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Hepatobiliary surgery and Nutrition 2024年第1期13卷 56-70页

作者： Caitlin P.Sok Karunesh Polireddy David A.Kooby department of surgery Emory University School of MedicineAtlantaGAUSA

The diagnosis and monitoring of disease through the detection of circulating protein biomarkers is a growing field in the practice of *** search for more effective protein biomarkers to aid in the diagnosis and treatment of patients with pancreatic ductal adenocarcinoma(PDAC)remains a valuable area of study,given the aggressive and often occult nature of this *** biopsies are attractive,as they offer a minimally invasive and cost-effective approach when compared to traditional biopsy methods and imaging modalities used for diagnosis and *** antigen(CA)19-9 is currently the most commonly used serum protein biomarker for the diagnosis and monitoring of patients with PDAC,but due to its sensitivity and specificity,its utility remains *** this review,we examine how circulating protein biomarkers are used in the diagnosis,prognostication,and surveillance of *** also highlight protein biomarkers that are currently under investigation that have the potential to enhance our ability to detect early-stage malignancies,predict response to therapy,and monitor for recurrence,but these markers require larger prospective validation studies before they can be widely *** efforts to identify and validate novel biomarkers will be crucial for improving the management and outcomes of patients with this challenging disease.

关键词： Biomarkers pancreatic adenocarcinoma protein

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

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World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko Yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of Hepato-Biliary-Pancreatic surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of *** use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative ***,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after *** To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after *** The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively *** were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower *** factors,including demographic data and perioperative D-dimer values,were compared between the two *** operating characteristic curve analysis was performed to determine the D-dimer cutoff *** and multivariate analyses were performed using logistic regression analysis to identify significant *** In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE *** the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after *** Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

Gastroesophageal reflux following per-oral endoscopic myotomy:Can we improve outcomes?

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World Journal of Gastroenterology 2024年第22期30卷 2834-2838页

作者： Inian Samarasam Raj Kumar Joel Anna B Pulimood department of surgery Upper Gastrointestinal Surgery UnitChristian Medical College&HospitalVellore 632004TamilnaduIndia department of Cardiothoracic surgery Christian Medical College&HospitalVellore 632004TamilnaduIndia department of Gastrointestinal Sciences Christian Medical College and HospitalVellore 632004Tamil NaduIndia

This editorial is an analysis the review article by Nabi et al recently published in this *** Cardia is a disease whose pathophysiology is still *** is known that there is inflammation of unknown aetiology leading to loss of ganglion cells in the muscularis *** end result is lower oesophageal sphincter spasm,loss of receptive relaxation,decreased oesophageal peristalsis,all leading on to varying degrees of *** treatment of this condition is palliative in nature,performed by myotomy of the lower oesophagus either surgically or *** reflux disease(GERD)has been associated with the myotomy performed,particularly with the Peroral Endoscopic Myotomy(POEM)*** et al have provided an excellent overview of the latest developments in predicting,preventing,evaluating,and managing GERD subsequent to *** on this theme,this review article explores the concept of using histology of the oesophageal muscle layer,to grade the disease and thereby help tailoring the length/type of myotomy performed during the POEM *** the future,will a histology based algorithm available preoperatively,help modify the POEM procedure,thereby decreasing the incidence of GERD associated with POEM?

关键词： Achalasia cardia Peroral endoscopic myotomy Laparoscopic Heller’s myotomy Histopathology Histologic grading

Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

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World Journal of Gastroenterology 2024年第23期30卷 2991-3004页

作者： Li-Qun Cai Da-Qing Yang Rong-Jian Wang He Huang Yi-Xiong Shi department of Colorectal and Anal surgery Whenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina department of Colorectal and Anorectal surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient *** predictive models for these reoperations lack precision in integrating complex clinical *** To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer *** Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively *** were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation *** were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve *** risk scores of the two groups were calculated and compared to validate the *** More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control *** logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(P<0.05):Prognostic Nutritional Index value,history of laparotomy,hypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists *** operating characteristic curve analysis showed that the model had good discrimination and clinical *** This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve tr

关键词： Colorectal cancer Postoperative unplanned reoperation Unplanned reoperation Clinical validation Nomogram Machine learning models

Action of circulating and infiltrating B cells in the immune microenvironment of colorectal cancer by single-cell sequencing analysis

