{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:12:31Z","timestamp":1788307951488,"version":"build-2803163510"},"reference-count":36,"publisher":"Baishideng Publishing Group Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastrointest Surg"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Duodenal stump fistula (DSF) is a rare yet serious complication following gastric cancer surgery. The risk factors associated with DSF, as well as the predictive models, remain insufficiently elucidated.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To identify DSF risk factors following radical gastrectomy with Roux-en-Y anastomosis, develop a predictive model, and evaluate impact on prognosis.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>This retrospective cohort study was conducted on patients undergoing radical gastrectomy with Roux-en-Y anastomosis for gastric cancer at Juntendo University from 2015 to 2021 (n  = 325). Univariate and multivariate analyses were performed to identify the risk factors associated with DSF. Based on the independent risk factors, a predictive nomogram was developed and subsequently evaluated using receiver operating characteristic curve analysis. Kaplan-Meier survival curves were utilized to assess the impact of DSF on overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS).<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Among the 325 patients analyzed, DSF was observed in 7 (2.2%) cases. No DSF was observed in 110 patients where the duodenal stump suturing fixation technique to the jejunal wall was used. Multivariate analysis confirmed that age [odds ratio (OR) = 1.17, P  = 0.015] and obstructive ventilatory failure (OVF) (OR = 14.03, P  = 0.001) were independent risk factors for DSF. The predictive nomogram was constructed based on age and OVF, which exhibited strong performance (area under the curve = 0.90, 95% confidence interval: 0.82-0.99). Kaplan-Meier analysis revealed a statistically significant reduction in CSS for patients with DSF, whereas no significant differences were observed in OS or DFS.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>Age and OVF are independent risk factors for DSF, which worsens CSS. A nomogram predicts DSF accurately, and innovative surgical techniques may reduce its occurrence.<\/jats:p>","DOI":"10.4240\/wjgs.v17.i6.104333","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T15:46:21Z","timestamp":1748533581000},"source":"Crossref","is-referenced-by-count":1,"title":["Predictive model and prognostic insights into duodenal stump fistula following radical gastrectomy with Roux-en-Y reconstruction for gastric cancer"],"prefix":"10.4240","volume":"17","author":[{"given":"Yang","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanae","family":"Kaji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Yube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motomi","family":"Nasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Yoshimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asako","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Orita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Ecoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuko","family":"Nojiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Mine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-You","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsu","family":"Fukunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00747-0"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-022-01331-8"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-014-0445-0"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i24.7571"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.02.042"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-024-01538-x"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2020.20.e4"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-019-0520-x"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4174\/astr.2016.90.3.157"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-013-0327-x"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/jso.22045"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2023.0259"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-024-02423-1"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2022.0454"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21614\/chirurgia.111.5.400"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.79879"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201204-0596PP"},{"key":"B18","unstructured":"WHO.   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