Surgery Today最新文献_第4页

Wedge resection versus segmentectomy in peripheral clinical stage IA lung cancer concerning ground-glass opacity. 楔形切除术与节段切除术治疗周围临床期IA期肺癌伴毛玻璃样混浊。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-22 DOI: 10.1007/s00595-025-03137-4

Atsushi Hata, Yutaro Sato, Takamasa Ito, Takayoshi Yamamoto, Yusuke Otani, Yuichi Sakairi, Takekazu Iwata

{"title":"Wedge resection versus segmentectomy in peripheral clinical stage IA lung cancer concerning ground-glass opacity.","authors":"Atsushi Hata, Yutaro Sato, Takamasa Ito, Takayoshi Yamamoto, Yusuke Otani, Yuichi Sakairi, Takekazu Iwata","doi":"10.1007/s00595-025-03137-4","DOIUrl":"https://doi.org/10.1007/s00595-025-03137-4","url":null,"abstract":"Purpose: Recent randomized controlled trials have shown the non-inferiority of sublobar-to-lobar resection for small peripheral non-small cell lung cancer (NSCLC); however, whether wedge resection (WR) or anatomical segmentectomy (SG) is superior remains unclear. We hypothesized that ground-glass opacity (GGO) is associated with the outcomes of WR and SG.Methods: Between 2010 and 2022, 219 consecutive patients with clinical stage IA peripheral NSCLC who underwent sublobar resection for frailty at our institution were retrospectively reviewed. Based on the high-resolution computed tomography findings, the tumors were classified into two groups: part-solid (GGO (+)) and solid (GGO (-)). The long-term outcomes were compared between the WR and SG groups.Results: In the part-solid group (n = 124; median CTR, 0.62), WR was equivalent to SG in terms of 5-year disease-free survival [DFS] (98% vs. 91%; p = 0.2) and recurrence rate (0% vs. 4.3%; p = 0.3). In the solid tumor group (n = 95), WR was inferior to SG in terms of the 5-year DFS (43% vs. 80%; p < 0.01) and recurrence rate (32% vs. 3.7%; p < 0.01).Conclusions: In our study population, WR was not inferior to SG for part-solid tumors. However, for solid tumors, the long-term outcomes of SG are superior to those of WR.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114161","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 between diaphragm thickness and postoperative complications in elderly patients with non-small-cell lung cancer. 老年非小细胞肺癌患者膈膜厚度与术后并发症的关系

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-20 DOI: 10.1007/s00595-025-03130-x

Shoji Kuriyama, Motoko Konno, Naoko Mori, Sumire Shibano, Shinogu Takashima, Tsubasa Matsuo, Yusuke Sato, Kyoko Nomura, Yoshihiro Minamiya, Kazuhiro Imai

{"title":"Association between diaphragm thickness and postoperative complications in elderly patients with non-small-cell lung cancer.","authors":"Shoji Kuriyama, Motoko Konno, Naoko Mori, Sumire Shibano, Shinogu Takashima, Tsubasa Matsuo, Yusuke Sato, Kyoko Nomura, Yoshihiro Minamiya, Kazuhiro Imai","doi":"10.1007/s00595-025-03130-x","DOIUrl":"https://doi.org/10.1007/s00595-025-03130-x","url":null,"abstract":"Purpose: Predicting perioperative complications in high-risk elderly patients with lung cancer has become increasingly important as the population ages. This study investigated the relationship between preoperative diaphragmatic thickness (DT) and perioperative complications.Methods: We enrolled 101 patients ≥ 75 years old who had undergone radical resection for primary lung cancer between 2013 and 2018. Bilateral DT was measured on axial and coronal computed tomography, and the mean DT (MDT) was calculated based on these measurements. Outcomes were assessed based on postoperative complications, defined as Clavien-Dindo classification ≥ 2.Results: The MDT was 3.51 ± 1.00 mm. Thirteen patients who experienced postoperative respiratory complications had a significantly lower MDT than a higher MDT (p = 0.0390). Multivariate logistic regression analyses revealed that an MDT ≤ 3.63 mm was an independent factor associated with postoperative complications (odds ratio, 5.559).Conclusions: Patients with a low MDT are at an increased risk of postoperative complications. Therefore, these patients require careful perioperative management.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092359","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

Effectiveness of introducing a health care application for prehabilitation in patients undergoing major hepatobiliary-pancreatic surgery: a pilot study. 在接受重大肝胆胰手术的患者中引入医疗保健应用程序进行康复的有效性：一项试点研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-19 DOI: 10.1007/s00595-025-03124-9

