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Surgery Today

Adriana Handra-Luca, Shuanzeng Wei
No abstract text is available yet for this article.
February 19, 2018: Surgery Today
Yoshinori Iwata, Seiji Ito, Kazunari Misawa, Yuichi Ito, Koji Komori, Tetsuya Abe, Yasuhiro Shimizu, Masahiro Tajika, Yasumasa Niwa, Kazuhiro Yoshida, Taira Kinoshita
BACKGROUND AND PURPOSE: Proximal gastrectomy (PG) is a widely accepted function-preserving surgical procedure; however, the incidence and treatment of metachronous gastric cancer (MGC) after PG have been the subject of a number of reports. METHODS: We collected data from 1576 consecutive patients who underwent gastrectomy for gastric cancer between January, 2003 and December, 2010, and analyzed the outcomes of 671 patients treated with PG or distal gastrectomy (DG) for cT1N0 disease...
February 19, 2018: Surgery Today
Atsushi Kohga, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Takeshi Aramaki, Keiko Sasaki, Katsuhiko Uesaka
BACKGROUND AND PURPOSE: To perform radical resection without leaving residual cancer, surgeons must distinguish between pancreatic head cancer (PHC) and intrapancreatic bile duct cancer (IPBDC) preoperatively. The aim of this study was to establish the points of difference between these two cancers, especially on preoperative multi-detector computed tomography (MDCT) images. METHODS: The subjects of this study were 28 patients with PHC and proven bile duct invasion who underwent pancreatoduodenectomy (PHC group) and 22 patients with IPBDC and upstream bile duct dilation (IPBDC group)...
February 19, 2018: Surgery Today
Matteo De Pastena, Maarten W Nijkamp, Thomas G van Gulik, Olivier R Busch, H S Hermanides, Marc G Besselink
Laparoscopic splenectomy is now established as a safe and feasible procedure. However, it remains associated with some short- and long-term postoperative complications, especially infectious complications. To our knowledge, this is the first report (with video) focusing on the safety and feasibility of laparoscopic hemi-splenectomy and its surgical outcomes for the treatment of splenic abscesses causing septic emboli. This technique combines the immunological benefits of partial splenectomy and the postoperative benefits of a minimally invasive approach...
February 17, 2018: Surgery Today
Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
PURPOSES: Modern electrosurgical tools have a specific coagulation mode called "soft coagulation". However, soft coagulation has not been widely accepted for surgical operations. To optimize the soft coagulation environment, we developed a novel suction device integrated with an electrosurgical probe, called the "Suction ball coagulator" (SBC). In this study, we aimed to optimize the SBC design with a prototyping process involving a bench test and preclinical study; then, we aimed to demonstrate the feasibility, safety, and potential effectiveness of the SBC for laparoscopic surgery in clinical settings...
February 17, 2018: Surgery Today
Italo Braghetto, Gustavo Martinez, Owen Korn, Marcelo Zamorano, Enrique Lanzarini, Enrique Narbona
BACKGROUND: Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) without resection of the distal stomach is largely performed over the world for morbid obesity. Potential risk of gastric remnant carcinoma development has been suggested. PURPOSE: To present the results obtained after LRYGB with resection of distal stomach. METHOD: This prospective study includes 400 consecutive patients. The mean body weight was 105.9 ± 16.8 Kg (range 83-145 kg), and body mass index (BMI) was 38...
February 15, 2018: Surgery Today
Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida
Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications...
February 12, 2018: Surgery Today
Takehiko Hanaki, Chihiro Uejima, Masataka Amisaki, Arai Yosuke, Naruo Tokuyasu, Soichiro Honjo, Teruhisa Sakamoto, Hiroaki Saito, Masahide Ikeguchi, Yoshiyuki Fujiwara
PURPOSE: Pancreatic fistula (PF) is the most serious complication following pancreaticoduodenectomy (PD). This study was performed to identify new clinical factors that may predict the development of PF after PD to improve perioperative management. METHODS: Seventy-five consecutive patients who underwent PD from 2012 to 2015 were evaluated. The patients' perioperative data including the computed tomography (CT) parameters were collected. The minimum, maximum, and mean CT attenuation values (HUmin, HUmax, and HUmean, respectively) were extracted from the pancreatic parenchyma (≥ 100 pixels), and the standard deviation of these values (HUSD) was determined from the slice in which the superior mesenteric and splenic veins were merged...
