Surgery Today最新文献_第5页

Impact of the learning curve on the outcomes of robotic surgery in obese patients with rectal cancer. 学习曲线对肥胖直肠癌患者机器人手术结果的影响。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-02 DOI: 10.1007/s00595-025-03113-y

Shota Izukawa, Masakatsu Numata, Toshiyuki Fukuda, Tatsunosuke Harada, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Shinsuke Suzuki, Teni Godai, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Aya Saito

{"title":"Impact of the learning curve on the outcomes of robotic surgery in obese patients with rectal cancer.","authors":"Shota Izukawa, Masakatsu Numata, Toshiyuki Fukuda, Tatsunosuke Harada, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Shinsuke Suzuki, Teni Godai, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Aya Saito","doi":"10.1007/s00595-025-03113-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03113-y","url":null,"abstract":"Purpose: One of the challenges in performing surgery on obese patients with rectal cancer is the prolonged operation time. This study investigates whether or not this issue can be overcome through the surgeon's learning curve as they become proficient in robotic surgery.Methods: A retrospective review of 396 consecutive robotic procedures. The cases were divided into a learning phase (LP) group (first 20 cases) and a stabilized phase (SP) group (from case 21 onward). Patients were divided into obese (BMI ≥ 25 kg/m2) and non-obese groups using 1:1 propensity score matching. This resulted in 130 and 72 patients in the LP and SP groups, respectively. The primary endpoint of this study was operation time.Results: In the LP group, obese patients had significantly longer operative times (329 min vs. 289 min) and greater blood loss (10 g [0-50] vs. 10 g [0-12]) than non-obese patients. In the SP group, the perioperative outcomes, including operation time, were similar between the two patient groups.Conclusion: This study suggests that during the early phase of the learning curve, operation time may be prolonged in obese patients. However, once the learning curve stabilizes, the issue of prolonged operative time can be overcome.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969992","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

Importance of systemic redox homeostasis biomarkers and transcription factors in patients undergoing open-heart surgery with cardiopulmonary bypass. 体外循环心内直视手术患者系统氧化还原稳态生物标志物和转录因子的重要性。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-18 DOI: 10.1007/s00595-025-03026-w

Jamila Tahmazli, Şeydanur Turgut, Tamer Cebe, Fatih Kızılyel, Erdem Atasever, Ayhan Üğüden, Bülend Ketenci, Gülnur Andican, Ufuk Çakatay

{"title":"Importance of systemic redox homeostasis biomarkers and transcription factors in patients undergoing open-heart surgery with cardiopulmonary bypass.","authors":"Jamila Tahmazli, Şeydanur Turgut, Tamer Cebe, Fatih Kızılyel, Erdem Atasever, Ayhan Üğüden, Bülend Ketenci, Gülnur Andican, Ufuk Çakatay","doi":"10.1007/s00595-025-03026-w","DOIUrl":"10.1007/s00595-025-03026-w","url":null,"abstract":"Purpose: Patients undergoing coronary artery bypass graft surgery and isolated valve disease surgery may experience redox dyshomeostasis associated with cardiopulmonary bypass (CPB).Methods: We investigated the impact of CPB on systemic redox homeostasis by analyzing redox biomarkers and antioxidant transcription factors preoperatively and postoperatively using spectrophotometric and immunochemical methods.Results: Our findings indicate significant variations in protein oxidation biomarkers, antioxidant capacity biomarkers, and transcription coactivator peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α) levels after CPB. The ROC analysis indicated that protein carbonyl was valuable in the preoperative (p = 0.009) and postoperative (p = 0.013) periods. We also found that glutathione peroxidase was a valuable redox biomarker during the postoperative period (p = 0.000). An ROC analysis of catalase activity (p = 0.017) before CPB indicated the importance of catalase in eliminating increased hydroperoxide load. The ROC graphs reinforced the value of PGC-1α (p = 0.000) as a biomarker, showing a similar trend to that of catalase before CPB.Conclusion: The earlier view of \"increased oxidative stress and decreased biofunction\" has shifted to exploring the physiological role of redox signaling regulation. We believe that future studies on the effects of CPB on systemic redox regulation processes through redox signaling mechanisms will significantly contribute to the relevant literature.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1320-1334"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658630","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

¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography as a prognostic marker of imatinib-resistant gastrointestinal stromal tumors. 18f -氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描作为伊马替尼耐药胃肠道间质肿瘤的预后标志物。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-28 DOI: 10.1007/s00595-025-03029-7

