Surgery Today最新文献_第8页

Prognostic significance of the hemoglobin, albumin, lymphocyte, platelet (HALP) score after hepatectomy for colorectal liver metastases. 结直肠癌肝转移患者肝切除术后血红蛋白、白蛋白、淋巴细胞、血小板（HALP）评分的预后意义。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-01-20 DOI: 10.1007/s00595-025-02993-4

Kohei Okazaki, Kenei Furukawa, Koichiro Haruki, Shinji Onda, Yoshihiro Shirai, Masashi Tsunematsu, Tomohiko Taniai, Michinori Matsumoto, Ryoga Hamura, Munetoshi Akaoka, Tadashi Uwagawa, Toru Ikegami

{"title":"Prognostic significance of the hemoglobin, albumin, lymphocyte, platelet (HALP) score after hepatectomy for colorectal liver metastases.","authors":"Kohei Okazaki, Kenei Furukawa, Koichiro Haruki, Shinji Onda, Yoshihiro Shirai, Masashi Tsunematsu, Tomohiko Taniai, Michinori Matsumoto, Ryoga Hamura, Munetoshi Akaoka, Tadashi Uwagawa, Toru Ikegami","doi":"10.1007/s00595-025-02993-4","DOIUrl":"10.1007/s00595-025-02993-4","url":null,"abstract":"Purpose: Inflammatory, nutritional, and immune biomarkers are associated with the prognosis of patients with various tumors. Recently, a comprehensive predictive biomarker, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, was introduced to predict clinical outcomes. We investigated the prognostic impact of preoperative HALP scores in patients who underwent hepatectomy for colorectal liver metastasis (CRLM).Method: The subjects of this study were 209 patients who underwent hepatectomy for CRLM between February, 2005 and September, 2023. The HALP score was defined as (albumin [mg/dL] × hemoglobin [g/L] × lymphocyte [count/L]) / platelet [count/L]. The cutoff value was calculated according to the receiver operating characteristic curve based on 3-year survival.Results: The cutoff value of the HALP score was 35, and a low HALP score was confirmed in 107 patients (51%). Multivariate analysis of disease-free survival identified lymph node metastasis (HR 1.53, p = 0.03), extrahepatic lesions (HR 2.48, p < 0.01), and a low HALP score (HR 2.0, p < 0.01) as independently poor prognostic factors. Multivariate analysis of overall survival identified extrahepatic lesions (HR 2.98, p < 0.01), a high CEA (HR 1.78, p = 0.02), and a low HALP score (HR 1.92, p = 0.02) as independently poor prognostic factors.Conclusions: The HALP score is a useful prognostic factor for patients undergoing hepatectomy for CRLM.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1052-1060"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011861","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. 日本儿科外科学会认证的督导医师和患者因素对单切口腹腔镜经皮腹腔外缝合术操作时间的影响：一项单中心回顾性研究

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub 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":"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":"1173-1180"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339580/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Germline variants detected by multigene panel testing in patients with suspected hereditary breast cancer. 用多基因面板检测疑似遗传性乳腺癌患者的种系变异。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-01-20 DOI: 10.1007/s00595-025-02994-3

Yusa Togashi, Masayuki Nagahashi, Mina Kashima, Chiho Okada, Chinatsu Kinjo, Ayako Miyazaki, Mako Ueda, Hiroshi Tsubamoto, Hideaki Sawai, Yasuo Miyoshi

