Fujita Medical Journal最新文献

{"title":"A case of irAE gastritis caused by cemiplimab administration.","authors":"Kurumi Isomura, Kyohei Takada, Ryoko Ichikawa, Chiaki Oshima, Yutaro Sato, Akiko Ohwaki, Mayuko Ito, Sayaka Otani, Yusuke Shimizu, Haruki Nishizawa","doi":"10.20407/fmj.2025-022","DOIUrl":"10.20407/fmj.2025-022","url":null,"abstract":"<p><strong>Introduction: </strong>While various immune-related adverse events (irAEs) have been associated with the use of immune checkpoint inhibitors (ICIs), gastritis as an irAE remains a rarely documented condition. We report a case of immune-related gastritis following cemiplimab administration, accompanied by a review of the relevant literature.</p><p><strong>Case: </strong>A 75-year-old woman, gravida 4, para 2, underwent six cycles of cemiplimab as second-line treatment for FIGO stage IIB squamous cell carcinoma of the cervix. Cemiplimab was discontinued 140 days after the initial dose due to the onset of anorexia, nausea, and vomiting. However, her symptoms did not improve during the subsequent follow-up. Upper gastrointestinal endoscopy revealed erythema and edematous changes of the mucosa, predominantly in the pyloric region, along with friable, easily bleeding mucosa and white exudate. Histopathological examination of the biopsied tissue showed dense intraepithelial infiltration of CD8-positive lymphocytes. These findings were consistent with irAE gastritis. As fasting alone failed to improve the symptoms, prednisolone (PSL) was initiated, resulting in amelioration of both symptoms and endoscopic findings.</p><p><strong>Conclusion: </strong>Cemiplimab-induced immune-related gastritis can be diagnosed based on its characteristic endoscopic and histopathological features, similar to irAE gastritis caused by other immune checkpoint inhibitors.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"84-87"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of an ICT-based educational tool in home care nursing: A pilot qualitative study.","authors":"Keisuke Iwase, Hironori Tsuzuki, Maki Ito, Tomomi Kawakami","doi":"10.20407/fmj.2025-010","DOIUrl":"10.20407/fmj.2025-010","url":null,"abstract":"<p><strong>Background: </strong>In home care nursing, nurses are required to assess not only the care recipient's condition but also their living environment. However, conventional paper-based case studies make it difficult for students to grasp the actual living environment.</p><p><strong>Objective: </strong>This study aimed to develop a learning support application (app) that combines 360-degree camera images with a paper-based case scenario and evaluate its usability among nursing students.</p><p><strong>Methods: </strong>Four areas inside the home of a single home care recipient were comprehensively photographed using a 360-degree camera. Thereafter, an app was developed to enable the users view the 360-degree images online by scanning with a smart device a QR code attached to a paper-based case scenario. To evaluate its usability, nursing students used the app and participated in semi-structured interviews. The data were analyzed using text mining techniques.</p><p><strong>Result: </strong>Text mining analysis revealed a co-occurrence network comprising four subgraphs. The representative keywords for each subgraph are as follows:Subgraph 1: Consider, Home, Fall, Risk, EnvironmentSubgraph 2: Think, Danger, Imagination, WatchSubgraph 3: Assessment, Learning support app, Residential environment, Home settings, UseSubgraph 4: Life, See, Person, Situation.</p><p><strong>Conclusion: </strong>The app supported students in understanding the home care environment and contributed to the development of care planning competence. Future studies should increase the number of cases and perform quantitative comparisons.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial use in patients with end-of-life status in intensive care units: A systematic review and meta-analysis.","authors":"Yoshifumi Kubota, Akane Takamatsu, Yuya Kawamoto, Yohei Doi, Hitoshi Honda","doi":"10.20407/fmj.2025-020","DOIUrl":"10.20407/fmj.2025-020","url":null,"abstract":"<p><strong>Objectives: </strong>Advances in critical care have increased antimicrobial use in intensive care units (ICUs), often extending to end-of-life patients without clear clinical benefit. This systematic review and meta-analysis investigated antimicrobial use in critically ill ICU patients with end-of-life care status.