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

{"title":"18F-fluorodeoxyglucose positron emission tomography-computed tomography as a prognostic marker of imatinib-resistant gastrointestinal stromal tumors.","authors":"Kota Kawabata, Tsuyoshi Takahashi, Toshirou Nishida, Yukinori Kurokawa, Kazuyoshi Yamamoto, Takuro Saito, Kota Momose, Kotaro Yamashita, Koji Tanaka, Tomoki Makino, Ryohei Kawabata, Atsushi Takeno, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1007/s00595-025-03029-7","DOIUrl":"10.1007/s00595-025-03029-7","url":null,"abstract":"Purpose: Unresectable or metastatic GISTs often develop resistance to imatinib, but the effectiveness of other drugs is limited. Thus, surgical treatment can be considered, especially for partial resistance. FDG-PET/CT is used for the diagnosis and evaluation of GISTs. We conducted this study to establish whether FDG-PET/CT findings could guide treatment decisions and predict the prognosis of patients with imatinib-resistant GISTs.Methods: We analyzed data retrospectively from 45 patients with imatinib-resistant GISTs that were assessed via FDG-PET/CT at our institution between 2003 and 2021. The patients were classified as having low (n = 18) or high (n = 27) SUVmax, with a cutoff value of 5.0.Results: The overall survival (OS) of the patients with low SUVmax after the diagnosis of imatinib resistance was significantly prolonged. Multivariate analysis identified SUVmax as an independent poor prognostic factor. In 23 patients with resected imatinib-resistant lesions, a close correlation was found between the SUVmax by preoperative FDG-PET/CT and the mitotic rate. A higher SUVmax was associated with a higher mitotic rate. Patients with a low SUVmax (n = 11) had significantly longer postoperative imatinib failure-free survival than those with a high SUVmax (n = 12).Conclusions: FDG-PET/CT assessment and diagnosis might reveal the pathological grades of imatinib-resistant GISTs and act as a prognostic marker.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1295-1302"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tele-robot-assisted minimally invasive esophagectomy using a double-surgeon cockpit on a cadaver. 远程机器人辅助微创食管切除术在尸体上使用双外科医生座舱。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-01-06 DOI: 10.1007/s00595-024-02986-9

Yuma Ebihara, Satoshi Hirano, Toshiaki Shichinohe, Hajime Morohashi, Eiji Oki, Kenichi Hakamada, Norihiko Ikeda, Masaki Mori

{"title":"Tele-robot-assisted minimally invasive esophagectomy using a double-surgeon cockpit on a cadaver.","authors":"Yuma Ebihara, Satoshi Hirano, Toshiaki Shichinohe, Hajime Morohashi, Eiji Oki, Kenichi Hakamada, Norihiko Ikeda, Masaki Mori","doi":"10.1007/s00595-024-02986-9","DOIUrl":"10.1007/s00595-024-02986-9","url":null,"abstract":"We conducted this study to evaluate the efficacy of robot-assisted minimally invasive esophagectomy (RAMIE) on cadavers in the prone position, utilizing telesurgical support through the double-surgeon cockpit (double SC) of the novel Japanese-made surgical robot system, hinotori™ (Medicaroid, Kobe, Japan). The Cadaveric Anatomy and Surgical Training Laboratory (CAST Lab) at Hokkaido University and Kushiro City General Hospital (KCGH) are interconnected by a dedicated 1 Gbps internet line, spanning 300 km. An operation unit and double SC were installed at CAST Lab, whereas the double SC proctor was installed at KCGH. RAMIE was performed with telesurgical support on two adult cadavers. The onsite and proctor operation times were recorded as 88/79 min and 64/75 min, respectively. Throughout the surgical procedures, communication remained stable, with an average communication delay of 13.1 ms (range: 11.0-15.0 ms). This study demonstrated the feasibility of performing RAMIE with the patient in the prone position, supported by telesurgical support using a double SC on the hinotori™ platform.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1335-1339"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932689","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

Changes in surgical versus nonsurgical treatments for gastrointestinal cancers during the COVID-19 pandemic: a nationwide analysis in Japan. 2019冠状病毒病大流行期间胃肠道癌症手术与非手术治疗的变化：日本的一项全国性分析

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-03 DOI: 10.1007/s00595-025-03021-1

