Surgery Today最新文献

The assessment of adjuvant chemotherapy benefits after D3 lymphadenectomy in patients with colon cancer: a propensity score matching study. 评估结肠癌患者 D3 淋巴腺切除术后辅助化疗的益处：倾向得分匹配研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-18 DOI: 10.1007/s00595-024-02965-0

Kiyoaki Sugiura, Kensuke Takebe, Junya Aoyama, Go Oshima, Hiroto Kikuchi, Koji Okabayashi, Satoshi Aiko, Yuko Kitagawa

{"title":"The assessment of adjuvant chemotherapy benefits after D3 lymphadenectomy in patients with colon cancer: a propensity score matching study.","authors":"Kiyoaki Sugiura, Kensuke Takebe, Junya Aoyama, Go Oshima, Hiroto Kikuchi, Koji Okabayashi, Satoshi Aiko, Yuko Kitagawa","doi":"10.1007/s00595-024-02965-0","DOIUrl":"https://doi.org/10.1007/s00595-024-02965-0","url":null,"abstract":"Purpose: Adjuvant chemotherapy (AC) for stage III disease is recognized as a standard treatment and is routinely performed in patients with colon cancer (CC). However, the recommendation for AC is mainly based on studies performed in past environments, where D3 lymphadenectomy was not routinely performed.Methods: We retrospectively analyzed CC patients who underwent curative resection with D3 lymphadenectomy in Keio Surveillance Epidemiology and End Results (K-SEER) database. After patients were divided into AC and non-AC groups, propensity score matching (PSM) was performed to match the two groups.Results: After PSM, 84 patients were included in each group. There were no significant differences between the AC and non-AC groups in the 5-year cancer-specific survival (CSS; 88.01% vs. 81.46%, p = 0.295) and 5-year recurrence-free survival (RFS; 69.57 vs. 70.08%, p = 0.820), respectively. In the subgroup analysis, AC improved both the CSS [hazard ratio (HR)0.273; 95% confidence interval (CI) 0.094-0.797, p = 0.017] and RFS (HR 0.376; 95% CI 0.174-0.806, p = 0.012) only for tumors with N2 disease compared to non-AC.Conclusion: The current indications for AC in patients with CC after D3 lymphadenectomy should be reconsidered. It is possible that AC is appropriate only for stage III CC patients with N2 disease.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mechanisms of polyglycolic acid sheet-induced abdominal wall adhesions in hamsters. 聚乙二醇酸片诱发仓鼠腹壁粘连的机制

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-14 DOI: 10.1007/s00595-024-02963-2

Shintaro Shigesato, Denan Jin, Wataru Osumi, Kohei Taniguchi, Koji Komeda, Mitsuhiro Asakuma, Hideki Tomiyama, Shinji Takai, Sang-Woong Lee

{"title":"Mechanisms of polyglycolic acid sheet-induced abdominal wall adhesions in hamsters.","authors":"Shintaro Shigesato, Denan Jin, Wataru Osumi, Kohei Taniguchi, Koji Komeda, Mitsuhiro Asakuma, Hideki Tomiyama, Shinji Takai, Sang-Woong Lee","doi":"10.1007/s00595-024-02963-2","DOIUrl":"https://doi.org/10.1007/s00595-024-02963-2","url":null,"abstract":"Purpose: A hamster adhesion model was used to investigate the mechanism by which polyglycolic acid (PGA) sheets reinforce the surgical site through the acceleration of postoperative adhesion formation.Methods: After receiving electrocautery burns on the inside of the abdominal wall, the hamsters were divided into the PGA group (a PGA sheet was placed on the burned area) and a non-treated group (a PGA sheet was not placed). The degree of adhesion was evaluated at 3, 14, 28, and 56 days after burn injury, and the mRNA levels of myeloperoxidase (MPO), tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β1 at the surgical sites were measured.Results: Adhesion formation was observed 3 days after the burn injury in the non-treated group, but it decreased at 14, 28, and 56 days. On the other hand, a significant increase in adhesion formation was observed at 3 days in the PGA group relative to the non-treated group, with the increase continuing at 14 and 28 days. Significant increases in MPO, TNF-α, and TGF-β1 mRNA levels at the adhesion site were observed 3 days after the burn injury in both groups, with the increase continuing in the PGA group, but not in the non-treated group, at 14 and 28 days.Conclusions: Acceleration of adhesion formation by PGA may be associated with upregulated MPO, TNF-α, and TGF-β1 mRNA levels.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Learning curve of consolers and bedside surgeons fused robotic-assisted thoracoscopic segmentectomy: insights from the initial 100 cases. 融合机器人辅助胸腔镜胸段切除术的安慰者和床旁外科医生的学习曲线：最初 100 例病例的启示。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-14 DOI: 10.1007/s00595-024-02957-0

