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Surgery Today

Hiroaki Komatsu, Nobuhiro Izumi, Takuma Tsukioka, Hidetoshi Inoue, Kantaro Hara, Hikaru Miyamoto, Noritoshi Nishiyama
PURPOSE: To investigate the influence of multiple primary malignancies (MPMs) on the prognosis of patients with completely resected non-small cell lung cancer (NSCLC). METHODS: The subjects of this retrospective study were 521 patients who underwent complete curative pulmonary resection for NSCLC. Patients were divided into two groups: those with and those without MPMs. RESULTS: The 521 NSCLC patients included 184 patients (35.3%) with MPMs and 337 patients without MPMs...
November 11, 2018: Surgery Today
Kohei Wakatsuki, Sohei Matsumoto, Kazuhiro Migita, Tomohiro Kunishige, Hiroshi Nakade, Shintaro Miyao, Masayuki Sho
PURPOSE: We assessed the prognostic value of the fibrinogen-to-platelet ratio (FPR) as an inflammatory and coagulative index by examining its clinicopathologic and prognostic efficiency in patients with gastric cancer (GC). METHODS: The subjects of this retrospective study were 182 GC patients whose FPR was measured preoperatively between January, 2001 and December, 2006. The FPR was defined as the plasma fibrinogen divided by the platelet counts. RESULTS: Patients aged ≥ 65 years and with venous invasion had a significantly higher FPR (p = 0...
November 8, 2018: Surgery Today
Norihiko Ishikawa, Makoto Oda, Kenji Kawachi, Go Watanabe
We successfully performed totally endoscopic single-port robotic surgery. A 50-year-old man with a mediastinal tumor underwent robot-assisted tumor resection. Only one port was placed on the right side of the chest, and a robotic endoscope and two robotic instruments were inserted through the port. The instruments were crossed while avoiding collision. Single-port robotic surgery for a mediastinal tumor using the cross-arm technique was safely achieved with good clinical results and excellent cosmetic results...
November 8, 2018: Surgery Today
Shingo Kanaji, Arata Takahashi, Hiroaki Miyata, Shigeru Marubashi, Yoshihiro Kakeji, Hiroyuki Konno, Mitsukazu Gotoh, Yasuyuki Seto
PURPOSES: To evaluate the reliability of data collected from the gastroenterological section of the National Clinical Database of Japan (NCD), which began registrations in 2011 with ten surgical subspecialty societies. METHODS: During 2014 and 2015, 1,136,700 cases involving 115 procedures at 4374 hospitals were registered in the gastroenterological surgery section of the NCD. After a test audit using the 2014 data, 17 hospitals were selected for the first audit and data verification for 2015...
November 7, 2018: Surgery Today
Yuichi Takama, Takehisa Ueno, Satoshi Umeda, Ryuta Saka, Yuko Tazuke, Hiroomi Okuyama
PURPOSE: A congenital extrahepatic portosystemic shunt (CEPS) associated with hyperammonemia requires occlusion of the shunt vessels. We evaluated the effectiveness and safety of laparoscopic ligation of a CEPS in children with hyperammonemia. METHODS: The subjects of this retrospective study were seven children with hyperammonemia who underwent laparoscopic ligation of a CEPS. Their median age was 5.2 years (range 1-16 years). Before the laparoscopic procedure, a catheter was inserted through the femoral vein and placed in the portal vein via the shunt vessel...
November 3, 2018: Surgery Today
Akimitsu Tanio, Hiroaki Saito, Chihiro Uejima, Seigo Takaya, Manabu Yamamoto, Naruo Tokuyasu, Teruhisa Sakamoto, Soichiro Honjo, Keigo Ashida, Yoshiyuki Fujiwara
PURPOSE: Associations between the preoperative absolute neutrophil count (NC), lymphocyte count (LC), and monocyte count (MC) in the peripheral blood and the prognosis of colorectal cancer (CRC) patients have not been widely studied. METHODS: We enrolled 361 patients who underwent surgery for CRC between January 2007 and December 2013 to analyze correlations among the LC, MC, and NC and prognosis. RESULTS: Based on cut-off values determined by a receiver operating characteristic analysis, patients were subgrouped as LymphHigh or LymphLow (cut-off: LC = 1460 cells/µL); as MonoHigh or MonoLow (cut-off: MC = 421 cells/µL); and as NeutHigh or NeutLow (cut-off: NC = 3247 cells/µL)...
