Annals of Gastroenterological Surgery最新文献

{"title":"Acknowledgments","authors":"","doi":"10.1002/ags3.12899","DOIUrl":"10.1002/ags3.12899","url":null,"abstract":"<p>The publication of invaluable papers in <i>Annals of Gastroenterological Surgery</i> depends on the prompt, careful review of submitted manuscripts. We would like to thank the following experts for reviewing manuscripts submitted between December 1, 2023 and November 30, 2024.</p><p>Reviewer Full Name</p><p>Abe, Tatsuya</p><p>Abe, Yuta</p><p>Aizawa, Masaki</p><p>Ajiki, Tetsuo</p><p>Akahoshi, Keiichi</p><p>Akamatsu, Nobuhisa</p><p>Akita, Hirofumi</p><p>Akiyoshi, Takashi</p><p>Aoki, Takeshi</p><p>Aoki, Taku</p><p>Aoyama, Toru</p><p>Araki, Kenichiro</p><p>Arigami, Takaaki</p><p>Arita, Junichi</p><p>Baba, Kenji</p><p>Ban, Daisuke</p><p>Bekki, Yuki</p><p>Booka, Eisuke</p><p>Daiko, Hiroyuki</p><p>Ebata, Tomoki</p><p>Ebihara, Yuma</p><p>Eguchi, Hidetoshi</p><p>Etoh, Tsuyoshi</p><p>Fujimura, Takashi</p><p>Fujita, Fumihiko</p><p>Fujita, Takeo</p><p>Fukagawa, Takeo</p><p>Fukami, Yasuyuki</p><p>Fukushima, Ryoji</p><p>Ganeko, Riki</p><p>Hagi, Takaomi</p><p>Hamabe, Atsushi</p><p>Hanaoka, Marie</p><p>Harada, Kazuto</p><p>Harimoto, Norifumi</p><p>Haruki, Koichiro</p><p>Hasegawa, Kiyoshi</p><p>Hasegawa, Yasushi</p><p>Hashimoto, Daisuke</p><p>Hashimoto, Masashi</p><p>Hatano, Etsuro</p><p>Hayami, Shinya</p><p>Hayashi, Hiromitsu</p><p>Hibi, Taizo</p><p>Hida, Koya</p><p>Hidaka, Masaaki</p><p>Hijioka, Susumu</p><p>Hirano, Satoshi</p><p>Hirano, Yasumitsu</p><p>Hirashita, Teijiro</p><p>Hiyoshi, Yukiharu</p><p>Honda, Goro</p><p>Hosoda, Kei</p><p>Ichikawa, Nobuki</p><p>Iguchi, Tomohiro</p><p>Ikeda, Masataka</p><p>Ikeda, Satoshi</p><p>Ikeuchi, Hiroki</p><p>Ikoma, Hisashi</p><p>Imamura, Yu</p><p>Inaki, Noriyuki</p><p>Inoue, Mikihiro</p><p>Iseda, Norifumi</p><p>Ishido, Keinosuke</p><p>Ishihara, Soichiro</p><p>Ishizawa, Takeaki</p><p>Ishizuka, Mitsuru</p><p>Itatani, Yoshiro</p><p>Ito, Takashi</p><p>Itoh, Shinji</p><p>Iwatsuki, Masaaki</p><p>Jiang, Xingming</p><p>Kagawa, Hiroyasu</p><p>Kagawa, Yoshinori</p><p>Kaibori, Masaki</p><p>Kaido, Toshimi</p><p>Kajiwara, Yoshiki</p><p>Kanda, Mitsuro</p><p>Kanemitsu, Yukihide</p><p>Kasai, Shunsuke</p><p>Kato, Atsushi</p><p>Kato, Motohiko</p><p>Kato, Yutaro</p><p>Kawachi, Shigeyuki</p><p>Kawada, Kenji</p><p>Kawai, Kazushige</p><p>Kawai, Manabu</p><p>Kawamura, Junichiro</p><p>Kawazoe, Tetsuro</p><p>Kim, Dong-Sik</p><p>Kimura, Yasutoshi</p><p>Kimura, Yutaka</p><p>Kinami, Shinichi</p><p>Kinoshita, Takahiro</p><p>Kitagawa, Akihiro</p><p>Kitago, Minoru</p><p>Kitai, Toshiyuki</p><p>Kitayama, Joji</p><p>Kiyomatsu, Tomomichi</p><p>Kobayashi, Hirotoshi</p><p>Kobayashi, Minako</p><p>Kobayashi, Shogo</p><p>Kobayashi, Toshimichi</p><p>Koda, Keiji</p><p>Koike, Yuhki</p><p>Komatsu, Shuhei</p><p>Konishi, Hirotaka</p><p>Kosuga, Toshiyuki</p><p>Kosumi, Keisuke</p><p>Koyama, Fumikazu</p><p>Koyanagi, Kazuo</p><p>Kubo, Shoji</p><p>Kubota, Takeshi</p><p>Kumagai, Koshi</p><p>Kumagai, Youichi</p><p>Kunisaki, Chikara</p><p>Kuroda, Shinji</p><p>Lee, Sang-Woong</p><p>Makino, Isamu</p><p>Manabe, Tatsuya</p><p>Marubashi, Shigeru</p><p>Maruyama, Suguru</p><p>Mats","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"211-213"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930483","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}

{"title":"Interview with Prof. Dr. Jeffrey Drebin, President of the 2024 President Elect of the American Surgical Association","authors":"Koshi Mimori,&nbsp;Tsutomu Fujii,&nbsp;Masayuki Sho,&nbsp;Itaru Endo,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12882","DOIUrl":"10.1002/ags3.12882","url":null,"abstract":"<p><b>Dr. Jeffrey A. Drebin</b> is Chair of the Department of Surgery at the Memorial Sloan Kettering Cancer Center and holds the Murray F. Brennan Endowed Chair. He is also Professor of Surgery at Weill Cornell Medical College. He was previously the John Rhea Barton Professor and Chair of the Department of Surgery at the Perelman School of Medicine of the University of Pennsylvania. He received his M.D. and Ph.D. degrees from Harvard, where his Ph.D. work involved the development of the first monoclonal antibodies targeting the HER2/neu oncogene. He subsequently performed his surgical training in General Surgery and a Fellowship in Surgical Oncology at the Johns Hopkins Hospital. Upon completing his clinical training, Dr. Drebin was recruited to Washington University School of Medicine in 1995, rising to Professor of Surgery and of Molecular Biology &amp; Pharmacology in 2002.