Surgery Today最新文献_第3页

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

Association of visceral fat with unresectable/recurrent gastric cancer patients following chemotherapy: a propensity score-matched analysis. 内脏脂肪与化疗后不可切除/复发胃癌患者的关系：倾向评分匹配分析

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-02 DOI: 10.1007/s00595-025-03093-z

Ryohei Nishiguchi, Takeshi Shimakawa, Shinichi Asaka, Masako Ogawa, Masano Sagawa, Kotaro Kuhara, Takebumi Usui, Hajime Yokomizo, Shunichi Shiozawa

{"title":"Association of visceral fat with unresectable/recurrent gastric cancer patients following chemotherapy: a propensity score-matched analysis.","authors":"Ryohei Nishiguchi, Takeshi Shimakawa, Shinichi Asaka, Masako Ogawa, Masano Sagawa, Kotaro Kuhara, Takebumi Usui, Hajime Yokomizo, Shunichi Shiozawa","doi":"10.1007/s00595-025-03093-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03093-z","url":null,"abstract":"Purpose: To clarify the association between visceral fat and the prognosis in patients with unresectable or recurrent gastric cancer following chemotherapy.Methods: A total of 118 patients were retrospectively analyzed and categorized into high- and low-visceral fat index (VFI) groups, using a cutoff value of 46.5 cm2/m2. Propensity score matching was performed to adjust for background factors. The overall survival (OS) and progression-free survival (PFS) were compared between the groups. In addition, the objective response rate (ORR), disease control rate (DCR), nutritional indicators, chemotherapy duration, transition rates, and adverse effects were analyzed. A multivariate analysis was used to identify the predictors of the OS and PFS.Results: After matching, the high-VFI group demonstrated a significantly better OS and PFS than the low-VFI group. The ORR (40.6% vs. 15.6%, P = 0.026) and DCR (90.6% vs. 67.7%, P = 0.025) were significantly higher in the high-VFI group than the low-VFI group. The high-VFI group also showed a better nutritional status, longer S-1-based chemotherapy duration, higher transition rates to second-/third-line therapy, and fewer adverse events than the low-VFI group. A multivariate analysis identified VFI loss and target lesions (peritoneal and liver) as independent predictors of the OS, whereas VFI loss and target/non-target lesions were predictors of the PFS.Conclusion: A high VFI was associated with an improved survival in patients with unresectable or recurrent gastric cancer by enhancing chemotherapy tolerance, reducing adverse events, and increasing the ORR and DCR.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554994","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

Safety and efficacy of neoadjuvant cisplatin + S-1 combined with radiation therapy for locally advanced non-small cell lung cancer. 新辅助顺铂+ S-1联合放疗治疗局部晚期非小细胞肺癌的安全性和有效性

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 Epub Date: 2025-02-27 DOI: 10.1007/s00595-025-03019-9

Takashi Karashima, Shinkichi Takamori, Miyuki Abe, Yohei Takumi, Atsushi Osoegawa, Kenji Sugio

{"title":"Safety and efficacy of neoadjuvant cisplatin + S-1 combined with radiation therapy for locally advanced non-small cell lung cancer.","authors":"Takashi Karashima, Shinkichi Takamori, Miyuki Abe, Yohei Takumi, Atsushi Osoegawa, Kenji Sugio","doi":"10.1007/s00595-025-03019-9","DOIUrl":"10.1007/s00595-025-03019-9","url":null,"abstract":"Purpose: To assess the safety and efficacy of neoadjuvant chemoradiotherapy with cisplatin plus S-1 for advanced non-small cell lung cancer (NSCLC), with a focus on real-world outcomes.Methods: This retrospective study analyzed 32 patients with stage II-III NSCLC eligible for resection, who received preoperative induction therapy between January 2012 and December 2022. Specifically, 20 patients received cisplatin, S-1, and radiation therapy.Results: Among the 32 patients who received induction therapy, the objective response rate (ORR) was 56.2%, and surgical resection was feasible in 29 patients (90.6%). The 5 year recurrence-free survival (RFS) rate was 76.4%, and the 3- and 5 year overall survival (OS) rates were 86.2% and 82.3%, respectively. In the cisplatin + S-1 + radiation therapy group (n = 20), the ORR was 65.0%, and surgical resection was feasible in 17 patients (85.0%). The 3-year RFS and OS rates were 78.3% and 83.8%, respectively. Ef. 3 (complete pathological response) was observed in 3 patients (10.3%). No recurrences occurred in the non-adenocarcinoma subgroup (n = 6), indicating better outcomes relative to the adenocarcinoma group (5-year RFS, 100% vs. 61.4%; p = 0.07).Conclusions: Induction therapy, particularly with cisplatin + S-1 + radiation was associated with promising RFS and OS in locally advanced NSCLC, with favorable tolerability and effectiveness.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"886-899"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516590","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

