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Surgery Today

Junji Yanagisawa, Atsuo Maekawa, Sadanari Sawaki, Masayoshi Tokoro, Takahiro Ozeki, Mamoru Orii, Toshiyuki Saiga, Toshiaki Ito
PURPOSES: We assessed the validity of three-port totally endoscopic repair (3PTER) for atrial septal defect (ASD). METHODS: Between February, 2000 and November, 2017, 151 patients underwent surgery for ASD. Forty-seven patients underwent 3PTER as minimally invasive cardiac surgery (MICS) and 104 patients underwent conventional median sternotomy (CMS). Propensity matching yielded 94 matched patients (47 vs 47). We compared the early results between the groups. The 3PTER technique was performed with the patient in the partial left lateral position, under cardio-pulmonary bypass (CPB) established through a groin incision...
September 20, 2018: Surgery Today
Haruchika Yamamoto, Seiichiro Sugimoto, Shin Tanaka, Takeshi Kurosaki, Shinji Otani, Masaomi Yamane, Naruto Taira, Takahiro Oto, Shinichi Toyooka
PURPOSE: Glucocorticoids are used to prevent chronic lung allograft dysfunction (CLAD) after lung transplantation (LT). Our study was aimed at assessing the association between the glucocorticoid-induced transcript 1 gene (GLCCI1) variant, which modulates glucocorticoid sensitivity, and the postoperative lung function and development of CLAD after LT. METHODS: A total of 71 recipients of LT were genotyped for the GLCCI1 variant (rs37972) and divided into three groups: the homozygous mutant allele (TT) group, the heterozygous mutant allele (CT) group, and the wild-type allele (CC) group...
September 18, 2018: Surgery Today
Yasuyuki Fukami, Atsuyuki Maeda, Yuichi Takayama, Takamasa Takahashi, Masahito Uji, Yuji Kaneoka
PURPOSES: Postoperative complications are associated with poor overall and cancer-specific survival after resection of various types of cancer, including primary colorectal cancer. However, the oncological impact of surgical site infection (SSI) after liver resection for colorectal liver metastases (CLM) is unclear. The aim of this study was to investigate the oncological impact of SSI after liver resection for CLM. METHODS: We reviewed data from 367 consecutive patients treated by curative liver resection for CLM between 1994 and 2015...
September 17, 2018: Surgery Today
Daijiro Hori, Yohei Nomura, Taketo Yamauchi, Hiroshi Furuhata, Harunobu Matsumoto, Naoyuki Kimura, Koichi Yuri, Atsushi Yamaguchi
PURPOSE: To identify the perioperative factors associated with aneurysm size changes after endovascular aortic aneurysm repair (EVAR). METHODS: Between August, 2008 and December, 2014, 187 patients underwent EVAR treatment in our institution. The subjects of this study were 135 of these patients without peripheral artery disease, who were followed up with computed tomography (CT) for 3 years. Significant aneurysm size change was defined as sac size change of more than 5 mm from the baseline...
September 12, 2018: Surgery Today
Tatsuaki Watanabe, Hideo Shimomura, Tatsushi Mutoh, Ryoko Saito, Ryoi Goto, Takehiro Yamada, Hirotsugu Notsuda, Yasushi Matsuda, Masafumi Noda, Akira Sakurada, Yasuyuki Taki, Yoshinori Okada
PURPOSE: The purpose of this study was to assess the usefulness of positron emission tomography/computed tomography (PET/CT) in the differential diagnosis of anterior mediastinal tumors. METHODS: A total of 94 patients with anterior mediastinal masses or nodules (male, n = 41; female, n = 53; age, 17-84 years) were retrospectively evaluated. All patients were evaluated by PET/CT and the masses or nodules were histologically diagnosed in our institution...
September 10, 2018: Surgery Today
Haruki Sada, Takao Hinoi, Hideki Ueno, Tatsuro Yamaguchi, Yasuhiro Inoue, Tsuyoshi Konishi, Hirotoshi Kobayashi, Yukihide Kanemitsu, Fumio Ishida, Hideyuki Ishida, Naohiro Tomita, Nagahide Matsubara, Kenichi Sugihara
PURPOSE: To investigate the recent Japanese prevalence of thyroid cancer and its characteristics in familial adenomatous polyposis (FAP) patients, through the development of surveillance programs. METHODS: The subjects of this study were 282 (93.1%) FAP patients for whom information on thyroid cancer was available, from among 303 patients registered in "the Retrospective Cohort Study of Familial Adenomatous Polyposis in Japan" database. We evaluated the prevalence and risk factors for thyroid cancer and integrated and/or compared our findings with those of previous reports, using a systematic review, including a meta-analysis...
