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Surgery Today

Michiko Watanabe, Hiroki Kohno, Yusuke Kondo, Hideki Ueda, Keiichi Ishida, Yusaku Tamura, Shinichiro Abe, Yasunori Sato, Yoshio Kobayashi, Goro Matsumiya
PURPOSE: Very few studies have investigated the efficacy of ganglionated plexus ablation during the conventional maze procedure. In this study, we sought to evaluate its additive effect in reducing recurrent atrial fibrillation after concomitant maze surgery. METHODS: A retrospective study was conducted of 79 patients who underwent Cox maze IV concomitantly with open-heart surgery with (GP group) or without (Maze group) ganglionated plexus mapping. All active ganglionated plexuses were ablated...
May 18, 2018: Surgery Today
Akihisa Matsuda, Marina Yamada, Satoshi Matsumoto, Nobuyuki Sakurazawa, Takeshi Yamada, Takeshi Matsutani, Masao Miyashita, Eiji Uchida
PURPOSE: Lysophosphatidylcholine (LPC), which is generated from phosphatidylcholine (PC) and metabolized by autotaxin (ATX), modulates immune responses via its anti-inflammatory property. We investigated the association between LPC and postoperative complications (POCs) after colorectal cancer surgery (CRC). METHODS: The subjects of this study were 43 patients who underwent surgery for CRC. Peripheral blood samples were collected preoperatively and immediately after surgery, and on postoperative days (PODs) 1, 3, 5, and 7...
May 17, 2018: Surgery Today
Jiong-Jie Yu, Li-Yang Sun, Tian Yang
No abstract text is available yet for this article.
May 17, 2018: Surgery Today
Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Tadafumi Asaoka, Takehiro Noda, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; however, the frequency of recurrence can be reduced if curative surgery following adjuvant chemotherapy is applied. At present, adjuvant chemotherapy is uniformly performed in all patients, as it is unclear which tumor types are controlled best or worst. We investigated patients with recurrence to establish the optimum treatment strategy. METHODS: Of 138 patients who underwent curative surgery for PDAC, 85 developed recurrence...
May 17, 2018: Surgery Today
Eiji Kobayashi, Jiro Nudeshima
Surgical skill training using cadavers is important for surgeons to gain an understanding of anatomical approaches. However, the laws and guidelines stipulating surgical technique training using corpses differ in each country. We discuss the new guidelines and the current situation in Japan in comparison with that in Western Europe and the United States.
May 16, 2018: Surgery Today
Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Kentaro Imanishi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shinichi Toyooka, Takahiro Oto
PURPOSE: The lung allocation score (LAS) has been generally recognized as a contributor to the overall survival in lung transplant candidates. However, donor-related risks have never been taken into consideration in previous research that validated the LAS. This study aimed to determine whether or not the role of the LAS as a predictor of the posttransplant outcome is influenced by the quality of the donor lungs. METHODS: We retrospectively reviewed 108 patients who underwent lung transplantation at Okayama University Hospital since 1998...
May 11, 2018: Surgery Today
Tetsunosuke Shimizu, Hirotada Kittaka, Kohei Taniguchi, Kazuhisa Uchiyama, Hiroshi Akimoto
Pancreatic complex deep injury extending to the main pancreatic duct (MPD), caused by strong external forces such as traffic accidents, is lethal without emergency surgery. However, the best surgical procedure for this serious injury has not been established. The Bracey procedure is a relatively simple reconstructive technique involving pancreaticogastrostomy, but it is often followed by postoperative complications, such as dilatation of the MPD caused by anastomotic stenosis, as well as subsequent serious sequela such as repetitive pancreatitis and new-onset pancreatic diabetes...
May 11, 2018: Surgery Today
Kenji Kawada, Koya Hida, Suguru Hasegawa, Yoshiharu Sakai
PURPOSE: To compare the time-course change in the postoperative anorectal function between laparoscopic intersphincteric resection (ISR) and low anterior resection (LAR). METHODS: This is a single-institution observational study. We evaluated the time-course change in the anorectal function using functional questionnaires before and at 6, 12, and 24 months after laparoscopic ISR or LAR. RESULTS: Sixty-two patients answered the functional questionnaires (28 in the ISR group and 34 in the LAR group)...
