Surgery TodayPub Date : 2025-07-01DOI: 10.1007/s00595-025-03089-9
Ikuko Shibasaki, Yasuyuki Yamada, Shunsuke Saito, Yusuke Takei, Toshiyuki Kuwata, Yuta Kanazaw, Takashi Kato, Go Tsuchiya, Hironaga Ogawa, Hirotsugu Fukuda
{"title":"Evaluating the efficacy of the simple patch closure technique in ventricular septal rupture repair following acute myocardial infarction: a retrospective single-center study.","authors":"Ikuko Shibasaki, Yasuyuki Yamada, Shunsuke Saito, Yusuke Takei, Toshiyuki Kuwata, Yuta Kanazaw, Takashi Kato, Go Tsuchiya, Hironaga Ogawa, Hirotsugu Fukuda","doi":"10.1007/s00595-025-03089-9","DOIUrl":"https://doi.org/10.1007/s00595-025-03089-9","url":null,"abstract":"<p><strong>Purpose: </strong>The simple patch closure technique is an alternative method for repairing ventricular septal rupture following myocardial infarction. This single-center study aimed to investigate the outcomes of ventricular septal rupture repair.</p><p><strong>Methods: </strong>This retrospective study included 23 patients who underwent initial surgery using the simple patch-closure technique between January 2009 and August 2024. Three primary endpoints were established: the rupture recurrence rate, in-hospital mortality rate, and mid-term survival rate. Survival curves were constructed using the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean patient age was 71.0 years, and 13 patients were male. Intraoperative transesophageal echocardiography detected no residual shunts; however, five (21.7%) patients experienced rupture recurrence at a median of 21 (range, 12-150) days postoperatively, all requiring reoperation. The hospital mortality rate was 8.7%, with one death each in the early and late surgery groups. The 60 month survival rate was 75.7% over a median follow-up period of 36 months (range: 4-149 months).</p><p><strong>Conclusion: </strong>The simple patch closure technique is safe and effective for ventricular septal rupture repair, even in early surgery; however, recurrence remains a challenge. Preventive measures, such as bovine pericardial patches and the double-patch technique for extensive infarctions, warrant further validation through larger studies with longer follow-up periods.</p>","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":"144544880","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}
{"title":"The potential efficacy of atezolizumab plus bevacizumab treatment for hepatocellular carcinoma patients with macroscopic portal vein tumor thrombus.","authors":"Shohei Komatsu, Yoshihiko Yano, Kazuki Terashima, Yoshimi Fujishima, Jun Ishida, Nobuaki Ishihara, Takanori Matsuura, Tomoaki Okimoto, Yuzo Kodama, Takumi Fukumoto","doi":"10.1007/s00595-025-03009-x","DOIUrl":"10.1007/s00595-025-03009-x","url":null,"abstract":"<p><strong>Purpose: </strong>The prognosis of patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) in the first-order or main trunk/contralateral branches (Vp3/4) is poor. The present study aimed to clarify the real-world data of atezolizumab plus bevacizumab treatment (Ate/bev) for HCC patients with Vp3/4 PVTT.</p><p><strong>Methods: </strong>The subjects of this study were 22 consecutive HCC patients with Vp3/4 PVTT, who were treated with Ate/bev. Survival rates and radiological responses were evaluated based on the modified albumin-bilirubin (mALBI) grade [mALBI 1 + 2a (1/2a) versus 2b + 3 (2b/3)] using the modified Response Evaluation Criteria in Solid Tumors.</p><p><strong>Results: </strong>The median survival time of the 22 patients was 15.0 months, with 1- and 2-year survival rates of 62.7% and 49.3%, respectively. The objective response (OR) rates of patients with mALBI 1/2a and 2b/3 were 91.7% (11/12) and 10.0% (1/10), respectively, with a significant difference (p < 0.001). The 2-year survival rates of patients with mALBI 1/2a and 2b/3 were 78.6% and 20.0%, respectively, with a significant difference (p = 0.0041).</p><p><strong>Conclusion: </strong>Ate/bev was effective for treating HCC patients with Vp3/4 PVTT. OR rate and MST were favorable, particularly for patients with preserved liver function (mALBI 1/2a), suggesting its great potential for the treatment of HCC in patients with Vp3/4 PVTT.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"900-908"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399972","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}
Surgery TodayPub Date : 2025-07-01Epub Date: 2025-01-04DOI: 10.1007/s00595-024-02982-z
Daqi Zhang, Lanlan Wan, Francesco Frattini, Gianlorenzo Dionigi
