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Time trends and outcomes of gastrostomy placement in a Swedish national cohort over two decades

World Journal of Gastroenterology 2024年第10期30卷 1358-1367页

作者： Martin Löfling Skogar Magnus Sundbom Department of surgical sciences Uppsala UniversityUppsala 75185Sweden

BACKGROUND Percutaneous endoscopic gastrostomy(PEG)and laparoscopically inserted gastrostomy have become the gold standard for adult patients and children,respectively,requiring long-term enteral nutrition ***-related mortality is a rare event,often reported to be zero in smaller *** data on 30-d mortality and long-term survival rates after gastrostomy placement are scarce in the *** To study the use of gastrostomies in Sweden from 1998-2019 and to analyze procedure-related mortality and short-term(<30 d)and long-term *** In this retrospective,population-based cohort study,individuals that had received a gastrostomy between 1998-2019 in Sweden were *** were identified in the Swedish National Patient Register,and survival analysis was possible by cross-referencing the Swedish Death *** cohort was divided into three age groups:Children(0-18 years);adults(19-64 years);and elderly(≥65 years).Kaplan-Meier with log-rank test and Cox regression were used for survival *** In total 48682 individuals(52%males,average age 60.9±25.3 years)were *** cohort consisted of 12.0%children,29.5%adults,and 58.5%*** increased use of gastrostomies was observed during the study period,from 13.7/100000 to 22.3/100000 individuals(P<0.001).The use of PEG more than doubled(about 800 to 1800/year),with a corresponding decrease in open gastrostomy(about 700 to 340/year).Laparoscopic gastrostomy increased more than ten-fold(about 20 to 240/year).Overall,PEG,open gastrostomy,and laparoscopic gastrostomy constituted 70.0%(n=34060),23.3%(n=11336),and 4.9%(n=2404),***-related mortality was 0.1%(n=44)overall(PEG:0.05%,open:0.24%,laparoscopic:0.04%).The overall 30-d mortality rate was 10.0%(PEG:9.8%,open:12.4%,laparoscopic:1.7%)and decreased from 11.6%in 1998-2009 vs 8.5%in 2010-2019(P<0.001).One-year and ten-year survival rates for children,adults,and elderly were 93.7%,67.5%,a

关键词： Gastrostomy Percutaneous endoscopic gastrostomy Dysphagia Enteral nutrition Long-term Survival Complication

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Why is early detection of colon cancer still not possible in 2023?

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World Journal of Gastroenterology 2024年第3期30卷 211-224页

作者： Valeria Tonini Manuel Zanni Department of Medical and surgical sciences University of BolognaBologna 40138Italy

Colorectal cancer(CRC)screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal *** the years,screening,particularly in those settings where it is well organized,has succeeded in reducing the incidence of colon and rectal cancer and improving the prognosis related to *** considerable advancements in screening technologies and strategies,the effectiveness of CRC screening programs remains less than *** paper examined the multifaceted reasons behind the persistent lack of effect-iveness in CRC screening *** a critical analysis of current methodologies,technological limitations,patient-related factors,and systemic challenges,we elucidated the complex interplay that hampers the successful reduction of CRC morbidity and mortality *** acknowledging the ad-vancements that have improved aspects of screening,we emphasized the necessity of addressing the identified barriers *** study aimed to raise awareness of how important CRC screening is in reducing costs for this *** and early diagnosis are not only important in improving the prognosis of patients with CRC but can lead to an important reduction in the cost of treating a disease that is often diagnosed at an advanced *** more sooner can mean saving money later.

关键词： Colorectal cancer Colorectal cancer screening Colorectal screening test Colon and rectal cancer

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Advancing hepatic recompensation:Baveno VII criteria and therapeutic innovations in liver cirrhosis management

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World Journal of Gastroenterology 2024年第23期30卷 2954-2958页

作者： Lorenzo Ridola Sara Del Cioppo Department of Medical and surgical sciences and Biotechnologies Sapienza University of RomePolo PontinoRome 00185Italy

The Baveno VII criteria redefine the management of decompensated liver cirrhosis,introducing the concept of hepatic recompensation marking a significant departure from the conventional view of irreversible *** to this concept is addressing the underlying cause of cirrhosis through tailored therapies,including antivirals and lifestyle *** on alcohol,hepatitis C virus,and hepatitis B virus-related cirrhosis demonstrate the efficacy of these interventions in improving liver function and patient *** intrahepatic portosystemic shunt(TIPS)emerges as a promising intervention,effectively resolving complications of portal hypertension and facilitating ***,optimal timing and patient selection for TIPS remain *** challenges,TIPS offers renewed hope for hepatic recompensation,marking a significant advancement in cirrhosis *** research is needed to refine its implementation and maximize its *** conclusion,TIPS stands as a promising avenue for improving hepatic function and patient outcomes in decompensated liver cirrhosis within the framework of the Baveno VII criteria.