Yuki Uno, Shinya Tane, Yugo Tanaka, Midori Takanashi, Takefumi Doi, Hiroyuki Ogawa, Daisuke Hokka, Yoshimasa Maniwa

{"title":"Learning curve of consolers and bedside surgeons fused robotic-assisted thoracoscopic segmentectomy: insights from the initial 100 cases.","authors":"Yuki Uno, Shinya Tane, Yugo Tanaka, Midori Takanashi, Takefumi Doi, Hiroyuki Ogawa, Daisuke Hokka, Yoshimasa Maniwa","doi":"10.1007/s00595-024-02957-0","DOIUrl":"https://doi.org/10.1007/s00595-024-02957-0","url":null,"abstract":"Purpose: This study examined the learning curve of segmentectomy using the \"fused surgery\" approach.Methods: We retrospectively collected data from 100 patients who underwent segmentectomy via fused robot-assisted thoracoscopy at our institution between September 2020 and February 2024. The learning curve was evaluated using the cumulative sum of the operative times in all cases and was analyzed separately for simple and complex segmentectomies.Results: After applying the cumulative sum method to all cases, we obtained a graph of the operative time that showed three well-differentiated phases: phase 1 (n = 23), the initial learning phase; phase 2 (n = 28), the increased competence phase; and phase 3 (n = 49), the highest skill phase. Comparing phases 1 and 2 with phase 3, we found significant differences in operative time (P < 0.001); however, no significant differences were observed in bleeding or rate of postoperative complications. We observed a significant reduction in operative time after 25 simple segmentectomies and 22 complex segmentectomies.Conclusions: The data suggested that the inflection point of the learning curve was achieved in 51 cases. Complex segmentectomy requires the same cases to achieve the same level of competence as simple segmentectomy.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of intestinal wall closure using vessel-sealing technology versus conventional closure: an in vivo study. 评估使用血管密封技术与传统闭合技术进行肠壁闭合的效果：一项体内研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-13 DOI: 10.1007/s00595-024-02961-4

Toshio Shiraishi, Takashi Nonaka, Tetsuro Tominaga, Shintaro Hashimoto, Hiroshi Maruta, Keisuke Noda, Terumitsu Sawai, Keitaro Matsumoto

{"title":"Evaluation of intestinal wall closure using vessel-sealing technology versus conventional closure: an in vivo study.","authors":"Toshio Shiraishi, Takashi Nonaka, Tetsuro Tominaga, Shintaro Hashimoto, Hiroshi Maruta, Keisuke Noda, Terumitsu Sawai, Keitaro Matsumoto","doi":"10.1007/s00595-024-02961-4","DOIUrl":"https://doi.org/10.1007/s00595-024-02961-4","url":null,"abstract":"Purpose: Anastomotic leakage is a major postoperative complication of colorectal surgery. LigaSure™ is used commonly for vessel-sealing, but its use for intestinal anastomosis or closure, particularly the healing process, is underreported. We conducted this study to evaluate the feasibility of using LigaSure™ for intestinal wall closure, compared with hand-sewn methods.Methods: We performed intestinal wall closure of the cecum in rat laparotomy procedures, dividing subjects into a LigaSure™ group (LS) and a hand-sewn group (HS). We compared operation times, tissue structure changes, and pressure resistance from immediately post-operatively to postoperative day (POD) 14.Results: No postoperative dehiscence or mortality occurred in either group. The LS group required significantly less closure time (113 s) than the HS group (321 s, p < 0.001). The adhesion rates for a midline incision were not significantly different between the groups (LS: 26.7% vs. HS: 6.7%; p = 0.142), with adhesions at the closure site seen in all subjects. The LS group had a lower burst pressure than the HS group until POD 3, with no significant differences thereafter. Structural continuity was established by POD 5 in both groups.Conclusions: LigaSure™ provides effective intestinal wall closure with a more distinct healing process than with hand-sewn methods, suggesting the potential for staple-free anastomosis.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postoperative pain management using high-dose oral acetaminophen for enhanced recovery after colorectal cancer surgery. 使用大剂量口服对乙酰氨基酚控制术后疼痛，促进结直肠癌手术后的恢复。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-13 DOI: 10.1007/s00595-024-02962-3