{"title":"Increased acute-phase reaction after the transoral endoscopic thyroidectomy vestibular approach (TOEVA) compared with minimally invasive video-assisted thyroidectomy (MIVAT) for unilateral thyroidectomy.","authors":"Daqi Zhang, Lanlan Wan, Francesco Frattini, Gianlorenzo Dionigi","doi":"10.1007/s00595-024-02982-z","DOIUrl":"10.1007/s00595-024-02982-z","url":null,"abstract":"<p><strong>Purposes: </strong>We analyzed the acute-phase response in unilateral thyroidectomy by comparing the transoral endoscopic thyroidectomy vestibular approach (TOEVA) with the minimally invasive video-assisted thyroidectomy (MIVAT).</p><p><strong>Methods: </strong>Patients were randomly assigned to undergo either TOEVA or MIVAT, after we obtained their written informed consent to participate in this study. Blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1β (IL-1β), IL-6 and tumor necrosis factor (TNF-) were measured before surgery and then 4, 24, and 48 h after surgery. The VAS pain score, analgesic utilization, and time to resume normal activities were recorded.</p><p><strong>Results: </strong>There were 29 patients who underwent TOETVA and 30 who underwent MIVAT. The groups were well balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, and preoperative values. There were no postoperative complications in this series. The operation time was longer in the TOETVA group (p < 0.001). Patients recommenced routine activities earlier after MIVAT (p < 0.05). The TOETVA group showed a greater drop in lymphocyte count 4 h (p < 0.01) and 24 h (p = 0.04) postoperatively, a higher ESR value 48 h postoperatively (p = 0.02), a longer increase in IL-6 (p = 0.05), 24 (p = 0.003) and 48 h postoperatively (p < 0.001), and a higher CRP 24 (p = 0.05) and 48 h postoperatively (p = 0.01) than the MIVAT group. There was no difference in postoperative IL-1β, TNF, total white blood cell count, polymorphonuclear cell count, and VAS or analgesic requirement between the groups, except on the day of surgery.</p><p><strong>Conclusions: </strong>An increased inflammatory response in the acute phase was observed after TOETVA compared with MIVAT, suggesting that TOETVA is associated with increased tissue trauma. This may account for the earlier recovery after the MIVAT procedure.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"969-976"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928056","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}
{"title":"Preventive effect of Clostridium butyricum MIYAIRI against pouchitis in children with ulcerative colitis.","authors":"Yuhki Koike, Koki Higashi, Yuki Sato, Shinji Yamashita, Yuka Nagano, Tadanobu Shimura, Takahito Kitajima, Kohei Matsushita, Yoshinaga Okugawa, Yoshiki Okita, Mikihiro Inoue, Keiichi Uchida, Yuji Toiyama","doi":"10.1007/s00595-024-02984-x","DOIUrl":"10.1007/s00595-024-02984-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pouchitis is a major complication after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis in children (UCc). In this study, we investigated whether the oral administration of Clostridium butyricum MIYAIRI 588 (CBM) can reduce the incidence of pouchitis after IPAA in UCc.</p><p><strong>Methods: </strong>We reviewed the data for pediatric patients with UC, who underwent IPAA in Mie University Hospital between 2004 and 2022. Data on the presence and type of postoperative probiotic medication and the timing of probiotic initiation, as well as clinical variables, were collected from the patients' medical records.</p><p><strong>Results: </strong>During the study period, 55 children with UC underwent radical surgery. During the first 5 years after ileostomy closure, 23 (41.8%) patients suffered at least one pouchitis episode. The incidence of acute pouchitis was significantly lower in the CBM group than in the non-CBM group (CBM vs. non-CBM: 10.5% vs. 58.3%, p < 0.01). Furthermore, even among patients who had been taking any probiotics postoperatively, the CBM group had a significantly lower incidence of both acute and chronic pouchitis than the 'other probiotics' group (p < 0.01).</p><p><strong>Conclusion: </strong>Oral CBM administration after ileostomy closure may be effective in preventing postoperative pouchitis.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"986-995"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882880","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}
{"title":"Clinical significance of the preoperative prognostic nutritional index in patients with resectable non-small cell lung cancer: a multicenter study.","authors":"Mamoru Takahashi, Akihiro Aoyama, Masatsugu Hamaji, Takashi Sozu, Masashi Kobayashi, Tatsuo Nakagawa, Masashi Ishikawa, Ryo Miyahara, Cheng-Long Huang, Takuji Fujinaga, Hiroaki Sakai, Hiromichi Katakura, Makoto Sonobe, Norihito Okumura, Hidenao Kayawake, Toshi Menju, Ei Miyamoto, Ryo Miyata, Harutaro Okada, Tomoya Kono, Ryota Sumitomo, Naoki Date, Takehisa Fukada, Akira Matsumoto, Yasuto Sakaguchi, Hiroshi Date","doi":"10.1007/s00595-024-02987-8","DOIUrl":"10.1007/s00595-024-02987-8","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data.