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2683-2696页

作者： Jing-Po Zhang Bing-Zheng Yan Jie Liu Wei Wang department of Hepatobiliary and Pancreatic surgery First Hospital of Hebei Medical UniversityShijiazhuang 050032Hebei ProvinceChina department of Hepatobiliary surgery Hunan Provincial People’s HospitalChangsha 410002Hunan ProvinceChina

BACKGROUND The complexity of the immune microenvironment has an impact on the treatment of colorectal cancer(CRC),one of the most prevalent malignancies *** this study,multi-omics and single-cell sequencing techniques were used to investigate the mechanism of action of circulating and infiltrating B cells in *** revealing the heterogeneity and functional differences of B cells in cancer immunity,we aim to deepen our understanding of immune regulation and provide a scientific basis for the development of more effective cancer treatment *** To explore the role of circulating and infiltrating B cell subsets in the immune microenvironment of CRC,explore the potential driving mechanism of B cell development,analyze the interaction between B cells and other immune cells in the immune microenvironment and the functions of communication molecules,and search for possible regulatory pathways to promote the anti-tumor effects of B *** A total of 69 paracancer(normal),tumor and peripheral blood samples were collected from 23 patients with CRC from The Cancer Genome Atlas database(https://***/).After the immune cells were sorted by multicolor flow cytometry,the single cell transcriptome and B cell receptor group library were sequenced using the 10X Genomics platform,and the data were analyzed using bioinformatics tools such as *** differences in the number and function of B cell infiltration between tumor and normal tissue,the interaction between B cell subsets and T cells and myeloid cell subsets,and the transcription factor regulatory network of B cell subsets were explored and *** Compared with normal tissue,the infiltrating number of CD20+B cell subsets in tumor tissue increased *** them,germinal center B cells(GCB)played the most prominent role,with positive clone expansion and heavy chain mutation level increasing,and the trend of differentiation into memory B cells ***,the

关键词： Colorectal cancer Multi-omics analysis Single-cell sequencing analysis Immune microenvironment Infiltrating B cells

The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 604-615,I0015-I0021页

作者： Jasper P.Sijberden Guido Fiorentini Jacopo Lanari Davit Aghayan Daniel Osei-Bordom Nadia Russolillo Arjun Takhar Andrea Benedetti Cacciaguerra Santi Lopez-Ben Mathieu D’Hondt Felice Giuliante David Fuks Fernando Rotellar Andrea Ruzzenente Adnan Alseidi Mikhail Efanov Burak Görgec Giuseppe Zimmitti Enrico Gringeri Federica Cipriani Åsmund Avdem Fretland Ravi Marudanayagam Marco Vivarelli John N.Primrose Alessandro Ferrero Robert P.Sutcliffe Bjørn Edwin Umberto Cillo Marc G.Besselink Mohammad Abu Hilal Luca A.Aldrighetti department of surgery Fondazione Poliambulanza Istituto OspedalieroBresciaItaly Amsterdam UMC location University of Amsterdam Department of SurgeryAmsterdamthe Netherlands Cancer Center Amsterdam Amsterdamthe Netherlands Hepatobiliary surgery Division IRCCS San Raffaele HospitalMilanItaly department of Surgical Oncological and Gastroenterological SciencesGeneral Surgery 2Hepatobiliary Surgery and Liver TransplantationPadua University HospitalPaduaItaly The Intervention Centre and department of HPB surgery Oslo University Hospital and Institute of Clinical MedicineUniversity of OsloOsloNorway department of surgery Ringerike HospitalVestre Viken Hospital TrustDrammenNorway Liver Unit Queen Elizabeth HospitalBirminghamUK department of General and Oncological surgery Umberto I Mauriziano HospitalLargo TuratiTurinItaly department of surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Hepatobiliary and Abdominal Transplantation surgery Department of Experimental and Clinical MedicineRiuniti HospitalPolytechnic University of MarcheAnconaItaly Servei de Cirurgia General i Digestiva Hospital Doctor Josep Trueta de GironaGironaCataloniaSpain department of Digestive and Hepatobiliary/Pancreatic surgery Groeninge HospitalKortrijkBelgium Chirurgia Epatobiliare UniversitàCattolica del Sacro Cuore-IRCCSRomeItaly department of Digestive Oncologic and Metabolic SurgeryInstitut Mutualiste MontsourisUniversitéParis DescartesParisFrance HPB and Liver Transplantation Unit Department of SurgeryUniversity ClinicUniversidad de NavarraNavarraSpain Institute of Health Research of Navarra(IdisNA) PamplonaSpain department of surgery University of VeronaVeronaItaly department of surgery Virginia Mason Medical CenterSeattleWAUSA department of surgery University of California San FranciscoSan FranciscoCAUSA department of Hepato-Pancreato-Biliary surgery Moscow Clinical Research CentreMoscowRussia

