Surgery Today最新文献_第2页

The outcomes and cost analysis of open repair and endovascular aneurysm repair for abdominal aortic aneurysms: a single-center experience in Japan. 腹主动脉瘤开放式修补术和血管内动脉瘤修补术的疗效和成本分析：日本单中心经验。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-09-04 DOI: 10.1007/s00595-024-02934-7

Yasumi Maze, Toshiya Tokui, Ryotaro Inoue, Tomotake Sekoguchi, Takahiro Narukawa, Masahiko Murakami, Ryosai Inoue, Koji Hirano, Shuji Chino, Ken Nakajima, Noriyuki Kato, Hisato Ito

{"title":"The outcomes and cost analysis of open repair and endovascular aneurysm repair for abdominal aortic aneurysms: a single-center experience in Japan.","authors":"Yasumi Maze, Toshiya Tokui, Ryotaro Inoue, Tomotake Sekoguchi, Takahiro Narukawa, Masahiko Murakami, Ryosai Inoue, Koji Hirano, Shuji Chino, Ken Nakajima, Noriyuki Kato, Hisato Ito","doi":"10.1007/s00595-024-02934-7","DOIUrl":"10.1007/s00595-024-02934-7","url":null,"abstract":"Purpose: Japan has adopted its own reimbursement system, which differs from other countries in terms of its diagnostic procedure combination (DPC) methods. However, there are few reports on the cost analysis of open repair and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms in Japan. We aimed to evaluate the long-term outcomes and cost-effectiveness of these two procedures.Methods: This study included patients who underwent open repair (n = 224) and EVAR (n = 87) between January 2012 and December 2022. After propensity score matching, we compared the two groups.Results: The drug and blood products, procedures, and DPC costs were significantly higher in the open repair group (p < 0.001) than in the EVAR group. The surgical equipment and total costs were significantly higher in the EVAR group than in the open repair group (p < 0.001). There was no significant difference in the 5-year survival rate (88.5% in the open repair group vs. 72.0% in the EVAR group; p = 0.33) and freedom from re-intervention rate at 5 years (93.1% in the open repair group vs. 89.9% in the EVAR group; p = 0.15) between the two groups.Conclusions: Open repair is more cost-effective than EVAR. The cost-effectiveness of EVAR may therefore depend on the cost of the endograft.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"560-568"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126786","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

Survival after surgery for lung cancer among patients with autoimmune diseases. 自身免疫性疾病患者肺癌手术后的存活率。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-09-25 DOI: 10.1007/s00595-024-02917-8

Masaaki Nagano, Yue Cong, Keita Nakao, Mitsuaki Kawashima, Chihiro Konoeda, Masaaki Sato

{"title":"Survival after surgery for lung cancer among patients with autoimmune diseases.","authors":"Masaaki Nagano, Yue Cong, Keita Nakao, Mitsuaki Kawashima, Chihiro Konoeda, Masaaki Sato","doi":"10.1007/s00595-024-02917-8","DOIUrl":"10.1007/s00595-024-02917-8","url":null,"abstract":"Purpose: While patients with autoimmune diseases (ADs) are at high risk for developing specific malignancies, including lung cancer, ADs may protect against the development of cancer through increased immune cell activity in tumors. This study aimed to investigate whether the presence of ADs affects surgical outcomes and survival after surgery for lung cancer.Methods: The medical records of 1236 patients who underwent surgery for non-small cell lung cancer between 2007 and 2018 were retrospectively reviewed. Perioperative and long-term outcomes were compared between patients with and without ADs using propensity score matching.Results: Among the included patients, 115 with ADs and 1121 without ADs underwent surgery. Using 1-to-1 propensity score matching, 114 pairs were selected. Although there were no significant differences in the perioperative outcomes of the two groups, the overall and relapse-free survival rates were significantly lower in the group with ADs than in the group without ADs.Conclusions: Surgery for lung cancer can be performed without increasing the complications in patients with ADs. However, the long-term outcomes were significantly worse in patients with ADs than in those without ADs, suggesting that close follow-up for lung cancer and careful whole-body examination might be needed for patients with ADs.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"518-525"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term outcomes of patients undergoing emergency surgery for corrosive injury of the upper digestive tract. 上消化道腐蚀性损伤急诊手术患者的长期疗效。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-08-23 DOI: 10.1007/s00595-024-02928-5