{"title":"Germline variants detected by multigene panel testing in patients with suspected hereditary breast cancer.","authors":"Yusa Togashi, Masayuki Nagahashi, Mina Kashima, Chiho Okada, Chinatsu Kinjo, Ayako Miyazaki, Mako Ueda, Hiroshi Tsubamoto, Hideaki Sawai, Yasuo Miyoshi","doi":"10.1007/s00595-025-02994-3","DOIUrl":"10.1007/s00595-025-02994-3","url":null,"abstract":"Purpose: To clarify the status of multigene panel testing for suspected hereditary breast cancer in our institute, and disclose the characteristics of the variants detected.Methods: This was a retrospective study of individuals who underwent next-generation sequencing-based multigene panel testing at our institute to investigate hereditary genetic variants for suspected hereditary breast cancer.Results: We identified 36 women who underwent multigene panel testing: 8 (22.2%) had a pathogenic variant, with or without other variants of uncertain significance (VUSs); 15 (41.7%) had VUSs only; and 13 (36.1%) had negative genetic test results. Of the eight pathogenic variants, five were BRCA2 variants and one each were BRCA1, MLH1, and RINT1 variants. The VUSs included BRCA1 and BRCA2, as well as other breast cancer-associated genes, such as ATM, CDH1, CHEK2, and PALB2. Referring to the latest ClinVar database, one of the variants identified as a VUS at diagnosis was re-determined as likely pathogenic, and three of the variants identified as VUSs at diagnosis were re-determined as benign.Conclusion: VUSs are frequently identified during testing and it is important to monitor these individuals because VUS evaluations can change over time.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1061-1067"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011745","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

Patterns of lymph node metastasis and long-term outcomes of splenic flexure colon cancer: a descriptive study from a Japanese high-volume center. 脾曲曲性结肠癌的淋巴结转移模式和长期预后：一项来自日本大容量中心的描述性研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-01-31 DOI: 10.1007/s00595-025-02999-y

Takashi Sakamoto, Toshiki Mukai, Tatsuki Noguchi, Shimpei Matsui, Tomohiro Yamaguchi, Takashi Akiyoshi, Hiroshi Kawachi, Yosuke Fukunaga

{"title":"Patterns of lymph node metastasis and long-term outcomes of splenic flexure colon cancer: a descriptive study from a Japanese high-volume center.","authors":"Takashi Sakamoto, Toshiki Mukai, Tatsuki Noguchi, Shimpei Matsui, Tomohiro Yamaguchi, Takashi Akiyoshi, Hiroshi Kawachi, Yosuke Fukunaga","doi":"10.1007/s00595-025-02999-y","DOIUrl":"10.1007/s00595-025-02999-y","url":null,"abstract":"Purpose: The pattern of lymph node metastasis and the appropriate extent of lymph node dissection in splenic flexure colon cancer remain unclear. This study aimed to describe the clinical characteristics, lymph node metastasis patterns, and oncological outcomes of patients with splenic flexure colon cancer.Methods: The data of patients with splenic flexure cancer diagnosed with pathological stages I-III were extracted from a hospital database. Lymph nodes were mapped and numbered according to the guidelines of the Japanese Society for Cancer of the Colon and Rectum. Five-year disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method.Results: Among 151 patients, 37.1% had lymph node metastasis. The proportion of lymph node metastasis were 30.1% at station 221, 5.1% at station 222, 2.8% at station 223, 19.8% at station 231, 2.7% at station 232, and 0% at station 253. Among the 59 patients with an accessory middle colic artery, 19 had lymph node metastasis only at stations 221 (14/47) and 231 (5/47). The 5-year estimated DFS rates were 100% for stage I, 94.4% (95% CI, 83.6-98.2) for stage II, and 79.9% (95% CI, 65.6-88.8) for stage III. Ten patients experienced distant recurrence: liver (n = 5), peritoneum (n = 2), para-aortic lymph node (n = 2), and lung metastasis (n = 1). No local recurrence was observed.Conclusion: In splenic flexure colon cancer, lymph node dissection around the IMA route may be omitted. Similarly, dissection along the left branch of the middle colic artery or the left colic artery may be unnecessary in the presence of an accessory middle colic artery.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1079-1087"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067974","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 in rectal cancer surgery reflecting current practices. 直肠癌手术中吻合口漏的危险因素反映目前的做法。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-01-11 DOI: 10.1007/s00595-024-02988-7

Tatsunosuke Harada, Masakatsu Numata, Yosuke Atsumi, Toshiyuki Fukuda, Shota Izukawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Aya Saito

