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Digestive Surgery

Manabu Yamamoto, Hiroaki Saito, Chihiro Uejima, Akimitsu Tanio, Seigo Takaya, Keigo Ashida, Yoshiyuki Fujiwara
BACKGROUND: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. METHODS: We enrolled 379 patients who underwent surgery for colorectal cancer (CRC) to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in patients with CRC. RESULTS: Pre- and postoperative LCs were significantly correlated (r = 0...
September 14, 2018: Digestive Surgery
Kazunosuke Yamada, Shunsuke Tsukamoto, Hiroki Ochiai, Dai Shida, Yukihide Kanemitsu
INTRODUCTION: The clinical benefit of extended lymphadenectomy for synchronous extraregional lymph node metastasis, such as para-aortic lymph node (PALN) metastasis in colorectal cancer, remains highly controversial. AIM: To evaluate the clinical benefit of PALN dissection in colorectal cancer patients with synchronous PALN metastasis with or without multiorgan metastases. METHODS: Thirty-six patients with pathologically positive PALN metastasis below the renal veins who underwent concurrent PALN dissection and primary colorectal cancer resection from January 1984 through September 2011 at the National Cancer Center Hospital in Tokyo, Japan, were included in this retrospective cohort study...
July 25, 2018: Digestive Surgery
Rüdiger Braun, Hans-Peter Bruch, Tobias Keck, Claudia Benecke, Martin Hoffmann
BACKGROUND: Despite multimodal treatment strategies, locoregional recurrence rates are still significant in colorectal carcinoma (CRC). METHODS: Clinical, pathological, perioperative, and survival data of 203 patients with recurrent CRC enlisted in a prospective database from 1990 to 2011 were analyzed. RESULTS: Median disease-free survival in our cohort of 203 patients was 23 months after resection of the primary tumor. In total, 113 of these patients had surgical therapy with resection of the recurrent tumor...
July 20, 2018: Digestive Surgery
Simone Conci, Andrea Ruzzenente, Francesca Bertuzzo, Tommaso Campagnaro, Alfredo Guglielmi, Calogero Iacono
BACKGROUND: Total dorsal pancreatectomy (TDP) is a conservative pancreatic resection that should be considered in cases of benign or low malignant tumors confined to the dorsal pancreas to preserve the viability of both digestive and biliary tracts, and to avoid the endocrine and metabolic consequences of total pancreatectomy. We report a new case of TDP and provide a literature review of this procedure. METHODS: The case reported was a 35-year-old female patient with a solid pseudopapillary tumor...
July 13, 2018: Digestive Surgery
Chinock Cheong, Seung Yeop Oh, Soo Jeong Choi, Kwang Wook Suh
BACKGROUNDS/AIMS: On the basis of acceptable oncologic results, ultralow anterior resection (ULAR) and colo-anal anastomosis plus hand-sewn coloanal anastomosis have been performed for treating very low-lying rectal cancer. However, many patients experience bowel dysfunction after ULAR. Studies have provided inadequate data on bowel dysfunctions and only a few functional studies have focused on low rectal cancer. Therefore, we aimed to elucidate the severity of bowel dysfunction after ULAR in a single-surgeon cohort...
July 10, 2018: Digestive Surgery
Fortuné M K Elekonawo, Manon M D van der Meeren, Geert A Simkens, Johannes H W de Wilt, Ignace H de Hingh, Andreas J A Bremers
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with considerable postoperative morbidity, including ileus and infectious complications. Perioperative care is believed to be an important factor for the development and treatment of postoperative morbidity. PATIENTS AND METHODS: Data on case-matched patients from a retrospective database of 2 Dutch HIPEC centres was compared. Patient selection and procedures were identical in both hospitals although perioperative management items differ slightly...
July 6, 2018: Digestive Surgery
Hiroaki Niitsu, Hiroaki Tsumura, Tetsuya Kanehiro, Hiroaki Yamaoka, Hiroyuki Taogoshi, Naoki Murao
AIM: To study the characteristics and surgical treatment of inguinal endometriosis (IEM), which can occur in women of reproductive age. METHODS: Patients who underwent groin surgery at the Hiroshima City Funairi Citizens Hospital between 2004 and 2017 were retrospectively examined. Patients with IEM were divided into 3 groups based on the site of occurrence as follows: at a hernia sac or hydrocele of Nuck's canal (type I), round ligament (type II), or subcutaneous area (type III)...
