Annals of Gastroenterological Surgery最新文献

{"title":"Recent trends in organ-preserving pancreatectomy: Its problems and clinical advantages compared with other standard pancreatectomies","authors":"Hiroyuki Kato,&nbsp;Yukio Asano,&nbsp;Masahiro Ito,&nbsp;Satoshi Arakawa,&nbsp;Akihiko Horiguchi","doi":"10.1002/ags3.12746","DOIUrl":"10.1002/ags3.12746","url":null,"abstract":"<p>In this review article, we focus on recent papers on organ-preserving pancreatectomy procedures published since 2010. When comparing central pancreatectomy (CP) and distal pancreatectomy (DP), most studies have concluded that the CP group exhibited significantly lower incidence of new-onset diabetes or diabetes exacerbation than the DP group postoperatively. However, because of increased incidence of morbidities such as pancreatic fistula, the surgeon faces a considerable trade-off between increased short-term morbidity and long-term preservation of endocrine function. When the outcomes of two types of spleen-preserving DP (Kimura and Warshaw procedures) are compared, most studies mentioned the low incidence of postoperative gastric varices and splenic infarction with the Kimura procedure. Although there are several reports regarding the effect of spleen preservation on prevention of postoperative infections, no report on the contribution of spleen preservation to the prevention of overwhelming post-splenectomy infection is seen. The advantages of duodenum-preserving pancreatic head resection (DPPHR) concerning endocrine and exocrine functions continue to be subjects of discussion, mainly due to the limited number of institutions that have adopted this approach; however, DPPHR should be presented as an option for patients due to its low incidence of postoperative cholangitis. Organ-preserving pancreatectomy requires meticulous surgical techniques, and postoperative complications may increase with this surgery compared with standard pancreatectomy, which may be influenced by the surgeon's skill and the surgical facility where the procedure is performed. Nonetheless, this technique has significant long-term advantages in terms of endocrine and exocrine functions and its wider adoption in the future is expected.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 1","pages":"8-20"},"PeriodicalIF":2.7,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135251321","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":"COVID-19 vaccine in liver transplant recipients","authors":"Hinpetch Daungsupawong,&nbsp;Viroj Wiwanitkit","doi":"10.1002/ags3.12747","DOIUrl":"10.1002/ags3.12747","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We would like to share ideas on the publication “Antibody titer after administration of mRNA-based vaccine against severe acute respiratory syndrome coronavirus 2 in liver transplant recipients.”&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The researchers wanted to look at antibody levels in liver transplant recipients who had received vaccinations against spike and nucleocapsid proteins. There were 125 liver transplant recipients and 20 healthy volunteers in the study. After the second, third, and fourth vaccine doses, antibody levels were tested. According to the findings, 89.1% of liver transplant recipients had a favorable humoral response after the second dose, which increased to 100% after the third dose. However, anti-spike antibody levels were significantly lower after 3 and 6 months compared to 1 month after the second treatment. Anti-spike antibodies were considerably increased in both liver transplant recipients and healthy controls after receiving a booster immunization. Antibody degradation rates were comparable between transplant recipients and controls. Only 4.0% of transplant patients were immunized.&lt;/p&gt;&lt;p&gt;While the study sheds light on the humoral response to vaccination in liver transplant recipients, it is vital to assess the technique and consider potential limitations. The study is restricted to a specific cohort of liver transplant patients and does not include an unvaccinated transplant recipient control group. This makes determining the baseline humoral response and comparing it to the reaction after vaccination difficult. Furthermore, while the study focuses on antibody levels as a marker of immunological response, it does not examine other components of immune protection, such as cellular immune responses or the presence of memory B and T cells. These elements are critical in determining the overall efficacy of vaccination. Furthermore, the trial provides no data on clinical outcomes or the efficacy of vaccination in reducing COVID-19 infection or severe disease in liver transplant recipients. In this susceptible population, it is critical to assess the influence of vaccination on reducing the risk of infection and its associated sequelae.