Ryo Seishima, Taizo Hibi, Masashi Takeuchi, Yusuke Takemura, Hiromichi Maeda, Masahiro Kondo, Shoko Ukita, Ryusei Kimura, Akinobu Taketomi, Yoshihiro Kakeji, Yasuyuki Seto, Hideki Ueno, Masaki Mori, Ken Shirabe, Yuko Kitagawa

{"title":"Changes in surgical versus nonsurgical treatments for gastrointestinal cancers during the COVID-19 pandemic: a nationwide analysis in Japan.","authors":"Ryo Seishima, Taizo Hibi, Masashi Takeuchi, Yusuke Takemura, Hiromichi Maeda, Masahiro Kondo, Shoko Ukita, Ryusei Kimura, Akinobu Taketomi, Yoshihiro Kakeji, Yasuyuki Seto, Hideki Ueno, Masaki Mori, Ken Shirabe, Yuko Kitagawa","doi":"10.1007/s00595-025-03021-1","DOIUrl":"10.1007/s00595-025-03021-1","url":null,"abstract":"Purpose: To investigate the impact of the COVID-19 pandemic on the treatment landscape of gastrointestinal cancers in Japan, focusing on the use of nonsurgical treatments.Methods: We conducted a retrospective cohort study using a nationwide insurance database and analyzed data for esophageal, gastric, colon, rectal, liver, and pancreatic cancers treated between July, 2019 and December, 2020. We calculated the surgical-to-nonsurgical-treatment ratio (SNR) for each type of cancer during the pandemic and defined April, 2020 as the pandemic onset. We used regression discontinuity designs to assess changes in the SNR.Results: A total of 31,169 cases were included. At the pandemic onset, the SNR decreased for gastric, colon, rectal, and liver cancers, indicating a shift toward nonsurgical treatments. Thereafter, these cancers showed a gradual increase in the SNR, returning to pre-pandemic levels. Notably, esophageal cancer showed an increase in the SNR at the pandemic onset, whereas pancreatic cancer showed no significant changes during the study period.Conclusion: The COVID-19 pandemic led to a significant decrease in gastrointestinal cancer surgeries in Japan, prompting a temporary shift toward nonsurgical treatments. However, most cancers showed a gradual recovery in the SNR, highlighting the resilience of the healthcare system.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1235-1242"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543452","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 impact of perioperative oral care on postoperative infection in patients with esophageal cancer: a retrospective cohort study before and during COVID-19. 围手术期口腔护理对食管癌患者术后感染的影响：一项COVID-19之前和期间的回顾性队列研究

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-14 DOI: 10.1007/s00595-025-03025-x

Aoi Kubo, Kimie Fujita, Satomi Tanaka, Yasue Kimura, Naohisa Wada

{"title":"The impact of perioperative oral care on postoperative infection in patients with esophageal cancer: a retrospective cohort study before and during COVID-19.","authors":"Aoi Kubo, Kimie Fujita, Satomi Tanaka, Yasue Kimura, Naohisa Wada","doi":"10.1007/s00595-025-03025-x","DOIUrl":"10.1007/s00595-025-03025-x","url":null,"abstract":"Purpose: This study evaluated the impact of preoperative oral hygiene on the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) in patients undergoing esophageal cancer surgery considering the influence of COVID-19 and developing effective perioperative oral care methods.Methods: The medical records of patients who underwent esophageal cancer surgery between January 2017 and March 2022 were analyzed. Patient characteristics and the incidence of PP and SSI before and during COVID-19 were compared. A multiple logistic regression analysis was performed with PP and SSI as the dependent variables.Results: This analysis included 207 participants. The mean age was 66.6 ± 8.3 years old, and 78.3% were male. There were no significant changes in the incidence of PP or SSI before and during the COVID-19 pandemic. Preoperative xerostomia significantly increased the risk of PP (odds ratio = 3.34, 95% confidence interval 1.10-10.08, p = 0.033), an advanced cancer stage, and recurrent laryngeal nerve palsy. Surgical procedures and reconstructive organs, but not preoperative oral hygiene factors, were associated with SSI.Conclusions: The incidence of PP and SSI in patients with esophageal cancer showed no marked changes before or during the COVID-19 pandemic. Managing preoperative xerostomia may be crucial for reducing the risk of PP.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1243-1251"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Appropriate methods of evaluating future liver remnant volume to predict postoperative liver failure after major hepatectomy based on the body mass of patients with normal hepatic reserve. 基于肝储备正常患者的体重评估未来肝残量预测肝大切除术后肝功能衰竭的合适方法

