Surgery Today最新文献_第4页

Preoperative risk-factors for secondary spontaneous pneumothorax surgery in Japan: a nationwide database study. 日本继发性自发性气胸手术的术前风险因素：一项全国性数据库研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-08-27 DOI: 10.1007/s00595-024-02926-7

Ryuichi Waseda, Hiroyuki Yamamoto, Yasushi Shintani, Toshihiko Sato, Kenji Suzuki, Yoshimasa Maniwa, Yukio Sato, Ichiro Yoshino, Masayuki Chida

{"title":"Preoperative risk-factors for secondary spontaneous pneumothorax surgery in Japan: a nationwide database study.","authors":"Ryuichi Waseda, Hiroyuki Yamamoto, Yasushi Shintani, Toshihiko Sato, Kenji Suzuki, Yoshimasa Maniwa, Yukio Sato, Ichiro Yoshino, Masayuki Chida","doi":"10.1007/s00595-024-02926-7","DOIUrl":"10.1007/s00595-024-02926-7","url":null,"abstract":"Purpose: We aimed to identify preoperative risk factors for secondary spontaneous pneumothorax surgery.Methods: The National Clinical Database of Japan, with six annual datasets from 2014 to 2019, was used. All patients who underwent surgery for secondary spontaneous pneumothorax were included, excluding those < 15 years old and those with incomplete data. The effects of preoperative risk factors were analyzed for operative mortality (mortality during hospitalization or within 30 days, regardless of hospitalization status), 30-day mortality, and postoperative respiratory morbidities.Results: Of the 18,309 patients enrolled in the study, operative mortality, 30-day mortality, and postoperative respiratory morbidities were observed in 654 (3.6%), 343 (1.9%), and 2258 (12.3%) patients, respectively. Increasing age, male sex, body mass index < 18.5 or > 30, performance status > 2, emergent surgery, interstitial pneumonia, and diabetes in preoperative co-morbidity, tumors, and other diseases in underlying lung disease were significant risk factors for operative mortality. Those for 30-day mortality included autoimmune disease instead of male sex and diabetes, while those for postoperative respiratory morbidities included lymphangiomyomatosis instead of a body mass index > 30.Conclusion: We identified many preoperative risk factors for operative mortality, 30-day mortality, and postoperative respiratory morbidities in secondary spontaneous pneumothorax surgery. These findings will assist in selecting appropriate surgical candidates.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"393-404"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073913","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

Prognostic impact of combination therapy with gemcitabine and cisplatin plus S-1 and subsequent conversion surgery for initially unresectable upper biliary tract cancers. 吉西他滨和顺铂加S-1联合疗法以及随后的转换手术对最初无法切除的上胆道癌的预后影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-08-13 DOI: 10.1007/s00595-024-02912-z

Hisashi Kosaka, Kosuke Matsui, Tsukasa Ikeura, Takashi Ito, Chisato Ohe, Yumiko Kono, Hideyuki Matsushima, Hidekazu Yamamoto, Mitsugu Sekimoto, Masaki Kaibori

