Surgery Today最新文献_第2页

A graft-to-recipient weight ratio of less than 0.7% under portal venous hemodynamics monitoring is a risk factor for early graft loss after living donor liver transplantation. 门静脉血流动力学监测下移植物与受体重量比小于0.7%是活体肝移植术后早期移植物丢失的危险因素。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-11 DOI: 10.1007/s00595-025-03103-0

Niang-Cheng Lin, Cheng-Yen Chen, Hao-Jan Lei, Hsin-Lin Tsai, Yi-Fan Tsou, Fang-Cheng Kuo, Meng-Hsuan Chung, Cheng-Yuan Hsia, Che-Chuan Loong, Shu-Cheng Chou, Shen-Chih Wang, Chinsu Liu

{"title":"A graft-to-recipient weight ratio of less than 0.7% under portal venous hemodynamics monitoring is a risk factor for early graft loss after living donor liver transplantation.","authors":"Niang-Cheng Lin, Cheng-Yen Chen, Hao-Jan Lei, Hsin-Lin Tsai, Yi-Fan Tsou, Fang-Cheng Kuo, Meng-Hsuan Chung, Cheng-Yuan Hsia, Che-Chuan Loong, Shu-Cheng Chou, Shen-Chih Wang, Chinsu Liu","doi":"10.1007/s00595-025-03103-0","DOIUrl":"https://doi.org/10.1007/s00595-025-03103-0","url":null,"abstract":"Purpose: To investigate the interaction between graft-to-recipient weight ratio (GRWR) and portal venous hemodynamics (PVH), with a net impact on the perioperative outcomes of living donor liver transplantation (LDLT).Methods: We analyzed, retrospectively, adult LDLT recipients divided into three groups according to their GRWR: Group 1, > 1.0% (n = 124); Group 2, 0.8 ~ 1.0% (n = 70); and Group 3, < 0.8% (n = 31).Results: The intraoperative PVH parameters did not differ significantly among the groups, but Group 3 had the highest number of patients needing portal inflow modulation to achieve optimal final portal pressure. Group 3 was also more prone to delayed recovery of liver function, a higher incidence of posttransplant kidney injury necessitating dialysis (16.1% vs. 3.2% for Group 1 and 4.3% for Group 2, p = 0.015) and a higher incidence of liver graft loss within 3 months post-LDLT (22.6% vs. 7.3% for Group 1 and 4.3% for Group 2, p = 0.007). Logistic regression analysis revealed that extremely small liver grafts (GRWR < 0.7%) were the most significant risk factor for early graft loss (HR: 16.951, 95% CI: 3.961 ~ 72.535). Survival analysis revealed comparable outcomes between patients who received liver grafts with a GRWR of 0.7 ~ 0.8% and those who received liver grafts with a GRWR > 0.8%. Patients with extremely small liver grafts had significantly lower graft survival rates (1-month, 3-months, and 1-year post-LDLT, of 66.7%, 50.0%, and 50.0%, respectively (p < 0.01).Conclusion: Under intraoperative PVH monitoring, the accepted GRWR in LDLT could be extended to 0.7%, but a GRWR < 0.7% remains a risk factor for early graft loss.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609662","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

Trends, demographic patterns, and regional disparities in gastrostomy: a nationwide population-based cohort study in Japan from 2014 to 2022. 胃造口术的趋势、人口模式和地区差异：2014年至2022年日本全国人口队列研究

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-10 DOI: 10.1007/s00595-025-03085-z

Masamitsu Kido, Katsutoshi Shoda, Ken Inoue, Ryotaro Ishii, Reiko Kato, Daisuke Ichikawa

{"title":"Trends, demographic patterns, and regional disparities in gastrostomy: a nationwide population-based cohort study in Japan from 2014 to 2022.","authors":"Masamitsu Kido, Katsutoshi Shoda, Ken Inoue, Ryotaro Ishii, Reiko Kato, Daisuke Ichikawa","doi":"10.1007/s00595-025-03085-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03085-z","url":null,"abstract":"Purpose: This study explored the trends, demographic patterns, and regional disparities in gastrostomy procedures using Japanese nationwide receipt databases.Methods: Age- and sex-stratified data on gastrostomy procedures from 2014 to 2022 were analyzed using Jonckheere-Terpstra tests and Poisson regression models. The number of inpatient gastrostomies, surgeons, physicians in gastroenterology, and neurologists (with and without board certification) were assessed by prefecture. Disparities across 47 prefectures and urban-rural disparities were quantified using Gini coefficients and unpaired t-tests. Correlations were assessed using Pearson's correlation method.Results: The average annual number of gastrostomies was 55,577 (rate: 44.0 per 100,000), with a slight male predominance (male-to-female ratio, 1:0.9). A minor peak occurred in the 0-4 year-old age group (9.6 procedures), followed by a sharp increase after 40 years old, peaking at ≥ 90 years (374.8 procedures). The age-adjusted rates declined overall (risk ratio: 0.957-0.959, P < 0.0001), particularly among the elderly. The Gini coefficient showed low inequality for gastrostomies. The number of gastrostomies was significantly higher in rural than in urban regions. Moderate correlations were found between the number of gastrostomies and the number of surgeons and physicians in gastroenterology without board certification.Conclusion: This study highlights demographic and regional disparities in gastrostomy practices in Japan.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601629","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

