Annals of Gastroenterological Surgery最新文献

{"title":"Impact of SARS-CoV-2 infection on short-term postoperative outcomes after gastroenterological cancer surgery using data from a nationwide database in Japan","authors":"Masashi Takeuchi,&nbsp;Taizo Hibi,&nbsp;Ryo Seishima,&nbsp;Yusuke Takemura,&nbsp;Hiromichi Maeda,&nbsp;Genta Toshima,&nbsp;Noriyuki Ishida,&nbsp;Naoki Miyazaki,&nbsp;Akinobu Taketomi,&nbsp;Yoshihiro Kakeji,&nbsp;Yasuyuki Seto,&nbsp;Hideki Ueno,&nbsp;Masaki Mori,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12812","DOIUrl":"10.1002/ags3.12812","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Due to the coronavirus disease 2019 (COVID-19) pandemic, cancer screening, diagnosis, and treatment have changed. This study aimed to investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prior to gastroenterological cancer surgeries on postoperative complications using data from a nationwide database in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on patients who underwent surgery for cancer including esophageal, gastric, colon, rectal, liver, and pancreatic cancer between July 1, 2019, and September 300, 2022, from real-world sources in Japan were analyzed. The association between preoperative SARS-CoV-2 infection and short-term postoperative outcomes was evaluated. A similar analysis stratified according to the interval from SARS-CoV-2 infection to surgery (&lt;4 vs. &gt;4 weeks) was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 60 604 patients were analyzed, and 227 (0.4%) patients were diagnosed with SARS-CoV-2 infection preoperatively. The median interval from SARS-CoV-2 infection to surgery was 25 days. Patients diagnosed with SARS-CoV-2 infection preoperatively had a significantly higher incidence of pneumonia (odds ratio: 2.05; 95% confidence interval: 1.05–3.74; <i>p</i> = 0.036) than those not diagnosed with SARS-CoV-2 infection based on the exact logistic regression analysis adjusted for the characteristics of the patients. A similar finding was observed in patients who had SARS-CoV-2 infection &lt;4 weeks before surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with a history of SARS-CoV-2 infection had a significantly higher incidence of pneumonia. This finding can be particularly valuable for countries that have implemented strict regulations in response to the COVID-19 pandemic and have lower SARS-CoV-2 infection-related mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"942-951"},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141054193","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":"Long-term quality of life after open and laparoscopic total gastrectomy for stage I gastric cancer: A prospective multi-institutional study (CCOG1504)","authors":"Chie Tanaka,&nbsp;Mitsuro Kanda,&nbsp;Kazunari Misawa,&nbsp;Yoshinari Mochizuki,&nbsp;Masashi Hattori,&nbsp;Satoshi Sueoka,&nbsp;Takuya Watanabe,&nbsp;Takanobu Yamada,&nbsp;Kenta Murotani,&nbsp;Yasuhiro Kodera","doi":"10.1002/ags3.12808","DOIUrl":"10.1002/ags3.12808","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Little information is available from prospective clinical trials on the influences of surgical approaches on postoperative quality of life (QOL). We aimed to prospectively compare chronological changes in postoperative body weight and QOL between laparoscopic and open total gastrectomy for stage I gastric cancer (GC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multi-institutional prospective study (CCOG1504) of patients who undergo laparoscopic or open total gastrectomy. Body weight was measured at the baseline and at the 1st, 2nd, and 3rd postoperative years (POY). QOL using the European Organization for Research and Treatment of Cancer quality of life questionnaire-C30 <b>(</b>EORTC QLQ-C30) and the Post-Gastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires were measured at the baseline and at the 1st, 3rd, 6th, 12th, and 36th postoperative months (POM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 84 patients from 15 institutions, and finally 43 patients for the laparoscopic group and 16 for the open group were eligible for data analysis. There were no significant differences in body weight change between the two groups. The role functioning score among the EORTC QLQ-C30 tended to be higher (i.e., better QOL) in the laparoscopic group at POM 1 and 12 after surgery compared to the open group. The dissatisfaction at working score among the PGSAS-37 at 1 month after surgery was lower (i.e. better QOL) in the laparoscopic group compared to the open group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of CCOG1504 indicated that laparoscopic approach for total gastrectomy was associated with a more favorable dissatisfaction at working score (PGSAS-37).