Thitiporn Chobarporn, Dudsadee Mesiri, Chadin Tharavej

{"title":"Long-term outcomes of patients undergoing emergency surgery for corrosive injury of the upper digestive tract.","authors":"Thitiporn Chobarporn, Dudsadee Mesiri, Chadin Tharavej","doi":"10.1007/s00595-024-02928-5","DOIUrl":"10.1007/s00595-024-02928-5","url":null,"abstract":"Purpose: Emergency surgery can save patients' lives in cases of severe caustic injury. However, the long-term outcomes are not well understood.Methods: Patients who underwent emergency organ resection for severe corrosive acid injury were included. Subsequently, digestive tract reconstruction was performed to fit patients. Long-term outcomes were analyzed.Results: Fifty patients underwent emergency digestive tract resection. The operative mortality rate was 6% (of 3/50). One of the 50 patients underwent successful immediate reconstruction. Of the 46 survivors with digestive tract discontinuity, 32 (70%) underwent subsequent reconstructive surgery, 10 (22%) died while awaiting reconstruction due to deterioration in their psychiatric and nutritional status, and 4 (9%) were unfit for reconstructive surgery. No operative mortality occurred during reconstruction. Among the 32 patients who underwent reconstruction, 30 (94%) achieved nutritional autonomy. Nutritional independence was achieved in 62% of the patients (31/50). At a median duration of 58 months, the median survival time of the 50 patients was 158 months. Patients who underwent reconstruction had a significantly better overall survival than those who did not (p < 0.0001).Conclusions: Emergency surgery remains the standard treatment for corrosive ingestion of complicated digestive tract injuries. However, only 60% of survivors can undergo subsequent digestive reconstruction and achieve long-term nutritional autonomy and a survival outcome.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"526-536"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037040","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 C-reactive protein-albumin-lymphocyte (CALLY) index is a useful predictor of postoperative complications in patients with a colonic stent for obstructive colorectal cancer: a Japanese multicenter study. C-反应蛋白-白蛋白-淋巴细胞（CALLY）指数是阻塞性结直肠癌结肠支架患者术后并发症的有效预测指标：一项日本多中心研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-08-23 DOI: 10.1007/s00595-024-02924-9

Toshio Shiraishi, Takashi Nonaka, Tetsuro Tominaga, Yuma Takamura, Kaido Oishi, Shintaro Hashimoto, Keisuke Noda, Rika Ono, Makoto Hisanaga, Hiroaki Takeshita, Mitsutoshi Ishii, Shosaburo Oyama, Kazuhide Ishimaru, Masaki Kunizaki, Terumitsu Sawai, Keitaro Matsumoto

