Surgery Today最新文献_第7页

Factors affecting the short-term outcomes of robotic-assisted thoracoscopic surgery for lung cancer. 影响机器人辅助胸腔镜肺癌手术短期疗效的因素。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-02-09 DOI: 10.1007/s00595-024-02797-y

Yugo Tanaka, Shinya Tane, Takefumi Doi, Suguru Mitsui, Megumi Nishikubo, Daisuke Hokka, Yoshimasa Maniwa

{"title":"Factors affecting the short-term outcomes of robotic-assisted thoracoscopic surgery for lung cancer.","authors":"Yugo Tanaka, Shinya Tane, Takefumi Doi, Suguru Mitsui, Megumi Nishikubo, Daisuke Hokka, Yoshimasa Maniwa","doi":"10.1007/s00595-024-02797-y","DOIUrl":"10.1007/s00595-024-02797-y","url":null,"abstract":"Purpose: Robotic-assisted thoracoscopic surgery (RATS) is a relatively new approach to lung cancer surgery. To promote the development of RATS procedures, we investigated the factors related to short-term postoperative outcomes.Methods: We analyzed the records of patients who underwent RATS lobectomy for primary lung cancer at our institution between June, 2018 and January, 2023. The primary outcome was operative time, and the estimated value of surgery-related factors was calculated by linear regression analysis. The secondary outcome was surgical morbidity and the risk was assessed by logistic regression analysis.Results: The study cohort comprised 238 patients. Left upper lobectomy had the longest mean operative time, followed by right upper lobectomy. Postoperative complications occurred in 13.0% of the patients. Multivariate analysis revealed that upper lobectomy, the number of staples used for interlobular fissures, and the number of cases experienced by the surgeon were significantly associated with a longer operative time. The only significant risk factor for postoperative complications was heavy smoking.Conclusion: Patients with well-lobulated middle or lower lobe lung cancer who are not heavy smokers are recommended for the introductory period of RATS lobectomy. Improving the procedures for upper lobectomy and dividing incomplete interlobular fissures will promote the further development of RATS.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707959","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

Proximal ligation technique prevents thrombus formation in the pulmonary vein stump after lobectomy. 近端结扎技术可防止肺叶切除术后肺静脉残端血栓形成。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-05-03 DOI: 10.1007/s00595-024-02846-6

Shin-Nosuke Watanabe, Kazuhiro Imai, Masafumi Mitsui, Takashi Ono, Hiroshi Toda, Shinogu Takashima, Nobuyasu Kurihara, Ryo Demura, Tatsuki Fujibayashi, Yoshihiro Minamiya

{"title":"Proximal ligation technique prevents thrombus formation in the pulmonary vein stump after lobectomy.","authors":"Shin-Nosuke Watanabe, Kazuhiro Imai, Masafumi Mitsui, Takashi Ono, Hiroshi Toda, Shinogu Takashima, Nobuyasu Kurihara, Ryo Demura, Tatsuki Fujibayashi, Yoshihiro Minamiya","doi":"10.1007/s00595-024-02846-6","DOIUrl":"10.1007/s00595-024-02846-6","url":null,"abstract":"Purpose: To assess the risk factors for thrombosis in the pulmonary vein stump (PVT) and the efficacy of proximal ligation in preventing PVT after lobectomy.Methods: In total, 649 surgical patients with lung cancer were retrospectively reviewed. To compare the clinical effectiveness of PV proximal ligation, the simple stapler group (290 patients) and the proximal ligation group (359 patients who underwent thread ligation at the pericardial reflection with/without a stapler) were analyzed.Results: In the simple stapler group, 12 of 290 patients (4.1%) developed PVT. Among these, 9 of 58 underwent left upper lobectomy (LUL). In contrast, 5 of the 359 patients (1.4%) in the proximal ligation group developed PVT. All five patients received LUL. The incidence of PVT in the proximal ligation group was significantly lower than that in the simple stapler group (p = 0.0295) as well as in the analysis by LUL alone (p = 0.0263). A logistic regression analysis indicated that higher BMI and LUL were associated with the development of PVT (p = 0.0031, p < 0.0001), and PV proximal ligation reduced PVT (p = 0.0055).Conclusion: Proximal ligation of the PV has the potential to prevent PVT, especially after LUL.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853025","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 for anastomotic leakage after low anterior resection for obese patients with rectal cancer. 肥胖直肠癌患者低位前切除术后吻合口漏的风险因素。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-02-28 DOI: 10.1007/s00595-024-02808-y