July 5, 2018: Digestive Surgery
Alberto Biondi, Domenico D'Ugo, Ferdinando Cananzi, Stefano Rausei, Federico Sicoli, Francesco Santullo, Antonio Laurino, Laura Ruspi, Francesco Belia, Vittorio Quagliuolo, Roberto Persiani
INTRODUCTION: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. METHODS: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. RESULTS: A total of 122 stage IV gastric cancer patients were assessed...
June 26, 2018: Digestive Surgery
Shinya Hayami, Masaki Ueno, Manabu Kawai, Toshiyuki Kuriyama, Tomoyuki Kawamata, Hiroki Yamaue
BACKGROUND/AIMS: Postoperative urinary retention (POUR) is one of the most frequent complications of epidural anesthesia. This study aims to clarify risk factors of POUR and to estimate the appropriate timing of urethral catheter removal. METHODS: Between September and December 2014, a retrospective cohort study was conducted on 120 patients who underwent epidural anesthesia and major abdominal surgery. To observe trends in incidence of POUR, we analyzed the order and interval of removal of epidural and urethral catheters using Cochran-Armitage trend test...
June 26, 2018: Digestive Surgery
Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Takuro Fushimi, Toshiyoshi Fujiwara, Takahito Yagi
BACKGROUND/AIMS: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. METHODS: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years)...
June 26, 2018: Digestive Surgery
Huai-Ming Sang, Jiu-Liang Cao, Muhammad Djaleel Soyfoo, Wei-Ming Zhang, Jian-Xia Jiang, Shun-Fu Xu
BACKGROUND/AIMS: To correlate the endoscopic characteristics with the histopathology of specimens of esophageal high-grade intraepithelial neoplasia obtained by endoscopic submucosal dissection (ESD). METHODS: This was a retrospective study developed from January 2010 to December 2015. The study included 169 patients who underwent ESD and were diagnosed with esophageal high-grade intraepithelial neoplasia according to endoscopic forceps biopsy, Lugol staining, endoscopic ultrasonography, computed tomography, and Narrow-Band Imaging...
June 26, 2018: Digestive Surgery
Stefano Siboni, Emanuele Asti, Pamela Milito, Gianluca Bonitta, Andrea Sironi, Alberto Aiolfi, Luigi Bonavina
BACKGROUND: Laparoscopic surgery has proven safe and effective in the treatment of large hiatus hernia. Differences may exist between objectively assessed surgical outcomes, symptomatic scores, and patient-reported outcomes. METHODS: An observational, single-arm cohort study was conducted in patients undergoing primary laparoscopic repair with crura mesh augmentation and Toupet fundoplication for large (> 50% of intrathoracic stomach) type III-IV hiatus hernia...
June 20, 2018: Digestive Surgery
Victor D Plat, Nora van Gaal, James A Covington, Matthew Neal, Tim G J de Meij, Donald L van der Peet, Babs Zonderhuis, Geert Kazemier, Nanne K H de Boer, Freek Daams
BACKGROUND: Esophagectomy or pancreaticoduodenectomy is the standard surgical approach for patients with tumors of the esophagus or pancreatic head. Postoperative mortality is strongly correlated with the occurrence of anastomotic leakage (AL). Delay in diagnosis leads to delay in treatment, which ratifies the need for development of novel and accurate non-invasive diagnostic tests for detection of AL. Urinary volatile organic compounds (VOCs) reflect the metabolic status of an individual, which is associated with a systemic immunological response...
June 15, 2018: Digestive Surgery
Annefleur E M Berkel, Joost M Klaase, Feike de Graaff, Marjolein G J Brusse-Keizer, Bart C Bongers, Nico L U van Meeteren
BACKGROUND/AIMS: To investigate the relation between skeletal muscle measurements (muscle mass, radiation attenuation, and sarcopenic obesity), postoperative morbidity, and survival after treatment of locally advanced rectal cancer. METHODS: This explorative retrospective study identified 99 consecutive patients who underwent neoadjuvant chemoradiation and surgery between January 2007 and May 2012. Skeletal muscle mass was measured as total psoas area and total abdominal muscle area (TAMA) at 3 anatomical levels using the patient's preoperative computed tomography scan...