Background:It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected ***,what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus *** aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral(AL)and posterosuperior(PS)***:In this international multicentre retrospective cohort study,laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score *** differential benefit of laparoscopy over open liver surgery,calculated using bootstrap sampling,was compared between AL and PS resections and expressed as a Delta of the ***:After matching,3,040 AL and 2,336 PS resections were compared,encompassing open and laparoscopic procedures in a 1:1 *** and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss,transfusion rate,complications,and length of ***,AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications(D-difference were 4.8%,P=0.046 and 3%,P=0.046)and blood loss(D-difference was 195 mL,Psurgery is greater in the AL segments than in the PS segments.

关键词： Liver neoplasms hepatectomy laparoscopic liver resection open liver resection

Parenchymal sparing anatomical liver resections for hepatocellular carcinoma

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 706-708页

作者： Matteo Donadon Guido Torzilli department of Health Sciences University of Piemonte OrientaleNovaraItaly department of surgery University Maggiore Hospital della CaritàNovaraItaly department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly Division of Hepatobiliary and General surgery Department of SurgeryIRCCS Humanitas Research HospitalRozzanoItaly

The rationale of the performance of anatomic resection(AR)of the liver in case of hepatocellular carcinoma(HCC)is the removal of portal pedicle feeding the tumor because of the tumor’s tendency to invade the portal veins(1).This technical approach is expected to be effective from an oncological perspective for a disease such as HCC,which is associated with a high rate of intrahepatic recurrence(2,3).In the eighties,Makuuchi et *** the systematic subsegmentectomy(4)reporting excellent results(5),and later some other authors reported new techniques to identify the portal territory of a given HCC and perform a true AR of the liver(5-7).

关键词： Parenchymal sparing anatomical resections hepatocellular carcinoma(HCC) surgical margin

Metformin and pancreatic neuroendocrine tumors:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 759-769页

作者： Maja Cigrovski Berkovic Alessandro Coppola Vibor Sesa Anna Mrzljak Quirino Lai department for Sport and Exercise Medicine Faculty of Kinesiology University of ZagrebZagreb 10000Croatia department of surgery Sapienza University of RomeRome 00185Italy department of Gastroenterology and Hepatology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia department of Medicine School of MedicineZagreb 10000Croatia General surgery and Organ Transplantation Unit Department of SurgerySapienza University of RomeRome 00018Italy

BACKGROUND Most patients with advanced pancreatic neuroendocrine tumors(pNETs)die due to tumor ***,identifying new therapies with low toxicity and good tolerability to use concomitantly with the established pNET treatment is *** this perspective,metformin is emerging as a molecule of *** studies have described metformin,a widely used agent for the treatment of patients with type 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR *** systematic review evaluates the role of T2DM and metformin in the insurgence and post-treatment outcomes in patients with *** To systematically analyze and summarize evidence related to the diagnostic and prognostic value of T2DM and metformin for predicting the insurgence and posttreatment outcomes of *** A systematic review of the published literature was undertaken,focusing on the role of T2DM and metformin in insurgence and prognosis of pNET,measured through outcomes of tumor-free survival(TFS),overall survival and progression free *** A total of 13 studies(5674 patients)were included in this *** of 809 pNET cases from five retrospective studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of pNET(OR=2.13,95%CI=1.56-4.55;P<0.001).The pooled data from 1174 pNET patients showed the correlation between T2DM and post-treatment TFS in pNET patients(hazard ratio=1.84,95%CI=0.78-2.90;P<0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the possibility of performing pooled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and prognosis of *** T2DM represents a risk factor for the insurgence of pNET and is a significant predictor of poor post-treatment TFS

关键词： Pancreatic neuroendocrine tumors Type 2 diabetes mellitus Prognosis Treatment Metformin

Application of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging in recurrent anastomotic tumors after surgery in digestive tract tumors