Ai Sadatomo, Hisanaga Horie, Koji Koinuma, Naohiro Sata, Yutaka Kojima, Takatoshi Nakamura, Jun Watanabe, Takaya Kobatake, Tomonori Akagi, Kentaro Nakajima, Masafumi Inomata, Seiichiro Yamamoto, Masahiko Watanabe, Yoshiharu Sakai, Takeshi Naitoh

{"title":"Risk factors for anastomotic leakage after low anterior resection for obese patients with rectal cancer.","authors":"Ai Sadatomo, Hisanaga Horie, Koji Koinuma, Naohiro Sata, Yutaka Kojima, Takatoshi Nakamura, Jun Watanabe, Takaya Kobatake, Tomonori Akagi, Kentaro Nakajima, Masafumi Inomata, Seiichiro Yamamoto, Masahiko Watanabe, Yoshiharu Sakai, Takeshi Naitoh","doi":"10.1007/s00595-024-02808-y","DOIUrl":"10.1007/s00595-024-02808-y","url":null,"abstract":"Purpose: We aimed to analyze the risk factors for anastomotic leakage (AL) after low anterior resection (LAR) in obese patients (body mass index [BMI] ≥ 25 kg/m2) with rectal cancer.Methods: Data were collected from four hundred two obese patients who underwent LAR for rectal cancer in 51 institutions.Results: Forty-six (11.4%) patients had clinical AL. The median BMI (27 kg/m2) did not differ between the AL and non-AL groups. In the AL group, comorbid respiratory disease was more common (p = 0.025), and the median tumor size was larger (p = 0.002). The incidence of AL was 11.5% in the open surgery subgroup and 11.4% in the laparoscopic surgery subgroup. Among the patients who underwent open surgery, the AL group showed a male predominance (p = 0.04) in the univariate analysis, but it was not statistically significant in the multivariate analysis. Among the patients who underwent laparoscopic surgery, the AL group included a higher proportion of patients with comorbid respiratory disease (p = 0.003) and larger tumors (p = 0.007).Conclusion: Comorbid respiratory disease and tumor size were risk factors for AL in obese patients with rectal cancer. Careful perioperative respiratory management and appropriate selection of surgical procedures are required for obese rectal cancer patients with respiratory diseases.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983859","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 practice guidelines for telesurgery 2022 : Committee for the promotion of remote surgery implementation, Japan Surgical Society. 远程手术临床实践指南 2022 ：日本外科学会远程手术实施推广委员会。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-06-03 DOI: 10.1007/s00595-024-02863-5

Masaki Mori, Satoshi Hirano, Kenichi Hakamada, Eiji Oki, Shigeo Urushidani, Ichiro Uyama, Masatoshi Eto, Yuma Ebihara, Kenji Kawashima, Takahiro Kanno, Masaru Kitsuregawa, Yusuke Kinugasa, Junjiro Kobayashi, Hiroshige Nakamura, Hirokazu Noshiro, Masaki Mandai, Hajime Morohashi

{"title":"Clinical practice guidelines for telesurgery 2022 : Committee for the promotion of remote surgery implementation, Japan Surgical Society.","authors":"Masaki Mori, Satoshi Hirano, Kenichi Hakamada, Eiji Oki, Shigeo Urushidani, Ichiro Uyama, Masatoshi Eto, Yuma Ebihara, Kenji Kawashima, Takahiro Kanno, Masaru Kitsuregawa, Yusuke Kinugasa, Junjiro Kobayashi, Hiroshige Nakamura, Hirokazu Noshiro, Masaki Mandai, Hajime Morohashi","doi":"10.1007/s00595-024-02863-5","DOIUrl":"10.1007/s00595-024-02863-5","url":null,"abstract":"Telesurgery is expected to improve medical access in areas with limited resources, facilitate the rapid dissemination of new surgical procedures, and advance surgical education. While previously hindered by communication delays and costs, recent advancements in information technology and the emergence of new surgical robots have created an environment conducive to societal implementation. In Japan, the legal framework established in 2019 allows for remote surgical support under the supervision of an actual surgeon. The Japan Surgical Society led a collaborative effort, involving various stakeholders, to conduct social verification experiments using telesurgery, resulting in the development of a Japanese version of the \"Telesurgery Guidelines\" in June 2022. These guidelines outline requirements for medical teams, communication environments, robotic systems, and security measures for communication lines, as well as responsibility allocation, cost burden, and the handling of adverse events during telesurgery. In addition, they address telementoring and full telesurgery. The guidelines are expected to be revised as needed, based on the utilization of telesurgery, advancements in surgical robots, and improvements in information technology.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200603","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

Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery. 虚弱和虚弱前兆对心脏手术后中期疗效和康复过程的影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-03-04 DOI: 10.1007/s00595-024-02807-z

Tasuku Honda, Hirohisa Murakami, Hiroshi Tanaka, Yoshikatsu Nomura, Toshihito Sakamoto, Naomi Yagi

{"title":"Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery.","authors":"Tasuku Honda, Hirohisa Murakami, Hiroshi Tanaka, Yoshikatsu Nomura, Toshihito Sakamoto, Naomi Yagi","doi":"10.1007/s00595-024-02807-z","DOIUrl":"10.1007/s00595-024-02807-z","url":null,"abstract":"Purpose: This study examined the impact of frailty and prefrailty on mid-term outcomes and rehabilitation courses after cardiac surgery.Methods: A total of 261 patients (median age: 73 years; 30% female) who underwent elective cardiac surgery were enrolled in this study. The Japanese version of the Cardiovascular Health Study Frailty Index classified 86, 131, and 44 patients into frailty, prefrailty, and robust groups, respectively. We examined the recovery of walking ability, outcomes at discharge, mid-term all-cause mortality, and rehospitalization related to major adverse cardiovascular and cerebrovascular events (MACCE) across the three cohorts.Results: The 3-year survival rates in the frailty, prefrailty, and robust groups were 87%, 97%, and 100%, respectively (p = 0.003). The free event rates of all-cause mortality and re-hospitalization related to MACCE were 59%, 79%, and 95%, respectively (p < 0.001), with a graded elevation in adjusted morbidity among patients in the prefrailty (hazard ratio [HR], 4.57; 95% confidence interval [CI], 1.08-19.4) and frailty (HR, 9.29; 95% CI 2.21-39.1) groups. Patients with frailty also experienced a delayed recovery of walking ability and a reduced number of patients with frailty were discharged home.Conclusion: Frailty and prefrailty adversely affect the mid-term prognosis and rehabilitation course after cardiac surgery.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022585","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

Practical methods to differentiate thymic malignancies by positron-emission tomography and tumor markers. 利用正电子发射断层扫描和肿瘤标记物区分胸腺恶性肿瘤的实用方法。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-08-01 Epub Date: 2024-02-27 DOI: 10.1007/s00595-024-02801-5

Takahiro Yanagihara, Tomoyuki Kawamura, Naoki Maki, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Hideo Ichimura, Yukio Sato

{"title":"Practical methods to differentiate thymic malignancies by positron-emission tomography and tumor markers.","authors":"Takahiro Yanagihara, Tomoyuki Kawamura, Naoki Maki, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Hideo Ichimura, Yukio Sato","doi":"10.1007/s00595-024-02801-5","DOIUrl":"10.1007/s00595-024-02801-5","url":null,"abstract":"Purpose: An accurate diagnosis of thymic malignancies is important, but challenging due to the broad range of differential diagnoses. This study aims to evaluate the efficacy of PET/CT and tumor markers for diagnosing thymic malignancies.Methods: Patients admitted to our department between January 2012 and December 2021 with primary anterior mediastinal tumors were retrospectively evaluated. We evaluated the relationship between the maximum standardized uptake value (SUVmax), tumor markers, and pathological diagnosis in four groups: thymic carcinoma, thymoma, lymphoma, and others.Results: In total, 139 patients were included in this study. The SUVmax was significantly higher in lymphoma, thymic carcinoma, and thymoma, in that order. The cytokeratin 19 fragment (CYFRA 21-1) was significantly higher in thymic carcinoma than in the other groups. An ROC curve analysis indicated that the optimal cut-off values of SUVmax for thymic carcinoma plus lymphoma and CYFRA 21-1 for thymic carcinoma were 7.97 (AUC = 0.934) and 2.95 (AUC = 0.768), respectively. Using a combination of cut-off values (SUVmax = 8, CYFRA 21-1 = 3), the accuracy rate for diagnosing thymic carcinoma was 91.4%.Conclusions: The SUVmax and CYFRA 21-1 levels are significant indicators for the diagnosis of thymic carcinoma. Combining these indicators resulted in a more accurate diagnosis of thymic malignancies, which could facilitate the decision-making process for determining the optimal treatment strategies.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973555","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 : 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The KRAS G12D mutation increases the risk of unresectable recurrence of resectable colorectal liver-only metastasis. KRAS G12D突变增加了可切除结直肠肝转移瘤不可切除复发的风险。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-07-31 DOI: 10.1007/s00595-024-02900-3