{"title":"The C-reactive protein-albumin-lymphocyte (CALLY) index is a useful predictor of postoperative complications in patients with a colonic stent for obstructive colorectal cancer: a Japanese multicenter study.","authors":"Toshio Shiraishi, Takashi Nonaka, Tetsuro Tominaga, Yuma Takamura, Kaido Oishi, Shintaro Hashimoto, Keisuke Noda, Rika Ono, Makoto Hisanaga, Hiroaki Takeshita, Mitsutoshi Ishii, Shosaburo Oyama, Kazuhide Ishimaru, Masaki Kunizaki, Terumitsu Sawai, Keitaro Matsumoto","doi":"10.1007/s00595-024-02924-9","DOIUrl":"10.1007/s00595-024-02924-9","url":null,"abstract":"Purpose: The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel score that offers a good reflection of nutritional status, inflammatory response, and immune system status. The CALLY index is reported to correlate with the prognosis of various carcinomas. The purpose of the present study was to investigate the association between the CALLY index and the short-term prognosis of obstructive colorectal cancer managed with a colonic stent.Methods: The subjects of this retrospective study were 263 patients who underwent colorectal resection after colonic stenting for obstructive colorectal cancer between 2016 and 2023. Patients were classified into a group with a low CALLY index (CALLY-L group, n = 85) and a group with a high (CALLY-H group, n = 178) CALLY index.Results: The CALLY-L group had greater blood loss (53 mL vs 20 mL, p = 0.002) and higher poor performance status (PS3; 20% vs 10.1%, p = 0.033), open surgery (21.2% vs 7.3%, p = 0.001), distant metastases (41.2% vs 20.8%, p = 0.01), and postoperative complications (30.6% vs. 18.5%, p = 0.039) than the CALLY-H group. Multivariate analysis identified a prolonged operative time (odds ratio 1.983, 95% confidence interval 1.013-3.881; p = 0.045), greater blood loss (odds ratio 2.572, 95% confidence interval 1.291-5.129; p = 0.007) and a low CALLY index (odds ratio 1.961, 95% confidence interval 1.013-3.795; p = 0.045) as independent predictors of complications.Conclusion: The CALLY index may be a useful predictor of postoperative complications of obstructive colorectal cancer.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"502-509"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037041","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

Outcome of hepatectomy after systemic therapy for hepatocellular carcinoma: a Japanese multicenter study. 肝细胞癌系统治疗后的肝切除术结果：一项日本多中心研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-08-27 DOI: 10.1007/s00595-024-02930-x

Norifumi Iseda, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Yuriko Tsutsui, Katsuya Toshida, Shoichi Inokuchi, Toru Utsunomiya, Takahiro Tomino, Keishi Sugimachi, Kazutoyo Morita, Mizuki Ninomiya, Noboru Harada, Ryosuke Minagawa, Tomoharu Yoshizumi

{"title":"Outcome of hepatectomy after systemic therapy for hepatocellular carcinoma: a Japanese multicenter study.","authors":"Norifumi Iseda, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Yuriko Tsutsui, Katsuya Toshida, Shoichi Inokuchi, Toru Utsunomiya, Takahiro Tomino, Keishi Sugimachi, Kazutoyo Morita, Mizuki Ninomiya, Noboru Harada, Ryosuke Minagawa, Tomoharu Yoshizumi","doi":"10.1007/s00595-024-02930-x","DOIUrl":"10.1007/s00595-024-02930-x","url":null,"abstract":"Background and purpose: In recent years, new systemic therapies have been developed for hepatocellular carcinoma (HCC). The aim of this study was to evaluate the prognosis of patients with unresectable HCC treated with R0 hepatectomy after systemic therapy.Methods: Data from 27 patients who underwent hepatectomy for HCC after systemic therapy at six facilities were analyzed retrospectively. Cancer-specific survival (CSS) and recurrence-free survival (RFS) after hepatectomy were investigated using Kaplan-Meier curves. We examined the prognostic value of the oncological criteria of resectability for HCC reported by the Japanese Expert Consensus 2023.Results: R0 resection was performed in 24 of the 27 patients. Using the Response Evaluation Criteria in Solid Tumors, 0 patient had a complete response, 16 had a partial response, 6 had stable disease, and 2 had progressive disease. Median CSS was not evaluated, but the median RFS was 17.8 months. Patients with resectable and borderline resectable (BR) 1 cancers had a better prognosis than those with BR2 cancers. The group whose oncological criteria were improved by systemic therapy had a lower recurrence rate than the group whose oncological criteria were maintained, but no difference was observed in CSS.Conclusions: The findings of this study suggest that hepatectomy after systemic therapy may improve the prognosis of HCC patients.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"510-517"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081549","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 relevance of the red blood cell distribution width measured preoperatively as a prognostic marker in patients with distal cholangiocarcinoma undergoing pancreaticoduodenectomy.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-29 DOI: 10.1007/s00595-025-03005-1