</p><p><strong>Methods: </strong>The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes. Patients were divided into a high PNI group and a low PNI group (cutoff: 45). We also performed exact matching and three propensity score-based methods to validate the results.</p><p><strong>Results: </strong>Among the total 2,770 patients, 2,272 (82.0%) had a high PNI (>45) and 498 (18.0%) had a low PNI (≤45). A low preoperative PNI was a predictor of increased overall postoperative complications (relative risk 1.49; 95% confidence interval (CI) 1.31-1.69) and an independent adverse prognostic factor for overall survival (hazard ratio 1.77; 95% CI 1.45-2.17) and recurrence-free survival (1.34; 95% CI 1.14-1.59). All the methods we used (whole cohort, exact matching, and three propensity score methods) showed consistent results.</p><p><strong>Conclusions: </strong>The findings of this multicenter study suggest that immune-nutritional assessment using the PNI will provide useful prognostic information for patients with resectable NSCLC.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"918-929"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011534","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}
{"title":"Interval laparoscopic cholecystectomy for acute cholecystitis should be performed within approximately 1 week after gallbladder drainage.","authors":"Erica Nishimura, Kiminori Takano, Hiroto Fujisaki, Takako Muroi, Keita Hayashi, Yuki Tajima, Kumiko Hongo, Motohito Nakagawa","doi":"10.1007/s00595-025-03076-0","DOIUrl":"https://doi.org/10.1007/s00595-025-03076-0","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal interval between gallbladder drainage for acute cholecystitis and laparoscopic cholecystectomy (LC) remains unclear. This study evaluated the ideal interval to perform LC after drainage from the perspectives of surgical difficulty and patient satisfaction.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent LC after drainage at our institution between April 2016 and November 2023. The patients were divided into early surgery (ES) and delayed surgery (DS) groups. The surgical outcomes and surgical difficulty scores were compared between the groups.</p><p><strong>Results: </strong>A total of 72 patients (30 in the ES group and 42 in the DS group) were included. The median interval periods were 8 and 56 days in the ES and DS groups, respectively. Operative time, blood loss, and the incidence of postoperative complications were comparable between the groups. However, the rates of achieving a critical view of safety and avoiding conversion to open surgery were significantly higher in the ES group than in the DS group. Finally, scarring around Calot's triangle was significantly greater in the DS group than in the ES group. In addition, 19% of the patients in the DS group experienced cholecystitis recurrence, and 40% had tube-related complications during the interval period.</p><p><strong>Conclusion: </strong>The results showed that interval LC should be performed relatively soon after drainage.</p>","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":"144544881","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}
Surgery TodayPub Date : 2025-07-01Epub Date: 2024-11-14DOI: 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":"10.1007/s00595-024-02963-2","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Acceleration of adhesion formation by PGA may be associated with upregulated MPO, TNF-α, and TGF-β1 mRNA levels.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"996-1003"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","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}
{"title":"Efficacy of robot-assisted double-flap techniques with refinements to minimize anastomosis-related complications after proximal gastrectomy.","authors":"Eiichiro Nakao, Masataka Igeta, Motoki Murakami, Shugo Kohno, Yudai Hojo, Tatsuro Nakamura, Yasunori Kurahashi, Yoshinori Ishida, Hisashi Shinohara","doi":"10.1007/s00595-024-02989-6","DOIUrl":"10.1007/s00595-024-02989-6","url":null,"abstract":"<p><strong>Purpose: </strong>The double-flap technique (DFT) is an anti-reflux reconstruction procedure performed after proximal gastrectomy (PG), but its complexity and high incidence of anastomotic stenosis are problematic. We conducted this study to demonstrate the efficacy of robot-assisted DFT, with refinements, to address these issues.</p><p><strong>Methods: </strong>Surgical outcomes were compared between the following procedures modified over time at our institution: conventional open DFT (group O, n = 16); early robotic DFT (group RE, n = 19), which follows the conventional open PG approach; and late robotic DFT (group RL, n = 21), which incorporates refinements to the early robotic DFT technique by exploiting more of the robotic capabilities available. These robotic capabilities include pre-anchoring the stomach to the diaphragmatic crus and connecting it to the esophagus, placing interrupted sutures for anastomosis, and maximally embedding the esophagus through the entire flap.