Zeng C, Lin XY, Ye SY, Zhao CF. Paradigm shift in postoperative monitoring: Integrating dynamic ultrasound and biomarkers for precision management following laparoscopic gastrectomy. World J Gastrointest Surg 2026; 18(8): 118327 [DOI: 10.4240/wjgs.118327]
Corresponding Author of This Article
Cheng-Fei Zhao, MD, PhD, Associate Professor, School of Pharmacy and Medical Technology, Putian University, No. 1133 Xueyuan Road, Chengxiang District, Putian 351100, Fujian Province, China. zhaochengfei209@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
editorial
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Zeng C, Lin XY, Ye SY, Zhao CF. Paradigm shift in postoperative monitoring: Integrating dynamic ultrasound and biomarkers for precision management following laparoscopic gastrectomy. World J Gastrointest Surg 2026; 18(8): 118327 [DOI: 10.4240/wjgs.118327]
World J Gastrointest Surg. Aug 27, 2026; 18(8): 118327 Published online Aug 27, 2026. doi: 10.4240/wjgs.118327
Paradigm shift in postoperative monitoring: Integrating dynamic ultrasound and biomarkers for precision management following laparoscopic gastrectomy
Chen Zeng, Xin-Yun Lin, Shen-Yi Ye, Cheng-Fei Zhao
Chen Zeng, Department of Ultrasound, Affiliated Hospital of Putian University, Putian University, Putian 351100, Fujian Province, China
Xin-Yun Lin, Shen-Yi Ye, Cheng-Fei Zhao, School of Pharmacy and Medical Technology, Putian University, Putian 351100, Fujian Province, China
Cheng-Fei Zhao, Key Laboratory of Pharmaceutical Analysis and Laboratory Medicine, Putian University, Putian 351100, Fujian Province, China
Co-first authors: Chen Zeng and Xin-Yun Lin.
Author contributions: Zeng C and Lin XY mainly wrote this paper; Zhao CF and Zeng C mainly designed this paper; Zeng C, Lin XY, Ye SY, and Zhao CF checked and proofread this paper; Zeng C, Lin XY, Ye SY, and Zhao CF searched related literatures and information for this paper. All authors have read and approve the final manuscript. Zeng C and Lin XY contributed equally to this work as co-first authors.
Supported by Scientific Research Project of Putian University, No. 2022059; Special Project for Outstanding Young Talents of Putian University, No. 2024072; and Natural Science Foundation of Fujian Province, No. 2023J01160.
Conflict-of-interest statement: The authors declare that there is no conflict of interest in this paper.
Corresponding author: Cheng-Fei Zhao, MD, PhD, Associate Professor, School of Pharmacy and Medical Technology, Putian University, No. 1133 Xueyuan Road, Chengxiang District, Putian 351100, Fujian Province, China. zhaochengfei209@163.com
Received: December 30, 2025 Revised: January 20, 2026 Accepted: February 3, 2026 Published online: August 27, 2026 Processing time: 228 Days and 13.5 Hours
Abstract
The advent of laparoscopic gastrectomy has significantly advanced the surgical management of gastric cancer by emphasizing minimally invasive techniques and enhanced recovery protocols. Nevertheless, postoperative intraperitoneal effusion remains a frequent and potentially severe complication, with risks including infection, abscess formation, and anastomotic leakage. Conventional monitoring methods, which rely on clinical symptoms and nonspecific inflammatory markers, often result in delayed diagnosis, thereby missing the critical window for early intervention. The recent study by Gao et al, published in World Journal of Gastrointestinal Surgery, presents a robust framework for a more refined and integrated surveillance approach. The authors demonstrate that systematic transabdominal ultrasonography-particularly when differentiating the nature of effusion (simple vs mixed)-combined with serial measurements of the biomarker procalcitonin, enables accurate identification of high-risk patients at the crucial 72-hour postoperative milestone. This editorial critically evaluates these findings, situates them within the broader context of enhanced recovery after surgery principles and precision medicine, and explores their implications for advancing clinical practice. We contend that the integration of dynamic, multimodal monitoring represents an essential shift from reactive complication management to proactive risk stratification and prevention, with the ultimate goal of improving patient outcomes and optimizing healthcare efficiency in surgical oncology.
Core Tip: Postoperative intraperitoneal effusion remains a significant clinical challenge following laparoscopic gastrectomy. This editorial highlights a paradigm shift toward proactive and precision-driven postoperative monitoring, as supported by emerging evidence. The integration of dynamic transabdominal ultrasonography-particularly the assessment of effusion characteristics (simple vs mixed echogenicity) at the critical 72-hour postoperative milestone-with serial procalcitonin measurements constitutes a superior dual-modality strategy for early risk stratification. This combined approach enables the timely identification of high-risk patients who are likely to develop infectious complications before clinical deterioration occurs. Incorporating this structured surveillance protocol into enhanced recovery after surgery pathways exemplifies a transition from reactive management to preemptive intervention, thereby improving patient outcomes, optimizing resource utilization, and advancing the delivery of personalized postoperative care in surgical oncology.
