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Surgery Today

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https://www.readbyqxmd.com/read/28324164/novel-intraoperative-use-of-the-tensipresser-to-assess-factors-predictive-of-pancreatic-fistula-after-pancreaticoduodenectomy
#1
Manabu Mikamori, Kunihito Gotoh, Hidenori Takahashi, Hirofumi Akita, Akira Tomokuni, Shogo Kobayashi, Masayuki Ohue, Yoshiyuki Fujiwara, Masahiko Yano, Osamu Ishikawa, Masato Sakon
PURPOSES: Pancreatic fistula (PF) is a challenging complication of pancreaticoduodenectomy (PD). 'Soft pancreas' is reported as a risk factor for PF; however, palpation by the surgeon is not an objective method of evaluating pancreatic texture. We conducted this study to investigate whether a texture analyzer called a "Tensipresser" can be used to quantify pancreatic tissue hardness and predict the development of postoperative PF. METHODS: We assessed pancreatic texture in 85 patients who underwent PD...
March 21, 2017: Surgery Today
https://www.readbyqxmd.com/read/28324163/new-macroscopic-classification-and-back-flow-thrombectomy-for-advanced-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-invading-the-contralateral-second-portal-branch
#2
Takumi Fukumoto, Masahiro Kido, Atsushi Takebe, Motofumi Tanaka, Hisoka Kinoshita, Kaori Kuramitsu, Shohei Komatsu, Daisuke Tsugawa, Tadahiro Goto, Sadaki Asari, Hirochika Toyama, Tetsuo Ajiki, Yonson Ku
PURPOSE: Patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) invading the portal trunk (Vp4) are poor surgical candidates because of the technical difficulties involved. To overcome the limitations, we developed a technique of back-flow thrombectomy (BFT) based on the inherent portal hemodynamics and the macroscopic form of PVTT. METHODS: Forty-six patients with multiple HCC and Vp4 PVTT underwent hepatectomy with tumor thrombectomy...
March 21, 2017: Surgery Today
https://www.readbyqxmd.com/read/28321575/safety-and-feasibility-of-laparoscopic-gastrectomy-for-gastric-cancer-patients-with-a-history-of-abdominal-surgery
#3
Kotaro Yamashita, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yasunori Masuike, Masaaki Motoori, Yutaka Kimura, Yukinori Kurokawa, Tomoki Makino, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
PURPOSE: To assess the safety and feasibility of laparoscopic gastrectomy (LG) for gastric cancer patients with a history of abdominal surgery (HAS). METHODS: This retrospective study analyzed data collected from gastric cancer patients with HAS, who underwent LG between 2004 and 2015. We compared the clinicopathological features that correlated with conversion to open surgery and the development of severe postoperative complications (Clavien-Dindo classification of grade III or higher)...
March 20, 2017: Surgery Today
https://www.readbyqxmd.com/read/28321574/a-report-of-the-first-joint-meeting-of-the-royal-college-of-surgeons-of-england-and-the-japan-surgical-society
#4
Paul O'Flynn, Toshiaki Watanabe
No abstract text is available yet for this article.
March 20, 2017: Surgery Today
https://www.readbyqxmd.com/read/28315009/severe-underweight-decreases-the-survival-rate-in-adult-lung-transplantation
#5
Teruya Komatsu, Toyofumi F Chen-Yoshikawa, Ayako Oshima, Shin-Ichi Harashima, Akihiro Aoyama, Nobuya Inagaki, Hiroshi Date
PURPOSE: The body mass index (BMI) before lung transplantation (LT) is a benchmark of the post-LT survival. The aim of the study is to determine the BMI inadequate for the post-LT survival. METHODS: We examined the survival after LT in patients grouped into the following BMI categories: <18.5 kg/m(2) (underweight), 18.5-24.9 kg/m(2) (normal weight), 25-29.9 kg/m(2) (overweight), and ≥30.0 kg/m(2) (obese) according to the World Health Organization (WHO) criteria...