May 11, 2018: Surgery Today
Tohru Tani, Shigeyuki Naka, Soichiro Tani, Hisanori Shiomi, Koichiro Murakami, Atsushi Yamada, Dang Tran Khiem
PURPOSE: We developed a microwave energy-based scissors device (MWCX) that is capable of performing cutting and coagulation using 2.45 GHz microwave energy. This paper aims to present the concept of the device and assess the basic functions including the hemostasis, cutting, and sealing abilities. METHODS: Seven beagle dogs were used in our experiments. In six dogs, we measured the coagulation time (CT), lateral thermal injury (LTI), bursting pressure (BP). The dogs were then subjected to re-laparotomy 1 week later to allow us to investigate the results...
May 10, 2018: Surgery Today
Tamotsu Kuroki, Hikaru Fujioka
In recent years, laparoscopic procedures have developed rapidly, and the reports of laparoscopic pancreatic resection including laparoscopic pancreaticoduodenectomy (LPD) have increased in number. Although LPD is a complex procedure with high mortality, the training system for LPD remains unestablished. Ensuring patient safety is extremely important, even in challenging surgeries such a LPD. At present, several tools have been developed for surgical education to ensure patient safety preoperatively, such as video learning, virtual reality simulators, and cadaver training...
May 10, 2018: Surgery Today
Stina Öberg, Kristoffer Andresen, Jacob Rosenberg
PURPOSE: Up to 6-7% of patients who have undergone laparoscopic groin hernia repair suffer from chronic pain, depending on various factors; however, the long-term course is unclear. The purpose of this study was to assess the prevalence of chronic pain 1-5 years after laparoscopic groin hernia repair. METHODS: The subjects of this nationwide cross-sectional questionnaire study were adults who underwent laparoscopic mesh repair of an inguinal or a femoral hernia...
May 9, 2018: Surgery Today
Nobuyuki Shimizu, Eiji Oki, Yutaka Tanizawa, Yutaka Suzuki, Susumu Aikou, Chikara Kunisaki, Takashi Tsuchiya, Ryoji Fukushima, Yuichiro Doki, Shoji Natsugoe, Yasunori Nishida, Masaru Morita, Naoki Hirabayashi, Fumihiko Hatao, Ikuo Takahashi, Yasuhiro Choda, Yoshiaki Iwasaki, Yasuyuki Seto
PURPOSE: This multicenter, randomized controlled study evaluates the safety of early oral feeding following gastrectomy, and its effect on the length of postoperative hospital stay. METHODS: The subjects of this study were patients who underwent distal gastrectomy (DG) or total gastrectomy (TG) for gastric cancer between January 2014 and December 2015. Patients were randomly assigned to the early oral feeding group (intervention group) or the conventional postoperative management group (control group) for each procedure...
May 2, 2018: Surgery Today
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Hideki Motoyama, Masatsugu Hamaji, Daisuke Nakajima, Akihiro Aoyama, Hiroshi Date
PURPOSE: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx. METHODS: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications...
April 30, 2018: Surgery Today
Kensuke Otani, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kazuhito Sasaki, Manabu Kaneko, Koji Murono, Shigenobu Emoto, Hiroaki Nozawa
Perforation of the colon is a rare complication for patients with colon cancer and usually requires emergent surgery. The characteristics of perforation differ based on the site of perforation, presenting as either perforation at the cancer site or perforation proximal to the cancer site. Peritonitis due to perforation tends to be more severe in cases of perforation proximal to the cancer site; however, the difference in the outcome between the two types remains unclear. Surgical treatment of colon cancer with perforation has changed over time...
April 24, 2018: Surgery Today
Kimitaka Tanaka, Toru Nakamura, Shungo Imai, Hiroki Kushiya, Daisuke Miyasaka, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
PURPOSE: The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole. METHODS: Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated...
