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1
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"Review summary and Recommendations
1. Clinical Context:
Walled-off pancreatic necrosis (WON) is heterogeneous in clinical course. While some patients resolve with transmural drainage alone, others deteriorate and require direct endoscopic necrosectomy (DEN). Chronological criteria, such as the 4-week cutoff in the revised Atlanta classification, do not reliably predict clinical trajectory.
2. Key Findings:
o Persistent sepsis, systemic inflammatory response syndrome (SIRS), hypoalbuminemia, anemia, extensive necrosis (>30–40%), and unfavorable anatomical patterns predict drainage failure and DEN requirement.
o Lone et al’s predictive model (AUC 0.892) demonstrates strong discriminative ability, supporting early identification of patients unlikely to respond to drainage alone.
o The concept of “passive drainage failure” captures patients at high risk, characterized by large solid debris, compartmentalized collections, and persistent systemic inflammation.
3. Step-Up vs Upfront DEN:
o Timing should not be guided solely by predefined intervals but by individualized risk assessment.
o Step-up strategies minimize unnecessary interventions but may delay care in high-risk patients.
o Upfront DEN can prevent deterioration in selected patients but carries higher procedural risk if overused.
o Guidelines support necrosectomy in cases of persistent sepsis, cavity compartmentalization, or failure of cavity collapse despite adequate drainage.
4. Safety Considerations:
o DEN is effective but carries 15–30% complication rates, including bleeding, perforation, stent occlusion, and infection exacerbation.
o Deferring DEN in patients with ongoing infection or high necrotic burden may worsen outcomes and complicate later intervention.
o Risk stratification is essential to balance procedural risk against the risk of inaction.
5. Future Directions:
o Integration of multivariate risk models, incorporating clinical, biochemical, and imaging variables, may individualize timing decisions.
o AI and machine learning could enhance predictive accuracy, using longitudinal data and quantitative necrosis assessment.
o The paradigm shift is toward intervention guided by patient-specific risk rather than temporal thresholds.
Recommendations
1. Clinical Practice:
o Implement early risk stratification in all WON cases to identify patients at high risk of drainage failure.
o Reserve step-up strategies for low-to-moderate risk patients and consider early DEN for high-risk phenotypes.
o Monitor clinical, laboratory, and imaging markers closely to guide escalation decisions.
2. Research:
o Validate predictive models like Lone et al’s across larger, multi-center cohorts.
o Investigate AI-driven, real-time risk scoring systems integrating necrosis quantification and host response metrics.
o Explore the interplay of nutritional status, necrosis morphology, and systemic inflammation as modifiers of intervention timing.
3. Guideline Implications:
o Guidelines should emphasize risk-based rather than time-based criteria for DEN.
o Step-up and upfront strategies should be framed as complementary, with risk stratification as the central decision-making tool.
Bottom Line:
Timing of DEN should transition from protocol-driven intervals to personalized, risk-guided decisions. Intervention becomes appropriate when waiting poses greater risk than acting.
"
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Singeap AM, Chiriac S, Minea H, Trifan A. Between step-up and upfront intervention: Risk stratification as the missing link in timing endoscopic necrosectomy. World J Gastrointest Endosc 2026; 18(3): 116865 [DOI: 10.4253/wjge.v18.i3.116865]
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2
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"This is a high-level evaluation of a study or meta-analysis that summarizes its overall quality, reliability, strengths, limitations, and clinical relevance without going into excessive technical detail. It’s the type of assessment a clinician, journal reviewer, or guideline committee might write to quickly judge how much weight to give the study’s findings.
Overall Quality:
The meta-analysis includes 17 randomized controlled trials with 1,689 patients, representing a moderate-to-high-quality evidence base. The search strategy was comprehensive, covering multiple international and Chinese databases, which minimizes publication bias.
Strengths:
• Large, pooled sample size with randomized controlled trial design.
• Direct comparison between minimally invasive ES and standard TS.
• Evaluates both efficacy and safety, including recovery time and costs.
• Clinically relevant outcomes such as bleeding, prolapse, complications, and hospital stay.
Limitations:
• Variation in ES and TS techniques across studies may introduce heterogeneity.
• Follow-up durations were not consistently reported, limiting assessment of long-term outcomes and recurrence.
• Most studies had relatively small individual sample sizes, which may affect statistical power for less common complications.
Clinical Relevance:
• Provides strong evidence that ES is a safe, effective, and cost-efficient alternative to TS.
• Supports adoption of ES as a first line minimally invasive option for internal hemorrhoid treatment, especially for patients seeking faster recovery.
Conclusion:
The meta-analysis is methodologically sound and clinically meaningful. While some heterogeneity exists, the findings are consistent and indicate that ES offers meaningful advantages over TS in terms of safety, recovery, and cost. Further large-scale, multicenter studies with standardized protocols would strengthen the evidence base.
"
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Wu SY, Chen YS, Li XH, Yu TJ, Xie F, Jiang QF, Lan Y, He P, Li SC, Li WS, Chen WD. Efficacy and safety of endoscopic sclerotherapy vs traditional surgery in the treatment of internal hemorrhoids: A meta-analysis. World J Gastrointest Endosc 2026; 18(3): 116697 [DOI: 10.4253/wjge.v18.i3.116697]
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3
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"Summary: This study presents an exploratory analysis of bilateral upper limb sEMG activity in an experienced endoscopist during simulated colonoscopy, focusing on different bowel loop configurations. Key findings include:
• Muscle activation and fatigue: Complex loops significantly increase muscle load and fatigue, particularly in the left extensor digitorum and stabilizing muscles like the left flexor carpi radialis and right middle deltoid.
• Bilateral asymmetry: The left arm consistently sustains high activation, while the right arm shows task-specific activation, suggesting differential biomechanical demands for gross stabilization versus fine manipulation.
• Correlation with procedure duration: Longer insertion times are associated with more rapid fatigue in stabilizer muscles.
• Implications: These results objectively demonstrate increased biomechanical demand during challenging colonoscopy maneuvers, supporting the need for ergonomic interventions, workload management, and device design optimization.
Strengths:
• Comprehensive sEMG analysis across 14 bilateral muscles with high temporal resolution (1500 Hz).
• Clear differentiation of muscle load and fatigue patterns across loop types.
• Quantitative correlation between loop complexity, insertion time, and fatigue metrics.
• Direct applicability to ergonomic and occupational health improvements in endoscopy.
Limitations:
• Single-operator study limits generalizability.
• Simulation model may not fully capture anatomical variability and real-world procedural stress.
• Small sample size; statistical power and inter-operator variability not addressed.
Recommendations:
1. Manuscript refinement: Emphasize novelty and clinical relevance, particularly the practical applications for ergonomic device design and occupational safety protocols.
2. Future research: Recommend multi-operator studies to validate muscle activation patterns across experience levels and real-world procedures.
3. Ergonomic integration: Suggest incorporating findings into colonoscopy training programs and device evaluation to reduce repetitive strain injuries.
4. Data visualization: Consider additional heatmaps or muscle activation timelines to highlight asymmetry and fatigue progression, enhancing interpretability for clinicians.
Overall Assessment:
The study provides valuable, objective biomechanical data supporting ergonomic improvements in colonoscopy. With minor clarifications and broader context regarding clinical translation, this manuscript is suitable for publication in this journal focusing on endoscopy, and also journals directing occupational health, or medical ergonomics.
"
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Wang RG, Wang YQ, Cao H. Bilateral upper limb surface electromyography analysis during single-operator colonoscopy: Implications for ergonomics and occupational health. World J Gastrointest Endosc 2026; 18(3): 116646 [DOI: 10.4253/wjge.v18.i3.116646]
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4
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"Summary:
This retrospective cross-sectional study evaluated 801 patients with inoperable esophageal malignancies undergoing self-expandable metallic stent (SEMS) placement using the vertebral column and diaphragm as fluoroscopic landmarks. Patients ranged from 18–95 years (mean 50 ± 15), with 50.9% female. Dysphagia was the presenting symptom (mean duration 3.84 months), and squamous cell carcinoma was the predominant histology (74.16%). Tumors most commonly involved the middle third of the esophagus, and inoperability was primarily due to distant metastases (52.81%). Tracheoesophageal fistula was present in 6%, and the mean stricture length was 8.4 cm. Pre-stent dilatation was required in 17.4% of patients. SEMS lengths ranged from 8–18 cm. The landmark-based technique achieved 100% technical success without major immediate adverse events. Repeat interventions were minimal (1.87% re-stenting for tumor overgrowth; 1.37% dilatation for tumor ingrowth).