{"title":"Risk factors for anastomotic leakage in rectal cancer surgery reflecting current practices.","authors":"Tatsunosuke Harada, Masakatsu Numata, Yosuke Atsumi, Toshiyuki Fukuda, Shota Izukawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Aya Saito","doi":"10.1007/s00595-024-02988-7","DOIUrl":"10.1007/s00595-024-02988-7","url":null,"abstract":"Purpose: In recent years, major advancements have been made in rectal cancer surgery with the introduction of new techniques such as robotic surgery and indocyanine green fluorescence imaging (ICG-FI). This study aimed to evaluate the comprehensive risk factors for anastomotic leakage (AL) following rectal cancer surgery, incorporating recently introduced techniques and other existing factors, to reflect current practices.Methods: A retrospective analysis was conducted of 304 patients who underwent either robotic or laparoscopic anterior resection between January 2019 and December 2023. The study analyzed patient, tumor, and surgical factors, with AL defined by clinical or radiological findings requiring intervention within 30 days after surgery.Results: A univariate analysis indicated that moderate or severe anemia and the non-use of ICG-FI were strongly associated with AL. A multivariate analysis identified moderate or more severe anemia (hemoglobin ≤10.9 g/dL for males and ≤9.9 g/dL for females) (odds ratio [OR]: 9.94, p = 0.002) and non-use of ICG-FI (OR: 10.40, p < 0.001) as independent risk factors for AL.Conclusion: Moderate or severe anemia and absence of ICG-FI were found to significantly increase the risk of AL. Preoperative anemia correction and the routine use of ICG-FI may help mitigate this risk, thus suggesting the need for further research in these areas.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1043-1051"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967042","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

Novel prognostic score for colorectal necrosis requiring emergency surgery. 需要紧急手术的结直肠坏死的新预后评分。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-03 DOI: 10.1007/s00595-025-03002-4

Kensuke Kudou, Shuhei Kajiwara, Takashi Motomura, Takafumi Yukaya, Tomonori Nakanoko, Yosuke Kuroda, Masahiro Okamoto, Tadashi Koga, Yo-Ichi Yamashita, Mototsugu Shimokawa, Eiji Oki, Tomoharu Yoshizumi

{"title":"Novel prognostic score for colorectal necrosis requiring emergency surgery.","authors":"Kensuke Kudou, Shuhei Kajiwara, Takashi Motomura, Takafumi Yukaya, Tomonori Nakanoko, Yosuke Kuroda, Masahiro Okamoto, Tadashi Koga, Yo-Ichi Yamashita, Mototsugu Shimokawa, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1007/s00595-025-03002-4","DOIUrl":"10.1007/s00595-025-03002-4","url":null,"abstract":"Purpose: Colorectal necrosis is a serious condition associated with high morbidity and mortality. We investigated the clinical features and prognostic factors of patients who underwent emergency surgery for colorectal necrosis.Methods: Data from 40 patients who underwent surgery for colorectal necrosis were reviewed retrospectively to assess the various clinical and operative factors and risk factors for hospital mortality.Results: The Kaplan-Meier method showed that total colectomy, a platelet count < 100,000/μL, a prothrombin time-international normalized ratio ≥ 1.5, creatine kinase ≥ 566 U/L, lactate ≥ 22.8 mg/dL, base excess < - 12 mmol/L, platelet-lymphocyte ratio < 321, and C-reactive protein/albumin ratio < 1.0 were significantly associated with poor prognosis. Multivariate analyses identified that a platelet count < 100,000/μL (hazard ratio = 7.101, p = 0.0070) and base excess < -12 mmol/L (hazard ratio = 3.663, p = 0.0464) were independent predictive factors for hospital mortality in patients with colorectal necrosis. We established a novel prognostic score based on platelet count, creatine kinase, and base excess. Patients with a novel prognostic score ≥ 4 had significantly poorer survival rates than patients with a score ≤ 3 (0.0% vs. 73.4%, p < 0.001).Conclusions: A platelet count < 100,000/μL and base excess < - 12 mmol/L are associated with a poor prognosis for patients with colorectal necrosis. This novel prognostic score may be a more accurate prognostic factor for patients with colorectal necrosis.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1095-1106"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081014","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

Feasibility of hybrid robotic rectal surgery. 混合机器人直肠手术的可行性。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-08 DOI: 10.1007/s00595-025-03001-5

Hideya Kashihara, Takuya Tokunaga, Toshiaki Yoshimoto, Yuma Wada, Chie Takasu, Masaaki Nishi, Mitsuo Shimada

