Surgical Management of Small Bowel Lymphoma
AbstractBackgroundPrimary small bowel non-Hodgkin ’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcomes in patients with small bowel lymphoma.Materials and MethodsPatients diagnosed with stage I –III small bowel lymphoma in 2004–2015 who underwent surgery were identified in the National Cancer Database. Two cohorts were created based on systemic chemotherapy treatment status. The primary outcome was ove...
Source: Journal of Gastrointestinal Surgery - July 14, 2020 Category: Surgery Source Type: research

Laparoscopic Radical Antegrade Modular Pancreatosplenectomy with Vascular Resection for Pancreatic Cancer: Tips and Tricks
ConclusionL-RAMPS with vascular resection is feasible and safe in selected cases when performed by advanced pancreatic surgeons with experience in laparoscopic surgery. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 14, 2020 Category: Surgery Source Type: research

Guidelines for the Treatment of Hepatocellular Adenoma in the Era of Molecular Biology: An Experience-Based Surgeons ’ Perspective
ConclusionsDue to the complexity of the disease, the treatment of HA is one the best examples of an individualized approach. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 14, 2020 Category: Surgery Source Type: research

Atypical Mycobacterial Infection a Threat for Developing Countries with Improper Sterilization Techniques
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 14, 2020 Category: Surgery Source Type: research

Gastrocolic Ligament Lymph Node Dissection for Transverse Colon and Hepatic Flexure Colon Cancer: Risk of Nodal Metastases and Complications in a Large-Volume Center
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 14, 2020 Category: Surgery Source Type: research

Is Sarcopenic Obesity an Indicator of Poor Prognosis in Gastric Cancer Surgery? A Cohort Study in a Western Population
ConclusionsSarcopenia, obesity, and sarcopenic obesity were not associated with worse outcomes after gastric cancer surgery. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 13, 2020 Category: Surgery Source Type: research

Adapted ERAS Pathway Versus Standard Care in Patients Undergoing Emergency Small Bowel Surgery: a Randomized Controlled Trial
AbstractBackgroundEmergency laparotomy for small bowel pathologies comprises a significant number of all emergency surgeries. Application of evidence-based adapted enhanced recovery after surgery (ERAS) protocol can potentially improve the perioperative outcome in these procedures.AimsTo determine the feasibility, safety, and efficacy of adapted ERAS pathway in emergency small bowel surgery.MethodologyThis was a single-center, prospective, open-labeled, superiority, randomized controlled trial. Patients suspected to have small bowel pathology by the emergency surgical team were randomized preoperatively into standard care ...
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Colorectal Sarcomatoid Carcinoma: a Rare Condition with Poor Outcomes
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Massive Acute Gastric Dilatation in a Patient with Anorexia Nervosa
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Colonic Inflammatory Myofibroblastic Tumor
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Younger Age Is Associated with Improved Survival in Patients Undergoing Liver Transplantation Alone for Metastatic Neuroendocrine Tumors
ConclusionsWaiting time longer than 6  months is associated to lower rates of tumor recurrence. Younger patients ≤ 45 years had significantly improved survival after LT for NET metastases. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Cardiopulmonary Exercise Testing in Oesophagogastric Surgery: a Systematic Review
ConclusionStudies report an association between CPX variables and postoperative mortality; however, there is conflicting evidence regarding the association between CPX variables and postoperative morbidity. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 6, 2020 Category: Surgery Source Type: research

Management of Ileal Neuroendocrine Tumors with Liver Metastases
AbstractPurposeAssessment of treating metastatic ileal neuroendocrine tumors (NETs) with complete resection of primary tumor, nodal and liver metastases, plus administration of long-acting somatostatin analogues (SSAs).MethodsA prospective database was queried for patients with ileal or pancreatic NETs with pathology-confirmed liver metastases and tumor somatostatin receptors. Patients did not have MEN-1 and had no previous treatment. The impacts of SSA treatment on the primary outcome of survival and secondary outcome of progression-free survival were assessed with Kaplan –Meier analysis. Log rank test was used to c...
Source: Journal of Gastrointestinal Surgery - July 1, 2020 Category: Surgery Source Type: research