关键词： Hepatic recompensation Baveno VII Transjugular intrahepatic portosystemic shunt Portal hypertension Cirrhosis Decompensation

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Emerging molecules,tools,technology,and future of surgical knife in gastroenterology

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 988-998页

作者： Ashok Kumar Anirudh Goyal Department of surgical Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

The 21^(st) century has started with several innovations in the medical sciences,with wide applications in health care *** development has taken in the field of medicines(newer drugs/molecules),various tools and technology which has completely changed the patient management including abdominal *** for abdominal diseases has moved from maximally invasive to minimally invasive(laparoscopic and robotic)*** of the newer medicines have its impact on need for surgical *** article focuses on the development of these emerging molecules,tools,and technology and their impact on present surgical form and its future effects on the surgical intervention in gastroenterological diseases.

关键词： Newer molecules Tools and technology Gastroenterology Future of surgical knife

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Beyond dentistry:could prevention and screening for neurodegenerative diseases start in the dental office?

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Neural Regeneration Research 2024年第1期19卷 156-157页

作者： Francesca R.Buccellato Daniela Galimberti Gianluca M.Tartaglia Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilanItalyFondazione IRCCS Ca’GrandaOspedale Maggiore PoliclinicoMilanItaly

The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological *** efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a *** the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.

关键词： diagnosis diseases prevention

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Amebic liver abscess: An update

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World Journal of Hepatology 2024年第3期16卷 316-330页

作者： Ramesh Kumar Rishabh Patel Rajeev Nayan Priyadarshi Ruchika Narayan Tanmoy Maji Utpal Anand Jinit R Soni Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Department of Radiodiagnosis All India Institute of Medical SciencesPatna 801507India Department of surgical Gastroenterology All India Institute of Medical SciencesPatna 801507India

Amebic liver abscess(ALA)is still a common problem in the tropical world,where it affects over three-quarters of patients with liver *** is caused by an anaerobic protozoan Entamoeba hystolytica,which primarily colonises the *** is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular *** of the male gender,during their reproductive years,are most prone to ALA,and this appears to be due to a poorly mounted immune response linked to serum testosterone *** is more common in the right lobe of the liver,is strongly associated with alcohol consumption,and can heal without the need for *** majority of ALA patients have an uncomplicated course,a number of complications have been described,including rupture into abdomino-thoracic structures,biliary fistula,vascular thrombosis,bilio-vascular compression,and secondary bacterial *** on clinico-radiological findings,a classification system for ALA has emerged recently,which can assist clinicians in making treatment *** research has revealed the role of venous thrombosis-related ischemia in the severity of *** years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited *** has been the drug of choice for ALA patients for many ***,concerns over the resistance and adverse effects necessitate the creation of new,safe,and potent antiamebic *** the indication of the drainage of uncomplicated ALA has become more clear,high-quality randomised trials are still necessary for robust *** drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis,for whom surgery represents a significant risk of *** regard to all of the aforementioned issues,this article intends to present an u

关键词： Amebic liver abscess Amebiasis Ruptured liver abscess Percutaneous drainage Metronidazole

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Optimizing prediction models for pancreatic fistula after pancreatectomy:Current status and future perspectives

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World Journal of Gastroenterology 2024年第10期30卷 1329-1345页

作者： Feng Yang John A Windsor De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China surgical and Translational Research Centre Faculty of Medical and Health SciencesUniversity of AucklandAuckland 1142New Zealand

Postoperative pancreatic fistula(POPF)is a frequent complication after pancre-atectomy,leading to increased morbidity and *** prediction models for POPF has emerged as a critical focus in surgical *** over sixty models following pancreaticoduodenectomy,predominantly reliant on a variety of clinical,surgical,and radiological parameters,have been documented,their predictive accuracy remains suboptimal in external validation and across diverse *** models after distal pancreatectomy continue to be pro-gressively reported,their external validation is eagerly ***,POPF prediction after central pancreatectomy is in its nascent stage,warranting urgent need for further development and *** potential of machine learning and big data analytics offers promising prospects for enhancing the accuracy of prediction models by incorporating an extensive array of variables and optimizing algorithm ***,there is potential for the development of personalized prediction models based on patient-or pancreas-specific factors and postoperative serum or drain fluid biomarkers to improve accuracy in identifying individuals at risk of *** the future,prospective multicenter studies and the integration of novel imaging technologies,such as artificial intelligence-based radiomics,may further refine predictive *** these issues is anticipated to revolutionize risk stratification,clinical decision-making,and postoperative management in patients undergoing pancre-atectomy.