{"title":"Prognostic impact of combination therapy with gemcitabine and cisplatin plus S-1 and subsequent conversion surgery for initially unresectable upper biliary tract cancers.","authors":"Hisashi Kosaka, Kosuke Matsui, Tsukasa Ikeura, Takashi Ito, Chisato Ohe, Yumiko Kono, Hideyuki Matsushima, Hidekazu Yamamoto, Mitsugu Sekimoto, Masaki Kaibori","doi":"10.1007/s00595-024-02912-z","DOIUrl":"10.1007/s00595-024-02912-z","url":null,"abstract":"Purpose and background: For the past decade, there have been few chemotherapy options for unresectable biliary tract cancer (BTC). Recently, however, combination therapy with gemcitabine and cisplatin plus S-1 (GCS) has been identified as a promising strategy. This retrospective study analyzes the clinical results of GCS therapy and subsequent conversion surgery (CS).Method: We analyzed the clinical data of 60 consecutive patients who received GCS therapy for unresectable upper BTC at our university hospital during the 5 years between September, 2018 and December, 2022.Results: All patients received GCS therapy as first-line chemotherapy. The response rate was 33.9% and subsequent CS was performed in 35.0%. Of the patients who underwent CS, 81% required more than bisectionectomy of the liver with extrahepatic bile duct resection. The median overall survival of the patients who received GCS therapy and underwent subsequent CS was significantly longer than that of the patients who received GCS therapy alone (28.0 months vs. 12.4 months, respectively; p < 0.001). A decrease in the CA19-9 level 1 month after chemotherapy and RECIST PR were independent positive predictors of CS, whereas unresectable gallbladder cancer and pretreatment ALBI grade 3 were negative predictors of CS.Conclusion: GCS therapy and subsequent CS may contribute to the longer term survival of patients with unresectable upper BTC.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"351-359"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971847","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

Indocyanine green fluorescence imaging as a predictor of long-term testicular atrophy in testicular torsion: a pilot study. 吲哚菁绿荧光成像作为睾丸扭转长期睾丸萎缩的预测指标：一项试点研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-07-31 DOI: 10.1007/s00595-024-02908-9

Shugo Komatsu, Keita Terui, Ayako Takenouchi, Yunosuke Kawaguchi, Katsuhiro Nishimura, Satoru Oita, Hiroko Yoshizawa, Shota Takiguchi, Tomoro Hishiki

{"title":"Indocyanine green fluorescence imaging as a predictor of long-term testicular atrophy in testicular torsion: a pilot study.","authors":"Shugo Komatsu, Keita Terui, Ayako Takenouchi, Yunosuke Kawaguchi, Katsuhiro Nishimura, Satoru Oita, Hiroko Yoshizawa, Shota Takiguchi, Tomoro Hishiki","doi":"10.1007/s00595-024-02908-9","DOIUrl":"10.1007/s00595-024-02908-9","url":null,"abstract":"Purpose: This pilot study evaluated indocyanine green-guided near-infrared fluorescence (ICG-NIRF) imaging of testicular blood flow to predict long-term testicular atrophy after testicular torsion (TT) surgery.Methods: The subjects of this retrospective study were patients who underwent surgery for TT at our hospital between December, 2020 and July, 2022. After detorsion, testicular blood flow was evaluated by ICG-NIRF imaging and classified into three categories: fluorescence detected, no fluorescence detected, and fluorescence detected only in the tunica albuginea vessels. Testicular volume was measured by ultrasonography up to 12 months after surgery to evaluate long-term outcomes.Results: Twelve patients were included in this analysis. We found a 100% correlation between the absence of ICG-NIRF signals and subsequent testicular atrophy. In three patients without an ICG-NIRF signal, the median testis size 12 months postoperatively was significantly smaller (16.5% of the contralateral testis; range 13-20%) than that in six patients with an ICG-NIRF signal (96%; 89-115%) (p = 0.013). Mild atrophy (74.5%; 73-76%) was also observed in the three patients for whom an ICG-NIRF signal was detected only in the tunica albuginea vessels.Conclusions: Our pilot study highlights the potential of ICG-NIRF imaging as a prognostic tool for guiding surgical decision-making for patients with TT, by predicting postoperative testicular atrophy.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"386-392"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861024","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

Morphological characteristics and outcomes of aortic repair of acute type A aortic dissection occurring in patients with aortic arch branching variants. 主动脉弓分支变异患者发生急性 A 型主动脉夹层的形态特征和主动脉修复的结果。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-09-25 DOI: 10.1007/s00595-024-02919-6

Takahiro Yamamoto, Naoyuki Kimura, Daijiro Hori, Makiko Mieno, Manabu Shiraishi, Homare Okamura, Koji Kawahito, Atsushi Yamaguchi