Motoki Nagaya, Yukihiro Yokoyama, Yota Mizuno, Hiroki Nakajima, Takayuki Inoue, Shinya Tanaka, Ryoya Yano, Naoki Hayashi, Yoshihiro Nishida, Tomoki Ebata

{"title":"Effectiveness of introducing a health care application for prehabilitation in patients undergoing major hepatobiliary-pancreatic surgery: a pilot study.","authors":"Motoki Nagaya, Yukihiro Yokoyama, Yota Mizuno, Hiroki Nakajima, Takayuki Inoue, Shinya Tanaka, Ryoya Yano, Naoki Hayashi, Yoshihiro Nishida, Tomoki Ebata","doi":"10.1007/s00595-025-03124-9","DOIUrl":"https://doi.org/10.1007/s00595-025-03124-9","url":null,"abstract":"Purpose: Prehabilitation is known to improve outcomes of gastrointestinal surgery; however, the issue of low adherence during the waiting period for surgery remains unresolved. This study evaluated the effectiveness and feasibility of a newly developed mobile health application, \"Preha,\" designed to support home-based prehabilitation.Methods: A single-group pilot study involving patients scheduled for major hepatobiliary-pancreatic (HBP) surgery for malignancy between March 2023 and September 2024 was conducted. The patients downloaded the Preha application, and there was no direct intervention from the medical staff during the preoperative period. The application recorded step counts, moderate-intensity exercise times, and squat counts. Adherence was defined as meeting at least one of the following: ≥ 5,000 steps/day, ≥ 10 min/day of ≥ 3 METS activities, or ≥ 30 squats/day, for more than three days per week.Results: Among 30 eligible patients, 21 (median age, 67 years) were included in the analysis. During prehabilitation, 52% achieved the step goal, 67% met the exercise time target, and 33% completed the squat goal.Conclusions: The \"Preha\" application facilitated good adherence to home-based prehabilitation without direct intervention, indicating its feasibility and potential as a perioperative support tool for patients undergoing HBP surgery. Trial registration https://jrct.niph.go.jp/ ; registration number: jRCTs042220106.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087465","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

Incidence of primary graft dysfunction and its associated risk factors after lung transplantation: a systematic review and meta-analysis. 肺移植术后原发性移植物功能障碍的发生率及其相关危险因素：系统回顾和荟萃分析。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-17 DOI: 10.1007/s00595-025-03129-4

Jing Pan, Jiejuan Zhang, Xiali Lu

{"title":"Incidence of primary graft dysfunction and its associated risk factors after lung transplantation: a systematic review and meta-analysis.","authors":"Jing Pan, Jiejuan Zhang, Xiali Lu","doi":"10.1007/s00595-025-03129-4","DOIUrl":"https://doi.org/10.1007/s00595-025-03129-4","url":null,"abstract":"This meta-analysis evaluates the prevalence of primary graft dysfunction (PGD) and its risk factors after lung transplantation (LT). We searched databases (PubMed, EMBASE, Cochrane Library, Web of Science) up until May, 2024. STATA 16 was used for data analysis. Random or fixed effects models were used to summarize the prevalence of PGD and associated risk factors according to statistical tests for heterogeneity. Risk of bias was assessed with the Newcastle-Ottawa Scale. A total of 61 studies with 59,865 patients were included. The pooled prevalence of grade 2 and grade 3 PGD was 27% (95% CI 0.19, 0.34) and 18% (0.16, 0.21), respectively. Donor-related risk factors included older age (OR = 1.04; 95% CI 1.00, 1.58), female gender (OR = 1.67; 95% CI 1.13, 2.48), and smoking history (OR = 1.84; 1.47, 2.30). Recipient factors were female gender (OR = 1.51; 95% CI 1.32, 1.74), higher BMI (OR = 1.22; 95% CI 1.11, 1.33), idiopathic pulmonary fibrosis (OR = 2.08; 95% CI 1.64, 2.63), and pulmonary hypertension (OR = 2.19; 95% CI 1.50, 3.21). Operative risks included higher reperfusion FiO2 (OR = 1.13; 95% CI 1.01, 1.23), prolonged ischemic time (OR = 1.03; 95% CI 1.01, 1.05), and cardiopulmonary bypass use (OR = 2.38; 95% CI 1.79, 3.16). This study highlights the donor, recipient, and operative factors contributing to PGD risk, and emphasizes the need for targeted strategies in high-risk populations and further mechanistic research.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076215","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 second-drop eosinophil ratio is useful for the early detection of severe complications after pancreaticoduodenectomy. 二滴嗜酸性粒细胞比值对早期发现胰十二指肠切除术后严重并发症有重要意义。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-15 DOI: 10.1007/s00595-025-03128-5