January 30, 2018: Surgery Today
Kouhei Fukushima, Akira Sugita, Kitaro Futami, Ken-Ichi Takahashi, Satoshi Motoya, Hideaki Kimura, Shusaku Yoshikawa, Yoshitaka Kinouchi, Hideki Iijima, Katsuya Endo, Toshihumi Hibi, Mamoru Watanabe, Iwao Sasaki, Yasuo Suzuki
PURPOSE: The prevention of postoperative recurrence is a critical issue in surgery for Crohn's disease. Prospective randomized trials in Western countries have shown that the postoperative use of anti-tumor necrosis factor α-antibodies was effective in reducing the recurrence rate. We investigated the efficacy of infliximab (IFX) for the prevention of postoperative Crohn's disease recurrence. METHODS: We performed a prospective randomized multicenter study. Patients who underwent intestinal resection were assigned to groups treated with or without IFX...
January 30, 2018: Surgery Today
Kotaro Yamashita, Masayuki Watanabe, Shinji Mine, Ian Fukudome, Akihiko Okamura, Masami Yuda, Masaru Hayami, Yu Imamura
PURPOSE: The aim of this study was to clarify the influence of Charlson comorbidity index (CCI) on treatment options, and on short- and mid-term outcomes in esophageal cancer patients who underwent esophagectomy. METHODS: Patients who underwent curative-intent esophagectomy from 2009 to 2014 were classified by CCI. A CCI of ≥ 2 was defined as high, while a CCI of 0 or 1 was classified as low. Clinicopathological parameters, including overall survival (OS) and disease-specific survival (DSS), were compared between the groups...
January 30, 2018: Surgery Today
Aya Harada Takeda, Yui Watanabe, Toshiyuki Nagata, Masaya Aoki, Tadashi Umehara, Soichi Suzuki, Go Kamimura, Kazuhiro Wakida, Tsunayuki Otsuka, Naoya Yokomakura, Kota Kariatsumari, Koichi Sakasegawa, Yoshihiro Nakamura, Masami Sato
PURPOSE: Pulmonary lymphatic fluid predominately flows along the bronchi. However, there are reports suggesting that an alternative lymphatic pathway exist, which may result in skip metastases. The aim of this study was to evaluate the subpleural lymph flow in vivo using indocyanine green (ICG) fluorescence. METHODS: One hundred cases were enrolled. ICG was injected into the macroscopically healthy subpleural space. Intraoperative fluorescence images were then observed in real time...
January 30, 2018: Surgery Today
Takuro Miyazaki, Shuntaro Sato, Takashi Kondo, Mamoru Kusaka, Mitsukazu Gotoh, Yoshikatsu Saiki, Minoru Ono, Norihiro Kokudo, Shin Enosawa, Shigeru Satoh, Etsuko Soeda, Hiroyuki Furukawa, Eiji Kobayashi, Takeshi Nagayasu
PURPOSE: In Japan, there have been no national surveys on the incidence of de novo malignancy after solid organ transplantation, which is one of the leading causes of death in transplant recipients. METHODS: A questionnaire was distributed to institutions that perform solid organ transplantation in Japan, and clinical information was collected from patients who underwent transplantation between 2001 and 2010 and who exhibited de novo malignancies. RESULTS: Nine thousand two hundred ten solid organ transplants (kidney, 49...
January 29, 2018: Surgery Today
Kohei Ishioka, Daisuke Hokuto, Takeo Nomi, Satoshi Yasuda, Takahiro Yoshikawa, Yasuko Matsuo, Takahiro Akahori, Satoshi Nishiwada, Kenji Nakagawa, Minako Nagai, Kota Nakamura, Naoya Ikeda, Masayuki Sho
PURPOSES: The relationship between the results of bacterial drainage fluid cultures in the early postoperative period after liver resection and the development of surgical site infections (SSIs) is unclear. We evaluated the diagnostic value of bacterial cultures of drainage fluid obtained on postoperative day (POD) 1 after liver resection. METHODS: The cases of all consecutive patients who underwent elective liver resection from January 2014 to December 2016 were analyzed...
January 29, 2018: Surgery Today
Keitaro Matsumoto, Shuntaro Sato, Meinoshin Okumura, Hiroshi Niwa, Yasuhiro Hida, Kichizo Kaga, Hiroshi Date, Jun Nakajima, Jitsuo Usuda, Makoto Suzuki, Takahiro Souma, Masanori Tsuchida, Yoshihiro Miyata, Takeshi Nagayasu
No abstract text is available yet for this article.