Preoperative Portal Vein Embolization Is Not Associated with Increased Postoperative Complications After Major Hepatectomy: a Study of the National Surgical Quality Improvement Database
AbstractBackgroundPreoperative portal vein embolization (PVE) is selectively performed to induce hypertrophy of the future liver remnant prior to major liver resection. The primary aim of this study was to determine the association of PVE with liver-specific and overall postoperative morbidity.MethodsA retrospective cohort study of patients who underwent major hepatectomy from 2014 to 2016 within the ACS-NSQIP hepatectomy-specific module was performed.ResultsOf the 3912 patients identified, 9.9% (N = 388) underwent PVE. Patients who underwent PVE were older (59.1 vs. 57.7 years). Most patients in the PVE...
Source: Journal of Gastrointestinal Surgery - July 1, 2020 Category: Surgery Source Type: research

Acute Gangrenous Cholecystitis: Proposal of a Score and Comparison with Previous Published Scores
ConclusionsThe AUC of our score exceeded 0.80, indicating that this score can help in diagnosing patients with GC, and thus in prioritizing these patients for surgery or choosing the adapted technique of drainage in critically ill patients. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Systemic Immune-Inflammation Index Predicts Overall Survival in Patients with Gastric Cancer: a Propensity Score –Matched Analysis
AbstractBackgroundThe systemic immune-inflammation index (SII), integrated by peripheral lymphocyte, neutrophil, and platelet counts, is used as an objective biomarker that reflects the balance between host inflammatory and immune response status in cancer patients. Herein, we examined the prognostic significance of SII in gastric cancer patients.MethodsWe retrospectively reviewed data of 415 patients who underwent curative laparoscopic gastrectomy using propensity score –matched (PSM) analysis. The prognostic value of SII was compared between two groups based on SII values: low SII group (SII 
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Gastrointestinal Malignancies and the COVID-19 Pandemic: Evidence-Based Triage to Surgery
ConclusionModerate evidence suggests that delayed resection of colorectal cancer worsens survival; the impact of time to surgery on gastric and pancreatic cancer outcomes is uncertain. Early resection of gastrointestinal malignancies provides the best chance for curative therapy. During the COVID-19 pandemic, prioritization of procedures should account for available evidence on time to surgery and oncologic outcomes. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Adequacy of EGD Reporting: a Review of 100 Reports from 100 Endoscopists
ConclusionEndoscopy reports frequently do not include the use of a grading system for esophagitis or the Prague system for CLE. This hampers the assessment of change with therapy or over time. The size of a hiatal hernia was typically reported in a subjective fashion and only infrequently was the type specified. Lack of clarity about the presence of a paraesophageal hernia can impede evaluation of acute symptoms. In patients with Barrett ’s esophagus a standard biopsy protocol was infrequently reported to be used. These findings raise concern about the quality of upper endoscopy, both in the performance of the proced...
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Hemobilia as a Complication of Transhepatic Percutaneous Biliary Drainage: a Rare Indication for Laparoscopic Common Bile Duct Exploration
ConclusionsBiliary obstruction secondary to hemobilia is a rare occurrence after PTBD. Surgical CBD exploration is required when conservative management and endoscopic treatment fail and can be done successfully through a minimally invasive approach. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Liver Solitary Fibrous Tumor: a Rare Incidentaloma
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Efficacy and Feasibility of Indocyanine Green for Mapping Lymph Nodes in Advanced Gastric Cancer Patients Undergoing Laparoscopic Distal Gastrectomy
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

Meleney ’s Synergic Gangrene
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 30, 2020 Category: Surgery Source Type: research

The Role of the Intestinal Microbiome on Colorectal Cancer Pathogenesis and its Recurrence Following Surgery
AbstractColorectal cancer is the result of multiple genetic mutations that drive normal cells to adenoma and then carcinoma. Recent technology has evolved to allow for an in-depth examination of the microbiota and it has become clear that many components of the intestinal microbiome play a role in promoting carcinogenesis. This review aims to describe the potential mechanisms that lead to the dysbiosis that initiates tumor formation and that influence the development of cancer recurrence following surgical resection. We further discuss how manipulation of the microbiome may  be a future novel strategy to prevent both ...
Source: Journal of Gastrointestinal Surgery - June 25, 2020 Category: Surgery Source Type: research