September 4, 2018: Surgery Today
Yu Tian, Cong Wang, Ming Lu
PURPOSE: Radical lymph-node dissection surgery in patients with cN0 middle thoracic esophageal squamous cell carcinoma (ESCC) remains controversial. We sought a novel biomarker that could be used for decision-making in relation to radical lymph-node dissection. METHODS: One hundred and nineteen patients with cN0 middle thoracic ESCC undergoing three-field lymph-node dissection (3FLND) or two-field lymph-node dissection (Ivor Lewis) esophagectomy were reviewed. A survival analysis, and Chi-square and parametric tests were performed...
September 4, 2018: Surgery Today
Shun-Ichiro Sakamoto, Atsushi Hiromoto, Yosuke Ishii, Takashi Sasaki, Yasuo Miyagi, Takashi Nitta
PURPOSE: We examined the outcome of modified-maze procedures reflecting a single-center strategy in the treatment of atrial fibrillation (AF) associated with atrial septal defect (ASD) in adults. METHODS: A retrospective chart review was performed for 29 patients who underwent surgical ASD closure and 2 types of maze procedures (full and simplified maze procedures) for AF. The outcome related to the each procedure was examined. A Cox proportional hazards analysis was performed to assess the independent predictors of AF and atrial tachycardia (AT) recurrence...
September 3, 2018: Surgery Today
Shunji Endo, Masakazu Ikenaga, Katsuya Ohta, Masami Ueda, Yujiro Tsuda, Ryo Kato, Hiroaki Itakura, Jin Matsuyama, Kazuhiro Nishikawa, Terumasa Yamada
PURPOSE: Positive peritoneal lavage cytology for gastric carcinoma cells (CY1) is considered distant metastasis and is classified as Stage IV. However, patients with CY1 comprise a heterogeneous population, and their prognosis varies greatly. The prognostic factors for gastric cancer patients with CY1 were retrospectively reviewed. METHODS: The participants were 80 gastric cancer patients with CY1 in our institution encountered between 2005 and 2017. Prognostic factors were analyzed using univariate and multivariate analyses...
August 30, 2018: Surgery Today
Eiji Nomura, Hajime Kayano, Sang-Woong Lee, Masaru Kawai, Takashi Machida, Soichiro Yamamoto, Kazuhito Nabeshima, Kenji Nakamura, Masaya Mukai, Kazuhisa Uchiyama
PURPOSE: Functional outcomes were prospectively compared between two types of reconstruction [double tract (L-DT; n = 15) and jejunal interposition (L-JIP; n = 15)] following laparoscopic half-proximal gastrectomy (LPG), including laparoscopic total gastrectomy (L-TG; n = 30) as a control group, at 1 year after surgery. METHODS: Clinical investigations were performed in each patient, and functional evaluations, involving the swallowing of an alimentary liquid containing acetaminophen (AAP), followed by measurements of the concentrations of AAP and hormones in the sitting (n = 5) and in the supine positions (n = 5), were carried out in each group...
August 29, 2018: Surgery Today
Paschalis Gavriilidis, Daniel Azoulay, Panos Taflampas
Defunctioning of colorectal anastomosis either with loop transverse colostomy or ileostomy was evaluated using updated and cumulative meta-analyses. Studies were identified by a systematic search of Embase, PubMed, Cochrane Library, and Google Scholar databases and were selected as per the PRISMA checklist. Both randomised control trials (RCTs) and retrospective studies were included. A sensitivity analysis was performed, and a cumulative meta-analysis was performed to monitor evidence over time. Significantly more male patients underwent loop ileostomy than transverse colostomy [odds ratio (OR) = 0...
August 27, 2018: Surgery Today
Huan-Jang Ko, Xu-Heng Chiang, Shun-Mao Yang, Ming-Chi Yang
PURPOSE: Needlescopic instruments allow us to perform complex laparoscopic procedures, which are almost painless and scarless postoperatively; however, their utilization in thoracoscopic surgery has been limited to minor procedures, including bullectomy and sympathectomy. We present our initial experience of performing thoracoscopic anatomical lung resection via a single utility incision with additional needlescopic working ports and compare the operative results with those of uniportal video-assisted thorascopic surgery (VATS)...
August 27, 2018: Surgery Today
Yuichi Endo, Masayuki Ohta, Kazuhiro Tada, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata
PURPOSES: The choice between performing routine and selective upper gastrointestinal endoscopy (UGE) before bariatric surgery remains controversial. This study aimed to evaluate the clinical significance of UGE before laparoscopic bariatric procedures. METHODS: We enrolled 155 obese Japanese patients who underwent laparoscopic bariatric procedures at our institute and evaluated their endoscopic findings, such as reflux esophagitis (RE), hiatal hernia (HH), Barrett's esophagus, gastritis, duodenitis, gastroduodenal ulcer, gastric cancer, and polyps...