</p><p><strong>Methods: </strong>A comprehensive search of Medline (PubMed) and Embase identified articles published from January 2000 through August 2023. Interventional and observational studies focusing on antimicrobial use for critically ill ICU patients with end-of-life status were included. Study types, demographics, clinical characteristics, and antimicrobial use (i.e., continuation or discontinuation) were extracted. A meta-analysis was conducted to estimate the proportion of antimicrobial use, with subgroup analyses by region and national income status.</p><p><strong>Results: </strong>From 13,542 publications, 26 studies met the inclusion criteria; no randomized or prospective studies were identified. Thirteen studies (50.0%) reported antimicrobial use and were included in the quantitative synthesis. The pooled proportion of antimicrobial prescriptions was 0.35 (95% CI, 0.18-0.54) with significant heterogeneity (I²=99.7%, P<0.01). Subgroup analysis revealed regional differences: 0.50 (95% CI, 0.11-0.89) in North America, 0.40 (95% CI, 0.10-0.76) in Europe, and 0.24 (95% CI, 0.10-0.76) in the Asia-Pacific region.</p><p><strong>Conclusions: </strong>Despite increasing emphasis on judicious antimicrobial use, studies comprehensively assessing antimicrobial prescribing in ICU patients with end-of-life care status remain scarce. Based on the limited available evidence, approximately one-third of such patients received antimicrobials. Regional differences in prescribing patterns were also observed, potentially influencing overall antimicrobial consumption in ICUs.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"20-28"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub-analysis of perfusion balloon predilatation with intracoronary nicorandil vs. distal protection for acute coronary syndrome: A comparative evaluation.","authors":"Masataka Yoshinaga, Takashi Muramatsu, Takashi Uwatoko, Akane Miyazaki, Takuo Toriya, Yuji Matsuwaki, Masato Ishikawa, Yuko Ukai, Yohei Kobayashi, Katsuyoshi Ito, Hideaki Ota, Yoshihiro Sobue, Eiichi Watanabe, Hideo Izawa","doi":"10.20407/fmj.2025-009","DOIUrl":"10.20407/fmj.2025-009","url":null,"abstract":"<p><strong>Objectives: </strong>Slow-flow or no-reflow events occur as a complication during percutaneous coronary intervention for acute coronary syndrome (ACS). A previous study demonstrated that prolonged perfusion balloon (PB) predilatation combined with intracoronary administration of nicorandil attenuates this phenomenon. This subanalysis compared the efficacy of the PB approach with that of conventional distal protection (DP).</p><p><strong>Methods: </strong>The study had a retrospective, single-center, observational design and included patients who underwent percutaneous coronary intervention for ACS between April 2020 and April 2022. The patients were divided into a PB group and a DP group. The PB group underwent thrombus aspiration, followed by 3 minutes of predilatation using the Ryusei^® PB, with simultaneous intracoronary administration of nicorandil 2 mg without a DP device and subsequent placement of a drug-eluting stent. The DP group underwent direct stenting or predilatation with a standard balloon combined with a DP device without a PB. Primary endpoints included the incidence of slow-flow or no-reflow events.</p><p><strong>Results: </strong>Sixty-four patients with ACS were enrolled (PB group, n=32; DP group, n=32). The incidence of slow-flow or no-reflow events was significantly lower in the PB group (3.1% vs. 46.8%, p<0.01), as was procedure time (87.1±26.4 minutes vs. 108.6±42.3 minutes, p=0.02) and volume of contrast used (186.0±65.0 mL vs. 228±75.8 mL, p=0.02).</p><p><strong>Conclusions: </strong>PB predilatation with intracoronary nicorandil significantly reduced the number of slow-flow or no-reflow events, shortened procedure time, and reduced the volume of contrast used. This method could be at least as effective as DP.