Hironori Shiozaki, Shuichi Fujioka, Yuki Takano, Takashi Shimazaki, Machi Suka, Taro Sakamoto, Takeshi Gocho, Keitaro Nakamoto, Naoki Toya, Toru Ikegami

{"title":"The second-drop eosinophil ratio is useful for the early detection of severe complications after pancreaticoduodenectomy.","authors":"Hironori Shiozaki, Shuichi Fujioka, Yuki Takano, Takashi Shimazaki, Machi Suka, Taro Sakamoto, Takeshi Gocho, Keitaro Nakamoto, Naoki Toya, Toru Ikegami","doi":"10.1007/s00595-025-03128-5","DOIUrl":"https://doi.org/10.1007/s00595-025-03128-5","url":null,"abstract":"Purpose: Pancreaticoduodenectomy is associated with high morbidity, notably due to complications, such as postoperative pancreatic fistula and intra-abdominal hemorrhaging. The early detection of such complications is crucial for improving outcomes. The peripheral blood eosinophil ratio, which reflects the endogenous corticosteroid activity, may indicate physiological stress or inflammation. This study evaluated whether or not changes in the eosinophil ratio could predict postoperative complications.Methods: A retrospective review of patients who underwent pancreaticoduodenectomy between January 2011 and December 2020 at Jikei University Kashiwa Hospital was conducted. The postoperative eosinophil ratio trends were analyzed in relation to complications.Results: Among 200 patients, 85 experienced Clavien-Dindo grade ≥ III complications. A biphasic pattern in the eosinophil ratio was observed in these patients, with a secondary decline correlating with the onset of complications. Using a cutoff of 0.95%, the sensitivity, specificity, and area under the curve for predicting severe complications were 0.92, 0.92, and 0.96, respectively (95% confidence interval 0.93-0.99).Conclusion: A sustained decrease in the peripheral blood eosinophil ratio was associated with severe postoperative complications. This marker may be useful for early detection, enabling prompt diagnostic and therapeutic intervention following pancreaticoduodenectomy.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064785","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

Correlation of residual lung complications with radiological findings after pulmonary segmentectomy. 肺段切除术后残余肺并发症与影像学表现的相关性。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-15 DOI: 10.1007/s00595-025-03134-7

Mari Ohkuma, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Hisashi Tomita, Kazuya Takamochi, Kenji Suzuki

{"title":"Correlation of residual lung complications with radiological findings after pulmonary segmentectomy.","authors":"Mari Ohkuma, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Hisashi Tomita, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s00595-025-03134-7","DOIUrl":"https://doi.org/10.1007/s00595-025-03134-7","url":null,"abstract":"Purpose: To investigate the clinical characteristics of residual lung complications following segmentectomy.Methods: Among 901 patients who underwent segmentectomy for lung cancer between 2009 and 2022, 256 patients who underwent postoperative computed tomography (CT) for abnormal shadows on chest radiography were retrospectively evaluated and categorized into three groups: Type 1 (consolidation only adjacent to the intersegmental line), Type 2 (partial infiltration extended to the residual segment [< 50%]), and Type 3 (infiltration extended to the large area of the residual segment [≥ 50%]). The association between the CT findings and complications was also assessed.Results: There were no significant differences in the background factors among the three types. However, Type 3 patients experienced more severe pulmonary-related complications than Types 1 and 2 (45.8% vs. 25.0%, P = 0.002). Most patients (n = 894, 99.2%) were discharged without surgical intervention, but seven (0.78%) required reoperation for complications. Of these, six had Type 3 CT findings, and five underwent left upper division segmentectomy.Conclusions: Extensive postoperative infiltrative shadows in the residual segment are associated with severe complications after segmentectomy. In cases in which the shadow occupies more than half of the remaining segment, special attention to postoperative management is necessary to prevent lethal complications.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065510","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

Risk factors of incisional hernia enlargement after colorectal cancer surgery: a retrospective, single-center study. 结直肠癌手术后切口疝扩大的危险因素：一项回顾性单中心研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-14 DOI: 10.1007/s00595-025-03131-w

Koki Tamai, Mitsuyoshi Tei, Naoto Tsujimura, Kentaro Nishida, Soichiro Mori, Yukihiro Yoshikawa, Masatoshi Nomura, Nobuyoshi Ohara, Takuya Hamakawa, Daisuke Takiuchi, Masanori Tsujie, Yusuke Akamaru