Maiko Niki, Shozo Mori, Shotaro Miyashita, Tomoaki Hayakawa, Genki Tanaka, Takayuki Shimizu, Takamune Yamaguchi, Kyung-Hwa Park, Takayuki Shiraki, Takatsugu Matsumoto, Taku Aoki

{"title":"Clinical relevance of the red blood cell distribution width measured preoperatively as a prognostic marker in patients with distal cholangiocarcinoma undergoing pancreaticoduodenectomy.","authors":"Maiko Niki, Shozo Mori, Shotaro Miyashita, Tomoaki Hayakawa, Genki Tanaka, Takayuki Shimizu, Takamune Yamaguchi, Kyung-Hwa Park, Takayuki Shiraki, Takatsugu Matsumoto, Taku Aoki","doi":"10.1007/s00595-025-03005-1","DOIUrl":"https://doi.org/10.1007/s00595-025-03005-1","url":null,"abstract":"Purpose: The clinical relevance of the red blood cell distribution width (RDW) in patients with distal cholangiocarcinoma (DCC) undergoing pancreaticoduodenectomy (PD) has not been clearly investigated.Methods: The relationship between the preoperatively measured RDW and prognosis for the recurrence/survival was evaluated in patients with DCC undergoing PD. A subgroup analysis was also performed in patients with pathological stage I DCC.Results: A total of 77 patients were included in the analysis. The cutoff value of the preoperatively measured RDW was set at 14%, and the normal reference range at our center was ≤ 14%. The patient group with an RDW > 14% (n = 30) had a significantly lower mean serum albumin level, higher mean serum carbohydrate antigen 19-9 level, and a higher proportion of cases with pathological lymphatic invasion and showed a significantly worse overall survival than the patient group with an RDW ≤ 14% (n = 47). Similar findings were noted in both the overall study population and patients with pathological stage I disease. Multivariate analysis identified an RDW > 14% and pathological lymph node metastasis as independent risk factors for a poor postoperative survival.Conclusion: The preoperatively measured RDW is a promising prognostic predictor in patients with DCC undergoing PD.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744009","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

¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography as a prognostic marker of imatinib-resistant gastrointestinal stromal tumors.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-28 DOI: 10.1007/s00595-025-03029-7

Kota Kawabata, Tsuyoshi Takahashi, Toshirou Nishida, Yukinori Kurokawa, Kazuyoshi Yamamoto, Takuro Saito, Kota Momose, Kotaro Yamashita, Koji Tanaka, Tomoki Makino, Ryohei Kawabata, Atsushi Takeno, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki

{"title":"18F-fluorodeoxyglucose positron emission tomography-computed tomography as a prognostic marker of imatinib-resistant gastrointestinal stromal tumors.","authors":"Kota Kawabata, Tsuyoshi Takahashi, Toshirou Nishida, Yukinori Kurokawa, Kazuyoshi Yamamoto, Takuro Saito, Kota Momose, Kotaro Yamashita, Koji Tanaka, Tomoki Makino, Ryohei Kawabata, Atsushi Takeno, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1007/s00595-025-03029-7","DOIUrl":"https://doi.org/10.1007/s00595-025-03029-7","url":null,"abstract":"Purpose: Unresectable or metastatic GISTs often develop resistance to imatinib, but the effectiveness of other drugs is limited. Thus, surgical treatment can be considered, especially for partial resistance. FDG-PET/CT is used for the diagnosis and evaluation of GISTs. We conducted this study to establish whether FDG-PET/CT findings could guide treatment decisions and predict the prognosis of patients with imatinib-resistant GISTs.Methods: We analyzed data retrospectively from 45 patients with imatinib-resistant GISTs that were assessed via FDG-PET/CT at our institution between 2003 and 2021. The patients were classified as having low (n = 18) or high (n = 27) SUVmax, with a cutoff value of 5.0.Results: The overall survival (OS) of the patients with low SUVmax after the diagnosis of imatinib resistance was significantly prolonged. Multivariate analysis identified SUVmax as an independent poor prognostic factor. In 23 patients with resected imatinib-resistant lesions, a close correlation was found between the SUVmax by preoperative FDG-PET/CT and the mitotic rate. A higher SUVmax was associated with a higher mitotic rate. Patients with a low SUVmax (n = 11) had significantly longer postoperative imatinib failure-free survival than those with a high SUVmax (n = 12).Conclusions: FDG-PET/CT assessment and diagnosis might reveal the pathological grades of imatinib-resistant GISTs and act as a prognostic marker.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731652","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