Prevalence of median arcuate ligament syndrome and associated visceral artery aneurysms: Insights from computed tomography radiology reports in a single institution and management strategies. 中弓韧带综合征和相关内脏动脉瘤的患病率：来自单一机构和管理策略的计算机断层放射学报告的见解。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-10 DOI: 10.1007/s00595-025-03074-2

Yusuke Endo, Kazunori Inuzuka, Masaki Sano, Kazuto Katahashi, Hajime Tsuyuki, Nozomu Ishikawa, Hiroya Takeuchi, Naoki Unno

{"title":"Prevalence of median arcuate ligament syndrome and associated visceral artery aneurysms: Insights from computed tomography radiology reports in a single institution and management strategies.","authors":"Yusuke Endo, Kazunori Inuzuka, Masaki Sano, Kazuto Katahashi, Hajime Tsuyuki, Nozomu Ishikawa, Hiroya Takeuchi, Naoki Unno","doi":"10.1007/s00595-025-03074-2","DOIUrl":"https://doi.org/10.1007/s00595-025-03074-2","url":null,"abstract":"Purpose: This study investigated the prevalence of median arcuate ligament syndrome (MALS) and its association with visceral artery aneurysms based on radiological computed tomography (CT) reports from a single institution.Methods: Among 392,111 abdominal CT scans (211,685 unique patients), 128 (0.06%) of celiac artery stenosis caused by MAL compression were identified after excluding calcified stenosis.Results: Of 128 patients, 18 (14.1%) were symptomatic and presented with abdominal pain, discomfort, or bowel irregularities. Two symptomatic patients underwent MAL release surgery, while the other 16 were managed conservatively with medication. Aneurysmal formation secondary to celiac artery stenosis was observed in 54 cases (42.2%), with no reported rupture or dissection. Pancreaticoduodenal artery aneurysms were identified in 6 cases (4.7%), which were treated with endovascular intervention or MAL release. Over a mean follow-up period of 57 months (100 patients), no recurrence or new aneurysm formation was observed. A positive correlation (r = 0.52) was found between the stenosis rate and post-stenotic vessel diameter, highlighting a potential link between stenosis severity and aneurysm formation.Conclusion: The prevalence was low, with most cases being asymptomatic. Further studies are needed to better understand the role of MAL release in managing pancreaticoduodenal aneurysms and preventing aneurysm formation.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601628","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

Impact of preoperative biliary drainage on postoperative outcomes in patients who undergo major hepatectomy after portal vein embolization for perihilar cholangiocarcinoma. 术前胆道引流对肝切除术门静脉栓塞治疗肝门周围胆管癌患者术后预后的影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-08 DOI: 10.1007/s00595-025-03080-4

Noriyuki Kitagawa, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Takahiro Yoshizawa, Kiyotaka Hosoda, Hikaru Hayashi, Shigeki Hayashi, Yuji Soejima

{"title":"Impact of preoperative biliary drainage on postoperative outcomes in patients who undergo major hepatectomy after portal vein embolization for perihilar cholangiocarcinoma.","authors":"Noriyuki Kitagawa, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Takahiro Yoshizawa, Kiyotaka Hosoda, Hikaru Hayashi, Shigeki Hayashi, Yuji Soejima","doi":"10.1007/s00595-025-03080-4","DOIUrl":"https://doi.org/10.1007/s00595-025-03080-4","url":null,"abstract":"Purpose: The influence of preoperative biliary drainage (PBD) and portal vein embolization (PVE) on the occurrence of post-hepatectomy liver failure (PHLF) remains unclear. We evaluated their influence on postoperative outcomes, focusing on PHLF, in patients who underwent major hepatectomy for perihilar cholangiocarcinoma (PHCC).Methods: A total of 240 patients underwent major hepatectomy for PHCC between January 1990 and March 2021. We evaluated the influence of PBD on short-term outcomes in all patients and in a subgroup (n = 111) that received PVE.Results: Although the incidence of grade B/C PHLF in patients with PBD was higher than that in those without PBD, a multivariable analysis identified PVE (OR 3.98, 95% CI 1.9-8.4; p < 0.001) and organ/space surgical site infection (SSI) (OR 3.48, 95% CI 1.6-7.4; p = 0.001), but not PBD, as independent risk factors for grade B/C PHLF. A multivariate analysis of patients who underwent PVE revealed that organ/space SSI was an independent risk factor for grade B/C PHLF (OR 4.5, 95% CI 1.6-12.7; p = 0.005).Conclusion: PBD did not have a negative impact on the occurrence of PHLF in patients undergoing PVE for an initially inadequate future liver remnant volume, provided that appropriate antimicrobial prophylaxis was selected.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584948","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