{"title":"Risk factors of incisional hernia enlargement after colorectal cancer surgery: a retrospective, single-center study.","authors":"Koki Tamai, Mitsuyoshi Tei, Naoto Tsujimura, Kentaro Nishida, Soichiro Mori, Yukihiro Yoshikawa, Masatoshi Nomura, Nobuyoshi Ohara, Takuya Hamakawa, Daisuke Takiuchi, Masanori Tsujie, Yusuke Akamaru","doi":"10.1007/s00595-025-03131-w","DOIUrl":"https://doi.org/10.1007/s00595-025-03131-w","url":null,"abstract":"Purpose: Incisional hernia (IH) often develops during surveillance after colorectal cancer surgery, with repair sometimes delayed due to the risk of recurrence. This study aimed to identify the risk factors for IH enlargement by objectively measuring the changes in defect size.Methods: We retrospectively analyzed 83 patients who developed IH after curative laparoscopic colorectal surgery at the Osaka Rosai Hospital between 2017 and 2021. Computed tomography was used to measure the IH defect sizes at diagnosis and at the end of the surveillance. Univariate and multivariate analyses were performed to determine the risk factors for enlargement.Results: The median IH defect size increased from 23.7 to 32.7 mm over a median follow-up of 1003 days. The highest quartile of defect size change was 12.1 mm and was used to classify patients into stable and enlarged IH groups. A multivariate analysis revealed that a high body mass index (≥ 25 kg/m2; odds ratio [OR] 3.527, p = 0.037), early IH discovery (< 225 days after surgery; OR 4.753, p = 0.012), and high neutrophil-to-lymphocyte ratio (> 2.45; OR 3.604, p = 0.031) were independent risk factors for IH enlargement.Conclusions: Obesity, early IH development, and systemic inflammation are associated with IH progression. Careful monitoring of patients with these risk factors is warranted.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064812","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

Induction chemotherapy followed by long-course chemoradiotherapy versus short-course radiotherapy followed by consolidation chemotherapy for achieving complete response in patients with locally advanced rectal cancer: a propensity-score matching study. 局部晚期直肠癌患者诱导化疗后长期放化疗与短期放疗后巩固化疗实现完全缓解：一项倾向评分匹配研究

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-13 DOI: 10.1007/s00595-025-03132-9

Kentaro Sato, Takashi Akiyoshi, Tatsuki Noguchi, Takashi Sakamoto, Shimpei Matsui, Toshiki Mukai, Tomohiro Yamaguchi, Masamichi Koyama, Senzo Taguchi, Akiko Chino, Hiroshi Kawachi, Eiji Shinozaki, Kensei Yamaguchi

{"title":"Induction chemotherapy followed by long-course chemoradiotherapy versus short-course radiotherapy followed by consolidation chemotherapy for achieving complete response in patients with locally advanced rectal cancer: a propensity-score matching study.","authors":"Kentaro Sato, Takashi Akiyoshi, Tatsuki Noguchi, Takashi Sakamoto, Shimpei Matsui, Toshiki Mukai, Tomohiro Yamaguchi, Masamichi Koyama, Senzo Taguchi, Akiko Chino, Hiroshi Kawachi, Eiji Shinozaki, Kensei Yamaguchi","doi":"10.1007/s00595-025-03132-9","DOIUrl":"https://doi.org/10.1007/s00595-025-03132-9","url":null,"abstract":"Purpose: This study compared complete response (CR) outcomes between two total neoadjuvant therapy (TNT) strategies for locally advanced rectal cancer: induction chemotherapy followed by long-course chemoradiotherapy (INCT-LCCRT) versus short-course radiotherapy followed by consolidation chemotherapy (SCRT-CNCT).Methods: The subjects of this retrospective study were 234 patients with clinical stage T3-4NanyM0 low rectal cancer, treated between 2011 and 2022 with TNT and either total mesorectal excision or non-operative management (NOM). CR was defined as pathological CR after resection or sustained clinical CR in NOM. Propensity score matching was applied to adjust baseline differences, resulting in 38 matched pairs. We evaluated CR rates and survival outcomes.Results: There were 194 patients treated with INCT-LCCRT and 40 treated with SCRT-CNCT. The INCT-LCCRT group had more advanced disease features, including higher rates of clinical T4 (29.9% vs. 2.5%) and lateral pelvic node metastases (62.4% vs. 10%). The CR rates were comparable in the full cohort (30.9% vs. 30.0%, p = 1) and after matching (34.2% vs. 28.9%, p = 0.81). No significant differences were observed in 3-year relapse-free or local recurrence-free survival.Conclusions: In the matched cohort of mainly intermediate-risk cases, INCT-LCCRT and SCRT-CNCT demonstrated comparable CR rates and oncological outcomes.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055640","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