The Long-Term Outcomes of Endoscopic Papillectomy and Management of Cases of Incomplete Resection: A Single-Center Study
ConclusionApproximately 80% of the patients in whom the histopathological evaluation of the resected margin was difficult had no recurrence even after approximately 5  years of follow-up. Thus, careful observation may be considered for these patients. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Relevant Clinical Trials for GI Surgeons: a Review of Recent Findings
AbstractOver the last decade, a number of practice-changing clinical trials have been published to guide the management of esophageal, gastric, liver, pancreas, appendiceal, and colorectal pathologies. The following review aims to provide a succinct summary of these important trials that merit further critical assessment by every gastrointestinal surgeon. After each review, per the Editors ’ request, the authors have provided their humble opinion as to the clinical context and application of the data. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Is Complete Pathologic Response in Pancreatic Cancer Overestimated? A Systematic Review of Prospective Studies
ConclusionsPathologic complete response in pancreatic cancer is actually infrequent: high-quality studies provide a more reliable picture of neoadjuvant effects, high rates of pCR are reported in selected retrospective studies but it is overestimated. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Minimally Invasive Hepatectomy in North America: Laparoscopic Versus Robotic
AbstractBackgroundMinimally invasive hepatectomy has been shown to be associated with improved outcomes when compared with open surgery. However, data comparing laparoscopic and robotic hepatectomy is lacking and limited to single-center studies.MethodsPatients undergoing major ( ≥ 3 segments) or partial (≤ 2 segments) hepatectomy were identified in the 2014–2017 ACS-NSQIP hepatectomy targeted database. Patients undergoing laparoscopic and robotic approaches were compared, and propensity score matching was utilized to adjust for bias.ResultsOf 3152 minimally invasive hepatectomies (MIHs), 86% (N&t...
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Preoperative Nomogram Predicts Non-home Discharge in Patients Undergoing Pancreatoduodenectomy
This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.MethodsPatients undergoing pancreatoduodenectomy from 2013 to 2018 were identified using an institutional database. Patients were categorized according to discharge location (home vs. non-home). Preoperative risk factors, including social determinants of health associated with non-home discharge, were identified using Pearson ’s chi-squared test and then included in a multiple logistic regression model. A training cohort composed of 80% of the sampl...
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Intracorporeal Stapled Ileocolic Anastomosis with Mechanical Closure of the Enterotomy After Minimally Invasive Right Colectomy for Cancer: Introduction of a New Technique
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Solitary Fibrous Tumor of the Pancreas
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 24, 2020 Category: Surgery Source Type: research

Near Infra-Red Technology to Evaluate Segment IV in Split Liver Transplantation
ConclusionThe case reported in this video is, to the best of our knowledge, the first in the English literature showing how near infrared technology has predictive value on the evaluation of a split graft. Fast diffusion of the colorant allows dynamic early evaluation and may confirm the presence of intra-hepatic venous shunt, which will determine a full recovery of the originally ischemic area. On the contrary, a permanent absence of the staining might be predictive of dysfunction. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 23, 2020 Category: Surgery Source Type: research

The Role of Ki-67 Index Cut-off of 55% and Differentiation in Redefining NET and NEC for Grade 3 Gastrointestinal Neuroendocrine Neoplasms
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 23, 2020 Category: Surgery Source Type: research

Tumor Deposits Should Not Be Ignored in the AJCC TNM Staging System for ypN(+) Stage Rectal Cancer with Neoadjuvant Chemoradiotherapy
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 22, 2020 Category: Surgery Source Type: research

Reply to Akbulut et al
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 22, 2020 Category: Surgery Source Type: research

Comment on Retrospective Study of Cystic Echinococcosis in a Recent Cohort of a Referral Center for Liver Surgery
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 22, 2020 Category: Surgery Source Type: research

Catheter-Related Complications of Percutaneous Drainage in Step-up Approach for Management of Pancreatic Necrosis
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 19, 2020 Category: Surgery Source Type: research

Pre-operative Sarcopenia Predicts Low Islet Cell Yield Following Total Pancreatectomy with Islet Autotransplantation for Chronic Pancreatitis
AbstractBackground and AimSarcopenia defined as degenerative loss of skeletal muscle mass associated with aging, represents an objective parameter to measure frailty and to estimate patient ’s physiologic reserves. It is a robust predictor of post-operative complications in transplantation and major oncologic surgeries. There is no data regarding the prevalence of sarcopenia in chronic pancreatitis or its impact on the outcome of patients undergoing TPIAT for CP. We sought to estimat e the prevalence of sarcopenia, its impact on post-operative morbidity and prediction of islet yield and metabolic outcomes in patients...
Source: Journal of Gastrointestinal Surgery - June 17, 2020 Category: Surgery Source Type: research