Kai Chen, Yukiyasu Okamura, Keiichi Hatakeyama, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, Yusuke Yamaoka, Teiichi Sugiura, Takashi Sugino, Akifumi Notsu, Takeshi Nagashima, Keiichi Ohshima, Kenichi Urakami, Yasuto Akiyama, Ken Yamaguchi

{"title":"The KRAS G12D mutation increases the risk of unresectable recurrence of resectable colorectal liver-only metastasis.","authors":"Kai Chen, Yukiyasu Okamura, Keiichi Hatakeyama, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, Yusuke Yamaoka, Teiichi Sugiura, Takashi Sugino, Akifumi Notsu, Takeshi Nagashima, Keiichi Ohshima, Kenichi Urakami, Yasuto Akiyama, Ken Yamaguchi","doi":"10.1007/s00595-024-02900-3","DOIUrl":"https://doi.org/10.1007/s00595-024-02900-3","url":null,"abstract":"Purpose: Unresectable recurrence is a critical predictor of outcomes for colorectal cancer patients. We attempted to identify the prognostic factors, especially for unresectable recurrence-free survival (URFS) as a new endpoint, in patients with resectable colorectal liver-only metastasis (CRLOM).Methods: We investigated patients with resectable CRLOM, who underwent an R0 resection for both CRC and CRLOM between January, 2014 and March, 2019 at a single institution. The exclusion criteria were patients who received neoadjuvant treatment, the absence of data for genetic analyses, and the presence of multiple cancers, synchronous CRC, or familial adenomatous polyposis. The prognostic factors were examined retrospectively using data on pre-hepatectomy factors, including primary tumor molecular profiling results.Results: We analyzed the data of 101 patients who underwent curative-intent surgery for CRLOM. Multivariate analysis revealed that KRAS G12D mutation-positivity (hazard ratio [HR]: 7.69; p < 0.01), RYR2 mutation-positivity (HR: 4.03; p < 0.01), and KRAS G12S mutation-positivity (HR: 3.96; p = 0.03), CA19-9 > 37 U/ml before hepatectomy (HR: 3.62; p < 0.01), and primary tumor pN2 stage (HR: 3.22; p = 0.03) were significant predictors of the URFS.Conclusions: This is the first study to show that specific KRAS and RYR2 mutations were associated with the URFS.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856618","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 : 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-30","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

The impact of preoperative skeletal muscle loss on the completion of S-1 adjuvant chemotherapy for gastric cancer. 术前骨骼肌缺失对完成胃癌 S-1 辅助化疗的影响。

IF 1.7 4区医学

Surgery Today Pub Date : 2024-07-30 DOI: 10.1007/s00595-024-02902-1

Yudai Nakabayashi, Takuma Ohashi, Takeshi Kubota, Keiji Nishibeppu, Masayuki Yubakami, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji

{"title":"The impact of preoperative skeletal muscle loss on the completion of S-1 adjuvant chemotherapy for gastric cancer.","authors":"Yudai Nakabayashi, Takuma Ohashi, Takeshi Kubota, Keiji Nishibeppu, Masayuki Yubakami, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji","doi":"10.1007/s00595-024-02902-1","DOIUrl":"https://doi.org/10.1007/s00595-024-02902-1","url":null,"abstract":"Purpose: Body weight loss after surgery for gastric cancer is related to S-1 compliance and it also affects the prognosis. However, it is unclear whether the preoperative skeletal muscle mass affects S-1 completion for gastric cancer. We investigated the impact of preoperative skeletal muscle mass loss on the completion of S-1 adjuvant chemotherapy for gastric cancer.Methods: We retrospectively analyzed data from 53 patients who underwent curative gastrectomy followed by adjuvant S-1 monotherapy for pStage II-III gastric cancer between 2012 and 2021 at our hospital. The psoas muscle mass index (PMI) was used as the index for preoperative skeletal muscle mass.Results: Thirty-six patients completed S-1 treatment and 17 discontinued treatment. The patients who completed S-1 treatment had a longer overall survival than those who discontinued treatment (log-rank test, p = 0.043). According to a univariate analysis, the patients in the discontinuation group had a significantly lower preoperative body mass index (< 22.9 kg/m2, p = 0.005) and a higher rate of adverse events (grade 2 or higher, p < 0.001) than those in the completion group. According to a multivariate analysis, preoperative PMI (HR 3.563, p = 0.030) was an independent predictive factor for S-1 completion.Conclusion: Preoperative skeletal muscle loss might therefore prevent the completion of adjuvant chemotherapy S-1 in patients with gastric cancer.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856617","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