</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"999-1007"},"PeriodicalIF":2.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581067","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":"New trends in surgery for colorectal liver metastasis","authors":"Philipp Kron,&nbsp;Peter Lodge","doi":"10.1002/ags3.12810","DOIUrl":"10.1002/ags3.12810","url":null,"abstract":"<p>By presenting the most up-to-date findings and incorporating the latest evidence, this article seeks to present a comprehensive guide for navigating the complexities inherent in the management of colorectal liver metastasis. It aims to serve as a valuable resource offering clinicians and healthcare professionals an understanding of the diverse modalities and approaches available for treating this challenging and multifaceted disease. In an era of rapidly evolving medical knowledge, this article examines the latest insights to make informed decisions in the realm of colorectal liver metastasis management. The article does not only highlight the up-to-date knowledge but also provides the evidence for existing therapeutic strategies. This practical tool provides evidence-based recommendations to clinicians, thereby contributing to the ongoing advancement of effective treatment strategies for this challenging disease.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 4","pages":"553-565"},"PeriodicalIF":2.9,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490585","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":"A comprehensive summary of the impact of the COVID era on various gastrointestinal cancers","authors":"Koshi Mimori","doi":"10.1002/ags3.12811","DOIUrl":"10.1002/ags3.12811","url":null,"abstract":"&lt;p&gt;The COVID era has ended as the pandemic subsided. It is anticipated that cancer care was hindered during the COVID era, which we expect had various negative effects. But what was the situation in actual clinical practice? Various reports have been published. In this issue, two reports have been made on the relationship between the treatment of gastrointestinal diseases and the pandemic. One is the impact of COVID-19 infection on colorectal perforation by Ogawa et al. They reported that among 13 107 cases of colorectal perforation, the 30-day postoperative mortality was 1371 cases (10.5%), and there was no difference compared to the pre-COVID era (DOI: 10.1002/ags3.12758). Furthermore, Akagi et al. clarified that the standard mortality rates for laparoscopic distal gastrectomy (LDG) for gastric cancer and laparoscopic low anterior resection (LLAR) for rectal cancer did not differ from the pre-COVID era, indicating that laparoscopic surgery was safely performed in Japan (DOI: 10.1002/ags3.12776). This editorial summarizes the impacts of the COVID era and pandemic on various gastrointestinal cancers by type of cancer.&lt;/p&gt;&lt;p&gt;Colorectal Cancer: 48 900 CRC patients were extracted from the Dutch cancer registry. Compared to the same period before COVID, CRC patients decreased by up to 36%. In particular, during the first peak (weeks 12–20 of 2020), Stage I decreased by 4%, while Stage IV increased by 7%.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In Japan, it has also been reported that the number of CRC screening participants has not returned to the pre-pandemic levels, with decreases of −13.4% (2020) and −7.3% (2021).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Gastric Cancer: A single institution in Korea compared a pre-pandemic surgical group (99 cases) with a during-pandemic group (118 cases) and found that while short-term outcomes and long-term complications were equivalent, perioperative outcomes were poorer during the pandemic.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Takeuchi and colleagues observed a decrease in 568 cases of gastrectomy. However, they reported that mortality and perioperative outcomes during the pandemic did not worsen compared to before the pandemic.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Esophageal Cancer: In the UK, diagnoses, management, and outcomes of esophageal cancer were investigated before and after the COVID-19 lockdown. Overall survival was 9.9 months before the lockdown and 6.9 months after, significantly worse post-lockdown.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; It is speculated that this was due to delayed examinations during the lockdown, leading to esophageal cancer being detected at more advanced stages. However, reports from Japan indicated similar (not inferior) outcomes to pre-COVID times, despite limited medical resources.