January 11, 2018: Surgery Today
Naoki Minato, Takayuki Okada, Shinya Kanemoto, Nobuya Zempo
We present a segmental clamp with distal perfusion technique to reduce myocardial ischemia during onlay grafting, on a beating heart. After a proximal coronary arteriotomy for 2-3 cm, the distal artery is perfused through a cannula, with femoral arterial blood (distal perfusion with external shunt). During proximal and distal coronary snare clamping with distal perfusion, onlay anastomosis is performed, from the heel toward the point of cannula insertion. We then move the proximal clamp to the onlay area and open the graft, to get early proximal coronary reperfusion...
January 9, 2018: Surgery Today
Takahiro Yamanashi, Takatoshi Nakamura, Takeo Sato, Masanori Naito, Hirohisa Miura, Atsuko Tsutsui, Masashi Shimazu, Masahiko Watanabe
PURPOSE: For locally advanced pathological T4 (pT4) colon cancer, the safety and feasibility of laparoscopic procedures remain controversial. Therefore, this study aimed to assess short-term and long-term outcomes and to identify the prognostic factors in laparoscopic surgery for pT4 colon cancer. METHODS: The study group included 130 patients who underwent laparoscopic radical resection for pT4 colon and rectosigmoid cancer from January 2004 through December 2012...
December 29, 2017: Surgery Today
Kenta Sui, Takehiro Okabayshi, Jun Iwata, Sojiro Morita, Tatsuaki Sumiyoshi, Tatsuo Iiyama, Yasuhiro Shimada
PURPOSES: Sarcopenia is known to be associated with a worse prognosis following abdominal operations; however, the relationship between sarcopenia and the outcomes of pancreaticoduodenectomy remains unclear. MATERIALS: We measured body composition parameters, including total abdominal muscle area, using preoperative staging computed tomography (CT), in patients undergoing pancreaticoduodenectomy for periampullary cancer. The incidence of sarcopenia among these patients was evaluated and multivariable analysis was performed to identify independent predictors of postoperative pancreatic fistula...
December 28, 2017: Surgery Today
Kazuhiko Sakamoto, Hiroaki Nagano
The prognosis of hepatocellular carcinoma (HCC) patients with tumor thrombus (TT) in the inferior vena cava (IVC) or right atrium (RA) is extremely poor. We reviewed the recent surgical treatments and outcomes of this form of advanced HCC. TT is classified into three types according to its anatomic location relative to the heart: the inferior hepatic type (type I), where the TT is in the IVC below the diaphragm; the superior hepatic type (type II), where the TT is in the IVC above the diaphragm, but still outside the RA; and the intracardiac type (type III), where the TT is above the diaphragm and has entered the RA...
December 26, 2017: Surgery Today
Ippeita Araki, Marie Washio, Keishi Yamashita, Kei Hosoda, Akira Ema, Hiroaki Mieno, Hiromitsu Moriya, Natsuya Katada, Shiro Kikuchi, Masahiko Watanabe
PURPOSE: The prognosis of most patients with stage IB node-negative gastric cancer is good without postoperative chemotherapy; however, about 10% suffer recurrence and inevitably die. We conducted this study to establish the optimal indications for postoperative adjuvant chemotherapy in patients at risk of recurrence. METHODS: The subjects of this retrospective study were 124 patients with stage IB node-negative gastric cancer, who underwent gastrectomy at the Kitasato University East Hospital, between 2001 and 2010...
December 18, 2017: Surgery Today
Misuzu Yamada, Kenichi Hirabayashi, Aya Kawanishi, Atsuko Hadano, Yumi Takanashi, Hideki Izumi, Yoshiaki Kawaguchi, Tetsuya Mine, Naoya Nakamura, Toshio Nakagohri
PURPOSE: Nectin-1 is a cell adhesion molecule that regulates the formation of adherens junctions and tight junctions. We measured the expression of nectin-1 in cancer-associated fibroblasts (CAFs) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Nectin-1 expression was measured via immunohistochemistry using tissue microarray blocks constructed from resected PDAC tissue from 258 patients. We screened for associations between nectin-1 expression and clinicopathological parameters...
December 18, 2017: Surgery Today
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