关键词： Pancreatic fistula Pancreaticoduodenectomy Distal pancreatectomy Central pancreatectomy Prediction model Machine learning Artificial intelligence

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Current status and future perspectives on stem cell transplantation for spinal cord injury

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World Journal of Transplantation 2024年第1期14卷 189-209页

作者： Edoardo Agosti Marco Zeppieri Andrea Pagnoni Marco Maria Fontanella Alessandro Fiorindi Tamara Ius Pier Paolo Panciani Division of Neurosurgery Department of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBrescia 25123Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Department of Medical and surgical Specialties Radiological Sciencesand Public HealthUniversity of BresciaBrescia 25123BSItaly Neurosurgery Unit Head-Neck and NeuroScience DepartmentUniversity Hospital of UdineUdine 33100Italy

BACKGROUND Previous assessments of stem cell therapy for spinal cord injuries(SCI)have encountered challenges and *** research primarily emphasizes safety in early-phase clinical trials,while systematic reviews prioritize effectiveness,often overlooking safety and translational *** situation prompts inquiries regarding the readiness for clinical *** To offer an up-to-date systematic literature review of clinical trial results concerning stem cell therapy for *** A systematic search was conducted across major medical databases[PubMed,Embase,Reference Citation Analysis(RCA),and Cochrane Library]up to October 14,*** search strategy utilized relevant Medical Subject Heading(MeSH)terms and keywords related to"spinal cord","injury","clinical trials","stem cells","functional outcomes",and"adverse events".Studies included in this review consisted of randomized controlled trials and non-randomized controlled trials reporting on the use of stem cell therapies for the treatment of *** In a comprehensive review of 66 studies on stem cell therapies for SCI,496 papers were initially identified,with 237 chosen for full-text *** them,236 were deemed eligible after excluding 170 for various *** studies encompassed 1086 patients with varying SCI levels,with cervical injuries being the most common(42.2%).Bone marrow stem cells were the predominant stem cell type used(71.1%),with various administration ***-up durations averaged around 84.4 *** 32.7%of patients showed functional improvement from American spinal injury association Impairment Scale(AIS)A to B,40.8%from AIS A to C,5.3%from AIS A to D,and 2.1%from AIS B to *** improvements were observed in 30.9%of patients.A relatively small number of adverse events were recorded,including fever(15.1%),headaches(4.3%),muscle tension(3.1%),and dizziness(2.6%),highlighting the potential for SCI recovery with stem cell *** In

关键词： Spinal cord injury Stem cell therapy Adverse events Functional outcomes Systematic review

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Preoperative prognostic nutritional index predicts long-term outcomes of patients with ampullary adenocarcinoma after curative pancreatoduodenectomy

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1291-1300页

作者： Chong-Yuan Sun Xiao-Jie Zhang Zheng Li He Fei Ze-Feng Li Dong-Bing Zhao Department of Pancreatic and Gastric surgical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND The prognostic nutritional index(PNI),a marker of immune-nutrition balance,has predictive value for the survival and prognosis of patients with various *** To explore the clinical significance of the preoperative PNI on the prognosis of ampullary adenocarcinoma(AC)patients who underwent curative *** The data concerning 233 patients diagnosed with ACs were extracted and analyzed at our institution from January 1998 to December *** patients were categorized into low and high PNI groups based on the cutoff value determined by receiver operating characteristic curve *** compared disease-free survival(DFS)and overall survival(OS)between these groups and assessed prognostic factors through univariate and multivariate *** The optimal cutoff value for the PNI was established at *** with a PNI≥45.3 were categorized into the PNI-high group,while those with a PNI<45.3 were assigned to the PNI-low *** within the PNI-low group tended to be of advanced age and exhibited higher levels of aspartate transaminase and total bilirubin and a lower creatinine level than were those in the PNI-high *** 5-year OS rates for patients with a PNI≥45.3 and a PNI<45.3 were 61.8%and 43.4%,respectively,while the 5-year DFS rates were 53.5%and 38.3%,*** in the PNI-low group had shorter OS(P=0.006)and DFS(P=0.012).In addition,multivariate analysis revealed that the PNI,pathological T stage and pathological N stage were found to be independent prognostic factors for both OS and *** The PNI is a straightforward and valuable marker for predicting long-term survival after *** PNI should be incorporated into the standard assessment of patients with AC.

关键词： Ampullary carcinoma Prognostic nutritional index Prognosis Pancreaticoduodenectomy

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surgical management of tegmen defects of the temporal bone and meningoencephalic herniation: our experience

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Journal of Otology 2024年第1期19卷 30-34页

作者： Giuseppe De Donato Emanuela Fuccillo Alberto Maria Saibene Elena Ferrari Giorgia Carlotta Pipolo Antonia Pisani Liliana Colletti Anastasia Urbanelli Luigi De Donato Giovanni Felisati Otorhinolaryngology Unit Head and Neck DepartmentASST Santi Paolo e Carlo HospitalVia Antonio di Rudinì820142MilanItaly Department of Health sciences University of MilanVia Festa del Perdono720122MilanItaly Department of Biomedical Surgical and Dental SciencesUniversity of MilanVia Festa del Perdono720122MilanItaly ENT Unit Department of Surgical SciencesUniversity of TurinVia Verdi810124TurinItaly

1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, comprised of the tegmen tympani(To′th et al., 2007), and a posterior one, formed by the tegmen antri and the tegmen mastoideum(Makki et al., 2011). In some patients, the tegmental region of the temporal bone can be interrupted, causing a tegmen defect(TD). A TD is sometimes associated with a meningoencephalic herniation(MEH), in which brain tissue herniates through a TD.

关键词： al. herniation bone

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