</p><p>In 2004 he was recruited to the University of Pennsylvania as Chief of the GI Surgery Division and in 2009 he became department Chair. At Washington University and at the University of Pennsylvania he established himself as a busy clinical surgeon, focusing on pancreaticobiliary, upper gastrointestinal, and liver surgery. He also established a successful translational research lab, receiving research support from the NIH, the Department of Defense, and the Burroughs Welcome fund for this work. Multiple surgery residents who worked in Dr. Drebin's laboratory have themselves gone on to successful academic surgical careers. He has published over 150 peer-reviewed articles, chapters, editorials, and reviews, and has served on the editorial boards of multiple journals.</p><p>Today, we are honored to have Professor Jeff Drebin, M.D., Ph.D., from Memorial Sloan Kettering Cancer Center, and the 2024 President Elect of the American Surgical Association, as our guest. We extend our sincere gratitude to Professor Drebin for taking time out of his busy schedule to join us at the 79th Annual Meeting of The Japanese Society of Gastroenterological Surgery. In addition, we deeply appreciate your participation and your contribution to the journal, <i>Annals of Gastroenterological Surgery</i>, an official journal of JSGS. Thank you very much, Professor Jeff.</p><p>We're going to wrap up this conversation. Thank you very much for your insightful elaboration and explanation about pancreatic cancer. We face significant challenges in curing pancreatic cancer, but today's discussion with Professor Drebin provides a glimmer of hope. In the future, we may be able to eradicate pancreatic cancer. Thank you very much for your active discussion.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"24-31"},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930462","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}

{"title":"Comparison of short-term outcomes and perioperative costs in laparoscopic versus robotic surgery for rectal cancers: A real-world cohort study using Japanese nationwide inpatient database","authors":"Hiroki Hamamoto,&nbsp;Masato Ota,&nbsp;Takafumi Shima,&nbsp;Toru Kuramoto,&nbsp;Kazuya Kitada,&nbsp;Kohei Taniguchi,&nbsp;Mitsuhiro Asakuma,&nbsp;Yasuhiro Oura,&nbsp;Yuri Ito,&nbsp;Sang-Woong Lee","doi":"10.1002/ags3.12884","DOIUrl":"10.1002/ags3.12884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Many studies have revealed the benefits of robotic surgery for rectal cancer; however, real-world data are insufficient. This study aimed to compare the short-term outcomes and perioperative costs of laparoscopic and robotic surgery for rectal cancer using a real-world database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients who underwent laparoscopic or robotic surgery for rectal cancer between January 2018 and January 2021 from a nationwide Japanese inpatient database provided by Medical Data Vision Co., Ltd. were analyzed. We performed propensity score matching (PSM) analysis to compare the in-hospital mortality, morbidity, readmission rate, reoperation rate, length of postoperative stay, and medical costs between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We performed PSM analysis on 18 952 eligible patients. After PSM, 1396 patients in the laparoscopic group and 1396 in the robotic group were compared. The robotic group had a lower surgical site infection rate (2.9% vs. 1.5%, <i>p</i> = 0.010), lower respiratory failure rate (1.3% vs. 0.6%, <i>p</i> = 0.049), and higher operative medical costs (1 291 371 vs. 1 312 462 JPY, <i>p</i> = 0.013). The total medical costs of the two groups were comparable (1 862 439 vs. 1 895 822 JPY, <i>p</i> = 0.051).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSM analysis revealed that robotic surgery was associated with better outcomes than laparoscopic surgery in terms of surgical site infection and respiratory failure rates. The operative medical costs of robotic surgery were significantly higher than those of laparoscopic surgery. However, there was no significant difference in the total medical costs between robotic and laparoscopic surgery for rectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"4-11"},"PeriodicalIF":2.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930488","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}