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-27 DOI: 10.1007/s00595-025-03030-0

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

{"title":"Appropriate methods of evaluating future liver remnant volume to predict postoperative liver failure after major hepatectomy based on the body mass of patients with normal hepatic reserve.","authors":"Tomohiko Ikehara, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Noriyuki Kitagawa, Hitoshi Masuo, Takahiro Yoshizawa, Kiyotaka Hosoda, Hiroki Sakai, Yuji Soejima","doi":"10.1007/s00595-025-03030-0","DOIUrl":"10.1007/s00595-025-03030-0","url":null,"abstract":"Purpose: Several parameters are used to assess future liver remnant (FLR) size before major hepatectomy. This study aimed to clarify which is the most appropriate method to use for the prediction of post-hepatectomy liver failure (PHLF).Methods: The subjects of this study were 307 patients with Child-Pugh class A only, who underwent major hepatectomy, to focus on FLR size. The parameters we evaluated for their accuracy in predicting Grade B/C PHLF (PHLF B/C) using receiver operating characteristic curve analysis were FLR volume (FLRV), the FLRV to total liver volume ratio (FLRV/TLV), standard liver volume (FLRV/SLV), and body weight (FLRV/BW) according to body mass.Results: The predictive value accuracy of these four parameters for PHLF was similar for the entire cohort. However, in the subgroup analysis based on body mass index, FLRV/BW accuracy was highest in the obese group, whereas that of FLRV/TLV was highest in the lean group. Multivariate analysis identified that FLRV/BW (< 0.7%) and blood loss (≥ 1000 ml) were independent risk factors for PHLF B/C in the obese group. In the lean group, FLRV/TLV (< 40%) and biliary reconstruction were risk factors for PHLF B/C.Conclusions: The FLR size evaluation method for predicting PHLF should be appropriately selected based on the patient's body mass.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1284-1294"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The safety of laparoscopic extraperitoneal colostomy in the introductory phase: A prospective observational study by the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1804. 腹腔镜腹膜外结肠造口术的安全性：神奈川横滨结直肠癌研究组（KYCC） 1804的一项前瞻性观察研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-26 DOI: 10.1007/s00595-025-03020-2

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

{"title":"The safety of laparoscopic extraperitoneal colostomy in the introductory phase: A prospective observational study by the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1804.","authors":"Akio Higuchi, Masakatsu Numata, Hiroyuki Saeki, Shota Izukawa, Suguru Nukada, Kenta Iguchi, Mamoru Uchiyama, Hironao Okamoto, Yosuke Atsumi, Aya Kato, Keisuke Kazama, Shinsuke Suzuki, Yusuke Katayama, Koji Numata, Sho Sawazaki, Hiroshi Tamagawa, Nobuhiro Sugano, Teni Godai, Hiroyuki Mushiake, Satoru Shinoda, Satomi Matsumoto, Yasushi Rino, Aya Saito, Manabu Shiozawa","doi":"10.1007/s00595-025-03020-2","DOIUrl":"10.1007/s00595-025-03020-2","url":null,"abstract":"Purpose: To assess the incidence of parastomal hernia in the introductory phase following laparoscopic extraperitoneal colostomy.Methods: The subjects of this observational study were 30 patients who underwent laparoscopic extraperitoneal sigmoid colostomy between April 2019 and November 2020. We evaluated the incidence of parastomal hernia over 2 years and the time required for stoma creation.Results: Parastomal hernia was diagnosed in five patients (17.2%), which was a higher incidence than that reported previously (0-13.3%). An exploratory analysis using the LASSO logistic regression model identified obesity (body mass index ≥25 kg/m2) and postoperative wound dehiscence as risk factors for parastomal hernia. The mean stoma creation time was 23.6 min, with >80% of cases completed within 30 min.Conclusion: Laparoscopic extraperitoneal colostomy can be adopted successfully, even in centers without prior experience. However, the incidence of parastomal hernia in this study was slightly higher than reported previously. Obese patients had longer stoma creation times and a higher incidence of parastomal hernia.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1274-1283"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical relevance of the red blood cell distribution width measured preoperatively as a prognostic marker in patients with distal cholangiocarcinoma undergoing pancreaticoduodenectomy. 远端胆管癌行胰十二指肠切除术患者术前测定红细胞分布宽度作为预后指标的临床意义

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-03-29 DOI: 10.1007/s00595-025-03005-1