March 17, 2017: Surgery Today
https://www.readbyqxmd.com/read/28315008/the-optimal-cut-off-value-of-the-preoperative-prognostic-nutritional-index-for-the-survival-differs-according-to-the-tnm-stage-in-hepatocellular-carcinoma
#6
Yukiyasu Okamura, Teiichi Sugiura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
PURPOSE: To establish the optimal cut-off value of the preoperative prognostic nutritional index (PNI) for prognosis according to the Tumor Node Metastasis (TNM) stage of hepatocellular carcinoma (HCC) after curative resection. METHODS: This retrospective study reviewed the records of 375 patients. The optimal cut-off value of the PNI was established according to the TNM stage, and overall survival was compared between the low and high PNI groups. RESULTS: The optimal cut-off value of the PNI decreased with increasing TNM stage, with 52, 47, and 43 patients having stage I, II, and III HCC, respectively...
March 17, 2017: Surgery Today
https://www.readbyqxmd.com/read/28303341/epidemiology-and-risk-factors-associated-with-surgical-site-infection-after-different-types-of-hepatobiliary-and-pancreatic-surgery
#7
Keita Morikane
PURPOSE: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database. METHODS: Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance...
March 16, 2017: Surgery Today
https://www.readbyqxmd.com/read/28293742/the-accumulation-of-regulatory-t-cells-in-the-hepatic-hilar-lymph-nodes-in-biliary-atresia
#8
Naoya Sakamoto, Toshihiro Muraji, Haruo Ohtani, Kouji Masumoto
PURPOSE: A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T reg cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA...
March 14, 2017: Surgery Today
https://www.readbyqxmd.com/read/28285463/video-assisted-thoracoscopic-surgery-node-dissection-for-lung-cancer-treatment
#9
REVIEW
Atsushi Watanabe, Masahiro Miyajima, Taijiro Mishina, Kodai Tsuruta, Yuki Takahashi, Ryunosuke Maki, Makoto Tada
PURPOSE: Mediastinal node dissection (MND) is an integral component of the surgical treatment for non-small cell lung cancer (NSCLC). Although video-assisted thoracoscopic surgery (VATS) has been used increasingly for lung cancer treatment, the accuracy of by VATS MND still remains controversial. We reviewed the surgical results of VATS MND for NSCLC. METHODS: A systematic review of literature was performed, and articles that fully described the surgical procedure, devices, and results of VATS MND were selected to compare the efficacy of MND by VATS and thoracotomy...
March 11, 2017: Surgery Today
https://www.readbyqxmd.com/read/28280984/treatment-of-lung-adenocarcinoma-by-molecular-targeted-therapy-and-immunotherapy
#10
REVIEW
Motonobu Saito, Hiroyuki Suzuki, Koji Kono, Seiichi Takenoshita, Takashi Kohno
Lung adenocarcinoma (LADC) is a cancer treatable using targeted therapies against driver gene aberrations. EGFR mutations and ALK fusions are frequent gene aberrations in LADC, and personalized therapies against those aberrations have become a standard therapy. These targeted therapies have shown significant positive efficacy and tolerable toxicity compared to conventional chemotherapy, so it is necessary to identify additional druggable genetic aberrations. Other than EGFR mutations and ALK fusions, mutations in KRAS, HER2, and BRAF, and driver fusions involving RET and ROS1, have also been identified in LADC...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28280983/the-influence-of-specific-technical-maneuvers-utilized-in-the-creation-of-diverting-loop-ileostomies-on-stoma-related-morbidity
#11
Masaaki Miyo, Ichiro Takemasa, Masataka Ikeda, Masaki Tujie, Junichi Hasegawa, Masayuki Ohue, Takeshi Kato, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: The association between technical maneuvers in fashioning a diverting loop-ileostomy and stoma-related complications remains unclear. Thus, this study aimed to evaluate their relevance to stoma-related morbidity. METHODS: This retrospective multicenter study was designed to collect data from 37 institutions. We evaluated the perioperative outcomes of consecutive patients who underwent surgery to create a diverting loop-ileostomy in 2013. RESULTS: A total of 4137 patients with colorectal disease underwent colorectomy, 279 of whom received an ileostomy...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28280982/risk-factors-for-anastomotic-leakage-after-laparoscopic-surgery-with-the-double-stapling-technique-for-stage-0-i-rectal-carcinoma-a-subgroup-analysis-of-a-multicenter-single-arm-phase-ii-trial