Reviewer Comments:
Strengths:
*Large patient cohort with comprehensive demographic and tumor characteristics.
*Clear demonstration of technical feasibility and safety of landmark-based SEMS placement.
*Low rates of immediate complications and repeat interventions indicate procedural reliability.
Limitations:
*Retrospective design limits causal inference and generalizability.
*Lack of comparative data with conventional SEMS placement techniques.
*No formal assessment of patient-reported outcomes (e.g., dysphagia relief scores, quality of life).
*Long-term stent patency and survival data are not reported.
Recommendations:
*Consider prospective, comparative studies to validate the landmark-based approach against standard techniques.
*Include standardized patient-centered outcomes (dysphagia scoring, nutritional status, and quality of life).
*Explore the applicability of this technique in anatomically complex or upper esophageal tumors.
*Discussion could be strengthened by addressing limitations related to stent type, tumor morphology, and fluoroscopic variability.
Overall Assessment:
The study presents a practical, reproducible technique for SEMS placement using vertebral and diaphragmatic landmarks with excellent technical success. The findings are clinically relevant, particularly for high-volume centers performing palliative esophageal stenting. Future prospective studies are warranted to assess long-term outcomes and patient-centered benefits."
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Siyal M, Asim M, Qureshi S, Ghazanfar S, Siddiqui AR, Ahmed N, Altaf A, Zakaria N, Yaseen A, Kakar F, Kadir S, Hasan MK, Niaz SK. Navigating self-expandable metallic stent placement in inoperable esophageal malignancies: A landmark-based technique using the vertebral column and diaphragm. World J Gastrointest Endosc 2026; 18(3): 116060 [DOI: 10.4253/wjge.v18.i3.116060]
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5
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"This study underscores the importance of considering systemic immune modulation in H. pylori infection, particularly in DU patients, and may inform future research on cytokine-mediated disease mechanisms and potential therapeutic strategies. Further, the study bridges gap between gastroenterology and systemic immunology, showing that H. pylori eradication can have meaningful systemic effects, which is clinically relevant for patient care, risk assessment, and possibly long-term outcomes. Furthermore, the findings suggest that H. pylori eradication confers systemic immunological benefits beyond the resolution of gastric pathology, including a distinct anti-inflammatory shift in duodenal ulcer patients. Incorporating disease-specific immune responses into clinical practice could support more personalized post-eradication monitoring and management. Future guidelines might consider systemic inflammation outcomes as an additional rationale for timely eradication, particularly in patients at risk for inflammation-related comorbidities."
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de Melo FF, Lemos FFB, Leal RAOS, Rocha GA, de Magalhães Queiroz DM. Helicobacter pylori eradication is associated with systemic anti-inflammatory shift in duodenal ulcer patients compared to those with gastritis. World J Gastrointest Endosc 2026; 18(3): 116958 [DOI: 10.4253/wjge.v18.i3.116958]
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6
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"Review Summary Report
Review Notes:
• The study addresses an important clinical question and provides practical guidance for treatment selection.
• Retrospective design and relatively small sample size, especially in the stent group, limit the strength of conclusions.
• Cost-effectiveness data are valuable but could be strengthened with more detailed breakdowns (e.g., procedural vs. post-procedural costs).
• Future prospective studies or randomized trials could validate these findings and refine patient selection criteria for SEMS use.
"
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Yuan HF, Liu P, Guo CQ, Bi YH. Comparative study of self-expandable stent placement, bougie dilation, and balloon dilation for post-inflammatory oesophageal strictures. World J Gastrointest Endosc 2026; 18(3): 117303 [DOI: 10.4253/wjge.v18.i3.117303]
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7
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"The manuscript addresses a highly relevant and timely topic in medical education. The focus on VR-based endoscopy training is well-motivated given patient safety concerns and the growing adoption of simulation-based methods. The systematic review methodology is appropriate, and the results are clearly summarized. Overall, the manuscript is of interest to readers in gastroenterology, medical education, and simulation-based training.
• Significance: Addresses a highly relevant topic in endoscopy training and patient safety; VR-based training is of growing interest.
• Strengths:
o Clear focus on multiple endoscopic procedures (EGD, colonoscopy, ERCP, EUS).
o Adherence to PRISMA 2020 guidelines is noted.
o Quantitative outcomes (odds ratios, P-values, competency scores) enhance rigor.
o Balanced conclusion emphasizes VR as an adjunct to conventional training.
• Major Points for Revision:
o Provide detailed search strategy (databases, terms, date range) and inclusion/exclusion criteria; consider adding a PRISMA flow diagram.
o Clarify study selection and screening process; report if independent reviewers were used.
o Include risk-of-bias assessment for included studies using standard tools (e.g., Cochrane RoB 2, ROBINS-I).
o Discuss heterogeneity across studies (simulator type, trainee experience, training duration) and its impact on results.
o Address clinical relevance beyond skill metrics (e.g., patient outcomes, procedural complications, skill retention).
o Standardize outcome reporting for clarity (odds ratios, mean ± SD, pass rates).
• Minor Points:
o Ensure consistent abbreviation usage (GIE vs GI endoscopy).
o Simplify complex sentences for readability.
o Include review registration information if available (e.g., PROSPERO).
• Recommendation: Minor to moderate revision; manuscript is strong but would benefit from enhanced methodological transparency and discussion of heterogeneity and clinical impact.
"
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Gadour E, Miutescu B, Nica C, Taheri E, Al Saeed Z, Raheem B, Facciorusso A, AlQahtani MS. Virtual reality training for gastrointestinal endoscopy: A systematic review of efficacy and outcomes. World J Gastrointest Endosc 2026; 18(3): 117820 [DOI: 10.4253/wjge.v18.i3.117820]
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8
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"Overall Assessment: This manuscript addresses a highly relevant and timely topic, evaluating the diagnostic performance of AI-assisted colonoscopy for real-time colorectal polyp histology. The study is well-structured, with rigorous methodology and clear presentation of results. The findings, demonstrating that AI outperforms human endoscopists—particularly in less experienced operators—are clinically important. However, several aspects require clarification and elaboration to strengthen the manuscript’s impact and reproducibility.
Major Comments: Search Strategy & Study Selection: Please provide full details of the literature search, including databases, search terms, date range, and inclusion/exclusion criteria. A PRISMA flow diagram would enhance transparency.
Quality Assessment: Include a table summarizing QUADAS-2 risk of bias assessments for all studies. Clarify how studies with high risk of bias were considered in analyses.
Heterogeneity: Substantial heterogeneity (I² = 74.3%) is reported. Consider subgroup or meta-regression analyses based on AI type, polyp characteristics, or endoscopist experience to explore sources of variability.
Statistical Analysis: Clarify whether hierarchical or bivariate models were considered, as these are often preferred in diagnostic accuracy meta-analyses.
Clinical Interpretation: Discuss the practical significance of AI’s improved accuracy, including potential impact on management decisions, optical biopsy strategies, and clinical workflows.
Limitations: Explicitly address publication bias, spectrum bias, and generalizability of AI algorithms across centers. Also, note that AI technology is rapidly evolving, which may limit applicability of current findings.
Minor Comments: Clarify the definition of “human experts” (experience, certification).
*Specify polyp types included in the analysis.
*Consider tables summarizing AI algorithms, training/validation datasets, and imaging modalities.
*Streamline some sentences for readability and consistency in terminology.