Clinical factors associated with surgical interventions in patients with intestinal obstruction caused by abdominal tuberculosis. 腹部结核性肠梗阻手术治疗的临床因素分析。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-08 DOI: 10.1007/s00595-025-03098-8

Shinya Urakawa, Hidemi Nishi, Daishi Yoshimura, Kazuya Sakata, Kimimasa Ikeda, Shoji Hashimoto, Yuki Han, Yoshitaka Tamura, Takayuki Nagai, Satoru Miyazaki

{"title":"Clinical factors associated with surgical interventions in patients with intestinal obstruction caused by abdominal tuberculosis.","authors":"Shinya Urakawa, Hidemi Nishi, Daishi Yoshimura, Kazuya Sakata, Kimimasa Ikeda, Shoji Hashimoto, Yuki Han, Yoshitaka Tamura, Takayuki Nagai, Satoru Miyazaki","doi":"10.1007/s00595-025-03098-8","DOIUrl":"https://doi.org/10.1007/s00595-025-03098-8","url":null,"abstract":"Purpose: Abdominal tuberculosis (TB), including Intestinal TB (ITB) and peritoneal TB (PTB), can cause intestinal strictures, leading to obstructions. However, the surgical indications for TB-related intestinal obstructions are yet to be established. This study investigates the clinical factors associated with these surgical interventions.Methods: Eighty-eight consecutive patients with ITB or PTB were enrolled in this study. The severity of abdominal TB was evaluated by the number of computed tomography (CT) findings of ascites, peritoneal nodules > 10 mm, intestinal wall thickening, and peritoneal or omental thickening.Results: Intestinal obstructions were diagnosed in 25 patients. The median duration of non-operative management was 11 (2-35) days, and 10 of the 25 patients required surgical intervention after non-operative management. The surgery group had a higher frequency of more CT features (70% vs. 13.3%, P = 0.0038) and a lower frequency of antitubercular therapy (ATT; 50% vs. 100%, P = 0.0075) than the non-surgery group. The severity of lung TB had no impact on the need for surgery and there was discrepancy between the chest and abdominal CT findings.Conclusion: Long-term non-operative management may be required for abdominal TB and the need for surgical intervention is associated with the ATT and CT findings.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592425","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

Impact of low anterior resection syndrome after rectal surgery on sleep quality. 直肠手术后低位前切除术综合征对睡眠质量的影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-07 DOI: 10.1007/s00595-025-03092-0

Akira Toyoshima, Toshihiro Nishizawa, Osamu Toyoshima, Ryuji Akai, Manabu Kaneko, Shin Sasaki

{"title":"Impact of low anterior resection syndrome after rectal surgery on sleep quality.","authors":"Akira Toyoshima, Toshihiro Nishizawa, Osamu Toyoshima, Ryuji Akai, Manabu Kaneko, Shin Sasaki","doi":"10.1007/s00595-025-03092-0","DOIUrl":"https://doi.org/10.1007/s00595-025-03092-0","url":null,"abstract":"Purpose: The factors contributing to the association between rectal cancer and sleep impairment remain unclear. We investigated the risk factors for sleep impairment after anus-preserving surgery for rectal cancer.Methods: This cross-sectional study investigated surviving patients who underwent low anterior or intersphincteric resection with curative intent for rectal cancer located < 15 cm from the anal verge. Defecatory dysfunction and sleep quality were assessed using the low anterior resection syndrome (LARS) score and the Pittsburgh Sleep Quality Index, respectively.Results: A total of 176 patients were included in this analysis. The sleep impairment rate in the \"major LARS\" group was significantly higher than that in the \"no/minor LARS\" group (54.5 vs. 24.2%; p < 0.001). Multivariable analysis identified that age (odds ratio = 0.943) and tumor height (odds ratio = 0.893) were independently associated with major LARS. In the multivariable analysis for sleep impairment, major LARS (odds ratio = 4.490, p < 0.001) and adjuvant (pre/post) chemotherapy (odds ratio = 3.400, p = 0.003) were independently associated with sleep impairment.Conclusion: Sleep quality was reduced significantly in patients with major LARS after rectal cancer surgery. Adjuvant chemotherapy also impairs sleep quality, while low tumor location and young age were independent risk factors for major LARS.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576223","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

