Background and Objectives: Metabolic syndrome (MetS) is characterized by a cluster of metabolic abnormalities, including abdominal obesity, hyperglycemia, insulin resistance, dyslipidemia, and hypertension. Growing evidence suggests that these components may contribute to the development of gastrointestinal (GI) malignancies. This review aims to explore the association between MetS and GI cancers, including esophageal, gastric, pancreatic, and colorectal cancers. Materials and Methods: A narrative literature review was conducted using PubMed, incorporating 22 sources published between 1991 and 2024. Search terms included “gastrointestinal malignant tumors”, “metabolic syndrome”, “diabetes mellitus”, and “obesity”. Priority was given to large-scale studies from Europe, America, and Asia. Case reports, commentaries, and conference abstracts were excluded. Results: By analyzing the available literature data, this study determined that hyperinsulinemia (IGF-1 pathway), hyperglycemia, and obesity (>102 cm in men and >88 cm in women) are highly associated with the development of esophageal cancer (primarily with Barret’s long and short segment as precancerosis), gastric cancer (through reactive oxygen species), and both pancreatic (1.5–2.4 higher risk) and colorectal cancer (30% higher risk). Patients with a high BMI (>40 kg/m²) show a 20%- or 1.18-times greater risk of developing colorectal cancer and a 1.72-times higher risk of developing pancreatic cancer. There is not enough evidence on the specific influence of hypertriglyceridemia, low HDL cholesterol, and high blood pressure on the development of gastrointestinal malignancy. However, those three conditions have shown a low to moderate association (from 6% to 12%) with the development of colorectal cancer. Conclusions: Metabolic syndrome (MetS) is increasingly being recognized as a significant risk factor for the development and progression of gastrointestinal cancers. Key components such as obesity, hyperglycemia, insulin resistance, and type 2 diabetes mellitus appear to contribute to carcinogenesis through mechanisms involving chronic inflammation, oxidative stress, and immune dysregulation. Further research is needed to clarify the biological pathways linking MetS to gastrointestinal malignancies and to inform effective prevention strategies.

Background and Objectives: The treatment of duodenal injuries remains one of the most challenging issues in clinical surgery due to their high morbidity and mortality rates. The primary objective of this study was to evaluate the histopathology and other diagnostic outcomes of wound repair following surgical reconstruction of large experimental duodenal defects using synthetic (ePTFE, expanded polytetrafluoroethylene) or organic (JSP, jejunal serosal patch) materials. Materials and Methods: A total of 20 European rabbits were randomly divided into two equal groups (n = 10 each). A grade III defect covering over 50% of the duodenum’s circumference was created in the second part of the duodenum of the rabbits. The anesthesia, duodenal injury, postoperative care, and animal sacrifice protocols were identical for all experimental rabbits. The effectiveness of JSP and ePTFE patch repair techniques was investigated based on clinical, macroscopic, and microscopic assessments at two and four weeks postoperatively. Results: Survival rates were comparable between groups (p > 0.05). Remarkable mucosal regeneration was evident in all experimental animals by two weeks, showing complete coverage of the jejunal serosal and ePTFE patches by re-epithelialized mucosa with functional villus formation. While partial development of the underlying muscular and serosal layers was observed in both groups at four weeks, the JSP group achieved a significantly higher median histological score (19 vs. 14; p = 0.003). Conversely, the ePTFE group exhibited a major safety concern: a highly significant increase (p ≤ 0.001) in Grade 4 dense, inseparable adhesions throughout the abdominal cavity, which were entirely absent in the JSP group. Conclusions: Both JSP and ePTFE are viable for duodenal reconstruction, but the autologous JSP is superior in tissue healing and safety. Severe adhesions associated with ePTFE constitute a significant clinical concern, limiting its use to a second-line alternative. Consequently, JSP is the preferred option, while ePTFE requires further long-term safety validation.

Low Anterior Resection Syndrome (LARS) is a common functional disorder following sphincter-preserving surgery for rectal cancer, significantly affecting patients’ quality of life. Its development is multifactorial and influenced by surgical factors, including the use of a diverting stoma, as well as perioperative management. The aim of this study was to evaluate the incidence and severity of LARS and to analyze its association with selected clinical and treatment-related variables. A retrospective analysis was conducted on 40 patients who underwent low anterior resection for rectal cancer. Functional outcomes were assessed using the validated LARS score questionnaire, and patients were classified into no LARS, minor LARS, and major LARS groups. Variables analyzed included type of surgery (with or without diverting stoma), preoperative radiotherapy, anastomotic leakage, and timing of stoma reversal. Among the included patients, 10 (25%) had no LARS, 12 (30%) had minor LARS, and 18 (45%) had major LARS. A higher proportion of major LARS was observed among patients who underwent surgery with a diverting stoma than among those without stoma protection. Delayed stoma reversal (more than 2 months) was strongly associated with severe LARS, whereas early reversal (less than 2 months) was not associated with major symptoms. Preoperative radiotherapy and anastomotic leakage were also associated with grater LARS severity. These findings emphasize the role of surgical planning and perioperative management in minimizing the functional impact of LARS. Further studies are required to better define risk factors and optimize postoperative bowel function in affected patients.

The biliary system is well known for its anatomical variability. Precise imaging and evaluation of the cystic duct are essential for surgeons and interventional radiologists. Herein we reported a rare case of cystic duct variation. Coronal oblique 3D magnetic resonance cholangiopancreatography (MRCP) revealed a posterior spiral course of the cystic duct, with a medial spiral insertion into the middle part of the extrahepatic bile duct. Intraoperative cholangiography confirmed this finding. Specific anatomical variations might require modifications to the surgical approach. Understanding the cystic duct anatomy, variants, and disease processes aids in better diagnosis and interpretation of imaging results. MRCP is essential for providing key anatomical information and helps to reduce the risk of complications during percutaneous, endoscopic, and surgical procedures.   DOI of the original article: 10.5937/afmnai42-53669Retraction DOI: 10.65641/afmnai-2025-170