{"title":"Annual report on National Clinical Database 2021 for gastroenterological surgery in Japan","authors":"Sunao Ito,&nbsp;Arata Takahashi,&nbsp;Hideki Ueno,&nbsp;Shuji Takiguchi,&nbsp;Yoshiki Kajiwara,&nbsp;Yoshihiro Kakeji,&nbsp;Susumu Eguchi,&nbsp;Takanori Goi,&nbsp;Akio Saiura,&nbsp;Akira Sasaki,&nbsp;Hiroya Takeuchi,&nbsp;Chie Tanaka,&nbsp;Masaji Hashimoto,&nbsp;Naoki Hiki,&nbsp;Akihiko Horiguchi,&nbsp;Satoru Matsuda,&nbsp;Tsunekazu Mizushima,&nbsp;Hiroyuki Yamamoto,&nbsp;Yuko Kitagawa,&nbsp;Ken Shirabe","doi":"10.1002/ags3.12868","DOIUrl":"10.1002/ags3.12868","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The Japanese National Clinical Database, which covers more than 95% of the surgeries performed in Japan, is the largest nationwide database. This is the 2021 annual report of the Gastroenterological Section of the National Clinical Database, which aims to present the short-term outcomes of cases registered in 2021 and discuss significant changes and insights into gastroenterological surgeries observed over the decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the data of patients registered in the National Clinical Database between 2012 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 5 788 093 cases, including 597 780 cases in 2021, were extracted from the National Clinical Database. The number of surgeries resumed its original trend after a uniform decrease due to the coronavirus disease 2019 pandemic. The patient population continues to age, and the proportion of female patients is steadily increasing. The trend of surgeries being conducted in certified institutions with the involvement of board-certified surgeons is consistently rising. Moreover, the increasing trend of endoscopic surgery rate is still maintained. Although operative mortality is declining, the trend of increasing postoperative complications continues. Surgery on the esophagus, liver, and pancreas has shown substantial improvements in operative mortality, with a high participation rate of board-certified surgeons. Surgical procedures with a high incidence of emergency surgeries are characterized by low participation rates of board-certified surgeons, increased morbidity rates, and worse mortality outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This overview of surgical patients in Japan, obtained using data extracted from the National Clinical Database, may serve as a critical cornerstone for the future development of gastroenterological surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"32-59"},"PeriodicalIF":2.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930485","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}

{"title":"y-shaped side overlap esophagogastrostomy in proximal gastrectomy","authors":"Yukinori Kurokawa,&nbsp;Takuro Saito,&nbsp;Kazuyoshi Yamamoto,&nbsp;Tsuyoshi Takahashi,&nbsp;Yuichiro Doki","doi":"10.1002/ags3.12859","DOIUrl":"10.1002/ags3.12859","url":null,"abstract":"<p>Several reconstruction methods are used in proximal gastrectomy. Esophagogastrostomy is the simplest and most physiological. The challenge in esophagogastrostomy is preventing reflux esophagitis. Various techniques have been developed to reduce reflux of gastric juice. Taking advantage of the usefulness of the recently reported modified side overlap with fundoplication by Yamashita (mSOFY) method, we developed a y-shaped mSOFY method that is simpler and has potential for a greater anti-reflux effect. Unlike the original mSOFY method, the pseudo-fornix does not go behind the esophagus and the axes of the esophagus