Treatment options for medication- and diet-resistant gastroparesis include drainage procedures such as pyloroplasty and gastric peroral endoscopic myotomy (G-POEM). While dumping syndrome (DS) and bile acid gastritis (BAG) have been documented as complications following pyloric drainage procedures, limited evidence exists concerning their incidence after pyloroplasty and G-POEM for refractory gastroparesis. We performed a systematic review of outcomes following pyloroplasty and G-POEM for refractory gastroparesis (PROSPERO: CRD42024559654). PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for articles reporting rates of DS and BAG following pyloric drainage procedures. Assessed outcomes included rates of DS and BAG. Results were narratively synthesized and presented descriptively. Of the 2278 records reviewed, 10 studies were included. Six studies evaluated pyloroplasty, and four studies evaluated G-POEM. Nine studies reported incidence of DS, and two studies reported rates of BAG. The incidence of DS ranged from 0% to 23.1%, with a median incidence of 3.23% and an interquartile range of 6.95% among nine studies. The incidence of BAG ranged from 0% to 15.4% in two studies. The studies displayed high heterogeneity in study design, patient population, and co-interventions, precluding collective data analysis and limiting generalizability. All studies displayed a moderate to serious risk of bias. There exists a paucity of data regarding the incidence of DS and BAG following pyloroplasty and G-POEM for refractory gastroparesis. Despite the theoretical association of these complications with pylorus-modifying procedures, our findings suggest that they may be uncommon or underreported in the treatment of refractory gastroparesis. Improved reporting of these outcomes and robust prospective studies investigating the incidence of such complications are required.

Background: Bibliometric comparisons can describe highly cited literature but do not represent the full output of a discipline. The NIH-supported Relative Citation Ratio (RCR) field- and time-normalizes citation rates, while the Altmetric Attention Score (AAS) summarizes online attention. This study compared article-level metrics and bibliometric features among the 1000 most-cited English-language publications per decade in the Web of Science (WoS) categories Anesthesia, Surgery, and Medicine during 1980–2019. Methods: The 1000 most-cited English-language records per decade in the WoS categories Anesthesia, Surgery, and Medicine were retrieved for four decades, 1980–2019, in September 2024. Mean RCRs were obtained from iCite. AAS values were obtained through Dimensions AI and treated as cross-sectional scores measured at the extraction date because historical attention-source coverage was not equivalent. Bibliometric features were summarized for this selected sample. Data linkage and analytic denominators: The 12 category-by-decade datasets each began with 1000 selected records, for 12,000 selections in total. The supplied analysis materials did not include a record-level flow table showing successful linkage to PMID/iCite, DOI/AAS, affiliations, or keyword fields for each field and decade. These counts were not imputed or reconstructed and are reported as a limitation. Results: Within this selected sample, MED had higher RCR values across the study period, whereas ANE and SUR did not show the same increase in RCR from their 1980s values. AAS values were summarized descriptively and were not interpreted as equivalent longitudinal growth because historical coverage and post-publication observation time differed. Funding rankings differed by measure: ANE had the highest NIH-funded proportion in 2010–2019, whereas MED had the highest non-NIH funding proportion. Semantic concentration measures varied by field and metric. Conclusions: Within this selected sample, ANE and SUR did not show the same increase in RCR observed for MED. Semantic measures showed field- and metric-specific changes. These descriptive findings do not establish that topic diversity, collaboration, or journal concentration caused differences in influence, and they should not be generalized to all anesthesiology, surgery, or medicine publications.

We report the case of a 14-year-old patient with a known history of Crohn's disease who was incidentally diagnosed with an asymptomatic cecal lipoma. A routine surveillance colonoscopy as part of the management of the patient's Crohn's Disease revealed a well-defined, submucosal, yellowish mass in the patient's cecum. Histopathological examination of a biopsy specimen revealed submucosal adipose tissue, consistent with the endoscopic images showing the characteristic appearance of the lipoma. A computed tomography examination further confirmed the diagnosis. While colonic lipomas are infrequent and typically manifest later in life, few cases report the coexistence of a cecal lipoma with Crohn's disease, particularly in the pediatric population. In this case, managing this dual condition posed a notable challenge. Here, we present the conservative approach to managing a pediatric patient with cecal lipoma and Crohn's disease. The decision to leave the lipoma in situ was based on the absence of symptoms and potential risks associated with surgical removal.