{"title":"Morphological characteristics and outcomes of aortic repair of acute type A aortic dissection occurring in patients with aortic arch branching variants.","authors":"Takahiro Yamamoto, Naoyuki Kimura, Daijiro Hori, Makiko Mieno, Manabu Shiraishi, Homare Okamura, Koji Kawahito, Atsushi Yamaguchi","doi":"10.1007/s00595-024-02919-6","DOIUrl":"10.1007/s00595-024-02919-6","url":null,"abstract":"Purpose: To investigate the morphological characteristics and operative outcomes of acute type A aortic dissection (ATAAD) in patients with aortic arch variants.Methods: Of 616 patients with ATAAD, 97 (15.7%) had aortic arch variants, including bovine aortic arch (BAA, n = 66), isolated left vertebral artery (ILVA, n = 25), and aberrant subclavian artery (ASA, n = 6). The characteristics and outcomes were compared between the normal branching group (control, n = 519) and the total/individual arch variant groups.Results: Compared to the control group, arch entry was more prevalent in the BAA (18.5% vs. 31.8%) and ILVA groups (44%) (both, P < 0.05), and right common carotid arterial occlusion was less common in the arch variant group (6.7% vs. 0%, P = 0.017). The in-hospital mortality (9.2% vs. 9.3%), new-onset stroke (7.3% vs. 7.2%), and 5-year survival (81.7% vs. 78.8%) did not differ markedly between the control and arch variant groups. Arch repair was performed in 28.9% (28/97) of the arch variant group using 3-4 vessel antegrade cerebral perfusion, with 3.8% in-hospital mortality and a 15.4% stroke rate, which were comparable to those of the control group.Conclusions: Aortic arch variants may influence tear location and involvement of the supra-arch vessels but may not affect postoperative outcomes.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"414-424"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of reconstructed portal vein morphology on postoperative nutritional status in pancreatoduodenectomy: a computational fluid dynamics study. 胰十二指肠切除术中重建门静脉形态对术后营养状况的影响：计算流体动力学研究。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-07-30 DOI: 10.1007/s00595-024-02903-0

Katsunori Sakamoto, Yukiharu Iwamoto, Kohei Ogawa, Oğuzhan Şal, Kei Tamura, Takahiro Hikida, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Mikiya Shine, Yusuke Nishi, Mio Uraoka, Tomoyuki Nagaoka, Masahiko Honjo, Naotake Funamizu, Yasutsugu Takada

{"title":"Impact of reconstructed portal vein morphology on postoperative nutritional status in pancreatoduodenectomy: a computational fluid dynamics study.","authors":"Katsunori Sakamoto, Yukiharu Iwamoto, Kohei Ogawa, Oğuzhan Şal, Kei Tamura, Takahiro Hikida, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Mikiya Shine, Yusuke Nishi, Mio Uraoka, Tomoyuki Nagaoka, Masahiko Honjo, Naotake Funamizu, Yasutsugu Takada","doi":"10.1007/s00595-024-02903-0","DOIUrl":"10.1007/s00595-024-02903-0","url":null,"abstract":"This study evaluated the impact of reconstructed portal vein/superior mesenteric vein (PV/SMV) morphology on the long-term nutritional status following pancreatoduodenectomy (PD) using computational fluid dynamics (CFD). Twenty-four patients who underwent PD with PV/SMV resection and reconstruction without tumor recurrence for over 9 months after the operation were enrolled in the study. Three-dimensional models were constructed from computed tomography images obtained 3-6 months postoperatively. The pressure (p) at the inlet and turbulence dissipation rate (ε) at the outlet were investigated in the models. Patients with values of either p or ε above the upper interquartile range were classified as the poor flow group. The prognostic nutritional index improvement rate was significantly lower at 9 postoperative months in the poor flow group than in the good flow group (P = 0.016). This finding indicates the utility of a CFD analysis for evaluating the reconstructed PV/SMV morphology.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"445-451"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856604","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