&lt;/p&gt;&lt;p&gt;These factors might alter how COVID-19 infection and vaccination behave, altering the vaccine's previously established scientific efficacy. It's possible that previous asymptomatic COVID-19 infections influenced the results. Genetic make-up may also have an impact on the response.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Evaluation of the vaccine's long-term effectiveness in preventing COVID-19 in people may be difficult due to the lack of a clear follow-up time in the experiment. Comorbidities, socioeconomic position, and accessibility to healthcare are examples of potential confounding variables that may have affected the findings but were not explored in this study.&lt;/p&gt;&lt;p&gt;None.&lt;/p&gt;&lt;p&gt;Approval of the research protocol: N/A.&lt;/p&gt;&lt;p&gt;Informed Consent: N/A.&lt;/p&gt;&lt;p&gt;Registry and the Registration No","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"365-366"},"PeriodicalIF":2.7,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135254750","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":"Novel choledochojejunostomy technique “T-shaped anastomosis” for preventing the development of postoperative cholangitis in pancreatoduodenectomy: A propensity score matching analysis","authors":"Nana Kimura,&nbsp;Takamichi Igarashi,&nbsp;Kenta Murotani,&nbsp;Ayaka Itoh,&nbsp;Toru Watanabe,&nbsp;Katsuhisa Hirano,&nbsp;Haruyoshi Tanaka,&nbsp;Kazuto Shibuya,&nbsp;Isaku Yoshioka,&nbsp;Tsutomu Fujii","doi":"10.1002/ags3.12744","DOIUrl":"10.1002/ags3.12744","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There have been few studies of countermeasures against postoperative cholangitis, a serious complication after pancreaticoduodenectomy (PD) that impairs quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate our recently developed, novel method of choledochojejunostomy with a larger anastomotic diameter, the “T-shaped anastomosis.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 261 cases of PD. The T-shaped choledochojejunostomy technique was performed with an additional incision for a distance greater than half the diameter of the bile duct at the anterior wall of the bile duct and the anterior wall of the elevated jejunum. To compensate for potential confounding biases between the standard anastomosis group (<i>n</i> = 206) and the T-shaped anastomosis group (<i>n</i> = 55), we performed propensity score matching (PSM). The primary endpoint was the incidence of medium-term postoperative cholangitis adjusted for PSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the PSM analysis, 54 patients in each group were matched, and the median bile duct diameter measured by preoperative CT was 8.8 mm versus 9.3 mm, the rate of preoperative biliary drainage was 31% versus 37%, the incidence of cholangitis within 1 month before surgery was 9% versus 13%, and the incidence of postoperative bile leakage was 2% versus 2%, with no significant differences. The incidence of medium-term postoperative cholangitis was 15% versus 4%, and multivariate logistic regression revealed that T-shaped choledochojejunostomy was an independent predictor of a reduced incidence of cholangitis (odds ratio, 0.17, 95% CI 0.02–0.81; <i>p</i> = 0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The T-shaped choledochojejunostomy technique was shown to be effective with a significant reduction in the incidence of medium-term postoperative cholangitis. Clinical trial identification: UMIN000050990.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"301-311"},"PeriodicalIF":2.7,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135425003","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":"Albumin-indocyanine green evaluation of future liver remnant predicts liver failure after anatomical hepatectomy for hepatocellular carcinoma: A dual-center retrospective study","authors":"Tomoyuki Nagaoka,&nbsp;Kohei Ogawa,&nbsp;Katsunori Sakamoto,&nbsp;Taro Nakamura,&nbsp;Yoshinori Imai,&nbsp;Yusuke Nishi,&nbsp;Masahiko Honjo,&nbsp;Kei Tamura,&nbsp;Naotake Funamizu,&nbsp;Yasutsugu Takada","doi":"10.1002/ags3.12743","DOIUrl":"10.1002/ags3.12743","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The albumin-indocyanine green evaluation (ALICE) score is a useful predictor of post-hepatectomy liver failure (PHLF); however, its usefulness in combination with future liver remnant (FLR), measured by 3-D volumetry, has not been investigated. This study aimed to investigate the relationship between the ALICE of the FLR (ALICE-FLR) score and severe PHLF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The clinical data of 215 patients who underwent anatomical hepatectomy for hepatocellular carcinoma without portal vein embolization at two institutes between January 2010 and December 2021 were analyzed retrospectively. PHLF occurrence and severity were determined according to the International Study Group of Liver Surgery's definition. Grades B and C PHLF were defined as severe PHLF. The ALICE-FLR, ALICE scores, and indocyanine green clearance of FLR (ICGK-FLR) were evaluated for severe PHLF