Surgery Today最新文献_第6页

A comparison of the diagnostic ability of 1-mm computed tomography and 3-mm magnetic resonance imaging for detecting lateral pelvic lymph node metastases from rectal cancer.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-26 DOI: 10.1007/s00595-025-03018-w

Ryutaro Kobayashi, Kay Uehara, Tomoki Ebata, Hiroshi Yatsuya, Yuanying Li, Koya Hida, Yojiro Hashiguchi, Soichiro Ishihara, Shimpei Ogawa, Akio Shiomi, Kazushige Kawai, Yoichi Ajioka

{"title":"A comparison of the diagnostic ability of 1-mm computed tomography and 3-mm magnetic resonance imaging for detecting lateral pelvic lymph node metastases from rectal cancer.","authors":"Ryutaro Kobayashi, Kay Uehara, Tomoki Ebata, Hiroshi Yatsuya, Yuanying Li, Koya Hida, Yojiro Hashiguchi, Soichiro Ishihara, Shimpei Ogawa, Akio Shiomi, Kazushige Kawai, Yoichi Ajioka","doi":"10.1007/s00595-025-03018-w","DOIUrl":"https://doi.org/10.1007/s00595-025-03018-w","url":null,"abstract":"Aim: The best modality for evaluating lateral pelvic lymph node (LPLN) metastases from rectal cancer remains unclear. This study compared the diagnostic ability of 1-mm computed tomography (CT) and 3-mm magnetic resonance imaging (MRI) in identifying LPLN metastases based on size.Methods: This observational study analyzed not individual patients but 191 sides from 100 rectal cancer patients without preoperative treatment for whom preoperative CT and MRI and corresponding pathological results for LPLNs were available. A swollen LPLN was defined as an LN with a short-axis size of ≥5 mm on 1-mm CT.Results: LPLNs were detected significantly more frequently with 1-mm CT than with 3-mm MRI (p < 0.001). Among the 117 sides without swollen LPLNs, metastasis was observed in 1.7% of patients. In contrast, LPLN metastasis was confirmed in 28.4% of 74 sides with swollen LPLNs. In the evaluation of swollen LPLNs, 3-mm MRI yielded a 34% improvement in the diagnostic performance of LPLN metastasis over 1-mm CT (categorical net reclassification improvement: 0.341, p = 0.045).Conclusions: In conclusion, 1-mm CT should be performed preoperatively to evaluate LPLNs. Further evaluations can be omitted in the absence of swollen LPLNs. In patients with swollen LPLNs, a careful assessment of LPLN metastasis should be conducted via additional MRI, even in early T-stage tumors.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516473","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

Reality of post-gastrectomy stress hyperglycemia revealed by continuous glucose monitoring: a prospective study.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-24 DOI: 10.1007/s00595-025-03015-z

Keiji Nishibeppu, Takeshi Kubota, Yudai Nakabayashi, Hiroyuki Inoue, Kazuya Takabatake, Takuma Ohashi, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji

{"title":"Reality of post-gastrectomy stress hyperglycemia revealed by continuous glucose monitoring: a prospective study.","authors":"Keiji Nishibeppu, Takeshi Kubota, Yudai Nakabayashi, Hiroyuki Inoue, Kazuya Takabatake, Takuma Ohashi, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji","doi":"10.1007/s00595-025-03015-z","DOIUrl":"https://doi.org/10.1007/s00595-025-03015-z","url":null,"abstract":"Purposes: Postoperative stress hyperglycemia is reported to be associated with increased postoperative complications (PCs) following various surgical procedures. However, most reports of postoperative hyperglycemia are based on conventional, point blood glucose measurements. We sought to clarify trends in post-gastrectomy glucose levels using continuous glucose monitoring (CGM) and investigate the relationship between postoperative hyperglycemia and stress-related factors such as PCs and the degree of surgical invasiveness.Methods: The subjects of this prospective study were 40 patients who underwent gastrectomy between November, 2022 and September, 2023. We recorded their glucose levels by CGM immediately after surgery until discharge (up to 2 weeks postoperatively).Results: There was no increase in glucose levels caused by open gastrectomy, a strong inflammatory response, or PCs. Hyperglycemia, defined as the percentage of time that the glucose level was > 140 mg/dL, was associated only with the preoperative HbA1c value (P = 0.039). Patients with an HbA1c ≥ 6% had a significantly longer duration of hyper- and hypo-glycemia and greater glycemic variability than those with an HbA1c < 6% (glucose level < 70 mg/dL, P = 0.027; > 140 mg/dL, P = 0.001, coefficient of variation P = 0.024).Conclusions: No association was observed between stress hyperglycemia during the acute phase following gastrectomy and PCs. Only patients with an elevated HbA1c had high rates of hypo- and hyper-glycemia and large glycemic variability, despite perioperative glucose management.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484060","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 Japanese Society of Pediatric Surgeons-certified supervisors and patient factors on manipulation time during single-incision laparoscopic percutaneous extraperitoneal closure: a single-center retrospective study.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-20 DOI: 10.1007/s00595-025-03013-1

Yohei Sanmoto, Akio Kawami, Yudai Goto, Kouji Masumoto

{"title":"Impact of Japanese Society of Pediatric Surgeons-certified supervisors and patient factors on manipulation time during single-incision laparoscopic percutaneous extraperitoneal closure: a single-center retrospective study.","authors":"Yohei Sanmoto, Akio Kawami, Yudai Goto, Kouji Masumoto","doi":"10.1007/s00595-025-03013-1","DOIUrl":"https://doi.org/10.1007/s00595-025-03013-1","url":null,"abstract":"Purpose: To assess the influence of supervisory surgeons certified by the Japanese Society of Pediatric Surgeons (JSPS) and patient-related factors on the manipulation time of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC).Methods: We retrospectively reviewed 469 SILPEC procedures that were performed between 2017 and 2023. Procedures were categorized based on whether or not the attending surgeons possessed JSPS certification as supervisors, and patient characteristics and manipulation time were compared. A multivariate analysis was also performed to evaluate the factors affecting manipulation time.Results: In male patients, procedures attended by JSPS-certified supervisory surgeon had a shorter median (IQR) manipulation time (491.5 [396, 626.3] s) than those attended by non-certified surgeons (581 [445.3, 753] s; P = 0.0092). However, no significant difference was observed in female patients (367 [267.8, 623] vs. 399 [269.5, 593] s; P = 0.94). A multivariate analysis showed that, in males, attendance by a certified supervisor was associated with shorter manipulation times, whereas a history of hernia incarceration lengthened them. Furthermore, asymptomatic contralateral patent processus vaginalis repair was associated with shorter manipulation times in females.Conclusion: Attendance by JSPS-certified supervisory surgeons significantly reduced manipulation time in male SILPEC cases. Considering patient background and procedural complexity, assigning JSPS-certified supervisory surgeons as attending surgeons may further enhance surgical efficiency.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469121","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

Lobectomy for primary lung cancer: a comparison of perioperative and postoperative outcomes between robot-assisted thoracic surgery and video-assisted thoracic surgery.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-17 DOI: 10.1007/s00595-025-03000-6

Harushi Ueno, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Yuta Kawasumi, Keita Nakanishi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa

{"title":"Lobectomy for primary lung cancer: a comparison of perioperative and postoperative outcomes between robot-assisted thoracic surgery and video-assisted thoracic surgery.","authors":"Harushi Ueno, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Yuta Kawasumi, Keita Nakanishi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.1007/s00595-025-03000-6","DOIUrl":"https://doi.org/10.1007/s00595-025-03000-6","url":null,"abstract":"Purpose: This study compared the peri- and postoperative outcomes of robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) lobectomy for primary lung cancer.Methods: This retrospective cohort study included patients who underwent RATS or VATS at Nagoya University Hospital between April 2018 and March 2022. Propensity score matching was used to balance patient characteristics between the two groups. The following long-term outcomes were assessed: the 3-year overall survival (OS), causes of death, 3-year disease-free survival (DFS), and recurrence patterns. Various peri- and postoperative outcomes were examined as short-term outcomes.Results: After propensity score-matching, 137 patients were included in each group. RATS was associated with a longer operative time (median 180 vs. 144 min, p < 0.001), less blood loss (median 5 vs. 12 ml, p = 0.005), and a lower rate of conversion to open thoracotomy (1 [0.7%] vs. 10 [7.4%], p = 0.010) than VATS. The 3-year OS and DFS were comparable between the groups.Conclusion: In lobectomy for lung cancer, RATS demonstrated long-term outcomes that were comparable to those of VATS. Although RATS has a longer operative time, it is associated with less blood loss and a lower conversion rate to open thoracotomy than VATS, suggesting that it is a beneficial surgical approach for patients.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440484","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

Perioperative changes in the quality of life and the impact of preoperative quality of life on the time to return to work after surgery among patients with colorectal cancer: a prospective, multicenter, cohort study.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-13 DOI: 10.1007/s00595-025-03012-2

Yusuke Fujita, Koya Hida, Tatsuto Nishigori, Shinya Hamasu, Tetsuya Shiota, Takatsugu Kan, Ryosuke Okamura, Yoshiro Itatani, Kazutaka Obama

{"title":"Perioperative changes in the quality of life and the impact of preoperative quality of life on the time to return to work after surgery among patients with colorectal cancer: a prospective, multicenter, cohort study.","authors":"Yusuke Fujita, Koya Hida, Tatsuto Nishigori, Shinya Hamasu, Tetsuya Shiota, Takatsugu Kan, Ryosuke Okamura, Yoshiro Itatani, Kazutaka Obama","doi":"10.1007/s00595-025-03012-2","DOIUrl":"https://doi.org/10.1007/s00595-025-03012-2","url":null,"abstract":"Purpose: This study investigated perioperative changes in quality of life (QOL) and the impact of preoperative QOL on the time to return to work (RTW) after surgery in patients with colorectal cancer.Methods: Patients with clinical stage I-III colorectal cancer who were employed at the diagnosis and scheduled for curative surgery between 2019 and 2020 were prospectively enrolled at 7 hospitals in Japan. The patients' EORTC-QLQ-C30 scores and employment status were collected before and at 6 and 12 months after surgery and compared using a paired t test. The Kaplan-Meier method and multivariable Cox regression model were applied to examine the impact of preoperative QOL on the time to RTW.Results: A total of 127 patients were analyzed. Regarding financial difficulties, 48% of patients had low preoperative scores, which significantly improved at 6 (preoperatively: 21.7 vs 6 months: 11.3; p < 0.001) and 12 months (6 months: 11.3; 12 months: 7.9; p = 0.016) postoperatively. RTW was significantly delayed in patients with a low preoperative cognitive function (p = 0.039) and severe fatigue (p = 0.024). The adjusted hazard ratio was 0.73 for a low cognitive function and 0.62 for strong fatigue.Conclusion: Working patients with colorectal cancer experienced severe financial difficulties preoperatively, which decreased postoperatively. The preoperative cognitive function and fatigue affected the postoperative time to RTW.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415344","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

Clinicopathological analysis of enlarged abdominal aortic aneurysms after endovascular aneurysm repair and the relationship with occult IgG4-related vascular disease.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-12 DOI: 10.1007/s00595-024-02966-z

Eisaku Ito, Takao Ohki, Kentaro Kasa, Kota Shukuzawa, Kenjiro Kaneko, Fuminori Kasashima, Atsuhiro Kawashima, Nozomu Kurose, Satomi Kasashima