and residual stomach are shifted by approximately 60° to form a “y” shape. In addition, fixation of the residual stomach and both sides of the esophagus and crus of the diaphragm is performed at the end of the procedure. We performed 12 cases of laparoscopic or robotic proximal gastrectomy with y-shaped mSOFY esophagogastric anastomosis located below the crus of the diaphragm for gastric or esophagogastric junction adenocarcinoma between August 2021 and March 2023. The median operative time and blood loss were 260 min and 5 mL, respectively. No postoperative complications of Clavien–Dindo classification grade II or higher occurred. No stenoses requiring balloon dilation occurred within 1 year after surgery, but endoscopy at 1 year after surgery revealed two cases (17%) of reflux esophagitis of Los Angeles grade B or higher. In conclusion, this y-shaped side overlap esophagogastrostomy method could be one of the recommended esophagogastrostomy procedures in proximal gastrectomy.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"205-210"},"PeriodicalIF":2.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930576","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}

{"title":"Robotic esophagectomy with function-preserving radical mediastinal lymphadenectomy for esophageal cancer","authors":"Raja Kalayarasan,&nbsp;Pothugunta Sai Krishna","doi":"10.1002/ags3.12862","DOIUrl":"10.1002/ags3.12862","url":null,"abstract":"<p>Radical lymphadenectomy is the critical component of surgery for esophageal cancer. However, lymphadenectomy significantly contributes to postoperative morbidity, particularly in terms of pulmonary complications following esophagectomy. Function-preserving mediastinal lymphadenectomy seeks to balance the procedure's necessary radicality and optimal functional outcomes. This approach emphasizes the preservation of the thoracic duct, tracheobronchial vascularity, and the pulmonary and recurrent laryngeal branches of the vagus nerve. Preservation of the thoracic duct is facilitated by indocyanine green fluorescence. Compared to the conventional technique of thoracic duct identification using anatomical landmarks, indocyanine green fluorescence lymphangiography offers real-time feedback, making it particularly advantageous in cases with complex anatomy or when the thoracic duct is challenging to visualize using conventional methods. Preservation of pulmonary branches of the right vagus during subcarinal lymphadenectomy and left recurrent laryngeal nerve during left paratracheal node dissection are technically challenging. The description of two types of left recurrent laryngeal nerve node dissection and technical tips for nerve function preservation are outlined in this review. Intraoperative neuromonitoring is a useful adjunct for nerve-sparing mediastinal lymphadenectomy. As ischemia to the respiratory tract impairs respiratory protective mechanisms, preservation of the tracheobronchial blood supply is critical. Preoperative imaging to detect bronchial artery anatomical variations and intraoperative assessment of perfusion using laser doppler flowmetry and indocyanine green fluorescence angiography are useful strategies to minimize tracheobronchial ischemia. Function-preserving mediastinal lymphadenectomy has the potential to improve short- and long-term outcomes after esophagectomy for esophageal cancer.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"12-23"},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930545","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}