April 23, 2018: Surgery Today
Seiichiro Sugimoto, Masaomi Yamane, Shinji Otani, Takeshi Kurosaki, Shuji Okahara, Yukiko Hikasa, Shinichi Toyooka, Motomu Kobayashi, Takahiro Oto
PURPOSE: Airway complications (ACs) after living-donor lobar lung transplantation (LDLLT) could have different features from those after cadaveric lung transplantation (CLT). We conducted this study to compare the characteristics of ACs after LDLLT vs. those after CLT and investigate their impact on outcomes. METHODS: We reviewed, retrospectively, data on 163 recipients of lung transplantation, including 83 recipients of LDLLT and 80 recipients of CLT. RESULTS: The incidence of ACs did not differ between LDLLT and CLT...
April 21, 2018: Surgery Today
Motoi Mukai, Tatsuru Kaji, Ryuta Masuya, Koji Yamada, Koshiro Sugita, Tomoe Moriguchi, Shun Onishi, Waka Yamada, Takafumi Kawano, Seiro Machigashira, Kazuhiko Nakame, Hideo Takamatsu, Satoshi Ieiri
PURPOSE: The late postoperative complications of choledochal cyst (CC) surgery are serious and include intrahepatic stones and biliary carcinoma; therefore, long-term follow-up is crucial. METHODS: The subjects of this retrospective study were patients who underwent surgery for CC at Kagoshima University Hospital between April, 1984 and December, 2016. We analyzed the operative results, early and late postoperative complications, and postoperative follow-up rate...
April 20, 2018: Surgery Today
Kazue Yoneda, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
A tissue biopsy is the "golden standard" for molecular profiling that is essential in decision-making regarding treatment for malignant tumors, including primary lung cancer. However, tumor biopsies are associated with several limitations, including invasiveness and difficulty in achieving access. Liquid biopsies have several potential advantages over tissue biopsies, and recent advances in molecular technologies have enabled liquid biopsies to be introduced into daily clinical practice. Cell-free blood-based liquid biopsies to detect mutations in the epidermal growth factor receptor (EGFR) gene in the plasma have been approved and may be useful in selecting patients for treatment with tyrosine kinase inhibitors of EGFR...
April 11, 2018: Surgery Today
Masatoshi Kochi, Takao Hinoi, Hiroaki Niitsu, Hideki Ohdan, Fumio Konishi, Yusuke Kinugasa, Takaya Kobatake, Masaaki Ito, Masafumi Inomata, Toshimasa Yatsuoka, Takashi Ueki, Jo Tashiro, Shigeki Yamaguchi, Masahiko Watanabe
PURPOSE: Postoperative pneumonia affects the length of stay and mortality after surgery in elderly patients with colorectal cancer (CRC). We aimed to determine the risk factors of postoperative pneumonia in elderly patients with CRC, and to evaluate the impact of laparoscopic surgery on elderly patients with CRC. METHODS: We retrospectively investigated 1473 patients ≥ 80 years of age who underwent surgery for stage 0-III CRC between 2003 and 2007. Using a multivariate analysis, we determined the risk factors for pneumonia occurrence from each baseline characteristic...
March 29, 2018: Surgery Today
Masashi Miguchi, Takao Hinoi, Kohji Tanakaya, Tatsuro Yamaguchi, Yoichi Furukawa, Teruhiko Yoshida, Kazuo Tamura, Kokichi Sugano, Chikashi Ishioka, Nagahide Matsubara, Naohiro Tomita, Masami Arai, Hideki Ishikawa, Keiji Hirata, Yoshihisa Saida, Hideyuki Ishida, Kenichi Sugihara
We conducted this study to establish whether drinking alcohol alters the risk of early-onset colorectal cancer (CRC) in Japanese patients with Lynch syndrome (LS). The subjects were 66 LS patients with pathogenic mutation of mismatch repair genes (MLH1, MSH2, and MSH6) from the nationwide Japanese retrospective multicenter study. Cox proportional hazards modeling was used to investigate the factors correlating with early-onset CRC diagnosis, using clinical data such as gender, tobacco use, alcohol consumption, body mass index, gene mutation (MLH1, MSH2 vs MSH6), and family cancer history...
March 24, 2018: Surgery Today
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