{"title":"Clinicopathological analysis of enlarged abdominal aortic aneurysms after endovascular aneurysm repair and the relationship with occult IgG4-related vascular disease.","authors":"Eisaku Ito, Takao Ohki, Kentaro Kasa, Kota Shukuzawa, Kenjiro Kaneko, Fuminori Kasashima, Atsuhiro Kawashima, Nozomu Kurose, Satomi Kasashima","doi":"10.1007/s00595-024-02966-z","DOIUrl":"https://doi.org/10.1007/s00595-024-02966-z","url":null,"abstract":"Purpose: To evaluate the incidence of IgG4-related vascular disease (IgG4-VD) in aneurysm enlargement after endovascular aneurysm repair (EVAR).Methods: Of 1482 EVAR cases in which patients underwent initial treatment at our hospital, 33 patients who underwent open surgery for an enlarged aneurysm were retrospectively identified. Histopathological examination of the aneurysm wall specimens was performed and the relationship of the histopathological findings with IgG4-VD was investigated.Results: The median aneurysm diameter at EVAR was 53 mm (interquartile range [IQR] 50-55), and the aneurysm diameter at open surgery was 79 mm (IQR 75-88). Six patients (18%) were histopathologically diagnosed with IgG4-VD. Relative to the non-IgG4-VD cases, the patients with IgG4-VD had a higher incidence of coronary artery disease (83% vs. 30%, p = 0.015) and greater aneurysm wall thickness at the time of open surgery (2.4 mm vs. 1.6 mm, p < 0.001). Serum IgG4 levels were significantly higher in patients with IgG4-VD than in those without IgG4-VD (218 mg/L vs. 46 mg/L, p = 0.002).Conclusions: IgG4-VD was found in 18% cases with enlarged aneurysms after EVAR. If aneurysm enlargement is observed after EVAR, measurement of the aneurysm wall thickness using preoperative CT angiography and the evaluation of serum IgG4 levels could be useful for diagnosing occult IgG4-VD.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399960","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

Advantages of ultrasound-guided reduction and elective surgery versus emergency repair for incarcerated obturator hernia.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-12 DOI: 10.1007/s00595-025-03014-0

Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi

{"title":"Advantages of ultrasound-guided reduction and elective surgery versus emergency repair for incarcerated obturator hernia.","authors":"Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi","doi":"10.1007/s00595-025-03014-0","DOIUrl":"https://doi.org/10.1007/s00595-025-03014-0","url":null,"abstract":"Purpose: To compare the benefits of ultrasound-guided reduction (UGR) followed by elective versus emergency repair for incarcerated obturator hernia (OH).Methods: This is a retrospective cohort study. Before UGR implementation, all patients with incarcerated OH underwent emergency surgery. To compare the UGR candidates fairly, only patients who did not require bowel resection were classified as the emergency group. Following UGR implementation, the patients without bowel necrosis, based on our criteria, underwent UGR. Among these, those who underwent elective repair were classified into the elective group. The surgical outcomes were compared between the groups and are presented as the median (range).Results: Among the 60 patients with incarcerated OH, 23 were in the emergency group and 11 in the elective group. UGR was successful in 16 of 17 cases (94%). The elective group had significantly shorter times to first defecation (4 [1-7] vs. 0 [0-1]) and meal initiation (3 [1-8] vs. 1 [1-3] days) than the emergency group. Although not statistically significant, the mesh repair rate was higher in the elective group (100% vs. 78%, respectively).Conclusions: UGR can be safely performed with an appropriate diagnosis. Compared with emergency surgery, UGR followed by elective repair led to reduced postoperative ileus and elevated mesh repair rates.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399859","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 potential efficacy of atezolizumab plus bevacizumab treatment for hepatocellular carcinoma patients with macroscopic portal vein tumor thrombus.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-11 DOI: 10.1007/s00595-025-03009-x

Shohei Komatsu, Yoshihiko Yano, Kazuki Terashima, Yoshimi Fujishima, Jun Ishida, Nobuaki Ishihara, Takanori Matsuura, Tomoaki Okimoto, Yuzo Kodama, Takumi Fukumoto

{"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":"https://doi.org/10.1007/s00595-025-03009-x","url":null,"abstract":"Purpose: 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.Methods: 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.Results: 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).Conclusion: 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.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","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}

