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Clinical Innovations in Digestive Disease Diagnosis and Treatment
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Clinical Innovations in Digestive Disease Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 March 2025 | Viewed by 6104

Special Issue Editors

Prof. Dr. Stefano Rausei

E-Mail Website
Guest Editor
General Surgery Unit, Department of Surgery, Cittiglio-Angera Hospital, ASST SetteLaghi, 21100 Varese, Italy
Interests: surgical oncology; gastric cancer; colon cancer; minimally invasive surgery; emergency surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Angelo Benevento

E-Mail Website
Guest Editor
General Surgery Unit, Department of Surgery, Gallarate Hospital, ASST Valle Olona, 21052 Busto Arsizio, Italy
Interests: digestive disease; laparoscopic surgery; surgical oncology; gastric cancer; colon cancer; minimally invasive surgery; emergency surgery

Special Issue Information

Dear Colleagues,

This Special Issue aims to highlight the latest advancements in the diagnosis and treatment of digestive diseases, with a focus on clinical innovations. The overarching goal is to address current challenges in the field and provide a comprehensive overview of the research status. Core problems, such as the need for improved diagnostic methods and innovative therapeutic interventions, will be emphasized. The scope of the Special Issue encompasses a wide range of topics, including novel diagnostic technologies, new therapeutic approaches and advancements for inflammatory bowel disease (IBD), early digestive cancers, emergencies in gastrointestinal surgical oncology, anastomotic leakage after surgery, etc. We encourage contributions such as research articles, case studies, and reviews that explore issues such as precision medicine applications, minimally invasive procedures, and the impact of lifestyle on digestive health.

We invite experts in gastroenterology, clinicians, and researchers to contribute their latest findings and experiences. By mobilizing knowledge within this Special Issue, we aim to foster collaboration, encourage idea exchange, and collectively work toward addressing challenges associated with digestive diseases. Additionally, contributions from the National Congress of the Italian Society of Digestive Disease (SIPAD, https://www.sipad.it/area_02_eventi/nazionale_2024.html) scheduled for next May 30–31 in Varese (Italy) are especially welcome, adding valuable insights to this dynamic and evolving field.

Prof. Dr. Stefano Rausei
Prof. Dr. Angelo Benevento
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastroenterology
  • digestive diseases
  • gastrointestinal endoscopy
  • upper GI surgery
  • colorectal surgery
  • hepatobiliary surgery
  • anastomotic leakage
  • gastrointestinal surgical oncology
  • inflammatory bowel disease
  • precision medicine in gastroenterology
  • minimally invasive gastrointestinal procedures
  • SIPAD congress contributions

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Published Papers (4 papers)