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Liver Cancer: Munoz-Martinez and colleagues reported a 2.2% decrease in mortality rates for HCV (and HBV)-related HCC, while mortality rates for NAFLD (alcohol-related liver disease)-related hepatocellular carcinoma in","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"372-373"},"PeriodicalIF":2.7,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12811","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658869","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":"Significance of blood culture testing after pancreatoduodenectomy","authors":"Tsukasa Aritake,&nbsp;Seiji Natsume,&nbsp;Tomonari Asano,&nbsp;Masataka Okuno,&nbsp;Naoya Itoh,&nbsp;Keitaro Matsuo,&nbsp;Seiji Ito,&nbsp;Koji Komori,&nbsp;Tetsuya Abe,&nbsp;Yasuhiro Shimizu","doi":"10.1002/ags3.12801","DOIUrl":"10.1002/ags3.12801","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 blood culture testing in the postoperative period of pancreatoduodectomy (PD), a highly invasive surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Rates of blood culture sampling and positivity were investigated for febrile episodes (FEs) in patients who underwent PD (2016–2021). FEs were defined as body temperature of 38.0°C or higher occurring on or after the 4th postoperative day. Fever origin was diagnosed retrospectively, and FEs were classified as pancreatic fistula (PF)-related or PF-unrelated FEs. Factors correlated with blood culture positivity were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 339 patients who underwent PD, 99 experienced 202 FEs. Blood culture testing was performed on 160 FEs occurring in 89 patients. The sampling and positivity rates were 79.2% and 17.5%, respectively, per episode and 89.9% and 28.1%, respectively, per patient. Thirty-six FEs were classified as PF-related and 124 were classified as PF-unrelated FEs. The blood culture positivity rate was significantly lower in PF-related vs. PF-unrelated FEs (1/36 vs. 27/124, respectively, <i>p</i> = 0.006). The blood culture positivity rate was significantly higher in patients with cholangitis, catheter-related blood stream infection, and urinary tract infection than PF-related FEs. Multivariate analysis showed that blood culture positivity was negatively associated with PF-related FEs and positively associated with accompanying symptoms of shivering, Pitt Bacteremia Score, and preoperative biliary drainage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients who underwent PD showed relatively high blood culture positivity rates. Based on these results, it may be possible to distinguish PF-related and -unrelated FEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"888-895"},"PeriodicalIF":2.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675287","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":"High risk of multiple gastric cancers in Japanese individuals with Lynch syndrome","authors":"Nobuhiko Kanaya,&nbsp;Thijs A. van Schaik,&nbsp;Hideki Aoki,&nbsp;Yumiko Sato,&nbsp;Fumitaka Taniguchi,&nbsp;Kunitoshi Shigeyasu,&nbsp;Kokichi Sugano,&nbsp;Kiwamu Akagi,&nbsp;Hideyuki Ishida,&nbsp;Kohji Tanakaya","doi":"10.1002/ags3.12809","DOIUrl":"10.1002/ags3.12809","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Lynch syndrome (LS) is a dominantly inherited syndrome characterized by an increased risk for LS associated tumors such as colorectal cancer (CRC) and gastric cancer (GC). However, the clinical benefit of surveillance for GC remains unclear while it has already been recommended for CRC. This study aimed to elucidate the clinical features of GC in Japanese individuals with LS, and the risk of developing multiple GCs to build regional-tailored surveillance programs in LS patients with GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on Japanese individuals with LS were retrospectively collected from a single institution. The clinical features of GC, including the cumulative risk of multiple GCs, were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 96 individuals with LS (<i>MLH1</i>/<i>MSH2</i>/<i>MSH6</i>, 75:20:1), 32 GC lesions were detected in 15 individuals with LS (male/female, 11:4). The median age at initial GC diagnosis was 52.7 y (range: 28–71). Histological examination revealed a predominance of intestinal type (19/24: 87.5%). Moreover, the majority of the GC lesions (82%) were determined to have high-frequency of microsatellite instability. The cumulative risk of individuals with LS developing GC at 70 y was 31.3% (<i>MLH1</i> 36.1%, <i>MSH2</i> 18.0%). Notably, the cumulative risk of individuals with LS developing metachronous and/or synchronous GCs at 0, 10 and 20 y after initial diagnosis of GC was 26.7%, 40.7%, and 59.4%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Due to a higher risk of developing multiple GCs, intensive surveillance might be especially recommended for Japanese individuals with LS associated initial GC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1008-1016"},"PeriodicalIF":2.