Asian Journal of Endoscopic Surgery最新文献

{"title":"Comparison of Laparoscopic Percutaneous Extraperitoneal Closure and Conventional Open Inguinal Hernia Repair for Inguinal Hernia in Children: A Meta-Analysis","authors":"ChaoYang Wang,&nbsp;Jiong Zhang,&nbsp;JiYun Zhang,&nbsp;JiaZheng Bian,&nbsp;KeJia Liu,&nbsp;WenPei Yang","doi":"10.1111/ases.70371","DOIUrl":"10.1111/ases.70371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to systematically evaluate the efficacy and safety of laparoscopic percutaneous extraperitoneal closure (LPEC) compared with conventional open inguinal hernia repair (OR) for inguinal hernia in children, and to provide high-quality evidence for clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases including PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to February 2026. Two reviewers independently performed literature screening, data extraction, and quality assessment. Meta-analyses were conducted using Rev Man 5.4 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies (14 retrospective cohort studies and 1 randomized controlled trial) were included. Meta-analysis demonstrated that, compared with OR, LPEC was associated with significantly shorter bilateral operation time (MD = −8.82, 95% CI −12.63 to −5.01, <i>p</i> &lt; 0.00001), lower incidence of contralateral metachronous inguinal hernia (RR = 0.06, 95% CI 0.04 to 0.09, <i>p</i> &lt; 0.00001), and lower incidence of testicular ascent (RR = 0.36, 95% CI 0.17 to 0.79, <i>p</i> = 0.01). Unilateral operation time was longer in the LPEC group (MD = 1.62, 95% CI 0.02 to 3.32, <i>p</i> = 0.05). No significant differences were observed between the two groups in recurrence rate (RR = 0.70, 95% CI 0.48 to 1.04, <i>p</i> = 0.08), postoperative hydrocele (RR = 0.49, 95% CI 0.24 to 1.02, <i>p</i> = 0.06), or incision infection (RR = 0.99, 95% CI 0.35 to 2.79, <i>p</i> = 0.99).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LPEC is superior to OR in shortening bilateral operative time and decreasing the risks of contralateral metachronous hernia and testicular ascent, with comparable recurrence and complication profiles. Despite slightly longer unilateral operative time, LPEC demonstrates favorable overall efficacy and may serve as the preferred surgical strategy for pediatric inguinal hernia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Experience With a Step-Specific Reconstructive Strategy During Robot-Assisted Radical Cystectomy Using the da Vinci SP System","authors":"Yuki Kamiyama,&nbsp;Shinya Abe,&nbsp;Akihiro Hoshiyama,&nbsp;Yuri Nishikawa,&nbsp;Naofumi Tsutsumi,&nbsp;Yoichiro Kajita,&nbsp;Takehiko Segawa","doi":"10.1111/ases.70372","DOIUrl":"10.1111/ases.70372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the technical feasibility, perioperative safety, and short-term reconstructive outcomes of a step-specific reconstructive strategy during robot-assisted radical cystectomy (RARC) using the da Vinci SP system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 17 consecutive patients who underwent single-port RARC (SP-RARC) with ileal conduit diversion. Extracorporeal bowel isolation and ileoileal anastomosis were performed in all patients. After confirmation of negative ureteral margins and adequate perfusion using indocyanine green fluorescence imaging, extracorporeal ureteroileal anastomosis was performed when tension-free anastomosis was feasible; otherwise, the robot was re-docked and intracorporeal ureteroileal anastomosis was selectively performed. Robot-assisted retroperitonealization of the ureteroileal anastomosis was attempted in all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median operative time was 405 min and median estimated blood loss was 345 mL. Bilateral extracorporeal ureteroileal anastomosis was completed in nine patients, whereas selective intracorporeal anastomosis of one or both ureters was performed in eight. In five of these eight patients, additional ureteral resection based on frozen-section or perfusion assessment resulted in insufficient length for tension-free extracorporeal anastomosis. Retroperitonealization was completed in 14 patients. No conversion to open surgery occurred. Clavien–Dindo grade ≥ II and ≥ III complications occurred in seven and three patients, respectively. At the most recent imaging follow-up, no renal unit had Society