Pancreaticoduodenectomy preserving blood flow of the gastroduodenal artery. 保留胃十二指肠动脉血流的胰十二指肠切除术。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-07 DOI: 10.1007/s00595-025-03096-w

Ai Shimazu, Yoshinori Takeda, Shoichi Irie, Koji Namekata, Hirofumi Ichida, Ryuji Yoshioka, Yoshihiro Mise, Akio Saiura

{"title":"Pancreaticoduodenectomy preserving blood flow of the gastroduodenal artery.","authors":"Ai Shimazu, Yoshinori Takeda, Shoichi Irie, Koji Namekata, Hirofumi Ichida, Ryuji Yoshioka, Yoshihiro Mise, Akio Saiura","doi":"10.1007/s00595-025-03096-w","DOIUrl":"https://doi.org/10.1007/s00595-025-03096-w","url":null,"abstract":"Purposes: Pancreaticoduodenectomy (PD) requires division of the gastroduodenal artery (GDA). In patients with previous surgical interventions, such as post-esophagectomy patients, the blood flow of the GDA should be preserved. However, a systematic surgical strategy has not been established for these patients. This study aimed to clarify the safety of a strategic diagram for PD that requires special caution during the GDA division.Methods: We retrospectively reviewed the records of patients who underwent PD at two hospitals between 2019 and 2023. All patients were evaluated for precise planning from the anatomical and oncological aspects after PD in the preoperative multidisciplinary team, including the radiologist.Results: Among 340 cases, there were 9 in which there were serious concerns regarding GDA division due to ischemic organ failure after standard PD. Among the 9 patients, 8 underwent GDA-preserving PD or PD with revascularization or organ reconstruction. In all cases, curative resection was achieved, and no patients developed ischemia in the remnant organs. Major postoperative complications (Clavien-Dindo grade ≥ 3) occurred in 2 patients (22%). There was no mortality.Conclusion: Ischemic organ failure occurs in 2.6% of patients undergoing PD. Our proposed flowchart may be useful for complete resection without organ ischemia.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576224","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

The association of intraoperative hyperglycemia and postoperative infectious complications after lung transplantation: a single-center retrospective study. 肺移植术后术中高血糖与术后感染并发症的关系：一项单中心回顾性研究

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-04 DOI: 10.1007/s00595-025-03083-1

Hideki Nagata, Takashi Kanou, Kenji Kimura, Eriko Fukui, Toru Kimura, Naoko Ose, Yasushi Shintani

{"title":"The association of intraoperative hyperglycemia and postoperative infectious complications after lung transplantation: a single-center retrospective study.","authors":"Hideki Nagata, Takashi Kanou, Kenji Kimura, Eriko Fukui, Toru Kimura, Naoko Ose, Yasushi Shintani","doi":"10.1007/s00595-025-03083-1","DOIUrl":"https://doi.org/10.1007/s00595-025-03083-1","url":null,"abstract":"Purpose: Postoperative infections remain a significant problem in lung transplantation. We explored factors associated with postoperative infection after lung transplantation, including intraoperative hyperglycemia.Methods: Forty-six lung transplant patients were included in the study. The background of these patients and the relationship between each factor and postoperative infectious complications were retrospectively investigated. In the present study, intraoperative hyperglycemia was defined as a mean intraoperative blood glucose level of ≥ 180 mg/dL.Results: Nineteen patients were classified into the intraoperative hyperglycemia group. Eighteen patients had postoperative infections, and the intraoperative hyperglycemia group had a higher rate of postoperative infections than the non-hyperglycemia group. A multivariate analysis showed that intraoperative hyperglycemia was independently associated with post-transplantation infection (p < 0.01). The 5-year overall survival rates of the intraoperative hyperglycemia and non-hyperglycemia groups were 59.2% and 75.0%, respectively, whereas those of the post-transplant infection and non-infected groups were 47.7% and 80.0%, respectively, with a trend toward a worse prognosis in the intraoperative hyperglycemia and post-transplant infection groups (p = 0.234 and 0.059, respectively).Conclusion: Intraoperative hyperglycemia is associated with the development of postoperative infections after lung transplantation. Patients with poor intraoperative blood glucose control may have an increased risk of postoperative infections. Intraoperative blood glucose management is crucial for improving the post-transplant clinical course.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561228","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