#12
Keitaro Tanaka, Junji Okuda, Seiichiro Yamamoto, Masaaki Ito, Kazuhiro Sakamoto, Yukihito Kokuba, Kenichi Yoshimura, Masahiko Watanabe
PURPOSE: The aim of this study was to determine the risk factors for anastomotic leakage after laparoscopic rectal surgery. METHODS: We conducted a prospective trial involving 395 patients with stage 0/I rectal carcinoma who underwent laparoscopic low anterior resection using a double stapling technique. Data concerning variables related to patient background, tumors and surgical factors were evaluated. The outcomes with respect to anastomotic leakage were recorded, and univariate and multivariate analyses were performed to identify relevant risk factors...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28271342/a-comparison-of-the-localization-of-rectal-carcinomas-according-to-the-general-rules-of-the-japanese-classification-of-colorectal-carcinoma-jccrc-and-western-guidelines
#13
Akira Tanaka, Sotaro Sadahiro, Toshiyuki Suzuki, Kazutake Okada, Gota Saito
PURPOSE: The aim of this study was to compare the localization of rectal cancers as classified according to the general rules of the Japanese classification of colorectal carcinoma (JCCRC) and also according to the European Society for Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN) guidelines, which are based on rigid endoscopic measurements. METHODS: The medical records of patients scheduled to receive curative surgery for histologically proven rectal adenocarcinoma during 2009-2015 were investigated (n = 230)...
March 7, 2017: Surgery Today
https://www.readbyqxmd.com/read/28265770/a-novel-preoperative-predictor-of-pancreatic-fistula-using-computed-tomography-after-distal-pancreatectomy-with-staple-closure
#14
Yasunari Fukuda, Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Takehiro Noda, Tadafumi Asaoka, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Masaki Mori, Yuichiro Doki
PURPOSE: A thick pancreas has proven to be a conspicuous predictor of pancreatic fistula (PF) following distal pancreatectomy (DP) using staples. Other predictors for this serious surgical complication currently remain obscure. This study sought to identify novel predictors of PF following DP. METHODS: One hundred and twenty-two patients were retrospectively assessed to determine the correlation between PF occurrence and the clinicopathological findings and radiologic data from preoperative computed tomography (CT)...
March 6, 2017: Surgery Today
https://www.readbyqxmd.com/read/28260136/cells-of-origin-of-pancreatic-neoplasms
#15
REVIEW
Junpei Yamaguchi, Yukihiro Yokoyama, Toshio Kokuryo, Tomoki Ebata, Masato Nagino
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignant disease associated with poor prognosis, despite recent medical advances. It is of great importance to understand the initial events and cells of origin of pancreatic cancer to prevent the development and progression of PDAC. There are three distinct precursor lesions that develop into PDAC: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs). Studies on genetically engineered mouse models have revealed that the initiation and development of these lesions largely depend on genetic alterations...
March 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28260135/efficacy-of-an-additional-flap-operation-in-bladder-preserving-surgery-with-radical-prostatectomy-and-cystourethral-anastomosis-for-rectal-cancer-involving-the-prostate
#16
Keita Noguchi, Yuji Nishizawa, Yoshinobu Komai, Yasuyuki Sakai, Akihiro Kobayasi, Masaaki Ito, Norio Saito
PURPOSE: Sphincter-preserving operations performed with bladder-preserving surgery and a cystourethral anastomosis (CUA) do not require a urinary stoma, but leakage from the CUA may develop. The aim of this study was to evaluate the efficacy of performing an additional flap operation. METHODS: The subjects were 39 patients who underwent bladder-preserving surgery for advanced rectal cancer involving the prostate, between 2001 and 2015.32 of whom had a CUA and one of whom had a neobladder...