for Fetal Urology grade ≥ 3 hydronephrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This step-specific strategy was technically feasible, preserving extracorporeal bowel reconstruction as the standard approach while allowing selective intracorporeal ureteroileal anastomosis when required. It prioritized negative margins, ureteral perfusion, anastomotic tension, and operative safety over rigid adherence to a single reconstructive method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-Assisted Thoracoscopic Surgery for Empyema Secondary to Upper Gastrointestinal Leakage After Surgical or Endoscopic Intervention: A Multicenter Comparative Study","authors":"Yo Tsukamoto,&nbsp;Takeo Nakada,&nbsp;Saki Tsubouchi,&nbsp;Yuto Watanabe,&nbsp;Lulu Li,&nbsp;Yu Suyama,&nbsp;Maki Nakashima,&nbsp;Satoshi Arakawa,&nbsp;Takamasa Shibazaki,&nbsp;Tomonari Kinoshita,&nbsp;Shohei Mori,&nbsp;Naoto Takahashi,&nbsp;Fumiaki Yano,&nbsp;Takashi Ohtsuka","doi":"10.1111/ases.70370","DOIUrl":"10.1111/ases.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Empyema secondary to upper gastrointestinal (GI) leakage after surgical or endoscopic intervention is a rare but severe complication for which the role of video-assisted thoracoscopic surgery (VATS) remains unclear. This study evaluated the short-term safety and procedural feasibility of VATS, using the outcomes of VATS for parapneumonic empyema as a clinical benchmark.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients undergoing surgery for empyema at two affiliated institutions (2015–2026). Patients with empyema secondary to upper GI leakage after surgical or endoscopic intervention were compared with those with acute Stage II–III parapneumonic empyema. The primary endpoint was 30-day mortality. Perioperative outcomes, including VATS completion, re-operation, postoperative hospital stay, and microbiological findings, were also compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 257 empyema surgical records, 142 patients were analyzed (GI leakage group, <i>n</i> = 11; parapneumonic group, <i>n</i> = 131). The recorded interval from symptom onset to VATS was shorter in the GI leakage group (median 3 vs. 18 days, <i>p</i> &lt; 0.001), and the incidence of multiloculated empyema on preoperative CT was lower (9.1% vs. 48.9%, <i>p</i> = 0.012). Re-operation was more frequent in the GI leakage group (36.4% vs. 5.3%, <i>p</i> = 0.005), and postoperative hospital stay was longer (median 34 vs. 16 days, <i>p</i> = 0.003). No 30-day deaths occurred in the GI leakage group, compared with 6 deaths (4.6%) in the parapneumonic group (<i>p</i> = 1.000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Empyema secondary to upper GI leakage after surgical or endoscopic intervention followed a refractory clinical course despite intervention before advanced pleural organization. VATS may be a feasible component of multidisciplinary source-control management, although frequent re-intervention may be required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe Encirclement of the Hepatoduodenal Ligament Using ICG-Fluorescent Gauze for a Challenging Pringle Maneuver in Minimally Invasive Hepatectomy","authors":"Yoshihiko Tashiro,&nbsp;Takeshi Aoki,&nbsp;Hidekazu Yasunaga,&nbsp;Shinji Ando","doi":"10.1111/ases.70361","DOIUrl":"10.1111/ases.70361","url":null,"abstract":"<div>\u0000 \u0000 <p>The Pringle maneuver (PM) is a widely accepted technique for inflow control during minimally invasive liver resection (MILR). However, postoperative adhesions following abdominal surgery make safe encirclement of the hepatoduodenal ligament technically challenging. Indocyanine green (ICG)–dyed gauze has recently been reported as a useful adjunct in minimally invasive surgery, with potential utility as an anatomical marker to guide surgeons and thereby enhance surgical safety, including by helping prevent gauze remnants. We describe a simple stepwise technique using ICG-fluorescent gauze as a landmark during a challenging PM. The ICG-dyed gauze was gently placed on the dorsal side of the hepatoduodenal ligament (HDL), and its fluorescence provided a clear landmark during adhesion division between the remnant stomach and the HDL. After widening the gate to divide the adhesions by following the fluorescence from the ICG-dyed gauze, the HDL was encircled with tape, and PM was safely performed without organ injury or other complications. This practical method may enhance safety during technically challenging PM in MILR.