*Briefly mention future considerations such as cost-effectiveness, regulatory, and ethical implications of AI deployment.
Recommendation: The manuscript is important and of high interest, but minor to moderate revisions are required to clarify methodology, address heterogeneity, and strengthen discussion of clinical applicability and limitations."
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Curlej P, Soldera J. Artificial intelligence in predicting colorectal polyp histology: Systematic review and meta-analysis of diagnostic accuracy in real-time procedures. World J Gastrointest Endosc 2026; 18(3): 116381 [DOI: 10.4253/wjge.v18.i3.116381]
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9
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"Post-ERCP pancreatitis (PEP) is comprehensive and clearly outlined both epidemiology and pathophysiology. The discussion appropriately highlights the multifactorial nature of PEP and effectively integrates patient- and procedure-related risk factors. The emphasis on individualized risk assessment and evidence-based preventive strategies is well-placed. To further strengthen the manuscript for a critical audience, consider the following suggestions:
1. Clarify incidence ranges: You report an incidence of 3–15% in general populations and up to 40% in high-risk patients. Providing references for these ranges and defining “high-risk” explicitly (e.g., presence of multiple risk factors, prior pancreatitis, or sphincter of Oddi dysfunction) would enhance clarity.
2. Risk factor hierarchy: While multiple risk factors are listed, it may be helpful to indicate which factors carry the strongest evidence or highest odds ratios, perhaps in a table or figure. This helps readers quickly gauge clinical impact.
3. Preventive strategies: The paragraph mentions rectal NSAIDs, pancreatic stenting, hydration, and precut sphincterotomy. It could be strengthened by briefly noting the level of evidence or guideline recommendation for each (e.g., ESGE or ASGE guidelines), distinguishing strategies supported by strong randomized trials versus observational data.
4. Pharmacologic agents: The statement that agents like somatostatin, gabexate, and nafamostat have inconsistent efficacy is accurate, but citing meta-analyses or systematic reviews would make this more authoritative.
5. Emerging tools: Mentioning AI and risk prediction models is forward-looking. Consider briefly highlighting specific models that have shown promise or limitations, to give readers a sense of current clinical applicability.
6. Future directions: The call for standardization and validation is important. You might also suggest exploring combination preventive strategies and personalized approaches based on risk stratification, which would align with precision medicine trends.
Overall, the paragraph is well-structured and readable, with a clear progression from epidemiology to pathogenesis, risk factors, prevention, and future directions. Addressing the points above would enhance rigor and utility for a specialist audience.
"
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Xu PW, Xu QQ, Yu Y, Jiao Y, Liu YH, Yang L. Risk factors and prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastrointest Endosc 2026; 18(3): 115736 [DOI: 10.4253/wjge.v18.i3.115736]
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10
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"Clinically, the report is worthy. It clearly frames the problem, current solutions, and future directions. Cholangiocarcinoma is an aggressive malignancy often diagnosed at an advanced stage due to nonspecific symptoms. Conventional imaging and ERCP-based sampling have limited sensitivity, with reported diagnostic yields of 50–70% for tissue acquisition. Digital single-operator cholangioscopy improves diagnostic accuracy to 85–95% through direct visualization and targeted biopsies and facilitates therapeutic interventions, including biliary drainage, stenting, photodynamic therapy, and radiofrequency ablation, with procedural complication rates typically <5%. Despite these advances, interobserver variability, operator expertise, and limited long-term outcome data remain challenges. Integration of artificial intelligence shows preliminary promise in real-time lesion characterization but requires prospective validation. Future studies should define comparative effectiveness, patient-centered outcomes, and standardized protocols to optimize cholangioscopy in multidisciplinary CCA management."
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Musalia JG, Alzayyat S, Aljahdli ES, Al-Lehibi A, Lara LF, Gabr M. Cholangioscopy in the diagnosis and management of cholangiocarcinoma. World J Gastrointest Endosc 2026; 18(3): 115412 [DOI: 10.4253/wjge.v18.i3.115412]
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11
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"The paper presents a clear and well-structured case report describing delayed intramural hematoma following Endoscopic submucosal dissection for a laterally spreading tumor. The case narrative is logical, clinically relevant, and supported by follow-up demonstrating complete resolution and a well-healed scar, which strengthens the clinical outcome.
However, the scientific contribution is limited by several factors. The conclusion overgeneralizes from a single case, suggesting that conservative therapy is effective without acknowledging that broader evidence is required. The article also does not clearly define the novelty of the case relative to previously reported intramural hematomas after ESD. In addition, important clinical and procedural details such as lesion size, risk factors, hematoma characteristics, and rationale for management are lacking. The discussion of mechanisms and alternative treatment approaches is also minimal.
Overall, the report is clinically informative but primarily descriptive, and it would be strengthened by clarifying its novelty, providing more procedural detail, and moderating the conclusion to reflect the limitations of a single-case observation.
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Xu YL, Zhang ML, Zhou HJ, Gao PJ, Zhang XN, Rao M. Giant rectal intramural hematoma following endoscopic submucosal dissection successfully treated with conservative therapy: A case report. World J Gastrointest Endosc 2026; 18(3): 115257 [DOI: 10.4253/wjge.v18.i3.115257]
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12
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"This article interprets the 5% plateau time model for colonoscopy in colonic diverticular bleeding and emphasizes that a 40-minute observation period should be treated as a flexible minimum floor rather than a rigid rule. By framing observation time as a “time-to-yield” curve, we propose practical strategies for computed tomography-stratified targets, a 20-25-minutes quality checkpoint, individualized shortening in high-risk patients and structured documentation. These suggestions aim to improve time efficiency and operational quality in the management of acute lower gastrointestinal bleeding."
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Li C, Liu YQ, Wang HX. Feasibility of a forty-minute post-colonoscopy observation period for diverticular bleeding: Assessing the five per cent plateau model. World J Gastrointest Endosc 2026; 18(3): 115049 [DOI: 10.4253/wjge.v18.i3.115049]
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13
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"This article addresses an important and clinically relevant issue in the management of acute caustic ingestion: the optimal role of esophagogastroduodenoscopy versus computed tomography in early triage and risk stratification. The authors clearly describe the strengths of early endoscopic evaluation, particularly its role as the gold standard for grading mucosal injury when performed within 12–24 hours. The manuscript also appropriately highlights the growing role of cross-sectional imaging, emphasizing how computed tomography can detect transmural injury and extra-luminal complications such as necrosis, perforation, mediastinitis, and peritonitis findings that may not be fully appreciated endoscopically.
The paper effectively frames these modalities as complementary rather than competing diagnostic tools. This balanced perspective reflects current clinical thinking and has practical relevance for emergency and gastroenterology teams managing caustic ingestion.
However, several areas could be strengthened to enhance the manuscript’s impact. First, the discussion of CT would benefit from greater attention to the heterogeneity of imaging protocols and the lack of universally accepted CT grading systems for caustic injury. Second, a more structured comparison of diagnostic accuracy, predictive value for complications, and influence on clinical decision-making (e.g., surgical referral) would improve the clinical utility of the review. Third, incorporation of a proposed triage algorithm integrating both modalities could provide readers with clearer practical guidance.
Overall, this is a timely and useful review that synthesizes the evolving literature on diagnostic strategies in caustic ingestion. With additional clarification of imaging criteria, standardization challenges, and clinical decision pathways, the manuscript would provide even stronger guidance for clinicians managing this high-risk emergency.
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Singh AK, Birda CL, Kochhar R. Optimizing triage in acute caustic ingestion: Choosing between endoscopy and computed tomography. World J Gastrointest Endosc 2026; 18(3): 114327 [DOI: 10.4253/wjge.v18.i3.114327]
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14
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"This is a valuable case report illustrating the diagnostic challenges of abdominal presentations of hereditary angioedema. With modest revisions—particularly expanding the clinical description and strengthening the discussion of the genetic findings—the manuscript would make a useful contribution to the literature. The manuscript would benefit from expanded clinical detail, stronger discussion of the mutation, and clearer differentiation between hereditary and acquired angioedema. Addressing these issues will significantly improve the clarity and impact of the case report."