Minimally invasive autologous pericardial patch reconstruction of the pulmonary artery for locally advanced lung cancer following neoadjuvant treatment. 新辅助治疗后局部晚期肺癌的微创自体心包补片肺动脉重建术。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-09-23 DOI: 10.1007/s00595-024-02940-9

Ze-Rui Zhao, Shou-Cheng Feng, Jia-Di Wu, Jing-Bo Zhang

{"title":"Minimally invasive autologous pericardial patch reconstruction of the pulmonary artery for locally advanced lung cancer following neoadjuvant treatment.","authors":"Ze-Rui Zhao, Shou-Cheng Feng, Jia-Di Wu, Jing-Bo Zhang","doi":"10.1007/s00595-024-02940-9","DOIUrl":"10.1007/s00595-024-02940-9","url":null,"abstract":"Pulmonary arterioplasty with an autologous pericardial patch helps avoid having to perform pneumonectomy in patients with locally advanced non-small cell lung cancer. However, a minimally invasive procedure for this technique has rarely been reported because the patch usually shrinks and recoils after retrieval, complicating the suturing procedure. We describe our experience with performing autologous pericardial patch arterioplasty without glutaraldehyde fixation using video-assisted thoracoscopic surgery in a patient who received neoadjuvant immunotherapy. The pulmonary bloodstream was temporarily controlled by an endoscopic tourniquet placed at the pulmonary artery proximal to the ligamentum arteriosum as well as at the inferior pulmonary vein. A pericardial patch harvested anterior to the phrenic nerve was used to repair the hemi-circumferential pulmonary artery defect. Patch angioplasty was performed using a running suture with a 5-0 nonabsorbable monofilament thread, with the epicardial layer facing inside. No graft-related complications including stenosis occurred during the follow-up period.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"452-456"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296030","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

Treatment outcomes in non-occlusive mesenteric ischemia and post-treatment return to social activities. 非闭塞性肠系膜缺血的治疗效果和治疗后恢复社会活动的情况。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-08-01 DOI: 10.1007/s00595-024-02909-8

Gaku Ohira, Koichi Hayano, Toru Tochigi, Tetsuro Maruyama, Takeshi Toyozumi, Yoshihiro Kurata, Michihiro Maruyama, Satoko Arai, Taka-Aki Nakada, Hisahiro Matsubara

{"title":"Treatment outcomes in non-occlusive mesenteric ischemia and post-treatment return to social activities.","authors":"Gaku Ohira, Koichi Hayano, Toru Tochigi, Tetsuro Maruyama, Takeshi Toyozumi, Yoshihiro Kurata, Michihiro Maruyama, Satoko Arai, Taka-Aki Nakada, Hisahiro Matsubara","doi":"10.1007/s00595-024-02909-8","DOIUrl":"10.1007/s00595-024-02909-8","url":null,"abstract":"Purpose: To investigate the treatment outcomes of patients with non-occlusive mesenteric ischemia (NOMI) at our institution, we focused on their post-treatment return to social activities.Methods: This study included patients with suspected NOMI who were referred to our department between 2011 and 2023. In-hospital mortality was also investigated as a prognostic factor. The Glasgow-Pittsburgh Outcome Categories (GPOC) score was used to evaluate the return to social activities. The relationship between in-hospital mortality and GPOC scores and patient background and treatment factors was examined.Results: Eighty-two patients were included in the study. Among them, 54 (65.9%) died during hospitalization. Only 9 patients (11%) returned to their social activities. In the multivariate analysis, non-surgical management was found to be the only independent factor for in-hospital mortality. Positive portal venous gas on computed tomography, no open abdomen, no pre-onset catecholamine administration, platelet count < 100,000/µL, lactate level < 5 mmol/L, APTT < 46 s, and Sequential Organ Failure Assessment score < 11 were factors significantly associated with an increased likelihood of return to social activities.Conclusion: This is the first study to assess the post-treatment return to social activities among patients with NOMI. Our findings highlight the concerning reality that survivors may face prolonged dependence on medical care.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"360-369"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861025","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