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"50-59"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can preoperative visual analogue scale chart patterns predict surgical outcomes in older adults with lumbar spinal stenosis? A two-center retrospective study.","authors":"Kohei Shibata, Soya Kawabata, Takehiro Michikawa, Yuki Akaike, Yukio Nakajima, Sota Nagai, Kurenai Hachiya, Takaya Imai, Hiroki Takeda, Atsushi Yoshioka, Shinjiro Kaneko, Yudo Hachiya, Nobuyuki Fujita","doi":"10.20407/fmj.2025-015","DOIUrl":"10.20407/fmj.2025-015","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with lumbar spinal stenosis (LSS) exhibit significantly different scoring patterns on the visual analogue scale (VAS) chart for low back pain (LP), buttock and lower limb pain (PL), and buttock and lower limb numbness (NL). This study investigated the usefulness of these preoperative scoring patterns on the VAS chart in predicting surgical outcomes in older adults undergoing LSS surgery.</p><p><strong>Methods: </strong>Time-course data from patients aged ≥65 years who underwent LSS surgery at two institutions were retrospectively assessed. All participants completed the Zurich Claudication Questionnaire and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, which included the VAS chart, before surgery and at 6 months and 1 year postoperatively.</p><p><strong>Results: </strong>In total, 334 participants were evaluated. Patients with equal preoperative scores across all three scales showed the highest average postoperative reduction in the three VAS scores. By contrast, those with the highest preoperative VAS scores for LP or NL had the lowest reductions. Based on the multivariable analysis, the highest preoperative VAS scores for LP (relative risk: 2.1) and NL (relative risk: 2.1) were significantly associated with poor surgical improvement in older adults with LSS.</p><p><strong>Conclusions: </strong>This study demonstrated the potential clinical utility of the preoperative VAS chart in predicting surgical improvement in older patients with LSS. Patients with equal preoperative VAS scores for LP, PL, and NL were more likely to have favorable surgical outcomes, while those with the highest preoperative scores for LP or NL were at higher risk for poor outcomes.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital systems for organ donation after brain death in Japan: A nation-wide survey-advancing brain-dead organ donation systems in Japan.","authors":"Yuuki Takaki, Tomoko Asai, Ayumi Tasaki, Sayuri Nakamura","doi":"10.20407/fmj.2025-007","DOIUrl":"10.20407/fmj.2025-007","url":null,"abstract":"<p><strong>Objectives: </strong>Brain-dead organ donations in Japan remain significantly fewer than in other countries, highlighting inadequacies in the organ donation system. This study aimed to examine the state of organ donation systems in hospitals that have conducted brain-dead organ donations and to explore potential in-hospital improvements.</p><p><strong>Methods: </strong>Among 148 hospitals that carried out at least one brain-dead organ donation between 2018 and 2023, 84 participated in an anonymous, self-administered online survey, yielding a 57% response rate.</p><p><strong>Results: </strong>A total of 96% of responding hospitals reported having in-hospital donor coordinators (IHCos), with an average of 7.0±6.0. Their IHCo teams included nurses in 98%, physicians in 50%, and administrative staff in 27% of hospitals. A significant positive correlation was observed between the numbers of organ donation options presented and actual organ donations. Hospitals offering more options tended to have six or more IHCos and/or a system for identifying potential donors. Furthermore, hospitals with full-time IHCos had significantly more deceased organ donors.</p><p><strong>Conclusions: </strong>Appropriate allocation of IHCos and the establishment of a system to identify potential donors can enhance the assessment of patients' or their families' willingness to donate organs and support the successful completion of the donation process.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 in an adult with right isomerism and Fontan circulation: Successful management using risk stratification.","authors":"Kazuyoshi Saito, Sayuri Yamabe, Arisa Kojima, Hidetoshi Uchida, Yuki Takigawa, Chihiro Nakashima, Meiko Hoshino, Kayoko Takada, Shigefumi Fukui, Tetsushi Yoshikawa, Hideo Izawa, Akira Yamada","doi":"10.20407/fmj.2025-019","DOIUrl":"10.20407/fmj.2025-019","url":null,"abstract":"<p><p>Reports regarding coronavirus disease 2019 (COVID-19) with Fontan circulation are limited. Most studies indicate a relatively good clinical outcome in which SARS-CoV-2 infection is abated; however, COVID-19 can still cause severe pneumonia, and some studies report circulatory breakdown associated with acute respiratory distress syndrome in patients with Fontan circulation. We