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Robotic Gastrectomy in Elderly Gastric Cancer Patients: A Propensity Score-Matched Comparison With Robotic Gastrectomy in Non-Elderly Patients and Laparoscopic Gastrectomy in Elderly","authors":"Rufuto Kubota,&nbsp;Sho Sato,&nbsp;Yu Fujii,&nbsp;Minoru Homma,&nbsp;Yusuke Takeshita,&nbsp;Kohdai Ueno,&nbsp;Hiroki Kondo,&nbsp;Hayato Watanabe,&nbsp;Yusuke Suwa,&nbsp;Yasuhiro Yabushita,&nbsp;Masakatsu Numata,&nbsp;Mayumi Ozawa,&nbsp;Tsutomu Sato,&nbsp;Takaki Yoshikawa,&nbsp;Takashi Kosaka,&nbsp;Hirotoshi Akiyama,&nbsp;Itaru Endo","doi":"10.1111/ases.70368","DOIUrl":"https://doi.org/10.1111/ases.70368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Surgery for gastric cancer in elderly patients is challenging because of comorbidities and diminished physiological reserve. Robotic gastrectomy (RG) may improve outcomes via technical precision; however, its impact on the elderly remains unclear. This study evaluated the short-term outcomes of RG between elderly and non-elderly patients, and between RG and laparoscopic gastrectomy (LG) in elderly patients using propensity score matching (PSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed elderly patients who underwent RG or LG and non-elderly patients who underwent RG for gastric cancer between April 2020 and December 2024. Patients were divided into elderly RG (≥ 80 years, <i>n</i> = 33), non-elderly RG (&lt; 80 years, <i>n</i> = 118), and elderly LG groups (<i>n</i> = 46). PSM (1:1) adjusted between elderly and non-elderly RG groups, and between elderly RG and LG groups. Short-term surgical outcomes and postoperative complications were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, there was no significant difference in surgical complication rates (16% vs. 6%; <i>p</i> = 0.43) between elderly and non-elderly RG groups. However, the elderly group had numerically higher non-surgical complications (12% vs. 3%; <i>p</i> = 0.35), primarily driven by non-surgical issues, such as acute heart failure, atelectasis, and urinary tract infections. Postoperative complication rates were also similar between elderly RG and LG groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RG appears to be a safe and feasible procedure for elderly patients aged ≥ 80 years, providing surgical stability comparable to that in younger and elderly patients who underwent LG. While the robotic platform may contribute to mitigating surgery-related risks, the higher incidence of non-surgical complications underscores the necessity of tailored perioperative management addressing elderly-specific vulnerabilities in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside Assistant Suction Response and Visual Field Recovery During Robot-Assisted Rectal Cancer Surgery: An Exploratory Propensity Score-Matched Comparison of Assistant-Access Workflows Using Hinotori and da Vinci Xi","authors":"Motoshi Miyagi,&nbsp;Yasutake Uchima,&nbsp;Tomoki Henna,&nbsp;Masaomi Eguchi,&nbsp;Yasukazu Ikehara","doi":"10.1111/ases.70351","DOIUrl":"https://doi.org/10.1111/ases.70351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Timely suction is essential when bleeding or oozing obscures the operative field during robot-assisted rectal cancer surgery; assistant-access workflow may influence the response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This exploratory, retrospective, matched cohort study compared a hinotori workflow with an additional assistant port and a conventional da Vinci Xi port configuration. Eleven hinotori and 82 da Vinci Xi cases were eligible. Propensity score matching was performed using body mass index, preoperative treatment, and tumor location; 10 matched pairs had analyzable videos. Visual field disturbance was defined as bleeding or oozing obscuring the operative view and requiring suction. The times from event onset to suction initiation and from onset to a restored view were defined as latency and time to recovery, respectively. Event-level outcomes were log-transformed; effect sizes were mean log differences and geometric mean ratios. Wilcoxon signed-rank tests using case-level medians were used for sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 