually made incidentally after appendectomy based on a preoperative diagnosis of *** if a patient undergoes preoperative colonoscopy,accurate endoscopic diagnosis is very difficult because GCC shows a submucosal growth pattern with invasion of the appendiceal *** SUMMARY Between 2017 and 2022,6 patients with GCC were treated in our *** presenting complaint for 5 of these 6 patients was abdominal *** 5 patients underwent appendectomy,including 4 for a preoperative diagnosis of appendicitis and the other for diagnosis and treatment of an appendiceal *** sixth patient presented with vomiting and underwent ileocecal resection for GCC diagnosed from preoperative *** 2 patients with GCC underwent colonoscopy,no neoplastic changes were *** of the six patients showed lymph node metastasis on pathological *** of the last followup(median:15 mo),all cases remained alive without *** As preoperative diagnosis of GCC is difficult,this possibility must be considered during surgical treatments for presumptive appendicitis.

关键词： Goblet cell carcinoid Appendix Preoperative diagnosis Endoscopic diagnosis Surgical treatment Case report

Statin as a therapeutic agent in gastroenterological cancer

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 110-123页

作者： Norio Uemura Hiromitsu Hayashi Hideo Baba Department of gastroenterological Surgery Graduate School of Medical SciencesKumamoto UniversityKumamoto 860-8556Japan

Statins inhibit 3-hydroxy-3-methylglutaryl-CoA reductase,the rate-limiting enzyme of the mevalonate pathway,and are widely used as an effective and safe approach handle *** mevalonate pathway is a vital metabolic pathway that uses acetyl-CoA to generate isoprenoids and sterols that are crucial to tumor growth and *** studies have indicated that statins improve patient prognosis in various *** research on the mechanisms underlying the antitumor effects of statins is *** development of new anti-cancer drugs is progressing,but increasing medical costs from drug development have become a major *** available,inexpensive and well-tolerated drugs like statins have not yet been successfully repurposed for cancer *** the cancer patients that may benefit from statins is key to improved patient *** review summarizes recent advances in statin research in cancer and suggests important considerations for the clinical use of statins to improve outcomes for cancer patients.

关键词： Statin HMG CoA reductase inhibitor Mevalonate pathway Cancer

Current status and future perspectives for the treatment of resectable locally advanced esophagogastric junction cancer:A narrative review

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World Journal of Gastroenterology 2023年第24期29卷 3758-3769页

作者： Yoshiaki Shoji Kazuo Koyanagi Kohei Kanamori Kohei Tajima Mika Ogimi Kentaro Yatabe Miho Yamamoto Akihito Kazuno Kazuhito Nabeshima Kenji Nakamura Takayuki Nishi Masaki Mori Department of gastroenterological Surgery Tokai University School of MedicineIsehara 259-1193Japan

Incidence rates for esophagogastric junction cancer are rising rapidly worldwide possibly due to the economic development and demographic ***,increased attention has been paid to the prevention,diagnosis,and the treatment of esophagogastric junction *** there are discrepancies in the treatment strategy between Asian and Western countries,surgery remains the mainstay of treatment for esophagogastric junction *** developments of perioperative multidisciplinary treatment may lead to better therapeutic effect,higher complete resection rate,and better control of the residual diseases,thus result in prolonged *** this review,we will focus on the treatment of locally advanced resectable esophagogastric junction cancer,and discuss the current status and future perspectives of the perioperative treatment including chemotherapy,radiation therapy,and immunotherapy,as well as the surgical *** understanding of the latest treatment strategy and future overlook may enable to standardize and individualize the treatment for esophagogastric junction cancer,thus leading to better prognosis for those patients.

关键词： Esophagogastric junction cancer Perioperative therapy Neoadjuvant therapy Surgery Multidisciplinary treatment