A comparison of pancreatojejunostomy using the modified Blumgart anastomosis with or without a four-needle three-loop suture device and continuous sutures for duct-to-mucosa anastomosis in robotic pancreaticoduodenectomy. 在机器人胰十二指肠切除术中使用改良Blumgart吻合器进行胰空肠吻合术与使用或不使用四针三环缝合装置和连续缝合进行导管到粘膜吻合术的比较。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-07-30 DOI: 10.1007/s00595-024-02904-z

Naohisa Kuriyama, Akihiro Tanemura, Benson Kaluba, Tatsuya Sakamoto, Yu Fujimura, Takuya Yuge, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Masashi Kishiwada, Shugo Mizuno

{"title":"A comparison of pancreatojejunostomy using the modified Blumgart anastomosis with or without a four-needle three-loop suture device and continuous sutures for duct-to-mucosa anastomosis in robotic pancreaticoduodenectomy.","authors":"Naohisa Kuriyama, Akihiro Tanemura, Benson Kaluba, Tatsuya Sakamoto, Yu Fujimura, Takuya Yuge, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Masashi Kishiwada, Shugo Mizuno","doi":"10.1007/s00595-024-02904-z","DOIUrl":"10.1007/s00595-024-02904-z","url":null,"abstract":"Purpose: Despite descriptions of different pancreatojejunostomy procedures using robotic pancreaticoduodenectomy (RPD), a standardized procedure has not yet been established. No prior report has described pancreatojejunostomy by RPD combined with modified Blumgart anastomosis with continuous suturing for duct-to-mucosa anastomosis. This study investigated this surgical technique and evaluated the short-term outcomes of the simplified pancreatojejunostomy procedure.Methods: Between December 2021 and March 2024, 36 patients underwent pancreatojejunostomy using modified Blumgart anastomosis with continuous suturing for duct-to-mucosa anastomosis using RPD. Patients were divided into an early group (n = 15), without the use of the new four-needle three-loop suture device during the modified Blumgart anastomosis and a late group (n = 21) that did use this device.Results: The late group had a significantly shorter pancreatojejunostomy duration (60 min vs. 49 min, p = 0.004) than the early group. Both groups showed equivalent postoperative outcomes; however, the late group exhibited a trend toward a lower rate of postoperative pancreatic fistula grade ≥ B (26.7% vs. 4.8%, p = 0.138).Conclusions: Pancreatojejunostomy using modified Blumgart anastomosis with a four-needle three-loop suture device and continuous suture for duct-to-mucosa anastomosis in patients undergoing RPD is simple and effective. This new suturing device may further reduce the incidence of postoperative pancreatic fistulas.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"343-350"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856603","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

Proposal of "borderline resectable" colorectal liver metastases based on analysis of risk factors for early surgical failure. 根据早期手术失败风险因素分析，提出 "边缘可切除 "结直肠肝转移瘤的建议。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-08-19 DOI: 10.1007/s00595-024-02920-z

Mizuki Ninomiya, Shinji Itoh, Kazuki Takeishi, Takeo Toshima, Shohei Yoshiya, Kazutoyo Morita, Ryosuke Minagawa, Tomohiro Iguchi, Eiji Oki, Tomoharu Yoshizumi