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Matsuura K, Ueda C, Hashimura C, Yakushiji H, Horiuchi T. Hereditary angioedema with recurrent abdominal pain in a patient with a novel SERPING1 gene mutation: A case report. World J Gastrointest Endosc 2026; 18(3): 113096 [DOI: 10.4253/wjge.v18.i3.113096]
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15
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"This review article summarizes the current knowledge regarding the structure and role of the gut–brain axis, particularly in the context of acute brain injury. The major components include direct connections between the intestines and the brain through neurological and hormonal systems, as well as indirect communication mediated by intestinal flora and inflammatory cytokines. The structural participants include the autonomic nervous system, comprising both sympathetic and parasympathetic pathways, and the hypothalamic–pituitary–adrenal axis.
Within these systems, a vicious cycle may easily develop. Brain inflammation can lead to systemic inflammatory spillover, which may induce increased intestinal permeability (“leaky gut”). This, in turn, can further exacerbate systemic inflammation and subsequently worsen brain inflammation.
Potential therapeutic approaches discussed in the manuscript include vagus nerve stimulation, prebiotics and probiotics, fecal microbiota transplantation, and nutritional support. However, the content of the manuscript is largely redundant and does not present novel therapeutic concepts. In addition, the manuscript lacks detailed discussion of the underlying mechanisms and does not provide specific guidance for clinical practice. Overall, the manuscript remains largely descriptive and narrative rather than presenting a rigorous scientific analysis."
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Zhao X, Zhang W, Zhang Y, Liu XA. Gastrointestinal dysfunction after brain injury: Mechanisms and the role of the brain-gut axis. World J Gastroenterol 2026; 32(10): 115731 [PMID: 41809453 DOI: 10.3748/wjg.v32.i10.115731]
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16
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Ribeiro Junior MAF, Dib Possiedi R, Stefani Pacheco L, de Cesaro Schpchacki N, Nafeesa Hashim S, Monteiro Tavares Pereira B. Direct peritoneal resuscitation in sepsis and intra-abdominal infection: A scoping review. World J Clin Cases 2026; 14(7): 118719 [DOI: 10.12998/wjcc.v14.i7.118719]
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17
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"Traditional Chinese Medicine has demonstrated satisfactory preclinical and clinical efficacy in patients with IBD. The data from the review under comment demonstrate that TCM primarily acts through a holistic approach, affecting multiple signaling pathways and other immunological mechanisms, including the composition of the gut microbiota, intestinal barrier integrity, autophagy, and gene expression. TCM treats IBD by synergistically modulating immunity, repairing the intestinal barrier, restoring the gut microbiota, and regulating inflammatory pathways and autophagy. In recent years, a large number of research papers, mainly by Chinese researchers, have sought to identify the therapeutic components of these treatments on the one hand and to investigate their mechanisms of action on the other. Moreover, clinical data and meta-analyses of randomized controlled trials support the effectiveness of PKI. Taken together, these actions will provide PKI with a scientific basis and foundation for its results. It is truly remarkable that both the large pharmaceutical industries and the health providers, as well as the officials of various countries, do not fund large multicenter studies that use PKI or the so-called Alternative Medicine in patients with IBD, at least as a complementary treatment to traditional Western medicine. I believe that the path towards this direction is inevitable in the coming years. Congratulations to the authors of the review."
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Zeng SH, Jiang XY, Lin DR, Zhang WJ, Wu YQ, Xu L, Guo SJ. Mechanisms and therapeutic potential of traditional Chinese medicine for inflammatory bowel disease. World J Gastroenterol 2026; 32(10): 115821 [PMID: 41809460 DOI: 10.3748/wjg.v32.i10.115821]
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18
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"The vascular anatomy of the head and neck is highly complex and variable, and accurately characterizing the spatial relationships between vessels and adjacent bony structures is essential for identifying high-risk patients and guiding surgical planning. In a well-written letter to the editor, Jiang and Li commented on the study by Karangeli et al., a computed tomography angiography-based investigation of the spatial relationship between the hyoid bone and the carotid arteries. That study, which included 224 patients, revealed significant anatomical variability and concluded that carotid–hyoid contact is far more common than previously recognized. These findings carry important implications for radiologists and surgeons, as such contact may predispose patients to dynamic carotid compression, transient ischemic events, or intraoperative vascular injury.
Jiang and Li discussed the clinical significance of carotid–hyoid anatomy, its surgical relevance, and age-related considerations. They acknowledged that the study by Karangeli et al. highlights the importance of translating detailed anatomical knowledge into preventive strategies that integrate imaging precision with vascular protection. Their review of the literature also summarized findings from other studies, noting that differences in suprahyoid muscular tension, cervical biomechanical loading, or hormonal influences may alter the course of the carotid arteries and contribute to previously unrecognized, sex-specific vascular risk profiles.
Certain anatomical configurations—particularly types VIII and XI—may lead to transient compression, displacement, or repetitive impingement of the internal carotid artery during swallowing, neck rotation, flexion-extension, or physical exertion. Jiang and Li called for comparable longitudinal and multiethnic population-based studies on the hyoid bone and proposed future research directions. They emphasized that the carotid–hyoid relationship is far from an anatomical curiosity; rather, it represents a critical interface with direct implications for cerebrovascular health, surgical safety, and diagnostic accuracy.
The authors further noted that radiologists should maintain a heightened awareness of this anatomical relationship in patients with cryptogenic stroke, recurrent focal neurological deficits, or unexplained cervical symptoms. Incorporating carotid–hyoid topographic evaluation into routine CTA reporting not only enhances diagnostic completeness but also facilitates timely risk identification and meaningful prevention, bridging the gap between structural anatomy and clinical protection.
The parent study holds substantial clinical significance and relevance, offering valuable insights that can aid clinicians in addressing complex clinical challenges and improving patient outcomes. The article was well written and edited in terms of structure, language and references, and no errors were identified."
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Jiang SY, Li R. When anatomy becomes pathology: Rethinking carotid-hyoid contact in cerebrovascular events. World J Radiol 2026; 18(2): 116873 [PMID: 41809708 DOI: 10.4329/wjr.v18.i2.116873]
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19
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"This study demonstrated that perioperative blood transfusions during gastric cancer surgery are associated with increased postoperative inflammation and stress responses, higher complication rates, and worse long-term outcomes. These results emphasize the importance of reducing unnecessary transfusions during surgery for gastric cancer patients. The immunomodulatory effects and enhanced inflammatory responses of transfusions may adversely affect the prognosis of cancer patients. The researchers concluded that avoiding unnecessary transfusions may facilitate postoperative recovery and improve long-term outcomes in gastric cancer patients. Going forward, it will be important to closely evaluate the need for blood transfusions and develop strategies to minimize transfusions, such as exploring alternative therapies and improving surgical techniques to reduce blood loss."
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Maurya P, Gupta A, Gupta N. Influence of blood transfusion on outcomes in patients with gastric cancer. World J Gastroenterol 2026; 32(10): 115683 [PMID: 41809457 DOI: 10.3748/wjg.v32.i10.115683]
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20
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"We know that Traditional Chinese Medicine is a comprehensive medical system with a history of over 2,000 years, whose offerings focus on restoring balance and harmony between body, mind, and environment. Among its therapeutic methods, herbal medicine holds a leading position through the use of natural recipes based on herbs and minerals, aimed at enhancing self-healing processes. It is particularly effective in treating, among others, autoimmune and inflammatory conditions.
Traditional Chinese Medicine is constantly gaining ground as a complementary therapy in the West. The World Health Organization has already officially recognized it by including it in the International Classification of Diseases, which facilitates its integration into national health systems. Currently, its adoption is usually proposed as a parallel to Western medicine rather than a replacement for it.
In the study under review, the authors, using complex methods, identified the main bioactive components of Lianhe Xiaozhi ointment and the pathophysiological mechanisms underlying its effective alleviation of metabolic dysfunction-associated steatotic liver disease.