October 31, 2018: Surgery Today
Seiichiro Sugimoto, Takeshi Kurosaki, Shinji Otani, Shin Tanaka, Yukiko Hikasa, Masaomi Yamane, Shinichi Toyooka, Motomu Kobayashi, Takahiro Oto
PURPOSE: When patients are mechanically ventilated for more than 5 days, they are usually declined as donors for lung transplantation (LTx); thus, the long-term outcomes of LTx from such donors remain unclear. We investigated the feasibility of LTx from donors that had been mechanically ventilated for prolonged periods. METHODS: The subjects of this retrospective comparative investigation were 31 recipients of LTx from donors who had been mechanically ventilated for < 5 days (short-term group) and 50 recipients of LTx from donors who had been mechanically ventilated for ≥ 5 days (long-term group)...
October 27, 2018: Surgery Today
Kunihiko Amamo, Hideyuki Ishida, Kensuke Kumamoto, Norimichi Okada, Satoshi Hatano, Noriyasu Chika, Yusuke Tajima, Tomonori Ohsawa, Masaru Yokoyama, Keiichiro Ishibashi, Erito Mochiki
PURPOSE: Stoma reversal carries a risk of surgical site infection (SSI). Purse-string approximation (PSA) has been reported as an attractive alternative to conventional primary wound closure for stoma reversal, but its efficacy is still under debate. METHODS: Patients undergoing elective stoma reversal were randomized to undergo PSA or primary closure with a drain (PCD). All patients received preoperative bowel cleansing and antimicrobial prophylaxis. The primary endpoint was the incidence of wound healing at the stoma site 30 days after surgery...
October 26, 2018: Surgery Today
Hirofumi Suzumura, Masashi Tsuruta, Hirotoshi Hasegawa, Koji Okabayashi, Takashi Ishida, Yusuke Asada, Akitsugu Makino, Shigeo Okuda, Yuko Kitagawa
PURPOSE: We aimed to clarify the impact of the apparent diffusion coefficient (ADC) value of the mesorectum from preoperative magnetic resonance imaging (MRI) on surgical difficulty in laparoscopic anterior resection (Lap-AR) for rectal cancer. METHODS: In total, 67 patients who had undergone curative Lap-AR for rectal cancer in our hospital from January 2008 to March 2015 and had preoperative MRI findings available were included. We randomly calculated the average ADC in three regions of the mesorectum at the level of the upper edge of the superior border of the femur...
October 19, 2018: Surgery Today
Yusuke Kono, Hiroaki Saito, Yuki Murakami, Yuji Shishido, Hirohiko Kuroda, Tomoyuki Matsunaga, Manabu Yamamoto, Yoji Fukumoto, Tomohiro Osaki, Keigo Ashida, Yoshiyuki Fujiwara
PURPOSE: Inflammation, together with immune and nutritional status, are associated with the progression of various cancer types. We evaluated the prognostic significance of the postoperative ratio (post-CLR) of the maximum C-reactive protein value (post-CRPMax ) to the minimum peripheral lymphocyte count (post-LCMin ) in patients with gastric cancer (GC). METHODS: The subjects of this retrospective study were 227 patients who underwent curative surgery for histopathologically diagnosed gastric adenocarcinoma...
October 13, 2018: Surgery Today
Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima
Esophagojejunal anastomotic leakage (EJAL) is a serious complication of total or proximal gastrectomy for gastric cancer, with a reported incidence of 2.1-14.6% and mortality of up to 50%. EJAL is an independent prognostic factor for the poor survival of gastric cancer patients. Meticulous surgical techniques, experience with anastomotic devices, and a thorough understanding of various risk factors and preventive measures are essential and early diagnosis is critical for preventing EJAL-related death. Patients with suspected EJAL must be evaluated promptly, but contrast swallow is not recommended...
October 13, 2018: Surgery Today
Atsushi Fushimi, Atsushi Yoshida, Hiroshi Yagata, Osamu Takahashi, Naoki Hayashi, Koyu Suzuki, Hiroko Tsunoda, Seigo Nakamura, Hideko Yamauchi
PURPOSES: The clinical behavior of multifocal and multicentric breast cancers (MMBCs) is not well characterized. We conducted this study to ascertain whether patients with MMBCs have a worse prognosis than patients with unifocal breast cancers (UBC). METHODS: The subjects of this retrospective study were 734 consecutive patients who underwent definitive surgery for invasive breast carcinoma at our hospital between January 2004 and December 2006. MMBC was defined as ≥ 2 separate invasive unilateral breast tumors and pathological T stage was redefined based on the sum of the maximum diameter of each tumor...