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673101","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":"Long-term outcomes of treatment for achalasia: Laparoscopic Heller myotomy versus POEM","authors":"Naoko Fukushima,&nbsp;Takahiro Masuda,&nbsp;Kazuto Tsuboi,&nbsp;Jun Watanabe,&nbsp;Fumiaki Yano","doi":"10.1002/ags3.12807","DOIUrl":"10.1002/ags3.12807","url":null,"abstract":"<p>Achalasia is a rare esophageal motility disorder characterized by nonrelaxation of the lower esophageal sphincter. Laparoscopic Heller myotomy (LHM) is the gold standard treatment for achalasia. Peroral endoscopic myotomy (POEM), a less invasive treatment, is performed extensively, and the selection of the intervention method remains debatable to date. In addition to the availability of extensive studies on short-term outcomes, recent studies on the long-term outcomes of LHM and POEM have shown similar clinical success after 5 y of follow-up. However, gastroesophageal reflux disease (GERD) was more common in patients who had undergone POEM than in those who had undergone LHM. Moreover, existing studies have compared treatment outcomes in various disease states. Some studies have suggested that POEM is superior to LHM for patients with type III achalasia because POEM allows for a longer myotomy. Research on treatment for sigmoid types is currently in progress. However, the long-term results comparing LHD and POEM are insufficient, and the best treatment remains controversial. Further research is needed, and treatment options should be discussed with patients and tailored to their individual needs and pathologies.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"750-760"},"PeriodicalIF":2.9,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680040","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":"Relationship between postoperative biliary complications and biliary anatomical aspects in performing right anterior- or central bisectionectomy: Single-center retrospective observational study","authors":"Masaki Ueno,&nbsp;Shinya Hayami,&nbsp;Atsushi Miyamoto,&nbsp;Ken-ichi Okada,&nbsp;Yuji Kitahata,&nbsp;Atsushi Shimizu,&nbsp;Hideki Motobayashi,&nbsp;Kyohei Matsumoto,&nbsp;Manabu Kawai","doi":"10.1002/ags3.12805","DOIUrl":"10.1002/ags3.12805","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Central liver resections are considered to be high-risk procedures due to postoperative biliary complications. However, anatomical aspect-related causes are underreported. Focusing upon right anterior sectionectomy (H58) and central bisectionectomy (H458), we assessed risk factors for postoperative biliary complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent H58 or H458 in our hospital between April 2008 and June 2023 (<i>n</i> = 58). We conducted univariate and multivariate analysis of risk factors of postoperative biliary complications among perioperative factors and anatomical factors including the branching type of the right posterior hepatic duct (RPHD) and the length of the right hepatic duct (RHD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six patients (44.8%) had postoperative biliary complications. Potent risk factors in univariate analysis were the tumor proximity to the right anterior Glissonean branch and longer RHD (both <i>P &lt;</i> 0.01). In multivariate analysis, longer RHD was the only independent risk factor and its hazard (95% confidence interval [CI] was 1.19 (1.05–1.35). Receiver operating characteristics curve (ROC) analysis and the area under the ROC showed that 10 mm was the optimal cutoff value with high discriminatory power (0.72). Considering intraoperative procedures of the right anterior segment Glissonean branch dissection, mass ligation at the second-order branch had marginal risk, especially in patients with RHD &gt;10 mm; its hazard (95% CI) was 5.83 (0.95–35.7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anatomical factors of RPHD and RHD influenced postoperative biliary complications in this cohort. The supraportal with RHD type was most common anatomy but considered to be hazardous if the RHD was &gt;10 mm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1076-1083"},"PeriodicalIF":2.9,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140691099","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":"Risk model for morbidity and mortality following liver surgery based on a national Japanese database","authors":"Tatsuya Orimo,&nbsp;Shinya Hirakawa,&nbsp;Akinobu