prediction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe PHLF was observed in 40 patients (18.6%). The areas under the curve (AUCs) for the ALICE-FLR, ALICE scores, ICGK-FLR, and FLR were 0.76, 0.64, 0.73, and 0.69, respectively. The AUC of the ALICE-FLR score was significantly higher than that of the ALICE score. The ALICE-FLR score was identified as an independent predictor of severe PHLF (the odds ratio for every 0.01 increment in the ALICE-FLR score was 1.24; 95% confidence interval, 1.070–1.453; <i>p</i> = 0.004). Among patients with severe PHLF, the ALICE-FLR score was significantly higher in the grade C than in the grade B PHLF group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of liver function models, including indocyanine green, albumin, and FLR is considered compatible for predicting severe PHLF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"293-300"},"PeriodicalIF":2.7,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136060276","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":"Prediction model of the risk for lateral local recurrence in locally advanced rectal cancer without enlarged lateral lymph nodes: Lessons from a Japanese multicenter pooled analysis of 812 patients","authors":"Atsushi Ogura,&nbsp;Akio Shiomi,&nbsp;Seiichiro Yamamoto,&nbsp;Koji Komori,&nbsp;Hiroki Hamamoto,&nbsp;Shoichi Manabe,&nbsp;Hiroshi Miyakita,&nbsp;Junji Okuda,&nbsp;Hiroshi Yatsuya,&nbsp;Kay Uehara","doi":"10.1002/ags3.12742","DOIUrl":"10.1002/ags3.12742","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although the oncological impact of lateral lymph node dissection on enlarged lateral lymph nodes has been gradually accepted over the last decade, that on lateral lymph nodes without swelling remains doubtful. This study aimed to develop a prediction model for the future risk of lateral local recurrence and to clarify the value of adding lateral lymph node dissection in locally advanced rectal cancer without enlarged lateral lymph nodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, multi-institutional study recruited 812 patients with cStage II/III low rectal cancer without enlarged lateral lymph nodes &lt;7 mm. Total lateral local recurrence was a hypothetical value of future risk of lateral local recurrence when lateral lymph node dissection was never performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, total lateral local recurrences were observed in 67 patients (8.3%). In the multivariate analyses, the strongest risk factor for total local recurrences was no preoperative chemoradiotherapy (odds ratio [OR][95%Cl]: 33.2 [4.56–241.7], <i>P &lt;</i> 0.001), followed by tumor distance ≤40 mm (OR [95%Cl]: 2.71 [1.51–4.86], <i>P &lt;</i> 0.001) and lateral lymph node 5–7 mm (OR[95%Cl]: 2.38 [1.26–4.48], <i>P =</i> 0.007). In patients with lateral lymph nodes of 5–7 mm, the total lateral recurrence rate was 4.8% after preoperative chemoradiotherapy. Lateral lymph node dissection could reduce from a total lateral local recurrence of 21.6% to an actual lateral local recurrence of 8.0% in patients without preoperative treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We introduce a novel prediction model of future risk of lateral local recurrences, which has the potential to enable us to indicate lateral lymph node dissection selectively according to the patients' risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"284-292"},"PeriodicalIF":2.7,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135059437","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":"Assessing Intra-abdominal status for clinically relevant postoperative pancreatic fistula based on postoperative fluid collection and drain amylase levels after distal pancreatectomy","authors":"Yosuke Mukai,&nbsp;Kei Asukai,&nbsp;Hirofumi Akita,&nbsp;Masahiko Kubo,&nbsp;Shinichiro Hasegawa,&nbsp;Hiroshi Wada,&nbsp;Hiroshi Miyata,&nbsp;Masayuki Ohue,&nbsp;Masato Sakon,&nbsp;Hidenori Takahashi","doi":"10.1002/ags3.12741","DOIUrl":"10.1002/ags3.12741","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the intra-abdominal status related to postoperative pancreatic fistula by combining postoperative fluid collection and drain amylase levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed the data of 203 patients who underwent distal pancreatectomy and classified their postoperative abdominal status into four groups based on postoperative fluid collection size and drain amylase levels. We also evaluated the incidence of clinically relevant postoperative pancreatic fistula in each group according to C-reactive protein values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of clinically relevant postoperative pancreatic fistula in the entire cohort (<i>n</i> = 203) was 28.1%. Multivariate analysis revealed that postoperative fluid collection, drain amylase levels, and C-reactive protein levels are considerable risk factors for clinically relevant postoperative pancreatic fistula. In the subgroup with large postoperative fluid collection and high drain amylase levels, 65.9% of patients developed clinically relevant postoperative pancreatic fistula. However, no significant difference was observed in C-reactive protein levels between patients with clinically relevant postoperative pancreatic fistula and those without it. In contrast, in the subgroup with a large postoperative fluid collection size or a high amylase level alone, a significant difference was observed in C-reactive protein values between the patients with clinically relevant postoperative pancreatic fistula and those without it.