March 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28258479/prevalence-and-clinicopathologic-molecular-characteristics-of-mismatch-repair-deficient-colorectal-cancer-in-the-under-50-year-old-japanese-population
#17
Okihide Suzuki, Hidetaka Eguchi, Noriyasu Chika, Takehiko Sakimoto, Keiichiro Ishibashi, Kensuke Kumamoto, Jun-Ichi Tamaru, Tetsuhiko Tachikawa, Kiwamu Akagi, Tomio Arai, Yasushi Okazaki, Hideyuki Ishida
PURPOSE: To clarify the prevalence and clinicopathologic/molecular characteristics of mismatch repair (MMR)-deficient colorectal cancer in the young Japanese population. METHODS: Immunohistochemical analyses for MMR proteins (MLH1, MSH2, MSH6, and PMS2) were performed in formalin-fixed paraffin-embedded sections prepared from the resected CRC specimens of 119 consecutive patients aged <50 years old, who underwent resection of the primary tumor at our institution between 1996 and 2015...
March 3, 2017: Surgery Today
https://www.readbyqxmd.com/read/28255633/impact-of-comorbidities-on-the-postoperative-outcomes-of-acute-cholecystitis-following-early-cholecystectomy
#18
Ryusuke Saito, Tomoyuki Abe, Keiji Hanada, Tomoyuki Minami, Nobuaki Fujikuni, Tsuyoshi Kobayashi, Hironobu Amano, Hideki Ohdan, Toshio Noriyuki, Masahiro Nakahara
PURPOSES: The purpose of this study was to evaluate the influence of comorbidities on the surgical outcomes of early cholecystectomy for acute cholecystitis. METHODS: Data were retrospectively collected for patients with acute cholecystitis who underwent early cholecystectomy. Patients were separated into three groups based on the cholecystitis severity grade, and the surgical outcomes of early cholecystectomy were analyzed. Patients with mild and moderate cholecystitis were subdivided into a comorbidity group (n = 10) and a non-comorbidity group (n = 83)...
March 2, 2017: Surgery Today
https://www.readbyqxmd.com/read/28251376/the-treatment-of-desmoid-tumors-associated-with-familial-adenomatous-polyposis-the-results-of-a-japanese-multicenter-observational-study
#19
Yasuhiro Inoue, Hideyuki Ishida, Hideki Ueno, Hirotoshi Kobayashi, Tatsuro Yamaguchi, Tsuyoshi Konishi, Naohiro Tomita, Nagahide Matsubara, Fumio Ishida, Takao Hinoi, Yukihide Kanemitsu, Toshiaki Watanabe, Kenichi Sugihara
PURPOSE: Familial adenomatous polyposis (FAP)-associated desmoid tumor (DT) is sometimes life threatening. However, the optimal treatment for DTs has not been established. The aim of this study was to analyze the outcomes of surgical and pharmacological treatments for DT in Japanese FAP patients. METHODS: We retrospectively reviewed the data of 303 patients who underwent colectomy for FAP between 2000 and 2012. We analyzed 41 patients with DTs in which the location was apparent...
March 1, 2017: Surgery Today
https://www.readbyqxmd.com/read/28251375/adjuvant-therapy-for-locally-advanced-gastric-cancer
#20
REVIEW
Toru Aoyama, Takaki Yoshikawa
D2 gastrectomy is now the globally accepted surgical standard for locally advanced gastric cancer. However, since 2000, different evidence has emerged regarding the efficacy of adjuvant chemoradiation, perioperative adjuvant chemotherapy, and postoperative chemotherapy for locally advanced gastric cancer. This review summarizes the background, current status, and future perspectives of adjuvant therapy for locally advanced gastric cancer. The Intergroup 0116 study was the first to show the significant overall survival benefits of adjuvant (chemoradiation) therapy for gastric cancer...
March 1, 2017: Surgery Today
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