Combining Appleby with RAMPS – Laparoscopic Radical Antegrade Modular Pancreatosplenectomy with Celiac Trunk Resection
ConclusionL-RAMPS and modified Appleby procedure is a curative option for patients with distal pancreatic cancers that invade the celiac trunk and in whom the tumor biology is well controlled. A preplanned approach with 3D reconstruction accounting for organ displacement due to pneumoperitoneum optimizes surgical decision making and port placement for visual alignment caudally along the SMA. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 17, 2020 Category: Surgery Source Type: research

Trends in Colectomies for Colorectal Neoplasms in Ulcerative Colitis: a National Inpatient Sample Database Analysis over Two Decades
AbstractBackgroundRates of colectomy for ulcerative colitis have been decreasing, particularly since the advent of biologics, but the subsequent impact of reduced colectomy rates on the development of neoplasms in chronically treated ulcerative colitis colons is unknown.PurposeTo determine trends in colectomy for colorectal neoplasms in adult patients with ulcerative colitis.MethodsAdult admissions with ulcerative colitis were identified from the National Inpatient Sample from 1993 to 2015. The rate of colectomy with concurrent colorectal neoplasm served as the primary outcome and was evaluated using time trend linear and ...
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

Tumor Regression Grade in Gastric Cancer After Preoperative Therapy
AbstractBackgroundTheCancer Staging Manual, 8th edition, now includes post-neoadjuvant therapy (ypTNM) staging for gastric cancer patients. Our purpose was to determine whether the tumor regression grade (TRG) of the primary tumor is useful for predicting the survival of these patients.MethodsWe performed a retrospective review of an institutional database and identified patients with clinically non-metastatic gastric adenocarcinoma who underwent preoperative chemotherapy or chemoradiation therapy before gastrectomy. Pathology reports were reviewed, and TRG was classified as follows: 0 (complete response), 1 (viable tumor ...
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

Laparoscopic Limited Resection for Duodenal Gastrointestinal Stromal Tumors
ConclusionLaparoscopic limited resection is a feasible, safe, and ideal treatment procedure for duodenal GISTs in terms of short- and long-term surgical outcomes. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

An Immunocompetent Model of Pancreatic Cancer Resection and Recurrence
ConclusionWe describe an immunocompetent animal model that recapitulates human disease in morphology and recurrence patterns. We show that it can be used to evaluate therapy in clinical scenarios associated with surgical resection and may help characterize factors responsible for disease recurrence. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

Genetic Risk Factors for Diverticular Disease —Emerging Evidence
AbstractDiverticular disease is traditionally understood as an environmental disease caused by diet and constipation. However, genes are increasing understood to play a role in pathogenesis. Twin studies suggest a substantial component of individual risk is due to heritable factors. Association of diverticular disease with other traits suggests an underlying biological mechanism and recently genome-wide association studies have described the genetic architecture underlying this complex phenotype. These studies suggest a new paradigm for understanding this common surgical disease. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

Reply to Letter to Editor — “ Catheter-Related Complications of Percutaneous Drainage in Step-up Approach for Management of Pancreatic Necrosis”
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

Comment on Predicting Hepatocellular Carcinoma Recurrence Beyond Milan Criteria After Liver Resection for Solitary Hepatocellular Carcinoma
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 15, 2020 Category: Surgery Source Type: research

The Biology of Anastomotic Healing —the Unknown Overwhelms the Known
DiscussionMuch remains unknown regarding the mechanisms of anastomotic healing, and research should focus on elucidating the dynamics of healing at a  molecular level. Doing so may help facilitate the transition from traditional surgical dogma to evidence-based medicine in the operating room. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 10, 2020 Category: Surgery Source Type: research

Germline MICA Polymorphism Is Associated with the Long-Term Outcomes in Patients Undergoing Hepatectomy for Colorectal Liver Metastases
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 10, 2020 Category: Surgery Source Type: research

Impact of a Preoperative Video-Based Educational Intervention on Postoperative Outcomes in Elective Major Abdominal Surgery: a Randomized Controlled Trial
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 10, 2020 Category: Surgery Source Type: research

Endoscopic Resection for Gastric Schwannoma: Our Clinical Experience of 28 Cases
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - June 10, 2020 Category: Surgery Source Type: research

Increasing Incidence of Left-Sided Colorectal Cancer in the Young: Age Is Not the Only Factor
AbstractBackgroundRecent single-institution studies have shown that colorectal cancer (CRC) in patients
Source: Journal of Gastrointestinal Surgery - June 10, 2020 Category: Surgery Source Type: research