In a global system of pharmaceutical treatment of ever-increasing cost, studies such as the one under review are necessary to determine, with adequate scientific methodology, the active ingredients and their precise mode of action in specific pathological conditions. I would like to congratulate the authors on their excellent work.
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Nie LJ, Wang GX, Yang XY, Sun J, Cao YT, Lou Y, Lu YF, Yu JY, Zhou XQ. Lianhe Xiaozhi ointment ameliorates metabolic dysfunction-associated steatotic liver disease via peroxisome proliferator-activated receptor alpha pathway activation. World J Gastroenterol 2026; 32(9): 114544 [PMID: 41810443 DOI: 10.3748/wjg.v32.i9.114544]
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"Thank you for the opportunity to review the quality of the following editorial. Please see my comments below:
1 Ethics: Not applicable given manuscript type
2 Methods: Not applicable given manuscript type
3 Results: Not applicable given manuscript type
4 Figures and tables: The included figure adds to the readability of the manuscript
5 Biostatistics: Not applicable given manuscript type
6 References: Appropriate/up-to-date references
7 Language: Concise/well-written editorial
8 Caveats or drawbacks: None "
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Huang HY, Tian L. Kill two birds with one stone: Reprogramming tumor microenvironment with growth differentiation factor 11. World J Gastroenterol 2026; 32(9): 115259 [PMID: 41810435 DOI: 10.3748/wjg.v32.i9.115259]
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"Re: Khalid A, Obadele OG, Alabi TO, Nedjim SA, Abdulwahab-Ahmed A, Mungadi IA. Practical approach to the review of bladder diverticulum and its management. World J Clin Urol 2026; 15(1): 114046 [DOI: 10.5410/wjcu.v15.i1.114046]
The authors report on “Practical approach to the review of bladder diverticulum and its management”
The article, which provides a combination of literature review and personal experience, included a detailed discussion of the definition, etiology, pathogenesis, clinical presentation, diagnosis and treatment of bladder diverticulum. The following comments can be of benefit for future considerations:
1.The causes and treatment of bladder diverticulum in children are different from those in adults. So, it would have been better to focus on either of them.
2. The authors stated that “For example, in boys with posterior urethral valves, these diverticula can serve as a pressure relief mechanism to protect the kidneys from damage and maintain bladder function”. In this context, is it possible to treat these diverticula conservatively without active surgical intervention? If the answer is yes, what are the indications.
3. It would have been better to include the pros and cons of the different surgical techniques, namely, extravesical, intravesical, or transdiverticular. Are they comparable? [1,2]
4. Among the active treatment options of bladder diverticulum is transurethral electrovaporization of the diverticular mucosa. It would have been better to include it among the endoscopic treatment procedures [3].
5. Is there a difference in the outcome between staged treatment versus concomitant treatment of the cause and the resulting secondary diverticulum, for example in cases with BOO? [4]
6. In cases of female diverticulum, which are very close to the urethra, what are the recommended tips and tricks [5].
References
[1]. Perri D, Roche JB, Petrut B, Bozzini G. Bladder diverticula management - conservative and surgical outcomes: a narrative review from EAU endourology. Curr Opin Urol. 2026 Jan 1;36(1):79-85. doi: 10.1097/MOU.0000000000001307. Epub 2025 Jun 12. PMID: 40548586.
[2]. Giannarini G, Rossanese M, Macchione L, Mucciardi G, Crestani A, Ficarra V. Robot-assisted Bladder Diverticulectomy Using a Transperitoneal Extravesical Approach. Eur Urol Open Sci. 2022 Sep 8;44:162-168. doi: 10.1016/j.euros.2022.08.016. PMID: 36110902; PMCID: PMC9468349.
[3]. Chandhoke RA, Ghoniem GM. Transurethral Electrovaporization of Bladder Diverticulum: An Alternative to Open or Laparoscopic Bladder Diverticulectomy. J Endourol Case Rep. 2015 Oct 1;1(1):11-3. doi: 10.1089/cren.2015.29002.cha. PMID: 27579375; PMCID: PMC4996560.
[4]. Gazzah W, Ben Taher S, Masmoudi S, Hamza M, Naouar S, Salem B. Management of multiple giant bladder diverticula: a comprehensive approach - a case report. Ann Med Surg (Lond). 2024 May 15;86(7):4187-4190. doi: 10.1097/MS9.0000000000002162. PMID: 38989198; PMCID: PMC11230813.
[5]. Liao C, He Z, Wang X, Guo P, Xiong W. Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report. Medicine (Baltimore). 2023 Sep 1;102(35):e34971. doi: 10.1097/MD.0000000000034971. PMID: 37657035; PMCID: PMC10476744.
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Khalid A, Obadele OG, Alabi TO, Nedjim SA, Abdulwahab-Ahmed A, Mungadi IA. Practical approach to the review of bladder diverticulum and its management. World J Clin Urol 2026; 15(1): 114046 [DOI: 10.5410/wjcu.v15.i1.114046]
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"The paper is an interesting review, concise, comprehensive, complex and well structured. I think this paper is welcome and relevant for medical daily practice even if the pathology debated is rare. Gastrointestinal bleeding is a frequent presentation in clinical practice, therefore is important to known all possible causes of bleeding including secondary to a GI melanoma. There are no grammatical or spelling errors throughtout the text. "
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De Nardi P, Guida S, Damiano G, Rizzo N, Samanes Gajate AM, Riva ST, Paolino G, Colombo M, Tummineri R, Rongioletti F, Mercuri SR, Chiti A, Sileri P, Russo V. Primary melanoma of the gastrointestinal tract. World J Gastroenterol 2026; 32(8): 114571 [PMID: 41809872 DOI: 10.3748/wjg.v32.i8.114571]
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"The dose of ursodeoxycholic acid that was prescribed to the study groups were not matched in this project. The uncontrolled PBC patients enface with hypercholesterolemia. This could make bias while diagnosing metabolic criteria for the definition of MASLD. At the same time, the study groups should be matched for the dose of statin consumption. Statins also influence the cholesterol level and should be adjusted as a confounding factor."
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Koky T, Drazilova S, Komarova S, Macej M, Toporcerova D, Janicko M, Spakova I, Rabajdova M, Marekova M, Jarcuska P. Adipokine profiles reflect metabolic dysfunction but not fibrosis in patients with primary biliary cholangitis. World J Hepatol 2026; 18(2): 113685 [PMID: 41809476 DOI: 10.4254/wjh.v18.i2.113685]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Bhati G, Mongardini FM, Bhati K, Singh P, Bansal R, Bansal A, Mahajan S, Docimo L, Caricato M, Capolupo GT, Carannante F. Ruptured primary intrahepatic ectopic pregnancy: A case report and review of literature. World J Clin Cases 2026; 14(6): 118135 [PMID: 41810054 DOI: 10.12998/wjcc.v14.i6.118135]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Aby Hadeer R, Ghattas S, Farhat H, Maalouf H, Bitar JE, Ayash D, Mohtar F, Elias B, Wakim R. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal mucocele tumors: Five case reports and review of literature. World J Clin Cases 2026; 14(6): 117655 [PMID: 41810050 DOI: 10.12998/wjcc.v14.i6.117655]
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"Duodenal ischemia in systemic lupus erythematosus (SLE) is a pathological condition of severe lupus enteritis, in which blood flow to the intestinal tract is impaired, mainly due to vasculitis and thrombosis. It begins with sudden abdominal pain, vomiting, and fever, and progresses to ulcers, perforation, and necrosis, so early diagnosis by CT and prompt immunosuppressive therapy, such as steroid pulse therapy, are essential. Surgical treatment: If perforation or necrosis is observed, emergency surgery to remove the affected area is required. The authors performed a duodenal anastomosis to avoid PD, and complications such as bile duct stricture were alleviated with a stent after surgery. This is a good paper."