Surgical treatment strategy for elderly patients with esophageal cancer in the new era: a narrative review. 新时期老年食管癌手术治疗策略述评

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-11 DOI: 10.1007/s00595-025-03133-8

Hiroshi Saeki, Makoto Sakai, Akihiko Sano, Kengo Kuriyama, Takuya Shiraishi, Takuhisa Okada, Yuji Kumakura, Akiharu Kimura, Ken Shirabe

{"title":"Surgical treatment strategy for elderly patients with esophageal cancer in the new era: a narrative review.","authors":"Hiroshi Saeki, Makoto Sakai, Akihiko Sano, Kengo Kuriyama, Takuya Shiraishi, Takuhisa Okada, Yuji Kumakura, Akiharu Kimura, Ken Shirabe","doi":"10.1007/s00595-025-03133-8","DOIUrl":"https://doi.org/10.1007/s00595-025-03133-8","url":null,"abstract":"The trend of aging among patients with esophageal cancer is expected to continue in the future. We herein review the current status and future perspectives of surgical strategies for elderly patients with esophageal cancer. According to published systematic reviews and/or meta-analyses evaluating surgical risks in elderly patients with esophageal cancer, the outcomes of elderly patients were worse in terms of postoperative mortality, overall complications, pulmonary complications, cardiac complications, and the overall survival than those of non-elderly patients. In recent years, minimally invasive surgery for esophageal cancer has rapidly gained worldwide popularity. There is a need to reassess whether or not minimally invasive esophagectomy alters surgical indications and treatment outcomes in elderly patients with esophageal cancer. Optimizing perioperative treatment and management is also expected to promote advances in multidisciplinary treatment, including surgery, for elderly patients. Clinical studies focusing on elderly patients, along with biomarker research aimed at personalizing multidisciplinary treatment, are expected to contribute to further improvements in the treatment outcomes of elderly patients with esophageal cancer.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041304","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

Surgical strategy for repeated metastasectomy for advanced colorectal cancer with synchronous liver metastases. 伴有同步肝转移的晚期结直肠癌重复转移切除术的手术策略。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-09 DOI: 10.1007/s00595-025-03125-8

Tetsuro Kawazoe, Ryota Nakanishi, Koji Ando, Yoko Zaitsu, Kensuke Kudou, Tomonori Nakanoko, Shinji Itoh, Eiji Oki, Tomoharu Yoshizumi

{"title":"Surgical strategy for repeated metastasectomy for advanced colorectal cancer with synchronous liver metastases.","authors":"Tetsuro Kawazoe, Ryota Nakanishi, Koji Ando, Yoko Zaitsu, Kensuke Kudou, Tomonori Nakanoko, Shinji Itoh, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1007/s00595-025-03125-8","DOIUrl":"https://doi.org/10.1007/s00595-025-03125-8","url":null,"abstract":"Purpose: Liver metastases from colorectal cancer (CRLM) are a major determinant of the prognosis of metastatic colorectal cancer. Although curative resection is recommended for resectable CRLM, recurrence remains a challenge and the criteria for patient selection and repeat resection are still unclear. We conducted this study to evaluate the outcomes of metastatic lesion resection with curative intent (R0 resection), to identify the factors associated with recurrence, and to establish the feasibility of repeat metastasectomy.Methods: This single-center retrospective study analyzed 135 patients with synchronous CRLM, who underwent surgical resection or received chemotherapy between January, 2013 and March, 2023.Results: R0 resection was achieved in 62 (45.9%), with a median recurrence-free survival of 12.3 months. Recurrence developed in 50 (80.6%) of these patients and 28 underwent repeat R0 resection. Initial R0 resection was associated with significantly improved overall survival (OS; hazard ratio [HR], 0.12; p < 0.01) and repeat R0 resection after recurrence improved survival further (HR, 0.32; p = 0.019). Conversion surgery, performed in 42 of 114 patients (36.8%) initially treated with chemotherapy, was significantly associated with the absence of extrahepatic metastases and H1 liver metastases.Conclusions: These findings highlight the importance of individualized treatment strategies for optimizing CRLM outcomes.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024277","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