June 13, 2018: Digestive Surgery
Ryo Ashida, Yukiyasu Okamura, Kanako Wakabayashi-Nakao, Takashi Mizuno, Shuichi Aoki, Katsuhiko Uesaka
AIMS: To investigate whether preoperative enteral diets -enriched in eicosapentaenoic acid (EPA) supplements could reduce the incidence of hypercytokinemia after pancreatoduodenectomy (PD) in a double-blinded randomized -controlled trial. METHODS: Patients with resectable periampullary cancer were randomized into either the control group or the treatment group. Patients in the treatment group received oral supplementation (600 kcal/day) containing EPA for 7 days before surgery...
June 8, 2018: Digestive Surgery
Minas Baltatzis, Ajith K Siriwardena
BACKGROUND: Selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres has been used together with systemic chemotherapy to treat patients with unresectable liver metastases. This study undertook the first systematic pooled assessment of the case profile, treatment and outcome in patients with initially inoperable colorectal hepatic metastases undergoing resection after systemic chemotherapy and SIRT. METHODS: A systematic review of the literature was performed using Medline and Embase for publications between January 1998 and August 2017...
June 8, 2018: Digestive Surgery
Luca Vigano, Luca Di Tommaso, Antonio Mimmo, Mauro Sollai, Matteo Cimino, Matteo Donadon, Massimo Roncalli, Guido Torzilli
BACKGROUND: Patients with numerous colorectal liver metastases (CLM) have high risk of early recurrence after liver resection (LR). The presence of intrahepatic occult microscopic metastases missed by imaging has been hypothesized, but it has never been assessed by pathology analyses. METHODS: All patients with > 10 CLM who underwent LR between September 2015 and September 2016 were considered. A large sample of liver without evidence of disease ("healthy liver") was taken from the resected specimen and sent to the pathologist...
June 7, 2018: Digestive Surgery
Andrea Anderloni, Chiara Genco, Marco Massidda, Milena Di Leo, Uberto Romario Fumagalli, Riccardo Rosati, Loredana Correale, Roberta Maselli, Elisa Chiara Ferrara, Manol Jovani, Alessandro Repici
BACKGROUND/AIMS: The study aimed to evaluate the effectiveness and safety of self-expanding metal stents (SEMS) in the management of post-surgical esophageal leaks. METHODS: Retrospective data of consecutive patients with a post-surgical esophageal leak treated by means of a metal stent between January 2008 and December 2014 at the Humanitas Research Hospital (Milan, Italy) were extracted from a prospectively maintained register of SEMS used for benign indications, such as post-surgical benign esophageal strictures and/or leaks...
June 5, 2018: Digestive Surgery
Gaëtan-Romain Joliat, David Petermann, Nicolas Demartines, Nermin Halkic, Markus Schäfer
BACKGROUND: Few data exist on postoperative outcomes of patients with pancreatic body-tail malignancies and tumoral venous invasion (VI). This study aimed at comparing survival and recurrence rate (RR) after distal pancreatectomy for adenocarcinoma in patients with and without tumoral VI. METHODS: All consecutive distal pancreatectomies (2000-2015) were collected. Demographics and peri- and postoperative data were recorded. Survivals were calculated using Kaplan-Meier curves...
May 31, 2018: Digestive Surgery
Manish S Bhandare, Nikhil Mehta, Vikram Chaudhari, Naveena An Kumar, Esha Pai, Mahesh Goel, Shailesh V Shrikhande
BACKGROUND: Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM: To evaluate reasons of initial in-operability, the feasibility of re-operative pancreatico-duodenectomy (R-PD) and short- and long-term outcomes after R-PD. METHODS: Data was collected from a prospective database of GI and hepato-pancreato-biliary service, TMC, Mumbai from January 2008 to December 2016...
May 23, 2018: Digestive Surgery
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