Appendectomy followed by two-stage right-sided colectomy with lymph node dissection for appendiceal cancer and risk factors for peritoneal recurrence: a single high-volume cancer center study in Japan.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-28 DOI: 10.1007/s00595-025-03031-z

Kentaro Sato, Shimpei Matsui, Manabu Takamatsu, Tatsuki Noguchi, Takashi Sakamoto, Toshiki Mukai, Tomohiro Yamaguchi, Takashi Akiyoshi

{"title":"Appendectomy followed by two-stage right-sided colectomy with lymph node dissection for appendiceal cancer and risk factors for peritoneal recurrence: a single high-volume cancer center study in Japan.","authors":"Kentaro Sato, Shimpei Matsui, Manabu Takamatsu, Tatsuki Noguchi, Takashi Sakamoto, Toshiki Mukai, Tomohiro Yamaguchi, Takashi Akiyoshi","doi":"10.1007/s00595-025-03031-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03031-z","url":null,"abstract":"Purpose: Few studies have evaluated whether the timing of colectomy affects the prognosis of appendiceal cancer. This study compared long-term outcomes and recurrence patterns between initial appendectomy followed by two-stage colectomy and one-stage colectomy for appendiceal cancer.Methods: We retrospectively evaluated 65 patients who underwent 2-stage (n = 17) or 1-stage (n = 48) right-sided colectomy with lymph node dissection for stage 0-III appendiceal cancer between August 2005 and December 2022. The recurrence types and risk factors were compared.Results: The 2-stage colectomy group had a more advanced disease stage than the 1-stage group (stage III cases: 29.4% vs. 14.6%, P = 0.03). The 5-year overall recurrence rates were similar between the groups (29.4% vs. 19.2%, P = 0.39). All peritoneal recurrence cases (n = 9) had pT3 or T4 depth. Among pT3 and T4 cases (n = 46), the peritoneal recurrence rates did not differ significantly (31.2% vs. 13.8%, P = 0.17). A multivariate analysis identified preoperative serum CA19-9 level of > 37 ng/mL (hazard ratio [HR], 35.4; 95% confidence interval [CI], 3.08-406.8; P = 0.004) and lymph node metastasis (HR, 42.6; 95% CI, 9.90-183.6; P < 0.001) as independent risk factors for peritoneal recurrence.Conclusions: Serum CA19-9 levels and lymph node metastasis are risk factors for peritoneal recurrence. The effect of colectomy timing on recurrence was not definitive.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731654","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

Appropriate methods of evaluating future liver remnant volume to predict postoperative liver failure after major hepatectomy based on the body mass of patients with normal hepatic reserve.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-27 DOI: 10.1007/s00595-025-03030-0

Tomohiko Ikehara, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Noriyuki Kitagawa, Hitoshi Masuo, Takahiro Yoshizawa, Kiyotaka Hosoda, Hiroki Sakai, Yuji Soejima