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Postoperative fluid collection status and the C-reactive protein value provide a more precise assessment of intra=abdominal status related to postoperative pancreatic fistula after distal pancreatectomy. This detailed analysis may be a clinically reasonable approach to individual drain management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"321-331"},"PeriodicalIF":2.7,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135155351","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":"Impact of resection for ovarian metastases from colorectal cancer and clinicopathologic analysis: A multicenter retrospective study in Japan","authors":"Hiroyasu Kagawa,&nbsp;Yusuke Kinugasa,&nbsp;Tomohiro Yamaguchi,&nbsp;Masayuki Ohue,&nbsp;Kazushige Kawai,&nbsp;Junichiro Hiro,&nbsp;Seiichi Shinji,&nbsp;Hiroaki Nozawa,&nbsp;Yasumitsu Hirano,&nbsp;Koji Komori,&nbsp;Yasumasa Takii,&nbsp;Takeshi Suto,&nbsp;Shunsuke Tsukamoto,&nbsp;Yoshito Akagi,&nbsp;Heita Ozawa,&nbsp;Yuji Toiyama,&nbsp;Kazuhito Minami,&nbsp;Tomoharu Shimizu,&nbsp;Kay Uehara,&nbsp;Kazuhiro Sakamoto,&nbsp;Keita Mori,&nbsp;Kenichi Sugihara,&nbsp;Yoichi Ajioka","doi":"10.1002/ags3.12740","DOIUrl":"10.1002/ags3.12740","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to clarify the significance of resection of ovarian metastases from colorectal cancer and to identify the clinicopathologic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter retrospective study, we evaluated data on ovarian metastases from colorectal cancer obtained from patients at 20 centers in Japan between 2000 and 2014. We examined the impact of resection on the prognosis of patients with ovarian metastases and examined prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 296 patients with ovarian metastasis. The 3-y overall survival rate was 68.6% for solitary ovarian metastases. In all cases of this cohort, the 3-y overall survival rates after curative resection, noncurative resection, and nonresection were 65.9%, 31.8%, and 6.1%, respectively (curative resection vs noncurative resection [<i>P &lt;</i> 0.01] and noncurative resection vs nonresection [<i>P &lt;</i> 0.01]). In the multivariate analysis of prognostic factors, tumor size of ovarian metastasis (<i>P &lt;</i> 0.01), bilateral ovarian metastasis (<i>P =</i> 0.01), peritoneal metastasis (<i>P &lt;</i> 0.01), pulmonary metastasis (<i>P =</i> 0.04), liver metastasis (<i>P &lt;</i> 0.01), and remnant of ovarian metastasis (<i>P &lt;</i> 0.01) were statistically significantly different.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prognosis after curative resection for solitary ovarian metastases was shown to be relatively favorable as Stage IV colorectal cancer. Resection of ovarian metastases, not only curative resection but also noncurative resection, confers a survival benefit. Prognostic factors were large ovarian metastases, bilateral ovarian metastases, the presence of extraovarian metastases, and remnant ovarian metastases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"273-283"},"PeriodicalIF":2.7,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134970854","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":"Clinical impact of very early recurrence after conversion surgery for stage IV gastric cancer","authors":"Atsushi Morito,&nbsp;Kojiro Eto,&nbsp;Masaaki Iwatsuki,&nbsp;Tasuku Toihata,&nbsp;Keisuke Kosumi,&nbsp;Shiro Iwagami,&nbsp;Yoshifumi Baba,&nbsp;Yuji Miyamoto,&nbsp;Naoya Yoshida,&nbsp;Hideo Baba","doi":"10.1002/ags3.12738","DOIUrl":"10.1002/ags3.12738","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The development and improved response to chemotherapy has resulted in a survival benefit of conversion surgery (CS) for advanced gastric cancer (GC). However, this benefit is limited in some cases, such as in those with very early recurrence (VER). This study investigated the relationship between outcome and clinicopathological characteristics after CS for stage IV GC, and the risk factors for VER after CS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 184 patients with stage IV GC who initially underwent chemotherapy, including 36 patients who underwent CS between May 2007 and January 2022. We evaluated the long-term outcome after CS for stage IV GC and the clinicopathological characteristics of the patients who underwent CS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median