{"title":"Proposal of \"borderline resectable\" colorectal liver metastases based on analysis of risk factors for early surgical failure.","authors":"Mizuki Ninomiya, Shinji Itoh, Kazuki Takeishi, Takeo Toshima, Shohei Yoshiya, Kazutoyo Morita, Ryosuke Minagawa, Tomohiro Iguchi, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1007/s00595-024-02920-z","DOIUrl":"10.1007/s00595-024-02920-z","url":null,"abstract":"Purpose: We aimed to define borderline resectable colorectal liver metastases (CRLM) based on the analysis of risk factors for early surgical failure and investigate the efficacy of neoadjuvant chemotherapy in these patients.Methods: This was a retrospective analysis of a multi-institutional cohort of patients diagnosed with technically resectable CRLM. Early surgical failure within 6 months of liver surgery was defined as ESF6. We classified CRLM into three grades (A, B, and C) according to the definition of the Japanese Society for Cancer of the Colon and Rectum.Results: Among the 249 patients with technically resectable CRLM, 46 (18.5%) developed ESF6. The survival rate of these patients was significantly lower than that of the patients without ESF6. In the multivariate analysis of synchronous CRLM patients, no neoadjuvant chemotherapy, Grade B/C, and Charlson comorbidity index ≥ 3 were independent predictors of ESF6. Among patients with synchronous and Grade B/C CRLM, ESF6 rates, surgical failure-free survival, and overall survival in the neoadjuvant chemotherapy group were significantly better relative to the upfront surgery group.Conclusions: Patients with synchronous and Grade B/C CRLM are at a high risk of early surgical failure, have a poor long-term prognosis, and can be defined as borderline resectable and good candidates for neoadjuvant chemotherapy.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"425-433"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000712","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

Prognostic factors for pediatric patients with severe intestinal motility disorders: a single institution's experience. 严重肠道运动障碍儿科患者的预后因素：一家医疗机构的经验。

IF 1.7 4区医学

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-08-07 DOI: 10.1007/s00595-024-02910-1

Keisuke Yano, Mitsuru Muto, Koshiro Sugita, Masakazu Murakami, Shun Onishi, Toshio Harumatsu, Yumiko Iwamoto, Masato Ogata, Lynne Takada, Nanako Nishida, Chihiro Kedoin, Ayaka Nagano, Mayu Matsui, Koji Yamada, Waka Yamada, Makoto Matsukubo, Takafumi Kawano, Tatsuru Kaji, Satoshi Ieiri

{"title":"Prognostic factors for pediatric patients with severe intestinal motility disorders: a single institution's experience.","authors":"Keisuke Yano, Mitsuru Muto, Koshiro Sugita, Masakazu Murakami, Shun Onishi, Toshio Harumatsu, Yumiko Iwamoto, Masato Ogata, Lynne Takada, Nanako Nishida, Chihiro Kedoin, Ayaka Nagano, Mayu Matsui, Koji Yamada, Waka Yamada, Makoto Matsukubo, Takafumi Kawano, Tatsuru Kaji, Satoshi Ieiri","doi":"10.1007/s00595-024-02910-1","DOIUrl":"10.1007/s00595-024-02910-1","url":null,"abstract":"Purpose: To identify the prognostic factors for pediatric severe intestinal motility disorder (IMD).Methods: We reviewed the medical records of patients with severe IMD, who required total parenteral nutrition (TPN) for ≥ 60 days at our institution between April, 1984 and March, 2023, examining their characteristics to identify prognostic factors.Results: The types of IMD in the 14 patients enrolled in this study were as follows: isolated hypoganglionosis (IHG, n = 6), extensive aganglionosis (EAG: n = 6), and chronic idiopathic intestinal pseudo-obstruction (CIIP, n = 2). There was no significant difference in mortality among the three types of severe IMD. Weaning-off TPN and the use of the colon were not significant prognostic factors, but cholestasis was a significant prognostic factor (p = 0.005). There was a high mortality rate (50%), with the major causes of death being intestinal failure-associated liver disease (IFALD) following hepatic failure, and catheter-related blood stream infection (CRBSI). One IHG patient underwent small bowel transplantation but died of acute rejection.Conclusion: Severe IMD is still associated with a high mortality rate and cholestasis predicts the prognosis. Thus, preventing or improving IFALD and CRBSI caused by long-term TPN is important for reducing the mortality rate.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"380-385"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898306","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}

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