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Research

9 pages, 252 KiB  
Article
Quadruple Assessment of Colorectal Anastomosis after Laparoscopic Rectal Resection: A Retrospective Analysis of a Propensity-Matched Cohort
by Filippo Carannante, Guglielmo Niccolò Piozzi, Valentina Miacci, Gianfranco Bianco, Gennaro Melone, Vincenzo Schiavone, Gianluca Costa, Marco Caricato, Jim S. Khan and Gabriella Teresa Capolupo
J. Clin. Med. 2024, 13(17), 5092; https://doi.org/10.3390/jcm13175092 - 27 Aug 2024
Viewed by 1026
Abstract
Background: Anastomotic leakage (AL) is one of the most feared complications in colorectal surgery, with an incidence of 12–39% and associated risk of mortality of 2–24%. The causes of AL and the ways to prevent it are currently under investigation. This study aims [...] Read more.
Background: Anastomotic leakage (AL) is one of the most feared complications in colorectal surgery, with an incidence of 12–39% and associated risk of mortality of 2–24%. The causes of AL and the ways to prevent it are currently under investigation. This study aims to verify if a quadruple assessment of colorectal anastomosis could reduce AL incidence. Methods: A retrospective analysis of prospectively collected data on rectal cancer surgery performed from January 2015 to December 2017 and from January 2021 to December 2023 at a tertiary referral cancer centre was performed. Demographics, clinicopathological features, short-term outcomes, recurrences, and survival were investigated. Results: A total of 293 patients were enrolled. AL incidence was lower in the quadruple assessment group than in the control group, reaching a statistically significant result (7.7% vs. 16%; p = 0.001). This result was also confirmed after a propensity score match analysis (PSM), in which the AL rate was lower in the quadruple assessment group (5.4% vs. 12.3%; p = 0.01). Conclusions: This study shows how the systematic implementation of a quadruple assessment when performing a colorectal anastomosis could increase awareness on anastomotic success and reduce the incidence of AL. Full article
(This article belongs to the Special Issue Clinical Innovations in Digestive Disease Diagnosis and Treatment)
18 pages, 2404 KiB  
Article
Relationship between Circadian System Status, Child–Pugh Score, and Clinical Outcome in Cirrhotic Patients on Waiting Lists for Liver Transplantation
by Laura Martínez-Alarcón, Antonio Martínez-Nicolás, Marta Jover-Aguilar, Víctor López-López, Felipe Alconchel-Gago, Antonio Ríos, Juan Antonio Madrid, María de los Ángeles Rol, Pablo Ramírez and Guillermo Ramis
J. Clin. Med. 2024, 13(15), 4529; https://doi.org/10.3390/jcm13154529 - 2 Aug 2024
Viewed by 2511
Abstract
Background/Objectives: Many patients suffering from liver cirrhosis are eventually added to waiting lists for liver transplantation whose priority is established based on scales such as the Child–Pugh score. However, two marker rhythms of the circadian system, motor activity and distal temperature, are not [...] Read more.
Background/Objectives: Many patients suffering from liver cirrhosis are eventually added to waiting lists for liver transplantation whose priority is established based on scales such as the Child–Pugh score. However, two marker rhythms of the circadian system, motor activity and distal temperature, are not evaluated. Methods: To determine the relationship between the functional status of the circadian system and the Child–Pugh scale in patients awaiting liver transplantation, distal temperature, motor activity, and light exposure rhythms were monitored for a full week using a wrist device (Kronowise 6.0) in 63 patients (17 women, 46 men) aged between 20 and 76 years. Results: Circadian parameters (amplitude, regularity, and fragmentation) of motor activity rhythms, distal temperature, and light exposure worsen in close association with liver disease severity as assessed by using the Child–Pugh score. Likewise, the worsening of rhythmic parameters and liver disease is associated with a deterioration in the markers of the red series: count, hemoglobin, and hematocrit. Conclusions: These results indicate the utility of ambulatory monitoring of marker rhythms to complement the clinical information provided by the Child–Pugh scale and to help establish nutrition, physical exercise, and sleep guidelines that promote better survival and quality of life in these patients. Full article
(This article belongs to the Special Issue Clinical Innovations in Digestive Disease Diagnosis and Treatment)
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19 pages, 302 KiB  
Article
Adherence to Guidelines for Diagnosis, Staging, and Treatment for Gastric Cancer in Italy According to the View of Surgeons and Patients
by Manrica Fabbi, Marika Sharmayne Milani, Simone Giacopuzzi, Carlo De Werra, Franco Roviello, Claudia Santangelo, Federica Galli, Angelo Benevento and Stefano Rausei
J. Clin. Med. 2024, 13(14), 4240; https://doi.org/10.3390/jcm13144240 - 20 Jul 2024
Viewed by 898
Abstract