survival times (MSTs) in the chemotherapy alone and CS groups were 13.4 and 36.5 months, respectively (<i>p</i> &lt; 0.0001). Of the 27 patients who underwent R0 resection, 22 remained free of early recurrence and five experienced VER. MSTs in the VER and free of early recurrence groups were 15.2 and 44.1 months, respectively (<i>p</i> &lt; 0.0001). Significantly more patients had liver metastasis before initial treatment in the VER group than in the FER group (<i>p</i> = 0.016). There were more patients with preoperative PNI &lt;40 in the VER group (<i>p</i> = 0.046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CS is an effective treatment for stage IV GC, but VER is associated with poor prognosis. We need to carefully consider the indications for CS, especially for patients with poor nutritional status and liver metastases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"214-220"},"PeriodicalIF":2.7,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971010","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":"Randomized controlled trial of olanexidine gluconate and povidone iodine for surgical site infection after gastrointestinal surgery","authors":"Hiroya Iida,&nbsp;Hiromitsu Maehira,&nbsp;Sachiko Kaida,&nbsp;Katsushi Takebayashi,&nbsp;Toru Miyake,&nbsp;Masaji Tani","doi":"10.1002/ags3.12739","DOIUrl":"10.1002/ags3.12739","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Antiseptics used at surgical sites are vital to preventing surgical site infections (SSI). In this study, a comparative investigation of the novel antiseptics olanexidine gluconate (OG) and povidone-iodine (PI) was conducted to determine whether OG is more effective than PI against SSI after gastrointestinal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, randomized, single-blind, interventional, single-center study was conducted between August 2018 and February 2021. Patients scheduled for large-scale gastrointestinal surgeries were randomized into two groups and administered OG (OG group) or PI (PI group) as preoperative antiseptics. The primary endpoint was the SSI occurrence rate within 30 days after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 525 patients were enrolled in this study, of whom 256 and 254 were in the OG and PI groups, respectively. The total SSI occurrence rate in the OG group (10.8%; <i>n</i> = 26) and the PI group (13.0%; <i>n</i> = 33) was not significantly different (<i>p</i> = 0.335). The occurrence rate of superficial incisional SSI and organ/space SSI did not significantly differ between the groups; however, that of deep incisional SSI showed a significant difference, with 0.4% (<i>n</i> = 1) in the OG group and 4.3% (<i>n</i> = 11) in the PI group (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OG, as a preoperative skin antiseptic, did not reduce the occurrence rate of total SSI. However, deep incisional SSI may be reduced using OG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"332-341"},"PeriodicalIF":2.7,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12739","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136192489","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":"Essential updates 2021/2022: Update in surgical strategy for perihilar cholangiocarcinoma","authors":"Fumihiro Kawano,&nbsp;Ryuji Yoshioka,&nbsp;Hirofumi Ichida,&nbsp;Yoshihiro Mise,&nbsp;Akio Saiura","doi":"10.1002/ags3.12734","DOIUrl":"10.1002/ags3.12734","url":null,"abstract":"<p>Resection is the only potential curative treatment for perihilar cholangiocarcinoma (PHC); however, complete resection is often technically challenging due to the anatomical location. Various innovative approaches and procedures were invented to circumvent this limitation but the rates of postoperative morbidity (20%–78%) and mortality (2%–15%) are still high. In patients diagnosed with resectable PHC, deliberate and coordinated preoperative workup and optimization of the patient and future liver remnant are crucial. Biliary drainage is recommended to relieve obstructive jaundice and optimize the clinical condition before liver resection. Biliary drainage for PHC can be performed either by endoscopic biliary drainage or percutaneous transhepatic biliary drainage. To date there is no consensus about which method is preferred. The volumetric assessment of the future remnant liver volume and optimization mainly using portal vein embolization is the gold standard in the management of the risk to develop post hepatectomy liver failure. The improvement of systemic chemotherapy has contributed to prolong the survival not only in patients with unresectable PHC but also in patients undergoing curative surgery. In this article, we review the literature and discuss the current surgical treatment of PHC.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"7 6","pages":"848-855"},"PeriodicalIF":2.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71477270","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}