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

{"title":"Clinical relevance of the red blood cell distribution width measured preoperatively as a prognostic marker in patients with distal cholangiocarcinoma undergoing pancreaticoduodenectomy.","authors":"Maiko Niki, Shozo Mori, Shotaro Miyashita, Tomoaki Hayakawa, Genki Tanaka, Takayuki Shimizu, Takamune Yamaguchi, Kyung-Hwa Park, Takayuki Shiraki, Takatsugu Matsumoto, Taku Aoki","doi":"10.1007/s00595-025-03005-1","DOIUrl":"10.1007/s00595-025-03005-1","url":null,"abstract":"Purpose: The clinical relevance of the red blood cell distribution width (RDW) in patients with distal cholangiocarcinoma (DCC) undergoing pancreaticoduodenectomy (PD) has not been clearly investigated.Methods: The relationship between the preoperatively measured RDW and prognosis for the recurrence/survival was evaluated in patients with DCC undergoing PD. A subgroup analysis was also performed in patients with pathological stage I DCC.Results: A total of 77 patients were included in the analysis. The cutoff value of the preoperatively measured RDW was set at 14%, and the normal reference range at our center was ≤ 14%. The patient group with an RDW > 14% (n = 30) had a significantly lower mean serum albumin level, higher mean serum carbohydrate antigen 19-9 level, and a higher proportion of cases with pathological lymphatic invasion and showed a significantly worse overall survival than the patient group with an RDW ≤ 14% (n = 47). Similar findings were noted in both the overall study population and patients with pathological stage I disease. Multivariate analysis identified an RDW > 14% and pathological lymph node metastasis as independent risk factors for a poor postoperative survival.Conclusion: The preoperatively measured RDW is a promising prognostic predictor in patients with DCC undergoing PD.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1313-1319"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reinforcement sutures for preventing anastomotic leakage following double-stapling anastomosis in rectal cancer surgery: a systematic review and meta-analysis. 加固缝线预防直肠癌手术双吻合器吻合后吻合口漏：系统回顾和荟萃分析。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-09-01 Epub Date: 2025-07-17 DOI: 10.1007/s00595-025-03099-7

Koji Tamura, Takaaki Fujimoto, Kinuko Nagayoshi, Yusuke Mizuuchi, Kyoko Hisano, Kohei Horioka, Koji Shindo, Naoki Ikenaga, Kohei Nakata, Kenoki Ohuchida, Masafumi Nakamura

{"title":"Reinforcement sutures for preventing anastomotic leakage following double-stapling anastomosis in rectal cancer surgery: a systematic review and meta-analysis.","authors":"Koji Tamura, Takaaki Fujimoto, Kinuko Nagayoshi, Yusuke Mizuuchi, Kyoko Hisano, Kohei Horioka, Koji Shindo, Naoki Ikenaga, Kohei Nakata, Kenoki Ohuchida, Masafumi Nakamura","doi":"10.1007/s00595-025-03099-7","DOIUrl":"10.1007/s00595-025-03099-7","url":null,"abstract":"Purpose: Anastomotic leakage (AL) is a major complication of anterior resection of rectal cancer. Reinforcement sutures at the anastomotic staple line may reduce the risk of AL; however, their efficacy remains uncertain. This meta-analysis evaluated the effectiveness of staple line reinforcement in preventing AL.Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines (PROSPERO registration; CRD42024581347). Literature published between January 2000 and August 2024 was searched. Randomized controlled trials (RCTs) and observational studies (OBSs) comparing reinforcement sutures with non-reinforcement sutures were included. The primary outcome was AL incidence, and secondary outcomes included reoperation rates, operative time, and mortality. Data were analyzed using a random-effects model.Results: One RCT and eight OBSs were included, with a meta-analysis performed only for OBSs. Reinforcement sutures significantly reduced AL (odds ratio [OR], 0.29; 95% confidence interval [CI] 0.18-0.46; p < 0.000001), with low heterogeneity (I2 = 0%). A subgroup analysis excluding diverting stoma (DS) creation confirmed reduced AL (OR, 0.41; 95% CI 0.27-0.62; p < 0.0001). The reoperation rate was also lower (OR, 0.32; 95% CI 0.14-0.72; p = 0.006). The mortality and operative time were unaffected.Conclusions: Reinforcement sutures can reduce the AL and reoperation rates in patients with rectal cancer undergoing stapled anastomosis. Large-scale RCTs are required to confirm the optimal benefits and long-term effects.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1217-1225"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660252","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}

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