引用次数: 0

Regional disparity in surgical residency training and work environment between urban and regional hospitals: an additional perspective from a nationwide survey of surgical residents.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-11 DOI: 10.1007/s00595-025-03011-3

Genki Watanabe, Jun Watanabe, Saki Hayashi, Takaaki Konishi, Saseem Poudel, Yoshiyuki Kiyasu, Masayuki Fukumoto, Takahiro Korai, Shinsuke Nomura, Naohiro Yamamoto, Masao Nakajima, Keiko Hosoya, Mitsue Saito

{"title":"Regional disparity in surgical residency training and work environment between urban and regional hospitals: an additional perspective from a nationwide survey of surgical residents.","authors":"Genki Watanabe, Jun Watanabe, Saki Hayashi, Takaaki Konishi, Saseem Poudel, Yoshiyuki Kiyasu, Masayuki Fukumoto, Takahiro Korai, Shinsuke Nomura, Naohiro Yamamoto, Masao Nakajima, Keiko Hosoya, Mitsue Saito","doi":"10.1007/s00595-025-03011-3","DOIUrl":"https://doi.org/10.1007/s00595-025-03011-3","url":null,"abstract":"Purpose: To investigate the current status of regional disparities in surgical residency training between urban and regional hospitals.Methods: Based on a nationwide online questionnaire survey of newly certified surgical trainees, the responding residents were divided into the following two groups according to the size of the city in which they had trained: the urban city group (UC group; population > 1 million) and the regional city group (RC group; population < 1 million. Surgical education and work environment of the two groups were compared.Results: The UC group (n = 317, 42%) was characterized by greater post-graduate experience, older age, a higher proportion of female surgeons, and a higher percentage of full-time working partners relative to the RC group (n = 439, 58%). More residents in the UC group were from urban areas, whereas the RC group had more residents from regional areas. No differences were observed in the number of surgeries performed, published papers, opportunities for off-the-job training, or satisfaction with the surgical residency training program. With the exception of higher income in the RC group, no differences were observed for other factors related to the work environment.Conclusions: There was little regional disparity regarding the impressions of surgical residency training between urban and regional cities, including surgical education and work environment.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399961","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

Effect of sarcopenia on the survival of patients undergoing liver transplantation: a meta-analysis.

IF 1.7 4区医学

Surgery Today Pub Date : 2025-02-10 DOI: 10.1007/s00595-025-03008-y

Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki

{"title":"Effect of sarcopenia on the survival of patients undergoing liver transplantation: a meta-analysis.","authors":"Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki","doi":"10.1007/s00595-025-03008-y","DOIUrl":"https://doi.org/10.1007/s00595-025-03008-y","url":null,"abstract":"Purpose: The relationship between sarcopenia and post-liver transplant (LT) mortality is still not well understood. This study aims to provide an updated and comprehensive meta-analysis evaluating the impact of sarcopenia on the survival of LT patients.Methods: We conducted searches in PubMed, Web of Science, and EMBASE up until May 2, 2024, without language restrictions. The primary outcome measured was the overall post-LT mortality risk associated with sarcopenia. The DerSimonian-Laird random effects model was used to calculate pooled adjusted hazard ratios (HRs).Results: Eighteen cohort studies comprising a total 6297 LT patients were included. The overall prevalence of sarcopenia was 27% (95% CI: 26%-28%), and this rate was lower when sarcopenia was defined using the third lumbar-skeletal muscle index in men, and among patients with lower Child-Pugh class. Sarcopenia remained significantly associated with higher mortality, with a pooled adjusted HR of 1.55 (95% CI 1.28-1.89). This association held across subgroups based on sex, study location, sarcopenia definition, study quality, and living donor LT recipients. A sensitivity analysis excluding groups with a high proportion of hepatocellular carcinoma patients showed similar findings (HR 1.63, 95% CI 1.13-2.35). No significant heterogeneity was identified in any of the analyses.Conclusions: This meta-analysis shows that sarcopenia is significantly associated with increased mortality after LT. Thus, the risk of sarcopenia should be factored into the initial evaluation of LT candidates.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383326","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