present the case of a 32-year-old Japanese woman with right isomerism and a single right ventricle who had undergone a fenestrated extracardiac total cavopulmonary connection (Fontan operation), atrioventricular valve replacement, and pacemaker implantation. Despite receiving three doses of the severe acute respiratory syndrome coronavirus 2 mRNA vaccine, the patient contracted COVID-19 and presented with pneumonia. Although her symptoms were mild, the patient was classified as high-risk based on the European Society of Cardiology risk stratification guidelines for COVID-19 in patients with adult congenital heart disease and was admitted to the hospital. Initially, the patient received only symptomatic treatment. However, 2 days later, the patient's COVID-19 condition worsened to moderate grade level II (SpO₂ ≤93%, oxygen demand), with SpO₂ dropping from 95% to 88% on room air. Treatment with remdesivir and dexamethasone following Japanese treatment protocols resulted in clinical improvement and discharge without hemodynamic complications. COVID-19 pneumonia risks disrupting Fontan circulation in affected patients. This case illustrates the importance of prompt risk stratification using anatomical and physical evaluation and adherence to treatment guidelines in the management of patients with Fontan circulation and COVID-19.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of cell-free and concentrated pleural effusion reinfusion therapy in terminal cancer patients.","authors":"Hiroyuki Fujisaki, Masanobu Usui, Akihiro Ito, Miyo Murai, Norimasa Tsuzuki, Akihiko Futamura, Kazuki Imai, Yoshinori Itani","doi":"10.20407/fmj.2024-034","DOIUrl":"10.20407/fmj.2024-034","url":null,"abstract":"<p><strong>Objective: </strong>Patients with advanced or recurrent cancer often suffer from excessive fluid retention, which substantially affects their quality of life. There are no detailed reports regarding cell-free and concentrated pleural effusion reinfusion therapy (CPRT). Thus, we investigated the usefulness of CPRT for pleural effusions in terminal cancer patients.</p><p><strong>Methods: </strong>We evaluated the efficacy and complications of CPRT in 29 patients treated at Fujita Health University Nanakuri Memorial Hospital between April 2016 and August 2020. Nutritional status before and after CPRT was evaluated by measuring serum albumin (Alb) and transthyretin (TTR) levels as indicators. Clinical symptoms were assessed to evaluate the following nine items: pain, general fatigue, anorexia, dyspnea, depression, nausea, insomnia, constipation, and dry mouth.</p><p><strong>Results: </strong>CPRT was performed a total of 71 times, with a median of one session per patient. Median volume of drained pleural fluid was 800 mL, and the median volume of reinfused fluid was 120 mL. Regarding nutritional status before and after CPRT, serum Alb and TTR values did not decrease significantly and were maintained. Clinical symptoms showed a tendency toward improvement; dyspnea, depression, and insomnia improved significantly.No correlation was observed between the volume of pleural fluid drainage and the reduction of dyspnea, but there was a mild correlation with general fatigue and nausea. Conversely, constipation was mildly inversely correlated with the volume of pleural fluid drainage.</p><p><strong>Conclusion: </strong>CPRT for pleural effusions in patients with terminal cancer was suggested to maintain nutritional status and may be useful in improving clinical symptom.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"12 1","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of severe diarrhea due to cytomegalovirus infection after living donor liver transplantation: successful treatment with butyrate-producing bacteria, immunosuppressive adjustments, and anti-cytomegalovirus therapy.","authors":"Masanobu Usui, Norimasa Tsuzuki, Miyo Murai, Akihiro Ito, Akihiko Futamura","doi":"10.20407/fmj.2024-032","DOIUrl":"10.20407/fmj.2024-032","url":null,"abstract":"<p><strong>Purpose: </strong>In recent years, the benefits of probiotics for perioperative management have been recognized, and butyrate-producing bacteria are attracting attention as new beneficial intestinal bacteria. The present study reports a case of cytomegalovirus (CMV) infection and frequent watery diarrhea caused by immunosuppressants after living donor liver transplantation, wherein administration of butyrate-producing bacteria was considered effective.