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Kim YK, Jung HI, Kim H, Bae SH. Ischemic duodenal injury due to systemic lupus erythematosus: A case report. World J Gastroenterol 2026; 32(8): 115654 [PMID: 41809873 DOI: 10.3748/wjg.v32.i8.115654]
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"1) Ethics - meets requirements («The study was approved by the Ethics Committee of National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College in accordance with the ethical standards outlined in the 1964 Helsinki Declaration»)
2) Methods - revision required.
Key concerns:
- Subjective criteria for SSA administration
The SSA-treated group includes zero patients with perineural invasion, but the endoscopy-alone group has 1 patient. Lymphovascular invasion was present in both groups (10.5% vs 9.6%), but no clear criteria for SSA initiation are provided. This distribution is clinically illogical and indicates selection bias.
- Deviation from international guidelines (ENETS/NCCN)
73.4% of patients had tumors ≤ 10 mm without muscularis propria invasion. Current guidelines do not recommend adjuvant SSA therapy in this low-risk population. A substantial proportion of SSA-treated patients may have received overtreatment.
Required revisions: Provide an objective, reproducible algorithm for SSA allocation. Perform a subgroup analysis of low-risk patients (≤10 mm, G1, no LVI/PNI).
3) Results - revision required.
• The authors state: «However, endoscopic treatment removes lesions without addressing the underlying pathogenesis, allowing gastrin to continue stimulating neuroendocrine cell growth. Therefore, G-NETs may recur after endoscopic treatment». However, gastrin levels were not measured in this study. As a result: the suppressive effect of SSAs on gastrin was not documented and a direct correlation between gastrin reduction and improved outcomes could not be established.
• Presented descriptively (n = 27, 6 mutations), with no integration into the main prognostic analysis. It is unclear how these data correlate with the risk of progression or response to therapy. This section appears redundant and detracts from the main clinical conclusions.
4) Figures and tables – good, minor issues
Tables 1–4 and Figures 2–4 are clear, well-structured, and properly labeled.
Figure 5: Descriptive genetic data only; not integrated into prognostic analysis. Limited relevance to main findings. Recommend moving to Supplementary Materials.
5) Biostatistics - adequate.
LASSO and Cox regression correctly used, but no sample size calculation, wide CIs, and potential immortal time bias—acknowledge in limitations.
6) References - good
Relevant, up-to-date, no over-citation.
7) Language – good
Clear, concise, grammatically correct.
8) Caveats or drawbacks
• Retrospective single-center design with inherent selection bias: SSA allocation was subjective and no reproducible algorithm provided.
• Deviation from guidelines: 73.4% of patients had low-risk where adjuvant SSAs are not routinely recommended — potential overtreatment.
• No gastrin data: The proposed mechanism (SSAs suppress gastrin) remains unverified; correlation between SSA use and reduced progression is statistical, not mechanistically proven.
• Genetic data (Figure 5): Descriptive only, not integrated into prognostic analysis; limited relevance to main clinical conclusions.
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Yang ZL, Wang HK, Liu Y, Dou LZ, Zhang YM, Ng HI, He S, Chi YB, Wang GQ. Progression after endoscopic treatment for type I gastric neuroendocrine tumors: A single-center retrospective study. World J Gastroenterol 2026; 32(8): 114268 [PMID: 41809874 DOI: 10.3748/wjg.v32.i8.114268]
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"Peroxiredoxin 1 (Prdx1) has recently been shown to effectively inhibit the growth of colon cancer in experimental carcinogenesis in mice. The anticancer activity of this substance is based on pyroptosis. Pyroptosis is a key component of cell death. It directly suppresses the tumor by promoting gasdermin D-induced cell lysis and by releasing inflammatory factors that affect the so-called “cell death-anti-tumor immunity”. Peroxiredoxin 1 warrants further investigation for the development of co-expression markers (Prdx1/GSDMD). Furthermore, as the authors note, the efficacy of combination therapies targeting rPrdx1 should be studied promptly to promote personalized treatment of colon cancer."
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Chen ZK, Zhao JW, Meng WY, Wang YG. Peroxiredoxin 1 as a novel pyroptosis inducer in colorectal cancer: Insights and future directions. World J Gastroenterol 2026; 32(8): 116016 [PMID: 41809877 DOI: 10.3748/wjg.v32.i8.116016]
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"As a systematic review, this paper comprehensively covers the core research content of tumor organoids and provides a systematic collation of knowledge in the field. However, there is room for optimization in terms of data rigor, content depth, and clinical relevance. To enhance its academic value, it is advisable to supplement detailed information on literature screening, strengthen the connection between technical details and clinical applications, enrich the comprehensiveness of discussions on limitations, and optimize the timeliness of case data and references. Other comments:
Figures and tables: I think the paper should have more figures, rather than only tabels."
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Agrawal H, Tanwar H, Gupta N. Tumor organoids in translational cancer research: Models for personalized therapy. World J Transl Med 2026; 12(1): 113050 [DOI: 10.5528/wjtm.v12.i1.113050]
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"The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Alvarez M, Luna M, Suarez E, Rincon O, Guzman I, Mancera P. Thyroid collision tumor and Graves’ disease: A case report and review of literature. World J Clin Cases 2026; 14(5): 117016 [PMID: 41700182 DOI: 10.12998/wjcc.v14.i5.117016]
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"The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Bouayad A. Human leukocyte antigen variants and clinical features of primary biliary cholangitis: Cumulative contributions. World J Clin Cases 2026; 14(5): 115814 [PMID: 41700179 DOI: 10.12998/wjcc.v14.i5.115814]
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"
Importantly, the authors of this study identified that prolonged disease duration and anxiety are independent high-risk factors for refractory GERD. Anti-anxiety interventions, standardized exercise prescriptions, and lifestyle factors such as sleep and weight management should be explored as a multidimensional risk-targeted intervention.
However, in the real world, we have to distinguish between true refractory GERD and refractory reflux-like symptoms. A systematic evaluation of the patients is essential, as up to 40% of patients with GERD report inadequate symptom control with PPIs, but only a minority have true refractory GERD. Therefore, we should evaluate multiple aspects of the patient's behavior (e.g., optimizing PPI therapy, ensuring correct timing, increasing to twice-daily dosing, or switching to a different PPI) before proceeding with exercise prescriptions and anti-anxiety interventions. Moreover, alternative pharmacologic options, including Histamine-2 receptor antagonists (administered at bedtime for nocturnal symptoms, though tachyphylaxis limits long-term efficacy), potassium-competitive acid blockers, alginates and antacids, prokinetic agents, neuromodulators, bile acid sequestrants, and lifestyle modifications, should be tried in these patients, indicating that individualized, multidisciplinary care is essential.
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Zuo XY, Chen QQ. Beyond monotherapy by acid suppression: Reshaping the management of refractory gastroesophageal reflux disease. World J Gastroenterol 2026; 32(7): 116425 [PMID: 41694490 DOI: 10.3748/wjg.v32.i7.116425]
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"The paper is interesting and fits well with the body of work addressing nontraditional factors causing myocardial infarction. In particular the discussion is well written. I don't know if I've missed it, but I haven't seen a correlation between myocardial infarction and ethnicity. In Europe ethnicity is an important factor, given that Asian populations have a higher incidence of myocardial infarction at young ages."
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Patel T, Farhan M, Bhatt NK, Fatah HA, Peniel JJ, Kaulgud VV, Mathew T, Bapat AM, Harazeen WS, Alatta AN, Awosika A. Non-traditional risk factors for myocardial infarction in adults under forty: A systematic review of emerging trends. World J Cardiol 2026; 18(2): 116172 [PMID: 41694029 DOI: 10.4330/wjc.v18.i2.116172]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Lee H, Han YH, Chung JW, Kim KO, Kwon KA, Kim JH. Upper gastrointestinal bleeding with duodenal varix: A case report. World J Clin Cases 2026; 14(4): 116648 [PMID: 41695764 DOI: 10.12998/wjcc.v14.i4.116648]
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"Obese people are prone to GERD and SG increases the frequency of GERD after surgery, so SG is worth considering for those with GERD. RYDG and OAB are good weight loss surgeries without the risk of GERD. For patients with GERD, the surgical procedure should be selected as suggested by authors."