{"title":"Laparoscopic median arcuate ligament release using an anterior approach for median arcuate ligament syndrome","authors":"Koji Kubota,&nbsp;Akira Shimizu,&nbsp;Tsuyoshi Notake,&nbsp;Satoshi Nakamura,&nbsp;Yuji Soejima","doi":"10.1002/ags3.12858","DOIUrl":"10.1002/ags3.12858","url":null,"abstract":"<p>Median arcuate ligament syndrome (MALS) is a rare condition characterized by nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Furthermore, the development and rupture of pancreaticoduodenal artery aneurysms pose a potentially fatal risk. Median arcuate ligament release (MALR) is useful in the treatment of MALS, with most procedures performed laparoscopically. However, detailed descriptions of laparoscopic MALR (lap-MALR) procedures are rare. In this study, we performed lap-MALR via an anterior approach with dissection of the right lateral wall of the celiac artery (CA). For optimal visualization of the right side of the CA, the right branch of the inferior phrenic artery was divided. We believe that this procedure allows the MAL to be released within a sufficient surgical field and without excess or deficiency. Here, we present the details of six patients who underwent lap-MALR for varying indications; three for pancreaticoduodenal artery aneurysms due to CA obstruction (unruptured, <i>n</i> = 1; ruptured, <i>n</i> = 2), two cases prior to hepato-biliary-pancreatic surgery, and one symptomatic case. In all cases, lap-MALR was performed as described above, and the CA stenosis was successfully released. Our case series demonstrates the safety and reliability of our lap-MALR procedure in the treatment of MALS-related disorders, including pancreaticoduodenal artery aneurysms associated with CA compression.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1137-1143"},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580797","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}

{"title":"Robotic right-sided colon cancer surgery: Dissecting the outermost layer of the autonomic nerve along the superior mesenteric artery","authors":"Dai Shida,&nbsp;Yuka Ahiko,&nbsp;Naoki Sakuyama,&nbsp;Satoko Monma,&nbsp;Shigehiro Kojima","doi":"10.1002/ags3.12861","DOIUrl":"10.1002/ags3.12861","url":null,"abstract":"<p>In right-sided colon cancer surgery, lymph node dissection around the superior mesenteric artery is necessary but technically challenging. Here we introduce the concept of “outermost layer-oriented robotic surgery” to improve the safety, efficacy, and reproducibility of superior mesenteric artery nodal dissection. In this procedure, the thin, loose connective tissue layer between the autonomic nerve sheath of the superior mesenteric artery and adipose tissue bearing lymph nodes, termed “the outermost layer of the autonomic nerve,” is dissected. The procedure exposes the outermost layer of the nerve plexus covering the surface of the superior mesenteric artery with a width of approximately 1 cm, enabling direct visualization of the anatomy of the main arteries and, if they exist, jejunal veins which cross the superior mesenteric artery ventrally. This allows for sufficient dissection of main lymph nodes at the roots of the ileocolic artery, right colic artery, and middle colic artery and minimizes the risk of unforeseen bleeding. Thirty-nine patients underwent robotic right hemicolectomy with this procedure. No intraoperative complications were observed. The median number of dissected lymph nodes was 50, including 16 main lymph nodes. The median operative time was 284 min, blood loss was 50 mL, and the median postoperative hospital stay was 8 days. Postoperative complications included two cases of Clavien–Dindo classification grade II, with no cases of grade III or higher. Chylous leakage as well as intractable diarrhea were not observed in any case. These findings demonstrate that the procedure can achieve safe and reliable lymph node clearance.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"199-204"},"PeriodicalIF":2.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930547","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}

{"title":"Digestive tract reconstruction after laparoscopic proximal gastrectomy: Double tract reconstruction or double flap technique?","authors":"Lindi Cai,&nbsp;Guanglin Qiu,&nbsp;Mengke Zhu,&nbsp;Shangning Han,&nbsp;Pengwei Zhao,&nbsp;Panxing Wang,&nbsp;Xiaowen Li,&nbsp;Xinhua Liao,&nbsp;Xiangming Che,&nbsp;Lin Fan","doi":"10.1002/ags3.12857","DOIUrl":"10.1002/ags3.12857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The reconstruction methods after proximal gastrectomy (PG) are varied but not standardized. This study was performed to evaluate the short-term clinical outcomes between double tract reconstruction (DTR) and double flap technique (DFT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed and collected data of patients who underwent DTR and DFT after laparoscopic proximal gastrectomy (LPG), respectively, between January 2020 and March 2023. Propensity score matching (PSM) was used to balance the baseline data of the two groups, then we compared their short-term clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 72 patients (48 and 24 patients in the DTR and DFT groups, respectively) were included. The anastomosis time was significantly longer in the DFT group than that in the DTR group (70.1 vs. 52.7 min, <i>p</i> &lt; 0.001). DFT was associated with shorter times of gas-passing, start of diet, and postoperative length of hospital stay (<i>p</i> &lt; 0.001). There were no significant differences between the two groups in terms of early and late postoperative complications (<i>p</i> = 0.710, <i>p</i> = 1.000, respectively). DFT was superior to DTR in maintaining body weight (<i>p</i> &lt; 0.001), total protein (<i>p</i> = 0.011) and albumin levels (<i>p</i> = 0.018). As for QOL, DTR showed better results in the meal-related distress subscale (<i>p</i> &lt; 0.001). However, DFT was superior to DTR in terms of reducing diarrhea, constipation, and dumping related symptoms (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Double flap technique emerged as a superior alternative to DTR in terms of facilitating early postoperative recovery, sustaining nutritional status, and improving QOL. DFT could potentially be the preferred reconstruction method following laparoscopic proximal gastrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"98-108"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930505","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}

{"title":"Intraluminal washout in rectal and sigmoid colon cancer surgeries with double-stapling technique anastomosis: A single-institution prospective study","authors":"Shinji Furuya,&nbsp;Kensuke Shiraishi,&nbsp;Hiroki Shimizu,&nbsp;Koichi Takiguchi,&nbsp;Makoto Sudo,&nbsp;Akaike Hidenori,&nbsp;Yoshihiko Kawaguchi,&nbsp;Hidetake Amemiya,&nbsp;Tetsuo Kondo,&nbsp;Daisuke Ichikawa","doi":"10.1002/ags3.12851","DOIUrl":"10.1002/ags3.12851","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to determine the necessity of intraluminal washout through cytological assessment to prevent implantation of exfoliated cancer cells (ECCs) in patients with rectal and sigmoid cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 140 patients with either sigmoid or rectal cancer who underwent anastomosis surgery using a double-stapling technique. An intraluminal washout sample was collected before and after irrigation with 1000, 1500, or 2000 mL of physiological saline or distilled water. Cytological assessments were conducted using the Papanicolaou classification system, where classes IV and V indicated positive cytological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Initially, 46.4% of the patients (65 out of 140) had positive ECCs. Patients with cancer cells had a significantly shorter distal free margin (DM) from the tumor (<i>p</i> &lt; 0.001). The length of the DM was significantly associated with the tumor distance from the anal verge (<i>p</i> &lt; 0.001). After irrigation with 2000 mL, ECCs were found in only 7.3% of patients. Logistic regression analysis showed that DM (≤50 mm) and tumor size (≥50 mm) were independent risk factors for positive ECCs after intraluminal washout, regardless of the type of irrigation solution used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with sigmoid colon cancer, adequate preoperative bowel preparation, a long DM, and a small tumor size, a 1000 mL intraluminal washout may be sufficient. By contrast, in patients with rectal cancer with a short DM and a large tumor size, a ≥2000 mL intraluminal washout is required. The different types of irrigation solution did not affect the ECCs. Large randomized controlled trials are required to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"137-144"},"PeriodicalIF":2.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930494","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}