</p><p><strong>Results: </strong>Anastomotic stenosis requiring balloon dilatation developed in two (11.8%) patients from group O and three (14.3%) from group RE, but not in any patients from group RL. Reflux esophagitis, classified as Los Angeles Classification grade ≥ B, decreased from 25.0% in group O to 10.5% in group RE and was completely controlled in group RL (group RL vs group O, odds ratio 0.065, 95% confidence interval < 0.001-0.684, P = 0.007).</p><p><strong>Conclusion: </strong>Robotic surgery helps minimize anastomotic stenosis, while enhancing the benefits of anti-reflux reconstruction with DFT.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"977-985"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955415","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}
{"title":"Current practice regarding the diagnosis and treatment of anorectal malformations in female patients: a multicenter questionnaire survey in Japan.","authors":"Toshio Harumatsu, Masakazu Murakami, Ayaka Nagano, Koshiro Sugita, Tetsuya Ishimaru, Akihiro Fujino, Mitsuyuki Nakata, Shigeyoshi Aoi, Hideki Soh, Yoshiaki Kinoshita, Keiichi Uchida, Takeshi Hirabayashi, Yasushi Fuchimoto, Hideaki Okajima, Takeo Yonekura, Tsugumichi Koshinaga, Minoru Yagi, Hiroshi Matsufuji, Seiichi Hirobe, Masaki Nio, Shigeru Ueno, Jun Iwai, Tatsuo Kuroda, Satoshi Ieiri","doi":"10.1007/s00595-024-02968-x","DOIUrl":"10.1007/s00595-024-02968-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the current practices in the diagnosis and surgical management of anorectal malformations (ARMs) in female patients in Japan, specifically focusing on anovestibular fistula (AVF), rectovaginal fistula (RVF), and persistent cloaca (PC).</p><p><strong>Methods: </strong>An anonymous online survey was conducted with 61 institutional members of the Japanese Study Group for Anorectal Anomalies.</p><p><strong>Results: </strong>Sixty-one institutions (100%) completed the survey. For AVF, fistulography/vaginography was the most common diagnostic method (98.4%), and anorectoplasty was usually performed at 3-6 months of age (86.9%) using anterior sagittal anorectoplasty (62.3%) or anal transposition (39.3%). Distal colostography (100%), MRI (71.7%), and cystscopy/urethroscopy/vaginoscopy (83.3%) were commonly used for PC. Patients with PC underwent anorectoplasty at 7-24 months (93.3%), predominantly posterior sagittal anorecto-urethro-vaginoplasty (PSARUVP) (41.7%), or laparoscopy-assisted anorectoplasty (LAARP) (43.3%). A subgroup analysis revealed that PSARUVP used blunt dissection (70.0% vs. 28.6%, p < 0.05) and visual confirmation by opening the rectum (80.0% vs. 4.8%, p < 0.001) significantly more often than LAARP for PC.</p><p><strong>Conclusion: </strong>This nationwide survey revealed distinct patterns in the diagnostic timing and surgical approaches for female ARMs in Japan, highlighting the varying preferences in fistula management techniques across different types of malformations.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"960-968"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792354","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}
{"title":"Laparoscopic cranial-first approach for gastric mobilization in McKeown esophagectomy.","authors":"Yasuhiro Okumura, Kousuke Narumiya, Ryo Muraishi, Naoaki Shimamoto, Hiroshi Suda, Masashi Takemura, Hiroharu Yamashita, Yukiyasu Okamura","doi":"10.1007/s00595-025-03094-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03094-y","url":null,"abstract":"<p><p>Minimally invasive esophagectomy (MIE) has been adopted widely, but achieving an adequate surgical view during laparoscopic gastric mobilization is difficult, which can prolong the operation time and increase intraoperative blood loss. We describe a new laparoscopic approach using 5 trocars, starting with mobilization of the gastric fundus. First, we dissect around the hiatus and mobilize the gastric fundus; then we divide the left gastric artery and vein, and mobilize the greater curvature. In our experience of performing this procedure in 10 patients, the median operative time and blood loss were 410 min and 200 mL, respectively, and the median duration of the procedure was 90 min. There were no cases of anastomotic leakage (AL) and only one case of anastomotic stricture, which was managed with endoscopic dilatation. Our novel laparoscopic approach for gastric mobilization demonstrates potential for safety and feasibility as a minimally invasive form of McKeown esophagectomy.</p>","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":"144544882","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}