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Xing Y, Yan WM, Bai RX. Effects of bariatric surgery on obesity associated gastroesophageal reflux disease: Insights from a systematic review and network meta-analysis. World J Gastroenterol 2026; 32(6): 114600 [PMID: 41695279 DOI: 10.3748/wjg.v32.i6.114600]
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"Obesity is associated with a high proportion of patients with gastroesophageal reflux disease (GERD). In recent years, metabolic and bariatric surgery (MBS) has been considered the most effective treatment for weight loss in obese patients. The most commonly performed surgical procedures are sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single-anastomotic gastric bypass (OAGB). MBS has different effects on obesity-related GERD depending on the type of procedure performed.
The results suggest that RYGB consistently leads to significant improvement or remission of GERD symptoms, reduced HCl exposure, and reduced need for PPI therapy in obese patients. RYGB and OAGB are more effective than SG for weight loss and GERD control. RYGB is therefore the preferred bariatric procedure for obese patients with clinically evident GERD.
SG is associated with a higher risk of new onset or worsening of GERD, an increased incidence of erosive esophagitis, and an increased risk of Barrett's esophagus. The pathophysiology of these effects is multifactorial and involves changes in gastric anatomy and lower esophageal sphincter function.
Therefore, the choice of the type of surgical procedure that should be performed must be individualized, with RYGB being preferred in obese patients with significant GERD or Barrett's esophagus, while SG can be performed in patients without reflux symptoms but requires careful preoperative assessment of GERD risk.
The aforementioned data should be taken seriously and guide the physician and patient with obesity and GERD towards making the right surgical decisions."
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Xing Y, Yan WM, Bai RX. Effects of bariatric surgery on obesity associated gastroesophageal reflux disease: Insights from a systematic review and network meta-analysis. World J Gastroenterol 2026; 32(6): 114600 [PMID: 41695279 DOI: 10.3748/wjg.v32.i6.114600]
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"Fatigue is a frequent and particularly burdensome symptom with significant impact on the quality of life of patients with Crohn's disease. In daily medical practice, its treatment is often inadequate since it is usually attributed to side effects of the drugs administered to treat the underlying disease or to psychological causes. The study under review found that indeed, psychological symptoms such as depression, anxiety, stress of any cause, and insomnia are related to its occurrence. In particular, stress is likely to induce the symptom through probable immunological effects. Of interest was the frequent occurrence of fatigue with increased white blood cell count. It therefore seems that fatigue in patients with Crohn's disease has a multifactorial etiology, not exclusively attributable to disease activity or inflammatory markers. As the researchers pointed out, fatigue among IBD patients should receive greater attention in the near future. By conducting additional relevant studies, we will be able to accurately identify the factors that contribute to fatigue, enabling us to develop and implement strategies to effectively identify and support patients experiencing fatigue."
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Morais TC, Couto G, Silva BCD, Lisbôa RA, da Cruz BS, Viana MGF, de Sousa GBC, Arenas LP, Nery ES, Fortes FML, de Almeida NP, Pimentel AM, Fontes JAM, Surlo VC, Chebli JF, Rocha R, Santana GO. Psychological and hematological factors associated with fatigue in patients with Crohn’s disease receiving pharmacological treatment. World J Gastroenterol 2026; 32(5): 115673 [PMID: 41693975 DOI: 10.3748/wjg.v32.i5.115673]
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"The editorial article summarizes current knowledge and clinical approaches to the diagnosis and management of cancer-related incomplete intestinal obstruction (CRIO). Given the multifactorial and complex pathophysiology of CRIO, it is inherently challenging to comprehensively describe all clinical conditions. Nevertheless, the authors successfully present a well-structured and comprehensive overview by organizing the discussion into a clear and logical framework."
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Liu JL, Wang CX, Wang HL. Advances in the management of cancer-related incomplete intestinal obstruction: Therapeutic strategies and emerging interventions. World J Gastroenterol 2026; 32(5): 115030 [PMID: 41693976 DOI: 10.3748/wjg.v32.i5.115030]
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"This article provides an interesting topic, with valuable first-hand information.
There were also some notable limitations, as addressed in the following:
Of the “Abstract”. The aim does not match well the conclusion.
Some “Keywords” are not adequate. “Metagenomic next-generation sequencing” should be moved from “Keywords”.
There was no “analysis” or associated description in the “Methods” of the “Abstract”, and this is not adequate.
The “Results” in “Abstract” were not consistent with the “Methods” of the “Abstract”.
There was no gold standard (guidelines) and criteria for the diagnosis of pulmonary nocardiosis in the “Materials and Methods”.
The imaging characteristics (Table 4) were not complete, and which should include a complex item comprising two or more imaging characteristics of the lungs .
A total of the pulmonary nocardiosis caused by different species in Table 4 was not 102.
The pulmonary nocardiosis treated by different medications in Table 5 was not clear, some patients treated using more than one medications, and the total number was not 102.
Figure 1 was not necessary, and associated information can be listed in table or presented in text.
Images of pulmonary nocardiosis were not sufficient, and more other representative images had better be added.
The English is not professionalism.
The “Conclusion” that “Nocardia pneumonia commonly coexists with bronchiectasis. Although mNGS has greatly enhanced its detection rate, N. wallacei pneumonia is distinguished on chest CT by its primary presentation of bronchopneumonia, unlike other types.” was not adequate, and it was not well matching the contents of the “Results”."
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Wang HJ, Zhang YN, An L. Clinical and radiographic feature of pulmonary nocardiosis: A study of 102 cases. World J Radiol 2026; 18(1): 114552 [PMID: 41640705 DOI: 10.4329/wjr.v18.i1.114552]
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"Please explain in more detail the mechanism of carcinogenesis caused by bile reflux into the esophagus. Author write Bile acids can act through specific signalling pathways, activating nuclear farnesoid X receptor and plasma-membrane-bound G protein-coupled bile acid receptors, and also likely through the interaction between these receptors. The coupling of G protein-coupled bile acid receptor to the stimulatory protein Gs leads to activation of adenylate cyclase, intracellular cAMP accumulation and protein kinase A activation, directly impacting on smooth muscle contractile activity.
Also, the author's theory of how bile reflux reduces esophageal motility is a new and interesting one. I would like to see more detailed research into esophageal motility beyond the 24-hour pH meter.
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Gadelha KKL, Santos AA, Correia-de-Sá P, Magalhães PJC, da Silva MTB. Can bile salts affect the contractile oesophageal activity associated with gastroesophageal reflux disease? World J Gastroenterol 2026; 32(4): 114560 [PMID: 41640876 DOI: 10.3748/wjg.v32.i4.114560]
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"The article presents a coherent and well‑structured argument by explaining why indocyanine green (ICG) fluorescence has become an essential tool in hepatocellular carcinoma surgery and supporting this with evidence from systematic reviews and clinical studies. It logically organizes the diverse applications of ICG—segmental mapping, detection of superficial lesions, thermal ablation guidance, and tumor‑biology assessment—showing how each technique addresses specific surgical limitations. The discussion consistently links fluorescence patterns to pathological features and clinical decision‑making, reinforcing the article’s central claim that ICG enhances precision, safety, and oncologic outcomes in minimally invasive liver surgery."
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Piccolo G, Barabino M, Benuzzi L, Formisano G, Bianchi PP. Clinical applications of indocyanine green fluorescence for the treatment of hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(1): 114339 [PMID: 41607756 DOI: 10.4251/wjgo.v18.i1.114339]
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"The article maintains clear logical flow by presenting a rare SMARCB1‑deficient pancreatic rhabdoid carcinoma case and linking the unusual initial presentation—spontaneous splenic rupture—to the tumor’s aggressive biology. Its diagnostic reasoning is coherent, moving from clinical findings to imaging, pathology, and molecular profiling that distinctly separate the ductal adenocarcinoma and rhabdoid components. The discussion logically integrates existing literature to highlight the rarity, poor prognosis, and potential benefit of aggressive multimodal therapy, underscoring the need for targeted approaches in this molecular subtype."