August 25, 2018: Surgery Today
Yasunori Otowa, Tetsu Nakamura, Yuta Yamazaki, Gosuke Takiguchi, Akio Nakagawa, Masashi Yamamoto, Shingo Kanaji, Takeru Matsuda, Taro Oshikiri, Satoshi Suzuki, Yoshihiro Kakeji
PURPOSE: The prognosis of esophageal cancer is dismal, and the 3-year overall survival of cStage III does not reach 50.0%. C-reactive protein (CRP) is a well-known protein that reflects the short- and long-term operative outcomes of esophageal cancer. However, since elevated CRP levels are often observed in cStage III esophageal cancer, whether or not CRP still reflects the prognosis is unclear. METHODS: Eighty-four patients who were diagnosed with cStage III esophageal cancer and underwent R0/1 operation from January 2007 to December 2014 were retrospectively evaluated...
August 23, 2018: Surgery Today
Yutaka Matsubara, Tadashi Furuyama, Ken Nakayama, Keiji Yoshiya, Kentaro Inoue, Koichi Morisaki, Masazumi Kume, Yoshihiko Maehara
PURPOSE: Sarcopenia is a major problem of the elderly. Although little is known about the cause of sarcopenia, the intramuscular adipose tissue content (IMAC) is known to be a cause of sarcopenia. The aim of this study was to investigate the significance of IMAC as a cause of sarcopenia. METHODS: We evaluated patients who underwent aneurysm repair and were monitored preoperatively and 3 years postoperatively by computed tomography (CT). The skeletal muscle area and IMAC were measured on preoperative L3 CT images...
August 22, 2018: Surgery Today
Takashi Matsumoto, Hirohisa Okabe, Yo-Ichi Yamashita, Toshihiko Yusa, Rumi Itoyama, Yosuke Nakao, Takanobu Yamao, Naoki Umzaki, Masayo Tsukamoto, Yuki Kitano, Tatsunori Miyata, Kota Arima, Hidetoshi Nitta, Hiromitsu Hayashi, Katsunori Imai, Akira Chikamoto, Hideo Baba
PURPOSES: Clinical predictive markers for the malignant potential of pancreatic neuroendocrine tumors (PNETs) are limited without histological investigation. We reported previously that a loss of the regular enhancement pattern in preoperative computed tomography (CT) was correlated with the malignant tumor phenotype. This study aimed to establish whether the metabolic aspect of the tumor evaluated by fludeoxyglucose (18 F) positron emission tomography/computed tomography 18 F-FDG PET/CT is associated with the tumor imaging characteristics and postoperative oncological outcome...
August 20, 2018: Surgery Today
Shunji Morita, Kansuke Yamamoto, Atsuhiro Ogawa, Atsushi Naito, Hitoshi Mizuno, Shinichi Yoshioka, Tae Matsumura, Katsuya Ohta, Rei Suzuki, Chu Matsuda, Taishi Hata, Junichi Nishimura, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: To assess the benefit of placing a self-expandable metallic stent (SEMS) as a bridge to surgery for obstructive colorectal cancer (OCRC) according to the tumor site. METHODS: The subjects of this retrospective multicenter cohort study were 201 patients with OCRC, but without initial bowel perforation, who were treated either with a self-expandable metallic stent (SEMS) as a bridge to surgery (n = 109) or with primary surgery (PS; n = 92) between 2014 and 2016...
August 13, 2018: Surgery Today
Makoto Hikage, Masanori Tokunaga, Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima
No abstract text is available yet for this article.
August 10, 2018: Surgery Today
Ai Tomotaki, Hiraku Kumamaru, Hideki Hashimoto, Arata Takahashi, Minoru Ono, Tadashi Iwanaka, Hiroaki Miyata
PURPOSE: The aim of this study was to examine the quality of data from the National Clinical Database (NCD) via a comparison with regional government report data and medical charts. METHODS: A total of 1,165,790 surgical cases from 3007 hospitals were registered in the NCD in 2011. To evaluate the NCD's data coverage, we retrieved regional government report data for specified lung and esophageal surgeries and compared the number with registered cases in the NCD for corresponding procedures...
August 7, 2018: Surgery Today
Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
PURPOSE: Stoma outlet obstruction (SOO) is a complication following colorectal surgery that requires stoma creation. We aimed to clarify the SOO incidence and identify risk factors for SOO after stoma surgery in patients with ulcerative colitis (UC) or rectal cancer. METHODS: The study included 345 patients with sporadic rectal cancer (n = 301) or UC (n = 44) who underwent stoma surgery between 2012 and 2017. Univariate and multivariate analyses were performed to identify risk factors for SOO...
July 25, 2018: Surgery Today
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