Decline in the surgical workforce in urban and rural Japan and the regional quota system as a potential solution to surgeon shortages. 日本城乡外科劳动力的下降和区域配额制作为外科医生短缺的潜在解决方案。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 DOI: 10.1007/s00595-025-03082-2

Nozomi Karakuchi, Masatoshi Matsumoto, Yoshihiro Saeki, Kazuaki Tanabe, Hideki Ohdan

{"title":"Decline in the surgical workforce in urban and rural Japan and the regional quota system as a potential solution to surgeon shortages.","authors":"Nozomi Karakuchi, Masatoshi Matsumoto, Yoshihiro Saeki, Kazuaki Tanabe, Hideki Ohdan","doi":"10.1007/s00595-025-03082-2","DOIUrl":"https://doi.org/10.1007/s00595-025-03082-2","url":null,"abstract":"Purpose: This study examined the decline in the number of surgeons in Japan compared with other specialists in urban and rural areas using a secondary analysis of government-owned census data. Furthermore, it evaluated the impact of the regional quota system in addressing the shortage of surgeons by comparing their proportion among the graduates of this system with that of the overall physician population.Methods: We analyzed national census data (2012-2022) to evaluate trends in the numbers of physicians and surgeons in 47 prefectures from urban and rural groups. Data on regional quota graduates were obtained from an open-source study.Results: The number of physicians increased by 13.4%, whereas the number of surgeons decreased by 2.1%. The change in the number of surgeons per 100,000 population did not differ between the rural (+ 0.6%) and urban (+ 0.7%; p = 0.997) prefectures. Regional quota graduates had a higher likelihood of being surgeons (9.5%) than all (8.2%; p < 0.01) or young (age 26-39 years) physicians (7.8%; p < 0.01), although female representation was highest among regional quotas (38.7%) relative to all (22.8%; p < 0.01) and young (32.8%; p < 0.01) physicians.Conclusion: The regional quota demonstrates the potential of addressing surgeon shortages.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544879","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

State of groin hernia repair in Japan: Annual Report of 2022 from the National Clinical Database. 日本腹股沟疝修补状况：来自国家临床数据库的2022年年度报告。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 Epub Date: 2024-12-02 DOI: 10.1007/s00595-024-02971-2

Saseem Poudel, Hiroyuki Yamamoto, Kyosuke Miyazaki, Hitoshi Idani, Masanori Sato, Tsuyoshi Takagi, Itsuro Nagae, Taketo Matsubara, Ken Shirabe, Hideki Ueno, Takehiro Hachisuka

{"title":"State of groin hernia repair in Japan: Annual Report of 2022 from the National Clinical Database.","authors":"Saseem Poudel, Hiroyuki Yamamoto, Kyosuke Miyazaki, Hitoshi Idani, Masanori Sato, Tsuyoshi Takagi, Itsuro Nagae, Taketo Matsubara, Ken Shirabe, Hideki Ueno, Takehiro Hachisuka","doi":"10.1007/s00595-024-02971-2","DOIUrl":"10.1007/s00595-024-02971-2","url":null,"abstract":"Purpose: The National Clinical Database (NCD) in Japan captures over 95% of the surgeries performed by general surgeons. In May 2021, the Japan Hernia Society (JHS) introduced additional categories for groin hernia repair at JHS-registered institutions. This study presents the 2022 data on groin hernia repair from the NCD.Methods: This study included all cases of groin hernia repair registered in the NCD for 2022. The basic data collected included age, sex, type of surgery, day surgery status, emergency status, and anesthesia involvement. For JHS-registered institutions, data on hernia laterality, whether the case was primary or recurrent, surgical details, and groin hernia classifications were also collected.Results: Of the 908 institutions reporting to the NCD, 459 (50.6%) were JHS registered. A total of 118,365 groin hernia repairs were recorded, of which 43,952 (37.1%) were from JHS-registered institutions. Endoscopic repair accounted for 53.3% (n = 63,208) of the patients. Day surgery was performed in 5.1% (n = 6045) of the patients. At JHS-registered institutions, 81.6% of bilateral hernias were treated by endoscopic repair; 68.1% were lateral hernias. The most commonly used method was the TAPP method, which was applied in 48.8% of cases.Conclusions: Although endoscopic repair is widely used in Japan, day surgery rates remain low. Improving data collection and increasing NCD participation are crucial for aligning with international standards.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"953-959"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772219","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

Oncological impact of the preoperative combined assessment of skeletal muscle mass for patients undergoing curative gastrectomy for gastric cancer. 术前骨骼肌质量联合评估对胃癌根治性胃切除术患者的肿瘤学影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 Epub Date: 2024-12-13 DOI: 10.1007/s00595-024-02978-9

Ryota Matsui, Manabu Ohashi, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Masaru Hayami, Takeshi Sano, Souya Nunobe