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Yao WQ, Ma XY, Wang GH. Clinicopathologic features of SMARCB1/INI1-deficient pancreatic undifferentiated rhabdoid carcinoma: A case report and review of literature. World J Gastrointest Oncol 2026; 18(1): 114021 [PMID: 41607752 DOI: 10.4251/wjgo.v18.i1.114021]
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"The article demonstrates strong logical coherence by clearly establishing the clinical gap in evidence for treating esophageal cancer patients with liver metastases and justifying the need to compare chemotherapy alone with chemoimmunotherapy. Its methodology is rigorous and transparent, using well‑defined inclusion criteria, detailed baseline characteristics, and standardized outcome measures such as RECIST, overall survival, and progression‑free survival. The conclusions logically follow from the data, showing that adding immune checkpoint inhibitors significantly improves survival and response rates without increasing severe toxicity, and the study further strengthens its argument by identifying independent prognostic factors through multivariate Cox regression analysis."
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Dai EH, Que SH, Xu H, Zhong GQ, Zhang Z, Liang X, Zhai SW, Li YT, Wang JJ, Feng W. Efficacy and safety of immune checkpoint inhibitors plus chemotherapy in esophageal cancer patients with liver metastases. World J Gastrointest Oncol 2026; 18(1): 113440 [PMID: 41607764 DOI: 10.4251/wjgo.v18.i1.113440]
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"The study presents a logically coherent argument by clearly identifying the clinical gap in evidence for nivolumab‑based chemotherapy in advanced gastric cancer with massive ascites and justifying the need for retrospective evaluation. Its methodology is well‑structured, using clearly defined ascites‑burden groups and standardized clinical criteria to ensure meaningful comparisons of outcomes and safety profiles. The conclusions follow naturally from the data, showing that although prognosis remains poor in the high‑ascites group, nivolumab plus chemotherapy provides measurable ascites improvement and acceptable toxicity, supporting its potential therapeutic value in this challenging population."
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Matsumoto T, Sugimoto S, Omori R, Makiyama C, Nakasya A, Nagai H, Yasui H, Higashi R, Sasamoto A, Satake H. Efficacy and safety of nivolumab plus chemotherapy in patients with advanced gastric cancer with massive ascites. World J Gastrointest Oncol 2026; 18(1): 112944 [PMID: 41607769 DOI: 10.4251/wjgo.v18.i1.112944]
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"The document presents a clear, logical structure with well‑labeled sections and concise summaries that guide the reader through the study’s objectives and findings. The methods and results are supported by detailed experimental design and high‑quality figures and tables, which enhance reproducibility and data transparency. The discussion highlights clinical relevance and practical implications, effectively linking mechanistic insights to potential therapeutic strategies."
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Vescio F, Curcio S, Aquila I, Ammendola M, Tarallo AP. Right patient approach to experimental stromal cell therapies for gastrointestinal tumors. World J Gastrointest Oncol 2026; 18(1): 112630 [PMID: 41607762 DOI: 10.4251/wjgo.v18.i1.112630]
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"Intraductal papillary mucinous neoplasms (IPMN) are clinically important precancerous conditions of the pancreas. Their accurate diagnosis requires a combination of imaging and endoscopic techniques. Pancreatoscopy enables direct visualization of the pancreatic duct, targeted biopsies, and the definition of disease boundaries. Existing data support the view that pancreatoscopy is a satisfactory and promising method for determining which patients with IPMN should undergo surgery, as well as the extent of resection for each patient. However, excessive enthusiasm should not prevail. The method is not widely applied; learning requires a dedicated endoscope and a sufficient number of patients per year to maintain and further increase experience, which is a very important factor. For the widespread acceptance and adoption of the method, it is necessary to conduct prospective, very well-designed multicenter studies aiming to precisely determine many parameters e.g. its diagnostic contribution and accuracy, which patients should undergo the examination, what is the impact on therapeutic decisions, what is the cost-benefit ratio and finally to determine whether it improves the survival and/or quality of life of patients. Based on the above observations, pancreatoscopy should be decided on a case-by-case basis and performed in specialized centers."
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Abusharar M, Barritt C, Mavroeidis VK, Aroori S. Role of pancreatoscopy in the management of suspected and confirmed intraductal papillary mucinous neoplasm of the pancreas. World J Gastroenterol 2026; 32(4): 112635 [PMID: 41640870 DOI: 10.3748/wjg.v32.i4.112635]
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"The paper is highly informative and comprehensive. The authors have gathered and synthesized the most significant and relevant data from the literature, presenting it in a clear and well-structured manner. The review provides valuable insights into the topic, highlights key mechanisms and clinical implications, and offers a solid foundation for future research and practical applications."
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Singh B, Singh H, Kaur S, Singh B. Preclinical pharmacology studies of zingerone with special reference to potential therapeutic applications. World J Immunol 2026; 16(1): 111511 [DOI: 10.5411/wji.v16.i1.111511]
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49
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"The editorial appropriately highlights that the target article opens a new avenue for potential therapeutic strategies in Parkinson’s disease and points out the lack of comprehensive studies to fully elucidate the underlying mechanisms. It also outlines future research directions. Overall, the editorial adds value to the target manuscript by providing complementary discussion and contextualization."
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Chen YX, Sun NQ, Mo SJ. Rhapontin activating nuclear factor erythroid 2-related factor 2 to ameliorate Parkinson’s disease-associated gastrointestinal dysfunction. World J Gastroenterol 2026; 32(4): 114468 [PMID: 41640872 DOI: 10.3748/wjg.v32.i4.114468]
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50
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"The work is a readable, visually clear review that reframes fatty liver through choline metabolism and mitochondrial stress, with solid editorial transparency. Concise upgrades—documented search/selection methods, figure/table evidence anchoring, explicit evidence‑tier labeling with effect sizes, and a short limitations/certainty note—would materially improve objectivity, credibility, and practical value for hepatology and metabolism audiences. The article is transparent on provenance, timelines, and authorship; it also includes a conflict‑of‑interest declaration. These are positives for editorial/ethical standards. For maximal clarity to non‑specialists, consider adding a one‑line ethics note that no new human/animal data were generated and that the work synthesizes published evidence only.
Methodologically, the piece reads as a narrative review. To support quality tracking and reproducibility, please add a concise 'search strategy and selection' box containing the following information: databases used, the exact date of the last search, key terms, language limits, inclusion/exclusion criteria and dual-reviewer screening/extraction. This would substantiate the statement of a comprehensive survey and help readers to assess selection bias.
The figures and tables are clear and helpful. Legends could be strengthened by stating whether panels are conceptual or data-derived, defining all abbreviations at first use, citing the primary sources that support each panel and adding n/assay details when values are quoted. Providing a single, consolidated evidence table per claim (model, dose/exposure, effect size/direction, study type and citation) would further aid readers.
The interpretation is generally cautious, but the evidence tier should be labelled consistently (in vitro vs. animal vs. human) and comparative claims (citicoline vs. α-GPC; LA/ethanol as 'mitochondrial toxins') should be anchored to primary studies with effect directions and context. It is important to explicitly note when human data are pilot/underpowered. A brief paragraph explaining why quantitative synthesis was not feasible (due to heterogeneity of models/endpoints) and a graded certainty statement for each major conclusion would prevent 'vote-counting'.
The biostatistics and data availability could be improved. Where numerical differences are cited in tables or text (e.g. '2.6-fold increase in plasma choline' or 'up to 30% reduction in triglycerides in preclinical models'), include the study design, sample size, comparator and 95% confidence intervals (CIs) where available. Consider including a small supplementary file with raw or minimally processed values from the cited studies."
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Mercola J. Fatty liver reexamined choline and mitochondrial toxin amelioration. World J Biol Chem 2025; 16(4): 111831 [PMID: 41378252 DOI: 10.4331/wjbc.v16.i4.111831]
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