152 events were identified (64 hinotori, 88 da Vinci Xi). The hinotori workflow was associated with shorter latency (mean log difference, −0.633; 95% confidence interval [CI], −1.021 to −0.244; <i>p</i> = 0.001; geometric mean ratio, 0.531; 95% CI, 0.360–0.783) and shorter time to recovery (mean log difference, −0.438; 95% CI, −0.739 to −0.137; <i>p</i> = 0.004; geometric mean ratio, 0.645; 95% CI, 0.478–0.872). Sensitivity analyses yielded consistent results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A hinotori-specific assistant-port workflow was associated with faster suction response and visualization recovery. These exploratory findings require cautious interpretation because of institutional and assistant-related confounding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Endometriosis on Surgical Outcomes of Total Laparoscopic Hysterectomy for Benign Indications: A Propensity Score-Matched Analysis","authors":"Yusuke Tanaka,&nbsp;Ayako Otsuka,&nbsp;Tomomi Ishii,&nbsp;Yasuhiko Shiki","doi":"10.1111/ases.70369","DOIUrl":"10.1111/ases.70369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The objective of the study was to retrospectively evaluate the impact of endometriosis on perioperative outcomes in patients undergoing total laparoscopic hysterectomy (TLH) for benign diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 836 patients who underwent TLH for benign conditions at our institution between January 2011 and December 2024, patients were divided into two groups: those with endometriosis (<i>n</i> = 115) and those without endometriosis (<i>n</i> = 721). Propensity score matching (PSM) was performed to balance baseline characteristics. After matching, 115 patients were included in each group. Perioperative outcomes were compared, including the incidence of surgical site infection (SSI), bowel injury, urinary tract injury, and deep venous thrombosis (DVT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before PSM, the endometriosis group had significantly higher rates of superficial and deep incisional SSI (4.3% vs. 1.2%, <i>p</i> = 0.032) and organ/space SSI (15.7% vs. 3.9%, <i>p</i> &lt; 0.001) compared with the non-endometriosis group. The incidence of intraoperative bowel injury was also significantly higher in the endometriosis group (3.5% vs. 0.3%, <i>p</i> = 0.004). In contrast, there were no significant differences between the groups in urinary tract injury (2.6% vs. 1.2%, <i>p</i> = 0.221) or DVT (0.9% vs. 0.1%, <i>p</i> = 0.256). After PSM, the incidence of organ/space SSI remained significantly higher in the endometriosis group (<i>p</i> = 0.032), whereas no significant differences were observed in superficial plus deep incisional SSI, bowel injury, urinary tract injury, or DVT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endometriosis was associated with an increased incidence of organ/space SSI in patients undergoing TLH for benign diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Short-Term Outcomes of Intracorporeal Anastomosis in Robot-Assisted colon Resection and Laparoscopic colon Resection: A Single-Center Study and Systematic Review and meta-Analysis","authors":"Yusuke Tomita,&nbsp;Kohei Shigeta,&nbsp;Yuzuko Momose,&nbsp;Masayoshi Monno,&nbsp;Satoru Morita,&nbsp;Koji Okabayashi,&nbsp;Yuko Kitagawa","doi":"10.1111/ases.70366","DOIUrl":"10.1111/ases.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study evaluates short-term outcomes of robot-assisted (Rt) and laparoscopic (Lap) intracorporeal anastomosis (IA) in colon resection using an exploratory single-center retrospective cohort and a systematic review and meta-analysis conducted in accordance with PRISMA guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with colon cancer who underwent laparoscopic or robotic surgery at our institution from 2015 to 2024 were retrospectively enrolled. Additionally, a meta-analysis was conducted using PubMed, Web of Science, Scopus, and the Cochrane Library to identify studies comparing Rt-IA and Lap-IA. Short-term outcomes were statistically compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 77 patients were included (Rt-IA 26, Lap-IA 51). Intraoperative blood loss was significantly lower in the Rt-IA group (median, 5 mL vs. 10 mL; <i>p</i> = 0.001). No statistically significant differences were detected in major postoperative complications or most recovery-related outcomes. For the meta-analysis, 11 studies (1 prospective and 10 retrospective) met the inclusion criteria. After adding our institutional data, the pooled analysis showed that operative time was significantly longer in the Rt-IA group (MD, 54.02 min; 95% CI, 34.18–73.86; <i>I</i>² = 95.4%), whereas the Rt-IA group demonstrated significantly less blood loss (MD, −14.33 mL; 95% CI: −27.04 to −1.63; <i>I</i>² = 19.