</p><p><strong>Case: </strong>The patient was a 75-year-old woman presenting with the chief complaints of weight loss and generalized muscle weakness. History of present illness: Seven years ago, the patient underwent living donor liver transplantation with her daughter as the donor at University Hospital A for liver cancer concurrent with cirrhosis. Following the postoperative outpatient visit, the patient was admitted to a local geriatric care facility because of her advanced age; however, she was urgently rehospitalized at the same university hospital for acute renal failure caused by decreased food intake and diarrhea. Although intensive care saved her life, she was admitted to our hospital for nutritional management and rehabilitation because of considerable weight loss and generalized muscle weakness caused by disuse syndrome resulting from prolonged bed rest. At admission, she was 142 cm tall, weighed 39.5 kg, and had a body mass index 19.6. She was unable to stand up unassisted or transfer to a wheelchair and remained in bed. After admission, central venous nutrition and rehabilitation therapy were initiated. However, on day 10 of admission, she abruptly developed watery diarrhea that occurred 12 times/day, with a blood test showing strong positive results for CMV antigen. Consequently, immunosuppressive drugs were reduced, valganciclovir was administered as an anti-CMV drug, and butyrate-producing bacteria were administered as a probiotic. Subsequently, the watery stools improved, and the frequency of defecation decreased to 4 times/day within 3 weeks after treatment initiation. One month later, she had normal stools twice daily, and CMV antigen results were negative. After her nutritional status improved, the patient was transferred to a different hospital.</p><p><strong>Conclusion: </strong>We experienced a case in which butyrate-producing bacteria effectively treated a patient with watery diarrhea following liver transplantation.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"11 4","pages":"199-202"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12576399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of severe subcutaneous emphysema after robotic versus conventional laparoscopic surgery: A retrospective single-center study.","authors":"Satoshi Komatsu, Tomoyuki Nakamura, Naohide Kuriyama, Takahiro Kawaji, Osamu Nishida","doi":"10.20407/fmj.2025-004","DOIUrl":"10.20407/fmj.2025-004","url":null,"abstract":"<p><strong>Objectives: </strong>Subcutaneous emphysema (SE) in pneumoperitoneum surgery is a complication not observed in open abdominal surgery, but data are scarce and epidemiology is inadequate. Although SE is considered less problematic because it is caused by carbon dioxide gas, past reports have shown that severe complications can occur, such as airway obstruction and cardiopulmonary collapse. We conducted an exploratory single-center retrospective study of patients admitted to the ICU after robotic or conventional laparoscopic abdominal surgery, focusing on epidemiological factors promoting severe SE.</p><p><strong>Methods: </strong>This retrospective study examined cases of severe SE following robotic or conventional laparoscopic abdominal surgery that necessitated ICU admission. Patients older than 18 years with unscheduled ICU admission for grade 5 head SE between 1 January 2010 and 31 December 2021 were included. All robotic surgeries used the da Vinci Surgical System.</p><p><strong>Results: </strong>We reviewed data from all 8 of 3,532 robotic surgeries and 5 of 10,305 conventional laparoscopic surgeries resulting in severe SE. By approach, the incidence of severe SE was 0.23% for robotic surgery and 0.05% for laparoscopic surgery (p=0.006). By organ, gastric surgery was the leading cause, with 6 cases from 2,224 gastric surgeries and 7 from a total of 11,613 other abdominal surgeries, giving incidences of 0.27% and 0.06%, respectively (p=0.011). The incidence in women was 0.15% (10/6,496), compared with only 0.04% (3/7,341) in men (p=0.048).</p><p><strong>Conclusions: </strong>Our findings confirmed that higher risk of severe SE-although still small-is associated with robotic and gastric surgeries and female sex.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"11 4","pages":"161-164"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12576402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}