Outcomes of patients with clinical stage IV esophageal squamous cell carcinoma treated initially with definitive chemoradiotherapy: a single-institution observational study and literature review. 临床IV期食管鳞状细胞癌患者最初接受明确放化疗的结果：一项单机构观察性研究和文献综述

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-04 DOI: 10.1007/s00595-025-03087-x

Kotaro Sugawara, Koichi Yagi, Shoh Yajima, Yoshiyuki Miwa, Shuichiro Oya, Asami Okamoto, Raito Asaoka, Hideomi Yamashita, Yoshifumi Baba

{"title":"Outcomes of patients with clinical stage IV esophageal squamous cell carcinoma treated initially with definitive chemoradiotherapy: a single-institution observational study and literature review.","authors":"Kotaro Sugawara, Koichi Yagi, Shoh Yajima, Yoshiyuki Miwa, Shuichiro Oya, Asami Okamoto, Raito Asaoka, Hideomi Yamashita, Yoshifumi Baba","doi":"10.1007/s00595-025-03087-x","DOIUrl":"https://doi.org/10.1007/s00595-025-03087-x","url":null,"abstract":"Purpose: To investigate the long-term outcomes of patients with cStage IV esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (dCRT) and the impacts of this treatment on inflammatory and nutrition markers.Methods: The subjects of this study were 84 patients who underwent initial dCRT for cStage IV (cT4 and/or cM1 according to eighth UICC staging system) esophageal squamous cell carcinoma (ESCC). Survival outcomes were investigated according to treatment modalities. Various inflammatory and nutrition markers, such as the C-reactive protein (CRP)-to-albumin ratio (CAR) and the lymphocyte-to-CRP ratio (LCR), were evaluated.Results: The 3-year overall survival (OS) rate of the 84 patients was 45.8%. Clinical complete response (CR) to dCRT was achieved in 30 patients (dCRT-CR group). Salvage surgery was performed for 35 patients and curative (R0) resection was achieved in 28 patients (surg-R0 group). Patients in the surg-R0 group exhibited comparable 3-year OS (60.7%) to patients in the dCRT-CR group (60.0%). CRP-derived markers (LCR and CAR) were significantly associated with the response to dCRT (both P < 0.01) and OS (both P < 0.01).Conclusions: Definitive chemoradiotherapy is appropriate for patients with cStage IV ESCC. Curative salvage surgery provides survival benefits for the tumor entity. Pre-therapeutic CRP-derived markers are useful for predicting the response to dCRT and long-term outcomes.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565320","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

Using computed tomography imaging for the quantitative assessment of bowel viability in incarcerated groin hernia. 应用计算机断层成像定量评估嵌顿性腹股沟疝患者肠道活力。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-03 DOI: 10.1007/s00595-025-03086-y

Junichi Sakamoto, Nobuhiko Okamoto, Keisuke Manaka, Yusuke Nie, Taiga Wakabayashi, Atsuko Tsutsui, Go Wakabayashi

{"title":"Using computed tomography imaging for the quantitative assessment of bowel viability in incarcerated groin hernia.","authors":"Junichi Sakamoto, Nobuhiko Okamoto, Keisuke Manaka, Yusuke Nie, Taiga Wakabayashi, Atsuko Tsutsui, Go Wakabayashi","doi":"10.1007/s00595-025-03086-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03086-y","url":null,"abstract":"Purpose: Rapid assessment of bowel viability in patients with incarcerated groin hernia (IGH) is crucial. However, there have been few studies on the quantitative indicators to assess bowel viability objectively. This study investigates the usefulness of the computed tomography (CT) value of the intestinal contents in this context.Methods: The subjects of this retrospective study were 84 patients with IGH diagnosed at our hospital between April, 2011 and March, 2023. The patients were divided into two groups according to whether they had necrotic (n = 24) or non-necrotic (n = 60) IGH. We reviewed the clinic-radiological factors associated with bowel necrosis.Results: The CT value of the incarcerated intestinal contents was significantly higher in the necrotic group than in the non-necrotic group (24.67 vs 9.33 HU, p < 0.001). Furthermore, multivariate logistic regression analysis identified the CT value of the incarcerated intestinal contents as an independent predictor of bowel necrosis (hazard ratio 275; 95% confidence interval 21.9-3450; p < 0.001).Conclusions: The CT value of the incarcerated intestinal contents in IGH is a reliable and objective indicator for bowel viability preoperatively. This quantitative method of evaluation is effective and independent of clinical experience and can improve decision-making in the management of this condition.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554995","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