{"title":"Oncological impact of the preoperative combined assessment of skeletal muscle mass for patients undergoing curative gastrectomy for gastric cancer.","authors":"Ryota Matsui, Manabu Ohashi, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Masaru Hayami, Takeshi Sano, Souya Nunobe","doi":"10.1007/s00595-024-02978-9","DOIUrl":"10.1007/s00595-024-02978-9","url":null,"abstract":"Purpose: We performed a combined assessment of skeletal muscle mass using the skeletal muscle mass index (SMI) and the psoas muscle index (PMI) to evaluate their association with the overall survival (OS) of gastric cancer patients after curative gastrectomy.Methods: We analyzed, retrospectively, the computed tomography records of skeletal muscle mass of patients who underwent radical gastrectomy for pStage I-III gastric cancer between April, 2010 and April, 2016. We then compared OS as the primary outcome, stratifying patients according to their SMI or PMI, and investigated prognostic factors using multivariate analyses.Results: The median follow-up duration was 62 months. Of the 550 patients analyzed, 262 (47.6%), 194 (35.3%), and 94 (17.1%) were classified into normal, single-low, and double-low SMI and PMI groups, respectively. Patients with double-low SMI and PMI had the poorest OS (P = 0.018). Multivariate analysis revealed that double-low indices were an independent prognostic factor for poor OS (hazard ratio, 1.808; 95% confidence interval 1.009-3.238; P = 0.046).Conclusions: This study revealed that evaluation of skeletal muscle mass based on the combined SMI and PMI can predict the survival outcomes of patients after curative gastrectomy for gastric cancer, and that the coexistence of a low-SMI and low-PMI was associated with the poorest survival.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"875-885"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819258","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 : 2025-07-01 Epub 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":"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":"865-873"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","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

Robotic pancreaticoduodenectomy for portal annular pancreas: how to do it. 机器人胰十二指肠切除术治疗门静脉环胰腺：如何做。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 Epub Date: 2024-12-23 DOI: 10.1007/s00595-024-02976-x

Jun Ishida, Hirochika Toyama, Yoshihide Nanno, Takuya Mizumoto, Shohei Komatsu, Hiroaki Yanagimoto, Masahiro Kido, Takumi Fukumoto

引用次数: 0

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 : 2025-07-01 Epub 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":"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":"909-917"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","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

Middle segment preserving pancreatectomy versus total pancreatectomy: a comparative analysis of short- and long-term outcomes. 保留中段胰腺切除术与全胰腺切除术：短期和长期结果的比较分析。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-07-01 Epub Date: 2024-12-10 DOI: 10.1007/s00595-024-02973-0

Masahiro Yamane, Yoshiya Ishikawa, Hironari Yamashita, Koichiro Morimoto, Daisuke Asano, Toshitaka Sugawara, Shuichi Watanabe, Hiroki Ueda, Keiichi Akahoshi, Hiroaki Ono, Shinji Tanaka, Minoru Tanabe

{"title":"Middle segment preserving pancreatectomy versus total pancreatectomy: a comparative analysis of short- and long-term outcomes.","authors":"Masahiro Yamane, Yoshiya Ishikawa, Hironari Yamashita, Koichiro Morimoto, Daisuke Asano, Toshitaka Sugawara, Shuichi Watanabe, Hiroki Ueda, Keiichi Akahoshi, Hiroaki Ono, Shinji Tanaka, Minoru Tanabe","doi":"10.1007/s00595-024-02973-0","DOIUrl":"10.1007/s00595-024-02973-0","url":null,"abstract":"Purpose: Middle-segment preserving pancreatectomy (MSPP) serves as an alternative to total pancreatectomy (TP) for preserving the pancreatic body in multifocal pancreatic neoplasms. Despite the potential benefits of TP, the detailed short- and long-term prognoses remain unclear. We evaluated the feasibility of MSPP by comparing the perioperative outcomes and postoperative endocrine and exocrine functions with those of TP.Methods: The study included 10 TP and 7 MSPP patients. Patients with pancreatic ductal adenocarcinoma and invasive intraductal papillary mucinous carcinoma were excluded.Results: MSPP was associated with a high incidence (57.1%) of postoperative pancreatic fistula (POPF); however, there were no cases of post-pancreatectomy hemorrhage or postoperative mortality in any group. The postoperative hospital stay and readmission rates were comparable between the groups. At 1 year postoperatively, MSPP reduced the risk of new-onset insulin-dependent diabetes mellitus, maintained good glycemic control with minimal hypoglycemic events, and preserved skeletal muscle, subcutaneous fat, and visceral fat. One patient in the MSPP group with a neuroendocrine tumor had postoperative recurrence in the para-aortic lymph node.Conclusions: Despite the high POPF rate and oncologic limitations, MSPP showed superior long-term outcomes in glycemic control and preservation of body composition. MSPP may be an acceptable treatment option for selected patients.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"930-940"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802144","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