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2474-2483页

作者： Deng-Feng Ge Hao Ren Zi-Chen Yang Shou-Xiang Zhao Zhen-Ting Cheng Da-Da Wu Bin Zhang department of Cardiothoracic surgery Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina department of Gastrointestinal surgery Shanghai Sixth People’s HospitalShanghai 250063China

BACKGROUND This study was to investigate the application value of whole-body dynamic ^(18)F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomogra-phy(PET/CT)imaging in recurrent anastomotic tumors of digestive tract after gastric and esophageal cancer *** patients with gastric and esophageal cancer have a high risk of tumor recurrence,and traditional imaging methods have certain limitations in early detection of recurrent ***-body dynamic ^(18)F-FDG PET/CT imaging,due to its high sensitivity and specifi-city,can provide comprehensive information on tumor metabolic activity,which is expected to improve the early diagnosis rate of postoperative recurrent tumors,and provide an important reference for clinical treatment *** A retrospective analysis was performed on 53 patients with upper digestive tract tumors after operation and systemic dynamic ^(18)F-FDG PET/CT imaging indi-cating abnormal FDG uptake by anastomosis,including 29 cases of gastric cancer and 24 cases of esophageal *** to the follow-up results of gas-troscopy and other imaging examinations before and after PET/CT examination,the patients were divided into an anastomotic recurrence group and anastomotic inflammation *** multi-parameter analysis software was used to obtain the metabolic rate(MRFDG),volume of distribution maximum(DVmax)of anastomotic lesions,and MRmean and DVmean of normal liver *** lesion/background ratio(LBR)was calculated by dividing the MRFDG and DVmax of the anastomotic lesion by the MRmean and DVmean of the normal liver tissue,respectively,to obtain LBR-MRFDG and *** independent sample t test was used for statistical analysis,and a receiver operating characteristic curve was used to analyze the differential diagnostic efficacy of each parameter for anastomotic recurrence and *** The dynamic ^(18)F-FDG PET/CT imaging parameters MRFDG,DVmax,LBR-MRFDG,and LBR-DVmax of post

关键词： Gastric cancer Esophageal cancer Anastomosis Dynamic positron emission tomography Differential diagnosis Metabolic rate

High rate of clinically relevant improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis

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World Journal of Orthopedics 2024年第2期15卷 156-162页

作者： Marc Randall Kristensen Nyring Bo Sanderhoff Olsen Alexander Amundsen Jeppe Vejlgaard Rasmussen Section for Shoulder and Elbow surgery Department of Orthopaedic SurgeryHerlev and Gentofte University HospitalHellerup 2900Denmark

BACKGROUND The minimal clinically important difference(MCID)is defined as the smallest meaningful change in a health domain that a patient would identify as ***,an improvement that exceeds the MCID can be used to define a successful treatment for the individual *** To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral *** Patients were treated with the Global Unite total shoulder platform arthroplasty between March 2017 and February 2019 at Herlev and Gentofte Hospital,*** patients were evaluated preoperatively and 3 months,6 months,12 months,and 24 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder index(WOOS),Oxford Shoulder Score(OSS)and Constant-Murley Score(CMS).The rate of clinically relevant improvement was defined as the proportion of patients who had an improvement 24 months postoperatively that exceeded the *** on previous literature,MCID for WOOS,OSS,and CMS were defined as 12.3,4.3,and 12.8 *** Forty-nine patients with a Global Unite total shoulder platform arthroplasty were included for the final *** age at the time of surgery was 66 years(range 49.0-79.0,SD:8.3)and 65%were *** patient was revised within the two years *** mean improvement from the preoperative assessment to the two-year follow-up was 46.1 points[95%confidence interval(95%CI):39.7-53.3,P<0.005]for WOOS,18.2 points(95%CI:15.5-21.0,P<0.005)for OSS and 37.8 points(95%CI:31.5-44.0,P<0.005)for *** years postoperatively,41 patients(87%)had an improvement in WOOS that exceeded the MCID,45 patients(94%)had an improvement in OSS that exceeded the MCID,and 42 patients(88%)had an improvement in CMS that exceeded the *** Based on three shoulder-specific outcome measures we find that approximately 90%of patients has a clinically relevant *** is a clear message when informing patients about the

关键词： Minimal clinically important difference Patient reported outcome measures Glenohumeral osteoarthritis Anatomical total shoulder arthroplasty Clinically relevant improvement