{"title":"Feasibility of hybrid robotic rectal surgery.","authors":"Hideya Kashihara, Takuya Tokunaga, Toshiaki Yoshimoto, Yuma Wada, Chie Takasu, Masaaki Nishi, Mitsuo Shimada","doi":"10.1007/s00595-025-03001-5","DOIUrl":"10.1007/s00595-025-03001-5","url":null,"abstract":"Purpose: To investigate the feasibility of combined robotic rectal surgery and transanal total mesorectal excision (hybrid robotic surgery).Methods: Among 143 robotic rectal surgeries performed from 2017 to 2022, 85 were hybrid robotic surgeries and were analyzed in this study. The cohort comprised 59 males and 26 females with a mean age of 65.8 years old and a mean body mass index of 22.6 kg/m2. The cStage was I in 20 cases, II in 21, III in 36, IV in 4, and other in 4. The operation types were low anterior resection in 21 cases, intersphincteric resection in 27, abdominoperineal resection in 32, total pelvic exenteration in 2, and other in 3. Twelve patients (14.1%) received neoadjuvant chemotherapy or chemoradiotherapy, and 39 (45.9%) underwent lateral lymph node dissection.Results: The mean operation time for total mesorectal excision was 302.7 min, and the median blood loss was 71.5 ml. No cases required conversion to laparotomy. The median length of postoperative hospital stay was 15.9 days. Complications of Clavien-Dindo grade ≥ 3 occurred in 3 cases (4.2%). Urinary dysfunction occurred in 6 cases (8.3%). Three (4.2%) patients were diagnosed with positive circumferential resection margins.Conclusion: Hybrid robotic surgery is safe and oncologically feasible.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1138-1142"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374930","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

Optimization of workflow processes for sustainable paternal involvement: case study of an academic "daddy surgeon" in Japan. 优化工作流程以实现可持续的父亲参与：日本一位学术“父亲外科医生”的案例研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub Date: 2024-12-07 DOI: 10.1007/s00595-024-02959-y

Nobuhiko Kanaya, Shinji Kuroda, Yoshitaka Kondo, Yuko Takehara, Yoshihiko Kakiuchi, Hitoshi Minagi, Masaki Sakamoto, Shunsuke Kagawa, Hitomi Kataoka, Toshiyoshi Fujiwara

{"title":"Optimization of workflow processes for sustainable paternal involvement: case study of an academic \"daddy surgeon\" in Japan.","authors":"Nobuhiko Kanaya, Shinji Kuroda, Yoshitaka Kondo, Yuko Takehara, Yoshihiko Kakiuchi, Hitoshi Minagi, Masaki Sakamoto, Shunsuke Kagawa, Hitomi Kataoka, Toshiyoshi Fujiwara","doi":"10.1007/s00595-024-02959-y","DOIUrl":"10.1007/s00595-024-02959-y","url":null,"abstract":"Work-life balance is often discussed in Japan. Yet surgeons find it challenging to take paternity leave because of their demanding surgical duties and a strong sense of responsibility. One Japanese male surgeon had his first paternity experience as a research fellow in the US. When he returned to Japan, he resumed his surgical training and started a research project to become an academic surgeon. When he and his wife were expecting their second child, they discussed his paternity participation before the delivery and decided on a sustainable paternity participation plan. By coordinating his responsibilities with his co-workers, he limited his attendance at work to daytime hours only for 1 month to manage paternity duties. This adjustment did not affect the number of main and assistant operations conducted that month and effective optimization of workflow processes decreased the extra workload for other team members. His experience suggests that the optimization of workflow processes can enhance personal life, including paternity participation. (150/150).","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1213-1215"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792361","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

Reality of post-gastrectomy stress hyperglycemia revealed by continuous glucose monitoring: a prospective study. 连续血糖监测揭示胃切除术后应激性高血糖的现实：一项前瞻性研究。

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub 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":"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":"1181-1188"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","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

Lobectomy for primary lung cancer: a comparison of perioperative and postoperative outcomes between robot-assisted thoracic surgery and video-assisted thoracic surgery. 肺叶切除术治疗原发性肺癌：机器人辅助胸外科手术与视频辅助胸外科手术围手术期和术后结果的比较

IF 1.6 4区医学

Surgery Today Pub Date : 2025-08-01 Epub 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":"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":"1162-1172"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339585/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0