Taketomi,&nbsp;Hisateru Tachimori,&nbsp;Taro Oshikiri,&nbsp;Hiroaki Miyata,&nbsp;Yoshihiro Kakeji,&nbsp;Ken Shirabe","doi":"10.1002/ags3.12803","DOIUrl":"10.1002/ags3.12803","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We evaluated the morbidity and mortality associated with liver surgery in Japan and developed a risk model for liver resection using information from a national database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 73 861 Japanese patients who underwent hepatectomy between 2014 and 2019, using information from the National Clinical Database (NCD) registrations. The primary endpoints were 30 days and in-hospital mortality, and the secondary endpoints were postoperative complications. Logistic regression risk models for postoperative morbidity and mortality after hepatectomy were constructed based on preoperative clinical parameters and types of liver resection, and validated using a bootstrapping method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 30-day and in-hospital mortality rates were 0.9% and 1.7%, respectively. Trisectionectomy, hepatectomy for gallbladder cancer, hepatectomy for perihilar cholangiocarcinoma, and poor activities of daily living were statistically significant risk factors with high odds ratios for both postoperative morbidity and mortality. Internal validations indicated that the c-indices for 30-day and in-hospital mortality were 0.824 and 0.839, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We developed a risk model for liver resection by using a national surgical database that can predict morbidity and mortality based on preoperative factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"896-916"},"PeriodicalIF":2.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696446","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":"The prognostic impact of perioperative dynamic changes in cachexia index in patients with hepatocellular carcinoma","authors":"Munetoshi Akaoka,&nbsp;Koichiro Haruki,&nbsp;Yuto Yamahata,&nbsp;Kohei Okazaki,&nbsp;Kenei Furukawa,&nbsp;Masashi Tsunematsu,&nbsp;Yoshihiro Shirai,&nbsp;Shinji Onda,&nbsp;Michinori Matsumoto,&nbsp;Toru Ikegami","doi":"10.1002/ags3.12804","DOIUrl":"10.1002/ags3.12804","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The cachexia index (CXI), which consists of skeletal muscle, inflammation, and nutritional status, has been associated with prognosis in patients with hepatocellular carcinoma (HCC). We hypothesized that dynamic changes in CXI might be associated with long-term outcomes in HCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study comprised 131 patients who had undergone primary hepatic resection for HCC between 2008 and 2019. Preoperative CXI (pre-CXI) and postoperative CXI (post-CXI) were calculated by the following formula: skeletal muscle index x serum albumin level / neutrophil-to-lymphocyte ratio. Pre- and post-CXI were classified into two groups (high vs. low). We retrospectively investigated the association of perioperative dynamic changes in CXI with disease-free and overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In multivariate analyses, negative HBs-antigen (<i>p</i> = 0.02), high serum PIVKA-II level (<i>p</i> &lt; 0.01), poor tumor differentiation (<i>p</i> = 0.02), multiple tumors (<i>p</i> &lt; 0.01), microvascular invasion (<i>p</i> &lt; 0.01), partial resection (<i>p</i> &lt; 0.01), postoperative complications (<i>p</i> &lt; 0.01), and low-pre-CXI (<i>p</i> &lt; 0.01) were significant predictors of disease-free survival, while high ICG_R15 (<i>p</i> = 0.01), poor tumor differentiation (<i>p</i> &lt; 0.01), multiple tumors (<i>p</i> = 0.01), postoperative complications (<i>p</i> &lt; 0.01), low-pre-CXI (<i>p</i> &lt; 0.01), and low-post-CXI (<i>p</i> &lt; 0.01) were significant predictors of overall survival. Low-post-CXI was associated with older age (<i>p</i> = 0.045), larger tumor (<i>p</i> &lt; 0.01), longer operation time (<i>p</i> = 0.047), greater intraoperative bleeding (<i>p</i> &lt; 0.01), and intraoperative blood transfusion (<i>p</i> &lt; 0.01). Moreover, dynamic changes in CXI were associated with overall survival in each subgroup of patients with low-pre-CXI (<i>p</i> = 0.02) or high-pre-CXI (<i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Not only post-CXI but also dynamic changes in CXI from pre- to post-hepatectomy can be a prognostic indicator of HCC, providing a compelling rationale for aggressive perioperative nutritional and physical interventions to improve long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"917-926"},"PeriodicalIF":2.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694913","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}