Background: Despite the strong declining trends in incidence and mortality over the last decades, gastric cancer (GC) is still burdened with high mortality, even in high-income countries. To improve GC prognosis, several guidelines have been increasingly published with indications about the most [...] Read more.
Background: Despite the strong declining trends in incidence and mortality over the last decades, gastric cancer (GC) is still burdened with high mortality, even in high-income countries. To improve GC prognosis, several guidelines have been increasingly published with indications about the most appropriate GC management. The Italian Society of Digestive System Pathology (SIPAD) and Gastric Cancer Italian Research Group (GIRCG) designed a survey for both surgeons and patients with the purpose of evaluating the degree of application and adherence to guidelines in GC management in Italy. Materials and Methods: Between January and May 2022, a questionnaire has been administered to a sample of Italian surgeons and, in a simplified version, to members of the Patient Association “Vivere Senza Stomaco” (patients surgically treated for GC between 2008 and 2021) to investigate the diagnosis, staging, and treatment issues. Results: The survey has been completed by 125 surgeons and 125 patients. Abdominal CT with gastric hydro-distension before treatment was not widespread in both groups (47% and 42%, respectively). The rate of surgeons stating that they do not usually perform minimally invasive gastrectomy was 15%, but the rate of patients who underwent a minimally invasive approach was 22% (between 2011 and 2022). The percentage of surgeons declaring to perform extended lymphadenectomy (>D2) was 97%, although a limited lymph node dissection rate was observed in about 35% of patients. Conclusions: This survey shows several important discrepancies from surgical attitudes declared by surgeons and real data derived from the reports available to the patients, suggesting heterogeneous management in clinical practice and, thus, a not rigorous adherence to the guidelines. Full article
(This article belongs to the Special Issue Clinical Innovations in Digestive Disease Diagnosis and Treatment)
16 pages, 1496 KiB  
Article
Identifying Novel Subtypes of Functional Gastrointestinal Disorder by Analyzing Nonlinear Structure in Integrative Biopsychosocial Questionnaire Data
by Sa-Yoon Park, Hyojin Bae, Ha-Yeong Jeong, Ju Yup Lee, Young-Kyu Kwon and Chang-Eop Kim
J. Clin. Med. 2024, 13(10), 2821; https://doi.org/10.3390/jcm13102821 - 10 May 2024
Cited by 1 | Viewed by 993
Abstract
Background/Objectives: Given the limited success in treating functional gastrointestinal disorders (FGIDs) through conventional methods, there is a pressing need for tailored treatments that account for the heterogeneity and biopsychosocial factors associated with FGIDs. Here, we considered the potential of novel subtypes of FGIDs [...] Read more.
Background/Objectives: Given the limited success in treating functional gastrointestinal disorders (FGIDs) through conventional methods, there is a pressing need for tailored treatments that account for the heterogeneity and biopsychosocial factors associated with FGIDs. Here, we considered the potential of novel subtypes of FGIDs based on biopsychosocial information. Methods: We collected data from 198 FGID patients utilizing an integrative approach that included the traditional Korean medicine diagnosis questionnaire for digestive symptoms (KM), as well as the 36-item Short Form Health Survey (SF-36), alongside the conventional Rome-criteria-based Korean Bowel Disease Questionnaire (K-BDQ). Multivariate analyses were conducted to assess whether KM or SF-36 provided additional information beyond the K-BDQ and its statistical relevance to symptom severity. Questions related to symptom severity were selected using an extremely randomized trees (ERT) regressor to develop an integrative questionnaire. For the identification of novel subtypes, Uniform Manifold Approximation and Projection and spectral clustering were used for nonlinear dimensionality reduction and clustering, respectively. The validity of the clusters was assessed using certain metrics, such as trustworthiness, silhouette coefficient, and accordance rate. An ERT classifier was employed to further validate the clustered result. Results: The multivariate analyses revealed that SF-36 and KM supplemented the psychosocial aspects lacking in K-BDQ. Through the application of nonlinear clustering using the integrative questionnaire data, four subtypes of FGID were identified: mild, severe, mind-symptom predominance, and body-symptom predominance. Conclusions: The identification of these subtypes offers a framework for personalized treatment strategies, thus potentially enhancing therapeutic outcomes by tailoring interventions to the unique biopsychosocial profiles of FGID patients. Full article
(This article belongs to the Special Issue Clinical Innovations in Digestive Disease Diagnosis and Treatment)
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