October 13, 2018: Surgery Today
Zhi-Jie Hong, Cheng-Jueng Chen, De-Chuan Chan, Teng-Wei Chen, Jyh-Cherng Yu, Sheng-Der Hsu
The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader...
October 9, 2018: Surgery Today
Takanori Kurogochi, Michitaka Honda, Kotaro Yamashita, Masaru Hayami, Akihiko Okamura, Yu Imamura, Shinji Mine, Masayuki Watanabe
PURPOSE: Neoadjuvant chemotherapy (NAC) followed by esophagectomy has become a standard treatment for esophageal squamous cancer (ESCC) in Japan. We used propensity-matching analysis to clarify the safety and efficacy of NAC in daily clinical practice. METHODS: We reviewed the medical records of 335 patients with clinical Stage II/III ESCC diagnosed between 2007 and 2012, including 191 who received preoperative NAC (NAC group) and 144 treated by upfront surgery (US group)...
October 1, 2018: Surgery Today
Hideaki Sato, Masaharu Ishida, Fuyuhiko Motoi, Naoaki Sakata, Takeshi Aoki, Hideyuki Suzuki, Akihiro Yamamura, Hideaki Karasawa, Tatsuo Hata, Hideo Ohtsuka, Masamichi Mizuma, Takanori Morikawa, Hiroki Hayashi, Kei Nakagawa, Takashi Kamei, Takeshi Naitoh, Shinichi Egawa, Michiaki Unno
PURPOSE: The Frey procedure is an effective surgery for chronic pancreatitis (CP) patients who have pancreatic head lesions with dilation of the main pancreatic duct. However, pancreatic tail lesions can cause relapsing pancreatitis after the procedure. Therefore, additional distal pancreatectomy (DP) might complement the therapeutic effect of the Frey procedure in controlling inflammation of the pancreatic tail. The Frey procedure with DP (Frey + DP) is indicated for inflammatory lesions in the pancreatic head and tail...
September 26, 2018: Surgery Today
Masaki Ohi, Yuji Toiyama, Yusuke Omura, Takashi Ichikawa, Hiromi Yasuda, Yoshinaga Okugawa, Hiroyuki Fujikawa, Yoshiki Okita, Shigeyuki Yoshiyama, Junichiro Hiro, Toshimitsu Araki, Masato Kusunoki
PURPOSE: Postoperative pulmonary complications (PCs) after thoracoscopic esophagectomy for esophageal cancer (EC) still occur too frequently. We conducted this study to identify the risk factors for PCs developing in EC patients who undergo thoracoscopic esophagectomy. METHODS: The subjects of this retrospective study were 89 patients with EC who underwent thoracoscopic esophagectomy in our department between January 2010 and December 2015. Univariate and multivariate logistic regression analyses were used to evaluate the association between the incidence of PC and clinical factors...
September 25, 2018: Surgery Today
Fumitoshi Hirokawa, Mitsuhiro Asakuma, Koji Komeda, Tetsunosuke Shimizu, Yoshihiro Inoue, Syuji Kagota, Atsushi Tomioka, Kazuhisa Uchiyama
PURPOSE: Neoadjuvant chemotherapy (NAC) for resectable liver metastasis from colorectal cancer (CRLM) is used widely, but its efficacy lacks clear evidence. This study aimed to clarify its worth and develop appropriate treatment strategies for CRLM. METHODS: We analyzed, retrospectively, the clinicopathological factors and outcomes of 137 patients treated for resectable CRLM between 2006 and 2015, with upfront surgery (NAC- group; n = 117) or initial NAC treatment (NAC+ group; n = 20)...
September 25, 2018: Surgery Today
Takanori Morikawa, Masaharu Ishida, Tatsuyuki Takadate, Takeshi Aoki, Hideo Ohtsuka, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Fuyuhiko Motoi, Takeshi Naitoh, Michiaki Unno
PURPOSE: The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments. METHODS: The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed...
September 24, 2018: 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
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