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of our institutional analysis together with meta-analysis suggest that Rt-IA may be associated with longer operative time but slightly lower blood loss than Lap-IA. These findings suggest that Rt-IA may be a feasible alternative to Lap-IA; however, the results should be interpreted with caution given the limitations of the available evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760947","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":"Real-World Perioperative and Early Oncological Outcomes of Robot-Assisted Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Single-Institution Series of 100 Consecutive Patients","authors":"Shugo Yajima,&nbsp;Gaku Okumura,&nbsp;Shu Gozu,&nbsp;Madoka Kataoka,&nbsp;Yasukazu Nakanishi,&nbsp;Hitoshi Masuda","doi":"10.1111/ases.70367","DOIUrl":"https://doi.org/10.1111/ases.70367","url":null,"abstract":"<div>\u0000 \u0000 <p>Robot-assisted radical nephroureterectomy (RANU) is increasingly used for upper tract urothelial carcinoma (UTUC), yet most published series are selected and real-world data from consecutive, unselected practice are scarce. We reviewed 100 consecutive RANU performed at a single institution between April 2022 and March 2026, including six cases with a concomitant procedure. Median age was 77 years and 39 patients had pT3–4 disease. Median estimated blood loss was 29 mL, operative time 200 min, and console time 141 min; three patients required transfusion. Clavien–Dindo grade II or higher complications occurred within 90 days in 13 patients, with only one grade III event. At a median follow-up of 15.5 months, the cumulative incidence of intravesical and of distant or local recurrence was approximately 17% and 18% at 12 months, and overall survival was approximately 86% at 24 months. RANU was feasible with favorable perioperative outcomes in this elderly, frequently advanced cohort.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent Intraoperative Use of Fluorescence Cholangiography Is Associated With Higher Surgical Difficulty in Laparoscopic Cholecystectomy","authors":"Hironari Kawai,&nbsp;Shunjin Ryu,&nbsp;Daiki Suzuki,&nbsp;Hyuga Kawakubo,&nbsp;Shunsuke Nakashima,&nbsp;Takehiro Kobayashi,&nbsp;Yuta Imaizumi,&nbsp;Ryusuke Ito","doi":"10.1111/ases.70360","DOIUrl":"10.1111/ases.70360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Intraoperative indocyanine green fluorescence is useful in laparoscopic cholecystectomy (Lap-C). The objective of this study was to identify clinical situations in which fluorescence cholangiography is advantageous.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed intraoperative videos of 64 patients who underwent Lap-C with fluorescence cholangiography and recorded the number of times intraoperative near-infrared mode (NIR-mode) was used. The relationship between the number of times NIRF-mode was used and certain clinical variables was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>NIR-mode was used in a single operation a median of 6 times and a maximum of 25 times. Multivariate analysis revealed that surgical difficulty score (in accordance with the Tokyo Guidelines 2018) was an independent and significant clinical factor affecting the number of times NIR-mode was used, which was significantly correlated with surgical difficulty and operation time. In the high NIR-mode group, surgical difficulty score, operative time, and blood loss were significantly higher compared with the low NIR-mode group; conversion to open surgery, bile duct injury, and postoperative complications were comparable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frequent use of fluorescence cholangiography is associated with higher surgical difficulty in Lap-C and may be helpful for avoiding misidentification of biliary anatomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}