Shinya Urakawa, Tatsushi Shingai, Junichiro Kato, Shinya Kidogami, Tadafumi Fukata, Hisashi Nishida, Hiroyoshi Takemoto, Hiroaki Ohigashi, Takayuki Fukuzaki

{"title":"Postoperative pain management using high-dose oral acetaminophen for enhanced recovery after colorectal cancer surgery.","authors":"Shinya Urakawa, Tatsushi Shingai, Junichiro Kato, Shinya Kidogami, Tadafumi Fukata, Hisashi Nishida, Hiroyoshi Takemoto, Hiroaki Ohigashi, Takayuki Fukuzaki","doi":"10.1007/s00595-024-02962-3","DOIUrl":"https://doi.org/10.1007/s00595-024-02962-3","url":null,"abstract":"Purpose: Postoperative pain management is important for enhanced recovery. High-dose oral acetaminophen is effective; however, the safety of its long-term use has not been established in gastrointestinal surgeries. This study aimed to investigate drug-induced liver injury (DILI) in patients with colorectal cancer using high-dose acetaminophen.Methods: One hundred sixty-eight consecutive colorectal cancer using high-dose oral acetaminophen (3600 mg/day between postoperative day 1 and 7) were enrolled.Results: One hundred forty-nine patients (88.7%) completed the administration of high-dose oral acetaminophen. DILI occurred in 58 patients (34.5%), and the cumulative incidence rates were 20.4% and 37.9% on postoperative 6 and 7, respectively. The severity of liver injury was grade 1 in all cases and returned to normal without treatment. Patients with DILI had a higher frequency of dyslipidemia (44.8% vs. 23.6%, P = 0.0047) and M1 staging (10.3% vs. 1.0%, P = 0.0036). A multivariate analysis showed that the presence of dyslipidemia (OR 2.61, P = 0.0067) and M1 stage (OR 12.4, P = 0.0053) were independent risk factors for DILI.Conclusion: The long-term use of high-dose oral acetaminophen in colorectal cancer patients enrolled in enhanced recovery protocols is feasible. Moreover, the presence of dyslipidemia and M status are risk factors for DILI.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of intermediate water in alleviating postsurgical intrapericardial adhesion. 中间水在缓解手术后心包内粘连中的作用。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-11-08 DOI: 10.1007/s00595-024-02953-4

Tatsuya Suzuki, Hayato Konishi, Akiyo Suzuki, Takahiro Katsumata, Yasuhiro Fukuda, Koki Miyamoto, Tomokazu Ise, Yukiko Tanaka, Aki Yamamoto, Panyue Wen, Shohei Shiomoto, Masaru Tanaka, Shintaro Nemoto

{"title":"Role of intermediate water in alleviating postsurgical intrapericardial adhesion.","authors":"Tatsuya Suzuki, Hayato Konishi, Akiyo Suzuki, Takahiro Katsumata, Yasuhiro Fukuda, Koki Miyamoto, Tomokazu Ise, Yukiko Tanaka, Aki Yamamoto, Panyue Wen, Shohei Shiomoto, Masaru Tanaka, Shintaro Nemoto","doi":"10.1007/s00595-024-02953-4","DOIUrl":"https://doi.org/10.1007/s00595-024-02953-4","url":null,"abstract":"Purpose: Various polymers have been used as postsurgical antiadhesive materials; however, the mechanisms underlying their efficacy remain unclear. Intermediate water has been found to prevent the adhesion between polymer molecules and proteins or cells. The present study investigated the role of intermediate water retained in the polymer in alleviating postsurgical pericardial adhesion.Methods: Hydrophobic fabrics were prepared using biodegradable polyglycolic acid. To add intermediate water, the fabric fibers were coated with poly(oxyethylene)oleyl ethers. Intermediate water in the hydrated state was detected by a thermal analysis for each material, and cell attachment to the fibers with or without coating was observed in vitro. Using a canine model of postsurgical pericardial adhesion, the severity of adhesion was examined along with a histological assessment during treatment, with or without fabric coating.Results: Intermediate water was detected in the coating materials but not in polyglycolic acid. Coating significantly reduced the cell attachment to the fibers. Coating also alleviated adhesion by reducing inflammation in the fibrous layer and replacing the fabric and granulomas that develop around the surgical sutures in the pericardial space.Conclusions: Intermediate water in the hydrated polymer of anti-adhesives may play an important role in alleviating postoperative pericardial adhesion.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0