{"title":"Appropriate methods of evaluating future liver remnant volume to predict postoperative liver failure after major hepatectomy based on the body mass of patients with normal hepatic reserve.","authors":"Tomohiko Ikehara, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Noriyuki Kitagawa, Hitoshi Masuo, Takahiro Yoshizawa, Kiyotaka Hosoda, Hiroki Sakai, Yuji Soejima","doi":"10.1007/s00595-025-03030-0","DOIUrl":"https://doi.org/10.1007/s00595-025-03030-0","url":null,"abstract":"Purpose: Several parameters are used to assess future liver remnant (FLR) size before major hepatectomy. This study aimed to clarify which is the most appropriate method to use for the prediction of post-hepatectomy liver failure (PHLF).Methods: The subjects of this study were 307 patients with Child-Pugh class A only, who underwent major hepatectomy, to focus on FLR size. The parameters we evaluated for their accuracy in predicting Grade B/C PHLF (PHLF B/C) using receiver operating characteristic curve analysis were FLR volume (FLRV), the FLRV to total liver volume ratio (FLRV/TLV), standard liver volume (FLRV/SLV), and body weight (FLRV/BW) according to body mass.Results: The predictive value accuracy of these four parameters for PHLF was similar for the entire cohort. However, in the subgroup analysis based on body mass index, FLRV/BW accuracy was highest in the obese group, whereas that of FLRV/TLV was highest in the lean group. Multivariate analysis identified that FLRV/BW (< 0.7%) and blood loss (≥ 1000 ml) were independent risk factors for PHLF B/C in the obese group. In the lean group, FLRV/TLV (< 40%) and biliary reconstruction were risk factors for PHLF B/C.Conclusions: The FLR size evaluation method for predicting PHLF should be appropriately selected based on the patient's body mass.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721320","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 safety of laparoscopic extraperitoneal colostomy in the introductory phase: A prospective observational study by the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1804.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-26 DOI: 10.1007/s00595-025-03020-2

Akio Higuchi, Masakatsu Numata, Hiroyuki Saeki, Shota Izukawa, Suguru Nukada, Kenta Iguchi, Mamoru Uchiyama, Hironao Okamoto, Yosuke Atsumi, Aya Kato, Keisuke Kazama, Shinsuke Suzuki, Yusuke Katayama, Koji Numata, Sho Sawazaki, Hiroshi Tamagawa, Nobuhiro Sugano, Teni Godai, Hiroyuki Mushiake, Satoru Shinoda, Satomi Matsumoto, Yasushi Rino, Aya Saito, Manabu Shiozawa

{"title":"The safety of laparoscopic extraperitoneal colostomy in the introductory phase: A prospective observational study by the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1804.","authors":"Akio Higuchi, Masakatsu Numata, Hiroyuki Saeki, Shota Izukawa, Suguru Nukada, Kenta Iguchi, Mamoru Uchiyama, Hironao Okamoto, Yosuke Atsumi, Aya Kato, Keisuke Kazama, Shinsuke Suzuki, Yusuke Katayama, Koji Numata, Sho Sawazaki, Hiroshi Tamagawa, Nobuhiro Sugano, Teni Godai, Hiroyuki Mushiake, Satoru Shinoda, Satomi Matsumoto, Yasushi Rino, Aya Saito, Manabu Shiozawa","doi":"10.1007/s00595-025-03020-2","DOIUrl":"https://doi.org/10.1007/s00595-025-03020-2","url":null,"abstract":"Purpose: To assess the incidence of parastomal hernia in the introductory phase following laparoscopic extraperitoneal colostomy.Methods: The subjects of this observational study were 30 patients who underwent laparoscopic extraperitoneal sigmoid colostomy between April 2019 and November 2020. We evaluated the incidence of parastomal hernia over 2 years and the time required for stoma creation.Results: Parastomal hernia was diagnosed in five patients (17.2%), which was a higher incidence than that reported previously (0-13.3%). An exploratory analysis using the LASSO logistic regression model identified obesity (body mass index ≥25 kg/m2) and postoperative wound dehiscence as risk factors for parastomal hernia. The mean stoma creation time was 23.6 min, with >80% of cases completed within 30 min.Conclusion: Laparoscopic extraperitoneal colostomy can be adopted successfully, even in centers without prior experience. However, the incidence of parastomal hernia in this study was slightly higher than reported previously. Obese patients had longer stoma creation times and a higher incidence of parastomal hernia.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721323","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